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Suggest Treatment For Withdrawal Symptoms Of Doxepin
Question: II have been taking the anti depressant medication Doxepin for over ten years since I started menopause.I decided 6 months ago that I no longer need it and it also caused restless legs. Tapered slowly but since coming off 3 weeks ago have been living hell. Insomnia, dizziness, nausea, chronic headache and just generally feeling unwell. Is there anything I can do to ease this transition and how long is it likely to last? At the end of my rope. Hope you can help even a little.
Brief Answer:
very gradual tapering; symptomatic treatment.
Detailed Answer:
Hello
Welcome to HCM.
I can understand your concerns.
Almost all psychotropic drugs are known to cause withdrawal symptoms when discontinued after being taken for long time.
Sometime, these drugs can cause withdrawal symptoms for more than even 6 months. This is known as protracted withdrawal syndrome.
I think you are having this protracted withdrawal.
There are two strategies which I usually recommend to my clients in my clinic:
1. Very gradual tapering of drug- You have tried slow tapering of drug but still facing withdrawal. A more gradual tapering of drug should be considered (reduce by 10% of total dose every month). You can restart with original dose and follow this regime (under your doctor's supervision).
2. Symptomatic treatment of withdrawal symptoms-
a. Klonopin (prescription drug) for insomnia.
b. ondansetron (prescription drug) for nausea.
c. tylenol for headache.
d. multivitamins.
e. plenty of water, green vegetables and fruits in diet.
The choice of strategy depends on the client's choice and comfort.
You can discuss this with your doctor and try to follow a comfortable regime.
Hope this helps.
Feel free to ask further.
Thanks.
very gradual tapering; symptomatic treatment.
Detailed Answer:
Hello
Welcome to HCM.
I can understand your concerns.
Almost all psychotropic drugs are known to cause withdrawal symptoms when discontinued after being taken for long time.
Sometime, these drugs can cause withdrawal symptoms for more than even 6 months. This is known as protracted withdrawal syndrome.
I think you are having this protracted withdrawal.
There are two strategies which I usually recommend to my clients in my clinic:
1. Very gradual tapering of drug- You have tried slow tapering of drug but still facing withdrawal. A more gradual tapering of drug should be considered (reduce by 10% of total dose every month). You can restart with original dose and follow this regime (under your doctor's supervision).
2. Symptomatic treatment of withdrawal symptoms-
a. Klonopin (prescription drug) for insomnia.
b. ondansetron (prescription drug) for nausea.
c. tylenol for headache.
d. multivitamins.
e. plenty of water, green vegetables and fruits in diet.
The choice of strategy depends on the client's choice and comfort.
You can discuss this with your doctor and try to follow a comfortable regime.
Hope this helps.
Feel free to ask further.
Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your detailed response. I would like to keep going without re starting the doxepin but am worried about becoming dependent on other drugs eg Klonopin in the process. Lack of sleep is the biggest issue at the moment I don't want to give up one medication only to become dependant on another. Should I be concerned about this?
Brief Answer:
gabapentin; sleep hygiene.
Detailed Answer:
Thanks for the follow up.
I understand this issue as well.
Ocassional and short-term use of klonopin does not cause dependence.
There is risk of dependence when it is taken for long term, say more 2-3 months.
Another possible option for insomnia is the use of gabapebtin(prescription drug).. This drug can be used for insomnia off-label. This will also take care of other anxiety symptoms as well.
Along with that, you can practice sleep hygiene habits to reduce requirement of sedative drugs:
1. Avoid naps in daytime.
2. Use bed only while you sleep.
3. Practice relaxation exercises like deep breathing and meditation.
4. Warm water bath and a glass of warm milk at bed time can be soothing.
5. Avoid heavy, fatty meals at bedtime.
6. Make a fixed sleeping schedule.
7. Donot take tea,coffee,chocolates at bedtime. These can disturb sleep.
Hope this helps.
You are most welcome if you have more doubts.
Take care.
Thanks.
gabapentin; sleep hygiene.
Detailed Answer:
Thanks for the follow up.
I understand this issue as well.
Ocassional and short-term use of klonopin does not cause dependence.
There is risk of dependence when it is taken for long term, say more 2-3 months.
Another possible option for insomnia is the use of gabapebtin(prescription drug).. This drug can be used for insomnia off-label. This will also take care of other anxiety symptoms as well.
Along with that, you can practice sleep hygiene habits to reduce requirement of sedative drugs:
1. Avoid naps in daytime.
2. Use bed only while you sleep.
3. Practice relaxation exercises like deep breathing and meditation.
4. Warm water bath and a glass of warm milk at bed time can be soothing.
5. Avoid heavy, fatty meals at bedtime.
6. Make a fixed sleeping schedule.
7. Donot take tea,coffee,chocolates at bedtime. These can disturb sleep.
Hope this helps.
You are most welcome if you have more doubts.
Take care.
Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much for your responses and reassurance that these are normal discontinuation symptoms. This in itself makes me feel a little bit better. I will try to keep toughing it out whilst following your advice about diet and sleep hygiene. I have purchased vitamins and also fish oil. I will mention the medications you suggested to my GP. Hopefully I will turn the corner any day now and start feeling like my old self.
Brief Answer:
happy to help.
Detailed Answer:
I am glad that you found my suggestions helpful.
I wish for your speedy recovery.
You can approach me directly anytime in future, if you have more doubts to discuss. I will be happy to help.
Kindly close the discussion if you have no more queries for now.
Hoping for a positive feedback from you.
Take care.
Thanks.
happy to help.
Detailed Answer:
I am glad that you found my suggestions helpful.
I wish for your speedy recovery.
You can approach me directly anytime in future, if you have more doubts to discuss. I will be happy to help.
Kindly close the discussion if you have no more queries for now.
Hoping for a positive feedback from you.
Take care.
Thanks.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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