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MMT1979: Fluoxetine tapering


MMT1979

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Hello!  How slowly should you taper off Fluoxetine when you’ve been taking it for 20 years?  I started taking 20mg fluoxetine every day in 2002.  In 2013 I reduced it to one every other day.  Then in 2019 I reduced it again to Mondays and Thursdays (i.e. alternating between every two and every three days).  Two weeks ago (Jan 2021) I reduced it further to every three days - and I am starting to get withdrawal symptoms.  How long do you think these symptoms will last for?  And should I wait until next year before reducing it to every four days?  Any advice would be very welcome!

1. 2002 to August 2006 - 20mg Fluoxetine daily

2. September 2006 to February 2007 - STOPPED.  However, my depression returned.

3. March 2007 to April 2013 - 20mg Fluoxetine daily (tapering between January and April 2013)

4. April to October 2013 - STOPPED.  However, the withdrawal symptoms never went away.

5. October 2013 to June 2019 - 20mg Fluoxetine every other day 

6. July 2019 to January 2021 - 20mg Fluoxetine every Monday, Thursday and Saturday 

7. January 2021 to present - 20mg Fluoxetine every two days

 

 

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  • manymoretodays changed the title to MMT1979: Fluoxetine tapering
  • Moderator

Hi MMT1979, and welcome,

Seems appropriate that I would be welcoming you, as my user name shortened, is mmt.

 

First, we don't recommend alternating days to do reductions.  That can lead to a lot of flucuations in the blood level of any drug.  And although Prozac has a long half life, often the inconsistency in dosing will catch up with you.......in the form of WD(withdrawal) symptoms which you have noticed.

*Why taper by 10% of my dosage

(Another popular taper method, skipping doses or alternating dosages, also produces a lot of people with severe withdrawal symptoms. See this link which includes a list of research papers:  NEVER SKIP DOSES TO TAPER )

 

And so we use a harm reduction approach to tapering, with each % decrease, based on the previous dosage.  With the assumption that each dose will be consistently taken, each day at the same time.

 

3KI's, keep it simple, slow, and stable

 

*Tips for tapering Prozac(fluoxetine)

 

What kind of WD(withdrawal) symptoms are you having?

Dr. Glenmullen's withdrawal symptom checklist

 

I think if I were you, I'd want to get on a daily dose of Prozac again, as soon as possible.

How were you doing with taking the 20 mg dose every 2 days?  And then how long ago was that?

I think if it was me, I might go back to a daily dose of 10 mg.  And you might expect a few bumps along the way, as you re-adjust to a steady state of the drug again.  Sometimes, with Prozac, it may take several days or longer, before even feeling a change, while the drug levels off in your body to a steady state.  Again, it's got a longer half-life.

 

However, you might be interested in this, if you haven't seen it yet:

Brain Remodeling

^ about how it isn't about just getting the drug out of your system and that it takes time for the nervous system to readapt, after the changes that the medication does.

 

Also, if you could please summarize your withdrawal history in your signature that will really help us out.  Just click on the underlined topic, that's the link, and you'll see what we are looking for with that, as well as how to do one.  This is the portion that you'll see below other members posts and your own, which provides a quick summary wherever you post, of your case.  Thank you.

 

And apologies MMT1979, for the wait time to approval.  Welcome, and look forward to getting you more information, and supporting your hopefully, new taper plan.

 

And best,

 

Love, peace, healing, and growth,

manymoretodays(mmt)

2022 May- continuing with limited activity on site, just something I need to do right now

Started with psycho meds/psychiatric care circa 1988.  In retrospect, and on contemplation, situational overwhelm.

Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time).

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!  Tapered @ 10% every 4 weeks, sometimes 2 weeks to

2016 Dec 16 medication free!!

Longer signature post here, with current supplements.

Herb and alcohol free since 5/15/2016.  And.....I quit smoking 11/2021.  Can you say Hallelujah?(took me long enough)💜

None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider. manymoretodays

 

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Dear Manymoretodays,

Thank you for your reply.  My GP told me that it would be OK to take Prozac every few days.  I really appreciate you saying that this is not actually recommended!  Do you think I should ask to be prescribed Fluoxetine in liquid form, and then take about 6mg every day?  It is difficult to get GP appointments nowadays.  While I’m waiting for my appointment, should I continue to take my 20mg every two days, or should I stop taking them altogether?  I am reluctant to increase the dose when I have made such good progress with coming off it!

