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Tapering to almost-zero and staying there?


Henosis

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Has anyone successfully reinstated and stabilized, tapered to almost zero (like 1mg Paxil or equivalent) and felt good enough to hang there long term? And if so, did re-instatement AD side effects (like amplified anhedonia, no emotions) or WD symptoms eventually resolve?

 

After reading horror stories about the "final jump" to zero despite long tapering, I'm wondering if it's even worth it if you are going to be non-functional for months or years and you could get your life back maintaining a tiny dose. And eventually you could keep reducing said tiny dose at even smaller increments for years to hopefully avoid W/D entirely?

Medication before problems: Took Paxil 60-100mg from 2003 to 2014 for OCD.
1) Last pill taken November 2014, horrendous withdrawal started six weeks later.

2) Re-instated successfully @ 20mg May 2015, but accompanied by severe anhedonia, loss of emotion, apathy, and fatigue

3) Switched to Prozac, Viibyrd, Zoloft, Nefazadone, Cymbalta, Nardil in attempt at abating WD symptoms while not re-introducing anhedonia. Each one either failed to relieve WD or brought back anhedonia. So re-stabilized on Paxil at 15mg

4) Tapered down to 7.5mg as of October 2016. More energy, anhedonia/loss of emotions remains apart from short windows.

5) May 2017 - down to 3.5mg of Paxil (no other meds)
6) Early 2018 - added 8mg of Prozac
7) January 2019 - down to 1.05 Paxil / 5mg Prozac and continuing

8) October 2019 - down to 0.2mg Paxil / 3mg Prozac

9) November 2019 - down to 0.1mg Paxil / 3mg Prozac 

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I think tapering to .01 mg using water titration, which is what i plan to do, will help you avoid post acute withdrawal syndrome. When i get there, i plan to hold at .01 mg for a couple of months at least before jumping off. There should be no lingering withdrawal from that small amount. It may take years to get to that point but i think it will be worth it. 

 

Maybe someone else can add to this thread there experience or advise.

Been taking paroxetine 20 mg for 20+ years for depression. Taking 300 mg of wellbutrin since October 2015 for adhd and depression. Take fish oil, calcium, and a multivitamin. Started taking risperidone late January 2015 3mg for a misdiagnoses of bipolar. Started tapering risperidone late July 2016. As of late September tapered down to 2mg at 5% a week off current dose. Oct 21/2016 1.58 mg Nov 21/2016 1.26mg No withdrawals so far.

 

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You can stay at whatever dose you wish.

 

If you're afraid of tapering lower than 1mg, you might stay that for a good long while and wait until you feel confident about making further decreases.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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I think tapering to .01 mg using water titration, which is what i plan to do, will help you avoid post acute withdrawal syndrome. When i get there, i plan to hold at .01 mg for a couple of months at least before jumping off. There should be no lingering withdrawal from that small amount. It may take years to get to that point but i think it will be worth it. 

 

Maybe someone else can add to this thread there experience or advise.

 

at such an insignificant dose are you experiencing standard SSRI/SNRI side effects? Did you experience anhedonia when you were on the drug? if so, did it (or other standard SSRI side effects) dissipate once you got to such a micro dose of a serotonin re-uptake inhibitor? 0.1mg in theory should barely be increasing serotonin whatsoever in your synapse.

Medication before problems: Took Paxil 60-100mg from 2003 to 2014 for OCD.
1) Last pill taken November 2014, horrendous withdrawal started six weeks later.

2) Re-instated successfully @ 20mg May 2015, but accompanied by severe anhedonia, loss of emotion, apathy, and fatigue

3) Switched to Prozac, Viibyrd, Zoloft, Nefazadone, Cymbalta, Nardil in attempt at abating WD symptoms while not re-introducing anhedonia. Each one either failed to relieve WD or brought back anhedonia. So re-stabilized on Paxil at 15mg

4) Tapered down to 7.5mg as of October 2016. More energy, anhedonia/loss of emotions remains apart from short windows.

