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Caring69

Mom's amoxapine discontinued

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Caring69

How do I help my mom?  The nurse called and said they discontinued Amoxapine. They could only find 6 pills. They are going to call other meds in and I don’t know what. Is there any you could suggest? How does she do the switch. I’m so upset. She is 83 years old. She has had chronic pain for 27 years. She has been doing better pain wise so we have slowly gone down on her methadone. She had gotten up to 9 pills a day. Over the past 2 years, we have gone down to 2 a day. The dr gave her the amoxapine to help with her pain.  I’m not sure how long she’s been taking it. 5 years or more. She has been on so many meds over the years. I didn’t know how bad they were until I came off my escitalpram cold turkey almost 2 years ago and still dealing with withdrawal. I’m so scared for her.

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potions

I don’t know how to help her but this breaks my heart. I hope a moderator can help you and I hope that your mom turns out okay. Why are they discontinuing amoxapine and what meds are they suggesting she take? Just make sure she tapers off everything that’s she’s coming off and ask her how she’s feeling frequently. Keep us updated and I hope your mom is okay. *hugs*

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Caring69

She can’t taper properly. She only has 8 pills left. The nurse hasn’t called to let her know what other med they are giving her. 

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Caring69

I really need some advice. My mom cut the 50mg tabs in half and took them for 5 days without telling me. We went to the dr and he was going to put her on Zoloft but I refused. He went out of the room and said he talked to psych specialist and to start taking 1/4 of the 50 now for a week and then cut that in half and that should be fine. My mom thinks that’s her only choice so she said it’s okay. We are going to let her because I don’t know what else to do. We can’t get any more pills. She is going to take the 1/4 tab for ten days and then I cut that in half and made 25 pieces for her to take after that

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Songbird

If there is no way to source more amoxapine, then she really has no other option than to discontinue it when the pills run out.  The question is, do you try to replace it with something else?  I'd be concerned about both withdrawal, and the pain management aspects.  What was the reason for declining the Zoloft?  Did the doctor explain why he had chosen it?  Are you able to talk to her doctor about other options? 

 

Amoxapine is a tetracyclic AD and is more similar to a tricyclic AD than an SSRI (such as Zoloft).  I would have thought a TCA (such as amitriptyline or nortripyline) would also be a more effective option for pain relief than an SSRI.  TCAs also have significant side effects, risks and interactions that need to be taken into account.  It may also depend on what kind of pain it is, as different meds can work better for back pain, headaches, etc. I'd probably want to avoid SNRIs  (e.g. Effexor, Pristiq, Cymbalta), as from what I've seen they can poop-out fairly quickly for some people.  Given her age and that it sounds like she will need to stay on medication, dependence and withdrawal may not be major concerns.  You really need to talk to her doctor about what other options are available.

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Altostrata

I am very sorry this has happened to your mom.

 

How is she feeling now that she's halved her dosage of amoxapine?

 

As Songbird said, she should demand a substitution of the equivalent dosage of a tricyclic antidepressant or a low dose of amoxapine's close relative loxapine, which is classed as an antipsychotic. Not knowing what's available, I cannot recommend a substitute. Also, going off drugs rather than switching them is what we do here.

 

A cross-over switch, in which she would be taking a partial dose of amoxapine and a partial dose of the new drug for at least 4 days before dropping the amoxapine and taking a full dose of the new drug is easiest on the nervous system.

 

I hope the switch goes well. Her doctors have been negligent in not attending to this earlier.

 

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Caring69

Thank for your reply songbird. I was injured by an SSRI and didn’t want my Mom having to deal with that is why I declined Zoloft. I was having adverse effects for so many years and didn’t realize that’s what it was. I’m still having trouble 2 years off because I cold turkeyed . I asked the dr to give her the same kind of drug but he wouldn’t. He said that she would be fine tapering down until she ran out. I’ve been going through a nightmare and don’t want my Mom to go through this. I only hope and pray that since it’s a different kind of drug it won’t be as bad. She’s been on and off so many different kinds of drugs for her chronic pain so maybe her body will be able to withdraw better. 

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Caring69

Thank you Alto. This dr has been good to her in so many ways over the years. He loves her like a mom but he has no clue about these types of drugs. I wanted him to change her to the same type and then taper her off but he said she would be fine. My Mom thinks it will be fine. She didn’t see me in my worst state but knows I’m going through a nightmare. She says she has no other choice. At least we will know what’s going on as she deals with it. I had no clue until My brother in law and sister suggested it could be withdrawal and I found this forum. Thank you for all you do for everyone going through the nightmare of effects of these drugs and the withdrawal. 

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Songbird
11 hours ago, Caring69 said:

I was injured by an SSRI and didn’t want my Mom having to deal with that is why I declined Zoloft. I was having adverse effects for so many years and didn’t realize that’s what it was. I’m still having trouble 2 years off because I cold turkeyed . I asked the dr to give her the same kind of drug but he wouldn’t. He said that she would be fine tapering down until she ran out. I’ve been going through a nightmare and don’t want my Mom to go through this. I only hope and pray that since it’s a different kind of drug it won’t be as bad. She’s been on and off so many different kinds of drugs for her chronic pain so maybe her body will be able to withdraw better. 

