scopolamine withdrawal

[gina111]

I have a complicated question.  I was given a scopolomine patch for surgery.  I was hospitalized for 4 days.  About 48 hours after I was discharged, I began suffering from significant nausea and vertigo.  My OB\GYN surgeon prescribed more scopolomine patches. I also developed severe sinusitis and bronchitis in the week after my discharge and was put on an antibiotic.  Each time I used the patch, the symptoms were controlled, but about 24-48 hours after removal, the symptoms were back with a vengeance.  I called after the third patch, and my surgeon said I needed to see my PCP because it was no longer surgery related.  I asked whether I was having some sort of "rebound" symptoms from the removal of my patch, and she told me no. I went to my pCP, he believed it was an inner ear problem,  gave me another round of antibiotics, a steroid shot, a medrol dose pack and two more patches in  case the symptoms came beck before the meds worked.  I continue to have the same problems.  With my own research, I am reading that my symptoms may well be withdrawal from my scopolomine patch.  My question is whether this sounds like what may be causing my problem and if so, now what?  What is the best course of action to get through the incapacitating symptoms and get off this patch?

[jeff0001]

Hi Gina. I tried posting a comment to you a minute ago, but I don't think it worked so here's the message again.

My wife has had the same symptoms as you after using the Transderm-Scop patch on a 7 day cruise that ended Jan. 20. The symptoms started just over 24 hours after she took the patch off. The first week was Hell; she couldn't even stand up straight because of the dizziness, the nausea was terrible, her vision was so blurred she couldn't see plus she had the worst headache of her life. Fast forward to today and she's still unable to walk more than a few feet without me there to support her, let alone drive her car or go back to work. The doctors we've seen tell her it's vertigo and gave her some anti-vertigo meds but either they're not working very well, or they are working very, very well and she's worse off than we think. She's having to go on short term disability because of this!

Since this all started I've done research on the web just as you have, and just like you I've found quite a few people who've suffered like this after taking the patch off. There are chat forums where people share their suffering, and even the manufacturer's web site indicates there can be withdrawal symptoms of dizziness, nausea and headache. Last night, my wife was talking to a nurse friend of hers who said she's seen many patients who've had this problem after taking the Transderm Scop patch and while it apparently usually does resolve itself, it can take weeks or longer to do so. I wish the pharmacist had told us about this, because I guarantee my wife would never have gone near the patch if she's know the side effects could be this bad.

Strangely, even with all this, the doctors she's seen dismiss the idea of Scopolamine withdrawal without even considering it. I believe this is another example of the arrogance and lack of attention -and caring- that's become so much a reality of our medical system. She's got an appointment with a specialist in early March and hopefully he won't be so arrogant that he dismisses something with so much evidence behind it.

I really hope both you and my wife get better soon, and I'm very curious to see if anyone with a medical background responds to your post. Good luck to you.

[Jeanie37215]

Hi Gina.  I am currently experiencing the same thing you are.  I went on a 7 day cruise, used the trans-derm scop patch, replacing it every 3 days.  After I got home, I left my last patch on one week (as suggested by my PCP).  Twenty-four hours after removal, I was nauseaous and dizzy and had a terrible headache.  After 3 days of this, and at the recommendation of my PCP, I put on another patch and within a few hours starting feeling fine.  That lasted about one week and am now going through the same symptoms.  I have just put on another patch, but am terrified that this is not ever going to get better.  I know that it is withdrawal from the scop and not inner ear or infections or others. What have others done when going through this?  Do I need to tell my work that I need 3 or 4 weeks off, and just bear through this horrible situation?  Someone must have better suggestions than to just grin and bear it... because it's unbearable.

[FredJL]

Hi Gina,

It is definitely from the scopolamine. I have been on 16 cruises and everytime I have stopped the scopolamine I have the same symptoms of extreme fatigue. The first 24 hours after I stopped the medication there was no problem, but when I awoke the next day I was really out of it. I do not suffere from the nausea or headache that you have encountered. It usually subsides after about 6 weeks. I have done extensive research on this and there is a syndrome known as mal debarquement that has the exact symptoms. Someohow it must be related to the inner ear from the fluid. The scopolamine does the job of calming this down to prevent motion sickness, but when it is no longer in the system is when the issues present themselves. From what I have found there is no known cure. People tell me, "just don't go on any more cruises"!

[jeff0001]

Hi Gina.

I tried posting a longer reply a minute ago, but it didn't work so I'm trying it again.

Long story short, the Ear, Nose and Throat specialist my wife finally got to see was also unable to find a cause for her illness. Everyone seems mystified as to the original cause but I still strongly believe it was the scop patch. We're waiting for an MRI to see if that will find something that the doctors and the x-ray have missed, just to make sure that she doesn't have a tumor or blood clot, or anything like that.

