Jump to content
brassmonkey

Ollie, Ollie Oxen Free, Managing The Endgame Taper

Recommended Posts

Gridley
Posted (edited)
3 hours ago, bubbles said:

It is getting a little trickier to taper at 10% as I'm currently restricted to 0.1mg increments.

I'm around 2% also.  I'm using the scale and am limited to 1mgpw (mg pill weight) decrements, which with my brand of Lexapro works out to 0.1mgai (active ingredient) decrements.  When I dropped from 4mgpw to 3mgpw the drop was 25%, and when I go from 3mg to 2mg it will be 33% and from 2 to 1 will be 50%. I'm holding longer now, 6 weeks instead of 4.

Edited by Gridley

Share this post


Link to post
Share on other sites
Miyan
On 4/23/2020 at 12:50 AM, brassmonkey said:

If a person is stable and not experiencing extreme symptoms by the time they get to 1mgai it is time to switch to a more aggressive taper. That would consist of reductions of 25%, 33%, 50% and 100%.  Holding at each dose for around six weeks. This will give doses of 0.75mgai, 0.5mgai 0.25mgai and finally the jump to "0". Using a hold period of six weeks that will give a total taper time of 18 weeks or three and a half months

@brassmonkey Rather going for 25% 33% 50% 100%. May we go by 4% every week for 25%.

Then may we go another reduction 33% by every two week as 10 or 11% andso.

50% by evey week by 8% 

100% by every week by 16%.

Need clarification.

 

Share this post


Link to post
Share on other sites
brassmonkey

Miyan-- I am in the process of rewriting this entire article and will be going into a lot more detail there. The numbers and taper schedule in the present article are inaccurate and are going to change.

 

What you are asking would be one way to do it if you are using a liquid. The problem with trying that with a powder is that the divisions are so small and rather inaccurate that it would be more bother than it's worth.

Share this post


Link to post
Share on other sites
Greenriver

Oh my God, I hope I'm reading this correctly.

 

I'm currently at 2.4mg of Fluoxetine. Do you mean when I reach 1mg, I can start dropping by 25% and potentially be off the stuff in two years? I assumed you had to be very careful with the drops below 1mg, due to how steep the serotonin occupancy curve is at the lower doses.

Share this post


Link to post
Share on other sites
brassmonkey

The actual start point for the Endgame Taper is different for each different drug. But yes, once you get to a very low dose it may be possible to speed things up a bit depending on how your are feeling at the time. Symptom load and your reaction to reductions are quite important in determining things.

 

Please note that this article is in the process of being rewritten to improve it's accuracy. The new article is forthcoming and will contain more detailed information.  For right now this article is more for reference only.

Share this post


Link to post
Share on other sites
Greenriver

Brilliant. One of the most depressing things about tapering is the length of time it takes. I thought I had another 4-5 years left. Honestly, I was debating whether to just admit defeat and stay on the stuff for life. This changes everything 

Share this post


Link to post
Share on other sites
bubbles
On 7/7/2020 at 6:04 AM, Greenriver said:

Brilliant. One of the most depressing things about tapering is the length of time it takes. I thought I had another 4-5 years left. Honestly, I was debating whether to just admit defeat and stay on the stuff for life. This changes everything 

 

it does, doesn't it. I'm at 2.1mg, or 2.1% of my original dose. It would be amazing if I could be off sooner than I'd anticipated, but then I'm also content to leave the last titch for much longer, if it makes the chances of longer term success more likely. Getting off isn't useful if it is followed by needing to go on again etc.

 

Has the thinking changed on those last few percent of the taper? I'd thought that really the end was the part where we needed to go extra slowly.

Share this post


Link to post
Share on other sites
Greenriver
14 hours ago, bubbles said:

 

it does, doesn't it. I'm at 2.1mg, or 2.1% of my original dose. It would be amazing if I could be off sooner than I'd anticipated, but then I'm also content to leave the last titch for much longer, if it makes the chances of longer term success more likely. Getting off isn't useful if it is followed by needing to go on again etc.

 

Has the thinking changed on those last few percent of the taper? I'd thought that really the end was the part where we needed to go extra slowly.

