Withdrawal From Trepiline

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I am trying to withdraw from trepiline by taking half a tablet (10mg)per day instead of one tablet. I am getting palpitations could this be from the trepaline.

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1

Hi, Margo! Sorry about the palpitations, they can be miserable and frightening.

And yes, it could be from a too rapid dose reduction of the Trepiline, this can happen with antidepressants and that's why the dosage is usually very slowly reduced to taper off of them, rather than just stopping suddenly.

If you were on a 20mg dosage, then the first step for tapering would most likely have been going to 15mgs.

Learn more Trepiline details here.

Have you consulted your doctor?

You need to do as soon as possible, because there is also a chance that the palpitations could be due to something else, so you need to have them checked out.

Your doctor can also help you with a proper tapering plan.

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2

Thank you so much for the reply, which helped a lot. You asked me to be more specific - the dosage I was taking was 10mg and I cut to 5 mg daily. I went back to the 10mg and while the palpitations did not stop, they are not as bad.

Thanks again for your help, I am grateful.

Margo

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3

You made one good guess. This advice should come from a licensed physician or other medical professional. We know there is an AD Withdrawal Syndrome with just about every AD, past and present, but unless you're a medical professional, make surer you SOURCE your advice before you give it. MY APOLOGIES — obviously you do! I checked one of your links and it was SPOT ON. I know many brand names of Amitryptiline, but TREPELINE isn't one of them. I assume all of your links are similar configured. I now see they are. The Wiki "PDR" links are good enough for laypersons and even most doctors. I din't recall if they include dosing recommendations.

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4

This is the American ELAVIL or amitriptyline and the dose is small. Average daily dose (after upward titration from about 50-75mg/day) is 150mg. It's a good tricyclic antidepressant. Tofranil was the first and Elavil the second, I THINK. (Could be the other way 'round.) There IS an withdrawal syndrome with amitriptyline, but I'm surprised to see it manifest at such a small dose. What are your other meds? Assuming this w/d syndrome (if that's what it is) is due in part of in whole to Elavil, best recommendation would be to cut the dose by 5mg (25%). However, I strongly urge you to see aa Board-certified Cardiologist and have a work up. Unless you have some co-morbidities or are taking drugs that might combine with Elavil to cause rapid heart beat, you would have to be EXTREMELY sensitive to the drug for this to occur. When I was struggling with an Major Depressive Epoisode - Moderate, my shrinks and I were trying "cocktails" and I said, "Do we have a stalemating AD that's not an amphetamine? [I already was on Dexedrine 60-80mg/day with Ads and bentos.] Something giggled at my memory and the name came to be VIVACITY (protriptyline). I researched and fund out it came out the seamier as mega-seller ELAVIL and didn't get a lot of PR. However, the chemical structure looked right and the rapid onset of a "stimulating" tricyclic could be just the thing. We conferred. I prescribed it. AS good doctors should do with an "unknown" new drug, I wrote from the west strength so we could start on the lower end of the spectrum. Not much in the literature, but what I read sounded good. WE shrinks have long accepted tricyclics as harmless EXCEPT for patients who are suicide risks (a moderate OD can cause an MI in a heartbeat; we prescribed in 2-week quantities until we knew the patient). Week 1 and part of Week 2 was fine. Then I started having MEGA PANIC ATTACKS...how? where? what from? I don't think I've taken so much Klonopin in one sitting in my life and some instinct told me to get ride of the Dexedrine with Thorazine. That pill I don't keep around the house, but my neighbor was a pediatrician. She had some inj. of T-zine and she gave me an IM inj. We send her son to my apartment to get that article. Susan read it thoroughly and said, "Joe, did you read THIS?" The final paragraph, which describes additive effects of Vivactil and amphetamines resulting in a synergistic effect. I was too scattered to look up the half-life and duration of effects of Vivactil although I was sure it was nothing like those Valum, Elavil or Trafranil. Susan called "the right friend" in the right kept at Columbia and this guy, a REAL MD as well as a PhD, Pharm.D and heaven knows what other cfeds, spoke to me and said, "Doc Joey? Take another 5mg Thorazine and 4mg of Klonopin 6 hours after the first dose. This will wash out SOON. You've taken it for how long at what dose? [About 12 days starting at 15mg.day and now on 30mg.day]. Any unusual cardiac stuff, well, just tell Susan' she'll hook you up." Fun how life works out. When I initially moved into the building, I helped her kids with their writing and book review assignments. They knew I was "Doctor Joey," but I told then they could skip the honorific because we're friends. All three kids were in TX with the same shrink and on meds. I was not far from my family, but these guys were closer and their Dadm a F Lee Bailey-type corporate lawyer, cooked as if he spent years in the nicest culinary institutes in the world. One day, the discussion came to the kids meds and I said, "You know, Susan, I"m really not comfortable with Serzone. It's to hepatoxic and too easily replaced by Paxil and a couple of others." The oldest kid, the Serzone Boy, said, "Are you an MD like Mom, too." Yes, I am. I'm a shrink, MD and all. The whole chorus chimed in. Oldest girl asked if I treat kids and I said I was certified in Child & Adolescent psychiatry and the chatter started. They wanted me to treat them. They liked me better, I calmed things down by asking Susan to call this doc and give him permission to discuss her jus; cases with me. Talk abut a kid with a script pad! Ultimately, my report to the parents was unfavorable. "Goes for the next best drug product in the block; arrogant and not as smart as he thinks he is." They had family meeting. I explained that to HAS to BE "DR JOEY" in session to remind them I"m not just a friend who is a doctor and I told the parents, when they mentioned fees, that "I don't charge my friends." Happy to say, they all made good-to-excellent progress. (Susan was technically a patient, but she has adult ADD/ADHD and just needed to check in and et scripts for Adderall monthly. I could and did do that.)Two girls off meds completely and the boy well, Asperger's in complicated and I called in some help. He's still on meds, but functioning. Part of his issue is that he won't conform to society's norms He writes brilliantly, but spelling and rather are thrown to the four winds. It was until I dug into my English studies and explained we NEEDED a common language with common rules, did he start to bend.

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5

Dr. Joey,
I enjoyed reading your post!!!
You are so very right when you said "funny how life works out". Again I enjoyed reading your post, everything from how you first met this family when you moved into the building to how you helped the children with their meds. Great story.

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6

Ive been on amitriptyline for 10yrs 150 to 200mgs at night for sleep..i thought it was a miracle when it was prescribed to me. But if i miss a dose or to much time has passed in between times iam severly sick with withdraw symptoms.Iam an recovering addict with great success to date.I didnt relize i was addicted to this medication till recently..iam so scared about this withdrawal and the hurdles i'll have to enendure,being recently married and considering the fact we'd like to start our family iam extremely worried id gladly except any advice..Signed worried and confused

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