4 hours ago, Catbird said:

So true @Tracey I miss the release of emotions through crying.

Me, too. Sometimes it’s possible and that feels so good.

 

4 hours ago, Catbird said:

I’m finding things very difficult at present, but I’m doing my own version of graded exposure. Two occasions where I’ve wanted to cancel but I’ve gone anyway. Lots of anxiety and somatic symptoms and I’ve managed to just sit with the discomfort. I think I’m getting better at it.

You are brave. I really appreciate your attitude, you are very inspiring. 
I hope you will have a good weekend, is it getting cooler now in your region ?

take care!
 

just wanted to say congrats for hitting 1mg ! you are most of the way down

25 minutes ago, Lighty said:

just wanted to say congrats for hitting 1mg ! you are most of the way down

Thanks @Lighty almost at 1mg. Few years to go yet, but heading in the right direction 🧡

Hi @Catbird

Just checking in to ask how you are doing atm. How are you reacting when you lower the dosis? Last time it was bearable, as I recall. 
You mentioned, you were going to pause and start tapering Amitriptyline. 
How long are you going to hold before doing so? We both have a long journey ahead. But we will get there, I know we will. 🙏💕

25 minutes ago, Haa said:

Hi @Catbird

Just checking in to ask how you are doing atm. How are you reacting when you lower the dosis? Last time it was bearable, as I recall. 
You mentioned, you were going to pause and start tapering Amitriptyline. 
How long are you going to hold before doing so? We both have a long journey ahead. But we will get there, I know we will. 🙏💕

Hi @Haa thanks for checking in. It means a lot. I get intense symptoms but few and far between. Have been practising acceptance for a few years and I think it's helping a lot. The symptoms are intense but don't repeat or last a long time.  I usually have a bit of a rough "off" feeling around day 4 or day 10. All my decreases are detailed in my signature.

I'm going to hold probably 4-6 weeks — see what my body's telling me. I'll know when the time is right. The Amitriptyline is a suspect in a blood cell dyscrasia which showed up over the last couple of weeks, so I'll either need to get off it completely or just halve the dose which was my original intention.

How are things with you?🤗

10 hours ago, Catbird said:

Thanks @Lighty almost at 1mg. Few years to go yet, but heading in the right direction 🧡

Congrats on the significant milestone @Catbird it's a victory, time is secondary, the path is the main thing, as long as it's bearable, that's what counts, well done, you're doing great! 🤗

10 hours ago, Catbird said:

Thanks @Lighty almost at 1mg. Few years to go yet, but heading in the right direction 🧡

I mean you got down from 10mg to almost 1mg in like 2 years ? you did got down most of the way receptor occupancy wise.

10mg is around 70% occupancy, when 1mg is around 25 receptor occupancy, you did get down 45 percentage in theory. 

Edited March 11Mar 11 by Lighty

32 minutes ago, Lighty said:

I mean you got down from 10mg to almost 1mg in like 2 years ? you did got down most of the way receptor occupancy wise.

10mg is around 70% occupancy, when 1mg is around 25 receptor occupancy, you did get down 45 percentage in theory. 

@Lighty I suppose in theory. The reality was I was so used to feeling symptomatic firstly from C-PTSD and secondly from a psychological injury — constant panic, hyperarousal and hypervigilance. All of my symptoms were somatic (somatisation is very common in trauma). so I lived with these symptoms while tapering. I did a brief stint micro tapering linearly at which point my body said STOP!! I joined SA and realised I'd been tapering way too fast. I held my dose for several months to let the cumulative load of symptoms of the leash. It wasn't pleasant. Coming out the other side was amazing. I've been micro tapering since then. It's now at a snail's pace.

35 minutes ago, Catbird said:

@Lighty I suppose in theory. The reality was I was so used to feeling symptomatic firstly from C-PTSD and secondly from a psychological injury — constant panic, hyperarousal and hypervigilance. All of my symptoms were somatic (somatisation is very common in trauma). so I lived with these symptoms while tapering. I did a brief stint micro tapering linearly at which point my body said STOP!! I joined SA and realised I'd been tapering way too fast. I held my dose for several months to let the cumulative load of symptoms of the leash. It wasn't pleasant. Coming out the other side was amazing. I've been micro tapering since then. It's now at a snail's pace.

yeah makes sense you tapering slower now, at some point it can become too much for the body and it doesn't adapt as fast.

how is your day to day nowadays? how good is it from 1-10 ?

