How to Taper Antidepressants to Avoid a Withdrawal (Discontinuation) Syndrome?
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- เผยแพร่เมื่อ 14 พ.ค. 2024
- Dr Sanil Rege discusses strategies to taper antidepressants to prevent or minimise a withdrawal (discontinuation) syndrome.
Dr Sanil Rege is a Consultant Psychiatrist; founder of Psychscene.com and Vita Health Care.
Prevalence rates range between 7% and 23% of patients. However, a recent systematic review reported that up to 56% of patients would experience Discontinuation and withdrawal symptoms (DaWS). Of these, almost half (46%; based on four surveys) will regard their severe symptoms.
The neurobiological mechanisms of withdrawal are related to the receptor-rebound phenomenon whereby the sudden discontinuation of medication affects several feedback mechanisms that control serotonin neurotransmission.
Withdrawal symptoms:
a. Somatic symptoms - Malaise, dizziness, light-headedness, vertigo, paresthesias, fatigue, headache, nausea, tremor, muscle spasms, diarrhoea, sweating, and hallucinations
b. Psychological symptoms - Anxiety, insomnia, emotional blunting, and irritability
DaWS are diverse and variably expressed; the acronym FINISH - Flu-like symptoms; Insomnia; Nausea; Imbalance; Sensory disturbances; Hyperarousal is a useful guide for assessing the domains affected.
Mitigation of withdrawal symptoms with SSRIs (selective serotonin reuptake inhibitor) and other antidepressants can be achieved through carefully tapered discontinuation due to the hyperbolic relationship between drug dose and activity.
The principle behind the tapered discontinuation is based on the law of mass action. There is a steep increase in effect at small doses of the drug, flattening out as receptors become increasingly saturated.
Tapers over a period of months and down to doses much lower than minimum therapeutic doses have shown greater success in reducing withdrawal symptoms.
Therefore, when tapering antidepressants, clinicians are suggested to follow a regimen that focuses on biological effect (e.g. SERT occupancy) rather than arbitrarily withdrawing medication using a linear stepwise approach. From a practical viewpoint, it may be necessary to switch to liquid formulations given the requirement for micro-modifications of dose during the later tapering stages.
Dose effects are important; using citalopram as an example, halving the dose from 60 mg to 30 mg reduces the pharmacological activity at the SERT transporter only by a couple of percentage points.
Dose reductions at the bottom end of the dose range have a much larger effect, and this is where care is needed. Antipsychotics show a similar phenomenon.
References:
Horowitz A and Taylor D. Tapering of SSRI treatment to mitigate withdrawal symptoms. Lancet Psychiatry. 2019;6(7):561-562.
Malhi, G.S., Bell, E., Bassett, D., Boyce, P., Bryant, R., Hazell, P., Hopwood, M., Lyndon, B., Mulder, R., Porter, R. and Singh, A.B., 2021. The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders. Australian & New Zealand Journal of Psychiatry, 55(1), pp.7-117.
Absolutely wild that I have to get this information from TH-cam instead of my doctor, but here we are. This regimen has been 100x better for me than what my doctor suggested (6 weeks of linear taper)
Glad it has been helpful.
Im there with you on that one.
Agreed, but how can I make this happen? I'm trying to taper off Desvenlaxafine and they are taking me down from 50 to 25 for six weeks and then nothing. There are no other tablets available.
Doctors don’t care. They are trained to write prescriptions, not deal with the repercussions of the side effects and withdrawal.
Disgraceful doctors don’t tell you how difficult it is to get off this stuff when they start you on it. GPs in particular are irresponsible in their handling of antidepressants.
Nope they don't or how bad side effects are
Absolutely true.
@@stephanieterry6404 they just want to get paid
@@jerrylwhitlow8197 your 1000% right!!!
Absolutely! In this hell myself!
Thank you for the information without charging me a co-pay. :)
🤣🤣🤣🤣
🤣🤣🤣
@@marleemall Reduce negative thoughts to have a healthier life with a simple practice. Your breath is directly related to your mind [brain] causing negative thoughts-anxiety. For a relaxed life sit on a chair, back straight, eyes closed, be as still as possible and observe the sensations of your incoming--outgoing breath at the entrance of the nostrils for around 5-10-15 minutes or more. Don’t fight with your thoughts. Slowly the mind will relax. No deep inhalation-exhalation needed. Anytime of the day or night before sleep sit or lie down on your back and observe your breath. Stillness brings internal peace. Like me, make this a lifetime daily habit to have a good life. Best wishes Shyaaam Sir. -Counsellor.
@@shyaaammeneen63 Thank you for the information.
@@marleemall Since many years I have made it a habit to observe my breath even when walking alone, speaking on mobile, when reading, before sleep etc and I feel relaxed and healthier. Stillness reduces negative thoughts. Do the practice daily and develop your mental muscles during these challenging times. Best wishes. Shyaaam Sir-Counsellor.
After getting sober realized probably prescribed AD for my alcoholism problem. 20 years on SSRI when what I really needed was different coping skills, not chemicals. Planning to start tapering in June and your info really helps!
You got this!!!
Be sure you look up your SSRI and the best way to wean off. Paxil is hard and you need to go very S L O W.... even getting a psychiatrist to help would be good. These types of drugs are wicked to get off of. I'm trying to get off paxil now and am having great difficulty. Wishing you the best outcome. Take care.
@@missEvaMarie58 that's the one I'm trying to get off too. I was down to 15mg but the move to 10mg is very different... Almost 2 weeks in. Good luck to you.
I only did 3 weeks on sertraline, came off them coz they caused night sweats & insomnia, now I have spasms like I'm gonna go into a seizure, night sweats & insomnia. I swear to God I am never touching them again!! I've needed a drink every night this week just to get through. I would rather try to get to the root of the problem & deal with it than numb myself out to the point of not caring.
20 years on ssri..do you have diabetes now? I am now on 2 years...paxil is the hardest to get off.
Love the visuals. Allows me to really understand. Thank you 💙
Oh my this was so very very informative and useful, thank you thank you!!!
Very well explained as well!
Good stuff. Love this kind of pathophysio in depth talk
Doctors and psychiatrists DO NOT tell you anything about this when prescribing and boy do they like to prescribe as many as possible..
Thanks for addressing this, my doctor had the gaul to deny withdrawals happened, invalidating the suffering I went through because of her, she should be made take the meds she pushes and then left to see what CT/ quick taper feels like..
Really it's time prescribers were made accountable for all the damage they do and suffering they cause..
Thanks a lot, this so informative and well-explained
Got yourself a new subscriber. What an excellent presentation and avoiding monotone. Actually stayed engaged the whole way.
Thanks for the feedback.
Really good explanation of what is happening during withdrawal, thank you!
