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Taking multiple psych drugs? Which drug to taper first?


Altostrata

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I was on Effexor for 6 weeks 15 years ago. For me, it was a huge accelerator. I had so many side effects on that drug I just stopped taking it. Back then, I didn’t know any better.  Now I know tapering is definitely  necessary. A 10% taper every 4 weeks MAY work for you, if you are one of the lucky ones. Just listen to your body and respect what is telling you. If it were my choice, tapering Effexor first would be it.  So few people are on Buspar. This is the first time I have read anything about it here, though you could search for others’ experiences. I hope you can “ chip away” at Effexor steadily and with w/d symptoms relatively controllable. 

 

Grace

 

 

 

  • amitriptyline from 1980-2002,
  • intermittent  use of benzos over 2 decades prior to 2002
  • 2002-2010 Klonopin 1-2 mg., ambien 10--20, mg, remeron 4 mg. and  trileptal 300 mg
  • 2011 Stopped ambien and crossed over to valium 17.5 mg. (updosing 2.5 mg. to cover ambien C/T )
  • tapered valium w/ long holds to 12.74 mg. from a high of approximately 20-30 mg/day
  • 2015-2023 tapered trileptal to 98 mg.  had to completely stop tapering due to multiple chronic, serious health issues
  • currently 2024 still on 98 mg. trileptal and 4 mg. remeron
  •   Currently on benzo hold as I have to cross-over from brand-name valium to generic diazepam.   The diazepam is way weaker and brought on severe acute w/d
  • Current dose of diazepam is 7.9 and valium is 6.6.  I had to up-dose the total valium/diazepam from 12.74 to 14.5 where I have stayed since June 2023.  I am crossing over to generic at a somewhat tolerable rate of .3mg/month after about 2 months of trial/error w/ updosing.  I am not currently tapering; will continue to cross over. 

 

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  • 2 months later...

I understand all of this but have one question as it relates to gabapentin and ssri’s. If you have a super long taper in front of you off the ssri, would it be wise to get off gabapentin first because being on it will prevent your nerves from healing(and thereby increase your likelihood of akathisia?).

 

1992 Prozac 60 mg - on and off since, currently on 60mg

2000 Gabapentin 600-3600, currently on 1200mg

January, 2014 Oxycodone 10-40mg, currently 30mg

March, 2012  Cortef 15mg

March, 2012 Liothyronine 110mcg

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Please read this topic from the beginning. Gabapentin is a "brake."

 

Your assumption that gabapentin is worse for your nerves than an SSRI is incorrect. It is no better or worse. As gabapentin is a "brake," going off gabapentin first might increase potential for activation or akathisia when you go off the SSRI.

 

If, however, you are having an identifiable adverse reaction to gabapentin, it may make sense to reduce gabapentin first.

 

Please put questions about your own specific situation in your Introductions topic, as discussion about it will take this thread off-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.

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  • 5 months later...

“Anyway, I think I figured out from "alternative" sources that my AD was interacting with my benzo, so stopping the AD made the benzo metabolize faster. So it was like a dosage cut, even though the dose was the same. I have maybe 80% recovered from that now. So I did a quick goggle on your drugs...even a mainstream source said both those ADs have moderate potential to interact with your benzo. So you probably had a really significant drop in your benzo level once the ADs got out of your system. Just something to think about.”

 

Bubble posted this a year ago and I agree wholeheartedly. In my case my anticonvulsant was inducing my benzo and remeron, almost completely wiping out their sedating effect, which I sorely need. I know this because after reducing oxcarbazepine by 50%, I am sleeping 50% better. These drug cocktails are extremely complex. Trial and error, attention to symptoms and trying to connect your own pattern is very important. Study up on your drugs. Look up interactions, but more specifically induction and inhibition. It is technical and hard to understand at first but once you do it all makes sense.  Now this lop-sided tapering of one drug has its downside, but I will post that in my own thread. The point is, drug interactions/clearance or lack of  matters just as much as whether they are brakes or accelerators. 

 

Grace

Edited by ChessieCat
deitalicised font
  • amitriptyline from 1980-2002,
  • intermittent  use of benzos over 2 decades prior to 2002
  • 2002-2010 Klonopin 1-2 mg., ambien 10--20, mg, remeron 4 mg. and  trileptal 300 mg
  • 2011 Stopped ambien and crossed over to valium 17.5 mg. (updosing 2.5 mg. to cover ambien C/T )
  • tapered valium w/ long holds to 12.74 mg. from a high of approximately 20-30 mg/day
  • 2015-2023 tapered trileptal to 98 mg.  had to completely stop tapering due to multiple chronic, serious health issues
  • currently 2024 still on 98 mg. trileptal and 4 mg. remeron
  •   Currently on benzo hold as I have to cross-over from brand-name valium to generic diazepam.   The diazepam is way weaker and brought on severe acute w/d
  • Current dose of diazepam is 7.9 and valium is 6.6.  I had to up-dose the total valium/diazepam from 12.74 to 14.5 where I have stayed since June 2023.  I am crossing over to generic at a somewhat tolerable rate of .3mg/month after about 2 months of trial/error w/ updosing.  I am not currently tapering; will continue to cross over. 

 

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4 hours ago, savinggrace said:

attention to symptoms and trying to connect your own pattern is very important.

 

Keep Notes on Paper

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • 4 weeks later...
On 5/4/2012 at 11:34 AM, Altostrata said:

ADMIN NOTE This topic is a general discussion about how to decide which drug to taper first. For case-by-case consideration of what YOU should do, please put your questions in an Introductions topic.
 
Do not put those questions in this topic, because detailed discussion of YOUR particular circumstances will take it off track and make this topic difficult for others to follow. The moderators will move any questions about YOUR particular case to the Introductions forum. Thank you.

 

For tips about tapering individual drugs, see Important topics in the Tapering forum and FAQ


 

Polypharmacy complicates tapering. Which drug to taper first?

Consider discussing the following considerations with your doctor.

 

You are having adverse effects from one or more of the drugs

Any drug causing a serious life-threatening adverse effect should be discontinued as soon as possible. Talk to your doctor about this immediately.

 

"Accelerators" and "brakes"
If no one drug is clearly causing an adverse effect, "discontinue the more activating drugs first," I have been advised by a doctor who studies withdrawal syndromes and iatrogenic damage.

 

Antidepressants and ADHD drugs (most are amphetamine analogs) tend to be activating drugs, causing jitteriness, anxiety, or sleeplessness.

 

Benzodiazepines, the "Z" drugs for sleep, anticonvulsants (such as lamotrigine), Lyrica, gabapentin (Neurontin), and antipsychotics tend to be regulating or sedating drugs, causing drowsiness, sluggishness, or dopiness.

 

The two types of drugs can be thought of as "accelerators" and "brakes."

 

Many people have a sedating drug -- a brake -- added to an activating drug -- an accelerator -- to treat drug-induced anxiety or sleep problems.

 

In those cases, unless you are having clear adverse reactions from a particular drug, taper the antidepressant or stimulant first. Otherwise, you will experience activation from the other drug as you decrease the "brake."

 

"Brakes" may temper withdrawal symptoms

The most common and significant antidepressant withdrawal symptoms are nervous system activations (indicating a too-fast taper): hyper-alerting, sleeplessness, abnormal anxiety, agitation, etc.

