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  1. ADMIN NOTE: Read this entire topic before attempting a switch to fluoxetine. Be sure to read details and cautions below . Consult a knowledgeable medical practitioner before changing medications. Also see Tips for tapering off fluoxetine (Prozac) Switching or bridging with another related drug, usually of a longer half-life, is a medically recognized way to get off psychiatric drugs, particularly if you find tapering your original drug to be intolerable. Many people with failed tapers from venlafaxine (Effexor), desvenlafaxine (Pristiq), paroxetine (Paxil), and duloxetine (Cymbalta) find they need to bridge in order to go off the drug. For many doctors, a switch to Prozac to go off a different antidepressant is routine. Because of the risks of switching drugs -- see below -- we recommend attempting a very gradual direct taper from your drug, with bridging with a different drug only a last resort. There are a lot of unknowns in bridging. Fluoxetine (Prozac) has the longest half-life of any of the modern antidepressants. Because it takes more than a week for a dose to be metabolized completely, a careful taper off fluoxetine is easier for many people -- see information about Tapering off Prozac. And, at least fluoxetine comes in a liquid. (Do not assume fluoxetine is "self-tapering"! We have many people here with Prozac withdrawal syndrome. While going off fluoxetine usually has less risk, one might still develop withdrawal symptoms going off fluoxetine. No bridging strategy is risk-free.) Citalopram (Celexa )and its sibling escilatopram (Lexapro) have half-lives of about 35 hours, a relatively long half-life among SSRIs, and are other candidates for a bridging strategy. They also come in a liquid form. You must find a knowledgeable doctor to help you to with a bridging strategy. The cross-taper method discussed below is probably the safest way to make a change in drugs. You might wish to print this post out to discuss it with your doctor. For most people the switch goes smoothly but for some it doesn't. The drawbacks of switching to another drug to get off the first drug, described below, apply to ALL bridging strategies for ALL drugs, including benzodiazepines (where people often want to bridge with diazepam per the Ashton method). Risks of bridging A bridging strategy has the following drawbacks for a minority of those who try it: Dropping the first antidepressant in the switch may cause withdrawal symptoms even though you're taking a bridge drug. Adverse reaction to the bridge drug, such as Prozac. Serotonin toxicity or adverse effects of a drug combination. If withdrawal symptoms are already underway, switching to a bridge drug may not help. A cross-taper requires a number of careful steps. Difficulty tapering off the bridge drug. All of the bridge drugs can be difficult to taper themselves. So, like anything else, a drug switch is not guaranteed to work. When to switch or bridge "The devil you know is better than the devil you don't know". A direct taper from the drug to which your nervous system is accustomed carries less risk than a switch to a new drug. You may have a bad reaction to the substitute drug, or the substitution may not work to forestall withdrawal symptoms. The risk of a switch is justified if you find a taper from the original drug is simply too difficult. Usually people will do a switch when they find reducing the original antidepressant by even a small amount -- 10% or even 5% -- causes intolerable withdrawal symptoms. (I have heard doctors say they don't even try tapering off paroxetine (Paxil) or venlafaxine (Effexor ), they switch to Prozac at the beginning of the tapering process.) If you are having intolerable withdrawal or adverse effects from an antidepressant, it may be worth risking the worst case, which is that a switch to a bridge drug doesn't help and you have withdrawal syndrome anyway. If you're thinking of switching simply as a matter of convenience, you need to weigh the risks against the amount of convenience you would gain. Generally, switching for convenience is a bad idea. CAUTION: A switch to a bridge drug is not guaranteed to work. It's safer to slow down a taper than count on a switch. A switch really should be used only when a taper becomes unbearable or there are other serious adverse effects from the medication. You must work with a doctor who is familiar with bridging, in case you develop severe symptoms. Overview of cross-tapering method For drug switches, many doctors prefer cross-tapering, where a low dose of one drug is added and gradually increased while the first drug is reduced. For a period, both drugs are taken at the same time. Here is a graphic representation of cross-tapering: If you are making a switch to Prozac, the second antidepressant is fluoxetine (Prozac). Given fluoxetine's long half-life, it may take a couple of weeks to reach full effect. The effect of the amount you add at each stage of the cross-taper will build throughout the process. As it is possible to overshoot Prozac dosage, it's best to be very conservative about increasing fluoxetine throughout the cross-taper, you could end up with serotonin toxicity from too much fluoxetine (see below). Also see this discussion about cross-tapering with Prozac: Serotonin toxicity and serotonin syndrome You run the risk of serotonin toxicity if you are taking too much serotonergic. Most antidepressants (and some other drugs, such as triptans and MDMA) are serotonergics. Serotonergic effects of antidepressants are added when you take more than one of them, particularly if you add an SSRI (such as Prozac, Celexa, or Lexapro) to an SNRI (such as desvenlafaxine (Pristiq), duloxetine (Cymbalta), venlafaxine (Effexor), venlafaxine XR (Effexor XR), milnacipran (Savella), and levomilnacipran (Fetzima)). (Other types of antidepressants should not be combined with tricyclics or MAOIs.) Symptoms of too much serotonergic can be: Nervousness, anxiety, akathisia, sleeplessness, fast heartbeat. Symptoms of serotonin toxicity can be these plus disorientation, sweating, and others. Serotonin syndrome is even more serious. See Serotonin Syndrome or Serotonin Toxicity Reduction of the drug dose should resolve serotonin toxicity. Note that if you cross-taper, you will be taking 2 drugs at once for part of the time. Because of the potential of serotonin toxicity by overdosing SSRIs as well as in combination with SNRIs, it's safest to err on the lower side of a Prozac dose "equivalent" -- such as 5mg -- to your original drug. This is why doctors familiar with the Prozac switch will cross-taper by adding an initial LOW DOSE of Prozac to an SNRI. Start low, the effect of fluoxetine will increase over several weeks. Another concern: Escilatopram (Lexapro) is several times stronger, milligram for milligram, than the other SSRIs. If you add 10mg escilatopram to the high dose of 60mg duloxetine (Cymbalta), for example, you run the risk of serotonergic toxicity -- 10mg escilatopram is equal to approximately 20mg-30mg duloxetine. How much fluoxetine (Prozac) to substitute for my drug? Since fluoxetine's half-life is so much longer than those of other antdepressants, its effect is a little different. It's not a stronger antidepressant, but the effect of each dose lasts much longer. This may be the reason a lower dose of fluoxetine often seems to adequately substitute for other antidepressants. For an idea of equivalent doses of your medication to fluoxetine (Prozac) read this post (January 7, 2018) in this topic. It compares fluoxetine 40mg/day (a fairly high dose of Prozac) to other antidepressants. Source of that data: https://www.ncbi.nlm.nih.gov/pubmed/25911132 If you have tapered to a lower dose of an antidepressant, an even lower dose of Prozac may be more tolerable. If you are about half-way down, you might want to try 10mg Prozac. If you have decreased further, you may wish to try 5mg Prozac. If you have substituted fluoxetine for your drug and after two weeks, you feel you have withdrawal symptoms, you may wish to gradually the fluoxetine dosage. After each change in fluoxetine, wait at least 2 weeks to see the effect before deciding on another increase. More is not better for nervous systems sensitized by withdrawal. EXAMPLES OF THE PROZAC SWITCH Below is information I've gathered from doctors about how to do the Prozac switch. You will see there is no standard protocol. Healy 2009 method for the Prozac switch From Healy 2009 Halting SSRIs withdrawal guidelines: Phelps-Kelly 2010 method for Prozac switch From Clinicians share information about slow tapering (2010) Jim Phelps, one of the authors of the above, posted in 2005 in some detail about the so-called "Prozac bridging" strategy. He said it is described in Joseph Glenmullen's book, Prozac Backlash, maybe in the chapter titled of "Held Hostage." The technique Dr. Phelps described in this post skips doses and finishes with alternating dosages, which we do not recommend for people who are sensitive to withdrawal symptoms. Given that fluoxetine liquid is available, this is completely unnecessary. Foster 2012 method for Prozac switch Dr. Mark Foster, a GP whose mission is to get people safely off psychiatric drugs includes this in a presentation he gives to doctors. http://www.gobhi.org/spring_conference_powerpoints/safewithdrawal_of_psychotropics%5Bautosaved%5D.ppt. His method involves overlapping Prozac with the other antidepressant -- cross-tapering. Prey 2012 method for Prozac switch Another knowledgeable doctor (whom I trust) explained his technique to me (this is the technique I personally would prefer if I had to do it, it seems much gentler) For a "normal" dose of Effexor (150mg per day or more) or Paxil (20mg) or Cymbalta (20mg), he would switch to 10mg Prozac with a week of overlap. In other words, take both medications for a week and then drop the Effexor. Lower doses of Effexor or other antidepressant require lower doses of Prozac as a "bridge." The lower dose of Prozac reduces the risk of excessive serotonergic stimulation (serotonin toxicity) from the combination of the two antidepressants during the overlap period. Do not stay on the combination of the first antidepressant and Prozac for more than 2 weeks, or you run the risk of your nervous system accommodating to the combination and having difficulty tapering off both antidepressants. Later, taper off Prozac. He acknowledged Prozac can have its withdrawal problems, but given Prozac's long half-life, gradual tapering should be easier than tapering off Effexor. Smoothing out a transition to fluoxetine Even with a cross-taper, your system might feel a jolt after you finally drop the initial antidepressant, particularly if it is an SNRI, such as Effexor, Pristiq, or Cymbalta, or other drug that is not an SSRI like fluoxetine. (Other SSRIs include Paxil, Zoloft, Luvox, Celexa, Lexapro). If you go through a rough patch after the transition, patients find they can take a tiny chip of the original drug (or a bead or two, if it's a capsule containing beads) for a week or two to smooth out the transition. Eventually, you'd take a chip as needed only when you feel a wave of withdrawal from the original drug, and then finally leave the original drug entirely behind. (A gelatin capsule might make a tablet fragment easier to get down, but it is not necessary if you can wash it down with a good swallow of water. The gelatin capsule quickly dissolves in your stomach.) Here's an example. There is no shame in doing this. Whatever works, works.