I hope it’s true. I don’t quite understand it myself. Perhaps at 1mg the drug has less of a hold on you, so to speak, and you can drop quicker. If not, I might just switch to low-dose Citalopram and be done with tapering for a while. Life is too short. Prozac gives me unpleasant blood pumping stimulation, even at low doses. If I can get off it in two years or less though, I’ll stick it out. Perhaps once I reach 1mg the stimulation will lessen

Share this post


Link to post
Share on other sites
ChessieCat

I've personally decided not to risk it.  It will be 5 years at the end of this October since I started tapering off 100mg Pristiq.  It's also cost me a lot of money for compounded capsules, although I was very fortunate that my pharmacist was charging me the lowest he could and never increased the price over the whole time ($15 per 100 capsules).  One day I will go back over my credit card statements and work out how much it has cost.  Thankfully I haven't had to pay full cost for my regular prescription (subsidised because I receive unemployment benefits) which also meant that I have been able to keep taking the brand, not generic.

 

The way I see it is that I've managed to be patient and get this far with very little issues so if the total takes 6 years so be it.  It could be that I might be able to get off in 6 months, but I don't know if going faster would cause problems.  After such a long time a few more months is not going to make much difference.

 

When I first came to SA I had hoped to be off by my 60th birthday.  I will be nearly 64 when I'm off.  But I'm doing okay withdrawal-wise and that is the main thing. 

Share this post


Link to post
Share on other sites
bubbles
10 hours ago, ChessieCat said:

I've personally decided not to risk it.  It will be 5 years at the end of this October since I started tapering off 100mg Pristiq.  It's also cost me a lot of money for compounded capsules, although I was very fortunate that my pharmacist was charging me the lowest he could and never increased the price over the whole time ($15 per 100 capsules).

 

That's an incredible price. I pay much more though I think I've found a good local supplier. Yes, it's expensive!

 

I'm not sure if I'll risk it or not. With capsules it isn't difficult to go down in 0.1mg increments - that's quite a small portion of my highest dose of 100mg. If I make the sertraline suspension I think I can do smaller cuts easily enough. I know, for me, that reinstating a tiny bit of the drug hasn't worked  in the past - when I've reinstated it's been back to square one, so I can't risk that happening. I will await the rewrite of the original post and evaluate then. But ultimately I want to be off, unscathed, and if I have to do that slowly, then so be it.

Share this post


Link to post
Share on other sites
Gridley
13 hours ago, Greenriver said:

Perhaps at 1mg the drug has less of a hold on you,

 

I don't know.  I did fine with dropping increasingly larger percentages from 1mgai (active ingredient) down to 0.4mgai over the past several months.  But  I've seen a considerable ramp up of symptoms since I dropped from 0.4mgai to 0.3mgai (a 25% drop). I'm using the scale and because of its limitations, I can reduce no less than 0.1mgai (for my brand of Lexapro that's 1mg pill weight), so I'm going to have to compensate with longer holds.

Share this post


Link to post
Share on other sites
Greenriver
On 7/9/2020 at 4:28 PM, Gridley said:

 

I don't know.  I did fine with dropping increasingly larger percentages from 1mgai (active ingredient) down to 0.4mgai over the past several months.  But  I've seen a considerable ramp up of symptoms since I dropped from 0.4mgai to 0.3mgai (a 25% drop). I'm using the scale and because of its limitations, I can reduce no less than 0.1mgai (for my brand of Lexapro that's 1mg pill weight), so I'm going to have to compensate with longer holds.

Can you still feel the drug's effects/side-effects at the dosage you're on? 

Share this post


Link to post
Share on other sites
Greenriver

Would you say the withdrawal symptoms are just as bad as when you were dropping down from the higher dosage range?

Share this post


Link to post
Share on other sites
Gridley
Posted (edited)
3 hours ago, Greenriver said:

Can you still feel the drug's effects/side-effects at the dosage you're on? 

I have had withdrawal symptoms (not side effects) to varying degrees for all of the taper down from 20mg.  The large majority of the time these symptoms have been tolerable, what we can WDnormal, not feeling good, not feeling too bad, without big swings in either direction).

