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#1 Altostrata

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Posted 01 August 2011 - 03:15 PM

If you have any recommendations for doctors, therapists, or clinics knowledgeable about tapering or withdrawal syndrome, please add a post to this topic.

Also see this topic: Doctors who will diagnose drug withdrawal

For withdrawal from benzodiazepines, see A list of benzo-wise doctors (This list may contain some entries that are out of date, but has been added to recently. These doctors may also grasp tapering of other drugs.)
 
MadinAmerica.com has a list of practitioners supporting withdrawal, mostly therapists but some doctors http://www.madinamer...-practitioner/ It's organized by region, be sure to look here as well.

The doctors below have shown concern and knowledge for slow tapering off antidepressants and indicated willingness to work with patients on treatment plans including non-drug treatments.
 
If you do not wish to take any other psychiatric medications after quitting, they should respect your wishes. If you find they do not, please let us know and we will remove them from this list.
 
If you consult any of these providers, please let us know your experience.

Click on their links to see more about these doctors:

PHYSICIANS

UNITED STATES
 
US East Coast

US Southeast

US Central

US West Coast

IRELAND

UNITED KINGDOM

AUSTRALIA

NEW ZEALAND

FINLAND

DENMARK

NETHERLANDS

INPATIENT (RESIDENTIAL) FACILITIES

PSYCHOTHERAPY

If you consult any of these providers, please let us know your experience.


Edited by Altostrata, 06 September 2014 - 12:12 PM.
updated list

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

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#2 ajay

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Posted 02 August 2011 - 01:17 PM

Just as an FYI, the benzo-wise doctor list has been around for awhile and may be out of date.
History is approximate; I didn't track my dosages.

1995 - started zoloft/sertraline for depression
1995-2008 - sertraline ranged from 100-200mg, may have gone as high as 250mg
2006 - 2009 - added welbutrin/budeprion SR, 150 mg
sometime in 2009-2010 - stopped budeprion c/t
sometime around 2009-2010, Tapered down sertraline w/o guidance to 50 mg, then 25mg.
~ feb 2010, stopped sertraline.
~ Apr 2010, resumed 25mg low dose (really bad business trip)
Oct 2010, stopped sertraline
Jan 2011 - another bad business trip "breaks" my sleep.

current issues include insomnia, anxiety, GI distress, depression.
Taking multivitamins, Vitamin D, fish oil, Chinese herbs, ~ 0.5mg melatonin in the evening.
Going to therapy and acupuncture once a week.

#3 Altostrata

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Posted 01 September 2011 - 10:30 AM

David Allen, MD
3173 Kirby Whitten Rd #104
Bartlett, TN 38134
(901) 758-8145

I've been corresponding with Dr. David Allen, a psychiatrist in Bartlett, Tennessee, phone number 901-384-8040. He sees patients at his private office one day a week. He has retired as a professor in the Department of Psychiatry, University of Tennessee.

Dr. Allen, a frequent commenter on various psychiatry blogs, seems to be very responsible about using medications. He says he frequently gets patients who are overmedicated and reduces their medications to the minimum. He sees through pharma hype.

He believes patients generally should take antidepressants for only 6 months.

He is skilled at tapering people off medications. Depending on the situation, he uses a 25% initial decrease but watches closely -- responding quickly to telephone messages -- for withdrawal symptoms. He will reinstate and taper more slowly from that point.

(I've asked him what the rate of withdrawal symptoms is from this initial rate of taper -- how many people he needs to reinstate and taper more slowly -- but he couldn't make an estimate. He says it's not common. He believes Paxil is the worst offender.)

His Facebook page is https://www.facebook...8565761?sk=wall

You can also contact him through Psychology Today http://www.psycholog...avid-m-allen-md

Here's how he describes his blog on Psychology Today:

This blog covers mental health, drugs and psychotherapy with an emphasis on the role of family dysfunction in personality problems. It discusses how family systems issues have been denigrated in psychiatry in favor of a disease model for everything by a combination of greedy pharmaceutical and managed care insurance companies, naïve and corrupt experts, twisted science, and desperate parents who want to believe that their children have a brain disease to avoid an overwhelming sense of guilt.


Edited by Altostrata, 15 February 2014 - 10:46 AM.
updated

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

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#4 cinephile

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Posted 01 September 2011 - 05:44 PM

David Allen is one of the good guys. I've been a silent admirer of his for a while. If only he were my psychiatrist so many years ago! Good to hear you're corresponding with him, Alto.
Been on SSRIs since 1998:
1998-2005: Paxil in varying doses
2005-present: Lexapro.
2006-early '08: Effexor AND Lexapro! Good thing I got off the Effexor rather quickly (within a year).

