thejoyoftapering: fluoxetine -- Establishing a current dose

[Thejoyoftapering]

Thank you. I took 20mg yesterday and 20mg today. I'm feeling good. There are a couple of unanswered questions about withdrawal that I have asked and would ask again but I'm guessing that the current consensus is that they are unanswerable. I hope this website contributes enough to influence more scientific research into withdrawal syndrome and its treatment. 

 

The most pertinent question is: why do I feel good now and why did I feel good yesterday? I know it is to do with reinstatement, I think anyone reading this entire thread would conclude that because reinstatement eradicated many withdrawal symptoms and some neuro-emotions.

 

More specific and vital are these related questions:

Could taking 40mg two days ago affect that?

Or was it because I took 30mg the day before that?

Was I destined to feel better now because I've stuck with 20mg consistently for just under two weeks and I'm beginning to stabilise?

 

If we don't have the evidence to answer such questions, it's okay. It's just the state of our collective comprehension, which we all hope to improve one day. On a case by case basis, of course things are even harder but it seems our general rules or guidelines are vague at best. 

 

Why did I keep changing my dose? Well I didn't much, just two days in the last two weeks and by a small amount. To answer the question though I did it because I've received conflicting advice here. Everyone is doing their best to help me so I don't mind, this is a website for advice not ultimatums or directives. It is not intended to replace professional medical advice but let's be honest, it is why most people come here. 

 

The consistent advice I've received though and what I will take away from this experience is:

 

1. In my case due to the messy year I've had, find a current dose for stability (the title of this thread and its purpose) then hold for about 4 months (I will aim for 6 to be sure)

2. Then taper 10% of my last dose every 4 to 6 weeks as long as no major adversity occurs, if it does, reinstate at the last dose and hold until things stabilize

3. Repeat step 2 until free of fluoxetine

 

I understood these three steps within minutes of finding the website. All I've been trying to do is get a current dose, to iterate my thread's title. I can see from some people's replies that not everyone has read this thread fully and that's fine. I don't mind, I get it, I'm verbose, probably not making much sense, and seem to be haphazardly changing my dose. I've been told to take four different doses: 10mg, 20mg, 30mg, and 40mg. I appreciate that it is up to me to take the responsibility to choose my dose and bear the consequences of my decisions. Again, I understood that from the outset. 

 

My final point is: your advice is appreciated and I thank you for what must be a tiring and often thankless task. This is a great place to feel less alone through withdrawal. However, I don't think there is enough conclusive evidence to make informed decisions that would provide accurate help on an individual basis. I trust this website's guesswork more than the advice I've received from doctors and pharmacists because I know that there is conclusive evidence that proves withdrawal syndrome can be avoided by tapering as slowly as possible. So, with that in mind, I'm just going to get on with managing my treatment and hopefully stick to 20mg until early next year, when I can begin tapering. If I need to updose, I guess only I can answer that but I will hold as long as I possibly can. 

 

Best of luck to you all!   

[ChessieCat]

"I've been told to take four different doses: 10mg, 20mg, 30mg, and 40mg. "

 

Just to clarify, SA mods do not tell members to take a particular dose, we make suggestions and provide information for members to make their own decisions.

 

Regarding your statement quoted above:  I have just read back over your entire topic with regards to doses and cannot see anywhere that 30mg or 40mg was suggested by the moderators.

 

Your dosing has been very erratic.  You started on 10mg and then took a 20mg dose.  I suggested on 17 Sept that 10mg would be the better dose.  You again took 20mg and Scallywag said on 18 September "Now that you 've decided on reinstating 20 mg, give yourself time to get steady on it -- at least 2-3 months."

 

You then took 10mg on 21 September.  I posted after this on 21 Sept "Please pick a dose, stick to it, be patient and give it time."

 

When you returned you posted:  "I have been on 20mg of fluoxetine for two weeks exactly, since the 22nd of September"

 

On 6 Oct you took 30mg, on 7 Oct you took 40mg, on 9 Oct you took 20mg.  Your poor brain doesn't know what to do having all these different doses thrown at it.  It is trying to regain homeostatis.  Please read the following links:

 

Keep it Simple, Slow and Stable

 

Windows and Waves Pattern of Stabilization

 

"Then taper 10% of my last dose every 4 to 6 weeks as long as no major adversity occurs, if it does, reinstate at the last dose and hold until things stabilize"

 

Listen to your body and keep daily notes on paper of symptoms which improve, worsen or stay the same.  If you do a long hold now and get stable, once you commence tapering you might be able to taper every 4 weeks.  Many members find that the lower they get in dose the slower they have to go and/or hold for longer periods.

 

If you find that you have symptoms that are unbearable and they persist, it will depend on how long since your previous taper dose whether you go back on the same dose.  I found after 3 days that instead of going back to the previous dose, just a small updose was enough to bring the symptoms to a bearable level.

 

"However, I don't think there is enough conclusive evidence to make informed decisions that would provide accurate help on an individual basis."

____________

 

EDIT:  I have just discovered that you were never given the link for About reinstating and stabilizing to reduce withdrawal symptoms.  However, the information you were given was consistent with the information provided in this topic.

____________

 

What SA recommends with the 10% taper with a holding period of 3-4 weeks to allow the brain to adapt to not getting as much of the drug is a harm reduction method.  Some members can go faster, other have had to do a very cautious and slow taper.  I found that I couldn't reduce my drug by 1/2 which is when I researched withdrawal symptoms and found SA.  There may be other people who could have dropped their dose by 1/2 with no problems.

 

Quote from Why taper by 10% of my dosage?: 

 

"The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs. We believe this conservative tapering method will cause harm to the fewest number of people.
 
The reason this site exists is because doctors are unaware of the greater safety of gradual dosage reduction, usually advise tapers that are too fast, do not sufficiently recognize withdrawal syndrome, and do not know what to do if it occurs.

 

According to the journal literature on antidepressant withdrawal syndrome, anyone who has been taking a drug for a month or more is at risk.

In a nutshell, the 10% taper method recommends a 10% dosage reduction every 4 weeks, with the 10% calculated on the last dosage. The amount of decrease is proportionate to the last dosage (not the original prescription) and keeps getting smaller.
 
(Those finding that this method too slow can always speed up by making 10% reductions more often. However, if you get withdrawal symptoms, your nervous system is telling you that you are tapering too fast.)"

 

Please remember to put your withdrawal history in your signature.  Doing this means that we don't have to read back through your posts to work out your drug history.  We are better able to offer suggestions if we can see it at a glance:  Please put your Withdrawal History in Signature

Edited October 9, 2016 by ChessieCat
Added Reinstatement link edit

[Thejoyoftapering]

Thank you JanCarol and nz11, your words got me through the last couple of weeks. I am feeling better now. A couple of setbacks (bad days) but they were all in my head I'll check back here now and again to update you all but absence makes the heart grow fonder