Marsha: can I taper off geodon before gabapentin?

[Marsha]

Your guess is as good as mine, Marsha. Gabapentin has a different sort of psychopharmacological action from Geodon.

 

I would not make any assessments based on serotonin uptake. Most likely, reducing trazodone was easier because you had two other brakes on board, Geodon and gabapentin.

 

Are you taking Geodon and gabapentin at the same time of day?

Hello Altostrata and thank you. I actually had three other brakes on board, geodon, gabapentin and clonazepam at the time. I have been off trazodone for eight months and I feel so much better. I take 300 mgs of gabapentin in the morning and I take 600 mgs between 7p.m. and 8pm with the geodon. 25 mgs of librium at 4pm and 35 mgs of librium at 10 pm. The only withdrawal symptoms I have are intermittent nights of difficulty falling asleep and the intermittent fear that occurs mainly at night and during the late afternoon for a few days following approximately seven days from the 10 percent drop in geodon. Do you have any thoughts on this? I warmly welcome all that you have in your depository. I started the omega 3 fish oil and ordered the Albion magnesium glycinate chelate again.

[Altostrata]

My guess is that carrying on reducing the Geodon is the way to go. It sounds like you have temporary withdrawal symptoms when you reduce the dosage. This conforms with the earlier effect you observed that when you reduce Geodon, it might affect metabolization of the benzo.

 

You might keep notes to see whether the sleepless nights follow any pattern after a decrease in Geodon.

[Marsha]

My guess is that carrying on reducing the Geodon is the way to go. It sounds like you have temporary withdrawal symptoms when you reduce the dosage. This conforms with the earlier effect you observed that when you reduce Geodon, it might affect metabolization of the benzo.

 

You might keep notes to see whether the sleepless nights follow any pattern after a decrease in Geodon.

Hello Altostrata and thank you again. Yes, the insomnia definitely occurs approximately 4-7 days after the geodon reduction. Since reducing the geodon increases the clearance time of librium this would explain the insomnia in addition to the reduction of the geodon. It takes about four weeks for my CNS to adjust. However, when I get to 20 mgs of geodon I am going to have to start alternating the geodon and the librium because I don't think my doctor will continue to prescribe 60 mgs of librium for the approximately 2 1/2 years a geodon only taper would take. So I'm looking at an approximate geodon and librium taper of four years. By that time I probably won't have to deal with drugs and tapering at all since the system of things we live in will probably be over.

[Altostrata]

Please don't worry about what will happen when you get to 20mg Geodon! At that point, you might not need that much Librium.

 

By that time I probably won't have to deal with drugs and tapering at all since the system of things we live in will probably be over.

 

 

LOL!

[Marsha]

Here's a question. I just read again and was reminded that librium and all benzodiazepines deplete serotonin levels. This causes depression. What can I do with my diet to prevent depletion of serotonin while I taper of geodon while still taking librium? Since geodon moderately uptakes serotonin might it be a good idea to start alternating tapering geodon and librium when I hit maybe 30 milligrams of geodon? What a paradox these drugs cause! Should this question be in the benzo forum?

[Altostrata]

"Depression" is a common side effect of benzos. Please don't worry about serotonin levels.

 

You haven't mentioned "depression" -- is this a problem for you?

[Marsha]

"Depression" is a common side effect of benzos. Please don't worry about serotonin levels.

 

You haven't mentioned "depression" -- is this a problem for you?

Hello Altostrata and thank you again. No, I have not and am not experiencing any depression whatsoever. What can I do to prevent this from happening?

[Altostrata]

Don't worry about it! If it hasn't happened so far....

[Marsha]

Okay. Got it. Lol!

[Marsha]

I met with the addiction doctor who said she would help me taper off geodon and she completely stonewalled me saying i had to taper the librium. She also was very cold and avoided my reasoning that I should get off the geodon first because it is the most toxic. What a betrayal. I had recommended her but now I believe she cannot be trusted. She is only interested in getting me off the librium no matter how much I have tried to reason with her about the neuroleptic. So I am going to my original psychiatrist who I hope won't try to force me off the benzo. I don't think he will. I am tapering the geodon as fast as my nervous system allows. I might have to go back to clonazepam because Medicare doesn't think librium is medically necessary. It was only approved to use when I was crossed over from clonazepam for tapering. This was before I found out about how toxic neuroleptics are and that the insomnia from the geodon was still an issue without the use of the benzodiazepine for sleep. Is there any way off this merry go round of drugs and doctors? I'm hoping my next doctor will work with me. He is available 24/7 and it is easy to get an appointment with him. He doesn't take but a few insurances and not Medicare so I have to pay the full fee. I tapered geodon from 54.27 to 48.84 mgs on Tuesday. Sleep remains good and no significant other withdrawal symptoms. I just feel so betrayed.

