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Narcissus

Stabilizing - what does that mean?

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Narcissus   
Narcissus

I have a few questions for you anti-depressant vets (I think we ought to come up with a snappy name for ourselves) about stabilizing. First, what do we really mean when we say 'stabilize'? I guess understand stabilizing to mean adjusting to an altered dose of medication. The implication is that there is a temporary period of instability following a change in dosage in a medication, whether we've gone down or up on a familiar drug, or we're starting a drug for the first time. But what does stabilizing mean after withdrawal syndrome has kicked in? For example, I want to 'stabilize' on my 75 mg of dosage Effexor (half of my original dose) before trying to taper down again. It's been about two months and I'm still having very dramatic waves of symptoms, and I get the sense that while they may decrease in intensity I'll be dealing with them for a while. Ugh. My brain isn't working very well tonight. Here is my question: At what point can we say that we've 'stabilized' at a certain dosage and are to begin tapering again when we've already entered the withdrawal syndrome stage, which seems so inherently unstable? It seems like we must be looking for a place of very relative stability, but how can we tell when we've reached it and are ready to go down again? Is this just a personal judgment call?

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primrose   
primrose

I'm an AD vet, but I have not started tapering my AD as I am tapering other meds.

What does stabilizing mean after withdrawal syndrome has kicked in?

 

To me, it means not being debilitated by your withdrawals, so that activities of daily life are disrupted.

Holding your dose and monitoring it (a journal is a good idea) and your instincts will tell you when you feel strong enough.

I need to be clear on the above, really in order to try and help.

 

I am not knowledgeable with tapering antidepressants, and have read on here that going back up may not work.

 

Some members of benzo forums on short acting benzos have found it helpful to split their dose evenly and take at evenly spaced intervals over the 24hours.

 

I am not sure, however, if you could do the same for effexor, so I urge you not to try this without first speaking to someone who is knowledgeable enough about coming off SNRI's like effexor, to tell you if 'the benzo way of stabilizing'

.

Edited by scallywag
deleted quote of immediately previous post for readability

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Skyler   
Skyler

I'm an AD vet, but I have not started tapering my AD as I am tapering other meds.

What does stabilizing mean after withdrawal syndrome has kicked in?

 

Stabilizing withdrawal symptoms, so they hopefully disappear completely between cuts. If after several months the symptoms do not fully disappear, some people will want to taper judiciously, watching that the overall level of symptoms do not increase in the process.

To me, it means not being debilitated by your withdrawals, so thatactivities of daily life are disrupted.

Holding your dose and monitoring said (a journal is a good idea) and your instincts will tell you when you feel strong enough.

I need to be clear on the above, really in order to try and help.

Your life should stabilize as withdrawal symptoms decrease but the way we use the word stabilizing is very direct... stabilize withdrawal symptoms.

 

Let me use myself as an example. I have tinnitus from withdrawal that was just aggravated because I tapered too fast (LOL, not by alot but by by enough!). I was being careful but not careful enough, so now I'm holding for another two months to regain my footing, so to speak. At that time, tinnitus may still be there, but it will be very faint. Then it will be possible to taper without every reduction causing an uptick in symptoms (and making me utterly miserable in the process)... this is my stable..

 

Stable may be somewhat different for each of us, depending on how withdrawal manifests, but if the symptoms do not entirely remit, when tapering recommences, there should be no significant fluctuation when a small cut is made.

Edited by scallywag
increased font size so that great information is legible. :)

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primrose   
primrose

 

I'm an AD vet, but I have not started tapering my AD as I am tapering other meds.

What does stabilizing mean after withdrawal syndrome has kicked in?

 

To me, it means not being debilitated by your withdrawals, so that activities of daily life are disrupted.

Holding your dose and monitoring it (a journal is a good idea) and your instincts will tell you when you feel strong enough.

I need to be clear on the above, really in order to try and help.

 

I am not knowledgeable with tapering antidepressants, and have read on here that going back up may not work.

 

Some members of benzo forums on short acting benzos have found it helpful to split their dose evenly and take at evenly spaced intervals over the 24hours.

 

I am not sure, however, if you could do the same for effexor, so I urge you not to try this without first speaking to someone who is knowledgeable enough about coming off SNRI's like effexor, to tell you if 'the benzo way of stabilizing'

 

Sorry, my above post does not make sense and should be dis-regarded.

I have changed it below (see red text) so that it makes sense.

 

I'm an AD vet, but I have not started tapering my AD as I am tapering other meds.

