Stardust Posted March 6 Share Posted March 6 What do you think about holding for another week, in case 6 weeks is the magic number? And then if your symptoms don't improve, updosing followed by a slow, careful taper... Current Taper Bupropion which I've taken for 20+ yrs- Start dose SR 100mg Jan '23, switched to IR 100mg. Held for 2 weeks; began taper using Brassmonkey Slide Method of Micro-Tapering; 2/23 Bup 100mg; 6/23 Bup 75mg; 7/22/23 Bup 64mg; 8/12/23 Bup 59mg; 9/2/23 Bup 56mg; 10/1/23 Bup 52mg; 11/4/23 Bup 46mg; 12/9/23 40mg; 1/13/24 35mg; 2/24/24 30mg; 4/13/24 25mg; 5/4/24 23mg; 6/10/24 20mg; 7/15/24 18mg; 8/5/24 16.6mg; 8/31/24 15mg; Other meds, supplements & previous tapers: buspirone plan to taper off after bupropion taper citalopram -20mg/day. Tapered from 40mg to 20mg using Brassmonkey Slide Method of Micro-Tapering clonazepam Tapered too fast - horrible withdrawal. BenzoBuddies.org is the best resource out there for benzo withdrawal. Vitamins D3, C , multivitamin, probiotics and Fish oil Link to comment Share on other sites More sharing options...
Tridentata Posted March 7 Share Posted March 7 I decided to updose by 10% to 1.1 mg and that seems to be helping a good bit after several days. So I just need to decide whether to stay here for a few weeks or get back down to 1.0 mg by the end of the month since I'll be asking my doctor for an Rx for compounded capsules I can take while travelling, and I'll need to specify the dose. (At home I use a water solution by dissolving 10 mg tablets.) For sure the slowness of a slow taper can be frustrating and inconvenient, but if in the long term it's better to have minimal withdrawal symptoms over that time than to speed things up and create shocks to the system that could have longer lasting effects, then it's worth it. Amitriptyline: prescribed 10 mg/day in mid-August 2022 Began fairly quick taper 18 October 2022 to 3 mg by 9 November (no withdrawal symptoms) Reinstated at 10 mg on 9 November leading to some serious sleep disturbance from 15 March 2023, continued slow taper (Brassmonkey slide, 2.5% week + 2 week hold every 4 weeks) to 0.7 mg as of June 2024. Other medications: albuterol inhaler as needed, acetaminophen as needed Supplements: daily multivitamin, magnesium glycinate 400 mg/day PRN, probiotics Link to comment Share on other sites More sharing options...
chevalier Posted June 9 Share Posted June 9 @brassmonkey So it makes sense that this method aims to minimize symptoms from tapering, and I know this is subjective, but for figuring out how much we want to cut per cycle (Ex. 10%, 5%, etc.), should I basically be having almost no symptoms, or is it ok/normal to have noticeable symptoms? For ex, I recently started this about two days ago with a goal of 5% drop per cycle (4 weeks + 2 weeks hold), I noticed some spaciness/head pressure with even such a small drop of 1.25% for the first week. It isn't debilitating or anything, but I guess I'm wondering if this is just part of the normal process and I should expect this after each drop, or if I need to stop tapering and then resume at an even lower drop per cycle. Any info recommendations you could provide would be appreciated, and I second what you've already expressed - the fear that I will start to spiral or crash and lose what stability I've had makes this process pretty daunting. Thanks! For record purposes, before I started tapering two days ago, I was on 40mg paxill total (2x 10mg tablets each morning and 2x10mg tablets at night). Went on/off various SSRIs and ability/latuda for several years (no issues) Feb 2021 - 40mg paxil Feb 2022: Tapered to 30mg paxil w/ 20mg prozac Mar 2022: Tapered to 20 mg paxil w/ 20mg prozac Last week of Mar 2022: Tapered to 10mg paxil w/ 20mg prozac Apr 10, 2022: Last day of paxil; still taking 20mg prozac Apr 22-Jun 4 - Bump to 40mg prozac with 50mg trazadadone Jun 27: Paxil reinstatement of 20mg with 50mg trazadone (no prozac) Jul 11: Bumped to 30mg paxil with 50mg trazadone Jul 28: Bumped to 40mg paxil with 50mg trazadone Aug 27: 40mg paxil with 50 mg trazadone Link to comment Share on other sites More sharing options...
