The Brassmonkey Slide Method of Micro-tapering

[Yesyes123]

21 hours ago, VaultOne said:

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. 

 

I'd wait a bit before reducing further aiming to stabilize.

 

6 months at the same dose go by quick, would help you stabilize week by week and your body would thank you for being gentle.

 

The thing is, we all want to be out and away from this as quick as possible - still, it's much better and smarter to go slow and once you're off, you're done with it for good.

 

Don't rush it!

 

Peace and healing

[Mahadeva]

i have a question about this method.

 

I don't know if its informed on the post, but the reduction is always the same rate of 2.5% of the full dose, or you reduce 2.5% of the last dose?

 

Like if u start with 10mg u start by removing 0.25mg peer week, this 0.25 will be followed till the end?

[ChessieCat]

@Mahadeva The reduction is based on the current dose, not the original or starting dose.  So if you are taking 100mg the first reduction is 90mg, the next reduction is 10% off 90mg (not 100mg) so it would be 81mg.

 

Please see Post #1 of this topic.  At the bottom of the post you will see 2 graphs, one is the graph of a 10% hyperbolic taper (calculated on previous dose) and the other one is a 10% linear taper (calculated on the original/starting dose).

 

why-taper-by-10-of-my-dosage

 

[Mahadeva]

3 minutes ago, ChessieCat said:

@Mahadeva The reduction is based on the current dose, not the original or starting dose.  So if you are taking 100mg the first reduction is 90mg, the next reduction is 10% off 90mg (not 100mg) so it would be 81mg.

 

Please see Post #1 of this topic.  At the bottom of the post you will see 2 graphs, one is the graph of a 10% hyperbolic taper (calculated on previous dose) and the other one is a 10% linear taper (calculated on the original/starting dose).

 

why-taper-by-10-of-my-dosage

 

 Ty Chessie,

 

It's really not safe in my case were i'm doing the standart 10% month liquid suspension taper at 5mg of Olanzapine, and when i reach 1mg following the schedule, to reduce from 1mg to 0 in 12 months? I'm afraid of needing to do the whole process for 6 years, when i will be 36 years old, and not being able to have a job and study because of this meds, i have been taking them many kinds, mostly anti psychotics for 12 years, and i'm unable to sleep well, wake up before 12 pm, cognitive and memory problems, so i cant have a job or study right now.

 

3 years ago after a psychotic outbreak , when the crisis went off i went cold turkey on 10mg aripirazole, i went throught a hell for 4 months, not psychotic, but a living nightmare, and on the 5 month i started to take back magnesium and valerian capsules, and i very quickly improved , on the 6-7 month i was feeling great and my life was back really quick.  I stayed like that for 1 year before going back to smoking weed and having another psychotic outbreak and put on meds again, so i think my brain had a good reset for 1 years,dunno, i don't want to mess the taper, but 6-8 years seems so much .

[brassmonkey]

The Brassmonkey Slide calculates the reduction in both ways. The overall 10% reduction is calculated off of the previous dose to provide the hyperbolic taper. While the 2.5% reductions are calculated off of the current dose.

 

If your previous does was 10mg a 10% reduction would give you a new total dose of 9mg. 

That reduction is broken into 4 equal parts of 2.5% each giving doses of 9.75mg, 9.5mg, 9.25mg and 9mg. Which are taken on successive weeks. The 9mg is then held for an additional 2 weeks. 

the next reduction cycle is calculated based on 9mg (9 X 0.9= new total reduction) and that reduction is divided into 4 equal parts of 2.5%.

 

Do not smoke weed while tapering psych drugs, it is almost guaranteed to derail your tapering process and set you back many months.

 

Tapering these drugs is a long and sometime difficult process, but it cant be rushed. The Brassmonkey Slide Method has a basic half life of 9 months. So if you are currently taking 10mg, nine months from now you will be taking 5mg and nine months after that 2.5mg. And so on until you reach about 0.02mg where it will be safe to make the jump to "0". If you try to speed things up it will more than likely take even longer.

