When to end the taper and jump to zero?

[ChessieCat]

I forgot to include my planned last dose: 

 

0.0025mg Pristiq

[Rusty1]

On 9/8/2021 at 8:04 PM, ChessieCat said:

After 6 years of tapering I'm nearly there folks!!  It is possible to get off a psychiatric drug even after approximately 30 years of being on them.

Congratulations! 

What is your best guess when you will make the jump?

[ChessieCat]

 

@Rusty1 Hi and thanks.

 

My first drug free day will be 23 October 2021.

 

Earlier this year I decided to speed my taper up and started reducing 10% every week.  Total taper time 6 years.

 

This is the first post explaining my final run to the finish line:

 

chessiecat-so-im-not-the-only-one-pristiq-desvenlafaxine

 

A member asked me about withdrawal symptoms and I posted about it here:

 

chessiecat-so-im-not-the-only-one-pristiq-desvenlafaxine

[S1989]

On 12/22/2014 at 10:01 PM, MatGMax said:

ADMIN NOTE The 10% rule keeps decreasing the dose but, mathematically, can never get to zero. As you approach zero, when do you simply stop taking the drug?

 

This is a very good question. This site advocates a very gradual taper for greatest safety. You may know of people who quit a drug very easily -- but if you ever had withdrawal symptoms, you are not that person.

 

Everyone's tolerance for dosage changes is different. It could be that you have been tapering by 10% with everything going smoothly. You may also have found you can decrease every 3 weeks or even every week with no problems. Even so, from what we've seen, you will want to taper as far below 1mg as you can. As you go lower in dosage, your system adapts to the lower dosage. Slide off as gradually as possible. 

 

If you are counting beads to taper, at the very end, when you are down to one bead, you will be unable to divide your dose to taper. You might want to skip doses to very gradually go off. This is the only situation in which we suggest skipping doses.

 

Sometimes people find that, even though they've quit at a very small amount, they might get slight, occasional withdrawal symptoms. You can take a tiny bit (such as one bead) occasionally until these withdrawal symptoms stop, which should be within a couple of weeks.

 

More clarification:

 

 

WARNING: DO NOT GO COLD TURKEY AT THE END OF YOUR TAPER

 

Cold turkey is cold turkey. Even though you might be down to a tenth of your original dosage, quitting suddenly may still be too much for your nervous system. You can undo all your tapering by jumping off at too high a dosage, and trigger severe withdrawal syndrome.

 

Ultimately, your tolerance for dosage decreases determines the speed of your taper, all the way to going off. Please listen to your body. If at any point in your taper you get withdrawal symptoms, continue going off very, very gradually at the end.

 

---

 

Hi All,

 

Apologies if this has been done to death...

 

I was playing around in excel with a taper protocol and thought I'd share.

 

The 10% is a good rule and very good at encouraging people to go slowly.

Something a lot of us have trouble with. (well me anyway...)

 

But like Achilles catching the tortoise, reducing 10% will never get you to 0.

(An aim a lot of us have).

 

I've plugged the following rule into excel (attached) to see how it comes out.

Rule 1:

new dose = old dose - (9% of old dose) - (1% of original dose).

You plug the starting dose in and it will always taper to 0 in 24 months.

Now this may be to quick for some which brings us to ....

 

Rule 2:

If you feel moderate to nasty withdrawal effects then stop and stabilize.

After stabilizing restart taper from current dose.

(which will also reset the end 0mg end point to 2 years from current dose).

 

 

Here is an example of the output for a 20mg taper (though just an example!!)

Month Dose

1 20.0

2 18.0

3 16.2

4 14.5

5 13.0

6 11.6

7 10.4

8 9.3

9 8.2

10 7.3

11 6.4

12 5.7

13 4.9

14 4.3

15 3.7

16 3.2

17 2.7

18 2.2

19 1.8

20 1.5

21 1.1

22 0.8

23 0.6

24 0.3

25 0.0

 

I'll probably look to start this from my current 2.5 mg Lexapro , thus aiming to be at 0 in 2 years.

 

Cheers

 

Damien

ssri_taper.xlsx 9.61 kB · 251 downloads

Hi...if i taper from 10 mg..why is my taper much longer then the steps of the 20 mg taper you wrote?

 

 

10
9
8.1
7.3
6.6
5.9
5.3
4.8
4.3
3.9
3.5
3.2
2.9
2.6
2.3
2.1
1.9
1.7
1.5
1.4
1.3
1.2
1.1
1
0.9
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0

 

[ChessieCat]

17 hours ago, S1989 said:

Hi...if i taper from 10 mg..why is my taper much longer then the steps of the 20 mg taper you wrote?

