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

[Andm9478]

How long did it take for the symptoms to go away and what helped

[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

[Casey08]

WoW!  I am so appreciative for all of you that have posted these comments, as yesterday began my first withdrawal (unbeknownst to me why I was feeling SO LOUSY) just about 24 hours after taking off the patch.  I began using it July 2nd preventative for surgery and have continued to take it along with Zofran 4 mg. to 8 mg on an as-needed basis to keep my nausea at bay from narcotic pain meds, et. al.  A physician (Family Practice) friend stopped by last night and assessed me with likely having withdrawal symptoms from the patch.  After reading all that you each have written, I am optimistic that his diagnosis was right on target.  I will share with you his suggestion:  Put the patch back on and in 72 hours at the change, cut the patch in 1/2 and supplement with the Zofran as needed.  (I have 12.5 mgs. of Meclizine but that makes my head too foggy relative to my cognitive ability).  After weaning from the 1/2, he suggested that I wean down to 1/4 of the patch and wean off using the Zofran (VERY EXPENSIVE BUT NO SIDE EFFECTS!).  As I do not begin the weaning process until Sunday when it time to make the 72 hour change, I don't have the answers to whether it will work but I am hopeful and his suggestions sound reasonable.  Good luck to you all and I will do a final post to let you know how I made out, as vomiting after a triple hernia repair is not top on my list of priorities, not to mention that I would like to get back to work!

[Casey08]

IMPORTANT ADDENDUM!!!  Despite the idea to cut the patch in 1/2 - DO NOT DO THIS!  The pharmacy just indicated that to do so could release too much medication too fast!!  

So, the idea of weaning with Meclizine and/or Zofran are apparently the ONLY way to go to reduce suffering.

DO NOT CUT THE PATCH in 1/2.  Great idea in theory but not medically safe!!!

[Mary2008599]

I wanted to let you all know that I am completely well!  I am off meclizine, totally symptom free.  I cannot tell you the freedom I feel.  After trying several times to stop the patch, only to put it back on for the debilitating nausea I would feel after about 18 hours, my pain-free cessation with the use of meclizine was wonderful.  Two weeks ago today I took the patch off.  Yes, I had a miserable Saturday and Sunday until my doctor friend advised the Meclizine.  But once I started that medication, I had no further symptoms and by weaning the meclizine I believe my vestibular system had time to gradually rehabilitate.  So...our wean was Meclizine 50 mg every six hours for 72 hours, then 25 mg every six hours for 72 hours, 25 mg every 8 hours for 72 hours, 25 mg every 12 hours for two days, then off.  The dose of 25 mg every 12 hours the last two days was probably more for my own peace of mind, as actually I was probably med free for several hours between doses (and felt fine), but was leary of quitting (after that horrible weekend when I quit the scope patch for the last time).  I am a physician myself, and although the idea of tapering the scope sounds good, I would not recommend it for reasons already given.  Other folks had suggested that when I was looking for advice, but I did not try it.  Good luck!  Mary

[Casey08]

Mary,

I have taken your "taper routine" and copied it for my physician to review.  My question to you is this:  how well did you manage (cognitively speaking) on the 50 mg. of meclizine?  Any side effects?

[Mary2008599]

I was pretty good.  I felt a tiny bit mellow, or slow, but not much.  I did note that I slept well when I put my head down at night, and it was easy to oversleep a few extra minutes.  I was not sleepy during the day, though.  Granted 50 mg every six hours is a high dose, but at the time I was SO sick, that my doc and I just picked that dose out of the air in an effort to get me upright and functioning.  It is very possible I could have done as well with a slightly lower dose to start.  I don't know.  After being so ill for two days straight, not taking in any oral liquids, etc. I was frantic.  I was scheduled to do surgery on that Monday, and the patient wouldn't let anyone else do her cancer surgery.  I sure didn't want to make her wait either, as it was a cancer procedure.  And I did not want to put the patch back on...so....  It all worked out very well.  My patient did great, I am cured, and hopefully you will do as well.  I do feel the two week taper helped me, since my vestibular system recovered during that time.  
The standard dose for Meclizine is 25 mg three times a day, which is the dose for folks who suffer from Meniere's disease,  so your doc might want to put you on a little higher dose.  You may need to wait till you are completely off the Scope patch (i.e. starting to feel sick) before you start the meclizine.  I don't know how it would be to take the meclizine while still having the scope in your system.  Meclizine is a form of anti-histamine, hence it might make you sleepy at the higher dose.  I didn't have much trouble with that, however.  Good luck, and let me know how it goes.  Mary

[Casey08]