[Eastcoastgirl]

I have been tapering for two years now using this method and it has saved me. I am almost done and thanks to this I went from thinking I wasn’t going to make it through to having almost no withdrawal symptoms the entire time, so thank you so much for coming up with this amazing method @brassmonkey, it’s been amazing. 

[Faure]

I have been doing this method since June 2020 and am now at 2/3 of my original dose with no loss of stability and a continual, gradual improvement in how I'm feeling. I also have more energy. At first I was reluctant to do the two week hold but I did it and have come to realise it's vital to give me a break from all the drops which do take a toll in the 3rd and 4th weeks. I now appreciate the two week hold very much as a time to adjust, start feeling a lot better and preparing to go again. Thanks @brassmonkey🙂

[neurogenesis]

This taper  is interesting i might do this with seroquel

I had psychosis supersensitivity from going 50 to 0 cold turkey ,i hope it will resolve with a slow taper like this

[ChessieCat]

@bastringue

The discussion has been moved to your Intro topic here:

 

bastringue-is-my-tapering-strategy-good

 

[Stardust]

I followed the Brassmonkey method for citalopram/Celexa taper and it was a smooth ride.  I plan to follow the method for my taper off bupropion too.

What is your suggestion for making reductions when the daily dose is split?  I'm switching from sustained release bupropion to immediate release bupropion for the taper. I'll be splitting my dose into two (or three) to mimic the sustained release.  Would you apply the 2.5% reduction to the total daily dose or would you apply the reduction to the afternoon dose first(because bupropion is activating and can interfere with sleep)?

[brassmonkey]

Either method would work fine.

 

I don't think splitting the dose will make much difference, it depends on how sensitive you are and how you react when you take the dose. If you do split the dose, I would take the percentage off of the evening dose because of the activation issues.

[LostInCanada]

On 4/22/2018 at 12:07 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.

 

Here is an online calculator based on the Brassmonkey Slide Method of Micro-tapering http://www.taperoff.co/

 

See also:

 

Calculators:

BrassMonkey Slide Online Calculator

tapering-calculator-at-reversepsychiatryorg

Micro Taper Off calculator with built-in 2 week hold  see this post how to check total reduction is <10%

simple-brassmonkey-slide-tapering-spreadsheet (below in this topic)

 

BrassMonkey Slide – Pick your taper rate

 

Micro-taper instead of 10% or 5% decreases
Making a liquid from a tablet or capsules

Using a digital scale to measure doses

---

 

 

The Brassmonkey Slide Method

 

Starting a taper can be a very scary proposition.  I’ve heard is mentioned repeatedly by our new members and even by members who have been on extended holds and are about to restart. The overwhelming concern is fear of the symptoms that can be unleashed by reducing the drug in question.  I was as bad as anyone else, I was scared to death before I started my taper, and just for that reason.

 

Most of us try to research our taper before we start, so we can make a plan and have some idea what we are getting ourselves into. That research often includes reading a lot of other people’s stories, which can be very upsetting.  This can be a source of a lot of misinformation, out of context statements and vivid details that are hard to ignore.  Which is why we have a large number of forums that give detailed information of how, when and why to taper.

 

The symptoms that are experienced during a taper can be far from pleasant and keeping them at a minimum is a prime goal of any taper plan. With this in mind, the protocol of reducing a person’s dose by 10% of the previous dose every four (4) weeks was established.  Over the years it has proven to be a good starting point and has been very effective for many people.  It does, however, prove to be too harsh for others.

 

The second option is the “micro-taper”.  This involves reducing a tiny amount every few days over a very long time.  It does a great job of reducing symptoms but is very tedious and takes a very long time to complete.  There needs to be something in between.  Something that can reduce the effects of the symptoms and yet doesn’t take forever to complete.  This is where the Brassmonkey Slide Method comes in.

