@getofflex I’d be glad to share my tapering info if I could figure out how to edit my profile. I had the same trouble on SA.  I’ve edited here before but damned I can figure it at the moment. 

On the top of the page, there is your name. There you click. Then you go to “account settings” and there, on the left side , you find “signature”. 
then you can edit your signature. I hope this helps.

I’m sorry. I still can’t get to where you are saying to go. Can’t find “ signature” 

You found account settings? Then in the left bottom corner.

 

 

 

 

 

 

Maybe if you’re just make a post with everything you want to have in your signature. Then @Chippy can later copy and paste it into your signature.

7 hours ago, Pokey449 said:

@getofflex I’d be glad to share my tapering info if I could figure out how to edit my profile. I had the same trouble on SA.  I’ve edited here before but damned I can figure it at the moment. 

@Pokey449

 

click here mate. Save the link in your favourites so you can get to it easily each time. Edit signature

Click on your name and avatar.  on the computer it's on the top left.  Select account settings.  Select signature.  Type it in the box.  Be sure and click "save".  

How are you, @Pokey449? 

Svetla

Hi @skamen Svetla. I’m much better today. I started the updose yesterday that Horowitz advised. Hopefully that will offer some extended relief. 
But I am more concerned about the bigger picture of what has been/may be going on. By that I mean 1) my history of sleep apnea, 2) my  cardiac history that includes mitral valve prolapse, & history of AFlutter & AFib and 3) taking a drug (doxepin) that should not have been prescribed to someone to begin with a history of 1-3 above.  It’s a common problem with the healthcare model in this country. The specialists stay in their specialty silos & not integrating what’s going on with the patient reviewing treatment from the other disciplines. They don’t talk to each othrr.  All 3 of the areas I listed above can potentially have profound affects on the other. For example: my cpap therapy is not going well. Is it because the settings of my cpap machine are off, is my heart issues affecting my therapy or is the psych drugs affecting my breathing or cardiac function. Could be one or all or none. But because the disciplines seldom interact with each other one may never know for sure what’s affecting what. Given my symptoms I’m concerned there’s way more going on than garden variety WD. But I’m not sure how to prove it with my various providers. 
 

39 minutes ago, Pokey449 said:

I’m much better today. I started the updose yesterday that Horowitz advised. Hopefully that will offer some extended relief. 

I am very happy to hear that! You seemed to me to be in a downward spiral and that you can have better days is a very good sign. 
 

 

40 minutes ago, Pokey449 said:

But I am more concerned about the bigger picture of what has been/may be going on. By that I mean 1) my history of sleep apnea, 2) my  cardiac history that includes mitral valve prolapse, & history of AFlutter & AFib and 3) taking a drug (doxepin) that should not have been prescribed to someone to begin with a history of 1-3 above.

I can understand that very well. It is complicated. …

 

I keep you in my prayers.

@Nemina I was in a downward spiral!! Scared the hell out of me. Better today, got more sleep last night But I’m taking today being better with a grain of salt. I still woke up last night a couple times feeling out of sorts. I’m having O2 issues both on and off CPAP per my Oximeter. It’s likely due to either apnea, my ticker alone, or the doxepin affecting respiration or cardiac function, or both. I was not having these issues before starting doxepin or earlier in my taper. For what it’s worth Google indicates doxepin can impact respiration, usually in higher doses.  But we’re all different with different conditions. So we will see  if I make it out of this taper alive. 

Great, Pokey. On day at a time, don't anticipate this night and tomorrow.

Svetla 

Glad you had a better day Pokey. Very very good news mate. Hope this continues at this dose.

£¥^}|&747$;:!!!!!! Another S***Y!!! night again last night despite falling right to sleep.  Awoke suddenly at about 230 all stopped up and couldn’t breathe well despite room humidifier + cpap machine humidifier going, had to yank my Cpap mask off to breathe   But on top of that was nauseous, very restless, had Akathisia, & cold hearted FEAR!!  Felt like hell. Could NOT get back to sleep. Got up finally at 5 for another LONG miserable boring day. Oxygen level was not good, often below 95.  Despite what  I’ve been told I think the doxepin/mirtazapine combo is affecting my respiration or my hearts ability to pump well on top of everything else. 
I up dosed a 1/2 mg on Thursday as advised. The first couple nights went much better. Yesterday I thought, OK everything is going to smooth out now for a while, I’ll get through this , but it seems it is not to be.

So I’m not convinced I’m suffering only, purely from WD. I think the doxepin/mirtazapine is a BAD combination that is literally poisoning me ☠️. I’ve got a bloody witches brew in my body.  Im starting to think it’s an ADR causing all this??  A negative function/interaction of the drugs themselves rather than WD. You can’t taper something like that away. When I reflect back on the past few months I can attest to a gradual slow decline to where I’m at today. If that’s the case I don’t know if I can survive this day after day. Or if I even want to 😩😢 Some not so healthy thoughts for my well being are surfacing in my mind. I’m scared to death!!!!

