Koovman1963: Taper off 3 different AD'S Effexor/Wellbutrin/Seroquel

[Koovman1963]

Taper sched needed for 375mg Effexor XR, 150 mg Wellbutrin, 350 mg Seroquel XR

Edited August 22, 2021 by Go2zero

[getofflex]

Hello, and welcome to SA.  We are a peer owned and run forum of people who have been or are getting off of psychiatric drugs.  I commend you for wanting to get off the drugs, and for researching it before you start tapering.  

 

Can you please give us specific information about your drug history for all drugs you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise list (no symptoms), only drug names, specific dates (as best you can say for example early March if you don't recall the day) and dosages of each medication decrease or increase.  Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Drug History in Signature

 

Here is some information about how these drugs actually work.  This explains why it is important to taper off very slowly and cautiously.

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is.  If you taper slowly and cautiously, hopefully you can avoid or minimize withdrawal syndrome.  

 

 Video on Recovery from Psych Drugs

 

What is Happening in Your Brain

 

What is Withdrawal Syndrome?

 

Tapering is best done very slowly, and we generally taper by 10% of the current dose no more than once every 4 weeks, so that the taper becomes exponentially smaller.  Instead of a rigid schedule, we suggest you listen to your body with each dose reduction, and wait until you are stable before reducing again.  

 

 Why Taper by 10% of my Dosage  

 

We suggest you only taper one drug at a time.  This link will help you decide which one to taper first.  

 

Taking Multiple Psych Drugs - Which to Taper First

 

 

Also, as we are recovering, we suggest keeping things slow, simple, and stable. This is extremely important. 

 

Keep it Simple, Slow, and Stable

 

 

When we recover, there may be times of feeling OK mixed in with times of feeling bad.  This is called windows and waves.  However, this may be minimal for you if you taper properly.  

 

Windows and Waves Pattern of Stabilization

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

 

Omega 3 Fish Oil

 

 

I've given you quite a bit of information here.  Feel free to ask questions.  Keep us posted, and let us know how it goes. 

[getofflex]

Here are the links that address how to taper each of your drugs:  

 

Tips for Tapering Effexor

 

Tips for Tapering Wellbutrin

 

Tips for Tapering Seroquel

[Koovman1963]

Well, that is plenty of precise info.  Appreciate that. 

 

Psychiatrist and I working together. Usual visits every 2 months for last 14 months.

 

20 years on AD'S

 

20 years of Effexor XR , worked up to current dose 375 mg back then, still on.

Seroquel XR have been on 10 years was as high as 600 mg, current dose 250mg.Still on.

Wellbutrin 5 years, 450 mg down to 150mg.

Still on.

 

Side note;  on clonazepam 2.5mg titrated down to .75mg over 1 year .7 tapers .25mg each , roughly every 2 months for over a year.

 

I have been on so many different AD'S and strengths,  it's not funny.  Trying to quit them , not easy. Do I need them Still? Getting off is going to be, and has been, long arduous process.  I wanna be drug free but my brain can't remember a time without them. Wish me luck.

[getofflex]

Hello, thank you for the drug history.  It would help if you could put it in your signature box, so it appears on each post. That way, other staff can see you history at a glance.  Click on your name in the upper right corner of the screen, select "account settings", then select "signature".  Remember to "save" after you type it in.  

 

Congratulations of tapering the clonazepam.  You may want hold on current dose of clonazepam for a while, and taper a more activating drug first.  That way, it can help preserve your sleep, which is important.  

 

Getting off is a long process, but in your case, it may not be too arduous.  Most people come in here after a too fast taper or CT and are in bad shape with withdrawal.  You can be drug free.  The key is time, and patience.  Good luck!  

[Koovman1963]

Taking 375mg daily EffXR.  Take beads out of pill and taper 10% every 4 weeks.  That would take many, many months.  

 

What about reducing by 37.5 mg every 4 weeks until I get around 150 mg then 10%, still a slow taper...

