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)
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.
@@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.
@@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!
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.
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!!
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..
You're talking about informed consent and how we didn't give it. It's a liability, buit we can't sue because of the nature of it and because there are hundreds of thousands of us online who've lost jobs/$/relationships/apartments/etc. Doctors get really flustered and defensive when you talk about side-effects/iatrogenic injuries while on the Psychotropic Pharmaceuticals and short-term/long-term withdrawal/discontinuation syndrome...iatrogenic injury. They know it's a fucking liability. But they do not fucking care. You're on your own to deal with the fall-out/aftermath. There are ZERO consequences or reperrcussions.
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.
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.
@@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.
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.
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
@@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.
@@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.
@@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.
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.
@@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
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'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 🙏
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 was on Celexa for 25 years. I was on 10 mg. I slowly tapered over period of two years. It was absolutely painless. No brains zaps, no emotional spells, no physical or mental discomfort. I did so by crushing a 10 mg tablet and suspending it in 100 mL water. Then with Drew by one milliliter every week. When I got down to the last 1 mg I went to a compounding pharmacy and was able to taper off that last milligram over a course of 100 days. I know it takes a long time to do this. But time passes anyway. I was getting Parkinson’s- like symptoms on Celexa. I knew I had to get off the drug. If you have any questions, feel free to ask.
@@CHRIS-k6e Do you mean was I numb during the many years I was on it? Absolutely not! Celexa saved me from suicidal depression. After many years, it was time to finally taper. I'm still tapering and am down to .55 mg. I have occasional bouts of anhedonia (emotional numbness) but not very often.
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.
@@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.
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.
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.
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.
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.
@@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)
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.
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.
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.
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.
@@stefanmarkovic1709 much better thanks, still monetering myself carefully, energy level up but still cant sleep without sleeping pills. I'm working on that now.
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.
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.
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?
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!
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!!!
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.
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
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)
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.
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!
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
@@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
Dr Sanil Rege 👍🏾👍🏾👍🏾👍🏾! Please keep making these videos - so useful to creating platform for dialogue between patients & physicians & empowering for patients to understand.
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
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!
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?
@@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.
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.
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...
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.
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 the valuable info. I'm prescribed 20 mg of escitalopram and am 70 years old. Through research I learned that people over 60 should not be prescribed more than 10 mg. I'm starting to slowly taper off and want to get below 10 mg or eliminate taking the drug completely.
That’s not true. It’s just that it should be prescribed low and go slow . But final doses are the same as for those below 70 . Sodium should be monitored and ECG if dose goes above 20 mg. Under monitoring it is safe agent. Ps not advice
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.
Wow so i started paroxentine 16 months ago and i started tapering off 4 months ago...went from 20mg to 10mg..stayed one month on 10mg, started taking 10mg every other day for 2 weeks..got very bad tension headaches so i went back to 10mg daily for another month..cut down to 5mg for another month and now i ve been on 2.5 mg for 2 weeks now...the symptoms after lowering each dose is crazy but tolerable for like a week but as i live in Nigeria and we have no access to liquid paroxentine ...im trying to brace myself up to stop at 2.5 in one more week...Hopefully i can do it but this video was GOLD...thanks Doc❤
Thank you for this! This is key for harbor duction. The idea that cold turkey is the only way is absolutely insane! Cold turkey is known to cause relapses and create a trauma response. The best way to achieve homeostasis is a smooth landing
I'm off of SSRI for a month now after at least 15 years of taking different anti depressants. The first week going from 1mg to 0mg I was vilently ill, after that I was well enough to work again but after a week ALLOT of symptoms came back. It's horrible. I tapered in liquid form and my doctor says this shouldnt happen. I.o.w.; it's not withdrawal symptoms. I can't believe him. Because what I'm going through is not normal and I can only think it's the SSRI withdrawal syndrome. I live a healthy life and had enough energy most of the time to live life. It's nearly impossible now..
Some medications require going well below 1mg. For example escitalopram would require 1-5% reductions from 1mg to .02 mg to avoid symptoms because at 1mg it still is very strong and is occurring many receptors
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.
Have you done a video of switching from and SNRI to an SSRI? You touch on it a little here but I hope to get more info because it’s what I’m about to do!
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.
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
Do you mean anti cholinergic withdrawal with cholinergic rebound? So when anti cholinergic is withdrawn abruptly there is a cholinergic rebound ( this can be counteracted by anticholinergic) - the same medication , anticholinergic can be reinstated and reduced gradually. Rebounds are avoided by gradual taper
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.