Withdrawal sleeplessness is a symptom you want to avoid. It makes tapering much harder and post-withdrawal syndrome more difficult to recover from.

If you reduce the accelerator while taking a sedating drug, the sedating drug may help alleviate the activation of withdrawal. You may plan to taper the sedating drug later.

BUT -- Don't add a "brake" to your cocktail to prepare for withdrawal
Do not increase your risk of neurological damage by increasing your polypharmacy. Adding drugs may conflict with a drug you're already taking.

The sedating drugs also will need tapering, and can incur a withdrawal syndrome of their own.

THE PROPER WAY TO MINIMIZE WITHDRAWAL EFFECTS IS TO TAPER AT A SLOW ENOUGH RATE FOR YOUR NERVOUS SYSTEM.

Benzos are addicting! Why not quit the benzo first?
Yes, benzos are defined as truly addicting drugs. But when it comes to withdrawal, the physical dependency incurred by other psychiatric drugs makes the concept of "addiction" moot.

Psychiatric drugs that are technically non-addicting can be just as hard to go off, and some cause much more physical damage than long-term benzos.

I am not minimizing at all the difficulty of a benzo taper or the seriousness of benzo dependency. We are in the disgusting situation of always having to evaluate the least bad choice. I know many people are anxious to get off benzos once they find they're addicted, but even though ADs are not technically addictive, severe antidepressant withdrawal syndrome is just as bad.

When you are taking an antidepressant and a benzo, if you are not having significant adverse effects from the benzo, consider tapering the antidepressant first for these reasons:

  • Antidepressants are activating while benzos are sedating. The action of the benzo can soften the suffering from antidepressant withdrawal symptoms.
  • Conversely, a concurrent antidepressant will not reduce withdrawal symptoms during a benzo taper. With all due respect, Prof. Heather Ashton's suggestion antidepressants might help is misguided, see http://survivingantidepressants.org/index.php?/topic/1510-ashton-manual-recommendation-of-antidepressants/page__view__findpost__p__14205

    In Dr. Stuart Shipko's e-book Xanax Withdrawal (2012), he addresses the Ashton Manual's apparent recommendation of antidepressants to counter benzo-withdrawal depression, see http://survivingantidepressants.org/index.php?/topic/1510-ashton-manual-recommendation-of-antidepressants/page__view__findpost__p__28759
  • Often, benzos are prescribed to cover up adverse effects, such as anxiety, insomnia, and akathisia, from an antidepressant. When you remove the benzo, the antidepressant's adverse effects come to the forefront. You then may be in such distress, it is difficult to taper the antidepressant slowly enough to forestall severe withdrawal symptoms.
  • Benzo withdrawal before antidepressant withdrawal increases the risk of a difficult antidepressant withdrawal.

    Going into an antidepressant taper with GABA downregulated by prior benzo withdrawal is a very perilous strategy. Your nervous system will need GABA to deal with antidepressant withdrawal symptoms.

    You may more easily control an antidepressant taper. Fast recovery from antidepressant withdrawal will enable you to tackle your benzo taper.

    The people who have the worst withdrawal syndrome are those suffering from both benzo withdrawal and antidepressant withdrawal, because two systems -- serotonin and GABA -- that might help them recover are not functioning due to downregulation.
  • If you have already done the hard work of getting off a benzo and then suffer severe withdrawal syndrome from the antidepressant, you are faced with the decision of whether or not to get on the benzo merry-go-round again.

    Many doctors treat antidepressant withdrawal symptoms with benzos, although that brings in a whole other set of problems, which you know well. Still, many people can't get through withdrawal without an occasional benzo dose. Consider using benzos very, very sparingly.

And then there are antipsychotics...
To make this a little more confusing, if you are taking an antipsychotic, e.g. Seroquel or Risperdal, you may wish to discontinue that first, because of serious adverse health effects from antipsychotics, such as diabetes.

However, if you're taking an antipsychotic to counter an adverse effect of an antidepressant, such as sleeplessness or agitation, you may want to discontinue the antidepressant first.

Conceivably, one might systematically lower the antidepressant part way, then lower the antipsychotic. If sleep doesn't break up, continue to get off the antipsychotic. If it breaks up, stop lowering the antipsychotic, stabilize, and lower the antidepressant, managing the tapers in a way that preserves sleep.

Before tapering, be sure to discuss the above with your knowledgeable medical caregiver.

 

I have found my SSRI taper to be much more severe than my benzo taper. 

I tapered klonopin 1.5 - .25 mg smoothly over many months. I am on 6 mg of Celexa and my discontinuation symptoms have been hellish.  I was put on a mood stabilizer Lamictal or lamotrigene 150 mg. Is Lamictal a brake drug or an activator in this context?

Citalopram 2 mg

Clonazopam .25 mg

Lamotrigine 150 mg

 

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On 4/20/2019 at 1:12 PM, JB1234 said:

I am on 6 mg of Celexa and my discontinuation symptoms have been hellish.  I was put on a mood stabilizer Lamictal or lamotrigene 150 mg. Is Lamictal a brake drug or an activator in this context?

 

Here is information about Lamictal.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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My reply is not working through email I tapered off clonazopam first

Citalopram 2 mg

Clonazopam .25 mg

Lamotrigine 150 mg

 

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  • 5 months later...

Anyone knows how to taper biperiden 4mg extended release? 

Abilify from 20 mg to 10 mg-Nov.29,2017 to March.24,2019; Abilify 10 mg March.24,2019 to Sep.26,2020; 9,4ml Sep.27,2020;9,8ml Sep.29,2020;9,6ml Oct.17,2020;9,4ml Oct.30, 2020;9,2ml Nov.15,2020;9ml November 25th,2020;8,8ml December 16th,2020;8,6ml December 30th,2020;8,4ml January 13th,2021;8,2ml February 2nd,2021;8ml February 25th,2021;7,8ml March 17th,2021;7,6ml April 6th,2021;7,4ml April 18th,2021;7,2ml May 4th,2021;7ml  May 26th,2021;6,8ml June 6th,2021;6,6ml July 5th,2021;6,4ml July 21st,2021;6,2ml July 31st,2021;6ml August 13th,2021;5,8ml August 31st,2021;5,6ml September 16th,2021;5,4ml October 1st,2021;5,2ml October 15th,2021;5ml Nov 1st, 2021;4,8 ml Nov 13th,2021;Abilify 4,6ml November 28th,2021;Abilify 4ml December 10th,2021;Abilify 3,8ml January 1st,2022;Abilify 3,6ml January 15th,2022;Abilify 3,4ml January 28th,2022;Abilify 3,2ml February 15th,2022;Abilify 3ml February 28th,2022;Abilify 2,8ml March 12th,2022;Abilify 2,6ml March 31,2022;Abilify 2,5ml April 19th,2022;Abilify 2,4 May 6th,2022;Abilify 2,35ml May 26th,2022;Abilify 2,3ml June 23,2022; Abilify 2,2ml June 28th,2022;Abilify 2,1ml July 19th,2002;Abilify 2ml August 19th,2022;Abilify 1,95ml November 6th,2022;Abilify 1,9ml December 16th,2022;Abilify 1,85ml January 13th,2023;Abilify 1,85ml January 14th,2023;Abilify 1,90ml January 15th,2023; Abilify 1,89ml February 5th,2023;Abilify 1,88 ml February 10th,2023; Abilify 1,88

ml February 15th,2023; Abilify 1,85 ml February,20th,2023; Abilify 1,83ml March,6th,2023, Abilify 1,80ml March 17th,2023; Abilify 1,77ml March 29th,2023; Abilify 1,75ml April 12,2023; Abilify 1,5ml September 22nd,2023

