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Cberg

Extreme difficulty when in final stretch? Stay on low dose forever?

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Cberg   
Cberg

Hello,

 

I am down to 4 mg of Paxil. I was lower but had to go back up. Why am I having so much trouble with these last 4 mg? I've had a real increase in my nausea, and also that awful feeling where you don't want to do anything and don't enjoy doing anything. Is this 'normal' when you get down toward the end of tapering? It seems like when you are that low, things should get easier not harder.

 

 

cberg

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indigo   
indigo

 I feel for you. I am also down to 4mg of Prozac and my last drop of 5mg was really difficult.

So hard in fact that after a month with no sign of stabilizing, I wondered if I'd ever be able to

get off this drug. And if this was the state I'd be in be in taking 4mg then I'd have to go back up. 

Recently an article was posted on this blog about the precipice towards the end oftapering down off a drug.

Showed great graphs of how tiny increments of dropping have more impact.

Apparently cutting down way less at a time towards the end of your taper, 

makes for a less nightmarish adjustment.

Possible to have your holds shorter.

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bubble   
bubble

Hi Cberg,

 

your observation about difficulties with tapering at low doses is very valid. Contrary to what we would expect, it does get harder.

 

This thread explains why this is so.

 

http://survivingantidepressants.org/index.php?/topic/6036-why-taper-paper-demonstrates-importance-of-gradual-change-in-plasma-concentration/

 

Hope it helps. In any case, we advise going extra slow at low doses. 

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mammaP   
mammaP

I'm also finding it hard at the low dose, it has to be slowed right down with extremely tiny cuts for some people.

If you can get, or make a liquid it would be much easier to get the lower doses.

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Sparrow   
Sparrow

I've gotten down to 2.0 mg Lexapro three times in the past year and had to updose due to unbearable symptoms. Can't seem to break through this barrier after more than 20 years on ADs. Very frustrating and disappointing after successfully withdrawing  from so many other drugs. And so close to the end...maddening.

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mammaP   
mammaP

I think a long hold would be best Sparrow, I see you updosed to 4mg in June and 3 months later you had dropped to 

2.7 which was more than 25% , without much time to stabilise from the updose. If you get what I mean? 

 

The liquid is better because you can dilute it to get tiny doses.  You can draw up the dose into a syringe then expel

5% of that dose back into the bottle and take the rest. When it gets too low for the syringe to measure it can be diluted.

Many people have success with tapering liquids at the very low doses, you just need to be able to work out the figures.

and have long holds in between.

If you find the figures difficult there are some members who are good at maths and would be happy to help. I'm not one of

them I'm afraid .  :blush:

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Micromonster   
Micromonster

I feel for you, take it slower. I vowed never to withdraw again after I got down to 6.8mg (from 15 years of 30mg). The Wd was horrendous. Went straight back up to 10mg (the last dose I was stable at). I took a 6 month break from tapering but am now trying again. I'm doing 5% every 3 weeks and may even go slower. The lower You get, the harder it is. Hugs. X

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Rhiannon   
Rhiannon

You're probably making your cuts too large. What's a small cut at 30 mg (3 mg for example, which is 10%) is a huge cut at 5 mg (3 mg of 5 mg is more than 50%).

 

It's pretty much universal that we need to slow down at the lowest doses. 

 

I would say, hold for a while until your symptoms settle down (which might be a few months), then try a smaller cut, maybe 5% of your current dose, and see how that goes.

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indigo   
indigo

I'm using a 1 mL syringe for pharmacy liquid prozac. Not mixed from powder. I'm now down to very low dose of 92 mL.

Each little black line is a 2% drop which wrecks my life for at least a couple of weeks.

Are there 1 mL syringes with more lines that are finer?

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Rhiannon   
Rhiannon

Indigo, does your liquid dissolve in water? You might try doing a dilution.

 

Also 92 mL sounds like a heckuva lot, especially if you're measuring it out 1 mL at a time with a 1 mL syringe. What am I not understanding here? Did you mean 0.92 mL?

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indigo   
indigo

Yes. I meant 0.92. I'm a bit dislexic about numbers. Not sure if this prozac liquid )from pharmacy)

would dissolve in water. Plan on looking into that. Diluting will be necessary when I get to lower doses. 

My last drop was  really wretched. So relieved I'm leveling off. Plan on taking a rest before dropping again,

and then a micro drop.

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Rhiannon   
Rhiannon

Sounds like a good plan to me!

 

You can ask your pharmacist about the liquid in water, but if you have the ingredients and one of them is water, it's probably good.

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DLB   
DLB

Going through this now at.32 mg. Paxil. I can't believe I felt fine last weekend and lowered from .48 to .32 and now severe fog and weakness. I thought I was pretty much safe. How do people just jump at 1 mg.? Had severe insomnia last week and then back to my normal insomnia. This is beginning to wear on me. Hope this works itself out.....

