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Are We There Yet? How Long is Withdrawal Going to Take?

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brassmonkey
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“Are We There Yet?”

  1. How Long Is Withdrawal Going to Take? (this post - see below)
  2. How Long, the Bottom Line
  3. Indirect Factors That Influence ADWD
  4. Is It Really Withdrawal?
  5. Stability
  6. But I only took it for a Week
  7. Tachyphylaxis or As It’s Lovingly Known “Poopout”
  8. CT and Fast Tapers
  9. Reinstatement
  10. Drug Interactions
  11. WDnormal (withdrawal normal)
  12. It doesn’t end at “0”
  13. Things to do Along the Way
  14. So, When Will We Get There?

 

How Long Is Withdrawal Going to Take?

 

(1)

 

 

One of the most frequently asked questions we get here at survivingantidepressants.org is some variation of “How long am I going to feel this way?”.  The simple answer is “we don’t know”.  I could stick with that and save myself writing the rest of this essay, but I’m not going to. It’s much too important a question to just brush off in that manner. For many, withdrawal from psychiatric drugs can be a process that puts one’s life on hold, causes extreme emotional disruption and intense physical symptoms, and we all want it to stop now.

 

Before we get too far there are some things I need to say about this essay.  Most of you will find it very upsetting, triggering and not what you want to hear.  The information presented here is what I have gathered from my experiences and from helping several thousand people with their journeys to remove these drugs from their lives.  To date there are no scientific studies dealing with this information, just data collected from forums such as survivingantidepressants.org and paxilprogress.com.  I am presenting it because people need to know what they are up against, and as many of us have discovered withdrawal from psychiatric drugs can be brutal.

 

An understanding the time involved in tapering, withdrawal and recovery from psych drugs is very important to that recovery.  The fact of knowing that there is an endpoint in sight makes it a little easier to bear. It also helps in making plans for one’s life and relationships while tracking one’s progress along the way.

 

There’s one very important point to bear in mind throughout this entire process:

 

Healing is happening all the time.

 

Even if you don’t feel it, from the very first dose reduction the body is sorting things out, making adjustments, reconnecting neural pathways.  There’s a tremendous amount of work for the body to do so at first it will seem that things are getting worse instead of better.  It’s all part of the healing process which is going on every minute of every day.

 

We often point out that each individual’s withdrawal experience will be unique, and they are.  This makes it very hard to predict how long any individual will be experiencing any given set of symptoms. making it so I will have to be talking in generalities for this essay. Although I will be saying that many things take a minimum of so many weeks or months, those numbers are just that, a minimum.  Many, many people will be on the long end of those statements and a good many will take even longer.

 

We frequently have people thinking “well, I’m a special case, so I can go faster”.  From painful experience, I can honestly tell you “you’re wrong”.  Trying to rush things is the most certain way of making them take longer and that longer time will be very uncomfortable.  If you have CTed or Fast Tapered, it is going to take a long time to stabilize and an even longer time to very slowly taper off.  The one hopeful note is, in the end, given enough time it does work.

 

I will be breaking this essay into a number of posts to make it more accessible and less over powering.  Each post will deal with a different aspect of the withdrawal process and its effect on the overall time required. I would also like to thank all of the Moderation team for their input, ideas and help.

 

Edited by ChessieCat
Added Index

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HOW LONG, THE BOTTOM LINE

(2)

So how long is it going to take?  I’m not going to string you along and will come right to the point.  For most people withdrawal and recovery is going to take a very long time.  A nice vague statement that will reassure some that it will all be over within a few months.  That is far from the truth.  Because to the nature of what psychiatric drugs do to the body they need to be removed slowly and carefully with plenty of time allowed for the body to adjust to each small change.  This process is not measured in weeks and months, but rather in years.

 

Each of the small adjustments involved in a taper, withdrawal and recovery requires many weeks to stabilize.  Because of the sheer number of small adjustments, they add up quickly.  The situation is compounded by the fact that if the process is not done very slowly the underlying symptoms do not have time to abate.  They then add to each other and grow until the body can’t contain them any longer and they breakout in the form of a crash.  These crashes are very destabilizing to the body, require very careful manipulation and even more time to control.

 

Part of why it takes so long is simple mathematics. When you add it up a 10% taper every 6 weeks starting at 40mg and ending at the currently accepted jumping off point of 0.016mgai will take about five and a half years. Been there, done that and it worked very well.  This took into consideration that there were no extra holds, no holds for changing manufacturer, no holds for changing from tablet to liquid, no holds for stabilizing after illness or vacations or any number or other delays.  There are some excellent spreadsheets and calculators available on the site to help you determine just how long a simple slow taper will take.

 

An easy way to look at this is that the half-life of a 10% taper done every four weeks will be six (6) months.  So, if you start tapering at 40mgai in six months, if all goes well, you will be taking 20mgai.  Another six months, one-year total, and you will be at 10mgai.  After a year and a half, you’ll be at 5mai and so on.  The frustrating part will come in the final years when the reductions are so small it seems like no progress is being made.

 

If everything is going smoothly a dose change of 10% will take effect and stabilize in a minimum of four to six weeks.  But a dose change is not just changing the amount of drug being taken.  It can also be changing manufacturers, changing from brand name to generic, changing from tablet to liquid or liquid to tablet.  It can also involve changing the time of day the dose is taken or splitting the dose during the day.  Every one of these Dose Change Events requires time to take effect and more time to stabilize.

 

 

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Indirect Factors That Influence ADWD

 

(3)

 

There are a number of other factors that are involved with how long withdrawal going to take.  Tapering off psych drugs is a very involved process where each piece has a direct effect on all the others. Factors like how long a person has been taking the drugs, how many drugs they are taking, how old they were when they started and how old they are now, maturity level and how many times they have made changes or tried to quit in the past are all a major part of the equation.

 

There has been a disturbing trend over the past several years of doctors prescribing cocktails of drugs.  The idea is to give a main drug to “treat the condition” and then several other drugs to make the side effects less severe.  In fact, all this does is muddy the waters and make the patient more miserable. It also increases the withdrawal time by a factor of the number of drugs, because each one must be tapered at the same slow rate and they should not be tapered at the same time. So, what could have been a four-year taper is now one that will last eight or possibly twelve depending on the number of drugs in the cocktail.  This may be a bit misleading because some drugs can be tapered at a faster rate and some will be prescribed at a lower dose.  But still, the more drugs the longer it will take to get off them.