1. 2002 to August 2006 - 20mg Fluoxetine daily

2. September 2006 to February 2007 - STOPPED.  However, my depression returned.

3. March 2007 to April 2013 - 20mg Fluoxetine daily (tapering between January and April 2013)

4. April to October 2013 - STOPPED.  However, the withdrawal symptoms never went away.

5. October 2013 to June 2019 - 20mg Fluoxetine every other day 

6. July 2019 to January 2021 - 20mg Fluoxetine every Monday, Thursday and Saturday 

7. January 2021 to present - 20mg Fluoxetine every two days

 

 

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  • Moderator

Hi other mmt, but capitalized with a year,

When did you go to the every three day dosing?

I was thinking that perhaps the 10 mg per day might be best, as it sounded like you were still alternating every 2 days with every 3 days.

So I thought the 10 mg for a daily dose might be the way to go.

 

What do you have available now?  Your 20 mg of Prozac, is it a capsule or a tablet?

 

And I don't really think you'd be increasing the dose, if you used to take 20 mg daily, then 10 mg daily is a 50% decrease already.

Which is a lot, depending on the time frame, since you started the taper.

Do you follow?

Try and get the signature done too.

 

And as it has only been a couple of weeks on the every 3 days taking a dose of 20 mg,  I think you might do okay, with going back to 10 mg every day.   I don't want you to suffer unnecessary WD symptoms, or for longer, if we can help it.  Once you stabilize on 10 mg each day you could, begin tapering again.

 

Versus continuing with this odd tapering program, but trust me, we've seen other doctors using it. 

 

NOOOOOO.  Do not stop taking them altogether.  Look at the topics, the why taper by 10%, and the tapering Prozac topic. 

And after 20 years of Prozac, please do not just stop taking it.

 

If you do decide to go to a pharmacy/druggist liquid, then it's important to do a bit of a crossover, while HOLDING at one dose as well.

We usually suggest:

1/4 of your dose in liquid and 3/4 in solid form and then HOLD for 3-7 days, without any dose change

then 1/2 liquid and 1/2 solid, same HOLD for 3- 7 days

then 3/4 liquid and 1/4 solid, with the HOLD

and then to all liquid

 

This way the transition goes smoother.  Some, including me, have had difficulties doing a direct switch to liquid.  Mine was with Lexapro, and it cost me a lot of time, and suffering.

 

Take a further look, at the tapering topic for Prozac and I'd prefer that you get to the 10 mg per day, with either a new prescription for a solid form, or using the capsules, or tablets that you have to adjust the dosage.  You can make your own liquid.  Or divide the capsule contents, using a scale.

I do prefer liquid, as that's what I did to taper off my last drug.

 

You can make a liquid from what you have now.  But then you'd also need to get oral syringes, and a mixing container too.  Which isn't real difficult, many use Amazon, or some of the druggists or vets will provide oral syringes.

 

Anyway, study the links I gave you, and mull it over a bit.  Just don't CT(cold turkey).  Ask away right here any questions you have.

And glad you're here.

 

Best, L, P, H, and G,

mmt

 

 

 

 

2022 May- continuing with limited activity on site, just something I need to do right now

Started with psycho meds/psychiatric care circa 1988.  In retrospect, and on contemplation, situational overwhelm.

Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time).

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!  Tapered @ 10% every 4 weeks, sometimes 2 weeks to

2016 Dec 16 medication free!!

Longer signature post here, with current supplements.

Herb and alcohol free since 5/15/2016.  And.....I quit smoking 11/2021.  Can you say Hallelujah?(took me long enough)💜

None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider. manymoretodays

 

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Thank you so much for your advice!  Would it be safe for me to open up my existing 20mg capsules and take one third per day mixed with water, until I’m able to get a prescription for liquid Fluoxetine?

1. 2002 to August 2006 - 20mg Fluoxetine daily

2. September 2006 to February 2007 - STOPPED.  However, my depression returned.

3. March 2007 to April 2013 - 20mg Fluoxetine daily (tapering between January and April 2013)

4. April to October 2013 - STOPPED.  However, the withdrawal symptoms never went away.

5. October 2013 to June 2019 - 20mg Fluoxetine every other day 

6. July 2019 to January 2021 - 20mg Fluoxetine every Monday, Thursday and Saturday 

7. January 2021 to present - 20mg Fluoxetine every two days

 

 

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Thank you so much for your advice!  I have been taking a 20mg capsule every two days for about four weeks now.

 

Would it be safe for me to open up my existing 20mg capsules and take one third per day mixed with water, until I’m able to get a prescription for liquid Fluoxetine?

