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phenylred


phenylred

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On 5/22/2018 at 5:04 AM, brassmonkey said:

 

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.

 

I

 

 

 

 

 

How did you calculate this? I put some numbers into an excel sheet, and I'm not getting the same taper length as you did here. Starting at 40 mg and tapering by 10% every six weeks, I get the following numbers.

40
36
32.4
29.16
26.244
23.6196
21.25764
19.13188
17.21869
15.49682
13.94714
12.55242
11.29718
10.16746
9.150717
8.235645
7.412081
6.670873
6.003785
5.403407
4.863066
4.37676
3.939084
3.545175
3.190658
2.871592
2.584433
2.325989
2.093391
1.884051
1.695646
1.526082
1.373474
1.236126
1.112514
1.001262
0.901136
0.811022
0.72992
0.656928
0.591235
0.532112
0.478901
0.431011
0.387909
0.349119
0.314207
0.282786
0.254507
0.229057
0.206151
0.185536
0.166982
0.150284
0.135256
0.12173
0.109557
0.098601
0.088741
0.079867
0.07188
0.064692
0.058223
0.052401
0.047161
0.042445
0.0382
0.03438
0.030942
0.027848
0.025063
0.022557
0.020301
0.018271
0.016444
 


 

IE, the taper will take a total of 75 10% reductions. That means 75*6 weeks = 450 weeks. That is about 8.7 years, not 5.5 years. Am I calculating something incorrectly?

 

Edited by ChessieCat
Moved from Are We There Yet
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  • Moderator Emeritus

Hi phenylred and welcome to SA,

 

I moved the post you made in the Are We There Yet topic and created your own Introduction topic where you can ask questions about your own situation, journal your progress and be supported by the community.

 

Please see this link Tapering Calculator - Online for the Brass Monkey Slide calculator.  Tabs are at the bottom of the page, you may need to click on the arrows to move it across to see it.

 

We ask all members to complete their drug signature so we can see your drug history at a glance.  Dates, ALL drugs, doses - no symptoms or diagnoses.  Account Settings – Create or Edit a signature

 MISSION ACCOMPLISHED:    13 November 2021 -  0mg Pristiq      

Woohoo!!!  Finally off Pristiq   

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 from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

My full 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.  Please DO NOT TAG me -thank you.

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  • Moderator Emeritus

I've just used the "regular" calculator and input today's day, 40mg, 42 day period and 10% reduction and come up with the following.  I will ask Brass Monkey to check his comment.

 

Enter data in pink cells below
starting date 7/18/18
starting dose 40.0000
reduction cycle (days) 42
% cut 10

cycle dose start date
start 40.0000 7/18/18
1 36.0000 8/29/18
2 32.4000 10/10/18
3 29.1600 11/21/18
4 26.2440 1/2/19
5 23.6196 2/13/19
6 21.2576 3/27/19
7 19.1319 5/8/19
8 17.2187 6/19/19
9 15.4968 7/31/19
10 13.9471 9/11/19
11 12.5524 10/23/19
12 11.2972 12/4/19
13 10.1675 1/15/20
14 9.1507 2/26/20
15 8.2356 4/8/20
16 7.4121 5/20/20
17 6.6709 7/1/20
18 6.0038 8/12/20
19 5.4034 9/23/20
20 4.8631 11/4/20
21 4.3768 12/16/20
22 3.9391 1/27/21
23 3.5452 3/10/21
24 3.1907 4/21/21
25 2.8716 6/2/21
26 2.5844 7/14/21
27 2.3260 8/25/21
28 2.0934 10/6/21
29 1.8841 11/17/21
30 1.6956 12/29/21
31 1.5261 2/9/22
32 1.3735 3/23/22
33 1.2361 5/4/22
34 1.1125 6/15/22
35 1.0013 7/27/22
36 0.9011 9/7/22
37 0.8110 10/19/22
38 0.7299 11/30/22
39 0.6569 1/11/23
40 0.5912 2/22/23
41 0.5321 4/5/23
42 0.4789 5/17/23
43 0.4310 6/28/23
44 0.3879 8/9/23
45 0.3491 9/20/23
46 0.3142 11/1/23
47 0.2828 12/13/23
48 0.2545 1/24/24
49 0.2291 3/6/24
50 0.2062 4/17/24
51 0.1855 5/29/24
52 0.1670 7/10/24
53 0.1503 8/21/24
54 0.1353 10/2/24
55 0.1217 11/13/24
56 0.1096 12/25/24
57 0.0986 2/5/25
58 0.0887 3/19/25
59 0.0799 4/30/25
60 0.0719 6/11/25
61 0.0647 7/23/25
62 0.0582 9/3/25
63 0.0524 10/15/25
64 0.0472 11/26/25
65 0.0424 1/7/26
66 0.0382 2/18/26
67 0.0344 4/1/26
68 0.0309 5/13/26
69 0.0278 6/24/26
70 0.0251 8/5/26
71 0.0226 9/16/26
72 0.0203 10/28/26
73 0.0183 12/9/26
74 0.0164 1/20/27
75 0.0148 3/3/27
76 0.0133 4/14/27
77 0.0120 5/26/27
78 0.0108 7/7/27
79 0.0097 8/18/27
80 0.0087 9/29/27
81 0.0079 11/10/27
82 0.0071 12/22/27
83 0.0064 2/2/28
84 0.0057 3/15/28

 MISSION ACCOMPLISHED:    13 November 2021 -  0mg Pristiq      

Woohoo!!!  Finally off Pristiq   

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 from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

My full 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.  Please DO NOT TAG me -thank you.

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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.

 

I hope this makes some sense.

 

Brass

 

 

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.

Final Dose 0.016mg.     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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