**PSYCHIATRY: TAKE YOUR CHEMICAL IMBALANCE AND CHOKE ON IT!
APA=FUBAR
FDA=SNAFU
NIMH=LMFAO

Currently tapering Lexapro ~10% every month:

STARTING: 15 mg
11/7/10: 13.5 mg
12/7/10: 12.2 mg
1/6/11: 10.9 mg
2/3/11: 9.8 mg
3/3/11: 8.8 mg
4/1/11: 7.8 mg
4/29/11: 7 mg
5/27/11: 6.4 mg
6/24/11: 5.7 mg
7/22/11: 5 mg
8/18/11: 4.5 mg
9/14/11: 4 mg
10/13/11: 3.6 mg
11/9/11: 3.2 mg
12/7/11: 2.6 mg
1/3/12: 2.1 mg
2/2/12: 1.8 mg

#5 compsports

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Posted 01 September 2011 - 08:58 PM

David Allen is one of the good guys. I've been a silent admirer of his for a while. If only he were my psychiatrist so many years ago! Good to hear you're corresponding with him, Alto.


I don't think he is horrible and that is good he understands withdrawal although he doesn't seem to realize that there is protracted withdrawal. I have just never had as favorable an impression. He still drinks too much of the cool-aid in the my opinion. See his latest blog entry.

http://davidmallenmd.blogspot.com/

"I pretty much agree with all the points made in these comments, and I am extremely disappointed in Angell, because she has in the past discussed what is going on between Pharma and academia and raised many valid points. When it comes to psychiatry, though, she knows nothing. Antidepressants are among the most effective drugs in all of medicine. "

He also is very critical of Bob Whitaker's book.

Still Cine, I agree with your that him being my psychiatrist would have made a big difference in my life also. I wouldn't have been on meds for all those years.

CS
Drug cocktail 1995 - 2006
Tapered off of Adderall, Wellbutrin XL, Remeron, and Doxepin for nearly 4 years
Drug free since June 10, 2010

#6 Altostrata

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Posted 02 September 2011 - 11:31 AM

We have to take good doctors where we can find them. What I'm looking for is doctors who are sensible about tapering, not theoretical orthodoxy. Dr. Allen is a gracious correspondent, and seems genuinely concerned about his patients, who tend to be bipolar. He's a specialist in that area. For all I know, they may be truly bipolar and helped by antidepressants. He's not a big fan of polypharmacy, which is a plus, and in his own way quite critical of pharma. Now, how many antidepressant enthusiasts do we know who advise taking them for only 6 months? Dr. Giovanni Fava would be proud to hear this (although he's saying 3 months now).
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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#7 Altostrata

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Posted 10 September 2011 - 04:00 PM

Dr. Joe Tarantolo, Washington, DC

A recommendation from ISEPP (International Society for Ethical Psychology & Psychiatry):

An MD who can help people withdraw from psychotropic drugs
Joe Tarantolo, psychiatrist who practices in Washington DC. 202-543-5290


(Also recommended: Mark Foster in Colorado, but we know about him already.)

UPDATE: Dr. Tarantolo cannot help with tapering or withdrawal syndrome.

Edited by Altostrata, 06 December 2011 - 11:21 AM.
updated

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#8 Altostrata

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Posted 17 September 2011 - 09:57 AM

Dr. Mark Foster, Greenwood Village, Colorado

Mark Foster is a primary care doctor in Greenwood Village, Colorado. He has become an advocate for non-drug treatment of so-called mental disorders and the restoration of healthy mood and lifestyle.

Dr. Foster's site and contact info: http://markfosterdo.blogspot.com/

Dr. Foster is a contributor to Robert Whitaker's Mad in America blog.

He is raising money for a clinic to taper people off psychiatric drugs and provide rehabilitative therapies (Here's a topic about his clinic plans.).

Other topics about Dr. Mark Foster:

WTF/Dr. Mark Foster terminated by employer

It's happening! Mark Foster is thinking of opening a psych withdrawal facility!

Dr. Mark Foster on non-drug alternatives for mental health

Dr. Mark Foster SPEAKS!