 

Neuroplasticity, the brains ability to recover from a traumatic injury, is the underlying mechanism by which recovery works. ADWD is a bit different from an actual traumatic injury like a railroad spike in the head, but the principle is still the same.  Although neuroplasticity is active throughout one’s life it is somewhat dependent on a person’s age.  Younger people tend to be more physically robust and are quicker to make the bodily changes that are required, where as people who have been around for a while are slower to heal. That’s not to say that older people will have more problems with WD, just that they need to be even more diligent with their tapers.

 

When a person started to take the drugs is also a factor. Neuroplasticity is again at the root of the matter.  A person’s brain and nervous system is not considered mature in a physical sense until they are about 25 years old.  Up until that time it is a developing organism and in constant flux.  Also, during those years, a person is learning the basics of socialization, relationships and building their basic belief system.  All this development is not negated by an early start on ADs, but rather slowed greatly or put on hold until after the influence of the drugs has been removed.  This is seen by many as a setback, but there has been a lot of subluminal growth going on in the interim that lays the ground work for the personal growth to happen.

 

For people with more life experience this effect on the psyche is not as profound. It is more a feeling of stagnation and loss of position in the world.  However, underlying emotions and beliefs are still present, just inaccessible and will reemerge when the influence of the drug is removed.

 

The interesting thing is, the people with more life experience are the ones who tend to weather ADWD better.  Many of them can realize that ADWD is just another bump in the road and, although it is a long one, just a detour on the path of life.  The realization that things will return to “normal” goes a long way to smoothing things out.

 

I mentioned being polydrugged at the beginning of this post.  This is a major factor for another reason.  The drugs that are often prescribed together frequently don’t play well together or one or more of them is not tolerated well by the patient.  This leads to switching the drugs to “tune” the cocktail.  This switching is often done by just stopping one drug and starting another.  This causes CT withdrawal effects from the first and startup symptoms from the second to be copped with.  It also sensitizes the body.  The first couple of changes can be pain free, but at some point, it’s all going to add up and the body shouts “no more”.  The body in now sensitized to the changes and any alteration of the dose will be meant with a fight.  The only solution is to take things extremely slow, make miniscule reductions and wait an even longer time between tapers.

 

We are all taught from childhood that we are the “captains of our ship”, “take control of our life” and “it’s all up to you”. Most of us have learned those lessons too well and when we are faced with a loss of control over our lives, we have a very hard time handling the situation.  From the very first pill, as long as there is a trace of the drug in our system, it is in control. 

 

This loss of control can be very upsetting and can cause a great deal of anxiety and fear. Both of which only serve to compound the situation and make things worse. Not only is it self-imposed anxiety and fear, but there is an element of neuroanxiety also present that is directly produced by the drug. Neuroanxiety is another thing we have no control over and helps to spiral the situation even further.

 

We do have a bit of control left over our emotions in the form of acceptance of the situation.  Even though it seems like it is taking forever, WD is just a short period of our lives and when it is over we can get back to the things we love.  Until then we are where we are and there isn’t much we can do to change it, so we need to accept the situation and enjoy the little things as we can.

 

These are just some of the factors that affect the time it takes to taper off these drugs.  They are all interrelated and each one can increase the time withdrawal/recovery takes.

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Is It Really Withdrawal?

(4)

We frequently get comments like “I’ve been tapering for six months and still am having symptoms” or “I tapered off over three months and have been drug free for six, why do I still feel so bad?”.  The simple answer is, because you’re still in withdrawal.  It is important to know that these "general rules" that I’m talking about are not universal and that if you are suffering the kind of symptoms that are typical of withdrawal, you are in the process of reducing or have reduced your drug (or perhaps are in tolerance) and there is no physical malady that can be detected to account for the symptoms, then you are in withdrawal

 

For this essay I will define Withdrawal as “experiencing any or all of the listed symptoms associated with the reduction of or tolerance to psychiatric drugs”.  There is a very long list of symptoms available elsewhere on the site that you can check out.  Also, we keep finding new symptoms not on that list.  That isn’t to say that what you are feeling is 100% withdrawal, but it more than likely is.  However, if you are having chest pains for instance, get them checked out.  We don’t want people having heart attacks.  But once those symptoms have been checked out and you’re given a clean bill of health, then you can blame it on the drugs.

 

While these drugs are in your system they will be affecting how you feel.  Even at the miniscule doses near the end of a taper the drug is still changing your body chemistry and the physical makeup of your body.  There are many threads here recounting how the member feels every drop up to and including the final jump to “0”. So as long as you’re taking any amount of the drug you will probably be feeling symptoms of some sort.  Also, if you are taking multiple drugs, you will be feeling the affects of the ones you’re not tapering even while tapering off of one of them.

 

The term Half-life gets a lot of use here at SA.  It is the length of time it takes for the body to use up one half of the dose of medication that is present. So, your body uses half of the original dose, then half of that half, then half of that half and so on. Each drug is different, and we see half lives that range from one and a half hours to over 200 hours. How a person’s body reacts to the drug also makes a difference and can extend or shorten that time quite a bit.  This means that even after discontinuation the drug may still be directly affecting you for many weeks in some cases.

 

The expectation of a quick recovery is a major cause of frustration.  For many people starting to take psych drugs is relatively easy.  Some don’t feel a thing while others have a couple of weeks of mild discomfort and then everything is fine. I’m not talking about those unlucky ones who have an immediate Adverse Reaction, that’s a whole different ballgame.  Because of this easy startup these people get the idea that it will be just as easy to stop.  The medical profession doesn’t help the matter by telling us the drugs are nonaddictive and you can “stop any time you like”. This is far from the truth.

 

These drugs are not like fast acting Over-the-Counter pain killers but rather work by making physical changes to every system in the body.  Those changes start with the very first dose and continue to be made and maintained until well after the drug has been removed.  Once the drug has been started it is a matter of only a few weeks until the changes are so extensive that they require the 10% taper method to undo safely and any reduction in dose will result in withdrawal symptoms.

 

What it boils down to is, if you’re worried about how you feel get it checked out.  When the results come back saying that there’s nothing wrong, “Let it go” it’s “just” withdrawal.

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STABILITY

(5)

 

Let’s start with one of the very basic concepts that we talk about a lot. Stability, or more appropriately, how long does it take to stabilize.  The idea of stability requires an essay all to itself so for right now I will just give a basic definition.

Stability is the state where symptoms are relatively the same from day to day without having any major swings for the better or worse. It is an established pattern that has been present for a good length of time. To establish a stable pattern requires at least a month and preferable two or three with no appreciable changes in the symptom pattern.  Stability is not the absence of symptoms or feeling good.

