Tapering off Fioricet/Bupap

[Krobette]

First, I'm so thankful to see a board dedicated to this monster medication -- and a support group.

My story -- I had take Fioricet as needed for tension headaches off and on for a few years. Last year, while pregnant with my third son, I had constant headaches (likely hormone triggered) and upped my amount of Fioricet (with doc's blessing). There were times I'm sure I just stopped for a day or two here or there, but it's all a fuzzy time period with two other kids and a business to run.

Fast forward to now. My son is 10 months old, and I'm still taking the fioricet. Usually 8 a day. I tried to stop them about 5 months back and my GP told me to take one a day for three days and then I should be fine. WRONG. I was in a spiral of panic and anxiety attacks. It was horrific. As someone who has battled OCD, PPD and anxiety my entire life, this was the first time I've felt physical panic. I went straight to my psychiatrist who refilled my meds and had me go back to my original dose and start to taper from there. At this point, whether from this experience or from the new depo birth control shot that wreaked havoc on my hormones, the taper was not working. My headaches were around the clock and when I tried to drop, I would cave and continue at my usual amount.

She referred me to a neurologist who has been very reassuring and helpful. I've also started having strong heart beating that worries me (which just makes it beat harder). Both docs (psych and neuro) suggested I see a cardiologist just to rule out anything. I wore a monitor and they said I was having PVCs which are harmless skipping of beats that most everyone has but some are more sensitive to it like me. Neuro also suggested that the barbituate in Fioricet can cause that heart sensation. First, he had me drop caffeine cold turkey. It was a horrific four days, but my heart calmed down after and my headaches improved some. I'm now taking Bupap (Fioricet minus the caffeine).

A few weeks ago my heart beating hard started coming back. Could be a number of life-related anxiety things. Could be the depo birth control shot wearing off and 'natural' hormones kicking in. Could be PPD. Could be my anxiety around knowing the taper of Bupap was coming up.

I had my appointment with him yesterday to plan my taper. He wanted me to go straight to 3 a day. I told him how anxious I was about this whole process and I think he is taking the 'rip off the band aid' approach. He said at that level I shouldn't worry about seizures (biggest fear) and to expect some headaches, maybe some heartbeats that are rapid/hard and maybe some anxiety.

My psychiatrist has me on klonopin at a dose that is ok with nursing my 10 month old. I think I'm reading that starting that med more regularly (which she has ok'ed) will help me through this taper process. After being at 3 for a week, he wants me to go down to 2 a week and then 1 a week. This is a much faster taper than I had in mind, and I'm kind of freaked out.

I usually take 8 a day. Today I will take 6. Tomorrow I plan to take 4 and THEN get to his 3 a day amount. I go back to see him on Monday and he assures me that he will get me through this. He's a smart man, and I want to trust him. That just was a bigger jump down than I had in mind. And I'm just plain scared. My anxiety and heart palps are through the roof and I haven't even started the taper!

Any reassurance and help would be much appreciated. I want to get off this med and hopefully feel like a new person - myself - again. It's been a really, really hard 6 months. (Typing through tears.)

[vicki595]

Hi-  Well...you've got a lot to deal with but try not to focus so much on the anxiety. It can be self perpetuating; I know this very well.

There's nothing wrong with holding at a month between drops in amount. It's a bit long but may work for you. I don't think it's always a one size fits all approach that works the best. Everyone is different with specific needs, worries, lifestyles, etc...

I'm going to encourage you to get down to 4 per day. It will be okay. You worry a little too much for your own good!  Trust me, if I can taper a 20 plus a day burden...anyone can!  So, do that and give it a few days to adjust. Be in touch with how you're feeling and I'm sure it will be fine.  Anxiety is normal during this process and in life. Learn to deal with it by taking a little nap, taking a walk, having a cup of tea, talking to a friend...Support is really important, as well.