 

Regarding your second question, are the symptoms just as bad as when I was dropping from the higher doses: as I said in my first post, right now they're worse but generally they've been about the same throughout the taper, some days better than others but within the same range of WDnormal.

 

Keep in mind that I'm on two other drugs, one of which I tapered too fast before discovering SA and then reinstated, so that might be contributing to my symptoms.

  

Edited by Gridley

Share this post


Link to post
Share on other sites
Greenriver

Cheers, that's good to know the withdrawal symptoms are roughly the same at the lower doses. It must be very low receptor occupancy at your dosage. Well done getting that far. Hope your final journey to 0mg isn't too torturous.  I'm hoping the side-effects from Prozac (excessive stimulation and brain fog) will lessen at the lower doses. 2.4mg is still about 47% receptor occupancy. 1mg is about 29%.

 

It is kind of fascinating how monstrous these drugs are. Real witches' brew stuff.  I just found out my Mum's Doctor offered her antidepressants for insomnia. She suffers from mild stress due to money worries and it's affecting her sleep. She told my Mum they're completely non-addictive. Unbelievable. Thankfully she declined.

Share this post


Link to post
Share on other sites
Gertie

Greenriver, would you mind sharing with me how you calculate receptor occupancy percentages?  I've read the Seratonoin Transporter Occupancy paper and looked at the graphs, but still don't get how to actually do the calculations.  My daughter, unfortunately, is on sertraline AND amitriptyline, so I'm interested in finding it out for both....

Share this post


Link to post
Share on other sites
Gridley
On 7/10/2020 at 4:57 PM, Greenriver said:

 I'm hoping the side-effects from Prozac (excessive stimulation and brain fog) will lessen at the lower doses.

As a general rule, side effects lessen as dosage decreases.

Share this post


Link to post
Share on other sites
Greenriver
On 7/13/2020 at 6:35 PM, Gertie said:

Greenriver, would you mind sharing with me how you calculate receptor occupancy percentages?  I've read the Seratonoin Transporter Occupancy paper and looked at the graphs, but still don't get how to actually do the calculations.  My daughter, unfortunately, is on sertraline AND amitriptyline, so I'm interested in finding it out for both....

 

Sorry Gertie, just getting your message

 

I calculated the serotonin receptor occupancy for Fluoxetine with this equation 86 x 20/(1.944+20). 20 being the dose you're on. So, I'm on 2.4mg of Fluoxetine, so my equation would be 86 x 2.4/(1.944+2.4). I found it on this thread:

 

https://www.survivingantidepressants.org/topic/6036-why-taper-sert-transporter-occupancy-studies-show-importance-of-gradual-change-in-plasma-concentration/page/3/

 

Unfortunately the equation that you would use for Sertaline and Amitriptyline is different from Fluoxetine. I'm not sure exactly as I can't find the info. Does anyone on here know the correct equation for these drugs?

Share this post


Link to post
Share on other sites
hayduke
On 5/17/2020 at 2:47 PM, brassmonkey said:

Thanks Hayduke that's very helpful.  Yes, as you get more information please pass it along.

 

Hi Brassmonkey - I opened a different brand of generic this week, "Olanzapine RBX".  That 2.5mg pill weighs 0.077g.  Cheers

Share this post


Link to post
Share on other sites
brassmonkey

Thanks Hayduke- I'll add it to the database.

Share this post


Link to post
Share on other sites
Flowers

Venlafaxine Taper:

 

I have been throughout the taper  weighing the pills and then adding to a 10 ml syringe of water.  My scales will only go down to .0004 which equals a dose of 1.00 mg. Putting this into the syringe I get a dose of .10 mg in 1 ml of water  which I take twice a day giving a  total dose of .20 mg. 

 

I have been reading Brass Monkey's article on when to take the plunge to drop off.  As I can no longer weigh the pills, if I read the article  correctly I am to take the pill weighed out at .0004 and divide it into 4. The amount of pill is very tiny now but on a dark surface I can do this.  Then discard a quarter of this amount and put the remainder in the syringe as normal. Take this dose for 6 weeks and then take off another quarter and so on. 

 

I hope I am correct?   Would be grateful if someone could clarify as I am no mathematician!

