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The Brassmonkey Slide Method of Micro-tapering


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Kristinhopes

I had this same question in regards to Prozac, since it takes 6 weeks to be fully out of system anyway. And so is making frequent reductions counterintuitive in that sense and also the two weeks hold for that reason? Trying to figure out how frequently I want to decrease the prizac . 


2000-2017Paxil 40 mg and Zoloft usually 100 mg most these years

2018-1.5 year pooped out reinstatement of Zoloft 100.

feb 2020 lexapro 10 mg but developed tinnitus and palls. taperoff lex in June

9/22/20: dropped 2.5 mg lexapro to 0 and started 10 mg Prozac Akathisia and insomnia and worse depression began after dropping to 2.5 (be4 starting Prozac) .

 9/20:  6 weeks intermittent but consistent Ativan and klonopin
10/22/20: last dose of klon

and dropped to 8 mg prozac

12-19-20: decreased Prozac to 7.4 
1-5-21: 7.68 prozac with adv effects so  1-7-21: back to 7.4 1-18/21: 7.2 and 1/25/21: 6.95 2/1: 6.8

 

 

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ADMIN NOTE Every nervous system is different. You may find a modification of the below method suits yours better. It is only a suggestion of a place to start if you're very sensitive to dosage reducti

Hi Wantrelief--  in this case it is specific to the people using the Slide Method.  It is however, a good idea to throw in a hold now and then when using the standard 10% taper also.  especially of yo

That's one of the nice things about it Rabe, the Brassmonkey Slide Method can be used with any medication that you can taper. We have people tapering ADs, APs, PPIs, and Benzos. It doesn't have to be

Yesyes123

@ChessieCat

 

Thank you so much!

July 2015 - Started Escitalopram 10mg (Lexapro) at age 15. Took it everyday until July 2020 (5 Years)

July 2020 - Turned 21 started tapering off until August (TOO FAST TAPER/ ALMOST SAME AS COLD TURKEY)

August 2020 -  Clear Manic episode (nothing absurd or life threatening)

September 2020 - Start feeling a bit weird

October 2020 - Crashed. The absolute worst time of my life. 

Late October 2020 - Reinstated Escitalopram 10mg. Perscribed Antipsychotics (Lithium, Seroquel) REFUSED

Early November 2020 - Psychiatrist wrongly upped the dosage to 15mg. Still taking 15mg / day as of today. 

 

22 January 2021: 

Beginning to stabilize on 15mg/day Escitalopram (Lexapro) 🧠

Taking 25mg Magnesium Citrate 4x per day / 2000mg Vitamin C Prolonged Release + Kiwis + Fresh Fruit / Salmon everyday for Omega3 Fatty Acids

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Greenriver
On 1/23/2021 at 3:19 PM, Kristinhopes said:

I had this same question in regards to Prozac, since it takes 6 weeks to be fully out of system anyway. And so is making frequent reductions counterintuitive in that sense and also the two weeks hold for that reason? Trying to figure out how frequently I want to decrease the prizac . 

Yea, that’s my thoughts on it. Also, it could be counterproductive spacing the dose reductions out week by week, when Prozac is already self-tapering. I’m not really sure what dosage drop I’m getting my withdrawals from; if it’s from the drop two weeks ago or six weeks ago, if you know what I mean. Tbh my withdrawals so far haven’t been too bad, so I might just carry on with the Brassmonkey method 

Past four years: Fluoxetine, 10mg; currently tapered down to 2.8mg. 

Diazepam, 5mg, once daily (goes up to 8mg sometimes during taper). 

1999-2016: Mainly sertraline but also Venlafaxine  and Paroxetine. 

