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The Brassmonkey Slide Method of Micro-tapering

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Blandell

I’m excited to hear this!! Yay and thanks in advance to you and your husband 

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Surfchick

MICRO Taper Off calculator with built-in 2 week hold we just created!  

Here it is--> http://www.taperoff.co/

 

hope this helps, ill be starting soon!

 

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DoctorMussyWasHere
2 hours ago, Surfchick said:

MICRO Taper Off calculator with built-in 2 week hold we just created!  

Here it is--> http://www.taperoff.co/

 

hope this helps, ill be starting soon!

 

 

Awesome calculator : ) Thank you

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StarEyes

Yes, this calculator works great! Thanks so much to you and your husband!

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jozeff

Great stuff!! 

 

I made an Excel sheet for myself but your app looks really good.

 

Thanks for sharing!!

 

Jozeff

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Rossho

Hi brassmonkey. Quick question. You state that a 10% taper with the slide method has a 5 month half life. Is this with reducing by your current dose or by a percentage of your starting dose? 

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Gridley

The percentage reduction, whether with the standard 10% every-four-weeks taper of with the Brassmonkey 2 1/2% per week taper, is always a percentage of your current dose.

 

With the standard 10% taper every four weeks, you will be at half your current dose in 6 months.  

 

With the Brassmonkey taper, you will be at half your current dose in 9 months.  The additional time is because there is a 2-week hold after the fourth 2 1/2% weekly taper.

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Pokeshaw

Hi Brass,

 

Checking in here now that it has been a little over 6 weeks since I updosed from 9 caps (.01 mg each) of the Lexapro aliquot to 10 caps meaning I went from .09 mg to .1 mg.  As you may recall from my posts, this was due to a very bad wave.

Things have improved considerably and I do have windows of symptom free time, but I am still dealing with some w/d symptoms - nausea, vertigo and now what I call side effect symptoms - neck/jaw clench and inner ear balance issues. The trend seems to be up though and the weight loss due to extreme nausea and inflammation along with the horrible dread have reduced considerably. So, after 6 weeks I am feeling I should stay longer at this dose before any reduction or change. I have in the past had to stay a good 3 months at a dose due to a bad wave.

I am hoping that things continue to even out so that I can comfortably continue using the aliquot compounded capsules for my taper.  

Also, we moved to new apartment and are starting to get settled. It was very intense but I survived!

 

Question when you have time - I am wondering what will be the best way to follow your taper method accurately when the time comes. Seems to me that since the ingredients of the capsules are not water soluble I might have to get a scale and weigh out the reductions.

The contents of the compounded .01 mg caps are: Lexapro, microcrystaline cellulose, Methocel E4M

Also, I havent done a lot of research on scales but wondering if I will be able to get one sensitive enough to handle this? These caps are not very big!

 

Again, thank you ever so much for your guidance and knowledge!

Poke

 

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brassmonkey

Hi Pokeshaw--  I'm glad to hear that things are settling down after the updose.  Yea, I'd give it some more time to get good and stable before trying any reductions.

 

I think using the scales is probably going to be the best way to go.  They're not expensive. Would you be able to find out the weight of the powder that they put into each capsule?  It would help to determine where we are headed with all of this.

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Pokeshaw

Hi Brass,

 

Thanks for your response.

Yes, I will wait before making any reductions. Usually what prompts me to make the reduction is that the side effect symptoms become intolerable. They are starting to appear.  Gut slows down, so constipation, neck/jaw clench increases as does pins/needles in arms and hands, sleep is choppy.

Because I originally stopped the 10 Mg of Lexapro too quickly  and stayed off for 8-9 months before reinstating, my system is very sensitive to it. The longer I stay at a dose the worse the side effects get. They were reason I stopped taking it. So it has been a see saw taper for me!

 

Re how to proceed from here

I tried dissolving one of the capsules in water and was able to do so pretty evenly. I am thinking that working with liquid dilution might be simplest way to go.

Also, I am considering switching back to the 0.1 mg compounded caps and working from there. The 0.1 mg caps are exactly same ingredients made by same compounding pharmacy as the 10 caps of .01 mgs that I am taking now.  I think that with a 5% accuracy range  10 caps can vary more than the 1 cap at .1 mg.  So I understand that switching back to the 0.1 mg cap will be an adjustment but I think for the better.

Then when the time comes I can make a 1-1 dilution and reduce from there following your taper method.

 

Does that sound reasonable?  

 

Pokeshaw

 

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Carmie

Hi @brassmonkey

 

Im thinking of doing the brassmonkey slide. I have been doing water titration from a 25mg tablet n I’ve gotten down to 7.5mg. I just changed to a 7.5mg capsule two weeks ago and it’s put me in withdrawals. I realised that all measurements aren’t the same as I measured syringes against each other and they were different, so when changing to capsule there may have been a difference in measurement.

 

When I stabilise I want to continue water titrating the capsule. 