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
I am on 2 antidepressants one is paroxetine and the other is mirtazapine at night. But after 4 years I’ve put on 40kg and am completely stressed and am hugely worried about my health.
They are both SSRIs with similar half lives. 25-30 hrs . So in general - it’s a different switch as one doesn’t need to taper - cross titration or stop and start may be applied depending on the dose. However this depends on the dose and individuals characteristics. Your doctor will be able to provide specific guidance. Ps not medical advice
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.
@@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.
@Prakash Roy likely try to cut the pill into quarters (2.5mg) and stay on that for a while to see how I react. From there I’ve read things about using a nail file to start making it even smaller to taper even more. Might try that!
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.
I was only 50mg, wasn’t all that hard to wean off. I feel so bad for those who were prescribed more than 150mg of Zoloft. It’s so hard to get off at those high levels. My psychiatrist always told me he didn’t want me going higher than 75 due to the difficult discontinuing would be. Wish other psychiatrists were that honest.
Hey any tips? My wife been taking 50mg for 3 months became suicidal and we both decided for her to quit… any tips will really help I’m new to all this thanks
@Mezmer My psychiatrist also told me that she feels better with me at a low dose 25mg of Zoloft but I’m still apprehensive about taking it. I’m currently withdrawing from a god awful antipsychotic Zyprexa and this past week has been a nightmare. I was misdiagnosed by a mental facility and placed on a medication that was way too powerful for what I truly suffer with. I’m seriously between a rock and a hard place rn.
For some of us getting off even 20mg is a complete nightmare. I tapered for months down to almost nothing before finally coming off, only to then spend the next 6 months (and continuing) experiencing extreme withdrawal.
@@ShadaeBalancesKnightAstro thanks. I can deal with most of it, even the uncontrollable moments of sobbing, but it's the anger I'm struggling with. It's a real rage with a sudden need to smash everything up, including myself. Thankfully, I live in a country where guns are not available, but it has made me wonder how many murders and suicides have happened due to these dreadful drugs. Knowing it's the effects of withdrawal, and not me, that is what is keeping me sane. I'm just wondering how long the maximum is that withdrawal can go on for.
It’s a discussion with your doctor - it’s inapprropriate for me to advise as your doctor will have chosen the medication for your needs. So it’s best to ask them about the risk benefit analysis. Wish you good health
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 for the helpful video! Are there any withdrawal symptoms or known side effects for coming off of Escitalopram when the original dosage was only 5mg? I've been taking Escitalopram for 2 years for anxiety and have been stable for more than 1 year. Does it make sense to reduce to 2.5mg before going off completely?
This is best answered by your doctor as they know your history. In general gradual reduction is recommended as a safer strategy. However after reduction and cessation ( if indicated ) one should monitor closely for any rebound or withdrawal. As the amygdala can be sensitive to stressors after being ‘calmed’ by the SSRI. Wish you well. Ps not medical advice
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
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.
I have serious withdrawal right now. Ive had to go back on them i duno wat to do. How long is it going to take me to come off these? Ive been on them 15 years!
Hi there, I was on them for 10 years, it took a long time and I didn't withdraw slowly or safely enough, I think that's key. Tbh it took me about 4 months to feel remotely normal again. What I found is I had been sheltered from the stresses of life by taking citalopram for ten years. Exercise, yoga, breathing is all key. Withdraw slowly and safely and be prepared that this could take some time.
@@Mariemaymoore you can have a read of this article which explains withdrawal in more detail and discuss it with your doctor psychscenehub.com/psychinsights/diagnosis-and-management-of-antidepressant-withdrawal-the-hyperbolic-curve-and-ssri-withdrawal-2/
Sorry due to medicolegal reasons unable to do. Doctors should be able to do this as there is a lot of guidance out there . A general practitioner or a psychiatrist can provide this advice
@@BluBlu111 Sooner or later anti-depressants have major side effects. It is quite easy to stop AD. Get rid of the root cause in the mind. 60,000 crazy thoughts. I transformed my life some years back. After 10 days of the simple meditation explained below slowly reduce dosage to the minimum and taper of after 25 days of daily meditation. Take only if needed. Your breath is directly related to your mind [brain] causing anxiety-stress. For a relaxed life without anxiety-stress sit on a chair, back erect, hands on lap with palms upwards, eyes closed, be still and observe your incoming--outgoing breath, body sensations, any soft buzzing sound in the head for around 10-15 minutes. Be as still as possible. Plenty of thoughts will come which is ok--slowly negative thoughts will reduce and your mind will relax with no desire for pills. Mind is reprogrammed. Avoid watching negative TV shows and over- reacting. Do the above meditation without expectations and your life will change for the better. Best wishes. Shyaaam Sir. -Counsellor-Teacher.