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Micromonster   
Micromonster

Could you still be getting wd symptoms from the drop you made 15th jan? I know mine peak after 2 weeks. I agree most people would try and jump at 1mg, I'd certainly be tempted.

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DLB   
DLB

Could be micro, it may have crept up on me. I just have a hard time believing that anything below 1 mg. can give us problems. I just want to be a fun dad for my kids again.

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aberdeen   
aberdeen

Hi DLB

I remember you from pp. I too have trouble believing we can have issues at such low doses but I see it happening to others! I do notice for me I can have drops that have very little effect, and drops where I feel awful. Sometimes I think its just our brains catching up from previous drops, and it would have happened regardless. I tend to keep my drops pretty regular, exactly 10% every 4-6 weeks. I have to believe if each 10% was wreaking havoc on my system, it would happen each time, but it doesn't. I would just keep an eye on things and not rush, you crashed a while back and that in itsself can take awhile to recover from. I just think we have to always keep in mind what happened previously, even several months prior, becaue that can have lingering intermittent effects. I also want to say that I really feel for you having small kids, I just want to be a fun mom too...not a yelling impatient boring one. This sucks, but we will get there. Just give yourself time. 

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indigo   
indigo

I'm finding my WD symptoms to be very unpredictable now that I'm down to such a low dose.

It makes me anxious not being able to predict when it will hit me and how severely.

So that it doesn't seem so random I keep looking for patterns and factors I can understand.

I came across this article that made sense to me. What do you think?

https://www.scribd.com/doc/219046742/Limibic-Kindling-hard-wiring-the-brain-for-hypersensitivities 

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Rhiannon   
Rhiannon

Hi Cberg,

 

your observation about difficulties with tapering at low doses is very valid. Contrary to what we would expect, it does get harder.

 

This thread explains why this is so.

 

http://survivingantidepressants.org/index.php?/topic/6036-why-taper-paper-demonstrates-importance-of-gradual-change-in-plasma-concentration/

 

Hope it helps. In any case, we advise going extra slow at low doses. 

 

 

Could be micro, it may have crept up on me. I just have a hard time believing that anything below 1 mg. can give us problems. I just want to be a fun dad for my kids again.

 

Take a look at the charts at that link, you can see that under 1 mg there is still quite a ways to go.

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Micromonster   
Micromonster

Interesting link rhi, although it's also quite scary and intimidating! "The road is long, with many a winding turn!"

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Rhiannon   
Rhiannon

I'm finding my WD symptoms to be very unpredictable now that I'm down to such a low dose.

It makes me anxious not being able to predict when it will hit me and how severely.

So that it doesn't seem so random I keep looking for patterns and factors I can understand.

I came across this article that made sense to me. What do you think?

https://www.scribd.com/doc/219046742/Limibic-Kindling-hard-wiring-the-brain-for-hypersensitivities 

 

We have a thread somewhere on limbic retraining, I believe. I've worked with it some for my MCS and I do think it probably applies to psych med withdrawal as well. Would love to hear other peoples' experiences with this, preferably in that thread however rather than hijacking this one.

 

http://survivingantidepressants.org/index.php?/topic/2761-neuroplasticity-and-limbic-retraining/

 

http://survivingantidepressants.org/index.php?/topic/6175-limbic-kindling-hardwiring-the-brain-for-hypersensitivity/

 

looks like there are a couple of them.

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DLB   
DLB

Hi DLB

I remember you from pp. I too have trouble believing we can have issues at such low doses but I see it happening to others! I do notice for me I can have drops that have very little effect, and drops where I feel awful. Sometimes I think its just our brains catching up from previous drops, and it would have happened regardless. I tend to keep my drops pretty regular, exactly 10% every 4-6 weeks. I have to believe if each 10% was wreaking havoc on my system, it would happen each time, but it doesn't. I would just keep an eye on things and not rush, you crashed a while back and that in itsself can take awhile to recover from. I just think we have to always keep in mind what happened previously, even several months prior, becaue that can have lingering intermittent effects. I also want to say that I really feel for you having small kids, I just want to be a fun mom too...not a yelling impatient boring one. This sucks, but we will get there. Just give yourself time.

 

. Thanks Aberdeen , hope your doing good. Yeah, I had a horrific time at around 2.5 in September. I also have been going faster than I should but I really feel like this stuff is poisoning me so I sped up a little and I'm sure you are right about it catching up to me.. Now for the good news, I am now at .25mg. And all head pressure is gone, head fog 95%better, anhedonia about 65% better and sleeping 5 hours a night consistently and just feeling better than I have in months and so far it has been almost 2 weeks of this! I know that this can change at any moment but this is a good sign I think. Just got over bad back muscle pain and am now dealing with real sore knees for 2 weeks though....nice to hear from you and I hope you are doing well. I also find that as much as I like to stay informed on here, I feel better not constantly reading all the misery that has happened to all of us, so I'm not on here as often even though it helps a lot to hear from everyone to give peace of mind that it's not just me.

