How to talk to a doctor about tapering and withdrawal? What to expect.

[ChessieCat]

I recently contacted PCCA - Professional Compounding Centers of America after another member had contacted compounding pharmacies in their area and was told that Pristiq could not be compounded (USA).  I am in Australia and have been getting my Pristiq compounded for the last 3 years.

 

I suggest that you contact the pccarx and ask them if your drug can be compounded.  Also mention that your doctor/psychiatrist says that it cannot.  If it is able to be compounded ask them to provide something in writing that you can give to the medical professional.  Also ask for contact details for the pharmacies in your area who can do the compounding.  

 

At least if you get the information from the pccarx you can then tell them that you have it from the horse's mouth that it can be done.

 

I have not provided Ranel's address because it may change in the future if this person leaves the organisation but this is the one I used and you can send it   Subject:   ATTN:  Clinical Compounding Pharmacist

 

customerserviceexternal AT SYMBOL pccarx DOT com

 

I received the following response:

 

Thanks so much for contacting us regarding this.  There are definitely some options on compounding this product [Pristiq] and we are happy to assist a pharmacy with the knowledge on how to do this.  We have many member pharmacies within the state of Washington that are PCCA members and would be able to assist this patient.  Do you know where in Washington State your contact is located?  If you can provide that information I can direct them to a pharmacy that is a PCCA member.  That pharmacy is welcome to contact me through our members only website or by calling customer service and I can assist them with a formulation. 

Thank you and have a wonderful day!

Ranel A. Larsen, Pharm D, RPh | Clinical Compounding Pharmacist

PCCA | 9901 South Wilcrest Dr. | Houston, TX 77099-5132

Ph: 800.331.2498    

Fax: 800.874.5760 | PCD Fax: 713-234-6009

www.pccarx.com

 

[BfromNJ]

1 hour ago, ChessieCat said:

I recently contacted PCCA - Professional Compounding Centers of America after another member had contacted compounding pharmacies in their area and was told that Pristiq could not be compounded (USA).  I am in Australia and have been getting my Pristiq compounded for the last 3 years.

 

I suggest that you contact the pccarx and ask them if your drug can be compounded.  Also mention that your doctor/psychiatrist says that it cannot.  If it is able to be compounded ask them to provide something in writing that you can give to the medical professional.  Also ask for contact details for the pharmacies in your area who can do the compounding.  

 

At least if you get the information from the pccarx you can then tell them that you have it from the horse's mouth that it can be done.

 

I have not provided Ranel's address because it may change in the future if this person leaves the organisation but this is the one I used and you can send it   Subject:   ATTN:  Clinical Compounding Pharmacist

 

customerserviceexternal AT SYMBOL pccarx DOT com

 

I received the following response:

 

Thanks so much for contacting us regarding this.  There are definitely some options on compounding this product [Pristiq] and we are happy to assist a pharmacy with the knowledge on how to do this.  We have many member pharmacies within the state of Washington that are PCCA members and would be able to assist this patient.  Do you know where in Washington State your contact is located?  If you can provide that information I can direct them to a pharmacy that is a PCCA member.  That pharmacy is welcome to contact me through our members only website or by calling customer service and I can assist them with a formulation. 

Thank you and have a wonderful day!

Ranel A. Larsen, Pharm D, RPh | Clinical Compounding Pharmacist

PCCA | 9901 South Wilcrest Dr. | Houston, TX 77099-5132

Ph: 800.331.2498    

Fax: 800.874.5760 | PCD Fax: 713-234-6009

www.pccarx.com

 

It wasn't that they said it can't be,  they weren't willing to even entertain it.  They pretended to not even know what compounding is. 

[ChessieCat]

If you want to get your drug compounded you are going to need to be assertive and/or find another doctor.

 

If you get the information from the pccarx you can present them with it, it in writing, and they won't have any excuse.

[BfromNJ]

19 hours ago, ChessieCat said:

If you want to get your drug compounded you are going to need to be assertive and/or find another doctor.