@@BluBlu111 Enter "Meditation and the mind" on Google search and read some interesting facts which will motivate you. . Do not have any expectations and doubts --do meditation with an open mind. The practice which I told you is very simple but do it with silence around you for 10-15 minutes. Avoid comparing with others. It is about your life. Best wishes. Shyaaam Sir.
@@shyaaammeneen63 When you are in withdrawl - meditation/yoga/mindfulness/breathing techniques and so on does nothing, absolutley nothing....you can just hold on for dear life and wait it out......ofc a health lifestyle is important but during hard withdrawl (that can last for month's/years) it's difficult to even take walks.
I was misled into taking paxil by my GI doctor due to constipation and left sided pain. I was like a Zombie with racing thoughts and body aches. My PCP switched me Lexapro 10mg ended up in the hospital with heart palpitations, nausea, vomiting & diarrhea. All of this Instead of giving me therapy and coping skills to manage stress & anxiety they just threw me into this mess. After 1 year on meds we are finally going to start getting off of it. Pray for me 🙏🏻
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.
I’d love to know a sert occupancy rate of Sertraline. Got down to 50mg and looking to take it slow. Would be great to have a link to a table similar to the one shown for citalopram in this video.
@@PsychiatrySimplified that’s great to know. Over a 6 week period I’ve gone from 150-50mg with the most noticeable drop so far being 75-50mg. I actually think 50-25mg may also be similar. It’s from 25-0mg I am going to really slow things down and use the table from your video to get off from there by using volumetric dosing.
@@mwa1254 Take action to reduce side effects and any relapse. . Reduce negative thoughts. Its quite simple. Your breath is directly related to your mind [brain] causing negative thoughts-anxiety For a relaxed life sit on a chair, back erect, hands on lap with palms upwards, eyes closed, be still and observe your natural incoming--outgoing breath at the entrance of the nostrils for around 10-15 minutes or more. Let thoughts come. Slowly negative thoughts will reduce and relax the mind. Whenever you are free during the day or night before sleep sit or lie down still for a few minutes and observe your breath. Being still reduces negative thoughts. Make it a habit. Do the above meditation daily to have a good life. Best wishes and prayers. Shyaaam Sir. -Counsellor.
I’ve been SSRI free for 6 weeks now. It was no way near as hard as I thought it would be. Probably because I’m armed with the knowledge that feeling “off” still was just a symptom of coming off of SSRI’s
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?
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!
This is the detailed article on withdrawal management psychscenehub.com/psychinsights/diagnosis-and-management-of-antidepressant-withdrawal-the-hyperbolic-curve-and-ssri-withdrawal-2/
I actually take paroxetine and I'm looking to get off of it. Do you know much about CBD oil as an antidepressant? I know there isn't much research into it yet, but I've been thinking of switching to that
No current evidence for antidepressant purposes. Other indications for CBD oil. A switch from AD to another treatment should be done cautiously and discussed with a medical professional.
I love CBD. I have been using it for over 3 years. Use a 3rd party testing and Organic brand. I don’t know if it would help with any withdrawal except the anxiety part. I just started tapering off my Lexapro. So far so good
@@sinnoboy0000 I was on 20 mg. I’m down to 10mg. (Lexapro ) I will take 50 mg. Of Full Spectrum oil, CBD. 1 or 2 a day. Just depends on the day I’m having. Also, it takes time for the CBD to get the desired results. In my opinion it takes a few weeks.
HEY DOC, great video. Want to ask you I went from 12.5 mg Paroxetine to 0. I am not taking any meds for the past 5 days as I thought it is time to stop eating those. and now I am having various symptoms like nausea, light headedness and a stomach bug. A little terrified. Should I start the meds again ??? What to do????
Sorry we cannot provide medical advice. That would be irresponsible. In general 1. Before stopping any medication a risk benefit analysis discussion should be considered with the doctor 2. While withdrawal symptoms can occur in many patients these do not persist beyond 2-4 weeks and continue to reduce in intensity. 3. There is a group of patients that can have withdrawal symptoms that persist much longer however clinically this is more exaggerated when patients have reduced or stopped medication when symptoms of underlying illness are still present or not completely remitted 4. Relapse of illness should always be considered when medication is stopped. Hence any reduction of medication should always be done under supervision. Wish you well.
