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How long does it take to stabilize after reinstating or updosing?


John

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When I was tapering and my brain was keeping up it was 4-7 days. Unfortunately I made to many big cuts to fast ( before I found this site!) on my doctors advice and when I got to half my dose it caught up with me and I got more symptoms than I can even remember. I reinstated back to 20 mg Paroxitine and after 20 days I am just starting to have windows. I will be way more conservative and cautious when I taper again.

40 years old and have been on 20 mg of Paxil for the last 19 years. Multiple unsuccessful attempts to quit over the years.01/2015 Was tapering using liquid Paxil. MD has prescribed 1 ml = 2mg taper every two weeks or once withdrawal symptoms at that dose subside. Reduced from 20 to 10 mg using this method and at 10 mg severe withdrawal set in. 1.5 months of pure hell. Found SA, learned what was happening, and reinstated to 20 mg. After a month of severe symptoms recovered with the reinstatement. Fish oil - Multi Vitamin - Pro-biotic, amino-acid/B Vitamin supplement every day. Magnesium as needed.08/09/15 - 18 mg - 09/08/15 - 16.4 mg - 10/10/15 - 15 mg - 01/02/16 - 13.6 mg 02/15/16 - 12.0 mg - Bad symptom flare up 40 days into drop - Dizziness, panic/anxiety, overheating (esp at night), low appetite, headache, insomnia with bizarre dreams, internal shaking. 04/16/16 - 11mg - 7/17/16 - 10 mg holding.....

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Hi Jonesy-- welcome to the group.  Like mommaP said "no two tapers are alike" so it is very hard to give exact numbers.  One thing I can say is that this is a time intensive process and trying to make it go faster causes a lot of people a lot of grief.  The recommended waiting period is usually 4 weeks between drops, this is a starting point and a reference only, and is frequently a little too fast for most people.  The problem is you won't know until it all catches up with you and you start having big problems.  I have been doing a steady taper at 10% every 6 weeks for the past three and a half years (I started at 40mg of paxil and am currently at 1.8mg.)  All in all it has been pretty smooth, but the timing of the symptoms is always unpredictable, as well as what symptoms they are.  I have been doing a modified drop I call "The Brassmonkey Slide Method"  where I drop 2.5% a week for four weeks and then hold an additional two weeks.  I came up with this to minimize the symptoms.  They hit a little less hard because of the smaller drops and seem to stabilize during the fourth or fifth week.  Others who have tried this method have reported similar results, but again YMMV.

 

Mild symptoms are a good sign, so you're off to a good start.  There are several dosage ranges between 20 and 0 that tend to give people more trouble than other ranges, so don't expect it to be this mild all the way down (I sure hope it will be though).  The trick is not to panic when you hit a rough spot, given a little time it will resolve itself, and sometimes you just have to push through.  It is also a good thing that you have only taken one medication.  The people who have been polydrugged always have a much rougher time of it.  Please, please, please don't be tempted to switch drugs or add drugs it will just cause you trouble down the road.

 

Hope that gives you a little clarity.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Final Dose 0.016mg.     Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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Thank you so much brassmonkey! Is your way of tapering similar to a microtapering schedule? Also, do you use the liquid paxil, and if so, do you multidose? I switched from the timed release paxil to the liquid, which is not timed release, so I'm scared not to dose it twice a day.

 

So far, my only stmptoms have been fatigue, but I also have low thyroid, so it's hard to say what is what!

 

I am in NO rush to get off. I would rather experience as few of symptoms as possible and go slowly!

 

Thank you for your feedback!

*2000: Started Paxil CR 20 mcg at age 13

*Fall 2009: Came off Paxil CR 20 mcg cold-turkey

*Summer 2012: Reinstated Paxil CR 20 mcg

*April 2015: Started taper from 20mcg

*August 2015: Currently on 16mcg

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Hi Jonesy-- It is similar to a microtaper but a little more aggressive in that I take bigger cuts and then hold.  The microtaper takes several tiny cuts and then holds.  I have been cutting up 40mg tablets the whole time and weighting them on a milligram scale gets a little tedious at times but its been working so far.  I do one dose in the morning.  I used time release for a while a long time ago but don't remember any big difference when I switched back and fourth.  I have heard people say that they have had trouble switching from the tablets to liquid, but it usually cleared up in a few weeks.  I don't see any problem with dosing twice a day.  Personally I don't think it is necessary unless the symptoms flair up, and it makes it much easier to miss a dose, which will cause some trouble too.  One big thing to learn is not to be afraid of the symptoms.  Yes they are uncomfortable at best and yes they are a big pain in the ***, but they are not going to harm you.  Being afraid of them adds what we call "secondary fear" which can intensify things off the chart.  While your symptoms are mild is a good time to start practicing AAF, Acknowledge, Accept, Float.  Acknowledge that the symptom is there and it's real, explore the symptom and get familiar with it.  Accept that it is happening and that there isn't anything you can do about it.  Let the symptom Float away as you go on about your life.  It is a lot like having an unwanted house guest.  Attitude is one of the biggest keys to getting through this, and I can tell that yours is pretty good already.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Final Dose 0.016mg.     Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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  • 1 month later...

Stabilizing usually took me 7 to 10 days average. Whereas in the beginning of tapering, I didn't notice any WD at all.

But even after feeling stabilize I waited for a few weeks more before tapering the next step.

Guess it's different for all of us.

Diagnosis: GAD (2008), clinical depression (2012), again clinical depression (2016) and ptsd (2016)

History of: paroxetine, lexapro, sertraline, bupropion, zyprexa, seroquel, nortrilen, oxazepam, lorazepam, diazepam, nortriptyline.

 

Successfully came off nortriptyline after a full year of tapering from 100 mg. Quit in May 2015.

February 2016 started mirtazapine, followed by levothyroxine in April 2016 (diagnosis hypothyroidism)

 

Current meds/supplements: mirtazapine 15 mg, levothyroxine 50 µg, diazepam 1mg (tapering off) and melatonin 5 mg.

 

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  • 3 weeks later...

Hi Jonesy-- It is similar to a microtaper but a little more aggressive in that I take bigger cuts and then hold.  The microtaper takes several tiny cuts and then holds.  I have been cutting up 40mg tablets the whole time and weighting them on a milligram scale gets a little tedious at times but its been working so far.  I do one dose in the morning.  I used time release for a while a long time ago but don't remember any big difference when I switched back and fourth.  I have heard people say that they have had trouble switching from the tablets to liquid, but it usually cleared up in a few weeks. 

Hey there, I know it's a few months after you posted this but I am searching for help and have a question about this. What did you mean when you said people have had trouble switching from the tablets to the liquid? I ask because I am currently taking 10mg tablet and 3ml aka 3mg of the liquid (to equal 13mg--I only have 10mg and 5mg tablets and breaking them up and weighing them has become too much of a pain). Do you mean that the mixture of the liquid and tablet is harmful? 

Current meds: Escitalopram

Was put on 20mg Lexapro for 4 years; was at 18mg for ~1 week.

4/19/15: 15mg; WD symptoms include: loss of appetite, weight loss, nausea and indigestion after eating, diarrhea, and anxiety. Most of these happen at night.

