Cleerity: clonazepam, alprazolam, aripiprazole & mirtazapine

[RubyJ]

I agree that doing 0.0125 reductions with a 1 ml syringe would be problematic -- your plan is probably safer, and since you already realize it will take longer, I think you're probably fine.  Good luck beginning your taper!

[Cleerity]

15 hours ago, RubyJ said:

I agree that doing 0.0125 reductions with a 1 ml syringe would be problematic -- your plan is probably safer, and since you already realize it will take longer, I think you're probably fine.  Good luck beginning your taper!

 

As the difference between .01 and .0125 is so very small, I would not necessarily say it is (much) safer, but definitely an easier endeavor to be accurate with the syringe I am using.  It is such a small cut, I am imagining the change may be hardly discernible to me.  Thank you for the well wishes, Ruby!  I will see how it goes.  If I find I tolerate it very well, I may be making larger cuts as I go, at least until I knock down the first 1 mg.    With the government on a partial shut down right now, it is delaying my starting the new work role, which is okay by me in light of my wanting to get this start on titrating the aripiprazole.

[Cleerity]

Hello...  

 

Since last week, I acquired new 1 ml syringes which are "smooth operators," compared to my old syringes, the plungers of which gripped the inside of the tube too much.  This is very helpful for making the small reductions I am.  

 

Today is day 7 at 1.98 mg Aripiprazole by liquid solution.  

 

On the crossover to liquid, the symptoms appeared on days 5 and day 6.  Since the small reduction I made last Sunday, I have not experienced any symptoms.  I actually feel to have leveled out even more, given I have a return of energy and have resumed my house refinishing tasks.  This is good!

 

What it tells me is that the small (.01) reduction I made last Sunday was less than what the crossover resulted in.  This gives me the confidence to make another drop tomorrow morning.  

 

My intention for tomorrow morning (barring any recommendation not to) is to drop to 1.95 mg, which is a decrement of ~ .0150.

 

The following week, I would begin a weekly drop of .0125, which is what Shep initially recommended, in light of my wanting to maintain stability given I am soon to begin a new work role.

 

I desire to step up my pace just this little bit tomorrow morning because (1) the symptoms (lack of at this point) are manageable and (2) I'd much rather have made a total reduction of 5% by the end of 4 weeks verses 5 weeks.

 

I am very glad you made the recommendation you did @Shep, as this has been like touching my toes in the water to test the temperature (reduction rate) before jumping in a too hot a body of water.  It is much better than having gotten overwhelmed with symptoms (burned by the water) that would have disrupted my life to too great a degree.  Thank you.

 

Once the president stops holding the government hostage and I get ready to begin my new work role, I may still go into a holding pattern while acclimating to the new work environment.  If, however, my symptoms remain little or next to nothing, I may just continue at this snail's pace.  

 

Best wishes to all,

 

Cleerity

 

[ChessieCat]

16 hours ago, Cleerity said:

I acquired new 1 ml syringes which are "smooth operators," compared to my old syringes, the plungers of which gripped the inside of the tube too much.  This is very helpful for making the small reductions I am.  

 

Are they a particular brand?  If so, please post about them in these topics.  Thank you.

 

• questions-and-answers-about-liquid-medications
• how-to-make-a-liquid-from-tablets-or-capsules
• using-an-oral-syringe-and-other-tapering-techniques

 

[Cleerity]

6 hours ago, ChessieCat said:

Are they a particular brand?  If so, please post about them in these topics.  Thank you.

 

• questions-and-answers-about-liquid-medications
• how-to-make-a-liquid-from-tablets-or-capsules
• using-an-oral-syringe-and-other-tapering-techniques

 

The syringes I am using are from BSTEAN, found on Amazon.com:  https://www.amazon.com/gp/product/B06ZZ4BZ15/ref=oh_aui_detailpage_o04_s00?ie=UTF8&psc=1

 

I have made posts in the suggested topics.  You are welcome!

[ChessieCat]

Thanks Cleerity.  Hopefully it will make some members lives just a lit bit easier.

[Cleerity]

14 hours ago, ChessieCat said:

Thanks Cleerity.  Hopefully it will make some members lives just a lit bit easier.

 

You are welcome.