 

6 hours ago, Pokey449 said:

£¥^}|&747$;:!!!!!! Another S***Y!!! night again last night despite falling right to sleep.  Awoke suddenly at about 230 all stopped up and couldn’t breathe well despite room humidifier + cpap machine humidifier going, had to yank my Cpap mask off to breathe   But on top of that was nauseous, very restless, had Akathisia, & cold hearted FEAR!!  Felt like hell. Could NOT get back to sleep. Got up finally at 5 for another LONG miserable boring day. Oxygen level was not good, often below 95.

Im really sorry Pokey to read this after a better day yesterday.

 

6 hours ago, Pokey449 said:

Despite what  I’ve been told I think the doxepin/mirtazapine combo is affecting my respiration or my hearts ability to pump well on top of everything else. 
I up dosed a 1/2 mg on Thursday as advised. The first couple nights went much better. Yesterday I thought, OK everything is going to smooth out now for a while, I’ll get through this , but it seems it is not to be.

So I’m not convinced I’m suffering only, purely from WD. I

Just want to share my thoughts with you my friend.

 

Im not dis agreeing that your circumstances are not on the complex side. They definitely are.

We are not doctors here as you know just fellow suffers. But I do think that if you remove the other elements from the equation and just take this as a pure WD issue there is plenty of evidence backing that case up.

 

1. Feeling better after an up dose I would say is a good sign.

2. It can take some time to feel the longer term benefits of an updose/RI and settle from the change itself.

3. I don't remember when you felt stable enough to make the drops that you have made fairly recently. (Could you update you signature to make this clear for us?) Dropping whilst feeling unstable often leads to further destabilisation.

4. Whilst not stable you split your dose recently and haven't had time to settle really from that process. Which in itself can cause more destabilisation.

5. Periods of feeling better and feeling worse, so typical waves and windows.

6. You have spoken to Dr H 3 times now and he thinks you are suffering with a WD related issue from what you have said.

 

To me it is completely possible that you are having WD symptoms/Kindling effects from the changes made whilst not stable.

 

I only say this to encourage you to stick true to the plan of holding and allowing your system to settle. I can't say that holding will solve all your problems but I think you should at least give that a good go at this stage and hope things calm down in a few weeks.

 

6 hours ago, Pokey449 said:

Im starting to think it’s an ADR causing all this??  A negative function/interaction of the drugs themselves rather than WD. You can’t taper something like that away. When I reflect back on the past few months I can attest to a gradual slow decline to where I’m at today. If that’s the case I don’t know if I can survive this day after day. Or if I even want to 😩😢 Some not so healthy thoughts for my well being are surfacing in my mind. I’m scared to death!!!!

If you were having an ADR I would think you would see an improvement in your symptoms as you dropped your dose but you recall the opposite here. You actually responded well to an up dose this doesn't to me spell ADR at all......

 

I truly wish there was a magic wand here mate. I hope that in the coming weeks you settle a bit and start to see some light at the end of what has been a very difficult tunnel for you to pass though.

 

Chippy

@Chippy why then did the updose only give me relief for only one night/day? 

As you know I’ve been working towards splitting my dose. 1/2 in the morning (8:00) and 1/2 at bedtime. Thus far I’ve only got my 2nd 1/2 dose moved to noon and I’m holding it there for now. I dont want to keep moving that 2nd 1/2 dose  until I’ve fully acclimated to the updose I started per Horowitz. Dont want to do to many things at one time given how I’ve been feeling.
Only taken the updose  2 days thus far. Should I expect relief from updosing to take a few days to get stable??

Hopefully getting 1/2 my dose closer to bedtime will help me sleep. Im

about worn out. 

@Chippy my apologies. I just now saw your additional comments after I posted my message above to you. 

23 minutes ago, Pokey449 said:

I dont want to keep moving that 2nd 1/2 dose  until I’ve fully acclimated to the updose I started per Horowitz

100% mate. 
 

23 minutes ago, Pokey449 said:

Should I expect relief from updosing to take a few days to get stable??

Have you read the SA post on how long it takes to stabilise mate?

How long does it take to stabilize after reinstating or updosing?

 

23 minutes ago, Pokey449 said:

Hopefully getting 1/2 my dose closer to bedtime will help me sleep. Im

about worn out. 

I get that. I’m hopeful moving it a bit closer as you have might help some even though it’s still some hours from bed it has already spread the dose out a bit for you. I think as I said above make no changes for a decent period of time is worth while. By decent I mean weeks rather than days. 