 

The idea behind the Brassmonkey Slide Method is to maintain the speed of a standard 10% taper while reducing the symptom load by taking the reductions in smaller bits.  When I was researching my taper, I observed that there was a large hit of symptoms that occurred several days after the reduction was made.  These symptoms would then peak and decrease over the next several weeks until the person would return to an average state of feeling bad.  My idea was that if the reduction were taken in smaller pieces fairly close together you would experience reduced symptoms for a shorter period of time and by doing reductions back to back, as the symptoms resolved, a person could maintain a 10% reduction and experience reduced symptoms.

 

The basic Brassmonkey Slide Method consists of four (4) weekly reductions of 2.5% in a row with an additional two (2) week hold.  This gives a total reduction of 10% ever six (6) weeks.  Although it isn’t the standard reduction plan it is very close.  The extra two (2) week hold is very necessary to let the cumulative effects of the four (4) reductions settle out and things return to baseline before attempting the next reduction.

 

So, the reduction schedule looks like this:

 

            Week 1 reduce 2.5%

            Week 2 reduce an additional 2.5% (for a total of 5%)

            Week 3 reduce an additional 2.5% (for a total of 7.5%)

            Week 4 reduce an additional 2.5% (for a total of 10%)

            Weeks 5,6 Hold at the last reduction level

 

This schedule proved very effective for the duration of my taper and has been used by many others with great success.  But, it’s not the only way to do it.

 

Some people find that even on this schedule the symptom spike after each drop is just too great.  For them the answer has been to take even smaller reductions.  Any combination of four (4) small reductions and a hold can be used. A reduction of 1.25% a week will yield a total drop of 5% or a reduction of 0.625% would give a total drop of 2.5%.  A very popular method is to reduce by 1% a week. 

 

We need to keep in mind though, the lower the reduction percentage the longer the taper will take to complete. The half-life of a standard 10% taper is six months.  Meaning that six months from now you will be at half of your current dose. If the taper is reduced to 5% the half life doubles to a year. Like wise a 2.5% taper would have a half-life of two years.

 

No matter what the reduction rate is it is very important to maintain the two (2) week hold every round of four (4) reductions. The symptoms that we feel after a drop are only a small part of what is happening to us.  Psych drugs work by making physical changes to the body.  As we taper these changes need to be undone in an orderly manner, so the body can continue to function the way it is meant to.  If we don’t allow time for these changes to be made properly they pile up and pile up until there are just too many of them.  The body then gets very confused and a crash occurs.  That crash will take a long time to correct and stabilize.

 

This behind the scenes repair work is one of the keys to the Brassmonkey Slide Method.  By making smaller reductions the bodies “to do” list is kept to a manageable size and most of the tasks can be completed before the next reduction happens.  Giving the body an extra two (2) weeks helps make sure it has enough time to get it all done. If the reduction is too large then the “to do “ list is also quite large and the body has a much tougher time getting started on the jobs and figuring out what to do first.

 

Another benefit to the Brassmonkey Slide Method is that it feels like it is very proactive.  I see a lot of comments from members who feel like they are not doing enough to help themselves get better.  Making any decision and sticking to it is being proactive with a taper but the long periods of time between decisions can cause people to lose track of that.  By making a controlled reduction in dose every week it makes it appear that things are progressing faster, even though the total reduction is the standard 10%.  This can be quite a boost for people who “want to take control of the situation”.

 

With all these changes being made it is a good idea to keep written records.  This will help track your progress, but it will also help keep things from getting confused.  With a constantly changing dose it is very easy to lose track of where you are and start making mistakes.  The records don’t have to be elaborate. I tracked the date of the reduction, the amount of the reduction, the strength of the dose in mgai and the weight that I would measure on the scales in mgpw, on a weekly basis.

 

Mgai, milligrams active ingredient, being the strength of the dose starting with the full strength listed on the bottle and reduced by the percentage of the reduction each week, i.e.33.2mgai.  While mgpw, milligrams pill weight, being the weight of the dose that is measured on the scales, starting with the weight of a whole tablet and decreased by the percentage of the reduction each week, i.e.265mgpw.

 

Example: October 23; 2.5%; 33.2mgai; 265mgpw

 

As with any taper it takes a long time to get off these drugs.  Using the Brassmonkey Slide Method is a way to keep that time as short and as painless as possible, while maintaining a feeling of control and allowing your body to make the changes necessary to heal in an orderly fashion.

