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The rule of 3KIS: Keep it simple. Keep it slow. Keep it stable.


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#1 Altostrata

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Posted 27 June 2014 - 04:00 PM

I'm going to post this here so everyone can see it.
 
Our basic rules of succeeding with tapering off psychiatric drugs or recovering from withdrawal syndrome are the rules of 3KIS: Keep it simple. Keep it slow. Keep it stable.
 
1. Keep it simple.
 
When the body reacts, often it's difficult to tell what the cause might be. When you're tapering or trying supplements or other treatments, keeping it simple helps reduce confusion during trial-and-error. Keeping it simple minimize confounding factors. For example:
 
1.a. Do not CHANGE the dosage of more than one drug or supplement at a time.
When you change 2 or more drugs at once and you get a bad reaction, you won't know which drug is causing it.
 
1.b. Do not ADD more than one drug or supplement at a time.
When you add more than one thing at a time -- or, worse, throw the kitchen sink into some kind of cocktail -- and you get a bad reaction, you won't have any idea what to do. Should you drop one thing or all of them?
 
This is also true of mixed supplements, supplements that contain more than one ingredient. It's better to try one ingredient at a time to see how you react.
 
2. Keep it slow.
 
Many people become very sensitive to drugs and supplements after they've experienced withdrawal symptoms for even a short time. Do not count on taking the big risks you used to take. Make changes slowly.
 
Introducing a drug or supplement or changing a dosage very gradually gives you the ability to sample how it might affect you before you go too far.
 
A big dose or big change probably will cause a worse bad reaction than a very small dose or change. You can injure your nervous system pretty badly with a big change -- it might take you months or years to feel better.
 
For example:
 
2.a. If you are tapering, we recommend a 10% reduction every month, based on the LAST dosage. (The amount of the reduction keeps getting smaller. Read this explanation: Why taper by 10% of my dosage?
 
2.b. Do not expect to feel better immediately. There are no silver bullets for withdrawal syndrome. There is no pill of any kind that will immediately put you back to normal. If you make a good change, the effect is likely to be slight at first. Be patient. Read this: What is withdrawal syndrome?
 
2.c. Do not jump around in dosage. For most drugs, it takes about 4 days for the change to fully register in your system. Unless you have an IMMEDIATE bad reaction, wait at least 4-7 days to see how the change affects you. (If you have an immediate bad reaction, go back to the dosage you were taking before.)  See steady state graph for Cymbalta.
 
Since withdrawal symptoms ordinarily fluctuate, you might have hours or days here and there when you don't feel well. One episode does not a pattern make. Do not panic and throw in another drug or supplement. Keep notes on paper of your daily symptom pattern. If you feel worse and worse over a week, the change was not a good one. It may be the decrease or increase was too large. Rather than jumping around in dosage, make an adjustment half-way.
 
2.d. Be patient, recovery is inconsistent and gradual. The nervous system is very complicated. It can repair itself, but it takes time to do this. In the meantime, you may experience The Windows and Waves Pattern of Recovery
 
3. Keep it stable.
 
The nervous system is delicate and very complicated. Normally, the autonomic system runs your body with numerous checks and balances, constantly gauging what hormones and transmitters need to be increased and which need to be decreased. Its job is to keep your body stable, at a tolerable temperature range, with everything running smoothly.
 
Psychiatric drugs interfere with the entire nervous system, not just the brain. This is why changing dosage of just one drug can affect your eyesight, your digestion, and your sleep. Taking psychiatric drugs affects the functions of the nervous system.
 
The nervous system, which works so hard to keep your body running smoothly, thrives on stability. When you take a psychiatric drug over a period of time (usually a month or more), your body becomes dependent on the drug. This is called physiological dependency.
 
The nervous system adapts itself to the drug like a plant growing on a trellis. If you tear the trellis away, the plant will be damaged. You need to remove the trellis gradually and allow the plant to retrain itself to its natural growth pattern.
 
Thus, the nervous system does best in a stable environment. Help your nervous system adapt to life without drugs by maintaining as much stability as you can. This is the way you can take care of yourself and help your nervous system to recover. We are our own worst enemies when it comes to stressing our nervous systems! Examples:
 
3.a. Do not suddenly quit taking your drugs. Do not skip doses to taper. These big, fast changes are the opposite of providing stability for your nervous system. Skipping doses causes the amount of the drug in your bloodstream to go up and down. Do not do this for any psychiatric drug.  See this graph which compares skipping days vs daily dosing.