 

What does stabilizing mean after withdrawal syndrome has kicked in?

 

To me, it means not being debilitated by your withdrawals, so that activities of daily life are disrupted.

Holding your dose and monitoring it (a journal is a good idea) and listening toyour instincts will tell you when you feel strong enough.

 

As you are suffering withdrawals at the moment, I am interested to know how you got down to 75mg effexor, did you halve the dose or did you rapid taper?

I need to be clear on the above, really in order to try and help.

 

I am not knowledgeable with tapering antidepressants, and have read on here that going back up may not work.

 

Some members of benzo forums on short acting benzos have found it helpful to split their dose evenly and take at evenly spaced intervals over the 24hours.

 

I am not sure, however, if you could do the same for effexor, so I urge you not to try this without first speaking to someone who is knowledgeable enough about coming off SNRI's like effexor, to tell you if 'the benzo way of stabilizing' is also suitable for stabilising on effexor or not

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Skyler   
Skyler

The concept of stabilization as used here is the same for ADs, benzos or any other class of psychotropic drug.

 

Stabilizing in this context means getting to the point that withdrawal symptoms disappear, hopefully completely between cuts. If after several months the symptoms do not fully disappear, some people will want to taper judiciously, watching that the overall level of symptoms do not increase in the process.

Most people are stable on psychotropic medications before their first taper, so there are no withdrawal symptoms. Holding helps to stabilize withdrawal symptoms that are acquired while tapering, going off CT, etc. The meaning of stabilization does not change with the drug. (And the steadier the dose in your system, the more stable you will be and so there are no resulting withdrawal symptoms) Withdrawal symptoms include those which are 'physical' as well as neuroemotions, the latter experienced as emotional while they are actually physical in origin. When withdrawal symptoms subside, your quality of life is better as your ability to cope with the daily demands of living improves.

 

So stable means few or no withdrawal symptoms, whether physical or emotional. The concept of stabilization as used on this forum does not refer to lifestyle issues, though those are obviously impacted when people feel unwell. Most people stabilize when they hold (sometimes for as long as several months), and if symptoms do not entirely remit during that time, they become more manageable.

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primrose   
primrose

The concept of stabilization as used here is the same for ADs, benzos or any other class of psychotropic drug.

 

Stabilizing in this context means getting to the point that withdrawal symptoms disappear, hopefully completely between cuts. If after several months the symptoms do not fully disappear, some people will want to taper judiciously, watching that the overall level of symptoms do not increase in the process.

Most people are stable on psychotropic medications before their first taper, so there are no withdrawal symptoms. Holding helps to stabilize withdrawal symptoms that are acquired while tapering, going off CT, etc. The meaning of stabilization does not change with the drug. (And the steadier the dose in your system, the more stable you will be and so there are no resulting withdrawal symptoms) Withdrawal symptoms include those which are 'physical' as well as neuroemotions, the latter experienced as emotional while they are actually physical in origin. When withdrawal symptoms subside, your quality of life is better as your ability to cope with the daily demands of living improves.

 

So stable means few or no withdrawal symptoms, whether physical or emotional. The concept of stabilization as used on this forum does not refer to lifestyle issues, though those are obviously impacted when people feel unwell. Most people stabilize when they hold (sometimes for as long as several months), and if symptoms do not entirely remit during that time, they become more manageable.

 

Hi Scuyler

 

Withdrawal symptoms include those which are 'physical' as well as neuroemotions, the latter experienced as emotional while they are actually physical in origin.

Why am I having such a struggle trying to get my doctor, or anyone for that matter, to understand neuroemotions being physical in origin?

 

Thanks

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Skyler   
Skyler

Why am I having such a struggle trying to get my doctor, or anyone for that matter, to understand neuroemotions being physical in origin?Thanks

Because unfortunately, most docs are clueless about withdrawal, same as the keyworker you talked about. That's why it's good to take materials from resources like Bliss Johns when you go for appts, and just pray the doc is open to what you want to share.

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primrose   
primrose

 

Why am I having such a struggle trying to get my doctor, or anyone for that matter, to understand neuroemotions being physical in origin?Thanks

Because unfortunately, most docs are clueless about withdrawal, same as the keyworker you talked about. That's why it's good to take materials from resources like Bliss Johns when you go for appts, and just pray the doc is open to what you want to share.

 

Hi Sculyer and thanks.

I read Bliss Johns page not so long ago and while it would be wonderful for my doctor to read that page, I am certain that she will just tell me she hasn't got time.

She never even rang Battle Against Tranquilisers.

