tramadol withdrawal begins (w/response)

[Guest guest]

Hello,

I am new to the group. I am in the process of weaning from Tramadol. From what

I have read, it is going to be a rough ride. I was given this drug by my doctor

under the advice that it was " non-narcotic " so safe for me...(I had a Percocet

addiction 5 years ago). According to my pharmacist, Tramadol isn't considered a

" narcotic " but it sure acts like one when you try to get off of it. I was up to

more than 300 mg per day plus 4 - 6 extra 'Tramacet'(short acting) tablets as

top up. I have weaned to 100 mg, once per day in morning and 2 Tramacet at 5pm.

I am experiencing headaches, tremors, diarrhea, anxiety, hot and cold sweats and

fatigue. I went to Doc today (looking for a new one by the way) and he gave me

Risperdol and Gravol for the withdrawal symptoms and told me to taper as slow as

possible. Has anyone experience with withdrawing from this or using Risperdol

(anti-psychotic) to help? I'm afraid to take anything he gives me at this point.

Thank you for your help. >>

** Whatever you do, DON'T take the Risperdal. If you think Tramadol is hard

to stop, it's a walk in the park compared to Risperdal.

You can't decrease any more right now. In fact, you may need to bring the

dose up. The goal is not to suffer. When you have symptoms this bad, they

don't stop when you decrease more. This will put you in the position of

suffering for years after you are no longer taking the drug.

Your doctor is woefully under-educated regarding Tramadol. Tramadol is a very

weak µ-opioid receptor agonist that induces serotonin release and inhibits the

reuptake of norepinephrine. It is a mild SSRI. This is the primary reason for

having to discontinue this slowly. If it was only an analgesic/opioid you could

move faster to discontinue it.

Will one of our more seasoned members explain the rule of thumb for

discontinuing a drug? Thanks.

Regards,

[Guest guest]

Sheri writes:

<<Hello

Thank you for your reply and advice. I will definitely not touch the

Risperadol. I should have also mentioned my other meds: I take 30mg Cymbalta

per day and sleeping med: Zopiclone 1-2 tabs at night. I have been taking the

Zopiclone for approx 5 years, since being diagnosed with PTSD.

I am presently taking 100mg of Tramadol at 9:00 am and 1 of the 37.5 Tramacet at

7pm. My withdrawal symptoms seem to have abated mostly at this dosage so I will

stick here for at least a week (?) Headache is the only lingering symptom but

I've always had headaches...is it safe to take Tylenol with codeine or should I

just stick to Ibuprofen? >>

** Think about this. What you'd be doing is trading Tramadol for an even

stronger opiate. I don't think you want to do that.

I think waiting a week is a good idea. Then, I'd spread the decrease between

the 1st 2 doses.

<<I had no idea that Tramadol was SSRI. No wonder the pharmacist suspected

Seratonin Syndrome last time I got a prescription filled--this Dr. had me up to

90 mg of cymbalta and 300mg of Tramadol plus the Tramacet as needed.

Again, thank you for the support.

Sheri>>

** It's a wonder you're still alive.

Regards,

[Guest guest]

Sheri writes:

<<Hello

Thank you for your reply and advice. I will definitely not touch the

Risperadol. I should have also mentioned my other meds: I take 30mg Cymbalta

per day and sleeping med: Zopiclone 1-2 tabs at night. I have been taking the

Zopiclone for approx 5 years, since being diagnosed with PTSD.

I am presently taking 100mg of Tramadol at 9:00 am and 1 of the 37.5 Tramacet at

7pm. My withdrawal symptoms seem to have abated mostly at this dosage so I will

stick here for at least a week (?) Headache is the only lingering symptom but

I've always had headaches...is it safe to take Tylenol with codeine or should I

just stick to Ibuprofen? >>

** Think about this. What you'd be doing is trading Tramadol for an even

stronger opiate. I don't think you want to do that.

I think waiting a week is a good idea. Then, I'd spread the decrease between

the 1st 2 doses.

<<I had no idea that Tramadol was SSRI. No wonder the pharmacist suspected

Seratonin Syndrome last time I got a prescription filled--this Dr. had me up to

90 mg of cymbalta and 300mg of Tramadol plus the Tramacet as needed.

Again, thank you for the support.

Sheri>>

** It's a wonder you're still alive.

Regards,

[Guest guest]

Sheri writes:

<<Hello

Thank you for your reply and advice. I will definitely not touch the

Risperadol. I should have also mentioned my other meds: I take 30mg Cymbalta

per day and sleeping med: Zopiclone 1-2 tabs at night. I have been taking the

Zopiclone for approx 5 years, since being diagnosed with PTSD.