 

If you get the information from the pccarx you can present them with it, it in writing, and they won't have any excuse.

Well then I suppose I have to find another doctor.   Because those two will not help me.  

[BfromNJ]

Ive hit a roadblock with my regular GP and psych nurse.  I will not be going back to my psych nurse, my last visit was upsetting to say the least.  He would not even answer me when I was speaking with him, just typed away on his computer looking for another me to put me on.  no way.   The way I am feeling, I was not in the frame of mind to argue with him and ive had it with his condescending, invalidating way.  Taking phone calls during my session and texting on his phone.     Nothing I say is taken seriously, just written off as yet more anxiety or my ocd.  So if I cannot find another doctor to help me with a taper, I need to do so myself.   I am frustrating and sick of being on meds that are making my symptoms worse everyday.  I feel that time is running out and I will be like this forever. 

[carefulprayerful]

Not sure if this is the right forum for this.  I haven’t read the whole thing through. 
 

I have a psychiatrist who knows about what I am doing and is collaborative, for which I try to be grateful. (I will ask if I can share her name online.)  I have not told her the full extent of my symptoms yet.  I usually smile and nod to a wide extent. 

I currently get to work from home a couple days a month.  Without the commute and stressful environment, my WD symptoms are much lighter.  
 

I would like to work from home (WFH) more, but this is not really done at my company (except for people that live in other states).  My employer is moving in the direction of more WFH, but there has been no policy change yet.  
 

I was thinking about asking my psychiatrist for a note, but then my employer would know her specialty. 
 

I was thinking maybe I could ask my PCP for a note since he knows about my WD experience (I was actually in the ER recently for fainting for a few seconds and vomiting unconscious.  The ER attributed the vomiting to WD.).
 

When I first started tapering, my psychiatrist said to me when I asked about this, « I don’t think that would help you. ».  Since then of course I have landed in the ER, and I still haven’t fully described to her the list of symptoms I have (mostly physical).  
 

I know someone at another organization who had a baby and simply asked to WFH.  They said yes.  

 

Of course maybe this is all wishful thinking.  

 

I mean the truth is my colleagues would probably ask me why I was working from home more, and it would be awkward. I’d have to make something up. 
 

I guess want to look able bodied and able minded if I can, tho I think I could taper faster if I could WFH.  
 

Any thoughts welcome.  

 

Thank you. 

[Altostrata]

Best not to bring up seeing a psychiatrist with your employer or anyone in your employer's human resources department.

 

Can you ask for more WFH because of covid-19 risks?

[carefulprayerful]

What I actually did one day in January was I simply decided to start working from home.  I took to heart what I had heard, "be the CEO of your own life."  The next day I went to my primary care doctor to ask for a note, which he agreed to write.  My company switched everyone to WFH in March!

 

My primary care doctor said he could write me prescriptions for Lamotrigine so I wouldn't need to go to a psychiatrist.  He said it is not a complicated meditation.  I have enough Risperidone to last a year and a half (before it expires), but I figure I could get that from him, too.

 

I canceled my most recent appointment with my psychiatrist.  I emailed her to say I'd reschedule with no intention of doing that, but she said she would like me to reschedule now.  I don't need her for Rx, but honestly I am considering making one more appointment to present her with academic journal studies, just to speak truth to power in a respectful way.  I think the $100 for the appointment would pay for itself for the fact that I could use my voice.  I think I have Stockholm syndrome, and it is hard for me to speak truth to her because I bear some affection for this person.  

 

Alto, do you think this is worth it?  She has been collaborative in this tapering process, but I think I need to speak the truth in order to feel empowered.  I have found it easier to speak up to a bully than to speak up to authority, but it may be time to grow up in that sense.  With global protests concerning police brutality, I just don't want to be like a sheep.  The money may be a paltry fee for the satisfaction I'd derive.  My psychiatrist is basically a good person, she just made a misguided choice of career.  I can say things in a very non-conflictual way.

