Riffick Want to reduce one of my pains meds: Lyrica or nortitypline?

[Riffick]

I am taking low dose Lyrica (75mg a day) and low dose nortriptyline (7.5mg) to control my sciatic pain.  I'm also using other painkillers such as an NSAID.

 

My pain has improved and I now want to reduce one of these meds.  I figure it might be better to reduce the one which is harder to get off but I don't know which that would be.

 

I read fearsome tales about Lyrica but that may be because it is widely prescribed whereas few people write about really terrible nortiptyline withdrawal but that may be because it is not a popular med.

 

Any thoughts on which would be better to reduce and get off?  I would be very grateful for any views.

 

 

 

 

[Skyler]

Nortiptyline has been around for along time and is not prescribed as much anymore, which is why you don't hear as much about it.  Neither are good... I'd taper the one that is giving you the most side effects, and use a step wise taper plan... Taper both until they are both lower, then settle in and taper one, then the other.  As with any psychotropic, you need to listen to your body.

[Riffick]

Hello Skyler.  Thank you for your reply.  At the moment both Lyrica and nortriptyline cause any problems.  My worry is about what may happen when I have to withdraw.  Do either one of these two have a worse reputation than the other for withdrawal?

 

Thank you for any info.

[Skyler]

Hello Skyler.  Thank you for your reply.  At the moment both Lyrica and nortriptyline cause any problems.  My worry is about what may happen when I have to withdraw.  Do either one of these two have a worse reputation than the other for withdrawal?

 

Thank you for any info.

 

I think you might need to direct this to Alto or Rhi... I'm biased toward tapering Lyrica first because I find the side effect profile to be distressing.  Not sure that's very scientific however and I suspect the AD is more activating.

[Altostrata]

Hello, Riffick.

 

Since you didn't have an Introductions topic, I've made this into your Intro topic.

 

What adverse effects do you ascribe to nortriptyline and which to Lyrica?

 

Please put ALL the drugs you take -- including the NSAIDs -- in the Drug Interactions Checker http://www.drugs.com/drug_interactions.html and post the results in this topic.

[chicken]

Hi Riff,

I'm tapering nortriptyline now. I down to 11.7 from 20 mg. I'm doing a 10% taper on it. So far I haven't had problems with it. I think if you go slowly you will be fine.

[Riffick]

Hello, Riffick.

 

Since you didn't have an Introductions topic, I've made this into your Intro topic.

 

What adverse effects do you ascribe to nortriptyline and which to Lyrica?

 

Please put ALL the drugs you take -- including the NSAIDs -- in the Drug Interactions Checker http://www.drugs.com/drug_interactions.html and post the results in this topic.

 

Hiya Alto.  I don't get any noticeable adverse effects at the moment but I am concerned that I may find myself in trouble when I come to withdraw.  I have very bad experience and a 2 year taper from benzodiazepines and don't ever want to risk that again.

 

My meds don't come out of that online checker as having any significant interactions.  The worst interaction listed is between Lyrica and nortriptyline (even that was vague) and as I am looking to come off one then I suspect it may not be very relevant.  It said "Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects".

 

Having just written that I don't any side effect, when I started to ease off my nortriptyline yesterday I found today I am getting clearer headed.  Perhaps this is a coincidence but if not then I may continue to reduce the nortriptyline first for this reason.

 

I still remain mindful of what Skyler said about Lyrica's side effect profile.

[Altostrata]

Please see Tips for tapering off nortriptyline

[Skyler]

 

I still remain mindful of what Skyler said about Lyrica's side effect profile.

 

 

Yeah.. but the bottom line is how things effect you.. this is all so danged individual!

 

How long ago did you last tapering the benzo?  Are you still taking .8 mgs of diazepam?

[jac84lp]

Hi Riffick. Nortriptyline can cause withdrawal symptoms. I'm currently having one hell of a time dealing with the withdrawal symptoms as I type. Make sure you taper it off and never go cold turkey. I went cold turkey almost 3 weeks ago and it has landed me in emerge 3 times so far. Take it slow and don't rush the tapering! Take care.

[Martina23]

Riffick, my withdrawal from lyrica is a nightmare. Please never go c/t. I hope you will have better experience. This other medicament I do not know.

[Riffick]

I know everyone is different and there is a huge range of responses but I'm looking for some rough guidelines to start experimenting from.  I would like to know approximately how soon after a 15% reduction would I feel symptoms and approx how long to wait before making another 15% reduction.

 

Here is some background:

 

I'm trying to get off Lyrica as quickly as possible because I've belatedly realized I am getting toxic effects from taking it.

 

I intend to cut by about 15% at a time rather than make frequent very small reductions.

 

I'm on 150mg a day.  I got very nasty interdose withdrawal I got on 3 doses a day which took months to identify properly.  So now I'm taking 6 doses a day.

 

So my questions, again, are how soon after a 15% reduction would I feel symptoms and usually how long would someone need to wait before cutting Lyrica again?  A very rough guideline would be very helpful.