6/5/15: 13mg; WD symptoms include: tiredness/lightheadedness, indigestion, numbness (emotionally)

7/6/15: 11mg --> 7/10/14: 11.7mg (wanted to taper by 10%)

8/10/15: 10mg; WD symptoms include: anxiety, nausea, GI upset, headaches

9/1/15: bumped back to 10.5mg (back to tapering by 10%); 10/5/15: back to 10mg

11/8: down to 9mg: feeling depressed so far ---> 11/16: bumped back to 10mg :(

1/23: back to 9mg; headaches, "motion sickness" feeling, anxiety

3/24: 8.5mg; 5/24: 8mg; nausea and dizziness bumped back to 8.5mg 3/26 :(

 

blog: https://offwithyourmeds.wordpress.com

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Hi Blackrabbit-- no, mixing the tablets and liquid is not harmful.  In the past I have know a number of people who have tried to switch from the tablets to the liquid exclusively  and have had a bad reaction to the liquid.  Their bodies seemed to handle the two differently and the liquid seemed to throw them into hardcore WD.  For some it settled out after a few weeks, but for others, they had to switch back to the  tablets to restabalize.  They then continued their tapers using just the tablets and weighting out the doses with scales.  If you are having no adverse effects, then I wouldn't worry about mixing them

 

Hope your taper is going well.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Final Dose 0.016mg.     Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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Hi Blackrabbit-- no, mixing the tablets and liquid is not harmful.  In the past I have know a number of people who have tried to switch from the tablets to the liquid exclusively  and have had a bad reaction to the liquid.  Their bodies seemed to handle the two differently and the liquid seemed to throw them into hardcore WD.  For some it settled out after a few weeks, but for others, they had to switch back to the  tablets to restabalize.  They then continued their tapers using just the tablets and weighting out the doses with scales.  If you are having no adverse effects, then I wouldn't worry about mixing them

 

Hope your taper is going well.

Thanks for the response. Just wasnt sure if it was going to take my body a few days to react to the mixing or not. This whole process has made me pay extra attention to everything my body does (idk if it's a good thing or a bad thing). I think about every possibility that could happen during this whole tapering process and stuff. 

Current meds: Escitalopram

Was put on 20mg Lexapro for 4 years; was at 18mg for ~1 week.

4/19/15: 15mg; WD symptoms include: loss of appetite, weight loss, nausea and indigestion after eating, diarrhea, and anxiety. Most of these happen at night.

6/5/15: 13mg; WD symptoms include: tiredness/lightheadedness, indigestion, numbness (emotionally)

7/6/15: 11mg --> 7/10/14: 11.7mg (wanted to taper by 10%)

8/10/15: 10mg; WD symptoms include: anxiety, nausea, GI upset, headaches

9/1/15: bumped back to 10.5mg (back to tapering by 10%); 10/5/15: back to 10mg

11/8: down to 9mg: feeling depressed so far ---> 11/16: bumped back to 10mg :(

1/23: back to 9mg; headaches, "motion sickness" feeling, anxiety

3/24: 8.5mg; 5/24: 8mg; nausea and dizziness bumped back to 8.5mg 3/26 :(

 

blog: https://offwithyourmeds.wordpress.com

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I posted this question in my intro blog, but I've been considering up dosing back to my original dose of 20 mg (currently taking 15, felt fine for 2 months, now experiencing withdraw. I know now from reading on here that I tapered too much, too fast. That's why i'm considering the up dose, so I can start to taper 10 % after well stabilized). Is 2 1\2 months too long a time for me to up dose to 20mg?

1987-1988 - severe depression after 4th child, was put on a med that has since discontinued, but worked (don't remember the name)

1993 - Zoloft, no success

1993 - 1999 - Prozac (with Zoloft for sleteping), stopped meds cause got pregnant, no extreme withdrawal, then after baby was born back on Prozac

1999 - quit Prozac, cold turkey, no withdrawal

2002 - Cymbalta, no success

2002 - present - Lexapro, 20 mil, Xanex, as needed for anxiety, Ambien, 12.5 mil, Quit Xanex a couple of months after starting Lexapro

2014 - stopped ambien

March 2015- started weaning off of Lexapro, ( down 15 from 20). 2 months in starting to experience withdrawal symptoms of depression, some anxiety and heart palpitations. General malaise. Going to try to continue w/o increasing

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  • 2 weeks later...

When is the time you know you need to taper your antidepressant rather than updose?

 

What is "stable" like?

How can I be my old self wheN the small dose benzo is making you tired and heavy specially in the mornings? I believe they also make you unmotivated.

 

What i know is i can now enjoy music at night but not loud. I guess our nervous system is a wreck.

Partner suddenly died 2014. Severe depression AGAIN (had previous episode 10 years ago). I was given escitalopram but could not bear the side effects, so i ask for an ECT (not sure if this helped). During the treatment and my hospital stay I was given Depakote mood stabilizer.  PDOC says I need to take it for two years. After 4-5 months I have a hard time with the Depakote. Hard to get up in the morning. Depression again or Depakote effects? So stopped Depakote (did not know about tapering then)

 

Januray 21, 2015. Severe depression again, started Pristiq 50mg and clonazepam 0.5 mg nightly. Had confusion, suicidal thoughts, thoughts about death, and find it hard to understand the TV, much more type in a computer.

 

Had adverse reaction to most antidepressants: muscle pain/spasms, irritablity, restlessness. Also Tried Prozac, Zoloft, Escitalopram years ago.

Started to taper pristiq and clonazepam after four months:

5th month:

2 weeks - 3/4 tablet PRISTIQ   (deducting the clonazepam also, so hard to cut)

2 weeks - 1/2 tablet PRISTIQ   (crumbs of clonazepam nightly)

2 weeks - 1/8 or less (hard to cut really) (zero clonazepam)

Then jump off pristiq.

I just wonder why I was cured during the 10 year period (2004-2014) I have no depression symptoms and no meds either. Pdoc said I might be biploar 2 but it is a "grey" area. Aren't bipolars supposed to be on maintenance meds?! Damn this diagnosis. I am tapering Pristiq either way.

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This topic may answer your question about stabilization:

 

What does stabilizing mean? - Surviving Antidepressants

I'm not a doctor.  My comments are not medical advise. These are my opinions based on my own experience and what I've learned. Please discuss your situation with a medical practitioner who has knowledge of tapering and withdrawal...if you are lucky enough to find one.

My Introduction Thread

Full Drug and Withdrawal History

Brief Summary

Several SSRIs for 13 years starting 1997 (for mild to moderate partly situational anxiety) Xanax PRN ~ Various other drugs over the years for side effects

2 month 'taper' off Lexapro 2010

Short acute withdrawal, followed by 2 -3 months of improvement then delayed protracted withdrawal

DX ADHD followed by several years of stimulants and other drugs trying to manage increasing symptoms

Failed reinstatement of Lexapro and trial of Prozac (became suicidal)

May 2013 Found SA, learned about withdrawal, stopped taking drugs...healing begins.

Protracted withdrawal, with a very sensitized nervous system, slowly recovering as time passes

Supplements which have helped: Vitamin C, Magnesium, Taurine

Bad reactions: Many supplements but mostly fish oil and Vitamin D

June 2016 - Started daily juicing, mostly vegetables and lots of greens.

