Jump to content

If you find useful information here, your gift would help keep this site going. Our staff is entirely volunteer.

Photo
- - - - -

Tapering packets to be produced for paroxetine and venlafaxine


  • Please log in to reply
35 replies to this topic

#1 Altostrata

Altostrata

    Administrator

  • Administrators
  • PipPipPipPipPipPip
  • 24,005 posts
  • LocationSan Francisco, CA

Posted 11 November 2013 - 09:53 AM

This is a project of the Netherlands Cinderella Therapeutic Foundation www.cinderella-tx.org

 

The "strips" are packages of tablets in customized dosages.

Press release from http://www.cinderell...-available.html
Tapering strips for paroxetine shortly available

Sunday 20 October 2013 15:09
 

Twenty two prominent Dutch psychiatrists recommend the use of specially designed tapering medication for the cessation of treatment with paroxetine and venlafaxine. In the Dutch professional journal Tijdschrift voor Psychiatrie P. Groot et al.*) explain why the tapering of these antidepressants should be much more gradual than is currently possible with the registered commercial preparations.

 

At present, many patients suffer from discontinuation symptoms upon stopping the treatment. Apart from the inconvenience, some patients take resort in resuming the treatment to get rid of the symptoms. The problem is that the lowest dosages on the market are much too high for use in a safe tapering regimen.

 

There is abundant evidence from the medical literature that the incidence and the severity of discontinuation symptoms decreases when the daily doses are lowered by very small decrements over a period of several weeks, especially in the final stages of tapering. 

 

In addition, the risk of recurrence of the depression is lower.

 

With the assistance of many experts, Cinderella has succeeded in getting consensus on a tapering schedule for paroxetine that meets these requirements and in having the appropriate formulations manufactured by Paul Harder, pharmacist in Bavel near Breda.

 

Two different tapering strips will be made available:

1. Tapering strip PRXT-20-28 to lower the daily dose of paroxetine from 20 mg over 28 days to zero.

2. Tapering strip PRXT-10-21 to lower the daily dose of paroxetine from 10 mg over 21 days to zero.

 

It is expected that the strips will ready for delivery in December. A prescription from the patients’ physician is required. Instructions how to order will be published by the end of November on this site. [color=#3366ff;][color=#3366ff;]www.cinderella-tx.org/tapering[/color].[/color]

 

Cinderella will proceed with the development of similar tapering strips for Venlafaxine and other drugs.

 
Tijdschr Psychiatr. 2013;55(10):789-794.
[Taperingstrips for paroxetine and venlafaxine.]
[Article in Dutch]
Groot PC. E-mail
 
Abstract and free full text [in Dutch] at http://www.ncbi.nlm....pubmed/24194351 English translation at http://www.cinderell...-available.html
 
BACKGROUND:

Tapering strips can be used for the gradual reduction of the dose of certain types of drugs such as antidepressants and benzodiazepines. The strips contain a slightly lower dose on each consecutive day. This prevents the withdrawal symptoms still experienced by too many patients and lowers the risk of relapse.
 
AIM:

To make tapering strips of antidepressant drugs available for patients in need of a tapering-off procedure.
 
METHOD:

The Consensusgroup Tapering studied the literature and consulted with experts to find out whether the plan to make tapering strips of paroxetine and venlafaxine available for patients is feasible.
 
RESULTS:

The Cinderella Therapeutic Foundation (www.cinderella-tx.org), a not-for-profit organisation which aims to give patients access to orphan drugs and treatments, wants to make tapering strips of paroxetine and venlafaxine available since these are the two antidepressants that cause the most problems. The process of producing, packaging and checking the tapering doses is ISO-certified; each strip is provided with a bar-code and can be followed and traced. Therefore the strips will conform to current safety regulations. In view of the large number of patients taking paroxetine and venlafaxine there is likely to be a considerable demand for tapering strips.
 
CONCLUSION:

From a financial, marketing and practical point of view, the introduction of tapering strips is feasable. Patients will derive considerable benefits. The paroxetine strips will be produced first and are expected to be available from December 2013.

 

 

 

From the full text, the Netherlands psychiatrists in the Consensusgroup Tapering are:

Namens de Consensusgroep Tapering, waarvan behalve de auteur deel uitmaken (in alfabetische volgorde): Baer Arts, psychiater,  Maastricht  u m c ;  Ton  van  Balkom,  psychiater  en  hoogleraar Evidence-based Psychiatrie, afd. Psychiatrie en emgo Instituut, v u mc  en  g g z  inGeest,  Amsterdam;  Aartjan  Beekman,  hoogleraar Psychiatrie, dienst onderzoek ggz inGeest/afd. Psychiatrie, Vumc, Amsterdam; Marc Blom, psychiater, directeur zorg en bestuurder, PsyQ; TomBirkenhäger, psychiater,ErasmusmcRotterdam; BertM. van Hemert, hoogleraar Psychiatrie, lumc, Leiden; Witte J. Hoogendijk, hoogleraar Psychiatrie, Erasmus mc Rotterdam; Jan van Ingen Schenau, arts, samensteller Silhouet literatuurservice angst en depressie, 1e Exloërmond; René S. Kahn, hoogleraar Psychiatrie, umc Utrecht; Ralph Kupka, hoogleraar Bipolaire stoornissen, vumc, en psychiater, ggz inGeest en Altrecht ggz; Roos C. van der Mast, hoogleraar Ouderenpsychiatrie/opleider Psychiatrie, lumc, Leiden; Willem A. Nolen, emeritus hoogleraar Psychiatrie, in het bijzonder Emotionele  Stoornissen,  afd.  Psychiatrie,  u m c  Groningen;  Jim van Os,  hoogleraar  Psychiatrische  epidemiologie,  Maastricht  u m c ; Frenk Peeters, psychiater, Maastricht umc en Riagg, Maastricht; Eric Ruhé, psychiater-epidemioloog, afd. Stemmings- en Angststoornis- sen,  u m c  Groningen  en  Zorgprogramma  Stemmingsstoornissen, afd. Psychiatrie, Amc Amsterdam; Aart Schene, hoogleraar Psychia- trie,  Zorgprogramma  Stemmingsstoornissen,  afd.  Psychiatrie,  Am c , Universiteit van Amsterdam; Floor Scheepers, hoofd afd. Psychiatrie, umc Utrecht; Robert Schoevers, hoogleraar Psychiatrie en afdelings- hoofd,umcGroningen; Anne Speckens, hoogleraarPsychiatrie,umc St Radboud, Nijmegen; Jan Spijker, hoogleraar Chronische depressie, umcStRadboud,Nijmegen,psychiater, ProPersona,Nijmegenen Trimbos-instituut, Utrecht; Jan Swinkels, psychiater en hoogleraar Richtlijnontwikkeling  in  de  gezondheidszorg,  Am c ,  Amsterdam; Ton Vergouwen, psychiater en opleider psychiatrie, Sint Lucas Andreas Ziekenhuis, Amsterdam; Frank C. Verhulst, hoogleraar Kinder-enJeugdpsychiatrie,Erasmusmc-Sophia,afd. Kinder-enJeugd- psychiatrie/psychologie, Rotterdam.


Edited by Altostrata, 11 November 2013 - 10:38 AM.
updated press release

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.

#2 Altostrata

Altostrata

    Administrator

  • Administrators
  • PipPipPipPipPipPip
  • 24,005 posts
  • LocationSan Francisco, CA

Posted 11 November 2013 - 10:36 AM

From the English translation of Groot, 2013 at http://www.cinderell...-available.html
 
Coming off antidepressants is in practice often harder than expected and is problematic in more than half of all cases (Van Geffen et al, 2005). This is particularly the case for antidepressants with a short half-life such as paroxetine and venlafaxine. With- drawal of these drugs is often accompanied by the occurrence of discontinuation symptoms, sometimes very serious (see below), especially after prolonged use at higher doses.
 
Why gradual dose reduction is important
The main cause of these problems is that withdrawal is too rapid, which does not give the body sufficient time to adjust to the lower doses. This is why official guidelines and package leaflets rightly state that people wishing to stop taking antidepres- sants should do so gradually and under the guidance of their doctor (Van Weel-Baumgarten et al. 2012).
 
What exactly is meant by ‘gradual’ is not mentioned however and guidelines for tapering of antidepres- sants are lacking (Groot & van Ingen Schenau 2013).
Following recovery from depression, relapse is known to occur more often and earlier if withdrawal is rapid rather than gradual (Baldessarini et al. 2010). The magnitude of this effect is unclear. Prospective studies in the form of randomised clinical trials – which might provide an answer – have never been done and appear to be hardly feasible.
....
Problem of unpredictability
Doctors face two problems when they help pa- tients to taper their antidepressants. The first problem is one of unpredictability: they do not (and cannot) know which type of tapering schedule will suit which patient. While some patients manage with current schedules, it is not clear to what degree these patients suffer from discontinuation symptoms and whether their doctor gets to hear this. With other patients, current schedules fail despite rigid adherence because of the occurrence of discontinuation symptoms.
 
