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  1. Just wanted to say hi. I am new here and hoping to post on the tapering forum for some advice coming off meds. I’m not sure when I can use that forum after joining, does anyone know? Thank you Ju
  2. Hello everyone! I am a new user here. I've lurked around this site before but have yet to introduce myself. I was a Prozac user for a year from August 2015 - September 2016. I had taken it for social and general anxiety. I was on 20mg/day. Initially, I was actually doing fine and great emotionally but had side effects like massive fatigue everyday (not even 3 cups of coffee could wake me up!) and constipation every time I went to poop (sorry for TMI). I also felt like a zombie for a brief period in which I was neither happy nor sad. In May 2016, I decided to abruptly stop taking the Prozac by choice without consulting my doctor (bad move!) and had brain zaps and mood swings which I assumed as worsening depression. I then just asked my doctor to simply increase my dose because I thought I was getting worse (bad move again!). I was put on 40mg/day from June - August 2016 in which I was ok at first but then I was hit with a panic attack so severe I had to rush to the ER. For that week, I was having very severe symptoms. So I was instructed to go back down to 20mg/day. From then on, I decided to stop taking it a few months ago in September because I felt better and didn't want to rely on medication anymore to make me happy. I consulted with my psychiatrist who said for me to just take 10mg for one month and then I can stop. I did just that. Over the month of October I was fine and felt completely normal. However, I realized symptoms would come later once the month of November started. I have since felt every type of symptom under the sun including brain zaps, hot flushes, insomnia, irritability, tingling sensation of the skin, anxiety, shortness of breath, sweating, tremors, and slight vertigo. I have never felt these symptoms in my life til now! I've talked to my doctor and he doesn't believe in withdrawals. At this point I feel helpless. I am experiencing waves and windows in which I have waves of really bad flare ups and then windows of good normal days where I feel fine. But they keep cycling back and forth. I now have questions to ask: 1. Do windows of no symptoms mean that my body is getting better? 2. Should I reinstate the Prozac and taper off more gradually? Someone suggested I shouldn't because I've already been clean for 3 months now. But what do you guys think? 3. Will symptoms go away if I keep pushing cold turkey? 4. Should I try medical weed to help ease tthe symptoms? I want to try natural ways of healing
  3. 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?
  4. 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?
  5. Hello everyone, I've been lurking on this site for a while now, gathering knowledge on how to come off psychotropics. I'm 37 year old female with a long history of depressive episodes and have been taking SSRI's of some sort (must have gone through most of them by now!) since 1998, when I was 17. Around 4 years ago (it's hard to tell, as my memory is utterly atrocious) I had a bad time again with depression and had psychotic symptoms. I was put under a psychiatrist who prescribed me 75mg quetiapine, and upped my sertraline from 100mg to 150mg. I've been on sertraline around 12 years and I haven't had much of an issue with it. The quetiapine, on the other hand, I am not prepared to live on indefinitely. I have put weight on (although not a huge amount), my blood sugar levels are causing concern (I exercise regularly, eat sensibly, have no diabetes in my family), I am like a zombie until lunchtime and I don't think there's been a night in 4 years where I haven't woken stuck to the sheets from profuse sweating. At night, especially if I've exercised in the day, my body is like a furnace. Makes not much difference if the room I'm in is cool; my body's thermostat is on the blink. If I miss a dose, I just don't sleep. The next day I'm a wreck. The last time I saw the psychiatrist (about 2 years ago) I asked him about coming off quetiapine - I've been on the lowest dose of 25mg since then. He was really cavalier in his attitude and said "it's fine - just come off it when you want to". So around a year ago, after I'd been stable for a good while, I did. And I didn't sleep for a week. So I caved in and started taking the 25mg again. 6 months later, I wanted to try again, so I went to my GP and asked for a short course of zopiclone so I could sleep whilst coming off the smallest dose. She would only give me 5 day's worth of Zopiclone (UK guidelines) - and even then, I still couldn't sleep without Quetiapine. In addition, I developed INTENSE itching all over my body, in really localised areas. I know now this is a histamine reaction and a common withdrawal symptom for quetiapine. At the time I thought I had some sort of weird invisible skin infestation! So I went back on the Q again after a week. THIS TIME, I'm even better armed. Despite being told that stopping 25mg quetiapine would not cause any problems, as it's such a low dose, I know better. The tablets are tiny, but I'm cutting them in half and then half again. My plan is to reduce in stages, taking once month for each stage. 25mg - > 18.75mg - > 12.5mg -> 6.25mg -> 0mg. If I manage this, I could be off it in three months. I'm currently 2 weeks into stage one (reduced by 25%). The first few days I had a little trouble getting to sleep, but that soon rectified itself. My mood over the last week has been steadily getting lower and I've been feeling more "mental" and unable to cope with stuff. I know the Q can augment the Sertraline. I haven't told my GP yet that I'm doing this, because every time I've brought it up there has been resistance and he tries to persuade me to stay on it. Probably because another hospital admission is far more costly than continuing the drug! (cynical..? Moi..?!) I'm being the most sensible I've ever been as regards self-care. No alcohol, eating well, exercising regularly, good sleep habits, etc etc. Anyways. Here I am. Hope my mood improves over the next two weeks in time for stage 2, though I am prepared to stick longer between reductions if needs be. Lunar