Hey Aashna- Going from 12.5mg to 0mg of paroxetine is a big jump. How are you doing now seeing how your comment is 2 weeks old? How long were you taking 12.5mg? Some people find success in reinstating their original dose (12.5mg in your case) and find that their withdrawal symptoms calm down after some time. The general advice for tapering off of SSRIs is to decrease your dose by 10% every 2-4 weeks to slowly allow your CNS to readjust and heal.
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.
We can’t advise individually so please discuss this with the doctor. In general 1.if a decision is made to taper - switch from FLUOXETINE which has a long half life to Zoloft with a half life of approx 26 hrs will be relatively straightforward. 2. Fluoxetine half life approx 7 days ( metabolite ) - by 35 days approx all fluoxetine (95% will be washed out) . Zoloft therefore can be initiated at a time when the combination of Prozac and Zoloft is least . This is cross titration . Most psychiatrists are able to cross taper 3. The safest strategy to avoid an overlap is to start Zoloft after week 5 - but this poses risk of withdrawal Sx & possible relapse. Please note this is not advice but general principles . Wish you well
I just cut my Cymbalta (Duloxetine) from 60 to 30mg in an attempt to get off of it last week....Been taking for ~2.5 years. First few days, felt euphoric. Libido skyrocketed, mood was great, wanted to do things, even danced a little. But now about 7 days later I am feeling pretty down, slightly dizzy, irritable and unmotivated. Maybe I should've taken it more slowly. The dilemma for me is, push through this difficult spell and hope for improvement? Or, increase the dosage again and play the long game? Tough call.
Wouid recommend discussing it with your doctor. Reduction of dose can result in both a relapse of original symptoms and some withdrawal. Differentiating the two is important in deciding if the dose should be increased. Also coming off medication is a decision that should be discussed with the primary prescriber. Recent study showed more than 50 percent of individuals have a relapse of depressive symptoms after ceasing ADs.
It took me 5 weeks to get off 10 mg of Citalopram, I went from 10 to 5mg for 2 weeks then 5mg to 2mg for another 2 weeks then the last week I was having a half of 2mg. I’m now 3 days with nothing at all, I’m feeling okay but dealing with vertigo/ dizziness only mild. I’m happy I’ve done it safely and slowly 🙏
The no harm taper method is 1-10% reduction at a time. At higher dosages no more than 10% reduction. At lower dosages you want to reduce 1-5% reduction, stabilize 2-4 weeks before next reduction…
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.
My dr. Said just take half for a month then just quit 😂
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.
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.
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..
You're talking about informed consent and how we didn't give it. It's a liability, buit we can't sue because of the nature of it and because there are hundreds of thousands of us online who've lost jobs/$/relationships/apartments/etc.
Doctors get really flustered and defensive when you talk about side-effects/iatrogenic injuries while on the Psychotropic Pharmaceuticals and short-term/long-term withdrawal/discontinuation syndrome...iatrogenic injury. They know it's a fucking liability.
But they do not fucking care. You're on your own to deal with the fall-out/aftermath. There are ZERO consequences or reperrcussions.
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.
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.
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 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
What were the reasons you wanted to wean off? I’m trying to decide if i should wean off or not.
Thank you for this video man I don’t think you realize how many people you helped understand how this type of stuff actually works.
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… ☹️
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.
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
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 🙏
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 🙏🏻
I was on Celexa for 25 years. I was on 10 mg. I slowly tapered over period of two years. It was absolutely painless. No brains zaps, no emotional spells, no physical or mental discomfort. I did so by crushing a 10 mg tablet and suspending it in 100 mL water. Then with Drew by one milliliter every week. When I got down to the last 1 mg I went to a compounding pharmacy and was able to taper off that last milligram over a course of 100 days. I know it takes a long time to do this. But time passes anyway. I was getting Parkinson’s- like symptoms on Celexa. I knew I had to get off the drug. If you have any questions, feel free to ask.
Where you emotional numb on it? And did your emotions come back after?
@@CHRIS-k6e Do you mean was I numb during the many years I was on it? Absolutely not! Celexa saved me from suicidal depression. After many years, it was time to finally taper. I'm still tapering and am down to .55 mg. I have occasional bouts of anhedonia (emotional numbness) but not very often.
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.
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
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)
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.
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.
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.
@@stefanmarkovic1709Yes, how do you feel now??
Tapering off venlaflaxine is like going to war. I would know. Hope you are feeling much better
Got yourself a new subscriber. What an excellent presentation and avoiding monotone. Actually stayed engaged the whole way.
Thanks for the feedback.
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. 💓
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.
Thank you for this video and explaining the difference between linear and hyperbolic dose reduction. I really appreciate it!