 

[Koovman1963]

How come no one is talking about steady state? I am taking 375 off Xr in a.m.  wouldn't it be better to spread the dose out morn, aft and evening, get more of a steady state and taper all 3 doses equally? Same with Wellbutrin sr 150 mg morn and seroque xr 250 mg in evening....just saying....

[Koovman1963]

Can you split extended release pills? Effexor XR (take out and count the beads). Wellbutrin 150 SR and Seroquel 200 XR? If not what about switching to instant release and cutting them instead. 

[Go2zero]

I saw that you had opened 4 different threads on this website. I merged them all together. Please post all your questions and comment in this thread only!  So that all you information is combined.

 

[Go2zero]

On 8/20/2021 at 9:52 PM, Koovman1963 said:

Taking 375mg daily EffXR.  Take beads out of pill and taper 10% every 4 weeks.  That would take many, many months.  

 

What about reducing by 37.5 mg every 4 weeks until I get around 150 mg then 10%, still a slow taper...

 

Best is to reduce 10% of the last taken dosage, not 10% of the initial dose. Too fast tapering very often leads to withdrawal problems. However when taking such high dosages as you are taking, we see sometimes that tapering in the high dosage areas one can taper a bit faster. But when one gets to the lower dosage regions, it becomes more difficult. Especially Effexor is know for difficult tapering when one gets under 35-50 mg.

 

So you could try (carefully) if you can taper faster to start with. But hold immediately when you start noticing WD symptoms and report then here. Then we can discuss what to do further.

 

14 hours ago, Koovman1963 said:

I am taking 375 off Xr in a.m.  wouldn't it be better to spread the dose out morn, aft and evening, get more of a steady state and taper all 3 doses equally?

XR meand extended release so it should be taken only once a day since it spread itself automatically over the day. That is what extended release means.

 

How do you take your current dosage of 375mg? How many pills of which dosages do you take and at which moment of the day?

 

[Go2zero]

14 hours ago, Koovman1963 said:

Can you split extended release pills? Effexor XR (take out and count the beads). Wellbutrin 150 SR and Seroquel 200 XR? If not what about switching to instant release and cutting them instead. 

 

As answer for Effexor XR please first answer the question in my earlier answer to you about what pills you take in dosages.

 

 

 

 

 

Please understand that on should not taper 2 or more meds at the same time. If WD symptoms occur you will never know what is causing it and neither what to do about it.

 

Furthermore you are taking Wellbutrin. If you would start tapering Wellbutrin while still taking Effexor, you would be tapering Effexor AND Seroquel effectively at the same time while keeping the dosage of Effexor AND Seroquel as it was before.

 

This is very important to know. Wellbutrin slowers down the metabolism of Effexor AND Seroquel. So when you would start tapering (only) Wellbutrin first, the metabolism of Effexor AND Seroquel will increase. This will give the same effect as if you were tapering all 3 meds at the same time!

 

So I advice to start tapering either Effexor or Seroquel first. Than the next of thesThe two and Wellbutrin as the last one.

 

There are ways to cut Wellbutrin XR. It will become instant release. But there are very good ways to work with that. I guess we better explain that in detail when you decide to taper the wellbutrin.

 

For the Seroquel XR tapering I think it will be better to ask for other pills. The instant release pills come in many different dosages. It would be possible to combine different pills while tapering. For instance 3 pill of 50 and 1 of 25 would be 175mg. You could take the dosages divided over the day. Your doctor could give you prescriptions for these different dosages.

 

 

 

[Koovman1963]

8 hours ago, Go2zero said:

 

As answer for Effexor XR please first answer the question in my earlier answer to you about what pills you take in dosages.

 

 

 

 

 

Please understand that on should not taper 2 or more meds at the same time. If WD symptoms occur you will never know what is causing it and neither what to do about it.

 

Furthermore you are taking Wellbutrin. If you would start tapering Wellbutrin while still taking Effexor, you would be tapering Effexor AND Seroquel effectively at the same time while keeping the dosage of Effexor AND Seroquel as it was before.