Cymbalta 120 mg Jun.28,2011; 90mg Feb.19,2013 to Jun 5,2014;60 mg Jun.5,2014 to present

Klonopin 1,25 mg Jan.3,2016; 0,25mg Nov.28,2017 to present

biperiden extended release 4mg April.25,2008 to Feb.6,2009;Jun 24.2011 to January 13th 2023;Biperiden 4mg extended release + biperiden 1mg

Risperidone 2mg May.4,2017 to Dec 6.2019

Risperdal 1,5mg 12/06/19; 1,75mg 12/08/19; 1,5mg 12/20/19; 1,75mg (0,018g) 12/26/19

Risperidone 1,75ml 1/8/20; 1,70ml 1/18/20; 1,62ml 1/30/20; 1,54ml 2/29/20; 1,44ml 5/6/20; 1,42ml 5/7/20; 1,40ml 5/18/20; 1,30ml 6/1/20; 1,25ml 6/11/20; 1,12ml 7/5/20; 1ml 7/21/20; 0,96ml 8/16/20; 0,875ml 8/18/20; 0,86ml 8/28/20; 0,80ml 3/24/21;0,84ml 3/27/21; 0,86ml 4/4/21

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When deciding whether to taper pregabalin or mirtazapine first - I find that the mirtazapine is by far the more sedating (at 3.75mg). Pregabalin seems to have very subtle effects, and certainly doesn't make me sleepy unlike the mirtazapine. Hence would this be the more activating drug?

Slowly getting better from multiple drug changes. Holding at 20mg fluoxetine, 150mg pregabalin, 3.75mg mirtazapine until I work through some personal issues.

 

 

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@Emphyrio , you have to take your entire set of drugs into account.

 

We don't rank the drugs according to how sedating they are, what's important is the effect they have in YOUR cocktail -- which is extensive. This is the reason we ask people to post such questions in their own Intro topics, where we can see the context of earlier drug changes, interaction reports, etc.

 

Please post questions about what YOU should do in your Intro 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.

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I think she was asking is pregablin an accelerator and mirtazapine a brake?  (Or is that not current thinking any more?) That said, this really is impacted by drug interactions so the question is  almost impossible to answer as interactions are unpredictable, especially from one person to another. It’s anybody’s guess what is going on when there are two or more drugs. 
 

Grace

  • amitriptyline from 1980-2002,
  • intermittent  use of benzos over 2 decades prior to 2002
  • 2002-2010 Klonopin 1-2 mg., ambien 10--20, mg, remeron 4 mg. and  trileptal 300 mg
  • 2011 Stopped ambien and crossed over to valium 17.5 mg. (updosing 2.5 mg. to cover ambien C/T )
  • tapered valium w/ long holds to 12.74 mg. from a high of approximately 20-30 mg/day
  • 2015-2023 tapered trileptal to 98 mg.  had to completely stop tapering due to multiple chronic, serious health issues
  • currently 2024 still on 98 mg. trileptal and 4 mg. remeron
  •   Currently on benzo hold as I have to cross-over from brand-name valium to generic diazepam.   The diazepam is way weaker and brought on severe acute w/d
  • Current dose of diazepam is 7.9 and valium is 6.6.  I had to up-dose the total valium/diazepam from 12.74 to 14.5 where I have stayed since June 2023.  I am crossing over to generic at a somewhat tolerable rate of .3mg/month after about 2 months of trial/error w/ updosing.  I am not currently tapering; will continue to cross over. 

 

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  • 11 months later...

Hi guys, I was hoping someone on here could help me please?

 

I was put on Zyban  300mg ( Bupropion ) in July as I had a breakdown and kinda had no choice but to start a antidepressant.  I had over the years been using Zoplicone for sleep as I am an athlete and need my sleep so I used this off and on for 5 years until last year when I started to feel sick every time I took it then without knowing I ended up creating a reliance on it and we think thats why I ended up having a breakdown as I was most likely experiencing major withdrawls. 

 

To help they said with the bupropion side effects I was told to use Diazepam & this would also help me with the benzo problem I had with Zoplicone. After 4 weeks of using 6mg of Diazepam I started tapering and of course have gone way to fast. I have had on & off withdrawls about 5 times now over 4 months and I am currently at 1.15mg and struggling big time.

 

The main problem I have now is sleep. I can't sleep anymore with the lower doses of Diazepam and taking the full 300mg of Bupropion. I have major dry mouth at night that keeps waking me up. I may get at best 1-2hrs a night now. I also am having major headaches at the end of the day & stomach problems as side effects.

 

After reading more on here the consensus seems to be to taper the AD as its an upper first and leave the benzo ( The brake they called it ) to last. I am starting to agree as my sleep has got worse the lower I reduce the Diazepam.

 

Question 1 -

 

Problem I have in NZ is they gave me Zyban SR 150 twice a day which I understand is more used for smoking. This is the only product we have in our country. I need clear advice as to weather Zyban SR & Wellbutrin SR are exactly the same drugs & release etc as the links on here are mainly talking about Wellbutrin for taper.

 

Question 2 - Can you cut Zyban 150mg to use for tapers & does it stay as SR or change to IR ? Meaning once cut it becomes instant release to be taken 3 times a day?

 

Question 3 - Can someone confirm that its best advised to hold the benzo for now & taper the Zyban first & does the side effects such as sleeplessness improve once lowered?

 

Thanks for the help so far too. Your a gem guys

 

2015 - Started Zoplicone for sleeping off & on for 5 years ( No more than a week to 10 days at time )

2016 - Stared Thyroxine as I have Hasimotos Hypothyroid ( Still taking today 25mg )

2019 - Problems with Zoplicone started, Tried Temazepham with same problems

2020 - June - Had massive problems with trying different medications and had a breakdown

2020 -  July - Started 6mg Diazepam to help with side effects of Zyban ( Bupropion ) 300mg  

2020 - August - Started Diazepam taper as I have a dependence to Benzo's ( Funny that after they said zoplicone was not a benzo...)

2020 - Oct - 1.2mg diazepam ( Have had 5 major withdrawls since Aug )

 

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@johnnyj

@savinggrace

 

Your discussion (16 posts) have been moved to Johnnyj's Introduction topic.

 

Please see my post here.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • 4 months later...
  • Moderator Emeritus

What if someone is on two activating drugs, for example, Prozac and Wellbutrin?  Assuming they have no adverse effects from either of the drugs? 

Please do not private message me.  Only tag me for urgent questions about tapering and reinstating - thank you.  

 

***Please note this is not medical advice.  Discuss any decisions about your medical care with a doctor who understands psych meds and how to withdraw from them, if you can find one.

