The Brassmonkey Slide Method of Micro-tapering

[brassmonkey]

Four weeks is the shortest hold that we recommend. Depending on how your body reacts even longer holds could be called for.

 

The way it works is, you are currently taking 12,5mg for your dose. For your first reduction you would take 11.9mg and keep taking it every day for four weeks. Then you would make your second reduction to 11,3mg and take that for four weeks, and keep going in that manner.

 

Do you have a way to measure the smaller doses? Jeweler scales, or liquid?

 

It would be best of we continue this on your intro thread, so I will post this there also.

[lillo9546]

On 3/4/2019 at 2:08 PM, jozeff said:

Hello fellow sufferers,

 

My tapering keeps me busy and I have created a tapering schedule. WWW.taperoff.co (which was created by some great guy who helped his wife) is exactly the same  but I created an offline sheet that does about the same. 

I made it to use it offline and print it etc.

 

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

 

It is according to Brass Monkey slide method.

 

cheers,

 

Jozeff

 

 

Taper spreadsheet.xls 153.5 kB · 384 downloads

I am not understanding how the taper works. If I am on 150mg, and I wanted to reduce 2.5% each week for 4 weeks and hold for 2 weeks, would it take me 7 years to go to 0.00 mg?

[Nivsch]

20 minutes ago, lillo9546 said:

I am not understanding how the taper works. If I am on 150mg, and I wanted to reduce 2.5% each week for 4 weeks and hold for 2 weeks, would it take me 7 years to go to 0.00 mg?

Yes. For me it will be 10 years because I can only 2-2.5% a MONTH (in average). Doesnt it make sense that the brain and body may need the exact same amount of years to go back all the changes they did during the years on the drug?

I think its very realistic and make sense.

[Mascasa]

I am wanting to switch over to the Brass Monkey tapering of 2.5% each week with a hold. Currently did a 10% with a hold of 6 weeks at 12mg. Using the oral Lexapro. Considering next taper soon. Okay to switch to this method? 

[lillo9546]

I mean, if I do a theraphy for 2 to 6 months (not years), the proper taper would last for 5 years. Thats huge.

Example: Paroxetine 20mg for 6 months, tapering 5 years?

Am i wrong?

[Go2zero]

It is not such a direct science. We all react differently. It may take 1 year if you are very lucky. It may 5 years or more when you are not lucky. 

 

Do you want to start taking meds that never have proven to be healing? Meds that just suppress feelings and do not heal. Meds that have a lot of mean side effects and even meaner WD symptoms?

 

If so, go and see a doctor. This site is meant for people that want to get off drugs or who believe in healthier ways of healing.

Edited August 7, 2021 by Go2zero

[Go2zero]

2 hours ago, Mascasa said:

I am wanting to switch over to the Brass Monkey tapering of 2.5% each week with a hold. Currently did a 10% with a hold of 6 weeks at 12mg. Using the oral Lexapro. Considering next taper soon. Okay to switch to this method? 

 

It is certainly OK and safe to switch to the BrassMoney Slide method. This may always more safer and smoother tapering than doing 10% in 1 time per month. It is a perfect method, where you have more control because the drops in dosages are more little.

[jozeff]

Hi!

 

Yes, 5 years is ridiculously long! Unfortunately it takes that long for some people (including myself). My wife is currently tapering sertraline and managed to go from 50 mg to 6 mg in 13 months without any problems .

 

My mother once jumped of sertraline 20 years ago CT and never looked back....we're all different.

 

The 10% per months taper is based on risk reduction and on experiences from people on this website and not on scientific data where thousands of people are tapering the same medicine at different speeds. That would be an amazingly interesting study.

 

I've read enough stories here to make up my mind and taper very carefully. 

 

Cheers and good luck you all!

 

Jozeff

 

 

[brassmonkey]

All the different tapering methods will take a shockingly long time to complete. We have collected a huge amount of data with working with thousands of people for many years and correlated that data with scientific studies to develop the tapers we recommend. As Jozeff pointed out we work with a "Harm Reduction" model to try and make the taper as painless as possible for as many people as possible. Some people can go faster than we recommend, but we don't see them here. 