5) May 2017 - down to 3.5mg of Paxil (no other meds)
6) Early 2018 - added 8mg of Prozac
7) January 2019 - down to 1.05 Paxil / 5mg Prozac and continuing

8) October 2019 - down to 0.2mg Paxil / 3mg Prozac

9) November 2019 - down to 0.1mg Paxil / 3mg Prozac 

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at such an insignificant dose are you experiencing standard SSRI/SNRI side effects? Did you experience anhedonia when you were on the drug? if so, did it (or other standard SSRI side effects) dissipate once you got to such a micro dose of a serotonin re-uptake inhibitor? 0.1mg in theory should barely be increasing serotonin whatsoever in your synapse.

 

I am tapering my anti-psychotic first, so i cant speak for ssri's at such i tiny dose, but ive read of people coming off Risperidone at .1, and having problems for a year.  My plan is to make it as small of a dose as possible before jumping off. No i have not experienced any anhedonia while on Paroxetine, but i have not started tapering it yet.

Been taking paroxetine 20 mg for 20+ years for depression. Taking 300 mg of wellbutrin since October 2015 for adhd and depression. Take fish oil, calcium, and a multivitamin. Started taking risperidone late January 2015 3mg for a misdiagnoses of bipolar. Started tapering risperidone late July 2016. As of late September tapered down to 2mg at 5% a week off current dose. Oct 21/2016 1.58 mg Nov 21/2016 1.26mg No withdrawals so far.

 

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  • 2 weeks later...

Is it possible to avoid post acute withdrawal, taking your dosage to almost an unmeasurable amount like .01 or less?

 

Any feedback is appreciated

Been taking paroxetine 20 mg for 20+ years for depression. Taking 300 mg of wellbutrin since October 2015 for adhd and depression. Take fish oil, calcium, and a multivitamin. Started taking risperidone late January 2015 3mg for a misdiagnoses of bipolar. Started tapering risperidone late July 2016. As of late September tapered down to 2mg at 5% a week off current dose. Oct 21/2016 1.58 mg Nov 21/2016 1.26mg No withdrawals so far.

 

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  • 3 weeks later...

I tapered Prozac from 20 mg to 3.4mg over three years. The lower the dose the more extreme the withdrawal symptoms became.  When I got down to 3.4 mg dropping even minute amounts of liquid prozac ( half the space between lines on a one ML syringe) caused terrible dark, obsessive thoughts, extreme anxiety and depression so I'd go back up to 3.4mg. Finally I decided to stay at 3.4mg. I'm not perfectly fine all the time. However since beginning 500 mg of Tryptophan  and 200 of GABA a day I have felt considerably steadier.

On 20 mg of Prozac for about ten years. Sept 2012 started reducing 10% a drop using gram scale, with average of one month holds.

When I'd reached the half way mark, taking 10 mg  powder out of the 20 mg capsules, I switched over to 10 mg capsules and cutting

down from those. Withdrawals got harder the lower I dropped.  May 2013 changed to 5% drops, holding until all withdrawal symptoms gone.

January 2015 changed to liquid prozac (concentration of 20MG per 5 mL) using a 1mL oral syringe.

Current dose of fluoxetine solution equivalent 3.4 mg. Any effort to drop below this has been disastrous so for the time being I'm staying at this level.
Adding 200 mg Tryptophan and 200 GABA a day has helped with anxiety.
Also take 1,300mg Omega- 3,  875mg  Magnesium, 1800mg Curcumin, 1000mg Vit C, 5000 Vit D.
 

 

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My all time goal was to be completely free from these evil drugs, until recently I was hit so hard since getting down to 1.2mg. I have been reading day in and out lately the horror stories being off the drug years still suffering.

 

This thread opened my mind about another option. This is also consistent with my other thoughts about tapering this last mg for infinite years like super slow before jumping off when my system is already used to the almost non drug situation.

Drug free Sep. 23 2017

2009 Mar.: lexapro 10mg for headache for 2 weeks.

2009-2012: on and off 1/4 to 1/3 of 10mg

2012 June--2013 Jan,: 1/4-1/3 of 10mg generic, bad jaw pain

2013 Jan-Mar: 10 mg generic. severe jaw and head pain;

2013 Mar--Aug. started tapering (liquid ever since) from 10 to 5 (one step) then gradually down to 2.25 mg by July. first ever panic attack, severe head/jaw pain