 

Lexapro   Started Apr 15 2010 - 10 mg;  started taper August 2017, recent taper info: Apr 2 '20  0.18 mg; Jul 16  0.17 mg, Aug 23  0.16 mg, Oct 7  0.15 mg, Nov 8 - 0.14, Jan 16 '21 - 0.13, Feb 7 - 0.12, Feb 22 - 0.11, Mar 26 - 0.10, May 21 - 0.09, June 15 - 0.08 Aug 16 - 0.07, Oct 6 - 0.06, Nov 21 0.05, Dec. 17 0.04, Jan 14 '22 0.03, Feb 19 0.02, Apr 18 0.01, May 15 0.005,  Jul 8, 0.00.  Psych Drug Free as of July 8, 2022!!  Woohoo!!!

other meds: Levothyroxine 75 mg

magnesium in small amounts at 4 AM, before bed

suppl AM: fish oil, flax oil, vit C, vit E, multivitamin, zinc

suppl 8 PM: magnesium 350 mg, extended release vitamin C, melatonin 2 mg

 

Paxil 2002 - 2010, switched to Lexapro 2010 

Trazodone 50 mg. 2002 - 2019, fast tapered in 2019 

Xanax 0.5 mg as needed 2002 - 2019, up to 3x weekly 

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Just some of my thoughts.

 

You check for side effects and drug interaction.  If the person had taken one of the drugs by itself and knows how it affects them then they might reduce the one that was started afterwards especially if they know that their sleep was okay on the single drug.

 

From https://www.drugs.com/:

 

Common Wellbutrin side effects may include:

  • dry mouth, sore throat, stuffy nose;

  • ringing in the ears;

  • blurred vision;

  • nausea, vomiting, stomach pain, loss of appetite, constipation;

  • sleep problems (insomnia);

  • tremors, sweating, feeling anxious or nervous;

  • fast heartbeats;

  • confusion, agitation, hostility;

  • rash;

  • weight loss;

  • increased urination;

  • headache, dizziness; or

  • muscle or joint pain.

 

Common Prozac side effects may include:

  • sleep problems (insomnia), strange dreams;

  • headache, dizziness, drowsiness, vision changes;

  • tremors or shaking, feeling anxious or nervous;

  • pain, weakness, yawning, tired feeling;

  • upset stomach, loss of appetite, nausea, vomiting, diarrhea;

  • dry mouth, sweating, hot flashes;

  • changes in weight or appetite;

  • stuffy nose, sinus pain, sore throat, flu symptoms; or

  • decreased sex drive, impotence, or difficulty having an orgasm.

 

In the case of Prozac and Wellbutrin because of the interaction is might be worth considering reducing one for a while and then reducing the other for a while.

 

When the Wellbutrin is reduced whilst taking fluoxetine then because it increases the effect of fluoxetine it might need to be reduced by less than 10%.

 

As with reducing any drug/s symptoms would need to be monitored.

 

From https://reference.medscape.com/drug-interactionchecker

Serious - Use Alternative

  • fluoxetine + bupropion

    fluoxetine increases toxicity of bupropion by unspecified interaction mechanism. Avoid or Use Alternate Drug. May lower seizure threshold; keep bupropion dose as low as possible.

Monitor Closely

  • bupropion + fluoxetine

    bupropion will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • Moderator Emeritus

@ChessieCatthanks for the info. I'm going to copy and paste it to Babs65 for her perusal, and recommend she taper the Wellbutrin first per your PM.  Thanks for the help! :)

Please do not private message me.  Only tag me for urgent questions about tapering and reinstating - thank you.  

 

***Please note this is not medical advice.  Discuss any decisions about your medical care with a doctor who understands psych meds and how to withdraw from them, if you can find one.

 

Lexapro   Started Apr 15 2010 - 10 mg;  started taper August 2017, recent taper info: Apr 2 '20  0.18 mg; Jul 16  0.17 mg, Aug 23  0.16 mg, Oct 7  0.15 mg, Nov 8 - 0.14, Jan 16 '21 - 0.13, Feb 7 - 0.12, Feb 22 - 0.11, Mar 26 - 0.10, May 21 - 0.09, June 15 - 0.08 Aug 16 - 0.07, Oct 6 - 0.06, Nov 21 0.05, Dec. 17 0.04, Jan 14 '22 0.03, Feb 19 0.02, Apr 18 0.01, May 15 0.005,  Jul 8, 0.00.  Psych Drug Free as of July 8, 2022!!  Woohoo!!!

other meds: Levothyroxine 75 mg

magnesium in small amounts at 4 AM, before bed

suppl AM: fish oil, flax oil, vit C, vit E, multivitamin, zinc

suppl 8 PM: magnesium 350 mg, extended release vitamin C, melatonin 2 mg

 

Paxil 2002 - 2010, switched to Lexapro 2010 

Trazodone 50 mg. 2002 - 2019, fast tapered in 2019 

Xanax 0.5 mg as needed 2002 - 2019, up to 3x weekly 

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  • 8 months later...
  • Moderator Emeritus
6 hours ago, DebM said:

I get it would make sense to titrate first of the sedating drug, Remeron.

 

Have you read this topic from the beginning?

 

If not, please at least read Post #1 carefully.

 

From Post #1 (note there is a lot more information about this in that post):

 

On 5/5/2012 at 4:34 AM, Altostrata said:

2. Identify "accelerators" and "brakes"
If no one drug is clearly causing an adverse effect, "discontinue the more activating drugs first" is a reasonable policy.

 

 

 

 

 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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4 hours ago, ChessieCat said:

 

Have you read this topic from the beginning?

 

If not, please at least read Post #1 carefully.

 

From Post #1 (note there is a lot more information about this in that post):

 

 

Thank you very much. Yes, I read it and it was very god information. The side effects I have are definitely related to the Remeron. I can see the sense in stopping Lexapro first. I am hoping since the Remeron was only started recently, well in October I can manage this if I follow titration plan. 

4 hours ago, ChessieCat said:

 

 

 

 

 

 

 

DebM

 

20 years Pamelor 20mg

2017 began titration / 2019 off Pamelor

2017 due to discontinuation syndrome (DS) prior to taper -Lexapro 5mg added

2019 Began titration Lexapro

2021 Lexapro .7mg DS 

2021 Lexapro 10/5/21 5mg 

2021 Remeron 15mg 10/11/21 added due to severe DS

2021 Lexapro 11/15/21 taper started-4mg Lexapro; 15 mg Remeron

2021 Lexapro 11/15/21 taper error and 3.6mg; 15mg Remeron

2021 Lexapro 11/29/21 4mg Lexapro; 15mg Remeron 

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  • 6 months later...

What I have not seen addressed here is cognitive decline associated with Benzes, particularly in the elderly. That's my big concern.

Doc is not God spelled backwards!

 

Mirtazapine 30mg 2003-February 2022

Vortioxetine 10mg December 2021

Quetiapine 12.5mg - 25mg - 50mg - 75mg January-March 2022

Trazodone 50mg 2003-present

Alprazolam 1 mg August 2019-present

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@unblocktheplanet and @Worthy

 

I've moved your conversation to Worthy's intro to keep this topic "on topic".

 

worthy

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • 1 year later...

