Posted by SLS on November 14, 2009, at 19:07:20
In reply to Re: Peter Breggin, posted by Alexanderfromdenmark on November 14, 2009, at 16:17:35
> What is a protracted withdrawel in your opinion?
Anything that allows one to experience withdrawal symptoms, either intermittently or continually, for an extended period of time. This is really a larger issue than I am prepared to discuss right now. There are ways to discontinue medications without relying on a fixed dosage schedule.
> I think with lexapro I went down 2,5 mg at a time. Tapering like that for a few months. Was that too slow?I don't think that is too slow, especially if you are under no time constraints and are not experiencing withdrawal symptoms. Somewhere, there is a balance. You don't want to taper too quickly, otherwise the withdrawal symptoms become too severe. If you are trying to discontinue medications in an effort to be medication-free, you would want to taper slowly. However, some people advocate discontinuing antidepressants and benzodiazepines by reducing the dosage at a rate of 10% every 3-4 weeks. If one were to begin to taper from a dosage of Lexapro of 40mg beginning today, he would not reach the endpoint until early 2011. And still, it is very likely that one would experience some withdrawal symptoms upon each dosage reduction. What's that all about? I don't understand it. I have yet to see a clinical study supporting such an algorithm. I only see accounts of people who still suffer during these protracted taper periods. The funny thing is, when confronted with a case like this, their answer is to cut back to 5% reductions.
There are lots of opinions as to how to best go about discontinuing an antidepressant. I came up with my own method. It allows me to discontinue Effexor 300mg within two weeks with almost no withdrawal symptoms. Prior to using this method, which I like to call a flexible-dose strategy, I would experience all the nasty stuff that comes with SRI discontinuation, including the brain zaps. Yuck. I am also able to discontinue benzodiazepines equally fast.
I guess the bottom line is that I can't recommend a universally effective taper strategy. Depending on who you talk to, the taper period can be anywhere from 3 days to 3 years. I would rather shoot for 3 weeks.
If you are not experiencing withdrawal symptoms, then I guess you are doing something right. Whatever it is, keep doing it.
- Scott
poster:SLS
thread:925110
URL: http://www.dr-bob.org/babble/20091107/msgs/925758.html