Pleasure
Important. I was taken off from 25mg to zero zoloft by phsyciatric Dr. Wish I knew about hyperbolic taper. Haven't been able to work for 1 year.
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
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
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.
@@shilohthecat6382that’s going pretty fast. I’m using the nail file strategy
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. 👍🏼
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.
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!
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
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 🙏
Thanks!
Thank you 🙏🏻
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
Really good explanation of what is happening during withdrawal, thank you!
Thanks for the feedback 🙏🏼
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!
Thank you for this. I needed these information 🙏🏻❤️
Pleasure
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.
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.
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.
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.
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 the valuable info. I'm prescribed 20 mg of escitalopram and am 70 years old. Through research I learned that people over 60 should not be prescribed more than 10 mg. I'm starting to slowly taper off and want to get below 10 mg or eliminate taking the drug completely.
That’s not true. It’s just that it should be prescribed low and go slow . But final doses are the same as for those below 70 . Sodium should be monitored and ECG if dose goes above 20 mg. Under monitoring it is safe agent. Ps not advice
Good stuff. Love this kind of pathophysio in depth talk
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.
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?
Not only that, psychiatrists would be out of a job, as insurance companies pretty much only pay for medication management now.
Wow so i started paroxentine 16 months ago and i started tapering off 4 months ago...went from 20mg to 10mg..stayed one month on 10mg, started taking 10mg every other day for 2 weeks..got very bad tension headaches so i went back to 10mg daily for another month..cut down to 5mg for another month and now i ve been on 2.5 mg for 2 weeks now...the symptoms after lowering each dose is crazy but tolerable for like a week but as i live in Nigeria and we have no access to liquid paroxentine ...im trying to brace myself up to stop at 2.5 in one more week...Hopefully i can do it but this video was GOLD...thanks Doc❤
Thank you. One can take a bit longer if needed with the last doses. It's important to look after sleep during this process.
Love the visuals. Allows me to really understand. Thank you 💙
Thank you for this! This is key for harbor duction. The idea that cold turkey is the only way is absolutely insane! Cold turkey is known to cause relapses and create a trauma response. The best way to achieve homeostasis is a smooth landing
I'm off of SSRI for a month now after at least 15 years of taking different anti depressants. The first week going from 1mg to 0mg I was vilently ill, after that I was well enough to work again but after a week ALLOT of symptoms came back. It's horrible. I tapered in liquid form and my doctor says this shouldnt happen. I.o.w.; it's not withdrawal symptoms. I can't believe him. Because what I'm going through is not normal and I can only think it's the SSRI withdrawal syndrome. I live a healthy life and had enough energy most of the time to live life. It's nearly impossible now..
Sorry to hear. Hope you feel better.
Some medications require going well below 1mg. For example escitalopram would require 1-5% reductions from 1mg to .02 mg to avoid symptoms because at 1mg it still is very strong and is occurring many receptors
Did you confined to the hospital? Hi dear i using this in the morning 😭i fell not good fell like a zombie 😭can i stop it now
I dont want to takw it again
how are you now?
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.
Oh my this was so very very informative and useful, thank you thank you!!!
Very well explained as well!
Have you done a video of switching from and SNRI to an SSRI? You touch on it a little here but I hope to get more info because it’s what I’m about to do!
you can read more on switching strategies here - there is also a table - psychscenehub.com/psychinsights/switching-or-augmenting-antidepressants/
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
How are you now?
Can cholinergic withdrawal effect be covered up by taking anticholinergic
Do you mean anti cholinergic withdrawal with cholinergic rebound? So when anti cholinergic is withdrawn abruptly there is a cholinergic rebound ( this can be counteracted by anticholinergic) - the same medication , anticholinergic can be reinstated and reduced gradually. Rebounds are avoided by gradual taper
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???
Thanks! May want to add vertigo to the list of symptoms!
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?
@@jonathankenningsworth9923 he killed himself... nah im joking
There is no time to get this info at the clinic. The appts are 15 min and they have appta to get to
I am on 2 antidepressants one is paroxetine and the other is mirtazapine at night. But after 4 years I’ve put on 40kg and am completely stressed and am hugely worried about my health.
Dnt worry bro..u will be fine
Can you tell us what if we are doing a cross taper say from zoloft to lexapro, do these same principles apply? 2:06
They are both SSRIs with similar half lives. 25-30 hrs . So in general - it’s a different switch as one doesn’t need to taper - cross titration or stop and start may be applied depending on the dose. However this depends on the dose and individuals characteristics. Your doctor will be able to provide specific guidance. Ps not medical advice
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.