Most symptoms appear to occur during the final phase of tapering. For many patients, the step from 5 mg paroxetine to nothing and from 37.5 mg venla- faxine to nothing appears to be too big. In order to understand why this happens, we must consider the difference between the biochemical effects of anti- depressants and their clinical effects, upon which the current standard dosages are based. SSRIs inhibit the reuptake of serotonin by blocking the serotonin receptor, a process that requires only very low con- centrations. At such low concentrations, occupancy of serotonin receptors increases exponentially as SSRI concentrations increase (Meyer at al. 2004). Vice versa, this means that a small decrease in the daily dose leads to a very strong decrease in the occupancy of serotonin receptors, particularly if the daily dose is already below the lowest standard dose. This may explain why it is at these low doses that discontinuation symptoms are most frequently seen.
 
Practical problem
The second problem faced by doctors helping their patients to taper is that currently there are only limited practical options available. For paroxetine, the patient can split a pill into two or into four parts, or have the drug prescribed in liquid form, which is not practical for all patients. Venlafaxine is only available in capsules. This is why, despite a doctor’s best intentions, some patients are wrongly advised to take a capsule every other day, leading to discontinu- ation symptoms every other day. In practice, some venlafaxine users solve this problem by opening the capsules, counting the grains within, and taking a few grains less each day. Although it is considered unde- sirable for patients to fiddle with their medication, this does allow patients to successfully taper their antidepressants at their own pace, sometimes over a period of months.
 
A final option is to first replace the antidepres- sant in question with fluoxetine, which has a very long half-life and therefore disappears from the body very gradually, resulting in fewer discontinuation symptoms or none at all. However, this makes dis- continuation more complicated for both patients and doctors. Actually, patients are being let down because pharmaceutical companies are failing to supply the formulations needed to properly taper these drugs.
....
TAPERING STRIPS: TECHNICALLY FEASIBLE
....
The pills to be taken by an individual patient are packaged by means of a fully automated process into a strip consisting of seperate compartments, each containing the medications for a specified time-point. The entire process is ISO- certified – after packaging, the pills or capsules are checked using a camera and each separate strip is provided with a barcode so that it can be followed and traced. Meeting the current safety requirements for medications will therefore not be a problem. Thanks to the automated nature of this process, it will also be possible to fill prescriptions for tailored tapering schedules. This will serve and reassure those patients who are still experiencing problems, even when they taper their medication very slowly.
....


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.

#3 Jemima

Jemima

    Platinum star

  • Administrators
  • PipPipPipPipPip
  • 2,441 posts
  • LocationUSA

Posted 11 November 2013 - 03:27 PM

At last, someone has figured out what to do. This may not be perfect, but it looks like a really good start to me.

 

Now, if doctors could be convinced to not prescribe this worthless, dangerous stuff in the first place....


Psychotropic drug history: Pristiq 50 mg. (mid-September 2010 through February 2011), Remeron (mid-September 2010 through January 2011), Lexapro 10 mg. (mid-February 2011 through mid-December 2011), Lorazepam (Ativan) 1 mg. as needed mid-September 2010 through early March 2012

"Never attribute to malice that which is adequately explained by stupidity." -Hanlon's Razor


Introduction: http://survivinganti...oducing-jemima/

 

Success Story: http://survivinganti...r-dickhead-too/

Please note that I am not a medical professional and my advice is based on personal experience, reading, and anecdotal information posted by other sufferers.

 


#4 Barbarannamated

Barbarannamated

    Platinum star

  • Members
  • PipPipPipPipPip
  • 4,179 posts
  • LocationSouthern California

Posted 11 November 2013 - 03:55 PM

I agree that there's good information and intention in this project. I'm not sure if I'm reading this correctly. Are these considered full doses of paroxetine to be tapered in 3 or 4 weeks? "Two different tapering strips will be made available: 1. Tapering strip PRXT-20-28 to lower the daily dose of paroxetine from 20 mg over 28 days to zero. 2. Tapering strip PRXT-10-21 to lower the daily dose of paroxetine from 10 mg over 21 days to zero."
Pristiq tapered over 8 months ending Spring 2011 after 18 years of polydrugging that began w/Zoloft for fatigue/general malaise (not mood). CURRENT: 1mg Klonopin qhs (SSRI bruxism), 75mg trazodone qhs, various hormonesLitigation for 11 years for Work-related injury, settled 2004. Involuntary medical retirement in 2001 (age 39). 2012 - brain MRI showing diffuse, chronic cerebrovascular damage/demyelination possibly vasculitis/cerebritis. Dx w/autoimmune polyendocrine failure.<p>2013 - Dx w/CNS Sjogren's Lupus (FANA antibodies first appeared in 1997 but missed by doc).

#5 Altostrata

Altostrata

    Administrator

  • Administrators
  • PipPipPipPipPipPip
  • 24,005 posts
  • LocationSan Francisco, CA

Posted 11 November 2013 - 03:58 PM

As I read it, the packets will contain tablets of decreasing dosages.


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.

#6 Jemima

Jemima

    Platinum star

  • Administrators
  • PipPipPipPipPip
  • 2,441 posts
  • LocationUSA

Posted 11 November 2013 - 04:08 PM

I agree that there's good information and intention in this project. I'm not sure if I'm reading this correctly. Are these considered full doses of paroxetine to be tapered in 3 or 4 weeks? "Two different tapering strips will be made available: 1. Tapering strip PRXT-20-28 to lower the daily dose of paroxetine from 20 mg over 28 days to zero. 2. Tapering strip PRXT-10-21 to lower the daily dose of paroxetine from 10 mg over 21 days to zero."

 

Whoops.  I didn't catch that at first glance.  That does seem a lot too fast.


Psychotropic drug history: Pristiq 50 mg. (mid-September 2010 through February 2011), Remeron (mid-September 2010 through January 2011), Lexapro 10 mg. (mid-February 2011 through mid-December 2011), Lorazepam (Ativan) 1 mg. as needed mid-September 2010 through early March 2012

"Never attribute to malice that which is adequately explained by stupidity." -Hanlon's Razor


Introduction: http://survivinganti...oducing-jemima/

 

Success Story: http://survivinganti...r-dickhead-too/

Please note that I am not a medical professional and my advice is based on personal experience, reading, and anecdotal information posted by other sufferers.

 


#7 Barbarannamated

Barbarannamated

    Platinum star

  • Members
  • PipPipPipPipPip
  • 4,179 posts
  • LocationSouthern California

Posted 11 November 2013 - 04:54 PM

This sounds very hopeful: "Thanks to the automated nature of this process, it will also be possible to fill prescriptions for tailored tapering schedules. This will serve and reassure those patients who are still experiencing problems, even when they taper their medication very slowly."
Pristiq tapered over 8 months ending Spring 2011 after 18 years of polydrugging that began w/Zoloft for fatigue/general malaise (not mood). CURRENT: 1mg Klonopin qhs (SSRI bruxism), 75mg trazodone qhs, various hormonesLitigation for 11 years for Work-related injury, settled 2004. Involuntary medical retirement in 2001 (age 39). 2012 - brain MRI showing diffuse, chronic cerebrovascular damage/demyelination possibly vasculitis/cerebritis. Dx w/autoimmune polyendocrine failure.<p>2013 - Dx w/CNS Sjogren's Lupus (FANA antibodies first appeared in 1997 but missed by doc).

#8 areyouthere

areyouthere

    Silver star

  • Members
  • PipPipPip
  • 943 posts
  • Locationmidwest

Posted 11 November 2013 - 06:45 PM

I do not understand this passage. Can someone further explain? :
 
"Most symptoms appear to occur during the final phase of tapering. For many patients, the step from 5 mg paroxetine to nothing and from 37.5 mg venla- faxine to nothing appears to be too big. In order to understand why this happens, we must consider the difference between the biochemical effects of anti- depressants and their clinical effects, upon which the current standard dosages are based. SSRIs inhibit the reuptake of serotonin by blocking the serotonin receptor, a process that requires only very low con- centrations. At such low concentrations, occupancy of serotonin receptors increases exponentially as SSRI concentrations increase (Meyer at al. 2004). Vice versa, this means that a small decrease in the daily dose leads to a very strong decrease in the occupancy of serotonin receptors, particularly if the daily dose is already below the lowest standard dose. This may explain why it is at these low doses that discontinuation symptoms are most frequently seen." 
 
