UkDave: stuck in the antidepressant loop

[Faure]

Oooh glad to hear you’re feeling better if not 100% yet.  What great news ☺️

[UkDave]

Received my new scales today, they're a million times better than my old 1's, great shout @Faure. I am more settled now even if I am still feeling the effects of these waves after decreasing my medication to quick.

 

Having the confidence in the scales knowing I was 95% there or there bouts was brilliant. I knocked up 1 months worth of 9.2mg, sat for a an hour, weighting the empty capsule then weighing 29 micrograms on the scales then weighing the capsule again after I had filled it up, worked out brilliant.

 

Thanks for the advice also @Embi I did notice a change in weight on the scales depending on my movement sometimes, I tried to keep everything stable and also let the scales warm up for a few minutes before I touched them, great advice.

 

I go back to work on Monday, I have changed to part time working in the warehouse for the foreseeable future which suits me down to the ground and also elevates my anxiety I have at the moment with driving plus gets rid of the stress of dealing with the customers.

 

I know the next few weeks will be difficult, dealing with settling down on my current dose after dropping down a bit too quick but I plan to stop on this same dose now for a few months to give my CNS a chance, I will get through this, I have before as somebody pointed out to me with great support 😁

 

All the best for now 😅

[Faure]

Sounds like you’re feeling better just in time to get back to work. Great news. 
 

When you feel ready, come back and we’ll help you start a taper that is far less likely to cause debilitating problems for you. 
 

Good luck with work and what great news you don’t have to drive anymore ☺️

[Embi]

I’m glad you’re feeling more positive! Your new scales sound a lot better. I think that staying at this dose for a while will be a good thing for you

[Faure]

Hey @UkDave, how are you? We’re you able to get back to work? Let us know how things are going ☺️

[UkDave]

23 minutes ago, Faure said:

Hey @UkDave, how are you? We’re you able to get back to work? Let us know how things are going ☺️

 

Hi Faure,

 

Thanks for reaching out, I really appreciate it 🙏🏼

 

I have been back to work for 3 weeks now, the first 2 weeks were difficult I am not going to lie. Which I expected them to be, starting to get comfortable now getting a routine going 😅 

 

Working in a warehouse suits me plus I can take my speaker into work and just get into a zone getting my work done without any outside stressors as I had before when I was driving.

 

Working is also helping me be distracted from my bad wave or negative thoughts, I never expected them to just disappear. Nevertheless I am in a much more positive mind frame this past week.

 

I have a week of my pre weighed out tablets left which when they run out I will be making another months worth of the same dose, hopefully level out more in the coming weeks 😊 

[Faure]

Glad to hear it’s all going well and it sounds much better than driving ☺️ Let’s hope you level out more in the weeks to come and I’m very glad to hear you’re doing the same dose for another month. 
 

Please remember to check in here when you are ready to taper and we can help you start tapering again in a way that will hopefully stop this happening again ☺️

[Faure]

Hello, check in time! How are you doing?

[UkDave]

Hi @Faure I'm ok thank you for asking 😁

 

Experiencing high sensitivity in my CNS, loud noises and vibrations especially. Great time to experience this now moving into summer with all the people cutting their garden grass with windows open in the house. I live on quite a busy street for cars and I feel every one of them going past. It's bizarre.  

 

Now heading onto my second month on the same medication dose. I don't intend to change that dose any time soon. Certainly not next month anyway.

 

I have kept your advice in mind. I haven't been to the gym in a while now. I went a few weeks back 2 days in a row and I literally was rock bottom for about a week. With work on top of that, I have to just take my time. I do about 10k steps a day at work even though I only work 4 hours it is quite taxing on my body, but I need to work for both the money and to get out of the house.

 

Reading a lot of books and Podcasts on self improvement which is settling me. OORRRR I downloaded the Calm app. I have been meditating daily as well as my breath work 🙏🏼

 

A very nice person once advised me; Slow and steady wins the race 😊

 

I hope you're well Faure, Thank you for reaching out. 

[Faure]

Just checking in….how’s things?

