ViolinStudent: Tinnitus - Withdrawal Symptom?

[ViolinStudent]

On 12/21/2019 at 1:20 AM, Gridley said:

This doesn't make a lot of sense to me. The Seroxat wasn't preventing the tinnitus.   You didn't have tinnitus at all until you reduced by 50%. (Also the skipping doses on those three days exacerbated the situation, since that was a further 50% reduction each day.)  The dose reduction didn't cause your tinnitus to "sound louder." The reduction created the tinnitus as a symptom of withdrawal.

 

Regarding informing your doctor, that is a complicated situation.  As I said in my earlier post, doctors have no understanding of withdrawal (they don't believe it exists) or safe tapering.  (Your GP's analysis of the cause of your tinnitus doesn't inspire confidence.) Some members don't tell their doctors about their tapering and just use their doctor as a drug source.  Others tell their doctors and receive no help or active opposition to the 10% taper (since they've been taught there's no such thing as withdrawal and thus no need to taper slowly).  These doctors invariably try to convince their patients to taper dangerously quickly. Other patients receive cooperation if not understanding or useful advice.  Obviously, this latter arrangement is the preferable one.  

 

Of some help may be the fact that the United Kingdom's medical treatment arbiter National Institute for Health and Care Excellence (NICE) just revised its guidelines for the use of antidepressants, changing the 2009 guidelines stating withdrawal symptoms were usually "mild" and

"self-limiting " over a week.  The new guideline highlights the possibility of "severe" and long lasting withdrawal symptoms.

 

You might print out this article from the UK's Royal Pharmaceutical Society journal for your doctor, highlighting the relevant portions..

 

https://www.pharmaceutical-journal.com/news-and-analysis/news/nice-amends-depression-guideline-highlighting-severe-and-long-lasting-withdrawal-symptoms/20207226.article

 

Here's a synopsis.
 

  Quote

 

NICE amends depression guideline highlighting 'severe' and long-lasting withdrawal symptoms

 

The Pharmaceutical Journal 22 OCT 2019 By Julia Robinson

 

The National Institute for Health and Care Excellence (NICE) has amended its guidelines on depression in adults to highlight that antidepressant withdrawal symptoms may be severe in some patients.

 

The guidance, which was published in 2009 originally said that antidepressant withdrawal symptoms were usually “mild” and “self-limiting” over the course of a week.

 

The amendment, dated September 2019, clarifies that there can be “substantial variation in people’s experience” and that symptoms can persist for months or more and be “more severe for some patients”.

 

It also advises that before stopping antidepressant medication, patients should discuss the decision with their practitioner.

 

The amendments are in line with a position statement released by the Royal College of Psychiatrists (RCPsych) in May 2019.

... 

 

The first thing you'll need to decide is what method you'll use to taper.  The choices basically are to cut tablets and weigh them, to use a prescription liquid or to make your own liquid.  Details about these methods are in the link below that I previously sent you.  It appears from my Internet research that liquid Seroxat is available in the U.K..  This would be the easiest method but you would of course need to cooperation of your doctor.  If you choose to cut and weigh tablets, many members use the AWS Gemini-20 scale, available on Amazon.  

 

Tips for tapering off Paxil (paroxetine)

 

I'm sorry you're having to deal with this just as you're beginning your studies in a foreign country.  We will help you any way we can.

 

 

 

 

 

Edit: this does not affect the main direction of the conversation, but I just want to clarify I went from 10mg per day to 10mg per two days instead of 20mg per day to 10mg per two days; I wasn't clear with my first post.

I will see the ENT on 2nd June. If they don't offer me an MRI to ensure the tinnitus is not an organic cause (in order to justify tinnitus being a withdrawal symptom in my case), I will have to arrange a referral by my private doctor (the one who prescribed me Paroxetine initailly) to do an MRI.

