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goodwill: end of clonazepam taper, beginning desvenlafaxine taper shortly


goodwill

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First of all, Thank God for this forum.

Thank everyone, the admins especially, for doing such a great job helping people out.

 

About me - On ADs since 2003 for mild anxiety.

I went with the hope of getting some oral counseling but ended up being prescribed medicines. Never knew the seriousness of what I was getting into, but before I knew, months turned into years and now its 13 years. Medicines changed, doctors changed but my overall health and wellbeing is severely compromised in the deal.

Main complaints – tinnitus since 2008 when doctor weaned me too abruptly, vertigo, light headedness, drowsiness, fatigue, low energy.

 

Medicine history

 

Paroxetene 25mg 2003-2007

Escitalopram 10mg 2007-2008

Mid 2008, wanted to get away from medicines. Doc did a quick taper from 10mg to 5mg and stopped in a short time. Within 2 weeks from stopping I had severe tinnitus, forcing me to get back to meds. But tinnitus persists to this day. Doctor shied away saying this had nothing to do with meds.

2009-2011 Combination of Escitalopram 10mg + Clonazepam 0.5 mg

2011-2015 Paroxetene 25mg + Clonazepam 0.25mg

Feb 2015  Desvenlafaxine 50mg, reduced Paroxetene to 12.5mg, Clonazepam 0.25mg

Apr 2015  Desvenlafaxine 50mg, twice daily, stopped Paroxetene, continued Clonazepam 0.25mg

Sep 2015  Desvenlafaxine 50mg, twice daily, started very slow tapering of Clonazepam .25mg on my own. Currently (Feb 2016) in the 6th month of tapering and on 1/16th of 0.25. (Went against doctor's suggestion to take Clonazepam on alternate days for 10 days and stop)

 

Clonazepam taper schedule followed:

 

0.25 mg on alternate days for 6 weeks

1/2 of 0.25 (=0.125mg) on alternate days for 6 weeks

1/4th of 0.25 (=0.0625mg) on alternate days for 6 weeks

1/8th of 0.25 (=0.03125mg) on alternate days for 6 weeks

1/16th of 0.25mg (=0.015625mg) on alternate days since past 2 weeks, still continuing. Plan to drop further and stop in a few weeks.

 

During the course of tapering, my tinnitus has absolutely worsened,  feeling more imbalanced and dizzy.

I have also developed mild pain in the neck and shoulders since a month. I googled and found that this is also related to the tapering.

 

After stopping Clonazepam I plan to start tapering Desvenlafaxine 50mg (twice). I saw this wonderful post from MogFish which talks about dry cutting the pill despite warnings (She was on 50mg) and tapering over a period of 14 months. I am planning to do the same.

 

Before starting the whole process I am planning to take Ayurveda medicines. I have consulted a doctor and he has given me a prescription which looks quite promising. I am hoping Ayurveda will support me through the withdrawal of Desvenlafaxine. I found Desvenlafaxine 25mg is available and that is going to be of great help in the taper I hope.

         

 

2003-2007    Paroxetene 25mg  +++++++  2007-2008    Escitalopram 10mg

 

Mid 2008, wanted to get away from medicines. Doc did a quick taper from 10mg to 5mg and stopped in a short time. Within 2 weeks from stopping I had severe TINNITUS, forcing me to get back to meds. But TINNITUS persists to this day. Doctor shied away saying this had nothing to do with meds.

 

2009-2011    Combination of Escitalopram 10mg + Clonazepam 0.5 mg  ++++++  2011-2015    Paroxetene 25mg + Clonazepam 0.25mg

Feb 2015      Desvenlafaxine 50mg, reduced Paroxetene to 12.5mg, Clonazepam 0.25mg

Apr 2015       Desvenlafaxine 50mg, twice daily, stopped Paroxetene, continued Clonazepam 0.25mg

Sep 2015      Desvenlafaxine 50mg, twice daily, Started very slow tapering of Clonazepam .25mg on my own.

Feb 2016   6th month of tapering and on 1/16th of 0.25. Clonazepam-free from April 2016. Currently Desvenlafaxine 50-0-50mg

Started Ayurveda medication Medha Kwath, Medha Vati, Ashwashila in June 2016. Had some breaks but continuing.

Planning to start tapering Desvenlafaxine in a couple weeks from now (Signed Sep 11,2016)

Jan 26,2017 Started Desvenlafaxine tapering. Betacap 40mg nightly. Dropped 1/4th of 25mg every 4-6 weeks from the 50mg night dosage. Stopped Ayurveda. Currently at 50-0-25 mg (tapered from 50-0-50) for over 8 weeks now (July 19,2017)

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  • Moderator Emeritus

Goodwill,

 

Welcome to SA.  Sorry you have to be here, but, as you know, this is the best place to be for this particular set of issues.

 

I will note that we have a separate "Benzo" area for members so you might well want to check that out regarding the Clonazapam taper.  Your situation has a lot to it so we need to address things serially.  As you are well into your benzo taper, we should start there.

 

 

Clonazepam taper schedule followed:

 

0.25 mg on alternate days for 6 weeks

1/2 of 0.25 (=0.125mg) on alternate days for 6 weeks

1/4th of 0.25 (=0.0625mg) on alternate days for 6 weeks

1/8th of 0.25 (=0.03125mg) on alternate days for 6 weeks

1/16th of 0.25mg (=0.015625mg) on alternate days since past 2 weeks, still continuing. Plan to drop further and stop in a few weeks.

 

We are not big fans of "every other day" tapers.  It is very destabilizing to the CNS to be on and off the drug on a daily basis.  Kind of like a series of cold turkeys and reinstatements.  Especially true as you get to the very low points in your taper.  Better to fine a way to take a stable amount on a daily basis.  Clonazapam can be diluted into either milk or water and then taken by syringe.  If you look at the Benzo taper forum you can see some discussion of that approach.  I would STRONGLY encourage you to do that as a means of getting off the last bit you have left.  You seem to have been pretty successful so far (other than the tinnitus) unless you've left a lot out.  I wouldn't want you to risk a problem here.  Also, rather than simply "jumping off", if you use the liquid method you can taper right down to 0 and "step off." 

 

From there, and I can say this from experience having gotten of the clonazepam and then, after a month, started immediately on my sertraline taper -- take some time off to allow your CNS to stabilize.  I would not begin the AD taper until at least 3 months.  Slow and steady as you've already seen wins the race.

 

As far as ayurvedic is concerned, it's great to seek support in alternative areas as you go through the process of withdrawing, but be careful because each person is different and may react differently to the herbs and plants that are introduced through the process.  Some people do great on something like Ashwaganda.  Others find it too activating.  My point is simply that when the time comes try not to be too dogmatic in any series of healing tools.  You may find that other things entirely are what works for you.

 

In any event, welcome again and let us know what other questions you have.

 

Best,

 

Andy

Sertraline 50mg and Clonazapam .375mg from 2000 -- symptoms of dizziness Spring 2012

increased to .5 Clonazapam and 100mg Sertraline -- no improvement

Benzo microtaper from November 2012 to November 2014 (followed benzo sites "taper benzo first")

Started Sertraline taper in December 2014 cut by 25mg to 75mg; 62.5mg 1/1/15 and 50mg on 2/1/15

Held at 50mg through April 5 to use liquid 
Reduced dosage in 10% or less drops from 50mg to 25mg -- at single tablet of 25mg on 10/5/15

Transitioned to all liquid for accuracy while tapering -- Horrible insomnia -- back to 25mg liquid and held until October 1, 2016

10/16 -- 11/18 tapered very slowly to 10.6mg.  No real improvement and never really stable so updosed to 12.5mg (1/2 a pill) for convenience and long hold.

After 8+ months of holding with no noticeable improvement decided to add .4ml of liquid Prozac (about 1.5mg) to see if that improves the situation

Supplements, Magnesium, D3, Omega 3, curcumin, Valerian, 81mg Aspirin, L-Theanine, Vit. C,

 

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Thank you Andy for that quick reply. For once, I feel heard and it's a nice feeling.

Right, I had read about clonazepam that only 50% of the dose is used up on the first day and the remaining the next day. This could be a pretty rough idea based on the half life of clonazepam. So I went ahead with this alternate day approach. But in any case I plan to follow your advice for the next cut and take it daily.

Sounds perfect about letting the body stabilise for 3 months after one withdrawal. But I am worried that would mean allowing the body 3 more months of dependence on Desvenlafaxine. I am already a year into it. Would it mean more harm? Or maybe I should wait? Just thinking.

Thanks also for your thoughts about alternate medicines. Iam also thinking about supplements especially magnesium which people have often mentioned on this forum. Is there one that you strongly advocate to aid during withdrawal?

2003-2007    Paroxetene 25mg  +++++++  2007-2008    Escitalopram 10mg

 

Mid 2008, wanted to get away from medicines. Doc did a quick taper from 10mg to 5mg and stopped in a short time. Within 2 weeks from stopping I had severe TINNITUS, forcing me to get back to meds. But TINNITUS persists to this day. Doctor shied away saying this had nothing to do with meds.

 

2009-2011    Combination of Escitalopram 10mg + Clonazepam 0.5 mg  ++++++  2011-2015    Paroxetene 25mg + Clonazepam 0.25mg

Feb 2015      Desvenlafaxine 50mg, reduced Paroxetene to 12.5mg, Clonazepam 0.25mg

Apr 2015       Desvenlafaxine 50mg, twice daily, stopped Paroxetene, continued Clonazepam 0.25mg

Sep 2015      Desvenlafaxine 50mg, twice daily, Started very slow tapering of Clonazepam .25mg on my own.

Feb 2016   6th month of tapering and on 1/16th of 0.25. Clonazepam-free from April 2016. Currently Desvenlafaxine 50-0-50mg

Started Ayurveda medication Medha Kwath, Medha Vati, Ashwashila in June 2016. Had some breaks but continuing.

