ScenicCityNeuro: How can I help my patients wean their antidepressants?

[ScenicCityNeuro]

I own and operate a practice in Chattanooga, TN that utilizes rTMS, accelerated TMS (theta burst), minimally-stimulated ketamine infusion therapy (MSKIT), with the goal for most being the removal for the need of a daily medication. We work with insurance on all our treatment options and more than 85% of patients reach a state of significant relief of depression or anxiety within weeks of beginning the program. My patients who are on antidepressant and anti-anxiolytic therapies do well until the weaning of medications begin. Any advice or resources this community might have on how patients can perform a slow taper in a safe and reasonably comfortable way would be appreciated. Our program is big on patient education and long term patient successful improvement of quality of life. Thanks in advance!!

Edited August 8, 2023 by manymoretodays
name to title

[Altostrata]

Welcome, @ScenicCityNeuro

 

Thank you for asking those questions. Our tips for tapering are listed here.

 

These topics lay out our general rationale for tapering. 

Why taper by 10% of my dosage?

Why taper? SERT transporter occupancy studies show importance of gradual change in plasma concentration

The slowness of slow tapers
 
Taking multiple psych drugs? Which drug to taper first?
 

 

NEVER SKIP DOSES TO TAPER

 

 

Horowitz, M. A., & Taylor, D. (2019). Tapering of SSRI treatment to mitigate withdrawal symptoms. The Lancet Psychiatry, 6(6), 538–546. https://doi.org/10.1016/S2215-0366(19)30032-X

 

Framer, A. (2021). What I have learnt from helping thousands of people to taper off antidepressants and other psychotropic medications. Therapeutic Advances in Psychopharmacology. https://doi.org/10.1177/2045125321991274

 

Hengartner, M. P., Schulthess, L., Sorensen, A., & Framer, A. (2020). Protracted withdrawal syndrome after stopping antidepressants: A descriptive quantitative analysis of consumer narratives from a large internet forum. Therapeutic Advances in Psychopharmacology. https://doi.org/10.1177/2045125320980573