[UkDave]

On 6/16/2023 at 5:38 PM, Faure said:

Just checking in….how’s things?

Hi @Faure

 

I'm not too well at present. I am experiencing Vertigo attacks at the moment. I've been to see an ENT doctor for a check up with a hearing test. I mentioned the side effects of the antidepressant. This then made the ENT doctor look at me like I was from another planet!

 

I've had issues with my left ear since I was a child, which is something that runs in the family. The only real time having an issue with vertigo is when I have come off my medication in the past. Bit low at the moment It is something i've gotten through before and will again.

 

Thank you for your message.

 

I hope you're well 🙂

[UkDave]

This is so profound it’s unreal! 

[UkDave]

Hi @Faure 

 

I’ve just weighed out more tablets till the end of the month. 
 

I’ve been on 9.4mg ish for roughly 5 months now. I’m thinking about reducing my dose! 
 

I was thinking about reducing by about .5 mg. The only issue I have is my scales only does mg weight in whole numbers! 

I think I need to look into using a different metric on the scales!

 

Is this a good move going forward ? 

[Faure]

Hi Dave, I was thinking about you the other day. I’m glad you’re feeling stable enough to continue tapering. What you must remember is how awful it is when things go wrong because you taper too fast, how long it takes to recover and how upset you feel when it happens. The priority is to stop this happening again and to do that by tapering small, regular percentages.  Not random amounts that you feel you might manage 😜

 

I suggest, especially given the number of hiccups you’ve had and how sensitive your body has probably become because of this, that you start doing the BrassMonkey slide. Picking a random amount (e.g. 0.5mg) to taper is probably a bad idea. You need to choose a tapering method and percentage and stick to it. How about you click the above link, have a read and let me know any thoughts / questions? I will check in more regularly if you’re going to start tapering (I’ve been on hols and got out the habit of looking here). 

 

Didn’t you get these scales? I thought you had. They measure what you need. I suggest you buy them!
 

Look forward to hearing your thoughts. 

[UkDave]

11 hours ago, Faure said:

I’m glad you’re feeling stable enough to continue tapering. What you must remember is how awful it is when things go wrong because you taper too fast.

 

Hi Faure, thank you for the reply.

 

I have been doing a lot of work on myself. I watch/listen to a lot of wellness and CBT orientated videos on YouTube or podcasts. Looking back I can see where my anxiety started long before I started taking tablets.

 

I always wish I never started the medication because of the numbness both cognitively and physically, the mad thing is now looking back they had a place in helping me... BUT... That's exactly what they did; numb my emotions to life, which in turn has made me never move towards my issues which I never even realized I had until I have started really delving into looking inwards in myself which is what I am now doing.

 

I now focus on breath work daily plus introducing meditation. I haven't learned to calm my mind fully yet. It is definitely a skill. Practice makes perfect right 🙏🏻 Cold therapy is amazing as well *Resets the CNS*...

 

11 hours ago, Faure said:

Didn’t you get these scales? I thought you had. They measure what you need. I suggest you buy them!

 

I did yes. They only do MG in whole numbers. If I wanted to do 8.5 say I would be guessing.

 

I will definitely be taking my time reducing the medication, I have no need to rush. 

 

I'm glad you've been on Holiday, I hope you had a nice relaxing time 😊

[Faure]

The scales do mg to 3 decimal places, for example when I was on 8.5mg of mirtazepine the reading on the scale was 0.085. 

I am not good enough at numbers to advise you on this but have tagged @brassmonkey who is numerate and will be able to help you. (BrassMonkey, UKDave has the gemeni scales recommended on SA, linked to in my previous post).

 

Dave - what taper are you planning? I think you would really benefit from guidance on this to try to avoid another hiccup. I’m sure mods will be happy to weigh in if you want advice from other people. Please let us know your plans ☺️

Edited August 24, 2023 by Faure

[brassmonkey]

@Faure You're close, but off by one place, which could cause problems. 8.5mg would read as 0.0085 (but the 5 would not show up on the readout). 0.085 would be 85mg which is a lot bigger dose.