[Altostrata]

The word has gone out to doctors to watch out for benzo addiction. Because they think dependence on other "non-addictive" drugs is better than dependence on an "addictive" drug (don't try to make sense of it), they're going to prioritize going off the benzo.

 

Given you complicated reactions when you lower dosage of anything, I would try to stick to your plan to reduce Geodon, don't worry about doctors and their attitudes towards benzos unless it comes to a point when you have to.

 

You have a good reason to stick with your tapering plan, it's clear you're not a craven drug addict, the addiction doctor should respect that.

[Marsha]

The word has gone out to doctors to watch out for benzo addiction. Because they think dependence on other "non-addictive" drugs is better than dependence on an "addictive" drug (don't try to make sense of it), they're going to prioritize going off the benzo.

 

Given you complicated reactions when you lower dosage of anything, I would try to stick to your plan to reduce Geodon, don't worry about doctors and their attitudes towards benzos unless it comes to a point when you have to.

 

You have a good reason to stick with your tapering plan, it's clear you're not a craven drug addict, the addiction doctor should respect that.

Please Altostrata I am depending on this site with my very life. Please I beg you to keep it going. You are my lifeline to getting off psychiatric drugs. I have no place else to go. I won't be able to get help from Beyond Meds anymore. I'm really scared about this and I'm in the midst of withdrawal. It seems this is the only site in the world that explains calculations and technical support. I will make a larger donation. How can I get the word out for people to make donations to support this essential website?

[Altostrata]

Marsha, please don't worry, you'll be able to taper, you're doing everything in a very smart, very responsible way.

 

Thank you very much for your offer of donations and helping to get the word out.

[Marsha]

Marsha, please don't worry, you'll be able to taper, you're doing everything in a very smart, very responsible way.

 

Thank you very much for your offer of donations and helping to get the word out.

Thank you Altostrata find your kind and reassuring words. I have some good news. I went to see my old psychiatrist and I am in control of my taper. He apologized for his mistakes and is completely supportive of my taper plan. He will maintain the librium until I am off the geodon and gabapentin. No problem! I am finally in charge of my drug tapering. He writes prescriptions every three months and has agreed to let me make monthly payments so It's not such a big hit on my pocketbook. This is after months of texting with him. He was actually happy for me.

[Altostrata]

!!!!!!!

[Marsha]

Why do members and moderators leave the forum when they have valuable experience that we desperately need? I hope that when I recover enough to be of assistance to someone in need, I will not abandon those desperately needing help.

[Altostrata]

Things change and people need to move on, just like real life. Some people work very hard and then get exhausted. Everyone adds what they can.

[nz11]

 I have some good news. I went to see my old psychiatrist and I am in control of my taper. He apologized for his mistakes and is completely supportive of my taper plan. He will maintain the librium until I am off the geodon and gabapentin. No problem! I am finally in charge of my drug tapering. He writes prescriptions every three months and has agreed to let me make monthly payments so It's not such a big hit on my pocketbook. This is after months of texting with him. He was actually happy for me.

 

Marsha this is Halloween not April fools.

You really are a comedian arent you!!!  

 

!!!!!!!!!!! seconded.

Are you really serious .......no way ...well whataya know.

Is his name on the list of rec docs.

The brick   bouquet of the week goes to your pdoc.

[Marsha]

Hi. NZ11 and everyone. I am continuing to improve as I carefully taper off psychiatric drugs (right now geodon) I finally stopped growing facial hair (obviously a side effect of geodon). I have occasional rough spots in the middle of the monthly taper but for the most part finding SA and learning how to taper is a gift I am treasuring. Thank you Thank you to everyone.

[Altostrata]

I am very happy to see that, Marsha. Whew! It's been a long and twisty path.