Aug 2016 - Oct 2016 Best window ever, felt almost completely recovered

Oct 2016 -Symptoms returned - bad days and less bad days.

April 2018 - No windows, but significant improvement, it feels like permanent full recovery is close.

VIDEO: Where did the chemical imbalance theory come from?



VIDEO: How are psychiatric diagnoses made?



VIDEO: Why do psychiatric drugs have withdrawal syndromes?



VIDEO: Can psychiatric drugs cause long-lasting negative effects?

VIDEO: Dr. Claire Weekes

 

 

 

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petunia, thanks

Partner suddenly died 2014. Severe depression AGAIN (had previous episode 10 years ago). I was given escitalopram but could not bear the side effects, so i ask for an ECT (not sure if this helped). During the treatment and my hospital stay I was given Depakote mood stabilizer.  PDOC says I need to take it for two years. After 4-5 months I have a hard time with the Depakote. Hard to get up in the morning. Depression again or Depakote effects? So stopped Depakote (did not know about tapering then)

 

Januray 21, 2015. Severe depression again, started Pristiq 50mg and clonazepam 0.5 mg nightly. Had confusion, suicidal thoughts, thoughts about death, and find it hard to understand the TV, much more type in a computer.

 

Had adverse reaction to most antidepressants: muscle pain/spasms, irritablity, restlessness. Also Tried Prozac, Zoloft, Escitalopram years ago.

Started to taper pristiq and clonazepam after four months:

5th month:

2 weeks - 3/4 tablet PRISTIQ   (deducting the clonazepam also, so hard to cut)

2 weeks - 1/2 tablet PRISTIQ   (crumbs of clonazepam nightly)

2 weeks - 1/8 or less (hard to cut really) (zero clonazepam)

Then jump off pristiq.

I just wonder why I was cured during the 10 year period (2004-2014) I have no depression symptoms and no meds either. Pdoc said I might be biploar 2 but it is a "grey" area. Aren't bipolars supposed to be on maintenance meds?! Damn this diagnosis. I am tapering Pristiq either way.

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Is five months enough to say that it is better to taper a drug than suffer the ill side effects it has on you? Been suffering for so long, i dont want anymore of this.

 

Is there really a treatment resistant depression or are they mostly chemically sensitive bodies unable to tolerate the side effects.

 

:( i am determined to get off.....

Partner suddenly died 2014. Severe depression AGAIN (had previous episode 10 years ago). I was given escitalopram but could not bear the side effects, so i ask for an ECT (not sure if this helped). During the treatment and my hospital stay I was given Depakote mood stabilizer.  PDOC says I need to take it for two years. After 4-5 months I have a hard time with the Depakote. Hard to get up in the morning. Depression again or Depakote effects? So stopped Depakote (did not know about tapering then)

 

Januray 21, 2015. Severe depression again, started Pristiq 50mg and clonazepam 0.5 mg nightly. Had confusion, suicidal thoughts, thoughts about death, and find it hard to understand the TV, much more type in a computer.

 

Had adverse reaction to most antidepressants: muscle pain/spasms, irritablity, restlessness. Also Tried Prozac, Zoloft, Escitalopram years ago.

Started to taper pristiq and clonazepam after four months:

5th month:

2 weeks - 3/4 tablet PRISTIQ   (deducting the clonazepam also, so hard to cut)

2 weeks - 1/2 tablet PRISTIQ   (crumbs of clonazepam nightly)

2 weeks - 1/8 or less (hard to cut really) (zero clonazepam)

Then jump off pristiq.

I just wonder why I was cured during the 10 year period (2004-2014) I have no depression symptoms and no meds either. Pdoc said I might be biploar 2 but it is a "grey" area. Aren't bipolars supposed to be on maintenance meds?! Damn this diagnosis. I am tapering Pristiq either way.

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  • 3 months later...

It's been 12 weeks since I reinstated after I crashed.. I do feel better than what I did in withdrawl.. I do have days where I get andrenaline surges, headaches and stomach problems but not everyday.

When I have done my tapering I never get withdrawls right away it's always takes months for me to feel them and crash so I feel that once I reinstate that it will take me months to feel almost 100% better.

 

Been on Paxil since 96”-97”, 40mg tried 3 times to get off and didn’t work, started a very slow taper Jan 2016, have only dropped down by 3 mg.. on 37mg currently.. have very delayed withdrawals. Last drop was in July 2017.. still have waves and windows. 

 

Magnesium 200mg, foilc acid 1 mg, vitamin d3 5000iu, Blood pressure meds-Verapamil & Irbesartan... Smoke cbd flower once in awhile. 

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How to judge if I am stable or not?
Depressed, low mood is something normal for me...
Wanting to die, suicidal, it is normal for me...
Lonely, it is normal...
Oversensitive, especially to noises, it is normal...
Fight, flight, it is normal...
Pains, aches, diarrhea, seems also normal...

Paresthesia is gone...

 

I find that people around me can help, too. 

 

Most of my close friends and loved ones know I am going through that, and I give them permission to chide me, "My aren't you a grumpy bum today?"  (irritable), or "I've missed you so much - it's great to see the real you again."  or "Yes, you're irritable, but you are also engaged with your life."

 

Feedback can let you know how you are going, when you can't quite get a clear perspective on yourself.  

 

As many of us here experience, sometimes it feels like the long, slow, crawl doesn't get any better - but the thing is, even though it seems slow, often others can see what we look like, better than we can.  But this is trusted others.  Sometimes it may be a therapist, doctor or counselor, but I always add "diagnostic goggles" to the things they say.  My friends, my family, know that I'm "eccentric" and "weird," and "goofy," but when I'm struggling - they can clearly point out things like:  "you have been sleeping better," or "you haven't had as much IBS these past 2 weeks." and "thank you for not biting my head off today!"  (I get that one from hubby sometimes!)

 

 

Is five months enough to say that it is better to taper a drug than suffer the ill side effects it has on you? Been suffering for so long, i dont want anymore of this.

Is there really a treatment resistant depression or are they mostly chemically sensitive bodies unable to tolerate the side effects.

:( i am determined to get off.....

 

"Treatment resistant depression" is, in my opinion, drug induced.  If you had never been put on the drugs, you would never have become "treatment resistant."  Treatment resistant depression hardly existed before the drugs.  Certainly, there was a small statistical part of the population who were always "melancholic," (the old word for depression) and could not be helped by anything other than rest, or abuse of their substance-of-choice (insert: alcohol, opium, absinthe, etc. here - some would call that, "self medicating.")

 

Your determination to get off is good.  This is what will hold you through the holds.  But if you plow on through the tapers without resting on the holds, it will become more an more difficult until it is tenable.  You need to listen to yourself, your body, your emotions, and make sure you are stable before you take another taper.

 

I refer you here to Rhiannon's excellent:  Rhis's Start Small Listen to Body Taper Plan

"Easy, easy - just go easy and you'll finish." - Hawaiian Kapuna

 

Holding is hard work, holding is a blessing. Give your brain time to heal before you try again.

 

My suggestions are not medical advice, you are in charge of your own medical choices.