Mark Foster/Early Stage Kidney Cancer

Edited by Altostrata, 14 July 2012 - 11:10 AM.
added links

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

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#9 Altostrata

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Posted 17 September 2011 - 10:05 AM

Dr. James R. Phelps, Corvallis, OR
Dr. Tammas F. Kelly, Fort Collins, CO

Dr. James R. Phelps
Samaritan Mental Health
3509 North West Samaritan Drive
Corvallis, OR 97330
Phone:
(541) 768-5235

Dr. Tammas F. Kelly
Depression and Bipolar Clinic
315 West Oak Street
Fort Collins, CO 80521
Phone:
(970) 484-5625

According to psycheducation.org, the author, Jim Phelps, and his colleague Tam Kelly advocate very gradual tapering off antidepressants.

Drs. Phelps and Kelly agree on this technique:

Summary: go slow, much slower than you would have thought necessary; and of course, not without your prescriber's direct involvement.

B. Guidelines on how to get off antidepressants

1. Educate/prepare the patient well ahead of time and repeatedly.

2. Chart GAF scores [a psychiatric standard, Global Assessment of Function, a single number summarizing how you're doing] over time. Sometimes getting off anti-depressants isn’t the right thing to do and can be used to identify “Sweet Spot” for dosing. For example, I recently had a patient who was doing poorly on 300 Effexor XR started when she was still “unipolar”. Took two years to wean off. Retrospectively I was able to see that she was doing best around 75mg. Charting the GAF at appointments and the Lowest in between is best.

3. If the patient stops them AMA [against medical advice] abruptly and they are doing well then leave them off. Watch for manic symptoms. (Sometimes patients get better despite our best efforts.)

4. If the patient stops them AMA abruptly and they are doing worse don’t jump back up to the whole dose. The longer they were at the lower without feeling bad before felling worse, the lower dose you can return to. You can sometimes use half-lives to calculate this. Calculate the dose based on when they started feeling bad. Watch patients very closely during this time, even daily by phone or at the office.

5. Warn patients that they will have mood swings if they do this. Warn patients that they will have mood swings if they don’t do this, probably worse. Warn them of this over and over again. The point is to try and stop them from major panic when they do have a down.

6. Slowly is best. The slower the better. I usually wait ... at least 6 – 8 weeks between dosage decreases. Prozac/fluoxetine can be an exception to this.

7. Longer if anxiety is a major feature.

8. Faster if they feel better as they decrease dose.

9. Longer if they have difficulty with dosage decreases.

10. Longer if they are doing relatively well.

11. Never decrease before a major event or holiday.

12. Avoid decreasing during times of major stress.

13. The pt can take longer if they want to take longer for any reason.

14. Reduce in the smallest possible increments. As you approach zero then take the dose changes smaller or longer. Get out that pill cutter. If you can’t get dosage changes in small enough changes do every other day between the smaller dose and the larger dose. You would be surprised how often this works even on very short half-life drugs like Effexor XR.

15. You can go faster if they feel better as they decrease dose, but not too fast. Look for signs and symptoms of mania as well as depression. I have seen both hypomania and even mania in a [patient with Bipolar II] who stopped their antidepressant without taper. This has been reported in the literature as well. Going down slowly also avoids manic reactions

C. Special Rules:

1. Effexor XR. If the pt can tolerate doing this then this is by far the best way to do this. Open up the capsule and take one more bead out each day. Rules 11 – 13 of how to get off antidepressants apply. Pour the beads out on a creased piece of paper and count out the correct amount of beads. Then using the crease of the paper to get the beads back in the capsule. [In my town I have the advantage of a compounding pharmacist who can make small doses from the patient's large doses and allow us to decrease

2. If pts can’t count beads or don’t want to do this then take out about ¼ capsule for 6 – 8 weeks and repeat.

3. For any anti-depressant you can add in 20 mg of Prozac, get them off the anti-depressant, then taper the Prozac.

4. Prozac is a special case because of its long half-life. I generally will drop of one day at a time when reducing dose, e.g. decrease to 6/7 days a week for 6- 8 weeks then decrease to 5/7 days a week. Prozac is also a good candidate for every other day decreases, e.g. from a dose of 40mg a day go to 20 alternating with 40 mgs a day [to make a 30 mg-equivalent dose].

(Also see http://survivinganti...h__1#entry11060)


Note: I disagree with the info on Dr. Phelps's site describing the biologic basis of mood disorders; please don't send me outraged pms and e-mails.

07/26/12 Note: Drs. Phelps and Kelly are skilled at using lamotrigine (Lamictal) to treat adverse symptoms of antidepressants. (They may wish to call this bipolar disorder, respectfully decline the label if you don't agree.)