 

I have a question for the moderators:  I know I have already provided details regarding my medication history and a bit of my personal history, but I have been thinking of documenting more of my story.  I think I would like to write a review of how/why and when I got started on psych meds.  Because much of it is old news (reaching back nearly 19 years), it would have little value for the moderators, as tapering advice goes.  In that respect, I don’t want to muddy my topic with details that would detract from the work of this forum.  However, it would have value for me, as I continue to move forward in my tapering, by way of documenting the fuller picture of where I came from in my psych med journey.  Would it be okay to write this here in my topic?  

[Shep]

Feel free, Cleerity. Many of our regular posters document various aspects of this journey along the way, including what they know now in hindsight. It's a valuable part of the un-patienting process. 

 

If you need mod help, please separate those posts into much shorter ones that don't get lost in larger narrations. We don't want any questions to get accidentally over-looked. 

 

[RubyJ]

On ‎1‎/‎5‎/‎2019 at 6:32 AM, Cleerity said:

Since the small reduction I made last Sunday, I have not experienced any symptoms.  I actually feel to have leveled out even more, given I have a return of energy and have resumed my house refinishing tasks.  This is good!

 

Great news! 

 

Sounds like what you're doing is working!  I hope it continues just as smoothly.  (And hopefully you and all the other government workers can return to work soon )

[Cleerity]

21 hours ago, Shep said:

Feel free, Cleerity. Many of our regular posters document various aspects of this journey along the way, including what they know now in hindsight. It's a valuable part of the un-patienting process. 

 

If you need mod help, please separate those posts into much shorter ones that don't get lost in larger narrations. We don't want any questions to get accidentally over-looked.

 

Thanks, Shep!  I will be sure to make separate posts containing information/questions about my tapering.

 

16 hours ago, RubyJ said:

Great news! 

 

Sounds like what you're doing is working!  I hope it continues just as smoothly.  (And hopefully you and all the other government workers can return to work soon )

 

Yes, so far so good, Ruby.  Hoping it remains true!   Presently, I work for an agency that was already fully funded for this year, so am still working and with pay ... many are working without pay right now.

[Cleerity]

I’m without power in my home due to a winter storm, so just a quick update via my phone.  

 

With the .0150 drop I made on January 6, I experienced no withdrawal symptoms.  So, I decided to drop by .0250 mg/ml this morning for a dose of ~1.90125 mg/ml.  (down from 1.95 mg/ml).  

 

Because I cannot contain all this data in my signature, I will will post my weekly drops in my topic and just update the signature with the new dose. 

 

Hoping for mild to nil withdrawal symptoms, again.

 

Best wishes to everyone... 

[Cleerity]

Making a weekly update on my Abilify/Aripiprazole titration...

 

With the .0250 mg/ml drop (for a dose of ~1.90125) I made on January 13, I again experienced no withdrawal symptoms.  

 

I will drop by .0250 again, tomorrow morning.  This will put me at a dose of ~1.85372 mg/ml.  This will be my 4th micro-drop.

 

Measuring 1.85 with my syringe is easy, but even trying to achieve 1.855 is hard, so I will just aim for 1.86 mg/ml.

 

After this drop, I will hold/rest for an additional 2 weeks, through February 9.

Edited January 19, 2019 by Cleerity
Added text for clarification

[Cleerity]

I just wanted to share that I am very pleased with the fact that the .0250 drops are not resulting in noticeable withdrawal symptoms.  This is great because it gives me the confidence to continue my tapering even as I begin my new work role.  I still do not have any word on that eventuality, as the other agency remains out of work during the government shutdown here in the U.S.  Today, however, I can celebrate the fact that I am down to 1.86 mg/ml on the Aripiprazole.  A small overall decrease, but I feel good each time I take it down a little notch!

[RubyJ]

That's great news!

[Cleerity]

15 hours ago, RubyJ said:

That's great news!

 

Hi Ruby!  It is indeed good news.  I am glad to be on a solid path to eliminating this medication.  I hope you are doing well!  

[Cleerity]

Hello...  

 

Today is day 28 of my Aripiprazole micro-taper by liquid preparation (using 50% Ora Plus with 50% water).  So, posting a recap record here to keep track of my information.