 

Hi, thanks for your time. When you tapered off Paxil, did you do it solely by cutting tablets? Or did you crush the tablet and fill gel capsules? What size of tablet did you use? Are you confident the drug distribution is even throughout the tablet? Also what scale did you use? My scale goes to .0001g, is it enough? 

[brassmonkey]

I did my entire taper by crushing tablets and filling capsules. I used 40mgai tablets the entire time. I used a Gemini-20 jewelers scale that weighted to 0.001g. If yours goes to 0.0001 that is more than adequate.

 

Your worry about the active ingredient not being well mixed in the tablet is quite common. I wrote an article several years ago called "Myths about your drugs". Here is a section of that article:

 

It’s All in the Mix:

 

One of the biggest fears regarding tapering we encounter here at SA is that the active ingredients in a medication are not evenly distributed throughout the fillers. This leads to people thinking that if they are taking a small portion of a tablet or of the powder in a capsule that they will not be getting the “full dose” that they are expecting. This assumption is totally wrong.

 

The manufacturing of drugs in one of the most regulated processes in the world and is overseen by the coordinated effort of a number of international organizations. These include the Current Good Manufacturing Practice regulations enforced by the FDA, the International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use, the World Health Organization, the Pan American Network on Drug Regulatory Harmonization (PANDRH), Internation Society for Pharmaceutical Engineering (ISPE), European Directorate for the Quality of Medicines and Healthcare (EDQM) and several others.

 

Each of these organizations has an extensive set of regulation on the manufacturing processes involved in making medications and has the power to enforce those regulations.  They also coordinate freely with each other to maintain unity in those processes and regulations. One of the foundations on which these regulations are based ins the Essential Standards for Pharmaceutical Manufacturing written by the American Society for Testing and Materials. Another document containing links to all the US federal guidelines for manufacture, testing and marketing drugs is here: https://www.dshs.state.tx.us/drugs/federal-regulations.aspx

 

What it comes down to is that, even though we here at SA don’t like what these products have done to us, they are some of the best products produced in the world when it comes to quality.

[LostInCanada]

Thank you so much for answering my question and lessening my fears 

[duffy]

On 10/12/2021 at 5:24 AM, brassmonkey said:

 

 

Do not smoke weed while tapering psych drugs, it is almost guaranteed to derail your tapering process and set you back many months.

 

What mechanism causes this are there some examples on this forum?

 

is it the same for cbd?

[caracol]

I have been tapering effexor. I started at 150mg and now am at 125mg and i reduce by 2.5% every 14 days. I smoked heavily up until 5 days ago. now i am weed free and It has been difficult but I know I need to do this to get a clear picture of how effexor and the reduction is making me feel. Weed was giving me anxiety and overstimulating my brain. 

[Tridentata]

I don't know what the mechanism is and I expect that THC/CBD doesn't affect everyone the same, but in my case eating one gummy with 25mg CBD and 2mg THC seriously derailed my taper off amitriptyline, taking nearly a month to stabilize. Never again.

 

Question for Brassmonkey or anyone else: should my goal with microtapering be to come as close to zero WD effects as possible, or should I expect there will always be at least a short wave period to suffer through as I decrease? My WD symptoms are mild as things go, mainly bad sleep disruption from cortisol flare. The bad waves have never lasted more than 3 or 4 nights, and for the past couple of months not more than maybe two nights. Should I try to reduce that to zero nights (which would probably require a sub-5% taper) or is that a reasonable "price" to pay for a reduction of 5% every 2 to 3 weeks (with holds as needed)?

[Gridley]

5 hours ago, Tridentata said:

should my goal with microtapering be to come as close to zero WD effects as possible, or should I expect there will always be at least a short wave period to suffer through as I decrease?

In my opinion, there will always be at a least a short period of WD.  From your description of your symptoms, the "price" you pay is reasonable.

