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#91 greyeyed123

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Posted 04 November 2016 - 11:48 PM

Things are going ok I guess. We had an appointment with the neurologist a couple weeks ago, and he said to drop from 12mg of the nortrip to 5mg for a week, and then none. (He also seemed to think that any vomiting she had after a 2% drop per week was psychological, although I didn't agree--she never knew when I was dropping it, and she hadn't had vomiting as a symptom of anything prior to taking the nortrip.) I thought that was too fast, but I figured I could try to reduce her by 4% a day and see how far we got. It was a little rough, but no where near as bad as the side effects were a couple of months ago. Sunday she started demanding more lorazepam and muscle relaxers (I redirected her well enough to avoid an argument because I wasn't giving her more of anything--it does no good to reduce one thing if we're increasing others), and her anxiety was starting to get the best of her (but no screaming/crying fits...at least none in the same league as a couple months ago).  So I paused the taper on Sunday at 8mg and left it there for the week. She has seemed to improve a little bit, but now her anxiety seems to be there almost all the time. She's complaining of nausea quite a bit, eating very little until the evening, and having some vomiting (I think dry heaves, as it was in the morning and she hasn't been eating anything in the morning). Thursday morning she got up at 3am and stayed in the bathroom until at least 7am when I went to work--apparently nauseous and constipated. Friday morning she seemed much better to me, but she said she didn't get her 7am pills until after 8am as she was so nauseous. She made an appointment with our family doctor this afternoon and he just prescribed a mild medication for constipation, although I honestly think her constipation is extremely mild compared to the constipation she has had over the previous two years. It improved greatly when we were reducing the lorazepam in May-June, and the neurologist agreed that that was probably the reason. But...

...

I tried reducing the lorazepam by 1% three weeks ago, and she did well for 3 days. I then got too confident and tried reducing it 2%. Within 2 days she was having such a rough time in the morning she was demanding an ambulance, claiming she had an infection, could barely move...all of the symptoms she had when reducing the lorazepam previously. So I moved some of her evening doses into the morning that day, and she snapped out of it by 9AM. So from that point I just went back to the 2.25 of lorazepam for now, and focus entirely on trying to get off the nortrip first.

...

At this point I think I'll have to leave her at 8mg for at least another week before trying to reduce again, hopefully down to 6mg over a few days and then leave it there for a while.  Her walking has improved quite a bit--she says she needs her walker, but today seemed to forget to use it most of the time. She even did some chores around the house today.  (Dad fired the caregiver a couple weeks ago. So far it doesn't seem to have made much difference.)

...

Our follow up appointment with the neurologist is in January, so I'm hoping we can be off the nortrip completely by then. I wish I had just said no to the nortrip from the beginning because now it looks like we've lost almost another year because of medication changes and withdrawals. Granted, it wasn't nearly as bad as the lyrica withdrawal last year, but she was doing so well in June, for the first time in such a long time...we should have just left things alone.


#92 fishinghat

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Posted 05 November 2016 - 07:54 AM

You are doing a great job greyeyed.  Talk about time and patience, you are an expert at that. Keep up the good work and continue to keep us posted.


#93 greyeyed123

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Posted 06 November 2016 - 03:34 PM

Thanks for reading my posts. Yesterday she had an outburst that lasted 45 minutes, and looked exactly like lorazepam withdrawal. The only lorazepam dose that she took herself (that I didn't give her personally) was in her 10am cup, and the cup was empty, and she swore she took it. It wasn't until bedtime that I found the dose on the floor in the kitchen, against a cabinet and not easily visible unless you got on all fours and looked in that exact spot...which is what I did, still convinced it was lorazepam problem and not a nortrip problem. It was only about 1/8 of a pill, but that was enough. It's nice to know someone out there knows what this is like.


#94 greyeyed123

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Posted 18 November 2016 - 11:27 PM

Reduced the nortrip down to about 7.2mg. She seemed to be having a hard time, so I paused there for 3 or 4 days. But she didn't seem to be doing any better and perhaps was a little worse as time went by. (Yesterday she seemed to be struggling all day, with a bit of confusion in the evening, and not wanting to eat very much. I guess she fell once, but she didn't complain of any pain/bruises yesterday or today, so I guess she didn't hurt herself.) So last night I dropped to 6.9, thinking maybe her worst symptoms now are more side effects than withdrawals and I might be making things worse by pausing.  Today she did much better, making herself something to eat twice. Tonight I dropped to 6.6 and will see how she does tomorrow.  At this point we're taking so little that I'm going to try to drop it every day until we're off, if I can. I feel like we're seeing the light at the end of the tunnel. When she is doing better now, she seems to be doing much better. When she's doing worse, the "worse" is much more muted than a week or a month ago (even though yesterday the "muted worse" lasted all day).