Can someone explain how are SSRIs toxic? I'm not saying that I don't believe that there is some toxicity, but I'm under the impression that antipsychotics are far more toxic.

This question is particularly relevant to me, as I am currently going on the assumption that Seroquel taken at a steady dose will lead to physical injury and possibly even death, whereas my assumption about Zoloft (whether correct or not) is that I can just keep taking it and not have significant health issues.

-First started taking Seroquel, Zoloft, and Lithium Carbonate in January of 2008 after mother's death. Continued to take these meds for several years.
-Had two Zoloft induced manic episodes, one in March 2013 and another in October 2014.

-Mostly off meds from October 2014 to April 2015.

-Went back on meds (Seroquel, Lithium and Zoloft)  in April 2015. Then started to also take Buspar.

-Summer 2021: Buspar = 45mg, Lithium Carbonate = 750mg, Seroquel = 350mg, Zoloft = 175mg. // Summer 2022: Buspar = 0mg, Lithium Carbonate = 525mg, Seroquel = 300mg, Zoloft = 87.5mg. // Summer 2023: Buspar = 0mg, Lithium Carbonate = 0mg (replaced with Lithium Orotate), Seroquel = 162.5mg, Zoloft = 37.5mg.

-Recent Zoloft Doses
    -Oct22 to May23: Z = 37.5mg -Jun23: Z = 50mg->37.5mg -Jul23: Z = 34.4mg, Aug23: Z=34.4mg->31.25mg, Sep23: Z= 31.25mg, Oct23: Z =34.4mg, Nov23: Z= 37.5mg, Dec23: Z = 37.5 (switched from night to morning)

-Recent Seroquel Doses
    -Dec22: S = 200mg -Jan23 & Feb23: S = 175mg / -Mar23: S = 162.5mg -Apr23: S = 150mg / -May23: S = 156mg / -Jun23-Oct23: S = 162.5mg, Nov23: S = 162.5mg -> 156mg, Dec23: S = 156mg

-Also taking: LTheanine, Fish Oil, VitC, D3&K2, GABA, Magnesium Glycinate.
-Current Situation: Just finished decreasing Seroquel to 156mg. Have felt overstimulated recently. Am currently switching the timing of taking Zoloft from night to morning. Have become depressed as I adjust to new timing of Zoloft.

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  • Mentor
On 7/25/2023 at 11:21 PM, MattNNN said:

Can someone explain how are SSRIs toxic? I'm not saying that I don't believe that there is some toxicity, but I'm under the impression that antipsychotics are far more toxic.

This question is particularly relevant to me, as I am currently going on the assumption that Seroquel taken at a steady dose will lead to physical injury and possibly even death, whereas my assumption about Zoloft (whether correct or not) is that I can just keep taking it and not have significant health issues.

Not a doctor or scientist, but the more I learn about these things, the more it makes sense that taking any chemical (even something like Tylenol) every day will affect the body. Feels like we have a lot to learn about long-term effects, as we unfortunately only learn as we see people age and die on these things which will take at least one generation of medicated people to study. Zoloft was released in the 90s, so we still have some decades to go till we know what a lifetime on it does to a person's body.

Pronouns: they/them/theirs 

Started on Prozac in early 2000s to treat cPTSD, been on various cocktails ever since.

2002-2004, 2017-2022: Buspar, tapered down to 0

2016-present: 100mg Seroquel for sleep -> May 2023: 90mg -> June 2023: 81mg -> September 2023: 72mg -> switched to brand name, much too strong, down to 60mg -> October 2023: 54mg -> November 2023: 50mg -> January 2024: 45mg

2016-Present: 100mg Wellbutrin SR -> January 2023: 75mg IR (37.5mg 2x a day) -> February 2023 (33.75mg 2x a day) -> July 2023 (30.37mg 2x a day) -> August 2023: 27.33mg 2x a day 

2018-present: 25mg Pristiq

2015-present: 600mg Gabapentin (200mg 3x a day) -> December 2022: 300mg Gabapentin (100mg 3x a day) per GP's recommendation after side effects -> March 2023: 90mg 3x a day (switched to liquid suspension) -> April 2023: 81mg 3x a day -> September 2023: bad generic, switched back to homemade liquid; too strong after bad generic, down to 70mg 3x a day, still bad. Adjusted slowly till at 60mg 3x a day, much better. Long hold till -> December 2023: 54mg, still feels too high after November Seroquel switch from brand name to generic, doc recommended 50mg which feels better -> January 2024: When Wellbutrin went down, Gabapentin started putting me to sleep, went down to 45mg, then 41mg to stay awake, so far so good -> February 2024: 36mg

Supplements: Multivitamin w/magnesium, probiotics, digestive enzymes, anti-viral nitric oxide nose spray as needed

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I did not know that there was any kind of accurate and definitive listing of toxicity from greatest to least.  It seems to me to be dependent on so many variables that vary from person to person...dose, longevity of us, genetics, epigenetics, gut health, enzyme function, etc.  I have a brother-in-law on countless drugs and he is much healthier than I am, but I doubt any of them are psych drugs.  (perhaps short-term as he has had countless surgeries)  He is overweight, age 76, gets little exercise and his quality of life is far greater than mine. (well, I have none) He mocks my clean, organic diet.  He eats what he wants even though he is pre-diabetic.  I get wild sugar swings from 1/2 of a gluten free cookie.

 

So, for me, I think that unless one eliminates one drug at a time, and gives a lengthy interval for the drug to clear the system and the brain to reset, a person has no idea of the negative effects the drug is/was having on their body.

 

I was sensitized long ago (didn't know about any of this then).  For me, now, everything is toxic; even many foods and many/most supplements....seemingly benign things...are toxic.

 

One can read about the side effects of long or even short-term use of these drugs but they vary so much from one individual to another.  I just assume that everything I put in my mouth has a possible negative effect, in some way, so keeping other drugs (even tylenol, ibuprofen) supplements and many foods (especially sugar and processed food) is the only thing I can control while I try to make tiny dents in my taper because even one "crumb" less of something can accumulate to many crumbs of improvement.

 

There is one thing I do know about psych drugs (and all drugs) and it is that the anti-cholinergic effect is much greater with some drugs than others, and this effect can drastically affect all our body systems.  So perhaps that is something to consider. Also if a drug makes you dreadfully sick right away it is a red flag, I think.  Otherwise, we are fooled by the idea they are not harming us as the accumulation effect is occurring all the time and as we age and our metabolism changes, the bad effects are likely to heighten.

 

My son was recently diagnosed as bi-polar.  He was on seroquel, then seraphis (sp?) and is now on lithium.  The first two made him dreadfully ill.  He is tolerating lithium but gaining weight and sluggish at best.

