Hawky

Hawky: Tricyclic withdrawal

17 posts in this topic

Hi Just wondered if anyone out there has discontinued ( or is in the process of ) any of the older type ADs known as trycyclics . The name of my medication is Dosulepin also known as Dothiepin and I am really struggling at the moment , I have tapered from 150mgs in February to my current dosage of 50 mgs but the withdrawal symptoms I am currently experiencing are awful , severe anxiety / nausea and extreme fatigue . Can anyone reassure me that this is normal and will subside ??

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Last year, before I discovered SA, I began tapering Imipramine on a 10% every three week schedule.  I did fine until I got from 75 mg to 25 mg, at which point I began experiencing anxiety and dizziness.  Even so, I continued tapering down to 15 mg with increasing anxiety.  Then I updosed to 25 mg to try to regain equilibrium.  

 
Based on my experience, I would say your symptoms are normal WD.  I wish I could tell you whether they will subside.  I still have some anxiety as well as insomnia, but my case is complicated by the fact that I'm in tolerance/withdrawal from Lorazepam, which also could be causing the symptoms.
 
Check out “How to create a signature” for this forum..  If you would put your signature up, with your tapering schedule and any other drugs you've been taking lately, perhaps one of the moderators could take a look at your history and give you some advice. 

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Thanks so much for that , it helps . It certainly seems as you say that the problems intensify when you least expect them to ie : not at the time of the larger dose reductions but when you feel you can see light at the end of the tunnel . My doctor doesn't seem to understand just how horrendous my symptoms are but thankfully I was given a private consultation with my pharmacist who did try to reassure me . I will gather up all my noted regarding my tapering experience and post as you advise . I too suffer badly with insomnia but this has been on going for years so for me has become the " norm " . Thanks again and I hope you manage to find a suitable balance with your medication soon .

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Once you get your signature up, you might ask whether the moderators think a small updose would be helpful.  Often just a little increase in your current dose  alleviates symptoms and allows you to stabilize, permitting you to taper back down at a slower rate.  The forum recommends tapering no more than 10% of current (not original) dose every four weeks with a 2-week hold.  It appears you tapered quite a bit more quickly, which may account for the horrendous symptoms you're experiencing.

 

Welcome to Surviving Antidepressants.  You're in the right place

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Hi Hawky and welcome to SA.

 

Please create a drug signature Create Your Signature.  Please include details for the last 12-18 months of  all drugs, dates, doses and discontinuations & reinstatements.  If you can't remember dates, please write it as "early March" or "mid-August".  Please provide a summary of any drugs prior to that which can just be listed with start and stop years. Please include all prescription, non-prescription drugs and supplements you are currently taking. Phone Instructions:  Withdrawal History Signature. Please also remember to update it with date and dose whenever make a change so that it remains current. Thank you.

 

As Gridley mentioned SA recommends a 10% (or less) taper of the previous dose followed by about a 4 week hold to allow the brain to adapt to not getting as much of the drug.

 

Why taper by 10% of my dosage?


Dr Joseph Glenmullen's WD Symptoms Checklist

 

These helped me to understand SA's recommendations:

 

Brain Remodelling


Video:  Healing From Antidepressants - Patterns of Recovery

 

This is your own Intro topic where you can ask questions and journal your progress.  If you click "Follow" top right you will be notified when someone responds.

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I've survived this brutality and healed quite a bit.  I was put into a situation that I was told was a normal taper, but it actually turned out to be a rapid taper followed by cold-turkey (thanks, doctors!).  I opted not to reinstate.  I've survived hell.  My life is different now, and my body did sustain permanent damage from the tricyclics, but I survived.

Just hold on.  It will get better.  Keep holding on until it does.    

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I like my doctor and he s always had time / patience with me with many issues over the years , but now with this on going problem , tapering off dosulepin after 3 years , he really is clueless . On 14th February my dose was 150 mgs every evening and had been for approx. 3 years , as this medication is being withdrawn by the manufacturer he advised that I needed to wean off ASAP but his plan was for me to be completely off the tablets within 4 weeks . As in the past I have stopped this same medication very easily without any problems but over many months I questioned his advice . Needless to say I have been back to see him 3 or 4 times after suffering with horrible discontinuation symptoms - severe anxiety / nausea / insomnia being the worse . He has reluctantly prescribed more tablets but can't seem to understand my symptoms and concerns . I am now taking 50 mgs each night but after 2 weeks my symptoms are not improving . What can I do as he s very reluctant to give me another prescription and I'm so scared .

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One of the moderators should be along shortly to help you, but one possibility would be a cross-taper to another antidepressant.  A quick google search of dosulepin bridge" gave a timeline (too short) for cross-tapering to Citalopram.  Then you could do a slow taper of Citalopram, or another SSRI, without being under the gun.

 

I sympathize, as Ecuador stopped importing Lorazepam from the U.S. and I didn't know what I was going to do until I found I was able to get South American-manufactured Lorazepam.  Not ideal, but it works.

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I've merged your new topic with your Intro because it is about your own situation and keeps your history in one place.