Thanks for the feedback 🙏🏼
Thankyou so much DR Sanil Rege.
Dr Sanil Rege 👍🏾👍🏾👍🏾👍🏾!
Please keep making these videos - so useful to creating platform for dialogue between patients & physicians & empowering for patients to understand.
Thank you for your feedback 🙏
Very informative and educational,I highly appreciate your effort,thank you!)
Agreed. Thank you Dr. Sanil Rege ❤️
This was easily the most comprehensive and easy to understand explanation of this subject I have ever seen- very well done.
As for me, I start to get withdrawal symptoms when I attempt to reduce below 10mg per day.
It’s nasty.
Awesome thanks! I've been on paxil for years and just feel I need to get off of it, from 20 down to 10 for a few weeks now, I believe you are correct in that the lower you go the slower you need to go!
Thank you so much! I told my Dr I was weaning off of this medicine. I am having serious hair loss and he didn’t want to listen to me and do other test(which is fine) but after educating myself more on the medicine I didn’t want to be on it for more reasons than just the hair loss. He told me to go back on my regular dose. I told him I refuse. Instead of him being a Dr who cares he didn’t give me any insight on how to wean off of the Zoloft. And If I would have known what I know now, I never would have started the medicine. My anxiety is high sometimes but I’d rather learn to cope with it than have been through what I’m going through now. Thanks for this video
When it was revealed that a lack of 14:04 seretonin does not cause depression, I promptly started my tapering. Before I began, I was on 300mg Venlaflaxine. I've been tapering for about 8 months as I experienced severe brain shocks and was on these drugs for 23 years. I don't feel as sluggish as I used to and embrace life now, not hide from it.
How u feel today
@@stefanmarkovic1709 much better thanks, still monetering myself carefully, energy level up but still cant sleep without sleeping pills. I'm working on that now.
What a helpful bunch of information.
Thank you so much for this explanation, you truly are a hero in my eyes, this changes the world for me. To keep a long story short I am 21 years old trying to cut off of Zoloft 25Mg, In a developing country where there are not many info nor infrastructure for mental health medicine. I will update this comment once i get to it. Wish me luck (i will show this to my general practitioner)
Thanks for the feedback. Wish you well. 👍🏼
Wow, really good presentation. Especially about the importance of tapering slower as you get lower.
Thank you for your feedback 🙏
@@PsychiatrySimplified your video is wonderful, I wish I would have seen it before my colomipramine withdrawal, I left it on 15mg,and now I am terribly suffering from its withdrawal symptoms.
I am going back to the same dosage again .
Would you please let me know how to prepare liquid form of clomipramin for tapering it very slowly?
@@anahitafaridmarandi4209 you can discuss this with the pharmacy - compounding pharmacies can help. Tapering strips and liquid are not available in all countries. Sorry to hear about the symptoms. Wish you well.
Many thanks for your reply,I live in Canada,I dont know where to find tapring liquid and strip ,can I buy them from any website?
@@anahitafaridmarandi4209 have a talk with your pharmacy and also compounding pharmacy. They can guide you. If you search for tapering strips there seems to be a company in Netherlands delivering. But we have no experience or afficliation with them.
I'm not sure how widely known that fascinating graph about SERT occupancy by dosage is among GPs but... As a patient finding the end of the taper tough going, I wanted to thank you so much for providing the science to explain why this is so. I'm taking escitalopram rather than citalopram but.... This mirrors my taper experience exactly (I barely felt anything dropping from 20mg to 5mg... the last 5mg however.... Wow, not easy!)
I appreciate your feedback 🙏🏻
Thank you for your presentation. Very clear.
Glad it was helpful!
Aprreciate your efforts : Very nice video with so much useful informations thank you :)
Excellent presentation Dr. Rege. So many SSRI prescribers rarely suggest tapering off medication and when their patients initiate this, the prescriber, whether it's a psychiatrist or GP, will follow a linear taper over a short period of time. When the patient has withdrawal symptoms, the prescriber mistakes them for a 'relapse' and wrongly assumes the patient needs to stay on the SSRI. The withdrawal symptoms (e.g. manic episode) are sometimes misdiagnosed as bipolar or schizophrenia and the patient is put on other medications. Dr. Mark Horowitz has done a lot of research on safely tapering to minimize withdrawal symptoms, which can be severe, and it's wonderful you have presented his research (along with co-author David Taylor) in a clear and comprehensive presentation. I hope practitioners watch your video and heed Horowitz's advice. Thank you!!
Pleasure 🙏🏻. Thanks for your feedback.
Thank you for this very informative video! 😊
I wish I (or my doctor!!!) would have known about this a year ago. When my treatment with Venlafaxine was stopped, the reduction from 300 mg to 37.5 mg went quickly and without withdrawal syndromes. The step from 37.5 to 0 mg was exactly as awful as that one time when I was on 300 mg and forgot to take my pills. After having watched your video, this makes sense.
My doctor told me to take 37.5 mg every other day, and then once a week over a period of some weeks. Here in Norway we (apparently) only have access to capsules with granules in them, which are impossible to break up into smaller pieces. There is no dose below 37.5 mg! While it wasn't awful, it interfered with my daily life, especially at work...
Sorry to hear. Glad it went well in the end. Yes the last drop is a real issue.
This is brilliant advice Dr thank you....
Excellent presentation Dr thank you.
Excellent explanation! I would sure like my doctor to see this but of course a patient doing that would be considered ‘problematic’.
Like me... my NP rolled her eyes up at me... I found someone else to go to.
That is so rude. I think that if these people got to experience this stuff first-hand they might be a bit more sympathetic to our plight.
They never listen to you, and the majority of doctors really don't know how to taper you off correctly.
@@missEvaMarie58 This is very common these days. Doctors just don't want to hear you out or listen to your concerns especially if you have been through the rabbit hole many times before. One doctor told me I could just quit taking Effexor XR 75mg with no problems or just go down to 37.5. Maybe some lucky people, but not me.
😂 I feel the pain your in! Dr.s are Gods in this culture… ☹️
Thank you for explaining all this. I have been on the generic form of Elavil for several years. I am now down to 5mg once a day. I am very frightened of experiencing these horrible side effects again. I was on Surmontil for over 25 years it was a capsule so there was no way to to divide the dose after a certain point. My withdrawal symptoms were so bad I ended up at a doctors office with super high blood pressure, sweating, shakes and severe anxiety, diarrhea, ect…that doctor had to prescribe blood pressure meds and then put me on Elavil. It was horrible. I was ready to go the ER I felt so awful. It is really awful that most doctors and psychiatrists never clue the patient in on how to withdraw on these antidepressants or get any help from them. I want to get off the amytriptyline but am truly frightened of the withdrawal and as such feel like a total failure as a human being.