2013 Aug.: back to 2.75 mg; Nov: back to Brand Lex. 2.75mg -- 3mg,

2014 June: stopped PPI, head pressure/numbness. up-dosed 4.5mg, severe reaction mental symptoms added on

2014 Aug--2015 Aug: Micro taper down to 3.2mg, .025mg (<1%) cut holding 2-3 weeks.

2015 Aug 15th, Accidental one dose of 4.2mg. worsening brain non-functional, swollen head, body, coma like, DR

2016 Feb., started dosing 10am through 11 pm everyday 2/13--3.2mg, 3/15-- 2.9mg, 4/19-- 2.6mg, 6/26--2.2mg, 7/22 --1.9mg, 8/16--1.8mg,8/31--1.7m g, 9/13--1.6mg, 9/27--1.5mg, 10/8--1.4mg, 10/14--1.3mg, 11/1--1.2mg, 11/29--1.1mg, 12/12--1mg, 12/22--0.9mg

2017: 1/7--0.8mg, 1/15--0.7mg, 1/17--0.6mg, 1/20--0.52, 1/21--0.4mg, 1/22--0.26, 1/23--0.2, 2/13--0.13mg, 2/20--0.06mg, 3/18--0.13mg, 6/1--0.12mg, 7/6--0.1mg, 7/14--0.08mg, 8/17--0.04mg, 8/20--0.03mg, 8/28--0.02mg, 9/6--0.0205mg, 9/8--0.02mg, 9/17--0.015mg, 9/20--0.01mg, 9/21--0.0048mg, 9/22--0.0001mg,

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I think tapering to .01 mg using water titration, which is what i plan to do, will help you avoid post acute withdrawal syndrome. When i get there, i plan to hold at .01 mg for a couple of months at least before jumping off. There should be no lingering withdrawal from that small amount. It may take years to get to that point but i think it will be worth it. 

 

Maybe someone else can add to this thread there experience or advise.

where can I find information on this water titration?

I am thinking that may be something I need to do.

i am taking 1/5 of a mg of liquid lexapro split into two doses, 0.1mgs AM and PM

I am still struggling a lot at this dose and thinking of possibly going up a tiny bit and staying there a LONG LONG time before I consider coming back down again

  • pysch med history: 1974 @ age 18 to Oct 2017 (approx 43 yrs total)
  •  Drug list: stelazine, haldol, elavil, lithium, zoloft, celexa, lexapro(doses as high as 40mgs), klonopin, ambien, seroquel(high doses), depakote, zyprexa, lamictal- plus brief trials of dozens of other psych meds over the years
  • started lexapro 2002, dose varied from 20mgs to 40mgs. I tried to get off it several times. WD symptoms were mistaken for "relapse". 
  •  2013 too fast taper down to 5mg but WD forced me back to 20mgs
  •  June of 2105, tapered again too rapidly to 2.5mgs by Dec 2015. Found SA, held at 2.5 mgs til May 2016 when I foolishly "jumped off". Crashed in Sept, reinstated at 0.3mgs in Oct. 2106
  • Tapered off to zero by  Oct. 2017 Doing very well
  • Nov. 2018 feel 95% healed, current age 63 
  • Jan. 2020 feel 100% healed, peaceful and content 
  • Nov. 2020, loving life ❤️ 
 
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catnapt: Water titration is another way of saying Making a liquid from a tablet or capsules . As the doses get lower and lower, you add larger quantities of water to allow you to draw smaller amounts of liquid and get the smaller desired dose.

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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catnapt: Water titration is another way of saying Making a liquid from a tablet or capsules . As the doses get lower and lower, you add larger quantities of water to allow you to draw smaller amounts of liquid and get the smaller desired dose.

 

ok but what if you have a liquid already, can you add water to that? (I'm concerned it might work like trying to mix oil and water, that it might separate?)

  • pysch med history: 1974 @ age 18 to Oct 2017 (approx 43 yrs total)
  •  Drug list: stelazine, haldol, elavil, lithium, zoloft, celexa, lexapro(doses as high as 40mgs), klonopin, ambien, seroquel(high doses), depakote, zyprexa, lamictal- plus brief trials of dozens of other psych meds over the years
  • started lexapro 2002, dose varied from 20mgs to 40mgs. I tried to get off it several times. WD symptoms were mistaken for "relapse". 
  •  2013 too fast taper down to 5mg but WD forced me back to 20mgs
  •  June of 2105, tapered again too rapidly to 2.5mgs by Dec 2015. Found SA, held at 2.5 mgs til May 2016 when I foolishly "jumped off". Crashed in Sept, reinstated at 0.3mgs in Oct. 2106
  • Tapered off to zero by  Oct. 2017 Doing very well
  • Nov. 2018 feel 95% healed, current age 63 
  • Jan. 2020 feel 100% healed, peaceful and content 
  • Nov. 2020, loving life ❤️ 
 
