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Mario's "turtle taper" opinion


Mario

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I did not say ssri's were stored in fat tissue I said there wasn't any adipose tissue in the brain like the op said..?

WARNING THIS WILL BE LONG
Had a car accident in 85
Codeine was the pain med when I was release from hosp continuous use till 89
Given PROZAC by a specialist to help with nerve pain in my leg 89-90 not sure which year
Was not told a thing about it being a psych med thought it was a pain killer no info about psych side effects I went nuts had hallucinations. As I had a head injury and was diagnosed with a concussion in 85 I was sent to a head injury clinic in 1990 five years after the accident. I don't think they knew I had been on prozac I did not think it a big deal and never did finish the bottle of pills. I had tests of course lots of them. Was put into a pain clinic and given amitriptyline which stopped the withdrawal but had many side effects. But I could sleep something I had not done in a very long time the pain lessened. My mother got cancer in 94 they switched my meds to Zoloft to help deal with this pressure as I was her main care giver she died in 96. I stopped zoloft in 96 had withdrawal was put on paxil went nutty quit it ct put on resperidol quit it ct had withdrawal was put on Effexor... 2years later celexa was added 20mg then increased to 40mg huge personality change went wild. Did too fast taper off Celexa 05 as I felt unwell for a long time prior... quit Effexor 150mg ct 07 found ****** 8 months into withdrawal learned some things was banned from there in 08 have kept learning since. there is really not enough room here to put my history but I have a lot of opinions about a lot of things especially any of the drugs mentioned above.
One thing I would like to add here is this tidbit ALL OPIATES INCREASE SEROTONIN it is not a huge jump to being in chronic pain to being put on an ssri/snri and opiates will affect your antidepressants and your thinking.

As I do not update much I will put my quit date Nov. 17 2007 I quit Effexor cold turkey. 

http://survivingantidepressants.org/index.php?/topic/1096-introducing-myself-btdt/

There is a crack in everything ..That's how the light gets in :)

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Dear Bdtd,

Thx for the observation. I guess that the authors of the protocol meant the set of all the possible tissues that surround the Blood Brain Barrier and in which the drug could potentially accumulate (I will suggest them to simplify the terminology...  may be "accumulates in the brain" can still give the idea).

What do you think ?

1) Started paroxetine in 1997 at 16 years old of age (maintenance dosage 10 mg)
2) Failed several reduction attempt up to 2007
3) Started a gradual reduction protocol in 2007 at a rate of 0.2 mg per month
4) Strong relapse at 3.6 mg of paroxetine (even trying to resist the symptoms for 3 months didn't work and a reinstatement of a slightly higher SSRI dosage didn't work as well)
5) Shifted to Sertraline, eliminated paroxetine and moved Sertraline dosage up to the correspondent maintenance dosage of 3.6 mg of Paroxeine, in few months and without problems
6) reducing Sertraline very slow (now at 8 mg, that corresponds to 3 mg of Paroxetine/Citalopram).
7) From now on I decided to follow the Turtle protocol: http://ssrigr.altervista.org

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Mario, what do you mean that withdrawal symptoms lack physiological interpretation? One of the most common symptoms are anxiety.

On Venlafaxine XR 75mg > 20 years, because a general MD decided to try these new "calming pills" taken from his sample closet because my pulse was a little high since I get nervous going to the doctor.

 

June 2010 - Cold turkey

September 2010 - Sudden onset of EXTREME anxiety, constant terror and fear that got marginally better at night.  I had no idea what or why this was; had no idea it was the quitting of Effexor.  (I was never in my life even remotely like this)

December 2010 - reinstated 75mgs Effexor XR, felt no better months later

January 2011 - Began 5% taper every month

2012 - Anxiety began improving by had many windows and waves

January 2014 - Fell back into sudden onset of same anxiety, fear as in 2010; realized I was tapering too quickly.  I was not allowing withdrawal effects to dissipate before another taper.  Began 2% taper every 6 to 8 months

2016 - Fear, anxiety began to wane

2017, 18 & 19 - Constant Fear & anxiety stopped, just occasional minor bouts that lasted 3 days or so

December 2020 - Now at ~40mgs Effexor XR, 2.5mgs Crestor (Cutting 5mg pill in half due to sudden palpitations or PVCs)

 
 
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Psychological I meant.