Sorry to hear. I hope things go well.
You are not the failure... you trusted "the doctors" like I did and now we are both in a mess. I am presently suffering from withdrawal symptoms from paroxetine and suffering so much. It is very hard. I don't have an appointment with the psychiatrist for another month!!! They are the ones to help you wean off. Not the GP's.
Wishing you lots of good luck.
hello how did it go? did you taper off amitriptyline? I'm suffering the withdrawal effects too, can barely stand up and walk without feeling dizzy and feeling like I'll faint
@@PsychiatrySimplified I am trying to taper from 10 mg to 5 mg. based on doctors advise i started from 10 mg to 5 mg on alternate days. As soon as I started doing feel weakness, decreased libido symptoms, diziness,feel like lying on bed, insomnia. I have taken rtms therapy before. As soon as I go from 10 to 5 i start facing problem. Please advise how to proceed
@@saurabhkunal3624 I'm unable to give advice as this is in appropriate on YT forum. Pleas discuss this with your doctor as they would know your history and can explain the rationale for the steps.
This is so helpful, thank you so much.
thank you very much for such an amazing video
Thank you for such an informative video. I stopped abruptly after being on lovan for years, as I didn’t know how to taper off as they were in capsules. It’s also very hard and expensive to see a Doctor. It’s been a hell ride but seeing the list of side effects here makes me feel a bit better as I’ve got them all 😢 the nerve shocks were really scaring me. I was even thinking about going back on them. Now I’m hopeful that if I keep on pushing through with healthy eating , walking my dog and structuring positive experiences like charity work and animal rescue. That I’ll eventually be ok. I should never have been put on them. I was just going through a very tough time caring for my precious dad until he passed. I needed physical support not chemical alterations of my brain.
Trying cleaning your gut with alkaline foods...helped me loads. 💓
Thanks for posting this, i have been dealing with severe post ssri withdrawal effects for over four years, from Escitalopram. If only more psychiatrists knew all of this, then people would have far less problems with withdrawal. Unfotunately, most psychiatrists and Drs I have dealt with are essentially clueless about how to handle SSRI withdrawal.
I'm thinking about starting Escitalopram soon actually... What are there withdrawal effects that you have for over 4 years now? Is it better to just stay on the meds forever?
@@mireille8444 you should probably not start anything that you will be dependent on from the government bc of the state the world is in. I'm trying to wean off all my meds so they don't try and force me to do anything I don't want to do just in order to get it. Just my opinion. Good luck too you and God bless 💙🙏💙
I also want to know what lasted 4 yrs and if its getting slowly better from escitalopram
I'm down from 60 mg of mirtazapine to 30 mg every other day. In 10 days I go to 15 mg. I have absolutely no side effects. Not any that I'm noticing anyway. Will update when I'm halfway through the 15 mg to update about side effects bc I know the lower the dose the worse they get or so I've been told. Hope everyone is doing ok 👌
I'm now off mirtazapine completely. Waking up in the middle of the night and being very emotional is the only effects I have noticed. I'll take that over being dependant on any government supplied drug any day. At least I won't die from not having the drug. I hope everyone else has been successful as well 🙏
Extremely valuable information thank you 🙏🙏
Thank you for your feedback
Terrific information! Thank you
I'm glad this research is now being done. I came off venlafaxine in 2017 using 10% reductions over three and a half years, against doctors wishing to take me off considerably quicker. Even then it was the worst hell imaginable during last stages and the first year completely off.
❤
Wow. How long had you been on? I hope you are better now and off medication.
How often did you do 10% reduction?
@@adamwiseman6117 15 years on. Then reductions every month or longer depending on how it felt. Apart from the occasional mild brain zap, feeling considerably better now thanks yes.
Did you feel really depressed? What was the most annoying symptoms?
I could not get under 6mg. Decreasing just one bead caused severe anxiety. Better described as horror. Never was closer to killing myself. Lasted 9 hellish months that I'm still not sure how I survived. Stuck on 6mg for 5 years. Plus freaking Prozac that the dr said would help get me off Effexor, but all that happened is I got stuck on Prozac too, and it gives me bad fatigue and avolition.
Thank You for posting this. I have been taking Citalopram for about 21 years. I have tried to "wean" off twice over the years without success. I will give this a try again and be much slower in my taper.
This crap is insane isn't it
@@jerryshunk7152 Hi Jerry, yes it is terrible! Wish I had never started it all those years ago
Have you had any luck weaning off?
@davegbw
Did u able to stop the medicine???
awesome! This was excellent presentation!!!
Thank you for your feedback. 🙏
@@PsychiatrySimplified I'm sorry to crush your presentation but Sertraline/Zoloft true half-life is actually 83hr's not 26hr's!
@@PeterBerisha thanks for the comment. Most literature and the paper included which I have referenced mention around 26 hours. Usually most SSRIs besides fluoxetine can be considered within 24-72 hours . Is there a reference for the longer half like with sertraline ?
@@PsychiatrySimplified /watch?v=QH0V59P73sA&t=334s go to 5min and 30sec to learn more!
Thank you so much for your video!
Thank you! This is so helpful!
I’ve been on 25mg of sertraline for two years. It works for me, but I never wanted to be on medication long term. I’m scared to feel the same lows I felt before meds, but I’m also afraid of what the drug might do to my brain and body if I stay on it for many more years.
Thank you for your feedback. It is important to recognise the effect of untreated depression on the brain - which has significant consequences biologically and psychosocially. Please discuss the risks and benefits with your doctor - who should be able to answer your specific questions with regard to your concerns.
Now do one that's exactly the same for neuroleptics!
I realize you wrote a summary on that. People taking neuroleptics are often, due to the perceived severity of their indicating conditions, left out of the loop even more severely when it comes to these things.
Qualitative research needs to be done on the experience of rebound psychosis, so as to be able to differentiate it from a return of the original symptoms; too often psychosis is seen as an homogenous category (craziness), so people end up on the meds forever, even when they might not actually be indicated.
Good point . There is more recognition about the phenomenon of dopamine super sensitivity psychosis ; with certain signs such as movement disorders, acute onset, different nature of symptoms etc as clues . But overall yes one should try to differentiate between the withdrawal vs true relapse. Hence reduction should be very gradual but more importantly in Rx dose adjustments should be made over the life span to avoid dopamine super sensitivity or using partial agonists . Thanks for raising this point .
Thank you for sharing
Thank you so much ❤️❤️
Thank you for this information ❤ I am currently going through hell.
Hoping all of us make it through these horrible withdrawals. I hope we all get through this quickly.
Wish you well.