[Altostrata]

Save yourself $100. Just mail her the studies with a note that you don't believe her advice has been helpful, though you think she means well.

[carefulprayerful]

@AltostrataThank you for that wording and money-saving tip 😃.  I just sent the letter.  I included copies of the following:

• Book: Anatomy of an Epidemic pp. 194-195 concerning a study by Martin Harrow.  "...here is how the long-term outcomes stacked up, from best to worst: manic-depressive off meds, schizophrenia off meds, manic-depressive on meds, and then schizophrenia on meds."  
• Drug label for Risperidone: "...there are no systematically obtained data to support the use of RISPERDAL in such longer-term treatment (i.e., beyond 3 weeks)."
• Journal article: Effects of 10 to 30 years of lithium treatment on kidney function.  "About one-third of the patients who had taken lithium for 10–29 years had evidence of chronic renal failure but only 5% were in the severe or very severe category." 
• Journal article: Schizophrenia, neuroleptic medication Schizophrenia, neuroleptic medication and mortality and mortality.  "Irrespective of chronic somatic diseases. Irrespective of the factors modelled, the relationship the factors modelled, the relationship between number of neuroleptic drugs and between number of neuroleptic drugs and mortality remained strong and statistically mortality remained strong and statistically significant….Obviously there are other factors associated Obviously there are other factors associated with mortality in schizophrenia and the with mortality in schizophrenia and the association with neuroleptic drugs was very association with neuroleptic drugs was very clear."
• Journal article: Congruencies in Increased Mortality Rates, Years of Potential Life Lost, and Causes of Death Among Public Mental Health Clients in Eight States.  "Deceased public mental health clients had lost decades of potential years of life; averages varied from 13 to more than 30 years depending on the state and year...Most public mental health clients died of natural causes in all six states. The leading causes of death for mental health clients are similar to those found nationwide and statewide; they include heart disease, cancer, and cerebrovascular, respiratory, and lung diseases."
• Journal article: Predicting the long-term risk of tardive dyskenesia in outpatients maintained on neuroleptic medications.  "Results: On the basis of 5 years of follow-up, we estimate the risk of persistent TD to be 32% after 5 years of neuroleptic exposure (95% confidence interval [CI] = 23%-43%), 57% after 15 years of exposure (95% CI = 47%-66%), and 68% after 25 years of exposure (95% CI = 58%-77%). For patients with 10 years of previous neuroleptic exposure, the risk is 15% after 5 more years of exposure (95% CI = 7.2%-27%) and 38% after 15 more years of exposure (95% CI = 24%-53%). Our results fall within the wide range of results found in other studies of TD incidence. Differences in incidence across studies may be explained in terms of patient characteristics and other methodological factors."
• Book: Psychiatric Drug Withdrawal by Peter Breggin. pp. 120, 124, 125, 127. 
• News article: The Impoverishment of Psychiatric Knowledge.  The Psychiatric Times. (entire article)

I found all the studies online without membership to any database.  I sent the cover page of the book or first page of the article, along with the selected pages where I underlined the above quotes.  

 

Putting together the letter and enclosures brought up some sadness and bitter feelings.  I just got back from the post office, however, and I feel free.

[Glosmom]

Way to go @carefulprayerful!!  Proud of you and what a good list of evidence.   Hugs, glosmom

 

 

[Altostrata]

5 hours ago, carefulprayerful said:

I just got back from the post office, however, and I feel free.

 

Consider it a closure ritual.

 

I'll bet she'll love the reading matter.

 

How are you feeling now that you're on a minimal dose of risperidone? (It could get more minimal, of course.)

[carefulprayerful]

Thanks @Glosmomfor the encouragement!  💛

 

On 6/20/2020 at 9:34 PM, Altostrata said:

How are you feeling now that you're on a minimal dose of risperidone? (It could get more minimal, of course.)