[brassmonkey]

Everyone is going to experience some sort of WD symptoms with each reduction. The trick is to keep them as manageable as possible.  That's the point behind the Brassmonkey Slide Method. The smaller reductions cause small symptoms that resolve faster, so you can do the smaller reduction more frequently.

 

Marijuana acts on the same neurotransmitters that psych meds work with. By smoking weed while tapering you are defeating the process. Both THC and CBD are at fault.

[LostInCanada]

I noticed as I weigh my 10mg paroxetine (generic Apotex), the pills vary between .117g to .126g. Most are around .12g. Would it be prudent of me, since I am trying to stabilize, for consistency, just cut my pills all to .06g pill weight. Then use that as my 5mg moving forward instead of fluctuations even if they are minor.

[brassmonkey]

Consistency is the key to smooth tapering. That is quite a wide variation you are getting with your tablets. Yes, I would try to work with a fixed weight to stabilize. Instead of trimming individual tablets, you may want to try crushing several and using the powder as a stockpile from which you draw a specific amount for each dose.

[LostInCanada]

Thanks so much, I was surprised to see such a range with this bunch.

[LostInCanada]

2 hours ago, brassmonkey said:

Consistency is the key to smooth tapering. That is quite a wide variation you are getting with your tablets. Yes, I would try to work with a fixed weight to stabilize. Instead of trimming individual tablets, you may want to try crushing several and using the powder as a stockpile from which you draw a specific amount for each dose.

I am glad I am cutting and weighing as opposed to making a liquid or else I would not have found this inconsistency. I weighed 50 pills and got an average weight of .118g so my dose will be half that moving forward. .059g of pill weight will be 5mg paroxetine. Did you use gel capsules or just took it as powder? 

[brassmonkey]

Gel caps make it so much easier. You can make up several weeks' worth at a time and not have to worry about.

[LightLovePeace]

On 10/11/2021 at 2:24 PM, brassmonkey said:

Tapering these drugs is a long and sometime difficult process, but it cant be rushed. The Brassmonkey Slide Method has a basic half life of 9 months. So if you are currently taking 10mg, nine months from now you will be taking 5mg and nine months after that 2.5mg. And so on until you reach about 0.02mg where it will be safe to make the jump to "0". If you try to speed things up it will more than likely take even longer.

I have a question here. If you were to taper off of 2.5mg lexapro, would it take 9months using this method? If someone could look at this PDF I made of the spreadsheet on this site, it would take about a year. Is that correct with the 10% taper per week and not the 2.5% taper recommended? Thank you for your help.

LightjoyPeace_Taper%20spreadsheet.pdf

[brassmonkey]

Yes, your spread sheet is correct. But this taper is far from recommended.

 

This schedule would give a reduction of 40% every six weeks. This is four times as fast as what we have found to be a safe rate of reduction. Things would go smoothly for the first several months, you might even be feeling wonderful. Then between months three and six it would all fall apart. You would get a major crash, the likes of which you don't want to experience. At this point, you would have to hold until things stabilize which could take six months to several years before you could start to taper again.

[LightLovePeace]

Yes, I saw that the reduction you recommend is 2.5 percent every week and a two week hold. So it would take 2-3-4 years to taper down from 2.5mg? Is this usually how long it takes? I'm no where near tapering. I'm not even stable yet if you read my thread. I'm scared to death right now. But I wanted to understand your method. Thank you so much for your time again.

[bastringue]

6 minutes ago, LightLovePeace said:

Yes, I saw that the reduction you recommend is 2.5 percent every week and a two week hold. So it would take 2-3-4 years to taper down from 2.5mg? Is this usually how long it takes? I'm no where near tapering. I'm not even stable yet if you read my thread. I'm scared to death right now. But I wanted to understand your method. Thank you so much for your time again.