I'm withdrawing from Paroxetine. Simply awful. It'll be liberating though once we've succeeded ❤
@@PsychiatrySimplifiedhi doctor can you please help me here? I was taking 20 mg of citalopram generic for celexa for 3 years them taking 40 mg fr 2 years now my doctor put me 20 mg of celexa together with lexapro 5 mg! The doctor wants me to take it like that for one month them e just want me to take lexapro only. Did he did it right? Please
The concept of SERT occupancy was mindblowing.
The first time I did a taper I did the linear approach you mentioned. The last few drops were really rough.
This time I'll follow the table you showed. What a lifesaver!
Very informative
Excellent Information
Am an RN and can not tell you how refreshing it is to see this information being explained in a clear conscience manner. So very interesting and thought provoking! Every patient should have the opportunity to have antidepressants explained like this to make a more informed choice. Antidepressants may be life saving, but patients should still be informed. Would you consider a video for cross tapering? Thank you 12:50
I will keep this on the list. I think it’s very relevant. Thank you for your feedback. I’m going to be doing another video on tapering soon so will include this.
Yeah especially if a person gets stuck on the antidepressant and can't get off due to debilitating withdrawals. Alot of people are on them for life. And what they do is make a person emotionally numb. That's how they work.
Good video, a lot better than you’ll see than almost all doctors, psychiatrists out there practicing. Unfortunately for some people like myself, withdrawal symptoms are unavoidable, never minding the dose reduction amount, speed of the taper. These drugs, SSRI, SSNRIs are only clinically trialled for 8 weeks tops, what occurs after that to someone’s CNS system, brain is completely unknown, hence people shouldn’t be on these drugs long term. There should be informed consent in the field of Psychiatry. This is something as a psychiatrist you should be looking at, which in my case has lead to TBI, traumatic brain impairment due to long term exposure. Neurotoxicity is also another impairment I’m learning to navigate through. It’s just ridiculous what I’m having to go through because of corruption and ignorance in the profession.
I’m currently on my 3rd taper, down to 88 % off the original dose of Effexor 75 mg after 17 years of physical dependence. This has taken nearly 5 years to achieve.
I’m hoping with time, this is another problem the field of psychiatry will catch up with, as for some like myself, it’s too late.
Sorry to hear. Thanks for sharing your experience. We wish you well.
Yes Effexor withdrawal is hell- so glad people r becoming more aware of this, like u I had to do a slow taper it took me 3 years even tho I still have symptoms-10% taper per month
I needed this information 7 yrs ago. Too many doctors just don't care or don't know this approach for reduction. I'm starting my journey this week. Life has been horrible for 15 years.
Sorry to hear
@@PsychiatrySimplified thanks for making a video of this empowering information
@RF
Did u able to come off from medicine????
@@sonamwangmo5012 hello. Yes I did. Thank you for asking. I took drastic measures. It required an 8 week short term disability period where I was not working. It was the hardest thing I've done mentally and emotionally. I was down to 10mg daily of Paxil before I knew I had to just cut it off and get better. I went "cold turkey" from 10Mg which some day isnt a big dose. The Paxil was masking trauma from my past. I learned I had D.I.D. and the meds made it very hard to detect. I have had healing and impressive recovery through a counselor at The Center for Christian Counseling. The power of Jesus Christ made my diagnosis, healing and recovery in record time. I cannot stress the importance of finding a counselor in Christian counseling. The mind, body, and spirit are very complex and we do not realize how much they can be impacted throughout our lives.
Some good advice. I plan on stopping my medication eventually. Much of the 'expert' advice out there on tapering SSRI medication isn't very good. Many of them will say something along the lines of reducing over a period of 2-3 weeks then stopping completely, which is just too fast for many people.
Is there any chance you could do a presentation specifically relating to mirtazepine withdrawal? It's got so many modes of action it would be great to try and understand what's happening during withdrawal, especially with regards to the antihistamine aspect.
Thank you for the request. I hope to do a video on antihistaminergic withdrawals at some point. The principles remain the same. The antihistaminergic effect can result in a rebound - so the last doses should continue to be reduced slowly. Rebound insomnia, agitation and anxiety are common symptoms. Importantly withdrawals should be differentiated from relapse which can be difficult to do in some cases. We have covered the mechanisms of mirtazapine on this channel in another video. th-cam.com/video/ZaClhWs6RzQ/w-d-xo.html
Does it affect kidney cholesterol or other side effects
Thank you for this. I’ve been on Paxil since I was 8, I’m now 29. It’s been difficult to find a doctor who is willing to take tapering off seriously.
Sorry to hear. Most psychiatrists will be able to provide a plan. Wish you well.
Hey Camille- I'm 34 and have been on paxil since I was 10 (originally put on it for OCD). Your comment made me stop in my tracks because I really haven't talked to anyone who has also been on paxil since they were a child.
I was on 20mg for 20 years and then at age 30 my dose was doubled to 40mg/day (due to work/life stress). The doubling of the dose made me slightly manic and gave me suicidal thoughts for months. This horrific experience set me off on a journey to really get a handle on my mental health and learn as much as I could. I realized I had been taking paxil for much longer than I should have. I felt betrayed and very confused. I read "Your Drug May Be Your Problem" and it was an eye-opener. I had tried (unsuccessfully) to get off of paxil twice before, once in high school and once in college. This is my third, final, and most successful taper mainly due to the education I've received.
In April 2021, I started tapering off paxil and I've learned a ton about the process. Happy to answer any questions you may have. I ended up leaving my psychiatrist (I had seen a few over the years) and found a doctor who was willing to support my taper. I also worked with a supplement doc and did got my gut health and adrenal glands up to speed.
Most doctors are not educated around SSRI de-prescribing but there are many independent groups online (Inner Compass Initiative, Medicating Normal, etc) who have gathered amazing resources to help educate around the de-prescribing of SSRIs/benzos. Most doctors will tell you to cut your pill in half or some nonsense. The long and short of it is that you should reduce your dosage no more than 10% every 2-4 weeks. The tapering process is less about getting the drug "out" of your system and more about slowly reducing the amount of drug at the same rate your body/brain/CNS can adjust. A low inflammation diet can be very helpful in supporting your taper, as is some light exercise, maybe some yoga/meditation, and decent sleep (although insomnia from withdrawal is common). Support from good friends and family is also crucial.
I'm currently on 8mg/day (down from 40mg). It's a tough journey to get off this crap but it is possible. I've met others who have also successfully gotten off. I wish you well and would be happy to talk more, if you'd like.
doctors are trained to prescribe drugs and have no real interest in getting you off them. It's bad for business
@@cowboyjohnsontown please help!!! How are you on 8mg?? I thought 10mg was the lowest. I'm so ready to slowly but surely taper off of this garbage.