On Venlafaxine XR 75mg > 20 years, because a general MD decided to try these new "calming pills" taken from his sample closet because my pulse was a little high since I get nervous going to the doctor.

 

June 2010 - Cold turkey

September 2010 - Sudden onset of EXTREME anxiety, constant terror and fear that got marginally better at night.  I had no idea what or why this was; had no idea it was the quitting of Effexor.  (I was never in my life even remotely like this)

December 2010 - reinstated 75mgs Effexor XR, felt no better months later

January 2011 - Began 5% taper every month

2012 - Anxiety began improving by had many windows and waves

January 2014 - Fell back into sudden onset of same anxiety, fear as in 2010; realized I was tapering too quickly.  I was not allowing withdrawal effects to dissipate before another taper.  Began 2% taper every 6 to 8 months

2016 - Fear, anxiety began to wane

2017, 18 & 19 - Constant Fear & anxiety stopped, just occasional minor bouts that lasted 3 days or so

December 2020 - Now at ~40mgs Effexor XR, 2.5mgs Crestor (Cutting 5mg pill in half due to sudden palpitations or PVCs)

 
 
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Mario, what do you mean that withdrawal symptoms lack psychological interpretation? One of the most common symptoms are anxiety.

On Venlafaxine XR 75mg > 20 years, because a general MD decided to try these new "calming pills" taken from his sample closet because my pulse was a little high since I get nervous going to the doctor.

 

June 2010 - Cold turkey

September 2010 - Sudden onset of EXTREME anxiety, constant terror and fear that got marginally better at night.  I had no idea what or why this was; had no idea it was the quitting of Effexor.  (I was never in my life even remotely like this)

December 2010 - reinstated 75mgs Effexor XR, felt no better months later

January 2011 - Began 5% taper every month

2012 - Anxiety began improving by had many windows and waves

January 2014 - Fell back into sudden onset of same anxiety, fear as in 2010; realized I was tapering too quickly.  I was not allowing withdrawal effects to dissipate before another taper.  Began 2% taper every 6 to 8 months

2016 - Fear, anxiety began to wane

2017, 18 & 19 - Constant Fear & anxiety stopped, just occasional minor bouts that lasted 3 days or so

December 2020 - Now at ~40mgs Effexor XR, 2.5mgs Crestor (Cutting 5mg pill in half due to sudden palpitations or PVCs)

 
 
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Dear Bdtd,

Thx for the observation. I guess that the authors of the protocol meant the set of all the possible tissues that surround the Blood Brain Barrier and in which the drug could potentially accumulate (I will suggest them to simplify the terminology...  may be "accumulates in the brain" can still give the idea).

What do you think ?

I have no clue. 

I know I have been trying hard to read this book by Grace E Jackson that has a ton of scientific links and articles in it and she states these drugs leave the brains much much more slowly than they leave the blood stream... 

I am sorry I am falling short in the understanding and the reading as I am grieving just now... 

But I knew darn well there was no andipose tissue in the brain the blood brain barrier is a very interesting topic and I will learn more about it I expect in the days ahead... as I am suffering memory problems it is hard for me to learn and hold onto information. 

Sorry I wish I could help you more I likely could figure it out on a good day and promptly forget it the next and have to do it again. 

The book if you want to read it is linked here.

http://www.amazon.com/Drug-Induced-Dementia-MD-Grace-Jackson/dp/1438972318

 

If you want to talk science this is your person to talk to .. as I think she knows her stuff. 

Drug Induced Dementia 

the perfect crime 

is full of science... 

 

and is wasted on me just now. 