 

A lifetime of being prescribed antidepressants that caused problems (30 years in total). At age 35 flipped to "bipolar," but was not diagnosed for 5 years. Started my journey in Midwest United States. Crossed the Pacific for love and hope; currently living in Australia.   CT Seroquel 25 mg some time in 2013.   Tapered Reboxetine 4 mg Oct 2013 to Sept 2014 = GONE (3 years on Reboxetine).     Tapered Lithium 900 to 475 MG (alternating with the SNRI) Jan 2014 - Nov 2014, tapered Lithium 475 mg Jan 2015 -  Feb 2016 = GONE (10 years  on Lithium).  Many mistakes in dry cutting dosages were made.


The tedious thread (my intro):  JanCarol ☼ Reboxetine first, then Lithium

The happy thread (my success story):  JanCarol - Undiagnosed  Off all bipolar drugs

My own blog:  https://shamanexplorations.com/shamans-blog/

 

 

I have been psych drug FREE since 1 Feb 2016!

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  • 2 weeks later...

Obviously there is a difference between the two - But how different really are they?  I have read on here that re-instating a drug from "0" is best done as soon as symptoms appear.  Does the same apply for up dosing? It is also commonly said that re-instating from "0" sometimes does not relieve symptoms. Does the same apply for up dosing , or are symptoms more commonly relieved when up dosing? And have you found relief of symptoms quite some time after up dosing? or is up dosing symptom relief fairly instant?

Started Citalopram in 2005 (aged 15) for apparent "OCD" - 60mg 

July 2015 attempted 2 x 10% + cuts 4 weeks apart. WD symptoms intense at times. Need to slow down.

 

November 2016 - Resumed taper. 1.25 - 1.5% decrease weekly approx.

44.5mg November 2016. Jan 2017 42.5 mg. March 2017 40 mg. June 2017 37mg. September 2018 22mg. Nov 2018 Holding at 22mg to stabilise from moderate wave. January 2020 - Holding, mostly feeling fine, but still having some waves at times. 

 

February 2020 - Resumed taper , 1.5% reduction weekly/every two weeks. 

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Hi Nick--  easy questions with not so easy answers.  Have you read the thread on reinstatement?  About reinstating and stabilizing to reduce withdrawal symptom

 

Reinstatement and updosing serve the same purpose, that is to try and reduce symptoms that are unbearable.  Reinstatement is to start taking the drug again after a person has stopped taking it all together, where as updosing is to increase the dose a small amount while still in the process of tapering off of a drug.

 

Doing a reinstatement is time sensitive and like you stated, the sooner the better after symptoms appear.  However, reinstatement is a rather drastic move and not to be done lightly.  These drugs are very powerful and if they are not tapered properly they can leave the brain in a very sensitized state.  Many people who are suffering intense symptoms after reaching "0" are in this sensitized state and the reintroduction of the drug can make it worse.  Also the sever symptoms frequently don't show up for several months after the drug has been stopped.  Which adds in even more risk factors.  Reinstating a very small amount, say 2mg for example, often will help take the edge off of the symptoms, but a higher dose could just throw the brain into more chaos.  We don't often recommend a reinstatement, but when we do it is always at a very low dose with the proviso of "and see what happens".

 

Updosing is never advised when symptoms just show up.  Because that's what symptoms do.  With every change in dosage the brain has to readjust and rebuild and that will cause symptoms, which can take several weeks to stabilize.  Which is why we recommend such small decreases, to minimize them.  Updosing is considered when the symptoms from a decrease have reached the unbearable level, which is an indication that the drop was too large or too soon.

 

There is no guarantee that either a reinstatement or an updose will elevate symptoms and the bad part is that it can take several weeks before you know.

 

That's the nutshell version.  

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Final Dose 0.016mg.     Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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Brassmonkey- thank you for that detailed response . One lingering question - if there is no improvement of symptoms from updose/ reinstatement after a few weeks, would it be safe to assume that withdrawal symptoms will improve/ diminish over time ?

Started Citalopram in 2005 (aged 15) for apparent "OCD" - 60mg 

July 2015 attempted 2 x 10% + cuts 4 weeks apart. WD symptoms intense at times. Need to slow down.

 

November 2016 - Resumed taper. 1.25 - 1.5% decrease weekly approx.

44.5mg November 2016. Jan 2017 42.5 mg. March 2017 40 mg. June 2017 37mg. September 2018 22mg. Nov 2018 Holding at 22mg to stabilise from moderate wave. January 2020 - Holding, mostly feeling fine, but still having some waves at times. 

 

February 2020 - Resumed taper , 1.5% reduction weekly/every two weeks. 

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I have yet to see someones symptoms NOT improve over time.  Even the worst cases eventually sort themselves out.  Everything else is just trying to keep ourselves functional/comfortable while we let the time pass.

 

Give your updose another month or so and you should be stabilizing by them.  Give the stability a month or so to really take affect then you can start your 5% taper.  You're on the right track.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Final Dose 0.016mg.     Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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Hi Nick,

I have had to updose several times in my taper - i get massive anxiety too if my cut is either too much or not enough time between cuts and i have a catch up going on.  For me, the anxiety does not go completely until about 4 weeks.  Looking back there is usually a gradual reduction but it doesn't really feel like that at the time.  One day i will wake up and it will be gone, and i know it's gone - I just FEEL different, difficult to explain.

 

Hang on, it will get better!

Started in 2000 - On 150mg most of the time, (but up to 225mg at highest dose for 6 months in the beginning)
Reduced off easily first time - but got depressed (not too much anxiety) 6 months later
Back on effexor for another 9 months.
Reduced off again with no immediate w/d - suddenly got depressed and anxious ++ again 3 or 4 months later.
Back on effexor - this time for 3 years
Reduced off over a month - 6 weeks later terrible anxiety - back on.
Rinse and repeat 4 more times - each time the period before the anxiety comes back got shorter and shorter
Jan - July 2012 75mg down to 37.5mg;, 8/3/12 - 35mg. 8/25/12 - 32mg. 9/11- 28mg, 10/2 - 25mg, 10/29 - 22mg, 11/19 - 19.8mg; 12/11 - 17m,
1/1- 15.5mg; 1/22 -14mg, 2/7 14.9mg, 2/18 - 17.8mg - crashed big time: back to 75mg where i sat for 2 years....

4th  March 2015 - 67.5mg;   31st March - 60mg;  24th April - 53mg; 13th May - 48mg; 26th May - 45mg;  9th June - 41mg; 1 July- 37.5mg; 20 July - 34mg; 11 August - 31mg; 1st Sept - 28mg;  1st Dec - 25.8mg;  28th Dec - 23.2mg; 23rd Jan-21.9mg; Feb 7th- 21mg; March 1st - 20.1mg, March 30th - 18mg

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  • 2 weeks later...

I don't know either what stabilizing would mean in my case.

I have symptoms that never end but sometimes get better and I have symptoms that get replaced by other symptoms.

I am surviving, I am not living.

My drug history may not be as long or as complicated as some but suffering is just as real.

My personal opinion is that in my case I won't fully heal until I fully get off.