@@kristalxleigh07 At first, I dropped from 40mg to 30mg to 20mg, because those are the pill sizes available. It took me about 6 months to get from 40mg to 20mg and looking back, these were pretty big drops. The bigger the drop in dosage= the more extreme the withdrawal.
After 20mg, my doctor and I worked with a compound pharmacy and I dropped to 17.5mg pills, then 15mg pills. A compound pharmacy is a little expensive but they can make you pills in whatever dose you need.
At 15mg I then learned that paroxetine (generic for Paxil) comes in liquid version. 1ml of liquid=2mg of paroxetine.
Then I ordered some liquid syringes off Amazon and I was off to the races. With the liquid, you can make small drops in dosage. Small drops in dosage are important to do when you're nearing 0mg. It's "easier" to drop from say, 40mg to 30mg, but harder to drop from 10mg to 0mg. In both cases, you're dropping 10mg, but it's a much bigger shock to the system to drop off the drug completely.
After I hit 10mg, I started dropping 1mg each month. I'm now down to 5mg and am hoping to be off completely come spring time of 2023.
(I should add: liquid paroxetine is expensive! I was paying $5 month for 40mg pills. Now to get off this crap, I pay $170 for a bottle of liquid paroxetine. Kind of ridiculous but I'm more than willing to invest some money in being free of this poison)
Nice, I was gonna go linear like doc suggested but now I know better.
You're good. Very good! Thanks mate.
Thanks for the feedback! 🙏
@@PsychiatrySimplified how can you be contacted doctor?
@@kashafsaima1785 LD, The brain needs to adjust. Gradually reduce medication to the lowest dose [mg] for 1 month, then take alternate days and depending on how you feel taper of completely. Do the following practice daily. Reduce negative thoughts to have a healthier life with a simple practice. Your breath is directly related to your mind [brain] causing negative thoughts-anxiety. For a relaxed life sit on a chair, back straight, eyes closed, be as still as possible and observe the sensations of your incoming--outgoing breath at the entrance of the nostrils for around 5-10-15 minutes or more. Don’t fight with your thoughts. Slowly the mind will relax. No deep inhalation-exhalation needed. Anytime of the day or night before sleep sit or lie down on your back and observe your breath. Stillness brings internal peace. Like me, make this a lifetime daily habit to have a good life. Best wishes Shyaaam Sir. -Counsellor.
I have been on around 3 to 4 mg of Prozac for 30 years. I decided 4 months ago to start tapering. 2 months at 3 mg then 2 months at 2 mg. What the doctor described is very true. Even though I was only taking a small dose, the jump from 3 to 2 mg has been more difficult. Thank you for the information and helping me see that what I am experiencing is normal.
3 mg is a sub sub therapeutic dose. Why were you on such a low dose?
Well I was started at 10 and could not tolerate it so we kept down dosing and settled at 3. To be honest I probably did not need any because I believe the depression I felt was just the natural rhythm of recovering from the anxiety episode.
@@richman1822i took prozac 20 mg I didn’t feel any withdrawal symptoms
7:27 This is an example of a rapid taper. 50% every 2-4 weeks is not ideal nor is it tolerable. If you're a doctor watching this, I urge you to please look into microtapering and harm reduction tapers. What is taught about tapering in medschool is so limited. What is known now, 30 years after Prozac, is 10% a month is the most you should taper pts. Tapers typically take months to years. Thanks to Rege for opening up the conversation about withdrawal 🙏🏽
Thank you for your comment. Both tapers are covered. 50 percent and then 10 percent. There is significant individual variability in sensitivity to withdrawal symptoms. Some can come off easily. Some longer. Typically keeping a duration of 3-6 months and monitoring is beneficial. Yes some may take a year or more. Tapering strips and liquid formualtions are mentioned.
@@PsychiatrySimplified i.m glad you sound aware of this. I came off effexor quickly due to prescribers not knowing just how much these drugs effect processes in us and a respected professor of endocrinology almost hit the roof when i told my story. Effexor along with cymbalta and aropax (rated the worst) are excrutiating to come off but to say others are low risk when there's thousands of real life experiences out there to say otherwise i think is something requiring urgent investigation. It's all of them that can cause equally intense wd. Yes Horo/Taylor have done much to have the college make this public. There aren.t many with titles who're brave enough to speak the truth. Are you aware of Horo's connection to this? What led him to it?
@@suckermofo1 Thank you for sharing this. We are not aware. Would be interested to know.
@@PsychiatrySimplified maybe i could share a clip of Horo telling it how it is?
@@suckermofo1 Please do
Sir, thank you so much for this video.
I've been taking Sertraline 100mg for 4 months, yesterday my doctor switched to ESCITALOPRAM 10 mg directly without tapering. Toady I'm having extreme dizziness & vertigo! Previously ,I also experienced terrible withdrawal symptoms from Paroxetine discontinuation.
Please bring this up with your doctor ? What was the rationale for this switch? Instead of reducing sertraline.
this is so helpful! thank you!
Glad you found it helpful.
Great information! Thank you. I’ve never met a doc who even speaks about coming off. Ever. I’m pretty sure they don’t learn that in school
M O N E Y
It’s just, they won’t be of any use, if they encouraged people to go off meds, also what would pharma companies do, without us?
I have seen one patient who withdrew by rubbing 10mg tablet 💊 of escilatopram by nail filer.
Each day he use to grind tablet with one additional rub and with in a period of 30-40 days completely withdrew the intake without any significant symptoms.
How about cutting the 10mg tablet in half? We cut my 10mg tablet in 4s.
For the 50% of people who experience severe withdrawals, that would not be safe. That is still considering a fast taper and a cold turkey quit. Many get protracted withdrawal symptoms 1-6 months after. It is safer to reduce over time and to taper well below .50 mg
Sorry but that is a total junkie method. Shows you how serious these drugs are.
This is so helpful, thank you
Glad it was helpful!
Thank you gonna try this the right way
I basically have all these symptoms to some degree. 115 days into stopping fluoxetine after a two week taper. I should have taken the taper more slowly. FLUOXETINE withdrawals ARE HELL! These symptoms are just delayed three weeks. I am paying for it. Thank you sir, I wish I had this information earlier.
What are you feeling?
Ian how r u now
@@sangeetalambh6389 I feel better each week that passes. Not 100% yet but slowly getting back to normal
@@ianmyers5784 did u feel depersonalization a flat feeling in ur withdrawal please ans 235 days sober now
@@sangeetalambh6389 no.
Wow you have no idea how much relief this video gave me. I’ve been doing my own research with getting off paroxetine that I’ve been on for 13 years now. I was on 20mg and I am all the way down to 5mg now but I was worried about how I would go any further because I read about how bad it could be going straight from 5 to 0. I’m gonna see if I can find a liquid dose somewhere but I will probably have to change my psychiatrist because he is naive about the withdrawal effects. Thanks so much for this information.
