Jump to content
Sign in to follow this  
Altostrata

NEVER SKIP DOSES TO TAPER

Recommended Posts

Altostrata

We have seen many people come here with severe withdrawal symptoms after following their prescribers' or their own misguided plan to skip doses in order to taper.

 

You may hear of people who got away with skipping doses to taper. That is possible, some people cold turkey without a problem. However, after cold turkey, skipping is perhaps the most risky way to come off psychiatric drugs. Both can result in terrible, severe withdrawal symptoms that might not fully be reversed by reinstatement of the drug.

 

Skipping doses causes the level of the drug in your bloodstream to go up and down, even with long-acting drugs such as fluoxetine. This puts stress on your nervous system, potentially causing withdrawal symptoms. It's like playing ping-pong with your brain.

 

NEVER SKIP DOSES TO TAPER.

 

If after seeing this, you decide to skip doses to taper and get withdrawal symptoms, do not come back here asking for help.

 

It is unaccountable why some doctors recommend skipping doses to taper. There is quite a large body of research showing that when people skip doses, they get withdrawal symptoms.

 

Baldwin, D. S., Cooper, J. A., Huusom, A. K. T., & Hindmarch, I. (2006). A double-blind, randomized, parallel-group, flexible-dose study to evaluate the tolerability, efficacy and effects of treatment discontinuation with escitalopram and paroxetine in patients with major depressive disorder. International Clinical Psychopharmacology, 21(3), 159–169. https://doi.org/10.1097/01.yic.0000194377.88330.1d
Bauer, R., Glenn, T., Alda, M., Sagduyu, K., Marsh, W., Grof, P., Munoz, R., Murray, G., Ritter, P., Lewitzka, U., Severus, E., Whybrow, P. C., & Bauer, M. (2013). Antidepressant dosage taken by patients with bipolar disorder: Factors associated with irregularity. International Journal of Bipolar Disorders, 1. https://doi.org/10.1186/2194-7511-1-26
Bulloch, A. G. M., & Patten, S. B. (2010). Non-adherence with psychotropic medications in the general population. Social Psychiatry and Psychiatric Epidemiology, 45(1), 47–56. https://doi.org/10.1007/s00127-009-0041-5
Dilsaver, S. C., & Greden, J. F. (1984). Antidepressant withdrawal phenomena. Biological Psychiatry, 19(2), 237–256.
Drug Ther Perspect. (2001). Antidepressant discontinuation syndromes: Common, under-recognised and not always benign. Drugs & Therapy Perspectives, 17(20), 12–15. https://doi.org/10.2165/00042310-200117200-00004
Gallagher, J. C., Strzinek, R. A., Cheng, R. J., Ausmanas, M. K., Astl, D., & Seljan, P. (2012). The effect of dose titration and dose tapering on the tolerability of desvenlafaxine in women with vasomotor symptoms associated with menopause. Journal of Women’s Health (2002), 21(2), 188–198. https://doi.org/10.1089/jwh.2011.2764
Greden, J. F. (1993). Antidepressant maintenance medications: When to discontinue and how to stop. The Journal of Clinical Psychiatry, 54 Suppl, 39–45; discussion 46-47.
Haddad, P. M. (2001). Antidepressant Discontinuation Syndromes. Drug Safety, 24(3), 183–197.
Henry, M. E., Moore, C. M., Kaufman, M. J., Michelson, D., Schmidt, M. E., Stoddard, E., Vuckevic, A. J., Berreira, P. J., Cohen, B. M., & Renshaw, P. F. (2000). Brain kinetics of paroxetine and fluoxetine on the third day of placebo substitution: A fluorine MRS study. The American Journal of Psychiatry, 157(9), 1506–1508. https://doi.org/10.1176/appi.ajp.157.9.1506
Kaplan, E. M. (1997). Antidepressant noncompliance as a factor in the discontinuation syndrome. The Journal of Clinical Psychiatry, 58 Suppl 7, 31–35; discussion 36.
Meijer, W. E. E., Bouvy, M. L., Heerdink, E. R., Urquhart, J., & Leufkens, H. G. M. (2001). Spontaneous lapses in dosing during chronic treatment with selective serotonin reuptake inhibitors. British Journal of Psychiatry, 179(6), 519–522. https://doi.org/10.1192/bjp.179.6.519
Michelson, D., Fava, M., Amsterdam, J., Apter, J., Londborg, P., Tamura, R., & Tepner, R. G. (2000). Interruption of selective serotonin reuptake inhibitor treatment. Double-blind, placebo-controlled trial. The British Journal of Psychiatry: The Journal of Mental Science, 176, 363–368. https://doi.org/10.1192/bjp.176.4.363
Osterberg, L. G., Urquhart, J., & Blaschke, T. F. (2010). Understanding Forgiveness: Minding and Mining the Gaps Between Pharmacokinetics and Therapeutics. Clinical Pharmacology & Therapeutics, 88(4), 457–459. https://doi.org/10.1038/clpt.2010.171
Rosenbaum, J. F., Fava, M., Hoog, S. L., Ascroft, R. C., & Krebs, W. B. (1998). Selective serotonin reuptake inhibitor discontinuation syndrome: A randomized clinical trial. Biological Psychiatry, 44(2), 77–87. https://doi.org/10.1016/s0006-3223(98)00126-7

Share this post


Link to post
Share on other sites
Sign in to follow this  

×
×
  • Create New...

Important Information

Terms of Use Privacy Policy