Here's the good news: the specialist confirmed that there was no hearing loss or physical damage to her ear. He recommened vestibular rehabilitation physiotherapy, which she started a few days later. What he said was that no matter what caused the problem, you still need to retrain your inner ear so it works right. It's been about a month and a half since she started, and there has been very significant improvement. It was quite tough on her at first but at this point she has very few dizzy spells, and when they hit they're shorter and not as intense. Her nausea is completely gone as well. We're hopeful that she'll be back to work in a couple of weeks and a complete recovery in the next few months seems likely.

If you're still sick, Gina (and everyone else), I'd strongly recommend finding a vestibular rehabilitation therapist in your area.

Good luck.

[Step1260]

Thank God, I have found this forum.

I also experience the same symptoms after using the scopolamine patches i.e. nausea, fatigue and feel depress. I was on a 11 night cruise and applied a total of 3 patches with a one day break on day 6 of our cruise. It has worked well for me during the cruise but I now regret that I have used these patches as I feel terrible now

[jeff0001]

Just a short update: after a few weeks of physiotherapy, my wife's symptoms are completely gone and she is back to her old self. She had a CAT scan -not an MRI- which was also negative. Bottom line, there was no physical cause for her sickness that could be found so we still believe strongly that the scopolomine patch is what caused all of her problems. Anytime the subject comes up, we warn people away from it because of what it did to her. At the end of the day, we're just happy she recovered.

Step1260, if your symptoms don't resolve themselves in a few weeks then I'd highly recommend finding a vestibular rehabilitation therapist.

Good luck!

[Dorene64]

I just returned from Asia, having used the patch for 3 weeks.  After removal, I went through the same hell after the 24 hours as others have described.  My doctor has no idea how to help, and checked with the hospital pharmacist who had no idea either.  I called the company that distributes the patch, and they had no answers.  My doc suggested I put the patch back on, and that alleviated the problem, but what am I in for when this one comes off?  If the manufacturer has no clue, it's time to call the FDA.  

Dorene

[gina111]

The same thing will happen when you take this one off.  I made my own plan for withdrawal of the medication.  I wore the patch fewer and fewer days each time and chose the days I took it off based on when I could afford to be sick.  It took at least a month to get completely off of them.  It took several months for the symptoms to totally abate.  The doctors just don't have a clue that oit happens or what to do about it.  My OB GYN who used it during surgery told me that there was no way that my symptoms were scopalomine related.  Good luck.  It will get better, but it sure is a lousy process.

Gina111

[Mary2008599]

One week ago, I read this webpage, trying to learn all I could about scope withdrawel.  I, too, had used the patch.  I had used it for about four to five weeks.  It started innocently enough, then I noticed getting sick the day after I took it off, so I would put it back on.  I thought I had something wrong with my eyes or ears.  Anyway, after learning more, I suspected I was having withdrawel symptoms from the patch.  Mine would occur about 16 to 18 hours after taking the patch off, and would cause nausea and vomiting.  As all of you have learned, there is very little information out there about what to do to help.  I certainly couldn't allow six weeks to get better (I am a surgeon), and am an hour away from a true "vestibular rehab therapist".  So...I picked Friday, July 11th as the day I'd take the patch off, and planned to go "cold turkey", not quite sure what I'd do if I wasn't better on Monday.  Friday night, after work, I took the patch off.  (I prayed as well, hoping the Lord Jesus would spare me the nausea I had already learned to expect.) Well, He had his reasons, so around 2 PM on Saturday I got sick.  From that point on I was in the bed, getting up to throw up, barely drinking six tablespoons of water in two days.  Sunday night we called a physician friend of ours, asking if he had any ideas.  He graciously went to the hospital and did some research.  He couldn't find much (as we all know), but he suggested I either put the patch back on (just to buy some time) or try high dose meclizine.  I really didn't want to put the patch back on.  I had already given two days of "hell" toward getting off the patch, and I didn't want to have to re-do them.  So I chose plan B.  I was able to get our hospital pharmacy to fill the prescription, and I started meclizine 50 mg every six hours.  (The usual dose is 25 mg three times a day for typical vertigo.)  Guess what!  I was able to go to work on Monday morning after a midnight dose and a six AM dose, and today it is Saturday evening and I am now on 25 mg every 8 hours.  I feel perfectly normal, and have even been 2 or 3 hours late on a dose and had no ill effects, but am too scared to quit the meclizine cold turkey.  We are gradually weaning.  In a day or so, I'll be down to one twice a day, and soon thereafter will be off.  My doctor friend has actually been studying alot about vestibular exercises and their effects on learning in children, so he is my vestibular rehab expert now.  I don't do any structured stuff, but I practice walking a straight line, and tipping my head in varied directions and moving my eyes in varied directions.  I feel fine, and it has been one week since my horrible scope withdrawel symptoms started for the last time.  Good luck to all.  Meclizine (anti-vert) helped me.  I feel that the Lord has helped me through this, taught me alot about how brave folks who take chemo are-imagine facing this kind of misery each time they take chemo!  Hopefully this post will help someone else.  Mary