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Using an oral syringe and other tapering techniques


stan

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ADMIN NOTE Also see

 

HELPFUL TIP:  Because the markings on the syringe can wear off, wrap the body of the syringe with clear tape.

 

Using an oral syringe to take liquid medication

One way to very gradually taper is to use the liquid form of a medication and take it with a 10 milliliter oral syringe or, for very tiny doses, a 1 milliliter or .5 milliliter oral syringe.

 

Some psych medications that come in liquid form are:

 

- Citalopram (Celexa, Seropram)

- Escitalopram (Lexapro)

- Fluoxetine (Prozac)

- Gabapentin (Neurontin)

- Paroxetine (Paxil, Seroxat)

 

Availability varies in different countries. Please see Important topics in the Tapering forum and FAQ for information pertaining to your particular drug.

 

In a pinch, you can make your own liquids from many non-extended release drugs, see How to make a liquid from tablets or capsules

 

Important note about using oral syringes

These are plastic tubes with little nozzles on the end. The little nozzles contain at least .5mL. Measure your dosage by the tickings on the tube, do not add the amount in the nozzle. When you take the medication, push the plunger in to the end of the tube. Don't try to get the last little bit out of the nozzle. Don't rinse your syringe to get this last little bit, it will throw the amount of your dosage off -- you'll be taking more than you intended.

 

If you find your dose is smaller than the ticks on the smallest 1mL or 0.5mL oral syringes,  you can dilute your suspension more (usually with water) so you can draw measurable amounts into your syringe. Please see Important topics in the Tapering forum and FAQ for information pertaining to your particular drug.

 


Image of 1 milliliter oral syringe  https://www.google.com/search?q=free+images+of+1+ml+syringes&client

image.png.d530cffb0cf2ecaddf628633a77868e6.png

 

How to use an oral syringe

 

The syringe fits into a small hole in the special bottle cap (or bung). Insert the syringe firmly, then turn the bottle upside down to draw a dose from it.

 

Proper Use of Adapter Cap and Oral Syringe Video

 

 

Edited by Altostrata
updated admin note

for anxiety 

12 years paxil - cold turkey 1,5 month - switch celexa 1 year taper; total 13 years on brain meds 

67 years old - 9 years  med free

 

in protracted withdrawal

rigidity standing and walking, dryness gougerot-szoegren, sleep deteriorate,

function as have a lack of nerves, improving have been very little 

 

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 1mL  oral syringe:

 

image.png.7832398f73c873270b520bd8ce423ab5.png

 

 

 

Edited by manymoretodays
replacing Stan's photobucket image, that got blurred

for anxiety 

12 years paxil - cold turkey 1,5 month - switch celexa 1 year taper; total 13 years on brain meds 

67 years old - 9 years  med free

 

in protracted withdrawal

rigidity standing and walking, dryness gougerot-szoegren, sleep deteriorate,

function as have a lack of nerves, improving have been very little 

 

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I found an image of a 10 mL syringe here 10_mL_oral_syringe

 

post-1-0-88894300-1339725581_thumb.jpg

 

Product feedback [on Amazon] suggests markings don't hold up well with repeated use...

 

....

 

I actually probably have just about every kind of syringe there is after taking care of two dying cats plus one who nearly died but survived. (At different times over literally decades, of course.) Some are needled variety where I just removed the needles and disposed of them (responsibly!) but others are oral. I'd have to look for them. As you might expect, although I saved them for various uses that sometimes arise, I put them out of the way and was glad I didn't need them at this time!

I was "TryingToGetWell" (aka TTGW) on paxilprogress. I also was one of the original members here on Surviving Antidepressants

 

I had horrific and protracted withdrawal from paxil, but now am back to enjoying life with enthusiasm to the max, some residual physical symptoms continued but largely improve. The horror, severe derealization, anhedonia, akathisia, and so much more, are long over.

 

My signature is a temporary scribble from year 2013. I'll rewrite it when I can.

 

If you want to read it, click on http://survivingantidepressants.org/index.php?/topic/209-brandy-anyone/?p=110343

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On 4/30/2011 at 10:55 PM, 'Brandy' said:

I found an image of a 10 mL syringe here 10_mL_oral_syringe

 

Product feedback [on Amazon] suggests markings don't hold up well with repeated use....

 

Where to get oral syringes

Many pharmacies carry the larger oral syringe and, as Brandy implies, veterinarians carry them, too, to give animals medication.

 

Compounding pharmacies will have a wider range of oral syringes.

 

They cost very little; most pharmacies will give them to you gratis.

 

What size oral syringe to get

The larger 10 mL syringe can measure out dosages as small as .2 mg; the small 1 mL syringe (see the first post in this topic) can measure out dosages as small as .01 mL.