 

This is very important to know. Wellbutrin slowers down the metabolism of Effexor AND Seroquel. So when you would start tapering (only) Wellbutrin first, the metabolism of Effexor AND Seroquel will increase. This will give the same effect as if you were tapering all 3 meds at the same time!

 

So I advice to start tapering either Effexor or Seroquel first. Than the next of thesThe two and Wellbutrin as the last one.

 

There are ways to cut Wellbutrin XR. It will become instant release. But there are very good ways to work with that. I guess we better explain that in detail when you decide to taper the wellbutrin.

 

For the Seroquel XR tapering I think it will be better to ask for other pills. The instant release pills come in many different dosages. It would be possible to combine different pills while tapering. For instance 3 pill of 50 and 1 of 25 would be 175mg. You could take the dosages divided over the day. Your doctor could give you prescriptions for these different dosages.

 

 

 

 

[Koovman1963]

375 mg effexor in 5x75mg capsules morning

150 mg , 1 purple pill morning

250 mg seroquel xr 1x200mg and 2x25mg all at night

[Go2zero]

7 hours ago, Koovman1963 said:

375 mg effexor in 5x75mg capsules morning

You can just reduce 1 capsule to  37,5 mg to start your taper. So then you would take 4 capsule Effexor of 75mg and 1 of 37,5 = 337,5 total

 

2nd step after at least 4 weeks step could be 4 capsule of  Effexor of 75mgs= 300 mg (is not exact reduction of 10%, but in these high dose regions should not be a problem).

 

3rd step  should be 90% of 300 mg+ 270 mg. So 3 capsule of 75 mg and 1 reduced capsule of 45 mg

 

And so on. Every time 90% of last taken dosage. 

 

[Koovman1963]

Tapering off Effexor XR

 

Hello,

 

I have come to the point in my tapering off of all my antidepressants (wellbutrin, mirtazapine, Seroquel, Clonazapam) that I have come to "old reliable".  Effexor XR.  I have been taking this drug daily for the past 20 years.  When all other anti-d's were being switched and lowered and increased, the effexor xr was the only constant.

 

I have now come to the point where I want to stop it as well.  My other tapers have gone swimmingly.  So........taper off Effexor XR 375 mg per day.

 

I am taking 5  - 75 mg effexor gel caps = 375 mg per day. Smallest dose is 37.5 mg,  so would make sense to do a 375 - 37.5 mg = 337.5 for a couple months then 337.5 - 37.5 mg = 300 mg for a couple more months, etc..... That taper schedule would take 20 months or 1 year and 8 months.  That sounds about right.

 

What do the rest of you think???

 

Edited November 14, 2021 by ChessieCat
added topic title before merging with intro topic

[ChessieCat]

Please edit your drug signature to show dates for the start of each drug as well as dates of dose changes like the following.

 

If you have stopped any of these drugs, please state date, last dose 'x'mg so we can see that you are no longer taking it:

 

Effexor XR: date,dose; date, dose; date, dose;

Seroquol XR:  date, dose; date, dose;

Clon (don't know what drug this is):  date, dose; date, dose;

Wellbutrin:  date, dose; date, dose;

 

This will allow the staff to see your drug history at a glance.  Please update it (that is add onto the end of the information) whenever you make a change.

 

SA's recommended tapering protocol is to reduce by no more than 10% of the CURRENT dose followed by a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.

 

I understand that you might think that you can get off more quickly, however we have members of SA who have tried to get off their drug too quickly and it has ended up taking them longer than if they had followed the recommended taper protocol.  Some of them have even ended up on additional drug/s and then they have had to taper off this/these as well.

 

Before you commence your taper, please check out the following.

 

If you taper too quickly you will most likely experience withdrawal symptoms:

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

Please see:

 

why-taper-by-10-of-my-dosage

 

Post #1 of this topic explains how to get non standard doses:

 

tips-for-tapering-off-effexor-and-effexor-xr-venlafaxine