Amazingly, it took just a little over a week and today was the first day I woke up "feeling myself" bright and early.  I am a light weight when it comes to taking medications and my vestibular system has has it's issues over the years so we did the 25 mg. taper dose using the 12.5 of Meclizine to reduce to and cut the time in half ... and thankfully, it worked like a charm!  I can tell you, it wasn't an easy withdrawal but it was successful!  The one thing I did do was take the meclizine within 18 hours of taking off the patch and used it in combination with the Zofran to avoid feeling sick.  It worked and I so VERY MUCH appreciate your input, guidance and support.  Casey

[Mary2008599]

I am so happy for you, that you are "free" of the curse of the scope patch.  My doc may write my experience up to report in the medical literature, since there isn't much out there for folks who are having problems getting off the patch.  I know I will never, ever, use the patch again.  Mary

[no_more_patch_for_me]

Long story, short…DO NOT EVER USE THE SCOPOLAMINE PATCH!!!!!  

But to the long story...

I was “addicted” to it for almost 4 months.  I do not have an addictive personality.  I don’t smoke, rarely drink.  This patch was HORRIBLE.  I used it for motion sickness while traveling only to realize the withdrawals were tenfold.  I went to remove it, 24 hours later was vomiting and nauseated beyond belief.  The only relief came via placing another patch on.  All withdrawals were gone within 2-3 hours.  Life was back to “normal”.  Replay that for 4 months.  I was in the middle of moving cross country from east coast to west, down one end of that coast and back up again and did not have time to lie up in bed and deal with the DT’s.

I purchased several packages of Meclizine and set a date after researching and discussing it with my Dr.  I TALKED IT OVER WITH MY DOCTOR BEFORE STARTING AS SHOULD YOU.  You can buy Meclizine over the counter, you don’t need a rx.  Fairly cheap, $4 a box for the generic brand.

I placed my last patch on Thursday evening, Sept. 11, 2008.  I wore it until Monday September 15, 2008.  Tuesday afternoon I fell a couple hours short of avoiding the vomiting, taking 25mg of Meclizine a little too late (about 45 min. prior to “episode”).

Immediately after recouping myself I took another 25mg out of fear I had “removed” the previous dose from my body.  (totaled 50mg)
It made me fairly drowsy (I have a decent tolerance) for the rest of that afternoon.  I slept most of it.  But I had no more issues with nausea or vomiting from there on out.

I continued with 50mg doses every 6 hours for 3 days.  By Friday September 19, 2008 I was spreading my doses to every 12 hours without realizing it.

By Monday September 22, 2008 I was down to 25 mg (half of starting dose) every 12 hours.  

2 days later…on the 24th, I WAS DONE WITH ALL MECLIZINE!!!!!!
I avoided driving the first couple days but was out and about with no issues thereafter.  I was not as drowsy either.  I did not suffer any serious vertigo, only when I moved my head too fast.  I had no issues walking or operating a normal routine.  NO ISSUES.

I am one day short of being free of all things motion sickness related and could not feel better.  Total I did a little over a week of the Meclizine after letting my last patch run 4 days.  I will NEVER place that patch on my body again.  

I have my leftover patches in my purse so I can take them to the pharmacy so they can dispose of them properly.  Don’t just throw them out.  If someone comes across them in the trash it could prove fatal.  A lot of addicts who find patches place them under their tongues for quicker absorption and they can overdose and die.

Please, believe that there is a way off this patch.  I was so scared of the after affects that I had experienced several times; swearing I would just “bear through it” that I kept it on for months.  I have never had such retching experiences in my life.  It is beyond brutal.  Meclizine worked wonders for me and I thank Mary2008599 soooooooooooooooo much for her input and strategy.  A variation of it worked for me and I am so relieved.  You can get off of it.  

Imagine that, being addicted to something not for the euphoria, but to prevent vomiting so profusely that you swear your appendix just found its way up.  Seriously, I never imagined how bad it would be.  The pamphlet was far from accurate.  FAR.

*no more patch for me*

[didpt]

Many of you say your doctors were not aware of this possible adverse reaction to scopolamine.  I suggest you file a report online to the FDA through Medwatch.  If the manufacturer and FDA aren't notified, there will never be any research into this side effect.  Without research there will never be anything in the literature to make doctors aware of it.