 

When I’m slowly switching from capsule form to liquid form, presumably I’ll need to open up the capsules anyway?

1. 2002 to August 2006 - 20mg Fluoxetine daily

2. September 2006 to February 2007 - STOPPED.  However, my depression returned.

3. March 2007 to April 2013 - 20mg Fluoxetine daily (tapering between January and April 2013)

4. April to October 2013 - STOPPED.  However, the withdrawal symptoms never went away.

5. October 2013 to June 2019 - 20mg Fluoxetine every other day 

6. July 2019 to January 2021 - 20mg Fluoxetine every Monday, Thursday and Saturday 

7. January 2021 to present - 20mg Fluoxetine every two days

 

 

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  • Moderator

Hey MMT1979,

Here is from the tapering off Prozac(fluoxetine) topic:

Making your own Prozac liquid
Prozac is one of the few psychiatric medications with a long history of do-it-yourself dilution in water or juice. Mixed in cranberry juice, it's been called "Cranzac."

My own personal preference would be to dilute it with water, to avoid any degradation that might be caused by sugar or acid in the juice. Also, it will be easier to see how well the Prozac is dissolved in water. (There may be particles swirling around, that's the filler in the Prozac capsule that doesn't dissolve.)

Your Prozac solution may be a little bitter -- just swallow it quickly. You might want to chase it with a little fruit juice.

For very gradual tapering, for example, you can dissolve a 10mg capsule or orally dispersible tablet in 10mL of water to make a solution with 1mg Prozac in 1mg of water. To take 1mg Prozac, use an oral syringe to take out 1mL.

Refrigerated, it's supposed to be stable for 14 days. From a pharmaceutical technician manual

 

And then also see: How to make a liquid from tablets or capsules

Questions and answers about liquid medications

Using an oral syringe and other tapering techniques

 

3 hours ago, MMT1979 said:

Thank you so much for your advice!  I have been taking a 20mg capsule every two days for about four weeks now.

 

Would it be safe for me to open up my existing 20mg capsules and take one third per day mixed with water, until I’m able to get a prescription for liquid Fluoxetine?

 

When I’m slowly switching from capsule form to liquid form, presumably I’ll need to open up the capsules anyway?

 

Is your capsule immediate release versus extended release?

And I'm still feeling better about having you go to 1/2 capsule and contents, or a 10 mg dose strength, if you want to do a do it yourself liquid.  Apparently, many have successfully done this.  I made my own liquid with my last medication, it wasn't Prozac, but it all worked out okay.

 

If you do your own liquid you just wait until the capsule and contents dissolve, often using tepid water, or room temperature water works best.  You need a covered container, glass is best.  If you can protect the contents from light and refrigerate between dose, that is good too.

Take a look at the links.  I used to have to wait for my medication to dissolve completely, and would swirl it a bit in the container, while waiting, and then mix/swirl again just before taking my dose.

 

You might be able to adapt, the crossover, a bit more, if you use a homemade solution.  It will likely absorb in from your gut a bit faster, than the capsule, so then you might notice some differences, or a few bumps, after the transition.

 

With the 10 mg dose strength, taken daily,  I just think you'll be better covered, as far as hopefully NOT getting into any further WD symptoms.  It's roughly equivalent to what you've been getting, with the exception of you having been taking only one full dose, of 20 mg, every 2 days, which may be closer to a 10 mg dose every day.

 

There's no reason to rush a taper.  None at all.  Once you've stabilized, or feel pretty stable on a 10 mg daily dose strength then you can begin to taper again, based on a reduction of only 10% of each of your daily doses.  I think it's wise to get on a daily dose, and then just sit tight with it for at least a month, if not more, before resuming your taper.

 

I want you to get going with a consistent method of getting the same dose each day.  And as accurately as possible.  So......look things over, all the links, and decide which is going to work best for you.

 

You could go with a homemade solution, all the way to zero, if that feels doable. 

 

And do not be in a hurry to get off.  That rarely, or hardly ever pays off......and often just leads to more WD woes, and struggles.

 

And okay, a lot for you to look at now, and decide on.  Sorry I'm not the briefest bulb around, or more concise. 

 

And hey, what are your WD symptoms like now?

 

Thanks.  Best.

 

L, P, H, and G,

mmt

 

 

2022 May- continuing with limited activity on site, just something I need to do right now

Started with psycho meds/psychiatric care circa 1988.  In retrospect, and on contemplation, situational overwhelm.

Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time).