#95 fishinghat

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Posted 19 November 2016 - 09:07 AM

Hang in there greyeyed. You are doing great.


#96 gail

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Posted 19 November 2016 - 04:44 PM

Greyeyed, it's beautiful to see you work your way through this. My hat to you!

#97 greyeyed123

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Posted 23 November 2016 - 12:14 AM

Down to 6.1mg tonight.  She did have brief (a few seconds) angry outbursts last night and tonight over not getting extra muscle relaxers, but calmed down very quickly--later almost crying in apology. This is pretty much miniscule versions of what was happening a few months ago (then, the angry outbursts were at least 30 minutes, and crying after that for some sustained amount of time).  I've read that muscle pain and muscle cramping can be withdrawal symptoms of nortrip, and she already had those symptoms from the Parkinson's...so I'm thinking some of the problems from withdrawals might be compounded a bit because she already had those underlying symptoms (and she has also gotten less exercise over the last few months simply because it's been too difficult). So again, I'm glad I decided to try to go more slowly than the neurologist recommended.

...

Thanks for reading this, and for all the moral support.


#98 Lynn155

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Posted 22 February 2017 - 10:36 PM

Hi Everyone  I just recently joined this forum.  I have been on antidepressants for about 13 years since my son was born.  I have been on Celexa, & Webutrin but mostly and currently, I have been on Cymbalta 30mg.  I want to be off this drug and as quickly as I can.  My Dr (who just retired but is in the office part time) suggested that I come off of it over a number of weeks.  Week 1, I am to skip one pill.  Week 2, I am to skip two pills, and so on, until I am off the drug.  She also gave me a script for Tryptophan to help me sleep, while I wean off the drug. I also went to see the new full time Doctor.  We are going to connect March 2 and until then I am decreasing my dosage by 2 pills per week.  She is going to talk to the pharmacy about compounding the drug.  The bead method seems awfully slow.  I do not want to be on this drug!  What will happen if I go cold turkey?  Also, if I do ween off the drug, like the doctor suggested, will the withdrawal symptoms last forever.  Do they ever stop?  I want to hear your suggestions to get me off of this drug and as quickly as I can! Dolo125


#99 fishinghat

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Posted 23 February 2017 - 09:22 AM

Welcome Dolo

 

The manufacturer and the FDA warn about going off this drug too fast as it can cause seizures, suicidal thoughts and even suicide as well as excessive anxiety/depression. I would advise against that route. yes the bead counting can be slow but it is a lot safer. also the every other day thing is absolutely wrong. Cymbalta has a half life of 12 hours. So if you take a capsule like normal on a Monday morning your blood levels go to full strength. By Tuesday morning that dose is at 25% and by Wednesday morning just before you take your next pill you will be at 6% blood levels on Cymbalta and in full withdrawal. You take the capsule and your blood levels spike and you feel better but the cycle of in and out of full withdrawal repeats over and over.

 

Now some good news. Around 20 to 30% do not have any significant withdrawal. Which group you fall in is a guess but the more overweight, the older you get and the higher the dose you are on all seem to contribute to a nasty withdrawal. Many start on the bead counting at removing 1% of the beads a day and increase that rate by 1 more bead each day to see how much they can stand. So if you have 300 beads you remove 3 beads the first day 7 beads the second day 12 beads the 3rd day BUT that is playing with fire. If the withdrawal hits it usually hits hard and the person then has to go back up on dosage a fair amount and taper from there slowly. some of our members have taken as long as1 to 2 years to wean off. most 4 to 8 months and that can still be very tough.

 

No matter what you decide we are here for you. Please keep us informed.


#100 fishinghat

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Posted 23 February 2017 - 09:29 AM

Also here is some info on tryptophan and 5htp (which you body makes from tryptophan) that you should read. Please start at a low dose on this medicine and work up gradually until you find the minimum dose that will help.