Edited by Altostrata, 26 July 2012 - 04:46 PM.
added note

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

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#10 Altostrata

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Posted 17 September 2011 - 03:09 PM

CooperRiis Center, North Carolina

For inpatient treatment and psychiatric drug withdrawal, if you have means, there's the CooperRiis center in North Carolina http://www.cooperrii...view/index.html

It's a residential facility, quite expensive: $12,500 a month. It sounds very pleasant. One location is a farm and the other is in Asheville.

My guess is you might be able to stay for a month or two, get your tapering instructions, and then leave.

Their intention is to rehabilitate psychiatric patients with minimal usage of drugs. I spoke to Debbie there on the phone and she said they've seen people who are misdiagnosed and overmedicated. In those cases, they taper people off medication.

Robert Whitaker is one of their allies.

My guess is one might be able to stay for a month or two, get tapering instructions, and then leave.

The phone number at CooperRiis is (800) 957-5155, email: info@CooperRiis.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

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#11 Altostrata

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Posted 17 September 2011 - 03:10 PM

Pajaro Valley Sunrise Center, Watsonville, CA (in fundraising stage)

Pajaro Valley Sunrise Center http://www.pvsunrise.org/ubercart/ won't open for a couple of years. One of their directors is Janet Foner in New Cumberland, PA, also on the MindFreedom board -- http://www.mindfreed...t-foner-raffle. The site e-mail address is postmaster .at. pvsunrise.org

James Joseph (Joe) Gallagher, M.D., a primary care physician, is the director of the center. With Amy Smith and Dr. Mark Foster, he recently spoke on "Paradigm Shift: What Should a Psychiatric Medication Withdrawal Facility Look Like?" at a recent grassroots mental health conference (http://www.power2u.o...h-dialogue.html).

Dr. Gallagher's contact information:

Dr. Joe Gallagher
268 Green Valley Road
Freedom, CA 95019-3139
(831) 728-0440
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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#12 Claudius

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Posted 18 September 2011 - 11:40 AM

CooperRiis Center, North Carolina

For inpatient treatment and psychiatric drug withdrawal, if you have means, there's the CooperRiis center in North Carolina http://www.cooperrii...view/index.html

It's a residential facility, quite expensive: $12,500 a month. It sounds very pleasant. One location is a farm and the other is in Asheville.

My guess is you might be able to stay for a month or two, get your tapering instructions, and then leave.


Do I read it right that the fee is twelve thousand dollars for a month? I think very, very few people can afford that, and surely not when one has lost his job due to w/d. Also I wonder what they can do in one or a few months time, while we know that there is no shortcut to w/d. Only the people who are still onthe drug or just so shortly off that they can reinstate will be able to get the right advice for tapering, but that is not worth tens of thousands of bugs I think.
I do not live in the USA but still think of consulting a doctor if the still very bad w/d symptoms really does not go away in the upcoming 1-2 years. Though I still postone it, one day a desicion should be made to stay off all drugs and be disabled for work for indefintite time, or treat it in an experimental way by a doctor who at least does recongize the problem. I tend to consider 6 years as the ultimate time for waiting it out.

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

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Posted 19 September 2011 - 04:55 PM

For psychotherapy, I personally recommend

Dr. Mary Jean (MJ) Paris, San Francisco, CA
760 Market Street
Suite 945
(between Grant Ave & O'Farrell St)
San Francisco, CA 94102
Neighborhoods: Union Square, SOMA
(415) 979-8767


Dr. Paris takes a range of insurance plans. She told me she will work with people over the phone.

She's supported me in withdrawal syndrome for more than 4 years and understands it as well as anybody. She lost part of her brain to a tumor when she was 15 and has to deal with chronic symptoms all her life. She's personally found Buddhist meditation to be very helpful.

I've found her to be extraordinarily supportive emotionally. Her approach is eclectic and existential.
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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#14 Altostrata

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Posted 26 October 2011 - 08:25 AM

Paul Abramson MD

450 Sutter Street
Suite 300
San Francisco, CA 94108
(415) 963-4431
Call us 24/7

http://mydoctorsf.com/faq.html

Dr. Abramson is the founder of an integrative medical group in San Francisco. According to individual needs, he will very gradually taper and carefully monitor withdrawal symptoms.

