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Concurrent Pregabalin/Lyrica AND Clonazepam/Klonopin Taper Help!


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hi all,

 

so i had weaned down from 900mg/day to 50mg/day and halted the taper because it became too intense and debilitating symptoms presented, but i don't want to remain on pregabalin given that it's a small dose in comparison to what i was on for years prior and because i do think it's not helping as much as the side effects may warrant. that said, because i'm taking multiple drugs, i'm not sure what's what.

 

anyhow, i had used the liquid pregabalin formulation to get down to 50mg/day from 75mg/day during the last bit before stopping but started up again this morning at a pace that i hope won't cause for extreme duress, especially given that i'm also tapering klonopin. i've stated here a number of times that for me, thus far, lyrica withdrawal has been about 10x worse than klonopin withdrawal and also ambien withdrawal, which i've successfully weaned off of.

 

so, i took a liquid reduction of 5mg, so a total of 45mg. i don't think this would be enough to put me into an extreme withdrawal state, but with these drugs and my underlying disorders, i just don't know. i know that no one will know how i'll react, but if i don't tolerate the 5mg reduction, so i reduce by approx 2.5mg? or what? my doctor had previously stated that if symptoms became too severe or that if the taper slowed to a snail's pace, that i should abandon that taper and focus on klonopin, which is what i've been doing, but i decided to try again.

 

is it not wise to taper both drugs at the same time? i would be willing to do one at a time, but really the effects these drugs have in combo with lexapro (which i cannot remove) upon sexual functioning is terrible and i'm off work for a period of time before starting a phd programme in the fall, so i thought now would be a good time to try to reduce these medications as much as possible to give for a better quality of life, i.e., a better compromise between sexual fx and control of the anxiety disorders.

 

thoughts to those who are tapering more than one medication concurrently? words of advice? words of caution? anything is appreciated because honestly i'm pretty scared but trying to think rationally.

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I wish I had some words of wisdom to offer you but I was pleased to see your doctor is supportive of your efforts. 

 

I noticed a few discussions around Pregabalin on the Support Groups board when I did a search, maybe you could glean some information by reading a few of those, I'm sorry I don't have more to offer.  Support Groups

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Europa,

 

I’m on Lyrica Klonopin as well as Baclofen. It looks like you’ve reduced your Lyrica does quite a bit and it is difficult to try to taper more than one drug at one time. Since the Lyrica seems to be giving you more trouble which may be understandable given the lower dosage have you thought about holding your Klonopin taper to finish the Lyrica taper? And if you’re finding 5 mg is too much which is a 10% reduction which is still a significant reduction have you considered tapering the Lyrica more slowly?

 

I have not tried tapering them both at the same time I’m tapering Klonopin right now. Lyrica is shorter acting so it could present more problems in terms of tapering. If you can it sometimes makes sense to get off the shorter acting medication’s first but everyone’s different. Wishing you well with your taper!

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Europa,

 

I’m on Lyrica Klonopin as well as Baclofen. It looks like you’ve reduced your Lyrica does quite a bit and it is difficult to try to taper more than one drug at one time. Since the Lyrica seems to be giving you more trouble which may be understandable given the lower dosage have you thought about holding your Klonopin taper to finish the Lyrica taper? And if you’re finding 5 mg is too much which is a 10% reduction which is still a significant reduction have you considered tapering the Lyrica more slowly?

 

I have not tried tapering them both at the same time I’m tapering Klonopin right now. Lyrica is shorter acting so it could present more problems in terms of tapering. If you can it sometimes makes sense to get off the shorter acting medication’s first but everyone’s different. Wishing you well with your taper!

 

thank you for the insight! i think that i'm going to hold lyrica where it is now because i have an appt with my doctor on wednesday of next week and see what she has to say. i'm not doing super horribly, but i'm not, as of right now, totally incapacitated. it's SO difficult to reduce lyrica and i feel as though i'm going to be tapering these medications forever and ever if i do them one at a time, so perhaps using the liquid formulation instead of reducing by .25ml or 5mg, i'll reduce next (whenever that may be) by .1 ml or about 2mg. lyrica withdrawal is hellish. if i fail, then i'll go back up to 50mg/day.

 

also, notable is that pregabalin withdrawal seems to have a lot more psychological side effects for me than bzd/z-drug withdrawal alongside the horrible physical symptoms. double whammy for sure.

 

i'm trying to remain strong and practice a ton of  self-care in order to be successful.

 

i wish you all well in your endeavours to taper off of these medications safely and successfully.

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Hey mate, how long does it take for you to find some stability with each previous cut made in the pregabalin dose? Can you acquire stability in symptoms after each cut?

 

I myself am working forward to taper of from It aswell

 

 

If you feel stable enough to be able to lower the dose of pregabalin, is it not a good idea to hold it there for a while and dedicate yourself ALL the way on the benzo ? lyrica may mitigate symptoms from benzodiazepine withdrawal, withdrawing lyrica may be unmasking symptoms from benzodiazepine insult and confusing you so in my opinion you could hold on and focus on benzodiazepines from personal experience when benzodiazepines start to cause problems they make other drugs totally useless, none of them are of any use under the influence of benzodiazepines which on their part in the acute phase of discontinuation or acute of each cut nothing can completely mitigate the symptoms

 

Wishing you strenght and patience

 

 

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Hey mate, how long does it take for you to find some stability with each previous cut made in the pregabalin dose? Can you acquire stability in symptoms after each cut?