5HTP is 5-hydroxytryptophan (5-HTP) a chemical that the body makes from tryptophan (an essential amino acid, which you get from food). After tryptophan is converted into 5-HTP, the chemical is then changed into another chemical called serotonin (a neurotransmitter, which relays signals between brain cells). 5-HTP dietary supplements help raise serotonin levels in the brain. Since serotonin helps regulate mood and behavior, 5-HTP may have a positive effect on sleep, mood, anxiety, appetite, and pain sensation. Usuall dosage around 50 mg
5-HTP is not found in the foods we eat, although tryptophan is. Eating foods with tryptophan does not increase 5-HTP levels very much, however. As a supplement, 5-HTP is made from the seeds of an African plant called Griffonia simplicifolia.
Source: http://www.umm.edu/a...m#ixzz2Q0VyOr4w

Side Effects
5-HTP is POSSIBLY SAFE when taking by mouth. However, some people who have taken it have come down with eosinophilia-myalgia syndrome (EMS), a serious condition involving extreme muscle tenderness (myalgia) and blood abnormalities (eosinophilia). Some people think EMS might be caused by an accidental ingredient (contaminant) in some 5-HTP products. However, there is not enough scientific evidence to know if EMS is caused by 5-HTP, a contaminant, or some other factor. Until more is known, 5-HTP should be used cautiously. Other potential side effects of 5-HTP include heartburn, stomach pain, nausea, vomiting, diarrhea, drowsiness, sexual problems, and muscle problems. 5-HTP is POSSIBLY UNSAFE when taken by mouth when pregnant or breast-feeding. Avoid using it.

Warnings on its use.
http://www.ncbi.nlm....les/PMC3415362/

Interactions
Medications for depression (Antidepressant drugs) interacts with 5-HTP.
5-HTP increases a brain chemical called serotonin. Some medications for depression also increase serotonin. Taking 5-HTP along with these medications for depression might increase serotonin too much (seratonin syndrome) can cause serious side effects including heart problems, shivering, and anxiety. Do not take 5-HTP if you are taking medications for depression without consulting with your physician.

5-hydroxytryptophan has been used in alternative medicine as an aid to relieve the symptoms of anxiety, depression, fibromyalgia, insomnia, chronic headaches, premenstrual syndrome, binge-eating related to obesity, attention deficit disorder, and chronic headaches. 5-hydroxytryptophan has also been used in treating certain seizures and symptoms of Parkinson's disease.
Source: http://www.drugs.com/

"Don’t use 5-HTP until more is known. 5-HTP might be UNSAFE."
Source: http://www.webmd.com

1. 5-HTP is changed into serotonin
2. Our body uses tryptophan to make 5-HTP
3. Vitamin B6, vitamin C, folic acid and magnesium are necessary for the metabolization of tryptophan. In addition, tyrosine and phenylalanine compete with tryptophan for absorption.
4. Several dietary, lifestyle, and health factors reduce the conversion of tryptophan to serotonin, including cigarette smoking, high sugar intake, alcohol abuse, excessive consumption of protein, hypoglycemia and diabetes.
5. The following foods contain tryptophan: red meat, dairy products, nuts, seeds, legumes, soybeans and soy products, tuna, shellfish, chicken, spinach and turkey.

Moderate effect of 5HTP on anxiety
http://www.ncbi.nlm..../pubmed/3312397

Erratic effects on 5HTP use.
http://www.ncbi.nlm..../pubmed/2139731

Moderate reduction in anxiety.
http://www.ncbi.nlm..../pubmed/3312397

L Tryptophan is an amino acid essential for human life, cannot be synthesized by our body, and therefore must be part of our diet. In addition, tryptophan functions as a biochemical precursor for the following compounds;
Serotonin synthesized via tryptophan "http://en.wikipedia....an_hydroxylase". Serotonin, in turn, can be converted to melatonin.

Niacin is synthesized from tryptophan.

L-tryptophan is possibly unsafe when taken by mouth. It has been linked to over 1500 reports of eosinophilia-myalgia syndrome (EMS) and 37 deaths. EMS is a neurological condition with symptoms that include fatigue; intense muscle pain; nerve pain; skin changes; baldness; rash; and pain and swelling affecting the joints, connective tissue, lungs, heart, and liver. Symptoms tend to improve over time, but some people may still experience symptoms up to 2 years after they develop EMS. Some people report that their symptoms have never gone away completely. Since the FDA has limited the doses available the occurrence of EMS has markedly dropped.