I would like to understand more thoroughly why it is at the lowest doses that it becomes more difficult. If anyone can help explain the above using examples or analogies to simplify I would appreciate it.
RU


Fall 1995 xanax, zoloft. switched to Serzone
1996- spring 2003serzone/ xanax/ lightbox.
b]Fall 2003- Fall 2004? Lexapro 10 mg. Light box /4 mg. xanax.[/b]
2004 - Fall of 2009 10 mg Lex, 150 mg Wellbutrin XL % 4 mg xanax
November 2009- Sept. 2011 10 mg lex., 300 Well. XL, 4 mg Xanax [/b
Sept.2012- July 2012 20 mg Lex 300 Well. XL, 4 mg Xanax
My mantra " go slow & with the flow "
3/2/13.. Began equal dosing 5 Xs /day xanax, while simultaneously incorporating a 2.5 % drop ( from 3.5 mg/day to 3.4 mg/day)

4/6/13 dropped from 300 mg. Wellbutrin XL to 150 mg. Difficult but DONE! Down to 3.3 mg xanax/ day / 6/10/13 3 mg xanax/day; 7/15/2013 2.88mg xanax/day.
10/ 1/2013...... 2.5 mg xanax… ( switched to tablets again) WOO HOO!!!!!! Holding here… cont. with Lexapro.
1/ 2/2014.. tapered to 18mg ( by weight) of a 26 mg ( by weight) pill of 20 mg tab. lexapro. goal is 13mg (by weight OR 10 mg by ingredient content) and STOPPED. Feeling very down with unbalanced, unpredictable WD symptoms.
1/2/2014- ??? Taking a brain-healing break from tapering anything after actively tapering something for 1.5 years. So… daily doses as of 2/2/2014: 18 mg by weight Lex, 150 mg Well. XL, 2.5 mg xanax, down from 26 mg by weight Lex., 300 mg well. XL, 4 mg xanax in August, 2012. I'll take it. :) 5/8/14 started equivalent dose liquid./ tabs. 5/13/14 1.5 % cut.

#9 Rhiannon

Rhiannon

    Platinum star

  • Moderators
  • 3,783 posts
  • LocationPacific Northwest US

Posted 12 November 2013 - 03:11 PM

I can't say I know the pharmacokinetics, but I think the key is in the word "exponentially." So that twice the dose does not produce 2 times the effect, it produces (effect to the power of 2). And a reduction by half doesn't produce half the effect, it produces the square root of the effect.  (For example, if the effect at a certain dose was at a level of 16 and you cut that dosage in half, if it was linear the effect would go down to 8, but if it's exponential the effect goes down to 4, which is the square root of 16).

 

When you are at higher doses there are more molecules available to take up the slack, so you don't get that exponential effect.

 

That's my speculation of roughly what that means.

 

Our version of the 10% reduction--10% of your current dose, not 10% of your original dose--is logarithmic (which follows the same nonlinear pattern as exponential). Maybe that's why it works. Personally I think there are many other factors involved in withdrawal--especially the endocrine effects, which are rarely if ever discussed in works like this--but I do think this "exponential/logarithmic versus linear" thing is very important.

 

I'm impressed with the amount of insight this author has into the problems of AD tapering and reduction. Not as much as our Alto does, true, but for a doctor he's not too stupid at all.


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" as I was told. Long and tragic story...lost everything. Life savings, home, physical and mental health, relationships, friendships, ability to work, everything.

 

Now tapering, ironically (but not surprisingly) healthier and more functional than I ever was during the years on the "meds," even with withdrawal (usually fairly mild at this slow pace).

 

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 14 2011:   86 mg Neurontin   144 Lamictal,    5.5 Celexa   0.42 Xanax      1.9 mg Valium

Feb 16 2012:   10 mg Neurontin   115 Lamictal     3.7 Celexa   0.285 Xanax     2.0 Valium

Feb 22 2013:   86 Lamictal    2.05 Celexa       0.23 Xanax      1.8 Valium

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    

Now:                43                    0.625                 0.0775            1.3

 

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


#10 areyouthere

areyouthere

    Silver star

  • Members
  • PipPipPip
  • 943 posts
  • Locationmidwest

Posted 12 November 2013 - 07:43 PM

" for a doctor he's not too stupid at all."

ha ! That's a GOOD one!! Thanks for the explanation Rhi. Just what the "doctor" ordered!!  ;)


Fall 1995 xanax, zoloft. switched to Serzone
1996- spring 2003serzone/ xanax/ lightbox.
b]Fall 2003- Fall 2004? Lexapro 10 mg. Light box /4 mg. xanax.[/b]
2004 - Fall of 2009 10 mg Lex, 150 mg Wellbutrin XL % 4 mg xanax
November 2009- Sept. 2011 10 mg lex., 300 Well. XL, 4 mg Xanax [/b
Sept.2012- July 2012 20 mg Lex 300 Well. XL, 4 mg Xanax
My mantra " go slow & with the flow "
3/2/13.. Began equal dosing 5 Xs /day xanax, while simultaneously incorporating a 2.5 % drop ( from 3.5 mg/day to 3.4 mg/day)

4/6/13 dropped from 300 mg. Wellbutrin XL to 150 mg. Difficult but DONE! Down to 3.3 mg xanax/ day / 6/10/13 3 mg xanax/day; 7/15/2013 2.88mg xanax/day.
10/ 1/2013...... 2.5 mg xanax… ( switched to tablets again) WOO HOO!!!!!! Holding here… cont. with Lexapro.
1/ 2/2014.. tapered to 18mg ( by weight) of a 26 mg ( by weight) pill of 20 mg tab. lexapro. goal is 13mg (by weight OR 10 mg by ingredient content) and STOPPED. Feeling very down with unbalanced, unpredictable WD symptoms.
1/2/2014- ??? Taking a brain-healing break from tapering anything after actively tapering something for 1.5 years. So… daily doses as of 2/2/2014: 18 mg by weight Lex, 150 mg Well. XL, 2.5 mg xanax, down from 26 mg by weight Lex., 300 mg well. XL, 4 mg xanax in August, 2012. I'll take it. :) 5/8/14 started equivalent dose liquid./ tabs. 5/13/14 1.5 % cut.

#11 Altostrata

Altostrata

    Administrator

  • Administrators
  • PipPipPipPipPipPip
  • 24,005 posts
  • LocationSan Francisco, CA

Posted 13 November 2013 - 10:06 AM

Pshah.

 

It seems this panel did some serious thinking about problems in withdrawal.


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.

#12 Claudius

Claudius

    Silver star

  • Members
  • PipPipPip
  • 350 posts
  • LocationNetherlands

Posted 15 November 2013 - 01:41 AM

I have read this before and I have been in contact with one of the authors, Peter Groot. I read his article about tapering in a well known Dutch paper and was very surprised to read a few of my own posts in his article, which he had cited from the website of "Tros Radar", a well known Dutch consumers TV program.  

 

I wrote him a mail early 2013 and he mailed me back and was very kind. He even stated that I could have contributed to this initiative. Indeed I am not fully confident about the tapering schedule of tapering off paroxetine in one month and I wrote him last month to tell him that. He has not reacted to that mail, but indeed is is a good start, albeit 20 years too late.    

 

Maybe you are interested in the mail he sent me, as well as my original email to him, I will post a Google translation below:        

 

Dear Mr. van G, dear Klaas ,

 

Thanks for your email. Nice to hear from one of those we have listed . Citations in our report something Those stories on the Internet make it very clear what problems patients themselves have to make , and that they therefore sometimes found the medical profession itself better solutions.  

 

It must be before a change takes place as long as I try to see as a fact- of-life as possible. Itself Myself excited about ( and I can very well ) leads me in the pratice only that I ruined my mood . Therefore , I'm trying to consciously do as much as possible in every case rather to the future. That I can not always , but it helps me and asked me at least be able to write as I have written bottlenecks note : focus on change and improvement . I experience more satisfying if I can contribute to change than when I myself - how justified it might be - for example winding lawsuits against pharmaceutical companies . I understand the anger and indignation , but also see that these lawsuits is a whole industry holding back on expensive lawyers to work. There is a cynical man easily and that is for someone with a depressive impact not useful emotion . What is more, it is often not achieved much . Because even if a pharmacist must ultimately pay a fine, what does that mean ? Patients would be better served with a generous confession and sincere apologies than with x - amount after so many years of litigation . That amount they might receive , but those excuses , I do not expect much . You write at the end of your e-mail ' Your research will hopefully change that here . " I hope with you that that will happen . A first step would be actually made ​​available to ' outfitting packages " can be. Paroxetine There is a concrete initiative in this direction where i can say. Much more at this time For you, that is unfortunately too late, but maybe it's a ( poor ) consolation for you to know you are there to have contributed . Indirectly with your comments on the Internet   with warm regards ,   Peter Groot    

 

From: Klaas van G [ mailto : klaasg@xxxxxxx ]

Sent : Saturday, January 5, 2013 12:52

To: x.x.groot @ xxxxx ; info@xxxxxxxx

Cc : redactie@xxxxxxxxx

Subject : Article Finishing antidepressants and experience Seroxat / Paroxetine  

to: Dr . And Dr. Peter Groot . Jan van Ingen Schenau

 

Utrecht , January 5, 2013

 

Dear Sirs Groot and van Ingen Schenau ,

 

I recently read the article " Finishing antidepressants could be much better " in Medical Help from December 14, 2012 , I received from my sister who works at the KNMG . The article immediately aroused my interest and on the website of Medical Help , I have also extensive article " Antidepressants better taper , Plea for a directive : discontinuation of antidepressants , a bottleneck " read.