He says: "If patients call my office my assistant can help them figure out if it's the right place, and set them up with an intro call."
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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#15 Barbarannamated

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Posted 04 November 2011 - 12:36 PM

Dr. Joe Tarantolo, Washington, DC

A recommendation from ISEPP (International Society for Ethical Psychology & Psychiatry):

An MD who can help people withdraw from psychotropic drugs
Joe Tarantolo, psychiatrist who practices in Washington DC. 202-543-529


See discussion of ISEPP 2011 about Dr. Tarantolo.
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).

#16 Altostrata

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Posted 25 November 2011 - 02:20 PM

David Bransford, MD, Grand Rapids, MN

Itasca Psychiatric Services
201 4th Street NW ( South Entrance of Central Square Mall), Grand Rapids, MN 55744
ipsoffice@qwestoffice.net
Phone 218 327 2284 (voice message) 218 327 3173 (fax)

From Itasca Psychiatric Services Facebook page:

Comprehensive Psychiatric Evaluations, ongoing psychotherapy, Case Management, for the full spectrum of children, adolescents, and adults

Referral by MD or Mental Health Professional only.

No Drug Reps seen. Strong concern about the overutilization of Psychotropic meds & over diagnoses of ADHD, Bipolar, & similar labels. In practice since 1977
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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#17 Altostrata

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Posted 26 November 2011 - 12:20 PM

Our esteemed member cinephile has had good experiences with these psychiatrists, both near Boston, Massachusetts:

Mark D. Green, M.D.
c/o Westbridge Inc.
275 Mystic Ave, Suite C
Medford, MA 02155

Phone: 617-913-2971
Email: markdgreenmd at mac.com

Bill (Wm D) Slaughter MD, MA
49 Hancock Street, Cambridge, MA 02139
Phone: 617.233.8957

Website: http://www.wds-md.net/
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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#18 alexejice

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Posted 26 November 2011 - 02:17 PM

I just got an email from an old copatient in a psych clinic who went on to spend 6 months at cooperriis. He had a negative report. He believed he was removed too quickly from his opiate sub suboxone, though this may have occurred at the first psych clinic and not cooperriis. However his chief complaint was that he was forced to work 6 hrs a day at manual farm labor which he said he was not physically capable of, he has ulcerative colitis. So he was outcast more or less and simply left to fend for himself.

His case may be special in that he has a bad scale of colitis. He is over six feet and weighs like 135 pounds. In any event he said he had a bad experience though he did say he met a girl with whom he had a physical relationship and that this was a positive.

Alex

Ps - of course he was not there to taper ADs. Still I thought I would pass along the gist of his feedback. He was a former Yale undergrad who got sick got a drug problem and now lives in Russia where he had his sixth surgery last week to alleviate his colitis symptoms. Good guy. Surprisingly bad chess player...


CooperRiis Center, North Carolina

For inpatient treatment and psychiatric drug withdrawal, if you have means, there's the CooperRiis center in North Carolina http://www.cooperrii...view/index.html

It's a residential facility, quite expensive: $12,500 a month. It sounds very pleasant. One location is a farm and the other is in Asheville.

My guess is you might be able to stay for a month or two, get your tapering instructions, and then leave.


Do I read it right that the fee is twelve thousand dollars for a month? I think very, very few people can afford that, and surely not when one has lost his job due to w/d. Also I wonder what they can do in one or a few months time, while we know that there is no shortcut to w/d. Only the people who are still onthe drug or just so shortly off that they can reinstate will be able to get the right advice for tapering, but that is not worth tens of thousands of bugs I think.
I do not live in the USA but still think of consulting a doctor if the still very bad w/d symptoms really does not go away in the upcoming 1-2 years. Though I still postone it, one day a desicion should be made to stay off all drugs and be disabled for work for indefintite time, or treat it in an experimental way by a doctor who at least does recongize the problem. I tend to consider 6 years as the ultimate time for waiting it out.


Visit my site:

notcrazyafterall.com


#19 Barbarannamated

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Posted 26 November 2011 - 03:09 PM

Lol! You ARE writing a book or screenplay or something for the world to appreciate I hope
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).

#20 alexejice

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Posted 26 November 2011 - 03:28 PM

Lol! You ARE writing a book or screenplay or something for the world to appreciate I hope


Only after I stick the landing; I have yet to live a big finale to make a book worthwhile.

I encourage someone else, a more facile writer perhaps, to beat me to it. I said before that one of us should really be on the Larry King show. Then I found out there is no more Larry King show. Oh well, still there's a lot of recovery on this board with a lot of hurt, misadventure and even maybe an odd anecdote or two. Someday someone like me (probably not me) will write a book about this shoot, and it will be a good one, even maybe a gamechanger.