 

These are very powerful drug in the way the affect the body. Taking them for more that a month will require a prolonged taper to get off of them. In some cases just one dose has caused people problems for many many months after they stop taking them. This is rare but does happen. I know it sounds very unfair but these long tapers really are the way to go.

 

We have seen too many cases of people thinking that they can "get the drug out of their system fast" and then recover quickly. Just the opposite it true. By rushing the taper a persons body doesn't get the time required to adjust/heal after each reduction. This causes a backlog of unresolved symptoms/changes that builds up to a breaking point and causes a major crash. That crash takes many months to stabilize before a new taper can be started. All in all it ends up being much quicker and less painful to follow the slow taper protocols.

 

The Brassmonkey Slide Method was developed to minimize symptoms while maintaining a good taper speed. It has a half life of 9 months if you use the standard 2.5% a week for 4 weeks plus a 2 week hold. I tapered from 40mg of Paxil with one extended hold and it took 5 and a half years to get to the point I could jump to "0". During that time I was able to hold a job as a Research Engineer, pay my bills, enjoy my hobbies and travel. There were ups and downs and challenges but overall life was quite  livable.

[Mascasa]

Thanks for the info. So if I figured it correctly at 12 mg. 2.5% would be 11.7. I think it was 0.3 of 12. Can someone confirm that for me? I do have a syringe that measured the .7. I got it at the vet. I hang there for a week. Then again from the 11.7 calculate the 2.5% off that etc. for 4 weeks. Then weeks 5/6 hang there at that last dose. Is that correct? @brassmonkey @Go2zero

[Go2zero]

7 minutes ago, Mascasa said:

So if I figured it correctly at 12 mg. 2.5% would be 11.7.

 

That is correct. I understand that you already have experience with liquid dosing.

 

Please know that when you get to lower dosages you better use syringes with a lower content. It is much more accurate dosing with these smaller syringes. There are even ORAL syringes available of only 1ml. You can dose very accurately with those.

[jozeff]

You are correct!

 

You multiply your dose by 0.975

 

12 x 0.975 = 11.7

 

11.7 x 0.975 = 11.4

 

Etc...

 

After 4 in a row you hold for 2 weeks.

 

You will be tapering approximately 10% in 6 weeks this way

[Mascasa]

@jozeff @Go2zeroThank you for confirming that. I started the taper with the liquid. Unknowingly, just switched from tablet to oral with no transition. But, I am getting used to it.

I measure it in a small measuring cup pharmacist gave me for the 12 or 11 and a syringe for the .7. 

 

[brassmonkey]

Calculating the interim steps for a Brassmonkey Slide is slightly different that that of a normal 10% reduction.

 

The interim steps are actually a linier reduction of the previous dose. The next cycle of interim steps is calculated off of the last dose which gives the hyperbolic reduction we are looking for.

 

It goes like this:

Cycle one

Week one; Previous dose X .975 = step one

Week two: Previous dose X .95 = step two

Week three: Previous dose X .925 = step three

Weeks four thru six: Previous dose X .9 = step four and hold

 

Cycle two

Week one: Week four thru six dose from cycle one X .975 = step one

Follow the same pattern as cycle one

 

Cycle three

use the dose from cycle two weeks four thru six and repeat the same pattern of calculations.

 

This gives an actual 10% reduction of the previous dose, but broken into four even steps.

 

[jordidog]

What does the .975, .95...refer to? Is that what we do for each round of tapering?

[Mascasa]

@brassmonkeyI did some calculations. We have done it twice. Just doesn't seem correct. Can you help me please?

Week 1 11.7 ( based off 12 x .975)

Week 2 11.7 x .95=11.1

Week 3 11.1 x .925=10.3 (10.28) Do we round?

Week 4/6 10.3 x .9= 9.25

[Mascasa]

I used the spreadsheet provided and it looks like the taper happens in a week every 2 or 3 days? My next taper would be the 10th and 11.41? How do you get that? Kathy

[jozeff]

11 hours ago, Mascasa said:

@brassmonkeyI did some calculations. We have done it twice. Just doesn't seem correct. Can you help me please?

Week 1 11.7 ( based off 12 x .975)

Week 2 11.7 x .95=11.1

Week 3 11.1 x .925=10.3 (10.28) Do we round?

Week 4/6 10.3 x .9= 9.25

This is way too fast!

