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Old 08-29-2013, 08:48 PM #21
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Default Hey Adamo

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Originally Posted by Adamo View Post
Your advice is super helpful. It is very kind of you to take an interest in my perhaps, in the scheme of things, quite trifling situation. As you say this may be purely an anxiety issue.
It is not at all trifling. Even if this is "just" anxiety, that is a real problem which needs to be medically addressed.

Quote:
I was prescribed Gabapentin because of anxiety that began over the serious nature of my Valley Fever. And again, the reduction of this may be aggravating the underlying (post-traumatic) anxiety with the GABAs already having been altered by the drug in the last month.
Time to see another doctor, IMHO. I can't understand prescribing this for anxiety... there are a couple of possible reasons standard meds were not chosen, but then... 2400 mg??? That is a phenomenal amount!

Quote:
When I take 800mg in the morning I feel sick and confused. Within an hour or two I am in a stoned haze and am incapable of working at my job — even if I drink coffee. By early afternoon I am exhausted and by latter afternoon I am agitated and anxious (when I have to take another dose).
Oh dear! I know the stoned haze thing but I only get that when I first start treatment... you are still having that, and then later get withdrawal? Yuck!! It sounds as though you do not even tolerate the drug peaks at this dosage. So 800 in the morning means you've been taking it 3 times a day? What if you tried splitting your daily amount into 4 doses, spaced evenly. That's how I usually take it. It is a bit of a pain, but it might help with the nasty grogginess at the "peaks" and also reduce the feeling antsy before the next dose. Your blood level will remain more even.

Quote:
Are the Gabas permanently altered by this drug
Absolutely not.
Quote:
or does it take a long time to recover normal functioning after cessation?
That depends on the individual -- you see that in the degree to which you can taper comfortably.
Quote:
Won't any prolonged taper increase the difficulty of reinstating normal function?
Well, generally speaking, the longer one is on a drug, the harder it is to get off it. So yes, the faster you could get off it, the better. However, you must do it safely (slowly enough to avoid seizures). The other question is, how much discomfort can you put up with? When you removed 400mg, you reported immediate restlessness (pacing), hyperventilation and chest pain -- these are severe anxious symptoms. Enduring that level of anxiety for any length of time is just not healthy. A small amount of anxiety might be ok, but I'd not make the next reduction immediately the first day your anxiety resolves. You need breathers from it.

Quote:
I remain as dysfunctional as I have become I am afraid of losing my livelihood. It is dismaying to me to have lost my mental acuity
I hear you. I can think of a few things you can try. This will be safe, but you have to see what works. Try these one at a time, not all together:

-- alter your doses just slightly so you take slightly less during the daytime. This will be safe, and it should buy you some daytime acutity even at the current higher dosage. (I'd suggest no more than 300 mg difference between one time of day and another, at any given time. Later in the reduction, you'll want to make that difference smaller).

-- If you find you are more comfortable (less post-dose grog, less pre-dose agitation) with a 4 times a day schedule, you might find you can tolerate reductions of 200mg in a single shot.

-- Whether you stay with 3 daily doses or go with 4, make dose reductions on rotation, always starting with the morning dose.

Quote:
everywhere I've turned I have been rejected for any medically supervised withdrawal of this.
What kinds of doctors have you seen? I'd choose a neurologist or a psychiatrist, not a GP, for help, as you need someone who is knowledgeable about this drugs. A neuro will be more used to dealing with gabapentin, but a psychiatrist might be more sensitive to your situation, and evaluate some alternatives with you regarding the anxiety and agitation. (Having these symptoms and choosing to see psychiatrist does not mean you are "crazy". )

Beware of the vocabulary you use with doctors. Sometimes we have to fence around with what we say to them. Asking to be "treated" can be interpreted by some doctors as "I need pills" and saying you are in "withdrawal" can mean "I am addicted", concept which many will reject when it comes to gabapentin. Also, when they see someone who feels they are "addicted" and asking for "treatment" or "substitution", they might interpret that as drug seeking behavior and refuse service accordingly. This is totally not your case, so pick your words accordingly.

You need: assistance and supervision with gabapentin discontinuation, because you experience severe side effects when you remove even small amounts.

Quote:
I even went to a Narcotics Anonymous meeting and ended up asking the speaker about this drug. He told me its withdrawal is a common problem among addicts who are given it for other withdrawals. I have never been addicted to anything so I am scared and at a loss by such an experience.
The NA folks don't relate because they are in a different boat than you are. Your desire is to get off the drug, you don't like it, it is not a drug of abuse for you, you don't engage in drug-seeking behavior.