Cheers,
Alex

Visit my site:

notcrazyafterall.com


#21 Barbarannamated

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Posted 26 November 2011 - 05:09 PM


Lol! You ARE writing a book or screenplay or something for the world to appreciate I hope


Only after I stick the landing; I have yet to live a big finale to make a book worthwhile.

I encourage someone else, a more facile writer perhaps, to beat me to it. I said before that one of us should really be on the Larry King show. Then I found out there is no more Larry King show. Oh well, still there's a lot of recovery on this board with a lot of hurt, misadventure and even maybe an odd anecdote or two. Someday someone like me (probably not me) will write a book about this shoot, and it will be a good one, even maybe a gamechanger.

Cheers,
Alex


Ah, you underestimate yourself. All great artists produce their most profound work from the depths...
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).

#22 Altostrata

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Posted 29 November 2011 - 05:13 PM

In her blog at http://www.inwhiteink.com, this doctor shows psychiatrists can be very sensitive and compassionate -- and concerned about withdrawal.

I am very pleased Dr. Yang has agreed to be added to our list of doctors.

Maria Yang, MD
[relocating]

Dr. Yang writes:

I can share my general guidelines for tapering medications, but please
please please note that this is not medical advice. When I work with
patients for tapers, I take into account many factors: current social
circumstances, involved family and friends, medical conditions,
hospitalization history, etc.

Ideally, the patient has some social support (spouse, friends, etc.)
who are aware of the patient's intentions to taper off of medications.
That way, there is someone in the patient's life (who, frankly, knows
the patient's mental status better than I do) who can help monitor for
any worrisome changes.

I generally do not begin tapers until I have known the patient for a
few months so I have a sense of their "baselines". Furthermore, I want
to build enough rapport so that the patient and I can work *together*
during the taper. (The greatest predictor of how a patient does in
treatment is the strength of the relationship between patient and
doctor, across all specialties.) On rare occasions I will recommend a
taper during our first meeting, but that's usually because they are
taking many, many medications that I don't think they need.

I taper one medication off at a time. Making more than one change at a
time makes it unclear what is helpful/not helpful.

Those medications that are the most "difficult" (e.g. cause the most
withdrawal or discontinuation effects, etc.) to taper off usually come
off later or last.

I also generally follow a schedule of 10% reduction every one to two
months. Sometimes cost becomes an issue: Most people don't like it
when I prescribe more medications (even if in smaller doses) when the
goal is to taper off completely.

It is vitally important that the patient keeps me posted with what
reactions (if any) they are having during tapers. Sometimes patients
start their own tapers faster than I recommend. If they want to slow
it down, I don't mind as much. Sometimes patients stop medications
entirely because they are tired of waiting. This is why it is
essential that there is good rapport.


Edited by Altostrata, 22 March 2012 - 03:26 PM.
updated

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

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#23 Altostrata

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Posted 06 December 2011 - 11:19 AM

It turns out that Dr. Tarantolo is sympathetic but is not knowledgeable about tapering or withdrawal syndrome. I've taken his name off our recommended list until he gets some training in this area.
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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#24 Barbarannamated

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Posted 06 December 2011 - 12:50 PM

Disappointing. Alto, do you have specific questions or methods to differentiate btwn docs who are aware of a problem and sympathetic and those who may have just mild grasp of the complexity? I know we touched on the endocrine issues awhile back. I did not find one MD who would offer any thoughts, even theoretical, on which tests will show primary endocrine problems and not yield false positives or values masked by the presence, exposure to or withdrawal from ADs. I didn't word it quite like that, but the answer was always the same: not a clue. My next question is 'what are we going to do with the results of the tests?' I personally believe that is an appropriate question before any testing or scans except to establish baseline. All to say, if they don't acknowledge endocrine involvement, they don't grasp the big picture. IMHO
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).

#25 Altostrata

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Posted 06 December 2011 - 05:48 PM

No, Barb, grasping endocrine involvement is not the litmus test. Even those who get it about gradual tapering will hesitate to ascribe symptoms to endocrines. Many doctors will say they understand withdrawal symptoms, even if they don't, because they ascribe it to "all in the head." You need to ascertain their tapering techniques.
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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#26 Barbarannamated

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Posted 06 December 2011 - 06:37 PM

No, Barb, grasping endocrine involvement is not the litmus test. Even those who get it about gradual tapering will hesitate to ascribe symptoms to endocrines.