 

There are also .5mL oral syringes, measuring as small as .01 mL.

 

All fit into a cap in the bottle if available

 

What brand of oral syringe to get

The Monoject syringe in the photo above is just one brand of oral syringe. There are many brands available.

 

In the US, Becton-Dickinson (B-D) oral syringes are widely available. They hold up through repeated uses (wash with hot water) but the markings are a little smeary.

 

My preferred oral syringe, Exactamed, is made by Baxa. The markings are clear and it holds up longer through repeated washings than the others. It comes in 10mL, 5mL, 3mL, 1mL, and .5mL sizes. Baxa Exactament oral syringes may be hard to find; Baxa will sends pharmacists or medical personnel free samples, see http://survivingantidepressants.org/index.php?/topic/235-tapering-techniques/page__view__findpost__p__38431

Edited by manymoretodays
updated

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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Where do you get a pipette? Is it marked with measuring ticks?

 

If you can find a photo, please post it in this topic.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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Getting your medication made into a liquid or smaller capsules for easier tapering

Compounding pharmacies are special pharmacies that can make most drugs into liquids or capsules containing custom dosages. This can be expensive but if you need to taper by a tiny amount, you may want to do this. See en.wikipedia.org/wiki/Compounding

Use Google to find other compounding pharmacies near you. There are mail-order compounding pharmacies, too. See Compounding pharmacies (US, UK, and elsewhere)

 

All compounding pharmacies need a prescription written by a doctor specifying the compound, e.g. "100 milligrams in 100 milliliters liquid. Take 10mL (10mg) twice a day."

Edited by Altostrata
updated

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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Using gelatin capsules to divide doses

 

Some people report success with dividing contents of capsules into smaller amounts. This is easier when the contents are granules or pellets rather than powder.

 

The technique, which requires a steady hand, is:

 

1) Purchase empty gelatin (or vegetarian equivalent) capsules at a health food store, herbal medicine store, or online (Puritan's Pride carries empty capsules with free shipping). Get the largest size you can find: 000 or 00 are best; they will be easiest for you to manipulate. (For capsule sizes, see https://cdn.shopify.com/s/files/1/1039/0262/files/size.jpg?10361313904309507296)

 

2) Open as many empty capsules as you intend to use.

 

3) Open a medication capsule by grasping it at both ends and gently twisting it. It should come apart in the middle.

 

4) Carefully pour the contents of the medication capsule onto a creased piece of clean black or dark paper. The fold will help keep beads from rolling around. The dark color makes them easier to see and count.

 

5) Using a knife or other straight edge, divide the pellets evenly into two, three, or four groups by eye. You may wish to count pellets. (Note: If you are especially sensitive to variations in dosage, use a digital electronic scale to measure the doses more precisely.)

 

6) With an empty gelatin capsule, carefully scoop up one pile. Put the cap on the capsule. Repeat with other piles.

 

7) Put the divided doses into a clean medicine bottle marked with the dosage.

Edited by Shep
fixed broken link

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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I mentioned in the other thread that benzos don't dissolve in milk. As it turns out, I think that, being fat-soluble, they would dissolve in whole milk. So I was wrong...

 

Alex

"Well my ship's been split to splinters and it's sinking fast
I'm drowning in the poison, got no future, got no past
But my heart is not weary, it's light and it's free
I've got nothing but affection for all those who sailed with me.

Everybody's moving, if they ain't already there
Everybody's got to move somewhere
Stick with me baby, stick with me anyhow
Things should start to get interesting right about now."

- Zimmerman

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Also, we must note not all drugs can be mixed in liquids. Some deteriorate upon contact.

 

To see if you can make a solution of your medication, try Googling the name of the medication and solubility. There may be some studies that will tell you what liquid the medication may be dissolved in and how long it will be stable after you make a solution 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

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  • 1 month later...
  • Administrator

Check the concentration of a liquid form of a medication

 

If you get the prescription liquid, always look on the label to check the concentration of the liquid you get as it can vary among manufacturers, and adjust your dosage calculations accordingly.

 

For example: A liquid might contain 5mg of the drug in 1mL, a 5:1 concentration. To take 1mg, take .20mL (1/5 of a milliliter).

Edited by Altostrata
updated

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Also, we must note not all drugs can be mixed in liquids. Some deteriorate upon contact.

 

To see if you can make a solution of your medication, try Googling the name of the medication and solubility. There may be some studies that will tell you what liquid the medication may be dissolved in and how long it will be stable after you make a solution of it.

 

The medication doesn't necessarily have to dissolve or be soluble in whatever you're titrating it in. Of the five meds I take using liquid titration, only two are actually soluble in anything you can drink.