  2. Most, if not all, of us on here keep notes or track symptoms, progress and tapering schedules. Wouldn’t it be wonderful if we could combine them all in one big AI database and have it spew out the statistically significant data? Until that comes to fruition, I wanted to share some patterns that I have tracked with my daughter’s anti-psychotic tapering progress over the last two years. Maybe others have seen similar patterns? Or can share their noticeable patterns on the specific days or weeks when they occur from a drop in dose/ taper time frame. So often in the throes of withdrawal agony we look for a way to ‘fix’ our current situation. We ruminate whether we should up dose, taper down, throw a supplement at it, add a different med …. In the hopes of making the current “pain”, better. Pretty much I have thought of all those things except throwing in the kitchen sink in an attempt to ‘make it stop’ for her. As it is often cited and discussed here on Survivingantidepressants.com, learning how to cope using non-drug techniques during these times is the best strategy. Can knowing when you are in the middle of something awful, that what you are experiencing is actually a typical pattern others have gone through and will eventually subside…be of benefit to help ‘ride the wave?' I vote, "yes it can." The pattern that I have noticed for my daughter, Glo, is what I call the “Week Three Phenomenon.” This phenomenon became more apparent as her dose became lower. Probably because she was pretty much ‘zombified’ on the higher doses and it was only when her level of alertness improved and just overall feeling better occurred that the ‘down patterns’ emerged more clearly. Week Three Phenomenon occurs between day 15 and 22 after a taper. It shows up as Emotional Spirals, (typically Anger Spirals), Crying Spells, Agitation and increased Insomnia. Week one and Week two have their share of symptoms but typically not these. Actually those weeks have more physical symptoms and less emotional symptoms. Additionally there is more “calm” in week 2. So one might think, “Ahh I made it through the rough parts of that taper” and then boom….not so much. But then by week 4…pretty much on cue for day 22 or 23…the calm returns. Maybe this is Windows and Waves but maybe it is actually repair work going on from the drop in dose. Maybe there is really a methodical way the brain heals and it impacts certain areas of the brain in succession (the amygdala, hippocampus, frontal lobe perhaps)? Similar to the old fashioned arcade Pinball Game only the “ball” pings the same areas of the brain in a repeatable fashion after a taper? I am certainly only a mother observing my daughters behaviors and actions through this process so, no expert am I. Nor do I really know what she is feeling as she does not talk much any more. However, I can count on these emotional spirals showing up on week 3 like clockwork. The other pattern I see relates to Menstruating Females. This pattern is most discernible when one is having regular periods. Glo went from amenorrhea in the beginning to irregular periods then to regular but shortened periods. But every month when she is regular her symptoms go ‘off the charts’ during ovulation. They last about 24 to 36 hours and occur mostly 14 days before the start of her next period. She has ramped up pacing (I am assuming akathisia), chewing/jaw tension, agitation, insomnia and decreased level of alertness/communication. This same pattern emerges 24 to 48 hours before she starts her period. So what happens if my sweet beautiful daughter is in Week Three of a taper and ovulation or her menstrual cycle arrives? Well, if the general public, doctors or psychiatrists were around they would lock her up in a psych ward and “med her up” (to refer to words by @puthappinessfirst) Fortunately, I will not let that happen. It is comforting to me to know these are patterns and that there is always calm after these storms; usually in the form of increased healing. She is better now than she has been at any time on this medication. She still has much healing to do. I still have patience to learn. But we are getting through to the other side of being on this poison. Peace to all who taper, Glosmom
  3. Topic title: 20 to 18mg duloxetine is harder than 30 to 20mg Hi there I spent most of last year on 30mg of duloxetine (20 years of depression generally pretty well managed by medication - lots of different ones). Having started meditating regularly in the summer which I've kept up along with regular exercise - I was feeling pretty good so went down to 20mg around November. I had no problems at all. Even with christmas and an operation to deal with! 2 weeks ago, I started following the guidance on this site on tapering duloxetine and used ball counting and gelatine capsules to taper to 18mg. It's been very hard. Tears and irritability. I haven't been like this in a long time. Why would it be harder to go from 20mg to 18 that it was from 90 to 60 , 60 to 30 or 30 to 20?? It doesn't seem right. I've booked to the see the psychiatrist next week because my family are a bit alarmed and worried. But he is very pro medication. I don't think he'll be happy about my plans. But now I know duloxetine is so hard to come off, I want off it more than ever! I would not be completely against starting something else additionally to see me through but I know Prozac is often preferred and it has a bad effect on me s isn't an option. I so grateful if you've taken the time to read this!
  4. Hi looking for help with a tapering schedule. On the 07/01/2020 i was prescribed 25mg Seroquel for insomnia and took it everyday for the next month. My prescription lapsed 07/02/2020 and initially attempted to Cold turkey it, immediately ran into rebound insomnia most nights. After doing a bit of reading here it seems its best to taper off, even if you have been on a drug for a short period. I decided to go this route and last night reinstated myself at 12.5mg, this allowed me to sleep for 4 hours. So can someone please help me with a tapering schedule, i want to get off this evil drug asap. But i know rushing it could be detrimental.
  5. Hi everyone. I've been reading this site for the past few months ever since I gratefully stumbled upon it and finally made an account. In early 2018 I successfully tapered from 30mg citalopram down to 20mg by cutting a 10mg tablet. I went down about 2.5mg/month. I tried a couple of times to go down to 17.5mg but the symptoms were intense and I realized it was too difficult to get a consistent amount with cutting the tablets so I decided to stick with 20mg until I found a more consistent way to taper. I read about the dissolve method working successfully on a post on this site and decided that would be my route. I bought some 10cc syringes with .2mL gradations. Last night I tried my first dose at an 8% taper - 18.4mg. I'm feeling worse than i'd expected/hoped considering it was such a small difference, but I have historically had a rather sensitive system. I'm starting to question whether I'm really meant to go down, if this is a sign I should keep my current dose. My life certainly isn't in a particularly solid place (though it's relatively stable). But I know it will only become more difficult the longer I'm on it, and I've seen only marginal if any benefit from taking it. Looking to document my process and experience here and contribute to this supportive community as well as find guidance about how to approach my own path.