@Chippy  thanks for the references by Brass Monkey. Looking back over my doxepin taper I’ve likely gone to fast with some of the cuts. I’ll try to post my cuts in my signature today so you and others can can see. I’ve been making cuts based on my past taper experience of doxepin. I cut a a pretty fast clip and had few issues. Guess I thought I could do that again but 2nd time is not proving to be a charm ☹️😢

When I think about this and all that’s ahead of me to get completely off I don’t think I can do it. Life is getting to short now that I’m 76 and this is REALLY HARD ON ME.  If I can get the doxepin down to 25mg as I told Horowitz I may/likely will stop there. He agreed that was a reasonable thing to consider.  I can think about then cutting the mirtazapine in 1/2 down to 3.75 as he suggested after I’m stable on the doxepin. 

8 minutes ago, Pokey449 said:

thanks for the references by Brass Monkey.

Pleasure mate. Hope that was helpful. 
 

8 minutes ago, Pokey449 said:

Looking back over my doxepin taper I’ve likely gone to fast with some of the cuts. I’ll try to post my cuts in my signature today so you and others can can see. I’ve been making cuts based on my past taper experience of doxepin. I cut a a pretty fast clip and had few issues. Guess I thought I could do that again but 2nd time is not proving to be a charm ☹️😢

Sounds good pokey yeah do that and we can take a look. These things we can get away with at first but then something snaps and it’s stops being ok. I’ve seen it loads. 
 

8 minutes ago, Pokey449 said:

When I think about this and all that’s ahead of me to get completely off I don’t think I can do it. Life is getting to short now that I’m 76 and this is REALLY HARD ON ME.  If I can get the doxepin down to 25mg as I told Horowitz I may/likely will stop there. He agreed that was a reasonable thing to consider.  I can think about then cutting the mirtazapine in 1/2 down to 3.75 as he suggested after I’m stable on the doxepin. 

I don’t think your goal needs to be med free just comfortable. It’s all your call. But the art to it is slow steady predictable accurate time patience. All the boring words. 
 

I’ll check your footer out once you ve done it. 
 

Go for a format like this

 

01 January 2020 Doxepin 30mg 

01 March 2020 Mirtazapine 20mg

01 April 2020 Doxepin 20mg

And so on……..

I just posted my tapering schedule before seeing your message. Would you mind checking what Ive done and see if that is acceptable. I focused on how many days between cuts. If it not acceptable I will redo it

 

Horowitz recommended a 0.5 mg updose. I'm doing a 0.6mg updose for greater ease/accuracy of measuring with my insulin syringe since the doxepin is in liquid form.....1mg would be lots easier to measure/draw. Do you know why he'd suggest only a 0.5mg updose. Doesn't seem like much for desired affect?? I got your link for making  small doses, my only concern is if the doxepin will dissolve homogeneously in water as it is a syrup like liquid

6 minutes ago, Pokey449 said:

just posted my tapering schedule before seeing your message. Would you mind checking what Ive done and see if that is acceptable. I focused on how many days between cuts. If it not acceptable I will redo it

Could you do it like my example with dates 🙂

can you put your mirt changes in there too?

 

6 minutes ago, Pokey449 said:

Horowitz recommended a 0.5 mg updose. I'm doing a 0.6mg updose for greater ease/accuracy of measuring with my insulin syringe since the doxepin is in liquid form.....1mg would be lots easier to measure/draw. Do you know why he'd suggest only a 0.5mg updose. Doesn't seem like much for desired affect?? I got your link for making  small doses, my only concern is if the doxepin will dissolve homogeneously in water as it is a syrup like liquid

Big changes are not good once your nervous system is dysregulated. 
 

This is a post on sa about reinstatement. A lot of what’s said applies to up doses too. 

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

6 minutes ago, Pokey449 said:

got your link for making  small doses, my only concern is if the doxepin will dissolve homogeneously in water as it is a syrup like liquid

As long as your liquid has water in it, it can be diluted with water. 

8 minutes ago, Pokey449 said:

Horowitz recommended a 0.5 mg updose. I'm doing a 0.6mg updose for greater ease/accuracy of measuring with my insulin syringe since the doxepin is in liquid form.....1mg would be lots easier to measure/draw.

Now that you’ve gone for 0.6mg stick to that don’t drop to 0.5mg will you mate. Consistency is key. 😊

Ok I will make the change with dates....No changes being made to the Mirtazapine

5 minutes ago, Pokey449 said:

Ok I will make the change with dates....No changes being made to the Mirtazapine

According to your Sa thread you tapered mirt in Feb 25? You should put all dose changes down. They are all important. 🙂