 

First of all I would like to compliment you on the detailed and clear analysis of the problems especially the SSRI and SNRI antdepressiva which have hardly been exposed and even to the absurd denied within the medical and pharmaceutical world . And then I was surprised to read this article which I have posted. As " expert by experience " in the course of the past 3 years on various forums some of my own contributions back These are the following amounts which of my hand : 5 . .... GPs and psychiatrists have no idea majority the terrible withdrawal symptoms these resources and the need to very , very slowly winding down .

 

I would be a kill for it if I could turn back but unfortunately I This site only when I found one and a half years in my cold turkey was and it was too late to build according to the only correct schedule. 11. .... However, the scheme as described above is still not completely times correctly . The highly skilled website is Paxilxxxxx.org leading in terms of knowledge in this area . The site focuses primarily on withdrawal from Paxil ( Paroxetine / Seroxat ) , but also many Members who want to quit venlafaxine or any of the other crap SSRI drugs. The site recommends a dose reduction of 5-10 % by 3-6 weeks. So no half rings ! And indeed means This count granules or pills filing and weigh .

 

It is encouraging to read that finally doctors / researchers who take note of the reports of ( ex ) users of these resources is often no other platform than internet forums to share their experiences and support in the often excruciating process together of reducing and stopping . For me, stopping Paxil ( Paroxetine / Paxil ) was absolutely the most horrific experience of my life and it was even very nearly it had been .

 

Recent experience

The last two years of my total five -year Paxil use had been a dramatic period of quit attempts followed by forced to start the absolutely intolerable withdrawal symptoms , which work and function perfectly normal daily made ​​it impossible to disappear again. Although I called the doctor and a psychiatrist visited was never explained to me about the risks of stopping this means , right then and reduction protocols hindsight I totally misinformed as said with disastrous consequences .

 

Finally I decided to quit the drug because lifelong swallow was totally unacceptable to me and I still had no idea what was waiting for me after final cessation of intake of daily 10 mg ( package insert advises even after repeated failed attempts however, a question still to be built in increments of 10 mg and because I " only" 10 mg used so this was a step, and I have therefore followed the official protocol ) . Among others I was told that the drug was " not addictive " ( which thus in my opinion very misleading pharmaceutical definition is used where addiction is completely disconnected from withdrawal symptoms , irrespective of the duration and severity ) , that withdrawal symptoms " are mild and within a few weeks on " should be the dose of 10 mg" homeopathic "and " I do not swallow " which was totally ignores the nature and severity of withdrawal symptoms , both physical , psychological and neurological and no relationship for nothing had a reason for writing , although let himself in such a way apply during the withdrawal my rather traumatic ( plague) past that I myself believed for some time that the traumatic memory , which came back as if it had happened yesterday, had made me sick because each associated with paroxetine was denied and was also said to be " out of my body was long " after so many weeks / months .

 

After the last stop , in September 2007 , I refused to start with and it has become the most hellish ride of my life . The terrible diarrhea and stomach cramps were after about twenty months the first " withdrawal symptom " that disappeared even though I do in all other respects still a living corpse felt with a range of piece by piece unbearable physical and mental symptoms including temper tantrums and endless crying for nothing , overall cognitive loss , tingling and electricity shoots through skin and heart region , eye muscle spasms , waves of nausea , headaches and electrically charged scalp to name but a few.

 

About the same time I discovered the then largest support site http://www.paxilxxxxxx.org and then finally the scales fell from my eyes. Now, five years after stopping there is much restoration but my job , I have long been lost because I was not very long able to work . Happy to work again for 50 % away from home that I get a small addition to the WIA and I hope my career in IT due time yet again to resume . At least as bad as the horrible symptoms was the wall of ignorance and denial that I was against it , both GPs , psychiatrists and occupational physicians . Even after I had found , among other reputable and independent researchers and authors of several books on the subject of many publications as Prof. David Healy , Prof. Dr. Peter Breggin and a astronomical number of reports of patients especially Seroxat ( paroxetine ) and Effexor ( venlafaxine ) was allowed to persist in this denial , they tried to get me to the pills again or gave several psychiatrists that I immediately asked " not to be available " when they heard what it was about . via email for help By now I had learned that because the damage was precisely due to the much too soon, in my case cold-turkey withdrawal that especially in the case of Paxil, also from 10 mg , a great drain on your body and mind is that this has nothing to do with waste material but rather to the abrupt stop of an agent whose chemical signals between nerve cells become total ( arguing that " it is already out of your body " is so totally disabled ) and to stimulate the for me it was too late to secure, ie to phase very slow , gradual and consistent ( the  doctors mentioned above recommend in consultation with the major online support site 5-10 % reduction per line 3-6 weeks ) and I could do nothing more than recovery wait and this could ever going to be a matter of years (the term of 4-7 years is often called ) without any possibility to speed up this process. All this time I've been in fear that my payment would be withdrawn because I was accused of " not listening to doctors , did not want to swallow my medication and did not want to deal with me," and knowing that even psychiatrists often not height and still rely on the guidelines of the drug manufacturers .

 

And while I had also discovered that Paxil manufacturer GlaxoSmithKline long and macabre history of concealment of information , " ghostwriting " and been convicted multiple times as massive fines , about 10 years ago already been two documentary series about Seroxat - scandal were broadcast on the BBC , but where apparently the manufacturer unfortunately still more lucrative to persist in denial, pay the fines and continue to go through. on the same footing In the case of Paxil now seem many doctors in the Western world to be the extreme risks of this agent still slowly penetrated and less frequently prescribe what bijkbaar response has been to bring the means now to the man for GlaxoSmithKline 's far East to still milking , including the last penny profit out clear from this publication : http://truthman30.wo...roxat-in-china/

 

Many of the problems I read back into your article and I hope this is the start will be in a situation where patients are informed honestly and assisted where necessary by safely dismantle these resources where the costs can be recovered from the manufacturers who have such juggled the definition of addictive and knowingly withheld information and manipulated so there is absolutely no question of a responsible and well- informed decision about a drug as Seroxat / Paroxetine / Paxil go swallow , nor proper guidance in phasing / stop . Unfortunately, it seems that this manufacturer has no interest to their means of an " exit strategy " to provide . And as Paxil , I still can not understand that this means at all is allowed , after all reports , lawsuits , TV reports and thousands of deceased children (who received the drug while GSK knew that this was absolutely unsafe , see in the 90s include below mentioned article) has still not been removed from the market and manufacturer GSK despite the fines it stays here and get away with the responsible criminals are still at large . See also the article on http://www.psy.nl/me...miljard-dollar/

 

I have , therefore , perhaps unnecessarily , in this mail are enclosed a copy of the petition Paxil site where thousands of victims to notify them that Paxil / Seroxat has done with them , especially during the withdrawal / withdrawal . If things are not true , and I myself had not experienced it I would perhaps also can not believe that this horror the bitter reality for hundreds of thousands of innocent people who are in a difficult period of their lives, sought help from a doctor to a "safe and not to get addictive " remedy their stress , anxiety or depression prescribed.

 

Finally, I would like to say that , now 5 years ill due to their habit , but now so does recovering , still do not have a formal diagnosis because the SSRI withdrawal syndrome still does not officially exist and is recognized only by very few physicians ( h ) . And I am also fallen to the level of benefits because of the extension of the WIA benefit a diagnosis of a medical specialist is needed now. Although money is not the only one, I find it incomprehensible that so far no doctor willing / has been able to establish that all information about Paxil, including patient reports , TV reports and the numerous lawsuits and the shameless correct diagnosis cheats manufacturer GlaxoSmithKline are included in the comparison. Not to mention a compensation for the fact that these "non - addictive wonder drug " has made inadequate and erroneous information to physicians and the deceit of the years of my life , and that of hundreds of thousands with me , to an unbearable hell manufacturer .

 

Therefore, I would also resolve to ask if you could recommend who is aware of this matter in all its facets to come . Establish a correct diagnosis to find a good doctor in the me My doctor , after an official complaint fro my side accompanied by a bulky suit publications finally tends me to believe has unfortunately mean because it falls outside the scope of general practice and psychiatry ( exceptions but I have this little could not find it ) in the Netherlands, all too often an extension of the pharmaceutical industry and has so far not been here I totally helpful.