 

I think you could get some very interesting hints just from the article I linked too I found it very interesting and think I will be back when I am feeling smarter to give it another look

WARNING THIS WILL BE LONG
Had a car accident in 85
Codeine was the pain med when I was release from hosp continuous use till 89
Given PROZAC by a specialist to help with nerve pain in my leg 89-90 not sure which year
Was not told a thing about it being a psych med thought it was a pain killer no info about psych side effects I went nuts had hallucinations. As I had a head injury and was diagnosed with a concussion in 85 I was sent to a head injury clinic in 1990 five years after the accident. I don't think they knew I had been on prozac I did not think it a big deal and never did finish the bottle of pills. I had tests of course lots of them. Was put into a pain clinic and given amitriptyline which stopped the withdrawal but had many side effects. But I could sleep something I had not done in a very long time the pain lessened. My mother got cancer in 94 they switched my meds to Zoloft to help deal with this pressure as I was her main care giver she died in 96. I stopped zoloft in 96 had withdrawal was put on paxil went nutty quit it ct put on resperidol quit it ct had withdrawal was put on Effexor... 2years later celexa was added 20mg then increased to 40mg huge personality change went wild. Did too fast taper off Celexa 05 as I felt unwell for a long time prior... quit Effexor 150mg ct 07 found ****** 8 months into withdrawal learned some things was banned from there in 08 have kept learning since. there is really not enough room here to put my history but I have a lot of opinions about a lot of things especially any of the drugs mentioned above.
One thing I would like to add here is this tidbit ALL OPIATES INCREASE SEROTONIN it is not a huge jump to being in chronic pain to being put on an ssri/snri and opiates will affect your antidepressants and your thinking.

As I do not update much I will put my quit date Nov. 17 2007 I quit Effexor cold turkey. 

http://survivingantidepressants.org/index.php?/topic/1096-introducing-myself-btdt/

There is a crack in everything ..That's how the light gets in :)

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Mario, are you gathering information here to help someone else revise the turtle taper?

 

There's a lot of information already in this Tapering forum, please look at all the pinned topics at the top of the forum, and the Symptoms forum as well.

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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Dear John,

In my previous post, where I wrote that "withdrawal symptoms lack a strong psychological interpretation"  I was thinking about traumas and or strong stress.

If upon reduction of an SSRI after 3 months (or even before) one starts to feel psychiatric symptoms (like anxiety),  he is obviously not going to find a strong psychological interpretation that could justify those symptoms (i.e. it is mainly the reduction of the drug that is causing the symptoms and not the stress itself.  ).  On the other way somebody who is conducting an happy life (e.g. wins the lottery every day) has more chances to be able to reduce the drug a little bit faster than somebody who is conducting a stressful life.

1) Started paroxetine in 1997 at 16 years old of age (maintenance dosage 10 mg)
2) Failed several reduction attempt up to 2007
3) Started a gradual reduction protocol in 2007 at a rate of 0.2 mg per month
4) Strong relapse at 3.6 mg of paroxetine (even trying to resist the symptoms for 3 months didn't work and a reinstatement of a slightly higher SSRI dosage didn't work as well)
5) Shifted to Sertraline, eliminated paroxetine and moved Sertraline dosage up to the correspondent maintenance dosage of 3.6 mg of Paroxeine, in few months and without problems
6) reducing Sertraline very slow (now at 8 mg, that corresponds to 3 mg of Paroxetine/Citalopram).
7) From now on I decided to follow the Turtle protocol: http://ssrigr.altervista.org

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Dear John,

In my previous post, where I wrote that "withdrawal symptoms lack a strong psychological interpretation"  I was thinking about traumas and or strong stress.

If upon reduction of an SSRI after 3 months (or even before) one starts to feel psychiatric symptoms (like anxiety),  he is obviously not going to find a strong psychological interpretation that could justify those symptoms (i.e. it is mainly the reduction of the drug that is causing the symptoms and not the stress itself.  ).  On the other way somebody who is conducting an happy life (e.g. wins the lottery every day) has more chances to be able to reduce the drug a little bit faster than somebody who is conducting a stressful life.

Mario, Im a little unclear as to the Emergency Plan 2.  What does Clonazepam 5 drops every 12 hours for 5 weeks mean?

On Venlafaxine XR 75mg > 20 years, because a general MD decided to try these new "calming pills" taken from his sample closet because my pulse was a little high since I get nervous going to the doctor.