Planning to start tapering Desvenlafaxine in a couple weeks from now (Signed Sep 11,2016)

Jan 26,2017 Started Desvenlafaxine tapering. Betacap 40mg nightly. Dropped 1/4th of 25mg every 4-6 weeks from the 50mg night dosage. Stopped Ayurveda. Currently at 50-0-25 mg (tapered from 50-0-50) for over 8 weeks now (July 19,2017)

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  • Moderator Emeritus

Hi goodwill,

 

Welcome to SA.  As you've already realised this is a great site and is an absolute Godsend.

 

I'm glad you are considering stabilising before starting your Desvenlafaxine taper.  You are fortunate that 25 mg is available where you are.  Australia only has 50 mg & 100 mg which is a nuisance but fortunately I've managed to get a good deal on getting them compounded.

 

"But I am worried that would mean allowing the body 3 more months of dependence on Desvenlafaxine. I am already a year into it. Would it mean more harm?"

 

The drugs change your brain.  These things helped me to understand why we need to take things slowly and allow the brain this to adapt:

 

Video: Healing from Antidepressants: Patterns of Recovery & Brain Remodelling

 

The other thing about having a break before starting the next taper is it may be easier to tell what symptoms you are getting from the new taper.  If you jump straight from one taper to the other, you might get symptoms and not know which taper is the culprit.

Please DO NOT TAG me - thank you

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Thank you ChessieCat. That was a good video. I am going to give myself time after I am done with clonazepam. Yes I was happy to find 25mg available here. I had also spoken to a compounding pharmacy and was working out the details but I hope 25mg should be enough to help. I see you are tapering Pristiq too. I hope you are doing well. Good luck. I will look around for details of your taper journey. 

2003-2007    Paroxetene 25mg  +++++++  2007-2008    Escitalopram 10mg

 

Mid 2008, wanted to get away from medicines. Doc did a quick taper from 10mg to 5mg and stopped in a short time. Within 2 weeks from stopping I had severe TINNITUS, forcing me to get back to meds. But TINNITUS persists to this day. Doctor shied away saying this had nothing to do with meds.

 

2009-2011    Combination of Escitalopram 10mg + Clonazepam 0.5 mg  ++++++  2011-2015    Paroxetene 25mg + Clonazepam 0.25mg

Feb 2015      Desvenlafaxine 50mg, reduced Paroxetene to 12.5mg, Clonazepam 0.25mg

Apr 2015       Desvenlafaxine 50mg, twice daily, stopped Paroxetene, continued Clonazepam 0.25mg

Sep 2015      Desvenlafaxine 50mg, twice daily, Started very slow tapering of Clonazepam .25mg on my own.

Feb 2016   6th month of tapering and on 1/16th of 0.25. Clonazepam-free from April 2016. Currently Desvenlafaxine 50-0-50mg

Started Ayurveda medication Medha Kwath, Medha Vati, Ashwashila in June 2016. Had some breaks but continuing.

Planning to start tapering Desvenlafaxine in a couple weeks from now (Signed Sep 11,2016)

Jan 26,2017 Started Desvenlafaxine tapering. Betacap 40mg nightly. Dropped 1/4th of 25mg every 4-6 weeks from the 50mg night dosage. Stopped Ayurveda. Currently at 50-0-25 mg (tapered from 50-0-50) for over 8 weeks now (July 19,2017)

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  • Moderator Emeritus

Sounds perfect about letting the body stabilise for 3 months after one withdrawal. But I am worried that would mean allowing the body 3 more months of dependence on Desvenlafaxine. I am already a year into it. Would it mean more harm? Or maybe I should wait? Just thinking.

 

Goodwill,

 

As Chessie has already responded, giving your CNS time to stabilize after one taper and before another is very important.  Will you be a little further dependent on the desvenlafaxine?  I suppose.  But it is not as if there is some kind of bright line that says that at one year you have no problem but at 15 months you do.  Each person's biochemistry and DNA is different.  There is no way to predict how anyone will respond to discontinuing any particular SSRI/SNRI.  The better course of action in my view is to go slowly, be smart and respect the power of these drugs and their impact on your nervous system.

 

Best,

 

Andy

Sertraline 50mg and Clonazapam .375mg from 2000 -- symptoms of dizziness Spring 2012

increased to .5 Clonazapam and 100mg Sertraline -- no improvement

Benzo microtaper from November 2012 to November 2014 (followed benzo sites "taper benzo first")

Started Sertraline taper in December 2014 cut by 25mg to 75mg; 62.5mg 1/1/15 and 50mg on 2/1/15

Held at 50mg through April 5 to use liquid 
Reduced dosage in 10% or less drops from 50mg to 25mg -- at single tablet of 25mg on 10/5/15

Transitioned to all liquid for accuracy while tapering -- Horrible insomnia -- back to 25mg liquid and held until October 1, 2016

10/16 -- 11/18 tapered very slowly to 10.6mg.  No real improvement and never really stable so updosed to 12.5mg (1/2 a pill) for convenience and long hold.

After 8+ months of holding with no noticeable improvement decided to add .4ml of liquid Prozac (about 1.5mg) to see if that improves the situation

Supplements, Magnesium, D3, Omega 3, curcumin, Valerian, 81mg Aspirin, L-Theanine, Vit. C,

 

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Very well said Andy.

So as per what you said earlier, I plan to move over to a daily dose of clonazepam and also use the liquid measures. Now I am on 1/16 of 0.25 alternate days for past over 2 weeks. Would you suggest I start daily dosing at this same strength or halve it now?

2003-2007    Paroxetene 25mg  +++++++  2007-2008    Escitalopram 10mg

 

Mid 2008, wanted to get away from medicines. Doc did a quick taper from 10mg to 5mg and stopped in a short time. Within 2 weeks from stopping I had severe TINNITUS, forcing me to get back to meds. But TINNITUS persists to this day. Doctor shied away saying this had nothing to do with meds.

 

2009-2011    Combination of Escitalopram 10mg + Clonazepam 0.5 mg  ++++++  2011-2015    Paroxetene 25mg + Clonazepam 0.25mg

Feb 2015      Desvenlafaxine 50mg, reduced Paroxetene to 12.5mg, Clonazepam 0.25mg

Apr 2015       Desvenlafaxine 50mg, twice daily, stopped Paroxetene, continued Clonazepam 0.25mg

Sep 2015      Desvenlafaxine 50mg, twice daily, Started very slow tapering of Clonazepam .25mg on my own.

Feb 2016   6th month of tapering and on 1/16th of 0.25. Clonazepam-free from April 2016. Currently Desvenlafaxine 50-0-50mg

Started Ayurveda medication Medha Kwath, Medha Vati, Ashwashila in June 2016. Had some breaks but continuing.

Planning to start tapering Desvenlafaxine in a couple weeks from now (Signed Sep 11,2016)

Jan 26,2017 Started Desvenlafaxine tapering. Betacap 40mg nightly. Dropped 1/4th of 25mg every 4-6 weeks from the 50mg night dosage. Stopped Ayurveda. Currently at 50-0-25 mg (tapered from 50-0-50) for over 8 weeks now (July 19,2017)

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  • Moderator Emeritus

Would you suggest I start daily dosing at this same strength or halve it now?

 

If you are feeling well on that dosage, Goodwill, I would suggest you do half of that but on a daily basis.  Try that for a little while just to get your body used to the daily dosing and see how you feel before you reduce again, but I don't see a reason to essentially double your dose by doing 1/16 of .25 on a daily basis.  I might feel differently if the drug was, say, Xanax with a shorter half life, but with K having a half-life of roughly a day and a half, you should be good with this approach and not suffer any interdose withdrawal.

 

Best,

 

Andy

Sertraline 50mg and Clonazapam .375mg from 2000 -- symptoms of dizziness Spring 2012

increased to .5 Clonazapam and 100mg Sertraline -- no improvement

Benzo microtaper from November 2012 to November 2014 (followed benzo sites "taper benzo first")

Started Sertraline taper in December 2014 cut by 25mg to 75mg; 62.5mg 1/1/15 and 50mg on 2/1/15

Held at 50mg through April 5 to use liquid 
Reduced dosage in 10% or less drops from 50mg to 25mg -- at single tablet of 25mg on 10/5/15

Transitioned to all liquid for accuracy while tapering -- Horrible insomnia -- back to 25mg liquid and held until October 1, 2016

10/16 -- 11/18 tapered very slowly to 10.6mg.  No real improvement and never really stable so updosed to 12.5mg (1/2 a pill) for convenience and long hold.

After 8+ months of holding with no noticeable improvement decided to add .4ml of liquid Prozac (about 1.5mg) to see if that improves the situation

Supplements, Magnesium, D3, Omega 3, curcumin, Valerian, 81mg Aspirin, L-Theanine, Vit. C,

 

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Right. I will do just that. 1/32 0.25mg K every day.

 

I had a couple more questions. Pl take your time to answer!

 

As I said in the intro, I have developed some neck and shoulder pain in the past over 1 month. Every morning I wake up with pain but it is manageable. Is that a known side effect of tapering K ? I am very worried and it is terrible to have new symptoms and keep wondering if this is something to do with the tapering or is this not ? Will it become a part of the rest of my life like the devastating Tinnitus or is it just a temporary stuff that has nothing to do with the tapering at all? Pl tell me if you have any idea about this as I see you had been on K too.

 

Is it possible to draw a potency equivalence between Klonopin and Pristiq? I was just curious to know what it means to be on a 100mg Pristiq dose in terms of Klonopin. I searched some threads on this site and also some charts but there was no comparison between the two.

Thanks again for all the advice.

2003-2007    Paroxetene 25mg  +++++++  2007-2008    Escitalopram 10mg

 

Mid 2008, wanted to get away from medicines. Doc did a quick taper from 10mg to 5mg and stopped in a short time. Within 2 weeks from stopping I had severe TINNITUS, forcing me to get back to meds. But TINNITUS persists to this day. Doctor shied away saying this had nothing to do with meds.