Stability is required before any changes can be made in the medication, because those changes will destabilize the system causing an increase in symptoms.  If the system is not stable in the first place the new destabilization compounds the original destabilization and makes matters worse.  There is one exception to this and that is tachyphylaxis or as it’s lovingly known “poopout”.  We’ll get into that later. If the system is in a stable condition the body can more easily make the changes needed to accommodate and adjust to the new situation.

 

When there is a Dose Change Event (anything that changes the amount, type, or timing of the medication) there are several things that must happen.  The first is the level of the medication in the blood needs to become steady state.  This means that there is a specific amount of the medication in the blood at all times. Medical research has shown that this will take a minimum of four days and could take up to a week.  This takes into account metabolic rates, half-lives and a number of other variables.  So right off the bat, every time we make a change there is a waiting period of four to seven days.

 

Once the drug is steady state in the blood the body can start adapting to the change.  The bodies initial reaction is to get confused.  It was functioning fine the way things were and now things are all confused.  That confusion manifests itself as symptoms and is a sign that the system has been destabilize.  However, there frequently is a placebo effect period just after a dose change event during which the body either doesn’t notice the change or will feel better because of it.  This placebo effect period doesn’t last long with the symptoms manifesting themselves several days after the change.  Many people report their symptoms ramping up between two and five days after the change, but it’s not uncommon for it to take several weeks for them to appear.

 

This time lag is referred to as a “honeymoon period”.  As mentioned for a dose change event it can last a couple of days to several weeks.  In the case of a Cold Turkey or Fast Taper it can last distractingly long.  Frequently in the range of three to four months and sometimes up to a year or more.  After which there is a dramatic crash of destabilization. 

 

Once the new symptoms have appeared they will start to stabilize. Using a controlled 10% taper it generally takes four to six weeks minimum for the system to restabilize.  It is not uncommon for to take two or three months for people to stabilize after such a drop.  Some people will take even longer.  When this occurs, it’s best to try a smaller decrease the next time to lower the amount of destabilization.  A smaller decrease means less confusion to the body and an easier time to sort it all out.  Decreases of greater than 10% cause a lot more chaos and greatly increases the time required to find stability.

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But I only took it for a Week

(6)

 

I think that some of the most unfortunate members we have are the ones who only took the drug for a short time and had an Adverse Reaction. Over the years I’ve seen a good number of members join who have taken their drugs for one day to a week and then stopped.  Yet they are suffering very acute symptoms.  This is an Adverse Reaction, acute symptoms that hit immediately and hard.  Some people’s chemical makeup just isn’t compatible with psych drugs and their body immediately tries to reject them, but in doing so throws itself into chaos.

 

The good news is that their body will sort itself out and they will return to normal.  The bad news is, it’s going to take a long time and there is nothing that will speed up the process.  There are a lot of coping strategies and tools that will help soften the experience, but time is the only thing that will cure it.  By time, we are looking at a minimum of eighteen months, but more than likely two to three years for a full recovery

.

That may sound very bleak, but it’s not going to all be pain and suffering.  These people tend to have a more liner recovery. The first several months will be acute.  Then things start to improve is a noticeable manner, with life starting to resume and get back on track.  All the members I have known have made full recoveries.  They then go on to graduate college, attend med school, and start successful careers in a variety of fields.

 

There is a variation to this theme and that is the ones who have taken the drug for a month or two.  They didn’t have the immediate Adverse Reaction, but the drug is not treating them well and they decide to stop taking it because of the way it makes them feel. Because they have only been on the drug for a short time and with their doctor’s encouragement they stop the drug cold turkey. After a “honeymoon period” this throws them into withdrawal and a whole carousel of doctor’s visits and new drugs typically follows. But that’s a different topic.

 

Psych drugs work by making physical changes to the body, affecting every system and every cell.  They start to make these changes from the first dose and by the end of the first month they have been quite successful in doing so. By the end of two months the changes have been significant. The upshot being that even after only two months a proper, slow 10% taper is required.  Yes, that means that you will be on the drug for several years longer than you took them originally.  But those changes, that were quick to happen, require a lot of time to sort out and undo without causing undo symptoms.

 

For those people who are at the one month mark it’s sometimes possible to do a quick taper lasting only a few months.  This is a very iffy proposition though, sometimes it works and sometimes it doesn’t. If it doesn’t it will take many months to find out it hasn’t, many months to stabilize from an updose/reinstatement and then the long slow 10% taper.

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TACHYPHYLAXIS OR AS IT’S LOVINGLY KNOWN “POOPOUT

 (7)

 

Although acute WD and Poopout are related they are not the same thing.  Acute WD is a severe case of WD Symptoms while Poopout is the body tolerating the effects of the drug, trying to work around them, and causing WD symptoms by doing so.  The harder the body rejects the medication the more severe the symptoms. 

It all stems from the body being a self-correcting homeostatic organism. It's designed to work with a specific balance of neurotransmitters and will do anything in its power to maintain that balance.  Taking an AD causes some the receptors for a specific neurotransmitter to stop working which floods the body with that NT and supposedly makes us feel better because of the excess.  After a while the body finds ways around this and works to regain homeostasis.  When the struggle for control that ensues becomes acute it is known as Tachyphylaxis, or Poopout.  In order to "cure" it, there must be a clear winner, leaving two options. Updose or taper.  

 

Once Poopout has set in it is going to continue to grow worse, no matter what. To Updose would just be buying a little time. By Updosing the drug is declared the winner, the symptoms subside somewhat, and you move on, but the body continues to fight.  This could last from a few months to a year or so, but in the end, things will go down hill again and leave a person in the same or worse situation and at a higher dosage, which would require a longer taper. To hold during poopout would only prolong the struggle and might make things worse as the body continues its fight for control.

 

When it comes to Poopout the only way out it down.  If a person tapers, the body is declared the winner, repair work is started on the body and the symptoms subside.  BUT, it takes a long time to undo the physical changes the drug has made, and the presence of the drug is required to maintain those changes while the changes are being repaired. Thereby necessitating a long slow taper.

 

Tapering out of Poopout is a very frustrating process because there are no visible results for quit a long time.  There is not a lot of information available on time frames because Poopout is not a well-documented phenomenon.  Many people don’t realize that they are involved let alone how to treat it. From the information I have seen it generally takes eighteen months to two years before stabilization starts to appear. It then takes another eighteen months before improvements start to be readily apparent. Once improvements have started to appear they will increase in fits and starts and must be monitored by referring to ones WDnormal baseline.