 

I've just made the calculations in an Excel spreadsheet and MatGMax was rounding down which makes some of the reductions greater than 10%.  SA recommends rounding up to keep reductions under 10%.

 

My calculations show that step 25 would be 1.59 if exact 10% reductions were made all the way through the taper.

 

Even though the "round downs" were only small, over the full taper they do add up.

 

Some members find that the lower their dose gets the slower they need to go, reducing less and/or holding for longer.

 

See:

 

Why taper paper: dose-occupancy curves

 

MaxGMax might have had no issue doing his taper this way (after type this I have since looked at his topic - see below).  However, with any taper, it is important to listen to your body/symptoms and also your life circumstances and taper according to those, not a calendar.  The idea is to get off the drug with minimal discomfort so that you can live your life as normally as possible.

 

The post you quote was made December 23, 2014 .

 

This is from Max's last post in his Intro topic April 8, 2018:

 

 

On 4/8/2018 at 4:55 PM, MatGMax said:

Doing ok. Not great but ok.

I'm back on 5mg lexapro and have been for 8 months. 

I've got no plans to change dosage. I think the SSRIs have taken out part of my brain and it just won't grow back. 

6 months after tapering to 0 (4 years of tapering I think) I got almost bed ridden with all sorts of weird symptoms.

 

Please note that Lexapro is a very strong drug. 

  

On 5/27/2011 at 12:16 PM, Altostrata said:

Special considerations
A significant characteristic of Lexapro is that milligram for milligram, it is much stronger than other SSRIs. Chemically, Lexapro is a variation of Celexa; the molecule was re-engineered to be patentable as Celexa's patent was about to expire. The streamlined molecule is a more potent SSRI, 2 to 4 times stronger than others. (Wikipedia has a good explanation of this at https://secure.wikimedia.org/wikipedia/en/wiki/Escitalopram.)

However, many doctors are unaware that escitalopram is stronger than other SSRIs and dose it as though it were the same strength. Although the so-called usual starting dose of escitalopram, 10mg, is equivalent to 20mg-30mg or more of, for example, paroxetine (Paxil), your doctor may have moved you to an even higher dose. If you are taking 20mg of escitalopram, you are taking a hefty dose of an SSRI.

If you are taking 5mg of Lexapro, it's not tiny, it's equivalent to 10-20mg Paxil or Celexa.

Consequently, when you taper off escitalopram, you should be careful to decrease by small amounts, as each drop is magnified by escitalopram's extra potency. If you find withdrawal symptoms from a 10% decrease to be too difficult, after 3-4 weeks decrease by a smaller amount.

 

 

[S1989]

On 9/10/2021 at 3:45 AM, ChessieCat said:

 

@Rusty1 Hi and thanks.

 

My first drug free day will be 23 October 2021.

 

Earlier this year I decided to speed my taper up and started reducing 10% every week.  Total taper time 6 years.

 

This is the first post explaining my final run to the finish line:

 

chessiecat-so-im-not-the-only-one-pristiq-desvenlafaxine

 

A member asked me about withdrawal symptoms and I posted about it here:

 

chessiecat-so-im-not-the-only-one-pristiq-desvenlafaxine

Hi Chessiecat..thanks for responding. So as I understand, MatGMax got protracted withdrawal after 6 months..and even when he tapered by 10% of previous dose method?

[ChessieCat]

2 hours ago, S1989 said:

Hi Chessiecat..thanks for responding. So as I understand, MatGMax got protracted withdrawal after 6 months..and even when he tapered by 10% of previous dose method?

 

I suggest you read back through MatGMax's topic.  I've been skimming the last page and it looks like he was getting withdrawal symptoms but keep reducing anyway.

[Altostrata]

16 hours ago, ChessieCat said:

 

I suggest you read back through MatGMax's topic.  I've been skimming the last page and it looks like he was getting withdrawal symptoms but keep reducing anyway.

 

Don't do this. Withdrawal symptoms can cumulate and get worse the more you provoke them.

[MattNNN]

I ran some numbers, involving decreasing both my medications (Seroquel and Zoloft) by 50% each year. These are the results I got:

2023: S=162.50, Z=37.50

2024: S=81.25, Z=18.75

2025: S=40.63, Z=9.38

2026: S=20.31, Z=4.69

2027: S=10.16, Z=2.35

2028: S=5.08, Z=1.17

2029: S=2.54, Z=0.59

 

My question is: how close do I need to get to zero before I can stop completely? I assume it's a different number for different medications.

[Altostrata]

Hello, @MattNNN I think the discussion in this topic may answer your question?