Jump to content

Seeker: Newbie seeking advice on Prozac tapering


Seeker

Recommended Posts

I take 20 mg prozac and 0.5mg etizolam daily since July 2020, started on these meds due to anxiety specifically health anxiety.

Now seems to recovered with intermittent bouts of anxiety on some days.

Planning to taper prozac, can I go on faster taper say 10% reduction every 10 days given my short period of drug exposure.

Edited by Gridley

July 2020 - Mar2021: On etizolam 0.5mg td and prozac 20 mg.

Apr21-May21- started alternating prozac, sometimes kept 1 day gap sometimes 2-4 days. Took 40 tablets in 60 days. Calculated 14mg/day consumption on this basis(highly approximate).

End May21- found SA, apprised my situation, got advice to keep steady on 14mg and watch for WDs should they arise.

From 30-05-21- on 14mg liquid suspension made by mixing the capsule powder with water and measuring it by syringe.

B12, zinc, magnesium glycinate.

Link to comment
  • Moderator

Welcome to SA, Seeker.  Thank you for completing your drug signature.

 

On 5/26/2021 at 8:36 PM, Seeker said:

 

Planning to taper prozac, can I go on faster taper say 10% reduction every 10 days given my short period of drug exposure.

 

We would not advise it.  You've been on Prozac for over ten months, and a person is at risk of withdrawal symptoms after only one month of taking an antidepressant.  We recommend tapering by no more than 10% of current dose every four weeks.  

 

Why taper by 10% of my dosage?

 

We strongly advise against tapering by alternating doses.  Alternating doses makes the amount of your drug in your blood stream go up and down, battering the nervous system and making withdrawal both worse and more likely.  This is true even with an antidepressant with a long half-life such as Prozac.  

NEVER SKIP DOSES TO TAPER - Tapering - Surviving ...

The following link is about withdrawal, which you definitely want to avoid.  

 

What is withdrawal syndrome.

 

I would recommend you take your dose every day and taper with the 10% method described in the first link above. The following link is specifically about tapering Prozac, including how to get the non-standard doses needed for a 10% taper.

 

Tips for tapering off fluoxetine (Prozac)

 

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

 

 

Add in one at a time and at a low dose in case you do experience problems. Get supplements that are single ingredient (not mixed with other types of supplements).

 

This is your Introduction topic, where you can ask questions and connect with other members.  We're glad you found your way here.

 

 

 

 

 

 

Edited by Gridley

Gridley Introduction

 

Lexapro 20 mg since 2004.  Begin Brassmonkey Slide Taper Jan. 2017.   

End 2017 year 1 of taper at 9.25mg 

End 2018 year 2 of taper at 4.1mg

End 2019 year 3 of taper at 1.0mg  

Oct. 30, 2020  Jump to zero from 0.025mg.  Current dose: 0.000mg

3 year, 10 month taper is 100% complete.

 

Ativan 1 mg to 1.875mg 1986-2020, two CT's and reinstatements

Nov. 2020, 7-week Ativan-Valium crossover to 18.75mg 

Feb. 2021, begin 10%/4 week taper.  Current dose as of Jan. 11, 2022: 5.4mg 

Taper is 71% complete.

 

Imipramine 75 mg daily since 1986.  Jan-Sept 2016 tapered to 16mg.  

Held until Aug 2021, tapered for 4 weeks to 14.4mg and holding.  

Taper is 80% complete.  

  

Supplements: omega-3, vitamins C, E and D3, magnesium glycinate, probiotic, zinc, melatonin .3mg


I am not a medical professional and this is not medical advice, but simply information based on my own experience, as well as other members who have survived these drugs.

Link to comment
  • Gridley changed the title to Seeker: Newbie seeking advice on Prozac tapering

Hi 

I reduced my prozac dosage by skipping tablets, doing this since April 2021. I have calculated my dose taken per day as a result of skipping to be 14mg. Lately I am experiencing stomach issues, slight increase in anxiety and not being able to continue sleep after 5 hours.

I was not aware of 10% tapering before I found SA. Now should I start taper from 14mg or take my dose back to 20mg per day for 4 weeks and then start the taper from there.

 

 

July 2020 - Mar2021: On etizolam 0.5mg td and prozac 20 mg.

Apr21-May21- started alternating prozac, sometimes kept 1 day gap sometimes 2-4 days. Took 40 tablets in 60 days. Calculated 14mg/day consumption on this basis(highly approximate).

End May21- found SA, apprised my situation, got advice to keep steady on 14mg and watch for WDs should they arise.