Many doctors will say they understand withdrawal symptoms, even if they don't, because they ascribe it to "all in the head."

You need to ascertain their tapering techniques.


Stick to basics?
What causes some docs to 'get it', in your opinion and experience?
EX: the doc Crocus saw at Kaiser read Anatomy of Epidemic and, I believe, also had a nurse who had or was DCing. Why would an MD consider reading about medicine as written by a journalist? Just for the record or anyone who might not be familiar, I believe Robert Whitaker has a grasp on the data and science far beyond most in medicine. I report from personal experience in my family... it is very disturbing for a physician to realize that they have blindly accepted data that has been severely manipulated.

Im seeing this from so many perspectives, I need focus.
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).

#27 Altostrata

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Posted 06 December 2011 - 06:55 PM

Barb, there's variation among doctors like any other population. Some doctors may actually have noticed withdrawal symptoms! I've talked to more than one doctor who said he or she had stopped prescribing Paxil because of the gruesome withdrawal. My gynecologist and internist LOVED their gifts of Anatomy of an Epidemic. Let's assume the best and most sensitive psychiatrists recognize problems with the medications, gotten curious, and done some reading.
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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#28 Skyler

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Posted 24 March 2012 - 12:05 PM

Good doc.. Denis Moonan, MD 1515 Smith Street Providence, RI 02911 Dr. Moonan's specialty is geriatrics, but don't let this scare you away.. docs in the area are usually good listeners. He also trained as a pathologist, so is up on the chemistry end as well.

 

NOTE 10/20/13: Dr. Moonan is in poor health and not taking any more patients.


Edited by Altostrata, 20 October 2013 - 09:11 AM.
updated

Lyrica: 9/11 72 mgs; 8/31 75 mgs; 8/17 78 mgs; 8/3 84 mgs; 7/20 90 mgs; 7/6 96 mgs; 6/22 102 mgs; 6/8 108 mgs; 5/25 114 mgs; 5/11 120 mgs; 4/28 126 mgs; 4/18 132 mgs; 4/9 138 mgs; 3/30 144 mgs; 3/20 150 mgs; 3/7 159 mgs; 2/27 168 mgs; 2/18 177 mgs; 2/8 186 mgs; 1/25/14 192 mgs .(restart taper 1/25/14 207 mgs. (held for 18 mos at 207)) Highest dose 300 mgs.

Requip - holding: .15 mgs start hold 1/12/14 (start taper .25 mgs 4/12)
............................................................

I'm using a step wise wise taper approach. WD symptoms are tinnitus, which has been long standing, and muscle spasms in my legs and feet which are related to the most recent Lyrica taper.

History: After 25 years (including a 3 yr 4 mo. taper), I'm BENZO FREE! Tapered from 7/2010 thru 10/13. Off benzos for the first time in 25 years. Started 4.5 mgs K. cross tapered to 20 mgs. diazepam 10-12/10. On requip .25 mgs. and on and off Lyrica 150 to 300 mgs. for several years prior to tapering, start tapers 3/12.

#29 Altostrata

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Posted 24 March 2012 - 06:39 PM

Thanks, Georgie. What's Dr. Moonan's approach to getting off psychiatric drugs?
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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#30 Skyler

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Posted 25 March 2012 - 07:22 AM

Thanks, Georgie. What's Dr. Moonan's approach to getting off psychiatric drugs?


LOL.. he listens to me and prescribes what I need to taper. I've given Dr. Moonan, who I call Dr. M., detailed printouts.. some of which he has read, others probably not so much. Dr. Moonan is a hospice doctor, so is familiar with many of the issues. My taper has been a 24 month odyssey and he has been there all the way. Sigh... now for the lyrica.

Georgie
Lyrica: 9/11 72 mgs; 8/31 75 mgs; 8/17 78 mgs; 8/3 84 mgs; 7/20 90 mgs; 7/6 96 mgs; 6/22 102 mgs; 6/8 108 mgs; 5/25 114 mgs; 5/11 120 mgs; 4/28 126 mgs; 4/18 132 mgs; 4/9 138 mgs; 3/30 144 mgs; 3/20 150 mgs; 3/7 159 mgs; 2/27 168 mgs; 2/18 177 mgs; 2/8 186 mgs; 1/25/14 192 mgs .(restart taper 1/25/14 207 mgs. (held for 18 mos at 207)) Highest dose 300 mgs.

