The Brassmonkey Slide Method of Micro-tapering

[jozeff]

You're welcome,

 

Well it's nothing new but it is just very simple to use. There are plenty of sheets available but I wanted to be flexible with tapering weeks and holding weeks. This required some puzzling in Excel. 

 

I didn't invent the wheel by no means. I just used other peoples material and created my own sheet.

 

Cheers

 

Jozeff

[Dizzy4]

awesome thank you!

[Gracee]

Hi Jozeff.   Love the spreadsheet.   I downloaded it.   Huge thanks for doing this for us.

G.

 

Edited March 5, 2019 by ChessieCat
removed quote

[noearthlyfamily]

On 3/4/2019 at 7:08 AM, jozeff said:

The schedule is filled in but you can (and should) use your own dose, and tapering speed 

I hope you can use it. It has some hidden columns that do the math so it is a simple spreadsheet to use

 

Taper spreadsheet.xls

 hey Jozeff,

 

how's it going man?

 

i have a question about this...will this spreadsheet let me put in 2 different dose times and both of them at different doses?

 

i need a spreadsheet that will let me do 2.5% reductions per week for 4 weeks with 2 weeks hold at the end of each 4 weeks aka Brass Monkey, but with a steady dose of 25mg at 8 am and the other dose being a 25mg pill and the titration in water of the remaining amount...like this:

 

example:

day 4/14/19:   total dose: 68.75mg     8AM 25mg pill (swallow whole)      8PM 25mg pill (swallow whole) + Dissolve a 25mg pill into 25ml H2O      Drink 18.75ml

day 4/21/19:   total dose: 67.03mg     8AM 25mg pill (swallow whole)      8PM 25mg pill (swallow whole) + Dissolve a 25mg pill into 25ml H2O      Drink 17.03ml  

day 4/28/19:   total dose: 65.36mg     8AM 25mg pill (swallow whole)      8PM 25mg pill (swallow whole) + Dissolve a 25mg pill into 25ml H2O      Drink 15.36ml  

day 5/05/19:   total dose: 63.72mg     8AM 25mg pill (swallow whole)      8PM 25mg pill (swallow whole) + Dissolve a 25mg pill into 25ml H2O      Drink 13.72ml  

day 5/12/19:   total dose: 63.72mg     8AM 25mg pill (swallow whole)      8PM 25mg pill (swallow whole) + Dissolve a 25mg pill into 25ml H2O      Drink 13.72ml  

day 5/19/19:   total dose: 63.72mg     8AM 25mg pill (swallow whole)      8PM 25mg pill (swallow whole) + Dissolve a 25mg pill into 25ml H2O      Drink 13.72ml  

day 5/26/19:   total dose: 62.13mg     8AM 25mg pill (swallow whole)      8PM 25mg pill (swallow whole) + Dissolve a 25mg pill into 25ml H2O      Drink 12.13ml  

                                                                                                                                 (...until the 8PM dose = just a 25mg pill)

day ?/??/??:     total dose: 50     mg      8AM 25mg pill (swallow whole)       8PM 25mg pill (swallow whole) 

day ?/??/??:     total dose: 49.38mg      8AM 25mg pill (swallow whole)      8PM Dissolve a 25mg pill into 25ml H2O  Drink 24.38ml

day ?/??/??:     total dose: 48.77mg      8AM 25mg pill (swallow whole)      8PM Dissolve a 25mg pill into 25ml H2O  Drink 23.77ml

                                                                                                                                 (...until the 8PM dose = 0)

day ?/??/??:     total dose: 25      mg      8AM 25mg pill (swallow whole)

day ?/??/??:     total dose: 24.38mg      8AM Dissolve a 25mg pill into 25ml H2O  Drink 24.38ml

day ?/??/??:     total dose: 23.77mg      8AM Dissolve a 25mg pill into 25ml H2O  Drink 23.77ml

                                                                    (...until the 8AM dose = 0)

 

will this spreadsheet work for these 2 different dose times and amounts?

thanks in advance ; )

[CharlieZ]

Got a question..

instead of doing 2.5% a week at once, can I do 1.25% for 3 days, then 1.25% the next 4?