[KYDRB]

I too have had the same horrible experience with the patch. Unfortunately I ended up in the ER because I had put a new patch on one night (after having SEVERE withdrawal symptoms and having my Dr. tell me to put it back on) and then taking it off the next day to get an MRI and then putting a new one back on after that. My husband had to call 911 because I was shaking, having trouble breathing, dizzy, EXTREME dry mouth and heart palpitations. It ended up I had an overdoes of the medication in my body. I was admitted into the hospital to have them help me through the withdrawal. I was put on phenergan to control the nausea and ativan to control the anxiety and shakiness. I was in the hospital for 2-1/2 days but even after being out for about 2 weeks I still have slight dizziness and anxiety. The dizziness it getting better each day and I think some of my anxiety it due to all that has happened, but I will NEVER use that patch again and am being sure to tell as many people about it so they never use it either. I have gone on the FDA website and reported it to to them. I am glad to see that each of you had been able to get off this horrible patch as well.

[pigeon809]

Thanks to everyone for their patch withdrawal stories. I am on day 2 of using the meclazine to get off this patch. I used it for surgery then when I got sick after taking it of they put another on. If I had not found this site when I got home I would still be retching from taking off the second one. Why don't they tell you this is a possible side effect????? I thought I had the flu, then food poisoning etc.

Will I start feeling less ill as the days go by until the end? Was there a "turnaround day" midpoint or anythng?  It seems so far off right now. I just want to feel better!!! Surgery is bad enough without dealing with this!!!

[catblues]

I took the patch off at night after 9 days and the next morning I couldn't think straight.  After 5 days of major depression and some anxiety I went to the MD and got tranquilizers and antidepressant.  Changed antidepressant after 4 wks. because of side effects,  and now on another.   Never had this feeling before.  Now it's 5 wks.  Got a counselor and psychiatrist for meds.  He never heard of scopolamine.  My question:

Could this be from the patch???  I'd love to go off the antidepressant, which may be starting to work now, but still with side effects of not sleeping well at all and tired, apathetic, sleepy in the day.  Hard to make myself do anything.

[MommyTracy]

Reading all of this scares me! I am a little over 17 weeks pregnant. The first time I had to go to the ER (been 3 times already) the doctor perscribed me Reglan and Scop patch. Yes I must admit it was a relief. But, when I ran out of Scop patch I got so sick I wound up back in the ER and begging for more patches to my OBGYN. He was very hesitant about giving them to me but, knowing my history he did indeed allow me to go back on them. Fast forward to Thursday. I was running out of my patches once again and wound up in ER. This time getting a dose of Zofran in my iv. That was an almost immediately relief. The ER doctor prescribed me Phenergan Suppositories and I am using them and I was past the 72 hour mark with my patch by almost a day so I took that patch off. Not even an hour later (this being TONIGHT and thus the reason I am here) I started to get that "feeling" again. Being that I have 3 children to take care of and a home to run I reluctantly put another patch on. Sigh I am so worried now. I don't want anything happening to my unborn child and I am so afraid that I am now the victim of the withdrawal symptoms you all are talking about and the ones I have experienced. Violent Emesis and not  being able to lift my head from my pillow. I simply CAN NOT be sick. My children and husband rely on me to be able to run the house hold. I have not drove our vehicle anywhere because I have just felt so dizzy and afraid that I would cause a wreck. I am so tired of this and I just want to function like a normal human being. I have even cried in my husband's arms over this. Ugh! I just hope and pray my baby is ok from this and I have not done any damage to him/her. I will be absolutely devastated and angry at myself!

[VertiCide]

I have been wearing the TDS patch for more than a Month (changing every 3 days).

It has done wonders in helping my "Acute Vertigo"

NOW -- I am deathly afraid to Stop using it !!

I hear stories of Major Withdrawals and I don't know if I should try to go to a detox in hospital, just in case, or what.

I really feel helpless.

P.S. -- No other Pill or Exercise has Relieved my Vertigo, as the TD-SCOP Patch.

Any else done this ? ... or have Feedback -- Thank you so Much.

[Mary2008599]

You can read my entries above, along with several others.  My opinion--you need to get off the patch.  Taking meclizine helped me and several others.  No nausea, no vertigo, and after a few days...no need for any meds.  Of course, check with your OB as far as safety of meclizine during pregnancy before you start.  Since taking the patch "tricks" the vestibular apparatus in the ear, when you get off the patch your ear has to re-train...thus the dizziness, vertigo, etc.  You experience the motion sickness without the motion!  I would be afraid that a baby would have the same "tricks" happening to his/her ear while the scopalamine patch is on you.  I wonder how it would affect a baby's sense of balance, positioning of head, etc.  Probably not alot as they don't do much balancing at first.  But would your baby go through the same detox after birth?  I suspect it would.  So, the sooner you get off, the better.  Just my opinion.  Best of luck.  

Oh, by the way, I did send a note to the FDA, but never heard anything.  Mary