 

Week 1 - (Dec. 30, 2018) - a drop of .0125 = 1.98 mg

Week 2 - (Jan. 6, 2019) - a drop of .0150 = 1.95 mg

Week 3 - (Jan. 13, 2019) -  a drop of .0250 = ~1.90

Week 4 - (Jan 20, 2019) - a drop of .0250 = 1.86 

 

While the cross-over from tablet to liquid resulted in symptoms, none of the reductions produced symptoms.  

 

While I do want to remain as functional as possible, I am willing to weather mild withdrawal symptoms.  

 

So, I am contemplating if there might be another safe approach that will afford me a little more speed in my journey of eliminating this medication...

 

Is there something between a once monthly drop (4 weeks) of 10% and the BrassMonkey slide @ 2.5% each week for 4 weeks and resting for 2 weeks (for a total of 6 weeks)? 

[Glosmom]

HI Cleerity,  Happy to hear your micro tapering is going well.  I am helping my daughter to taper off her anti-psychotic, so I am only reporting my observation of this process over the last 2 years. She is mentally handicapped and although, before, she could talk in simple ways, she lost her ability to talk during this process so I have been trying to do the best i can as a Mom who loves her daughter very much.

 

So, I have been documenting her progress and have noted several things about her tapering experience.  She/we have reduced by 10%, less than 10%, micro tapering weekly, and also by more than 10%... during this journey.  And what seems to be the common denominator for her is that she needs to hold at some point, to continue on. During the micro tapering, she did okay with weekly drops until we reached around the 10% ish  mark then she needed a 2 week hold otherwise she would have worsening symptoms if we tried tapering again without a hold. With other drops (10% or larger), she needed to hold for at least 4 weeks before the next one.  We went at a faster pace in the beginning (dropping after 3 weeks) and that pace caught up with her. 

 

We are having really good success lately (since we got below 0.5mg)  and have dropped by .1mg every 5 weeks. this is probably possible because she was/is getting to a lower dose and so she was/is feeling better by being less medicated and that made her withdrawal symptoms more tolerable during larger reductions.  Glo has had withdrawal symptoms with every drop (weekly micro tapers withdrawal showed up after 3 weeks of drops.)  But, she has had a very predictable pattern of 'stabilization to withdrawal normal.' Even though she has not been able to get through this without suffering, she IS getting through it and having real improvements (finally). I know as soon as she gets off completely she will do her best healing.

 

There are several others on here who have made larger drops and then held for 2 months and then dropped again so, it seems that the holds are what is important once you reach a certain taper reduction percentage with anti-psychotics.  Additionally, i think just following your body signals will probably give you the best indication.  If you can taper with minimal symptoms that would be great.....but i am not sure anyone can get off an anti-psychotic without some sort of withdrawals hitting them eventually.

 

Anyway, just wanted to share to see if it would be helpful.  Best wishes to you....you will get to zero one day!  Glosmom

 

[Cleerity]

Hi Glosmom...and thank you for sharing!  

 

I truly hope that, once off the medication,  Glo will find the ability to speak again!

 

7 hours ago, Glosmom said:

During the micro tapering, she did okay with weekly drops until we reached around the 10% ish  mark then she needed a 2 week hold otherwise she would have worsening symptoms if we tried tapering again without a hold. 

 

This fits with the wisdom and logic of the BrassMonkey Slude method of micro-tapering.  

 

7 hours ago, Glosmom said:

We went at a faster pace in the beginning (dropping after 3 weeks) and that pace caught up with her. 

 

The same may well prove true for me, IF I tried to go faster.   

 

I just wish to be free of the effects of this medication!  I want my mind unchained! Hence, my desire  to speed things along.  But, I shall take heed of your shared experiential knowledge, as well as the wisdom of all I have thus far read on the forum.

 

I will hold the additional 2 weeks, through Feb. 9, and then resume with the 2.5%/week for 4 weeks with 2 week holds in between.

 

7 hours ago, Glosmom said:

We are having really good success lately 

 

7 hours ago, Glosmom said:

she IS getting through it and having real improvements (finally). I know as soon as she gets off completely she will do her best healing.

 

This is really good news!  I wish Glo continued success and all possible good health!  She is fortunate to have a caring, concerned and discerning mother. 

 

7 hours ago, Glosmom said:

but i am not sure anyone can get off an anti-psychotic without some sort of withdrawals hitting them eventually.