Doctors don’t care about withdrawals symptoms, greedy sons of b***es
How much of tapering you did ,how long you were holding on, did you had any withdrawals systoms tks
Ok. I DID NOT FOLLOW THE DR. ORDER IT FUCKED ME UP. HAD ME FEELING LIKE I WAS VEING SLAMMED TO THE GROUND 360 DEGREE STYLE. ON IT FOR 10 +.....
OK. It took me a YEAR TO GET OFF BUT IM OFF ITS BEEN 4 YRS AND NO WITHDRAWLS. CANT SPEAK FOR THE LONG TERM EFFECT BUT IM BETTING THE PAXIL FUCKED UP MY NERVES IN MY BACK. I TELL U WHY AT THE END. This is what u do . Lower the dosage to 5 mil BY PRESCRIPTION. . NoW take that 5 mil and cut it in half. Take for 6 months than cut THE PILL THAT U CUT IN HALF....CUT IT IN HALF AGAIN .... take for 6 months. Than cut that pill in half THE SAME AS BEFORE and start taking every other day for 6 months. Until u feel ur energy returning .. drink lots of water . It sounds like along time but it's not it's to a new begining and u don't realize that day by day of weening urself slowly helps the immune .. brain to slowly start operating. And u now have all paxil out if ur system. WITHOUT WITH DRAWL... Get a load of this I have back problems and all the medication that they trying to treat the nerves with us all antidepressant FAMILY 😲🤔🤔.. hell no I will take the pain before I even lick the stuff
THAN GAVE ME APPETITE STIMULANT .. THE SHIT HAS ANITDEPRESSANT PROPERTISE. I COULD HAVE SLAPPED HIM!! IM LIKE WHAT THE FUCK. BUT WONT GET ME THIS TIME.
GOOD LUCK. .. U CAN DO IT. !!!!!;
Don't scare withdraw effects with sport vitamines walking will be reduced i experienced it 2 months and it vanished but the symptoms of pd return unfortunately so i back
Most GP's and Psychiatrists are naive unfortunately and see their patients as a diagnosis and money. Fortunately there are some really brilliant doctors out there including the one running this channel. Thank God we have smart and conscious doctors. 🙏
This is so helpful!!
Glad you found it useful
Very informative thank you sir
Thank you for your feedback 🙏🏼
I’m happy patients can learn from this guy. I wish the ignorant doctors would as well tho. The doctors cause more harm than good when they tell a patient to ‘just get off of it’. It’s horrible.
I attempted a linear tapering of Citalopram 40mg to 30. 20 and 10 (suggested by my doctor!) two years ago. and I still have bouts of dizziness and fatigue. Despite being back on 40mg now. I’m planning on tapering hyperbolically by 5% now. With an initial jump from 40 to 36.
Thank you for this video.
How are you now? I'm currently day 3 of feeling like crap because i was too lazy to pick up refills for my Pristiq. So dizzy, light headed, etc. Been on 50mg daily for 10 years now. I finally got more pills today and took my first one a few mins ago, hate feeling so bad!
Great video. I have been taking Cymbalta for long term back pain and went from 20mg BID to 20mg QD recently and WOW is all I can say. For about two weeks I felt like electricity was running over my entire body and was stumbling around. Weird thing is if I would put my foot down too hard there would be a shock from my toes to the top of my head. Was going from Gabapentin BID to Gaba QD at the same time. Wouldn't recommend doing it the way I did it. Do it slow.
thank you so much!
I've been on Paxil for 7 months and I'm going to start tapering next week and I'm so nervous because of what I'm reading about Paxil specifically. I'm going into the tapering with lots of prayer. I'm ready to come off of this
Just go slow Quiana I tampered off Lexapro. Ssri ..get the liquid if they make it and just go really really slow
@@garysimone4977 I've been reading about the liquid. I have my telehealth apt with my doc on Thursday and I plan to start my taper on Friday. I'm going to talk with him about the liquid
@@QMW11 what ever your Dr says go even slower. They. Just don't know ...you have any questions. Email me. Gary.a.simone@gmail.com I have been through it all You can do this as keep saying slooooow No one ever was yelled at for going to slow... seriously email if needed
I’m on Paxil too.. down from 40 to 20 still getting anxious thoughts especially when the weather is gloomy.. how’s your taper coming along?
@@PS-hl6ml mine is going great actually. I'm on week 1 of tapering and have zero side effects
I’ve been using escitalopram 10mg for about 8 years. I really want to give it a go tapering off. Just started to do 5mg today. Reading all these comments is making me extremely nervous about withdraw symptoms but I will do my best to taper extremely slowly after the 5mg drop. Here’s hoping all goes well.
Important thing to recognise is th withdrawal symptoms vary in nature and severity. Some patients have it minimally. Importantly any decision to taper should be made after medical advice. Symptoms of anxiety and depression can relapse and confound withdrawal state. Wish you well.
@@PsychiatrySimplified thanks doc. I’m glad I found you and did more research. My doctor seemed to think 10->5->0 would be sufficient taper but after reading comments here I think after 2.5 I will try to go down 10% and just base it on how I feel to continue the taper. Hope you’re doing well. Thanks again.
How did it go?
@@PCP-ov7nj hi! So far since this post I’ve cut down to 5mg and honestly I feel quite good. Had minor symptoms of withdrawal maybe. Had some negative thoughts but I’ve been able to navigate them alright through meditation and breath-work. I will stay on 5mg for a while until I feel fully secure and probably try going down to 2.5mg and see how it goes.
How will you taper below 5mg?
Thank you so much.
Thank you for this informative and helpful video. I have a question. If I don't find the ssri form I take in a liquid form, can I dissolve it in water? And if so, how exactly to do it?
Thank you for doing this. DR never never talk about this NEVER ...are medical system sucks.. sadly
What a fantastic explanation! Thank you! I reduced Escitalopram from 20mg, down to 10 and 5mg over a year without a single withdrawal symptom. However, from 5mg to 0mg it was really bad after day 6! Make sure you get some time off from work on this phase!
Hey mate, how are you? I was on 10 mg and reduced to 7.5 without side effects. Now i reduced to 5 and experiencing slight anxiety and nausea. How long did it take for it to level out?
How long had you been on escitalopram? And how long did the withdrawals last when you went to 0? hope you are well.
So for how long you had been taking Escitalopram 20 mg ?
@@vaishakvijaykurup1204 how you feeling now
@@amritasurendran091 hey I'm doing really good. I'm on 2.5 mg right now. Those initial side effects only lasted for 3-4 days. I have no issues right now. Include physical exercise and a good diet into your life and it improves your mental health a lot. Also, while reducing i suggest you see a therapist as well.
God the intros and outros are loud.