 

June 2010 - Cold turkey

September 2010 - Sudden onset of EXTREME anxiety, constant terror and fear that got marginally better at night.  I had no idea what or why this was; had no idea it was the quitting of Effexor.  (I was never in my life even remotely like this)

December 2010 - reinstated 75mgs Effexor XR, felt no better months later

January 2011 - Began 5% taper every month

2012 - Anxiety began improving by had many windows and waves

January 2014 - Fell back into sudden onset of same anxiety, fear as in 2010; realized I was tapering too quickly.  I was not allowing withdrawal effects to dissipate before another taper.  Began 2% taper every 6 to 8 months

2016 - Fear, anxiety began to wane

2017, 18 & 19 - Constant Fear & anxiety stopped, just occasional minor bouts that lasted 3 days or so

December 2020 - Now at ~40mgs Effexor XR, 2.5mgs Crestor (Cutting 5mg pill in half due to sudden palpitations or PVCs)

 
 
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Mario, what we see is that hardly anyone is in an ideal life situation for tapering. Certainly, if one is under intense stress, it makes sense to reduce that stress before taking on more by changing drug dosage.

 

The factor that causes withdrawal difficulties is individual neurological sensitivity to dosage reduction, not a life situation.

 

Taking clonazepam 5 drops every 12 hours for 5 weeks is a good recipe for physical dependence on clonazepam.

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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Dear Altostrata, John,

Yes, I do agree.  Effectively get rid of the stress before starting a reduction is indeed a good idea :-)

However, at least from my experience, I couldn't see really a clear cut in these two states (stress and no-stress). We are not talking about stress that you have for 2 weeks (let's say a pick of work in your company), but we are talking more about the average happiness/stress that you have during the year.

This average happiness/stress could be a little bit difficult even to quantify… 

Hence, yes, we could somehow be able to feel that we are not very happy and take it into account somehow.  But, why avoid to reduce the SSRI, when still is possible to reduce it at a slower speed  ? (and hence more safely).  I would suppose that this could be a sort of missed opportunity  (you could have reduced the drug, even if very very slow, and you did not).

That's why I tend to believe in this protocol that propose to reduce extremely slow (so to be safe even if you have some stress, like everybody has in life), more than waiting the perfect moment and then hazard a faster reduction.

1) Started paroxetine in 1997 at 16 years old of age (maintenance dosage 10 mg)
2) Failed several reduction attempt up to 2007
3) Started a gradual reduction protocol in 2007 at a rate of 0.2 mg per month
4) Strong relapse at 3.6 mg of paroxetine (even trying to resist the symptoms for 3 months didn't work and a reinstatement of a slightly higher SSRI dosage didn't work as well)
5) Shifted to Sertraline, eliminated paroxetine and moved Sertraline dosage up to the correspondent maintenance dosage of 3.6 mg of Paroxeine, in few months and without problems
6) reducing Sertraline very slow (now at 8 mg, that corresponds to 3 mg of Paroxetine/Citalopram).
7) From now on I decided to follow the Turtle protocol: http://ssrigr.altervista.org

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My point is: Choosing a "perfect moment" does not reduce the risk of withdrawal syndrome. Withdrawal syndrome is determined by individual sensitivity, which cannot be predicted. Thus, everyone should reduce slowly -- you don't know if you're sensitive or not, slow tapering reduces the risk.

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, I agree with you completely.  I am also of the idea that if one manages to find the right reduction speed everything is going to go smoothly (and in general, the slower the safest…).

If one make the mistake of reducing too fast, he is going to loose something between 4 months and 16 months of time (i.e. the time that he needs to cure his crisis and start to reduce again from the same dosage), and the symptoms are of course not nice to bear.