  6. I am new here. I have tapered myself off of a low (50mg) dose of sertraline. (This time) I have been on and off Zoloft/ sertraline for decades. It's been several months of no SSRI and I am looking for any and all help with learning more about surviving and staying off of these drugs after watching several videos and checking into Mad in America.
  7. My Gemini scale arrived this week with a set of glass graduated cylinders. I've read that the transition from solid to liquid dosing can be a little hairy. Can anyone help with suggestions for making the switch? Am currently taking ~8mg, in pieces, with a glass of water. I would like to be dosing completely in liquid form by the time my dose gets down to 5 mg in a few months. Should I just start dissolving all 8mgs now, or divide the dose into liquid and solid portions. If so, is there any ratio I should be targeting? I also have 00 gelatin capsules that I can fill with solid portions to conserve the bits that disintegrate to powder if necessary.
  8. anytriptaline

    Particle size after using a grinder

    I've been doing 4 tapers since September, so far so good, no real benefit really but the side effects continue to be the same I've done it with an analytical scale and this pill grinder https://www.amazon.com/gp/product/B07D3X37L8/ref=ppx_od_dt_b_asin_title_s00?ie=UTF8&psc=1 Something I've noticed (as show in my attachment) is that the consistency is not homogeneous, it's not great picture, but the darker, more colorful particles are considerably bigger than the ones you see as more pale, who have the consistency of pretty fine dust Just to be sure, I mix the resulting grind before filling the capsules in an attempt to make them more homogeneous I do kinda wonder if it's just the quality of the grinder or the particle size represents something I should be more careful about (filling vs active substance for example) In this case the mix is amitriptyline
  9. Can anyone Help me with how to taper my daughter off Risperidone please. shes only been on it for 10 weeks and first reduction has seen an improvement what next with doctors meeting coming up 17th Dec 2019. thanks Rob Tapering Risperidone. 3mg Risperidone for 6 weeks 2.5mg Risperidone for 4 weeks (till 17th December) 8th October 2019 3mg Risperidone prescribed. 19th November 2019 .5mg reduction to 2.5mg (Positive effects) 17th December 2019 (Want further reduction and tapering plan in place) Psychotic Event 20th August 2019, In France on Holiday before going to Italy for completion of University degree, was to return home for Christmas 2019 to New Zealand. Lead up to Event Previous 2-3 years build up of stresses boy friend, University studies. late night parties working at bar. 6 months prior to event Stresses even greater with overseas trip planning and organization and having to achieve b+ average grades. Key stressors immediately prior to event. Break up with boyfriend, afraid of boyfriends mothers actions. Lots of alcohol and lack of sleep. Time line. 20th August 2019 call for help. Phone calls and paranoia close to being admitted in France. Looked after by friends and slipped some mild anti anxiety pills. Paranoid and little sleep. 27th August 2019 Dad Arrives in France. Need to bring her back to NZ as soon as. Paranoia no sleep and very distressed. Mild sleeping pills and anti anxiety pills from gp but said he cant help. 7th September 2019 Arrived back in New Zealand. Condition worsening. 10th September 2019 Hospitalised. Tried with a medley of drugs until psychosis was interrupted with Risperidone 3mg showing real improvement from 8th of October. 2019. 8th October 2019 3mg Risperidone 15th October 2019 released from hospital. Side effects stiffness flat no spark. 19th of November .5 mg reduction in Risperidone from 3-2.5mg per day. Benzatropine taken for 5 days to see affect improved side affects. But reduced meds seems to have the same affect and Benzatropine no longer taken. 10th Of December Today. I has improved with the drop in dose and is showing signs of improvement. She sleeps 12 hours a day movemnets are slow and sluggish and she is flat without much spark. Stable and well doing exercise, staying with family, working as painting helper with dad 4-5 hours a day 5 days a weelk. Has had no anxiety, strange thoughts disrupted sleep or paranoia feelings at all and is talking lucidly about her experience. Both her parents would like to see her tapered right off Resperidone safely (and obviously as quickly as possible but fully aware of the risks) 17th December 2019 next meeting with Doctor when we will be requesting a tapering program and reduction till zero
  10. 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!