Yes, i drag my butt to work, usually by 11 and I can't really do any work, i leave by 4. I feel any slight pressure at work and I will be gone and I can't get another job now.

Lexapro messed up my vision or I should say visual processing I can't live half drunk all the time. I had to abandon team sports, sleeping is a major issue.

I look at my daughter and it is just a child I don't feel it is my child, this is heart wrenching and heart breaking.

I force to exercise daily with sleepless zombie delirium i am in. I drive because i have to but i feel driving drunk all the time.

I get glimpses, i do!!! I know deep down somewhere is me!!!

I refuse to live with this "stability".

I feel like a Roman Empire in 5th century and the only reason barbarians haven't overrun me is because beyond the few soldiers on the border that still echo the previous might, I have no legions i only play barbarians zoloft and lexapro against each other.

I need my own legions, I cannot rely on barbarian stability

10/2012 - Lexapro 10mg

2013/2014 - Started experiencing visual disturbances, like visual processing was slow, feeling drunk all the time

9/2014 - Lexapro 5mg, didn't notice any withdrawal, drunk feeling went away

2015 - Drunk feeling came back

5/2015 - Lexapro 2.5mg - 1.25mg - insomnia started

6/2015 - Lexapro 0.625mg

7/2015 - Severe symptoms started, in desperation on advice of pdoc restarted 5mg Lexapro - total disaster

8/2015 - Lexapro 5mg, disoriented, sleepless zombie

9/2015 - Very reluctantly started transitioning to Zoloft

as of 10/10/2105 - no lexapro, 37.5mg Zoloft

12/14/2015 - 35mg zoloft, 1/16/2016 - 34mg

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  • 2 months later...

I think it takes between 2 to 3 weeks usually to stabilise, provided the cut was small, i.e. a 5% cut every 2 weeks is better than 10% every 4 weeks.  I'm confused, you say you never really stabilise but feel better with each drop - how long do you wait before the next cut?

 

 

  • Finally finished tapering from Mirtazapine (Remeron) 22.1.2017

September 2014 started 15 mg Mirtazapine.  Started a slow taper, (5% every 2 weeks) in October 2015

P.doc advised to stay on Mirtazapine for at least 6 months preferably a year.

April 2014 suffered chronic insomnia which lead to anxiety and then depression.

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Hi Calmer , I'm not sure that sunflower will respond - she hasn't been on the site since March last

year.

 

When I was tapering much too fast in 2013 , I felt better within days after each cut.

This was not to be confused with stability - I became a little euphoric , my thinking was clearer , the

colours were brighter , increased energy , that sort of thing. I subjectively felt better for a short time , and never allowed myself to stabilize before cutting again , and getting the same rush of symptoms.

 

Really dumb thing to do cause it all caught up and I crashed badly. I wonder if that's what sunshine was meaning?

Please could you start an introduction thread for yourself when you're ready.

 

Good to have you on board , Fresh

 

.

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

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I have a question:

 

So, I was never really able to stabilize. Sometimes I feel way worse, sometimes I feel a little better but there is a "stable" pattern when I feel about 3/10.

I would guess, this is my "level" until brain re-calibrates.

Since my original med was Lexapro and Zoloft just doesn't seem to relieve withdrawal I feel continuing to taper is the only way to go.

Opinions?

10/2012 - Lexapro 10mg

2013/2014 - Started experiencing visual disturbances, like visual processing was slow, feeling drunk all the time

9/2014 - Lexapro 5mg, didn't notice any withdrawal, drunk feeling went away

2015 - Drunk feeling came back

5/2015 - Lexapro 2.5mg - 1.25mg - insomnia started

6/2015 - Lexapro 0.625mg

7/2015 - Severe symptoms started, in desperation on advice of pdoc restarted 5mg Lexapro - total disaster

8/2015 - Lexapro 5mg, disoriented, sleepless zombie

9/2015 - Very reluctantly started transitioning to Zoloft

as of 10/10/2105 - no lexapro, 37.5mg Zoloft

12/14/2015 - 35mg zoloft, 1/16/2016 - 34mg

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Several people have asked me privately if I have noticed and patterns in the timing of symptoms over the course of my taper.  I thought it would be good to share the answer on this thread. Bear in mind that I have been doing the Brassmonkey Slide Method my entire taper until I reached about 2.5mg.  At which point it became physically impossible to weigh the doses and I'm too stuck in my ways to switch to liquid.  I started my taper four and a half years ago at 40mg of paxil.  I have done a cumulative 10% every 6 weeks by dropping 2.5% a week for four weeks and then holding an additional 2 weeks.

 

For the majority of my taper symptoms would hit me on day three after the first cut.  These would generally clear back to WDnormal by the end of day six. The second and third cut would be pretty much the same.  The fourth cut frequently was different with the symptoms hitting again about the third but sometimes the second day but not clearing back to WDnormal until around the tenth thru sixteenth day.

 

Things were pretty miserable the entire time I was going from 40mg down to 25mg.  But I could feel a bit of stabilization by the end of each six week period.  My brain also had a lot of sorting out to do as I had been in severe poopout for well over a year before I started to taper and I had also just almost CTed a very heavy alcohol habit at the same time.  By the time I got to 25mg I was starting to notice a general improvement in the symptoms and was having fifteen minute windows about once a month.  I can still remember the first one because I didn't realize that it had happened until  a few hours later with an aha moment of "hey, I had a window this afternoon, this is really going to work."

 

When I got to the 5mg range things seemed to be hitting sooner, frequently on the second day and some times on the first. But they would clear be the sixth.  All this time the baseling or WDnormal was raising as things improved in general.

 

Because of the limitations of the scales when I reached about 2.5mgai (active ingredient) I switched from tapering 10%ai to tapering 1mgpw (pill weight). This put me in the 8-10% range per drop.  I also increased the speed to every four weeks, with longer holds when it felt like I should.

 

With the new schedule the pattern changed a bit.  The first few drops tended to have symptoms start up around day three, peak on days four or five then taper down over the next week and be cleared by the end of the four week period.  After passing 1.5mgai things changed again to nothing until day four or five and then hitting fairly hard for a day or two, subsiding and holding fairly steady for a week or so and then fading off to WDnormal.  There were two instances where I held an extra week because things hadn't settled out.  My impression has been that WDnormal has raised with each drop since 1.5mgai.

 

 

Currently I am getting hit for a few hours on the morning of the third and fourth days and then drag on for about a week before clearing to WDnormal.

 

It's been a very long drawn out experience, and still has some time to go before I can finally jump off.  Although it hasn't been a pleasant experience the symptoms have been manageable to the point I have maintained a full time job, traveled, and indulged my hobbies.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Final Dose 0.016mg.     Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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I think you need to create a line dance called the Brassmonkey Slide. And make a video for us. So we can all do it.

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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It's just a jump to the left..

Then a step to the right....

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Final Dose 0.016mg.     Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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starcontrol, the answer to that question depends so much on your particular history of switching, your Intro topic is the proper place for 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.

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  • 5 weeks later...
  • Administrator

merged similar topics

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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  • 7 months later...

Please see next posts.

If on a Benzo for a relatively short period of time, such as less than 6-12 months, one may want to consider tapering off their Benzo first (please see Will Hall's book on Harm Reduction)

 

Prior to commencing with an AD taper please consider what problems the AD is causing, as tapering is an extremely serious endeavor.   