 

As long as it forms a suspension and you can keep the suspension uniformly mixed while you measure out your dose (or the part you're removing from your dose) the liquid method will work.

 

(None of the benzos, for example, are soluble in anything you can drink, but people use liquid titration for benzos successfully.)

 

Alto, I'm sorry, I have to disagree. I really doubt that drugs are so chemically unstable that they would deteriorate on contact with liquid. I can't imagine it. All drugs have to be chemically stable enough that they won't break down while they're being administered, either orally or via IV. They need to be absorbed chemically intact. Bodies are big sacks of liquid.

 

There may be some exceptions, some kinds of drugs that are designed to break down in the stomach and be absorbed in some kind of broken-down form. That's something a pharmacist would know about. It might be Google-able.

 

Not to say that they might not deteriorate if left in the liquid for a long enough period of time. Especially in heat or sunlight. Probably would.

 

What might deteriorate are the binders and fillers in the pill, which are designed to break down once they hit the stomach.

 

I'm working on writing up a simplified liquid titration method, will get that together soon. Having some problems with postviral fatigue and nausea right now.

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

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

 

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

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

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

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

2/12/20             12                       0.045               0.007                   1 

May 2021            7                       0.01                  0.0037                1

Feb 2022            6                      0!!!                     0.00167               0.98                2.5 mg Ambien

Oct 2022       4.5 mg Lamictal    (off Celexa, off Xanax)   0.95 Valium    Ambien, 1/4 to 1/2 of a 5 mg tablet 

 

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

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I mentioned in the other thread that benzos don't dissolve in milk. As it turns out, I think that, being fat-soluble, they would dissolve in whole milk. So I was wrong...

 

Alex

 

The term "fat-soluble" is misleading. It doesn't mean that a drug will dissolve in fat. If it did, we'd all be liquid titrating our drugs in olive oil.

 

"Fat-soluble" is the usual translation of the obscure chemical term "lipophilic." It means the molecule doesn't carry a partial charge, so it's not attracted to water molecules and tends to be pushed aside by them, hence tending to clump up with other lipophilic molecules that are doing the same thing.

 

I have to run now but I'll get back to this, please remind me. Basically, regarding titration using milk, some people swear by it, and I did find a Google reference to an article about Valium molecules (which are lipophilic) adhering to (or clumping up with) microscopic particles of fat (which you would find in homogenized milk) so there may be something to it.

 

I prefer water because (a) you can see your suspension and ensure, visually, that it's uniform; and (B) for me, personally, since I dose two of my meds every three hours and have to carry them around with me, milk would be yuck.

 

Gotta go, more later, ask questions...?

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

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

 

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

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

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

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

2/12/20             12                       0.045               0.007                   1 

May 2021            7                       0.01                  0.0037                1

Feb 2022            6                      0!!!                     0.00167               0.98                2.5 mg Ambien

Oct 2022       4.5 mg Lamictal    (off Celexa, off Xanax)   0.95 Valium    Ambien, 1/4 to 1/2 of a 5 mg tablet 

 

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

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Thanks for that additional knowledge, Rhi! Your knowledge abouthow to handle titrating drugs is definitely welcome here.

 

Stability is definitely a problem, though. Can you keep a mixture for 2 days? an hour? 15 minutes?

 

There are some drugs that cannot be mixed in liquids: Cymbalta, for one, because it needs to be protected from stomach acids (that's what the coating on the pellets is for).

 

Other drugs might be damaged by, say, the acid in orange juice.

 

I always see if I can find solubility info for a particular drug by Googling

 

[drug chemical name] solubility

 

Yeah, stability is probably the most unknown factor. I think you can safely assume it'll be stable long enough to measure out your dose. A lot of folks tapering benzos will make up the day's liquid and then drink from it at intervals through the day over 24 hours. It seems to work. But that's to cover interdose withdrawal. Is i/d w/d an issue with ADs? I just take my Celexa once a day.

 

Remember that just because something isn't soluble doesn't mean you can't liquid taper it. As long as the glues holding the pill together will dissolve and allow the pill to turn into a liquid suspension in water, if you keep it evenly stirred up while you measure, you can taper it. The actual drug chemical itself doesn't necessarily have to be dissolved. It just needs to be uniformly dispersed.

 

Something else you can't liquid titrate, besides the capsules with pellets, is an extended-release tablet.

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

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

 

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

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

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

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

2/12/20             12                       0.045               0.007                   1 

May 2021            7                       0.01                  0.0037                1

Feb 2022            6                      0!!!                     0.00167               0.98                2.5 mg Ambien

Oct 2022       4.5 mg Lamictal    (off Celexa, off Xanax)   0.95 Valium    Ambien, 1/4 to 1/2 of a 5 mg tablet 

 

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

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Most antidepressants are once a day. Some people have to take regular Effexor or Wellbutrin twice a day.