Quote:
He said increased physical exercise is the only way to counteract the withdrawal symptoms. But really: When your are working how much can you possibly exercise?
LOL, yeah. Don't take it too badly... just, any little bit of activity you can add in great. I know personally I'm not real safe to go out and run or similar, when I'm all goofy on gabapentin, but an exercise you can work into your day will help you with anxiety in general. Barring that, try 5 mins of meditation, relaxation, breathing, or mindfulness exercises. Or try 2 mins at a time, two or three times a day.

Quote:
Again, grateful for your help!
No problem at all. I'd really like to see you get help from a doc on this. I can at most try to talk you through some things, but I do know anxiety is a bad beastie (personal experience) and I hate to think of you dealing with that without medical support.

waves

Last edited by waves; 08-29-2013 at 09:05 PM.
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Old 08-30-2013, 01:22 AM #22
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Default This has meant a world of difference

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Originally Posted by waves View Post
It is not at all trifling. Even if this is "just" anxiety, that is a real problem which needs to be medically addressed.

Time to see another doctor, IMHO. I can't understand prescribing this for anxiety... there are a couple of possible reasons standard meds were not chosen, but then... 2400 mg??? That is a phenomenal amount!

Oh dear! I know the stoned haze thing but I only get that when I first start treatment... you are still having that, and then later get withdrawal? Yuck!! It sounds as though you do not even tolerate the drug peaks at this dosage. So 800 in the morning means you've been taking it 3 times a day? What if you tried splitting your daily amount into 4 doses, spaced evenly. That's how I usually take it. It is a bit of a pain, but it might help with the nasty grogginess at the "peaks" and also reduce the feeling antsy before the next dose. Your blood level will remain more even.

Absolutely not.
That depends on the individual -- you see that in the degree to which you can taper comfortably.
Well, generally speaking, the longer one is on a drug, the harder it is to get off it. So yes, the faster you could get off it, the better. However, you must do it safely (slowly enough to avoid seizures). The other question is, how much discomfort can you put up with? When you removed 400mg, you reported immediate restlessness (pacing), hyperventilation and chest pain -- these are severe anxious symptoms. Enduring that level of anxiety for any length of time is just not healthy. A small amount of anxiety might be ok, but I'd not make the next reduction immediately the first day your anxiety resolves. You need breathers from it.

I hear you. I can think of a few things you can try. This will be safe, but you have to see what works. Try these one at a time, not all together:

-- alter your doses just slightly so you take slightly less during the daytime. This will be safe, and it should buy you some daytime acutity even at the current higher dosage. (I'd suggest no more than 300 mg difference between one time of day and another, at any given time. Later in the reduction, you'll want to make that difference smaller).

-- If you find you are more comfortable (less post-dose grog, less pre-dose agitation) with a 4 times a day schedule, you might find you can tolerate reductions of 200mg in a single shot.

-- Whether you stay with 3 daily doses or go with 4, make dose reductions on rotation, always starting with the morning dose.

What kinds of doctors have you seen? I'd choose a neurologist or a psychiatrist, not a GP, for help, as you need someone who is knowledgeable about this drugs. A neuro will be more used to dealing with gabapentin, but a psychiatrist might be more sensitive to your situation, and evaluate some alternatives with you regarding the anxiety and agitation. (Having these symptoms and choosing to see psychiatrist does not mean you are "crazy". )

Beware of the vocabulary you use with doctors. Sometimes we have to fence around with what we say to them. Asking to be "treated" can be interpreted by some doctors as "I need pills" and saying you are in "withdrawal" can mean "I am addicted", concept which many will reject when it comes to gabapentin. Also, when they see someone who feels they are "addicted" and asking for "treatment" or "substitution", they might interpret that as drug seeking behavior and refuse service accordingly. This is totally not your case, so pick your words accordingly.

You need: assistance and supervision with gabapentin discontinuation, because you experience severe side effects when you remove even small amounts.

The NA folks don't relate because they are in a different boat than you are. Your desire is to get off the drug, you don't like it, it is not a drug of abuse for you, you don't engage in drug-seeking behavior.

LOL, yeah. Don't take it too badly... just, any little bit of activity you can add in great. I know personally I'm not real safe to go out and run or similar, when I'm all goofy on gabapentin, but an exercise you can work into your day will help you with anxiety in general. Barring that, try 5 mins of meditation, relaxation, breathing, or mindfulness exercises. Or try 2 mins at a time, two or three times a day.