 

so instead of reducing the whole 2.5% at once, spread it out over the week so it has even less of a shock to the body? 

 

I have been micro tapering, but feel like I need something in the middle between cut and holds and micro tapering as I feel like not seeing the numbers drop fast enough is mentally defeating.

 

one last question. For the highly sensitive people like myself who have been on the med for 15 years, is 10% too much? If so, what % would you recommend from your experience helping others?

Thanks for your help. 

 

[brassmonkey]

Hi CharlieZ.  I think there is a typo in your first sentence, but I can see where you're going with it.  We really need more information before we an make any recommendations, so it would be a good idea to start an intro thread for yourself in the introduction forum.  Welcome to SA.

 

Brassmonkey

[CharlieZ]

On 4/1/2019 at 3:44 PM, brassmonkey said:

Hi CharlieZ.  I think there is a typo in your first sentence, but I can see where you're going with it.  We really need more information before we an make any recommendations, so it would be a good idea to start an intro thread for yourself in the introduction forum.  Welcome to SA.

 

Brassmonkey

Where is there a typo?

i was asking, instead of doing 2.5% a week, couldn’t u do 1.25% for 3 days, then 1.25 for 4days. (Breaking the 2.5% a week down even smaller for gentler shock to the CNS. 

 

Hopefully that cleared it up. 

 

 

[Iowan]

Here's my version of a BM Slide calculating spreadsheet. It uses the standard 4 week - 10% reduction. It also takes into account that most scales only measure to the 0.001 g. Please feel free to either incorporate into your other calc docs or delete my post all together. Thanks, Iowan

 

I took a little time today to work on an auto populating Excel spreadsheet for the BrassMonkey Slide Taper method. Please see my attached doc and feel free to download and use. There are 2 tabs. The 1st (4_Wk) tab is if you want to taper every week all the way through to zero. The 2nd (6_Wk) tab is if you want to taper every week for 4 weeks and then hold for 2 weeks before beginning your taper again, (per what's suggested by the original BM Slide Taper method).

 

Obviously, this is just an initial plan that does not take into any account for any unexpected or longer hold times.

 

Once you pick which tapering plan you want to go with, all you need to do is populate the 4 Yellow highlighted cells with your own information. The doc will automatically populate the rest and show you when you will reach zero, if you stick to the plan. Whatever row that the mgai, Weight and mgpw columns zero out is the date that you will be Anti Depressant medication FREE!!!

 

I've pre-populated the the 4 Yellow highlighted cells, to demonstrate how it works. Just write over my pre-populated values with your own, in these 4 cells ONLY.

 

Pre-Populated Values

20 mgai = 20 milligrams of active ingredient, (e.g. a 20 mg pill of Lexapro).

0.310 g Weight = The physical weight of your current dosage, (e.g. a 20 mg pill of Lexapro).

Sunday Day = Day of the week you begin your taper.

07/07/19 Date = Date you begin your taper.

 

God bless!

BM Slide Taper.xlsx

[Iowan]

Here's an updated version of my BrassMonkey Slide doc. Due to file size restrictions, I had to split the doc into 2 docs. The first tab in each doc provides 'Instructions' and hyperlinks to each of the 2 plans available to choose from within each doc, (listed below).

 

10% Taper Doc

10% Taper over 4 weeks with 2 weeks hold. (True BrassMonkey Slide)
10% Taper over 4 weeks with 0 weeks hold. (Shortest taper plan, but doesn't provide hold weeks)

 

5% Taper Doc

5% Taper over 4 weeks with 2 weeks hold. (Longer but gentler True BrassMonkey Slide)

5% Taper over 4 weeks with 0 weeks hold. (Longer, gentler taper plan, but doesn't provide hold weeks)

10-Pct BM Slide Taper.xlsx

[Iowan]

I finally got a chance to work in Google Sheets, in order to save on my attachment size and doc space allowed within SA. Please click on the link below to review and use the automated dosage doc that I've created for the BrassMonkey Slide.

 

https://docs.google.com/spreadsheets/d/175I8LTe0QbXboxxtNr7454JN_9TTT4GqbSAxgcHxJls/edit?ts=5d2f1e0c#gid=1066749400

 

Thanks, Iowan

[India]

On 4/22/2018 at 10:24 PM, Gridley said:

This method is working for me.  Using it, I've gone from 20mg Lexapro to 7.2mg  in 16 months with tolerable WD symptoms and no need to updose. I rate my symptoms daily, with 0 being very mild symptoms and five being extremely bad symptoms, and my log has mostly 0's and 1's, an occasional 2, a few 3's, maybe one 4 and no 5's.  I plan to use it to taper Imipramine when the time comes.   

When I stabilise I’d like to try this method..

[Eastcoastgirl]

I'm seeing conflicting things from different moderators. Some say a 4 week hold is necessary, and some say a 2 week hold. Which is best? If reducing by 2.5% rather than doing 10% all at once, is a 2 week hold sufficient? 

[ChessieCat]

If you do a 10% BrassMonkey Slide taper you are making 10% reduction over a 6 week period, which is an average of 6.66% reduction per month.  You can choose to make a smaller reduction using the same tapering method.  To calculate the average monthly taper rate (not the amount you reduce by), you divide the x% by 6 and then multiply by 4.

 

SA's "regular" tapering protocol is to make a 10% (or less) reduction and then stay on that dose for 4 weeks.  The next month you would then make another "full" reduction.

 

The benefit of doing the BrassMonkey method of tapering is that if after 1 week (during the 4 week period) or at the end of the 6 week period you are still feeling symptomatic you can hold for longer on that dose.  This may be better for members who find that doing the "regular" 10% reduction in one go brings on withdrawal symptoms.  This may start to happen as a member gets to the lower doses.  The BrassMonkey Slide gives you more control over your taper because the withdrawal symptoms after a partial reduction are probably not as bad as after a "regular" reduction.  This also means that a member is less likely to need/feel the need to make an updose, which keeps the dosing more consistent, instead of going up and down and up and down in dosing.

 

An explanation of the BrassMonkey Slide:

 

Reduce every week for 4 weeks (holding for 1 week each time) and then hold for an extra two weeks

 

Or you could say reduce every week for 4 weeks and then hold for 3 weeks (which is the 1 week after the 4th reduction and then the extra two weeks)

 

or explaining in it a detailed way:

 

Day 1 of Week 1:  reduce

Day 1 of Week 2:  reduce

Day 1 of Week 3:  reduce

Day 1 of Week 4:  reduce

From day 1 of Week 5:  hold

From day 1 of Week 6:  hold

 

Week 7 is then the start of the new reduction cycle so start from Day 1 of Week 1 above.

[Giulietta]

 

Does anyone use compounded capsules with the BrassMonkey method?

 

Huge thanks to BrassMonkey for this.

 

G.

[Giulietta]

Hello Tom,

 

What do you do when you are down to 1 mg (5 beads)? These beads are enteric coated and cannot be crushed (dulox/cymbalta).

 

The average capsule has 100 beads/capsule - so:

 

1 mg = 5 beads

.8 = 4 beads

.6 = 3 beads

.4 = 2 beads

.2 = 1 beads

and finally zilch!

 

I couldn't find on this topic  so sorry if I overlooked this.

 

Thanks, 

 

Giulietta

 

[brassmonkey]

The end of a taper is where it can get tricky, as you are seeing.  Because of the very small amounts we are dealing with and in this case the predetermined size of the beads, the last few reductions will end up being at a higher percentage than we would like.  But it can't be helped.  At the end of my taper I was having to visually divide a small pile of powder so I ended up with reductions of 25 and 50 percent.  It was all the scales would allow me to do.

 

It looks like reducing by one bead every six weeks is going to be the best option.  I would play it by ear and go slowly maybe extending the hold by several weeks depending on how I felt.

[Giulietta]

7 hours ago, brassmonkey said:

It looks like reducing by one bead every six weeks is going to be the best option.  I would play it by ear and go slowly maybe extending the hold by several weeks depending on how I felt.

 

Thanks. I had wondered how long one would hold on a single bead. So if I am at .8 mg now - I am at 24 weeks ...1/2 year?  Did I calculate wrongly based on about 100 beads per 20 mg capsule?

[brassmonkey]

That looks right.  100 / 20 = 5 so if 5 beads contains 1mgai that would be correct. 

 

If you just started at .8mgai then yes it will take a minimum of 24 weeks to get to the jump off point.  That is assuming that everything goes smoothly and you don't do any extra hold time.  Because each of your reductions will get progressively bigger, you just did 20%, the next would be 25%, then 33%, 50% and finally 100%, it is very important to listen to your body and watch how you react to each reduction.  You may need to do longer holds each time.

[Giulietta]

Thank you. This is very helpful.

[Pokeshaw]

 

[Zans]

Hey @brassmonkey

 

I am doing liquid taper of Brintellix going down about 4% every two weeks. I am doing this because syringe goes by 0.25 (5ml - 4.8 - 4.6 etc) graduals so it's more convenient to round it up to percentage that allows jump by grads instead of classical 2.5% which doesn't fit in these numbers (I get awkward numbers such as 4.9xxx which even if rounded up to 4.9 still presents issues within syringe increments).

 

So my plan is:

 

reduce approx 4% - two weeks hold

reduce another 4% - two weeks hold + one week additional

 

This similar to your method but instead of total 10% I end uplowering 8% and "resting" 1 additional week instead of two. I figured since overall load gets reduced by 8% instead of 10% I can rest one instead of two weeks. Obviously any issues and I'll hold longer.

 

Do you think it's still as legit as your method?

 

Thanks

 

 

[brassmonkey]

I see no problem with this.  Let us know how it goes.

[Nivsch]

On 1/29/2019 at 3:32 PM, ChessieCat said:

Just found a small issue with this calculator:  Micro Taper Off calculator with built-in 2 week hold

 

Using the calculator for the following the total reduction would be higher than 10%.

 

You would have to round up the 1.67 to 1.68.

 

How to work out the percentage:

 

(Start dose - end dose) divided by start dose x 100 = % reduction

 

(1.86 - 1.67) divided by 1.86 x 100 = 10.215%

 

(1.86 - 1.68) divided by 1.86 x 100 = 9.6774%

 

Starting dose

1.86

 

1.81 1.77 1.72 1.67 1.67 1.67

But here there are 3 weeks of hold (not 2) - 1.67, 1.67, 1.67...

[ChessieCat]

6 hours ago, Nivsch said:

But here there are 3 weeks of hold (not 2) - 1.67, 1.67, 1.67...

 

There are two different ways of saying the same thing.

 

Reduce once a week for 4 weeks (each reduction means taking the dose for 1 week) and hold for an additional 2 weeks, OR reduce for 4 weeks and hold for 3 weeks(instead of 1 week) after the 4th reduction.

 

I will use the doses from above as an example.

 

Start of week 1, reduce and hold for 1 week     dose 1.86

Start of week 2, reduce and hold for 1 week     dose 1.81

Start of week 3, reduce and hold for 1 week     dose 1.77

 

Start of week 4, reduce and hold for 1 week     dose 1.67

Hold for 2 more weeks, ie weeks 5 and 6          dose 1.67

 

OR

 

Start of week 4, reduce and hold for 3 weeks     dose 1.67

 

I hope that helps.

 

Edited May 20, 2020 by ChessieCat
clarified

[bmi197143]

On 4/22/2018 at 7:54 PM, brassmonkey said:

Hi Wantrelief--  in this case it is specific to the people using the Slide Method.  It is however, a good idea to throw in a hold now and then when using the standard 10% taper also.  especially of you are making reductions every four (4) weeks.  This is due to the reasons I gave above, there has to be enough time allowed for the healing going on in the background to get done.  Otherwise the "to do" list gets out of control and people lose control of their taper.

