Martha

[Martha]

I have been taking lexapro 10 mg for about 5 yrs.  i will be discussing a 5% and 10% taper with my doc.   Do you have a taper schedule I can show her?

[Gridley]

Welcome to SA, Martha.

 

We recommend tapering by no more than 10% of current dose every four weeks.  A 5% reduction is also fine.  This link describes the 10% taper and is also applicable to a 5% taper.

 

Why taper by 10% of my dosage?

 

We don't have a tapering schedule per se.  The excerpt below shows the first three dose reductions from 10mg using a 10% taper rate: 

                                                                                               ---------
If you have been tapering, you calculate the 10% on your last dosage. The amount of the decrease keeps getting smaller for the duration of your taper.

- If you started at 10mg, the first reduction would be 10% of 10mg, or 1mg, for a reduced dose of 9mg.

- Your second reduction would be 10% of 9mg, or .9mg, for a reduced dose of 8.1mg.

- Your third reduction would be 10% of 8.1mg, or .81mg, for a reduced dose of 7.29mg.

And so on.

This ensures that your nervous system is eased down a gentle 10% slope at every step of the process. It's important that drops become smaller, not larger, as you go. Once you find the rate at which you can comfortably taper, you don't want to jolt your nervous system with a larger drop than it can handle.

Mathematics whizzes may recognize that the 10% reduction formula is a geometric progression (asymptote) approaching but never equaling zero. At a very small dosage, likely less than 1mg, when reductions no longer cause any withdrawal symptoms, you may want to simply stop.
                                                                                                  -----------

 

You might want to print out those sections of the link you think would be helpful in your discussion with your doctor.  You should be aware that the vast majority of doctors taper their patients far too fast and don't believe in the existence of prolonged and severe withdrawal.

 

The U.K. is quite a bit ahead of us in the U.S., and the psychiatric association there recently changed its guidelines to admit for the first time the danger of severe, prolonged withdrawal.

UK's NICE health guidelines now caution about severe and ...

This is your Introduction topic, where you can ask questions and connect with other members.  We're glad you found your way here.

[Rhiannon]

You might also bring her some information about why we use the "exponential decay" of taking 10% of the previous dose not the original dose. Discussion here:

https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(19)30032-X/fulltext

 

And in this section from this forum, lots of links, some of them don't work but the graphs showing how SERT occupancy is a curve not a straight line are good if you can print one out:

 

And this article goes into that and also discusses slow tapering:

https://www.nytimes.com/2019/03/05/health/depression-withdrawal-drugs.html