 

2009-2011    Combination of Escitalopram 10mg + Clonazepam 0.5 mg  ++++++  2011-2015    Paroxetene 25mg + Clonazepam 0.25mg

Feb 2015      Desvenlafaxine 50mg, reduced Paroxetene to 12.5mg, Clonazepam 0.25mg

Apr 2015       Desvenlafaxine 50mg, twice daily, stopped Paroxetene, continued Clonazepam 0.25mg

Sep 2015      Desvenlafaxine 50mg, twice daily, Started very slow tapering of Clonazepam .25mg on my own.

Feb 2016   6th month of tapering and on 1/16th of 0.25. Clonazepam-free from April 2016. Currently Desvenlafaxine 50-0-50mg

Started Ayurveda medication Medha Kwath, Medha Vati, Ashwashila in June 2016. Had some breaks but continuing.

Planning to start tapering Desvenlafaxine in a couple weeks from now (Signed Sep 11,2016)

Jan 26,2017 Started Desvenlafaxine tapering. Betacap 40mg nightly. Dropped 1/4th of 25mg every 4-6 weeks from the 50mg night dosage. Stopped Ayurveda. Currently at 50-0-25 mg (tapered from 50-0-50) for over 8 weeks now (July 19,2017)

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  • Moderator Emeritus

As I said in the intro, I have developed some neck and shoulder pain in the past over 1 month. Every morning I wake up with pain but it is manageable. Is that a known side effect of tapering K ?

 

It's always hard to say what is causing any kind of shoulder pain.  Having said that, clonazepam is a benzodiazepine which is often used as a muscle relaxant.  When one withdraws from a medicine that relaxes muscles one of the effects is known to be tightening of the same muscles.  It is very possible, probably even likely, that the withdrawal from clonazepam is the cause of the pain.  It is, in my experience, rarely if ever permanent.  I would just give it some time and hopefully it will all recede over time.  If you start to see it lessening over time that would be a very good sign.  In fact, I would hope that it would recede prior to the time you start the taper off the A/D.  Just be careful in your taper off the clonazepam.  If your dizziness and other symptoms increase or are more disturbing, do not be afraid to hold the taper so that you don't suffer in the process.

 

Is it possible to draw a potency equivalence between Klonopin and Pristiq? I was just curious to know what it means to be on a 100mg Pristiq dose in terms of Klonopin. I searched some threads on this site and also some charts but there was no comparison between the two.

 

There is no equivalence in my view.  Clonazapam is a benzo and pristiq is an SNRI.  You can compare strengths of clonazepam to other benzos, such as valium, Xanax, lorazapam, etc.  Pristiq can be compared to other A/Ds such as Effexor, Cymbalta, Zoloft, etc. but there is no meaningful comparison between Clonazapam and Pristiq. 

 

Best,

 

Andy

Sertraline 50mg and Clonazapam .375mg from 2000 -- symptoms of dizziness Spring 2012

increased to .5 Clonazapam and 100mg Sertraline -- no improvement

Benzo microtaper from November 2012 to November 2014 (followed benzo sites "taper benzo first")

Started Sertraline taper in December 2014 cut by 25mg to 75mg; 62.5mg 1/1/15 and 50mg on 2/1/15

Held at 50mg through April 5 to use liquid 
Reduced dosage in 10% or less drops from 50mg to 25mg -- at single tablet of 25mg on 10/5/15

Transitioned to all liquid for accuracy while tapering -- Horrible insomnia -- back to 25mg liquid and held until October 1, 2016

10/16 -- 11/18 tapered very slowly to 10.6mg.  No real improvement and never really stable so updosed to 12.5mg (1/2 a pill) for convenience and long hold.

After 8+ months of holding with no noticeable improvement decided to add .4ml of liquid Prozac (about 1.5mg) to see if that improves the situation

Supplements, Magnesium, D3, Omega 3, curcumin, Valerian, 81mg Aspirin, L-Theanine, Vit. C,

 

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  • Moderator Emeritus

Hi goodwill ,    I saw your post on mogfish's thread , and want to let you know I'm tapering pristiq too.

 

Your body will let you know if / when dry cutting is becoming a problem -  you get dose-dumping and interdose

withdrawal.   I was fine till around 37.5mg.

It's more economical to stay off the compounded caps as long as possible , but when you get to that point , do get

quotes from several pharmacies. They vary enormously , here in Oz anyway.   Contact the Compounding Pharmacy

Association of America for compounders near you.  

It's worked well for me to have a bunch of 10's , 5's , 2.5's and 1's to mix 'n' match.  

 

There are lots of tips in the "Tips for Tapering Pristiq" thread here  Tips for tapering off Pristiq (desvenlafaxine)

 

Regarding your neck and shoulder pain , you might try taking magnesium each day.

See  

Magnesium, nature's calcium channel blocker

 

 

Also , your tinnitus is part of your symptom package , and is not by any means permanent.

 

Best wishes ,  Fresh

1987-1997 pertofran , prothiaden , Prozac 1997-2002 Zoloft 2002-2004 effexor 2004-2010 Lexapro 40mg

2010-2012Cymbalta 120mg

Sept. 2012 -decreased 90mg in 6months. Care taken over by Dr Lucire in March 2013 , decreased last 30mg at 2mg per week over 3 months. July 21 , 2013- last dose of Cymbalta

Protracted withdrawal syndrome kicked in badly Jan.2014 Unrelenting akathisia until May 2014. Voluntary hosp. admission. Cocktail of Seroquel, Ativan and mirtazapine and I was well enough to go home after 14 days. Stopped all hosp. meds in next few months.

July 2014 felt v.depressed - couldn't stop crying. Started pristiq 50mg. Felt improvement within days and continued to improve, so stayed on 50mg for 8 months.

Began taper 28 Feb. 2015. Pristiq 50mg down to 45mg. Had one month of w/d symptoms. Started CES therapy in March. No w/d symptoms down to 30mg.

October 2015 , taking 25mg Pristiq. Capsules compounded with slow-release additive.

March 2016 , 21mg

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Thank you Fresh. 

Out here there are not many compounding pharmacies but then the few that are there are quoting high. I will keep them for the very end of taper. As of now the plan for me is to jump off clonazepam sooner, give myself 2 or 3 months and if all goes well start tapering Pristiq. 

Thanks for dropping by! 

2003-2007    Paroxetene 25mg  +++++++  2007-2008    Escitalopram 10mg

 

Mid 2008, wanted to get away from medicines. Doc did a quick taper from 10mg to 5mg and stopped in a short time. Within 2 weeks from stopping I had severe TINNITUS, forcing me to get back to meds. But TINNITUS persists to this day. Doctor shied away saying this had nothing to do with meds.

 

2009-2011    Combination of Escitalopram 10mg + Clonazepam 0.5 mg  ++++++  2011-2015    Paroxetene 25mg + Clonazepam 0.25mg

Feb 2015      Desvenlafaxine 50mg, reduced Paroxetene to 12.5mg, Clonazepam 0.25mg

Apr 2015       Desvenlafaxine 50mg, twice daily, stopped Paroxetene, continued Clonazepam 0.25mg

Sep 2015      Desvenlafaxine 50mg, twice daily, Started very slow tapering of Clonazepam .25mg on my own.

Feb 2016   6th month of tapering and on 1/16th of 0.25. Clonazepam-free from April 2016. Currently Desvenlafaxine 50-0-50mg

Started Ayurveda medication Medha Kwath, Medha Vati, Ashwashila in June 2016. Had some breaks but continuing.

Planning to start tapering Desvenlafaxine in a couple weeks from now (Signed Sep 11,2016)

Jan 26,2017 Started Desvenlafaxine tapering. Betacap 40mg nightly. Dropped 1/4th of 25mg every 4-6 weeks from the 50mg night dosage. Stopped Ayurveda. Currently at 50-0-25 mg (tapered from 50-0-50) for over 8 weeks now (July 19,2017)

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  • Moderator Emeritus

 

 

As of now the plan for me is to jump off clonazepam sooner, give myself 2 or 3 months and if all goes well start tapering Pristiq. 

 

WHOA, Goodwill!  Slow down.  What plan to "jump off clonazepam sooner"?

 

Don't go off that too soon or you might find it creates a problem for you.  Taper it down further than you think you need.  Better to be safe than sorry and if it adds an extra couple of months to the process so be it.

 

Just a word to the wise.

 

Best,

 

Andy

Sertraline 50mg and Clonazapam .375mg from 2000 -- symptoms of dizziness Spring 2012

increased to .5 Clonazapam and 100mg Sertraline -- no improvement

Benzo microtaper from November 2012 to November 2014 (followed benzo sites "taper benzo first")

Started Sertraline taper in December 2014 cut by 25mg to 75mg; 62.5mg 1/1/15 and 50mg on 2/1/15

Held at 50mg through April 5 to use liquid 
Reduced dosage in 10% or less drops from 50mg to 25mg -- at single tablet of 25mg on 10/5/15

Transitioned to all liquid for accuracy while tapering -- Horrible insomnia -- back to 25mg liquid and held until October 1, 2016

10/16 -- 11/18 tapered very slowly to 10.6mg.  No real improvement and never really stable so updosed to 12.5mg (1/2 a pill) for convenience and long hold.

After 8+ months of holding with no noticeable improvement decided to add .4ml of liquid Prozac (about 1.5mg) to see if that improves the situation

Supplements, Magnesium, D3, Omega 3, curcumin, Valerian, 81mg Aspirin, L-Theanine, Vit. C,

 

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Hi Andy and others.. The past week has been fairly good. Tinnitus has become milder,  neck pain is receeding,  not much of dizziness. So overall feeling good and positive..comparatively that is! 

So last 3 weeks I have been on 1/32 of 0.25 K. Specifically,  1/16 on alternate days followed by past 5 days of 1/32 as per your advice. Am I good to go for the next cut starting today. I will be doing the liquid thing and taking 1/64 of 0.25. Should that be okay?! 