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indigo   
indigo

Thanks Rhi for adding these links. I had a childhood pervaded by emotional trauma and have noticed over the years how a certain stressful situations 

can trigger very intense emotional response. My Dr diagnosed this as PSTD. Because of this was interested to learn how chronic

anxiety and stress in childhood can cause brain changes and hyper-sensitivity. 

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Rhiannon   
Rhiannon

Thanks Rhi for adding these links. I had a childhood pervaded by emotional trauma and have noticed over the years how a certain stressful situations 

can trigger very intense emotional response. My Dr diagnosed this as PSTD. Because of this was interested to learn how chronic

anxiety and stress in childhood can cause brain changes and hyper-sensitivity. 

 

Yep, actually the limbic retraining stuff is interconnected with the same mechanisms in the brain that are involved in PTSD, which I definitely have, due to horrific childhood abuse and trauma.

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camel   
camel

Hey all,

 

As you can see in my signature, i'm not a newbie in tapering and i am on a very small dosage now.... But these last bits seem extemely hard to get rid off. I'm now on a stable dosage for some months, but start having a awkward feeling in my head last couple of weeks. I can't think clear, have a little headache, i am not being able to actually think and feel absolutely tired in my head... Monday howerver, i have a very important job interview (i absolutely want that job and i have a good chance at getting it)...

 

I consider a small updose (from 7.7% to 10%) in order to feel fine again and get that job... However: going from 10% to 7.7% has cost me half a year... On the other hand, if i feel like this, i'm not going to be able to succesfully do this possible new job.... And i just want to feel fine/normal again... What should i do?

 

Second question: I spend the last years on relatively small dosages, but getting rid off them completely seems so, so hard... Is this a common thing? 

 

Grs,

Camel

Edited by KarenB
merged similar topics

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SquirrellyGirl   
SquirrellyGirl

Hi Camel, 

 

I'm not really understanding your sig using the percentages.  It would be more helpful if you could present your history in terms of mgs.

 

Have you experienced any stressors relative to these symptoms rising up?  It could be that the stress of this interview could be enough to cause a little wave.  I know many, including myself, have had wd symptoms pop up when subjected to stress, even while tapering.  I would NOT make any changes right now with the interview so close, because the change itself could create symptoms which themselves could disrupt your interview.  Besides, it takes four days for a dosage change to become steady-state.  Also, the fact that you were otherwise stable before these symptoms came up a couple of weeks ago means that the dosage you are on was actually ok, with your nervous system adapting to that dosage, so up-dosing doesn't make any sense and could even cause an adverse reaction.

 

I am thinking that your best bet would be to practice some self care that focuses on calming, meditation/mindfulness, EFT tapping, etc.

 

SG

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Junglechicken   
Junglechicken

Very best of luck with the interview Camel!

 

You will nail it I'm sure :0)

 

Best,

JC

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camel   
camel

I don't think i experienced any stressor, i have that job interview monday, but i'm surprisingly calm about it... (maybe unconsiously?). It really started last week, when i went out all day for a long walk in the first sunny day of the year. In the morning, i felt fine, but throughout the day i got a severe headache and felt really head-tired and dizzy... I thought it would go over after a couple of days, but it didn't although it became less severe... Could it be like 'seasonal affective disorder'? Before i was on meds, i never suffered from this... (WHY did i take thes 'meds' anyway... :-( )

 

Updosing is tempting, because when i updose, i feel immediate positive effects (my ssri worked from day 1 immediately without bad effects, the same with the few updoses i did) but i know updosing will keep me longer (again) on these meds i want to get rid off and i may suffer later with the same problem... I didn't updose today..

 

Today i experience a sort of dull feeling in the brain part behind my ears a slight headache in de front part of the brain along with a bit of dizziness. I don't feel anxiety or stress, but resignation.  Are these common symptoms? Sometimes i think it's the 'depression' coming back, but on the other hand, i have felt good on this dosage...but maybe i still 'need' a slighter higher dosage?

 

What are your thoughts? Is it likely that i need this small amount of ssri in order to treat depression or is this dosage simply to small to treat anything and is it pure withdrawal... At wich dosage i should jump off? Are the symptoms i described common withdrawal symptoms? I've had the numb feeling before, but now i'm on a stable dosage for 3.5 months and did go very slow the year before... So i think it's strange to experience it now... Are you in withdrawal more prone to seasonal affective disorder?