I am feeling much better.  Things that used to cause a wave--exercise, having to get up early for something and not getting a full night's sleep, my menstrual cycle--no longer have much effect.  I rarely have symptoms, and when I do, they are mild and momentary (abdominal pain, stomach ache, headache, ears ringing, muscle tension).  I feel almost normal.  I'm so grateful to be writing that. Current dose is 0.185 mg risperidone.  I am currently microtapering for a total of 10%/month.  I'm not sure when to start tapering at a faster rate.

[madmert9]

Most of you are luckier than me. I was given Sertraline + Aripiprazole since the beginning of my treatment.I have never got the chance of using antidepressants alone.I always trusted my doctor and I'm feeling betrayed now for sure.I still can't understand what the reason was for using an antipsychotic in my treatment plan.Maybe it was just about money.You know abilify was a money maker for most doctors.

 

The problem is, I didn't even know what withdrawal was. When I stopped taking both of them I didn't feel anything bad.But after a few months I was left with mania.And the next year the same thing has happened to me one more time.Of course my doctor didn't say that It was about withdrawal.First he prescribed me an antipsychotic and after I used it for 5 years when I decided to come off it I had a manic attack.Even if the same pattern has occured 2 times, my doctor didn't say anything about withdrawal.

 

I was trapped because of abilify and they always behaved me like I was bipolar.My reason to go to a psychiatrist was not related to psychosis or mania.I was just a little bit obsessed with some kind of thoughts.

 

Tomorrow I'm gonna talk to him about this.And I will sue him because of the things which he did.I'm alone on this road.My family doesn't support me in this process at all.

Wish me luck

[ChessieCat]

 

This has been added to Post #1 of this topic:

 

You can PRINT OUT the "Stopping antidepressants" leaflet:

 

48 minutes ago, Shep said:

 

From CEPUK, 9/24/2020:

 

Major milestone: Royal College releases new guidance on stopping antidepressants

 

And here is the leaflet from Royal College of Psychiatry website: 

 

Stopping antidepressants

 

Might be useful to print out and take to doctors ignorant of withdrawal. May also be helpful for helping family members understand. 

 

 

[ccfb]

My 2 cents:

 

You are the patient ("client").  Physicians answer to you.  You don't answer to them.  If a doctor gives you advice that doesn't make sense or refuses to cooperate with a slow taper (i.e. "cut the pill in half," "liquid taper is unnecessary," etc.), respectfully find a second opinion.  You can always fire a doctor. 

 

You must have a physician though—would strongly advise against "going it alone."  

 

As for how to talk to doctors, I would suggest the following:

 

(1) Relentlessly educate yourself about your issues (peer support online, G Scholar, Pub Med, Examine, etc.), then confidently ask difficult questions. 

 

Don't assume the "white coat" comes with superpowers. 

 

A great many doctors are not too bright or informed about particular issues.  Doctors don't know everything, and they are expected to do a lot.  If you "become [an expert] on the thing that is threatening you," you will know what pointed questions to ask.

 

(2) I would suggest against trying to convince a treating physician about the existence of a systemic problem like "antidepressant" withdrawal.  (Others may disagree.)

 

For a physician, it's much easier to dismiss one patient, than to face the cognitive dissonance of having unknowingly prescribed harmful or addictive substances for many years.  

 

A better approach from my experience is to communicate that you yourself are extremely sensitive to medications and dose changes.  (After all, this is the truth.)  Listen to what your body is telling you.  If you react strongly to a dose change, that's probably a sign that something in your body isn't going the way that it should be going.  Communicate that.

 

If you can form a good relationship with a doctor over time (formed on trust and knowledge of goals), you will be better off.  The doctor will know the effect of a dose change on you based on how you were last month, last year, etc.

 

(3) The advice on this site about tapering gradually and avoiding impatience is solid.  This can play into your relationship with doctors.

 

If you change "antidepressant" doses too quickly, there is a chance that you may become temporarily emotionally unstable, which is a bad place to be.  Reinstatement after dramatic dose reductions is unpredictable, can cause awful side effects, and sometimes does not work at all.