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Skyler   
Skyler

Hi Sculyer and thanks.

I read Bliss Johns page not so long ago and while it would be wonderful for my doctor to read that page, I am certain that she will just tell me she hasn't got time.

She never even rang Battle Against Tranquilisers.

Could well be she did not (you took a copy of the page with you??.. they won't go to an URL). Half the battle is advocacy, just as long as doc gives you what you need to taper yourself. You may never get validation from her, but the ability to taper slowly is where it's at.

 

Hope you made out okay with the keyworker.

 

Schuyler

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primrose   
primrose

Hi Schuyler

 

No I didn't take the bliss johns page with me because I did not want the 'kick in the teeth feeling' of her saying she doesnt have time, or pretending to read it and just skimming through.

My keyworker does not understand the withdrawal problems niether so I feel like suffering caused by other people is being ignored and penalised. I am on welfare so if they do not acknowledge the suffering from the withdrawal, they cannot support withdrawal in my application for welfare, so those who pay it will not have supporting evidence. These are my fears, however I intend to create my own income so that I no longer have to rely on welfare, and so that it no longer matters whether people acknowledge my suffering or not.

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Rhiannon   
Rhiannon

 

What does stabilizing mean after withdrawal syndrome has kicked in?

 

To me, it means not being debilitated by your withdrawals, so that activities of daily life are disrupted.

 

That's pretty much how I see it too. Plus, having it be like that not just on occasional good days, but on more days than not. Ideally all the time with maybe occasional small wobblies. When I get to where I feel about 80% steady and not symptomatic, I consider that pretty stable.

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Nikki   
Nikki

Hi everyone....

 

Good question. I could mean different things to each one of us, depending on the WD symptoms and how hard they hit. That was my first thought.

 

During a Lexapro taper, it meant, that I would stop crying and the anxiety would abate, AND the neuro-emotions would subside and I could laugh and let things go.

 

With Celexa...yes, there are the neuro-emotions after a drop (crying, hopelessness, wired/fried brains) and then it subsides and if I stay put for a long enough time, I feel just fine. Able to carry on and see life thru a better color glass.

 

I think the drug may affect all of this, some are worse than others.

 

I am not looking at my self as WDing this time around. I am looking at differently or somewhat different. I am getting off of Celexa, dropping after a good amount of time, living my life and then dropping again at some point in time. Working better for me this way.

 

Hugs

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jr1985   
jr1985

Hmm, I thought stable was when you had zero withdrawal symptoms. The presence of withdrawal symptoms indicates your nervous system is unstable, so isn't it best to hold until they go away completely? Even if they are manageable, surely reducing the dose, even by tiny amounts, could cause debilitating symptoms in the future?

 

At the minute, I am holding my Effexor dose in hopes that any symptoms I have will eventually disappear, as my nervous system regain stability, after the battering I gave it with all the drug switching, etc. Am I just wasting my time? Should I taper regardless? I can still live my life, etc but couldn't starting a taper now cause more serious problems?

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Narcissus   
Narcissus

Jr, I'm having the exact same dilemma at the moment. It's been over two months trying to stabilize, and it just doesn't seem to be happening. I get the sense sometimes that starting a taper might actually relieve some of my symptoms. Is this possible? Or does dropping down always further destabilize things? Has anyone ever experienced relief from lowering their dose? I really don't know if I can keep waiting this out.

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Nikki   
Nikki

Yes I have. It happened a number of times with two different drugs at two different periods of time.

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Narcissus   
Narcissus

^Thanks, Nikki. If I've been at the same dose for two and half months without much improvement should I consider trying a small reduction? What do you think about this Alto?

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Altostrata   
Altostrata

pgd, you have such a complex history with the medications, I don't know what to say.

 

Sometimes people report stabilizing over 6 months. Other times, reinstatement does not completely work. So I can't say if it makes sense to hold or reduce in your situation.

 

If the medication is not causing adverse effects, I suggest holding. So-so stability is better for your nervous system than no stability.

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lexicon   
lexicon

And what are the chances that someone like me, who had two AD 'S dropped within 15 days, and has been, and is completely in distress, totally unstable, and debilitated after almost 3 months?

What are chances that I can stabilize in this century?

Thank you for any input ..

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Altostrata   
Altostrata

People heal at different rates. In 6 months, you might find you're much better.

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basildev   
basildev

Yeah

 

I'm still experiencing fluctuating sleep after 2 months (since updosing). I'm beginning to wonder if I'll ever get better. It's comforting to know that others here have take longer than the seemingly 'average' 4-6 weeks to completely stabilize.