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!  Tapered @ 10% every 4 weeks, sometimes 2 weeks to

2016 Dec 16 medication free!!

Longer signature post here, with current supplements.

Herb and alcohol free since 5/15/2016.  And.....I quit smoking 11/2021.  Can you say Hallelujah?(took me long enough)💜

None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider. manymoretodays

 

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Thank you again!  I really appreciate all your advice.  Back in 2013 I asked my GP to prescribe me 10mg, but he recommended I take 20mg every other day instead.  Then in 2019 I asked his advice about reducing the dose again, and he said to space things out further.  It doesn’t surprise me to hear that he was wrong, as he’s the one who prescribed me with Fluoxetine back in 2002 when I wasn’t even depressed and I was extremely reluctant to take it at the time.  (I had booked an appointment to see him purely to pacify my mum, because she wanted me to go on antidepressants, as she thought I was depressed when I was not.  My GP responded by promptly prescribing me with 20mg Fluoxetine, insisting I give it a go.)  I wish I had never taken my GP’s terrible advice.

 

Anyway, I think what I shall do is dissolve one capsule in water and then drink a third every day.  This would equate to taking a capsule every two days.  (Since January I’ve been taking it one day on, two days off.)  I’d been doing so well on 20mg every two days, taking 10mg would feel like taking a step backwards.  This can be my interim solution while I try to get a prescription for Fluoxetine in liquid form.  Do you agree that’s a good way forward?  And once I’ve stabilised on 6.66mg per day, roughly how long do you think I should remain on that before tapering again by 10%?

 

If taking 66.6mg per day brings on withdrawal symptoms for more than a fortnight, I’ll go back up to 10mg per day and then start tapering gradually by 10%.  (Or do you think I’m being a bit silly and should just start with 10mg in the first place?)

 

To answer your questions:

There is nothing on the packaging to suggest whether it’s immediate or slow release.  I gather it’s just the standard version prescribed on the NHS.  Would it be dangerous to make a liquid solution out of either immediate or slow release?

The withdrawal symptoms which I had a week or so have actually stopped, and now I’m feeling absolutely fine.  (I had been feeling a bit spaced out and irritable before.)  Having said that, since last summer my skin has been constantly itchy and prickly - my back, chest and face mainly, and the occasionally my arms and legs too.  The cause has been something of a mystery, but I wonder whether it’s because of the erratic taking of 20mg Fluoxetine?

 

Thank you again!!

1. 2002 to August 2006 - 20mg Fluoxetine daily

2. September 2006 to February 2007 - STOPPED.  However, my depression returned.

3. March 2007 to April 2013 - 20mg Fluoxetine daily (tapering between January and April 2013)

4. April to October 2013 - STOPPED.  However, the withdrawal symptoms never went away.

5. October 2013 to June 2019 - 20mg Fluoxetine every other day 

6. July 2019 to January 2021 - 20mg Fluoxetine every Monday, Thursday and Saturday 

7. January 2021 to present - 20mg Fluoxetine every two days

 

 

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  • Moderator
On 2/14/2021 at 12:52 AM, MMT1979 said:

Anyway, I think what I shall do is dissolve one capsule in water and then drink a third every day.  This would equate to taking a capsule every two days.  (Since January I’ve been taking it one day on, two days off.)  I’d been doing so well on 20mg every two days, taking 10mg would feel like taking a step backwards.  This can be my interim solution while I try to get a prescription for Fluoxetine in liquid form.  Do you agree that’s a good way forward?  And once I’ve stabilised on 6.66mg per day, roughly how long do you think I should remain on that before tapering again by 10%?

 

Hey MMT1979,

Here's the thing though, it doesn't really equate........the every other day dosing, to being the same as a daily dose of 1/2 of the dose used every other day. 

Me, if it was me, I would most definitely take it daily, at a dose strength, equivalent to 10 mg.  And then I'd stay at that dose for at least a month, going forward.  You might even feel a bit of WD symptoms again, briefly while your body adjusts, and a decent steady state of the fluoxetine is achieved.  Very likely that changes made today, won't even register for at least a week and it might take even longer for your nervous system, so to speak, to adjust/adapt.

 

I think it's going to take that long for it all to settle.  And then, at that point,  let's see where you are at.  After a good month of 10 mg taken each day.

Me, I'd just go with the homemade liquid, and at least a 1 mg per 1 mL solution.  As it's closest to what you have been taking, and will work out well in the long run, for continued accuracy, and consistency too, when you do start tapering.