1) Started paroxetine in 1997 at 16 years old of age (maintenance dosage 10 mg)
2) Failed several reduction attempt up to 2007
3) Started a gradual reduction protocol in 2007 at a rate of 0.2 mg per month
4) Strong relapse at 3.6 mg of paroxetine (even trying to resist the symptoms for 3 months didn't work and a reinstatement of a slightly higher SSRI dosage didn't work as well)
5) Shifted to Sertraline, eliminated paroxetine and moved Sertraline dosage up to the correspondent maintenance dosage of 3.6 mg of Paroxeine, in few months and without problems
6) reducing Sertraline very slow (now at 8 mg, that corresponds to 3 mg of Paroxetine/Citalopram).
7) From now on I decided to follow the Turtle protocol: http://ssrigr.altervista.org

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Dear John,

I think now I can try to answer one of your previous questions:

"Mario, Im a little unclear as to the Emergency Plan 2.  What does Clonazepam 5 drops every 12 hours for 5 weeks mean?"

 

It basically means that if you have been so smart to conduct the reduction very gradually (like in this forum and also in my protocol suggested) but so unlucky to have a relapse, you have the opportunity to apply a sort of "lighter" emergency plan with respect to reinstating the full SSRI dosage:

it could be enough to stop the reduction and sedate the brain for 5weeks, using Clonazepam, and then starting to reduce Clonazepam very gradually at a rate of 1 drop per week (hence removing Clonazepam in about 3 or 4 months). 

Obviously if this doesn't work (i.e. if when you are starting to reduce Clonazepam you have strong symptoms again), you can obviously increase the SSRi level. But if it does work, you could manage to save quite a significant amount of time in your reduction plan (about 8-10 months).

 

Clonazepam must be used 2 times x day (in order to ensure a constant sedation during the whole 24 hours).

It is obviously good to know that Clonazepam is the only anxiolytic drug that can be used for this purpose (all the other drugs, especially Xanax, would have too high probability to fail because of their too short half life and hence are dangerous and their use strongly discouraged by the protocol).

I hope to have answered your question.

1) Started paroxetine in 1997 at 16 years old of age (maintenance dosage 10 mg)
2) Failed several reduction attempt up to 2007
3) Started a gradual reduction protocol in 2007 at a rate of 0.2 mg per month
4) Strong relapse at 3.6 mg of paroxetine (even trying to resist the symptoms for 3 months didn't work and a reinstatement of a slightly higher SSRI dosage didn't work as well)
5) Shifted to Sertraline, eliminated paroxetine and moved Sertraline dosage up to the correspondent maintenance dosage of 3.6 mg of Paroxeine, in few months and without problems
6) reducing Sertraline very slow (now at 8 mg, that corresponds to 3 mg of Paroxetine/Citalopram).
7) From now on I decided to follow the Turtle protocol: http://ssrigr.altervista.org

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I'm sorry, Mario, I do not agree that one should counter SSRI withdrawal by becoming dependent on clonazepam, and one should counter clonazepam withdrawal by increasing or adding an SSRI.

 

Some people get past SSRI withdrawal with very occasional use of clonazepam. But if you are just off an SSRI, the preferred route is to reinstate a very small dosage of the SSRI. If you are in the middle of tapering an SSRI and run into withdrawal symptoms, again, the preferred route is to increase (updose) the SSRI slightly.

 

We would never, ever recommend regular use of clonazepam for 5 weeks or even 2 weeks to cope with SSRI withdrawal syndrome unless there are absolutely no other options available. Benzodiazapine withdrawal can be just as difficult or more than antidepressant withdrawal.

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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Dear Altostrata,

I do understand and respect your different opinion with respect to mine ;-)

1) Started paroxetine in 1997 at 16 years old of age (maintenance dosage 10 mg)
2) Failed several reduction attempt up to 2007
3) Started a gradual reduction protocol in 2007 at a rate of 0.2 mg per month
4) Strong relapse at 3.6 mg of paroxetine (even trying to resist the symptoms for 3 months didn't work and a reinstatement of a slightly higher SSRI dosage didn't work as well)
5) Shifted to Sertraline, eliminated paroxetine and moved Sertraline dosage up to the correspondent maintenance dosage of 3.6 mg of Paroxeine, in few months and without problems
6) reducing Sertraline very slow (now at 8 mg, that corresponds to 3 mg of Paroxetine/Citalopram).
7) From now on I decided to follow the Turtle protocol: http://ssrigr.altervista.org

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