L-tryptophan can cause some side effects such as heartburn, stomach pain, belching and gas, nausea, vomiting, diarrhea, and loss of appetite. It can also cause headache, lightheadedness, drowsiness, dry mouth, visual blurring, muscle weakness, and sexual problems. This supplement must be taken together with vitamin C and B-complex vitamins to support the transformation of tryptophan into serotonin. Dosages range from 5 to 1000 mg/day.

L tryptophan reacts with most antidepressants (seratonin syndrome), MAOIs, benzos and sedatives. There is an extensive number of drug interactions. Please research before use.

http://www.ncbi.nlm....les/PMC3195213/
http://www.ncbi.nlm....les/PMC2908021/


#101 TryinginFL

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Posted 23 February 2017 - 05:37 PM

Welcome Dolo!

 

We have all been where you are, so please keep us posted!

 

#1 -Please take suggestions from fishing hat - he has done much research (as you can tell from his post above)

 

#2 - DO NOT GO COLD TURKEY !!!!  I and many others have gone that route and it was the worst thing I have been through.  It was a good year before I considered myself somewhat recovered.  I have been off 3 yrs since Jan.10

 

#3 - Bead counting is the best way to go -- that keeps you in control and you want to be comfortable...please remember that there is no time line here and this is not a race.  It just takes as long as it takes.  Please don't be in such a hurry!  We are all different and you may be one of the lucky ones who can get off this stuff easily - time will tell!

 

Some of us have stayed on this site to help Newbies - just remember that we have already been there!

 

We are always here for you so feel free to come back with updates and questions!

 

 

Liz


#102 greyeyed123

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Posted 27 March 2017 - 07:29 PM

Haven't posted in a while. Things are going fairly well with my mother.  We've gotten down to about 3-4 mg of Nortriptyline, and just over 2mg of lorazepam.  I've been doing a water taper on the Nortriptyline for several months, and started (water) tapering the .25mg of lorazepam in December (we're down to 64% of the .25, which is .1675--that puts her daily lorazepam at 2.1675).

...

Today I have a dilemma.  Context: Yesterday I spread her 1/2 doses of lorazepam out every six hours, which seemed to work very well. She had a very good day. I also reduced her nortriptyline about 3% last night--she hasn't been having much reaction to any reductions of the nortrip lately, but I'm still afraid to go too fast.  I got a call at work--dad said her 2:00pm Parkinson's med cup was empty, with a little water in the bottom. She's still having some memory problems, so I knew she took them early and used the cup for water to take them. She was upset, swore she didn't take them, so I was concerned that she may have missed her noon pills, which included 1/2 lorazepam.  When she misses that, she can get very upset. I called back at 3pm, and she was better. But by the time I got home a 3:30, she slowly got worse--angry outbursts, but it was a slower burn than when she had completely missed a dose previously. I gave her her 5:30 lorazepam at 4:00pm, and she was better by 4:30 and mostly calmed down by 5:00pm.

...

On top of this, she talked to her brother today who is not expected to live through the year, which they apparently discussed over the phone today.

...

So this outburst could be due to:

Missing 1/2 lorazepam at noon, in which case if I don't make that up she will have another outburst within 12 hours or so.

Dropping the Nortriptyline last night, although she hasn't had that reaction from reducing the nortrip in a long time.

Being upset about her brother.

Or all three.

...

I guess my plan right now is to just assume she got her 1/2 of lorazepam at noon. If she has another outburst within 12 hours, I can safely assume she missed it and make it up by giving her 1/2 of lorazepam (searched everywhere on the floor around all of her normal spots and found nothing--and there are other pills in that noon cup, so I would think something would be obvious to find).  I'm EXTREMELY reluctant to ever give her any lorazepam that might end up being extra, especially after working so hard to reduce the damned things so very little over the past 3 months.  I don't know what else to do.


#103 fishinghat

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Posted 28 March 2017 - 09:05 AM

That is the right call Greyeyed. Just keep with her current dosage for a few days and she will settle down. Once she does then you can go on weaning. That 'missed' medicine issue has happened to all of us. All you can do is continue the dosage until her blood levels return to normal, which they will.  It really sounds like she has come a long ways and I must admire your ability to handle this situation, Challenging at the least.

 

God Bless


#104 greyeyed123

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Posted 28 March 2017 - 11:29 AM

She had no outbursts over night, or any indication of lorazepam withdrawal.  I think she was just upset about her brother which triggered everything else.  I moved the nortrip back up 1% last night just in case, but I don't really think that is what it was.


