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Rabe: how to taper and adjust Viibryd while on Clonazepam

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Altostrata

I personally have experienced electrolyte and other types of imbalances from withdrawal syndrome.

 

When you reduced Viibryd in the spring, how did that affect your electrolytes? What symptoms did you get from your last reduction of Viibryd?

 

Your doctor doesn't have to believe Viibryd is the problem. He or she is responsible for treating the hypokalemia. You can take the lead in the decision to reduce Viibryd.

 

I would explore compounding more, with an eye to 5% reductions.

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Rabe

You have?  Did they adjust eventually or only after off drugs completely? It is so difficult Alto because they mimic anxiety and even depression symptoms sometimes...but I am knowing the difference now.  The kidney Dr said my electrolytes can't fluctuate that rapidly even though lab tests have said otherwise....K 4.4 one day and 3.1 the next or vice versa.  Nobody really understands this.  

Actually, I did reduce the Viibryd in April and May and had my first 'dehydration' in June!  Ws tapering  Clonazepam in the spring as well...but major taper then was from 20 to 10 of the Viibryd.  After that I was heat intolerant and often felt sick if walked in heat.  Then it was the rapid Clonazepam taper in Sept that really seemed to throw me off the cliff....but the Viibryd side effects i.e. agitation seem worse since the Clonazepam has been lowered.

I have asked him many times about reducing the Viibryd and did get in touch re calling that pharmacist so see if we could get it compounded...never heard back.

I will call the compounding pharmacy again tomorrow and see if that pharmacist is there.  Right now we are also trying to get the Clonazepam dose more regulated with compounded capulses...with brown rice flour...hope don't react to that!  Thank you!

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Rabe

The electrolyte issues have just really grounded me and it is an awful feeling!  I get out very little now...not good for me or family.  Seems more I use y muscles the worse it is sometimes.

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Altostrata
2 minutes ago, Rabe said:

the Viibryd side effects i.e. agitation seem worse since the Clonazepam has been lowered

 

Of course. The clonazepam was masking these adverse effects. Is that why clonazepam was prescribed in the first place?

 

Good to hear that you're looking into the compounding. There are many fillers they can use that are less reactive.

 

Why did you decide to go off clonazepam?

 

Hypokalemia is very frightening. I had a bout of that, too. Sodium drives out potassium, do you eat a lot of salt?

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Rabe

Just have been very down today as seem to be no answers.

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Altostrata

There are no easy answers, but there are answers.

 

21 minutes ago, Altostrata said:

What symptoms did you get from your last reduction of Viibryd?

 

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Rabe

Well....yes!  I was on clonazepam for panic attacks but Im wondering if was K .... I had trouble eating certain foods etc and learned not to eat before working 

or traveling...but that seemed after was on Clonazepam awhile.  Also learned to stop all salt...no salt foods and no added salt except what is in foods naturally.  Had lots of kidney issues as a child though.  

Viibryd wasn't started until last year and have been on Clonazepam nearly 30 years?  But I do think it was masking the Viibryd symptoms which were there but the doctor ignored...alomg with the rash and high BP and trembling!

Im hoping brown rice is a less reactive filler.

I didn't decide to go off it...my PCP doubled the dose when I moved from my home and was exposed to environmental toxins and surgical and procedure meds that caused lots of anxiety.  After I did that my system just collapsed and I got psoriasis and my heart wasn't compensating.  Then a doctor had me take a dissolving tablet in tapering twice when the first time it caused a bad reaction...the second time my system just really revved up and I was reacting to all the Clonazepam and ended up in ER wheezing.

 

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Rabe

During the Viibryd taper it was really mostly anxiety....as I recall.  And some eye puffiness and lip puffiness which seems to go along with the electrolyte issues as well!

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Rabe

When I take the liquid K supplement my head feels SO SO HOT esp at night!

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Altostrata

Do you consume a lot of sodium?

 

Please review

 

You might get a digital scale and weigh tablets to taper.

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Rabe

This is all been so crazy and getting more so...some days I have to admit I wonder after such a nice longer life raising my children and all.  Now it is jut so hard for them....and I can understand that.  Could not drive 40 minutes to my daughters lately!  She gets crushed by it all but I honestly feel so awful...and takes a lot for me to give in to that.  The anxiety I could work through but I can't do that with the electrolytes.

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Rabe

I get the hypokalemia repeatedly!  So they want to start another med for that which scares me at this point because they wonder if there is a connection to the psych meds as well and, being a nurse, a little better if K is low than high tho both aren't good long term.  Its Amiloride

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Rabe

But then with the last Viibryd taper try in Dec it was anxiety, depression, electric shocks in head, dizzy, sobbing, horrible headache etc...was really horrendous...worse than clonazepam.  