 

@UkDave trying to weigh out by half a milligram on these scales is quite difficult because they are not that accurate, and the display doesn't show that small. For the smaller doses we usually end up rounding and hoping for the best. The other alternative is to switch to a liquid, which can be measured much more accurately. Switching to another scale won't help much. You would have to go to a laboratory grade scale and we are talking thousands of dollars to get one.

 

As Faure mentioned, tapering by a set amount is not a good idea. Especially at the lower doses. This gives a linear reduction that increases the percentage each time, which the body doesn't like. It is much better to do a percentage reduction.

[Faure]

On 8/24/2023 at 9:31 PM, brassmonkey said:

@Faure You're close, but off by one place, which could cause problems. 8.5mg would read as 0.0085 (but the 5 would not show up on the readout). 0.085 would be 85mg which is a lot bigger dose.

Oh dear - this is why I try to avoid giving any sort of number advice 🙄. Fortunately I have made it this far (2mg from 15mg) without any major mishaps which is amazing! I do have a very numerate friend who is always on hand to advise!

 

@UkDave, I am a bit worried about what you are planning to do next. You’ve had so many mishaps I really don’t want you to have another. If you want to stay well it really would be best to share / discuss your plan and get advice; unfortunately, so far, your tapering decisions have not been that helpful in keeping you well and functioning. Please let us know your taper plan so we can help you 🙏

[UkDave]

1 hour ago, Faure said:

Please let us know your taper plan so we can help you 🙏

Hi Faure, I really appreciate your concern. Don't worry I won't be doing no big changes.

 

Slow and Steady wins the race right ? 😉

 

I have just put the weights into the <Dose weights> spread sheet I have used from the start << not always sticking to the accurate dose as I wanted to be off them quickly, hence me resulting in holding and stabilising on 9mg for the past 5 months. I am now going for a 5 percent taper and hold.

 

I'm currently on 9mg dose, On a 5 percent taper the next dose weight is 8.7mg then 8.2mg. I will have a look this week how to make up the liquid form as Brass monkey said it to be a lot more accurate. 

 

I am going to start the next phase of tapering a week today.

 

Thanks again for the support 🙏🏻

[Faure]

2 hours ago, Faure said:

On 8/24/2023 at 9:31 PM, brassmonkey said:

@Faure You're close, but off by one place, which could cause problems. 8.5mg would read as 0.0085 (but the 5 would not show up on the readout). 0.085 would be 85mg which is a lot bigger dose.

Oh dear - this is why I try to avoid giving any sort of number advice 🙄. Fortunately I have made it this far (2mg from 15mg) without any major mishaps which is amazing! I do have a very numerate friend who is always on hand to advise!

Actually, thinking about this I didn’t get it wrong. With the filler the pill weighs 10x more than the dose (mirtazepine is lucky like this!) so when I was on 8.5mg active ingredient the pill weight was 0.085.  Anyway hopefully @UkDave is better at numbers than me 🤞

 

Dave, thank you for letting me know you are doing a 5% drop. I’ll stop worrying ☺️If possible it would be good to get your body into a regular taper pattern, if WD effects are such that you can manage that. Let us know how you react to the change and remember heavy exercise can exacerbate symptoms, so go easy on the gym!  Last week I overdid my own exercise and felt anxious all day. I rarely feel anxious anymore so I am fairly confident it was down to the exercise. 
 

I make a liquid now and it is much easier than weighing as I only have to weigh a large amount, add water, then divide it up. I have copied my method below, (again, don’t expect me to know how to help my numerate friend did all the figures for me!):

 

I have found a very easy way to deal with making a liquid from a powdered tablet.  I couldn’t get my head around the method that most use here so a friend came up with this. It relies on having scales to weigh the right amount of powder first.  Then you always add the same amount of water (either 20 or 25ml depending if it’s for 3 or 4 days) regardless of reducing the dose of meds (at least while I’m on current doses, once I get very low the method may change a bit.  I’m on 3mg at the moment and have just changed to making a liquid.)

 

Method

 

 

I already have a spreadsheet of my BrassMonkey slide doses.