 

Meanwhile I'm on 4.052555153018976‬‬mg now (49mg actual weight), I have got no other withdrawal symptoms nor panic attacks relapse so I'm glad I've discovered this site; I really hope getting off Paroxetine completely can speed up the stopping of withdrawal syptoms. 😔

 

Edited February 4, 2022 by ChessieCat
removed background colour

[ViolinStudent]

On 12/19/2019 at 11:15 PM, Gridley said:

How and when can it stop?  As posts in the link about tinnitus indicate, it will stop eventually once you're off the drug and the effects of your too-fast taper fade.

Hi. Sorry I don't know if this is a stupid question; as I've got tinnitus as a withdrawal symptom from reducing from 10mg per day to 10mg per two days (too quickly), and you have mentioned the two conditions need to be met to hopefully make the tinnitus stop: 1) once I'm off the drug and 2) the effects of my too-fast taper fade.

 

Is it safe to continue tapering, or I have to maintain the dosage when the withdrawal symptom has started infinitely until it goes away? (Although if I did it wrong it's too late because I'm already reducing according to th 10% tapering plan, and now on 4.052555153018976‬mg per day [49mg actual weight) Thank you.

[Gridley]

42 minutes ago, ViolinStudent said:

Is it safe to continue tapering, or I have to maintain the dosage when the withdrawal symptom has started infinitely until it goes away?

It's not realistic to expect no withdrawal symptoms as you taper.  If your symptoms are pretty much the same from day to day and haven't spiked due to a recent reduction, I'd say it's safe to continue with your 10% taper.

[ViolinStudent]

34 minutes ago, Gridley said:

It's not realistic to expect no withdrawal symptoms as you taper.  If your symptoms are pretty much the same from day to day and haven't spiked due to a recent reduction, I'd say it's safe to continue with your 10% taper.

Thanks for the quick reply. The tinnitus haven’t worsened or lightened, and there are no other withdrawal symptoms during the 10% tapering.

[Gridley]

42 minutes ago, ViolinStudent said:

The tinnitus haven’t worsened or lightened, and there are no other withdrawal symptoms during the 10% tapering.

It sounds like you're in good shape for tapering.

[ViolinStudent]

Update 1st Aug, 2021

 

Did hearing test and MRI for both ears. Results indicated there's no hearing loss or any abnormality in inner ear and hearing nerve. I think at this point it is pretty much safe to say the tinnitus is related to Paroxetine, although the original doctor who prescribed Paroxetine still insists my tinnitus to be solely due to anxiety.

 

Currently, I'm following the 10% tapering plan with discipline: I'm on 3.282569673945371‬‬mg active ingredient per day, which means 241.8mg x (3.282569673945371‬‬ / 20) ≈ 40mg actual weight of Paroxetine per day.

 

However, I'm moving to Canada soon. I understand Paroxetine is a prescription drug. Does anyone know how do I get Paroxetine? Do I just go to the doctor and tell them I need Paroxetine? I have a letter from my original doctor stating I need Paroxetine, which I used to convince the UK (I'm currently living in UK) doctor to prescribe me it.

The tinnitus still hasn't stopped, but I believe it will stop eventually at a certain point after I am finally off the drug. Thank you.

[Jayy]

On 8/1/2021 at 7:38 PM, ViolinStudent said:

Update 1st Aug, 2021

 

Did hearing test and MRI for both ears. Results indicated there's no hearing loss or any abnormality in inner ear and hearing nerve. I think at this point it is pretty much safe to say the tinnitus is related to Paroxetine, although the original doctor who prescribed Paroxetine still insists my tinnitus to be solely due to anxiety.

 

Currently, I'm following the 10% tapering plan with discipline: I'm on 3.282569673945371‬‬mg active ingredient per day, which means 241.8mg x (3.282569673945371‬‬ / 20) ≈ 40mg actual weight of Paroxetine per day.