[Marsha]

Well, it appears that indeed tardive dyskenisia is beginning to manifest. I am working with my doctor to aggressively get me off the geodon. I never got a response from the movement disorders center so my doctor is going to help me without go into hospital.

[Altostrata]

Are you sure you have not experienced a withdrawal symptom?

 

How is your doctor going to help?

[Marsha]

Are you sure you have not experienced a withdrawal symptom?

 

How is your doctor going to help?

My jaw keeps moving back and forth and is clenching and unclenching.This is a classic sign of tardive dyskinesia beginning to manifest itself. He said it is complicated and is scheduling me for an appointment asap. He suggested benzodiazepines for agitation and anxiety and propranolol for akathisia. He hasn't suggested a schedule for the reduction yet.

[Meimeiquest]

I know this is simplistic, but you might try a long Epsoms salts bath. It has saved my bacon so many times, but of course everyone is different.

[Marsha]

I know this is simplistic, but you might try a long Epsoms salts bath. It has saved my bacon so many times, but of course everyone is different.

I am really scared meimei. I read the link you sent me again about tardive dyskenisia and the withdrawal schedule that was suggested. 10 % of the original dose and be monitored closely during withdrawal. With the fast taper of the trazodone, I don't think I could take anything without getting a paradoxical reaction. Geodon moderately uptakes serotonin plus all the other brakes I am on I have been spared withdrawal akathisia. But if it is determined I must come off the geodon much sooner than I had planned I greatly fear withdrawal akathisia. And then also deal with tardive dyskenisia. I am so scared.

[Altostrata]

Breathe and stay calm, Marsha. This might not be as bad as you think.

 

How often does the jaw movement happen?

[Marsha]

Breathe and stay calm, Marsha. This might not be as bad as you think.

 

How often does the jaw movement happen?

thank you Altostrata. The jaw clenching and movement is constant. I have to make a conscious effort to control it.

[Meimeiquest]

I guess I've already told you the experiences in my family have been reversible. But let's imagine your jaw keeps moving for a year. It would be unpleasant on many levels, but would it be the end of the world? Even apart from this, you are in the midst of a giant endeavor going off these complex drugs. Staying calm and doing the "next right thing" will carry you through. You are wise to see the doctor, that's your next right thing. I would just ask your doctor to share openly with you his experiences with TD so you can "consider the source" as you weigh his advice (I mean that in a very neutral way).

 

But you are more than welcome to share your "scared" here...we do understand it is very hard.

[Marsha]

I guess I've already told you the experiences in my family have been reversible. But let's imagine your jaw keeps moving for a year. It would be unpleasant on many levels, but would it be the end of the world? Even apart from this, you are in the midst of a giant endeavor going off these complex drugs. Staying calm and doing the "next right thing" will carry you through. You are wise to see the doctor, that's your next right thing. I would just ask your doctor to share openly with you his experiences with TD so you can "consider the source" as you weigh his advice (I mean that in a very neutral way).

But you are more than welcome to share your "scared" here...we do understand it is very hard.

my doctor is a specialist in neurology as well so I am fairly confident he has seen his share of TD cases. He is going to try to get me in December 4. It's just the unrelenting fear of akathisia that is getting to me after having experiencing several times the most debilitating akathisia imaginable from geodon,latuda and librium. Until I found SA I had no clue that withdrawal from drugs could also bring it on. I just don't think I could go through akathisia again.

[Meimeiquest]

Now that makes sense...akathisia is the very worst. Maybe he can explain if/how they might be (or not be) connected.

[Marsha]

I am so desperate to get off geodon, I just want to taper 10% of the original dose or just stop taking it. Or 10 mgs every two weeks. I can't bear the thought of being on geodon for several more years. I would rather be sick from withdrawal than to have to face three years of wwithdrawal. I feel so desperate

[Meimeiquest]

You know, it really is your call. You have to judge what you can handle. I went off my AP in 8 months (I was on a low dose) but I was a hot mess by the end. But life goes on. And it took me about 18 months to get off the benzo I reinstated near the end of the AP taper. So I didn't really save myself any time. BUT if I had understood all I have learned here, I could have made it without a benzo. You don't even have to taper at the same rate all the time. I have two tapering principles: I only have to decide what dose I am going to take today, (I have to go with the flow, it really can't be planned), and I have to have enough margin in my life to feel worse when I make a cut, because I've had at most maybe two asymptomatic cuts in the whole process. BUT you can certainly understand Alto's position, she doesn't want to suggest something that could be harmful to many people, this process is risky enough as it is,

 

I think the best way to make it go faster is to vigilantly look for what caused the original problem that led to the first drug being ingested. Which is much easier said than done. It's amazing the things that people have come up with, parasites to an IUD and everything in between.