I do not consume much sodium...but kidney dr thinks even when I add little something it is too much.

If cannot compound I will have to get a scale...cannot imagine doing that tho Alto...at my age and alone...cutting the Clonazepam pills drove me crazy and the tapering really took a toll.  Cannot imagine tapering another horrible drug!!!  So angry it was ever started to treat what was withdrawal depression!

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Rabe

Thank you for the tapering tips...

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Altostrata

I've very sorry it's complicated, I've gone through all this myself. (My mistake earlier, I had hyponatremia, not hypokalemia.)

 

Yes, those would be withdrawal symptoms from Viibryd. However, having gone off clonazepam earlier, your nervous system might have been vulnerable, along with your adrenals.

 

Can you take the potassium supplement in divided doses? It probably would be more effective and have less adverse effects.

 

Many people do better with fish oil and magnesium supplements, see
http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

http://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

A lot of people find them helpful. Try a little bit of one at a time to see how it affects you.

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Rabe

Hi Everyone,

Have been having trouble with the Viibryd 10mg and seems to get worse as time goes on.  Same...get very agitated and pale and headache and weakness about 3 1/2 to 4 plus hours after take it.  And it lasts a couple hours.  Then I am just sick until about 1AM.  Everything I take ... potassium supplement, Premarin, all make me and my head feel even more hot and awful.  I'm absolutely getting so sick.  Tried to get a hold of my psych again but no response.  He has not called compounding pharmacy yet either and they seem willing to help.  Today I wonder if my body will make it through all of this.  Yesterday had a nice day with my daughter and grand baby and am SO SO grateful for that...but did not start the potassium until later so just had the agitation to deal with.  Just feel so sick and sicker with almost each passing day.  Can a supplement make things worse?

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Rabe

I so want to get off this drug!  Looked at a scale and may just order that.  Have no idea how I will get through another move.  Keep wondering how did all this come to be????? Oh well...so nice to be here!

 

 

 

Edited by ChessieCat
changed some caps to lower case

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Rabe

Alto do you think it is ok to take a potassium sparing diuretic?  Is that a safe med?  

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Rosetta

HI Rabe,

Wow.  You have been through a lot lately.  I wish I had answers for you.  It seems that your doctor is being very pigheaded.  Any possibility you can find a new one?  I suppose it's hard as you feel so bad.  I'll be thinking of you. -- Rosetta

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Rabe
Posted (edited)

Hi, I am new on the site having been so impressed with the knowledge and personal experience that I have read as I continue my journey of tapering psychiatric medications.  I have been on Clonazepam for many years for a severe panic disorder with agoraphobia and had no problems with it until I moved, had surgery, was exposed to environmental toxins and my doctor doubled the dose.  I broke out in a weeping rash and was so very ill.  I tried tapering on my own and became very very ill, lost weight, muscle and fat and was extremely depressed.  My children brought me to a treatment center to get help with the tapering but instead I was put on an antidepressant.  I am now finding myself tapering the Clonazepam and the Viibryd with a doctors help, but his knowledge seems quite limited.   We did taper the Viibryd to 10mg in the spring and it was not too bad.  I tried tapering by about 10% now and had horrible HA, nightmares, depression, stomach upset, agitation, anxiety, headache, electrical feelings in my head, weakness...

 

I saw the doctor today and he would like to split the dose to 5 in AM and 5 in PM to help in tapering.  My concern is that I take Premarin and the larger Clonazepam dose at night and I am concerned about having to eat that late d/t GERD, about less anxiety coverage during the day as well as the sleepiness from both the Viibryd and Clonazepam together at night.  I was wanting to get any thoughts or experience on this if possible.  Thank you so very much.  This has been such an overwhelming and physically and mentally draining experience with little support for almost 2 years.  I am grateful to be here!

 

Edited by ChessieCat
fixed line endings

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Rabe

whoops ... I need to learn to navigate here better.

I am having trouble with compounded medications....wondering if anyone has had issues?

Could someone please help me....

I am switching from Clonazepam tablets to capsules compounded with rice flour.....  .2mg in day and .7mg at night as I have yellow dye allergy and the 

1mg pills are so hard to cut evenly etc. and the Dr wanted me on a steady dose. Started just the noon ones (2 of the .1mg capsules) for about a week and things seemed ok.  Started the evening ones(7of the .1mg capsules) about 3 days ago and my eyes and lower lip were getting puffy and my eyes irritated and I have been so anxious.  Thought it was food I was eating and stress of a move.  But tonight it feels like withdrawal...loud ringing and music in my ears, that inner anxiety, headache, some brain zaps, crying and such awful anxiety all through these days.  