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Share on other sites

Drug free Sep. 23 2017

2009 Mar.: lexapro 10mg for headache for 2 weeks.

2009-2012: on and off 1/4 to 1/3 of 10mg

2012 June--2013 Jan,: 1/4-1/3 of 10mg generic, bad jaw pain

2013 Jan-Mar: 10 mg generic. severe jaw and head pain;

2013 Mar--Aug. started tapering (liquid ever since) from 10 to 5 (one step) then gradually down to 2.25 mg by July. first ever panic attack, severe head/jaw pain

2013 Aug.: back to 2.75 mg; Nov: back to Brand Lex. 2.75mg -- 3mg,

2014 June: stopped PPI, head pressure/numbness. up-dosed 4.5mg, severe reaction mental symptoms added on

2014 Aug--2015 Aug: Micro taper down to 3.2mg, .025mg (<1%) cut holding 2-3 weeks.

2015 Aug 15th, Accidental one dose of 4.2mg. worsening brain non-functional, swollen head, body, coma like, DR

2016 Feb., started dosing 10am through 11 pm everyday 2/13--3.2mg, 3/15-- 2.9mg, 4/19-- 2.6mg, 6/26--2.2mg, 7/22 --1.9mg, 8/16--1.8mg,8/31--1.7m g, 9/13--1.6mg, 9/27--1.5mg, 10/8--1.4mg, 10/14--1.3mg, 11/1--1.2mg, 11/29--1.1mg, 12/12--1mg, 12/22--0.9mg

2017: 1/7--0.8mg, 1/15--0.7mg, 1/17--0.6mg, 1/20--0.52, 1/21--0.4mg, 1/22--0.26, 1/23--0.2, 2/13--0.13mg, 2/20--0.06mg, 3/18--0.13mg, 6/1--0.12mg, 7/6--0.1mg, 7/14--0.08mg, 8/17--0.04mg, 8/20--0.03mg, 8/28--0.02mg, 9/6--0.0205mg, 9/8--0.02mg, 9/17--0.015mg, 9/20--0.01mg, 9/21--0.0048mg, 9/22--0.0001mg,

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Lex, that only tells you how to take the liquid as it comes in the bottle

 

I'd like to know if- and how- to dilute it further so that I am taking even smaller amounts.

I currently take 0.1mL (- 0.1mg) twice a day, AM and PM

 

I want to micro taper this but the page you linked to, says not to mix this liquid with anything else.

Which is confusing, because it also says you can put the drops into a liquid you drink-

I'll C&P that part:

 

 

"Oral solution 10 mg/mL: To assist with the dosing, a syringe is provided in the pack with a scale ranging from 1 mg to 10 mg, in 1 mg increments. Dispense the required volume of solution into your drink (water, orange juice or apple juice), stir briefly then drink all of it.

Oral solution 20 mg/mL: Count the required number of drops into your drink (water, orange juice or apple juice), stir it briefly and then drink all of it.

Do not mix the LEXAPRO oral solution with other liquids and do not mix them with other medicinal products."

 

I don't know what they mean by "other liquids"- do they mean besides the water or orange or apple juice?

 

confusing!

  • pysch med history: 1974 @ age 18 to Oct 2017 (approx 43 yrs total)
  •  Drug list: stelazine, haldol, elavil, lithium, zoloft, celexa, lexapro(doses as high as 40mgs), klonopin, ambien, seroquel(high doses), depakote, zyprexa, lamictal- plus brief trials of dozens of other psych meds over the years
  • started lexapro 2002, dose varied from 20mgs to 40mgs. I tried to get off it several times. WD symptoms were mistaken for "relapse". 
  •  2013 too fast taper down to 5mg but WD forced me back to 20mgs
  •  June of 2105, tapered again too rapidly to 2.5mgs by Dec 2015. Found SA, held at 2.5 mgs til May 2016 when I foolishly "jumped off". Crashed in Sept, reinstated at 0.3mgs in Oct. 2106
  • Tapered off to zero by  Oct. 2017 Doing very well
  • Nov. 2018 feel 95% healed, current age 63 
  • Jan. 2020 feel 100% healed, peaceful and content 
  • Nov. 2020, loving life ❤️ 
 
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We can figure it out, catnapt.