  • amitriptyline from 1980-2002,
  • intermittent  use of benzos over 2 decades prior to 2002
  • 2002-2010 Klonopin 1-2 mg., ambien 10--20, mg, remeron 4 mg. and  trileptal 300 mg
  • 2011 Stopped ambien and crossed over to valium 17.5 mg. (updosing 2.5 mg. to cover ambien C/T )
  • tapered valium w/ long holds to 12.74 mg. from a high of approximately 20-30 mg/day
  • 2015-2023 tapered trileptal to 98 mg.  had to completely stop tapering due to multiple chronic, serious health issues
  • currently 2024 still on 98 mg. trileptal and 4 mg. remeron
  •   Currently on benzo hold as I have to cross-over from brand-name valium to generic diazepam.   The diazepam is way weaker and brought on severe acute w/d
  • Current dose of diazepam is 7.9 and valium is 6.6.  I had to up-dose the total valium/diazepam from 12.74 to 14.5 where I have stayed since June 2023.  I am crossing over to generic at a somewhat tolerable rate of .3mg/month after about 2 months of trial/error w/ updosing.  I am not currently tapering; will continue to cross over. 

 

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  • 4 weeks later...
On 28.07.2023 at 19:01, savinggrace said:

Nie wiedziałem, że istnieje jakiekolwiek dokładne i ostateczne zestawienie toksyczności od największej do najmniejszej. Wydaje mi się, że zależy to od wielu zmiennych, które różnią się w zależności od osoby... dawka, długowieczność, genetyka, epigenetyka, zdrowie jelit, funkcja enzymów itp. Mam szwagra zażywającego niezliczoną ilość leków i jest znacznie zdrowszy ode mnie, ale wątpię, żeby którykolwiek z nich był psychotropem. (być może krótkotrwałe, ponieważ przeszedł niezliczoną liczbę operacji) Ma nadwagę, ma 76 lat, mało ćwiczy, a jakość jego życia jest znacznie lepsza niż moja. (no cóż, nie mam żadnego) Kpi z mojej czystej, organicznej diety. Je, co chce, mimo że jest w stanie przedcukrzycowym. Dostaję dzikie wahania cukru od 1/2 bezglutenowego ciasteczka.

 

Dlatego według mnie myślę, że jeśli nie wyeliminuje się jednego leku na raz i nie zapewni się długiej przerwy, aby lek oczyścił organizm i zresetował się mózg, osoba nie ma pojęcia o negatywnych skutkach, jakie lek ma/miał na ich ciele.

 

Już dawno byłem uczulony (wtedy jeszcze o tym nie wiedziałem). Dla mnie teraz wszystko jest toksyczne; nawet wiele produktów spożywczych i wiele/większość suplementów… pozornie łagodne rzeczy… są toksyczne.

 

Można przeczytać o skutkach ubocznych długotrwałego lub nawet krótkotrwałego stosowania tych leków, ale są one bardzo zróżnicowane u poszczególnych osób. Po prostu zakładam, że wszystko, co wkładam do ust, może w jakiś sposób mieć negatywny wpływ, więc trzymanie innych leków (nawet tylenolu, ibuprofenu), suplementów i wielu pokarmów (zwłaszcza cukru i przetworzonej żywności) jest jedyną rzeczą, którą mogę kontrolować podczas spróbuj zrobić maleńkie wgniecenia w moim stożku, bo nawet jeden „okruszek” mniej może zgromadzić się w wiele okruszków ulepszeń.

 

Jedno wiem na temat leków psychotropowych (i wszystkich narkotyków) a mianowicie, że działanie antycholinergiczne w przypadku niektórych leków jest znacznie większe niż w przypadku innych, a efekt ten może drastycznie wpłynąć na wszystkie układy naszego organizmu. Więc może warto to rozważyć. Poza tym, jeśli lek od razu wywołuje okropną chorobę, jest to czerwona flaga, tak myślę. W przeciwnym razie dajemy się zwieść poglądowi, że nie wyrządzają nam szkody, ponieważ efekt akumulacji występuje cały czas, a wraz z wiekiem i zmianami naszego metabolizmu niekorzystne skutki prawdopodobnie się nasilą.

 

U mojego syna niedawno zdiagnozowano chorobę afektywną dwubiegunową. Brał seroquel, potem seraphis (sp?), a teraz jest na litu. Pierwsze dwa spowodowały, że był śmiertelnie chory. Toleruje lit, ale przybiera na wadze i jest w najlepszym wypadku powolny.

Hello, I was also prescribed seroquel because escitalopram was considered to be too active for me.There are mineral waters rich in lit (max.probably 27mg/L) I have to buy one, 
 

 

2022 escitalopram from July 25 2.5 mg, 5 mg, 10 mg August-December- 7.5 mg, 5 mg, (1 month) 2.5 mg - C/T 
WD
2023 Short reinstatement from WD date: 

escitalopram May 25-June 12 5 mg, 2.5 mg plus interrupted

Reinstatement 24 07.23 0.5mg escitalopram, 18.08.23 0.22 escitalopram, 07.09. 0.28
Now 0.30 mg escitalopram 

Last year 6 months on escitalopram, I was very agitated, hypomaniacal and with little need for sleep. 
Since July 2023 reinstated and reduced from 0.50 mg to 0.30 mg Lexapro - difficulty sleeping and lack of sleep, eye pain and IBS. Anhedonia. 

November 2023 - 0mg

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  • 1 month later...

This thread is very helpful and contains lots of insight I wasn't up on. Was still under the impression -- probably from benzo forums -- that one should always get off the benzo first. Since I've made so much progress lowering the clonazepam, I'll continue with that and then taper the ADs. 

 

I'm wondering if others in an active taper have any trouble following the details of the mechanisms of the different types of drugs. I do. Sometimes, I seriously wonder whether having been on a psychiatric drug cocktail since early 1990s has damaged my brain and nervous system beyond complete repair. Some days my thinking feels slower than molasses...my processing speed greatly diminished.

 

Thanks to all who have contributed to this super-important discussion. I'd guess that a lot of us who come to this site aren't aware of much of this and may be in no cognitive condition to easily absorb it. Here, it's in writing...and I can read as many times as necessary! 

Current:

 

*Abt 1995, started fluoxetine 20 mg/day, later raised to 40 mg; *Abt 1997, started Klonopin ? mg/day

*Abt [??] started first, very slow Klon taper

*Sept 2016, Klon updosed; swapped fluox for duloxetine/lamotrigine/Seroquel (very small dose of last, for sleep) cocktail

*Early 2018, stopped Seroquel; *2020, started second Klon taper

*Abt July 2022, accidental 33% Klon cut, w/no updose; have been holding for 15 mos

*Mar 2023, abrupt lamotrigine cut from 75- to 50 mg/day; *May-June 2023, abrupt dulox cut from 90 mg- to 60 mg/day

*As of June 2023, taking lamotrigine 50 mg/day, duloxetine 60 mg/day, Klonopin .25 mg/day, metoprolol 50 mg/day, Eliquis 5 mg/day, levothyroxine 75 mcg/day

 

"Forget to remember; remember to forget."

 

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  • 3 months later...

I know that I should not post this here but into my own introduction, but this latter triggered no much reaction, so I dare asking my question here.
In Feb 2023, I had been on venlafaxine for 29 years for fibromyalgia, and on pramipexol (a dopamine agonist) for 2 years for a restless legs syndrom triggered by venlafaxine. I tapered off venlafaxine from Feb to Aug 2023. In Sep 2023, I started taper off pramipexol, and my nervous system crashed. I ended up at the hospital, twice. The first time, they diagnosed me as suffering from a post-accute venlafaxine withdrawal syndrom + DAWS (dopamine agonist withdrawal syndrom) They put me on benzo and then withdrew abruptly pramipexol which strongly aggravated my DAWS (dopamine agonist withdrawal syndrom). After a week in a miserable state at home, I had to go back to the hospital. They understood their mistake (dopamine agonists should never be stopped cold turkey) and reintroduced one (rotigotine 2mg) + two benzos (clonazepan 0.5mg + alprazolam 0.75mg) + a gabapentinoid (pregabaline 300mg) + an opioid (tramadol 100mg) to control my symptoms. I felt a bit better and went home.