If you do go with the pharmacy made grade, just do some form of crossover, and then I still think it will be well worth it, to give it a month or even more, on a daily dose, and after going to liquid, before tapering any further.

 

It's the turtle who really wins the race, around here.  Turtles are smart!

 

And that's good then.  Immediate release, or regular Prozac(fluoxetine).

 

The skin stuff sure could be some WD, and most definitely the brain fog. 

And I'd love to see the rest of your taper be almost or WD symptom free. 

It's hard to say with the skin stuff, I went through, some itchiness I believe, at one point.   Could it just be dry skin?

And there is certainly no reason to hurry, after 20 years........a nice judicious, more educated approach could really pay off. 

 

You might also, want to get started soon with the 2 supplements, that most do find helpful during WD, and beyond:

BASIC SUPPLEMENT TOOLKIT

King of supplements: Omega-3 fatty acids (fish oil)

Magnesium, nature's calcium channel blocker

 

Many find these to be calming.  Do start slowly, and again, only introduce one new thing at a time(or a change in anything), and then start low.  As we've found many to be a bit hypersensitive, to many things, due to WD.  Those links are fairly long, but most of the information, can be found in the first couple of posts in topic.  And then often, there is much discussion that follows which can be interesting too.

 

And best,

L, P, H, and G,

mmt

2022 May- continuing with limited activity on site, just something I need to do right now

Started with psycho meds/psychiatric care circa 1988.  In retrospect, and on contemplation, situational overwhelm.

Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time).

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!  Tapered @ 10% every 4 weeks, sometimes 2 weeks to

2016 Dec 16 medication free!!

Longer signature post here, with current supplements.

Herb and alcohol free since 5/15/2016.  And.....I quit smoking 11/2021.  Can you say Hallelujah?(took me long enough)💜

None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider. manymoretodays

 

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I can’t thank you enough!!

 

Today I managed to have a telephone appointment with my GP (not the same one as before!)  She said it’s complicated to prescribe either 10mg or Fluoxetine in liquid form on the NHS.  However, she sees nothing wrong with me opening the capsules and making my own liquid.  I have placed an online order for some syringes and 10ml plastic pots with lids.  I’ll take your advice by dissolving the contents of each 20mg capsule in 20ml water, then dividing the solution between the pots using a syringe - storing them in the fridge.

 

I’ll also take your advice by starting with 10mg per day, for at least four weeks.   Then I’ll decrease the dosage to 8mg per day by dissolving two capsules in 40ml water and dividing the solution into five pots.  I’ll stay on that dosage for at least four weeks.   Next, I’ll decrease it to 6.66mg (i.e. a third of a capsule) for a minimum of four weeks.  I might keep it like that until 2022, or reduce it further to 5mg per day (i.e. a quarter of a capsule).  At any rate, I won’t go any further in 2021.  
 

Then in 2022 I’ll go down to 4mg (a tenth of 40mg); then 2.2mg (an eighth of 20mg).  I might wait until 2023 to then go down to 1mg, and finally stop altogether.

 

Does that sound like a good tapering programme to you?

 

Thank you for considering the possibility my prickly skin condition might be a withdrawal symptom.  I have sensitive skin anyway, so maybe it’s not a WS.

 

I am so, so grateful for all your advice!! 

1. 2002 to August 2006 - 20mg Fluoxetine daily

2. September 2006 to February 2007 - STOPPED.  However, my depression returned.

3. March 2007 to April 2013 - 20mg Fluoxetine daily (tapering between January and April 2013)

4. April to October 2013 - STOPPED.  However, the withdrawal symptoms never went away.

5. October 2013 to June 2019 - 20mg Fluoxetine every other day 

6. July 2019 to January 2021 - 20mg Fluoxetine every Monday, Thursday and Saturday 

7. January 2021 to present - 20mg Fluoxetine every two days

 

 

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  • Moderator

Hi MMT1979,

So, to calculate 10 % tapers from a previous dose, I'll show you how:

Once you've stabilized on 10 mg Fluoxetine, and again you'll need to wait it out for 4-6 weeks.

Then:

10 mg X .90 = 9 mg  So 9 mg would be your first decrease by 10% of 10 mg

Then:

9 mg X .90 = 8.1 mg  So 8.1 mg will be the next decrease by 10% of 9 mg

 

and so on, and so forth

When you do the first taper, in a month or two, try to keep some record, a calendar, some notes, and note when and if you notice any WD symptoms.  Like I said, sometimes with fluoxetine, and some of the drugs.......you might not notice anything until a couple of weeks, or even a whole month or more.