 

 Tachyphylaxis in ADs is quite similar to the concept of “Tolerance Withdrawal” associated with Benzos.  Because of the nature in the actions of the two drugs they present in slightly different manners, but the mechanism is still the same. In cases where a person is taking both drugs the situation is complicated by effects of one drug masking the symptoms of the other.  This makes detecting true Tachyphylaxis very difficult. 

 

There is also the matter of Tachyphylaxis being confused with more common symptoms such as burn out.

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CT and Fast Tapers

(8)

 

I will be blunt.  Unless there is a medical reason such as pregnancy Do Not CT or Fast Taper.  The pain and suffering are just not worth it, and over time you will get off the drugs and recover much faster by doing a slow taper.

 

Many members have indicated that their doctor refuses to renew their prescription as a reason for a CT.  There are just too many resources available for this to be a valid reason.  Any doctor can prescribe these medications. They can be obtained through Urgent Care, the ER/A&E, on line prescription services, to name a few of the sources available. Sometimes they are available directly from the manufacturer. There will be some footwork involved, but it is best to do what needs to be done to maintain your supply, so you can keep control over your situation.  No one is going to do this for you.

 

For this discussion I will define a Cold Turkey (CT) as stopping your drugs overnight from any dose greater than 1mgai. I will also define a Fast Taper as anything faster than the recommended 10% every four weeks.  I would like to point out that that there will be a difference between a Fast Taper of one month and a Fast Taper of a year of more. They both have the same affect on the body, just to a different degree.  Both the CT and the FT follow the same patterns and for ease of writing I will refer to both collectively as CT.

There is very little information about how many people do manage a CT successfully. Which would indicate that not many do. There is however, a lot of discussion about how almost everyone who CTs or Fast Tapers ends up back on some form of psych med within a few months because of a return of “their original condition”.

 

There is a well-established pattern to a CT.  The person stops taking their medication and for the first several days, up to a week, they have a variety of mild symptoms, headaches, nausea and the like.  These symptoms resolve themselves and the person starts to feel better than they have for years. A sense of “wow, I’ve kicked this and not suffered like all those other people, I must be a special case.” pervades their thinking.  There is an off chance that this has happened. 

 

For most people this time, referred to as the “Honeymoon Period”, ends abruptly after three months.  It’s surprising just how frequently this time period shows up.  For a few it could be shorter, and some take a bit longer, but most frequently things change overnight at the three months mark. Most describe it as “I was fine when I went to bed, but I woke up in H***”, and that’s where they stay for a very long time.

 

Psych drugs work by making physical changes to the body.  The body then requires the presence of those drugs to maintain the changes and to keep functioning.  Remove the drug and the body doesn’t know how to work.  It then starts to scramble to return itself to it’s normal, pre-drug, state.  While that is happening none of the systems in the body can function correctly and we get WD symptoms.  Because the body is in such chaos those symptoms will be very acute.

 

Because the body is in such chaos those symptoms will last for a very long time. In the nervous system alone, there are hundreds of billions of electrical connections that have to be reviewed and repaired.  Throw on top of that the endocrine system, hormonal interactions and a lot of other things, the body doesn’t know what hit it.  Over many months the body takes inventory and starts making the changes it thinks will correct the situation, however, some of those changes will be wrong and have to be done over and re tested.  This is where the familiar pattern of “Waves and Windows” comes from.

 

Like everything else WD there are no statists on how long recover will take.  But we have a lot of case histories that give us some indication.  The answer is very disheartening. It will take years.  I frequently post about several of my taper buddies that CTed 40mgai of Paxil at the same time I started my taper. Currently it’s been six years, I’m off all my meds and living life at about 95% plus of normal.  They, on the other hand, are still suffering waves that rival their initial acute period.  On the positive side they are also experiencing very nice Windows.  But they are still struggling on a daily basis.  Reading through SA you will find many, many examples of people CTing who are still struggling three to five years later.  In the extreme there are members who report struggling as far out as seven or eight years.

 

There is a strong indication that persistent PSSD is also connected with CT.  PSSD is common in many cases of WD but seems to be more pronounced and harder to recover from for the people who have CTed than for people who have Slow Tapered.  PSSD does eventually correct itself in most cases, although we are looking at a dishearteningly long time-frame of two to five years and in some cases even longer.  There are a number of other factors involved with recovery from PSSD any one of which can cause the recovery time to increase.

 

So, I will conclude by restating my second sentence.  Unless there is a medical reason such as pregnancy Do Not CT or Fast taper.  If you are at all able to resume taking your meds, please look into our threads on Reinstatement.

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REINSTATEMENT

 

(9)

 

Reinstatement is seen by many as a cure-all for a CT or Fast Taper that has gone wrong.  SA has devoted several threads specifically to reinstatement, so I won’t go into the details of how and why it’s done, but rather I will talk about how long it will take.  If a person is contemplating Reinstatement, it means they’re already in a really bad way.  Their system is highly destabilized, their mind and body are in chaos, their symptoms are out of control.  They want relief now. 

 

This is one of the worse places to be during withdrawal, and it’s going to take a long time to get out of it.  We must start with everything we talked about earlier concerning the Dose Change Event. The drug becoming steady state in the blood will take the same amount of time.  There may or may not be a Honeymoon Period, and then we get down to Restabilization.

 

Restabilization from a Reinstatement is not going to happen overnight.  Many people will start to get some relief from their symptoms right away. While for some people it can take several days to weeks to see improvements.  This is to see improvements in symptoms though.  Once symptoms have started to improve they must continue to do so until they reach that state of being the same day in and day out.  If there are large fluctuations in symptoms from week to week then stability has not been achieved and more time is required.  Reaching stability is very individual and will frequently take three to six months.  It’s not unheard of for it to take eighteen months to two years to fully stabilize from a reinstatement.  A lot of this depends on how bad the symptoms were and the amount of time a person had been off the drug at the time of the reinstatement.

 

For many this would be the worst-case scenario and probably wouldn’t happen.  Reinstatement is a very useful tool if used correctly, but it is a slow, frustrating and frequently painful process that is best avoided by doing a proper slow taper in the first place.