Can you please help me with my taper I would like to use your method as the meds are giving really bad side effects. I am not good at math so need help in the dose amount per week. I am currently taking .017 mg Amitriptyline a day and .030 Ropinerole a day can you help with numbers for a a 4 week taper and 2 week hold .

[brassmonkey]

Hi BMI-- it will be best if we could talk about this over on your intro thread because it is specific to your taper. I asked a few questions over there.

[Bruci]

Ive  been on SSRIs off and on for 30 years. I have been advised by a tapering counsellor that a 10% reduction is too high because “ it can produce withdrawal which can risk the REM Sleep Disorder or Serotonin Syndrome or the 3 options the FDA warns of which is suicide, hostility or psychosis - none of which are worth the risk in my opinion!”

 

She recommend a reduction of about 1 1/3 years for each 5 years on SSRI to taper off safely. After 30 years that would take me approximately EIGHT YEARS to get off!! I am currently on 30 mg Celexa.

 

Can this be true? That is an extremely long time!

 

Bruci

[jordidog]

Who knows what is true but I believe in slower than slow taper. I’m sensitive to the med changed and will start at 1% for 6-8 months to be determined by how I feel 

I will get my Paxil compounded to 14.85 mg as at 15 mg now

[ChessieCat]

2 hours ago, Bruci said:

I have been advised by a tapering counsellor that a 10% reduction is too high

 

The 10% taper is a starting point.  Some people can taper faster whilst some need to go slower.

 

SA also suggests that members listen to their body/symptoms and taper/hold according to those.

 

Please see Post #1 of this topic:  why-taper-by-10-of-my-dosage

 

This is in Post #1:

 

On 8/6/2011 at 6:43 AM, Altostrata said:

The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs. While it is not a guarantee you will have trouble-free withdrawal, we believe this conservative tapering method will cause harm to the fewest number of people.

 

And also see:

 

why-taper-sert-transporter-occupancy-studies-show-importance-of-gradual-change-in-plasma-concentration

 

 

Edited September 27, 2020 by ChessieCat

[Superwoman]

On 4/22/2018 at 3:07 PM, brassmonkey said:

 

ADMIN NOTE Every nervous system is different. You may find a modification of the below method suits yours better. It is only a suggestion of a place to start if you're very sensitive to dosage reductions. Listen to your body and tailor this method to it.

 

Could women customize the Brass Monkey Slide to work around a women’s period or would this create problems?  I have been avoiding tapering during the week of my period because my body is more sensitive during this time and WD symptoms sometimes flare up when I am on my period.  I think that many other women also avoid tapering while menstruating.  So, I think that this question will apply to many women. 
 

With the standard 10% taper it is easy to work around my period.  With the Brass Monkey Slide it would not be possible to avoid tapering during menstruation without modifying the taper slightly.  Does the 2 week hold have to be consecutive and at weeks 5 and 6?   Could a woman hold 1 week during her period sometime during weeks 1 through 4 and then 1 week at the end during week 5 or 6?  Or would this cause problems?  Or perhaps a woman could hold during the week of her period and the week after her period.  This modification would still follow the Brass Monkey Slide protocol of 4 reductions of 2.5% (or less) and 2 weeks of holding for a total of 10% or less.  The only difference would be that the 2 weeks of holding would either not be consecutive, or the two weeks of holding would be consecutive, but not necessarily during weeks 5 and 6, depending on how one tailors it.    
 

Idea A Example........

Week 1: Reduce 2.5 %

Week 2: Reduce 2.5 %
Week 3: Hold, On Period

Week 4: Reduce 2.5%
Week 5: Reduce 2.5%
Week 6: Hold

 

This is just an example.  The weeks holding would depend on what week a woman is menstruating.  So, in the above example a woman would hold during week 3.  However, if a woman was menstruating on week 2 she would hold during week 2.

 

Idea B Example.....

 

Week 1: Taper 2.5%
Week 2: Hold, On Period

Week 3: Hold

Week 4: Taper 2.5%
Week 5: Taper 2.5%
Week 6: Taper 2.5%

[brassmonkey]

I have seen a lot of discussion regarding the affects of hormonal cycles on tapering and think this might be something we should look into further. Thank you for bring up the subject.