  6. Hello, I'm new to this forum and I'm working toward tapering off of 225 mg of venlafaxine. I am a 70 year old male, that has been very active and health conscious. My weakness has been depression. I previously had two periods of feeling depressed that involved obtaining an antidepressant from my general practice doctor. I would get to the point of feeling spacey and or lethargic, then do talk therapy to get back off of the drug. These where phase one antidepressants, and I would taper off slow over say 4 to 6 months without noticeable side effects. These events occurred between 2005 to 2008 per notes I still have. I retired from Highway Engineering March 1, 2014. Many emotional events piled upon me during the next five months. The stressors where; retiring and adjustment period, daughter coming home to live with us and get a divorce, a vicious son in law (being divorced), one or two other more minor stressors that I do not recall, and a huge spiritual crisis in which I felt I had not lived as graciously as God would have wanted me to. In July 2014 I became fixated on thinking about all these things. I sat in a stupor for days, lost 15 pounds, thought the devil was speaking and accusing me of my wrongs and tempted me to deny God and just die. My wife asked me If I had thought of suicide and I admitted that I had. She called 911 and got help. They took me to a hospital and put me on suicide watch till they could transfer me to a psych ward for treatment. I was confined for a week and given many medications. I also had a physical problem that they dealt with. I was released to an out-patient psychiatrist. The psychiatrist told me he would take me off all the previous medications except for increasing my dose of venlafaxine to 225 mg. I have been on venlafaxine for four (4) years. In May 2018 I stopped drinking all alcohol and also stopped experimenting with legalized cannabis. I quickly felt a bit more energy. I put this energy toward searching the internet for information about venlafaxine and antidepressants. I have learned much, but still want to keep learning. My Psychiatris agreed to allow me to get off Venlafaxine October 4, 2017, after telling him repeatedly about my desire to and why. He reduced my venlafaxine from 225 mg to 150 mg. The short of it is that I did not make it, and went back to the full dose. After learning more about how to decrease slowly, I am ready to try again. I have sought the help of my general practice doctor, who is supportive and has reduced me to 187.5 mg. Since I know that a 10% reduction is better, I cut open a 37.5 mg capsule, counted the beads, and took 40% of those beads, 15, and added them to the 187.5 mg, for a new total of 202.5 mg. I'm also taking daily notes of my physical and mental state, and dosage. I will see my general practice doctor monthly. I will be also talking to my Psychiatrist about my plans. I plan to start talk therapy also. Does anyone have any advise or comments?
  7. Hi all, In 2013 I received the diagnosis of Generalized Anxiety Disorder when I started having therapy for the first time in my life - I was 23 then. I've been anxious through my teens and early adulthood, and also suffered from bouts of low mood, but did not think much of it - I thought it was just how I was. In 2013 because I was at a particularly bad phase in college, I went to a psychiatrist through which I started taking 20mg Lexapro (I take the generic - Escitalopram). Everything improved a lot. Anxiety greatly reduced, mood also better, more drive to do stuff. And basically no side effects. So I kept taking it religiously, and basically forgot about it. About 3 years later, it started to bug me that I was taking a drug to keep myself mentally stable. I knew nothing about how bad the withdrawals from this type of drug were, and I felt good, so I just cold turkey'd - 20 to 0. You can imagine how this goes. After some days I was hit by what I thought was the worst flu I had ever had. I could not leave bed. That was odd. Didn't think just stopping that drug would cause that, as the effect of the drug is pretty much non-noticeable (it's not like taking a benzo where you feel drowsy and so on) and you just feel pretty much like the normal you. Either way, just to be safe I went back on the 20mg and all the symptoms disappeared after some time and again I did not think much about it anymore. I think I attempted cold turkeying again after some time just to experience exactly the same symptoms. So I thought "alright, this really is the Lexapro, not a flu". From then on I started being more uncomfortable for taking the Lexapro. Here's this drug that apparently makes me feel stable, but I stop taking it and I'm completely wrecked. This doesn't feel right. So in 2018 I started a slow tapper, or at least what I considered a slow tapper. I was reducing around 2.5mg every month or every other month. I was going linearly - no percentage reduction. That was the logical thing for me to do as my doctor never told me about the liquid form of Lexapro and with the tablets available where I live it's impossible to do a precise lower division lower than 2.5mg. Throughout the tapper I felt what I now acknowledge as withdrawal symptoms, but again I did not think much of it. I was in a difficult life situation, living abroad and always extremely stressed, so I thought the life situation was what was causing that. In May 2019, I was down to already 2.5mg. Not feeling that well, but that was such a low dose that I thought it was insignificant and dropped to zero. This overlapped with a break-up and with starting a job that was really quite demanding. That's when I got into hell. I started waking up at night with panic attacks. In the morning my arms and legs were burning - I felt the anxiety burning my body. I just wanted to leave my body and my mind, that feeling was just too unbearable. Crying non-stop, huge feelings of rage - I just wanted to destroy stuff and just felt this huge urge sometimes to beat up anyone that did something even mildly annoying (and mind that I've always been quite a controled person - this was not at all me). I also had muscle spasms, couldn't digest anything properly and lost a bunch of weight. I had never been so thin in my life. That's when I started thinking I had to have something serious in my brain - I even forgot about the Lexapro then - I thought I was developing a neurological disease. This person was not me. My psychiatrist had tried to put me on other antidepressants - Fluvoxamine and Mirtazapine. None of them worked. Then I was put back on the Lexapro (only 10mg). And I wasn't seeing much improvement on my state. I started becoming suicidal. I did not want to go through the realization that I had a disease that would invalidate me for the rest of my days. I was going to doctor after doctor, doing exam after exam, and they didn't seem to find anything wrong which left me feeling even more helpless. I thought that was never going to end. I started thinking every day about suicide. That's all I thought about. I just could not bear that reality. That's when I told my parents - "I need to be checked in at the hospital. I won't last much longer like this." So I was checked in at the hospital. Even the doctors who checked me in did not believe I was in such a bad state - I guess even in that state I kept my composure. I spent 2 weeks there, in what was the most horrible experience of my life. The people there were for sure much worse than I was - most of them had even lost touch with reality. But deep down I know this was the experience I needed to snap out of it. While I was there the doctor who was supervising me increased my Lexapro dose to 20mg. I became reeeaally sleepy after that. Just as I had become the first time I went into 20mg back in 2013. By then I still did not believe I did not have a horrifying disease. It was really hard to believe this was coming just from a psychological source. And it took quite long for me to become convinced that was the case. The months right after the hospital were tough. I was sleeping a lot - around 12 hours a day. Very, very slowly things started improving. Too slowly for me to even notice a difference. But little by little I started sleeping less, recovered my appetite, some days even saw a glimpse of contentment. At some point I was feeling good more often than I was feeling bad. I started exercising every day, having psychotherapy twice a week, taking supplements, getting sun light, meditating. Everything I could do to improve, I did. Around April of this year, I was already entering a pretty stable stage. Some days I still had energy and mood breaks which I had no idea where they came from and were pretty demotivating - now I realize they are likely something akin to the "waves" that I've seen mentioned here at SA. I also still had some lingering symptoms such as some vague leg pain here and there, as well as teeth pain. But those bad days and lingering symptoms started becoming more and more rare. So for some months I was doing really good. Feeling drive and contentment with life. Optimistic. Last month I had an appointment with my psychiatrist, and as I really want to be med-free he suggested that I attempted a new reduction again. At first he suggested me to drop to 15mg, but I thought it was better to go first down to 17.5mg instead. And that's the dosage I'm at right now. The reduction was not that large, but I can for sure feel the withdrawals - even though I know the reduction was larger than the 10% recommended here at SA - my next drops I will follow that guidance. After the drop to 17.5mg, I started having more of those down days. Also the days right afterwards I had rebound anxiety, which has already disappeared. Some days my energy and mood breaks. And I'm more irritable, less drive, etc. Also those lingering pains I mentioned are back sometimes. Furthermore, I feel like I can't train at the gym at the same level I did - even though my body weight and composition is exactly the same as it was before the drop to 17.5mg, I feel significantly less strength some days. So for now I will stick with cardio. Now I know much better than I did in the past and will wait to fully stabilize from the current withdrawal until I attempt another reduction. I am also building a sauna at my place, which I have read has many benefits for mood, so that's another resource I will have to deal with the tapering process. Hope this post can be useful for someone.