I am presently taking 100mg of Tramadol at 9:00 am and 1 of the 37.5 Tramacet at

7pm. My withdrawal symptoms seem to have abated mostly at this dosage so I will

stick here for at least a week (?) Headache is the only lingering symptom but

I've always had headaches...is it safe to take Tylenol with codeine or should I

just stick to Ibuprofen? >>

** Think about this. What you'd be doing is trading Tramadol for an even

stronger opiate. I don't think you want to do that.

I think waiting a week is a good idea. Then, I'd spread the decrease between

the 1st 2 doses.

<<I had no idea that Tramadol was SSRI. No wonder the pharmacist suspected

Seratonin Syndrome last time I got a prescription filled--this Dr. had me up to

90 mg of cymbalta and 300mg of Tramadol plus the Tramacet as needed.

Again, thank you for the support.

Sheri>>

** It's a wonder you're still alive.

Regards,

[Guest guest]

[Thanks, ! I'll add just a little note here. I'd word the 2nd sentence a

little clearer. I would say, " After 2 weeks ask yourself if you feel as well or

better than you felt

prior to the last decrease.... "

There's just one thing to remember here. If it has been 2 weeks and you've

felt no withdrawal at all, you need to wait longer. There are a few drugs that

last a long time in your system. You want to make sure you've waited long

enough. Of course, you could always ask here. --]

Hi new person (name?),

Welcome to the group.

Rule of thumb ------ do a 3-5% decrease. Ask yourself after about 2-4 weeks

(depending on drug) if you feel as well or better than you felt prior to the

last decrease. If you can say YES with certainty it is time for the next

decrease. If you can't say yes with no doubt, you cannot do your next decrease

yet. It doesn't matter whether it's been 4 weeks. If you don't get a " yes " to

the question, you can't do another decrease yet.

[Guest guest]

[Thanks, ! I'll add just a little note here. I'd word the 2nd sentence a

little clearer. I would say, " After 2 weeks ask yourself if you feel as well or

better than you felt

prior to the last decrease.... "

There's just one thing to remember here. If it has been 2 weeks and you've

felt no withdrawal at all, you need to wait longer. There are a few drugs that

last a long time in your system. You want to make sure you've waited long

enough. Of course, you could always ask here. --]

Hi new person (name?),

Welcome to the group.

Rule of thumb ------ do a 3-5% decrease. Ask yourself after about 2-4 weeks

(depending on drug) if you feel as well or better than you felt prior to the

last decrease. If you can say YES with certainty it is time for the next

decrease. If you can't say yes with no doubt, you cannot do your next decrease

yet. It doesn't matter whether it's been 4 weeks. If you don't get a " yes " to

the question, you can't do another decrease yet.

[Guest guest]

Sheri writes:

<<Hello, 

Thank you and for your advice and support.  

Could someone clarify what you mean by 3-5 percent decrease? Sorry to be

dumb...just don't want to screw this up.  I had no idea it would take so long

to wean...according to the doctors I could just drop down every few days...thank

God I found this group.  

Gratefully,

Sheri>>

** Hi Sheri,

3-5% means 3-5% of your dose you're currently taking.

Example: If you are taking 100 mg. you figure out what is 5% of 100 mg .

Your answer 5% . So you want to take only 95 mg. of the drug.

You do this by dissolving the 100 mg pill in hot water or something fizzy.

After it i dissolved, you want to take that and add enough liquid to it to get

10 ounces.

Now you have a liquid drug. 10 ounces of this liquid drug = 100 mg. To t drop

5% (5 mg) you drink 9.5 oz. of the mixture or pour off half an ounce and drink

the rest.

You may be able to go somewhat more quickly in that this drug is a weak SSRI

but it's important to begin slowly. As we go along I will guide you. I do

think you'll be able to boost your reductions but they can never be done as

quickly as the foolish doctors will tell you. I can count on one hand how many

people have come here saying their doctor knew it would take months or even

years to get off the drug they were taking.

The biggest challenge you face is not giving in and taking more. Unlike most

psych drugs (other than benzodiazepines), people crave drugs like Tramadol

because they stimulate the " pleasure center " of the brain. But if you are

determined and hold yourself to it, you can do it.

Regards,

________________________________

I'll add just a little note here. I'd word the 2nd sentence a little clearer.

I would say, " After 2 weeks ask yourself if you feel as well or better than you

felt

prior to the last decrease.... "

There's just one thing to remember here. If it has been 2 weeks and you've felt

no withdrawal at all, you need to wait longer. There are a few drugs that last

a long time in your system. You want to make sure you've waited long enough.

Of course, you could always ask here. --]

Hi new person (name?),

Welcome to the group.