 

If you consult an ill-informed doctor with whom you do not have a good relationship after a too-rapid dose reduction, he or she may simply suggest that you go on another medication.  In a bad place, you may make bad decisions out of desperation.  This can set you back.

 

From my personal experience, it's better to remain in a stable place, reduce symptoms, remain as healthy & productive as you possibly can, and allow the "antidepressant taper" part of your life to fade in the background.  Again, from my own experience, the withdrawal symptoms are really not too bad if you don't rush it.  If you do—then, yeah... it's bad.

 

 

 

[GNz11]

Hi!

 

I've just talked to my psychiatrist about my experience with Lithium withdrawal and I have to say that she was 'skeptic' to say the least. I tried not to bring up the fact that I want to get off setraline too, some day in the future, after Lithium taper, and to smile, act in control etc... It didn't help in really persuading her, but at least she agreed to help me get the right dosage for my taper.

 

Now I'm collecting all the references to the scientific articles about withdrawal syndrome in one document (the dedicated session of the forum was very helpful!!) and I plan to email them to her.

I was thinking that maybe it could be helpful for many others to have a unique "pamphlet" with all the major studies and articles all together, specifically dedicated to Psychiatrist 

If any of the administrators is interested, I can send it to you, you can double check / add whatever I may have forgot and post it for everyone use.

[Leila]

Ehi @GNz11! It's a good idea! It could help me too! Thanks!

Edited December 16, 2020 by Shep
updated to reflect new username of tagged member

[GNz11]

1 hour ago, Leila said:

Ehi @GNz11! It's a good idea! It could help me too! Thanks!

 @Leila sure, I'll send you the document I've prepared. L'unione fa la forza!!! 💚

Edited December 16, 2020 by Shep
updated with new username in quote box

[getofflex]

This short video explains common attitudes of doctors, and why they tend to dismiss WD.  

 

https://www.youtube.com/watch?v=UCPNC2a_oyg&t=253s

[ChessieCat]

I cannot find a doctor to support me tapering off my drug/s

 

Hopefully this will help someone who doesn't have a supportive doctor.  I wrote this to a member recently but thought it would be a good idea to add it here:

 

  

On 10/3/2021 at 9:43 AM, ChessieCat said:

 

BUT that doesn't mean that you are not able to reduce or get off your drugs.  There are many members here who are in a similar situation who have managed to get off their drugs without a good doctor or the support of a doctor.  All that is needed is to be able to get the prescriptions for your drugs.  The doctor does not need to know what dose you are taking of the drugs, unless you are getting an injection.

 

And I think it is time for you to start doing what is best for you and your health.  You are the one who is taking drugs, not the doctor.  It is you and your body and health that are being affected by what you are taking, not the doctor.

 

...

 

There are some things that we do not have control over and for you, having a bad doctor is not in your control.  However, you do have control over what you do with the drugs you take.

 

 

[buggedout]

On 10/26/2021 at 3:29 PM, ChessieCat said:

I cannot find a doctor to support me tapering off my drug/s

 

Hopefully this will help someone who doesn't have a supportive doctor.  I wrote this to a member recently but thought it would be a good idea to add it here:

 

  

 

 

This is pretty much where I am at now.

 

I used to have a really good naturopath and she had no problem prescribing me the highest dose of Effexor XR (so that the capsule would go further) with the instructions "take as per weaning schedule."

 

Unfortunately, I also worked for her and my employment came to an abrupt end due to a conflict with someone else at the clinic. So it was too awkward for me to continue seeing her and I had to find a new doctor.

 

My new doctor would not prescribe me Effexor XR at all! She said it is not recommended to open the capsules -- that was her reasoning. I explained to her that I have been doing this for years and am well aware of what I am doing. The only thing she was willing to do is to have me switch to the tablet and have me cut them.

 

That wasn't going to work for me. I have no idea how the dosing would work if I switched to tablet and I don't even think I can get a tablet in brand name (generic makes me sick).