 

However, I'm moving to Canada soon. I understand Paroxetine is a prescription drug. Does anyone know how do I get Paroxetine? Do I just go to the doctor and tell them I need Paroxetine? I have a letter from my original doctor stating I need Paroxetine, which I used to convince the UK (I'm currently living in UK) doctor to prescribe me it.

The tinnitus still hasn't stopped, but I believe it will stop eventually at a certain point after I am finally off the drug. Thank you.

I have been struggling with tinnitus for 8 months off pristiq and i took it for 1 month. I dont know what happened, but I am very worried it is permanent. I have always read that it either goes away when you discontinue or takes years. I hate tinnitus, and after 8 months all i want is silence again.

[ViolinStudent]

On 9/15/2021 at 4:51 AM, Jayy said:

I have been struggling with tinnitus for 8 months off pristiq and i took it for 1 month. I dont know what happened, but I am very worried it is permanent. I have always read that it either goes away when you discontinue or takes years. I hate tinnitus, and after 8 months all i want is silence again.

I think tinnitus as a side effect and withdrawal symptom are different. However, according to Gridley, it is just a matter of time for it to stop after appropriate discontinuation, as the human brain is constantly remodelling itself. I have faith and I believe our tinnitus will stop one day, and I won't let it take my happiness away in this period.

[Jayy]

On 9/18/2021 at 1:08 AM, ViolinStudent said:

I think tinnitus as a side effect and withdrawal symptom are different. However, according to Gridley, it is just a matter of time for it to stop after appropriate discontinuation, as the human brain is constantly remodelling itself. I have faith and I believe our tinnitus will stop one day, and I won't let it take my happiness away in this period.

I have a feeling that in 24 days I was on pristiq I had an ototoxic reaction that hyper activated my dorsal cochlear nucleus and now I am stuck with tinnitus. I am so much more depressed than ever before. I never in my life wanted to take an antidepressant, and I have always been against them, but I made a mistake to try them, and now my life is ruined. I can't live with my brain hurting and the tinnitus ringing constantly, I never get peace, I hate it so much. I just want the ringing to stop, which it should have when I stopped taking the drug if it was''t permanent damage. My doctor is an idiot and gave me the worst possible drug that now has ruined my life

[ViolinStudent]

Very Confused by Jumping from Final Tapering Dose to 0mg

 

Hi. I've been tapering by deducting 10% since I've been on the forum, and have no new withdrawal symptoms (except the one I already got before I discovered this forum; tinnitus) since then.

I understand the equation to calulate the actual weight of dose is:

 

∵ actual average weight per tablet x (current strength according to 10% tapering / strength per tablet) = actual weight of dose

e.g. for my current dose:

∴ 241.8mg x (1.570042899082082‬‬ / 20) = 18.98181864990237‬mg ≈ 19mg

 

My question is, as the 10% tapering is calculated from the current dose, in the final few doses:
 

(0.1127130637840909 / 20) x 241.8 = 1.362700941149659mg  ≈ 1mg
(0.1014417574056818 / 20) x 241.8 = 1.226430847034693‬mg  ≈ 1mg
(0.0912975816651136 / 20) x 241.8 = 1.103787762331223‬mg  ≈ 1mg
(0.0821678234986023 / 20) x 241.8 = 0.9934089860981018mg  ≈ 1mg
(0.0073951041148742 / 20) x 241.8 = 0.0894068087488291mg  ≈ 1mg
(0.0665559370338678 / 20) x 241.8 = 0.8046612787394617mg  ≈ 1mg
(0.059900343330481 / 20) x 241.8 = 0.7241951508655153mg  ≈ 1mg
(0.0539103089974329 / 20) x 241.8 = 0.6517756357789638‬mg  ≈ 1mg
(0.0485192780976896 / 20) x 241.8 = 0.5865980722010673mg  ≈ 1mg
(0.0436673502879207 / 20) x 241.8 = 0.5279382649809613mg  ≈ 1mg
(0.0393006152591286 / 20) x 241.8 = 0.4751444384828648‬mg  ≈ 1mg

 

and obviously, after the final dose:

 

(0.0353705537332157 / 20) x 241.8 = 0.4276299946345778mg ≈ 0mg

 

does that mean I take 1mg actual weight of Paroxetine in the final year of tapering, despite there is no dosage difference, or I can jump from the first time I reduced to 1mg to 0mg? Thanks so much.