Can the compounded capsules be less of a dose and/or absorbed less efficiently?  I am not feeling well at all and am not sure whether to go back to 1/2 a 1mg tablet and 2 capsules at night which seemed to be ok or what to do???  Any thoughts please? Probably ought to have waited until less stress but thought it would be a pretty even exchange.  I don't think so...unless it is something else?  Thank you!!!!

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ChessieCat

Hi Rabe,

 

I have merged the new Intro topic you created with your original Intro topic.  Each member has only 1 Intro topic where they can ask questions and journal their progress.  Please do not create any more Intro topics.  Thank you.

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ChessieCat
56 minutes ago, Rabe said:

not sure whether to go back to 1/2 a 1mg tablet and 2 capsules at night which seemed to be ok or what to do???  Any thoughts please?

 

I am assuming that you did not make a decrease at the same time.  If you haven't changed the dose and all you did was change to capsules I think  the easiest and quickest way to see if it was the capsules causing the issue/s would be to return to the previous form you were taking.

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ChessieCat
1 hour ago, Rabe said:

my eyes and lower lip were getting puffy

 

This sounds like an allergic reaction.

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Rabe

I'm sorry about the topic...I honestly didn't realize thats what I was doing.  Still don't navigate well here...so thank you for the help CC!  Appreciate it!

No decrease in the CLonazepam dose...he just wanted to stabilize the dose but I feel less stable.  Seemed to start after took all capsules.  Oh well. Can you be allergic to rice flour?  But I am up and down...when feel good a bit of a day it is so so SO nice!!!  Its usually in the AM and then once take the Viibryd and continue with meds my day goes down hill.  

 

I missed Altos last comment til now about the magnesium and fish oil...does fish oil have potassium?  They started me on a potassium sparing diuretic and things seem some better except the medication itself doesn't seem to sit well with me.  

And yes, Alto, I definitely agree that my nervous system is still a mess from the rapid Clonazepam taper in less than 2 weeks in Sept from 1.85 to less little less than 1mg.  I just don't feel well ever really but keep praying evens out.  And yes I think the adrenals have definitely been more affected.  I had a biofeedback a year ago and they were very compromised then...can imagine they are sputtering loudly by now!!

 

I will try a half tablet tonight and see what happens with that.  Thank you so much!!

 

 

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Rabe

Also saw my doctor today and he would like to try tapering the Viibryd which scares me a lot but he is going to check with a compounding pharmacy first.  

 

Doesn't seem to sit right with me but worries me to start when my system seems to still be so rocky.  Not lots of windows.  Tonight my head feels like it is in a vice! Grateful for this morning!

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ChessieCat
3 hours ago, Rabe said:

Can you be allergic to rice flour?

 

I imagine that there would be other things in them as well.  Or it may be something they added to the powdered drug that you have reacted to.  My compound pharmacist adds slow release formula to mine.

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Rabe

Very down today.  Started off fine this morning.  Took Amiloride that was started little over week ago and felt awful suddenly chatting on phone....then Viibryd and have had horrible headache and off the wall agitation and anxiety nonstop all day until about hour ago.  My head feels so wrong.  I try to say something to the doctors and they want me to go to behavioral health for my anxiety!  Somedays this all seems so crazy...that's one thing...but when I am so over reactive and am trying to battle side effects from medications ad can get no one to hear me I just want to stop.  Its nice to have potassium better controlled but not if medication just makes me feel awful as well.  Seems like a circle that just continues.  Going to switch back to the Clonazepam tablets and not compounded capsules and see if that makes a difference and if thats not it then I am going to stop the Amiloride and try a potassium supplement, though the dyes in those didn't agree with me either.  They put yellow dye in all these!!! UGH!!  Golly some days are such a challenge and doctors just don't get that some people don't do well with certain drugs!  SO FRUSTRATED!!!!  I'M beginning to believe I am crazy!!!!!  SO depressing!!!

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Rabe

And I'm supposed to move in a week!!!! Shoot me!!!!

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powerback
5 hours ago, Rabe said:

Very down today.  Started off fine this morning.  Took Amiloride that was started little over week ago and felt awful suddenly chatting on phone....then Viibryd and have had horrible headache and off the wall agitation and anxiety nonstop all day until about hour ago.  My head feels so wrong.  I try to say something to the doctors and they want me to go to behavioral health for my anxiety!  Somedays this all seems so crazy...that's one thing...but when I am so over reactive and am trying to battle side effects from medications ad can get no one to hear me I just want to stop.  Its nice to have potassium better controlled but not if medication just makes me feel awful as well.  Seems like a circle that just continues.  Going to switch back to the Clonazepam tablets and not compounded capsules and see if that makes a difference and if thats not it then I am going to stop the Amiloride and try a potassium supplement, though the dyes in those didn't agree with me either.  They put yellow dye in all these!!! UGH!!  Golly some days are such a challenge and doctors just don't get that some people don't do well with certain drugs!  SO FRUSTRATED!!!!  I'M beginning to believe I am crazy!!!!!  SO depressing!!!