#105 gail

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Posted 28 March 2017 - 03:14 PM

Hey Greyeyed,

So nice to hear from you and the update for mom.
Nice steady work!

#106 greyeyed123

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Posted 28 June 2017 - 02:24 PM

Update and any advice...and/or just thanks for reading:

 

Mom is doing well compared to a year ago.  Still weaning off lorazepam and nortriptyline (1/10 of 1% a day on lorazepam with several day pauses whenever we need them, down to just barely a hair above 2mg;  nortrip is down to about 2mg).  I'm a teacher, so the end of May and beginning of June was hectic, so I paused both tapers for a couple of weeks until I was home.  She did well after the pauses at first, then seemed to do worse.  Her family doctor suggested stopping one of her Parkinson's meds and see how that worked, but that seemed wrong to me and I figured she's already having some withdrawals from two medications and I don't want to add a third.  So after school was out I started the taper on the nortrip again.  She seemed to do better for several days, maybe a week. I was reducing by about 2-3% a day since she was on so very little now as it is.  But now she's complaining of being stiff and unable to move in the middle of the night, which was one symptom of lorazepam withdrawal previously (I've still paused that taper for the last 2-3 weeks, so I don't think that's what it is).  I paused the nortrip taper Sunday since she had a bad day that day.  Yesterday she had a doctor's appointment with the urologist, which was a PA--and she started suggesting lyrica and nortrip, etc, everything that made everything much worse in the past, so mom started to get upset and anxious.  I gave her her 1/2 of lorazepam at 1:00pm instead of 2, and by the time we got home she was feeling better.

...

Now today, she was a little agitated when she first got up, but usually she's better by 11:00AM (I've been assuming it's because she gets her 120mg of duloxetine at 10am and that kicks in by 11, perhaps making up for the tiny bit of nortrip that's now missing, but I might be wrong).  Today she started getting more and more upset, and by 11:00 she was screaming and crying, wanted to die, etc, much like last year when going ON TO the nortriptyline (she's only had one or two outbursts like that in the last 6 months, so now I'm concerned).  I finally gave her her 2:00PM lorazepam at 11:00AM, but by 11:15 or so she completely reversed and became very slow and calm and quiet (usually it takes an hour for the lorazepam to kick in, so I don't think that's what it was, but I may be wrong).  Now it's 10 min after 12, and she's really sleepy, slow and calm.  She's actually taking a nap.  Now I'm second guessing that maybe I should have just waited it out a few more minutes instead of giving the lorazepam early.

...

I'm thinking I may have reduced too much nortrip too fast, and it just now caught up with her.  I'm not sure.  Maybe the lorazepam has been masking some of the nortrip withdrawal symptoms?  I know I am impatient to get off the nortrip because I have seen an improvement over the last 2 months when reducing it.  But now she has the same complaints she had last summer when we initially went from 75mg to 50mg to 25mg (of course, she had barely been on it 3 weeks when we did that taper; now she's been on it a year, so maybe reducing even 2% of 2mg each day for a few days might have a bigger reaction?  I don't know).

...

The urology physician's assistant said we might get a second opinion from a different neurologist, but I feel like adding more doctor's to the mix is a really bad idea, as all her major problems in the last 3 years have come from different doctors working at cross purposes (some of them substitute doctors because the regular one was gone).

...

My plan is to just pause the nortrip taper for a few more days or a week and see if she improves.  The lorazepam taper is already paused so I'll just continue pausing that as well.


#107 fishinghat

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Posted 28 June 2017 - 03:44 PM

Hi Greyeyed
 
I am glad to hear from you. I too think this is nortrip related. She is getting down there on her dosage and with her age and medical condition you may need to drop that wean rate in half once she stabilizes. When you gave her her 2 pm at 11 AM and she reacted so quickly it sounds like something set her off (stress that is) or maybe a placebo effect from knowing she just took a lorazepam.  You are doing an incredible job and I want you to know that you are  a hero to me. You have so much discipline and love for your mom and her situation. Keep up the good work and keep us posted.


#108 greyeyed123

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Posted 29 June 2017 - 12:37 PM

It's 10:30 and she has been fine all morning.  I gave her her bedtime 1/2 of lorazepam at 6PM last night, and her 2:00AM 1/2 at 12 midnight, then back to normal 7:00AM 1/2 of lorazepam this morning (no extras, just a bit earlier, then back on time at 7AM).  