Rule of thumb ------ do a 3-5% decrease. Ask yourself after about 2-4 weeks

(depending on drug) if you feel as well or better than you felt prior to the

last decrease. If you can say YES with certainty it is time for the next

decrease. If you can't say yes with no doubt, you cannot do your next decrease

yet. It doesn't matter whether it's been 4 weeks. If you don't get a " yes " to

the question, you can't do another decrease yet.

[Guest guest]

Sheri writes:

<<Hello, 

Thank you and for your advice and support.  

Could someone clarify what you mean by 3-5 percent decrease? Sorry to be

dumb...just don't want to screw this up.  I had no idea it would take so long

to wean...according to the doctors I could just drop down every few days...thank

God I found this group.  

Gratefully,

Sheri>>

** Hi Sheri,

3-5% means 3-5% of your dose you're currently taking.

Example: If you are taking 100 mg. you figure out what is 5% of 100 mg .

Your answer 5% . So you want to take only 95 mg. of the drug.

You do this by dissolving the 100 mg pill in hot water or something fizzy.

After it i dissolved, you want to take that and add enough liquid to it to get

10 ounces.

Now you have a liquid drug. 10 ounces of this liquid drug = 100 mg. To t drop

5% (5 mg) you drink 9.5 oz. of the mixture or pour off half an ounce and drink

the rest.

You may be able to go somewhat more quickly in that this drug is a weak SSRI

but it's important to begin slowly. As we go along I will guide you. I do

think you'll be able to boost your reductions but they can never be done as

quickly as the foolish doctors will tell you. I can count on one hand how many

people have come here saying their doctor knew it would take months or even

years to get off the drug they were taking.

The biggest challenge you face is not giving in and taking more. Unlike most

psych drugs (other than benzodiazepines), people crave drugs like Tramadol

because they stimulate the " pleasure center " of the brain. But if you are

determined and hold yourself to it, you can do it.

Regards,

________________________________

I'll add just a little note here. I'd word the 2nd sentence a little clearer.

I would say, " After 2 weeks ask yourself if you feel as well or better than you

felt

prior to the last decrease.... "

There's just one thing to remember here. If it has been 2 weeks and you've felt

no withdrawal at all, you need to wait longer. There are a few drugs that last

a long time in your system. You want to make sure you've waited long enough.

Of course, you could always ask here. --]

Hi new person (name?),

Welcome to the group.

Rule of thumb ------ do a 3-5% decrease. Ask yourself after about 2-4 weeks

(depending on drug) if you feel as well or better than you felt prior to the

last decrease. If you can say YES with certainty it is time for the next

decrease. If you can't say yes with no doubt, you cannot do your next decrease

yet. It doesn't matter whether it's been 4 weeks. If you don't get a " yes " to

the question, you can't do another decrease yet.

[Guest guest]

Sheri writes:

<<Hello, 

Thank you and for your advice and support.  

Could someone clarify what you mean by 3-5 percent decrease? Sorry to be

dumb...just don't want to screw this up.  I had no idea it would take so long

to wean...according to the doctors I could just drop down every few days...thank

God I found this group.  

Gratefully,

Sheri>>

** Hi Sheri,

3-5% means 3-5% of your dose you're currently taking.

Example: If you are taking 100 mg. you figure out what is 5% of 100 mg .

Your answer 5% . So you want to take only 95 mg. of the drug.

You do this by dissolving the 100 mg pill in hot water or something fizzy.

After it i dissolved, you want to take that and add enough liquid to it to get

10 ounces.

Now you have a liquid drug. 10 ounces of this liquid drug = 100 mg. To t drop

5% (5 mg) you drink 9.5 oz. of the mixture or pour off half an ounce and drink

the rest.

You may be able to go somewhat more quickly in that this drug is a weak SSRI

but it's important to begin slowly. As we go along I will guide you. I do

think you'll be able to boost your reductions but they can never be done as

quickly as the foolish doctors will tell you. I can count on one hand how many

people have come here saying their doctor knew it would take months or even

years to get off the drug they were taking.

The biggest challenge you face is not giving in and taking more. Unlike most

psych drugs (other than benzodiazepines), people crave drugs like Tramadol

because they stimulate the " pleasure center " of the brain. But if you are

determined and hold yourself to it, you can do it.

Regards,

________________________________

I'll add just a little note here. I'd word the 2nd sentence a little clearer.

I would say, " After 2 weeks ask yourself if you feel as well or better than you

felt

prior to the last decrease.... "

There's just one thing to remember here. If it has been 2 weeks and you've felt

no withdrawal at all, you need to wait longer. There are a few drugs that last

a long time in your system. You want to make sure you've waited long enough.

Of course, you could always ask here. --]

Hi new person (name?),

Welcome to the group.