Tridentata Posted June 9 Share Posted June 9 I'm not sure there's a general rule, given how individual people's tapering experiences are to various medications. I do know that in my case, once I had stabilized from an initial much too fast taper, I found a taper schedule that came close to producing no symptoms (a Brassmonkey slide, 2.5%/week for four weeks + 2 week hold). The "waves" I did still have were maybe once every two or three weeks, and lasted no longer than a couple of days in a row. (Sleep disruption has been my primary withdrawal symptom from the start.) I think a good target to aim at is to get to a place, if you can, where whatever symptoms you're having do not interfere with your everyday life. For what it's worth, I'm down to less than 0.75 mg daily from a starting dosage of 10 mg of amitriptyline (the lowest prescribed dosage), and that seems to be a low enough dosage in terms of effect on the system (receptor occupancy) that I'm able to increase the tapering percentage significantly. It took over a year to get to that point, and I may still need to slow down/hold if symptoms increase. It never hurts to start out with a very conservative slow taper, and as you get experience with your personal response you'll gain confidence in decisions about modifying it. Just one other thing based on experience: try as much as you can to avoid adding variables that might upset the process, like a new medication known to interact with the one you're tapering off. Amitriptyline: prescribed 10 mg/day in mid-August 2022 Began fairly quick taper 18 October 2022 to 3 mg by 9 November (no withdrawal symptoms) Reinstated at 10 mg on 9 November leading to some serious sleep disturbance from 15 March 2023, continued slow taper (Brassmonkey slide, 2.5% week + 2 week hold every 4 weeks) to 0.7 mg as of June 2024. Other medications: albuterol inhaler as needed, acetaminophen as needed Supplements: daily multivitamin, magnesium glycinate 400 mg/day PRN, probiotics Link to comment Share on other sites More sharing options...
Moderator brassmonkey Posted June 9 Author Moderator Share Posted June 9 As Tridentata mentioned, there is no set standard for how large of reductions to do, except to not exceed 10%. It comes down to how you are doing at the time and how much tolerance you have for the symptoms. As long as the symptoms are not debilitating, then you could with the larger reductions. Many people have reported that they are getting very mild symptoms with each reduction, even when doing the full 10% option. One thing to take into consideration is how long you will be tapering. The half-life of a 10% Brassmonkey slide is 9 months. So, if you are at 40mgai today, in nine months you would be at 20mgai. And so on until you make the jump. If you go with 5% you will double the half-life to 18 months. Considering that, with paxil, you should get down to 0.06mgai to make the jump, this ends up taking a very long time, even at 10%. The problem is that you can't rush it, or you will cause yourself great problems. Even with the smaller reduction you will be getting symptoms with each reduction. The plan is to make them more tolerable by breaking a large reduction into smaller bits. If you can tolerate the symptoms, then I would go with the 10% option. You can always "fine tune" the amount as you gain experience. 2 20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013. Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks. The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better. Final Dose 0.016mg. Current dose 0.000mg 04-15-2017 "It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general." Stephen Hawking Link to comment Share on other sites More sharing options...
Tania Posted September 28 Share Posted September 28 Hi, I'm a member of a Mirtarzapine slow taper group, and when I said I do a 10% over 4 weeks with a 2 weeks hold, they say its too fast, I should hold for 30 days as it takes that long to feel the effects...any feedback on that please? As I work full time and am a single mum Mirtarzapine: 2017 - 2018, 30mg 2019 - 2021, 45mg 11 December 2021: 41.25mg x 1 day, 45mg x 2 days (in alternate fashion) 22 December 2021: 41.25 approx (still cutting pills manually), 8 January 2022: 42mg, 16 February 2022: 40mg, 18 February 2022: 39mg, 25 April 2022: 36mg, 9 August 2022: 35.5mg, 23 August 2022: 35mg, 08 Sept 2022: 34mg, (Brassmonkey method started on 8th Jan) 29 Jan 2023: 31.8mg, 11 April 30mg Link to comment Share on other sites More sharing options...
Stardust Posted Tuesday at 04:32 PM Share Posted Tuesday at 04:32 PM @Tania How is your taper going? Does it feel too fast to you? Are you struggling with withdrawal symptoms? I wish I had the answer for you. I'm not tapering Mirtazapine but I'm using Brassmonkey Slide Method to taper off Wellbutrin/bupropion and it's been going well for me. There are always people with strong opinions about how things should be done. But I would weigh those opinions against others who are more moderate. Best wishes, Stardust Current Taper Bupropion which I've taken for 20+ yrs- Start dose SR 100mg Jan '23, switched to IR 100mg. Held for 2 weeks; began taper using Brassmonkey Slide Method of Micro-Tapering; 2/23 Bup 100mg; 6/23 Bup 75mg; 7/22/23 Bup 64mg; 8/12/23 Bup 59mg; 9/2/23 Bup 56mg; 10/1/23 Bup 52mg; 11/4/23 Bup 46mg; 12/9/23 40mg; 1/13/24 35mg; 2/24/24 30mg; 4/13/24 25mg; 5/4/24 23mg; 6/10/24 20mg; 7/15/24 18mg; 8/5/24 16.6mg; 8/31/24 15mg; Other meds, supplements & previous tapers: buspirone plan to taper off after bupropion taper citalopram -20mg/day. Tapered from 40mg to 20mg using Brassmonkey Slide Method of Micro-Tapering clonazepam Tapered too fast - horrible withdrawal. BenzoBuddies.org is the best resource out there for benzo withdrawal. Vitamins D3, C , multivitamin, probiotics and Fish oil Link to comment Share on other sites More sharing options...
Moderator brassmonkey Posted Tuesday at 06:24 PM Author Moderator Share Posted Tuesday at 06:24 PM What ever hold length makes you feel comfortable. Just don't go less than two weeks. 20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013. Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks. The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better. Final Dose 0.016mg. Current dose 0.000mg 04-15-2017 "It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general." Stephen Hawking Link to comment Share on other sites More sharing options...
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