If one has been on an AD for more than 10 yrs. please consider the potential long term negative consequences of AD withdrawal prior to tapering. (please see Drs. Healy, Glenmullen and Shipko) 

Prior to re-starting an AD taper, please do not resume tapering until all w/d sx's from any prior taper, especially CT, have resolved. 

 

2004 - Dec. 2015,  Cymbalta 20mg/d  for neck pain - Never had problems with Cymbalta.   Dec 2015, CT 20mg/d Cymbalta.  5 weeks later reinstated 20mg/d Cymbalta - without increase in CT sx's.   

Feb 2016 STARTED VALIUM 25mg/d for CT Cymbalta wd sxs.    Jan-April 2016 Held Cymbalta 20mg/d - doing pretty well (AM 3/10 anxiety and 3/10 tinnitus)

April 2016, CT Cymbalta sx's had not yet resolved and I prematurely tapered 10% q 4 wks x 3 mos.  After 3rd cut developed 10/10 wd sx's of Anxiety, Anhedonia, Anorexia, Panic attacks, dark, incresaed Valium to 28mg/d. 

November 2016, after 3 cuts, UP-DOSED all (41 beads) back up to 20mg (193 beads total) Cymbalta - from , dark to light.

VALIUM TAPER: Jan 2017 28mg to March 2019 Zero   Cymbalta has partially stabilized and helped with the Valium taper.  The only sx I have now is 3/10 Tinnitus, which I only notice when it is quiet.

http://survivingantidepressants.org/index.php?/topic/11900-woof-cymbalta-re-stabilization-after-cold-turkey-withdrawal/  Benzo Posts http://survivingantidepressants.org/index.php?/topic/11951-woof-valium-scheduling-and-dosage-with-cymbalta-wd-symptoms/

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It takes 3-4 days for a dosage change to reach steady-state in your bloodstream. You may not feel the entire effect until then. This is a good topic for others to see, too, basildev. Your experience could be a good example (I hope) of fine-tuning dosage when updosing.

 

Are sx's such as, anhedonia and loss of appetite some of the sx's which generally take 3-4 four days to feel a positive effect from when updosing?

If on a Benzo for a relatively short period of time, such as less than 6-12 months, one may want to consider tapering off their Benzo first (please see Will Hall's book on Harm Reduction)

 

Prior to commencing with an AD taper please consider what problems the AD is causing, as tapering is an extremely serious endeavor.   

If one has been on an AD for more than 10 yrs. please consider the potential long term negative consequences of AD withdrawal prior to tapering. (please see Drs. Healy, Glenmullen and Shipko) 

Prior to re-starting an AD taper, please do not resume tapering until all w/d sx's from any prior taper, especially CT, have resolved. 

 

2004 - Dec. 2015,  Cymbalta 20mg/d  for neck pain - Never had problems with Cymbalta.   Dec 2015, CT 20mg/d Cymbalta.  5 weeks later reinstated 20mg/d Cymbalta - without increase in CT sx's.   

Feb 2016 STARTED VALIUM 25mg/d for CT Cymbalta wd sxs.    Jan-April 2016 Held Cymbalta 20mg/d - doing pretty well (AM 3/10 anxiety and 3/10 tinnitus)

April 2016, CT Cymbalta sx's had not yet resolved and I prematurely tapered 10% q 4 wks x 3 mos.  After 3rd cut developed 10/10 wd sx's of Anxiety, Anhedonia, Anorexia, Panic attacks, dark, incresaed Valium to 28mg/d. 

November 2016, after 3 cuts, UP-DOSED all (41 beads) back up to 20mg (193 beads total) Cymbalta - from , dark to light.

VALIUM TAPER: Jan 2017 28mg to March 2019 Zero   Cymbalta has partially stabilized and helped with the Valium taper.  The only sx I have now is 3/10 Tinnitus, which I only notice when it is quiet.

http://survivingantidepressants.org/index.php?/topic/11900-woof-cymbalta-re-stabilization-after-cold-turkey-withdrawal/  Benzo Posts http://survivingantidepressants.org/index.php?/topic/11951-woof-valium-scheduling-and-dosage-with-cymbalta-wd-symptoms/

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I have yet to see someones symptoms NOT improve over time.  Even the worst cases eventually sort themselves out.  Everything else is just trying to keep ourselves functional/comfortable while we let the time pass.

 

Give your updose another month or so and you should be stabilizing by them.  Give the stability a month or so to really take affect then you can start your 5% taper.  You're on the right track.

 

Hi Brass,

Is anxiety generally the symptom which takes at least 3-4 weeks to get relief from when udosing?

If on a Benzo for a relatively short period of time, such as less than 6-12 months, one may want to consider tapering off their Benzo first (please see Will Hall's book on Harm Reduction)

 

Prior to commencing with an AD taper please consider what problems the AD is causing, as tapering is an extremely serious endeavor.   

If one has been on an AD for more than 10 yrs. please consider the potential long term negative consequences of AD withdrawal prior to tapering. (please see Drs. Healy, Glenmullen and Shipko) 

Prior to re-starting an AD taper, please do not resume tapering until all w/d sx's from any prior taper, especially CT, have resolved. 

 

2004 - Dec. 2015,  Cymbalta 20mg/d  for neck pain - Never had problems with Cymbalta.   Dec 2015, CT 20mg/d Cymbalta.  5 weeks later reinstated 20mg/d Cymbalta - without increase in CT sx's.   

Feb 2016 STARTED VALIUM 25mg/d for CT Cymbalta wd sxs.    Jan-April 2016 Held Cymbalta 20mg/d - doing pretty well (AM 3/10 anxiety and 3/10 tinnitus)

April 2016, CT Cymbalta sx's had not yet resolved and I prematurely tapered 10% q 4 wks x 3 mos.  After 3rd cut developed 10/10 wd sx's of Anxiety, Anhedonia, Anorexia, Panic attacks, dark, incresaed Valium to 28mg/d. 

November 2016, after 3 cuts, UP-DOSED all (41 beads) back up to 20mg (193 beads total) Cymbalta - from , dark to light.

VALIUM TAPER: Jan 2017 28mg to March 2019 Zero   Cymbalta has partially stabilized and helped with the Valium taper.  The only sx I have now is 3/10 Tinnitus, which I only notice when it is quiet.

http://survivingantidepressants.org/index.php?/topic/11900-woof-cymbalta-re-stabilization-after-cold-turkey-withdrawal/  Benzo Posts http://survivingantidepressants.org/index.php?/topic/11951-woof-valium-scheduling-and-dosage-with-cymbalta-wd-symptoms/

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I have yet to see someones symptoms NOT improve over time.  Even the worst cases eventually sort themselves out.  Everything else is just trying to keep ourselves functional/comfortable while we let the time pass.

 

Give your updose another month or so and you should be stabilizing by them.  Give the stability a month or so to really take affect then you can start your 5% taper.  You're on the right track.

 

Hi Brass,

Is anxiety generally the symptom which takes at least 3-4 weeks to get relief from when udosing?