 

Do you have any tricks about keeping the suspension even while you're measuring it out?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • 2 weeks later...
  • Moderator Emeritus

Just stir it up before you start to draw it up and then draw it up quickly past where you are measuring to, and then push out down to the line you're measuring to. It's not going to settle out quickly enough to be a problem.

 

The turbidity of the solution will give you a visual cue as to how well mixed it is, but what you're seeing are the large particles of filler, not the actual clumps and molecules of the drug, which will settle out much more slowly because of their size.

 

So give it a good stir and then draw it up fast while it's still looking all cloudy and mixed up and you should be fine.

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

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

 

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

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

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

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

2/12/20             12                       0.045               0.007                   1 

May 2021            7                       0.01                  0.0037                1

Feb 2022            6                      0!!!                     0.00167               0.98                2.5 mg Ambien

Oct 2022       4.5 mg Lamictal    (off Celexa, off Xanax)   0.95 Valium    Ambien, 1/4 to 1/2 of a 5 mg tablet 

 

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

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I just wanted to add, for anyone discouraged by the videos further up in this thread, liquid titration really doesn't have to be that complicated.

 

I haven't found a pill yet that won't dissolve in water if you let it sit there for a while, so you can dispense with all the crushing and blending business, and really you'll get a smoother suspension if you just let the glues and binders dissolve like that. And you won't be losing as much of the drug to the various surfaces it's exposed to (best to expose it to the minimum number of different surfaces because some will always adhere to anything that touches it).

 

I dissolve my Celexa tablet (it does have to sit a while, maybe ten or fifteen minutes) in water plus a little ethanol (you can skip the ethanol though). I dissolve it in a shot glass. I draw up the now-dissolved contents with a pipette, then put the pipette in a jar of water and draw up enough more water to make 10 mL. I add another 10 mL of water for a total of 20 mL.

 

I stir the mixture with the pipette then quickly draw up my dose for the day and then take it. Then I throw away the rest.

 

This could be adapted to use syringes instead of pipettes. Basically they're the same thing, pipettes are just bigger and easier to read.

 

You can also dissolve the pill in a small amount of water in the bottom of a graduated cylinder, then add water up to whatever total amount you're using, stir, and draw out the amount you're going to "toss" and toss it; then take what's left in the cylinder, then rinse the cylinder well and drink the rinse water.

 

The most important thing is to do it the same way every time.

 

ALSO VERY IMPORTANT: When beginning to use liquid titration, just the fact that you're going from dry cutting to liquid is going to be a cut in itself. There's no way to do this without losing some amount of drug that sticks to the various surfaces you're working with. So don't try to cut when you start to titrate; start the titration at your full dose, and once you've adjusted to the cut, begin to cut down.

 

If any of this is unclear please feel free to say so and I'll try to make it more clear. I think it's well worth the trouble, personally, because I can cut my Celexa 0.05 mg at a time, easily.

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

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

 

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

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

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

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

2/12/20             12                       0.045               0.007                   1 

May 2021            7                       0.01                  0.0037                1

Feb 2022            6                      0!!!                     0.00167               0.98                2.5 mg Ambien

Oct 2022       4.5 mg Lamictal    (off Celexa, off Xanax)   0.95 Valium    Ambien, 1/4 to 1/2 of a 5 mg tablet 

 

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

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I mentioned in the other thread that benzos don't dissolve in milk. As it turns out, I think that, being fat-soluble, they would dissolve in whole milk. So I was wrong...

 

Alex

 

The term "fat-soluble" is misleading. It doesn't mean that a drug will dissolve in fat. If it did, we'd all be liquid titrating our drugs in olive oil.

 

Ha. That's funny. I'm not a chemistry buff, if not apparent. This is really too bad, considering...

 

I used water for titrating Klonopin (brand) very effectively.

 

Re pipettes:

 

I used a disposable straw as a pipette since I could not find pipettes for sale anywhere except in bulk. I would submerge a bit of the straw in the suspension (well agitated) and create a vacuum by covering the tip w/ finger. Lift straw, swivel, hold over empty cup, lift finger... fluid drops out. Worked fine. And straws are free at any McDonalds around the world.

 

Alex.i

"Well my ship's been split to splinters and it's sinking fast
I'm drowning in the poison, got no future, got no past
But my heart is not weary, it's light and it's free
I've got nothing but affection for all those who sailed with me.

Everybody's moving, if they ain't already there
Everybody's got to move somewhere
Stick with me baby, stick with me anyhow
Things should start to get interesting right about now."

- Zimmerman

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:-) glad you liked it, you have cracked me up so many times I'm glad I made you smile.