Rule of thumb ------ do a 3-5% decrease. Ask yourself after about 2-4 weeks

(depending on drug) if you feel as well or better than you felt prior to the

last decrease. If you can say YES with certainty it is time for the next

decrease. If you can't say yes with no doubt, you cannot do your next decrease

yet. It doesn't matter whether it's been 4 weeks. If you don't get a " yes " to

the question, you can't do another decrease yet.

[Guest guest]

Thank you . I had no idea I could dissolve them to decrease dosage. I agree, the doctors seem to think that this is no big deal...I think there needs to be a lot more education around this drug...it's very insidious. As compared to Percocet, which kind of slaps the high on, this stuff worms its way into your brain and body. I don't crave this drug the way I did with Percocet withdrawal but I can certainly see how failure could happen by not sticking to a slow weaning. The withdrawal symptoms would push you back to increasing the dosage as you said. Again, very grateful here for your guidance. Many thanks, Sheri To: "Withdrawal_and_Recovery " <Withdrawal_and_Recovery > Sent: Sunday, August 5, 2012 10:43 PM Subject: Re: tramadol withdrawal begins (w/response)

Sheri writes:

<<Hello,

Thank you and for your advice and support. Â

Could someone clarify what you mean by 3-5 percent decrease? Sorry to be dumb...just don't want to screw this up. Â I had no idea it would take so long to wean...according to the doctors I could just drop down every few days...thank God I found this group. Â

Gratefully,

Sheri>>

** Hi Sheri,

3-5% means 3-5% of your dose you're currently taking.

Example: If you are taking 100 mg. you figure out what is 5% of 100 mg . Your answer 5% . So you want to take only 95 mg. of the drug.

You do this by dissolving the 100 mg pill in hot water or something fizzy. After it i dissolved, you want to take that and add enough liquid to it to get 10 ounces.

Now you have a liquid drug. 10 ounces of this liquid drug = 100 mg. To t drop 5% (5 mg) you drink 9.5 oz. of the mixture or pour off half an ounce and drink the rest.

You may be able to go somewhat more quickly in that this drug is a weak SSRI but it's important to begin slowly. As we go along I will guide you. I do think you'll be able to boost your reductions but they can never be done as quickly as the foolish doctors will tell you. I can count on one hand how many people have come here saying their doctor knew it would take months or even years to get off the drug they were taking.

The biggest challenge you face is not giving in and taking more. Unlike most psych drugs (other than benzodiazepines), people crave drugs like Tramadol because they stimulate the "pleasure center" of the brain. But if you are determined and hold yourself to it, you can do it.

Regards,

________________________________

I'll add just a little note here. I'd word the 2nd sentence a little clearer. I would say, "After 2 weeks ask yourself if you feel as well or better than you felt

prior to the last decrease...."

There's just one thing to remember here. If it has been 2 weeks and you've felt no withdrawal at all, you need to wait longer. There are a few drugs that last a long time in your system. You want to make sure you've waited long enough. Of course, you could always ask here. --]

Hi new person (name?),

Welcome to the group.

Rule of thumb ------ do a 3-5% decrease. Ask yourself after about 2-4 weeks (depending on drug) if you feel as well or better than you felt prior to the last decrease. If you can say YES with certainty it is time for the next decrease. If you can't say yes with no doubt, you cannot do your next decrease yet. It doesn't matter whether it's been 4 weeks. If you don't get a "yes" to the question, you can't do another decrease yet.

[Guest guest]

Thank you . I had no idea I could dissolve them to decrease dosage. I agree, the doctors seem to think that this is no big deal...I think there needs to be a lot more education around this drug...it's very insidious. As compared to Percocet, which kind of slaps the high on, this stuff worms its way into your brain and body. I don't crave this drug the way I did with Percocet withdrawal but I can certainly see how failure could happen by not sticking to a slow weaning. The withdrawal symptoms would push you back to increasing the dosage as you said. Again, very grateful here for your guidance. Many thanks, Sheri To: "Withdrawal_and_Recovery " <Withdrawal_and_Recovery > Sent: Sunday, August 5, 2012 10:43 PM Subject: Re: tramadol withdrawal begins (w/response)

Sheri writes:

<<Hello,

Thank you and for your advice and support. Â

Could someone clarify what you mean by 3-5 percent decrease? Sorry to be dumb...just don't want to screw this up. Â I had no idea it would take so long to wean...according to the doctors I could just drop down every few days...thank God I found this group. Â

Gratefully,

Sheri>>

** Hi Sheri,

3-5% means 3-5% of your dose you're currently taking.

Example: If you are taking 100 mg. you figure out what is 5% of 100 mg . Your answer 5% . So you want to take only 95 mg. of the drug.

You do this by dissolving the 100 mg pill in hot water or something fizzy. After it i dissolved, you want to take that and add enough liquid to it to get 10 ounces.

