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  1. 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.
  2. 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
  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. 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.
  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, 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.
  8. Hi all, I am writing from the BBC. The Victoria Derbyshire show in the UK are producing a short film about anti-depressant withdrawals and are looking to speak to individuals who have used local street drug dependency services for support throughout this process. If you are someone who has used the support services of street drug charities in the UK for antidepressant withdrawal and are interested in taking part, please do reach out to me via the personal messaging system . We appreciate the very sensitive nature of this difficult experience and anything spoken about will remain confidential unless otherwise agreed. Many thanks.
  9. Dear all, I have done all the research possible and contact all persons in the Netherlands who could help me find the answers for coping with this rollercoaster ride of tapering my last 2,5 mg of paroxetine (paxil). I managed to get in touch with a researcher in the area of tapering and withdrawal effects of anti-depressants. He was really helpful with my questions about tapering of and was so kind to share his latest upcoming publication about withdrawal effects and the importance of good guidance from our doctors. I found this article very inspirational and heart warming to know we are not alone in this battle of coming of our medications. I wanted to share this with you, thought it could be helpfull for others as well. Here is the link to the manuscript. It is still under review but already publiced at https://iipdw.org/user-knowledge-psychotropic-drug-withdrawal/ greetings Julia
  10. 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
  11. 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
  12. Hello forum! Female, 33, Sweden. Have been on Paroxetine, 20mg, for more than 5 years. In April 2017 I had my first major panic attack and ended up in the ER. My life completely changed and I developed panic disorder along with some GAD. Though the GAD may have been the underlying cause of panic, I don't really know. Since September 2017 I have been reducing my dose of Paroxetine, and am now on 10mg. Somewhere in December I got down to 10mg and thought I'd wait until I'm stable at this dose before continuing my taper. I have been using the Claire Weekes-method of trying to completely relax in the face of panic, and I seem to only have smaller attacks now. Palpitations have lessened, and I am less startled by my nervous system signaling panic. I have lately been feeling very off-balance/dizzy and sometimes theres an intense feeling of anxiety and dread in my body. Feels like there are bugs crawling around inside. Weird buzzing nerves? Dizziness is so bad I have to lie down sometimes. Last night I was holding on to the walls when moving around in my house. Feels like I'm losing my balance all the time, even when sitting on the toilet, but I can stand on one leg and walk in a straight line. So it seems to be some sort of misinterpretation happening in my brain, rather than an actual problem with my balance. Now to my question: When I wake up in the morning I usually feel perfectly fine. It is after taking Paroxetine that all of the horrible sensations start, and they seem to calm down slightly in the evening. Is this normal during withdrawal? Or does it sound more like I'm having actual adverse reactions to Paroxetine? They sort of worked until I developed panic disorder. But I clearly remember growing increasingly fearful and illogical during several months before I had that massive panic attack. Thank you in advance.