 

A related subject is updosing.  This is making a slight increase in the dose taken to try and reduce symptoms that are starting to get out of control.  It is considered as a Dose Change Event with all the associated timeframes applying.  Once the drug is steady state in the blood an updose will frequently show improvements within a few days to a couple of weeks.  However, it can drag out to the several months range before significant improvements are seen.  Then an additional two to three months is required for full stabilization before any reduction can be considered.  All in all, it’s best to wait four to six months after an updose before continuing with a taper.

 

These drugs do not act like OTC pain killers, take one and the pain is gone in half an hour.  They work by making changes to the physical makeup of the body and nervous system.  People frequently will think of Updosing as a safety net.  Comments such as “if this is too fast, then I will just do an updose and be okay” are all too common. Updosing is a useful tool if symptoms get to be unbearable, but if done too many times (there is no definition of “too many”) it can sensitize the body and cause an Adverse Reaction.  An Adverse Reaction can take many months to stabilize.

 

 

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brassmonkey

Drug Interactions.

(10)

Psychiatric drugs do not play well with each other or with other drugs and supplements. Used in the wrong combinations they can cause extreme reactions such as Serotonin Toxicity or Serotonin Syndrome to name two.  These extreme reactions are quite dangerous. 

 

A big problem is that many doctors disregard the issue and will prescribe dangerous combinations. These combinations are usually discovered when the patient takes it upon them selves to research their drugs because they are feeling so bad.  This makes it imperative to check all the drugs a person is taking when ever they are told to add another drug to their cocktail or want to add a supplement on their own.

 

Experimentation with supplements is the second main cause of bad interactions. Any supplement that it sold to “improve mental health”, “help your think clearer” or “take the edge off your day” is more than likely to react badly when taken in combination with psych drugs. In general supplements are of questionable value to healthy people, but for people who are involved with psych drugs many of them are downright dangerous.

 

Once the interaction has started, which technically happens the first time the medications are taken together, fixing the situation is not as simple as just stopping one or more of the drugs.  As we have seen each drug must be tapered over time to withdraw from it successfully.  If the interactions are listed as “Extremely Serious” a rapid taper may be called for, for safety reasons, triggering the effects of a Fast Taper by doing so. But the kicker is that even with a Fast Taper the interactions of the drugs can continue for one to two months after the drugs have been removed (different drugs react at different rates).  So even with a CT of one or more drugs to alleviate the situation the adverse reaction they have caused will continue for quite some time.

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brassmonkey

WDnormal

(11)

WDnormal is the overall baseline of where you are in general. The place you are when you're not feeling good, but you're not feeling bad. Sort of a rolling average of the past couple of months between the windows and waves.  Watching the level of WDnormal is a good indicator that things are improving.  Over time you should be seeing a raising of the standard for WDnormal.  Like how you're feeling now is better than say six months ago. It changes very slowly but is a very good indicator.

 

 Many people have the idea that stability is feeling good again, when in fact it's feeling the same level of blah day after day with no big swings to the better or bad. When a person does a drop in dose there will be a corresponding increase in WD symptoms over the next few days.  These symptoms will resolve themselves over the following several weeks and return the person to a slightly raised baseline of discomfort.

 

The time frame and severity are dependent on a huge number of factors and end up being unique to each individual.  But the pattern remains.  This is why paying attention to your WDnormal is very important.  It is a part of listening to your body.  After a reduction in dose and the symptoms have resolved to WDnormal the person then should wait a couple of more weeks to let things really settle out (there are a lot of little unfelt changes still going on) before considering doing their next drop.

 

During that waiting time people may think that they're not doing anything and want to get on with it.  When in fact doing nothing is very proactive.  It's those little unfelt things that need to be finished before the next step can be taken.  It's letting the glue harden, the paint dry, the cement cure.  The things that need to be complete before the path is safe to walk on again.  If these details are ignored then they start to pile up and compound each other, then somewhere down the line the foundation slips out from under us and the whole thing collapses.

 

As you're learning this is a very slow process and at first changes in WDnormal are very small and slow in coming. At the beginning of a taper the body is often in such chaos that no discernible improvements will be seen for many months. Some lucky people see an improvement in WDnormal after just a few weeks. However, it is more common for the first real increase in the level of WDnormal to be seen between nine months and a year. Depending on one’s starting condition it could be even longer.  I was in very rough shape when I started to taper, and it took about two and a half years before I saw any notable improvements.

 

As time passes and one’s body heals those changes become more pronounced and more frequent. But it can be frustratingly slow.  At first WDnormal will be all the things that one is feeling at the time, acute anxiety, panic, extreme swings in mood, total lack of emotion, energy and caring.  From there the acute withdrawal symptoms are the first to stabilize.  As I have mentioned this can take many months, but when a person is stable it marks a rise in the level of WDnormal.  Once their taper has been started it may be several more months before any stable improvement is noticed.  And so, it goes through out withdrawal.  People who have CTed or Fast Tapered will also see positive results but because of the turbulent nature of their experience it will be much harder to recognize and take a longer time to appear.

 

 

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brassmonkey

It doesn’t end at “0”.

(12)

 

The completion of a taper is in some ways just the beginning, now the real healing can start without the interference of the drugs.  The last traces of the drug will be cleared from your system in a matter of weeks.  This leaves the body in a position that it can make the necessary changes without having to fight against the drugs influence.  One of the big disappointments of reaching “0” is finding out the all those nasty symptoms don’t just magically stop.  If the taper has been done correctly the symptoms should be at a minimum but there is still a good chance that a person will experience the wave and window pattern for a while longer.

 

The big question is “how much longer?”.  That we can’t tell because as I’ve said before “every person’s experience is different”.  It’s also hard to know because members of these forums tend to reach “0”, make the jump and disappear.  There is very little in the way of journal entries to guide us.  What we have seen is that most people will still be symptomatic for the first year or so after jumping off. These symptoms will follow the typical windows and wave pattern with the bonus that the windows will be better and last longer and in general the waves will decrease in severity and length.

 

There is one big exception to this pattern.  This is referred to as the “ten-month wave”, because it typically hits during month ten.  In reality it can hit any time between seven and twelve months, but ten months is the most common.  A contributing factor to this wave pattern is that this is about the time that people are feeling very comfortable with their recovery.  This can cause them to get careless in their actions.  Drinking alcohol is a major factor in excellent recoveries getting derailed, and this is when it frequently happens.  We just had a case of a member who has been drug free for several years with an excellent recovery underway.  They had a couple of drinks over the weekend and tripped off their symptoms all over again.  Luckily it cleared in a few days, but that is not usually the case.