 

I also hope that my mail still contributes to knowledge in this field and questions I am always willing to answer . Incidentally, I have been through several online support sites reach a large number of people, warned of the consequences of the withdrawal , and pointed to the need to be extremely cautious and slow to do so. Unfortunately, it's the year 2013 apparently still need people to sort this yourself via the Internet, which many never get the truth because their doctors remain confident and that would not be like that. I still get very often emails from people who hear their doctor got that you can just quit Paxil , or the most bizarre and dangerous reduction schedules apply , including phasing in a few weeks or , worse , skipping doses , and thus are at risk of coming . same hell I give these people explain the 5-10 % reduction rule and some have already let me know that I probably saved their lives ... Many have thus lost all confidence in the regular medical care . Your research will hopefully change anything here .

 

Sincerely , Klaas van G


Edited by Altostrata, 15 June 2014 - 10:56 AM.

10 mg Paxil/Seroxat since 2002
several attempts to quit since 2004
Quit c/t again Oktober 2007, in protracted w/d since then
after 3.5 years slight improvement but still on the road

after 6 years pretty much recovered but still some nasty residual sypmtons
We are not lost even though it may feel that way. We are in transition.


#13 Altostrata

Altostrata

    Administrator

  • Administrators
  • PipPipPipPipPipPip
  • 24,005 posts
  • LocationSan Francisco, CA

Posted 15 November 2013 - 10:39 AM

Hi, Claudius! Thanks for letting us know about this. I have no doubt your testimony in Web posts influenced this research group.

 

Please consider sending Dr. Groot a link to our Tapering section http://tinyurl.com/42ewlrl

 

I believe the way it is organized will inform the researchers as they develop tapering packets for other drugs.


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.

#14 Fenrir

Fenrir

    Member

  • Members
  • PipPip
  • 90 posts
  • LocationItaly

Posted 18 November 2013 - 01:44 PM

completely useless, 28 days to get off paroxetine is way too fast. It takes months or years


end of 2010, prescribed paxil 20mg

1 year off cold turkey  september 2011- september 2012 (nightmare) escitalopram for 4 months (didn't help).

RI september 2012 20mg

october 2013 crash reaching 10mg

10/31/2013 updose to 14mg

1/3/2014-13mg

2/23/2014-12mg

4/6/2014-11mg

august 2014-10mg

November-December 2014 Big mistake, skipping doses BIG Crash

January 2015- 12 mg

 


#15 Claudius

Claudius

    Silver star

  • Members
  • PipPipPip
  • 350 posts
  • LocationNetherlands

Posted 19 November 2013 - 03:14 PM

I also have some doubts about this method, it would be better to produce tablets of 1 and 2 mg with a divider slice so that every dosage with an interval of 0.5 mg can be made using the 5, 2 and 1 mg tablets.

If the tapering strips do not give the possibilty to stay on a certain dose for some time, it is indeed far from the best solution.

 

But at least a group of psychiatrist does recognize the withdrawal problems and that is more than we could dream of a few years ago...


10 mg Paxil/Seroxat since 2002
several attempts to quit since 2004
Quit c/t again Oktober 2007, in protracted w/d since then
after 3.5 years slight improvement but still on the road

after 6 years pretty much recovered but still some nasty residual sypmtons
We are not lost even though it may feel that way. We are in transition.


#16 btdt

btdt

    Fingers of titanium

  • Members
  • PipPipPipPipPipPip
  • 7,153 posts
  • LocationCanada

Posted 15 June 2014 - 06:39 AM

I did a new search on this today as I thought it was a great step forward to have people taper and avoid cold turkeys long and horrid effects. IF it were to come to pass. I found this  but still can't tell if these pills are on the market or not?????

 

Taperingstrips for paroxetine and venlafaxine.

10:32 EDT 15th June 2014 | BioPortfolio

Summary of "Taperingstrips for paroxetine and venlafaxine."

Tapering strips can be used for the gradual reduction of the dose of certain types of drugs such as antidepressants and benzodiazepines. The strips contain a slightly lower dose on each consecutive day. This prevents the withdrawal symptoms still experienced by too many patients and lowers the risk of relapse.

Affiliation

 

Journal Details

This article was published in the following journal.

Name: Tijdschrift voor psychiatrie
ISSN: 0303-7339
Pages: 789-794

Links

 

link here

http://www.bioportfo...enlafaxine.html

PubMed Articles[49 Associated PubMed Articles listed on BioPortfolio]

Rapid weight gain associated with edema after use of paroxetine and venlafaxine: 2 case reports.

Edema is a rarely observed adverse effect of the usage of antidepressant, with only few case reports of peripheral edema in the literature. This report included 2 patients who presented with rapid wei...

Response to "Understanding CYP2D6 and Its Role in Tamoxifen Metabolism".

In light of the article "Understanding CYP2D6 and Its Role in Tamoxifen Metabolism" (Smith, 2013), we feel it imperative to comment on the recent, unexpected approval by the U.S. Food and Drug Adminis...

New validated HPLC methodology for the determination of (-)-trans-paroxetine and its enantiomer in pharmaceutical formulations with use of ovomucoid chiral stationary phase.

A new chromatographic method for the enantioseparation and the determination of (-)-trans-paroxetine and (+)-trans-paroxetine has been developed with the aid of amylose ovomucoid-based chiral stationa...

Paroxetine versus other anti-depressive agents for depression.

Paroxetine is the most potent inhibitor of the reuptake of serotonin of all selective serotonin reuptake inhibitors (SSRIs) and has been studied in many randomised controlled trials (RCTs). However, t...

Acute Bilateral Parotitis Occurring during Venlafaxine Titration in an Adolescent Female with Major Depression.

Parotitis is a fairly uncommon adverse drug reaction of psychopharmacological treatment. Here, we report on an acute bilateral parotitis, which was associated with titration of venlafaxine in a 20-yea...

Clinical Trials[163 Associated Clinical Trials listed on BioPortfolio]

Effect of Antidepressants on the Treatment for Korean Major Depressive Disorder Patients

The primary purpose of this study is to investigate the effectiveness of antidepressants on the treatments for non-psychotic major depressive disorder (MDD) in Korea. The study divides MDD...

Physiologic Monitoring of Antidepressant Treatment Response

Primary: to identify physiologic indicators of venlafaxine treatment response using quantitative EEG (QEEG) cordance, and to determine if cordance changes are specifically associated with...

Study Evaluating Venlafaxine Extended-Release in Depressed and Anxious Patients

To examine the efficacy and safety of venlafaxine XR in the treatment of physical and emotional symptoms in patients with an operationally-defined diagnosis of multisomatoform disorder (MS...

Antidepressant Prophylaxis for Interferon-Induced Depression: Efficacy of Paroxetine

Objectives: 1. To determine whether paroxetine can prevent major depression in patients with hepatitis C (HCV) who are receiving pegylated-interferon (Peg-IFN). 2. To dete...

Single Dose Pharmacokinetic (PK) Study Of Paroxetine CR(12.5-37.5mg) In Healthy Chinese Subjects

The study was designed to describe the relationship between dose and pharmacokinetic parameters of paroxetine over the range of proposed dosage strengths of the paroxetine CR tablet (12.5...

Medical and Biotech [MESH] Definitions

Paroxetine

A serotonin uptake inhibitor that is effective in the treatment of depression.

It has todays date...???

WARNING THIS WILL BE LONG
Had a car accident in 85
Codeine was the pain med when I was release from hosp continuous use till 89
Given PROZAC by a specialist to help with nerve pain in my leg 89-90 not sure which year
Was not told a thing about it being a psych med thought it was a pain killer no info about psych side effects I went nuts had hallucinations. As I had a head injury and was diagnosed with a concussion in 85 I was sent to a head injury clinic in 1990 five years after the accident. I don't think they knew I had been on prozac I did not think it a big deal and never did finish the bottle of pills. I had tests of course lots of them. Was put into a pain clinic and given amitriptyline which stopped the withdrawal but had many side effects. But I could sleep something I had not done in a very long time the pain lessened. My mother got cancer in 94 they switched my meds to Zoloft to help deal with this pressure as I was her main care giver she died in 96. I stopped zoloft in 96 had withdrawal was put on paxil went nutty quit it ct put on resperidol quit it ct had withdrawal was put on Effexor... 2years later celexa was added 20mg then increased to 40mg huge personality change went wild. Did too fast taper off Celexa 05 as I felt unwell for a long time prior... quit Effexor 150mg ct 07 found ****** 8 months into withdrawal learned some things was banned from there in 08 have kept learning since. there is really not enough room here to put my history but I have a lot of opinions about a lot of things especially any of the drugs mentioned above.
One thing I would like to add here is this tidbit ALL OPIATES INCREASE SEROTONIN it is not a huge jump to being in chronic pain to being put on an ssri/snri and opiates will affect your antidepressants and your thinking.