 

 

This really depends on the person and on how unstable you were. In my experience, it can take several weeks for an updose to alleviate symptoms, but I feel some improvement within days.

 

On the other hand, people who were very unstable for longer periods of time may take months to stabilize completely.

 

So it doesn't depend so much on the type of symptom. It depends more on the person and on how long you had been unstable...

  • SSRIs 3-4 times in the last 14 years; would take them for 6-8 months and then taper off under dr supervision with no problems.
  • Med history prior to 2015: http://survivingantidepressants.org/index.php?/topic/6012-newbeginning-my-withdrawal-story/?p=267313#entry267313
  • 04/2015: Prozac decreased to 15mg over last 3 months; effexor held steady at 8mg; current effexor XR: 20 beads of a 75mg capsule per day (about 8mg)
  • 06/2015: Prozac: 10mg; effexor XR: 19 beads (about 7.5mg); 07/2015: Prozac: 8.5mg; effexor 18 beads; 08/2015: Prozac: 7.5mg; effexor: 17 beads
  • End of August: withdrawal: depressive symptoms, crying spells. Realized I was measuring prozac dose wrong for the last 2 months. Reinstated Prozac 8.5mg; Kept effexor at 17 beads. Stabilized in 5 weeks.
  • 10/2015: Prozac: 8.5mg; effexor: 17 beads11/2015: Prozac: 1.9ml (7.5mg); effexor: 16 beads12/2015: Prozac: 1.6ml; effexor xr: 16 beads. Withdrawal: neuroemotions
  • 01/2016: prozac: 1.6ml; effexor xr: reinstated 17 beads, withdrawal improved; 02/2016: Prozac 1.5ml; Effexor: 17 beads; 03/2016: Prozac 1.3ml(5mg); Effexor: 17 beads (7mg)-withdrawal (flu-like malaise, lightheaded, drowsy) started end of March. April 15: reinstated Prozac 1.5ml. Stabilized. 2 weeks ok. End of April: Withdrawal (neuroemotions). Eventually stabilized in April-May. Apathy improved.
  • 3 month hold until August. August 2016: apathy came back;

  • October 2016: updosed to Prozac 1.6ml. Bad reaction: anxiety, depression. End of October: went down Prozac 1.5ml. Stabilized over several weeks.

  • Dec 9: tried macca for energy: anxiety/depression. Improved over several weeks, but not completely resolved.

  • Dec 31: cut Effexor 5% to 16 beads. After 9 days: withdrawal anxiety, depression; tried updosing to 17 beads Feb 7 but anxiety got worse; went down to 16 beads

    May 2017: Anxiety improved; severe depression continuesSeptember 2017: finally stabilized!!!!!! 09/07/2017-12/31/2017: hold

  • Stable on Effexor 6mg and Prozac 6mg until around 2019-2020. Side effects (fatigue, anhedonia) continued, but had some long lasting windows thanks to therapy. Windows lasting 5-6 months each year followed by relapses.

  • 2019: bad reaction to melatonin 3 mg. Withdrawal after taking it 2 months. When I tried to stop it developed severe insomnia that lasted 6 months even after I reinstated melatonin. Only slept again because I took hydroxyzine 5 mg 3 times a week for few months. Stopped hydroxyzine with no issues. Sleep normalized.

  • 2020-2021: Holding on Prozac 6mg, Effexor 6mg, Tapered melatonin 1 drop every 2-4 weeks down to 1.5mg. Had to hold because further cuts were causing severe drowsiness. 

  • 2021: Insomnia returned due to caffeine use for few months (only started after months of use). I also had a concussion at this time.

  • 2023: took hydroxyzine 5-100mg for one month (kept increasing dose every 3 days because I developed tolerance). Tapered for 1 week. After 1 month: withdrawal neuroemotions. Reinstated 5mg 2 months after stopping. Gradually increased to 25mg, stabilized, but withdrawal came back after 10 days. Kept increasing dose and withdrawal returning. Currently at 40mg. Not sure how to stabilize. 

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Has anyone become unstable after a long (4 month) hold? How does reinstating work in that case? I was stable for months and holding because I was trying supplements. I got off all supplements 2 weeks ago, but there's been minimal improvement only. My next option is reinstating a bit.

 

I'm worried that if I reinstate after a long hold, I might destabilize my system and/or make future tapers harder.

  • SSRIs 3-4 times in the last 14 years; would take them for 6-8 months and then taper off under dr supervision with no problems.
  • Med history prior to 2015: http://survivingantidepressants.org/index.php?/topic/6012-newbeginning-my-withdrawal-story/?p=267313#entry267313
  • 04/2015: Prozac decreased to 15mg over last 3 months; effexor held steady at 8mg; current effexor XR: 20 beads of a 75mg capsule per day (about 8mg)
  • 06/2015: Prozac: 10mg; effexor XR: 19 beads (about 7.5mg); 07/2015: Prozac: 8.5mg; effexor 18 beads; 08/2015: Prozac: 7.5mg; effexor: 17 beads
  • End of August: withdrawal: depressive symptoms, crying spells. Realized I was measuring prozac dose wrong for the last 2 months. Reinstated Prozac 8.5mg; Kept effexor at 17 beads. Stabilized in 5 weeks.
  • 10/2015: Prozac: 8.5mg; effexor: 17 beads11/2015: Prozac: 1.9ml (7.5mg); effexor: 16 beads12/2015: Prozac: 1.6ml; effexor xr: 16 beads. Withdrawal: neuroemotions
  • 01/2016: prozac: 1.6ml; effexor xr: reinstated 17 beads, withdrawal improved; 02/2016: Prozac 1.5ml; Effexor: 17 beads; 03/2016: Prozac 1.3ml(5mg); Effexor: 17 beads (7mg)-withdrawal (flu-like malaise, lightheaded, drowsy) started end of March. April 15: reinstated Prozac 1.5ml. Stabilized. 2 weeks ok. End of April: Withdrawal (neuroemotions). Eventually stabilized in April-May. Apathy improved.
  • 3 month hold until August. August 2016: apathy came back;

  • October 2016: updosed to Prozac 1.6ml. Bad reaction: anxiety, depression. End of October: went down Prozac 1.5ml. Stabilized over several weeks.

  • Dec 9: tried macca for energy: anxiety/depression. Improved over several weeks, but not completely resolved.

  • Dec 31: cut Effexor 5% to 16 beads. After 9 days: withdrawal anxiety, depression; tried updosing to 17 beads Feb 7 but anxiety got worse; went down to 16 beads

    May 2017: Anxiety improved; severe depression continuesSeptember 2017: finally stabilized!!!!!! 09/07/2017-12/31/2017: hold

  • Stable on Effexor 6mg and Prozac 6mg until around 2019-2020. Side effects (fatigue, anhedonia) continued, but had some long lasting windows thanks to therapy. Windows lasting 5-6 months each year followed by relapses.

  • 2019: bad reaction to melatonin 3 mg. Withdrawal after taking it 2 months. When I tried to stop it developed severe insomnia that lasted 6 months even after I reinstated melatonin. Only slept again because I took hydroxyzine 5 mg 3 times a week for few months. Stopped hydroxyzine with no issues. Sleep normalized.