 

3.b. Avoid binges. Even if you had no problems with them before, avoid overindulgence in alcohol, food, partying, sugar, staying up late, even exercise. All of these put the body and the nervous system under stress.
 
3.c. Manage emotional stress. Yes, that abusive relationship can be keeping you from recovering from withdrawal syndrome. You may wish to reduce contact with any people who tend to upset you. If you are an argumentative person, you may wish to minimize your confrontations.
 
3.d. Direct your time and efforts to pastimes that are calming or pleasurable. Calm is good for the nervous system. Always make time for a pleasant walk of at least a half-hour every day. Many people find a place for meditation in their lives because it makes them feel better. Spending time with pets or in nature ("forest bathing") can also be soothing. See our Symptoms and Self-Care forum for more suggestions.
 
3.e. Keep your daily circadian rhythm steady. Your body runs on a daily pattern governed by sunrise and sunset -- the circadian rhythm. Our bodies do best when we wake in the morning, go to sleep at night, and eat at about the same times every day. You may wish to reduce artificial light at night. Do what you can to maintain a regular daily schedule, this helps your nervous system function. See Important topics about symptoms, including sleep problems.


Edited by ChessieCat, 23 February 2017 - 05:49 PM.
updated 28.12.14 Alto/CC added link to skipping days graph & steady state graph

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

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#2 alex

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Posted 28 June 2014 - 09:13 AM

Thank you Altostrata for your time and advice.

You have saved my life as well as many others.

 

Eternally greatful.


4 years aprox. on 150mgs.Effexor for situational major depression.No AD before.
Tapered 150-0mgs in 3 months.

Tapered Quetiapine,Xanax in the last 18 months.NO med of any kind anymore.
First 3 months off acute w/d
Protracted w/d ever since.
Symptoms:Anxiety,anhedonia,insomnia,tinnitus,PSSD

04/13/2014 Awful Relapse.Recovered fairly fast.

3 years and 4 months off.

waves and windows.Very much recovered.

November 2015,health issue.Setback.
 

 


#3 Pitykitty

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Posted 28 October 2014 - 04:37 PM

Excellent tools. BTW, pets do help. This is great...thank u!

#4 tam

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Posted 01 January 2015 - 07:38 PM

Very interesting thank you Tyson for directing me to this thread and Alto great information. This is by far the best information site around on these topics :)
I can't really remember all my doses and years but here is what I can remember...
I struggle with Anxiety, Depression, BP and PMMD...
 
Past 2000-2013 ...Off and On
Effexor 225 mg for BP for few years (then went off then stayed at 125 mg -75 mg for a bit)
w/ Divalproex - mood stabilizer
 
September 2014 to present
Paxil 20 mg for Anxiety ( I may of started Paxil sooner than September I have to find out lol)
Seroquel 25 mg for sleep - took it for a month, ate too much and felt like a zombie had to go off it. Then prescribed me 
Trazdone for sleep when needed, only took for one month as side effect from Paxil kept me awake at beginning.
Ativan 5 mg for anxiety attacks when needed
 
Recent:
Tapering off Paxil from 10 mg starting Jan 2, 2014
supplements - Omega 3 fish oil, Vital Greens oral, & Silica gel oral for healthy hair and skin and nails lol.
 
Throughout the past year I have had severe constipation issues, fighting it and hopefully being of Paxil with help too.
 
Still updating this when I can remember more of my history my mind is mush lol...

#5 indigo

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Posted 11 January 2015 - 12:18 PM

Thank you for your wisdom and support Altostrata.

You and my dog are invaluable in helping me survive this.


On 20 mg of Prozac for about ten years. Sept 2012 started reducing 10% a drop using gram scale, with average of one month holds.

When I'd reached the half way mark, taking 10 mg  powder out of the 20 mg capsules, I switched over to 10 mg capsules and cutting

down from those. Withdrawals got harder the lower I dropped.  May 2013 changed to 5% drops, holding until all withdrawal symptoms gone.

January 2015 changed to liquid prozac (concentration of 20MG per 5 mL) using a 1mL oral syringe.

