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How long does it take to stabilize after reinstating or updosing?


John

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I have read all the posts on this thread and am still not sure what to do. I tapered too quickly. As I tapered, my worst WD symptom, insomnia, keep getting worse and worse, but I was just determined to get off of Remeron at all costs. Got down to zero and the insomnia was so bad that I could only sleep an hour a night. For my sanity — literally — I have to either reinstate or get on another drug to help me sleep. I reinstated at .6 mg two days ago. The first night, I woke up frequently but fell right back to sleep and got decent rest. I thought I’d found my solution, but then last night insomnia was bad again. Does this argue for me to increase again tonight, maybe up to 1 mg, or to hold steady at .6 to see if things will improve?

  • Started 7.5 mg Remeron in February 2020
  • Stopped CT in August 2020, I think?
  • Reinstated at about 2.5 mg in September 2020 (liquid taper)
  • Started Buspirone (5 mg 3x day) in November 2020 to deal with debilitating anxiety during remeron taper
  • Tapered to 2 mg for October, then dropped to 1.05 for November, and then down by .15 mg once/week for December (.9 first week, .75 second week, .6 third week, .45 fourth week, .3 fifth week) so that I was at .15 mg (1 mg of liquid) at the start of January 2021
  • Stopped in second week of January 2021 and couldn’t tolerate the insomnia, so reinstated to .6 mg and tapered slowly until Sept 2021 — jumped off at .075 mg because it was impossible to take less
  • Sept 2021, 0 mg remeron, 15 mg/day buspirone
  • Supplements: 300 mg magnesium, 3 mg melatonin, 2000 mg Vitamin D, Omega 3 (kelp-based)
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@Oriyah4: I'm not a moderator and don't think I'm really equipped to be giving proper advice. Hopefully you've done an "intro page" and some moderator has sent you links to various important things you should read to start (looks like it, since you have a proper signature thing). So again, I'm not a medical doctor, this is just my opinion...

 

But to me you should very likely NOT make any changes so quickly. That much I've learned. Two days of reinstatement isn't even enough time for the drug to really get into your system (5-10 days?). If I'm reading you right 0.6 was actually what you were at several weeks ago, a few steps higher from when you finally went off, but lower than the 2mg you were stable with in October? I think it is good that you are thinking about a reinstatement now (I waited way too long b/c I didn't know what was happening to me), as you don't want to wait too long, but figuring out what dose to go with is challenging. I think you've likely picked the right neighbourhood. Avoid picking too high (as you've read) - you should pick low and then increase (slowly, not after two days) if necessary. The main thing (I think) is to pick and then hold for decent periods (like two weeks or more) and then assess. Rigorously journal if you can. 

 

Also, not to be discouraging at all, but just prepare yourself for some more bad nights and try to accept that if you can. Insomnia is by far my most stubborn symptom, and is shared by almost everybody on this site. I've had some nights of just zero sleep, and my moderator has it even worse than me. I used to complain about waking up at 5 - now I'd give my teeth to be able to sleep unbroken till 5! On the plus side your sleep WILL settle down, but I really don't think it is going to change immediately and forever based on a small change you make today. Read the various insomnia pages and try some of it out (breathing, music, melatonin, masks, etc. etc.) and hopefully a few good nights will come to you. Your body will eventually conk you out to sleep when it really needs to. 

 

Wishing you a better night tonight, and calm acceptance if it doesn't happen - it will eventually. You're on the right track. Hang in there!

15+ years Citalopram 10mg (sometimes 20?)

2019 Citalopram 5mg. No problem reduction.

2020 Citalopram 5mg to zero. (Feb)

2020 (Feb - mid Oct): Very rare use of 0.125 or .25mg Xanax for really bad symptoms

2020 (Feb - Nov): Occasional use of "Nytol" sleep aid (an antihistamine). 

2020 Failed reinstatement: Escitalopram by accident (not Citalopram).  

 -- using a scale, started July 27 0.5mg, doubled every week or so to reach 5mg by Aug 30. Too fast - terrible depression, quit.

2020 (Oct-current): Supplements:

 -- Morning: Magnesium 300mg, Omega 3(483 EPA, 360 DHA +Vit E) Night: Liquid Valerian/Passiflore/Escholtzia - French organic herbal sleep aid, 1.9mg LD Melatonin 

2020 Current - new Citalopram reinstatement. (Accidentally started with Escitalopram before realizing and switching to Citalopram Oct. 30)

 -- using pipette method: Oct 30, 0.25mg; Nov. 4th, 0.375; Dec. 1st 0.5mg, Dec. 21st 0.75mg Jan 19: Decide reinstatement fail: Jan 21 0.625mg, Jan 28: 0.5mg Feb 8 0mg

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@HardTimes: thank you so much for your response and support. I’m on Day 5 of the reinstatement at .6 mg and, as you suggested, it’s hardly helping. With the help of melatonin, I think I’m getting about 4 hours of broken sleep a night. When and how will I know that reinstatement either is or isn’t working? And if it isn’t working, do I just go back to 0 mg and tough it out b/c I have no other choice, or do I increase my dose again, at which point I potentially will still have the same withdrawal symptoms but then will have set myself up for an even LONGER taper for no reason???

  • Started 7.5 mg Remeron in February 2020
  • Stopped CT in August 2020, I think?
  • Reinstated at about 2.5 mg in September 2020 (liquid taper)
  • Started Buspirone (5 mg 3x day) in November 2020 to deal with debilitating anxiety during remeron taper
  • Tapered to 2 mg for October, then dropped to 1.05 for November, and then down by .15 mg once/week for December (.9 first week, .75 second week, .6 third week, .45 fourth week, .3 fifth week) so that I was at .15 mg (1 mg of liquid) at the start of January 2021
  • Stopped in second week of January 2021 and couldn’t tolerate the insomnia, so reinstated to .6 mg and tapered slowly until Sept 2021 — jumped off at .075 mg because it was impossible to take less
  • Sept 2021, 0 mg remeron, 15 mg/day buspirone
  • Supplements: 300 mg magnesium, 3 mg melatonin, 2000 mg Vitamin D, Omega 3 (kelp-based)
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Hi @Oriyah4

I'm so sorry you are going through this. It really stinks. I am too - and it is likely as hard as it has ever been for me right now! 

 

I'm really not a moderator here, and I think you can get better advice from others with more experience, if anybody is out there. I don't really know anybody except for @DataGuy, so I'm tagging him here. DataGuy - I have no idea what the moderator protocol is (and I'm sorry to call on you like this), but you're in a better position to know than I am? And also, this should likely all be moved to your Introduction post. 

 

Best advice I can give you (and again, listen to a moderator or someone else too!!!): The goal should be reduction of symptoms, even if it takes longer. You do not want these symptoms growing and ruining your life as they have ruined mine. The mantra of this whole site is very much STABILIZE, then slowly reduce. But determining whether or not a reinstatement is working can be difficult for some (it was extremely difficult for me). IF you are certain that the current dose isn't making things worse, then it might be safe to go UP a bit and see if that helps once you're sure this dose is in your system (maybe 1 more day?). If you have immediate bad symptoms, stop! But you have to give each up-dose time to sink in, as in 4 days to get into your bloodstream properly and maybe a few more to see results (1 week). These drugs are NOT like Tylenol for a headache! The worst thing you can do is go up and down and on and off every few days - insomnia will be the least of your worries!

 

You should likely take the time to read that whole main thread on reinstatement as well if you haven't already done so - the more you know the better your decisions will be. I'm attaching a chart that some kind person took the trouble to make that shows different users' experiences with reinstatement. You'll see that lots of people have had successful reinstatements that helped quite quickly, and maybe you'll see something about your drug and/or timeframe specifically. That's why I wanted to reinstate, as it seems like the fastest path to health, but in my case it doesn't seem to have worked. 

 

Finally: is insomnia your only major symptom right now? I totally sympathize, as it is a real struggle for me (and for almost everybody here). Still, just FYI, while it might really seem like only getting 4 hours is a really bad situation, that is still a very livable amount for a short period (like a month or two). It stinks, for sure, and it might feel pretty grim, but it really won't cause any major long term harm. 

 

Good luck! Courage! Positive attitude! Hang in there!

SADrugReinstatement.xlsx

15+ years Citalopram 10mg (sometimes 20?)

2019 Citalopram 5mg. No problem reduction.

2020 Citalopram 5mg to zero. (Feb)

2020 (Feb - mid Oct): Very rare use of 0.125 or .25mg Xanax for really bad symptoms

2020 (Feb - Nov): Occasional use of "Nytol" sleep aid (an antihistamine). 

2020 Failed reinstatement: Escitalopram by accident (not Citalopram).  

 -- using a scale, started July 27 0.5mg, doubled every week or so to reach 5mg by Aug 30. Too fast - terrible depression, quit.

2020 (Oct-current): Supplements:

 -- Morning: Magnesium 300mg, Omega 3(483 EPA, 360 DHA +Vit E) Night: Liquid Valerian/Passiflore/Escholtzia - French organic herbal sleep aid, 1.9mg LD Melatonin 

2020 Current - new Citalopram reinstatement. (Accidentally started with Escitalopram before realizing and switching to Citalopram Oct. 30)

 -- using pipette method: Oct 30, 0.25mg; Nov. 4th, 0.375; Dec. 1st 0.5mg, Dec. 21st 0.75mg Jan 19: Decide reinstatement fail: Jan 21 0.625mg, Jan 28: 0.5mg Feb 8 0mg

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  • Altostrata changed the title to Stabilizing, what does that mean? How long does it take after reinstating or updosing?
  • 7 months later...

Hey all-

I had a setback from a med that I took in April '21 (low dose naltrexone- 1 dose) and it has been a rollercoaster of symptoms. Some have come and gone but head pressure, stomach pains and stress intolerance have been pretty constant throughout. I'm 10 months out and wondering if I should start my taper to see if I feel any better. Any thoughts or experiences would be welcomed!

 

Ryan

2005- 2008: Lorazepam (max dose- 1 MG daily)

2008- 2016: Lexapro (max dose-10 MG daily)

January 2017- March 2017- Pristiq (max dose- 100 MG daily)

April 2017- June 2017: Trintellix (max dose- 10 MG)

July 2017- October 2017:  Lexapro (max dose-10 MG daily)

November 2017- April 2018- Luvox (max dose- 100 MG)

May 2018- Zoloft (max dose- 18.75)

5/28/18- 3 MG Lexapro, 6/3/18- 3 MG Lexapro, 6/7/18- 3.5 MG Lexapro, 6/13/18- 4 MG Lexapro, 6/21/18- 4.5 MG Lexapro, 6/28/18- 3/29/21- 4 MG Lexapro, 3/30/21- Present- 3.8 MG Lexapro

**Bad Wave Caused by Trileptal 150 MG (one pill) in December '20 and Low Dose Naltrexone .12 MG (one pill) in April '21**

 

"The Journey is The Reward"

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  • 3 months later...
On 3/15/2013 at 9:03 PM, Altostrata said:

 

It takes 3-4 days for a dosage change to reach steady-state in your bloodstream. You may not feel the entire effect until then.

 

I did a Cut 3 days ago and very much feel the Cut even on day 2. Would that mean that the Cut was too big? I went from 3 mg to 2,9 mg after a 9 month hold. 

2009 Escitalopram 10mg

April 2013 got off August 2013 reinstated 

July 2015 Ketipinor 50mg (Quetiapin)

April 2021 got off Quetiapin 4w taper

May 2021 tapered off Escitalopram 

9 August 2021 back on Escitalopram 2,5mg. Down to 2 mg. Updosed to 2,2mg August 24 Down to 2mg September 2

Updosed to 3mg Sept 28 

December Still holding ❤️

June 9 2022 2,9 mg

June 19 2022 2,85 mg

December 2022 switched syringes and realized i am actually taking 3,4 mg

Supplements vitamin E 400 magnesium malate a fraction of 400, Rosita Cod liver oil

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  • Moderator

The unpredictable nature of symptoms is one of the biggest challenges we face while tapering. It is very common for symptoms to flare up sometime after doing a reduction. How's that for a vague answer. The effects of even a small reduction can be experienced anywhere from not at all to immediately, through a couple of days to several weeks or months later. It is all up to how the body wants to react to that particular reduction. How your body reacted to this reduction is only a small indicator as to how it will react to the next.

 

Getting an uptick in symptoms 2 days after a reduction of 3.5%, which is what you did, is very common, and although uncomfortable, is nothing to be concerned about.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Final Dose 0.016mg.     Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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Thank you @brassmonkey

This is my first Cut since reinstating and stabilizing after going CT with both Lexapro and Seroquel so a bit concerned to say the least. 
I Guess i Will just have to wait and see, just like everyone else here at SA 😏

2009 Escitalopram 10mg

April 2013 got off August 2013 reinstated 

July 2015 Ketipinor 50mg (Quetiapin)

April 2021 got off Quetiapin 4w taper

May 2021 tapered off Escitalopram 

9 August 2021 back on Escitalopram 2,5mg. Down to 2 mg. Updosed to 2,2mg August 24 Down to 2mg September 2

Updosed to 3mg Sept 28 

December Still holding ❤️

June 9 2022 2,9 mg

June 19 2022 2,85 mg

December 2022 switched syringes and realized i am actually taking 3,4 mg

Supplements vitamin E 400 magnesium malate a fraction of 400, Rosita Cod liver oil

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  • Administrator

Observe for a week and see how you do with this decrease.

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.

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  • 9 months later...

Hello everyone.

 

I’ve tried looking for answers here but I can’t seem to find some that answers my question, so I’ll try here.

 

 

what does stabilising mean and what does it feel like? How long do you have to feel stabilise in order to taper down again?

 

I stopped taking seroquel in April 2022, and while I have had improvements and lots of windows, I still experience waves but my symptoms haven’t changed..

2018 (citalopram 75mg for social anxiety + 75mg Seroquel for sleep)

2021 Jan - tapering down to 50mg citalopram (no reaction)

2021 Feb - tapering down to 25mg citalopram (withdrawal symptoms for weeks and slowly got better)

2021 May - tapered down to 12mg and had HORRIBLE withdrawal

2021 June - went up 3mg and felt slightly better and staying on a 15mg dose until this day

2021 Aug - 2022 Apr - tapered down Seroquel from August 2021 till last dose of 6.25 mg in April 2022. Horrible withdrawal, but slightly improving everyday

Supplements: none

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  • 1 month later...
On 1/30/2015 at 7:10 PM, Narcissus said:

Hey, Itee.  Tapering's been on my mind too lately.  The question of when to begin a taper is personal and difficult, especially after having had a frightening withdrawal experience.  I've waited two years since withdrawal started, and I have yet to begin or plan my taper.  Like you, I worry about ending up back in the hell that was earlier withdrawal.  And I worry also about the effects of continuing to stay on the drug.  It's a tough situation we find ourselves in.  

 

Can I ask what your Naturopath's tapering plan is?  I would consider changing your pdoc if I were you, they sound dismissive and unhelpful.  

 

I'm sure someone who's taken the taper plunge will come around and share their experiences, just thought I'd try to commiserate a little.  

 

P.S. Here is another thread on the same topic:

http://survivingantidepressants.org/index.php?/topic/4244-after-reinstating-how-long-before-beginning-taper/
 

Hi, its been a while since this post. but what you said "The question of when to begin a taper is personal and difficult, especially after having had a frightening withdrawal experience.  I've waited two years since withdrawal started, and I have yet to begin or plan my taper.  Like you, I worry about ending up back in the hell that was earlier withdrawal.  And I worry also about the effects of continuing to stay on the drug.  It's a tough situation we find ourselves in." is the position I am in in. Have you tapered? Or are you still on meds? Thanks for your time.  

About 10 years ago started 30mg Cymbalta, I can't remember if I took consistently.

Since 2018 Cymbalta 60mg, consistently.

Since 2018 Buspirone 15mg, consistently.

Since 2019 Buspirone 30mg, consistently.

2022 Fall tapered off Buspirone while on Cymbalta. No withdrawal systems.

2022 Mid-October tapered off Cymbalta over 6 weeks that ended on Thanksgiving. 60-40-20. Major withdrawal systems.

2023 End of February reinstate Buspirone 15mg (5mg morning, 5mg noon, 5mg late afternoon) Still withdrawal systems.

Had to reinstate something to get rid of the extreme anxiety, restlessness, nervousness, couldn't sit still.

Was too scared to get back on Cymbalta with all the horror stories of trying to get off. So I tried Lexapro.

2023 March 13 quit Buspirone. Started 2.5mg Lexapro for one week. Then 3.75mg Lexapro for two days. 

Currently 5mg Lexapro for 2.5 weeks. Anxiety calmed down a bit. Sleep is bad still. Brain fog is there but less than when I started. Feel slow and detached.

Been feeling jittery, nervous, anxious on 5mg. So two days ago, went down to 3.75mg. First day still bad, but second day on 3.75 felt better. Maybe I was on too high of a dose. Third day bad. Don't know what to do.

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On 12/22/2016 at 2:25 PM, woof said:

If one did not have problems with the AD in the first place.  Tapering off them may not be the best choice for that person.  My situation is admittedly a bit odd in that I just wanted off of all meds, because I thought it was a good thing.

 

Please see my intro below.  Hopefully this can be of some help to someone in a situation like myself. 

 

For over 10 years I never experienced any problems with 20mg/d Cymbalta, It actually helped my sleep.  I wish I never started it for my neck pain, but that is way in the past.  I arrogantly just wanted to get off of all meds.

 

It's been 4 weeks now since I fully updosed to 20mg/d Cymbalta, after 3, 10% cuts.  The first cut was good as my AM anxiety immediately went away, so I thought that tapering was right for me.

 

Now I believe Alto's words above are extremely wise and that the anxiety and insomnia would have resolved, given a few more months at my reinstated dose of 20mg/d; as is empirically evidenced by my current state.

 

I was so scared to updose by 41 beads, but I did have confidence in the 4 doctors I consulted with and they all independently concurred with the action I should take - take the full 20mg pill.

 

One of these MDs is one of the 3 most cited MD's on this site, as well as within the healthcare community. 

 

While 41 beads sounds like a lot, if you look at the exponential activity curve (which these MDs were all well aware of) in combination with my dose and the fact that I had had no problems with Cymbalta in the first place,  I took their advice.

 

With the exception of my 1-3/10 tinnitus all of my sxs have resolved at this point. 

 

All of my sx's just got better and better after I updosed to my original 20mg/d level.

 

After a full year my sleep finally has come back, anxiety is gone, appetite is great, BM's are normal, I can watch sports or anything I want on TV again and Anhedonia is gone :)

 

Unfortunately, now I have to taper off of 25mg/d of Valium which I was maintaining as I was tapering, but at least my mind seems quite a bit more stabilized.

 

I will be tapering slowly off of the Valium after about another month or so of stabilization.

 

Everyone on this site has been wonderful to me and I have learned so very much from all of you, this is without question the best online site. 

 

I just hope that this post may help others. 

 

Warmest Regards,

Woof :)  

Hi are you still on Cymbalta?

About 10 years ago started 30mg Cymbalta, I can't remember if I took consistently.

Since 2018 Cymbalta 60mg, consistently.

Since 2018 Buspirone 15mg, consistently.

Since 2019 Buspirone 30mg, consistently.

2022 Fall tapered off Buspirone while on Cymbalta. No withdrawal systems.

2022 Mid-October tapered off Cymbalta over 6 weeks that ended on Thanksgiving. 60-40-20. Major withdrawal systems.

2023 End of February reinstate Buspirone 15mg (5mg morning, 5mg noon, 5mg late afternoon) Still withdrawal systems.

Had to reinstate something to get rid of the extreme anxiety, restlessness, nervousness, couldn't sit still.

Was too scared to get back on Cymbalta with all the horror stories of trying to get off. So I tried Lexapro.

2023 March 13 quit Buspirone. Started 2.5mg Lexapro for one week. Then 3.75mg Lexapro for two days. 

Currently 5mg Lexapro for 2.5 weeks. Anxiety calmed down a bit. Sleep is bad still. Brain fog is there but less than when I started. Feel slow and detached.

Been feeling jittery, nervous, anxious on 5mg. So two days ago, went down to 3.75mg. First day still bad, but second day on 3.75 felt better. Maybe I was on too high of a dose. Third day bad. Don't know what to do.

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17 hours ago, LightLovePeace said:

Hi, its been a while since this post. but what you said "The question of when to begin a taper is personal and difficult, especially after having had a frightening withdrawal experience.  I've waited two years since withdrawal started, and I have yet to begin or plan my taper.  Like you, I worry about ending up back in the hell that was earlier withdrawal.  And I worry also about the effects of continuing to stay on the drug.  It's a tough situation we find ourselves in." is the position I am in in. 

I can totally identify with this and am having a pretty much identical internal debate.  Do you feel you've completely recovered from the withdrawal experience two years ago?

  • August 2004:  Citalopram 20mg for "postnatal anxiety".  
  • May-Sept 2011:  Adverse reaction to the contraceptive pill, causing severe anxiety and panic.  Was switched from 7 years on Citalopram to Lofepramine briefly, then Mirtazapine 30mg.  Was an anxious, depressed, suicidal wreck and got misdiagnosed with GAD by a psychiatrist.  I now realise my symptoms were all medication related, as opposed to so-called psychiatric diagnosis.
  • October 2011:  Pregabalin 450mg and propranolol 40mg TID added by psychiatrist. 
  • Feb 2013: Tapered off pregabalin 450mg; stopped propranolol.
  • July 2013: Switched from Mirtazapine 30mg to Cipralex 10mg in a two-week cross titration, which caused horrific withdrawal symptoms lasting months.
  • April 2015: Increased to 15mg Cipralex. 
  • 2017:  Was treated by a clinical psychologist for medication-related trauma and slowly tapered down to 2mg Cipralex over the next four years. 
  • December 2021: Switched from Cipralex tablets to drops to facilitate further tapering; this caused withdrawal reaction lasting approx 6 weeks. 
  • May 2022: Experienced severe withdrawal reaction after inadvertently taking expired drops.  
  • 3rd June 2022: Reinstated 2mg Cipralex drops. Stabilisation hindered by drinking alcohol socially; didn't realise impact of this. Nil alcohol since September 2022.
  • Supplements: Cycling Magnesium, Omega 3, Evening Primrose, Vitamin D3, Vitamin C, Vitamin B Complex, Zinc, Ashwagandha, Sage.  Had been taking these prior to withdrawal incident.
  • Feb 2023:  Relatively stable and aiming to hold on 2mg Cipralex and with a view to tapering down in 2024.  Tapered off Ashwagandha.
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  • 2 weeks later...

Hi all - I have an introduction topic that outlines my story, but you'll get the gist from my drug history.

 

After a month off of 10mg lexapro (25% reductions taper) I suffered debilitating withdrawal symptoms, and decided to reinstate at 5mg for approximately 6 days before upping to 7.5mg.

 

In both instances some withdrawal symptoms were mitigated, but I'm still very broken. I had a window of about 5 days, but I've fallen into another wave, and I have no idea how to proceed.

 

Is white-knuckling through the 7.5mg until I stabilise my only option?

 

Thank you - please help.

 

W

Lexapro (10mg) for 5 years. Began to titrate in December of 2022.

Dec 2022 - 10mg
January 2023 - 7.5mg
February 2023 - 5mg and 2.5mg (2 weeks apart)
April 2023 - 0mg
Nervous system crash

May 2023 - 5mg
May 2023 - 7mg

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  • Administrator

We answer questions like that in people's Introduction topics. Please see this.

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.

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  • Altostrata changed the title to How long does it take to stabilize after reinstating or updosing?
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