 

And.....it's going to be important going forward to begin to learn how you adapt to the changes.  And if WD symptoms hit, figure out when they hit, and then when they let up.

 

Again I want you to have a really smooth sailing taper plan and I'm hoping for a minimum of symptoms. 

 

Important too, to begin to use non-drug coping.  For the kind of things that might have got you on the drug to begin with.  And it's like a huge time lapse after 20 years sometimes.  And then sometimes, WD puts us into even worse states than anything like what we experienced before.

That might not be the case for you.  But just in case.  Get ready.

 

Do you do any exercise or focused movement?  Any meditation or prayer?  Do you eat pretty clean?  You might also want to avoid Alcohol and caffiene.  Or minimize the caffiene.  The Alcohol can throw many off, during tapering, or if already into some WD symptoms.

 

Your plan might be a bit fast.  When you can, look through the links you've got.  But do stay positive, just don't let yourself get stuck with a plan, that is too fast.  The best tapers are when you can continue to live a full life through them, or even build a better life while tapering.

 

Okay, todays lesson over.  And do keep us updated big MMT1979.

 

L, P, H, and G,

mmt (little mmt) B)

2022 May- continuing with limited activity on site, just something I need to do right now

Started with psycho meds/psychiatric care circa 1988.  In retrospect, and on contemplation, situational overwhelm.

Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time).

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!  Tapered @ 10% every 4 weeks, sometimes 2 weeks to

2016 Dec 16 medication free!!

Longer signature post here, with current supplements.

Herb and alcohol free since 5/15/2016.  And.....I quit smoking 11/2021.  Can you say Hallelujah?(took me long enough)💜

None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider. manymoretodays

 

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Thank you!  I do know how to calculate 10%.  (I promise you my maths is not that bad!)  The reason why I selected the doses (8, 6.66, 5, etc.) is that it’s easier to divide the solution made from one or two 20mg capsules in that way.  I hope that’s not too fast.  I shall ensure I space it out by a minimum of four weeks starting from the time that I feel like I’m stabilised.  (Hopefully that will equate to two months per dosage - but we’ll see!)

 

I see what you mean about playing things by ear, rather than sticking to a plan.  That makes perfect sense, seeing as this is all about how I feel emotionally, mentally and physically - and that’s not something I can regiment within a plan.

 

I’m not sure what you mean by “eating pretty clean”, but I do have a balanced diet.  I have up to three cups of tea per day, and don’t drink very often.  Thank you for your recommendation of taking fish oils and magnesium.  I shall do that.  I have been practising yoga since 2000, so it’s second nature to me, and I do my own gentle self practice most days.  I also meet my dad for a walk in the park with the dog, and go for the occasional ten minute run around the block!
 

Thank you again!  I have never received support like this before, and I really appreciate it!

1. 2002 to August 2006 - 20mg Fluoxetine daily

2. September 2006 to February 2007 - STOPPED.  However, my depression returned.

3. March 2007 to April 2013 - 20mg Fluoxetine daily (tapering between January and April 2013)

4. April to October 2013 - STOPPED.  However, the withdrawal symptoms never went away.

5. October 2013 to June 2019 - 20mg Fluoxetine every other day 

6. July 2019 to January 2021 - 20mg Fluoxetine every Monday, Thursday and Saturday 

7. January 2021 to present - 20mg Fluoxetine every two days

 

 

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Hello!  Me again!  I’m sorry to bother you again - but I have a couple more questions...

 

A friend of mine has just made a very good suggestion.  She said that seeing as I had previously stabilised on 20mg every other day for several years, why don’t I cut down to 18mg every other day - instead of taking 10mg every day?  This makes perfect sense.  What are your thoughts?

 

Another question: I am finding that when I have 10mg worth of Prozac daily (having dissolved the contents of  a 20mg capsule in 20ml water), I am buzzing within a few hours, but by the evening I feel low - and in the morning I feel even lower, until I have my next dosage.  I think this is because the drug is getting into my bloodstream faster, in the absence of the capsule coating.  Do you think I’ll stabilise and stop getting the highs and lows?  Or do you think the capsule was necessary in order to regulate way in which my body absorbs the drug?