Current dose of fluoxetine solution equivalent 3.4 mg. Any effort to drop below this has been disastrous so for the time being I'm staying at this level.
Adding 200 mg Tryptophan and 200 GABA a day has helped with anxiety.
Also take 1,300mg Omega- 3,  875mg  Magnesium, 1800mg Curcumin, 1000mg Vit C, 5000 Vit D.
 

 


#6 Altostrata

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Posted 11 January 2015 - 04:39 PM

Thank you, indigo. I am honored by association with your dog. Photo, please!


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

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#7 JayPea

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Posted 03 February 2015 - 08:41 AM

Thank you for this. I have just taken the first steps of my journey and am feeling supported. I hope to be of support to others too.

 



#8 Altostrata

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Posted 03 February 2015 - 05:38 PM

Thank you, JayPea.


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

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

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#9 Micromonster

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Posted 10 February 2015 - 01:24 PM

Only just got round to reading this! Thank you x
Seroxat AKA Paxil/paroxatine.
30mg-1998-2014 (16years)
15mg March 2014
15mg may 2014 every two days on docs advice, went nuts so went up to 10mg. Took 2months to stabilise.
10mg July 2014-sept 2014 (6.9mg)tried WD at 10% every two weeks. went nuts, nearly left husband, cats and country.
10mg sept-December 2014
9mg Dec-Jan 2015 (4 weeks)
8.5mg Jan-Feb 2015 (4 weeks)
8mg Feb-March 2015 (4 weeks)
7.5mg march 2015 (4weeks)
7mg march-present.

#10 withdrawlsucks

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Posted 14 February 2015 - 04:13 AM

This is great info.. gutted I didn't find it 2 years ago...
Citalopram 15mg Feb 2009 to Feb 2013 stopped cold turkey... no withdrawal till july.. Hell on earth
Citalopram 5mg July for two weeks ... Living Hell
venlafaxin 37mg august two weeks even worst Hell
Zoloft november 2013 till Jan 2014 Hell
mirtazapine Feb for 6 weeks.. fatigue
Over the next six month tried nearly very antidepressant could not tolerate anything
tried fish oil, 5htp , nearly every herb, you name it I bought it.. system could not take anything..
Oct 2014 to November 2014 trazodone.. ooo nooo !!!

#11 Mort81

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Posted 26 February 2015 - 07:40 PM

New to the forum. This info is precious.
Was on 30mg (Lexapro) for 7-8yrs20mg for 3 months (This was my choice my Doc wanted me to drop much faster)15 mg 2week10mg 2 weeks 5 mg 1 week0 since August 24th Clonazapam. Currently 0.10mg daily. PPI Dexlant 20-30mg for last 29 months currently at 30mg

#12 Mort81

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Posted 03 March 2015 - 09:51 PM

This info is hitting me hard right now, I've miss managed my benzos so much over the years with a lack of knowledge of course. My doctor weaned me off Lexapro way to fast. Oh boy
Was on 30mg (Lexapro) for 7-8yrs20mg for 3 months (This was my choice my Doc wanted me to drop much faster)15 mg 2week10mg 2 weeks 5 mg 1 week0 since August 24th Clonazapam. Currently 0.10mg daily. PPI Dexlant 20-30mg for last 29 months currently at 30mg

#13 clarabella79

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Posted 16 March 2015 - 06:53 AM

Only just got around to reading this, too! Thank you Altostrata - it's all extremely valuable advice. The "Keep It Calm" is particularly important in the healing process and something I constantly have to remind myself of!


1st Sep '14 - reduced to 18mg from 20mg; 15th Sep - 17mg; 29th Sep -16mg; 21st Oct - 15mg; 10th Nov - 13.5mg; 1st Dec - 13mg;

11th Dec - 12.5mg; 5th Jan '15 - 12mg; 20th Jan - 11.5mg; 11th Feb  - 11mg; 26th Feb - 10.5mg; 5th Mar - 10mg; 1st Apr - 9mg; 29th Apr - 8.5mg; 29th May - 8mg; 18th Jun - 7.7mg; 9th July - 7.4mg; 11th Aug - 6.8mg; 2nd Sep - 6.5mg; 12th Sep - 6.3mg; 26th Sep - 6mg; 10th Oct - 5.7mg; 30th Oct - 5.3mg; 28th Nov - 4.8mg; 20th Dec - 4.4mg. 