 

The ten-month wave will typically hit very hard and very fast.  Flaring up unexpectedly overnight.  It is common for this wave to be severe for two to five weeks before it ends.  Sometimes it ends as quickly as it started while in other cases it tapers off over several days.  There is frequently a similar but less severe wave that hits again at twelve months and in some cases, another in the eighteen-month range.  The latter two tend to be less severe in each case. Lately I’ve been hearing about another wave that happens about the three-year mark, but I haven’t been able to find out much about it.

 

These waves, particularly the ten-month wave, are important milestones if they occur.  In most cases they are a marker of great improvements and are followed by a large rise in the RecoveryNormal baseline that a person experiences. RecoveryNormal being the post “0” equivalent to WDnormal which is the baseline during the tapering phase.  The RecoveryNormal baseline will continue to improve over the next several years until some semblance of full normality is achieved.

 

In some case’s WD will end over night with the opening of a final window.  But most of the time it slowly fades into the background and disappears unnoticed.

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brassmonkey
Posted (edited)

Things to do Along the Way

(13)

This is not an essay on how to taper, but there are some things that can be done that will improve the situation and quite possibly speed things up for some people. People reading the SurvivingAntidepresants.Org forum will be seeing references to these things every day and should be familiar with them. Communications, Support System, Coping Toolkit and Acceptance are four important keys to a successful journey

.

Feelings and emotions are hard to talk about at the best of times.  When our minds are fogged, and memories are shot it gets really tough.  But, talking it through or writing about it in a clear manner is very important. Otherwise no one will know what is going on, on the inside. What we are feeling, what we have been doing, how we feel, the good things that happened today are all important to document and let people know about.

 

It must be remembered though that long lists and descriptions of “how painful it is” and generalities of “I can’t go on like this” do not serve a useful purpose and in many cases will reinforce the negative aspects of ADWD.  By doing so a person gives power to the bad feelings and painful experiences making them even harder to survive.  Being overly optimistic however, can have the same effect.  Balance in everything is important.

 

Having the support of a loving family and friends will help ease the load.  This is no mean trick because of how long ADWD takes.  Many friends will drop by the wayside because of what they see as a lack of trying and progress.  This is where the communications mentioned above comes in.  Especially with a spouse or loved one.  The experience is quite frustrating for them being on the outside.  Some reassurance, an “I love you” and “thank you for all the support you’ve shown” go a long way maintaining their support. We all want to crawl under a rock and stay there until it’s all over but having friends and family around and interacting with them is a good thing.

 

The physical things we can do about ADWD are quite limited.  We can carefully adjust our dosage and wait it out. There are only two supplements* (see note at bottom of post) that can be of use to some people, but other than that there is nothing much else we can change.  This is where the coping toolkit comes in.  There is a myriad of things that can be done to mentally ease the symptoms, too many in fact to try and list here.  But they do make a difference and with practice can change the course of recovery for the better and provide tools for a lifetime of dealing with things.

 

The last of the four keys, but probably the most important thing is Acceptance.  We have found ourselves forced into a position that no one should have to go through.  Yet here we are and there’s not much we can do about it. That gives us two options, we can fight against it, scream, shout and beat our chests, or we can accept the position we are in and do what we can to make it tolerable while we work our way out of it. In short “making the best of a situation that is not our preference”.

 

There is one last thing that can really help and that’s a good night’s sleep. Unfortunately, this can be a big problem of many people trying to reduce their drugs. Every one of the drugs we see has the side effect and the WD symptom of insomnia. This symptom come in waves and can be very debilitating while it’s happening.  Waves, however, wash out and end at some point.  In the mean time learning and practicing good sleep hygiene is very important.  The body requires sleep to heal and we need to do everything possible to help it achieve this goal.

 

Not paying attention to our natural sleep patterns can cause major problems.  Staying up late using the computer to research WD can be a big factor and should be discouraged.  There are several threads on managing sleep, so I won’t go into detail here. Except to say, “turn off the computer and go to bed”.  Even if you don’t fall asleep lying there quietly will help.

 

ADWD causes so much stress on the body it literally tears it apart.   Adding mental stress on top of this just feeds the fires and makes things worse.  By accepting the situation, talking about it to friends and doing what we can to make ourselves comfortable we will be making a long uncomfortable journey a bit more tolerable.

 

The only 2 supplements which SA recommends are Magnesium and Omega-3 Fish OilA lot of people find them helpful. Try a little bit of one at a time to see how it affects you.
 

Edited by ChessieCat
CC added supplement* and links

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brassmonkey

So, When Will We Get There?

(14)

Like any other parent faced with this question I will give the traditional answer. “We will be there when we arrive”.  There are just too many factors with the medication and when combined with each person’s individual physiology and circumstances it becomes impossible to say.  The one thing we can say is that it will take a lot longer than any of us would like.

 

When we decide to reduce our dependence on psych drugs we are taking a large frightening step into the unknown.  The medical establishment knows very little about how to reduce dependence on these drugs and will frequently give out faulty information as to how to do it and through their lack of knowledge can sometimes force people into very unpleasant conditions. As frightening and painful as those conditions are, after removal of the drugs, they will eventually correct themselves and our bodies will heal.  The one thing that is sure to work is time, lots, and lots of time.

 

Each step of the journey must be taken carefully because it’s a very slippery path filled with things that can trip a person up.  Once they’ve fallen, it’s even harder to get back up to start traveling again.  Everyone is different in how fast they can traverse the path, but everyone must take it very slowly, one step at a time.  There is very little to hang on to along the way to keep from falling and almost nothing that can help speed things up. But there are a few things that will help make the time pass a bit more comfortably.

 

The human body is an amazing thing. From the first combining of two single cells it contains all the information necessary to build itself.  If it gets broken, it has all the information it needs to fix and adjust itself.  It’s such a complex mechanism though it takes a lot of time to sort out what is wrong, adjust the problem one cell at a time and test the results.

 

The latest calculations determined that on average there are 37.2 trillion cells in the human body. About 95% of those cells are replaced each year.  That’s a lot of cells and replacement to keep track of.  Then throw on top of it trying to sort out the changes made by psych drugs to every part and system of the body, and you have a monumental job ahead of you. Which brings up the old question “How do you eat an elephant? One bite at a time.” Time after time after time……..

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Rabe

I wanted to tell you those are so wonderful brassmonkey....think your should do a book!!!  in any case thank you!

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Centime

This is all incredibly useful. THANK YOU!

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bubbles

I need to go back and re-read this entire thread, but I'm due at work, so I will have to do that later! In the meantime, a question.