1-3 currently. Mainly middle ground - so mainly 2.

Hello @Catbird, I hope and believe  that you will feel better once you lower the amitriptyline. I took it for a short while and it had terrible side effects. On higher doses, the reductions will be easier probably. So I think it is a good idea to put Lexapro on hold and reduce the A.

on the numbers you mentioned: what is 1 and what is 10?  
 

I wish you a peaceful day!

7 hours ago, Nemina said:

Hello @Catbird, I hope and believe  that you will feel better once you lower the amitriptyline. I took it for a short while and it had terrible side effects. On higher doses, the reductions will be easier probably. So I think it is a good idea to put Lexapro on hold and reduce the A.

on the numbers you mentioned: what is 1 and what is 10?  
 

I wish you a peaceful day!

@Nemina a lot of people here rate how how they are affected by symptoms each day on a scale from 1 to 10, with 10 being the worst.

i hope you have a good day too N.

15 minutes ago, Catbird said:

@Nemina a lot of people here rate how how they are affected by symptoms each day on a scale from 1 to 10, with 10 being the worst.

i hope you have a good day too N.

that's pretty good then !

i didn't understand it either.

 

thanks for clarifying. I have seen it the other way round, too. 
 

 1-3 is great then! Wow. I’m happy for you. 😊

 

18 minutes ago, Nemina said:

 

thanks for clarifying. I have seen it the other way round, too. 
 

 1-3 is great then! Wow. I’m happy for you. 😊

 

Maybe I’ve got it wrong. I don’t use it on a regular basis. Someone just asked me to rate my symptoms.

There is no wrong or right,  it’s just two different ways how one  can do this.

 

I am very happy that you feel so much better than before your long hold. 
since you had some dramatic symptoms, I thought you were not doing so well. But this seemed to have been short spells. Great.

45 minutes ago, Nemina said:

There is no wrong or right,  it’s just two different ways how one  can do this.

 

I am very happy that you feel so much better than before your long hold. 
since you had some dramatic symptoms, I thought you were not doing so well. But this seemed to have been short spells. Great.

Yes, I do have these very intense spikes - SVT which felled me, overwhelming panic - they are instantly disabling. The thing is they seem to be one off and I just as quickly return to baseline.

The 3.5 month hold was a whole different story - weeks and months of intensifying symptoms. I couldn't leave the house. That was constant, whilst what I experience now seems to be transient and very intense. Most days I just go bout my business, energy levels permitting.

6 hours ago, Nemina said:

 

thanks for clarifying. I have seen it the other way round, too. 
 

 1-3 is great then! Wow. I’m happy for you. 😊

 

Yes some have a mood rating. 10 being good! Rather than a symptom severity scale! Gets confusing! 🤪

I think ct folk off the drug generally go that way round and those tapering go the other! 😆

The last few days I’ve had abdominal wall muscle spasms flowed by upper back muscle spasms. I asked Chat BP about this. It’s 33days since my last decrease of 16mcg of Escitalopram. Chat said I’m ina wave and it’s not unusual to have such symptoms arise somewhere between 2-5 weeks after a decrease. This is going to really slow my taper if these symptoms don’t emerge until nearly 5weeks later but so what. It is what it is. Autonomic disregulation coupled with serotonins big effect on the gut. Anyone else suffering with similar waves of symptoms like mine?

1 hour ago, Catbird said:

The last few days I’ve had abdominal wall muscle spasms flowed by upper back muscle spasms. I asked Chat BP about this. It’s 33days since my last decrease of 16mcg of Escitalopram. Chat said I’m ina wave and it’s not unusual to have such symptoms arise somewhere between 2-5 weeks after a decrease. This is going to really slow my taper if these symptoms don’t emerge until nearly 5weeks later but so what. It is what it is. Autonomic disregulation coupled with serotonins big effect on the gut. Anyone else suffering with similar waves of symptoms like mine?

just as a note, most AIs like chat one tend to make up data and change what they tell you based on what you tell them, so it's unreliable most of the time.