 

So I had to yet again find another doctor which I finally did last week. I wasn't going to mention anything about weaning to him, but they already had it in my record because I went to their walk-in clinic last year and made the mistake of mentioning it then. Ugh. But the doctor and I decided that he would prescribe me 37.5's and his plan is for me to go up to 37.5 since I told him it is inconvenient to make up the pills and I am tired of doing it (which is true lol).

 

But I don't plan to go up to 37.5 lol. I hate that I have to be dishonest. But from now on, no matter what clinic I go to, or who I see, I am going to keep it on record that I take 37.5 and not mention anything about weaning ever again.

 

I swear that these medications and the system in general is designed to keep people dependent on them.

[Faure]

My GP practice contacted me out of the blue to say they need to review my medication. I went into something of a spin because the nice GP, who I felt supported my decisions, left.  Anyway in researching for my review I found the NICE guidelines for anti depressants and other dependence forming drugs published in April 2022. In good time for my review!  I will print the relevant pages and have them ready for my phone conversation. Hopefully he will have read them too, hence the review. Lots of positives in there to support what we are doing here:

 

https://www.nice.org.uk/guidance/NG215

 

Near the top of the page, to the right of Guidance, is the option to download the document ☺️
 

The guidance also talks about sign posting people to peer support. I will be interested to see if he knows about SA. 

 

@Altostratahave you seen these? I guess you might have as you may have contributed - thank you so much for all you do ❤️

 

 

Edited September 25, 2022 by Faure

[Altostrata]

Yes, I commented extensively on both NICE guideline updates.

 

They do not mention any specific peer support organizations, but there are several charities in the UK for this.

[JandD]

The following situation:

My wife is receiving Olanzapine (10 + 7.5mg tablets - current dose 10.1mg) and Mirtazapine (30mg tablets - current dose 30mg). The package lasts for 28 days. Usually we could pick up the tablets 5 days before the end of the last dose. Doctors and nurse know that we are very careful reducing the Olanzapine. They feel this is unnecessary and excessive and recommended a reduction from 20mg to 15mg in the beginning.
 

In the last 6 months, the pharmacy told us on two occasions (out of six), that on the prescription it says, that picking up medication would only be possible 3 days later, 2 days before the last dose is used up. This was an unpleasant situation at the pharmacy and stress for my wife.
 

We therefore described the situation to the Community Mental Health Nurse at a meeting and asked her to be able to pick up the medication already two weeks before expiration, since the taking of the medication should not be interrupted in any case and this means stress for my wife. We have now received the answer: "Although I understand your anxieties around wanting to collect medication in advance, the most we can do is by a couple of days. We are unable to prescribe medication to be collected two weeks in advance for safety reasons."
I honestly cannot comprehend this. The medications are stored safely and whether we have a 28 day dose or a 42 day dose there now makes no difference to me. We live in a place which has very similar guidelines like the UK / NHS. 
 

Is it normal to only have such a short buffer of about 5 days of medication? I definitely have concerns also about supply shortages or sudden changes to the amount of medication by the doctors. 

(yes due to reductions we have a buffer of several weeks on Olanzapine. With Mirtazapine there are only 5 extra daily doses (5x30mg) which were once too much in the package due to an error at the pharmacy....).

[concerned]

15 hours ago, JandD said:

Is it normal to only have such a short buffer of about 5 days of medication? I definitely have concerns also about supply shortages or sudden changes to the amount of medication by the doctors.

 

On several occasions, I have been able to pick up medications early if I purchased them without insurance, using GoodRx instead. Likewise, if you were to "lose" your prescription somehow, you could request a refill and purchase it with GoodRx, without insurance getting involved. Since your medications are not controlled, you wouldn't have to involve your prescriber, only the pharmacy. 

 

Here is an excerpt from GoodRx's [website]: "If the "refill too soon" roadblock means that your insurer is unwilling to provide coverage, check goodrx.com for a coupon to lower your out-of-pocket cost. This is a good short-term solution if you need your emergency refill today and your insurer will not cover it."

 

I hope this helps!