  13. Hello everybody. I'm from Finland. My health problems started 2015 when I tried to change my diet to vegan even I had build my physics with gym and eating much of meat half of my life and I had big muscles. This suddenly diet changing caused problems. My nervous system didn't recover anymore and I start to lost muscles and power very fast. I stop gym but half year later I started it again but still trying to eat vegan diet and that led me to bad problems. I got sinus problems and cat allegy and I had two cats. All this led me problems caused by medicines. First some medicine caused panic attack when I was sleeping and then I got anxious and doctor gave me benzos. They caused problems and when I tried to get off them but I made some mistakes because I didn't understand how it should to do and doctors also didn't understand. I started to use mirtazapine (same than remeron) for sleeping when tapering benzos and it caused even bigger problem and when I tried to get off mirtazapine the situation went so bad that I started to SSRI named Escitalopram (same than Cipralex or Lexapro) because pressure by the doctor and my symptoms was also so bad. Doctors didn't believe withdrawal symptoms by mirtazapine. When I reducing the mirtazapine dose my digestive system also stop working properly and I think that also made me feel so horrible. It took time to find how I should eat. When I tried to reduce my Escitalopram dose I failed few times. Then I started to looking some ways to make systems of my body working better that reducing the medicine could working and one after another I found some things that worked for me. Finally the reducing the dose start to working. I also found a good method from one Facebook group. The problem was that escitalopram is not water soluble. I developed that method a little better. In this video I show how I made that: How I tapering Escitalopram I tapered the dose about one year from 15 milligrams to 5,73 milligrams. Then I started suspect that the medicine itself make the tapering harder. That is a little hard to explain. I decided to jump to zero from that dose and I knew it's huge jump. With all my systems that I had found my symptoms have stay tolerable. I mean food system and some supplements. I kind of manipulate my nervous system with them that the symptoms stay away or not completely away but they stay much easier. I took my last dose in 28 th september 2019. It was over 4 months ago. Now I feel this is gonna take very long time to heal. I can't sport much and I can't even use computers too much. I need even limit reading books or listening audio books because capacity of my brain is so low. So I need allways consider where to I want to use my limited capacity. If I have used too much computer and smart phone it can took few days to recover from that. Sometimes I also feel anxious and depressed. My nervous system is also extreme sensitive to many things like herbal spices, vitamins, many foods and so on. My food system is very very limited and exact. I have to eat certain foods exactly in certain ratio. If they are not in that same ratio I get symptoms. All those my systems protect me that my situation stay tolerable. I also need to take certain supplements at a certain time and just the certain dose or I get symptoms. Now I'm just waiting how long this is gonna take and when all this is going to get better or is the worst yet to come. I guess this is going to take at least year but probably longer to heal. So my problems started from very little but because my and doctors weak understanding the small problem grew very big problem. Every time I understood certaing things when it was already too late and the situation was got worst.
  14. 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.
  15. Hi All, I have been reading/lurking a lot here in the last few months but I have decided to finally post. My history is 20mg Paxil for 6 months from 9/18 - 3/19. Then tried to cold turkey and lasted a few days so reinstated 10mg which sucked for about 11 weeks but became stable. Then started cutting 10-15% a month for 8 moths doing fine until about 3-4mg. Then the bottom fell out at around 3.5mg and it has been pretty hardcore for the last 2 months (anxiety, panic, intrusive thoughts, feeling insane, poor sleep, loss of motivation, anhedonia, other indescribable feelings in the body) but managing with mindfulness, floating through the symptoms, reading this forum, trying to distract myself, staying social and busy etc. Vaguely stable again but I have a dilemma. I have been reading some work by Dr Peter Breggin and he suggests minimising exposure to any psy drug as much as possible, even in a taper. He has case study stories taking many of his patients off of the drugs in a year or less, then supporting them with therapy. If I was to cut 10% per month down to 0.5mg (where I want to get off in theory) I would be on Paxil for almost 2 more years. I think my slow cut has already doubled my total exposure to the drug (keeping in mind the SERT occupancy charts https://ils.unc.edu/bmh/neoref/nrschizophrenia/jsp/review/tmp/352.pdf). So I want to bite the bullet and jump off soon from 2.8mg and just get hit with another few months of crap but get this drug out of my system. In theory I am a 30% SERT occupancy which is still significant so I am afraid I could just make myself terribly worse for a long long time. But I also have this nagging feeling my body wants this drug out of my system and I think a lot of what is manifesting could be managed by talk therapy, CBT, exercising, staying busy. What are peoples experiences at this junction? Anyone else take Paxil or other SSRIs for a much shorter time than their taper? Am I falling into a classic trap of thinking I can speed this up or is there merit to reducing my exposure to this drug? Any advice is worth its weight in gold here. Thank you all for participating in this important forum 🙏🙏🙏
  16. 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.
  17. 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.
  18. 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
  19. 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
  20. 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
  21. 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.
  22. 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.
  23. 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
  24. 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
  25. 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!
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