 

I myself am working forward to taper of from It aswell

 

 

If you feel stable enough to be able to lower the dose of pregabalin, is it not a good idea to hold it there for a while and dedicate yourself ALL the way on the benzo ? lyrica may mitigate symptoms from benzodiazepine withdrawal, withdrawing lyrica may be unmasking symptoms from benzodiazepine insult and confusing you so in my opinion you could hold on and focus on benzodiazepines from personal experience when benzodiazepines start to cause problems they make other drugs totally useless, none of them are of any use under the influence of benzodiazepines which on their part in the acute phase of discontinuation or acute of each cut nothing can completely mitigate the symptoms

 

Wishing you strenght and patience

 

yeah, i think that you guys/gals are right. i think that i'm going to hold steady perhaps at 45mg, going back up to 50mg/day if i can't handle it only because i was thinking that i should get down to 2mg of klonopin as the withdrawal thus far on that drug isn't nearly as debilitating as the lyrica withdrawal. then hold klonopin at 2mg and focus on lyrica? or the other way around?  i dunno, my main worry is that i'll never be off of lyrica because it's so damn severe to get off of which i guess doesn't matter if it's not the drug causing problems, but it might be and that i don't know which is, is beyond frustrating. 

 

i do stabilise after about four or five days of reducing lyrica (and sooner with klonopin at this point with fewer debilitating sx), but again, i'm using the liquid lyrica formulation, but it would be terrible to get stuck at like say 30mg/day and not be able to go down further and be on some funky combo of a capsule and the liquid formulation at the same time.

 

thankfully neither drug has stopped working. i'm not in tolerance withdrawal nor interdose withdrawal with the benzo and it still (after about 15 years) works to quell anxiety, albeit not nearly as robustly as it did initially. lyrica, on the other hand, does work just as well as when i began taking it. the side effects, however, are horrible, so i'm trying!

 

like, my concern is which is the greater evil of the two in terms of side effects? i don't know the answer to that question and my doctor doesn't either, so it's kinda like, well, i'm down to a low dosage comparatively of lyrica but am still on a sizable amount of klonopin. that isn't to say that lyrica is causing for the majority of the negative side effects still, though, even at 45/50mg/day. i'm just super unsure of which drug to focus on because i don't know what is doing what.

 

 

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I understand the confusion but at the end of the day knowing which one is causing the problems doesn't matter, you will be adapting on each cut. the way I'm thinking in your case is the following, because of the insult promoted by the benzodiazepine, the functionality of the gabaa receptors is impaired and the lyrica somehow mitigates the symptoms related to this by withdrawing pregabalin you suffer from pregabalin iself and the symptoms that are being mitigated by it which leads you to concider being caused only by pregabalin,  so I believe in my opinion that it is better for you to hold on to 50 and focus on the benzodiazepine and just think about pregabalin at the end
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I understand the confusion but at the end of the day knowing which one is causing the problems doesn't matter, you will be adapting on each cut. the way I'm thinking in your case is the following, because of the insult promoted by the benzodiazepine, the functionality of the gabaa receptors is impaired and the lyrica somehow mitigates the symptoms related to this by withdrawing pregabalin you suffer from pregabalin iself and the symptoms that are being mitigated by it which leads you to concider being caused only by pregabalin,  so I believe in my opinion that it is better for you to hold on to 50 and focus on the benzodiazepine and just think about pregabalin at the end

 

yeah, i mean, it really is confusing and because i don't want to taper for another like five years, i have to figure out how to best go about this, particularly because i'm beginning a phd program in the fall of '22. i think right now i'm going to hold at 45mg/day of pregabalin bc i've already stabilised on that amount and also hold 2mg/day of klonopin and wait to see what my psychiatrist has to say on wednesday when i have an appointment with her. i know that the ssri, lexapro/escitalopram, is also causing problems but i feel like that medication is really holding me together throughout this all and i've never done well off an ssri without a major relapse occurring.

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i decided to increase lyrica back to 50mg/day and await the dr's consult on wednesday. i know this isn't an antidepressant focused board, but she had mentioned switching lexapro to perhaps paxil but at a lower dosage than would be considered the equivalent. i would be okay with this but the potential for this to go wrong is higher because it can take several weeks to a month to really feel the full impact of an ssri decrease and similarly, the same amount of time for it to be rectified whereas i know that i can take the old dosage of lyrica tomorrow and be fine within a day or two. same for klonopin.

 

polypharmacy is a total mess.

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How are you now with the SSRI swap? Paxil is quite fast to reach its therapeutic effect compared to other SSRIs in my experience and its profile it's quite sedating too.
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How are you now with the SSRI swap? Paxil is quite fast to reach its therapeutic effect compared to other SSRIs in my experience and its profile it's quite sedating too.

 

my dr didn't want to switch ssris before trying to stabilise me on lamotrigine first and then taper/reduce/eliminate the ssri slowly.  i was okay with this plan, so i'm going with it. she also strongly  advised against proceeding with the bzd taper at this point, but gave me the choice to do what i felt was appropriate. she said that she has seen far too many failed attempts whereby patients try to taper significantly quicker than advised and then hit a wall hard even if not presenting with symptoms up until that point. so right now, i've started on lamotrigine and have left everything else as is.

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  • 8 months later...

Hey! I hope you are doing better. How exactly did you stopped pregabalin? I am at 200mg right now and using it since more than 1 year. I wonder what should I taper first. I need to update my signature as I am now at 100mg of fluvoxamine and 7.74mg of diazepam together with the dose I mentioned of pregabalin.

 

My OCD is tough and I don't know what to do.

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