No problem at all. I'd really like to see you get help from a doc on this. I can at most try to talk you through some things, but I do know anxiety is a bad beastie (personal experience) and I hate to think of you dealing with that without medical support.

waves
What can I say? I am overwhelmed. This is of immense help to me. I now know that there is a way to overcome such things. If I hadn't reached out in this forum I would have been left with the dull-eyed and glib answers that are part and parcel with people — be they doctors or psychiatrists — who often have no idea of what it is like to personally face such challenges. In truth, experience counts for a lot. I hope to make another 100mg reduction in 2-3 days rather than tomorrow as I had planned. It seems like it is the second day after such reduction that it is the worst (in a tapering plan of a reduction every 4 days). You are right about not being able to withstand 24 hours of high-level somatic anxiety symptoms. I imagine that this sets the withdrawal psychology back by preventing one from moving forward in fear of repeating such agony ten or more times. It would be one thing if one were stopping a drug cold turkey knowing that this could be done and over and one would pop out of the other end after a short duration — something that you can't do with Gabapentin — but if you're tapering slowly that kind of thing doesn't seem right. What am I willing to endure? I think I could endure most withdrawals as long as they are not causing me debilitating somatic symptoms. I want to be off this stuff by sometime in December, do you think this is too aggressive, 100mg at a time (i.e. from current 2200mg to 0)?
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Old 08-30-2013, 08:58 AM #23
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Quote:
Originally Posted by Adamo View Post
I want to be off this stuff by sometime in December, do you think this is too aggressive, 100mg at a time (i.e. from current 2200mg to 0)?
I think it's possible—even doable—but dependent upon your determination and ability to figure out how to deal with this beastie. As you go along, I think you'll figure out what works for you and what doesn't in terms of stepping it down. OTOH, I have mixed feelings about assigning a specific date as a goal; it works well for some, but for others can cause further stress if not "on schedule". You know yourself best in this regard.

We'll be here either way.

Doc
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Old 08-30-2013, 02:25 PM #24
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Smile Hey again, Adamo

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Originally Posted by Adamo View Post
I imagine that this sets the withdrawal psychology back by preventing one from moving forward in fear of repeating such agony ten or more times.
Many of us who have had anxiety have also experienced the fear of it. It is pretty human. The anxiety is a setback, and it sucks. The fear doesn't need to be -- treat it as your body and brain telling you to pace your reductions carefully. Try to self-soothe rather than be hard on yourself about the anxiety OR about the fear of it.
Quote:
What am I willing to endure? I think I could endure most withdrawals as long as they are not causing me debilitating somatic symptoms.
Sensible goal!
Quote:
I want to be off this stuff by sometime in December, do you think this is too aggressive, 100mg at a time (i.e. from current 2200mg to 0)?
I fully concur with Dr. Smith's comments on this.

I did some arithmetic -- you'd need to reduce every 5 days to be off it in December. You could do 6 days a few times. It seems a reasonable schedule to start out with, but you'll have to see how it goes.

When I have to taper something, I generally start out with a reduction plan (e.g., reduce by X mg every N days). I pay attention to the way I feel and adjust the plan as I go along. With some meds, especially with long tapers, it has helped me to keep a written chart of my dosages.

Personally, I don't set deadlines. Is there a reason you need/want to be done within the December time-frame?

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Old 08-30-2013, 03:07 PM #25
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Default Hi ademo

Just reading through the posts. I want you to have hope, that in time all this withdrawing will have an end. You will feel better, the anxiety will go away. I know it sucks, but keep telling yourself gently, there will be an end. Take this easy. I hope your doctor will listen to you and advise correctly for your own situation. You are not drug seeking, you are doing the opposite, trying to remove a medication from your body. He should work with you accordingly. A physiatrist is another type of doctor who may be more prone to helping you. ginnie
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Old 08-30-2013, 10:40 PM #26
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Default Thanks for the encouragement

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Just reading through the posts. I want you to have hope, that in time all this withdrawing will have an end. You will feel better, the anxiety will go away. I know it sucks, but keep telling yourself gently, there will be an end. Take this easy. I hope your doctor will listen to you and advise correctly for your own situation. You are not drug seeking, you are doing the opposite, trying to remove a medication from your body. He should work with you accordingly. A physiatrist is another type of doctor who may be more prone to helping you. ginnie
The thing is whenever I take this drug I feel rotten. It doesn't do anything it was prescribed to me for. It just stands in the way of any direct connection with anything because it suppresses every normal daily sensation one has. Your post means a lot to me because I get very discouraged by the thought of feeling like crap or undergoing withdrawal symptoms every 4-5 days for the next three months! Its hard to even think there can be an end when its the first time you've experienced this kind of thing... Thanks for the morale boost!
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Old 08-31-2013, 01:25 AM #27
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Default Will try to do 5-day plan

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Many of us who have had anxiety have also experienced the fear of it. It is pretty human. The anxiety is a setback, and it sucks. The fear doesn't need to be -- treat it as your body and brain telling you to pace your reductions carefully. Try to self-soothe rather than be hard on yourself about the anxiety OR about the fear of it.
Sensible goal!