Hi Rabe I get you I really do ,I'm in a mostly bad wave for months with some windows,this issue your having with potassium ,its worth it to go down the dietary avenue ,google potassium rich foods and eat them ,your on the correct track about supplements ,all the additives and other things in them are not good . 

Take care .

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Rabe

Thank you PB for your thoughts...means alot.  Im sorry you are having a rough time...it is hard isn't it?  To have a window and it feels SO wonderful to have a sense of yourself again .... and the then the next day is just the opposite.  I find myself then always trying to connect that bad day/days to something else...like food or medications or the walks I took or the potassium ... I forget about the withdrawal that keeps going ...I keep thinking it will actually stop...but nope!  Hard for my children, especially my daughter who thinks one good day means her mom is back...and then she's not.  I so wish she would read some of the information here to better help her through it as well.  

I am going to try the Amiloridide one more time and if I get a bad reaction again then I am going to ask the doctor for plan B.  I had been eating lots of K rich foods but my kidneys were releasing too much K so it kept going low no matter what I ate and drank.  This diuretic is K sparing and keeps them from doing so...danger is K going too high!  I have eaten K rich foods for so long it is hard to eat otherwise..so have to find a balance....hope I can. I just don't appreciate another drug that makes me feel quite bad...at least this one I can stop if need be.  

Take care of you!  Hoping more windows are heading your way!!!

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Altostrata
On 3/7/2018 at 9:48 PM, Rabe said:

....

No decrease in the CLonazepam dose...he just wanted to stabilize the dose but I feel less stable.  Seemed to start after took all capsules.  Oh well. Can you be allergic to rice flour?  But I am up and down...when feel good a bit of a day it is so so SO nice!!!  Its usually in the AM and then once take the Viibryd and continue with meds my day goes down hill.  

....

 

Rabe, what is your drug schedule and symptom pattern? Please keep daily notes on paper about your symptoms, when you take your drugs, and their dosages.

 

On 3/6/2018 at 11:22 PM, Rabe said:

Started just the noon ones (2 of the .1mg capsules) for about a week and things seemed ok.  Started the evening ones(7of the .1mg capsules) about 3 days ago and my eyes and lower lip were getting puffy and my eyes irritated and I have been so anxious.  Thought it was food I was eating and stress of a move.  But tonight it feels like withdrawal...loud ringing and music in my ears, that inner anxiety, headache, some brain zaps, crying and such awful anxiety all through these days.  

Can the compounded capsules be less of a dose and/or absorbed less efficiently?  I am not feeling well at all and am not sure whether to go back to 1/2 a 1mg tablet and 2 capsules at night which seemed to be ok

 

You're taking 0.2mg clonazepam at noon and 0.7mg in the evening? Is this a different schedule from the prior clonazepam dosing?

 

Yes, it sounds like the doses are too weak. I would double-check with the compounding pharmacy. It sounds like they might have made an error.

 

Were you splitting a 1mg clonazepam tablet before? You were taking 2 capsules of what at night?

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Rabe

I was taking less than a quarter of a tablet in afternoon and then a half and less than a quarter in eve...no problems.  Now taking two .1mg capsules in afternoon and was taking 7 of them at night but have gone back to half a tablet and two capsules.  

Other thing is at bout same time started capsules I started Amiloride...Potassium sparing diuretic...having problems with that.  Just looked it up and it affects GABA receptors....competitive antagonist.  I don't know what is up I just know I don't feel well...and awful hot headaches and agitation with the Amiloride...and/or capsules?  The potassium supplements gave me terrible hot headaches as well.  Im so over all this craziness!  And I say something to the doctor and his NP and they tell me to go to behavioral health!  GRRRRRR!!!!!

Do you have any input or thoughts PLEASE??????

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Rabe

I will keep track. Things seem to change some each day it seems...not exact but I felt better this weekend without Amiloride and also took less capsules.  

Have that really hot headache now...took Premarin at 930...that has caused issues along way as well.  Things are stirred up from something and I don't know what...just know feel pretty awful! 

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Rosetta

I'm sorry for what you are going through, Rabe.

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Rabe

Altostrata do you know a GABA antagonist can cause issues in a CLonazepam taper?  The potassium sparing diuretic Amiloride is one.

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