@brassmonkey

 

Does this quote:


 

Quote

 

There is one big exception to this pattern.  This is referred to as the “ten-month wave”, because it typically hits during month ten.  In reality it can hit any time between seven and twelve months, but ten months is the most common.  A contributing factor to this wave pattern is that this is about the time that people are feeling very comfortable with their recovery.  This can cause them to get careless in their actions.  Drinking alcohol is a major factor in excellent recoveries getting derailed, and this is when it frequently happens.  We just had a case of a member who has been drug free for several years with an excellent recovery underway.  They had a couple of drinks over the weekend and tripped off their symptoms all over again.  Luckily it cleared in a few days, but that is not usually the case.

 

The ten-month wave will typically hit very hard and very fast.  Flaring up unexpectedly overnight.  It is common for this wave to be severe for two to five weeks before it ends.  Sometimes it ends as quickly as it started while in other cases it tapers off over several days.  There is frequently a similar but less severe wave that hits again at twelve months and in some cases, another in the eighteen-month range.  The latter two tend to be less severe in each case. Lately I’ve been hearing about another wave that happens about the three-year mark, but I haven’t been able to find out much about it.

 

 

refer to people who did a slow taper with minimal upsets along the way, or only to people to tapered fast? Are you aware of any evidence of this? As in journal articles etc?  I'm trying to prepare myself for that time - even though it's at least 18 months away for me - and gather some literature for my health care providers.

 

Cheers, Brassmonkey

 

 

 

 

 

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brassmonkey

I don't know of any actual studies or articles that talk about the ten month wave Bubbles. This is based on empirical information from watching many members both here and at Prior Place.  It appears to be very common in people who have done slow event-less tapers and is quite pronounced in those who jumped a bit high, like in the 1mgai (milligram active ingredient) range.  For the ones doing faster tapers or who have had problems on the way down and just before making the jump there seem to be more post "0" turmoil making the pattern harder to spot, but it' usually still there.

 

I do hope you're not planning on tapering the last 9mgai in only 18 months.  The half life of a recommended 10% X 4 week taper is six months.  So 18 months would put you at 2.25mgai. That's still way to high to consider jumping off and is considered by many to be a CT. 

 

When the wave happens it's pretty much like any other wave, just this time we don't get totally blindsided and there is a fairly well established pattern of what to expect. By making plans in advance it is possible to be triggering the "self fulfilling prophecy" aspect of it all.  Knowing it may happen can be helpful, expecting it to happen could make things worse. It's one of those times where it's best to expect what you get and be happy if you don't get what you expected.  The wave can seem pretty intense at the time, but it's nothing close to what a person has already been through.  It just seems really bad because they've had several months of feeling pretty good and then it all changes.

 

So much of our information has been gleaned from the experiences of others and is not backed up with proper scientific studies it makes it very hard to have meaningful discussions with out healthcare providers.  They want hard data, we have empirical evidence. It's one of the harder things we face with trying to get the word out.

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bubbles

I am trying to find hard data - published literature - to take to my provider, but I'm not having much luck so far.

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DaveB

This is such great info @brassmonkey! Thank you for doing this! Question, what was your "condition" that put you on Paxil to begin with, why did you stay on it so long, and did you have "symptoms" while on it for all those years?

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Rabe

Thank you again Brassmonkey...I just keep copying and pasting to my desktop...so much wisdom!!!  Thank you for sharing the way you do!

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Brussellsprout

@brassmonkeyTHANK YOU for putting so much time and effort into drafting this as it’s obviously done solely for the benefit of others. 🙂 I hope you’ve generated a lot of good karma for this. 

 

What do you think of a situation where the person has started on a small dose (I titrated up to 6 mg Pristiq over a month- specially compounded) and began tapering off 6mg after 5 weeks at that dose. In the past 9 weeks I’ve dropped to 3.25 mg. I see that’s too fast but now I don’t know what to do.  I am suffering with a concussion so I don’t know what’s wd and what’s concussion symptoms re-emerging. If I understand correctly, I was on this drug for 2 months but it will take me 3 years to get off. Unfortunately my dilemma is that I had an adverse effect to Effexor so I can’t swap over to titrate and compounding pristiq is not an exact science although they do the best they can. So in doses of less than 1mg, the accuracy drops even more. In this case, to lessen Events, would it be better to perhaps drop by 1 mg and then hold longer? I honestly am already suffering so much that I don’t want to add even more but I feel stuck in a tough situation because of the particular drug. Thanks for any insight!

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bubbles
Quote

When you add it up a 10% taper every 6 weeks starting at 40mg and ending at the currently accepted jumping off point of 0.016mgai will take about five and a half years.

 

@brassmonkey

 

When I start at 8.1mg and calculate like this - 8.1*90% - and aim to drop every 4 weeks, that is a bit over four and a half years; at 6 weeks it would be close to 7 years. What am I doing wrong?

 

Also, how was that 0.016mgai arrived at?

 

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brassmonkey

Hi Bubbles-- yea, that works out about right.  In simple terms the half life of a 10% taper every four weeks is about six months.  So if you start at 8mgai, six months later you'll be at 4mgai and at 2mgai after a year. Another year and your at 0.5mgai, a third year to 0.06mgai and a forth year to 0.015mgai.  My taper of 10% every 9 weeks would have had a half life of 9 months.

 

The 0.016mgai is the approximate number I ended up with on my taper working with an Active ingredient Concentration of 0.08mgai/mgpw (milligrams active ingredient per milligrams pill weight)  My final dose was .5mgpw which gives a dose of 0.016mgai.

 

It's shocking how long a taper will take if done properly.  But it usually ends up taking a good bit longer if a person tries to rush things and go faster.  Going faster will always cause a person to crash, then they have to spend the time to restabilize and start over again and possibly have go even slower the second time around.

 

Brass

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bubbles
Quote

Hi Bubbles-- yea, that works out about right.  In simple terms the half life of a 10% taper every four weeks is about six months.  So if you start at 8mgai, six months later you'll be at 4mgai and at 2mgai after a year. Another year and your at 0.5mgai, a third year to 0.06mgai and a forth year to 0.015mgai.  My taper of 10% every 9 weeks would have had a half life of 9 months.

 

Your figure is quite different to mine though, which is interesting - there must be an increase in the percentage at some point?