Very informative, thank you for the information. Probably more clear than a college textbook.
This video is gold💗💗💗
Thank you for your feedback
Really thank you. It's the opposite of what my doc said repeatedly but I knew myself. Gonna work out my own tapering off system much much slower. Thank you 💗
@@LD-ju7ge also take into account that every person is different. Some can come off quick some take time. Individualised approach is best. Most will know with their first reduction. And usually the initial part tends to go faster until lower doses are reached which take longer due to the curve. Good luck
Been on Zoloft for 20 years. It’s affecting my kidney function and cholesterol. I have weaned myself from 150mg to 125(two weeks at 125). Today started at 100 and will give it a few weeks at 100 before reducing again. Have had tingling in extremities, headache but nothing truly frightening yet. Thank you for your information!
Wish you well. 👍🏼
Get the liquid Zoloft. Calculate mg per ml. Use a tuberculin syringe to measure it out. I mixed it with oj. You can can titrate down to 1 mg. Taper down at the pace you can tolerate without side effects. Good luck. My extra weight melted off after I got off of it. I tried 4 times prior to doing it this way without success.
@@sallywallace851 I’m in the throes of menopause too! It took me a while but I lost 20 pounds- about 2 years- when I gave up my beloved red wine every night the pounds really went off!!!
Do slow to 2-5 % as you get to lower dosages so can reduce protracted withdrawals
How are you doing now
Thank you for the explanation. I have been on Wellbutrin for years due to an event. I feel it's well past the time to wean off. I've been linear and taking my time (thank goodness I was educated years ago about withdrawal symptoms) but I was never given an explanation like yours. I am at the lower levels and wondering why I feel the worst after 2 months of weaning down.
It's actually the time I should be very attentive at slowly closing the valve off so to speak then any other time in the process.
I feel better hearing your information because I now know, the side effects I'm feeling are normal at this lower level where I felt I would have had the battle won by now.
Just a little longer at this minimal level (couple weeks possibly) and I should be good. Thank you doctor.
Are you off completely yet? I’m planning for my own tapering of Wellbutrin and Lexapro.
@@lisadixon6617 yes, been fully off for over a month.
Although we are all different, I felt good. What I have noticed is energy is a little lower. Maybe the Wellbutrin was artificially "jacking me up" where I now feel my normal 62 year old self lol.
Most of all, I an actually relax. While on meds I felt there was "something" I should be doing, relaxing was kinda unacceptable.
Again, possibly jacked up.
One huge side effect issue that's gone thank goodness is constipation. Wellbutrin I now know was the culprit. I was never constipated and the doctor had me thinking it was my diet and or getting older. My diet is rather healthy but age was well... maybe?
Since being off I'm back to regular. On top of that, I was also taking medication for enlarged prostate. Now, I urinate practically like I was any years ago. I've investigated and came up with the theory that the backup of constipation was playing havoc with my bladder and urinary trac.
I've been off enlarged prostate meds for about 2 months now.
If I feel any huge changes occur after this post I will post them but for me, I feel better than ever.
This is my testimony only, everyone needs to be alert to their own needs and feelings and not use my experience.
I wish you the very best.
@@tonythomas5153 Awesome to hear you are doing so well and back to normalcy! I’m in my mid 40s and have been on my two meds for about 13 years. The weening will be a very slow process for me. I’m not looking forward to it but maybe the withdrawals won’t that bad. (It’s just been such a long time) We’ll see how it goes!
I’ve been on Wellbutrin and lexapro for many years. When a new doctor prescribed me new meds I told him I want off lexapro and we’ll button. He told me I can quick Wellbutrin immediately that I didn’t have to wean off of it and then told me to wait on the lexapro. I quit the Wellbutrin that day and it’s been two years and I’m just starting to wean off lexapro on my own. I quit my doctors.
respect for taking this on. the doctor's don't really no what there doing with aftercare. no help from GPS. they give there professional opinion to put ubin them. then have no dealings with you when your stopping them..I've stepped down from esitalipram. half dose every 2 weeks. I am down to 1.2 mg for 1 week. I also take kratom which for me. realy help with negative effects from SSRIs.
If you are having a hard time with trying to, literally, cut your medication into smaller doses. I would suggest looking up your local compounding pharmacy. Compounding pharmacists can put drugs into specially flavored liquids, topical creams, transdermal gels, suppositories, or other dosage forms suitable for patients' unique needs.
Hi thank you for the informative video, I’ve been on sertraline for just under 4 weeks and am going to taper off due to the side effects, since I’ve only been on the medication a short period of time does this impact the taper time?
Each individual is different but in general ( exceptions can be present) - shorter the time on medication a quicker taper regime can be adopted. This however needs to be monitored
Hi Edward, may I know the side effects you experienced? Thank you!
Im in the same boat. Been on it for 6 weeks. And it was helping much w my anger and bot being able to let go off it. (25mg) but this week i have been having hard time searching for words and remembering things. So I want to go off but I'm afraid of being angry and short tempered again.
UPDATE: 75 days ago I started tapering for 1 month from 10 mg escitalopram. After that month I stopped taking escitalopram completely. So , I am now "clean" for 45 days and I feel O.K. :D
PROS: My intelligence is back. My mind is sharper, and I acquire knowledge easier and faster. Currently, am trying get back to work and find a good paying job.
CONS: I am now full aware of my situation. I also have a heart problem, which makes me sometimes very tiered and I am often not fit enough to do basic staff. My initial motivation to get of the medication was to "get 100% of my brain back", to catch up on technical staff I missed in the past, to get a job again, and earn good money. I applied for some positions and some companies already showed interest in me, which is good. But (never start sentence with a but :) ) now this whole concept of earning money and having a job, is not more appealing to me. My mindset is now in the state like: why do I need this money, it won't make me happy, the world is broken anyway.
So I went to square one. For now, I'm fine, but I expect the depression could kick in again.
CONCLUSION: With meds I was semi-happy and dumb. Now without meds I am sharp minded, but more nervous, emotional and questioning the whole meaning of everything, risking to fall into depression again.
SIDE NOTE: During tapering I noticed that at dosage of 2,5 mg (which is 1/4 of original dosage) I felt pretty good. My brain was almost back at 100%, but I still had just enough of that fake happiness feeling. It was like some kind of sweet spot.
PLAN: First, I will wait. But if it get worse, I consider taking only 2,5 mg. I will give update soon.
DISCLAIMER: Doc, you are allowed to use my story in your future book. As a doc, you HAVE to write a book. :)
Thanks
Thanks for sharing your story. 🙏🏼
How are you feeling now?
This is absolutely great information. Thank you for sharing. I used this to successfully taper off of Escitalopram 10mg. Experienced zero discontinuation syndrome.