  8. Hi there, I'm new to this site but need help! Have had 15 years of AD use, which include a couple of changes due to 'poop outs'. My last change was 9 weeks ago when the 15mg paroxetine that I'd been on for 7 years pooped out. Ended up under crisis team and physchiatrist switched me to 15mg Mirtazapine (straight switch from one day to the next). I had done a similar switch back in 2007 when my lexapro pooped out (tapered down over 2 weeks then switched straight over to the paroxetine). Over the last 6 weeks on Mirtazapine, the physchiatrist titrated me up to 45mg as I was in a bad state. 45mg WAY too high for me and caused akathisia, so he dropped me back to 30mg (after 3 weeks on 45mg). Akathisia better, but still lingering, so he wants to drop me down to 22.5mg. What do I do... I need this akathisia to stop ASAP, so a drawn out taper seems like far too long to wait! But I'm sure my body is in crisis from the med switch and titrating up then quick drop back down. Also used benzos over 4 weeks during switch, and titrated off them. Am I better to put up with the akathisia and do a slow taper? He thinks that drop percentage is fine (25%), but after reading this site combined with the weird experiences I'm having I'm too scared (so I'll need to enlist the help of a chemical compounding pharmacy) . Am I better to do that drop (25%) to stop the akathisia quickly, or just let my body settle down? Do 10% in another 2 weeks time (so that will be 4 weeks after my drop from 45mg to 30mg). I don't know what to do... I have been under the care of the crisis team and been going along with the plan, but can't help but feel these side effects are worse than having no treatment! I'm only 43 with a beautiful husband and son, but I'm scared that I've screwed my poor body up for life. I need advice, and stories of hope (and of easy withdrawls, not just horror stories, to give me hope). P. S Could my akathisia actually be paroxetine withdrawls even though I went straight onto another med?
  9. Hey everyone, i’m new to the website.I’m so glad i’ve found it now that i’m ready to taper. I’m sorry if i’m posting in the wrong topic. I’m being prescribed citalopram 20mg around 7months ago and i’m now ready to taper off as i feel theyhave already stopped working, and i want to do it with the 10% method. I’m currently taking tablets of 20mg(weight 0.18 g). Would it be better/easier switching to the liquid or i can make it with the tablet?should i crash it or dilute it in water? Did anyone experience bad withdrawals even using this method? Thank you so much for your help🙂
  10. ADMIN NOTE 17 March 2019 A scientific paper has been published based on the hypothesis put forward in this topic, see Horowitz, 2019 Tapering of SSRI treatment to mitigate withdrawal symptoms NY Times article about Lancet tapering study: How t Quit Antidepressants: Very Slowly, Doctors Say To search for whether there is a serotonin transporter occupancy study for your medication, google the generic name of the drug with this other search terms: 5HTT occupancy If you find a paper, please post the both the name of the medication and a link to the paper, such as 2016-July-01, Cymbalta (duloxetine) MMarie Found this paper on dose and 5HTT occupancy of duloxetine. Takano, 2005 A dose-finding study of duloxetine based on serotonin transporter occupancy The site, academia.edu, requires login: Link to screen shot of dose-occupancy and dose-plasma concentration curves 2016-November-12, Anafranil (clomipramine) and Luvox (fluvoxamine) Suhara, 2003 High levels of serotonin transporter occupancy with low-dose clomipramine in comparative occupancy study with fluvoxamine using positron emission tomography. Link to study on occupancy vs. dose Link to chart of occupancy-dose relationship A simple explanation: The Last Psychiatrist has an amusing essay on SERT saturation with this illustration for citalopram: Hi, I thought I'd share this as it's quite relevant, not 100% sure if this is the right subforum, will post in both this and research. PDF of American Journal of Psychiatry article or Summary and excerpts from study in the Journals forum of survivingantidepressants The pretty pictures are from page 4 onwards in the PDF. (Admin note: Pretty pictures here. See this post for graph of "perfect" 10% taper of previous dose with 4 week holds) What these fellows did here, was attempt to measure serotonin transporter occupancy at various doses for 5 different drugs. (Zoloft, celexa paxil, effxor and Prozac, not in that order). They fit curves for both the oral doses and blood concentrations. Long story short for anyone who doesn't know, SSRI’s ‘work’ by binding to the serotonin transporter protein (SERT) and stopping it doing it’s normal thing (reuptake of post-synaptic serotonin), resulting in serotonin hanging around for longer. Now a couple of interesting things: -at minimum therapeutic doses in every case, there was about 80% SERT occupancy. That shocked me personally. Even the minimum doses are locking down 80% of your brains reuptake ‘capacity’. Higher doses do more but it’s obviously not linear – they actually have plotted curves, and they’re quite a good fit statistically, particularly for the blood concentrations. Really good in fact. Point here though is that there’s a long way between 0% at no drug and 80% at the minimum dose. -the curves man, look at the curves. This gives a fairly good indication of why some people find tapering necessary. You NEED a percentage taper just to get a linear decrease in SERT occupancy. Linear decreases in dose will actually hit you with exponentially increasing drops in SERT occupancy, particularly drops between the minimum therapeutic dose and 0 Basically, this paper provides a real basis for percentage reductions in dose when discontinuing SSRI’s. I realize I'm kinda preaching to the converted and telling people what they already know, but it seems there may actually be a real reason why some people find it necessary to do these percentage tapers to get off SSRI's. Caveat: I have no idea what the relationship between SERT occupancy and post synaptic serotonin is, it’s probably not linear since if it was higher doses would have basically no effect, but this is nevertheless very interesting to look at. They were only looking at one part of the brain but pointed out it correlated strongly to elsewhere. GRAPHS - both graphs start at 100mg dose for the period 1 January 2019 to October 2022. Note the difference in the "jump to 0" dates. The following shows a HYPERBOLIC taper of 10% every 4 weeks. This shows tapering from 100mg to 0mg, but the curve would be the same for any starting dose. The following shows a LINEAR taper of 10% of starting dose every 4 weeks.
  11. Hi everyone. I am hoping to get some much needed (and very much appreciated) advice on my situation. As you see, I had been on Sertraline for almost 2 years, or around the two year mark, before I began a too fast taper in 2016 which lead to my withdrawal syndrome in September 2016. My doctor had me taper in 6 weeks completely off Sertraline, jumping off at 25mg and not even tapering the 25mg, just cold turkeying the 25 per his instruction. Well, I was feeling some withdrawal symptoms, I just didn't realize what they truly meant, and my doctor had told me not to worry 'they will clear up in a few weeks" well they didn't really clear up, but actually got worse two-three months later. I want to make this as short as possible so it is easy to read, but long story short, I ended up reinstating Sertraline at 12.5mg first week, at the same time tapering the 30mg of buspirone my doctor had tried to test out on me for almost two weeks. Each week, he upped my dose of Sertraline during my reinstatement, until I reached 57mg and my body rejected anything above the 57mg. However, I did not know anything about withdrawal or tapering back then, and realize that I was put on way too high of a dose for reinstatement. This has me very scared and very anxious, I try hard not to be, and most of it is likely neuro related, but I wonder what I can do if I feel it's too high? I've got the anhedonia, but I've had this since December, and it actually was brought on more or less by my doctor trying to put me back up to 75mg, maybe that was just a coincidence, but I am not so sure. Each adjustment of the sertraline left me with worsened insomnia, worsened panic, trembling and what I can only describe as body jolts every morning for four months straight. And trying to sleep at night I felt like I was having seizures almost, where my body would jolt me awake just as I was drifting off to sleep, heart would be racing, fear and panic would run rampant and worsen in the morning. I still have mild teeth chattering every morning and especially when the anxiety or stress comes on. I reinstated pretty quick, where I reinstated as soon as my withdrawal symptoms started getting worse, I didn't wait it out even though I really wanted to. I didn't want to go back on the medication after what it had done to me, but didn't know what else to do. Then, everyone I trusted, my doctor especially, had me convinced I had developed several new mental disorders in a matter of three days. I was so so scared, and my anxiety was through the roof. I really stressed myself out a lot trying to figure out "what was wrong with me" because I did not know at the time. On top of that I had the professionals I trusted assuring me it was my "symptoms coming back" (they actually said that right after I already told them I never ever had these symptoms before in my life, not even one of them.) Then I happened to find SA, during my research into my symptoms and the ssri I was taking. I learned a lot in one night, and my jaw dropped. My gut had been telling me all this time it was the drug, it was withdrawal. But I ignored it and listened to the "experts" instead. HUGE MISTAKE!! Now I am stuck in a situation that makes me fear for the future, and not sure what I can do now that I am back on a higher dose. If I would've known better, I would not have allowed my doctor to titrate me up so high. I would've sat at the lowest possible dose, even the 12.5mg. My withdrawal symptoms had really settled down a lot for the last two or three months now though. My appetite came back, libido came back, depression lifted almost instantly upon reinstatement, the anxiety and panic took a while to lift but that has really settled down a ton and only sporadically (maybe lasting a second or two) I'll feel a blip of panic and anxiety (typically when under a lot of built up stress), and my biggest gripe for withdrawal symptoms as of now is the anhedonia, but even that was beginning to lift where I'd get moments of joy or contentment or my interests peaking through the veil of anhedonia. My sleep actually went back to normal in the last week or two, and I haven't been waking with the dread or anxiety for the past three months now, and I have been feeling pretty good except now I got back into this wave and I think it's because I'm stressing over tapering and my dosage after what I read last night. I read on SA someone said that being on too high a reinstatement dose can permanently damage your brain, where you will never heal from it. So I am really scared... I really need advice or wisdom on where to go from here. At this point, I worry I'll always feel this way and I'll never recover any further than where I currently am. I'd be fine if I felt somewhat normal, where I could handle the withdrawal symptoms temporarily until they pass, and I do admit that on my better days I certainly can handle them. But I feel like reinstatement was pointless or worse for me than just muscling through the withdrawals after what I read about high dose reinstatement. I feel like A) it's going to take forever just to stabilise on this dose and B it's going to be painful trying to taper when the time comes, due to that I may have permanently damaged my brain with my reinstatement. I guess what I am wondering now is, do I stay on this dose and wait for the anhedonia to completely go away, or how do I know when I am ready to begin tapering? At this point I am just feeling very confused and afraid about my dose and tapering in the future. I feel lost. I'd really appreciate any help! Thank you!