@Prakash Roy likely try to cut the pill into quarters (2.5mg) and stay on that for a while to see how I react. From there I’ve read things about using a nail file to start making it even smaller to taper even more. Might try that!
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.
I was only 50mg, wasn’t all that hard to wean off. I feel so bad for those who were prescribed more than 150mg of Zoloft. It’s so hard to get off at those high levels. My psychiatrist always told me he didn’t want me going higher than 75 due to the difficult discontinuing would be. Wish other psychiatrists were that honest.
Hey any tips? My wife been taking 50mg for 3 months became suicidal and we both decided for her to quit… any tips will really help I’m new to all this thanks
@Mezmer My psychiatrist also told me that she feels better with me at a low dose 25mg of Zoloft but I’m still apprehensive about taking it. I’m currently withdrawing from a god awful antipsychotic Zyprexa and this past week has been a nightmare. I was misdiagnosed by a mental facility and placed on a medication that was way too powerful for what I truly suffer with. I’m seriously between a rock and a hard place rn.
For some of us getting off even 20mg is a complete nightmare. I tapered for months down to almost nothing before finally coming off, only to then spend the next 6 months (and continuing) experiencing extreme withdrawal.
@@djbethell That’s awful. I know exactly how you feel, the withdrawals are much worse than the initial issues I was struggling with.
@@ShadaeBalancesKnightAstro thanks. I can deal with most of it, even the uncontrollable moments of sobbing, but it's the anger I'm struggling with. It's a real rage with a sudden need to smash everything up, including myself. Thankfully, I live in a country where guns are not available, but it has made me wonder how many murders and suicides have happened due to these dreadful drugs. Knowing it's the effects of withdrawal, and not me, that is what is keeping me sane. I'm just wondering how long the maximum is that withdrawal can go on for.
So well done and helpful thank you!
Thank you
Thanks a lot, this so informative and well-explained
Doctor my doc precribed tablet combining both ssri and benzo is it safe tablet
It’s a discussion with your doctor - it’s inapprropriate for me to advise as your doctor will have chosen the medication for your needs. So it’s best to ask them about the risk benefit analysis. Wish you good health
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?
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 for the helpful video! Are there any withdrawal symptoms or known side effects for coming off of Escitalopram when the original dosage was only 5mg? I've been taking Escitalopram for 2 years for anxiety and have been stable for more than 1 year. Does it make sense to reduce to 2.5mg before going off completely?
This is best answered by your doctor as they know your history. In general gradual reduction is recommended as a safer strategy. However after reduction and cessation ( if indicated ) one should monitor closely for any rebound or withdrawal. As the amygdala can be sensitive to stressors after being ‘calmed’ by the SSRI. Wish you well. Ps not medical advice
@@PsychiatrySimplified thank you so much!
Excellent presentation Dr thank you.
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.
Do you have a bipolar treatment and pharmacology video? Search isn't showing one for your channel.
I have serious withdrawal right now. Ive had to go back on them i duno wat to do. How long is it going to take me to come off these? Ive been on them 15 years!
Hi there, I was on them for 10 years, it took a long time and I didn't withdraw slowly or safely enough, I think that's key. Tbh it took me about 4 months to feel remotely normal again. What I found is I had been sheltered from the stresses of life by taking citalopram for ten years. Exercise, yoga, breathing is all key. Withdraw slowly and safely and be prepared that this could take some time.
@@alexgreen1102 thankyou.x
@@Mariemaymoore you can have a read of this article which explains withdrawal in more detail and discuss it with your doctor psychscenehub.com/psychinsights/diagnosis-and-management-of-antidepressant-withdrawal-the-hyperbolic-curve-and-ssri-withdrawal-2/
Go on prozac for a week or two. Go on low doses of it and then quit after two weeks. Prozac is a sugar pill. It kills the major withdrawals.
@@anorsegoddess9797 as in the video - fluoxetine having a longer half life lowers the risk of withdrawal.