 

The final two week hold, weeks 5 & 6, are designed to be consecutive. The WD symptoms created during the reduction phase are not always full resolved by the end of week four (4), the the hold period for weeks 5 & 6 is added as a wash out period to let the body catch up and resolve the symptoms. So it is important that it be maintained.

 

However, there is no problem with adding an extra hold period during the reduction phase. One could say reduce on week one and week two, then continue to hold at the week two level during the TOM, then restart with the week three and four reduction after things have settled down. Week four would then be followed by the normal week 5 & 6 hold. The extra hold time would rotate through the schedule because of the differences in timing and could probably be skipped when it aligns with the week 5 & 6 hold. That would be up to the individual and how they are reacting at the time.

 

[Superwoman]

2 hours ago, brassmonkey said:

I have seen a lot of discussion regarding the affects of hormonal cycles on tapering and think this might be something we should look into further. Thank you for bring up the subject.

 

The final two week hold, weeks 5 & 6, are designed to be consecutive. The WD symptoms created during the reduction phase are not always full resolved by the end of week four (4), the the hold period for weeks 5 & 6 is added as a wash out period to let the body catch up and resolve the symptoms. So it is important that it be maintained.

 

However, there is no problem with adding an extra hold period during the reduction phase. One could say reduce on week one and week two, then continue to hold at the week two level during the TOM, then restart with the week three and four reduction after things have settled down. Week four would then be followed by the normal week 5 & 6 hold. The extra hold time would rotate through the schedule because of the differences in timing and could probably be skipped when it aligns with the week 5 & 6 hold. That would be up to the individual and how they are reacting at the time.

 

Your Welcome.  The idea B example that I gave has a two week hold in it.  So if I understand correctly this idea would not work because there still needs to be a hold at weeks 5 and 6.  But I could add a hold at the TOM as an additional hold, and maintain the weeks 5 and 6 hold.   This would make it a 10% reduction over 8 weeks versus over 6 weeks.  Is this correct?  Just clarifying.  I was trying to figure out a way to work around my cycle, but still keep it to a 10% reduction over 6 weeks as I did not want the taper to take any longer than it already will.   

 

4 hours ago, Superwoman said:

Idea B Example.....

 

Week 1: Taper 2.5%
Week 2: Hold, On Period

Week 3: Hold

Week 4: Taper 2.5%
Week 5: Taper 2.5%
Week 6: Taper 2.5%

 

[Superwoman]

2 hours ago, brassmonkey said:

 

I have seen a lot of discussion regarding the affects of hormonal cycles on tapering and think this might be something we should look into further. Thank you for bring up the subject

 

Serotonin levels in the body and brain are lower when menstruating or right before.  Add this to the sudden drop in serotonin that you get from reducing an AD and this may add up to greater than a 10% drop from the brains stand point.  That is my theory at least.   

[brassmonkey]

I was thinking just a 1 week TOM hold to be used when needed for a total of 7 weeks. I'm guessing that 1 additional week will be enough as I don't have any practical experience with the subject. Rough estimate says you would be adding the extra hold to two out of three Slide cycles, It will add some extra time to the total taper, so it depends on if the extra relief offsets the added time. There may be a very subjective element to the TOM hold making it an option to use as needed and not required for every Slide cycle, another option for the person to consider.

[Ryder]

Hi BrassMonkey,

 

I am looking into re-starting my Valium taper using your method or a similar one with minor reductions. I entered in my desired reductions using your calculator taperoff.co

 

Could you explain for the first week, why there is such a big reduction in the dose or am i missing something? Here is what i am seeing on my page.

[Ryder]

I would like to be at 16mg by the end of the month. So shouldn't my taper schedule look like this:

 
Week 1: 16.75

Week 2: 16.5

Week 3: 16.25

Week 4: 16.00

 

(two weeks hold for Diazepam).

 

This is the way i would like to do it. Please advise if this is possible.