  12. I'm desperate for help and advice. I've been in protracted withdrawals for almost 4 years caused by Effexor. Doctors tried to cover up the withdrawls with different drugs which made it worse. I reinstated Effexor after being drug free for 6 months as the wd were unbearable (I didn't know at the time that it was to late to reinstate) I managed to stabilize a bit but it also made things worse. After the reinstatement I became hyperactive, developed akathisia and became suicidal. I'm at 14 mg now but I've hit tolerance. I'm dreading every time I take the dose cause I start to hallucinate when the drug kicks in. Any advice of what to do would be greatly appreciated. Thanks in advance.
  13. Hello Everyone, Let me introduce myself. You can call me Sebas (38), i'm from Amsterdam. Hope my English is okay. I was diagnosed with anxiety issues around 2004 and then started using Seroxat, I believe it's called Paxil in the US. I'm aware by now of all the problems this medicine is causing. In other words, i've read a lot, and i mean A LOT about it. I can almost graduate about the subject After several attempts to stop, I found out in 2015 or 2016 about the 5-10% reduction rule. That helped me from 20 mg (10 ml) tot 12 mg (6 ml) in about 1,5 years (estimated). I'm using the fluid suspension and some squirts for accurate dosage. From 6 ml down to 5,8 took me 5 weeks to feel allright, then i stabilized for a week and went back down from 5,8 tot 5,6. All the usual withdrawal symptoms occur during tapering periods such as illness, nerve system problems, visual, fatigue, stomache cramps and also i'm countering eye circles. Since the last dosage (from 5,8 tot 5,6) i've been feeling bad for 9 weeks already. Especially my stomache and my energy. So i'm now wondering what to do, wait (and wait...), go back to 5,8, go back to 6,0 of try to switch to another AD. Cause this one is really @#$%&* mainly cause of the fast half-life period. I've read about a cross tapering method. I asked my doktor for a psychiatric consult about it. Or...could it be my body (and mind) is telling me this dose is beneath the minimum that i just need for my personal wellbeing. I'm familiair with magnesium, omega 3/fish oil and multi vitamin for support. I'm looking forward fto exchanging some knowledge. Bye Sebas
  14. Hey everyone, so I decided I'm not going to take my monthly antipsychotic injections anymore. I had it with the side effects and my psychiatrist wasn't supportive to taper me off slowly (he thought I should be on them forever). I know it's not the best decision considering the risks, but I have faith in God and my capability to overcome any side effects. I'm thankful that I didn't face any major withdrawal effects so far (except for whole body soreness for a day or two which was acceptable) and I hope it continues that way. It's almost 2 months from my last injection and the half-life of Invega Sustenna is 25 - 49 days so I definitely crossed it. I don't know if it helped, but I am taking Ratfish liver oil 15 drops twice daily. Now, I wanted to know if it would be a good idea to start taking a natural dopamine/serotonin reuptake inhibitor (Catuaba) to down-regulate my already up-regulated dopamine/serotonin receptors. The reason I suspect they up-regulated is because the Invega I was taking acts as an antagonist at both dopamine and serotonin receptors. I would like to start healing my brain to return to my former intellectual/cognitive state before starting the medication (I suspect I was misdiagnosed with Bipolar to begin with). The extra dopamine could possibly help with the motivation/focus issues as well. Do you think I'd be overloading my brain at this stage? Would the Catuaba cause me to go manic? Any thoughts are welcome (including how to overcome/bounce back/heal after stopping antipsychotics)...
  15. Aka Remeron, Remeronsoltab, Avanza, Axit, Mirtabene, Mirtaz, Mirtazon, Norset, Promyrtil, Remergil, Remergon, Remeron SolTab As with other psychiatric drugs, we recommend trying a 10% taper of mirtazapine per month, based on the last dosage you took. If you get withdrawal symptoms from a 10% taper, go down by smaller amounts. See Important topics in the Tapering forum, particularly why-taper-by-10-of-my-dosage A very common withdrawal problem with mirtazapine is rebound insomnia, which reinforces the need for very gradual tapering. From FDA information at http://www.drugs.com/pro/mirtazapine-tablets.html From Malhi, et al 2003 Dual-Action Antidepressants: Mechanisms of Action and Clinical Use Per http://www.drugbank.ca/drugs/DB00370, Half-life is 20-40 hours. Mirtazapine tablet dosages are 7.5mg, 15mg, 30mg, and 45mg. The "orally disintegrating" version melts in the mouth and is widely available as a generic or brand-name Remeron SolTabs. Reduce by splitting tablets Request that your prescription be filled with the lowest dosage tablets or combination that includes the lowest dosage and split them into quarters for the smallest decrements. (A quarter of a 7.5mg tablet would be 1.875mg.) If you are very sensitive to dosage reductions, you may wish to weigh tablet fragments, see Using a digital scale to measure doses Reduce by titrating a liquid A liquid is easier to measure in order to taper by small amounts using an oral syringe. Unfortunately, mirtazapine liquid is not widely available. In the UK, mirtazapine liquid is available from Rosemont Pharmaceuticals in Leeds. Ingredients of the liquid are here: https://www.medicines.org.uk/emc/medicine/31587. Shelf-life after being opened is 6 weeks. Ordering information is here. To taper, many people make mirtazapine liquids themselves. While water solubility of mirtazapine is "slight" according to http://www.drugbank.ca/drugs/DB00370 you can make a suspension of it yourself with a tablet and water or a pharmaceutical liquid such as Ora-Plus. See How to make a liquid from tablets or capsules Refrigerate the DIY suspension for up to 5 days, then discard. Have a compounding pharmacy make a liquid for tapering Compounding pharmacies can make a liquid from the tablets. You will need a prescription written for the customized drug preparation. The only drawback is this can be quite expensive. While your pharmacy may say the liquid is good for a month, people have noticed potency decreases over that time: Please note the do-it-yourself liquids are kept for less than a week. Reduce by making a liquid with the "orally disintegrating" tablets You may be able to dissolve the orally disintegrating tablets ("Soltabs") in water and use an oral syringe to take a measured dosage. I couldn't find any reports of doing this but, since the orally disintegrating tablet is designed to dissolve in saliva, it seems likely to work. After making the liquid, I would take the dose immediately and discard the rest -- do not count on it keeping for any length of time. For instructions on how to make a liquid, see how-to-make-a-liquid-from-tablets-or-capsules If you do this and it works, please let us know in this topic. Using a combination of tablets or capsules and liquid Rather than switch directly to an all-liquid dose, you may wish to take part of your dose in liquid and part in lower-dose tablets or capsules, gradually converting to all liquid as you get to lower dosages. This can be very convenient and reduce any problems switching from one form of the drug to another. If your doctor prescribes liquid and tablets or capsules at the same time, most likely, he or she will have to indicate "divided doses" in the prescriptions to get the drugs covered by insurance. Tapering mirtazapine and venlafaxine or "California rocket fuel" This is a combination of mirtazapine and venlafaxine (Effexor) that has some popularity among psychiatrists, but also can have dangerous side effects. If you are taking this combination, you probably will want to taper the Effexor first with the hope that the remaining mirtazapine will maintain sleep. See About going off mirtazapine plus venlafaxine (Effexor) aka "California rocket fuel"
  16. Hi all, This is my first post here and my first real attempt at tapering off of all psychiatric medications. A very brief background, I have been on 20+ medications since I was 12, ranging from antidepressants, mood stabilizers, benzodiazepines, anti-convulsants, anti-psychotics, and sleep drugs. I am 22 now and finally, (sober this time) investigating some of the core issues that caused me to self medicate-via doctor and drug dealer-and I'm ready to really sit with my emotions and feel them fully. Currently I am on Lithium-1050mg, Gabapentin-600mg, Celexa-5mg I have been reading as much as I can on comingoff.org and SA and would like to prepare myself and set myself up for success. From what I understand 10% taper is ideal. I am not in any hurry, I just want this to be as positive experience as possible so this is fine. I met with my psychiatrist today and she had some smaller dosages prescribed for me and is on board and on my team for which I am thankful. I am wondering if there are other things I can do smartly prepare. I read briefly about remineralization but am not sure what that entails. Any foods, supplements, behaviors that would ease me into this journey? Ideas? Thoughts? I start this process April 1st and will post updates. Thank you!