...

I do think it was the nortriptyline because she asked for some emetrol for nausea yesterday, and she hasn't used that in several months and only when she was clearly having withdrawal from the nortrip (nausea).  I also thought it odd that she wasn't sweating, as that seemed to be a main withdrawal symptom of nortrip, but she was sweating pretty bad last night and I just didn't realize it.

...

Thanks so much for your help last year, and whenever I hit a bump in the road.  I used to take the good days for granted, but (mostly) I don't do that anymore.


#109 greyeyed123

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Posted 25 July 2017 - 10:41 AM

Still weaning the nortrip. Paused the lorazepam taper for a couple weeks just to have the rest.

Question: mom takes her 120mg duloxetine each day at 10AM.  Mornings used to be her best time, but now the 7-8-9 hours are kind of rough. I thought maybe splitting the dose 60mg every 12 hours might be better. I asked her doctor, but it was another substitute doctor and she said it would be fine...which makes me second guess it as the substitutes always seem to steer us in the wrong direction. I've also kind of been scared to try it.  I thought maybe moving one up an hour and one back an hour each day until we're 12 hours apart.

...

She's been complaining more of pain and burning, but it seems to come and go (the complaints, at least, and her outward appearance of pain/discomfort--if I ask her randomly she always says she hurts, even when she looks much better).  I assume it's because of the nortrip taper. It's hard for me to believe that such tiny, tiny drops can have that kind of effect, but it always seems to be worse the next day after a 1% drop (sometimes less than 1%), and she never knows when I'm dropping it.  I was thinking maybe the duloxetine is lowest in her blood right before her dose at 10AM.  Sometimes she also has weird episodes of confusion between 11AM and 2PM and I thought maybe that was because the duloxetine was too high in her blood?  I don't know, but there seems to be some pattern somewhere that's not jumping out at me.


#110 fishinghat

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Posted 25 July 2017 - 11:46 AM

Once again I think you are right on.

"Sometimes she also has weird episodes of confusion between 11AM and 2PM and I thought maybe that was because the duloxetine was too high in her blood?" That sounds like a side effect to me and I agree it may be be from the Cymbalta when 1 to 3 hours after dose is the high point in the blood stream. The substitute dr was correct. When patients have issues with side effects from a ssri/snri the drs will typically split the dose so as to lessen the severity of those side effects.

 

Your plan to just slide them a couple 3 hours at a time until it is every 12 hours is excellent.

 

How far down on the nortrip is she?


#111 greyeyed123

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Posted 25 July 2017 - 12:15 PM

I'm guessing about 2mg.  (I know the following is convoluted, but it's where I ended up after a year of weaning...)  

...

I mix the powder from 25mg capsule with 6ml of water, mix it up, then use a medicine dropper to remove all except 20 drops (well, 20 drops plus the residue in the bottom of the dixie cup). I then rinse out the medicine dropper, add 30 drops of water to the 20 drops of of medicine, and remove 17 and 1/2 drops of that mixture.  I then add a little water to be sure she gets it all. After she drinks that I add water to the cup again to get any residue that might be left.  It may sound crazy, but I can tell a difference in her in just removing 1/3 of a drop.  But I can also tell if I've paused too long, as she seems to get worse as well.

...

Her doctor's nurse told me I should try just dropping to zero, but that scares me.  I'm just going to keep going slow.


#112 fishinghat

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Posted 25 July 2017 - 01:19 PM

Nothing wrong with that method. It is a variation of the water titration method used so successfully for benzos and other drugs. That is slow but so be it. Better than a tough withdrawal. By the way your 2 mg estimate is right. You and her have come a long way. Keep up the good work. I always look forward to your posts.


#113 greyeyed123

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Posted 29 July 2017 - 11:30 AM

This morning seems to be a good morning.  I moved the duloxetine from two  60mg capsules at 10AM, to 1 at 7AM and one at 1PM, and today 3AM and 3PM (I have to get up at 3AM to give her her parkinson's meds anyway; I was hoping getting it at 3am would make for a good morning, and so far it has).  I even reduced the nortrip 1% last night and so far I see no reaction to that at all.  I'm thinking the reduction in the nortrip made the fluctuations of duloxetine over 24 hours have a more noticeable effect (an increase in pain at times if not an actual withdrawal effect).  I may be able to speed up the nortrip taper now. I'll wait a couple days and see how she does, then start tapering again. Right now this finally feels like it might actually work.