  11. ADMIN NOTE: Read this entire topic before attempting a switch to Prozac. Be sure to read details and cautions below . Consult a knowledgeable medical practitioner before changing medications. Also see Tips for tapering off Prozac (fluoxetine) Switching or bridging with another related drug, usually of a longer half-life, is a 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 most 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 or Celexa and its sibling escilatopram or 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. 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: 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. Difficulty tapering off the bridge drug. All of the bridge drugs can be difficult to taper themselves. About serotonin toxicity: For antidepressants, you run the risk of serotonergic toxicity if you are taking an SNRI, particularly at a high dose, with an SSRI, or too much of one antidepressant. (Never take an MAOI in combination with another antidepressant!) Serotonergic effects of an SSRI such as Prozac, Celexa, or Lexapro are ADDED when combined with an SNRI such as desvenlafaxine (Pristiq), duloxetine (Cymbalta), venlafaxine (Effexor), venlafaxine XR (Effexor XR), milnacipran (Savella), and levomilnacipran (Fetzima). This is why doctors familiar with the Prozac switch will cross-taper by adding a LOW DOSE of Prozac to an SNRI. Another concern: Escilatopram (Lexapro) is several times stronger, milligram for milligram, than the other SSRIs. If you add 10mg Lexapro to the high dose of 60mg Cymbalta, for example, you run the risk of serotonergic toxicity -- 10mg Lexapro is equal to approximately 30mg Prozac. So, like anything else, a drug switch is not guaranteed to work. When to switch or bridge 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 a new drug, or the substitution may not work to forestall withdrawal symptoms. This is the "the devil you know is better than the devil you don't know" rule. 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 Effexor and Paxil, they do the Prozac switch from the beginning.) If you are having intolerable withdrawal from another antidepressant, it may be worth risking the worst case: 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. 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 Prozac 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. Note on above: If you have tapered to a lower dose of Seroxat/Paxil, Effexor, Cipramil/Celexa, Lustral/Zoloft, etc., 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. More is not better for nervous systems sensitized by withdrawal. 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. What should the final Prozac dose be? Please 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 probably safest to err on the lower side of a Prozac dose "equivalent" -- such as 5mg -- to your original drug. Here is a graphic representation of cross-tapering: If the second antidepressant is Prozac, given Prozac's long half-life, it may take up to 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 it throughout the cross-taper, you could end up with serotonin toxicity from too much Prozac. 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 Also see this discussion about cross-tapering with Prozac: Smoothing out a transition to Prozac 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 Prozac. (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.
  12. 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.
  13. cathnz

    cathnz: Tapering off Mirtazapine

    Hi there, I'm getting ready for a future reduction in Mirtazapine. It won't be any time soon (I need to get stable first) but am just wondering how I will go about this. I live in NZ and Mirtazapine only comes in the form of tablets (i.e not liquid or capsules with beads). I have 2 options... getting a compounding pharmacy to make up capsules (very expensive), or getting some gemini scales and shaving the tablets. All the info I can find on here is about taking beads out of capsules (which isn't possible with a compacted tablet). Is the shaving off and weighing on a gemini scale an option? And the pink coating that is on the tablet... is this part of the active ingredient too?