 

 

[JandD]

Thanks "concerned" for your answer, but it is not helping in my case. GoodRx`s is only available in the US. In our case the medication is paid by the country. So we need (have) a rolling prescription from a doctor. 

My question is mainly, how long is your reserve to the last dose and is it normal that it may only be 4-5 days according to the nurse due to safety concerns (Olanzapine & Mirtazapine)?!

[concerned]

I apologize. I wrongly assumed you were from Channel Islands, California. I need to brush up on my geography. 

 

In my limited experience, four to five days seems normal to me. 

 

Assuming I use insurance, I can pick up a prescription two or three days before my last dose, maybe earlier. I've never really tested the limit on this. Concerning the nurse's safety claims, I have no idea. In the United States, olanzapine and mirtazapine are not controlled substances. The restriction on early refills may have more to do with insurance companies (or your country, for example) saving money on their end by not paying for patients to have a surplus of medication. I'm sorry I couldn't be of any more help. Someone else may clarify this issue. 

[Faure]

Hi, I am in the UK and saw your post yesterday but didn’t really know what to say. I can’t say that I have anything to add other than a few thoughts. I’ve looked up Olanzepine and see it is an anti psychotic (rather than a benzo which might be more understandable if they didn’t want to issue those early). So I can’t see why they would object to you wanting a two week buffer in stock.

 

If it were me I’d speak to the actual GP and calmly make your request. I had a medication review recently when my GP reduced my script from a 56 day supply to 28 because I’m now on 1/3 of my original dose.  When I thought about it I wrote to ask for the 56 day to be reinstated as my usual brand is not being supplied at the moment and I’m probably going to have to switch brands. I’d rather not have to switch more often than necessary. He wrote back to say he was happy to reinstate 56 days (this will last almost a year I think and l’ll probably order quite soon again to stock up on the same brand while it’s available). Anyway, the point is I spoke to my GP and he acquiesced to my request. So it may be worth trying. 

 

As for them not being happy about your slow (sensible) taper you might want to share with them the new guidelines from the Royal College of Psychiatrists which follows exactly the 10% recommended here (although perhaps prioritise getting your script sorted first).  I can’t believe your GP would agree it is necessary to cause your wife anxiety because of no buffer of her meds.  Be very careful not to get emotional during any conversation. Calm reason works best. Any sense of emotion and they will think you’re unwell / unstable. 
 

One final thought is that since all these supply chain issues started I think pharmacies have been told to tighten up on issuing scripts early. I had an issue with this with something else….this might also be influencing things. 
 

Good luck and let us know how you get on. 

[Katy398]

What about Protracted Withdrawal. How can we help the medical profession understand that a miss-managed taper can lead to years of suffering? 

[Peter23]

How can you get your doctor to believe that you have protracted antidepressant withdrawal if you are still suffering 2 years after stopping antidepressants? 

[Catina7]

Angie Peacock, a psychiatric survivor and tapering coach, just released a letter she wrote that you can share with your doctor and/or therapist about tapering and withdrawal.  I hope this will assist those of you who are having a difficult time talking to your providers about psychiatric drug withdrawal.  

 

Letter for Doctor/Therapist (Google Docs)

[Gumtree]

Anyone done a bridge from Cymbalta to Zoloft?

I’m in Australia and seeing my general doctor next week to discuss my taper off Cymbalta. The Dr is aware I’m doing a taper but isn’t very knowledgeable about pace or relapse/withdrawal symptoms and I’m concerned they don’t have any experience in bridging medication. I’m in a reasonably remote area of Australia so it’s not like I have a lot of Drs to choose from, without flying interstate.

Has anyone done this path rather than to Prozac? 
My reason is I was on Zoloft before I was switched to Cymbalta, so I’d rather bridge to something I know as I had no issues with it.

 

Ive been doing a microtaper and and super sensitive to changes/drops. Currently at about 30mg Cymbalta.

 

Can bridging offset some of the w/d symptoms? (I really really want to get off C)

Might i be better doing a bridge when I’m at 20mg Cymbalta?