 

Pipettes for sale except in bulk: websites for people doing science fair experiments for their kids! (I know, supposedly kids doing science fair experiments, but if you're a parent you know how THAT goes, and don't get me started on how stupid it is to force 8-year-olds to come up with science experiments when their brains aren't yet developed enough to think concretely).

 

http://www.thesciencefair.com/

 

and I think there are others.

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

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

 

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

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

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

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

2/12/20             12                       0.045               0.007                   1 

May 2021            7                       0.01                  0.0037                1

Feb 2022            6                      0!!!                     0.00167               0.98                2.5 mg Ambien

Oct 2022       4.5 mg Lamictal    (off Celexa, off Xanax)   0.95 Valium    Ambien, 1/4 to 1/2 of a 5 mg tablet 

 

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

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  • 2 months later...

Here's a great little trick for tapering, that I learnt from a homeopathic doctor:

 

It's for tablets.

 

You just get a nail file and do one little stroke with it from the side of the tablet.

Do this for one week before each dose

 

Next week do - wait for ! - TWO strokes with the file, again for one week.

 

And so on.

 

Very slow and gentle.

 

All the Best with that!

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  • 2 months later...
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This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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  • 1 month later...
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About the tiny 1mL oral syringe:

 

The 1mL oral syringe should have ticks at .02mL (5 ticks between 10ths) or .01mL (10 ticks between 10ths).

 

The Becton Dickinson 1mL oral syringe is marked at .02mL. The Danish-made Baxa Exacta-Med 1mL oral syringe is marked for .01mL.

 

Oral syringes may be found at pharmacies, veterinary offices, or medical supply stores. I've always gotten them for no charge from my pharmacy. They should be less than U$.25 if you have to pay for them.

 

It's always good to have a few of them, so you can wash them and let them dry between uses.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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  • 2 months later...
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I just got .5mL syringes from my compounding pharmacy. Wow, are they tiny, but with very clear markings. Made by the Danish company Baxa.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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Note: Solubility is not that important. For more detail, see http://survivingantidepressants.org/index.php?/topic/2693-how-to-make-a-liquid-from-tablets-or-capsules/

 

About making a liquid from your medication

 

Many medications are soluble in water. To find out if you can make a DIY liquid from your medication, and how long the medication will last if you put it in water, use the search box up above in the right corner to look for our topic on it or Google

 

medicationname solubility water

medicationname stability water

You can make a liquid from many medications:

 

1) Measure out the amount of water you'll need in milliliters with an oral syringe. Put the water in a small, clean clear wide-mouth container with a tight cap, such as a brown or green plastic medicine container.

 

Do NOT use juice. Use water so you can see how well the particles are mixed in the water.

 

2) Crush a tablet by cutting it up and then crushing it into a powder with the back of a spoon. Do this on a piece of plastic or paper so you don't lose the particles.

 

You can open a capsule by grasping both ends and twisting gently. The capsule is in two parts and will open in the middle.

 

3) Carefully put the powder into the water. Put the cap on tightly and shake.

 

The particles may not dissolve well, floating around in the liquid. This is called a suspension rather than a solution. Make sure the particles are evenly distributed throughout the liquid.

 

4) Using an oral syringe, withdraw your dosage from the middle of the liquid.

 

 

 

Another way to have your medication made into a liquid is to have a compounding pharmacy make it for you -- but they will need a prescription from your doctor.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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How to find oral syringes

 

Your local pharmacy probably has oral syringes. They are used to give medications to infants. They will give these away if you ask for one. They may also have more expensive oral syringes in packages for sale, in the area where they have pill cutters and pill boxes.

 

Those oral syringes may not be what you need. They may be too large or the markings may not be precise enough. The clear oral syringes are best, it can be hard to see small liquid doses in the colored ones, which may be amber or green.

 

Oral syringes come in .5mL, 1mL, 3mL, 5mL, 10mL etc. sizes, from various manufacturers. Two manufacturers I've seen who make good oral syringes are Becton-Dickenson (BD) and Baxa, a Danish company. (The Baxa oral syringes have more detailed markings.)

 

One oral syringe costs the pharmacy less than U$.20.

 

A one-milliliter (1mL) oral syringe is the same as a needle-less slip tip syringe. (Slip tip rather than lock tip.)

 

Where you can get oral syringes:

  • Your local pharmacy
  • If you are getting medicines compounded, from your compounding pharmacy
  • If you are not getting medicines compounded, find a compounding pharmacy in your town and buy some from them
  • Veterinarians. They use oral syringes to give medication to animals.
  • Medical supply stores
  • Web sites. You may need to buy in bulk, for example, a 10-pack http://www.amazon.com/Syringe-Luer-Slip-Sterile-Pack/dp/B000FMYDLU/ref=cm_cr_pr_product_top or a box of 100. (If you buy too many, share the new, unused ones with our members.)