 
Possible situation:

At some point you're ready to taper, you want to be cautious so decide that you'd like to reduce
by 5%, 0.005 mg from 0.1 mg to 0.095 mg.

  • Put 0.1 ml of the Lex liquid in a marked container.
  • Add water to the 100 ml line.
  • Shake or stir to distribute the Lex.
  • Remove and discard 5 ml of the solution.
  • Drink the remaining 95 ml of the solution.

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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awesome! thanks, and thanks for putting it in my thread too. You rock!

  • pysch med history: 1974 @ age 18 to Oct 2017 (approx 43 yrs total)
  •  Drug list: stelazine, haldol, elavil, lithium, zoloft, celexa, lexapro(doses as high as 40mgs), klonopin, ambien, seroquel(high doses), depakote, zyprexa, lamictal- plus brief trials of dozens of other psych meds over the years
  • started lexapro 2002, dose varied from 20mgs to 40mgs. I tried to get off it several times. WD symptoms were mistaken for "relapse". 
  •  2013 too fast taper down to 5mg but WD forced me back to 20mgs
  •  June of 2105, tapered again too rapidly to 2.5mgs by Dec 2015. Found SA, held at 2.5 mgs til May 2016 when I foolishly "jumped off". Crashed in Sept, reinstated at 0.3mgs in Oct. 2106
  • Tapered off to zero by  Oct. 2017 Doing very well
  • Nov. 2018 feel 95% healed, current age 63 
  • Jan. 2020 feel 100% healed, peaceful and content 
  • Nov. 2020, loving life ❤️ 
 
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Share on other sites
  • 1 month later...

I have off prozac at 3.4mg. Whenever I've tried to drop lower however minute the drop, 

I am overwhelmed with dark repetitive thoughts and anxiety which did not let up een after six weeks.

SoI am staying at 3.4mg.I read all about the benifits of Amino acids 5-HTP and Tryptophan in Julia Ross's book The Mood Cure.

I started taking 50 mg of 5-HTP at night. It did help me sleep but invariably woke with a headache. Because it seemed to be helping me sleep and improve my mood I kept taking it in spite of the headaches. Then after a couple of weeks I noticed I was getting very anxious and weepy.

 Though  hadn't been dropping from prozac for eight months, this felt like bad withdrawal symptoms. I stopped the 5-HTP and the anxiety and crying let up. Wonder if anyone else had this kind of experience.

I also tried taking 500 mg of L-Tryptophan in the mornings with B6. I always had a strange prickling sensation in my skin, mild nausea and feeling out of breath afterwards. A bit like a flush after taking Niacin but not the same. I can't find any reports of this as a known side effect. 

It's disheartening because I thought these amino acids were working and would help me get off prozac completely (as many have done according Ross). I'd appreciate hearing  the experiences of others who nearing the end of their taper have tried amino acid support.

On 20 mg of Prozac for about ten years. Sept 2012 started reducing 10% a drop using gram scale, with average of one month holds.

When I'd reached the half way mark, taking 10 mg  powder out of the 20 mg capsules, I switched over to 10 mg capsules and cutting

down from those. Withdrawals got harder the lower I dropped.  May 2013 changed to 5% drops, holding until all withdrawal symptoms gone.

January 2015 changed to liquid prozac (concentration of 20MG per 5 mL) using a 1mL oral syringe.

Current dose of fluoxetine solution equivalent 3.4 mg. Any effort to drop below this has been disastrous so for the time being I'm staying at this level.
Adding 200 mg Tryptophan and 200 GABA a day has helped with anxiety.
Also take 1,300mg Omega- 3,  875mg  Magnesium, 1800mg Curcumin, 1000mg Vit C, 5000 Vit D.
 

 

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LawyerLiz - it's hard to answer your question without knowing to which medication you're referring. Dosage ranges vary widely for medications.

 

There's absolutely nothing wrong with staying at a low or very low dose that is effective for you. In fact telling your doctor that you want to find the lowest effective dose of a medication for you can be a good way to get their support for tapering.

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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