1. 2002 to August 2006 - 20mg Fluoxetine daily

2. September 2006 to February 2007 - STOPPED.  However, my depression returned.

3. March 2007 to April 2013 - 20mg Fluoxetine daily (tapering between January and April 2013)

4. April to October 2013 - STOPPED.  However, the withdrawal symptoms never went away.

5. October 2013 to June 2019 - 20mg Fluoxetine every other day 

6. July 2019 to January 2021 - 20mg Fluoxetine every Monday, Thursday and Saturday 

7. January 2021 to present - 20mg Fluoxetine every two days

 

 

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  • Moderator
On 2/17/2021 at 1:39 AM, MMT1979 said:

Thank you!  I do know how to calculate 10%.  (I promise you my maths is not that bad!)  The reason why I selected the doses (8, 6.66, 5, etc.) is that it’s easier to divide the solution made from one or two 20mg capsules in that way.  I hope that’s not too fast.  I shall ensure I space it out by a minimum of four weeks starting from the time that I feel like I’m stabilised.  (Hopefully that will equate to two months per dosage - but we’ll see!)

 

7 hours ago, MMT1979 said:

A friend of mine has just made a very good suggestion.  She said that seeing as I had previously stabilised on 20mg every other day for several years, why don’t I cut down to 18mg every other day - instead of taking 10mg every day?  This makes perfect sense.  What are your thoughts?

 

Another question: I am finding that when I have 10mg worth of Prozac daily (having dissolved the contents of  a 20mg capsule in 20ml water), I am buzzing within a few hours, but by the evening I feel low - and in the morning I feel even lower, until I have my next dosage.  I think this is because the drug is getting into my bloodstream faster, in the absence of the capsule coating.  Do you think I’ll stabilise and stop getting the highs and lows?  Or do you think the capsule was necessary in order to regulate way in which my body absorbs the drug?

 

MMT1979,

I repeat Never Skip Doses to Taper

and from ^

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.

 

My thoughts are this, your and your friends idea just does not make perfect sense. 

What is so difficult about taking a daily dose of 10 mg, and then when you've adjusted to that, about 4-6 weeks.  Then going down to 9 mg each day, HOLDING again for 4-6 weeks.  And then to 8.1 mg, Holding, and then to 7.3 mg, and then 10% of 7.3 mg and on you go.

It's so simple to do.  You have a one to one concentration.

 

Yes, the absorption is different.  Yes, you should adjust to it.  If you want to ease the cross over to your homemade liquid, you could take 1/2 capsule contents, and divide it into 2, get some empty gelatin capsules to put 1/2 of the contents into, so you take 5 mg of your dose in a capsule, and then take 5 mg  of the liquid.  That might smooth the transition a bit.  You can get capsules at some Health Food Stores here, or at Amazon online.  Get the big ones, they are easier to fill.  Size 00.


Dividing contents of capsules into empty gelatin capsules
One way of tapering is to split up the powder in a capsule into smaller dosages. Go to a health food store and get empty gelatin capsules, the biggest they've got.

When you open up a Prozac capsule, you can carefully pour a fraction of the powder into empty gelatin capsules.

You won't have 5mg per capsule exactly, because it's difficult to eyeball the amounts.

If you want to be more precise, carefully pour the powder onto a piece of black paper and divide it into quarters with a knife, then scoop each 1/4 into an empty gelatin capsule.

See more about this technique at http://survivingantidepressants.org/index.php?/topic/235-tapering-techniques/page__p__3033#entry3033

 

You could get a prescription for lower strength capsules too, so that you can take, 1/2 liquid, and 1/2 capsule contents.  Although you said your doctor can't do that, right?  Due to NHS restrictions.

 

Please review.  Why taper by 10%?  and tips for tapering Prozac, and Never Skip doses to taper.  You just click on the underlined passage to get to them.  The first two are in the first post I made to you.

 

And heres another link, that might help understand why we go with these protocols here too.

 

Maybe you can read the links over with your friend too.  We don't promote every other day dosing.  Ever.  Sorry.

 

 

Why taper? SERT transporter occupancy studies show improtance of gradual change in plasma concentration

 

When you came in, you said you had done the odd, every 3 day dosing for only 2 weeks.  AND, lo and behold, were having some symptoms of WD.  So why do you want to keep going against the flow of information here.  You will be tapering for awhile.  It's not a big deal to just get stabilized on a dose every day now, and before you really begin to taper.

 

Okay, and I don't mind, you are not bugging me with your questions.  Look over the information again please, including the information about doing a crossover from solid form(in your case a capsule with contents) to liquid.  And make some adaptions to that, to go from your capsule to home made liquid. 

 

If your Prozac doesn't say it's extended release, the capsule just slows the absorption a little bit.  And I think you should adjust to the liquid in a little time.  But why not minimize the bumps and do a more gradual transition to the liquid?