 

On Mondays I weigh 4 days worth of powder that I ground up myself and I will make 3 days worth of liquid. 

I measure 20ml of water using a 5ml syringe that a friend picked up at his local chemist.

I tip the powder into the 20ml of water and give it a good, gentle stir.

While the water is still swirling I draw up 5ml of water and dispense into a mini jam jar.

I repeat 2 more times (stirring is key to ensure even distribution of the powder across the water)

I keep the jars in the fridge
I dispose of the remaining liquid (I believe it is important to have more liquid than you need to account for losing it on the way and also so that there is enough liquid to keep the mixture swirling around for the final extract.) I am very suspicious of dregs where the particles settle so make sure when I draw up liquid I draw from the middle of the suspension (not at the bottom). 
This gives me 3 doses to use Mon - Wed 

 

On Thursdays I repeat but because this will do 4 days (thurs - sun) I use 25ml of water and weigh 5 days worth of powder.

 

The general opinion on SA is that homemade liquids last no longer than 4 days and it’s better to be safe than sorry. 

 

This is *really* easy to do and will work for quite some time as I’m weighing 3-4 days worth of powder at a time which means I’m weighing quite a large amount and the scales are accurate at these high amounts. At some point it will be necessary to change my method and when I get there I can share how I do that

[UkDave]

1 hour ago, Faure said:

Dave, thank you for letting me know you are doing a 5% drop. I’ll stop worrying ☺️ If possible it would be good to get your body into a regular taper pattern,

Again @Faure I really appreciate your concern 😊

 

I have not been to the gym since June, I do have a very physical job though which I regularly do 10k plus steps a day as well as picking up to 25kg parts at any 1 time. 
 

This is why I stopped the gym as I couldn’t do both, plus trying to get off the medication. I listen Faure, I listen 😉

 

If I’m honest I have never looked into the liquid method!

 

Do you still use capsules, I’m confused! 
 

Doesn’t take much mind. To confuse me that is 😆

[brassmonkey]

@Faure  That makes sense. Easy mix-up to make. Because both are measured in mg, is why we try to use mgai (milligrams active ingredient) and mgpw (milligrams pill weight) to differentiate between the two.

[Faure]

11 hours ago, UkDave said:

Do you still use capsules, I’m confused! 

I don’t use capsules for the liquid, I use an old fish paste jar for mixing and then decant onto those tiny jam jars you get if you go out for afternoon tea ☺️ take your time to get your head round the liquid method. With the dose you’re on I expect you could stick with weighing for a while. I changed at 3mg active ingredient. How much does your actual pill weigh? Probably a lot more than the 9mg active ingredient you’re on…..

[Faure]

Hello, I think you may have done a drop on Monday….how are things?

 

Next Monday I’ll drop below 2mg which I’m looking forward to. My drops are now tiny but the effect (in terms of feeling better) far outweighs the drop ☺️ ☺️☺️

[UkDave]

8 hours ago, Faure said:

Hello, I think you may have done a drop on Monday….how are things?

Hi Faure, yeah I reduced my dosage on Monday. I was taking 29mg on those scales, equating to 9.2mg for roughly 6 months.

 

On your & BrassMonkeys advice, I have dropped from 29mg to 28mg for the next two weeks, which equates to roughly 9gs. So a drop of .2 🤷🏼‍♂️

 

I weighed out six weeks worth of tablets, which I will take fortnightly 28mg then 27mg and 26mg. The chart states that is a reduction of .2 at a time. Sssssoooooooooo nice and slowwwwww 🙏🏼

 

I will continue this reduction seeing how it goes. If I start to feel any adverse effects, I will hold again.

 

8 hours ago, Faure said:

Next Monday I’ll drop below 2mg which I’m looking forward to. My drops are now tiny but the effect (in terms of feeling better) far outweighs the drop ☺️ ☺️☺️

This is fantastic news Faure, I am really glad everything is going really well for you 😁

[Faure]

22 hours ago, UkDave said:

On your & BrassMonkeys advice, I have dropped from 29mg to 28mg for the next two weeks, which equates to roughly 9gs. So a drop of .2 🤷🏼‍♂️

 

I weighed out six weeks worth of tablets, which I will take fortnightly 28mg then 27mg and 26mg. The chart states that is a reduction of .2 at a time.