Now you have a liquid drug. 10 ounces of this liquid drug = 100 mg. To t drop 5% (5 mg) you drink 9.5 oz. of the mixture or pour off half an ounce and drink the rest.

You may be able to go somewhat more quickly in that this drug is a weak SSRI but it's important to begin slowly. As we go along I will guide you. I do think you'll be able to boost your reductions but they can never be done as quickly as the foolish doctors will tell you. I can count on one hand how many people have come here saying their doctor knew it would take months or even years to get off the drug they were taking.

The biggest challenge you face is not giving in and taking more. Unlike most psych drugs (other than benzodiazepines), people crave drugs like Tramadol because they stimulate the "pleasure center" of the brain. But if you are determined and hold yourself to it, you can do it.

Regards,

________________________________

I'll add just a little note here. I'd word the 2nd sentence a little clearer. I would say, "After 2 weeks ask yourself if you feel as well or better than you felt

prior to the last decrease...."

There's just one thing to remember here. If it has been 2 weeks and you've felt no withdrawal at all, you need to wait longer. There are a few drugs that last a long time in your system. You want to make sure you've waited long enough. Of course, you could always ask here. --]

Hi new person (name?),

Welcome to the group.

Rule of thumb ------ do a 3-5% decrease. Ask yourself after about 2-4 weeks (depending on drug) if you feel as well or better than you felt prior to the last decrease. If you can say YES with certainty it is time for the next decrease. If you can't say yes with no doubt, you cannot do your next decrease yet. It doesn't matter whether it's been 4 weeks. If you don't get a "yes" to the question, you can't do another decrease yet.

[Guest guest]

Thank you . I had no idea I could dissolve them to decrease dosage. I agree, the doctors seem to think that this is no big deal...I think there needs to be a lot more education around this drug...it's very insidious. As compared to Percocet, which kind of slaps the high on, this stuff worms its way into your brain and body. I don't crave this drug the way I did with Percocet withdrawal but I can certainly see how failure could happen by not sticking to a slow weaning. The withdrawal symptoms would push you back to increasing the dosage as you said. Again, very grateful here for your guidance. Many thanks, Sheri To: "Withdrawal_and_Recovery " <Withdrawal_and_Recovery > Sent: Sunday, August 5, 2012 10:43 PM Subject: Re: tramadol withdrawal begins (w/response)

Sheri writes:

<<Hello,

Thank you and for your advice and support. Â

Could someone clarify what you mean by 3-5 percent decrease? Sorry to be dumb...just don't want to screw this up. Â I had no idea it would take so long to wean...according to the doctors I could just drop down every few days...thank God I found this group. Â

Gratefully,

Sheri>>

** Hi Sheri,

3-5% means 3-5% of your dose you're currently taking.

Example: If you are taking 100 mg. you figure out what is 5% of 100 mg . Your answer 5% . So you want to take only 95 mg. of the drug.

You do this by dissolving the 100 mg pill in hot water or something fizzy. After it i dissolved, you want to take that and add enough liquid to it to get 10 ounces.

Now you have a liquid drug. 10 ounces of this liquid drug = 100 mg. To t drop 5% (5 mg) you drink 9.5 oz. of the mixture or pour off half an ounce and drink the rest.

You may be able to go somewhat more quickly in that this drug is a weak SSRI but it's important to begin slowly. As we go along I will guide you. I do think you'll be able to boost your reductions but they can never be done as quickly as the foolish doctors will tell you. I can count on one hand how many people have come here saying their doctor knew it would take months or even years to get off the drug they were taking.

The biggest challenge you face is not giving in and taking more. Unlike most psych drugs (other than benzodiazepines), people crave drugs like Tramadol because they stimulate the "pleasure center" of the brain. But if you are determined and hold yourself to it, you can do it.

Regards,

________________________________

I'll add just a little note here. I'd word the 2nd sentence a little clearer. I would say, "After 2 weeks ask yourself if you feel as well or better than you felt

prior to the last decrease...."

There's just one thing to remember here. If it has been 2 weeks and you've felt no withdrawal at all, you need to wait longer. There are a few drugs that last a long time in your system. You want to make sure you've waited long enough. Of course, you could always ask here. --]

Hi new person (name?),

Welcome to the group.

Rule of thumb ------ do a 3-5% decrease. Ask yourself after about 2-4 weeks (depending on drug) if you feel as well or better than you felt prior to the last decrease. If you can say YES with certainty it is time for the next decrease. If you can't say yes with no doubt, you cannot do your next decrease yet. It doesn't matter whether it's been 4 weeks. If you don't get a "yes" to the question, you can't do another decrease yet.

[Guest guest]

Terry writes:

<<Hi ,

Aren't there some medications that are have a time release coating on the tablet

or the shell and the sprinkles inside the shell?