2003-2007    Paroxetene 25mg  +++++++  2007-2008    Escitalopram 10mg

 

Mid 2008, wanted to get away from medicines. Doc did a quick taper from 10mg to 5mg and stopped in a short time. Within 2 weeks from stopping I had severe TINNITUS, forcing me to get back to meds. But TINNITUS persists to this day. Doctor shied away saying this had nothing to do with meds.

 

2009-2011    Combination of Escitalopram 10mg + Clonazepam 0.5 mg  ++++++  2011-2015    Paroxetene 25mg + Clonazepam 0.25mg

Feb 2015      Desvenlafaxine 50mg, reduced Paroxetene to 12.5mg, Clonazepam 0.25mg

Apr 2015       Desvenlafaxine 50mg, twice daily, stopped Paroxetene, continued Clonazepam 0.25mg

Sep 2015      Desvenlafaxine 50mg, twice daily, Started very slow tapering of Clonazepam .25mg on my own.

Feb 2016   6th month of tapering and on 1/16th of 0.25. Clonazepam-free from April 2016. Currently Desvenlafaxine 50-0-50mg

Started Ayurveda medication Medha Kwath, Medha Vati, Ashwashila in June 2016. Had some breaks but continuing.

Planning to start tapering Desvenlafaxine in a couple weeks from now (Signed Sep 11,2016)

Jan 26,2017 Started Desvenlafaxine tapering. Betacap 40mg nightly. Dropped 1/4th of 25mg every 4-6 weeks from the 50mg night dosage. Stopped Ayurveda. Currently at 50-0-25 mg (tapered from 50-0-50) for over 8 weeks now (July 19,2017)

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As of now the plan for me is to jump off clonazepam sooner, give myself 2 or 3 months and if all goes well start tapering Pristiq. 

 

WHOA, Goodwill!  Slow down.  What plan to "jump off clonazepam sooner"?

 

Don't go off that too soon or you might find it creates a problem for you.  Taper it down further than you think you need.  Better to be safe than sorry and if it adds an extra couple of months to the process so be it.

 

Just a word to the wise.

 

Best,

 

Andy

 

Oh yes Andy! Not too soon! Still going on with the taper.  Sooner could mean few weeks! 

2003-2007    Paroxetene 25mg  +++++++  2007-2008    Escitalopram 10mg

 

Mid 2008, wanted to get away from medicines. Doc did a quick taper from 10mg to 5mg and stopped in a short time. Within 2 weeks from stopping I had severe TINNITUS, forcing me to get back to meds. But TINNITUS persists to this day. Doctor shied away saying this had nothing to do with meds.

 

2009-2011    Combination of Escitalopram 10mg + Clonazepam 0.5 mg  ++++++  2011-2015    Paroxetene 25mg + Clonazepam 0.25mg

Feb 2015      Desvenlafaxine 50mg, reduced Paroxetene to 12.5mg, Clonazepam 0.25mg

Apr 2015       Desvenlafaxine 50mg, twice daily, stopped Paroxetene, continued Clonazepam 0.25mg

Sep 2015      Desvenlafaxine 50mg, twice daily, Started very slow tapering of Clonazepam .25mg on my own.

Feb 2016   6th month of tapering and on 1/16th of 0.25. Clonazepam-free from April 2016. Currently Desvenlafaxine 50-0-50mg

Started Ayurveda medication Medha Kwath, Medha Vati, Ashwashila in June 2016. Had some breaks but continuing.

Planning to start tapering Desvenlafaxine in a couple weeks from now (Signed Sep 11,2016)

Jan 26,2017 Started Desvenlafaxine tapering. Betacap 40mg nightly. Dropped 1/4th of 25mg every 4-6 weeks from the 50mg night dosage. Stopped Ayurveda. Currently at 50-0-25 mg (tapered from 50-0-50) for over 8 weeks now (July 19,2017)

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  • Moderator Emeritus

Sounds good, goodwill.  Yes, I would try another reduction.  If at any point you become symptomatic just bump back up a level.  You seem like you are doing well which is great news.

 

Best,

 

Andy

Sertraline 50mg and Clonazapam .375mg from 2000 -- symptoms of dizziness Spring 2012

increased to .5 Clonazapam and 100mg Sertraline -- no improvement

Benzo microtaper from November 2012 to November 2014 (followed benzo sites "taper benzo first")

Started Sertraline taper in December 2014 cut by 25mg to 75mg; 62.5mg 1/1/15 and 50mg on 2/1/15

Held at 50mg through April 5 to use liquid 
Reduced dosage in 10% or less drops from 50mg to 25mg -- at single tablet of 25mg on 10/5/15

Transitioned to all liquid for accuracy while tapering -- Horrible insomnia -- back to 25mg liquid and held until October 1, 2016

10/16 -- 11/18 tapered very slowly to 10.6mg.  No real improvement and never really stable so updosed to 12.5mg (1/2 a pill) for convenience and long hold.

After 8+ months of holding with no noticeable improvement decided to add .4ml of liquid Prozac (about 1.5mg) to see if that improves the situation

Supplements, Magnesium, D3, Omega 3, curcumin, Valerian, 81mg Aspirin, L-Theanine, Vit. C,

 

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Thanks Andy! 

2003-2007    Paroxetene 25mg  +++++++  2007-2008    Escitalopram 10mg

 

Mid 2008, wanted to get away from medicines. Doc did a quick taper from 10mg to 5mg and stopped in a short time. Within 2 weeks from stopping I had severe TINNITUS, forcing me to get back to meds. But TINNITUS persists to this day. Doctor shied away saying this had nothing to do with meds.

 

2009-2011    Combination of Escitalopram 10mg + Clonazepam 0.5 mg  ++++++  2011-2015    Paroxetene 25mg + Clonazepam 0.25mg

Feb 2015      Desvenlafaxine 50mg, reduced Paroxetene to 12.5mg, Clonazepam 0.25mg

Apr 2015       Desvenlafaxine 50mg, twice daily, stopped Paroxetene, continued Clonazepam 0.25mg

Sep 2015      Desvenlafaxine 50mg, twice daily, Started very slow tapering of Clonazepam .25mg on my own.

Feb 2016   6th month of tapering and on 1/16th of 0.25. Clonazepam-free from April 2016. Currently Desvenlafaxine 50-0-50mg

Started Ayurveda medication Medha Kwath, Medha Vati, Ashwashila in June 2016. Had some breaks but continuing.

Planning to start tapering Desvenlafaxine in a couple weeks from now (Signed Sep 11,2016)

Jan 26,2017 Started Desvenlafaxine tapering. Betacap 40mg nightly. Dropped 1/4th of 25mg every 4-6 weeks from the 50mg night dosage. Stopped Ayurveda. Currently at 50-0-25 mg (tapered from 50-0-50) for over 8 weeks now (July 19,2017)

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Hello Andy and Fresh,

 

I seem to be doing reasonably okay the past week after the cut from 1/32 to 1/64 of 0.25mg K. Like you said, I dissolved the 1/32 bits that I already had, in water 10 ml, and took 5 ml of it.

 

Meanwhile I have spoken to the compounding pharmacy for 10mg and 5mg doses. And this is the taper plan I intend to follow.

I am thinking of a taper schedule like this: <Picking up from what I just posted on MogFish's thread>

 

95 mg - 50-25-10-10

90 mg - 50-25-10-5

85 mg - 50-25-10

80 mg - 50-20-10

75 mg - 50-25 etc..

 

 

This is less than 10% reduction. Each dose would be for a couple of weeks or going slower or faster as the body demands.

 

Once I reach 45mg, I can no longer go with 5 mg reductions, so then I would go in for 2.5mg, 1mg and so on as I progress to lower doses.

 

45 mg    - 25 10 10

42.5 mg - 25 10 5 2.5

40 mg    - 25 10 5

37.5 mg - 25 10 2.5 so on

 

I think this way the taper would go for more than 1.5 years. But I'll get an idea if I can speed up when I really start doing it.

 

Only catch here is with the compounding pharmacy telling me that they would have to dispatch a minimum of 300 capsules at one go of any dose that I order and that the expiry period would be just 6 months. With a combination of 10 and 5 mg I may not really use up all of them within the 6 month period and I might have about 50% or more that would be past expiry date at the end of 6 months and would need to order fresh batches for later use.

 

Is the expiry period for compounded medicines only 6 months?

Fresh, since you use compounded meds can you throw some light on this?

I still have time before I begin the taper, just pondering.

2003-2007    Paroxetene 25mg  +++++++  2007-2008    Escitalopram 10mg

 

Mid 2008, wanted to get away from medicines. Doc did a quick taper from 10mg to 5mg and stopped in a short time. Within 2 weeks from stopping I had severe TINNITUS, forcing me to get back to meds. But TINNITUS persists to this day. Doctor shied away saying this had nothing to do with meds.

 

2009-2011    Combination of Escitalopram 10mg + Clonazepam 0.5 mg  ++++++  2011-2015    Paroxetene 25mg + Clonazepam 0.25mg

Feb 2015      Desvenlafaxine 50mg, reduced Paroxetene to 12.5mg, Clonazepam 0.25mg

Apr 2015       Desvenlafaxine 50mg, twice daily, stopped Paroxetene, continued Clonazepam 0.25mg

Sep 2015      Desvenlafaxine 50mg, twice daily, Started very slow tapering of Clonazepam .25mg on my own.

Feb 2016   6th month of tapering and on 1/16th of 0.25. Clonazepam-free from April 2016. Currently Desvenlafaxine 50-0-50mg

Started Ayurveda medication Medha Kwath, Medha Vati, Ashwashila in June 2016. Had some breaks but continuing.

Planning to start tapering Desvenlafaxine in a couple weeks from now (Signed Sep 11,2016)

Jan 26,2017 Started Desvenlafaxine tapering. Betacap 40mg nightly. Dropped 1/4th of 25mg every 4-6 weeks from the 50mg night dosage. Stopped Ayurveda. Currently at 50-0-25 mg (tapered from 50-0-50) for over 8 weeks now (July 19,2017)

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Whatever Fresh Says !! 