  17. ChessieCat

    Email Campaign

    At the beginning of February I sent an email to Australian Psychiatrists, Psychologists and Counsellors and to NZ & UK (counsellors, if I remember correctly). Members are welcome to use any parts of the following Email & Business Card and refer to my website if they wish. The website is meant to be a "one stop spot" for ease of getting important information and as a pointer to SA's website. Please note that the website is not searchable in search engines. ________________________________________________ Email stats: 5,935 - successfully sent 2,029 - opened (but it is possible to read an email via preview without opening) Unique click stats: 35 - Surviving Antidepressants (link to Welcome to SA) 44 - Intro to AD WD Syndrome (link to SA's Intro to AD WD Syndrome) 21 - Founder of SA's Bio About Paxil Withdrawal (link to Alto's Bio on patientslikeme) 43 - adwithdrawal.weebly.com (my website created with info links to keep email brief but point interested people in right direction) Total: 143 ________________________________________________ PLEASE NOTE: I have tried to be careful regarding copyright etc but if there is anything I had done incorrectly please let me know. ________________________________________________ THE EMAIL I SENT: Dear Sir/Madam, I am writing in the hope that by sharing information I have recently discovered people will not have to suffer debilitating withdrawal symptoms when reducing or stopping antidepressant drugs. Of course a person’s original condition, for which they were prescribed an antidepressant, will still need to be addressed with non-drug methods of coping taught/learnt. My aim is to inform so people don’t suffer unnecessarily The brain changes when an antidepressant drug is taken and it becomes physiologically dependent on the drug. Because of this the process needs to be REVERSED SLOWLY to allow the brain to adapt to not receiving as much of the drug. Unfortunately, many people are advised to stop the drug cold turkey, reduce it too quickly, take it on alternate days or take different doses alternately. Any of these methods may, in many cases, result in the person suffering bad withdrawal symptoms. Although the person may feel okay for a while, symptoms can appear weeks or months later, with ongoing symptoms occurring for several years. When this occurs they may be told that their original condition has returned or may be diagnosed with a new condition. They may be put back on the same drug (possibly at an even higher dose), prescribed a different drug, or a combination of these. When researching my own antidepressant withdrawal issues I found that there is a way to minimise withdrawal symptoms. The Surviving Antidepressants support website recommends that a drug be tapered by 10% (of the previous dose) followed by a holding period of 4-6 weeks to allow the brain to adapt to receiving a little less of the drug. The analogy is given of it being like a plant growing on a trellis. If you take away the entire trellis the plant will collapse whereas if you take it away gradually the plant is able to adapt to the changes as parts of the trellis are removed. To gain an insight into what stopping antidepressant drugs can do I urge you to visit the following links: Introduction to Antidepressant Withdrawal Syndrome Founder of Surviving Antidepressent’s Bio About Paxil Withdrawal My website adwithdrawal.weebly.com (this is not searchable) has links to more withdrawal and various other related information. Thank you for taking the time to read my email and I hope I have provided you with some valuable information. If you have found it helpful I would appreciate you forwarding this email to anyone you think would benefit so that they too can become informed. I can be contacted via my website if you have any comments or questions. Regards, A Concerned Individual (I am not receiving any form of payment for my website or contacting you) ________________________________________________ I have also printed up Business Cards to hand out to pharmacies and people who I might chat with: Front: ANTIDEPRESSANT WITHDRAWAL Information Website: http://adwithdrawal.weebly.com Support & Information Website: http://survivingantidepressants.org Back: If antidepressants are stopped too quickly a person might feel okay at first but start feeling worse after a week or more. Doctor may say it's original condition back or diagnose new condition, not recognise it's caused from stopping the antidepressant. Please visit websites listed to get information about antidepressant withdrawal issues and safer, better ways to reduce antidepressants slowly to reduce withdrawal symptoms and their severity. I can be contacted via: http://adwithdrawal.weebly.com __________ Responses I received to my email: "I totally disagree with what you have written. It is ill-informed, technically incorrect, and a danger to patients who require the medication in the same way a diabetic requires insulin." _____ "This has been standard practice in medicine for decades." _____ "I understand you are well intentioned and wish to share your experience with others. The thing is that there are many types of antidepressant medication and what you describe applies to some, but not others. There are some that have less physiological habituation and thus need less gradual withdrawal than others. So really you probably need to work with someone who understands both the pharmacology of antidepressant medications and their use in psychiatry if you wish to issue some guidelines for people contemplating ceasing to take this medication. The doctors who understand psychotropic medications well are the psychiatrists. Many general practitioners prescribe this kind of medication without really knowing a lot about it. It is possible you were in this kind of situation where the prescribing doctor was not much help to you in dealing with ceasing to take an antidepressant. I am sorry you had this experience. It does happen but it is not a universal one." _____ "Thank you. I will pass it on. I like the metaphor of the trellis." _____ "Good on you for getting this together." _____ "I agree with the main points in your letter! My view is as follows; In my practice I have always told people if are taking SSRI antidepressants and decide they want to stop after talking with their doctor, the process must be slow! The drug company recommendation is almost always too fast. Rapid reduction in the medication can in my experience produce dissociative effects which can be disconcerting or even frightening to the patient. This can cause the person to conclude that they must keep taking the medication. (going cold turkey is of course at the high end of rapid reduction of the medication) My experience of nearly 29yrs as a psychologist is to (after discussing with their doctor) suggest they come off slowly over a period of 2-3 months and keep in contact with their doctor during this time. Obviously post antidepressant medication the patient needs to find other ways of dealing with their depression. My efforts are directed at giving the patient new skills showing them ways of reducing stress and dealing with anxiety and depression." _____ "thank you, This has been a big concern for me. It is very hard to advise clients about antidepressant use, usually conflicting the advice of their GP or Psychiatrist, and their own subjective experience. At the very least antidepressant complicate issues, especially regarding reactive depression." _____ "Thank you very much for this email, and for sending out (I assume to psychiatrists and others Australia wide) your very reasonable and well-founded concerns regarding effectively withdrawing from SSRI/SNRI medications." _____ "Thank you very much for this information - it segues well into a presentation I made to my peers about antidepressant medication." __________ CC
  18. Hello Everybody! In December 2010 (I just turned 21) I started taking Paxil because I was having severe anxiety (Agoraphobia / Emetophobia). After intensive therapy I made a good recovery which allowed me to pick up daily life (the Anxiety is never completely gone, but it no longer has a big impact on my life). I tried to stop twice and twice this failed extremely hard. By then me and my psych/GP thought it was easy and with todays knowledge I can say that the failures were probably due to way to fast withdrawal schedules (first time I halved to 10mg and stopped the week after.. second time I reduced by 2mg each week). Early summer 2016 I was feeling better than ever on every aspect of my life, but in the second half of the summer suddenly I started feeling worse. Fatigued, unmotivated, tingling sensations and a somewhat drugged/absent feeling. Even though I did feel familiar (to Paxil symptoms, which I had a lot the first ~2-3 months when starting Paxil each time) I did not immediately link it to my medication due to no increase in anxiety. However after a thorough checkup (both physically and mentally) without any other possible finding the only remaining hypothesis was the sudden change in how my body responded to the medication. I decided to start tapering of paxil, but this time I would be prepared: I found out about the 5-10% in 3-6 weeks schedules and found a psychiatrist to help me with my tapering. I also switched to liquid Seroxat to make tapering easier. My plan was to start with tapering 10% each 4 weeks and only reduce dosage once I felt mainly stable/good during the last week. The first taper step went good with only minor/innocent side effect. The second step already became a bit heavier especially with the addition of headaches and eye floaters both of which reduced my daily productivity/concentration. However after 5 weeks I felt stable/better and decided to taper again. The first week on my new dosage (14.4mg) went surprisingly well. But after that suddenly everything changed: The anxiety came back in full force. In addition I felt hunted/restless, nauseous, vague/absent (like I'm a spectator in my own life), still had headaches, almost no energy, heart palpitations and sometimes hyperventilating. We are now three months further and I slowly/steadily start feeling better each week but still feel far from stable (more like a house without foundation which could collapse any moment). Besides all I remain positive and hope to feel better in a couple of weeks, but I am uncertain of what to do next: - I could continue tapering Paxil as if nothing happened, but given the insane symptoms I just recovered from I might consider a smaller step of 5%. - An alternative could be, due to the heavy symptoms in a this early stage of tapering to switch to an AD which is famous for being still-horrible-but-slightly-less-horrible-than-parox with regards to tapering and withdrawal symptoms. I found this topic on this site which states this and that Prozac is often used for this. I can not decide what to do.. hopefully this and other topics on this site will help me make this decision..