For example, how does one do a 5% reduction of a 20 mg capsule of cymbalta? or a

125 mg capsule of delayed release sprinkles of depakote? Must the services of a

compounding pharmacist be utilized or are there other methods to " do it

yourself? "

Thank you!

Terry>>

** Hi Terry,

Thanks for asking this. First, when a drug is a time-released product, most

of the time the name indicates this bu using a couple of letters (ex. Effexor

XR, Paxil CR, etc.). An exception is Cymbalta. This is deliberate. People

were choosing time-released drugs less often (for obvious reasons). The answer

to this was to create a drug that was advertised as being available by capsule

and by extended release. But they created no shorthand for the latter; thus,

people don't include this info when telling the name of the drug they are

taking.

Fortunately, most of these extended release/Sustained release, etc. drugs are

capsules with little spheres or pellets inside. This design has each

sphere/pellet covered with the coating to slow down assimilation. Since each is

covered it is not a problem to reduce these types of drugs. A person need only

count the pellets to titrate a dose. There's no need for a liquid titration with

a drug like this (it would also not work).

If the time-released drug is a powder in a capsule, the way to reduce it is to

get some empty capsules, a drug scale (available on Ebay), weigh the powder

from one capsule, then split it up by weighing it. Put your titrated doses in an

empty capsule. Empty capsules can be purchased from herbal stores, and some

natural markets/supplement stores.

Regards,

[Guest guest]

Terry writes:

<<Hi ,

Aren't there some medications that are have a time release coating on the tablet

or the shell and the sprinkles inside the shell?

For example, how does one do a 5% reduction of a 20 mg capsule of cymbalta? or a

125 mg capsule of delayed release sprinkles of depakote? Must the services of a

compounding pharmacist be utilized or are there other methods to " do it

yourself? "

Thank you!

Terry>>

** Hi Terry,

Thanks for asking this. First, when a drug is a time-released product, most

of the time the name indicates this bu using a couple of letters (ex. Effexor

XR, Paxil CR, etc.). An exception is Cymbalta. This is deliberate. People

were choosing time-released drugs less often (for obvious reasons). The answer

to this was to create a drug that was advertised as being available by capsule

and by extended release. But they created no shorthand for the latter; thus,

people don't include this info when telling the name of the drug they are

taking.

Fortunately, most of these extended release/Sustained release, etc. drugs are

capsules with little spheres or pellets inside. This design has each

sphere/pellet covered with the coating to slow down assimilation. Since each is

covered it is not a problem to reduce these types of drugs. A person need only

count the pellets to titrate a dose. There's no need for a liquid titration with

a drug like this (it would also not work).

If the time-released drug is a powder in a capsule, the way to reduce it is to

get some empty capsules, a drug scale (available on Ebay), weigh the powder

from one capsule, then split it up by weighing it. Put your titrated doses in an

empty capsule. Empty capsules can be purchased from herbal stores, and some

natural markets/supplement stores.

Regards,

[Guest guest]

Terry writes:

<<Hi ,

Aren't there some medications that are have a time release coating on the tablet

or the shell and the sprinkles inside the shell?

For example, how does one do a 5% reduction of a 20 mg capsule of cymbalta? or a

125 mg capsule of delayed release sprinkles of depakote? Must the services of a

compounding pharmacist be utilized or are there other methods to " do it

yourself? "

Thank you!

Terry>>

** Hi Terry,

Thanks for asking this. First, when a drug is a time-released product, most

of the time the name indicates this bu using a couple of letters (ex. Effexor

XR, Paxil CR, etc.). An exception is Cymbalta. This is deliberate. People

were choosing time-released drugs less often (for obvious reasons). The answer

to this was to create a drug that was advertised as being available by capsule

and by extended release. But they created no shorthand for the latter; thus,

people don't include this info when telling the name of the drug they are

taking.

Fortunately, most of these extended release/Sustained release, etc. drugs are

capsules with little spheres or pellets inside. This design has each

sphere/pellet covered with the coating to slow down assimilation. Since each is

covered it is not a problem to reduce these types of drugs. A person need only

count the pellets to titrate a dose. There's no need for a liquid titration with

a drug like this (it would also not work).

If the time-released drug is a powder in a capsule, the way to reduce it is to

get some empty capsules, a drug scale (available on Ebay), weigh the powder

from one capsule, then split it up by weighing it. Put your titrated doses in an

empty capsule. Empty capsules can be purchased from herbal stores, and some

natural markets/supplement stores.