31 Oct: discontinued Fluoxetine.

1 Nov 2019: started Sertraline, 12.5mg, once every two days. 

13 Nov 2019: Reinstated Fluoxetine due to adverse effects from Sertraline. Plan to start Citalopram once stabilised on Fluoxetine 

 

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brassmonkey

Getting the drug "out of the system" is not the object of a taper. Prozac has a reputation for being "self tapering" because of it's long half life, but it is far from the truth. A taper according to the half life would mean reductions of 50% every week for six weeks. This is far too fast for the body to make adjustments.

 

The object of a taper is to reduce the drug in a way that the body can undo the physical changes the drug has caused, in such a manner that the body doesn't realize that it's happening. When the drug is removed too fast the body can't keep up with the healing required, gets confused and manifests the WD symptoms we experience. Because of it's long half life Prozac is the easiest one to taper because the fluctuations in it's blood serum concentration are minimal.  Where as with some of the other medications with short half lives the concentration fluctuates widely on a daily basis, making them harder to taper.

 

That is the main premise behind the Brassmonkey Slide. Make smaller controlled reductions that the body is more likely to handle and the give it a little more time to catch up before doing it all again. Instead of taking a big hit all at once and waiting it out. 

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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Kristinhopes

I am currently doing the brass monkey method with the Prozac although I don’t know if necessary to do it that way or once a month. I think my and green rivers confusion is in the fact we are making a small dose adjustment each week before the one from the week before has only been decreased one half life at the most. Could that further confuse the nervous system to make a dose decrease when the previous weeks dose decreased still has a long way to go? Any hypothesis ? In any case I am three weeks in so far and doing okay and will do a two week hold after the four weeks. I will report back in my thread how it goes from there. As long as it’s not any more harmful to do it this way with the prizac, I do actually like the weekly decreases beCause it helps with the patience part of tapering. You still feel like you are actively working towards decreasing even though it’s not more than if you did it once per month it just feels that way, 


2000-2017Paxil 40 mg and Zoloft usually 100 mg most these years

2018-1.5 year pooped out reinstatement of Zoloft 100.

feb 2020 lexapro 10 mg but developed tinnitus and palls. taperoff lex in June

9/22/20: dropped 2.5 mg lexapro to 0 and started 10 mg Prozac Akathisia and insomnia and worse depression began after dropping to 2.5 (be4 starting Prozac) .

 9/20:  6 weeks intermittent but consistent Ativan and klonopin
10/22/20: last dose of klon

and dropped to 8 mg prozac

12-19-20: decreased Prozac to 7.4 
1-5-21: 7.68 prozac with adv effects so  1-7-21: back to 7.4 1-18/21: 7.2 and 1/25/21: 6.95 2/1: 6.8

 

 

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brassmonkey

The overlapping half life cycles should only help to make things smoother. Because of the long half life it might be a good idea to add a few weeks of additional hold time every three or four Slide cycles. This would allow any backlog of symptoms to resolve before it grew too big. We haven't seen any problems with this but there is the possibility.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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Hello all

 

I'm strictly following the Brassmonkey 10% monthly taper and experiencing good results in my Nortriptyline taper. I still get WD symptoms but they are way too brief and short-lived and tend to get resolved in just a few days (hypnic jerks are the most disturbing WD symptom for me as they result in insomnia on some nights). I'd tasted nervous system crash from rapid tapers before I became familiar with the Brassmonkey slide taper, so I know from experience that the WDs in Brassmonkey taper are far more bearable than the ones you get from a crash. My question now is whether Nortriptyline is comparable in its long half-life to prozac or not. Also, would it be wise to switch from Nortriptyline to Prozac from where I am now at 15 mg Nortriptyline?

 

2015 september zoloft (20 mg updosed to 125) plus clonazepam for anxiety and panic attacks

2016 Jan replaced clonazepam with chlorodiazpoxide 20 mg

2016 April cold turkeyed both after a urinary retention surgery with no withdrawal symtom at all (still bizzare to me how!!!)