  19. Hi. Was taking 4 mg of risperidone for two months. Suddenly stopped taking it for a week (didn't notice any withdrawal). Then took 2 mg for two weeks (approved by psychiatrist). Then took 1 mg for two weeks (approved by psychiatrist). Have not noticed any withdrawal symptoms. Asked psychiatrist if it was okay for me to suddenly go from 4 mg to 2 mg, and then 2 mg to 1 mg. She said it was okay since I hadn't been showing any symptoms. I have read that withdrawal symptoms can surface after months or even a year after you stop taking it. I am not sure what that person's credibility was. I have also read, from a .org website that the withdrawal symptoms are mild and rare. I have stopped taking the 1 mg for almost a week, and I am wondering if I will be alright. I have not noticed any withdrawal symptoms, and I feel like I will still be seeing my psychiatrist for a little while at least. I am also wondering if it is true that withdrawal symptoms can surface months or even a year after you stop taking the medication. That just seems far-fetched to me. Any help is appreciated!
  20. Hey guys, I wanted to come back here and just pass on a few things that may help someone. My full story is in the introductions section, but I weaned off Prozac over last year (did the last bit a little too quickly) and due to a variety of factors had a few episodes of intense withdrawal symptoms over Christmas and the start of January. I reinstated at 2mg recently and am glad to report I'm doing absolutely fantastic. However, I noticed a few patterns which caused me to go into symptom mode. Number 1 was reading too many posts on the forum - I used to be a moderator on an OCD support forum and am aware of the dangers of excessive forum use! In fact it was one of the first things we'd advise newbies to the site. In the week before I reinstated, I went into a mode that I hadn't done for a long time. I was checking for success stories, reading other people's symptoms, and was preoccupied with my health for most of the day. I developed new symptoms and old patterns began to emerge. I've been practicing meditation for 2 years now. I stopped temporarily (funnily enough, just before withdrawal symptoms emerged) for a number of reasons. I forgot how wild an unobserved mind can get, and how we continually create our reality moment by moment. Thankfully I was seeing an amazing Reiki therapist once a week over the past month. He pretty much helped me drag myself out of a potentially long term situation, and helped me take responsibility for the symptoms in order to diffuse them incredibly quickly. I also became disheartened by the horror stories and the lack of success stories, but I knew on some level there was more to it. I've seen incredible recoveries over recent years from a variety of illnesses including severe mental illness, chronic pain, cancer. But as soon as I began getting too involved in the world of 'withdrawal', all of that was thrown into doubt. So I did a test. I know intellectually that my mind is a constant flux of thoughts created from my own awareness, nothing is really external or separate from us, it's all the creation and response of mind. When we know that on an experiential level, there is no reason to suffer, because you are aware that you are creating everything that appears to your consciousness. You can create anything. I mentally put out a request for real life success stories. Within about 6 hours an old friend got in touch. I havent seen her in years since we were in a psychiatric hospital, she was a bit older than me and was like a mother figure. She had been one a severe case of clinical depression, in hospital many times. Her doctors told her she was a lost cause and would be dead within the next few years. Turns out she stopped her meds three years ago, refused any medical help, found a great therapist who understood her desire not to be medicated, and she is happier than she's ever been. She is in a new relationship, has gone back to college, and has absolutely no symptoms in regards to withdrawal (she said there was at first but they didn't last intensely after she started therapy). The following day I bumped into a lady who owns a shop near me who I haven't spoke to in months. She confided that she is also medication free since last summer, after years of being on antidepressants. While things have been up and down, she was still positive, running her business, and very positive. From that day I stopped researching anything to do with illness or withdrawal, I got strict with myself in terms of observing thoughts, and detaching from as many as possible throughout the day. Letting them be there without making a 'story' out of them. Of course, the 2mg reinstatement took the edge off almost immediately, but the transformation between now and the horror I experienced a few weeks ago is unimaginable. In the midst of a crisis the smallest of things can mean the difference between a temporary episode and a wave of days or weeks of awfulness. My main withdrawal episodes lasted no more than a day or two at a time, whereas years ago they would have knocked me for six for weeks. I credit that in part to an ongoing understanding of the how the mind works and not exposing myself to negativity as much as possible, especially in such vulnerable states. Forums and the internet are a great resource, but that's just it, they are a tool and as much as it feels like it's the last thing we want to do, it's essential to spend the majority of our time in 'the world' so we get a fuller picture of it. So I guess what I mean is, don't spend time exposing your mind to anything that reaffirms sickness. People, media, tv, situations. In the psychiatric hospitals I was in in the past they had a term for it (I forget what it was), where patients who were around other patients for too long would develop similar symptoms. They would try and get people out quickly and not encourage them to become too close because the statistics for them later being diagnosed with further disorders was much higher the longer you were in there. I guess it's the same in life, we become what we fill our consciousness with. I was very aware that I was spending most of my time reading about withdrawal and thinking about what my symptoms were like day to day, rather than actually healing. Suffering is inevitable, for everyone, that is the nature of being human. But we have so, so much more power to react to it differently, and even be comfortable with it, than we ever imagine. Glimpses of this astonishing power have saved me many times, although we do need to be still enough for it to be revealed. This may or may not be of use to anyone, but I wanted to share it anyway in the hope that it may help. Love and courage to all of you who are struggling.