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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How to care for an oral syringe

 

These plastic syringes are disposable, but they can last a long time. I've had Becton-Dickinson and Baxa oral syringes; the markings wear off only after many months of use.

 

Rinsing with warm water is sufficient for daily use.

 

Make sure you put the oral syringe somewhere to dry before using it the next time, or the water left in it will throw measurements off.

 

It's good to have a few oral syringes to rotate, to let them dry.

 

Every week or so, I wash them by rinsing them out with a little soap and very hot water, and letting them air-dry.

 

They're not sterilized to begin with, they do not have to be boiled or purified for your own reuse. Just make sure to clean them occasionally with soap and hot water. I wouldn't put them in the dish washer.

 

If the markings wear off, rinse them and recycle them with plastics, or use for crafts to apply glue, etc.

Edited by Altostrata
updated and expanded

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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How to use an oral syringe and bottle cap adapter (bung)

 

From the UK site netdoctor.co.uk

 

http://www.netdoctor.co.uk/health_advice/facts/oralsyringe.htm

 

Quote

....An oral syringe is a measuring device used to accurately measure small doses of liquid medicine, which are then given to your child by mouth.

 

You will be given the following pieces of equipment.

  • A bung or stopper with a hole through the centre that fits in the top of the medicine bottle.
  • A plastic oral syringe with a measuring scale on it. This will normally have a line marked on it to indicate how much medicine you need to give.

Note for US readers: A bung is a cork with a hole in the middle. I get a blue plastic cap with a hole in it from my compounding pharmacy to put on the medication bottle. It does the same thing.

 

Quote

Syringes come in various sizes. The most common sizes are 1ml, 2.5ml and 5ml syringes, but you can get 10ml and larger syringes. Liquid medicine doses are often expressed in terms of millilitres or ml. ....

 

How to use an oral syringe

  • If the medicine is a suspension the label will remind you to shake the bottle.
  • Remove the lid and push the bung firmly into the top of the bottle.
  • Push the tip of the oral syringe into the hole in the bung.
  • Turn the bottle upside down.
  • Pull the plunger of the syringe back so that the medicine is drawn from the bottle into the syringe. Pull the plunger back to the point on the scale that corresponds to the dose prescribed....If you are at all confused about how much medicine to draw into the syringe, ask your pharmacist or doctor to clarify this for you.

     

    [IMPORTANT note: The solution you have drawn into the syringe may have air bubbles in it. With the syringe still stuck in the bottle, pump the syringe a couple of times until you draw a dose of liquid with no bubbles.]

  • Turn the bottle back the right way up and carefully remove the syringe from the bung, holding it by the barrel rather than the plunger.

THEN open your mouth, aim the syringe towards the middle of your tongue, and gently push the plunger down, depositing the medication in your mouth. Swallow.

 

Don't push too forcibly on the plunger or the liquid might splash out of your mouth and you won't get your full dose.

 

I then put the oral syringe in a glass of water, pump the plunger a couple of times to get all the medication out of the syringe, and drink the water -- because I want to be precise about my dosage.

 

How can I get a bottle cap in which I may insert an oral syringe?

Your pharmacy should be able to give you a bottle cap with a hole in it for an oral syringe. Sometimes they'll have smaller plastic bottles that fit the caps. You can carefully pour some of your liquid into the smaller bottle and use that with an oral syringe.

 

It will be easier to draw a dose in an oral syringe from an upended smaller bottle than a larger bottle.

 

If your pharmacy cannot supply the proper bottle cap:

On 3/23/2019 at 11:17 AM, Happy2Heal said:

hi 
I usually have these small bottles on hand as I've used them for mixing meds for various pets, the round ones with the red cap,  I mean, you can snip off the spout to make it fit a 1 ml syringe but sometimes I don't get it exactly right and need to try with a new bottle. however, they are super cheap

 

on this same page are adapters, I can't vouch for those as I've never tried them

https://www.totalpharmacysupply.com/universal-bottle-adapters.html

 

this online pharmacy store also sells a universal adapter, I'd call them to be sure it fits the your syringe:

https://www.totalpharmacysupply.com/universal-bottle-adapters.html

 

In my experience, most drug stores don't carry these things, you need to buy them online. Ebay often has good deals on stuff like this, too.

....

 

 

In the UK, you may be able to get a bottle with a bung or graduated bungs from

 

https://www.rosemontpharma.com/liquid-medicine

 

or  https://oralsyringes.uk/shop/clear-tapered-bottle-bung/

Edited by Altostrata
updated

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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  • 4 weeks later...