I’m glad to hear you are taking it slowly. I take it you are doing a percentage reduction and not a linear one? Percentage reductions are safer because you’re always dropping the same proportion. Eg 5% if the latest dose every 2 weeks. Linear ones e.g. 0.2mg every time mean the proportion will start small and get larger as a proportion as you reduce. This is not good and should be avoided. I think you said you’re doing 5% but just want to double check. 

[chevalier]

On 3/26/2023 at 2:26 AM, Faure said:

Good morning ☺️ This is the scale I use.  It’s about £40 and is the one recommended on here. I had a look at yours. You want to be sure it’s consistent in the weight it gives. You might like to test it over and over with the calibration weight.  Maybe calibrate the scale first then weigh the weight several times to check it gives the same reading each time. Repeat with something else like a whole pill.  If it’s consistent great, if not be a bit concerned.

 

Making up pill instructions 

 

I make up 7 tablets at a time, so when you start you’ll need to pulverise all 7 and then weigh out 7 identical amounts. Much better this way as it’s all done in about 15 mins (when you get the hang of it) just once a week, rather than daily. I also like to believe doing it all in one go gives the best chance of getting identical weights with the calibration etc. These days I use just over 2 pills a week, so I usually pulverise 3.  Here is how I do it: 

 

Step 1, only necessary the very first time: weigh three whole pills and divide the total weight by 3 to get the average weight per pill. Put this into a tapering spreadsheet to get the reduction schedule. Print reduction schedule and if you’re at all bad with numbers change the decimal points so the schedule looks the same as the scale readout.  I think you already know the pill weighs more than the dose of meds you are taking because of filler. 

 

Step 2 calibrate the scales

 

Step 3 grind 7 pills, I put the powder into an egg cup and stir it with a toothpick, including the outer layer of the pills (my outer layer is yellow and the powder is white). 
 

Step 4, open a capsule. Using a teaspoon scoop up some powder and using a toothpick knock it into the measuring tray till you get the right weight. I take off excess powder with the tweezers that come with the scale. 
 

Step 5 tip the powder into a folded small piece of paper and use this to transfer the powder into the capsule. Don’t worry about microscopic bits not making it into the capsule. 
 

Step 6 repeat till 7 pills are complete and store spare powder in a separate capsule for next time.  I then use this powder first in my next session. Be sure to keep pills in the dark. 

 
I don’t recommend making up more than 7 at a time.  It takes a lot of concentration and I personally find I can concentrate for 7 pills but then I start to get sloppy and not so careful. It is obviously vital the pills are all as accurately weighed as possible. 

 

 

Thanks for posting, I think I will have to try this since I'm doing a very slow taper (1% per week) and the pills can vary in weight significantly when you're tapering such small amounts. Do you know if most these pills (capsules or regular pills) are homogenous? That is, does a pill with slightly different weight contain slightly less active ingredient? Or is a 117mg paxil tablet and 123mg paxil tablet both contain exactly the same amount of paxil? Thanks.

[Faure]

Oooh 2 months since I checked in @UkDave, how’s things?

[Faure]

8 hours ago, chevalier said:

Thanks for posting, I think I will have to try this since I'm doing a very slow taper (1% per week) and the pills can vary in weight significantly when you're tapering such small amounts. Do you know if most these pills (capsules or regular pills) are homogenous? That is, does a pill with slightly different weight contain slightly less active ingredient? Or is a 117mg paxil tablet and 123mg paxil tablet both contain exactly the same amount of paxil? Thanks.

Hi, there are strict rules around accuracy in these pills so I would say that the active ingredient in each pill (from the same manufacturer) is the same (within the tolerance allowed in the rules) and any difference is probably in the filler part. Of course pill weights vary between manufacturer and it’s a good idea to always get the same brand ☺️ 

 

Please post any further questions in your own thread to keep UkDave’s on topic ☺️

Edited November 7, 2023 by Faure

[UkDave]

On 11/7/2023 at 11:57 AM, Faure said:

Oooh 2 months since I checked in @UkDave, how’s things?