 

I've been following this tapering strategy so far and something that has helped me a lot is : eating well, taking magnesium, taking omega-3s, vitamin D3 (with K2!) and I've had some success with amino acids as well, mainly l-tryptophan and 5-htp (++serotonin) for sleep and l-tyrosine (++ dopamine) for motivation. Things are going so smooth for me right now that I will slowly accelerate the process as I've never ever got any depression from April to August. I will go down 5% per week for four weeks (then stay at the same lever for two weeks) from now until August, then will go back to 2.5%. Of course, with 5% per week I will be sure to continue on my amino acids supplementation for maximum serotonin / dopamine boost.

 

I also tried folate and B12, which are usually depleted when on antidepressants, but got mixed results. YMMV

 

I know everyone won't agree with me about this, but I also feel that waiting for like 5-6 years to taper down is kind of slow. It's important to be safe and to know oneself, and I feel confident because summer is my best time of the year and supplements seem to work fine for me.

 

Maybe you can try some of the supplements listed above?

[Jilla]

Greetings!

I have been withdrawing from CT Paxil for the past year…getting better but still having withdrawals.
While in hospital, Dr.’s put me on Trazadone and Duloxitine as they thought I was in relapse not withdrawal…quite common I’ve heard.

My question is this: Would it be better to slowly start tapering one of the other meds while still in withdrawal from Paxil? Or wait until totally healed? 
I’m concerned about being on these other meds for too long. I mean, what if my withdrawals last for a few more years? That means I will have been in these other meds for longer. I know this is probably not an easy one to answer, but would like your thoughts. And has anyone tried this? Thanks!

[Tridentata]

I've been following the 2.5%/week reduction plus two-week hold after 4 reductions for a while now, and my WD symptoms are much milder--very little sleep disruption, nothing like a real "wave" for several weeks. Wondering whether, if that continues to be the case, it might be worth trying a 3%/week reduction, aiming at 12% over 4 weeks then 2 week hold. Current schedule would have me tapering for a bit over two more years (down from original 10 mg); shaving four months off that wouldn't be huge but would make the light at the end of the tunnel a little brighter. Experience of others who have done something similar with success (or the opposite) would be helpful!

[Kelsears]

@brassmonkey

 

could I get help with taper plan of 7.5mg of liquid Zoloft micro taper? I’m looking for syringes what can measure out the odd doses. 
 

thank you 

Kelly

[bastringue]

4 minutes ago, Kelsears said:

@brassmonkey

 

could I get help with taper plan of 7.5mg of liquid Zoloft micro taper? I’m looking for syringes what can measure out the odd doses. 
 

thank you 

Kelly

 

What about simply diluting it in water? You can get 60 ml small bottle. You then simply pour your 7.5 mg into 60 ml, and then you'd get 8 ml per mg, so simply math then. Or maybe you pour the 7.5 mg first and then fill to 60 ml. Whatever you choose, it's simply math and you can now easily taper down.

 

I do the same with amitryptilyne. I fill the bottle to 60 ml, then put 3 X 10 mg in there, so I get 30 mg for 60 ml, or 2 ml per mg. It's much easier then to taper down. 

 

Hope it helps!

[Kelsears]

@bastringue

my brain is not functioning and this went way over my head. I currently measure the 7.5mg and place in 1/4 cup water per instructions on the bottle. 

[LostInCanada]

@Kelsears 1/4 cup is 60 ml. I think it is important to use ml as a measurement because that is what syringes use. Most people on here get syringes on Amazon. There are various sizes 1ml, 3ml, 5ml etc. Are you taking 7.5 mg of Zoloft daily or 1.5 mg? Are you wanting to use the brass monkey slide method or the straight 10%?

[Kelsears]

@LostInCanada

I'm currently at 7.5mg of liquid Zoloft using a 1ml syringe then dispensed into water and drink.  I want to do a slow taper this is my reinstatement dose. So slow and steady. I also have to wean Ativan after tapering off Zoloft. 

[LostInCanada]

@Kelsears not sure if I am understanding correctly. You are taking 7.5 mg of Zoloft daily? If so your new dose would be 6.75 mg for 4 weeks. If you wish to do the brass monkey slide, your dosages would be week 1-7.32 mg, week 2-7.14 mg, week 3-6.96 mg, week 4-6.78 mg. Then you hold for 2 weeks.