You've talked with the doctors about nursing and they're fine with that? Have they suggested slowly transferring to a bottle or sippy cup? Maybe too soon for a sippy cup but talk to them about it. I think you should speak to your pediatrician, preferably.  The baby is getting a barbiturate every day here and that's not the best thing.  So, work on that and try to find some moments to relax, okay?   Keep in touch-

[vicki595]

I'm concerned about the effect this is having on the baby; both taking and tapering the Bupap. Do your GP and Psych. know you're breast feeding?  

[Krobette]

Hi Vicki. I'm having a 'down on myself' kind of day about all of this and I wanted to come back here and update. And I saw your post. They are actually both aware that I'm nursing and my son is now one and only nurses 3 times a day usually. Because I also took it while pregnant, no one has seemed concerned that I've been taking it while nursing (though certainly it's not ideal). I had a freak out moment the other day that what if my tapering and weaning at same time was not keeping steady meds in him and my psych told me she doubted he'd notice at all if I quit nursing altogether. He being my son. And I trust her. I'm having a hard time with the taper though. I went down from 8 to 5 to 4. I didn't do the jump to 3 like the Neuro said b/c it scared me. And I didn't need to go into it with anxiety. My psych and him are working together to keep me at a slow pace. Right now, I'm at 5 and I NEED to go to 4 but I'm terrified. Because my anxiety is through the roof. I keep hoping and praying that once I'm off this my body will level out and be normal again. That his ongoing anxiety and depression will go away. Because right now, with three kids, a business to run and schedules and tapers and OCD and hormones, I'm a mess. I just want to feel normal again, desperately. I don't know if my spike in anxiety is b/c I'm tapering or b/c of my fear of tapering. Or not related at all. It's making me a little crazy, can you tell? The plan now is to stay at 4 for a month. But I kind of want to just get off this stuff as fast as possible, I just don't know that my anxiety will fare well. Any advice would be greatly appreciated.

[vicki595]

Your taper plan is still a little too fast, to me. I went very slowly though. I only dropped 2 per month.  The important thing is your comfort and anxiety. If you feel okay after a few days you can try to drop again. Go by how you feel, always going down on the dose. Don't go up on the dose at all because that just confuses your body.

There's nothing wrong with going slow. It does take patience though along with communication and support from your doctor.  

Definitely keep me posted. I know you want this and that's half the battle! You're doing great so far.

[Krobette]

Thank you so much for writing, Vicki!

I went down from 8 to 6/day for the last 2 days and all seems fine. I think I'm going to go down to 5 tomorrow and hang there a few days. I go back to the doc on Monday where I will inform him that I did nothing he told me to do. :)

Thank you for the reassurance about the seizures. I'm prone to anxiety in a bad way, so my mind gets so stuck on how 'awful' this can be and stays there in the negativity. I'm so happy to have your suggestions and support.

I'll keep you posted. Does my taper plan so far sound ok?

[vicki595]

Hi there- I have a lot of experience with fioricet. I took it for years, tapered off, and haven't touched it for 6 years and 3 months.

A couple things: I think the taper is too fast especially dropping a couple everyday until you get down to 3 per day. It's a shock to your system. Plus, with your anxiety it's even more important to go slowly. Ask the doctor if you can slow it down and maybe try dropping 2 per day every week or something similar. You need to follow his advice but there's no rush here and it's better if you're comfortable with the process. You'll be more inclined to stay away or not increase the dose while trying to taper. I think a very slow taper can almost guarantee a good outcome.

As far as seizures are concerned, you're more susceptible when you stop abruptly and not when you taper. With you, the klonopin covers you anyway because it hits the same receptors in your brain as butalbital. Don't worry about seizures.

I'm happy to help you in any way I can. This can be done!  I think the biggest two symptoms will be headache and anxiety.  A slow taper calms that down.

Be sure to get enough rest and eat properly, too.  Keep your fluid intake up so you're flushing your system.  Worrying will only make it all worse and will never help so work at distracting yourself. You'll do just fine!  

I'll try to answer any questions you may have-  Hang in!   Vicki