  14. Tomorrow morning I’m starting the dreadful journey of withdrawing from Effexor. Currently taking 300mg mane. I’ve been taking for >10 years, so I’m expecting the worst. My GP is very much onside, thank goodness. Over the last 4 years, I’ve taken myself off quetiapine, nitrazepam, regular lorazepam (up to 8mg per day), dihydrocodeine and tapentadol (opiate). I’m still taking OxyContin and Pregabalin. I suppose I’ll have to get off them sometime.
  15. 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.
  16. 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!
  17. 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!
  18. 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)...
  19. Hello guys, I'm Giuseppe from Italy. I've stumbled upon your website when looking for some help with the withdrwal sindrome that I'm experiencing in this period. I've finished tapering the Citalopram last week and now I feel some side effects (mostly dizziness). Just wonder if somebody is experiencing the same and how he/she is coping with that. Thanks to anybody who would like to give me some advices. best to all, Giuseppe
  20. My introductory post. I have a sleep disorder associated with Fibromyalgia. Fibro also is associated with anxiety and depression and inability to relax the muscles. So, Venlafaxine has been a real help for me to live a normal life for 20 years. But I'm 68 and want to get off. Today is the 6th day following a failed tapering, my second. My first tapering was a year ago. I have a terrible sleep disturbance: I have a panic attack while falling asleep. My husband is helping me find a better psychiatrist, one who is experienced with both a sleep disorder and tapering. But this time around as I tried to fall asleep a loud buzzing sound and vibrating sensation occurred inside my right nasal passage. As I type this I am aware it sounds unbelievable. It's so embarrassing. "Doctor, I have a bee in my nose." Well, I googled "my own snoring wakes me up" and found Sleep-Doctor http://sleep-doctor.com/blog/does-your-own-snoring-wake-you-up-from-sleep/ . Anyone have a similar weird sleep disorder? I bet it was due to tapering - some kind of neurological trauma. I'm exhausted. Last night I finally slept through the night.
  21. Hi All, I am new here, and I hope that the collective experience across the forum is helpful for my situation. I am currently 27 years old and have been on medication since I was 18 years old for depression, OCD, and IBS-Constipation (directly tied to when I feel more depressed). I have mostly been on SSRIs, which have been helpful with depression, OCD, and regulating my peristalsis.. Medication summary below: 2009-2012: Celexa (up to 40 mg) 2012-2013- Lexapro / Abilify 2014 - Clomipramine. Clomipramine + Abilify. Result: Realized higher doses of clomipramine caused too many side effects for me and could not tolerate it, even though it was helpful.Became tachycardic and other anticholinergic effects of combination led me and physician to revert back to SSRIs. 2015: Zoloft; Verdict: Made my IBS symptoms worse; depression and OCD better. However, due to increased diarrhea had to go off Zoloft. 2016: Due to gut that was made worse by Zoloft and doing very short-term trials of other SSRIs which also made my gut worse, I tried EMSAM (MAOI) for three months. Verdict: Did not help at all 2016 - 2017: Went back to Celexa (40 mg). Helped but felt it was not effective as back in 2009, even at maximal dosage. Eventually had relapse of depression in Summer 2017. Summer 2017: Tried course of Transcranial Magnetic Stimulation after Celexa stopped working. Verdict: Did not help at all 2017-Present: 200 mg Luvox Verdict: In summer 2018, Luvox also stopped working and had relapse of depression. Summer 2018: I ended up going to homeopath in mid, which has been the most helpful thing to me so far. I have adopted the SCD diet, which has greatly helped my gut, and the remedies she has prescribed actually pulled me out of the depression I was in and made my OCD better, all while still on 200 mg The current situation is that I am still on 200 mg Luvox and with the homeopathy, my symptoms have greatly improved. Back in January 2019, I tried to go down on the Luvox, first to 175 mg (wait 2-3 weeks), then to 162.5 (wait 3 weeks), then to 150 mg (for about 5 weeks). It appears, that although I did not realize it at the time, my symptoms were getting worse, with more mood swings again, and my constipation was becoming more frequent. Most recently, I became completely non-functional and could barely get through one day. Just a few days ago I increased back up to 175 mg to see if I would feel better. So now I am in a predicament, as I really don't think the SSRIs are helping me much because 2 different ones have now pooped out on me in less than a year, but the homeopathy has allowed me to return to normalcy gradually. I am certainly still not far along in the homeopathy (only about a year), but I have definitely felt a difference. I thought I was ready to taper off the Luvox gradually, but clearly, given my relapse of depression and constipation, I maybe went too fast. I have read about the 10% rule, which I largely stuck to, but maybe I will have to go slower. Maybe I will use compounding next time around, maybe weighing out the pills. I do have some questions for the community. -Anybody have any thoughts on my experience or anything they experienced with Luvox? -Over the years of going up and down on SSRIs, I developed muscle twitching and a weird pain in the back left of my head, which I feel especially when my mood gets worse (as was the case recently when I lowered the dose of Luvox). Anyone experienced this / any tips on how to deal with these or what this could be? -I've only been on Luvox for about 16 months. However, I have been on SSRIs for a long time (about 10 years). Does that mean it can still take me forever to get off Luvox?