Medication History:

January 1997: 20mg Paroxetine (Seroxat) daily for depression with anxiety. CT withdrawal attempted 1997 and 1999. Dividing pills withdrawal attempted 2002. Liquid/pill 13 month tapered withdrawal 2007/8. Started to become very ill days after CTing at 2mg. Prescribed other antidepressants (CitalopramMirtazipine) but neither were as effective and had more side effects, so Paroxetine 20mg reinstated June 2008.


#14 wantmyhubbyback

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Posted 15 May 2015 - 11:18 AM

might be worthwhile to point out that published medical info on tapering schedules is incredibly wrong

 

https://www.document...tipsychotic.pdf--25% a WEEK! yikes

http://www.medscape....cle/529317#vp_2-- "4-8 weeks" -- yikes again!

http://www.nmsis.org...nsyndromes2.asp-- "4 weeks to 3 months" -- still wrong.

 

who are the people writing this crap?

it continues to floor me that the psych community still doesn't understand or seem to care about getting people off of these drugs. i get the whole revenue stream, big pharma, "fox in henhouse' thing ...but still, wow.


diagnosed with MDD/GAD nov 2013, 6 months following CMV complications post-kidney transplant

lst zyprexa taper 12 months; /increased paxil to 30 mg; crash nov 2014 w/ suicidal ideation & 10day hospitalization

2nd zyprexa taper 6 months; crash after 6 weeks; reinstated zyprexa 15mg in 6/15 (both tapers worked well to the 2.5mg dose)

3rd zyprexa taper in progress ... 17mg 3 mos;  15mg 1 mo; 10mg 3 mos, 5 mg 3 mos. 2.5mg caused some decompensating, so back to 3mg and now doing the 10% redux

mirtazapine 30 mg 45mg

ativan .5mg 1x/day, occasionally .5 addl  if needed for sleep 3x/day n now 1x/day

paxil 20 mg 1x/day 

gabapentin 1200 - 1800 mg 2 -3 x/day

immunosuppressive drugs for kidney transplant: sirolimus, mycophenalate, prednisone, levothyroxin and a whole handful of others

 


#15 Altostrata

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Posted 15 May 2015 - 11:41 AM

At least they give some idea of what "tapering" means.


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

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#16 Lilu

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Posted 19 July 2015 - 03:21 PM

Wish I had read this a long time ago.


2005-2008 Effexor xr; 1/2008 Tapered 3 months, then quit.
7/2008-2009 Reinstated Effexor xr due to crying spells.
2009-3/2013 Switched to Pristiq 50 mg then 100 mg
3/2013 Switched to Lexapro 10mg. Cut down to 5 mg. CT for 2 weeks then reinstated for 6 weeks
8/2013-8/2014 Tapering Lexapro
11/2014 -8/2015: Developed severe insomnia, resumed using Ambien & Klonopin
12/2014-6/2015 Tried Ativan, Lunesta, Sonata, Trazadone, Seroquel, Rameron - Adverse Reactions
7/2015 Reinstated Lexapro at 2 mg; Quit Klonopin CT suddenly paradoxical)
Started Gabapentin 100-300 mg for 3 weeks. Developed severe lumbar jerking movements (myoclonus).Quit Gabapentin CT.
8/2015 Continuing Lexapro 2 mg. Baclofen 10mg-AM/20mg-PM - tapered off by 5/2016
1-7/2016 Lexapro 5 mg 
Intro page: http://survivinganti...rsened-by-meds/


#17 Mitchie

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Posted 01 August 2015 - 11:54 AM

I thank you hugely for this excellent website. I've been looking for something like this for 20 months, since the day I said good bye to anti-depressants and hello to brain zaps. Wonderful thinking here! Some new to me, some things I'd figured out on my own through trial and error, but it always feels good to have my thinking validated by another voice. Again, thank you, thank you, thank you!


MITCHIE

Celexa/Citalopram for 6 yrs. (20 mg 5 years; 40 mg. for last year). Tapered down over probably 6 mths, if that (can't remember), 1/2 every 2-4 wks. to zero in November 2013. Worst withdrawal condition: brain zaps that were incapacitating at first, but have slowly decreased and now occur only at night when I get dehydrated while sleeping, 3-4 times a week.

Vicodin for 30 years. Stopped cold turkey 8 months ago. Many withdrawal conditions related to water retention changes in the body (ie. loose stools, sweating, sinus drainage). Set the brain zap recovery back a few steps.

Completely off all Rx drugs now except Valium (10 mg) 1-2 times/wk. for muscle relaxation.