2018 Jan perscribed Nortriptyline 10 mg for vestibular vertigo 

2018 Feb due to the horrible side effects which my psychiatrist took for depression and anxiety, Nortriptyline began to be updosed to reach 100 in June

2018 Oct noticed I was experiencing no pleasure in life and decided to taper(zombie-style kind of life)

Tapered to fast to reach 50 mg in 2019 Feb

Terrible withdrawal symtoms began to creep up, had to updose to 75 in June 2019

Began make changes in diet and lifestyle and tapered again to reach 30 by 2020 Jan (only in the middle of this taper did I become familiar with the golden formula of Brassmonkey slide taper ten perecnt each month and I'm forever thankful)

By May 2020 reached 22.5 when my whole taper process hit the wall due to infection to God-damned Covid 19

Late Sep 2020 restarted my taper process using the Brassmonkey 10 percent method and reached 16 mg Jan 20 2020 when I'm writing this now

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16 hours ago, Kristinhopes said:

the fact we are making a small dose adjustment each week before the one from the week before has only been decreased one half life at the most. Could that further confuse the nervous system to make a dose decrease when the previous weeks dose decreased still has a long way to go?

 

15 hours ago, brassmonkey said:

Because of the long half life it might be a good idea to add a few weeks of additional hold time every three or four Slide cycles. This would allow any backlog of symptoms to resolve before it grew too big.

@Kristinhopes @brassmonkey

Ya'll are really making me think and use my brain. 🤔 I guess my question...(mostly because I don't understand 1/2 life) is should I be rolling on with my BMS-2 wk hold, or should I be holding every 3-4 cycles also? I'm on a Lexapro (off brand) taper....

 

2005-2017 started on AD for sleep then on and off Paxil, Zoloft, Lexapro, and others that I can't remember

2017 Lexapro 10 mg

2018 Jan-Tried getting off lexapro. (within about a 4-6 week period) 

2018 March- Got back on Lexapro 10mg

2018 June Switched to Wellbutrin. (don't remember dosage)

2018 August Switched to Sertraline. 25 mg, 50, 75, then back down to 50 

2019 December...back on Sertraline 25 mg 

2020 January-switched back to Escitalopram 5 mg

2020 March-December Escitalopram 10 mg

2021 Jan-started BMS taper w/2 wk hold (using liquid form)

2021 March 7.97mg

Occasionally .25mg Melatonin (as needed)

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brassmonkey

Do your regular Brassmonkey Slide of four reductions and a hold.

 

Sorry for getting you confused, Kristinhopes and I are getting sidetracked on a discussion of tapering prozac which could be handled a little differently than Lexapro.

 

The body processes/uses up the drug at a fairly set rate. The time it takes to use up half of the drug is called its Half Life. In general terms, if a drug has a Half Life of 24 hours, and I take a dose of 4mg at noon, then at noon tomorrow only half of that dose (2mg) will still be active in my body. At noon the next day half of that (1/4 of the original dose) will still be active. Then at noon on the third day half of that (1/8 of the original dose) will be active, and so on until there is nothing left.

 

When you take a dose every day you add more drug as the previous dose is getting used up. The addition and subtraction balances out over time (usually a week or two depending on the medication) and becomes what we call "Steady State". Meaning the same amount of drug in the body all the time. A long Half Life makes it easier to achieve and maintain this Steady State, where as a short Half Life is a little more difficult.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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@brassmonkey Gotcha! Makes sense! Thanks for the explanation. I will continue on as I'm doing. :)

 

2005-2017 started on AD for sleep then on and off Paxil, Zoloft, Lexapro, and others that I can't remember

2017 Lexapro 10 mg

2018 Jan-Tried getting off lexapro. (within about a 4-6 week period) 

2018 March- Got back on Lexapro 10mg

2018 June Switched to Wellbutrin. (don't remember dosage)

2018 August Switched to Sertraline. 25 mg, 50, 75, then back down to 50 

2019 December...back on Sertraline 25 mg 

2020 January-switched back to Escitalopram 5 mg

2020 March-December Escitalopram 10 mg

2021 Jan-started BMS taper w/2 wk hold (using liquid form)

2021 March 7.97mg

Occasionally .25mg Melatonin (as needed)

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Yesyes123

When considering the weight of the pill, should one be worried about the weight of the active ingredient vs the weight of the filler substance?