 

This is 25 % in 6 weeks.

You shoukd use a percentage of previous dose or bezinning dose with decreasing percentage..

 

You should get something like:

 

Week 1 12x0.975  = 11.7

Week 2 12 x 0.95 = 11.4

Week 3 12 x 0.925 = 11.1

Week 4 12x 0.9= 10.8

Week 5 and 6 ....10.8

 

OR....

 

Week 1 12 x 0.975 = 11.7

Week 2 11.7 x 0.975 = 11.4

Week 3 11.4 x 0.975 = 11.12

Week 4 11.12 x 0.975 = 10.84

Week 5 and 6 ....10.84

 

Either way you will be tapering about 10 % in 6 weeks.

 

Let us know if you get it!

 

Cheers

 

Jozeff

[Mascasa]

I knew my calculations were incorrect. Quick question on the tapering spreadsheet it created doses down every couple days?

[brassmonkey]

Jozeff's first example is the correct one.

 

"You should get something like:

 

Week 1 12x0.975  = 11.7

Week 2 12 x 0.95 = 11.4

Week 3 12 x 0.925 = 11.1

Week 4 12x 0.9= 10.8

Week 5 and 6 ....10.8"

 

Then next time you would start with 10.8 instead of 12 and do the same calculations.

 

You would take dose levels 1, 2, 3 for 7 days each and level 4 (5, 6) for a total of 21 days.

 

Which spreadsheet did you use? I'll take a look at it to make sure it is working correctly.

 

Please bring your signature up to date.

[Mascasa]

@brassmonkey Here is the link to the spreadsheet with my info.

https://docs.google.com/spreadsheets/d/1iywZ_U96z3JIb-QM_W2jl2eJq4mFuEJheB5m6chVhoE/edit#gid=0

Also, how do I edit the signature page. I don't see how to do that.

 

[Mascasa]

@brassmonkey I see my error in the calculations now. It is always being multiplied by 12 each time. I was using the dose or the product and multiplying that each time. 

So I get it now.

If you did a 5% reduction this way it is the 10.8* the last dose in the cycle above then multiplying that by 0.95%? Not sure about that.

[brassmonkey]

To do a straight 5% reduction you multiply the previous dose (in the case of cycle 2 above that would be 10.8) times 0.95.  10.8 X 0.95 = 10.26

[brassmonkey]

I don't seem to be getting into that spread sheet. We have a large selection of them here that you can use

 

https://www.survivingantidepressants.org/topic/9167-how-to-calculate-dosages-and-dilutions-spreadsheets-and-calculators/

 

 

[Mimosa]

Hello@brassmonkey

 

I am just getting back to you as I have started my taper now, ( from 150mg Venaflaxine) using tapering strips from the Netherlands. 

 

I am using the brassmonkey method and worked out the doses using the excel sheet from Josef and my GP signed the prescription.

 

The only issue is is that they don't make pills and capsules at very small amounts so they let me know that they would have to round the figures up. So instead of my first weekly dose being 146.25mg Venaflaxine it was 146.5mg and the next instead of 142.59mg was 142.5mg and the next instead of 139.03mg was 139.5mg   I am on the third week now 139.5mg and my sleep is not good and have been feeling anxious/wired. I have started taking magnesium glycerinate 120mg at night, but it's not making much difference.

 

Do you think that the fact that the doses have had to be rounded up and so are not exact are causing the sleep problems/ anxiety? . I thought it would be fine as the doses are higher not lower.

 

I will be posting to tell others about the possibility and experience of using Tapering Strips, but am waiting till I've got through at least a month. Also this issue of not being able to supply exact doses may be a problem?

 

Would welcome your thoughts,

 

Thank you

 

Mimosa

[brassmonkey]

Rounding up is a quite common practice. It is impossible to hit the small increments that are calculated so we have to round up. The sleep problems are just one of those things that happen from time to time during a taper. They are quite upsetting to some people but are more a bother than anything else. The more a person worries about not sleeping the harder it is to get good sleep. Check out the recent posts on my Tao of the Brassmonkey thread I have a nice post about sleep problems there.

 

Excellent to hear that your doctor is working with you on this and they will supply the tapering strips according to the schedule. This might end up being a good thing for a lot of people.