 

As previously requested please complete your drug signature.  It will appear every time you post so that members can see your history at a glance.  Thank you.

 

The only known way of reducing the withdrawal symptoms is to updose.  I suggest you read this topic:  About reinstating and stabilizing to reduce withdrawal symptoms

 

I think the first thing you need to do is to find out when the drug will no longer be available.  I would also be asking the doctor, or maybe even finding a new doctor who is more understanding, whether it would be possible to stockpile enough of the drug so you can do a reasonably paced taper.   

 

You might find these topics helpful:

 

How do you talk to a doctor about tapering and withdrawal?


What should I expect from my doctor about withdrawal symptoms?

 

You could also print out Post #1 of this topic:  dr-peter-breggins-10-taper-method

 

And it might be helpful to print out some of this one too (especially the graphs):  why-taper-paper-demonstrates-importance-of-gradual-change-in-plasma-concentration

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Hi Hawky 

 

I was put on Dothiepen when I lived in the U.K. I now live in Australia and it's called Dothep here. So far you are the only person I have found on this forum who is on Dothep (I am new). 

How are you going? I've just started reducing from 100mg to 75 mg. 

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Hi and so sorry for very late reply but I'm not doing do good . It is 4 weeks since I took my last 25mg of Dothiepin and I thought I was doing ok but for nearly 2 weeks now I have really suffered . Nighttime is horrendous I'm existing on about 3 hours poor quality sleep and then wake suddenly with the worst anxiety I have ever known , one night last week it was so bad I considered driving myself to my local hospital to beg for help . My doctor has now prescribed mirtazapine but I've not yet taken any as I am scared . I really am at the end of my tether , never felt so hopeless and unwell .

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Your doctor has likely been following the guidelines here.....we get angry at doctors all the time but this is what they are taught :angry:

If the drug has not been withdrawan yet can you ask your doctor to prescribe it for you for until it is no longer available so you can taper for longer? Even those guidelines say that some patients need longer to taper. It sounds like he is reasonable. If you could reinstate a small dose of 5mg, that may help and then you can taper from that using the prescriptions that you can collect in the meantime. Hope that makes sense to you. I am not always good at explaining things!  If you can get prescriptions for the next 2 months at 150mg per day, one tablet could last 30 days if you crush it and weigh the powder. I tapered for almost 2 years with one pack of effexor by counting the tiny beads in the capsules.  If you decide to take mirtazepine I would try a very very small dose. Often we become sensitive to drugs when in withdrawal and react to higher doses that may be fine for other people. It is available in tablets that dissolve in the mouth and so possibly could be made into a liquid but I will check that out. 

 

http://mm.wirral.nhs.uk/document_uploads/guidelines/CWPDosulepinGuidanceJuly2015.pdf

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Hawky:  You have decreased the dosage of dothiepin too quickly.  Do you have any Dothiepin tablets or capsules?

 

The best way, in fact the only known and proven way, to reduce withdrawal symptoms is to reinstate a small dose of the drug that was recently withdrawn/discontinued.  Please read the first post of this topic:

About reinstating and stabilizing to reduce withdrawal symptoms.

 

Would you please provide the dates you decreased dose to 25 mg and the date you last took Dothiepin?


2017 Dothiepin Doses

?? [month/year] started taking Dothiepin

Feb. - 150 mg

May - 50 mg

?  - 25 mg

mid June - 0 mg


You can just copy and paste the information between the lines into a new post and then edit the information.  This can also serve as your signature.  You can copy the text and paste it here: Account Settings – Create or Edit a signature.

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You can make a liquid from mirtazepine, it is also available in a liquid in the UK.  I don't know if dosulepine is suitable for making into liquid, most tablets are but i will need to do some research. 

 

Here is our topic on mirtazepine. If you decide to take it I would start with 5mg, 15mg is the lowest starting dose but you can divide the tablet or make a liquid. 

http://survivingantidepressants.org/index.php?/topic/5301-tips-for-tapering-off-mirtazapine-remeron/

 

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Hi

 

I don't know if this will help.  I took dothiepin for years in the UK and only managed to get down from 225 mg to 50 mg, I found after 50 mg that the nausea was so bad, sleeping wasn't too bad, but nausea was terrible.  It was also being withdraw in UK at that time if it was possible but that people could stay on it if necessary.  It was still being manufactured, I don't know about now.

 

I was then crossed to mirtazapine, but the weight gain was instant and unbearable, so then went on to citalopram, 20 mg, and after about 8 weeks things settled, I ultimately went to 30 mg citalopram as I found as an antidepressant citalopram was not as effective as dothiepin.  Ultimately I am now wanting to get off citalopram but that is another story.

 

When I was tapering dothiepin it was standard treatment from GP to use an antihistamine like Benadryl at the same time. 

 

Joy

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Hawky, if I were you, I would find legal suppliers in the UK who would fill a dosulepin prescription, then reinstate at 5mg per day (or night). After you stabilize, you can taper off later by tiny amounts.

 

Reinstating a liquid probably is the most convenient way to go about this. See

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