 

For example, we know that a 15mg Lexapro tablet will weight 0.XXXg. But inside this value, how much is the active ingredient (Escitalopram) and how much is the other filler substance that is used to make up the tablet? 

 

If we reduce the weight very slightly in order to taper, how to know if we aren't taking away only the filler ingredient?

 

I suppose that if we crush the tablet into powder and stir the powder up very well, that's enough to mix the filler ingredient with the active ingredient and then reduce the weight of this mixed-powder, safely reducing the amount of active ingredient in the intended proportion. 

 

I just want to make sure with you guys - I will be starting my 15mg Lexapro taper in a few months, once I'm completely stable.

 

@brassmonkey

July 2015 - Started Escitalopram 10mg (Lexapro) at age 15. Took it everyday until July 2020 (5 Years)

July 2020 - Turned 21 started tapering off until August (TOO FAST TAPER/ ALMOST SAME AS COLD TURKEY)

August 2020 -  Clear Manic episode (nothing absurd or life threatening)

September 2020 - Start feeling a bit weird

October 2020 - Crashed. The absolute worst time of my life. 

Late October 2020 - Reinstated Escitalopram 10mg. Perscribed Antipsychotics (Lithium, Seroquel) REFUSED

Early November 2020 - Psychiatrist wrongly upped the dosage to 15mg. Still taking 15mg / day as of today. 

 

22 January 2021: 

Beginning to stabilize on 15mg/day Escitalopram (Lexapro) 🧠

Taking 25mg Magnesium Citrate 4x per day / 2000mg Vitamin C Prolonged Release + Kiwis + Fresh Fruit / Salmon everyday for Omega3 Fatty Acids

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ChessieCat

Generally the active ingredient would be reasonably well distributed throughout a tablet.  If it wasn't the case then they would not be able to make tablets that are scored and can be broken into two.

NEW!!!     INTERVIEW with Altostrata, SA's founder    NEW!!! 

 

Plodding along inch by inch:  12" = 1',  3' =  36 " or 1 yard,  1760 yards  = 63,360" or 1 mile

Current from 17 Apr 2021:  Pristiq 0.2665mg  now holding each dose for 3 weeks

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 Oct 2015 

My tapering program   My Intro (goes to my tapering graph)  My website

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

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brassmonkey

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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Yesyes123
25 minutes ago, brassmonkey said:

 

Thanks a ton - extremely useful.

 

From reading that link, it seems to me shaving off the pills with a nail file and weighting them is as safe as crushing the pills to powder then weighting then putting the powder in gelatin capsules.

July 2015 - Started Escitalopram 10mg (Lexapro) at age 15. Took it everyday until July 2020 (5 Years)

July 2020 - Turned 21 started tapering off until August (TOO FAST TAPER/ ALMOST SAME AS COLD TURKEY)

August 2020 -  Clear Manic episode (nothing absurd or life threatening)

September 2020 - Start feeling a bit weird

October 2020 - Crashed. The absolute worst time of my life. 

Late October 2020 - Reinstated Escitalopram 10mg. Perscribed Antipsychotics (Lithium, Seroquel) REFUSED

Early November 2020 - Psychiatrist wrongly upped the dosage to 15mg. Still taking 15mg / day as of today. 

 

22 January 2021: 

Beginning to stabilize on 15mg/day Escitalopram (Lexapro) 🧠

Taking 25mg Magnesium Citrate 4x per day / 2000mg Vitamin C Prolonged Release + Kiwis + Fresh Fruit / Salmon everyday for Omega3 Fatty Acids

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