I fully concur with Dr. Smith's comments on this.

I did some arithmetic -- you'd need to reduce every 5 days to be off it in December. You could do 6 days a few times. It seems a reasonable schedule to start out with, but you'll have to see how it goes.

When I have to taper something, I generally start out with a reduction plan (e.g., reduce by X mg every N days). I pay attention to the way I feel and adjust the plan as I go along. With some meds, especially with long tapers, it has helped me to keep a written chart of my dosages.

Personally, I don't set deadlines. Is there a reason you need/want to be done within the December time-frame?

waves
I will do 5-day 100mg reductions at a time. I just need to be able to handle the second day after the reduction because that seems to be the worst.
Will keep you posted and appreciate your advice.

December is my goal because I have a chance at a much more demanding job that I have dreamed about for the last ten years. It will involve a lot of international travel and I just can't imagine that I could handle it going up and down on sleep and somatic anxiety as I am experiencing now....
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Old 08-31-2013, 08:08 AM #28
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Thumbs up Wishing you well!

Hey Adamo

I wish you well with the 5-day/100mg reduction plan... and yes, please keep us posted as to your progress. I hope for you that the withdrawal symptoms ease up as your dosage comes down, and that things will be smoother sailing.

Wow... chance of a dream job! I sure do understand wanting to be free and clear for that! Best wishes on the job front, too, then!

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Old 08-31-2013, 08:17 AM #29
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Quote:
Originally Posted by Adamo View Post
The thing is whenever I take this drug I feel rotten. It doesn't do anything it was prescribed to me for. It just stands in the way of any direct connection with anything because it suppresses every normal daily sensation one has.
This is almost identical to my reaction to gabapentin—no attenuation of pain whatsoever, and feeling of overall ill-being. Worse (IMO), it deprived me of my ability to think clearly/concentrate, and worst of all, robbed me of my ability to create (both imagination and abstract thought) —my vocation. Perhaps it was fortunate that I never got beyond 900-1200 mg/day; I was in intractable pain at the time, and that may have masked/overridden whatever withdrawal there was.

Quote:
Originally Posted by Adamo View Post
I will do 5-day 100mg reductions at a time. I just need to be able to handle the second day after the reduction because that seems to be the worst.
Will keep you posted and appreciate your advice.

December is my goal because I have a chance at a much more demanding job that I have dreamed about for the last ten years. It will involve a lot of international travel and I just can't imagine that I could handle it going up and down on sleep and somatic anxiety as I am experiencing now....
Acknowledging that jobs involving travel often/usually have no regard for the five-day work week, will this new job require "on-call" or erratic scheduling? It occurs to me that if you can reasonably count on the second day as being the worst, and you have any ability to incorporate that into your working schedule, you might be able to arrange to have that worst day (or worst 2 days) coincide with your "weekend"/(off days). This will indubitably suck until you're off the beastie, but by December, may only be for a couple/few more weeks at worst.

I share your reluctance on this one (and by all means discuss it with your doctor), but thinking it through, it also occurs to me that using something else (e.g. a diazapine prescribed by your doctor) to attenuate withdrawal symptoms one or two days out of 5 - 7 (~a week) through this step-down period is quite different than taking it every day for a month or more, and far less likely to produce/trigger another dependence (or swap one for another). Speaking only for myself, and under the circumstances outlined above, I would seriously consider this option. Planning ahead, maybe ask your doctor about a prescription for a couple days worth—not enough to produce dependence, but enough to test/see if it's worthwhile considering for you.

Doc
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Old 08-31-2013, 08:51 AM #30
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Default Hi Adamo

I do feel your anxiety in this withdrawing from medication. I have been through it myself with another, Morphine. I was on that med. for 10 years. The doctor who prescribed it said most likely I would take it for my life. I decided I did not want to do that. I got a new doctor, who helped me wean off. I was sick of living my life around a pill!!!!!!!!!!! I also believed I could manage pain better without IT!!! So I spent 6 months of a nightmare. I remember standing in the hall, just yelling, and I didn't know at what! I sure do remember the anxiety, the moods, trembling, feeling sick, all of it. Never ever want to go through that again with any medication!!!!!!
There was an end to it Adamo, and I feel so much better!!!! It was worth all I had to go through to be rid of it. Keep on trucking, keep going forward, every day is one less day you have of that awful withdraw. I am here anytime to talk to. ginnie
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