As I do not update much I will put my quit date Nov. 17 2007 I quit Effexor cold turkey. 

http://survivinganti...ng-myself-btdt/

There is a crack in everything ..That's how the light gets in :)


#17 Altostrata

Altostrata

    Administrator

  • Administrators
  • PipPipPipPipPipPip
  • 24,005 posts
  • LocationSan Francisco, CA

Posted 15 June 2014 - 10:46 AM

You'll have to ask the authors of the paper, btdt.

 

Please do not copy big chunks of off-topic information and post them here. It makes the topics tedious to read.


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.

#18 SouthernFreeze

SouthernFreeze

    Member

  • Members
  • PipPip
  • 85 posts
  • LocationNew Zealand

Posted 15 June 2014 - 11:43 AM

finally a bit of progress , ill probably be dead by the time it gets recognized by any psychiatrist or doctor here though 


10 years on various anti-depressants

 

first Aropax

then citalopram 

then fluoxetine

then the last 5 years Effexor xr

tappered of 150mg in 6 months

was on 35.7mg for 2 months

tappered off 35.7 mg in two weeks

nothing for two weeks

warned of future withdrawals on this site from tapering too fast

back on 15 beads for 50 days


#19 btdt

btdt

    Fingers of titanium

  • Members
  • PipPipPipPipPipPip
  • 7,153 posts
  • LocationCanada

Posted 15 June 2014 - 05:23 PM

You'll have to ask the authors of the paper, btdt.

 

Please do not copy big chunks of off-topic information and post them here. It makes the topics tedious to read.

If you tell me how to do that I will.


WARNING THIS WILL BE LONG
Had a car accident in 85
Codeine was the pain med when I was release from hosp continuous use till 89
Given PROZAC by a specialist to help with nerve pain in my leg 89-90 not sure which year
Was not told a thing about it being a psych med thought it was a pain killer no info about psych side effects I went nuts had hallucinations. As I had a head injury and was diagnosed with a concussion in 85 I was sent to a head injury clinic in 1990 five years after the accident. I don't think they knew I had been on prozac I did not think it a big deal and never did finish the bottle of pills. I had tests of course lots of them. Was put into a pain clinic and given amitriptyline which stopped the withdrawal but had many side effects. But I could sleep something I had not done in a very long time the pain lessened. My mother got cancer in 94 they switched my meds to Zoloft to help deal with this pressure as I was her main care giver she died in 96. I stopped zoloft in 96 had withdrawal was put on paxil went nutty quit it ct put on resperidol quit it ct had withdrawal was put on Effexor... 2years later celexa was added 20mg then increased to 40mg huge personality change went wild. Did too fast taper off Celexa 05 as I felt unwell for a long time prior... quit Effexor 150mg ct 07 found ****** 8 months into withdrawal learned some things was banned from there in 08 have kept learning since. there is really not enough room here to put my history but I have a lot of opinions about a lot of things especially any of the drugs mentioned above.
One thing I would like to add here is this tidbit ALL OPIATES INCREASE SEROTONIN it is not a huge jump to being in chronic pain to being put on an ssri/snri and opiates will affect your antidepressants and your thinking.

As I do not update much I will put my quit date Nov. 17 2007 I quit Effexor cold turkey. 

http://survivinganti...ng-myself-btdt/

There is a crack in everything ..That's how the light gets in :)


#20 Altostrata

Altostrata

    Administrator

  • Administrators
  • PipPipPipPipPipPip
  • 24,005 posts
  • LocationSan Francisco, CA

Posted 15 June 2014 - 05:51 PM

Don't copy such big chunks!!!!!!!!! Your copy method captured a lot of irrelevant material -- what do those associated articles from Pubmed have to do with 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

All postings © copyrighted.

#21 btdt

btdt

    Fingers of titanium

  • Members
  • PipPipPipPipPipPip
  • 7,153 posts
  • LocationCanada

Posted 15 June 2014 - 08:10 PM

 

You'll have to ask the authors of the paper, btdt.

 

Please do not copy big chunks of off-topic information and post them here. It makes the topics tedious to read.

If you tell me how to do that I will.

 

I was addressing this - "You'll have to ask the authors of the paper, btdt." 


WARNING THIS WILL BE LONG
Had a car accident in 85
Codeine was the pain med when I was release from hosp continuous use till 89
Given PROZAC by a specialist to help with nerve pain in my leg 89-90 not sure which year
Was not told a thing about it being a psych med thought it was a pain killer no info about psych side effects I went nuts had hallucinations. As I had a head injury and was diagnosed with a concussion in 85 I was sent to a head injury clinic in 1990 five years after the accident. I don't think they knew I had been on prozac I did not think it a big deal and never did finish the bottle of pills. I had tests of course lots of them. Was put into a pain clinic and given amitriptyline which stopped the withdrawal but had many side effects. But I could sleep something I had not done in a very long time the pain lessened. My mother got cancer in 94 they switched my meds to Zoloft to help deal with this pressure as I was her main care giver she died in 96. I stopped zoloft in 96 had withdrawal was put on paxil went nutty quit it ct put on resperidol quit it ct had withdrawal was put on Effexor... 2years later celexa was added 20mg then increased to 40mg huge personality change went wild. Did too fast taper off Celexa 05 as I felt unwell for a long time prior... quit Effexor 150mg ct 07 found ****** 8 months into withdrawal learned some things was banned from there in 08 have kept learning since. there is really not enough room here to put my history but I have a lot of opinions about a lot of things especially any of the drugs mentioned above.
One thing I would like to add here is this tidbit ALL OPIATES INCREASE SEROTONIN it is not a huge jump to being in chronic pain to being put on an ssri/snri and opiates will affect your antidepressants and your thinking.

As I do not update much I will put my quit date Nov. 17 2007 I quit Effexor cold turkey. 

http://survivinganti...ng-myself-btdt/

There is a crack in everything ..That's how the light gets in :)


#22 btdt

btdt

    Fingers of titanium

  • Members
  • PipPipPipPipPipPip
  • 7,153 posts
  • LocationCanada

Posted 15 June 2014 - 08:12 PM

Don't copy such big chunks!!!!!!!!! Your copy method captured a lot of irrelevant material -- what do those associated articles from Pubmed have to do with this topic?

All the other links were about antidepressants too.. I thought somebody may find them interesting as I did.


WARNING THIS WILL BE LONG
Had a car accident in 85
Codeine was the pain med when I was release from hosp continuous use till 89
Given PROZAC by a specialist to help with nerve pain in my leg 89-90 not sure which year
Was not told a thing about it being a psych med thought it was a pain killer no info about psych side effects I went nuts had hallucinations. As I had a head injury and was diagnosed with a concussion in 85 I was sent to a head injury clinic in 1990 five years after the accident. I don't think they knew I had been on prozac I did not think it a big deal and never did finish the bottle of pills. I had tests of course lots of them. Was put into a pain clinic and given amitriptyline which stopped the withdrawal but had many side effects. But I could sleep something I had not done in a very long time the pain lessened. My mother got cancer in 94 they switched my meds to Zoloft to help deal with this pressure as I was her main care giver she died in 96. I stopped zoloft in 96 had withdrawal was put on paxil went nutty quit it ct put on resperidol quit it ct had withdrawal was put on Effexor... 2years later celexa was added 20mg then increased to 40mg huge personality change went wild. Did too fast taper off Celexa 05 as I felt unwell for a long time prior... quit Effexor 150mg ct 07 found ****** 8 months into withdrawal learned some things was banned from there in 08 have kept learning since. there is really not enough room here to put my history but I have a lot of opinions about a lot of things especially any of the drugs mentioned above.
One thing I would like to add here is this tidbit ALL OPIATES INCREASE SEROTONIN it is not a huge jump to being in chronic pain to being put on an ssri/snri and opiates will affect your antidepressants and your thinking.

As I do not update much I will put my quit date Nov. 17 2007 I quit Effexor cold turkey. 

http://survivinganti...ng-myself-btdt/

There is a crack in everything ..That's how the light gets in :)


#23 Altostrata

Altostrata

    Administrator

  • Administrators
  • PipPipPipPipPipPip
  • 24,005 posts
  • LocationSan Francisco, CA

Posted 16 June 2014 - 06:44 PM

Please don't do that. It makes these topics difficult to read and it's off-topic besides.


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.

#24 bolletje

bolletje

    Member

  • Members
  • PipPip
  • 16 posts
  • LocationHolland

Posted 02 February 2015 - 01:51 AM

Hi,

 

I just contacted Drs Harder (the pharmacist from Bavel); he told me he 'd probably have taperingstrips for Venlafaxine in about 3 months from now as well...