 

[ChessieCat]

@Frogie Are you able to help this member please?  Thank you.

[Frogie]

@ViolinStudent

 

Hi!

 

I don't quite understand your numbers, so I'm going to do it on here the way I was taught and see if we come up with the same number.

 

10 mg equals 242 mg. And you got this number from taking 10 tablets and weighing them, so it would have been 2.24 grams on the scale. Then dividing by 10 to get the average weight 242 mg?

 

Then take the 242 mg and x (times) by .90 (because you are taking 10% off). Your first taper would be: 218 mg. That's what you would take for 4 weeks.

 

Then the next 10% taper would be 218 mg. x (times) .90 (because, once again you are taking 10% off). Your second taper would be 196 mg.

 

Every 4 weeks you would take 1% off the last taper mg (so this would be 196).

 

Does that make sense?

 

Please let me know if you need further help and I'll be happy to do so.

 

 

[ViolinStudent]

8 hours ago, Frogie said:

@ViolinStudent

 

Hi!

 

I don't quite understand your numbers, so I'm going to do it on here the way I was taught and see if we come up with the same number.

 

10 mg equals 242 mg. And you got this number from taking 10 tablets and weighing them, so it would have been 2.24 grams on the scale. Then dividing by 10 to get the average weight 242 mg?

 

Then take the 242 mg and x (times) by .90 (because you are taking 10% off). Your first taper would be: 218 mg. That's what you would take for 4 weeks.

 

Then the next 10% taper would be 218 mg. x (times) .90 (because, once again you are taking 10% off). Your second taper would be 196 mg.

 

Every 4 weeks you would take 1% off the last taper mg (so this would be 196).

 

Does that make sense?

 

Please let me know if you need further help and I'll be happy to do so.

 

 

 

Hi. 241.8mg is the average weight per tablet (used to calulate the actual weight of dose I have to take). This is the average weight calculated by adding up the weight of 10 tablets divided by 10, for a more accurate calculation (recommeded by a member some pages before).
 

I understand every taper is calculated from the (previous dose x 90%), I'm just calculating in a more prudent equation (hence the numbers); the 11 lines of numbers you see are the doses I'm gonna have in 2024, and according to tapering rule they're all 1mg, hence my question is whether this is correct. Thanks.

 

Edited February 4, 2022 by ChessieCat
removed background colour

[Frogie]

I'm going to tag @brassmonkeyand see if he can take a look at this.

 

He's not on a lot right now, but hopefully he can answer your question for you😊

[brassmonkey]

Hi ViolinStudent -- I'm glad to hear that your taper is going well and to see that you are planning ahead for making the final jump to "0".

 

Unless you really like playing with numbers, you are making your calculations unnecessarily complicated. Because of the limitations of the scales we use and the tablets themselves anything past 4 decimal places is not needed. We physically just can't work that precise.

 

The easiest way to do the calculation is  (current dose X 0.9 = new dose).  This works for both the physical weight of the dose and the strength of the dose.

 

When you get to the final doses before making the jump to "0" things get a little different. This is where we really run into the limitations of our equipment. It is referred to as "The Endgame Taper" and in the case of Paroxetine there are two options: switch to a liquid to give more precise control of the dose or continue to dry cut using the visual division method. Switching to a liquid is the preferred method, but myself and many others have continued to dry cut the entire way down.

 

It is very important to continue to taper during the endgame. A dose weight of 1mgpw (milligram pill weight) will give a dose strength of 0.08mgai (milligrams active ingredient). For your tablets you should be looking for a Target Exit Dose strength of 0.0125mgai.

 

This is how the dry cutting method would work:

 

DRY CUTTING METHOD

Starting with the smallest amount the scales can accurately weigh, 4mgpw, you will need to visually divide your pile of powder into eighths, or 12.5% portions. This will not be our 10% per month hyperbolic reduction, but it will have to do. First divide the 4mgpw powder into halves, then quarters, and then divide each quarter into 2 parts. You will have 8 piles.

Use a sharp object, like a razor blade or craft knife, to carefully divide the pile of powder into equal parts. As you’re working, you may wish to put each pile into a large gelatin capsule (size 00 works well) to preserve it.

Hold at each dose as required by listening to your body.

MONTH 1. For the first month’s reduction, you will take 7 of these piles each day, storing the 8th pile in a large gelatin capsule (size 00 or 000) to take later.

MONTH 2. The second month’s dose will be 6/8 of the 4MGPW powder, or 3/4. Divide your pile in half, and one of the halves in half again. That’s your ¾. Put the last ¼ into a gelatin capsule, label the container for use later.

MONTH 3. This dose will be 5/8 of the 4MGPW powder. Divide your pile in half, and one of the halves in half again, then divide each of the quarters into half, making 4 eighths. Take the half and one of the eighths as your daily dose. Save the other 3 eighths in gelatin capsules, keep them in a labeled container.

MONTH 4. This dose will be 4/8 or ½ of the 4MGPW powder. Divide your pile in half. One-half is your daily dose. Save the other half in a gelatin capsule in a labeled container to take the next day.

How do you feel? You have reduced to half the 4MGPW powder over 3 months. If you have withdrawal symptoms, stop here for a long hold, perhaps several months, before you taper slower.

To taper more slowly, divide the 4mgpw powder in half and each of the halves into 8 parts (each 1/16 or 6.25% of 4mgpw), following the same method as above. Taper using a similar stepwise method.

 

For using a liquid, you would use a combination of dose volume and liquid dilution strength to get very precise reductions.

 

Hope that helps.

[ViolinStudent]

9 hours ago, brassmonkey said:

Hi ViolinStudent -- I'm glad to hear that your taper is going well and to see that you are planning ahead for making the final jump to "0".

 

Unless you really like playing with numbers, you are making your calculations unnecessarily complicated. Because of the limitations of the scales we use and the tablets themselves anything past 4 decimal places is not needed. We physically just can't work that precise.

 

The easiest way to do the calculation is  (current dose X 0.9 = new dose).  This works for both the physical weight of the dose and the strength of the dose.

 

When you get to the final doses before making the jump to "0" things get a little different. This is where we really run into the limitations of our equipment. It is referred to as "The Endgame Taper" and in the case of Paroxetine there are two options: switch to a liquid to give more precise control of the dose or continue to dry cut using the visual division method. Switching to a liquid is the preferred method, but myself and many others have continued to dry cut the entire way down.

 

It is very important to continue to taper during the endgame. A dose weight of 1mgpw (milligram pill weight) will give a dose strength of 0.08mgai (milligrams active ingredient). For your tablets you should be looking for a Target Exit Dose strength of 0.0125mgai.

 

This is how the dry cutting method would work:

 

DRY CUTTING METHOD

Starting with the smallest amount the scales can accurately weigh, 4mgpw, you will need to visually divide your pile of powder into eighths, or 12.5% portions. This will not be our 10% per month hyperbolic reduction, but it will have to do. First divide the 4mgpw powder into halves, then quarters, and then divide each quarter into 2 parts. You will have 8 piles.

Use a sharp object, like a razor blade or craft knife, to carefully divide the pile of powder into equal parts. As you’re working, you may wish to put each pile into a large gelatin capsule (size 00 works well) to preserve it.

Hold at each dose as required by listening to your body.

MONTH 1. For the first month’s reduction, you will take 7 of these piles each day, storing the 8th pile in a large gelatin capsule (size 00 or 000) to take later.

MONTH 2. The second month’s dose will be 6/8 of the 4MGPW powder, or 3/4. Divide your pile in half, and one of the halves in half again. That’s your ¾. Put the last ¼ into a gelatin capsule, label the container for use later.

MONTH 3. This dose will be 5/8 of the 4MGPW powder. Divide your pile in half, and one of the halves in half again, then divide each of the quarters into half, making 4 eighths. Take the half and one of the eighths as your daily dose. Save the other 3 eighths in gelatin capsules, keep them in a labeled container.

MONTH 4. This dose will be 4/8 or ½ of the 4MGPW powder. Divide your pile in half. One-half is your daily dose. Save the other half in a gelatin capsule in a labeled container to take the next day.

How do you feel? You have reduced to half the 4MGPW powder over 3 months. If you have withdrawal symptoms, stop here for a long hold, perhaps several months, before you taper slower.

To taper more slowly, divide the 4mgpw powder in half and each of the halves into 8 parts (each 1/16 or 6.25% of 4mgpw), following the same method as above. Taper using a similar stepwise method.

 

For using a liquid, you would use a combination of dose volume and liquid dilution strength to get very precise reductions.

 

Hope that helps.

Thanks so much for the detailed explanation. I don't like playing with numbers, I was just worried if I don't include as many decimals as possible, I will have miscalculated and tapered too fast. I plan to do the dry cutting method all the way until "0", but my electronic scale can only measure 1mgpw minimum... What I've done so far is to cut small slices of tablet out every morning, until it is correct (say current mgpw is ≈ 19, so I cut little pieces of tablet and weigh them until the total is 19mg, and I take them). My confusion is for the endgame taper, I take 1mgpw for the whole year, as the following mgais all constitute to the result of 1mgpw (the smallest unit that can be measured on the scale)?

0.1127130637840909
0.1014417574056818 (calculated by 0.1127130637840909 x 0.9)
0.0912975816651136 (calculated by 0.1014417574056818 x 0.9)
0.0821678234986023 (and so on)
0.0073951041148742
0.0665559370338678
0.059900343330481
0.0539103089974329
0.0485192780976896
0.0436673502879207
0.0393006152591286 

Thanks.

[ChessieCat]

There are calculators here
 

how-to-calculate-dosages-and-dilutions-spreadsheets-and-calculators

 

 

Edited February 5, 2022 by ChessieCat

[brassmonkey]

Which is why I included the description of how to do a visual taper at the end. The limitations of the scales is a big problem with the dry cutting method for just the reason you point out. By visually dividing the dose it is possible to continue to have a somewhat controlled taper that will decrease the dose over the last few reductions. It is not the most accurate way (that would be to use a liquid) but it does work. So, no, you do not take 1mgpw for the final year but step the dose down by taking smaller and smaller portions of a 1mgai pile of powder.

[ViolinStudent]

2 minutes ago, brassmonkey said:

Which is why I included the description of how to do a visual taper at the end. The limitations of the scales is a big problem with the dry cutting method for just the reason you point out. By visually dividing the dose it is possible to continue to have a somewhat controlled taper that will decrease the dose over the last few reductions. It is not the most accurate way (that would be to use a liquid) but it does work. So, no, you do not take 1mgpw for the final year but step the dose down by taking smaller and smaller portions of a 1mgai pile of powder.

Thank you very much.

[ViolinStudent]

Update 13/02/2022:

 

Today I sat down and very serious tested the AWS Gemini-20 Portable Milligram Scale, which I've been using since I starte the tapering on 10/01/2020 — I see the lowest mgpw it can measure is about 6mg, which means starting from 2023, I either have to rely on my eyes to estimate pill weight or get Paxil in liquid form.

I have a few questions:
1) How can I get liquid form of Paxil in Canada?

2) According to other members, does switching from of Paxil from tablet to liquid cause withdrawal? (please don't, I'm still suffering from tinnitus from the initial withdrawal onset)
3) What is the formula to caluclate the actual volume of liquid consumed? (i.e. if my current active ingredient should be 1.57mg, how much Paxil liquid should I consume?)

4) Which model of syringe do you recommend for tapering?

Thanks so much!

[ChessieCat]

4 hours ago, ViolinStudent said:

I see the lowest mgpw it can measure is about 6mg

 

I am sure that BrassMonkey was able to weigh much smaller amount.

 

@Frogie Are you able to assist here because I know you were weighing your dose too?  Thank you.

 

 

[Frogie]

@ViolinStudent

 

Brassmonkey explained it very well for you above. I copied it here again for you to read.

 

On 2/4/2022 at 12:19 PM, brassmonkey said:

Hi ViolinStudent -- I'm glad to hear that your taper is going well and to see that you are planning ahead for making the final jump to "0".

 

Unless you really like playing with numbers, you are making your calculations unnecessarily complicated. Because of the limitations of the scales we use and the tablets themselves anything past 4 decimal places is not needed. We physically just can't work that precise.

 

The easiest way to do the calculation is  (current dose X 0.9 = new dose).  This works for both the physical weight of the dose and the strength of the dose.

 

When you get to the final doses before making the jump to "0" things get a little different. This is where we really run into the limitations of our equipment. It is referred to as "The Endgame Taper" and in the case of Paroxetine there are two options: switch to a liquid to give more precise control of the dose or continue to dry cut using the visual division method. Switching to a liquid is the preferred method, but myself and many others have continued to dry cut the entire way down.

 

It is very important to continue to taper during the endgame. A dose weight of 1mgpw (milligram pill weight) will give a dose strength of 0.08mgai (milligrams active ingredient). For your tablets you should be looking for a Target Exit Dose strength of 0.0125mgai.

 

This is how the dry cutting method would work:

 

DRY CUTTING METHOD

Starting with the smallest amount the scales can accurately weigh, 4mgpw, you will need to visually divide your pile of powder into eighths, or 12.5% portions. This will not be our 10% per month hyperbolic reduction, but it will have to do. First divide the 4mgpw powder into halves, then quarters, and then divide each quarter into 2 parts. You will have 8 piles.

Use a sharp object, like a razor blade or craft knife, to carefully divide the pile of powder into equal parts. As you’re working, you may wish to put each pile into a large gelatin capsule (size 00 works well) to preserve it.

Hold at each dose as required by listening to your body.

MONTH 1. For the first month’s reduction, you will take 7 of these piles each day, storing the 8th pile in a large gelatin capsule (size 00 or 000) to take later.

MONTH 2. The second month’s dose will be 6/8 of the 4MGPW powder, or 3/4. Divide your pile in half, and one of the halves in half again. That’s your ¾. Put the last ¼ into a gelatin capsule, label the container for use later.

MONTH 3. This dose will be 5/8 of the 4MGPW powder. Divide your pile in half, and one of the halves in half again, then divide each of the quarters into half, making 4 eighths. Take the half and one of the eighths as your daily dose. Save the other 3 eighths in gelatin capsules, keep them in a labeled container.

MONTH 4. This dose will be 4/8 or ½ of the 4MGPW powder. Divide your pile in half. One-half is your daily dose. Save the other half in a gelatin capsule in a labeled container to take the next day.

How do you feel? You have reduced to half the 4MGPW powder over 3 months. If you have withdrawal symptoms, stop here for a long hold, perhaps several months, before you taper slower.

To taper more slowly, divide the 4mgpw powder in half and each of the halves into 8 parts (each 1/16 or 6.25% of 4mgpw), following the same method as above. Taper using a similar stepwise method.

 

For using a liquid, you would use a combination of dose volume and liquid dilution strength to get very precise reductions.

 

Hope that helps.

 

 

I'll also give you the link for using a digital scale:

 

 

Edited February 14, 2022 by Frogie