Many SSRI's and SSNRI's over 20 years. Zoloft for 7 years followed by Effexor, Lexapro, Prozac, Cymbalta, Celexa, Pristiq, Valdoxan, Mianserin and more - on and off. No tapering. Cold turkey off Valdoxan - end of May 2014

 

                                                  Psych Drug - free since May 2014
.
         

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  • Moderator Emeritus

I had the same questions goodwill , and I was given the following article.

 

Excerpt:

" Lee Cantrell is the director of the California Poison Control Centre based in San Francisco and is one of only a handful of researchers in the world who have studied the potency issue around expired drugs. And when I say “expired,” I mean “very expired.” The drugs he examined for a 2012 study in the Journal of the American Medical Association were 28 to 40 years beyond their expiry date.

 

His study looked closely at 14 expired drugs, 12 of which were “present in concentrations at least 90 percent of the labelled amounts.” This is considered the minimum “acceptable potency.” Basically, these decades-old drugs were as potent as the day they were manufactured; in fact, he found that those 12 medications “retained full potency for at least 336 months, and eight of these for at least 480 months.

 

Cantrell’s study was unique but tiny compared to what the US military did when it launched its Shelf Life Extension Program (SLEP) in 1986. Because the US government stores one of the biggest stockpiles of medications, it needs to know how potent those drugs are after their expiry dates. SLEP examined 122 different drugs past their expiry dates and found that almost 90% of them could easily have had their expiry date extended by a year. In fact, on average, they felt they could safely extend the expiry dates of those drugs by more than five years."

 

Full article is here http://commonground.ca/2015/11/drug-expiry-dates-are-they-ever-too-old/

 

Based on this , I decided that I believe the system of expiry dates is another way to increase consumerism. The pharmacist I spoke with here agreed with me that they are required by law to put 6 months as the expiry date. I'm very comfortable taking my capsules beyond the dates on the label.

 

Here's a hot tip: have the different strengths made up in different coloured capsules.

That way when you drop them or confuse them (as happens now and then) you'll know what's what. Wish I'd done that before I dropped a pill box with a week's worth of capsules ;). I couldn't tell which were 10's and which were 5's , so had to throw them all out.

1987-1997 pertofran , prothiaden , Prozac 1997-2002 Zoloft 2002-2004 effexor 2004-2010 Lexapro 40mg

2010-2012Cymbalta 120mg

Sept. 2012 -decreased 90mg in 6months. Care taken over by Dr Lucire in March 2013 , decreased last 30mg at 2mg per week over 3 months. July 21 , 2013- last dose of Cymbalta

Protracted withdrawal syndrome kicked in badly Jan.2014 Unrelenting akathisia until May 2014. Voluntary hosp. admission. Cocktail of Seroquel, Ativan and mirtazapine and I was well enough to go home after 14 days. Stopped all hosp. meds in next few months.

July 2014 felt v.depressed - couldn't stop crying. Started pristiq 50mg. Felt improvement within days and continued to improve, so stayed on 50mg for 8 months.

Began taper 28 Feb. 2015. Pristiq 50mg down to 45mg. Had one month of w/d symptoms. Started CES therapy in March. No w/d symptoms down to 30mg.

October 2015 , taking 25mg Pristiq. Capsules compounded with slow-release additive.

March 2016 , 21mg

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  • Moderator Emeritus

Great find, Fresh!

 

I had always assumed that to be the case but never had proof (other than effective use of some meds well after expiration).

 

Thanks for sharing.

 

Andy

Sertraline 50mg and Clonazapam .375mg from 2000 -- symptoms of dizziness Spring 2012

increased to .5 Clonazapam and 100mg Sertraline -- no improvement

Benzo microtaper from November 2012 to November 2014 (followed benzo sites "taper benzo first")

Started Sertraline taper in December 2014 cut by 25mg to 75mg; 62.5mg 1/1/15 and 50mg on 2/1/15

Held at 50mg through April 5 to use liquid 
Reduced dosage in 10% or less drops from 50mg to 25mg -- at single tablet of 25mg on 10/5/15

Transitioned to all liquid for accuracy while tapering -- Horrible insomnia -- back to 25mg liquid and held until October 1, 2016

10/16 -- 11/18 tapered very slowly to 10.6mg.  No real improvement and never really stable so updosed to 12.5mg (1/2 a pill) for convenience and long hold.

After 8+ months of holding with no noticeable improvement decided to add .4ml of liquid Prozac (about 1.5mg) to see if that improves the situation

Supplements, Magnesium, D3, Omega 3, curcumin, Valerian, 81mg Aspirin, L-Theanine, Vit. C,

 

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  • 6 months later...

Hello everyone, I last posted on this thread in March.

 

Updates after March:

 

In April I successfully ended my Clonazepam taper. Although the dose was only 0.25mg I did a good long taper lasting several months based on all your advices and thanks Andy for warning me to take it very slow through the very end. I did just that and now I am 5 months off K.

No new symptoms but for the past few weeks my pounding heart is definitely on the higher edge.

 

Meanwhile since July I started seeing an Ayurveda physician who has prescribed me Ayurvedic medines to support me with my about-to-begin taper of Desvenlafaxine (50mg-0-50mg). That includes Ashwagandha.

 

As I had noted in my earlier posts, I was planning to go with a compounding pharmacy so I could taper in less than 10% dose every 3 weeks. So the plan was to go down from 100 to 95,90,85,80... et al (not a fixed percentage but that's the best I could do the compounded way)

 

So after having spoken to the pharmacy that offered to give compounded capsules with the Doc's prescription, I made an appointment with my doc today. But he ridiculed the idea and said he had never heard of anyone providing compounded medicines in psychiatry. He says he just cant vouch for such a thing being safe. So now I am back to square one with my doctor outright refusing a prescription for that. And further, he told me to switch from Desvenlafaxine (50-0-50)  to Venlafaxine and take 37.5mg-0-37.5 for a month, stop the night dose the next month and then totally stop. I am sure none of you would suggest me this and I am myself now warned enough to never repeat a mistake I had done in the past ( with Escitalopram ). I had a good mind to tell my doc about the SA forum.

 

So there I am and I request your suggestions on what to do.

 

1. Do you think it would be easy for me to find another doctor and get him to render me such a prescription?

2. Or should I go with the dry cut approach as Mogfish did? If I do decide to follow this, I plan to file the tab like less than 10% of its size each time and not the half cut approach Mogfish followed. I also don't know how easy or safe is it to file the tab.

 

Please people,  I need your guidance.

 

 

2003-2007    Paroxetene 25mg  +++++++  2007-2008    Escitalopram 10mg

 

Mid 2008, wanted to get away from medicines. Doc did a quick taper from 10mg to 5mg and stopped in a short time. Within 2 weeks from stopping I had severe TINNITUS, forcing me to get back to meds. But TINNITUS persists to this day. Doctor shied away saying this had nothing to do with meds.

 

2009-2011    Combination of Escitalopram 10mg + Clonazepam 0.5 mg  ++++++  2011-2015    Paroxetene 25mg + Clonazepam 0.25mg

Feb 2015      Desvenlafaxine 50mg, reduced Paroxetene to 12.5mg, Clonazepam 0.25mg

Apr 2015       Desvenlafaxine 50mg, twice daily, stopped Paroxetene, continued Clonazepam 0.25mg

Sep 2015      Desvenlafaxine 50mg, twice daily, Started very slow tapering of Clonazepam .25mg on my own.

Feb 2016   6th month of tapering and on 1/16th of 0.25. Clonazepam-free from April 2016. Currently Desvenlafaxine 50-0-50mg

Started Ayurveda medication Medha Kwath, Medha Vati, Ashwashila in June 2016. Had some breaks but continuing.

Planning to start tapering Desvenlafaxine in a couple weeks from now (Signed Sep 11,2016)

Jan 26,2017 Started Desvenlafaxine tapering. Betacap 40mg nightly. Dropped 1/4th of 25mg every 4-6 weeks from the 50mg night dosage. Stopped Ayurveda. Currently at 50-0-25 mg (tapered from 50-0-50) for over 8 weeks now (July 19,2017)

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  • Moderator Emeritus

Please (re-)read the thread on Pristiq (desvenlafaxine).

 

 

If you choose to work with your current doctor or another one:

Tell your doctor you're VERY concerned about preventing the discontinuation symptoms listed on the the patient information sheet that comes with your prescription of desvenlafaxine. There will almost certainly be a strong recommendation about gradually discontinuing the medication. Tell the doctor that

  • you can't afford to lose time at work because of symptoms and that you'd prefer to be very cautious and conservative when reducing dosage
    -- and --
  • getting compounded doses would be the best way the doctor can ensure that you get the prescribed dose because a pharmacist will be doing it rather than you -- a person with no training in medications.

 

Often pharmacies can print the patient information sheet for you; I'm not sure of how this works in India. There may be a state or national health authority website with the information.

 

Here is what is included for patients in the USA.

 

From the thread on desvenlafaxine: The official prescribing information from the FDA contains this:
 

Discontinuation Syndrome
Discontinuation symptoms have been systematically and prospectively evaluated in patients treated with Pristiq during clinical studies in Major Depressive Disorder. Abrupt discontinuation or dose reduction has been associated with the appearance of new symptoms that include dizziness, nausea, headache, irritability, insomnia, diarrhea, anxiety, fatigue, abnormal dreams, and hyperhidrosis. In general, discontinuation events occurred more frequently with longer duration of therapy.

During marketing of SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors), and SSRIs (Selective Serotonin Reuptake Inhibitors), there have been spontaneous reports of adverse events occurring upon discontinuation of these drugs, particularly when abrupt, including the following: dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesia, such as electric shock sensations), anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania, tinnitus, and seizures. While these events are generally self-limiting, there have been reports of serious discontinuation symptoms.