Are you running out of time?  Probably not.

 

Okay.  Good Day, and night time here.

 

L, P, H, and G,

mmt

 

Oh, and sounds like some good non-drug coping.  Tea has a lot of caffeine in it.  You might want to minimize it a bit, and many just can't do alcohol while tapering, or if WD symptoms hit.  The tendency is, to be more sensitive to stuff that we weren't so sensitive to before.  No drink is worth being set back with symptoms.

Edited by manymoretodays

2022 May- continuing with limited activity on site, just something I need to do right now

Started with psycho meds/psychiatric care circa 1988.  In retrospect, and on contemplation, situational overwhelm.

Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time).

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!  Tapered @ 10% every 4 weeks, sometimes 2 weeks to

2016 Dec 16 medication free!!

Longer signature post here, with current supplements.

Herb and alcohol free since 5/15/2016.  And.....I quit smoking 11/2021.  Can you say Hallelujah?(took me long enough)💜

None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider. manymoretodays

 

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Thank you very much!  My friend’s advice did make sense, because I had not experienced any withdrawal symptoms at all when alternating days (which I did between 2013 and 2019), nor when taking 20mg on Mondays, Thursdays and Saturdays only (which had been my regime since Summer 2019).  It was only when I reduced it further to every two days in January of this year that I started to have some mild symptoms - but those subsided after about three weeks.  
 

I am experiencing some much greater symptoms while on 10mg per day (by opening up the capsules and dissolving them in water).  I trust I will start to get used to it within a few weeks and then everything would be fine - but I think my friend had a point that 18mg every two days might have been less of a shock to the system.  
 

Thank you for your advice about making my own capsules.  This does sound like a lot of fuss and bother, so I’ll remain on the home-made liquid for a little longer and see how it goes.

 

Thanks again!

1. 2002 to August 2006 - 20mg Fluoxetine daily

2. September 2006 to February 2007 - STOPPED.  However, my depression returned.

3. March 2007 to April 2013 - 20mg Fluoxetine daily (tapering between January and April 2013)

4. April to October 2013 - STOPPED.  However, the withdrawal symptoms never went away.

5. October 2013 to June 2019 - 20mg Fluoxetine every other day 

6. July 2019 to January 2021 - 20mg Fluoxetine every Monday, Thursday and Saturday 

7. January 2021 to present - 20mg Fluoxetine every two days

 

 

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  • 2 weeks later...
  • Moderator

Hi big MMT1979,

I wanted to see how you've been doing.

On 2/19/2021 at 2:58 AM, MMT1979 said:

I am experiencing some much greater symptoms while on 10mg per day (by opening up the capsules and dissolving them in water).  I trust I will start to get used to it within a few weeks and then everything would be fine - but I think my friend had a point that 18mg every two days might have been less of a shock to the system.  

And yes, some bumps are to be expected, when going from every other day, or every third day dosing, and then also to shifting directly, to a home made liquid.

The alternate day dosing, however, does have a way of sneaking up on you too, with WD symptoms.  Maybe not immediately, with Prozac's long half life, but without a doubt, I think it would lead to a precarious WD up the road, or later.

 

Have you been able to stay put with the 10 mg each day for 2 weeks now?

Try to just start thinking in terms of tapering, for a probably couple of years to come, with minimal symptoms of WD, hopefully, and breathe in the success of cutting your dose in half already.  I mean that's an accomplishment.......one that you won't get much understanding of in the general population, or even in the current medical paradigm from.  You will here.  Party hats, balloons, and confetti!!!  So hoping you are managing pretty good, and picking up some alternative coping at this point.  It sounded like you had some good healthy practices already in place.......clean eating, outdoor time, walks and dogs, and some family/friends to stave off any of the isolated feelings and despair, that is so prevalent right now.........as we all continue to move along in spite of this darn covid19 pandemic.

 

And best.  Love, peace, healing, and growth,

mmt

 

 

2022 May- continuing with limited activity on site, just something I need to do right now

Started with psycho meds/psychiatric care circa 1988.  In retrospect, and on contemplation, situational overwhelm.

Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time).

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!  Tapered @ 10% every 4 weeks, sometimes 2 weeks to

2016 Dec 16 medication free!!

Longer signature post here, with current supplements.

Herb and alcohol free since 5/15/2016.  And.....I quit smoking 11/2021.  Can you say Hallelujah?(took me long enough)💜

None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider. manymoretodays

 

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