 

I think the symptoms I experienced when crossing over to liquid were due to withdrawal in that I believe my system was metabolizing the liquid preparation differently.  I realize I may encounter more symptoms.  Thanks to the shared information of those who have gone before me, I will be better prepared to meet them with understanding and patient compassion.

 

8 hours ago, Glosmom said:

Anyway, just wanted to share to see if it would be helpful.  Best wishes to you....you will get to zero one day! 

 

It was helpful!  I read your response earlier today, then spent reflective time taming the impetus/desire to attempt to move more quickly.  

 

I look forward to arriving at zero! 

 

Thank you, and very best wishes to you and for Glo,

 

Cleerity

[ChessieCat]

On 1/27/2019 at 1:41 AM, Cleerity said:

Is there something between a once monthly drop (4 weeks) of 10% and the BrassMonkey slide @ 2.5% each week for 4 weeks and resting for 2 weeks (for a total of 6 weeks)? 

 

You can tailor these to suit yourself.  The regular BrassMonkey slide averages out to 6.67% per 4 weeks.  You could always increase the 2.5% to 3% which would average out to 8% per 4 weeks.

 

BRASSMONKEY SLIDE – Pick your taper rate

 

Calculation:  Average monthly % reduction = weekly % x 4 divided by 6 x 4

 

Wkly %                 Mthly %               = av Mnthly %

Reduction           Reduction              Reduction

for 4 wks              to calc wkly

 

2.5                          10                           6.67

2.75                        11                           7.33

3                              12                           8

3.25                        13                           8.67

3.5                          14                           9.33

3.75                        15                           10

 

NB:  Please see following posts discussing taper rates.

 

 

Edited January 28, 2019 by ChessieCat
Added note.

[Cleerity]

11 hours ago, ChessieCat said:

BRASSMONKEY SLIDE – Pick your taper rate

 

Calculation:  Average monthly % reduction = weekly % x 4 divided by 6 x 4

 

Wkly %                 Mthly %               = av Mnthly %

Reduction           Reduction              Reduction

for 4 wks              to calc wkly

 

2.5                          10                           6.67

2.75                        11                           7.33

3                              12                           8

3.25                        13                           8.67

3.5                          14                           9.33

3.75                        15                           10

 

Thank you, Chessie!  This is exactly the kind of thing I was looking for.  

 

One additional factor in doing the slide method of micro-tapering is that "each week" I have to round up a bit.  This rounding up adds up over the course of 4 weeks.  

 

For example, computing 2.5% weekly reductions from my current dose of 1.86 mg/ml of Aripiprazole:

 

Doses of the next 4 weeks of tapering           Difference resulting from rounding up

1st week dose:   1.8135 becomes 1.82                                 .0065

2nd week dose:  1.7745 becomes 1.78                                 .0055

3rd week dose:   1.7355 becomes 1.74                                 .0045

4th week dose:   1.6965 becomes 1.70                               +.0035

                                                                                                     .0200 Total

 

So, at the end of 4 weeks, one actually loses almost one full drop.

 

I have done the math on a few different rates, 3%, 3.5% and 3.75% and the results are similar.

 

Taking this rounding up factor into consideration, when I resume tapering on Feb. 10, I am going to go with a weekly drop rate of 3.75% for 4 weeks and resting the additional 2 weeks.

[Shep]

38 minutes ago, Cleerity said:

Taking this rounding up factor into consideration, when I resume tapering on Feb. 10, I am going to go with a weekly drop rate of 3.75% for 4 weeks and resting the additional 2 weeks.

 

Just want to touch base and clarify - do you mean a cumulative 3.75% for the entire month? Or 3.75% per week? If it's 3.75% per week, that's going to be a 15% reduction for the month, which is higher than the 10% monthly reduction we advise here.

 

Please let us know. 

[Cleerity]

2 minutes ago, Shep said:

Just want to touch base and clarify - do you mean a cumulative 3.75% for the entire month? Or 3.75% per week? If it's 3.75% per week, that's going to be a 15% reduction for the month, which is higher than the 10% monthly reduction we advise here.

 

Please let us know. 

 

I was considering the 3.75% each week for 4 weeks and resting for 2 weeks.   Averaged out over over the 6 week period, it equates to 10%/month.

 

Please see Chessie's post above.  

 

Did I misconstrue something/understand that wrong? 

