Malingos: Inconsistent tapering

[Malingos]

Hello. I’ve been taking Fluox 40mg for a number of years. Want to come off - emotional coldness / lack of feeling ‘emotionally sober’ is causing me problems in my personal life. 
 

Spoke to my doc, dropped me to 30mg. 
 

Obviously; this is more than the general consensus here of 10%. However, my reading of Horowitz makes me believe this is not likely to be an issue as the intake vs. Impact at receptor level is non linear. I.e. the drop from 10 to 8mg has way more impact that the drop from 40 to 30mg. 
 

As such, I was wondering if anyone had any experience of tapering at higher rates to start and then moving to lower tapering rates? 
 

I obviously want to do this as quickly as possible, but without risking major side effects. 
 

My thoughts (and what I suspect doc will prescribe) is 40->30->20->10. At which point I would then want to move to liquid (if available in the uk) and do the ten percent. 
 

Any thoughts / experiences? 
 

 

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  I'm glad you found us early in your taper.  Have you had any symptoms since you dropped from 40 mg to 30 mg fluoxetine?  If not, it's probably because these drugs are given to us at excessively high doses, and often reducing them at the higher doses has a small to no effect on our nervous systems.  But, as we go down in dose, they have a bigger and bigger effect on us.  What date did you reduce to 30 mg?  Please add this to your drug signature.  Have you been on any other drugs besides fluoxetine or tricycles?  If so, please add this info to your drug signature. 

 

Here is some important information about how these drugs actually work.  This explains why we get symptoms from going off of these medications, and why it's so important to taper slowly and carefully, and be very cautious about changing our doses: 

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

Video on Recovery from Psych Drugs

 

Windows and Waves Pattern of Stabilization

 

 

I can understand your being anxious about wanting to get off the drug quickly.  A safer way to do this, is to go ahead do the conservative taper rate of 10% of the current dose every 4 weeks, and if you have no symptoms for a couple of reductions, you can do another reduction after 3 weeks, instead of 4.  The link below will explain this.  Once you have thrown your nervous system into chaos by tapering with big reductions, it can take months to years to recover from that, so rushing a taper is like playing Russian roulette with your brain.  Some people get away with it, but for those who don't, it's very unpleasant, and takes a long time to recover from.   Unfortunately, the vast majority of doctors taper people off psych meds way too fast, which is why this site exists.  

 

Tapering is best done extremely slowly, and we generally taper by 10% of the current dose no more than once every 4 weeks, so that the reduction becomes exponentially smaller.

 

 Why Taper by 10% of my Dosage  

 

Tips for Tapering off Fluoxetine (Prozac)

 

Here is a link with checklists of common WD symptoms, just in case: 

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

Stability is really important when we are tapering off psych meds.  Please read the link about stability:

 

Keep It Simple, Slow, and Stable

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

Omega 3 Fish Oil

 

 

[Faure]

Hello, my thoughts are to suggest you read some threads on here to see just how bad WD can get….I’d strongly recommend following Frogie’s advice of 10% every 4 weeks, decreasing to 3 if you don’t get WD effects. 
 

After about 3 failed attempts to get off myself and taking a year to stabilise after the final go I am now having great success with the BrassMonkey slide. Yes, it’s slow, but life has improved immensely already which gives me hope that things will continue to get better steadily and I have the best chance of staying well doing it this way. When life falls apart because of WD it takes far too long to get it back on track for me to want to take any risks. I’d also say consider this in your decision making ☺️

[Malingos]

Thanks for the advice. Only a week into my 40->30 change. Will discuss getting on liquid for the next scrip to make the taper less of a faff 

[Toast]

Hi @Malingos 

I was on prozac for 15 years (I guess 17 now since I’m still tapering). I would recommend following SA guidelines but I did just want to mention my own experience. I went from 40 mg to 10 mg over the course of a month. Then I held at 10 mg for a year. I experienced no withdrawal during this year. (The following year, when I tried to go to 10 mg to 0 mg, no taper, then I experienced severe withdrawal). I explain my experience according to the paper you mentioned by Horowitz, SERT blockade-wise, prozac has around the same magnitude effect on receptors at 40 mg as it does at 10 mg.

 

That said, it is always better safe than sorry, so I wouldn’t necessarily recommend what I did, even though it gave me no problems. Please keep in mind too that fluoxetine has an active metabolite (norfluoxetine) and as such a very long half life of 10-14 days so you may not feel the effects of a change until a month later. My own experience was like descending into the depths of Hell, one step at a time. Would not recommend

[Malingos]

Thank you for sharing, Toast. 
 

Still unsure as to what to do in 2.5 weeks when my 30mg scrip runs out. I have loads of 20s in stock. 
 

Will have to speak to my GP soon.