Edited May 13, 2016 by KarenB
merged Intro threads

[SquirrellyGirl]

Hi Riffick, 

 

I don't think anyone can answer your question definitively since everyone's response to a certain level of cut will be a bit different.

 

I noticed that you have been a member here for quite some time but have never created an intro for yourself.  You've successfully tapered off of benzos?  Are you only on Lyrica now?  You might want to create an intro where you can document your journey coming off Lyrica.

 

15% is of course steeper than we usually recommend.  If you have never reduced this med before, you might want to start with the 10% on your first go round and give it a month to see how it plays out for you.   If WD comes up, hopefully it would be mild, and you could get a sense of how many days after the cut it comes up, what the symptoms are, and how long they stick around before returning to baseline. It would be nice to give it another week to 10 days for your nervous system to get settled into that new place.  If that is all tolerable, then you can try the deeper cut.  If your symptoms come up quickly but settle quickly, you could taper more frequently.  I still think it is a good idea to give the nervous system at least a week after symptoms clear before challenging it again. 

 

You won't know until you try.  I know you are feeling an urgency because of problems the drug is causing, but you don't want to trade those problems with a whole new set in the way of severe withdrawal.  Hopefully, you will find that your system can handle the 15% readily.

 

Just to cover my bases, I'm including a couple of links.

 

Rate symptoms daily to track patterns and progress

Tips for tapering off Lyrica (pregabalin)

Why taper by 10% of my dosage?

 

I'm sure you've read these before, but just in case...

 

I hope that helps!

SG

[Riffick]

Hello SG.  Thank you for your kind reply. 

 

Unfortunately I can't afford a leisurely taper because the med is causing me so much trouble by merely having it in me. 

 

I think the 10% a month rate we hear so much about comes from people like Peter Breggin who may have chosen it because it is so slow that almost no one will have problems.  Of course there are claimed exceptions but these are very much outliers and there may be other factors at play.  That 10% is more or less equivalent to the permitted variation in manufacturing between the strength of tablets, so even those on a steady dose may experience variation similar to that - although I'm over simplifying somewhat.

 

In my case, I am wondering firstly about the time to allow Lyrica to wash out and secondly the average time required for the body to recover from its effects.  Medication half life is only part of the story.  So in benzo terms for a 15 or 20% cut in Valium symptoms might appear after 4 or 5 days and with the time needed for recovery the two periods together might be about 2 to 4 weeks.  (I follow Ashton here and find her tapering schedule only slightly too quick.)

 

By contrast, baclofen (which I also happen to be tapering at the moment) hits me with symptoms on days 2 and 3 and maybe day 4 after which a large amount of recovery occurs very quickly compared to benzos.  If I followed the typical benzo taper advice for baclofen then the taper would be unnecessarily long and I don't want to fall into the same trap with Lyrica.

 

Not all these psychotropic drugs have the same elimination recovery times and that is what I was wondering about.  I just need a starting point for Lyrica and I will experiment from there to see my own individual responses.

 

If you or anyone else has any further thoughts about getting off Lyrica then I would be interested!

 

 

Riffick

 

PS:  I thought I had provided a profile a few years ago but I'll go and check.

[Martina23]

Hello Riffick, I tapered off of Lyrica one year ago. My first attempt was cold turkey, my withdrawal started three weeks after. So if you cut I would wait it one month to see how you react. My second attempt was regular tapering, first I went slower (10% ca) and in the end ca 12,5 mg (that is half of 25 mg tablet) each three or two weeks, how I felt. Lyrica has quite short half-life of 6 hours, but when I finally jumped, I felt that my brain chemistry came back next day in the evening. For example my last dose was Friday in the evening and my emotions I felt for the first time on Saturday ca at three o clock pm. What is also important, some people can have problems with tapering when they make water solution from Lyrica. I had definitely problems. I read somewhere that that the coating of Lyrica has a protective function that it is soluted first when it comes to gut. If water tapering is used it will be soluted in the stomach and its effect is too strong, it can increase anxiety. You have to try for yourself if the tapering based on making water solution of Lyrica fits for you or not. I hope I helped you. Sorry for my bad English, it is not my first language.If something is unclear to you you can PM me anytime.

[Riffick]

Hello Martina. I looked at some of your posts and saw you certainly have had a busy time tapering Lyrica! I can get ready made liquid Lyrica so I am using that.

 

I seem to get bad interdose withdrawals even if I take Lyrica every 8 hours, so I am now taking it every 4 hours. (I need to be careful I am not confusing symptoms of Lyrica withdrawal with other meds I am taking.)  This does not seem to be very typical and I have read few people with the same experience.

 

Your comments about getting improvement within a day of reducing Lyrica is extremely interesting to me. I seem to get something very similar to that but I am still trying to form a clear picture of what I am experiencing.

 

If you have any more comments about quick responses to changes in dose then I would be interested.

[Riffick]

Please ignore this thread as it gives a muddled and misleading poor picture of my situation and my needs for assistance.  

 

If anyone had the ability then please delete this thread, or at any rate, delete all my posts in it.  Thank you very much.