Regards,

[Guest guest]

On 8/4/2012 7:34 PM, Ditchburn wrote (to Wells -

forwarded it to the list):

<<No disrespect to the person who gave you the reply to your question. I'm not

sure which drug yr in. I myself have been on Paxil for 3 and a half years. Been

wanting to reduce for a while due to weight gain. Was on 30mgs. Doctor suggested

20mgs for a mth then 10mgs for a mth then stop. Me my partner and my family were

very concerned. 2 days into taking 10mgs found out I was pregnant, got told to

stop pills immediately. Which I sud nearly 10 days ago was terrified as I've ran

out(when I was in 30mgs) and by day 4 was really poorly. In my case I can say

I've felt very little. From 3 and a half yrs of 30mgs. 4wks of 20mgs then a few

days of 10mgs. I know everyone is different and if tr un the us you will pay for

your prescriptions. In uk if yr unwell or struggle financially the government

pay. I was never offered liquid Paxil. My spouse wanted me to reduce to 5mgs.

This wasn't prescribed I think because they have to tighten their belts as the

government pay. It has done me no harm. >>

replies:

** I can tell you why it has seemingly caused you no harm. If I am

understanding correctly, you have stopped less than a month ago -- right? If

Paxil was the only antidepressant you've taken for more than a few weeks, this

is why you are experiencing little to no difficulty. Nearly everyone who is on

an antidepressant for the first time is able to come off with no problems. The

problems come if you ever take an antidepressant again.

You see, the drug has made some permanent alterations to your chemistry and

brain structure. The serotonin transporter system has been structurally changed

and numerous serotonin receptors have been killed off. This will limit your

ability to tolerate the effects of an antidepressant should you take one again.

If you do take one and decide to stop it, you will understand what others are

talking about when they speak of difficulty.

said:

<<Maybe people look to much into things. >>

** That's quite offensive (and egocentric). In essence what you're saying

is that because you didn't have that experience anyone who did must be weak.

Let me explain. People are biochemically unique. Some people can eat a peanut

and have their throats close off while others can eat them all day with no

adverse effects. Some people have no problem taking Penicillin while it will

kill others. This is the nature of biochemical individuality. Your experiences

cannot be extrapolated and applied to others. You'd find yourself getting

better reception if you trusted when someone told you their experience was

different from your experience.

said:

<<And I'm sorry I find it quite offensive to five dosage advice unless you are

medically trained. You maybe, I'm not sure.>>

** Good point. You don't know. So why would you say something based upon

a lack of knowledge? Are you sure you're having no reaction to stopping the

Paxil? That's a very strange way to communicate with people. If you want to

know something about a person, ask them. Don't make assumptions and then speak

rudely because of your assumptions.

said:

<<Keep busy try not too look into things do much. I worry bout the medical

state un USA, as it's a business and will draw things out for cash. Not yr best

interests at heart. Seek a 2nd opinion. A Paxil free friend as of 2 wks. Little

dizziness. But that's all. Pill free that's the main thing. Maybe you have to

suffer a little to be free, don't read to much into everything. Be strong, fight

it >>

** I'm curious if you are still feeling okay. It's now been another week

to two since you wrote this. Were you on the regular version of Paxil or the CR

version (Continuous Release)?

Regards,

[Guest guest]

On 8/4/2012 7:34 PM, Ditchburn wrote (to Wells -

forwarded it to the list):

<<No disrespect to the person who gave you the reply to your question. I'm not

sure which drug yr in. I myself have been on Paxil for 3 and a half years. Been

wanting to reduce for a while due to weight gain. Was on 30mgs. Doctor suggested

20mgs for a mth then 10mgs for a mth then stop. Me my partner and my family were

very concerned. 2 days into taking 10mgs found out I was pregnant, got told to

stop pills immediately. Which I sud nearly 10 days ago was terrified as I've ran

out(when I was in 30mgs) and by day 4 was really poorly. In my case I can say

I've felt very little. From 3 and a half yrs of 30mgs. 4wks of 20mgs then a few

days of 10mgs. I know everyone is different and if tr un the us you will pay for

your prescriptions. In uk if yr unwell or struggle financially the government

pay. I was never offered liquid Paxil. My spouse wanted me to reduce to 5mgs.

This wasn't prescribed I think because they have to tighten their belts as the

government pay. It has done me no harm. >>

replies:

** I can tell you why it has seemingly caused you no harm. If I am

understanding correctly, you have stopped less than a month ago -- right? If

Paxil was the only antidepressant you've taken for more than a few weeks, this

is why you are experiencing little to no difficulty. Nearly everyone who is on

an antidepressant for the first time is able to come off with no problems. The

problems come if you ever take an antidepressant again.

You see, the drug has made some permanent alterations to your chemistry and

brain structure. The serotonin transporter system has been structurally changed

and numerous serotonin receptors have been killed off. This will limit your

ability to tolerate the effects of an antidepressant should you take one again.