 


#18 Altostrata

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Posted 01 August 2015 - 12:08 PM

Thanks, Mitchie. Please start an Introductions topic for yourself so we can get to know you better.


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

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

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#19 omnia

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Posted 05 September 2015 - 03:53 PM

thank you for this :) . I'm new and today is my first day in my withdrawal journey. I hope I  can survive as all of you :)



#20 Nomoreheadmeds

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Posted 06 September 2015 - 08:02 AM

welcome 'omnia' would you like to tell us your story in the 'introductions and updates' thread ?


Sertraline 100mg amytrip 60mg diazepam 4mg (and when needed) since late 90's.Reduced all meds over 6 wks (too short) last doses 13 wks ago.Still having withdrawals.I would have done it differently
5th august 2015 reinstated 5mg amytripiline.increased to 10mg amtrip 9th sept 2015.

#21 Carouselisalie

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Posted 28 October 2015 - 02:04 PM

Great recommendations.

 

Capacity for self regulation is often lacking in those of us with nervous systems altered to adapt and survive traumatizing social environments. Limited self regulation is often what leads people to starting on anti-depressants and mood stabilizers in the first place.

 

Self regulation and groundedness are skills and capacities we can learn and develop. Good book: "Full Body Presence" by Suzanne Scurlock-Durama.


On Zoloft 200 mg for 16 yrs. Lamictal 100-150 mg for 14 yrs. A few times I've lowered the dose of Zoloft from 200 mg to 175 or 150 mg for a day or 2. At 175 mg I have decreased focus/concentration within the same day. From 200mg to 150 mg, some sadness and slight confusion. 2 days at 150mg, shorter attention span, less patience, frustrated easily. I've never tried a slow, long term taper. My only experience being off meds completely has been unintentional, "cold turkey" cessation because I forgot to take them that day or forgot to order refill on time and ran out. Withdrawals start less than 4 hours off regular doses, cold turkey. Symptoms: Very hard to retrieve info and express thoughts succinctly. Circumstantial speech. Lose patience with people. If refill is delayed for several days, by day 2, I start to overeat, eat sweets late at night, oversleep, late to work. Day 2 to day 3, a gradual increase of morbid obsessive thoughts, wrenching guilt for any mistake, suicidal ideation. Day 3, I see the world through a watery lense. Nothing is clear or sharp. Night of day 4 off meds cold turkey - Panic attacks, crying, spikes of suicidal ideation. Day 5, Brain feels like a hard ball jostling around when I turn my head. I lose train of thought, lose sense of direction, get lost easily. I shower but no energy for grooming. Can't get myself together to get anywhere on time. Increasingly convinced my life is worthless. The symptoms completely remit within 2 hours after restarting meds. Never completely off meds longer than 5 days in the past 16 yrs.


#22 Altostrata

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Posted 28 October 2015 - 05:48 PM

Good points, Carousel. Thank you.


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

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

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#23 dds

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Posted 24 May 2016 - 10:59 PM

Wish I had read this a long time ago. My life could be much less miserable when I had major depression 10 years ago. I agree with you 100 %. This is real advice!



#24 desertchild

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Posted 10 June 2016 - 11:22 PM

Thank you so much for this. Wellness gave me the link and had I known I would have saved myself, family and supporting friends so much of the continuing, seemingly endless, at the moment, misery. But I have to try turn, what has become agony for me, into something positive by helping or directing the people I know who would like to make a change, to wise information like the above, to prevent for them what I'm going through at the moment. So thank you Wellness and thank you Alto.

Desert Child


1991 – Tofranil; 2005 – Celexa; 2007 – Jan 2014: 300mg WellbutrinJan 2014 – Jul 2014: quetiapine fumarate 300 mg; lamotrigine 200 mg; alprazolam 1 mg; midazolam 30 mg; May 2014 quetiapine fumarate (no tapering), Abilify 20 mg, ; lamotrigine 200 mg; alprazolam 1 mg; midazolam 30 mg; Jul 2014 (new psychiatrist): Abilify (no tapering) lamotrigine 200 mg; Paxil 30 mg; olanzapine 5 mg; Ambien MR 25mg; clobazam 10 mg;  alprazolam SR 0,5 mg; Dec 2014: Paxil (no tapering), Brintellix 20 mg; Trazodone 100 mg; lamotrigine 100 mg; clobazam 10mg; Alprazolam 0,5 mg; Ambien MR 12,5 mg; Oct 2015 – 9 Dec 2015 I “tapered” everything except for alprazolam – 5 mg, Ambien  