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brassmonkey

When the dose gets to be under 1mgai the scales have a real problem measuring the weight, so it's necessary to use a combination of weight and visual division of the powder.  This can lead to doing a larger percentage.  Also the last couple of tapers just plain end up being bigger in order to break out of the mathematical progression.  We have several good calculators available to help work things out:

 

https://www.survivingantidepressants.org/topic/9167-how-to-calculate-dosages-and-dilutions-spreadsheets-and-calculators/

 

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Fightinglikehell42478

Thank you for your insight on this topic.  Its the most logical explanation I have recieved thus far.  I did an 8 wk taper off 10 mgs lexapro and am in a world of hurt right now; 6 weeks post discontinuation.  The reason for the FT was simply because I was so sick on the med that I did not have an option but to stop it quickly.  I  am currently in a rehab facility to get through the most accute phase, but things seem only to be getting worse.  I have two young children to return home to, and am driving myself crazy wondering how I am going to be a good mom to them ever again!  They are my life and I don’t even know how we are all going to get through this.  

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HeyYo210

I really needed to read this today.  Especially the part about 10 months.  I'm at right about 10 months now and couldn't figure out why I'm feeling worse all of a sudden.

 

Thanks Brassmonkey.

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brassmonkey

Hi Jelz-- please start  thread in the introduction forum, that will be the best place to get personal help and all your questions answered.

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Rosetta
8 hours ago, Fightinglikehell42478 said:

Thank you for your insight on this topic.  Its the most logical explanation I have recieved thus far.  I did an 8 wk taper off 10 mgs lexapro and am in a world of hurt right now; 6 weeks post discontinuation.  The reason for the FT was simply because I was so sick on the med that I did not have an option but to stop it quickly.  I  am currently in a rehab facility to get through the most accute phase, but things seem only to be getting worse.  I have two young children to return home to, and am driving myself crazy wondering how I am going to be a good mom to them ever again!  They are my life and I don’t even know how we are all going to get through this.  

 

I'm a mom, too.  I quit Zoloft when my daughter was 5.  She's 7 now, and I'm still slowly getting better.  I found out about reinstatement too late.  So, I've been struggling through this after a fast taper like yours for 16 months.

 

You need to seriously consider reinstating a small amount of Lexapro.  If the rehab facility won't let you do that you need to go home.  We aren't aware of any rehab facilities that understand AD withdrawal and trade it correctly.  I hope they are not encouraging you to stop taking the Valium.  That would probably compound your problems.  

 

Please start an introductions thread and read 

 

https://www.survivingantidepressants.org/topic/7562-about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms/

 

The moderators can help you understand reinstatement in your introduction thread. If you decide to reinstate, it's better to do it earlier rather than later.  So, it's something you should learn about and decide on right away.  

 

Peace, Rosetta

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DMV64

Wow! this has been such a great read for me. And today in a window I can read! Reading your essays have helped me feel normal, because everything is taking kind of a long time and now I feel like I am right where I am supposed to be. Thank you!

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DMV64
On 7/6/2018 at 2:27 PM, brassmonkey said:

real problem measuring the weight

I am encountering this with my Saphris dosage. At 1.4mg and I know I am going to have problems ahead. I guess there are no other scales?

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brassmonkey

The question has come up as to why there is such a big difference between what the taper calculators give as the length of a taper and the length that I calculated and wrote about above.  I will try to explain the difference and by doing so should reduce some of the anxiety that happens when people find out just how long a taper will last.  It's still a long time, but not nearly as bad as the calculators would make you think.

 

This is a very good question and as with most very good questions there isn't a simple answer. The difference between my calculations and the computers lay somewhere in the realm between the precision of a logarithmic equation, the lower accuracy of a not quite linear equation and the practicals of physically dividing up a small pile of powder.  The proper logarithmic  equation will produce the 84 steps you've listed above. The calculation for the half life method is not logarithmic but it's not linear either and will produce a smaller number of steps because of the differences. Then you get to the practical aspect of dividing up a tiny pile of powder. Please note that using a homemade liquid would decrease this problem.

 

The scales we have available have a real problem weighing anything less than 4mgpw (milligrams pill weight).  When the Active Ingredient Concentration is applied to this it gives us a practical lower limit of a little less than .5mgai. Which corresponds to to step 42 above.  For people tapering with crushed tablets this is essentially the end of a proper 10% taper. Although it would be possible to divide the small amount of powder into tenths visually the remaining piles would be so small that they would be impractical to handle. It is possible to work with dividing the pile into quarters.  Which leaves you doing three 25% reductions and a final 100% reduction as you jump to "0".  This results in a total of 46 reductions for the full taper.  I played around a bit more with the visual division and ended up doing a total of 48 reductions.

 

So that leaves us with 48 reductions of 6 weeks each.  48 x 6 = 288;  288/52 = 5.5 years total.

 

Because of the practical limitations,  to taper anything beyond step 50 is pretty useless.  If a person is super sensitive to changes in the medication then it would be possible to continue with steps 51-84 by using a water titration with careful manipulations of the AIC in the liquid and working with single drops as the administered dose.  These however, would be for extreme cases.

 

So as you can see even though a taper is going to take a  long time it's not nearly as bad as mathematics would make it seem.

 

Brassmonkey

 

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bubbles

Hi @brassmonkey

 

Thank you for your clarification.

 

With your thoughts of those drops below 0.5mgai in mind, and inputting my starting dose as 7.3mg (yesterday - second part of a two part drop, now to be held for three weeks) - that magic 0.5mgai comes at step 26/27, depending how you round. I know my pharmacy can measure out to 0.1mg accuracy, so I can go lower than 0.mgai in those doses. So for me, if I go down to 0.5mgai according to the calculator, I can then go down for another 5 drops. Hmm, ok that isn't much better than the four you outlined! Still, it has me off entirely at somewhere about 2.5 years (at 4 weeks per drop), which is much better than the four years I thought were in front of me and which was making me despondent.

 

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bubbles

Actually, the compounding pharmacy advise that they can compound 0.01mgai capsules if requested.

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Waiting12
On 5/21/2018 at 2:07 PM, brassmonkey said:

  These people tend to have a more liner recovery. The first several months will be acute.  Then things start to improve is a noticeable manner, with life starting to resume and get back on track.  All the members I have known have made full recoveries. 

 Hey brassmonkey. Thank you for including adverse reactions in your post. You mention all the members you have known did make full recoveries. Can you elaborate a bit? I have had a hard time finding any success stories for adverse reaction people. 

 

Also, does this include people who could previously tolerate the drug in the past and tried it again a year or more later with adverse reactions?

 

Thank you very much. 

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