How do I get the bubbles out of my oral syringe?

 

I shake the bottle of liquid Celexa. Do I need to do that? It does cause bubbles in the syringe. When that happens I empty the syringe and start again.

 

Last night I didn't and I felt 'not so good' this morning. Anxiety came back and my head bothered me.

 

I am thinking that if there is a bubble or two I would actually be decreasing more than what I intended to do.

 

I am now down to 3/5 of mL. Slowly approaching the 4mL mark on the syringe which will be 2mgs. leaving me at 38mgs. Can't wait to get there. I do know from this taper that tiny cuts and a good respite between doses is the best route.

 

We live and learn.....sometimes the hard way <_<

Intro: http://survivingantidepressants.org/index.php?/topic/1902-nikki-hi-my-rundown-with-ads/

 

Paxil 1997-2004

Crossed over to Lexapro Paxil not available

at Pharmacies GSK halted deliveries

Lexapro 40mgs

Lexapro taper (2years)

Imipramine

Imipramine and Celexa

Now Nefazadone/Imipramine 50mgs. each

45mgs. Serzone  50mgs. Imipramine

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How do I get the bubbles out of my oral syringe?

 

Look at the instructions for your liquid medication. Do they say it needs to be shaken? If not, don't do it -- this will make it frothy and bubbles will end up in your oral syringe.

  • If you are drawing from a bottle having a cap with a hole in it (upside-down method, see http://survivingantidepressants.org/index.php?/topic/235-using-an-oral-syringe-and-other-tapering-techniques/page__view__findpost__p__2284 :

     

    - Draw more liquid than you need into the oral syringe. If it has bubbles in it,

     

    - Pump the plunger on the syringe until the liquid you've drawn into the syringe has no bubbles or only a few tiny ones. Pumping the plunger sends the bubbles back into the bottle, where they will float upward, leaving less bubbly solution for you to draw from.

     

    - Gently push the plunger to your desired dosage.

  • If you are drawing from a small container or jar with no cap:

     

    - Draw more liquid than you need into the oral syringe. If it has bubbles in it,

     

    - Hold the syringe upright. The bubbles will tend to float towards the tip.

     

    - The bubbles may "stick" to the sides of the syringe. Gently snap the syringe with your fingernail (like you see nurses do on TV) until the bubbles have floated to the tip.

     

    - Holding the syringe upright over a container or sink, gently push the plunger to your desired dosage. Some of the liquid will dribble or spurt out. Shake the syringe gently to dislodge any drops sticking to the outside of the syringe.

     

    - Shoot the medication into your mouth.

Edited by Altostrata
updated and expanded

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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  • 2 weeks later...
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The bubbles can definitely make a difference in the amount of medication that gets into you!

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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Drawing liquid medication from a bottle with an oral syringe

 

To use the oral syringe, you need a special cap to put on the bottle of liquid medication. The cap should have a hole in the middle of it, the tip of the oral syringe fits into this.

 

If there's no cap to fit your bottle, ask for a smaller medicine bottle with this type of cap. Pour some of your liquid Prozac into it and draw your dosage from the smaller bottle.

 

To draw a dose from the bottle

 

1) Push the plunger in the oral syringe all the way to the tip. (The syringe is empty.)

 

2) Fit the tip of the oral syringe tightly into the hole in the cap.

 

3) With the oral syringe stuck into the cap, gently tip the bottle over. Securely hold the bottle upside down with one hand at eye level.

 

4) With the other hand, gently draw your dosage into the syringe. You should be able to see the liquid level and amount of dosage by the markings on the syringe.

 

5) If there are bubbles in the liquid, pump the syringe several times, pushing the liquid back into the bottle. Draw the liquid again until there are no bubbles.

 

6) Gently set the bottle right side up on a table and carefully withdraw the syringe without moving the plunger.

 

7) Shoot the liquid in the syringe into your mouth. Make sure it all goes in your mouth.

 

8) Take the plunger out, rinse the syringe and plunger in hot water, set aside to dry and use again. (Don't use a syringe with water drops inside, it will affect your dosage.)

 

Here's an illustration of how to draw the medication from the bottle http://survivingantidepressants.org/index.php?/topic/235-tapering-techniques/page__view__findpost__p__2284

 

Also see http://survivingantidepressants.org/index.php?/topic/235-tapering-techniques/page__view__findpost__p__21391

Edited by Altostrata
updated

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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  • 5 months later...
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The most precise oral syringe?

 

The best oral syringes I've found, with the clearest markings, are from the Danish company Baxa. They are called ExactaMed oral syringes (with a non Luer tip).

 

You do not need a prescription to get oral syringes, although pharmacy supply sites may require that you be a business to make an order.