Feb ‘16: 0,25mg alprazolam - am; 0,25 alprazolam; 5mg Ambien – pm; March ‘16: 0,125mg alprazolam(cut too big – withdrawal sx’s worsened); 0,25mg Alprazolam, 0,5mg Ambien – pm; discovered SA! mid-March ‘16: 0,0625mg Alprazolam, 1,25mg Valium - am, 0,25mg Alprazolam; 5mg Ambien - pm; mid-April ‘16: 0,0625mg Alprazolam, 1,25mg Valium - am; 0,125mg Alprazolam, 2,5mg Valium; 5mg Ambien – pm; mid-May ‘16: 1,25mg Valium - am; 0,125mg Alprazolam, 2,5mg Valium; 5mg Ambien – pm; Cross-over to Valium developed severe, worsening depression; 22 June –  started cross-taper back to alprazolam; Tried 6 hrly dozing - had very negative effect on my psyche with severe insomnia and deepening depression, feelings of suicide; 7 July '16: dropped Valium, replaced with alprazolam; returned to 5x/day dozing liquid titration alprazolam (0.0625 x 5) (Total: 0.31mg alprazolam) (8am, 1pm, 6pm, 11pm, 3:30 am), 5mg Ambien;

22/7 Stopped Ambien and replaced with alprazolam: increased alprazolam: 0.088 x 5 (Total 0.44 mg )

Magnesium; Omega 3; Magnesium bath; Magnesium spray; thyroid, bloodpressure medication; Livifem (Tibolone): estrogen-progesterone combo

 

 

 


#25 Altostrata

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Posted 12 June 2016 - 04:35 PM

You're very welcome, DesertChild.


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

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#26 2befree4me

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Posted 17 June 2016 - 02:25 PM

Thank you so much for all your work on this site and advise.  This is an invaluable site and am so glad I found it.

 

 I personally love my two cats and one dog a jack russell, I will sometimes on my lunch break come home, lie down and let them all surround me with there love to help me get through the rest of the day.

 

just thought I would throw that in.

 

keep on keeping on

Xena


2011 I was put on Bupropion xl 150 mg, Venlafaxine xr 150 mg, & Zopiclone 7.5 mg & increased my Clonazepam from one pill once a day @ 0.5 to 3 pills a day @ 0.5, I tried going off Bupropion cold turkey a few years back and it caused severe depression, with suicidal thoughts & major flu like symptoms so I had to go back on it within 3 days.  I then tried going down from 150mg to 112.5mg dose of Venlafaxine 3 weeks back and had brain zaps for two weeks & dizziness with it. The first week I had major flu like symptoms, however my blurry vision improved with just one dose lower, and all the other symptoms have cleared, I did have one crying spell and felt like I did not want to face the world that day. I cannot go lower @ 80mg, I go into severe depression, suicidal, nightmares, sick to my stomach.  


#27 Susanne

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Posted 20 June 2016 - 07:37 AM

"3.a. Do not suddenly quit taking your drugs. Do not skip doses to taper. These big, fast changes are the opposite of providing stability for your nervous system. Skipping doses causes the amount of the drug in your bloodstream to go up and down. Do not do this for any psychiatric drug."

This one! Didn't know this...Just 10 weeks ago I started skipping doses. I was one Lexapro 5 mg for more than two years (or something like that) and I've read somewhere (Dutch website or forum) that it was an option to take the lowest dose every other day. There are no smaller pills available and since my doctor sais that 5 mg was "nothing" I thought it wouldn't do any harm.  This was also based on my past (and positive) withdrawal from Luvox.
I remember when coming off Luvox that I didn't follow any schedule at all. I didn't do it cold turkey, but one day I just forgot to go to the pharmacy and nothing weird happened. The next day I picked up my new prescription, but the following weeks I just took them really irregular. Nothing weird, no withdrawal symptoms. I was probably very lucky.

2,5 months after my last pill I relapsed (suddenly something triggered an 'old program' in my head and the obsessions were back)and when I started the lowest dose Luvox again and updosed over 9 weeks I just didn't have any effect. The side effects were little more severe but nothing I couldn't handle at the time.