 

(Not that I want to take any pleasure whatsoever in other people's discomfort!)

 

I wish I could believe my sleep is going to get back to normal. Everything else has(:

 

I'd love to hear from anybody who has experienced complete (symptom free) stabilization after updosing/reinstating, but had to wait a much longer than average time for this to happen(EG: months instead of weeks).

 

Anybody out there?

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strawberry17   
strawberry17

I'm interested in this as well Basildev, I'm in a similar boat and wondering if I'll ever get back to normal.

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Rhiannon   
Rhiannon

I'm beginning to wonder if I'll ever get better. It's comforting to know that others here have take longer than the seemingly 'average' 4-6 weeks to completely stabilize...I'd love to hear from anybody who has experienced complete (symptom free) stabilization after updosing/reinstating, but had to wait a much longer than average time for this to happen(EG: months instead of weeks).Anybody out there?

 

After a severe CT in 2009 it took me about six months to get to feeling stable again. I've seen this in dozens of people, here on this forum and elsewhere.  It's not at all uncommon, especially after a CT or a series of ups and downs in dosage or a series of changes of meds, to take many months to stabilize; sometimes a year or more.

 

Seems like everyone does get better eventually, though. I know there must be rare exceptions, but from what I've seen they're extremely rare.

 

Anyway, months instead of weeks is a common variation.

 

It does require more patience but it's not a sign of a bad outcome. Many people have gone through spells like this, stabilized, and then gone on to do slow tapers quite successfully. 

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basildev   
basildev

That's very comforting to know, Rhi.

 

For my part it's definitely months.

 

I'm learning to just take it as it comes now.

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abir   
abir

it seems that it is going to be months for me too... it has been 3 months since re-instating, but i still have not stabilized yet, lthough I am feeling better now...

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Rhiannon   
Rhiannon

That's very comforting to know, Rhi.

 

For my part it's definitely months.

 

I'm learning to just take it as it comes now.

 

With your history I would expect it to take a while. You've gone up and down a number of times now rather traumatically, it sounds like, if I'm reading your sig line right. Like Alto says, our nervous system (not to mention endocrine) isn't made of rubber. I know I used up all my slack a long time ago.

 

If and when you decide to taper again I think you'd probably do better with smaller cuts and longer holds--especially the long holds. Plan on taking at least a couple of years.

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basildev   
basildev

With your history I would expect it to take a while. You've gone up and down a number of times now rather traumatically, it sounds like, if I'm reading your sig line right. Like Alto says, our nervous system (not to mention endocrine) isn't made of rubber. I know I used up all my slack a long time ago.

 

You're right Rhi,

 

In fact my last taper was too fast. In hindsight I was actually cutting by 25% and that's why I got into trouble. I was feeling fine so was cutting faster, then it all caught up with me. Then I added the whole Valium debacle into the mix and I'm now trying to stabilise from that mistake!

 

 

 

it seems that it is going to be months for me too... it has been 3 months since re-instating, but i still have not stabilized yet, lthough I am feeling better now...

 

Abir, I have been following your story and you've made huge progress since your first post here. Often others can see our progress more clearly than we can:). I believe you will fully recover.

Edited by Petu
fixed text

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abir   
abir

 

Abir, I have been following your story and you've made huge progress since your first post here. Often others can see our progress more clearly than we can:). I believe you will fully recover.

 

I hope so, and I hope the same for everyone on this site...

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misterZ   
misterZ

Hi All,

This is my first post.  I've been consistently on ADs in various combinations for 20 years.  I got got off everything about five years ago in a difficult taper and stayed off for about three month untill the stress and super- rapid cycling got the best of me and I started back on ending up at 300mg Wellbutrin XR, 300mg Lamictal and 900mg Neurontin.  I have functioned, at least holding down a responsible job, taking care of a disabled parent, who died six months ago and a disabled sibling.  But my personal life isn't good. All my relationships are tainted by my anxiety. Any, six weeks ago I started to taper the Lamictal, 50mgs a week and it went smoothly, but when I got to zero, after a few days I started to feel really bad, fuzzy headed, anxious (sorry I can't better describe it).  At that point I called my psychiatrist who said to go back up on the Lamictal,  I immediately took 50mg and in a hour a so I felt okay. (that's my contribution to the topic)  Now I've started to go down on the Neurontin, 800mg as of three days and it's tolerable.  I'm seeing the doc tomorrow to strategize on how best to continuing to taper.  I guess I don't really have any questions as I've read about the ideas of super slow tapering and doing the ADs first, (of course I'm ignoring them by doing a fast Lamictal taper and moving on to the Neurontin instead of the Wellbutrin).  Patience isn't my strong suit.  I'm happy to have found this site.