If you do take one and decide to stop it, you will understand what others are

talking about when they speak of difficulty.

said:

<<Maybe people look to much into things. >>

** That's quite offensive (and egocentric). In essence what you're saying

is that because you didn't have that experience anyone who did must be weak.

Let me explain. People are biochemically unique. Some people can eat a peanut

and have their throats close off while others can eat them all day with no

adverse effects. Some people have no problem taking Penicillin while it will

kill others. This is the nature of biochemical individuality. Your experiences

cannot be extrapolated and applied to others. You'd find yourself getting

better reception if you trusted when someone told you their experience was

different from your experience.

said:

<<And I'm sorry I find it quite offensive to five dosage advice unless you are

medically trained. You maybe, I'm not sure.>>

** Good point. You don't know. So why would you say something based upon

a lack of knowledge? Are you sure you're having no reaction to stopping the

Paxil? That's a very strange way to communicate with people. If you want to

know something about a person, ask them. Don't make assumptions and then speak

rudely because of your assumptions.

said:

<<Keep busy try not too look into things do much. I worry bout the medical

state un USA, as it's a business and will draw things out for cash. Not yr best

interests at heart. Seek a 2nd opinion. A Paxil free friend as of 2 wks. Little

dizziness. But that's all. Pill free that's the main thing. Maybe you have to

suffer a little to be free, don't read to much into everything. Be strong, fight

it >>

** I'm curious if you are still feeling okay. It's now been another week

to two since you wrote this. Were you on the regular version of Paxil or the CR

version (Continuous Release)?

Regards,

[Guest guest]

On 8/4/2012 7:34 PM, Ditchburn wrote (to Wells -

forwarded it to the list):

<<No disrespect to the person who gave you the reply to your question. I'm not

sure which drug yr in. I myself have been on Paxil for 3 and a half years. Been

wanting to reduce for a while due to weight gain. Was on 30mgs. Doctor suggested

20mgs for a mth then 10mgs for a mth then stop. Me my partner and my family were

very concerned. 2 days into taking 10mgs found out I was pregnant, got told to

stop pills immediately. Which I sud nearly 10 days ago was terrified as I've ran

out(when I was in 30mgs) and by day 4 was really poorly. In my case I can say

I've felt very little. From 3 and a half yrs of 30mgs. 4wks of 20mgs then a few

days of 10mgs. I know everyone is different and if tr un the us you will pay for

your prescriptions. In uk if yr unwell or struggle financially the government

pay. I was never offered liquid Paxil. My spouse wanted me to reduce to 5mgs.

This wasn't prescribed I think because they have to tighten their belts as the

government pay. It has done me no harm. >>

replies:

** I can tell you why it has seemingly caused you no harm. If I am

understanding correctly, you have stopped less than a month ago -- right? If

Paxil was the only antidepressant you've taken for more than a few weeks, this

is why you are experiencing little to no difficulty. Nearly everyone who is on

an antidepressant for the first time is able to come off with no problems. The

problems come if you ever take an antidepressant again.

You see, the drug has made some permanent alterations to your chemistry and

brain structure. The serotonin transporter system has been structurally changed

and numerous serotonin receptors have been killed off. This will limit your

ability to tolerate the effects of an antidepressant should you take one again.

If you do take one and decide to stop it, you will understand what others are

talking about when they speak of difficulty.

said:

<<Maybe people look to much into things. >>

** That's quite offensive (and egocentric). In essence what you're saying

is that because you didn't have that experience anyone who did must be weak.

Let me explain. People are biochemically unique. Some people can eat a peanut

and have their throats close off while others can eat them all day with no

adverse effects. Some people have no problem taking Penicillin while it will

kill others. This is the nature of biochemical individuality. Your experiences

cannot be extrapolated and applied to others. You'd find yourself getting

better reception if you trusted when someone told you their experience was

different from your experience.

said:

<<And I'm sorry I find it quite offensive to five dosage advice unless you are

medically trained. You maybe, I'm not sure.>>

** Good point. You don't know. So why would you say something based upon

a lack of knowledge? Are you sure you're having no reaction to stopping the

Paxil? That's a very strange way to communicate with people. If you want to

know something about a person, ask them. Don't make assumptions and then speak

rudely because of your assumptions.

said:

<<Keep busy try not too look into things do much. I worry bout the medical

state un USA, as it's a business and will draw things out for cash. Not yr best

interests at heart. Seek a 2nd opinion. A Paxil free friend as of 2 wks. Little

dizziness. But that's all. Pill free that's the main thing. Maybe you have to

suffer a little to be free, don't read to much into everything. Be strong, fight

it >>

** I'm curious if you are still feeling okay. It's now been another week

to two since you wrote this. Were you on the regular version of Paxil or the CR

version (Continuous Release)?

Regards,