[Shep]

Yes, but please note in her chart, she has the "Mthly % Reduction to calc wkly" (the middle column).

 

I would be hesitant to go over the "10" that's listed in that column. This would be 10% in a month. 

 

41 minutes ago, Cleerity said:

I was considering the 3.75% each week for 4 weeks and resting for 2 weeks.   Averaged out over over the 6 week period, it equates to 10%/month.

 

While it does average out to 10% in 6 weeks, because you will have reduced 15% in the first four weeks, you'd be relying on that 2 week hold to recover should the 15% be too much. 

 

Since you are working full time and want to stay as functional as possible, I like the earlier post you made:

 

14 hours ago, Cleerity said:

I will hold the additional 2 weeks, through Feb. 9, and then resume with the 2.5%/week for 4 weeks with 2 week holds in between.

 

This rate really sticks to the ethos of the Brassmonkey Slide. 

 

I was on Benzo Buddies for a couple of years and they have a recommended taper rate of 5 - 10% every 2 - 4 weeks, which is as high as 20% a month. I saw a lot of people crash and burn at that rate, so I'm a bit more cautious about going full-force in a month and then trying to recover with a hold. 

 

Anyways, just some thoughts. 

 

 

[Cleerity]

27 minutes ago, Shep said:

While it does average out to 10% in 6 weeks, because you will have reduced 15% in the first four weeks, you'd be relying on that 2 week hold to recover should the 15% be too much. 

 

Good point!  For, if it did prove to be too much, I may have to hold even longer than 2 weeks.

 

But freeing myself from this medication, sooner than later, is important to me.  So, whilst considering my tapering rate over the past couple days, I have also been playing with the tapering calculators and may use a daily micro-taper instead of the Brass Monkey Slide.  This would keep me at a true rate of 10%/month.  Hopefully, sneaking the medicine away by just a little bit on a daily basis would keep my withdrawal symptoms within a mild if at all discernible range.   

[Cleerity]

Quote

 Micro-tapering does NOT mean making a reduction every day -- don't go faster than your nervous system allows!

 

Okay, I just read the topic on micro-tapering again.  SA does not actually advocate a daily micro-taper.  

 

On 8/31/2012 at 10:22 AM, Altostrata said:

Example of how to do a micro-taper

• Decide on the amount of your micro-taper, for example, 1 bead of Cymbalta.

   

  If you have had problems with a 10% taper, the amount of your micro-taper will be much smaller than 10%. For example, if you find you can't reduce 10% from 25mg -- 2.5mg -- without withdrawal symptoms, your micro-taper would be a fraction of 2.5mg, such as .5mg.

• Reduce your dose by the micro amount. Take this dose for a week.
• If no withdrawal symptoms, you may be able to reduce by the micro amount more often, such as every 4 days. For most drugs, it takes about 4 days for a change to fully register. If you go faster than that, you might exceed your tolerance for dosage reduction and not know it until it's too late.
• You may wish to hold on reduction ever so often, to allow your nervous system to rest and integrate at the reduced level of medication.
• This may work fine for a while, then you might find you feel the micro decrease. This is a sign to either 1) make the micro decrease even more micro, or 2) you need longer holds between drops.
• Keep a journal of your symptom pattern and dosage drops so you can see how the decreases are affecting you.
• As with any tapering schedule, if withdrawal symptoms appear, slow your tapering or hold on the current dosage until the nervous system stabilizes.

 

I imagine that even if I did do a daily micro-taper, I would end up needing to take hold periods!

[ChessieCat]

On 1/28/2019 at 12:21 AM, Cleerity said:

For example, computing 2.5% weekly reductions from my current dose of 1.86 mg/ml of Aripiprazole:

 

Doses of the next 4 weeks of tapering           Difference resulting from rounding up

1st week dose:   1.8135 becomes 1.82                                 .0065

2nd week dose:  1.7745 becomes 1.78                                 .0055

3rd week dose:   1.7355 becomes 1.74                                 .0045

4th week dose:   1.6965 becomes 1.70                               +.0035

                                                                                                     .0200 Total

 

When doing the BrassMonkey slide you reduce the same amount each week.

 

Clarification to be added.

 

On 1/28/2019 at 2:00 AM, Shep said:

 

I would be hesitant to go over the "10" that's listed in that column. This would be 10% in a month. 