Edited by Altostrata
updated

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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  • 4 weeks later...
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What to do about air bubbles in the oral syringe

- Fill the syringe with more water (or milk, or pharmacy liquid) than you need.

 

- Hold the filled syringe with the tip pointing up.

 

- Snap it a few times with your fingernail to get the bubble to go to the top.

 

- Carefully push the plunger in to force all the air out and make liquid come out of the tip. (Do this over a sink.) Push it in to hold the amount of liquid you want.

 

- The tip does indeed hold some amount of liquid. When you empty the syringe, push the plunger to the end. You'll see some liquid remaining in the nozzle. Don't worry about this, don't attempt to measure it or include it in your solution, it will mess up your measurements. Discard 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

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  • 1 month later...

This seems like a stupid question but really has me concerned: In order to be precise when drawing in the zoloft liquid exactly which part the plunger end do I line up with the dosage measurement line...is it the bottom or top of the black layer,or is it the white, very lowest part of the plunger end? Using a 5ML syringe, it seems there's room for error when trying to measure out 2.25 ML of this thick, gooey zoloft suspension concoction my compounding pharmacist gave me.

SSRI History:

8 years on SSRIs (Luvox, Paxil, Effexor)

4 years on Zoloft 100MG daily

1 year on Zoloft 50MG daily

1 week off Zoloft cold turkey

Began Zoloft taper Jan. 26, 2013 starting at 25MG daily

 

Other Presriptions

-Amiloride 5MG-50MG daily (blood pressure)

-Rabeprazole 20MG daily (acid reflux)

-Atorvastatin 20MG daily (high cholesterol)

-Lorazepam 0.5MG as needed

Supplements

-Vitanin B-100 complex

-Cal-Mag Supreme (also includes potassium, zinc, boron, vitamins D and K)

-Vitamin D

-Vitamin E

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Cats this is not a stupid question at all, it's the kind of thing I've agonised about! Not being able to see your syringe, I would say it's the bottom of the bottom black line, but, you can decide what it is and stick very firmly to that decision every single day.

 

I did find a couple of links which might help you, the first one is about using oral syringes, the second one is about tapering Zoloft:

 

http://survivingantidepressants.org/index.php?/topic/235-tapering-techniques/page__p__2284__hl__oral__fromsearch__1#entry2284

 

http://survivingantidepressants.org/index.php?/topic/1441-tips-for-tapering-off-zoloft-sertraline/

*** Please note this is not medical advice,discuss any decisions about your medical care with a knowledgeable medical practitioner***





http://prozacwithdrawal.blogspot.com/
Original drug was sertraline/Zoloft, switched to Prozac in 2007.
Tapering from 5mls liquid prozac since Feb 2008, got down to 0.85ml 23/09/2012, reinstated back to 1ml(4mg) 07/11/2012, didn't appear to work, upped to 1.05ml 17/11/2012, back down to 1ml 12/12/2012 didn't work, up to 1.30ml 16/3/2013 didn't work, bumped up to 2ml (8mg) 4/4/2013 didn't work, in July 2013 I reinstated Sertraline (Zoloft) 50mg, feeling better now. 

A few months down the line I switched to 5ml liquid Prozac and tapered down to a compromise dose of 3ml liquid Prozac and have stayed there ever since, no withdrawals and no emotional blunting/loss of libido.

 

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cats, I know exactly what you mean, is the black rubber gasket the correct line or is it the white plastic?

 

The very top of the black rubber gasket should align with the tick on the syringe. This measures the amount of liquid in the chamber.

 

(After you push the plunger in, don't worry about what might be left in the nozzle, discard 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

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Strawberry, I've been thinking the same. Thanks for your kind words.

 

Alto, when you refer to "the very top of the black rubber gasket" would you be holding the syringe with the tip pointing up or down?

 

The syringe I have is an orange Exacta-Med 5 ML. The thickness of the black rubber gasket is equivalent to .2 ML dosage.

 

To ensure greater accuracy in tapering from 2.5 ML to 2.25 ML I'm thinking I should get a different size. What do you suggest?

SSRI History:

8 years on SSRIs (Luvox, Paxil, Effexor)

4 years on Zoloft 100MG daily

1 year on Zoloft 50MG daily

1 week off Zoloft cold turkey

Began Zoloft taper Jan. 26, 2013 starting at 25MG daily

 

Other Presriptions

-Amiloride 5MG-50MG daily (blood pressure)

-Rabeprazole 20MG daily (acid reflux)

-Atorvastatin 20MG daily (high cholesterol)

-Lorazepam 0.5MG as needed

Supplements

-Vitanin B-100 complex

-Cal-Mag Supreme (also includes potassium, zinc, boron, vitamins D and K)

-Vitamin D

-Vitamin E

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