 

What reason did the doc give for not wanting to prescribe a similar drug?  I'm thinking your mom's situation is a bit different to most people here.  Given her age and chronic pain condition, tapering off all meds may not be a realistic proposition - her wellbeing and stability could be more important considerations, particularly avoiding a severe withdrawal if possible.

 

 

10 hours ago, Caring69 said:

I wanted him to change her to the same type and then taper her off but he said she would be fine. My Mom thinks it will be fine. She didn’t see me in my worst state but knows I’m going through a nightmare. She says she has no other choice. At least we will know what’s going on as she deals with it. 

 

Being aware in advance of what could happen is valuable.  If severe problems do crop up, perhaps the doc may reconsider his refusal, as it may become necessary to find a substitute med.

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Caring69

I don’t know why he didn’t want to give her a similar drug even when I asked. I think it’s his lack of knowledge about withdrawal. After he talked to the psych specialist, he came in and told us it would be fine for her to just get off this med. my Mom never wanted to be on an antidepressant. He says he was not the one that put her on it but she says she remembers years ago when he gave it to her, she said she didn’t want it and he said it’s not for depression. It’s for the pain. The last few years, her pain has lessened. She has gone down from 8 methadone a day to 3. I don’t think it was helping with her pain anyway. If my Mom gets too bad then I will take her back and demand a similar drug. Thank you for all your help.

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Madison1997

Hello, 

I made an account  just  so that I would be able to tell you this. I and my grandmother have been on amoxapine for about two years to handle depression as SSRI’s  do not work for us. We’ve been to every pharmacy possible since amoxapine has been on a nationwide backorder and unfortunately no one has it right now. But I did want to let you know that when I went to the pharmacy a few days ago the pharmacist was kind enough to give me the suppliers number that supplies amoxapine and I called them yesterday and they did say that amoxapine has indeed already been made but  there was some sort of shipping error. He says by the end of April it is expected to start being distributed to pharmacies once again but I did want to let you know that it is going to be back on the market it might just not be for another few weeks. Stay hopeful the drug will be coming back soon!!

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Altostrata

Caring69, how is your mom doing with a halved dose?

 

If she starts having severe withdrawal symptoms, you may need to put your foot down with the doctor and demand a substitute.

 

Madison1997, thank you for stopping by with that good information. The problem is, Caring's mom and others may have severe withdrawal symptoms for weeks before they can reinstate the drug. Although doctors like to think they're trivial, withdrawal symptoms can be terrible and last a long time. Nobody should have to put their nervous systems through that torture.

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Madison1997

 Right I understand that as I am one of the people who is directly affected by this. All I’m trying to say is that it will be coming back into circulation within the next few weeks just to let  people know that it won’t be a permanent thing. For the time being we will have to find a substitute. 

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Altostrata

These drugs are not so easily stopped and swapped. Still, thanks again for your concern for others.

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Caring69

Thank you so much for Madison1997 for making an account to let me know. That is such a caring thing to do. My Mom never wanted to be on this type of medication but listened to a Dr. she trusted. Now he’s saying he’s not the one that prescribed it for her. I know he thought it would help her but his ignorance of this type of medication might be what hurts her. I’m hoping my Mom won’t have the same horrible withdrawal I’m having. Mine was from an SSRI. She does not want to continue taking it but I wish we had enough for her to taper correctly. Thank you again!

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Caring69

Alto, my Mom was on a half a dose for about 5 days and then we went to the dr. He suggested we go down to 1/4 that night so my Mom listened to him. She has been taking that for about 4 days and she seems to be okay so far. I know she might not show signs of withdrawal right away. I’m really worried that when we run out they will hit. I’m thankful for caring people like you for helping so many that have to go through all of this. Without this site I wouldn’t of known what was happening to me. 

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Songbird

Just wondering how things are going - is your mom doing okay?

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Caring69

Thank you for asking songbird. She is doing better than I thought she would. She is cutting down on her methadone at the same time. I didn’t want her to but the drs don’t understand. She was in horrible pain for the last 2 weeks but the last 2 days have been better. She has an all over restless feeling at night and is having trouble sleeping. She has said that simple things seem hard now. She is an amazing woman that has a strong faith I God that has seen her through so many things in her life. I know God is with her and is with me. I’m worried about when she takes the last pill. It should be the 30th of this month. I was thinking that maybe we should make a liquid out of her last few pills but I’m not sure that would help. She is taking 1/8th of a 50 mg tablet.

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Songbird

I'm glad she is coping okay so far.  Magnesium might help with restlessness - maybe an epsom salts bath.  It's a shame the silly doctors have reduced the methadone at the same time, that isn't very bright of them.

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