Patients should be monitored for these symptoms when discontinuing treatment with Pristiq. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose, but at a more gradual rate..... [see Dosage and Administration (2.4) and Adverse Reactions (6.1)].
....
Discontinuing Pristiq
Symptoms associated with discontinuation of Pristiq, other SNRIs and SSRIs have been reported [see Warnings and Precautions (5.9)]. Patients should be monitored for these symptoms when discontinuing treatment. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose, but at a more gradual rate.
....

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results

Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to  0.0 mg  Aug. 12; details here


scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet

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  • Moderator Emeritus

Goodwill,

 

Have you read through this thread?

 

http://survivingantidepressants.org/index.php?/topic/876-tips-for-tapering-off-pristiq-desvenlafaxine/

 

Pristiq is a tough one.  A switch to Effexor might be worth trying but not with a reduction at the rate your P-doc suggests.

 

I would certainly consider looking for a new doctor if his taper approach is that cavalier.

 

Best,

 

Andy

Sertraline 50mg and Clonazapam .375mg from 2000 -- symptoms of dizziness Spring 2012

increased to .5 Clonazapam and 100mg Sertraline -- no improvement

Benzo microtaper from November 2012 to November 2014 (followed benzo sites "taper benzo first")

Started Sertraline taper in December 2014 cut by 25mg to 75mg; 62.5mg 1/1/15 and 50mg on 2/1/15

Held at 50mg through April 5 to use liquid 
Reduced dosage in 10% or less drops from 50mg to 25mg -- at single tablet of 25mg on 10/5/15

Transitioned to all liquid for accuracy while tapering -- Horrible insomnia -- back to 25mg liquid and held until October 1, 2016

10/16 -- 11/18 tapered very slowly to 10.6mg.  No real improvement and never really stable so updosed to 12.5mg (1/2 a pill) for convenience and long hold.

After 8+ months of holding with no noticeable improvement decided to add .4ml of liquid Prozac (about 1.5mg) to see if that improves the situation

Supplements, Magnesium, D3, Omega 3, curcumin, Valerian, 81mg Aspirin, L-Theanine, Vit. C,

 

Link to comment

 

Please (re-)read the thread on Pristiq (desvenlafaxine).

 

 

If you choose to work with your current doctor or another one:

Tell your doctor you're VERY concerned about preventing the discontinuation symptoms listed on the the patient information sheet that comes with your prescription of desvenlafaxine. There will almost certainly be a strong recommendation about gradually discontinuing the medication. Tell the doctor that

  • you can't afford to lose time at work because of symptoms and that you'd prefer to be very cautious and conservative when reducing dosage

    -- and --

  • getting compounded doses would be the best way the doctor can ensure that you get the prescribed dose because a pharmacist will be doing it rather than you -- a person with no training in medications.

 

Often pharmacies can print the patient information sheet for you; I'm not sure of how this works in India. There may be a state or national health authority website with the information.

 

Here is what is included for patients in the USA.

 

From the thread on desvenlafaxine: The official prescribing information from the FDA contains this:

 

Discontinuation Syndrome

Discontinuation symptoms have been systematically and prospectively evaluated in patients treated with Pristiq during clinical studies in Major Depressive Disorder. Abrupt discontinuation or dose reduction has been associated with the appearance of new symptoms that include dizziness, nausea, headache, irritability, insomnia, diarrhea, anxiety, fatigue, abnormal dreams, and hyperhidrosis. In general, discontinuation events occurred more frequently with longer duration of therapy.

 

During marketing of SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors), and SSRIs (Selective Serotonin Reuptake Inhibitors), there have been spontaneous reports of adverse events occurring upon discontinuation of these drugs, particularly when abrupt, including the following: dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesia, such as electric shock sensations), anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania, tinnitus, and seizures. While these events are generally self-limiting, there have been reports of serious discontinuation symptoms.

 

Patients should be monitored for these symptoms when discontinuing treatment with Pristiq. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose, but at a more gradual rate..... [see Dosage and Administration (2.4) and Adverse Reactions (6.1)].

....

Discontinuing Pristiq

Symptoms associated with discontinuation of Pristiq, other SNRIs and SSRIs have been reported [see Warnings and Precautions (5.9)]. Patients should be monitored for these symptoms when discontinuing treatment. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose, but at a more gradual rate.

....

 

Thanks Scally. I have discussed all these points with the doctor even earlier. But our discussion does not last more than 10 minutes as he is quite casual and stubborn about his sharp taper approach and does not want to hear anything more.

I don't think I can work with him anymore.

As a last resort I will forward him this snippet from FDA and also the link to the website of the compounding pharmacy here.

If he chooses not to reconsider, I'll just have to go ahead with my doc hunt.

2003-2007    Paroxetene 25mg  +++++++  2007-2008    Escitalopram 10mg

 

Mid 2008, wanted to get away from medicines. Doc did a quick taper from 10mg to 5mg and stopped in a short time. Within 2 weeks from stopping I had severe TINNITUS, forcing me to get back to meds. But TINNITUS persists to this day. Doctor shied away saying this had nothing to do with meds.

 

2009-2011    Combination of Escitalopram 10mg + Clonazepam 0.5 mg  ++++++  2011-2015    Paroxetene 25mg + Clonazepam 0.25mg

Feb 2015      Desvenlafaxine 50mg, reduced Paroxetene to 12.5mg, Clonazepam 0.25mg

Apr 2015       Desvenlafaxine 50mg, twice daily, stopped Paroxetene, continued Clonazepam 0.25mg

Sep 2015      Desvenlafaxine 50mg, twice daily, Started very slow tapering of Clonazepam .25mg on my own.

Feb 2016   6th month of tapering and on 1/16th of 0.25. Clonazepam-free from April 2016. Currently Desvenlafaxine 50-0-50mg

Started Ayurveda medication Medha Kwath, Medha Vati, Ashwashila in June 2016. Had some breaks but continuing.

Planning to start tapering Desvenlafaxine in a couple weeks from now (Signed Sep 11,2016)

Jan 26,2017 Started Desvenlafaxine tapering. Betacap 40mg nightly. Dropped 1/4th of 25mg every 4-6 weeks from the 50mg night dosage. Stopped Ayurveda. Currently at 50-0-25 mg (tapered from 50-0-50) for over 8 weeks now (July 19,2017)

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Goodwill,

 

Have you read through this thread?

 

http://survivingantidepressants.org/index.php?/topic/876-tips-for-tapering-off-pristiq-desvenlafaxine/

 

Pristiq is a tough one.  A switch to Effexor might be worth trying but not with a reduction at the rate your P-doc suggests.

 

I would certainly consider looking for a new doctor if his taper approach is that cavalier.

 

Best,

 

Andy

 

 

Yes I have read through that very useful thread on Pristiq withdrawal.

I guess I have to find a doc who will approve of the compounding pharmacy.

 

On a different note, do you have any idea how the compounding thing works?

Where do they obtain the chemicals from? This particular pharmacy that I am talking to has mostly dealt with thyroid, gynaec, fertility meds.

I hope the field of medicine should not matter. I will confirm with them about the timed-release coating. I remember they mentioned about it.

 

Also do I have to worry about this point that the pharmacy mentioned to me:

 

"Compounding is an accurate method for getting the required strength of a medicine

However there is a 10% variation that will be allowed as we do such small quantities"

2003-2007    Paroxetene 25mg  +++++++  2007-2008    Escitalopram 10mg

 

Mid 2008, wanted to get away from medicines. Doc did a quick taper from 10mg to 5mg and stopped in a short time. Within 2 weeks from stopping I had severe TINNITUS, forcing me to get back to meds. But TINNITUS persists to this day. Doctor shied away saying this had nothing to do with meds.

 

2009-2011    Combination of Escitalopram 10mg + Clonazepam 0.5 mg  ++++++  2011-2015    Paroxetene 25mg + Clonazepam 0.25mg

Feb 2015      Desvenlafaxine 50mg, reduced Paroxetene to 12.5mg, Clonazepam 0.25mg

Apr 2015       Desvenlafaxine 50mg, twice daily, stopped Paroxetene, continued Clonazepam 0.25mg

Sep 2015      Desvenlafaxine 50mg, twice daily, Started very slow tapering of Clonazepam .25mg on my own.

Feb 2016   6th month of tapering and on 1/16th of 0.25. Clonazepam-free from April 2016. Currently Desvenlafaxine 50-0-50mg

Started Ayurveda medication Medha Kwath, Medha Vati, Ashwashila in June 2016. Had some breaks but continuing.

Planning to start tapering Desvenlafaxine in a couple weeks from now (Signed Sep 11,2016)

Jan 26,2017 Started Desvenlafaxine tapering. Betacap 40mg nightly. Dropped 1/4th of 25mg every 4-6 weeks from the 50mg night dosage. Stopped Ayurveda. Currently at 50-0-25 mg (tapered from 50-0-50) for over 8 weeks now (July 19,2017)

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  • Moderator Emeritus

Unfortunately with Pristiq we don't have much option.  The tablets can't be cut evenly, although they could be weighed.  Member Fresh is also taking Pristiq.  Fresh's Pristiq knowledge helped me immensely when I first started here.  See Fresh's Fractured Fairytale: How Much Can a Koala Bear?

 

From Tips for tapering off Pristiq (desvenlafaxine):

 

"You may be able to go off Pristiq by taking part of your dose in lower-dose tablets and part in liquid Effexor, gradually converting to all-liquid Effexor as you get to lower dosages. This may offer a convenient and gradual path off Pristiq."

 

 

For doses above 50 mg I was taking a Pristiq tablet + compounded capsules.

 

I'm now below 50 mg and am taking only compounded capsules.  I started this on 11th September dropping from 50 mg to 47.5 mg.  So far I'm going okay.  Just a very small amount of anxiety which I manage with some controlled deep breathing.