No the same thing after 6  years of taking Lexapro. Updosing, but no effect on my mood or thoughts and even more severe side effects.
Now dropping again and feeling OK but it has been a hell of a week last week (going from 15 mg to 10 in a few days....and just a few days ago I found this forum...). So will NOT skip doses and I will slow down!

Thanks so much for the information!


All my life: Occasional panic attacks. 2003: Burnout  2004: intrusion (OCD'ish) / anxiety. Therapies: acupuncture, Chinese herbs, hypnotherapy --> symptoms were manageable (did return once in a while), depression lifted.
2007 - Relapse, started with Cognitive Behavioral Therapy. Therapist recommended Fevarin (fluvoxamine) 150 mg. Recovery after 3 months and remained stable. Mild side effects.
2009 - Tapered fluvoxamine. No withdrawal symptoms. 2010 - Relapse, same Pure O thought and anxiety.  Started taking 100 mg of fluvoxamine but after 9 weeks no change in symptoms. Did not have any effect on Pure O thought. Switched to Lexapro (escitalopram) 20 mg.  Drug started working within 3 weeks. Mild side effects. Slowly over the years tapered to 5 mg.
2015: Lots of personal issues and setbacks, occasional panic attack. 2016: April started skipping doses; 5mg escitalopram every other day (in hindsight a bad idea)
May: Major relapse, anxiety and intrusion returned. Depression. Increased from 2,5 mg 15 mg in two weeks. Side effects: neuro-emotions
June: Escitalopram has no effect on the frequency of the intrusion...after 4 weeks my general doctor advised me to do a fast taper to 5mg. Withdrawal effects (2/3 weeks): neuro-emotions, lack of focus, crying spells, fatigue, muscle twitches in legs, cortisol spikes just before waking up July: Stable on 5 mg. Depression and intrusion lifted during holiday (lots of sunshine, long walks and relaxing) August: Drop down to 2,5 mg. Withdrawal effects (tinnitus, headagues) are noticeable, but still mild in comparison to the big drop earlier.
22th August: stopped escitalopram completely. Cortisol spikes just before waking up, still OCD (only temporary improvements), WD-depression and WD-neuro emotions.
Update 6 dec: no medication, any withdrawal symptoms not noticable. Taking supplements for intrusive thoughts and overall well being: N-Acetyl Cysteine (NAC) omega 3 fish oils, zinc, vitamin d, magnesium l-threonate, ginko biloba

 


#28 elbee

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Posted 28 June 2016 - 02:55 PM

All of these are such good tips! Sometimes I feel I can do some of them, sometimes I just can't seem to muster the energy / motivation. In general I'm doing well with section 1, and with section 2 until item d (patience) ... that's a tough one for me. In general, I have the hardest time with the simple self care stuff (eating well and regularly, finding calm things to do that I enjoy, getting some amount of exercise in EVERY day, etc.). But this is a great summary for me to come back to and remind myself of what's important.

1990 (age 20, in college) - First major panic attacks (diagnosis, PD, GAD, Depression). Prescribed 100 mg sertraline, 2.5 mg lorazepam. Tried to reduce meds several times but essentially took these meds for about 25 years.
Summer of 2014 - Quit drinking alcohol and 3.5 month taper off all meds under doc supervision. October 2014 - Return of severe panic attacks, with 8-month "SSRI/Benzo chase" to try and stabilize. June 2015 - Found a drug "reinstatement" (more drugs than I had ever been on) that stopped the panic attacks, but was left with severe anxiety, depression, and numerous side effects: 150 mg sertraline (Z=Zoloft), 15 mg mirtazapine (R=Remeron), 2 mg clonazepam (K=Klonopin)

-- Begin new taper -- 12/11/16: Z=100 mg, R=6 mg, K=1 mg, 11/13/16: Z=100 mg, R=7.5 mg, K=1 mg, Z=100 mg, R=7.5 mg, K=1.5 mg, 9/1/16: Z=112.5 mg, R=7.5 mg, K=1.5 mg, 7/27/16: Z=125 mg, R=7.5 mg, K=1.5 mg, 5/1/16: Z=135 mg, R=7.5 mg, K=1.5 mg, 4/10/16: Z=150 mg, R=7.5 mg, K=1.5 mg, 3/1/16: Z=150 mg, R=7.5 mg, K=2.0 mg

My introduction thread.