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PostPosted: Wed Jul 29, 2015 6:22 pm 
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I'm suffering a lot and would really appreciate some guidance...
About five weeks ago, my sub doctor tapered me from 10mg (SL tablets) down to 8mg. I had been on 20mg for about a year and a half, and we were tapering at a rate of 2mg every 2-3 weeks. Until this last drop, I was comfortable; when I went down to 10mg I experienced some really mild symptoms from time to time, but they disappeared quickly.
I've been on 8mg for five weeks now, and I'm miserable. Withdrawal symptoms appear after about 20 hours, and seem to be exacerbated by exercise and elevated body temperature, be it from vigorous exercise or a hot day. But regardless of the circumstances, about 20 hours after dosing, I get the gamut: cold sweats, goosebumps, severe anxiety, fatigue, loss of appetite, indigestion...
After having already clocked five weeks of this, I've decided that going back up to 10mg is not an option. So I'm looking for ways to keep myself functional on this dose. I've gone against the advice of my doctor and have split the dose into 2x 4mg, as of yesterday, and it seems to be helping some, but I'm still feeling w/d.
I read that grapefruit juice can magnify the effects of suboxone-- does anybody know when the juice should be consumed? Before? After?
And as much as I hate the idea: what about insufflation? How would that impact the effects?
St. John's wort is not an option, as it interferes with other meds I'm taking.
I'd appreciate any advice-- actually, if anyone could even give me a clue about how to combat the anxiety alone...other than benzos...anything available otc? Sometimes I feel that, if I could get a handle on the anxiety symptoms, the w/d would be a lot more manageable. Thanks :)


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PostPosted: Wed Jul 29, 2015 8:53 pm 
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Hi, and welcome to the forum!

I need to get clarification from you about something. When you say you don't want to go back up to 10 mg, is it because you would see that as some kind of failure on your part? Or because you just wouldn't want to tell your doctor that you feel better at 10mg?

The reason I'm asking is that if you want to be on the lower dose of 8 mg because it's lower than 10 mg, then you would be defeating that purpose by raising the bioavailability of the 8 mg by insufflation or grapefruit juice. Say that you're absorbing 4 mg of the 10 mg at that dose through normal sublingual administration and that at 8 mg you are absorbing 3 mg (I know the ratios aren't right). However, through a different route of administration you are absorbing 4mg of the 8 mg dose. Then you haven't really lowered your dose. So if progress in lowering your dose is what's important to you, you're not obtaining that result through the methods you mentioned.

If, however, you don't want to go back up to 10 mg because it be a huge hassle with your doctor, or a similar reason, you could go ahead and try those methods to bring your relief from withdrawal symptoms. That being said, I'm not a doctor and I don't know if insufflation or grapefruit juice would produce any dangerous results. I doubt they would cause any kind of overdose, but asking a doctor would be wise.

Amy

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PostPosted: Thu Jul 30, 2015 2:25 am 
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What is insufflation?


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PostPosted: Sun Aug 02, 2015 5:21 am 
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Sniffing.

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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

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