 

Because I am using compounded capsules, it is more convenient to taper by dose rather than by calculating a 10% drop.  My tapering details are in my signature with a link to my topic.  One of the other mods recently mentioned that she has her AD made up into money amounts, 1, 2, 5, 10, 20.  I found 10, 5, and 2.5 useful for making up 75 mg and I've recently had 40, 30, 2.5 and 1's made up.

 

The most important thing is to listen to your body and throw out the calendar.

Please DO NOT TAG me - thank you

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

Link to comment

Unfortunately with Pristiq we don't have much option.  The tablets can't be cut evenly, although they could be weighed.  Member Fresh is also taking Pristiq.  Fresh's Pristiq knowledge helped me immensely when I first started here.  See Fresh's Fractured Fairytale: How Much Can a Koala Bear?

 

From Tips for tapering off Pristiq (desvenlafaxine):

 

"You may be able to go off Pristiq by taking part of your dose in lower-dose tablets and part in liquid Effexor, gradually converting to all-liquid Effexor as you get to lower dosages. This may offer a convenient and gradual path off Pristiq."

 

 

For doses above 50 mg I was taking a Pristiq tablet + compounded capsules.

 

I'm now below 50 mg and am taking only compounded capsules.  I started this on 11th September dropping from 50 mg to 47.5 mg.  So far I'm going okay.  Just a very small amount of anxiety which I manage with some controlled deep breathing.

 

Because I am using compounded capsules, it is more convenient to taper by dose rather than by calculating a 10% drop.  My tapering details are in my signature with a link to my topic.  One of the other mods recently mentioned that she has her AD made up into money amounts, 1, 2, 5, 10, 20.  I found 10, 5, and 2.5 useful for making up 75 mg and I've recently had 40, 30, 2.5 and 1's made up.

 

The most important thing is to listen to your body and throw out the calendar.

 

Thank you Chessie. Effexor liquid, I believe is not available in India. I just checked online. Even otherwise, I am so tired of switching medicines, now I just dont want to try another one.

 

So I see you have been tapering by 2.5mg. I planned to do a 5mg taper until 50mg (I am on 100mg) and then go down by 2.5 until some point and then even slower. Does that sound ok or you recommend 2.5 right from the beginning?

 

Could you also help me with these questions please?

 

1. Do you require the doctor's prescription for compounded capsules in Australia?

2. Did you order all the different strengths (1,2,5,10..) in one go?

3. What is the expiry date on these compounded meds stipulated by your pharmacy?

 

And regarding your symptoms.. did/do you experience tinnitus (ringing in the ears) and/or pounding heart during your taper?

2003-2007    Paroxetene 25mg  +++++++  2007-2008    Escitalopram 10mg

 

Mid 2008, wanted to get away from medicines. Doc did a quick taper from 10mg to 5mg and stopped in a short time. Within 2 weeks from stopping I had severe TINNITUS, forcing me to get back to meds. But TINNITUS persists to this day. Doctor shied away saying this had nothing to do with meds.

 

2009-2011    Combination of Escitalopram 10mg + Clonazepam 0.5 mg  ++++++  2011-2015    Paroxetene 25mg + Clonazepam 0.25mg

Feb 2015      Desvenlafaxine 50mg, reduced Paroxetene to 12.5mg, Clonazepam 0.25mg

Apr 2015       Desvenlafaxine 50mg, twice daily, stopped Paroxetene, continued Clonazepam 0.25mg

Sep 2015      Desvenlafaxine 50mg, twice daily, Started very slow tapering of Clonazepam .25mg on my own.

Feb 2016   6th month of tapering and on 1/16th of 0.25. Clonazepam-free from April 2016. Currently Desvenlafaxine 50-0-50mg

Started Ayurveda medication Medha Kwath, Medha Vati, Ashwashila in June 2016. Had some breaks but continuing.

Planning to start tapering Desvenlafaxine in a couple weeks from now (Signed Sep 11,2016)

Jan 26,2017 Started Desvenlafaxine tapering. Betacap 40mg nightly. Dropped 1/4th of 25mg every 4-6 weeks from the 50mg night dosage. Stopped Ayurveda. Currently at 50-0-25 mg (tapered from 50-0-50) for over 8 weeks now (July 19,2017)

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  • Moderator Emeritus

So I see you have been tapering by 2.5mg.

I only held for 8 weeks after dropping from 100 to 75. If I had held longer I might have been able to have done larger drops. After having to updose a couple of times I decided it was better to just go slower. I wasn't sweating as much on the lower dose and I was started to feel more like my old self, being able to laugh and finding things more enjoyable so I figured it was better to go at a sensible pace rather than try and go too quickly. When I first joined SA I read many members' topics and a lot of them made the mistake of bouncing their doses around and suffered accordingly.

 

I planned to do a 5mg taper until 50mg (I am on 100mg)

Being on such a high dose, dropping by 10% (10 mg for the first drop) may be okay. You could try it for the first drop and see how you go. Either that or you could see how you go dropping by 5 mg and then drop again after 3 weeks if you are feeling okay.

 

1. Do you require the doctor's prescription for compounded capsules in Australia?

No, at least not in NSW. I get a script for tablets, get the tablets and then take them to the compounder.

 

2. Did you order all the different strengths (1,2,5,10..) in one go?

My compounder gave me a discount for getting a bulk order of 500 capsules. He made 100 or 200 capsules of the doses, depending on my requirements. You do need to get quotes because some compounders charge a very high price.

 

If you are reducing by 5mg you could get 20mg, 10mg and 5mg doses made up.

 

That way you can make up (50 being a Pristiq tablet):

 

95mg 50 + 20x2 + 5

90mg 50 + 20x2

85mg 50 + 20 + 10 + 5

80mg 50 + 20 + 10

75mg 50 + 20 + 5

 

or get 20mg and 5mg doses (which I think is the better option):

 

95mg 50 + 20x2 + 5

90mg 50 + 20x2

85mg 50 + 20 + 5x3

80mg 50 + 20 + 5x2

75mg 50 + 20 + 5

70mg 50 + 20

 

3. What is the expiry date on these compounded meds stipulated by your pharmacy?

6 months although at the moment I am using up the last of some of my older capsules made last November (5 mg dose so only a small portion of the total 47.5mg).

 

And regarding your symptoms.. did/do you experience tinnitus (ringing in the ears) and/or pounding heart during your taper?

I have had tinnitus for a while. I also take perindopril, a blood pressure medication. I'm not sure what has caused the tinnitus, however I have found as my Pristiq dose has become lower my tinnitus is not as loud.

 

When taking 100mg I was getting serotonin toxicity and my diastolic blood pressure was very high. I would also have times when it felt like my heart flipped. I also experienced profuse sweating as well as agitation/anxiety. I didn't realise that the anxiety was from the Pristiq until after my dose became lower and the agitation and anxiety became almost non-existent.

 

The main withdrawal symptoms have been: foggy head (when I dropped my dose by half); ear pain and pressure; minor middle of the forehead headache; minor irritability.

Please DO NOT TAG me - thank you

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Thank you again dear ChessieCat for the elaborate response. I think the challenge for me is going to be to find a sensible doc who will agree to prescribe compounded doses without which the pharmacy will not go ahead. There is only one compounding pharmacy in my place and they have never dealt with psychiatric meds.

We get 25mg Pristiq here so I guess I can manage with 5s and 10s or just 5s to begin with.

2003-2007    Paroxetene 25mg  +++++++  2007-2008    Escitalopram 10mg

 

Mid 2008, wanted to get away from medicines. Doc did a quick taper from 10mg to 5mg and stopped in a short time. Within 2 weeks from stopping I had severe TINNITUS, forcing me to get back to meds. But TINNITUS persists to this day. Doctor shied away saying this had nothing to do with meds.

 

2009-2011    Combination of Escitalopram 10mg + Clonazepam 0.5 mg  ++++++  2011-2015    Paroxetene 25mg + Clonazepam 0.25mg

Feb 2015      Desvenlafaxine 50mg, reduced Paroxetene to 12.5mg, Clonazepam 0.25mg

Apr 2015       Desvenlafaxine 50mg, twice daily, stopped Paroxetene, continued Clonazepam 0.25mg

Sep 2015      Desvenlafaxine 50mg, twice daily, Started very slow tapering of Clonazepam .25mg on my own.

Feb 2016   6th month of tapering and on 1/16th of 0.25. Clonazepam-free from April 2016. Currently Desvenlafaxine 50-0-50mg

Started Ayurveda medication Medha Kwath, Medha Vati, Ashwashila in June 2016. Had some breaks but continuing.

Planning to start tapering Desvenlafaxine in a couple weeks from now (Signed Sep 11,2016)

Jan 26,2017 Started Desvenlafaxine tapering. Betacap 40mg nightly. Dropped 1/4th of 25mg every 4-6 weeks from the 50mg night dosage. Stopped Ayurveda. Currently at 50-0-25 mg (tapered from 50-0-50) for over 8 weeks now (July 19,2017)

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  • Moderator Emeritus

Rehearse what you are going to say before seeing the doctor.  Something like:  "I have considered this carefully and decided that I want to reduce my drug slowly so I need a prescription for compounded Pristiq in 5mg capsules (or whatever dose/s you decide on) with slow release formula."

 

Don't be emotional, be assertive, but not arrogant.  Basically know what you want and go in and request it.  If he questions or ridicules you further say you have read The Icarus Project's The Harm Reduction Guide to Coming Off Psychiatric Drugs (just make sure you have read it though ;) ) and you could suggest he read it.  Something like:  "I've read The Icarus Project's Harm Reduction Guide to Coming Off Psychiatric Drugs and it says ... or I'd rather reduce cautiously.  The Guide is available free online if you want to check it out."

 

These also might give you some tips about how to talk to your doctor:

 

What should I expect from my doctor about withdrawal symptoms?


How do you talk to a doctor about tapering and withdrawal?

 

I hope this gives you some ideas of how to approach this.  Remember you are the customer.  You have a right to ask for what you want.  Even though doctors have studied and do know a lot, they are human beings and (unfortunately) don't know everything.