  22. Hi guys, sorry this may be a long post, I think it is okay to share my story on this. I am 21 years old, a college student about to graduate, and I have been on an SSRI for about 5 years now. I was diagnosed with ADHD and GAD when I was about 12, I have always been somewhat anxious and had issues with regulating my emotions. In 2013 my girlfriend broke up with me and I was really sad and feeling hopeless. After a few months of being down and also anxious, my doctor (pediatrician) decided to put me on 5mg of Lexapro. The Lexapro seemed to help (I think?) and I recovered somewhat quickly. Over the next few years, however, my doctor fluctuated my dosage quite a bit. I would get anxious, he would up my dosage, and then I would become a zombie and he would lower it. It did seem to blunt my emotions on a high dose. Other than that it was fine. However, the summer after my freshman college, I became extremely anxious and had an existential crisis, prompting my doctor to change me over to Zoloft and Trazodone. When starting Zoloft, I took 50mg and worked up to 100mg. It possibly helped my anxiety but my emotions became blunted again (or maybe it was depression?). I did not feel hopeless or sad, but I kind of lost the ability to have pleasure over simple things. After going through a hard time on Zoloft and Trazodone feeling empty and dull, my doctor and I decided to taper off to see if that would help. Every time I tapered, we would allow three weeks to go by to see if it helped. I went from 100mg to 75mg to 50mg to 25mg and eventually to nothing. Every time I lowered, I felt a little more in touch with my emotions. With the Trazodone, I stopped cold turkey on a dose of 50mg. When I went completely off of the Zoloft and Trazodone, I started having crying episodes, brain zaps, insomnia, anxiety, occasional anhedonia/brain fog, and severe social anxiety. After a month or two, all of these symptoms went completely away (except sometimes the anhedonia/brain fog). I was doing good and feeling very in touch with my emotions. After a few months off of the Zoloft though, the school year was coming back around, and the girl I had been dating for 2 years broke up with me unexpectedly. It devastated me and left me feeling sad and hopeless. I was crying all of the time, I was thinking about her all of the time, losing the ability to feel pleasure, and had anxiety because I still saw her every day. This continued on through the semester and I went home for winter break feeling depressed and anxious. I was feeling brain fog/anhedonia, and lost overall enthusiasm for life. It got bad enough that I knew I needed help, so I started talking to a therapist (I had seen a few before this one) and it was helping. I still was depressed, but was slowly improving. I started taking Adderall again to study for a certification exam over the break and this helped boost my mood tremendously. It cleared my mind, helped with the brain fog/anhedonia, and made me feel a little more peaceful inside (less racing thoughts). My psychiatrist decided he wanted me to take Trintellix and put me on a 5mg dose. I went back to school feeling down and anhedonic again. All the progress I made during seemed to start disappearing. I stopped taking the Adderall, and once the Trintellix seemed to start working I started becoming extremely anxious. I felt extreme depersonalization, started having weird sensory problems (visual snow, eye floaters, tinnitus, and my body started fluctuating between feeling tingly and numb) and was scared. My doctor upped my dose of Trintellix to see if that would help. I ended up taking Ativan to help with the anxiety. I was feeling less anxious but still had the sensory/depersonalization problems. Not to mention, my emotions went away again. The Ativan lowered my anxiety but made me feel completely dull and emotionless. I ended up tapering off of it and feeling better after a few months, but having a lot more anxiety/sensory issues. Since this (which was earlier in the summer), I started taking Adderall because I read a lot and it seemed my problems were kind of related to Adult ADHD. I always feel internally restless and have a hard time focusing, and taking therapeutic doses (20 mg or lower) seem to calm me down and clear my mind. Not to mention, it helps with my emotional regulation problem. Overall my academics and state of mind are improving. I have lowered the Trintellix from 20mg to 10mg over two months. I have had more sensory problems and