Thanhs Dr Rege. Do you online consultation? I need to treat a case of tampering escitalopram
Sorry due to medicolegal reasons unable to do. Doctors should be able to do this as there is a lot of guidance out there . A general practitioner or a psychiatrist can provide this advice
If I’d know I definitely would have asked for another med. I’m taking to keep from going through withdrawals and the med isn’t working. Ugh
Take melatonin when you're feeling anxious 😰
@@BluBlu111 Sooner or later anti-depressants have major side effects. It is quite easy to stop AD. Get rid of the root cause in the mind. 60,000 crazy thoughts. I transformed my life some years back. After 10 days of the simple meditation explained below slowly reduce dosage to the minimum and taper of after 25 days of daily meditation. Take only if needed. Your breath is directly related to your mind [brain] causing anxiety-stress. For a relaxed life without anxiety-stress sit on a chair, back erect, hands on lap with palms upwards, eyes closed, be still and observe your incoming--outgoing breath, body sensations, any soft buzzing sound in the head for around 10-15 minutes. Be as still as possible. Plenty of thoughts will come which is ok--slowly negative thoughts will reduce and your mind will relax with no desire for pills. Mind is reprogrammed. Avoid watching negative TV shows and over- reacting. Do the above meditation without expectations and your life will change for the better. Best wishes. Shyaaam Sir. -Counsellor-Teacher.
@@shyaaammeneen63 I'll definitely try that. Thank you. Anything else like nutritional supplements I should take or is it all I'm my mind?.
@@BluBlu111 Enter "Meditation and the mind" on Google search and read some interesting facts which will motivate you. . Do not have any expectations and doubts --do meditation with an open mind. The practice which I told you is very simple but do it with silence around you for 10-15 minutes. Avoid comparing with others. It is about your life. Best wishes. Shyaaam Sir.
@@shyaaammeneen63 When you are in withdrawl - meditation/yoga/mindfulness/breathing techniques and so on does nothing, absolutley nothing....you can just hold on for dear life and wait it out......ofc a health lifestyle is important but during hard withdrawl (that can last for month's/years) it's difficult to even take walks.
This is so helpful, thank you so much.
Extremely valuable information thank you 🙏🙏
Thank you for your feedback
I was misled into taking paxil by my GI doctor due to constipation and left sided pain. I was like a Zombie with racing thoughts and body aches. My PCP switched me Lexapro 10mg ended up in the hospital with heart palpitations, nausea, vomiting & diarrhea. All of this Instead of giving me therapy and coping skills to manage stress & anxiety they just threw me into this mess. After 1 year on meds we are finally going to start getting off of it. Pray for me 🙏🏻
Very informative and educational,I highly appreciate your effort,thank you!)
Agreed. Thank you Dr. Sanil Rege ❤️
Hi, can I stop using zoloft cold turkey after only 7 day use?
Thanks
Sorry can’t answer that. This is for your doctor . Wish you well
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!
How do u suggest me to wean of 20mg escitalopram and over how many months .
I’d love to know a sert occupancy rate of Sertraline. Got down to 50mg and looking to take it slow. Would be great to have a link to a table similar to the one shown for citalopram in this video.
Based on the half lives the approach to reduction would be similar.
@@PsychiatrySimplified that’s great to know. Over a 6 week period I’ve gone from 150-50mg with the most noticeable drop so far being 75-50mg. I actually think 50-25mg may also be similar. It’s from 25-0mg I am going to really slow things down and use the table from your video to get off from there by using volumetric dosing.
@@mwa1254 that approach fits in with the studies and the hyperbolic curve. Wish you well 👍
@@mwa1254 Take action to reduce side effects and any relapse. . Reduce negative thoughts. Its quite simple. Your breath is directly related to your mind [brain] causing negative thoughts-anxiety For a relaxed life sit on a chair, back erect, hands on lap with palms upwards, eyes closed, be still and observe your natural incoming--outgoing breath at the entrance of the nostrils for around 10-15 minutes or more. Let thoughts come. Slowly negative thoughts will reduce and relax the mind. Whenever you are free during the day or night before sleep sit or lie down still for a few minutes and observe your breath. Being still reduces negative thoughts. Make it a habit. Do the above meditation daily to have a good life. Best wishes and prayers. Shyaaam Sir. -Counsellor.
I’ve been SSRI free for 6 weeks now. It was no way near as hard as I thought it would be. Probably because I’m armed with the knowledge that feeling “off” still was just a symptom of coming off of SSRI’s
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?
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?
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/
I actually take paroxetine and I'm looking to get off of it.
Do you know much about CBD oil as an antidepressant? I know there isn't much research into it yet, but I've been thinking of switching to that
No current evidence for antidepressant purposes. Other indications for CBD oil. A switch from AD to another treatment should be done cautiously and discussed with a medical professional.
im oncparoxetine for 3 years and now i want to stop it how are you? did you stop it
I love CBD. I have been using it for over 3 years. Use a 3rd party testing and Organic brand. I don’t know if it would help with any withdrawal except the anxiety part. I just started tapering off my Lexapro. So far so good
@@practicehonesty452 how many mg lexapro were you on and how are you tapering?