 

Best Wishes

 

Flowers

 

(have also posted in my thread)

 

Share this post


Link to post
Share on other sites
Terry

@brassmonkey  Don't mean to bug you, but how's the article re-write coming?  I'm trying to wait patiently. 😇

Share this post


Link to post
Share on other sites
brassmonkey

Hi Terry-- The new article has been causing a lot of discussion between Alto and myself, there have been some general direction and small technique questions that needed to be worked out.  I'm in the middle of the revised draft right now, it's taking a lot longer than expected because of all the permutations that need to be addressed. The upshot is that the Endgame Taper is different from a regular taper because of managing the small amounts of medication involved and the fact that it is directed by listening to ones body for when to make reductions, instead of following a schedule.

 

One reason for the rewrite is that my original article indicated that the Endgame Taper could be seen as going much faster than a regular taper because of the way the Dry Cut dosing must be handled. When, in fact, it can end up being slower, depending on how one's body react. You still have a ways to go with your taper. I'm making a rough estimate of a Target Exit Dose of 0.07mg. This is just a rough estimate for a point to aim for and not a hard and fast number. Seeing as how you are at 0.50mg currently, it would be a good idea to really start paying attention to how your body reacts to each reduction.  Any spike in symptoms would be a signal to take a hold and let things stabilize before continuing. We don't want to be paranoid about the feelings, but rather let our body call the shots and do what it asks for and not what we think is best for it.

Share this post


Link to post
Share on other sites
Miyan
On 4/21/2020 at 1:22 AM, brassmonkey said:

Using a hold period of six weeks this will give a total taper time of 18 weeks or three and a half months

@brassmonkey 18 weeks means Four and a half months?

Share this post


Link to post
Share on other sites
brassmonkey

Good catch Miyan. Thanks for the edit I'll take care of that.

Share this post


Link to post
Share on other sites
Greenriver
On 8/4/2020 at 9:22 PM, brassmonkey said:

Hi Terry-- The new article has been causing a lot of discussion between Alto and myself, there have been some general direction and small technique questions that needed to be worked out.  I'm in the middle of the revised draft right now, it's taking a lot longer than expected because of all the permutations that need to be addressed. The upshot is that the Endgame Taper is different from a regular taper because of managing the small amounts of medication involved and the fact that it is directed by listening to ones body for when to make reductions, instead of following a schedule.

 

One reason for the rewrite is that my original article indicated that the Endgame Taper could be seen as going much faster than a regular taper because of the way the Dry Cut dosing must be handled. When, in fact, it can end up being slower, depending on how one's body react. You still have a ways to go with your taper. I'm making a rough estimate of a Target Exit Dose of 0.07mg. This is just a rough estimate for a point to aim for and not a hard and fast number. Seeing as how you are at 0.50mg currently, it would be a good idea to really start paying attention to how your body reacts to each reduction.  Any spike in symptoms would be a signal to take a hold and let things stabilize before continuing. We don't want to be paranoid about the feelings, but rather let our body call the shots and do what it asks for and not what we think is best for it.

I kind of thought it was a bit too good to be true. 5-6 years sounds more realistic to me than 18 months. Oh the joys.

Share this post


Link to post
Share on other sites
brassmonkey

It should be somewhere in between. If you are able to maintain our recommended schedule of 10% every 4 weeks you should be at 0.06mg in about two years.

Share this post


Link to post
Share on other sites
ChessieCat
3 hours ago, brassmonkey said:

It should be somewhere in between. If you are able to maintain our recommended schedule of 10% every 4 weeks you should be at 0.06mg in about two years.

 

But remember to hold when necessary.  It is silly to push ahead just to get off the drug.  Some members have tried to go too quickly and it is taking/took them longer.  Some have ended up on different or additional drugs.  Some because destabilised and don't return to their previous stability.

 

Patience is the key.  Even being a mod here for 4 years and tapering for nearly 5 years somebody suggested to me the other day that it would be a good idea for me to hold for a while.  I'm recovering from a back injury and have been taking codeine, antihistamine and ibuprofen and I also had a tooth extracted a few weeks ago.  And of course the covid situation is also an added stress at the moment.

Share this post


Link to post
Share on other sites

×
×
  • Create New...

Important Information

Terms of Use Privacy Policy