Requip - holding: .15 mgs start hold 1/12/14 (start taper .25 mgs 4/12)
............................................................

I'm using a step wise wise taper approach. WD symptoms are tinnitus, which has been long standing, and muscle spasms in my legs and feet which are related to the most recent Lyrica taper.

History: After 25 years (including a 3 yr 4 mo. taper), I'm BENZO FREE! Tapered from 7/2010 thru 10/13. Off benzos for the first time in 25 years. Started 4.5 mgs K. cross tapered to 20 mgs. diazepam 10-12/10. On requip .25 mgs. and on and off Lyrica 150 to 300 mgs. for several years prior to tapering, start tapers 3/12.

#31 Altostrata

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Posted 18 April 2012 - 10:56 AM

I am honored to have received e-mail from Charles Whitfield, MD, author of
  • The Truth about Mental Illness: Choices for Healing
  • Healing the Child Within: Discovery and Recovery for Adult Children of Dysfunctional Families
  • The Truth about Depression: Choices for Healing
and other fine books about mental healing.

He also wrote the paper Psychiatric Drugs as Agents of Trauma (topic).

Dr. Whitfield asked to be included on our list of recommended doctors. His Web site is http://www.cbwhit.com

Contact information:


Charles Whitfield, MD
3462 Hallcrest Dr
Atlanta Ga 30319-1910

404-843-3585 9:30 AM to 7 PM
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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#32 Barbarannamated

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Posted 18 April 2012 - 11:49 AM

I am honored to have received e-mail from Charles Whitfield, MD

Dr. Whitfield asked to be included on our list of recommended doctors. His Web site is http://www.cbwhit.com


Great news, Alto! His work looks very interesting.

Congrats!
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).

#33 Jemima

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Posted 18 April 2012 - 03:48 PM

Woo-hoo! :D

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.

 


#34 Jemima

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Posted 19 April 2012 - 10:41 AM

I hope that Dr. Whitfield will join us here and at least read the intro posts. I'm very encouraged that we've come to this psychiatrist's attention, and I hope it leads to more "spreading of the word". This forum is quite an accomplishment, Alto. Go, girl! :D

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.

 


#35 Skyler

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Posted 19 April 2012 - 12:29 PM

Very Professional Site. And still a home to rogues like us. :D Awrightttt... WAY TO GO
Lyrica: 9/11 72 mgs; 8/31 75 mgs; 8/17 78 mgs; 8/3 84 mgs; 7/20 90 mgs; 7/6 96 mgs; 6/22 102 mgs; 6/8 108 mgs; 5/25 114 mgs; 5/11 120 mgs; 4/28 126 mgs; 4/18 132 mgs; 4/9 138 mgs; 3/30 144 mgs; 3/20 150 mgs; 3/7 159 mgs; 2/27 168 mgs; 2/18 177 mgs; 2/8 186 mgs; 1/25/14 192 mgs .(restart taper 1/25/14 207 mgs. (held for 18 mos at 207)) Highest dose 300 mgs.

Requip - holding: .15 mgs start hold 1/12/14 (start taper .25 mgs 4/12)
............................................................

I'm using a step wise wise taper approach. WD symptoms are tinnitus, which has been long standing, and muscle spasms in my legs and feet which are related to the most recent Lyrica taper.

History: After 25 years (including a 3 yr 4 mo. taper), I'm BENZO FREE! Tapered from 7/2010 thru 10/13. Off benzos for the first time in 25 years. Started 4.5 mgs K. cross tapered to 20 mgs. diazepam 10-12/10. On requip .25 mgs. and on and off Lyrica 150 to 300 mgs. for several years prior to tapering, start tapers 3/12.

#36 meistersinger

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Posted 22 April 2012 - 12:17 PM

Anyone familiar with Joseph Glenmullen, MD, author of The Antidepressant Solution: A Step-by-Step Guide to Safely Overcoming Antidepressant Withdrawal, Dependence, and Addiction? I saw this book advertised on a web page regarding Cymbalta discontinuation.
History:
1995--Prozac--Quit CT by GP
1995--Effexor--Quit per my GP
1996--Amitriphene--Quit CT when changed GP
2005--Citalopram and BusPar. Prescribed when I decompensated in my GP's office. GP referred me to behavior health. Psychiatrist prescibed these drugs. Taken off citalopram in 2011 due to FDA warning. Quit Buspar during transition to viibryd.
Viibryd--2011 to present. Had a severe reaction in March 2012. Advised both GP and Psychiatrist I was trying to get off these drugs.