 

I though I’d get the capsule as it’s easier to do smaller amounts with 7.5mg rather than 25mg. I saw on Rabe’s thread though that you said it’s better to use the original tablet. When I stabilise do you think I should go back to the original tablet and stabilise on that again n go from there? Or is it okay to continue with the compounded formula?

 

Would appreciate your input, thank you.

 

Sending hugs🤗

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Carmie

@brassmonkey

 

P.s. I only take one capsule in the evening. 

 

Thanks again

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brassmonkey

Hi Pokeshaw-- if each of the .01 capsules was off by 5% it would be the same as 1 of the .1 capsules being off by 5%.  If some of the .01 capsules were off by only 2% then you would actually be getting just a bit more medication by using them.  But the amount would be so small it shouldn't make much difference. Just remember that each time you switch methods you need to let things settle for six to eight weeks before going any further.

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brassmonkey

Hi Carmie-- it looks like you got caught between changes in measuring and delivery system.  With each one being just a little different it's pretty easy for symptoms to take an upswing.  Give it a few weeks and things should be back to normal.

 

Using the 7.5mgai compounded capsules shouldn't cause any problems.  The compounding just throws another variable into the mix that might at some point cause some problems.  I'm a big fan of working with the original medication.  It has better consistency than compounded capsules, the source material is more predictable to get and it usually costs less.  Currently you'd be getting just over three doses from one tablet, so you would be getting a "free dose" about every three tablets.  This would accelerate as you decrease further saving more money.

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Carmie

Hi @brassmonkey

 

Thank you so much for replying. I’m in a bit of a dilemma as to what to do now. I’ve got six months worth of compounded 7.5mg capsules. Maybe I should just keep using those for now. I’m still deciding. If I go back to the original tablet after I stabilise from the compounded capsule I will go back into withdrawals again because as you said different measuring n delivery systems. I’m worried changing so much so close will destabilise me and make me go into a major wave. 

 

Another thing i ponder though is when i when I get my next batch of 7.5mg in six months time will they be the same as this last batch? At least the delivery system is still the same I guess. 

 

Maybe I should just continue with the compounding formula n if I decide to do so somewhere down the track I can go back to the tablets. You said the compounding formula shouldn’t cause too many problems. I just don’t want to skip back n forth so close together as it might play havoc with my brain. 

 

Thanks again 💚

 

 

 

 

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Pokeshaw

@brassmonkey

 

You're right! 

 

So, I guess I will stay where I am for now (10 caps of .01 mg) and wait to see if I reach the level of stability that I have reached before (using individual caps rather than the aliquot) when dealing with a bad wave.  Seems to be working so far, just slow. I certainly dont want to make any unnecessary changes after what I have been thru these past months. 

 

 - When the time does come to resume taper -

An engineer friend created a spreadsheet for me to assist with the 2.5% redux calculations using the aliquot caps and diluting. 

 

As below, for instance at first 2.5% reduction I would drop down from taking 10 caps of .01 mg to 9 caps of .01 mg and then 75% of one .01 mg capsule.

 

The question is - which is better, diluting in water or using scale?  I think i lean toward diluting because it seems easier thing to do daily -  do you think Ok to go with that?

 

Thanks again!

Pokeshaw

 

 

Num of whole capsules to take ml of solution with 1 capsule dissolved in 100ml Capsules (whole + fraction) Total mg of powder to take Reduction fraction
10 0.0 10.00000 0.10000  
9 75.0 9.75000 0.09750 0.975
9 50.6 9.50625 0.09506 0.975
9 26.9 9.26859 0.09269 0.975
9 3.7 9.03688 0.09037 0.975
8 81.1 8.81096 0.08811 0.975

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brassmonkey

Hi Pokeshaw-- that sounds like a good plan. Looks like a useful spread sheet too. Diluting in water should work fine.

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brassmonkey

Hi Carmie-- I'm just here to add to the confusion by pointing out things that could be a factor and need to be taken into consideration. BTW you're doing a great job of understanding.  If you already have six months worth, by all means use them, no need to spend money on others.  The next batch could be just a little different (5% from what you've been saying) so it might be a good idea to plan for a cross taper between the two batches, when the time comes.  That will minimize the chances of having an upswing in symptoms. It's not a given fact that there will be problems when starting the new batch but adding secondary anxiety by worrying about it is a sure way to make it happen. When it comes down to it, stability and consistency are the two most important parts of a good taper plan.  How you get there is just adjusting the details.

 

Brassmonkey

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Carmie

Thanks for your message @brassmonkey

 

Well I’ll just keep taking the capsules for now. When I stabilise I’ll start tapering them, it may be a little while yet. 

 

No hurry as it will be five or six months or so before I get my next bunch of meds but how do you cross taper between two batches? As you said though there probably won’t be any problems. I might just take the new batch n hold it for a while before tapering just in case. 