[Marsha]

You know, it really is your call. You have to judge what you can handle. I went off my AP in 8 months (I was on a low dose) but I was a hot mess by the end. But life goes on. And it took me about 18 months to get off the benzo I reinstated near the end of the AP taper. So I didn't really save myself any time. BUT if I had understood all I have learned here, I could have made it without a benzo. You don't even have to taper at the same rate all the time. I have two tapering principles: I only have to decide what dose I am going to take today, (I have to go with the flow, it really can't be planned), and I have to have enough margin in my life to feel worse when I make a cut, because I've had at most maybe two asymptomatic cuts in the whole process. BUT you can certainly understand Alto's position, she doesn't want to suggest something that could be harmful to many people, this process is risky enough as it is,

I think the best way to make it go faster is to vigilantly look for what caused the original problem that led to the first drug being ingested. Which is much easier said than done. It's amazing the things that people have come up with, parasites to an IUD and everything in between.

Thank you so much meimei. The original circumstances were mild depression and anxiety due to pre menopause hormonal changes. I know that now. The prozac and then zoloft caused such anxiety that I had a panic attack. That's how I got put on xanax. Both my mother and sister are nurses so I was raised to trust the word of a doctor as gospel. The different antidepressants I was on kept changing and I was having more and more anxiety. I guess that's how I got put on AP. I had no clue what these drugs were and how dangerous they are until 2013 which was my first attempt to get off geodon. I WAS off! But I just didn't understand that it was just withdrawal symptoms. Plus a doctor telling me I needed it. I sure wish I had known better. I am going to test the waters for a more aggressive taper and also I am going in to my doctor December 8. Then we will discuss a referral to Stanford medical center if I have TD. But he is confident he can get me off geodon. What a mess.

[Altostrata]

Marsha, the unusual challenge you've had tapering Geodon is that when you lower the dose, it seems to affect the way the other drugs interact and you get unexpected consequences.

 

You've had to decide your own way of tapering. If you need to go off faster because of a serious adverse effect, you are not required to keep on tapering at 10%.

 

What has your doctor proposed as a tapering regimen? Is he aware of the interaction problem?

[Marsha]

Marsha, the unusual challenge you've had tapering Geodon is that when you lower the dose, it seems to affect the way the other drugs interact and you get unexpected consequences.

 

You've had to decide your own way of tapering. If you need to go off faster because of a serious adverse effect, you are not required to keep on tapering at 10%.

 

What has your doctor proposed as a tapering regimen? Is he aware of the interaction problem?

we will discuss this when I see him December 8. If it can be done without going to Stanford that's what will happen. Meimei's link which is a very recent paper suggests 10% of the original dose. So it would be. 16 mgs each reduction. Of course, at that pace supportive measures most probably need to be in place such as benzodiazepines to control agitation etc. I don't have any buffer besides benzodiazepines as a chemical restraint and I certainly would not agree to any other psychoactive substance if I must be hospitalized to accomplish this endeavor. We will see what transpires.

[Altostrata]

According to http://emedicine.medscape.com/article/1151826-overview#a11

 

Whenever possible, it is preferable to taper the dose slowly (by 10% increments of the original dose) while closely observing the patient for exacerbation of psychotic symptoms.

 

 

A straight 10% taper is better than nothing, and by medical standards, it's very gradual, but it doesn't make any sense at all to decrease at an ever-increasing rate.

 

This paper does not specify the interval of reductions. Is it 10% per week? Without this, I wouldn't take this as anything but a suggestion. These are doctors making their best guesses. (Note the laundry list of possible treatments.) What they're saying is to taper gradually and be prepared with a benzo.

 

Please review this with your doctor. What's been your experience with 10% reductions? Does he have no appointments prior to Dec 8? Are you on the waiting list for cancellations?