[Mimosa]

Thanks. Its also hard to tell whether my sleep being erratic is due to the taper or not.  I read that thread and I agree we are so conditioned to have to sleep at certain times and we have lost touch with the natural rhythms of our bodies

 

Yes it is great about the tapering strips! I will post about it on the tapering strips topic too, so people know that its possible to customise your own schedule. 

 

[Greatful]

@brassmonkey  

Does the active ingredient differ from tablet to tablet?

My Lexapro is a 5mg tablet.  It weighs between 62mgpw to 66mgpw 

My husband thought if we started shaving all the pill to the lowest one 62mgpw then we would be getting the most consistent amount of active ingredient per pill.

62mgpw=4.84mgai  would this be correct?

 

Thank you

  

[brassmonkey]

No, the inconsistencies in weight are from the amount of filler added to the tablet. Because the active ingredient is sell mixed with the filler removing any filler will decrease the dose amount. This is why it is recommended that the pills be crushed and the powder used as a "stock pile" from which you measure the desired weight for your dose.

[Mimosa]

Hi @brassmonkey I started my taper from 150mg Venaflaxine  2 months ago using the Brassmonkey method 

 

Although early days, what I have found is that the weeks I am dropping a dose I am having sleep problems,( sleeping v lightly and waking up v early) feeling agitated in the day time, its a physical feeling like I've had loads of coffee.  I'm experimenting taking magnesium but haven't found right dose yet. I took 120mg capsules to start off with and they made me feel really groggy and didn't give me better sleep so I'm now trying 50mg in morn and 50mg at night.

 

However when I did the 2 week hold I felt much better and slept better too.

 

The lack of sleep now is really affecting me and I'm feeling both wired and spaced out in the day, so I'm thinking I may have to taper even slower. 

 

I'm just surprised and that I'm having these symptoms with such small drops in dose. Do you think I should carry on with the same schedule and see if things get better and the magnesium works? Does this calm down after a while?( I know it must be different for everyone)

 

I need to order my next taper strips from Netherlands in the next few days so I'm wondering whether to change the schedule and in what reductions?

 

I was also thinking of trying melatonin which I haven't used before. Do you think that's a good idea?

 

 

[brassmonkey]

Even with the weekly small reduction there are going to be some symptoms following each drop. As long as you can work with them that is fine. If they are too much then a smaller reduction is called for. It sounds like they clear up pretty well with the hold which is a good thing. If the symptoms are too strong then you could try using a 1.25% week instead of the 2.5%.

 

Sleep problems are one of the biggest complaints we get. They are very unpredictable and most people find the unduly upsetting. Magnesium can help relax you, but it isn't a sleep aid. Melatonin works for some people and not for others. For it, more is not better, keep the dose to 1mg or less. Also it is not a "sleeping pill", it doesn't make you sleep, but rather tells the body it is time to sleep. 

[92sharks]

@MimosaI've been tapering Venlafaxine for 3 years and am down to 10 beads. I started at 188mg Effexor XR capsules. I had a failed attempt to get off 12 years ago with severe wd for 7 months before reinstating. I find the tapering strips very interesting. I don't quite understand how you ingest the tapering strips. Go slow if you're having any symptoms, especially physical. The emotional ones are tough enough! In my experience, when I continued tapering with symptoms, I hit a wave with much worse physical and emotional symptoms. It is a very long, slow road, but it is much better to feel good as you taper than try to hurry and get off of the Effexor. I am VERY familiar with Effexor withdrawal symptoms! 😜

[Mimosa]

Thank you @brassmonkeyand @92sharksfor your replies.

 

The sleep problems are continuing to be a problem and I can't got on with such lack of sleep!. That in itself is causing me anxiety and has started to affect my work so yes I'll have to taper more slowly. Maybe the micro tapering doesn't suit me and I may need to do it another way but that would mean I'd have to take a bigger drop at one time... I am going to order two months holding dose to follow to on from the next two week hold, so I can decide what to do.

 

Thanks @brassmonkey for the advice about melatonin and for answering me so quickly- really appreciate it. Especially as though my GP is not at all supportive and although has agreed to sign the forms for the tapering prescription, she has made it clear that she thinks I'm tapering too slowly and is more worried about covering herself legally if the medication I get from Holland isn't legit.