From 30-05-21- on 14mg liquid suspension made by mixing the capsule powder with water and measuring it by syringe.

B12, zinc, magnesium glycinate.

Link to comment
  • Moderator
11 hours ago, Seeker said:

Now should I start taper from 14mg or take my dose back to 20mg per day for 4 weeks and then start the taper from there.

Over the time that you skipped doses, your system has gotten accustomed to the lower dose, which you calculate now to be 14mg.  So I would not go back up to 20mg, which could cause further destabilization.  I would go to the new dose, taken every day at the same time,  for 3 months to allow your system to stabilize from the month of skipping doses.   Then, if you are feeling stable, you can begin a 10% taper.

 

How are you going to calculate your dosage so that you get 14mg?  This link, which I supplied in my first post, describes several methods to get non-standard doses.

 

Tips for tapering off fluoxetine (Prozac)

 

After reading the link, please let me know the method you plan to use so we can discuss that further.  There are advantages and disadvantages to each method.  Prozac comes in a prescription liquid and is accurate and convenient, but I don't know if it's available in India and transitioning from tablet to liquid requires a crossover period.  Dry cutting tablets and weighing them with a digital scale is another method.  For this, many members use the Gemini-20 digital scale, available on Amazon.  Another method is making you own liquid and another is using a compounding pharmacy.

 

The calculation you made that you're now on 14mg is approximate since it's impossible to tell exactly the effect of skipping doses in terms of your current dosage.  As you begin your new dosage and continue to hold there, monitor your symptoms.  If they worsen, it might be a good idea to updose (increase your dose) very slightly.  If this happens, let us know and we can suggest a dosage.  Do not increase your dosage without letting us know so we can suggest an updose dosage.

 

The symptoms your describe are typical of withdrawal and fortunately do not sound severe.  Here is some information on withdrawal.

 

 

 
Do consider the two supplements I recommended in my previous post, which are calming to the system.

 

 

 

 

 

Edited by Gridley

Gridley Introduction

 

Lexapro 20 mg since 2004.  Begin Brassmonkey Slide Taper Jan. 2017.   

End 2017 year 1 of taper at 9.25mg 

End 2018 year 2 of taper at 4.1mg

End 2019 year 3 of taper at 1.0mg  

Oct. 30, 2020  Jump to zero from 0.025mg.  Current dose: 0.000mg

3 year, 10 month taper is 100% complete.

 

Ativan 1 mg to 1.875mg 1986-2020, two CT's and reinstatements

Nov. 2020, 7-week Ativan-Valium crossover to 18.75mg 

Feb. 2021, begin 10%/4 week taper.  Current dose as of Jan. 11, 2022: 5.4mg 

Taper is 71% complete.

 

Imipramine 75 mg daily since 1986.  Jan-Sept 2016 tapered to 16mg.  

Held until Aug 2021, tapered for 4 weeks to 14.4mg and holding.  

Taper is 80% complete.  

  

Supplements: omega-3, vitamins C, E and D3, magnesium glycinate, probiotic, zinc, melatonin .3mg


I am not a medical professional and this is not medical advice, but simply information based on my own experience, as well as other members who have survived these drugs.

Link to comment

Thanks for your guidance. You are right that 14mg is an approximate calculation. I have consumed 40 tablets in last 60 days so the average dosage comes to 13.33mg per day, I have rounded it to 14mg. I plan to make a liquid solution from my capsule and start 14mg/day for three months as suggested by you.

In case of worsening of symptoms I will surely let you know and seek further guidance.

Liquid prozac is available here, I will ask for crossover guidance before starting on the prescription oral suspension.

July 2020 - Mar2021: On etizolam 0.5mg td and prozac 20 mg.

Apr21-May21- started alternating prozac, sometimes kept 1 day gap sometimes 2-4 days. Took 40 tablets in 60 days. Calculated 14mg/day consumption on this basis(highly approximate).

End May21- found SA, apprised my situation, got advice to keep steady on 14mg and watch for WDs should they arise.

From 30-05-21- on 14mg liquid suspension made by mixing the capsule powder with water and measuring it by syringe.

B12, zinc, magnesium glycinate.

Link to comment

@GridleyThanks for your guidance. You are right that 14mg is an approximate calculation. I have consumed 40 tablets in last 60 days so the average dosage comes to 13.33mg per day, I have rounded it to 14mg. I plan to make a liquid solution from my capsule and start 14mg/day for three months as suggested by you.

In case of worsening of symptoms I will surely let you know and seek further guidance.

Liquid prozac is available here, I will ask for crossover guidance before starting on the prescription oral suspension.