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camel   
camel

There seems to be great difficulty in the final stretch. The assumptium is that low levels of ssri has huge impact, so very small alterations in dosage leads to huge impact. On this subject i was wondering the following:

 

* we use digital scales to define the dosage, but are these scales really accurate (especially on low weights)? This could lead to daily small differences in dosage, but these small differences can have huge impact?

* is the way the body absorbs these meds 100% constant? i mean, could the way the body absorbs these meds be subject to what we eat, stress,changes in body weight,... if this is so, this could also lead to small changes of dosage absorbed wich have great impact.

 

Any thoughts on this subject?

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SkyBlue   
SkyBlue

Hi Camel,

 

These are great questions.

 

I find it so counter-intuitive that the lower doses are so difficult. ?????

 

Re: Digital scales: That is an excellent point and one that would cause me paranoia if I was using a scale (I'm using liquid). In scientific/engineering settings when they use super-sensitive scales, they have to even account for the air that is in the room and on the scale. So how might this translate to tiny beads or dust of medicine???

 

We can't / don't currently know about changes in absorption based on stress /weight changes/, but extremely worthwhile to think about. Especially when we know that WD is in itself a huge stress on the system. 

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camel   
camel

Hi all,

 

I'm struggling for almost 2 years now to get rid of the last bits of these meds. i recently updosed to 5,2mg of zoloft. 3.9mg was the lowest i've ever been. During those 2 years i've really taken it slowly with drops <10% for severel months. This is the second time i have to updose and waste my tapering...

 

I'm really considering to end my taper and stay on this 5,2mg. I mean, it's not a high dosage and i'm really done with this tapering disturbing my life and having a breakdown where i need to updose again. One of my concerns is the long use of a medecine. Are there any long term risks known with SSRI use? And how does this relate to dosage? The 'normal' dosage is 50mg, so if i take 1/10th of the dosage, does this mean the long term risks are also reduced to 1/10th? Is one year of 50mg use equivalent to 10 years of 5mg use in respect of possible long term negative heath harms? Any studies or personal experiences?

 

 

 

 

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AmyK   
AmyK

Hi Camel.

I am so sorry you had to updose. When did you do that?

Have you tried smaller drops, like 2-5 %?

That could be easier.

 

(I am tapering zoloft too.)

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peggy   
peggy

Hi Camel,

 

i understand exactly where you are coming from - i have tried to go slow too - probably not slow enough considering that i have been on for 16 years - but i always hit a hump around about 18mg effexor - at the moment i have decided to stop tapering again, have updosed and will sit for a while - i may have to pay the piper one day, but no one knows what the future holds. I am really sad about it, but have to do what i have to do to keep me functioning.

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camel   
camel

Thx for the responses AmyK and Peggy

 

Hi Camel.

I am so sorry you had to updose. When did you do that?

Have you tried smaller drops, like 2-5 %?

That could be easier.

 

(I am tapering zoloft too.)

 

I just recently updosed a few days ago. I was doing OK, but have trouble sleeping again the last month (average of 5hours a night) and feel anxious about it, like i will never been able to sleep again, never function normally again, fail my life etc... So i updosed a bit... I'm looking for a job right now and these interviews and the prospect of having a job with responsibility again make me  nervous and hinder my sleep. Sometimes I think I subconsious sabotage myself by not sleeping, that i'm not worthy of having a normal life...a sort of self harm. At this moment i feel like i'm lacking the self confidence of coping with a new job etc. I just miss the selfconfidence and maybe bad sleeping is my way to express this...And there is the vicious circle, cause not enough sleep makes me depressed and anxious... It's really bizarre, cause when i feel good, i'm a really confident, capable and happy person...

 

I tried the smallest drops i could: 1mg less of the pill than the previous dosage (i'm now on 16mg of the pill, so there are 16 drops ahead), so it was like 7%. I don't want to mess with liquids, tried it in the begin of my taper but couldn't measure exact dosages. I don't understand how you can define such small dosages exactly...

 

Any other ideas about long term (negative) side effects of a small dosage? 

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Altostrata   
Altostrata

I'm sorry, camel, no one knows the long-term effects of these drugs at any dosage.

 

Taking a lower dose is definitely less of a long-term health risk than a higher dose -- adverse effects tend to be dosage-related.

 

It could be that, after a long time at 5.2mg, you could resume tapering.

 

If you wish to remain on any dosage, that decision is up to you. If your symptoms are currently minimal, why not take a vacation from worrying about them?

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camel   
camel

If you wish to remain on any dosage, that decision is up to you. If your symptoms are currently minimal, why not take a vacation from worrying about them?

 

A withdrawal vacation is tempting, but since i'm on such a low dosage, i really wanted to finish it. But this seems much more difficult then i thought it would be...

 

Maybe it's time to see things in perspective. What would be more harmfull. Smoking or a low dose of SSRI? What do you think?

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