The video shows Sert occupancy for Citalopram. Out of curiosity, what is the Sert occupancy for Fluoxetine HCL at 10mg and 20mg tablets? I am considering use of Fluoxetine for future needs.
Same for SNRIs like Effexor- nearly died following doctor orders on how to decrease! Had to go back on and open caps and count beads down over several months.
Very helpful sir! I am on Paxil 50 mg extended release and am trying to figure out how I can taper off successfully. I tried dropping from 50 to 37.5 but got bad withdrawal effects of heart palpitations and anxiety. I have been on Paxil for almost 20 years. I have a feeling I am going to need a very slow taper process.
The slow withdrawal from paroxetine has been covered in the video - the second algorithm. Reductions of 10% or less may be required which means liquid formulations or tapering strips may be required. Please discuss this with your doctor who should be able to help.
@@PsychiatrySimplified Thank you!
Currently going through Paroxatine withdrawals, today has been fun... Similar to my Fluvoxamine withdrawals from a while back.
Thanks for your great presentation!
Oh-I have to tell you that Paroxatine withdrawal is so difficult. I really feel for you, but hang in there. I went through it years ago when it was a relatively new drug, and when I tried to get off it and got terribly sick, everyone told me I was imagining it. I even called the drug manufacturer, and they were super dismissive and acted as though I needed to get back on my meds because I was mentally ill! Mind you, I was taking it for a low grade, totally functioning depression, but they treated me as if I was severely mentally ill. I wouldn't wish that withdrawal on anyone.
@@mrkennethj7232 I’m going through a similar thing, how long did it take for you to finally be okay?
@@serahsanamfahiz Hi, Sirah. If it Paxil (Paroxatine), it is an especially difficult withdrawal. I quit cold turkey, which is a huge mistake, and it was a while back (1999ish) but if I recall correctly, the process was really bad for about 14-20 days and then got a bit more manageable-- I would say it was a good month before I didn't have symptoms. But it was really rough and if you can do it under a doctor's supervision, I would recommend it. hang in there. It's rough and you will feel a bit like you're losing your mind, but you can get through it!
@@mrkennethj7232 how long were you on it and what mg?
@@chantalclarke5305 Hi! It was many years ago, shortly after Paxil came on the market in the mid to late 1990s, so I don't recall the dose, but I think it was probably just the basic dose that they start people on. I took it for about a year. I quit it cold turkey, which is a big mistake. One really needs to taper off very very slowly, under medical supervision. Think in terms of months, not weeks.
Thank you.
As I got off Lexapro I took more and more grapefruit st John's wort and triptophan as I titrated and no withdrawl symptoms. 👍🏼😁
That is interesting. Had you heard of this before? Do you know anyone else do this?
Thank you for this. Currently coming off escitalopram 20mg. Began taking 10mg a few days ago. A big issue is cutting the tablets, I find. Wanting to quarter them past 5mg is just too hard so hopefully that last drop is ok. Helpful to know that it might be the more severe one though
Wishing you luck! I’ve been on 10mg for about 8 years and am starting to taper today. I hope you’re doing wel.
@@gunshow2121 Went fine, thank you! Second drop in dose and a little after I had a few zaps, not at all bad or hurtful, just like a little glitch.
I was happy to be able to cry and laugh again and not be so robotic. It’s my situation and environment that causes my depression, so no tablet can really solve it.
How have you gone?
@@alice5515 I’m so happy to hear that! I have cut down from 10mg to 5mg for the last 5 weeks or so and I feel fairly good! No terrible symptoms. I am taking this process very slowly just to ease my own mind. I think I will stay at 5mg for a month or 2 and try to go down to 2.5 and stay there until I feel like my body and mind are at a balanced point to the new dose. If I feel good at that point I’ll try to taper even more and so on until, hopefully, 0!
Really glad you’re doing well❤️
@@alice5515my main symptoms for anxiety is shortness of breath do u get any physical issues like me? And when u reduced the dose did it helped?
@@alice5515 how long were you on the 20mg? I've been on for 9 years and I'm struggling so much. I've gone for 20mg to 10mg, and it's been 5 months. Now I'm trying to go to 5mg and I am really struggling with anxiety and my legs are extremely sore, like I've been working out. It's terrible. My doctor is not very helpful in this regard. 😕
Good info. I'm tapering off of sertraline. Went from 200 to 150 to 100 with no issues. I feel better in fact. The next step will be 50. After that I'll look into switching to fluoxetine for a more gradual taper. I used the same method many years ago and had very minimal withdrawal.
How fast did you go from 200 to 150 to 100? How long were you on it? Thanks.
Thank you for sharing
Be careful on the drops when you get lower brother. It’s a lot stronger
Thank you for this valuable information as most of the psychiatrist don't understand what they are talking about. Can you please tell me how to taper d venizep 50 and reduced it to 1/4th
Just read the article you linked. Saw the mention of gabapentin and Lamotrigine (sp) in withdrawal help. Can you share more about this?
This is the detailed article on withdrawal management psychscenehub.com/psychinsights/diagnosis-and-management-of-antidepressant-withdrawal-the-hyperbolic-curve-and-ssri-withdrawal-2/
Hi. I've been on 10mg escitalopram for 2 years - I started my taper 10 days ago. My GP gave me this taper schedule: 10mg every other day (for 2 weeks) I've had some headaches and anxiety but I know its due to the reduction. Then 10mg every 3 days for 2 weeks....10mg every 4 days for 2 weeks then hopefully done.. This whole withdrawal thing is just too much but I will not give up!
How are you now?
That's how I did it 👍. You must have a good doctor. I didn't but I did your schedule by myself. Common sense really. I was on citalopram for 22years but now a year later I'm two weeks off them. Feeling tired and a little achy but mentally fine.
I had been on Zoloft for about two years at 100 mg. I tapered down to 75 mg over four weeks then 50 mg over four weeks and then 25 mg over for four weeks and then zero. I was extremely irritable and emotional during that time with low energy and no desire to leave the house. It was nothing short of Hell. The one positive was that I lost 30 lbs and got back to my "normal" weight. I have been at zero for almost six weeks and it too has been Hell. I now have trouble sleeping and am constantly bombarded by negative thoughts and a sense of impending doom. I go to bed hoping that I don't wake up. This has been the most unpleasant/painful experience of my life. Praying for everyone going through this.
Sorry to hear. One of the under recognized aspects is the REM rebound that occurs with discontinuation of sleep. Would recommend ensuring that the sleep aspect is looked at to avoid worsening agitation if the situation does not improve. Please seek medical advice. Wish you well
Try Ashwaganda
@@LLJR I will. Is it best to take in the morning or evening?
dmmartin10......I really feel for you. I send you strength to get through this. How are you doing today?
thank you doc
Thanks so much