 

Don’t our minds do weird things when new things are thrown into the equation of tapering! Okay time to tame the secondary anxiety. 

 

I hope you’re doing well, have a happy day☀️☀️☀️

 

 

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Carmie

Hi @brassmonkey

 

You mentioned cross tapering the old n the new compounded capsules. How does one do that? I won’t be doing that for months as yet but was just curious. I open up a new 7.5mg capsule every day at the moment n mix it with water n drink it. Haven’t been able to taper it as yet though.

 

Would I take the new batch on certain days n the old batch on other days? Or would that cause problems? I know I may not even have a problem changing to the new batch to begin with. 

 

Just wanted to know your thoughts. 

 

Thanks a lot💚

 

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Gridley

The usual method for cross-tapering is this:

 

3/4 dose of the old compound, 1/4 dose of the new compound for 3 days

1/2 dose old, 1/2 dose new for 3 days

1/4 dose old, 3/4 dose new for 3 days

Only new compound thereafter

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Carmie
3 hours ago, Gridley said:

The usual method for cross-tapering is this:

 

3/4 dose of the old compound, 1/4 dose of the new compound for 3 days

1/2 dose old, 1/2 dose new for 3 days

1/4 dose old, 3/4 dose new for 3 days

Only new compound thereafter

 

Hi Gridley, 

 

Thanks for that information. I’ve actually read that somewhere before but don’t know how to get my head around doing the math to figure it out. At the moment I’m using a 7.5mg compounded capsule in 20ml of water every day. I don’t use a scale. I have always used 20ml of water tapering down my 25mg tablet. 

 

I dont know how to do the cross tapering. Maybe put 3 capsules of the old formula n one capsule of the new formula into water to make the 3/4 to 1/4 ratio n keep it in the fridge n use it for three days. Then put 2 capsules of each in water n store it again n use it for three days. Then one capsule old and three new doing that for three days again. That’s how I would get the ratio I guess?

 

I don’t have a clue as to how much water I would have to add to that. I’m guessing I would just quadruple the water to 80ml n then I would just take out of that on a daily basis what I would normally take out, whether it would be a whole 20ml which would be 7.5mg or a little less, depending on whether I’ve managed to taper by then. 

 

Is this correct?

 

Thanks Gridley and Brassmonkey💚

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Rabe

WOW....you are good Carmie Einstein!!! Thinking about you!!💜

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Rabe

@Gridley Thank you for that information.  I have found just starting a new batch of capsules makes a difference.  Hard to get a steady dose seems.  Thank you again! 

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Gridley

Carmie, I've never used water but your calculation looks right to me.

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brassmonkey

Hi Carnie--  You're very close to correct.  You are essentially making four doses at one time using different pills, so you would use four times the water (80mL total) and add differing numbers of each tablet.  The trick is you would end up with 4 days worth not 3.  This is a good thing, so instead of wasting one dose just do each level for 4 days.  It will slow the process by a few days, but will make the transition gentler and less likely to cause problems. 

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Carmie

Thanks @Gridley @brassmonkeyfor checking my calculations, 

 

Yes, I’d end up with four days supply. I was just thinking of throwing away the fourth day but as you said brassmonkey I might just do it for four days each time instead of three, more smoother transition. 

 

Do you anything about water evaporation when you keep batches for a while? I’ve always made a new batch every day throughout my tapering n just thrown away the excess. 

 

Thanks again💚

 

 

 

 

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brassmonkey

Just keep them in a sealed bottle in the refrigerator and you shouldn't have any problems. 

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Carmie
On 9/12/2018 at 11:52 AM, brassmonkey said:

Hi Carmie-- it looks like you got caught between changes in measuring and delivery system.  With each one being just a little different it's pretty easy for symptoms to take an upswing.  Give it a few weeks and things should be back to normal.

 

Using the 7.5mgai compounded capsules shouldn't cause any problems.  The compounding just throws another variable into the mix that might at some point cause some problems.  I'm a big fan of working with the original medication.  It has better consistency than compounded capsules, the source material is more predictable to get and it usually costs less.  Currently you'd be getting just over three doses from one tablet, so you would be getting a "free dose" about every three tablets.  This would accelerate as you decrease further saving more money.

 

Hi Brassmonkey, 

 

Im still going through withdrawals from changing to a compounded formula . It’s been over two months since I’ve changed n I’m still going through lots of waves, though I did accidentally updose one night. 

 

Ive been thinking about what you said n I don’t want the compounded formula to keep causing problems so once I stabilise, which might be a month or longer I’m going back to my tablet. Then, off course I’ll go through withdrawals again. Even if it takes another three or four months of withdrawals n I’ve gone backwards I think in the long run it is the best thing to do as I’ll be tapering another ten years or so.

 

Once I get down to the teeny tiny doses I definitely don’t want to have any discrepancies there. 

 

Thank you soooooooo much for your help💚

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