 

@92sharks, the tapering strips are pouches attached together ( 4 weeks worth on one long strip) You open a pouch a day and take out the medication inside.and take it. They are numbered 1- 28 and are made up the dosing schedule that you ask for. (they have their own schedules to chose from but they're much to fast)

 

Their smallest tablet is 1mg so (when and if!) I get to that stage I will change to a liquid. here their website

https://www.taperingstrip.com

 

I decided to go with the strips as the Venaflaxine XL I was getting from my pharmacy was not the one with lots of beads that I could use for counting beads and also the pharmacy couldn't guarantee that I'd always get the same brand (what I have got has changed over the years) It sounds good BUT what I have found is now that I need to make an adjustment I need to go back to my GP who needs to sign the prescription for new schedule of tapering strips and last time she took a week to sign it. I  then email a new request to Holland. It took 2 weeks for me to receive the tapering strips last time, so I have no choice as to bear this for another 2 weeks until I receive the new strips 

 

@92sharks It is really good to be in touch with someone that has gone through the Effexor taper it looks like you have done really well being at only 10mg now. How have you done it?

 

 

 

 

 

 

 

 

 

[92sharks]

@MimosaThank you for explaining the tapering strips. I'm sorry you are not able to obtain the capsules with beads. It sounds like you have to be really organized and do things way in advance so that you're guaranteed to have your doses. If you read my signature you can see how long I've been tapering. I just started counting the beads, pretending 1 bead=1mg. I don't think that is probably true, but it was close enough for me. I've read others on SA say their capsules had "bead numbers" way different than my capsules did in the same mg dose. But for me, I just started decreasing 1 bead every 3 days in Jan/2018. I also started a notebook with doses and symptoms. I have a very supportive husband and children and this taper has just been in the background for the last 3 years. I've done some holds along the way, especially when life was nutty. I eventually settled into decreasing 1 bead/1mg(?) once a week for the past year. I thought I would be off next month. But it turned out that I ignored symptoms that could be explained either by wd or stressful life events. I just kept decreasing and not paying attention. It wasn't until I forgot an 11mg dose one day and then dropped to 10mg the next day that I experienced severe vertigo and realized I had probably been having a wd wave for months. Even at this very low dose it does have an effect. It sounds terrible to think that it could take years to get off of Effexor, but it has mostly been a pain in the ass to go so slowly. An annoyance. But having experienced severe withdrawal for 7 months 12 years ago when I dropped from 37.5mg CT I did not want to go too quickly. During this very slow taper I had very few physical symptoms, and when I did it alerted me to space out the drop in doses further. I probably have had a number of emotional symptoms that I attribute to just being me, depression, life events, life stresses, etc, etc. But, I need to realize there are emotional wd symptoms, too. This last 10 beads will be the slowest of all, I'm thinking. In looking at my own signature, I think "Oh, 8 days of vertigo.That's not so bad." But at the time you don't know how long these symptoms will last. Thank goodness it did only last 8 days. And the emotional issues are so much worse. I am not looking forward to dropping to 9 beads. Be gentle and kind to yourself, Mimosa. Go very slow. Don't let the Effexor win!😂

[92sharks]

@MimosaTy for the link to the tapering strips. So interesting! I'm sorry that your dr. isn't supportive. I wonder if you could find another who is? I worry if this takes you a long time she may not continue signing the forms for the tapering med. 

[VaultOne]

I just began my re-taper after a late reinstatement that has been partially successful. I was quite taken aback by the adverse reaction I had to my first 5% drop. I must have been very lucky when I weaned from 100 mg of Zoloft before I jumped off in January. I did a 10% a month taper with minimal WD symptoms aside from brain zaps and lightheadedness which only lasted a day or two after my reduction. Of course I hit protracted withdrawal two weeks after my jump and have been there ever since. I wonder if I’m going to have a much more difficult time with my drops now that my system has been sensitized and my reinstatement as never really settled my WD symptoms. Although they have improved. Perhaps I should wait longer before proceeding with more  drops . @brassmonkey I am going to drop down to the slide method and begin my 2.5% drops in 4 to 6 weeks once my system settles. Out of curiosity if I have an adverse reaction do you recommend up-dosing a small amount or holding until I settle?  Thanks.