 

On 1/28/2019 at 2:00 AM, Shep said:

 

While it does average out to 10% in 6 weeks, because you will have reduced 15% in the first four weeks, you'd be relying on that 2 week hold to recover should the 15% be too much. 

 

Thanks for clarifying this Shep.  I was so busy working on the average that I didn't realise that in a 4 week period it would in fact be more than the 10% recommended by SA.  I've edited the post I made and added a note.

Edited January 29, 2019 by ChessieCat

[Cleerity]

Thanks for clarifying, @ChessieCat.  And thank you for seeing the error, @Shep.

 

I do think, though, that I will go with a daily micro-taper when I resume, reducing by 10% over the course of 4 weeks.  If I need to take hold periods, I will.  

[Shep]

4 hours ago, ChessieCat said:

Thanks for clarifying this Shep.  I was so busy working on the average that I didn't realise that in a 4 week period it would in fact be more than the 10% recommended by SA.  I've edited the post I made and added a note.

 

Thanks, CC.

 

1 hour ago, Cleerity said:

I do think, though, that I will go with a daily micro-taper when I resume, reducing by 10% over the course of 4 weeks.  If I need to take hold periods, I will.  

 

Please keep in mind that aripiprazole has a half-life of 4 - 7 days, so you may not feel the reductions that culminate for a week or more. 

 

Since your goal is not to exceed 10%, you may be okay, but please touch base and let us know how you're doing periodically. 

 

[Cleerity]

   On 1/27/2019 at 7:21 AM,  Cleerity said: 

For example, computing 2.5% weekly reductions from my current dose of 1.86 mg/ml of Aripiprazole:

 

Doses of the next 4 weeks of tapering           Difference resulting from rounding up

1st week dose:   1.8135 becomes 1.82                                 .0065

2nd week dose:  1.7745 becomes 1.78                                 .0055

3rd week dose:   1.7355 becomes 1.74                                 .0045

4th week dose:   1.6965 becomes 1.70                               +.0035

                                                                                                     .0200 Total

15 hours ago, ChessieCat said:

When doing the BrassMonkey slide you reduce the same amount each week.

 

Hi Chessie:  I was computing the same amount/reduction each week:  2.5%, as stated.  If you do the math, you will see .  Or, am I really missing something?   Are you saying that I should not have computed the 2.5% from each subsequent dose?  But, instead, the same 2.5% from the first week?  So, counting down from 1.86, 2.5% = .0465.  Are you saying I should have been reducing by that amount each week?   Did I miss the boat here?!

[ChessieCat]

Micro Taper Off calculator with built-in 2 week hold

 

This calculator is very easy to use:

 

1.81 1.77 1.72 1.67 1.67 1.67   The funny thing is that it made sense to me previously, but all of a sudden my brain won't compute.  What you have posted my be correct, but with the small numbers it makes it harder for me.  Sorry.   You calculate the 10% reduction and then divide that by 4 (= "y").  In the example below it is 0.5mg.  You then reduction the dose by "y" each week for 4 weeks.   Example: You are currently taking 20 mg of your medication and want to reduce 10% using the slide.   Calculations starting dose = 20 mg 10% reduction = 2 mg ending dose = 18 mg 4 weekly dose reductions = 2 mg / 4 = 0.5 mg   In the six week cycle each week's dose is: 19.5 mg (20 - 0.5) 19.0 mg 18.5 mg 18.0 mg 18.0 mg 18.0 mg If symptoms are tolerable or non-existent, do another slide from 18 mg to 16.2 mg (10% decrease). If symptoms persist and are challenging, hold until they settle.   The above is from this post.   ☼-brassmonkey-talking-about-myself

Edited January 29, 2019 by ChessieCat

[Cleerity]

7 hours ago, ChessieCat said:

Example:

You are currently taking 20 mg of your medication and want to reduce 10% using the slide.

 

Calculations

starting dose = 20 mg

10% reduction = 2 mg

ending dose = 18 mg

4 weekly dose reductions = 2 mg / 4 = 0.5 mg

 

Yes, I was essentially saying the same thing in my most recent post above.

 

Said another way, current dose of 1.86 x .10 = 0.186, divided by  4 = .0465, the same .0465 in my most recent post.  I get it now.  Thank you for clarifying!