Hi @Faure

 

I'm ok; I have been reducing my tablets fortnightly, which has been fine. I am, however, in a bit of crash mode at the moment. I somehow missed three of my tablets last week. 🤷🏼‍♂️ 

 

I have this pot where I put my daily supplements plus an antidepressant capsule. For what reason I don't know, but it seems I forgot to add my antidepressant capsule.

 

Catastrophizing off the charts, a few head zaps, and the dreaded Man Flu have kicked in with the weather change. I realised I had to make up some more tablets this week after finding out I had extra tablets. I was going to reduce my tablets this time around, but I have stopped taking the same dose to get back to some form of equilibrium.

 

I walked out of my job, which I have had for a few years, at the beginning of October. I was landed with double the work load when a college left, which had me physically and emotionally drained. So I put my notice in and left.

 

I now have a new job, which I start on Saturday, which will suit me much better physically and emotionally. I am okay financially for the moment, so I am concentrating on putting myself first.

 

I have been meditating daily for the past 3 months or so. Ice baths 2 to 3 times a week. I am in a good place, bar missing tablets 😵‍💫

 

Thanks for checking in.

🙏🏼

[Faure]

Hi @UkDave, have things settled down for you now? How’s the new job?

 

All good wishes for Christmas, ☺️🎄☺️

[UkDave]

Hi @Faure I’m not doing very well at the moment. 
 

I didn’t last in the new job. I have just signed on the sick hopefully receiving universal credit benefit. 

[Nigel]

@UkDave I've just read through your whole thread and I resonate a lot with your story. I just want to say hang on in there brother, nothing lasts forever. 

 

I myself am struggling to work but I force myself to go volunteer somewhere a couple of days a week. You may find this really helpful as there is no pressure. 

[UkDave]

1 hour ago, Nigel said:

I just want to say hang on in there brother, nothing lasts forever. 

Hi @Nigel cheers for the support.

 

I have been holding on a the same dose *roughly* 7.8mg for about 10 weeks now. I say roughly because I crush up the tablets, I have found this method very effective, naturally you're not going to get the dose spot on every time. As opposed to the sharp tapers or CT I have done in the past this is much more stable.

 

I had been in the same industry for over 15 years, I didn't go down the sick route from work because with these tablets I have been on the sick on and off for years from said symptoms, I left for political reasons then got a new job which killed me from anxiety. 

 

Work isn't the problem, I believe I am stuck in a bad wave. I do Ice baths, walking in nature, breath work, reading self help books about phycology trying to encourage my self out of this wave. 

 

Its just a time thing 🙏🏼

[Faure]

Sorry to hear things aren’t so good Dave, stress does cause symptoms, I had that myself the past few days. Fortunately for me they were brief and I’m ready to cook and eat for Christmas! 

 

I hope your symptoms pass quickly and sorry you’re back on UC.  I hope things pick up for you before too long. Take care and I hope you manage to enjoy at least a little bit of Christmas x

[Nigel]

14 hours ago, UkDave said:

Hi @Nigel cheers for the support.

 

I have been holding on a the same dose *roughly* 7.8mg for about 10 weeks now. I say roughly because I crush up the tablets, I have found this method very effective, naturally you're not going to get the dose spot on every time. As opposed to the sharp tapers or CT I have done in the past this is much more stable.

 

I had been in the same industry for over 15 years, I didn't go down the sick route from work because with these tablets I have been on the sick on and off for years from said symptoms, I left for political reasons then got a new job which killed me from anxiety. 

 

Work isn't the problem, I believe I am stuck in a bad wave. I do Ice baths, walking in nature, breath work, reading self help books about phycology trying to encourage my self out of this wave. 

 

Its just a time thing 🙏🏼

 

I think next time I try to reduce I'll have to do it gradually. I'll have to figure out how to make my own pills or hopefully get the doctor to prescribe me the liquid. 

 

Merry Christmas bud, take it easy