July 2020 - Mar2021: On etizolam 0.5mg td and prozac 20 mg.

Apr21-May21- started alternating prozac, sometimes kept 1 day gap sometimes 2-4 days. Took 40 tablets in 60 days. Calculated 14mg/day consumption on this basis(highly approximate).

End May21- found SA, apprised my situation, got advice to keep steady on 14mg and watch for WDs should they arise.

From 30-05-21- on 14mg liquid suspension made by mixing the capsule powder with water and measuring it by syringe.

B12, zinc, magnesium glycinate.

Link to comment
On 5/29/2021 at 5:48 PM, Gridley said:

Prozac comes in a prescription liquid and is accurate and convenient, but I don't know if it's available in India and transitioning from tablet to liquid requires a crossover period.

Please elaborate on the crossover method from capsule solution (It is very bitter) to liquid prozac.

July 2020 - Mar2021: On etizolam 0.5mg td and prozac 20 mg.

Apr21-May21- started alternating prozac, sometimes kept 1 day gap sometimes 2-4 days. Took 40 tablets in 60 days. Calculated 14mg/day consumption on this basis(highly approximate).

End May21- found SA, apprised my situation, got advice to keep steady on 14mg and watch for WDs should they arise.

From 30-05-21- on 14mg liquid suspension made by mixing the capsule powder with water and measuring it by syringe.

B12, zinc, magnesium glycinate.

Link to comment
  • Moderator
6 hours ago, Seeker said:
On 5/29/2021 at 7:18 AM, Gridley said:

 

Please elaborate on the crossover method from capsule solution (It is very bitter) to liquid prozac.

Here's the crossover we recommend:

 

3/4 dose of old version (in your case capsule solution), 1/4 dose liquid for 3 to 7 days

1/2, 1/2 for 3 to 7 days

1/4 dose capsule solution, 3/4 dose liquid for 3 to 7 days

all liquid thereafter

 

Do not taper during the crossover period.  Hold at your current dose.

Gridley Introduction

 

Lexapro 20 mg since 2004.  Begin Brassmonkey Slide Taper Jan. 2017.   

End 2017 year 1 of taper at 9.25mg 

End 2018 year 2 of taper at 4.1mg

End 2019 year 3 of taper at 1.0mg  

Oct. 30, 2020  Jump to zero from 0.025mg.  Current dose: 0.000mg

3 year, 10 month taper is 100% complete.

 

Ativan 1 mg to 1.875mg 1986-2020, two CT's and reinstatements

Nov. 2020, 7-week Ativan-Valium crossover to 18.75mg 

Feb. 2021, begin 10%/4 week taper.  Current dose as of Jan. 11, 2022: 5.4mg 

Taper is 71% complete.

 

Imipramine 75 mg daily since 1986.  Jan-Sept 2016 tapered to 16mg.  

Held until Aug 2021, tapered for 4 weeks to 14.4mg and holding.  

Taper is 80% complete.  

  

Supplements: omega-3, vitamins C, E and D3, magnesium glycinate, probiotic, zinc, melatonin .3mg


I am not a medical professional and this is not medical advice, but simply information based on my own experience, as well as other members who have survived these drugs.

Link to comment

@Gridley Many Thanks for your reply. I have another query specifically related to prozac taper. As prozac has a longer half life compared to other AD and its withdrawal can manifest weeks later and not in few days then the tapering schedule for prozac could be modified by taking a larger percentage cut but a longer hold period say 3 months. This would in my opinion give the taperer a better information on WD. Mark Horowitz has stated the following in his paper:

"Fluoxetine
Substitution of short-acting SSRIs with fluoxetine has
been suggested as a way to avoid intolerable withdrawal
symptoms.3,77 Fluoxetine has been routinely identified to
cause less severe withdrawal effects than other SSRIs,
which has been attributed to its longer half-life.3,29,77
Fluoxetine takes 35–75 days to reach steady state,47 which
is likely to be responsible for observations that its
withdrawal symptoms can arise weeks after cessation.9,56
Therefore, it would be prudent to wait 3 months
(35–75 days plus 4 weeks) to observe for late-arising
withdrawal symptoms.
Given this property of fluoxetine,
which is similar to an in-built tapering system, it could
be reasonable to reduce doses by the equivalent of
approximately 30% serotonin transporter occupancy in
each iteration, titrated to patient tolerance.

