retexan599 Posted December 17, 2015 Share Posted December 17, 2015 (I think) I follow the reasoning for the suggested 10% tapering policy. But what are the suggested times to wait between tapering steps? That is probably covered in various posts, but I have not been able to find a consensus or suggestions in those posts. So...your experience/suggestions on how long to wait between steps? Thanks. John 1989 -1995: Nortriptlyline, then Zoloft. 1997: New psych Dr. T; ‘Weaned’ off Zoloft; medication carousel next 3 years. 1998-1999: Open heart surgery; divorce; prostate cancer treatment. 1999-2001: Horrible period, new psych Dr. B; hospitalizations, ECT; medication carousel: Paxil, Zyprexa, Lithobid, Depakote, Wellbutrin, Effexor, Nortriptyline, Lamictal, Serzone, Seroquel (what a mess). January 2001, new psych Dr. R, whom I have been with ever since. He saved my life after a long period of experimentation. Seroquel as high as 600mg; added Remeron & Paxil. Stable last several years: Quetiapine 75mg, Mirtazapine 45mg, Paroxetine 30 mg, Clorazepate 3.75mg, L-methylfolate (Deplin) 15mg 2015: Weaned off of Quetiapine completely over several months; no problems. Paroxetine: 10/6/2015 - 30mg -> 20mg; 11/24/2015 - 20mg -> 15mg; 12/14/2015 -15mg -> 10mg; 1/29/2016 -10mg -> 5mg; 2/25/2016 5mg -> zero. All under psychiatrist supervision. No ill effects seen so far as of 12/22/2016. Continuing Mirtazapine and L-methylfolate. I have lost about 22 lbs. (207->185) over the last year or so; probably Paroxetine discontinuation (leptin effect). Link to comment Share on other sites More sharing options...
Administrator Altostrata Posted December 17, 2015 Administrator Share Posted December 17, 2015 See Why taper by 10% of my dosage? This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted. Link to comment Share on other sites More sharing options...
retexan599 Posted December 18, 2015 Author Share Posted December 18, 2015 See Why taper by 10% of my dosage? Thanks for the reference. It will be interesting when I talk with my pdoc about this in mid-January. 1989 -1995: Nortriptlyline, then Zoloft. 1997: New psych Dr. T; ‘Weaned’ off Zoloft; medication carousel next 3 years. 1998-1999: Open heart surgery; divorce; prostate cancer treatment. 1999-2001: Horrible period, new psych Dr. B; hospitalizations, ECT; medication carousel: Paxil, Zyprexa, Lithobid, Depakote, Wellbutrin, Effexor, Nortriptyline, Lamictal, Serzone, Seroquel (what a mess). January 2001, new psych Dr. R, whom I have been with ever since. He saved my life after a long period of experimentation. Seroquel as high as 600mg; added Remeron & Paxil. Stable last several years: Quetiapine 75mg, Mirtazapine 45mg, Paroxetine 30 mg, Clorazepate 3.75mg, L-methylfolate (Deplin) 15mg 2015: Weaned off of Quetiapine completely over several months; no problems. Paroxetine: 10/6/2015 - 30mg -> 20mg; 11/24/2015 - 20mg -> 15mg; 12/14/2015 -15mg -> 10mg; 1/29/2016 -10mg -> 5mg; 2/25/2016 5mg -> zero. All under psychiatrist supervision. No ill effects seen so far as of 12/22/2016. Continuing Mirtazapine and L-methylfolate. I have lost about 22 lbs. (207->185) over the last year or so; probably Paroxetine discontinuation (leptin effect). Link to comment Share on other sites More sharing options...
Administrator Altostrata Posted December 19, 2015 Administrator Share Posted December 19, 2015 Don't be surprised if your pdoc has never heard of it. This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted. Link to comment Share on other sites More sharing options...
Moderator Emeritus Fresh Posted December 21, 2015 Moderator Emeritus Share Posted December 21, 2015 I like to wait at least 2 weeks AFTER all w/d symptoms have resolved before decreasing again. Sometimes this is longer than 4 weeks. 1987-1997 pertofran , prothiaden , Prozac 1997-2002 Zoloft 2002-2004 effexor 2004-2010 Lexapro 40mg 2010-2012Cymbalta 120mg Sept. 2012 -decreased 90mg in 6months. Care taken over by Dr Lucire in March 2013 , decreased last 30mg at 2mg per week over 3 months. July 21 , 2013- last dose of Cymbalta Protracted withdrawal syndrome kicked in badly Jan.2014 Unrelenting akathisia until May 2014. Voluntary hosp. admission. Cocktail of Seroquel, Ativan and mirtazapine and I was well enough to go home after 14 days. Stopped all hosp. meds in next few months. July 2014 felt v.depressed - couldn't stop crying. Started pristiq 50mg. Felt improvement within days and continued to improve, so stayed on 50mg for 8 months. Began taper 28 Feb. 2015. Pristiq 50mg down to 45mg. Had one month of w/d symptoms. Started CES therapy in March. No w/d symptoms down to 30mg. October 2015 , taking 25mg Pristiq. Capsules compounded with slow-release additive. March 2016 , 21mg Link to comment Share on other sites More sharing options...
Administrator Altostrata Posted January 14, 2016 Administrator Share Posted January 14, 2016 People should see what happens after a few 10% decreases a month apart. This will give you an idea of your tolerance for decreases. If you have no symptoms tapering at 4-week intervals, you may wish to try 3-week intervals a few times and see how it goes. Same with 2-week intervals. I would never decrease faster than every 2 weeks, withdrawal symptoms often take that amount of time to show up. If you get them, you need to hold for a bit and slow down your tapering schedule. This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted. Link to comment Share on other sites More sharing options...
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