anxiety since lowering the medicine, but it seems my emotions are slowly coming back. Every now and then, I get a nostalgic feeling that reminds me of what life used to feel like. It gives me hope. But I have been so up and down for the past 5 years, I am sick of feeling so unstable. I want to have emotions again and not deal with brain fog/anhedonia and anxiety for the rest of my life. I didn't have the former problem until taking medicine. I want the sensory problems to be gone. They only started after I started taking Trintellix. I need help with tapering off I think. Does anyone have any advice for me? I want to learn to treat my depression and anxiety in natural ways, and learn to regulate my emotions better. I want to believe I can live without taking medicine for these issues, because they only seem to exacerbate them. Do I have any hope of being stable again? I always feel uneasy inside and am constantly trying to distract my mind from this. I am sick of being anxious about these weird symptoms, everyone thinks I am crazy and writes me off. Will slowly tapering help this? I long for a day that I am not constantly thinking about being better, and can handle life's ups and downs. I am not wanting to be perfect, just to be able to not always think and worry about my mental health. I am always worrying about exercising enough, meditating enough, sleeping enough, eating well enough, and lowering stress enough. I think my issues could be related to tons of different things, but it is so hard to tell when you are put on medicines that only seem to compound the issue. School has been a big source of stress/anxiety and I am almost done, so I really want to take the time to improve my physical/mental/emotional/spiritual state of mind so life is not always this rocky. Thanks for listening, sorry this was so long.
  23. I found my way here from the New Yorker article published online last week. Very thought-provoking and not exactly encouraging about this process. I started taking Effexor probably 18 or so years ago; it was my first antidepressant and worked well from the get-go. After 8 or so years I was feeling well enough that I wanted to quit taking it, so my medical person (nurse practitioner) advised me to taper VERY slowly. I was only taking 75 mg XR at the time, and she had me taper over 4 months. I was very impatient with the process but followed instructions exactly and never had a single withdrawal symptom. It went perfectly. A few years later, I was struggling with depression again and once more started Effexor. It worked as well, but I required a higher dosage (150 mg). Last year, my husband died and my depression deepened considerably. I gradually increased the dosage to 300 mg, which seemed to be working more or less. Recently, my therapist and I decided that it would be a good idea to get off Effexor and try Wellbutrin, as Effexor no longer seemed to be helping. My most recent attempt to taper off was a miserable failure; I had several nasty withdrawal problems and stopped almost immediately. One problem I have is that the dose I take now consists of a solid pill, not a capsule filled with tiny pills that I can divide into several doses. The directions say not to cut, chew, or otherwise damage the pill before taking it, so really gradual tapering is not possible. I have to use various sizes of pills to try and work around this problem, and it doesn't seem to be gradual enough. I'm hoping to get some practical help from others who have been through this themselves. Thanks for listening.
  24. 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
  25. Hi everyone, I just joined this site. I am tapering from 200 mg of Zoloft. I've been taking Zoloft for about 20 years now, and a better amount of that time has been 200 mg. I started tapering by 25 mg every 2 weeks on February 7, 2019. I just started 100 mg today. I had a bit of a hiccup and had to take 125 mg for a bit longer than expected. The reason for my taper is that I was diagnosed with Borderline Personality Disorder. I was originally diagnosed with depression, and used alcohol as a crutch. I quit drinking early November of 2018 and am enrolled in DBT classes. My psychiatrist seems to think that my issues are mainly BPD and alcohol so I may be able to get off the Zoloft. I'm having a multitude of symptoms and I would love to be welcomed in your group so that I can share my experiences and learn from others.
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