Nevertheless, we should be wary of the idea that
fluoxetine is self-tapering, and can therefore be abruptly
or rapidly ceased, as guidelines suggest.29,78 Although its
pharmacokinetic profile predicts a gradual decline in
plasma level, a short reduction (eg, 2 weeks)27 could still
represent a rapid withdrawal schedule that exceeds a
10% decrease in biological effect per month. "

 

Eager to know your thoughts whether 10% monthly taper schedule for prozac will be as effective as for other shorter half life ADs and no consideration is necessary on the Pharmacokinetics of the drug being tapered. 

July 2020 - Mar2021: On etizolam 0.5mg td and prozac 20 mg.

Apr21-May21- started alternating prozac, sometimes kept 1 day gap sometimes 2-4 days. Took 40 tablets in 60 days. Calculated 14mg/day consumption on this basis(highly approximate).

End May21- found SA, apprised my situation, got advice to keep steady on 14mg and watch for WDs should they arise.

From 30-05-21- on 14mg liquid suspension made by mixing the capsule powder with water and measuring it by syringe.

B12, zinc, magnesium glycinate.

Link to comment
  • Moderator

@Seeker

 

I've brought your question to the attention of the other SA staff.

Gridley Introduction

 

Lexapro 20 mg since 2004.  Begin Brassmonkey Slide Taper Jan. 2017.   

End 2017 year 1 of taper at 9.25mg 

End 2018 year 2 of taper at 4.1mg

End 2019 year 3 of taper at 1.0mg  

Oct. 30, 2020  Jump to zero from 0.025mg.  Current dose: 0.000mg

3 year, 10 month taper is 100% complete.

 

Ativan 1 mg to 1.875mg 1986-2020, two CT's and reinstatements

Nov. 2020, 7-week Ativan-Valium crossover to 18.75mg 

Feb. 2021, begin 10%/4 week taper.  Current dose as of Jan. 11, 2022: 5.4mg 

Taper is 71% complete.

 

Imipramine 75 mg daily since 1986.  Jan-Sept 2016 tapered to 16mg.  

Held until Aug 2021, tapered for 4 weeks to 14.4mg and holding.  

Taper is 80% complete.  

  

Supplements: omega-3, vitamins C, E and D3, magnesium glycinate, probiotic, zinc, melatonin .3mg


I am not a medical professional and this is not medical advice, but simply information based on my own experience, as well as other members who have survived these drugs.

Link to comment
  • Moderator

Hello @Seeker

 

I don't have an absolute answer to your question :

one thing we learn from all the testimonies is that when we talk about tapering/WD there are no universal rule, except being careful.

 

This means that someone might do fine with the strategy you shared, while someone else could suffer from too big drops.

And there's no way to predict how a body will react, we simply know too little about all the factors involved in this process.

 

I understand that you would like to be off the drug as soon as possible, we all can understand that very well.

 

Even if you started it in July 2020, you are now taking a drug that remodel your brain since one year.

Please see :

-how-psychiatric-drugs-remodel-your-brain/

 

As we promote a harm reduction approach, my suggestions would be :

 

- Give time to your body to stabilise on 14mg and to your crossover to liquid.

 

- After some months, if you feel ready to taper : try a first drop, lower than 30%; 5 or 10% or even less.

Then observe how your body react for some weeks, how you react to a low percentage, before thinking about a larger drop.

You don't know yet how you will react to a change in your dosage, so better to learn from your body before thinking about a 30% drop.

 

Fluoxetine has indeed the reputation to be self-tapering but, as usual with psych drugs, nobody can never predict how ones'body will react and every journey is unique.

There are people who can taper from it relatively easily while others need small drops and long holds.

 

 

The key is to listen to our bodies, to see how it reacts, to give time to our CNS to do his repair work. This is the best way we found to taper safely these drugs.

 

Take care 🙏

 

2006 : 20mg Paxil + Bromazepam 2008 : cold turkey of both

2010 : Reinstatement 20mg Paxil + Bromazepam

2014-June2017 : Switch from Bromazepam to Prazepam, slow taper to 0mg.

2018 to August 2019 : Paxil 20mg taper (3% every 15 days).

- 22 Aug 2019 updosed To 10mg (was at 8.4mg)

25th Sept 2019 To April 2020 : found SA, holding at 10mg Paxil. 

April 2020 : Paxil 10mg to Prozac 7mg bridge. Details topic/21457-

 

Current Supplements : magnesium citrate/ fish oil/ evening primrose oil 

Current medication :

* 1mg Diazepam (since 29 Aug 2020)

* Prozac : 6.64mg (4 Nov 2021) / 6.72mg (8 oct 2021) / 6.8 mg (15 Sept 2021)6.88mg (14 Aug 2021)/ 6.92mg (23 Jun 2021)

Link to comment
  • Administrator

From your signature:

Quote

Alternating prozac by one day. 