The doctors' plan is first a slow taper off rotigotine over 10 months (now at 1.6mg), and then to taper off the other drugs. Still, I don't like the idea of taking so many depressing drugs, so I started also to taper off pregabaline (now at 150mg) and alprazolam (now at 0.5mg). Does this make sense, or should I first taper off rotigotine like suggested by my doctors, and then the other drugs (and which ones first?).

1994 to Feb 2023: under Venlafaxine XL with doses ranging from 37.5mg to 225mg
2019: diagnosed with restless legs syndrome (RLS) likely due to the long-term use of Venlafaxine.
2020-2021 - RLS treate by Sifrol (pramipexol, a dopamine agonist) 0.18 mg. Sifrol dose increased to 0.36mg in 2021.
2022 - pramipexol replaced by Mirapexin 0.26mg (= pramipexol extended release form)
Feb - Aug 2023 - Tapering off Venlafaxine 112.5mg to 0 from Feb to August.

Sep 2023: Tapering off Mirapexin (0.26 -> 0.13mg) -> A few days later, start of strong withdrawal symptoms.

Oct 2023: moving to Sifrol 0.18mg + tramadol 50mg. Still severe withdrawal symptoms. Cold turkey stop of dopamine agonist at the hospital -> extreme withdrawal symptoms (DAWS syndrom).

Nov 2023: Put back on dopamine agonist (rotigotine 2mg) + pregabalin 300mg + alprazolam 0.75mg + tradonal retard 100mg + clonazepam 0.5mg

Since Dec 2023: slowly tapering off my drugs, -0.2mg rotigotine and -0.125mg alprazolam per month.

Now (March 2024): 1.2mg rotigotine, 0.125mg alprazolam, 300mg pregabaline, 100mg tradonal retard, 0.5mg clonazepam.
Goal: 0mg alprazolam in Apr, 0mg rotigotine in Sep, 0mg clonazepan and tradonal in Dec. Could keep pregabaline for RLS if needed, or could use dipyrimadole instead.

 

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  • 2 weeks later...

Thank you for this very interesting article.  I was put on valium 30 mg at the end of November 2023 to switch venxalafine to prozac.  I reached 5 mg of valium. I suffered a huge wave of 10 days when going from 10 to 5 mg over 7 days.... I plan to reduce by 5% every 14 days with valium drops.  I would also like to start reducing the prozac... Do you think this is a good strategy?

@Altostrata?

 

01/2008-08/2008 : 20 mg deroxat Crash après 1 mois

01/2009-04/2014 : 20 mg deroxat

Crash au bout de 3 mois 

09/2014-11/2022   : 10 mg deroxat, 0 émotion, 0 énergie, pleine anxiété 

11/2022 : arrêt du deroxat sur 5 jours

01/2023-05/23 : plusieurs dépressions 10 mg Deroxat pendant 4 mois crash

06/2023-11/2023 : 75 mg Effexor aucun effet

SWITCH 01/12/23 : 20 mg de Prozac, diminuer 30 mg de Valium à 2 mg... Crash 28 janvier 

02/01/24 : 20 mg de Prozac, 5 mg de valium pour la nuit.

20/02/24 : 20 mg prozac 4,66 mg de Valium 

1/03/24 : 20 mg prozac 4.33 de Valium

08/03 : 4G Valium

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This was a huge drop of valium from 30 down to 5 in less than 2 months.  I suspect this has caused quite a bit of de-stabilization along with the change/tapering of of venlafazine to prozac.  Doing both tapers at once is risky, but if you do them I think 5% is reasonable.  I would advocate from cutting the benzo first as dependence is so insidious.  As is pointed out on SA, tapering one drug at a time may not always be the best strategy but it is easier to discern what is causing what. 

 

(I suspect your post needs to be moved to your own thread)  A mod will probably to that...

 

Best of luck

Grace

  • amitriptyline from 1980-2002,
  • intermittent  use of benzos over 2 decades prior to 2002
  • 2002-2010 Klonopin 1-2 mg., ambien 10--20, mg, remeron 4 mg. and  trileptal 300 mg
  • 2011 Stopped ambien and crossed over to valium 17.5 mg. (updosing 2.5 mg. to cover ambien C/T )
  • tapered valium w/ long holds to 12.74 mg. from a high of approximately 20-30 mg/day
  • 2015-2023 tapered trileptal to 98 mg.  had to completely stop tapering due to multiple chronic, serious health issues
  • currently 2024 still on 98 mg. trileptal and 4 mg. remeron
  •   Currently on benzo hold as I have to cross-over from brand-name valium to generic diazepam.   The diazepam is way weaker and brought on severe acute w/d
  • Current dose of diazepam is 7.9 and valium is 6.6.  I had to up-dose the total valium/diazepam from 12.74 to 14.5 where I have stayed since June 2023.  I am crossing over to generic at a somewhat tolerable rate of .3mg/month after about 2 months of trial/error w/ updosing.  I am not currently tapering; will continue to cross over. 

 

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IMG_20240202_094653.thumb.jpg.176001717a18812191b9ef994e1b0e5c.jpg

 

Ci-joint le protocole établi !!

 

Merci pour la réponse@grâce salvatrice! Mon psychiatre avait peur que je devienne dépendante du valium et m'a donné des paliers de 5 jours... Sauf que fin janvier j'ai subi une diminution trop brutale du valium et certainement l'arrêt brutal de la venxalafine pour le prozac. L'anxiété est forte mais gérable... Je veux arrêter le valium rapidement mais ce n'est pas possible mon système nerveux en dépend désormais... Les antidépresseurs ne soulagent pas mon anxiété, ils m'ont sauvé de la dépression. J'ai besoin de vos conseils et expériences. Je comptais prendre 4,75 mg pendant 15 jours, 4,50 mg pendant 15 jours...

01/2008-08/2008 : 20 mg deroxat Crash après 1 mois

01/2009-04/2014 : 20 mg deroxat

Crash au bout de 3 mois 

09/2014-11/2022   : 10 mg deroxat, 0 émotion, 0 énergie, pleine anxiété 

11/2022 : arrêt du deroxat sur 5 jours

01/2023-05/23 : plusieurs dépressions 10 mg Deroxat pendant 4 mois crash

06/2023-11/2023 : 75 mg Effexor aucun effet

SWITCH 01/12/23 : 20 mg de Prozac, diminuer 30 mg de Valium à 2 mg... Crash 28 janvier 

02/01/24 : 20 mg de Prozac, 5 mg de valium pour la nuit.