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sunflower   
sunflower

Dear Fellow Survivors:

 

Do most of you stabilize after a dose reduction and notice an improvement of WD sxs? How long does it typically take to stabilize (e.g., weeks...months)?

 

The reason I'm asking is because when I was tapering Klonopin I typically did not stabilize. However, because I felt better so much better with each drop, I continued to taper without waiting to stabilize.

 

Any feedback is appreciated.

 

Thank you.

 

Sunflower

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Altostrata   
Altostrata

Hi, sunflower. From what I've seen, most people stabilize within a few days after a reduction. Some do not feel it at all.

 

I changed the title of this topic because I think that there's a lot of variation and the experience of others will be very informative.

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Rhiannon   
Rhiannon

You might enjoy reading through this topic:

http://survivingantidepressants.org/index.php?/topic/3949-what-does-stabilizing-mean/

 

I'm doing a micro taper and I adjust my cuts and holds according to life stressors and how I'm feeling. Seems like I generally feel the cuts within two to four days after making them, and then I hold for however long it takes (usually a week or two, with the micro cuts). I definitely do stabilize and feel better, although if I know I have a period of time with not much stress coming up, I will push it and make a couple more small cuts before I'm fully at my best. I know I'm going to feel crappy for a while as a result but I know I will hold and it will pass.

 

When I hold for a longer period I am (so far) always rewarded with a spell of feeling pretty good, which lasts even after I start cutting again, for a while.

 

I have always felt better after holds and I have never done well with the "keep cutting even if you're suffering" approach, although some people apparently do okay with that. As always, our own bodies are the experts.

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aberdeen   
aberdeen

I used to notice my drops somewhere after the first week. I will wake up extra anxious and feel more jumpy and shakey, with DR...for a few days. Once i got below 3mg or so, Ive noticed the symptoms take longer to show up. Also in there, have been random spells where I just get a wave, be it depression, higher anxiety, DR, in any combination, and there seems to be no connection to any specific timeframe...it might last  a few weeks, or just a few days. When I have these spells, and its time to drop, I will sometimes wait another week and re-assess. I cant say my drops are causing much issue. My biggest issue is anhedonia and anger...and that I think has to do with the situation that occured prior to my tapering. I had a tolerance reaction to Effexor, it was intense and horriible and caused me to come off much too fast and then switch around a few meds all in 3 months time, which made everything worse. By the time i started tapering, i was already in a scenario of seeing windows and waves, and having anhedonia creeping up for the long haul, so I  cant ever say Im 100% between drops, for that reason. I drop 10% every 4-5 weeks, sometimes longer.

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sunflower   
sunflower

Dear Rhi and Aberdeen,

 

Thanks for your input! Really appreciated!

 

Sunflower

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JanCarol   
JanCarol

Bump.  Stability.  

 

My big lesson for today is that a hold is harder work than a taper.

 

We get impatient and want to take it down and down, or a pdoc pressures us into discontinuing since we're not at "therapeutic levels" anyway.

 

But to hold.  And hold.  And hold.  and wait until you're not suffering before you do a cut - and plan that cut weeks in advance.  And talk it over here, in SA, and with your support team if you have it.  If you hear enough people say, "I think you're doing really well," then a plan your next taper. 

 

Most of you are young, a year or two added to your taper is nothing - especially since you start to feel immeasurably better once you get down to 50% of "therapeutic dose."  Your head starts to clear, you start to take interest in things, you may care more about people, or even feel creative again.  And that's the payoff for the head zaps, blinding flashes, gut trouble, sinus difficulty, restlessness - that you had to go through to get there.

 

Holding is the key, for me.  It makes me feel like I am in control of the process.  If my life is disrupted, then it's time to hold.  If I'm having health issues or symptoms, then it's time to hold.  Holds are my friend, and I can feel the healing taking place during them.

 

But there is a possibility of permanent damage.  And maybe holding forever just increases the side effects you are suffering.  It's really difficult, in withdrawal, to separate drug side effects from w/d.  In that case, trying a taper is probably warranted, if the hold doesn't seem to be improving things.  You can always reinstate if it goes amiss.  And by tapers and reinstate, I'm talking the smallest possible amount.  5% maybe.  What I think of as a "test taper" to see if it's okay.

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