 

 

Do not skip doses to taper! How long have you been doing this?

 

As Erell said, it's best go cautiously and see what your tolerance is for reductions. Keeping notes is a good idea. 

 

We do not recommend people taking Prozac go any faster than 10% per month, like everyone else. It's not a magic drug.

 

If you're already experiencing withdrawal symptoms from skipping doses, you will definitely have to taper more slowly.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Link to comment

@Gridley@Erell

Thanks erell for your reply.

I will keep everything in mind.

 

July 2020 - Mar2021: On etizolam 0.5mg td and prozac 20 mg.

Apr21-May21- started alternating prozac, sometimes kept 1 day gap sometimes 2-4 days. Took 40 tablets in 60 days. Calculated 14mg/day consumption on this basis(highly approximate).

End May21- found SA, apprised my situation, got advice to keep steady on 14mg and watch for WDs should they arise.

From 30-05-21- on 14mg liquid suspension made by mixing the capsule powder with water and measuring it by syringe.

B12, zinc, magnesium glycinate.

Link to comment

@Gridley@Erell

Thanks erell for your reply.

I will keep everything in mind.

 

July 2020 - Mar2021: On etizolam 0.5mg td and prozac 20 mg.

Apr21-May21- started alternating prozac, sometimes kept 1 day gap sometimes 2-4 days. Took 40 tablets in 60 days. Calculated 14mg/day consumption on this basis(highly approximate).

End May21- found SA, apprised my situation, got advice to keep steady on 14mg and watch for WDs should they arise.

From 30-05-21- on 14mg liquid suspension made by mixing the capsule powder with water and measuring it by syringe.

B12, zinc, magnesium glycinate.

Link to comment
4 hours ago, Altostrata said:

Do not skip doses to taper! How long have you been doing this?

I skipped doses for 2 months, now I am taking a steady liquid form dose of 14mg made from the capsule powder. I shall continue to keep this dose steady for atleast 2 months while watching any emergent WDs. 

July 2020 - Mar2021: On etizolam 0.5mg td and prozac 20 mg.

Apr21-May21- started alternating prozac, sometimes kept 1 day gap sometimes 2-4 days. Took 40 tablets in 60 days. Calculated 14mg/day consumption on this basis(highly approximate).

End May21- found SA, apprised my situation, got advice to keep steady on 14mg and watch for WDs should they arise.

From 30-05-21- on 14mg liquid suspension made by mixing the capsule powder with water and measuring it by syringe.

B12, zinc, magnesium glycinate.

Link to comment
  • Moderator
4 hours ago, Seeker said:

I skipped doses for 2 months, now I am taking a steady liquid form dose of 14mg made from the capsule powder. I shall continue to keep this dose steady for atleast 2 months while watching any emergent WDs. 

Please update your signature, it will be easier to understand your situation ;)

 

Have a nice day !

2006 : 20mg Paxil + Bromazepam 2008 : cold turkey of both

2010 : Reinstatement 20mg Paxil + Bromazepam

2014-June2017 : Switch from Bromazepam to Prazepam, slow taper to 0mg.

2018 to August 2019 : Paxil 20mg taper (3% every 15 days).

- 22 Aug 2019 updosed To 10mg (was at 8.4mg)

25th Sept 2019 To April 2020 : found SA, holding at 10mg Paxil. 

April 2020 : Paxil 10mg to Prozac 7mg bridge. Details topic/21457-

 

Current Supplements : magnesium citrate/ fish oil/ evening primrose oil 

Current medication :

* 1mg Diazepam (since 29 Aug 2020)

* Prozac : 6.64mg (4 Nov 2021) / 6.72mg (8 oct 2021) / 6.8 mg (15 Sept 2021)6.88mg (14 Aug 2021)/ 6.92mg (23 Jun 2021)

Link to comment

@Erell signature updated

July 2020 - Mar2021: On etizolam 0.5mg td and prozac 20 mg.

Apr21-May21- started alternating prozac, sometimes kept 1 day gap sometimes 2-4 days. Took 40 tablets in 60 days. Calculated 14mg/day consumption on this basis(highly approximate).

End May21- found SA, apprised my situation, got advice to keep steady on 14mg and watch for WDs should they arise.

From 30-05-21- on 14mg liquid suspension made by mixing the capsule powder with water and measuring it by syringe.

B12, zinc, magnesium glycinate.

Link to comment
  • Administrator

Please let us know how you're doing.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Link to comment

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
×
×
  • Create New...

Important Information

Terms of Use Privacy Policy