  21. Hi All, First of all I am so pleased that I found out about this website because in my own country The Netherlands, there is so little information about withdrawal effects of SSRI and SNRIs. It really warms my heart, that there is so much support and sharing of experiences here, I know now I am not alone! I am a female of 32 years and use paroxetine (seroxat) for 11 years now. After an intense 3 months inside a psychology clinic I learned a lot about myself and decided I don't longer need the medication. My journey so far: 9 years 20 mg, 1,5 year 10 mg. Now tapering to get off the Seroxat medication, first tapered from 10 mg to 5 mg in one month without problems. 2 weeks ago I started the tapering from 5 mg and after two weeks around the 2,5 mg I noticed severe withdrawal effects. First I thought I had the flu, but now I know better My Withdrawal symptoms are: Irritability, agitation, dizziness, sensory disturbances ( electric shock sensations in my fingers), emotional lability, insomnia and heavy feeling in my upper legs. Since I became aware this are withdrawal symptoms I stabilized at 2,5 mg by taking an suspension of 2mg/ml and would like some advise how to go on from here. I am considering the 10% Brassmonkey tapering ( decreasing your dose by 2.5% a week for four weeks and then holding an additional two weeks to stabilize). I use Omega 3 oil and magnesium supplements and am now 5 days on the 2,5 mg. Although i notice a decrease in some of the withdrawal effects, it is still pretty severe. The dizziness is better but the other symptoms are still there. Is updosing helpfull? and how far back I have to go? 5 mg gave no withdrawal effects, they started somewhere in the two weeks when I was tapering off between 5 and 2,5 mg. I really hope you can help me. thanks a lot greetings Julia
  22. I am new to this site and hoping to get some tips. I have been on Lexapro for about 19 years ( now mid50s) and really want to come off it. I first went on when I suffered anxiety after suddenly losing my mother and really should not have stayed on so long. Tried coming off a few times and got irritable/ mood changes so resumed (all attempts were cold turkey). Since Oct, at the advice of my doctor I halved to 10mg in one go for 6 weeks and then to zero from there about 6 weeks ago. I thought I was being slow and careful, but reading some of your posts, I have gone way too quick! I had no idea about the withdrawal effects - and neither did my doctor either, it would seem! in the last few weeks I have had vertigo/ dizziness which now seems to have resolved, but am very irritable/ short fused for the past 3-4 weeks. I am unsure what to do now - should I wait it out and stay off the pills, or am I likely setting myself up for a big fail? Shoukd I go back on some dose, and stay there for a while before tapering more slowly in 3-6 months time? There is no big hurry, I just want to be aiming to get to zero at a safe point any advice on the best path from here would be appreciated. Unsure what I should do and if these symptoms will stay/ or get worse if I stay off tge a Lexapro
  23. Hi there everyone, Im really hoping to get some perspective on my situation as it feels as though Im a bit of a loss. My story: In May 2016 I suffered a mental break due to high situational stress which resurfaced trauma. I experienced panic attacks, depression, paranoia (induced by an acne medication started in the days prior) instrusive thoughts, etc. Not knowing what was happening I saw an MD that prescribed me Zoloft. After 2 days on it I became desperate and ended up in hospital where I was switched onto Lexapro 15mg and Risperidone 0.5 for my racing thoughts and sleeping pills. I was released after 2 weeks and soon after I quickly gave up the sleeping pills. I underwent psychotherapy and in February 2017 I gave up the dose of Risperidone and reduced my Lexapro to 10 mg. In spring of 2018 I talked to my MD about feeling strong enough to begin my taper as I felt like I'd been functioning well. The side effects of reduced emotions, 30lb weight gain and low libido were nagging me so he said I was approved to go. I did some research and began reducing at what I thought was a slow taper; in retrospect I can see it wasn't. I did my best to cut the pills and did this: -10mg to 7.5mg for 2 weeks - 7.5mg to 6mg for 3 weeks - 6mg to 5mg for 2 weeks And so forth... As I tapered I experienced WD symptoms like anxiety, panic, dizziness, crying spells etc. As a result I started seeing a therapist who was supportive of what I was trying to do. When I got to smaller doses I switched to a liquid form of lexapro and managed to wean myself to 1.2mg and then it was TOO MUCH. I reinstated to 1.3mg and recovered for months as my work life became so complicated and I needed time to help myself. That last taper was in Sept 2018 and here I am nearly 10 months later. I have been changing my lifestyle and working through again resurfaced traumas with a new therapist, and Im feeling more like that mild to moderate depression is lifting. I have been struggling again with a lack in range of emotions and wondering if this is a me problem or a medication issue. The therapist seems to think that my anxiety and mild/moderate depression are back and new meds is the key solution. With all the progress I've made and how I've grown in over 3 years makes me think otherwise, so I feel stuck. Being on such a low dose how should I go about continuing my taper? Is it possible Im experiencing a poop-out that I've read about? Just looking for advice! On the day to day my mood is stable not much anxiety except around my cycle. Just again those flattened emotions which is frustrating. This website has been a guide post for me in educating myself, thank you so much!
  24. I was prescribed Citalopram (Celexa) by my doctor in London UK, when I was depressed during a period of unemployment. I took it for 3 years, taking 20mg once a day. I never felt like it did much good helping me, and it made me feel a bit spaced out, not all there. After 2 years on Citalopram I started to have some suicidal thoughts, but far more homicidal thoughts. I wanted to kill people. I had thoughts of driving head on into traffic, pushing people under trains, killing my partner, my dogs and burning the house down. I had never had these kinds of thoughts or ideas before, and was convinced they were a side-effect of the anti-depressant Citalopram which i was taking. I told my doctor about my suicidal/ homicidal thoughts and he was told me to double my dose of citalopram! I told him that the drugs were the problem, not me! I then slowly reduced my dose once each week for 10 weeks, taking the drug on alternate days, and then cutting the pill in half and only taking it on alternate days. Every time I reduced the dose I woke up the next day with cramps in my intercostal muscles? (muscles between my ribs), feeling very sore and stiff, like I'd been kicked in the ribs. I also felt quite sharp electric shock; in my neck and shoulders, and had some jerky twitches of my neck and shoulders from time to time. The symptoms went away after day or two, until the next time I reduced my dose. After 10 weeks I was off of Citalopram completely, and have been off them for 5 years now. It took about 3- 6 months for me to feel normal again after coming off of Citalopram, My life is much better without Citalopram, and I have had NO suicidal or homicidal urges or thoughts since I gave up the SSRI drug. I do not think doctors are not helping their patients by drugging them with SSRI's.
  25. Hi, After reading many many posts, I'm more confused than ever ... I just obtained a prescription to have Pristiq compounded and reduced by 10% of current dose each month in hopes of getting off this beast. After reading some of the posts, it appears that it may not be a good idea to compound this drug because of the extended release properties of the 50mg pill. Is there anyone on this site that has had success tapering off of this drug using a compound pharmacy to do a 10% taper per month? I"m now nervous to get the prescription filled after reading some of the posts. I contacted the compound pharmacy (Guardian Drugs in Toronto, Canada) and they have the same reservations about crushing the extended release tablets as they tell me, that while they can do it, they don't know exactly how the compounded drug with react in my system. In compounding it, the drug will most likely be weaker (by exactly how much they can't say with any accuracy) and therefore she cannot say with any certainty whether or not it will cause withdrawal symptoms which I am desperate to avoid. Tried to taper off about five years ago (second or third try) by cutting the pill and reducing it gradually and had such bad withdrawal symptoms, I thought I was going to go mad so back on the stupid drug I went. The compounding pharmacy offered to call my family doctor and suggest to her that I switch to Effexor (75mg) which she said is equivalent to 50mg of Pristiq. She said that Effexor is much easier to come off of and much easier to compound. She said it didn't sound like my family doctor has much experience with coming off antidepressants (don't think my doctor is alone on this point). She also suggested reducing the Effexor by 5% each month rather than 10% to help avoid withdrawal altogether. She said it is better to taper very gradually and to take as long as possible to get off these drugs. Even a year or more sounded reasonable to her. So I guess my questions are (1) is it feasible/best approach to switch to Effexor to taper or am I just switching to a different beast even more difficult to get off of? (2) should I just get the Pristiq compounded and hope for the best ... ? (3) better suggestions/experience than the above two points? I would really like to get off of Pristiq, have been on anti-depressants far too long and never able to get off of them properly because of the horrific withdrawal symptoms so basically I've been held hostage by a little pill and would like my life back. Tired of feeling flat and not having any real emotions and don't want to Stepford Wife/Walking Dead it anymore. I've been taking 50mg of Pristiq for about 7 years and prior to that was on Effexor extended release 37.5 x 2 for about the same amount of time. Any suggestions from people with experience getting off these drugs would be most welcomed and appreciated. Thank you for reading.
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