 

Yes I’m aware of the limitations, but thank you.

I think I've finally reached a level of stability after my last decrease of 16mcg Escitalopram almost 6 weeks ago. I was trying to reach 1mg around the end of last year but my CNS is way too sensitised at present. When I resume the Escitalopram taper I estimate it will take at least another 2 years of tapering. I am going to hold now for 4 weeks.

 

I want and need to decrease Amitriptyline 20mg to at least 10mg because of side effects because of awful side effects. I'm scared of how this will play out given the degree of CNS sensitivity. I would really appreciate anyone who has had experience in similar situations to share their experiences +/- advice.  Thinking you might have some pointers @Chippy.

 

 

Just now, Catbird said:

I think I've finally reached a level of stability after my last decrease of 16mcg Escitalopram almost 6 weeks ago.

glad you reached some sort of stability ! make sure to take your time.

1 hour ago, Catbird said:

I think I've finally reached a level of stability after my last decrease of 16mcg Escitalopram almost 6 weeks ago. I was trying to reach 1mg around the end of last year but my CNS is way too sensitised at present. When I resume the Escitalopram taper I estimate it will take at least another 2 years of tapering. I am going to hold now for 4 weeks.

It is good to see you have reached some stablity @Catbird so happy to read. Yes I think a nice hold here is a good idea and see how are you.

 

1 hour ago, Catbird said:

I want and need to decrease Amitriptyline 20mg to at least 10mg because of side effects because of awful side effects. I'm scared of how this will play out given the degree of CNS sensitivity. I would really appreciate anyone who has had experience in similar situations to share their experiences +/- advice.  Thinking you might have some pointers @Chippy.

Tapering down off a drug that is causing side effects is a good idea IMO. You may/hopefully find that the benefits of reducing the dose and loosing the side effects is worth the potential short term WD effects of making the reduction.

 

Amitriptyline, according to the Maudsley, has liitle data to support making charts to record actual sert response to certain doses. It would appear, some taper from quite high doses, 100mg is the start point for taper shedules in the book. So it is safe to assume 20mg, might well be doing quite alot of heavy lifting. So caution IMO about how quickly you reduce. Obviously you want to try get enough drug gone to get the benefit of the reduced side effects without upsetting the apple cart.

 

Rough calcs suggest you would take this long to achieve your goal, assuming you tapered the same overall % per month every time without holds.

 

10% - 6/7 months

5% - 14 months

4% - 17 months

 

My guess is a Micro taper of sorts would be the way to go. Lots of different ways to approach this. Maybe 1/30 daily drops of your monthly choosen reduction, might suit you. You might find, some do, that you won't notice the reductions. But as you know everyone is different. 

 

I would suggest picking a reduction of 5 or 10% and then try to reduce 1/30 of that for the first day and see how you are. From there you could feel your way into it. Perhaps if it goes ok, keep that up for a week or two. Then hold. If it goes ok keep it up. If you start to get in trouble, hold again or updose a little and hold might be wiser. Can always adjust the rate or frequency of drops.

 

You will want to factor in at best a few strategic holds on route.

 

Note, you would recalculate your drop daily drop each month to ensure it is no more than 10% per month total of your last final monthly dose.

 

Gonna take a while I imagine to get it down which ever way you go.

 

Guide for Micro Tapering is nearly there but not quite. The Cutting Calc is live now.

 

Cutting Calc 2.1

 

Chippy

1 hour ago, Chippy said:

I would suggest picking a reduction of 5 or 10% and then try to reduce 1/30 of that for the first day and see how you are. From there you could feel your way into it. Perhaps if it goes ok, keep that up for a week or two. Then hold. If it goes ok keep it up. If you start to get in trouble, hold again or updose a little and hold might be wiser. Can always adjust the rate or frequency of drops.

Thanks @Chippy the thing I’m worried about Amitriptyline is it’s not just the one drug I’m going to be tapering, it’s 2: Amitriptyline’s active metabolite is Nortriptyline and they both have different half lives. If I put in holds in the schedule the Nortriptyline can cause WD symptoms some time later due to its longer half life. Well that’s my understanding anyway. Maybe I’m overthinking it, and I don’t want to go off half cocked either.