Please DO NOT TAG me - thank you

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Chessie, I did just that this visit except telling him I read up anything online. Last time I did that and he went wild saying Internet has a lot of exaggerated info and one needs to stay away from searching online.

I'll give it another go by sending him links to some of them.

 

Iam wondering why we can't do anything about these drug companies for not providing a safe way out. And we have a whole big community in this predicament.

2003-2007    Paroxetene 25mg  +++++++  2007-2008    Escitalopram 10mg

 

Mid 2008, wanted to get away from medicines. Doc did a quick taper from 10mg to 5mg and stopped in a short time. Within 2 weeks from stopping I had severe TINNITUS, forcing me to get back to meds. But TINNITUS persists to this day. Doctor shied away saying this had nothing to do with meds.

 

2009-2011    Combination of Escitalopram 10mg + Clonazepam 0.5 mg  ++++++  2011-2015    Paroxetene 25mg + Clonazepam 0.25mg

Feb 2015      Desvenlafaxine 50mg, reduced Paroxetene to 12.5mg, Clonazepam 0.25mg

Apr 2015       Desvenlafaxine 50mg, twice daily, stopped Paroxetene, continued Clonazepam 0.25mg

Sep 2015      Desvenlafaxine 50mg, twice daily, Started very slow tapering of Clonazepam .25mg on my own.

Feb 2016   6th month of tapering and on 1/16th of 0.25. Clonazepam-free from April 2016. Currently Desvenlafaxine 50-0-50mg

Started Ayurveda medication Medha Kwath, Medha Vati, Ashwashila in June 2016. Had some breaks but continuing.

Planning to start tapering Desvenlafaxine in a couple weeks from now (Signed Sep 11,2016)

Jan 26,2017 Started Desvenlafaxine tapering. Betacap 40mg nightly. Dropped 1/4th of 25mg every 4-6 weeks from the 50mg night dosage. Stopped Ayurveda. Currently at 50-0-25 mg (tapered from 50-0-50) for over 8 weeks now (July 19,2017)

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  • Moderator Emeritus

You could tell him you have been discussing it with another Pristiq user who tried to drop from 100mg to 50mg.  In Australia we don't have 25mg tablets so dropping from 100mg to 75mg wasn't an option using what was available.  Did I mention that I wasn't able to type after 3 weeks of being on 50mg?  I am a professional typist.  I updosed and within 4 hours I was able to type again.  This was measurable, definitely not placebo.

 

"Last time I did that and he went wild saying Internet has a lot of exaggerated info and one needs to stay away from searching online."

 

I can understand doctors being anti-internet, because there is so much garbage on it, so I would be reluctant to provide him with information and saying you "found it on the internet".  You could agree and say, yes, I know there is but there is also a lot of excellent information.  It's no good throwing out the baby with the bath water.  It might be better to say I have researched and found ...

 

Here is a non-internet idea, which could be followed up with internet information:

 

You could print out this excerpt from a book to give him:  Your Drug May Be Your Problem - Chapter 8:  How to Stop Taking Psychiatric Drugs and at the back attach information to these videos of Peter Breggin which are excellent, and free.  Go to Youtube and search Peter Breggin simple truths.  Click on the image which has 9 videos, play all.

 

The "blurb" on Youtube under the first video:

 

Trailblazing psychiatrist Peter R. Breggin, MD in his first of the series: Simple Truths About Psychiatry: Do You Have A Biochemical Imbalance? Dr. Breggin debunks the myth of biochemical imbalance and examines what is known about "mental illness." Further information may be found on Dr. Breggin's website and in his many books, including his latest: "Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and Their Families." See more at his website http://www.breggin.com

 

This is the link to this book overview and its reviews:  http://www.springerpub.com/psychiatric-drug-withdrawal.html

 

Please note that I cannot recommend it because it is a 25% drop, it is just an idea that I am putting forward if you are not able to get the compounded Pristiq.  You may be able to get away with trying a drop from 100mg to 75mg for your first drop.  OR you could take 50mg + 25mg + 1/2 25mg.  However, it is very hard to cut the Pristiq evenly.  If you found that you get symptoms, you could then "confront" the doctor and say, "see, I told you so" :P .  Or as my daughter says:  I.T.Y.S.  Just not in those words  ;)  .  You could then do a longer hold, perhaps 3-4 months to give your brain a chance to stabilise before tapering more conservatively.  During this time you could try and either get the doctor on side or find another one who will give you what you need.  There is a discussion here about the Why taper paper: dose-occupancy curves.  It may be a bit hard to get your head around, but the more I read of this whole topic, the more it seemed to make sense to me.  Posts #12 & #18 are interesting.  Many SA members find that the lower their dose gets the slower they have to go.

 

I hope these ideas help.  The internet isn't all "bad", where would we be without it and without SA??? :wacko:

Please DO NOT TAG me - thank you

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Chessie, you have given me plenty options to convince the doc. Iam going to use your suggestions and let the doc know about some of these along with the note on the "official prescribing info from the FDA" that Scally sent. I looked up the videos too.. Brilliant information there.

Thank you so much. I'll keep you posted on what the doc says.

2003-2007    Paroxetene 25mg  +++++++  2007-2008    Escitalopram 10mg

 

Mid 2008, wanted to get away from medicines. Doc did a quick taper from 10mg to 5mg and stopped in a short time. Within 2 weeks from stopping I had severe TINNITUS, forcing me to get back to meds. But TINNITUS persists to this day. Doctor shied away saying this had nothing to do with meds.

 

2009-2011    Combination of Escitalopram 10mg + Clonazepam 0.5 mg  ++++++  2011-2015    Paroxetene 25mg + Clonazepam 0.25mg

Feb 2015      Desvenlafaxine 50mg, reduced Paroxetene to 12.5mg, Clonazepam 0.25mg

Apr 2015       Desvenlafaxine 50mg, twice daily, stopped Paroxetene, continued Clonazepam 0.25mg

Sep 2015      Desvenlafaxine 50mg, twice daily, Started very slow tapering of Clonazepam .25mg on my own.

Feb 2016   6th month of tapering and on 1/16th of 0.25. Clonazepam-free from April 2016. Currently Desvenlafaxine 50-0-50mg

Started Ayurveda medication Medha Kwath, Medha Vati, Ashwashila in June 2016. Had some breaks but continuing.

Planning to start tapering Desvenlafaxine in a couple weeks from now (Signed Sep 11,2016)

Jan 26,2017 Started Desvenlafaxine tapering. Betacap 40mg nightly. Dropped 1/4th of 25mg every 4-6 weeks from the 50mg night dosage. Stopped Ayurveda. Currently at 50-0-25 mg (tapered from 50-0-50) for over 8 weeks now (July 19,2017)

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  • Moderator Emeritus

Good luck.  I hope it goes well.

Please DO NOT TAG me - thank you

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • 1 month later...

Back here with some updates and questions.

 

I wrote to the doc about compounded medicines and how desperate I am to do a very careful taper this time. The doc finally agreed and I still have to meet him for the prescription which I need to produce to the compounding pharmacy.

 

Meanwhile, as I noted in my earlier posts, I have been taking Ayurvedic medication for the past over 4 months. Initially I felt that the medication was doing some wonders - my generalized body weakness, aches and pains etc were better. Even the pounding heart I used to have all the time, seemed to be decently under control. Drowsiness was almost gone and I felt more energetic in the day time and could do without a midday nap on most days. But now since past 2 weeks I feel that most of it is back. Especially heart pounding is always there with varying degrees of intensity and it is a very nasty feeling. The ayurveda physician says none of their meds (which includes Ashwagandha) cause any side effects.

 

Now I am at cross-roads. My idea of using Ayurveda as a support and then beginning the taper is now becoming questionable. I am not able to decipher whats going on at the moment - Am I at an overdose of medicines (Pristiq 50mg twice + 3 different Ayurveda meds) which is causing all this. Or has my body just gotten used to the meds again and I require more meds ? (which I am anyway not going to entertain anymore).

 

My question is, is there anything else I should do to feel right before starting the taper. Should I add any more supplements to curb the pounding heart? Or should I just sign up with the compounding pharmacy and begin the taper unmindful of all the problems that I mentioned above?

 

Totally confused. Please help.

2003-2007    Paroxetene 25mg  +++++++  2007-2008    Escitalopram 10mg

 

Mid 2008, wanted to get away from medicines. Doc did a quick taper from 10mg to 5mg and stopped in a short time. Within 2 weeks from stopping I had severe TINNITUS, forcing me to get back to meds. But TINNITUS persists to this day. Doctor shied away saying this had nothing to do with meds.

 

2009-2011    Combination of Escitalopram 10mg + Clonazepam 0.5 mg  ++++++  2011-2015    Paroxetene 25mg + Clonazepam 0.25mg

Feb 2015      Desvenlafaxine 50mg, reduced Paroxetene to 12.5mg, Clonazepam 0.25mg

Apr 2015       Desvenlafaxine 50mg, twice daily, stopped Paroxetene, continued Clonazepam 0.25mg

Sep 2015      Desvenlafaxine 50mg, twice daily, Started very slow tapering of Clonazepam .25mg on my own.

Feb 2016   6th month of tapering and on 1/16th of 0.25. Clonazepam-free from April 2016. Currently Desvenlafaxine 50-0-50mg

Started Ayurveda medication Medha Kwath, Medha Vati, Ashwashila in June 2016. Had some breaks but continuing.

Planning to start tapering Desvenlafaxine in a couple weeks from now (Signed Sep 11,2016)

Jan 26,2017 Started Desvenlafaxine tapering. Betacap 40mg nightly. Dropped 1/4th of 25mg every 4-6 weeks from the 50mg night dosage. Stopped Ayurveda. Currently at 50-0-25 mg (tapered from 50-0-50) for over 8 weeks now (July 19,2017)

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  • ChessieCat changed the title to goodwill: end of clonazepam taper, beginning desvenlafaxine taper shortly

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