...

Then maybe I can think about continuing the lorazepam taper.  Seems never ending, but we are making progress I think.


#114 fishinghat

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Posted 29 July 2017 - 05:30 PM

greyeyed, I tip my hat  (that is fishinghat, lol) to you. You have been very intuitive about all this and very smart. You are a sharp lady.


#115 greyeyed123

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Posted 29 July 2017 - 06:16 PM

Well, she had a bit of a crash at 2:30.  I thought maybe it was "off time" between doses of Parkinson's, but by 3 (when they've fully kicked in) she was still not feeling well.  

...

I decided to put her duloxetine in her 2:00pm pills because she doesn't take any others at 3pm, and I'm glad I did because I think that's what it was. By 3:40 she was improving, and by 4:00 she was fine again.  I think I finally figured it out, as it seems even minor drops in nortrip  are making withdrawals show up between doses of duloxetine.

...

Also, I'm a very sharp gentleman, lol.  (I don't know how you keep track of all these people you are helping, but you have my respect.)  Thanks so much for your help over this last year and I'll keep coming back for input.


#116 fishinghat

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Posted 30 July 2017 - 07:35 AM

Either way you are great. It does explain why you are so intelligent and capable  ( my male ego showing there, lol)


#117 bronxbomber

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Posted 30 July 2017 - 09:47 PM

I have the greatest respect for anyone who is helping an elderly parent with their drug issues. This is a difficult process for any of us, and it would be impossible for an elderly person to succeed without continuous help.

You have my blessings and my prayers.

#118 greyeyed123

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Posted 18 August 2017 - 11:09 AM

Thanks for all the support.  Mom's having some vomiting issues now. Mostly dry heaves.  I paused the Nortrip taper for about 2 weeks, and have reduced the lorazepam about 1%, although that has been paused for several days also (and usually vomiting wasn't a withdrawal symptom of Lorazepam withdrawal).  Last night I figured I didn't have much to lose by dropping the nortrip 2% as she was already not feeling well for 2-3 days, and previously I had noticed if I paused too long she seemed worse (I figured at least a 50/50 chance I had paused to long).

...

This morning she seemed better outwardly, but then had dry heaves and went back to bed.

...

I'm somewhat at a loss as to what this is.  The nortrip withdrawal is the only real thing that caused vomiting with her in the last 5+ years, but the timing of it seems unrelated to the drop time now (previously she was immediately worse the next day).  She is having episodes that might be "off" time when her Parkinson's meds are between doses, but that doesn't exactly match either because she is still walking well during those times--she's just slow, in more pain, with a "droopy" face and affect (and sometimes she has these when it should be the peak time for her parkinson's meds working, but also similar to "off" time previously except walking was much harder).  She generally seems better 1 hour, or a little more, after an lorazepam dose, although not always...but I'm not sure if that indicates interdose withdrawal from the lorazepam, or if it's just masking something else...or both.

...

She seems to have completely stabilized from moving the duloxetine to 60mg at 3AM and 60mg at 2PM as I haven't noticed the same confusion during the 11AM to 2PM hours, nor the same distress in the morning hours (she used to take 120 at 10AM, with distress before the dose and confusion in the hours after).

...

The other issue is that she doesn't always tell me when she's vomited or had the dry heaves, so depending on the timing, she may be missing a bit of lorazepam, or anything else, which may cause who-knows-what symptoms.  Usually we put the lorazepam under the tongue, and usually if she misses anything significant (which, for her, is any tiny bit) she flies into a rage within 6 hours, and that hasn't happened at all...so I'm assuming that's not the problem.

...

Anyway, thanks for reading and all the support.  Her extended family doesn't really understand this at all, so I'm on my own.


#119 fishinghat

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Posted 18 August 2017 - 01:56 PM

I kind of believe that this may be the recent lorazepam drop on top of the earlier nortrip. I know for me, the first time I did lorazepam withdrawal by GI issues, including nausea and vomiting were pretty bad. That was before I found out about water titration and was dropping 10% every 2 weeks. Anyway, just a thought.


#120 greyeyed123

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Posted 18 August 2017 - 02:27 PM

Well, it's 12:30 and she seems better.  She is complaining about being "nervous" off and on, but no outward signs...and she's eating now, so...I don't know.





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