Daughter on Venlafaxine 37,5 mg for 2 years

tried to quit cold turkey

after 5 days back to 1 x 37,5 mg

advice on tapering

20-4-2015: after 5 weeks now 15 beads per capsule less


#25 btdt

btdt

    Fingers of titanium

  • Members
  • PipPipPipPipPipPip
  • 7,153 posts
  • LocationCanada

Posted 02 February 2015 - 10:57 AM

Hi,

 

I just contacted Drs Harder (the pharmacist from Bavel); he told me he 'd probably have taperingstrips for Venlafaxine in about 3 months from now as well...

Wonderful news!!

Please let us know when you can finally buy them.  I sure hope it works. 


WARNING THIS WILL BE LONG
Had a car accident in 85
Codeine was the pain med when I was release from hosp continuous use till 89
Given PROZAC by a specialist to help with nerve pain in my leg 89-90 not sure which year
Was not told a thing about it being a psych med thought it was a pain killer no info about psych side effects I went nuts had hallucinations. As I had a head injury and was diagnosed with a concussion in 85 I was sent to a head injury clinic in 1990 five years after the accident. I don't think they knew I had been on prozac I did not think it a big deal and never did finish the bottle of pills. I had tests of course lots of them. Was put into a pain clinic and given amitriptyline which stopped the withdrawal but had many side effects. But I could sleep something I had not done in a very long time the pain lessened. My mother got cancer in 94 they switched my meds to Zoloft to help deal with this pressure as I was her main care giver she died in 96. I stopped zoloft in 96 had withdrawal was put on paxil went nutty quit it ct put on resperidol quit it ct had withdrawal was put on Effexor... 2years later celexa was added 20mg then increased to 40mg huge personality change went wild. Did too fast taper off Celexa 05 as I felt unwell for a long time prior... quit Effexor 150mg ct 07 found ****** 8 months into withdrawal learned some things was banned from there in 08 have kept learning since. there is really not enough room here to put my history but I have a lot of opinions about a lot of things especially any of the drugs mentioned above.
One thing I would like to add here is this tidbit ALL OPIATES INCREASE SEROTONIN it is not a huge jump to being in chronic pain to being put on an ssri/snri and opiates will affect your antidepressants and your thinking.

As I do not update much I will put my quit date Nov. 17 2007 I quit Effexor cold turkey. 

http://survivinganti...ng-myself-btdt/

There is a crack in everything ..That's how the light gets in :)


#26 Altostrata

Altostrata

    Administrator

  • Administrators
  • PipPipPipPipPipPip
  • 24,005 posts
  • LocationSan Francisco, CA

Posted 02 February 2015 - 01:26 PM

bolletje, did you speak to any of the Netherlands doctors? Are any helping you with tapering?


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.

#27 bolletje

bolletje

    Member

  • Members
  • PipPip
  • 16 posts
  • LocationHolland

Posted 05 February 2015 - 09:24 AM

I talked to this dr Harder from Bavel; he told me it would take probably another 3 months before he could come up with usable tapering strips; he said normal pharmacy industries would take years on trying to get some reliable results and thus proof that something would actually work, he said I would have to be a little more patient and that he would have results sooner than that ,so in 3 months...


Daughter on Venlafaxine 37,5 mg for 2 years

tried to quit cold turkey

after 5 days back to 1 x 37,5 mg

advice on tapering

20-4-2015: after 5 weeks now 15 beads per capsule less


#28 Altostrata

Altostrata

    Administrator

  • Administrators
  • PipPipPipPipPipPip
  • 24,005 posts
  • LocationSan Francisco, CA

Posted 05 February 2015 - 02:04 PM

Oh, I meant, did you speak with any of the psychiatrists?

 

I think the tapering packets would be of great benefit, but they still will not contain the very gradual dosage ranges some people will need. Still, they're a start and it's good to see so many doctors agreeing tapering can be a problem.


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.

#29 btdt

btdt

    Fingers of titanium

  • Members
  • PipPipPipPipPipPip
  • 7,153 posts
  • LocationCanada

Posted 05 February 2015 - 02:24 PM

I would think they would talk to people who have been able to taper and keep a life but perhaps not and that would be a huge disappointment.. in so many ways when people fail because the system it not right... still having small stable amounts may come in handy people are quite creative when it comes to getting the right dose of drug they need.  Guess we will wait and see what happens. Doing a range gradually smaller doses would have made more sense.... but we get what they gives us don't we... and them make the best of it.  Maybe it will have a place maybe not.. hate to see people fail trying and give up on taper tho that would suck


WARNING THIS WILL BE LONG
Had a car accident in 85
Codeine was the pain med when I was release from hosp continuous use till 89
Given PROZAC by a specialist to help with nerve pain in my leg 89-90 not sure which year
Was not told a thing about it being a psych med thought it was a pain killer no info about psych side effects I went nuts had hallucinations. As I had a head injury and was diagnosed with a concussion in 85 I was sent to a head injury clinic in 1990 five years after the accident. I don't think they knew I had been on prozac I did not think it a big deal and never did finish the bottle of pills. I had tests of course lots of them. Was put into a pain clinic and given amitriptyline which stopped the withdrawal but had many side effects. But I could sleep something I had not done in a very long time the pain lessened. My mother got cancer in 94 they switched my meds to Zoloft to help deal with this pressure as I was her main care giver she died in 96. I stopped zoloft in 96 had withdrawal was put on paxil went nutty quit it ct put on resperidol quit it ct had withdrawal was put on Effexor... 2years later celexa was added 20mg then increased to 40mg huge personality change went wild. Did too fast taper off Celexa 05 as I felt unwell for a long time prior... quit Effexor 150mg ct 07 found ****** 8 months into withdrawal learned some things was banned from there in 08 have kept learning since. there is really not enough room here to put my history but I have a lot of opinions about a lot of things especially any of the drugs mentioned above.
One thing I would like to add here is this tidbit ALL OPIATES INCREASE SEROTONIN it is not a huge jump to being in chronic pain to being put on an ssri/snri and opiates will affect your antidepressants and your thinking.

As I do not update much I will put my quit date Nov. 17 2007 I quit Effexor cold turkey. 

http://survivinganti...ng-myself-btdt/

There is a crack in everything ..That's how the light gets in :)


#30 mammaP

mammaP

    Platinum star

  • Moderators
  • 4,089 posts
  • LocationEurope

Posted 09 February 2015 - 04:10 PM

It would be good if people could get 30 of the strips, then they could take the first dose of every strip. That would take 30 days, then the second dose of every strip, another 30 days and so on. This would take 28/30 months? for 20mg and a much safer taper. I wonder if any doctor would agree to that, or even if they would be able to prescribe that way! 


**I am not a medical professional, if in doubt please consult a doctor with withdrawal knowledge.

 

See how to create a signature here http://survivingantidepressants.org/index.php?/topic/12364-please-put-your-withdrawal-history-in-your-signature/

 

Many drugs for many years, prescribed diazepam first 1973, took occasionally. 3 or 4 tricyclics  for short periods.

1993 had a breakdown leading to 10 years of drug experiments with all classes of psych drugs.

2002  effexor. 

Tapered by counting beads from March 2012 to March 2013, ending with 5 beads.

Withdrawal April 2013 . Reinstated 5 beads reduced to 4 beads May 2013

Restarted taper  Nov 2013  

OFF EFFEXOR Feb 2015    :D 

 

Also tapered atenolol and omeprazole Dec 2013 - May 2014

 

Tapering tramadol, Feb 2015 100mg , March 2015 50mg -hold- Feb2016 46mg  March 8 2016 45 April 44mg  May 11  43mg June 14 42mg

Taking fish oil, magnesium, pro biotic.

 

My story http://survivinganti...king-in/page-33

 

Lesson learned, slow down taper at lower doses. Taper no more than 10% of CURRENT dose if possible

 

Following every sunset is a brand new day


#31 btdt

btdt

    Fingers of titanium

  • Members
  • PipPipPipPipPipPip
  • 7,153 posts
  • LocationCanada

Posted 10 February 2015 - 06:56 AM

It would be good if people could get 30 of the strips, then they could take the first dose of every strip. That would take 30 days, then the second dose of every strip, another 30 days and so on. This would take 28/30 months? for 20mg and a much safer taper. I wonder if any doctor would agree to that, or even if they would be able to prescribe that way! 

 

What a great idea!  

I think doctors can do as they please when it comes to how they prescribe most drugs at least here in Canada.  I have had pharmacies give me enough ppi for a year on one script. 

The only time I could see this being a problem is if there had been an over dose previously of an snri or other drug.  In that case the doc gives the pills out a wk at a time so there are not enough drugs on had to overdose with. 

Seems the best way to get beyond this problem is to have the companies making the strips understand the tapering protocol and why it needs to be the way it is.  Since nobody asked us I guess they don't want our input but by talking more to our doctors and explaining why it needs to be the way it is we could maybe shave years off the development process so they can get it right faster. The questionable side of this comes from doctors not taking psych patients seriously when we are able to explain our needs they often still believe we don't understand our own issues as well as they do.  