@@sinnoboy0000 I was on 20 mg. I’m down to 10mg. (Lexapro )
I will take 50 mg. Of Full Spectrum oil, CBD. 1 or 2 a day. Just depends on the day I’m having. Also, it takes time for the CBD to get the desired results. In my opinion it takes a few weeks.
HEY DOC, great video. Want to ask you I went from 12.5 mg Paroxetine to 0. I am not taking any meds for the past 5 days as I thought it is time to stop eating those. and now I am having various symptoms like nausea, light headedness and a stomach bug. A little terrified. Should I start the meds again ??? What to do????
Sorry we cannot provide medical advice. That would be irresponsible. In general 1. Before stopping any medication a risk benefit analysis discussion should be considered with the doctor 2. While withdrawal symptoms can occur in many patients these do not persist beyond 2-4 weeks and continue to reduce in intensity. 3. There is a group of patients that can have withdrawal symptoms that persist much longer however clinically this is more exaggerated when patients have reduced or stopped medication when symptoms of underlying illness are still present or not completely remitted 4. Relapse of illness should always be considered when medication is stopped. Hence any reduction of medication should always be done under supervision. Wish you well.
Hey Aashna- Going from 12.5mg to 0mg of paroxetine is a big jump. How are you doing now seeing how your comment is 2 weeks old?
How long were you taking 12.5mg? Some people find success in reinstating their original dose (12.5mg in your case) and find that their withdrawal symptoms calm down after some time. The general advice for tapering off of SSRIs is to decrease your dose by 10% every 2-4 weeks to slowly allow your CNS to readjust and heal.
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.
How would you recommend going from prozac 40 mgs to zoloft?
What type of taper?
We can’t advise individually so please discuss this with the doctor. In general 1.if a decision is made to taper - switch from FLUOXETINE which has a long half life to Zoloft with a half life of approx 26 hrs will be relatively straightforward. 2. Fluoxetine half life approx 7 days ( metabolite ) - by 35 days approx all fluoxetine (95% will be washed out) . Zoloft therefore can be initiated at a time when the combination of Prozac and Zoloft is least . This is cross titration . Most psychiatrists are able to cross taper 3. The safest strategy to avoid an overlap is to start Zoloft after week 5 - but this poses risk of withdrawal Sx & possible relapse. Please note this is not advice but general principles . Wish you well
I just cut my Cymbalta (Duloxetine) from 60 to 30mg in an attempt to get off of it last week....Been taking for ~2.5 years. First few days, felt euphoric. Libido skyrocketed, mood was great, wanted to do things, even danced a little. But now about 7 days later I am feeling pretty down, slightly dizzy, irritable and unmotivated. Maybe I should've taken it more slowly. The dilemma for me is, push through this difficult spell and hope for improvement? Or, increase the dosage again and play the long game? Tough call.
Wouid recommend discussing it with your doctor. Reduction of dose can result in both a relapse of original symptoms and some withdrawal. Differentiating the two is important in deciding if the dose should be increased. Also coming off medication is a decision that should be discussed with the primary prescriber. Recent study showed more than 50 percent of individuals have a relapse of depressive symptoms after ceasing ADs.
@@PsychiatrySimplified thanks for response, appreciate it.
Hi is there a video people can share with their sppuses so they are aware how to support tapering off of SNRIs ???
It took me 5 weeks to get off 10 mg of Citalopram, I went from 10 to 5mg for 2 weeks then 5mg to 2mg for another 2 weeks then the last week I was having a half of 2mg. I’m now 3 days with nothing at all, I’m feeling okay but dealing with vertigo/ dizziness only mild. I’m happy I’ve done it safely and slowly 🙏
Glad it went well. wish you well.
I've even on escitalopram for around 2 years
Started with 20mg then 10mg and now 5mg. Tell me how's is it goes after 5mg?
In case if a person stopped medicine without tapering, and if some symptoms come back, will they go away after some days?...and how are you doing now?
do you get overeating and sexual incontinence?
@@PsychiatrySimplified hi doc im starting scitalprom this morning im felling like a robot 😭😭can i stop using it i need to know pls i i just take 1 day
Lexapro only comes in 20mg and 10mg, what do I do
The pharmacist can help
The no harm taper method is 1-10% reduction at a time. At higher dosages no more than 10% reduction. At lower dosages you want to reduce 1-5% reduction, stabilize 2-4 weeks before next reduction…
Good advice! Doctors should know these basics about tapering off of SSRIs!
Please tell me use medicine another day but how long use another day and when increase days to take medicine
Thank you for doing this. DR never never talk about this NEVER ...are medical system sucks.. sadly