  • 2020-2021: Holding on Prozac 6mg, Effexor 6mg, Tapered melatonin 1 drop every 2-4 weeks down to 1.5mg. Had to hold because further cuts were causing severe drowsiness. 

  • 2021: Insomnia returned due to caffeine use for few months (only started after months of use). I also had a concussion at this time.

  • 2023: took hydroxyzine 5-100mg for one month (kept increasing dose every 3 days because I developed tolerance). Tapered for 1 week. After 1 month: withdrawal neuroemotions. Reinstated 5mg 2 months after stopping. Gradually increased to 25mg, stabilized, but withdrawal came back after 10 days. Kept increasing dose and withdrawal returning. Currently at 40mg. Not sure how to stabilize. 

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I updosed after holding about a month from 4mg to 5mg and I had back reaction to it(akathisia, insomnia ect.). I also updosed from 2.6mg to 2.8mg after holding a week and had back reaction (akathisia). I never tried to hold for 4 days to stabilize and I think it is dangerous to try to hold if you get bad reaction. Also I think that there cannot be 4 days rule since different drugs have different half lives. I think that bad reaction means serotonin syndrome since the symptoms are so alike. Maybe receptors have become more sensitive and that's why even little updosing means big stimulation in the brain?

Citalopram 40mg from 2003-2015

Jan 2015 started tapering first dropped to 35mgFeb 30mg, March 25mgApril 20mg, May 17,5mg, June 15mgJuly 12,5mg, Aug 12,5mg,

Sep 0mg for 5 days because of stomac flu and after I raised to 7,5mg. All the symptoms of acute WD shaking, diarrhea, vomiting, barely could walk ect. Still didn't realize that it wasn't only stomac flu but I was also going through WD.

Oct 2,5mg and crashed again badly and quickly raised to 4mg. It was then when I knew my symptoms were due to WD.

Then in November after a month holding on 4mg raised to 5mg due to muscle weakness and had a VERY BAD reaction to reinstatement: akathisia(lasted for one or two weeks), insomnia, anhedonia... Drop quicly back to 4mg, Dec 3mg

Jan 2016 2,6mg( in the middle of Jan after I had been on 2,6mg for a week I tried to updose to 2,8mg and immediately had bad reaction to it: akathisia for a day, andehonia got worse. The next day dropped back to 2,6mg), Feb 2,4mg( a new symptom PGAD lasted 24/7 for 2 months after that on and off), March 2,4mg, April 2,3mg, May 2,2mg, June 2,1mg, July 2,0mg( Pgad almost nonexisting, sleeping pretty good, still some anhedonia but there has been a lot of gradual progress), Aug 1,97mg-1,89mg, Sep 1,88mg-1,49mg, Oct 1,48mg- 1,70mg,

Nov 0,65mg- current dose 0,5mg

 

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On the first instance of updosing, perhaps it was too much of an increase? When you had been holding for a month, I assumed you were in withdrawal?
 
On the second updosing, you didn't increase a lot, but I wonder how you were before that? Looking at your signature, you've been going rather fast. If you've been having withdrawal and kept cutting, your reactions to updosing may just be the same withdrawal that you had before, which the reinstatement didn't help. Sometimes if we get very unstable, reinstating doesn't work or can make us worse.
 
In my case, I've updosed several times and it always helped me stabilize. However, I never had withdrawal without cutting. It's been 4 months on the same dose so I'm not sure how my body will react if I updose. I don't even understand why I'm having withdrawal after 4 months of being stable right after another updose. My last change was an updose, not a cut! And it was over 5 months ago. I've been stable for 3 months and the last month had issues.

  • SSRIs 3-4 times in the last 14 years; would take them for 6-8 months and then taper off under dr supervision with no problems.
  • Med history prior to 2015: http://survivingantidepressants.org/index.php?/topic/6012-newbeginning-my-withdrawal-story/?p=267313#entry267313
  • 04/2015: Prozac decreased to 15mg over last 3 months; effexor held steady at 8mg; current effexor XR: 20 beads of a 75mg capsule per day (about 8mg)
  • 06/2015: Prozac: 10mg; effexor XR: 19 beads (about 7.5mg); 07/2015: Prozac: 8.5mg; effexor 18 beads; 08/2015: Prozac: 7.5mg; effexor: 17 beads
  • End of August: withdrawal: depressive symptoms, crying spells. Realized I was measuring prozac dose wrong for the last 2 months. Reinstated Prozac 8.5mg; Kept effexor at 17 beads. Stabilized in 5 weeks.
  • 10/2015: Prozac: 8.5mg; effexor: 17 beads11/2015: Prozac: 1.9ml (7.5mg); effexor: 16 beads12/2015: Prozac: 1.6ml; effexor xr: 16 beads. Withdrawal: neuroemotions
  • 01/2016: prozac: 1.6ml; effexor xr: reinstated 17 beads, withdrawal improved; 02/2016: Prozac 1.5ml; Effexor: 17 beads; 03/2016: Prozac 1.3ml(5mg); Effexor: 17 beads (7mg)-withdrawal (flu-like malaise, lightheaded, drowsy) started end of March. April 15: reinstated Prozac 1.5ml. Stabilized. 2 weeks ok. End of April: Withdrawal (neuroemotions). Eventually stabilized in April-May. Apathy improved.
  • 3 month hold until August. August 2016: apathy came back;

  • October 2016: updosed to Prozac 1.6ml. Bad reaction: anxiety, depression. End of October: went down Prozac 1.5ml. Stabilized over several weeks.

  • Dec 9: tried macca for energy: anxiety/depression. Improved over several weeks, but not completely resolved.

  • Dec 31: cut Effexor 5% to 16 beads. After 9 days: withdrawal anxiety, depression; tried updosing to 17 beads Feb 7 but anxiety got worse; went down to 16 beads

    May 2017: Anxiety improved; severe depression continuesSeptember 2017: finally stabilized!!!!!! 09/07/2017-12/31/2017: hold

  • Stable on Effexor 6mg and Prozac 6mg until around 2019-2020. Side effects (fatigue, anhedonia) continued, but had some long lasting windows thanks to therapy. Windows lasting 5-6 months each year followed by relapses.

  • 2019: bad reaction to melatonin 3 mg. Withdrawal after taking it 2 months. When I tried to stop it developed severe insomnia that lasted 6 months even after I reinstated melatonin. Only slept again because I took hydroxyzine 5 mg 3 times a week for few months. Stopped hydroxyzine with no issues. Sleep normalized.

  • 2020-2021: Holding on Prozac 6mg, Effexor 6mg, Tapered melatonin 1 drop every 2-4 weeks down to 1.5mg. Had to hold because further cuts were causing severe drowsiness. 

  • 2021: Insomnia returned due to caffeine use for few months (only started after months of use). I also had a concussion at this time.

  • 2023: took hydroxyzine 5-100mg for one month (kept increasing dose every 3 days because I developed tolerance). Tapered for 1 week. After 1 month: withdrawal neuroemotions. Reinstated 5mg 2 months after stopping. Gradually increased to 25mg, stabilized, but withdrawal came back after 10 days. Kept increasing dose and withdrawal returning. Currently at 40mg. Not sure how to stabilize. 

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