 

I was sticking to the rule that said each reduction is measured from the last dose, but this does not apply in the case of the Brass Monkey Slide, where the dose reduction is spread over the 4 weeks.

 

So, now, if I look at the rounding up factor, which is inevitable because my syringe cannot accommodate the small fractions on the tail of the dose...

 

1.86 - .0465 = 1.8135, which I must round up to 1.82 ... and the difference in rounding = .0065

1.82 - .0465 = 1.7735, which I must round up to 1.78 ... and the difference in rounding = .0065

1.78 - .0465 = 1.7335, which I must round up to 1.74 ... and the difference in rounding = .0065

1.74 - .0465 - 1.6935, which I must round up to 1.70  ... and the difference in rounding = .0065

                                                                                                                                                              .026 Total loss of reduction from rounding up over the course of 4 weeks, slightly more than 2.5%

 

If I did not have to round up each week, I could achieve a true 10% reduction over the course of the 4 weeks.  With rounding up, I lose slightly more than a 1 week reduction over the 4 weeks.

 

Just working out my logic for choosing the daily micro-taper, where I will also have to round up, but am running out of time this morning, so will finish writing later today.

[ChessieCat]

2 hours ago, Cleerity said:

If I did not have to round up each week, I could achieve a true 10% reduction over the course of the 4 weeks.  With rounding up, I lose slightly more than a 1 week reduction over the 4 weeks.

 

If you were doing a 10% reduction in one go it is best to round up.  However, because you are reducing 10% over 4 weeks you can round down as well, because it's to do with the overall reduction not the individual reduction.  The calculator worked that out.  However, I've just checked and the calculator total decrease would be 10.215%.  You would have to round up the 1.67 to 1.68 which would be a 9.6774% reduction.

 

Micro Taper Off calculator with built-in 2 week hold

 

1.86 starting dose

 

1.81 1.77 1.72 1.67 1.67 1.67

Edited January 29, 2019 by ChessieCat

[Cleerity]

8 hours ago, ChessieCat said:

If you were doing a 10% reduction in one go it is best to round up.  However, because you are reducing 10% over 4 weeks you can round down as well, because it's to do with the overall reduction not the individual reduction.  The calculator worked that out.

 

Thank you, Chessie!  I think that whoever made the calculator did a fine job.

 

It makes sense that when doing the Brass Monkey Slide one can round down as well as up (staying within the 10% per 30 days reduction guideline), when needed, so as to not lose the desired progress one wants to achieve.  This is what more I wanted to write about this morning, for rounding both up and down seems absolutely necessary when doing a micro-taper.

 

I am going to go with a daily micro-taper plan, as I think it may afford me the opportunity to reach my goal more quickly. 

 

On 1/28/2019 at 5:40 AM, Shep said:

Please keep in mind that aripiprazole has a half-life of 4 - 7 days, so you may not feel the reductions that culminate for a week or more. 

 

Since your goal is not to exceed 10%, you may be okay, but please touch base and let us know how you're doing periodically. 

 

I will be careful, hold when needed, and will check in from time to time.

[ChessieCat]

It took a bit of working out by us both, and a bit of input from Shep, but we got there.

 

Good luck with your taper.  Sounds like you've got it all planned now and pleased to know that you will hold as needed.

[Cleerity]

Just a quick update...

 

My three-week hold since my last reduction is complete.  No symptoms appeared.  

 

I began my daily micro-taper of aripiprazole this morning.  I will update my signature with my current dose at the end of each week of tapering.

 

The new job finally came through.  I should begin my role with the new agency on February 19.  Good news is that my position will not be affected by government shutdowns.  The Human Resources folks were/are, hence the delay, but my role is excepted from furlough.  I am happy about that ...and feeling eager (though also somewhat anxious) to get started and settled into the new environment.

 

Best wishes to all here,

 

Cleerity

[Cleerity]

Just a brief update:  I titrated down to 1.80 mg/ml Aripiprazole as of February 17.  Because I started a new job on February 19, I am holding still at this dose.  I forgot how overwhelming a new work environment can feel!  Or, maybe, adapting and adjusting is a bit harder now that I am older ... for change sure seemed much easier when I was younger!  Once the stress dissipates, I will resume my daily micro-taper.    

 

Best wishes to all,

 

Cleerity