20/02/24 : 20 mg prozac 4,66 mg de Valium 

1/03/24 : 20 mg prozac 4.33 de Valium

08/03 : 4G Valium

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IMG_20240202_094720.jpg

01/2008-08/2008 : 20 mg deroxat Crash après 1 mois

01/2009-04/2014 : 20 mg deroxat

Crash au bout de 3 mois 

09/2014-11/2022   : 10 mg deroxat, 0 émotion, 0 énergie, pleine anxiété 

11/2022 : arrêt du deroxat sur 5 jours

01/2023-05/23 : plusieurs dépressions 10 mg Deroxat pendant 4 mois crash

06/2023-11/2023 : 75 mg Effexor aucun effet

SWITCH 01/12/23 : 20 mg de Prozac, diminuer 30 mg de Valium à 2 mg... Crash 28 janvier 

02/01/24 : 20 mg de Prozac, 5 mg de valium pour la nuit.

20/02/24 : 20 mg prozac 4,66 mg de Valium 

1/03/24 : 20 mg prozac 4.33 de Valium

08/03 : 4G Valium

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Hi None 79,

 

That is a 5% cut which is very do-able, I think although if it were me, I would see how I was doing at 2 weeks before just cutting 5% again.  .25 valium is not a small dose to be cutting.  Go by your symptoms and not by the calendar.  If it takes longer, it takes longer, but believe me tapering from a place of de-stabilization will not work, or at the very least will be a lot harder on you.  As far as tapering prozac goes, I personally, would not taper both of them at the same time unless the side effects are more intolerable than a taper would be.

 

I could not read the image of the note you posted.  I did not know what you were trying to illustrate.

 

Take care,

Grace

  • amitriptyline from 1980-2002,
  • intermittent  use of benzos over 2 decades prior to 2002
  • 2002-2010 Klonopin 1-2 mg., ambien 10--20, mg, remeron 4 mg. and  trileptal 300 mg
  • 2011 Stopped ambien and crossed over to valium 17.5 mg. (updosing 2.5 mg. to cover ambien C/T )
  • tapered valium w/ long holds to 12.74 mg. from a high of approximately 20-30 mg/day
  • 2015-2023 tapered trileptal to 98 mg.  had to completely stop tapering due to multiple chronic, serious health issues
  • currently 2024 still on 98 mg. trileptal and 4 mg. remeron
  •   Currently on benzo hold as I have to cross-over from brand-name valium to generic diazepam.   The diazepam is way weaker and brought on severe acute w/d
  • Current dose of diazepam is 7.9 and valium is 6.6.  I had to up-dose the total valium/diazepam from 12.74 to 14.5 where I have stayed since June 2023.  I am crossing over to generic at a somewhat tolerable rate of .3mg/month after about 2 months of trial/error w/ updosing.  I am not currently tapering; will continue to cross over. 

 

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@savinggrace , this is my withdrawal protocol prescribed by my psychiatrist but I write it to you below: 22/12/23-02/01/24: 5mg morning 10 mg bedtime / 03/01/24-07/01  /24: 2mg morning 10 mg bedtime / 01/08-01/12: 10mg bedtime / 01/13-01/17: 7mg bedtime 01/18-01/22: 5mg bedtime 01/23-01/28: 2mg bedtime  CRASH on 01/29 restored to 5mg at bedtime.  Continuation of the withdrawal which was planned: 01/29-04/02: 2mg every other day then stop.  .  I decided to stabilize at 5 mg of Valium until my appointment on February 19 to switch to drops and not start stopping Prozac for the moment.  THANKS

01/2008-08/2008 : 20 mg deroxat Crash après 1 mois

01/2009-04/2014 : 20 mg deroxat

Crash au bout de 3 mois 

09/2014-11/2022   : 10 mg deroxat, 0 émotion, 0 énergie, pleine anxiété 

11/2022 : arrêt du deroxat sur 5 jours

01/2023-05/23 : plusieurs dépressions 10 mg Deroxat pendant 4 mois crash

06/2023-11/2023 : 75 mg Effexor aucun effet

SWITCH 01/12/23 : 20 mg de Prozac, diminuer 30 mg de Valium à 2 mg... Crash 28 janvier 

02/01/24 : 20 mg de Prozac, 5 mg de valium pour la nuit.

20/02/24 : 20 mg prozac 4,66 mg de Valium 

1/03/24 : 20 mg prozac 4.33 de Valium

08/03 : 4G Valium

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19 minutes ago, None79 said:

@savinggrace , this is my withdrawal protocol prescribed by my psychiatrist but I write it to you below: 22/12/23-02/01/24: 5mg morning 10 mg bedtime / 03/01/24-07/01  /24: 2mg morning 10 mg bedtime / 01/08-01/12: 10mg bedtime / 01/13-01/17: 7mg bedtime 01/18-01/22: 5mg bedtime 01/23-01/28: 2mg bedtime  CRASH on 01/29 restored to 5mg at bedtime.  Continuation of the withdrawal which was planned: 01/29-04/02: 2mg every other day then stop.  .  I decided to stabilize at 5 mg of Valium until my appointment on February 19 to switch to drops and not start stopping Prozac for the moment.  THANKS

I think you have made a good choice. 
I’m always here to listen. 
 

Grace

  • amitriptyline from 1980-2002,
  • intermittent  use of benzos over 2 decades prior to 2002
  • 2002-2010 Klonopin 1-2 mg., ambien 10--20, mg, remeron 4 mg. and  trileptal 300 mg
  • 2011 Stopped ambien and crossed over to valium 17.5 mg. (updosing 2.5 mg. to cover ambien C/T )
  • tapered valium w/ long holds to 12.74 mg. from a high of approximately 20-30 mg/day
  • 2015-2023 tapered trileptal to 98 mg.  had to completely stop tapering due to multiple chronic, serious health issues
  • currently 2024 still on 98 mg. trileptal and 4 mg. remeron
  •   Currently on benzo hold as I have to cross-over from brand-name valium to generic diazepam.   The diazepam is way weaker and brought on severe acute w/d
  • Current dose of diazepam is 7.9 and valium is 6.6.  I had to up-dose the total valium/diazepam from 12.74 to 14.5 where I have stayed since June 2023.  I am crossing over to generic at a somewhat tolerable rate of .3mg/month after about 2 months of trial/error w/ updosing.  I am not currently tapering; will continue to cross over. 

 

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Thank you for your kindness, I will keep you informed of my progress, happy to have found this forum and people who understand the pain I feel!  THX and good luck to you too in getting off these medications 💪

01/2008-08/2008 : 20 mg deroxat Crash après 1 mois

01/2009-04/2014 : 20 mg deroxat

Crash au bout de 3 mois 

09/2014-11/2022   : 10 mg deroxat, 0 émotion, 0 énergie, pleine anxiété 

11/2022 : arrêt du deroxat sur 5 jours

01/2023-05/23 : plusieurs dépressions 10 mg Deroxat pendant 4 mois crash

06/2023-11/2023 : 75 mg Effexor aucun effet

SWITCH 01/12/23 : 20 mg de Prozac, diminuer 30 mg de Valium à 2 mg... Crash 28 janvier 

02/01/24 : 20 mg de Prozac, 5 mg de valium pour la nuit.

20/02/24 : 20 mg prozac 4,66 mg de Valium 

1/03/24 : 20 mg prozac 4.33 de Valium

08/03 : 4G Valium

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