That is what makes sites like this a good resource with support and understanding maybe more people will be able to identify their issues when they see others here with the same problems.  With the right information perhaps they will be able confidently persuade a doctor to help them do a slow slow taper. 

Peace Mamma and good plan. 


WARNING THIS WILL BE LONG
Had a car accident in 85
Codeine was the pain med when I was release from hosp continuous use till 89
Given PROZAC by a specialist to help with nerve pain in my leg 89-90 not sure which year
Was not told a thing about it being a psych med thought it was a pain killer no info about psych side effects I went nuts had hallucinations. As I had a head injury and was diagnosed with a concussion in 85 I was sent to a head injury clinic in 1990 five years after the accident. I don't think they knew I had been on prozac I did not think it a big deal and never did finish the bottle of pills. I had tests of course lots of them. Was put into a pain clinic and given amitriptyline which stopped the withdrawal but had many side effects. But I could sleep something I had not done in a very long time the pain lessened. My mother got cancer in 94 they switched my meds to Zoloft to help deal with this pressure as I was her main care giver she died in 96. I stopped zoloft in 96 had withdrawal was put on paxil went nutty quit it ct put on resperidol quit it ct had withdrawal was put on Effexor... 2years later celexa was added 20mg then increased to 40mg huge personality change went wild. Did too fast taper off Celexa 05 as I felt unwell for a long time prior... quit Effexor 150mg ct 07 found ****** 8 months into withdrawal learned some things was banned from there in 08 have kept learning since. there is really not enough room here to put my history but I have a lot of opinions about a lot of things especially any of the drugs mentioned above.
One thing I would like to add here is this tidbit ALL OPIATES INCREASE SEROTONIN it is not a huge jump to being in chronic pain to being put on an ssri/snri and opiates will affect your antidepressants and your thinking.

As I do not update much I will put my quit date Nov. 17 2007 I quit Effexor cold turkey. 

http://survivinganti...ng-myself-btdt/

There is a crack in everything ..That's how the light gets in :)


#32 Altostrata

Altostrata

    Administrator

  • Administrators
  • PipPipPipPipPipPip
  • 24,005 posts
  • LocationSan Francisco, CA

Posted 17 August 2015 - 10:36 AM

Update from this Netherlands organization:

 

Tapering strips to make stopping with diazepam easier

Diazepam tapering strips are a new pharmacotherapeutic tool to make stopping with or dose-reduction of diazepam easier and safer. Gradual dose reduction gives patients time to adjust to the gradually decreasing doses and prevents withdrawal symptoms. Tapering strips allow patients to choose themselves how slow they wish to taper, which will enhance patient commitment and compliance. Taperingstrips are prescription medicines and do not replace standard treatment.

Realization of tapering strips is an initiative of Cinderella Therapeutics. Cinderella does not make the strips themselves and has no commercial interest in providing the strips. Pharmacist drs Paul Harder has been found willing to do this.

Cinderella Therapeutics is a not-for-profit foundation that attempts to make neglected medical drugs and treatments available to patients.

*More detailed info on http://www.cinderella-tx.org


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.

#33 Toulouse

Toulouse

    Silver star

  • Members
  • PipPipPip
  • 194 posts
  • LocationUnited States

Posted 17 August 2015 - 05:02 PM

did they ever make these strips available in the US? I'd have imagined my doctor or pharmacist would have mentioned it to me as they both know I'm tapering off Paxil.  This would have made things much easier for those who want to get off.


Been on Paxil 14 years. 40mg for the bulk of those.

20mg in 2014

10mg March of 2015 - then tapered to 5mg

Then to 2.5 to 1.5 - to 1mg, from Mar-August.

As of August 23 2015, I am flying without a net.  Paxil free!

 

WD symptoms since tapering mid- 2015:

 

Short temper, hostile. Brain zaps. Bruxism. Wild vivid dreams  Hives Food intolerance Lump in throat, . Joint pain. Knees, elbows.  Pain in feet. Numbness in hands. Shaking, like I'm cold. Trembling. Tremors, muscle twitches all over. Facial tics. Eye, lips. Head.  Floaters in my eyes. Severe Insomnia (between months 4-5)  then returned from March-October 2016. I'm sleeping better now. Dreams have returned to normal (month 7) High levels of anxiety when around large crowds or in large rooms. Intestinal spasms, heartburn.  Dizzy spells.  Panic/Anxiety Attacks suddenly developed months 8 out.  1.5 years out, 90% feeling back to normal.  (April 25, 2017)

 

 

 


#34 Altostrata

Altostrata

    Administrator

  • Administrators
  • PipPipPipPipPipPip
  • 24,005 posts
  • LocationSan Francisco, CA

Posted 28 August 2015 - 03:25 PM

You'll have to write the company to find out where they're available.


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.

#35 primekittycat

primekittycat

    Silver star

  • Members
  • PipPipPip
  • 111 posts
  • LocationMichigan

Posted 07 September 2015 - 06:41 AM

did they ever make these strips available in the US? I'd have imagined my doctor or pharmacist would have mentioned it to me as they both know I'm tapering off Paxil. This would have made things much easier for those who want to get off.


Toulouse, let me know if you plan on writing. If not, I will as this would be very useful for my effexor xr taper.

Began suffering from panic attacks when my father passed away in 2005. Been on and off SSRIs (Celexa, Lexapro, Effexor XR), and therapy since then.

2009 - Started Effexor XR 75mg. Therapy on and off since then, but consistent weekly starting Oct 2013

Feb 2014 - Therapist and I felt I was ready to come off Effexor - went to half dose (37.5mg) for a week and then off completely by advice of psychiatrist - bad w/d for a week then gone

May 2014 - bad protracted w/d came out of nowhere.. constant dizziness, agoraphobia(never had before), headaches, fatigue for 3 months, all tests (brain MRI, inner ear tests, blood tests, etc.) normal.

Aug 2014 - back on Effexor XR 75mg as neurologist thought these symptoms were my anxiety coming back, all w/d symptoms disappear within 2 weeks.

 

Tapering Effexor XR.. let's do this!:

Started on 75mg. 7/12/15 - 67.5 mg (10% cut - 5% cuts from here on out); 8/10/15 - 64.9 mg; 8/30/15 - 61.7 mg; 10/9/15 - 58.6 mg; 11/3/15 - 55.7 mg; 11/17/15 - 52.9 mg; 12/7/15 - 50.3mg; 12/21/15 - 47.7mg; 1/4/16 - 45.3mg; 1/22/16 - 43mg; 2/5/16 - 41mg; 2/19/16 - 38.9mg; 3/4/16 - 37.5mg (HALF DOSE)!! Added one bead on 3/10/16 due to bad withdrawal. 4/14/16 - 37.5mg; 5/27/16 - 35.6mg; 6/9/16 - 33.8mg; 7/14/16 - 32.1mg; 7/28/16 - 30.5mg; 8/11/16 - 29mg; 9/2/16 - 27.5mg; 10/20/16 - 26.1mg; 11/3/16 - 24.8mg; 11/17/16 - 23.6mg; 12/1/16 - 22.5mg; 12/15/16 - 21.3mg, 12/29/15 - 20.3mg; 2/9/17 - 19.2mg; 3/16/17 - 18.3mg (QUARTER DOSE!!); 3/30/17 - 17.4mg; 4/13/17 - 16.5mg

 

Supplements: Fish oil, spray on magnesium oil, yoga, daily exercise, clean diet


#36 scallywag

scallywag

    Platinum star

  • Moderators
  • 3,989 posts
  • LocationOntario, Canada

Posted 03 April 2017 - 11:54 AM

This is a cross-post about taper kits in the Netherlands. In Feb. 2017, Airwave, a new member from The Netherlands, posted a photo of the taper options available for venlafaxine (Effexor):


... I've recently moved houses so most information is scattered around the place, but i'll try my best to find some of the documents.

At the very least, here is a screenshot of the options i had available for tapering(The one checked here is the one i actually used):

w6lha02d6rlu4ui6g.jpg

some quick translation:
dag = day,
dagen = days,
duur afbouw traject = duration of total tapering program in days.


Link to Airwave's Intro topic


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results
Cymbalta (brand name), 60 mg 2012 - 2015; 20 mg to 7 mg in 2016, exact doses and dates in this post;
2017: 6.3 (58 beads) Feb. 1; 5.6 mg (52) Feb. 22; 5.4 mg (50) Mar. 15; 5.1 mg (47) Mar. 25; 4.9 mg (45) Apr. 5; 4.5 mg (42) Apr. 14;
Current dose: 3.5 mg (32) 2017-Apr-26
+ Supplements: fish oil (1500 mg EPA/500 mg DHA), Vitamins: D3, K2, C; Minerals: Mg, Se, Cr, I, V
scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet