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Relapse or Long-Term Iatrogenic Effects Less Likely With Slow Taper?


MissSerene

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Is it generally correct that a slow or very slow taper will reduce the chances of permanent or lingering withdrawal or iatrogenic effects? Or might a person who's done a long, slow taper still experience a depressive "relapse" or drug/withdrawal-induced downward mood change even weeks or months after the taper ends? If taper slow enough to make withdrawal tolerable, is this pretty good sign that such a relapse won't happen?

Prozac 20 mg/daily since 1995

July 19, 2013, initial cut to 15 mg; Aug. 2 updosed to 18 mg; Aug. 19, to 16.2 mg
Held at 2.52 ml/day Jan. 11-April 16, 2014
April 16, 2014, cut to 2.40 ml/day
Dec. 29, 2014, 1.84 ml/day, and held there almost six months
June 23, 2015, 1.75ml/day; July 21, 2015, 1.70 ml/day
Aug. 13, 2015, 1.60 ml/day

Feb. 7, 2016, .7 ml/day; April 26, 2016, .6 ml/day

 

Taking anastrozole (estrogen blocker)
 
Successfully completed long, slow Klonopin taper November 2011. :ph34r:

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We believe that tapering in a way to avoid stress on the nervous system reduces the risk of long-term iatrogenic problems, that's correct.

 

However, some people have a very difficult time going off psychiatric drugs no matter how they taper. It's impossible to predict who might have this difficulty.

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

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The problem is, nobody's really done studies on this, so it's impossible to say absolutely that a slower taper will reduce the odds of protracted withdrawal, etc.  

 

Everything I know about tapers I've learned from observing and working with people who are actively tapering and posting on forums.  I've known a lot of those. But I haven't really heard from many people who've done slow tapers and then come back months or years out to report on whether they had a relapse or protracted problems afterwards.  

 

Actually I can't think of anyone like that who I have heard from. That could mean it's not happening--that the people who taper slowly and reach bottom and get stable and leave stay good from there on out. But the absence of information is not really information.

 

I wish I could answer your question. I can only say that people who taper slowly and adjust their taper so as to minimize withdrawal symptoms seem to do best during the taper process, until they leave the forum, after which I don't really know what happens.  

 

I'm certainly hoping that doing a slow, stable taper will mean that when I'm done I'll continue to do well. I think the chances are pretty good. I've always done very poorly with CTs or large rapid cuts, but I'm doing great with the slow taper. Hopefully that's a good sign. We shall see.

Started on Prozac and Xanax in 1992 for PTSD after an assault. One drug led to more, the usual story. Got sicker and sicker, but believed I needed the drugs for my "underlying disease". Long story...lost everything. Life savings, home, physical and mental health, relationships, friendships, ability to work, everything. Amitryptiline, Prozac, bupropion, buspirone, flurazepam, diazepam, alprazolam, Paxil, citalopram, lamotrigine, gabapentin...probably more I've forgotten. 

Started multidrug taper in Feb 2010.  Doing a very slow microtaper, down to low doses now and feeling SO much better, getting my old personality and my brain back! Able to work full time, have a full social life, and cope with stress better than ever. Not perfect, but much better. After 23 lost years. Big Pharma has a lot to answer for. And "medicine for profit" is just not a great idea.

 

Feb 15 2010:  300 mg Neurontin  200 Lamictal   10 Celexa      0.65 Xanax   and 5 mg Ambien 

Feb 10 2014:   62 Lamictal    1.1 Celexa         0.135 Xanax    1.8 Valium

Feb 10 2015:   50 Lamictal      0.875 Celexa    0.11 Xanax      1.5 Valium

Feb 15 2016:   47.5 Lamictal   0.75 Celexa      0.0875 Xanax    1.42 Valium    

2/12/20             12                       0.045               0.007                   1 

 

I'm not a doctor. Any advice I give is just my civilian opinion.

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This is sort of off-topic, but my sister once accompanied a woman in psych distress to a specialized clinic in FL. The director told my sister he was (had) bipolar but had been able to add enough structure to his life that he no longer needed to take medication. There is a doctor in England who says she has been able to manage her bipolar without medication for the past ten years. I have no idea how they tapered or how hard it was, but it seems like lifestyle management was a big part of their success.

1st round Prozac 1989/90, clear depression symptoms. 2nd round Prozac started 1999 when admitted to dr. I was tired. Prozac pooped out, switch to Cymbalta 3/2006. Diagnosed with bipolar disorder due to mania 6/2006--then I was taken abruptly off Cymbalta and didn't know I had SSRI withdrawal. Lots of meds for my intractable "bipolar" symptoms.

Zyprexa started about 9/06, mostly 5mg. Tapered 4/12 through12/29/12

Wellbutrin. XL 300 mg started 1/07, tapered 1/18/13 through 7/8/13

Oxazepam mostly continuously since 6/06, 30mg since 12/12, tapered 1.17.14 through 8.26.15

11/06 Lithium 600mg twice daily, 2.2.14 400mg TID DIY liquid, 2.12.14 1150mg, 3.2.14 1100mg, 3.18.14 1075mg, 4/14 updose to 1100mg, 6.1.14 900 mg capsules 7.8.14 810mg, 8.17.14 725mg, 8.24.24 700mg...10.22.14 487.5mg, 3.9.15 475mg, 4.1.15 462.5mg 4.21.15 450mg 8.11.15 375mg, 11.28.15 362.5mg, back to 375mg four days later, 3.4.16 updose to 475 (too much going on to risk trouble)

9/4/13 Toprol-XL 25mg daily for sudden hypertension, tapered 11.12.13 through 5.3.14, last 10 days or so switched to atenolol

7.4.14 Started Walsh Protocol

56 years old

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This is an interesting question. It's easy to blame withdrawal for every symptom because

it is responsible for so much suffering. I think even after all drugs are gone, a period of

being 'under the weather' or physical illness, virus etc, or situational depression could

be put down to withdrawal or a relapse when it is neither. I know I could fall into that trap! 

 

I would think that most people who have fought hard to come off drugs responsibly and

carefully will have gained enough self discipline and developed habits that will mean 

they are healthier and in tune with their body and so avoid the situations that got us there

in the first place.  That's what I'm hoping for.

**I am not a medical professional, if in doubt please consult a doctor with withdrawal knowledge.

 

 

Different drugs occasionally (mostly benzos) 1976 - 1981 (no problem)

1993 - 2002 in and out of hospital. every type of drug + ECT. Staring with seroxat

2002  effexor. 

Tapered  March 2012 to March 2013, ending with 5 beads.

Withdrawal April 2013 . Reinstated 5 beads reduced to 4 beads May 2013

Restarted taper  Nov 2013  

OFF EFFEXOR Feb 2015    :D 

Tapered atenolol and omeprazole Dec 2013 - May 2014

 

Tapering tramadol, Feb 2015 100mg , March 2015 50mg  

 July 2017 30mg.  May 15 2018 25mg

Taking fish oil, magnesium, B12, folic acid, bilberry eyebright for eye pressure. 

 

My story http://survivingantidepressants.org/index.php?/topic/4199-hello-mammap-checking-in/page-33

 

Lesson learned, slow down taper at lower doses. Taper no more than 10% of CURRENT dose if possible

 

 

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I would think that most people who have fought hard to come off drugs responsibly and

carefully will have gained enough self discipline and developed habits that will mean 

they are healthier and in tune with their body and so avoid the situations that got us there

in the first place.  That's what I'm hoping for.

 

 

that is largely true! healing from drug iatrogenesis is a heck of an education...and one heals all aspects of their being in the process. 

Everything Matters: Beyond Meds 

https://beyondmeds.com/

withdrawn from a cocktail of 6 psychiatric drugs that included every class of psych drug.
 

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I hadn't thought of this but will from now on...that healing from drug dependence, and then from iatrogenic effects, is a great education, and that our whole body/being can change in the process. It never occurred to me that if I had known how to take care of myself physically, emotionally, and spiritually -- or had known how to respond differently to events I couldn't control, and to my own feelings -- I might never have landed in the place I'm in. Will remember that awareness and some self discipline are key. I've usually thought of self-care as selfish, but it seems it can help to create joy and prevent a lot of unnecessary misery (there's enough unavoidable pain in life, isn't there?).

Prozac 20 mg/daily since 1995

July 19, 2013, initial cut to 15 mg; Aug. 2 updosed to 18 mg; Aug. 19, to 16.2 mg
Held at 2.52 ml/day Jan. 11-April 16, 2014
April 16, 2014, cut to 2.40 ml/day
Dec. 29, 2014, 1.84 ml/day, and held there almost six months
June 23, 2015, 1.75ml/day; July 21, 2015, 1.70 ml/day
Aug. 13, 2015, 1.60 ml/day

Feb. 7, 2016, .7 ml/day; April 26, 2016, .6 ml/day

 

Taking anastrozole (estrogen blocker)
 
Successfully completed long, slow Klonopin taper November 2011. :ph34r:

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Dr. Shipko's book called it "the ultimate behavioral therapy"

1st round Prozac 1989/90, clear depression symptoms. 2nd round Prozac started 1999 when admitted to dr. I was tired. Prozac pooped out, switch to Cymbalta 3/2006. Diagnosed with bipolar disorder due to mania 6/2006--then I was taken abruptly off Cymbalta and didn't know I had SSRI withdrawal. Lots of meds for my intractable "bipolar" symptoms.

Zyprexa started about 9/06, mostly 5mg. Tapered 4/12 through12/29/12

Wellbutrin. XL 300 mg started 1/07, tapered 1/18/13 through 7/8/13

Oxazepam mostly continuously since 6/06, 30mg since 12/12, tapered 1.17.14 through 8.26.15

11/06 Lithium 600mg twice daily, 2.2.14 400mg TID DIY liquid, 2.12.14 1150mg, 3.2.14 1100mg, 3.18.14 1075mg, 4/14 updose to 1100mg, 6.1.14 900 mg capsules 7.8.14 810mg, 8.17.14 725mg, 8.24.24 700mg...10.22.14 487.5mg, 3.9.15 475mg, 4.1.15 462.5mg 4.21.15 450mg 8.11.15 375mg, 11.28.15 362.5mg, back to 375mg four days later, 3.4.16 updose to 475 (too much going on to risk trouble)

9/4/13 Toprol-XL 25mg daily for sudden hypertension, tapered 11.12.13 through 5.3.14, last 10 days or so switched to atenolol

7.4.14 Started Walsh Protocol

56 years old

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