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How To Taper Antidepressants
THE FDA HAS
published approved guidelines for tapering off these
Those guidelines are what the authors published a decade ago
and this approach is as effective now as it was in 1999. The
American Medical Association published a report in 2010
acknowledging at least 10% of the population will not be
able to get off their antidepressant because of the
withdrawal side effects. One particular side effect
associated with antidepressant withdrawal is the “brain
zaps.” This is an electrical jolt that runs from the base of
the neck to the base of the skull and the jolt can happen
several times a day or non-stop.
The Road Back program is the pioneer in this area and we
were the ones that found the solution years ago. Omega 3
fish oil is the key to get rid of the brain zaps as well as
to never allow them to start. Using the correct omega 3 fish
oil is critical and you need to know just any fish oil will
not do the trick. It takes an omega 3 fish oil made from
sardines and the EPA to DHA ratio content needs to be
specific. Flax seed will not work; please do not waste your
time and the unneeded trauma. If you are a vegetarian it is
time to take a break if you want to have a chance of
eliminating the brain zaps. To be blunt, it is time to
decide which is worse for you; an antidepressant or fish oil
for a short time.
We only recommend Omega 3 Supreme TG, a fish oil that is
distilled and brought back to the true natural form of the
oil of fish.
Reducing the Medication
Reduce the medication gradually and if side effects begin
that are too severe, go back to the last dosage you were
doing fine with, get stable again and then reduce the
medication again, but this time at a slower reduction
The above can seem too basic and too easy to understand for
it to be misinterpreted. However, that is not the case.
– Most of us take the word gradual to mean slowly, but there
is a need to give a good example of gradual. Imaging you are
in an airplane that is about to descend for the landing.
What would you like that landing to be like? Would you
prefer to not feel the decent and when the plane touches the
runway you do not even feel the tires touch ground. This is
a landing where I have heard the passengers cheer and thank
the pilot when they get off the plane. This is also the
gradual landing we want for you when reducing your
Gradual when tapering off a medication would be; a slow and
steady decent that does not jar and bump the person reducing
the drug. Gradual would also be a speed of reduction that
would allow the person to still function in life and reduce
to a minimum the chance of withdrawal side effects.
If you agree with the above, this removes the idea of
skipping days of the medication in order to reduce the
dosage and get off the drug. Skipping days or alternating
from a higher dosage to a lower dosage every other day is
not gradual. One only needs to examine the half-life of the
medication to establish that datum. You go in withdrawal
every other day and feel an overdose effect the days you are
going back up on the dosage.
Reduce the antidepressant as close to 10% with each
reduction as possible. With this approach 10 reductions and
you are off the antidepressant.
Never Skip Days of the Drug
All drugs in this class come in completely different dosages
and with some being in a time-release the variances are too
vast to list in a book of this type.
We will first take what to do with a non-time release
ONLY REDUCE MEDICATION EVERY 14-DAYS
Non-Time Release Medication
If you are taking a non-time release medication, reduce the
medication at the smallest reduction possible. We understand
the “smallest reduction possible” is an arbitrary and we
assure you it will be interpreted differently by many
physicians and pharmacists.
With most medications being different there is no way for us
to describe each one and your physician and pharmacist
should be involved in this process regardless.
Some medications can be compounded in to exact and precise
reductions. Compounding is when the pharmacist takes the
medication and grinds it to a powdered form and then
encapsulates to a new dosage. This is the ideal way to
reduce all medications but some cannot be compounded and the
cost can also be out of reach for some individuals.
With your pharmacist, see if purchasing a pill slicer will
work for you. You can also purchase a relative low cost
digital scale that will measure milligram amounts. Talk with
your pharmacist about putting the medication in a solution
measuring reductions. Some
medications dissolve well and can be crushed
and put in water and then you
pour out of a flask the reduction amount.
An experienced pharmacist will be of great value to you
during this process.
Remember, as close to 10% reduction as you can do.
Time Release or Extended Release Medication
When it comes to reducing medication that is time release,
the process needs to be a little different with the program.
Sometimes time release medications are also offered in a
non-time release form and it is best to cross-over to the
non-time release form of the drug. Your physician and
pharmacist are the ones to guide you through how to take the
medication. Cross over to the non- time release form of the
medication if that is at all possible. Count the cross- over
as the first reduction and do not lower the
medication for 14-days.
You have specific dosages of a time release antidepressant.
DO NOT OPEN THE
CAPSUES AND COUNT THE BALLS. Over the years, many people
sent us an e-mail about how well they were doing with
removing the balls from the capsule. Invariably, each of
them contacted us again but this time in full withdrawal and
it took an extended period of time to get them back on track
again. Please, do not taper an antidepressant in this
DO NOT OPEN THE CAPSUE AND POUR THE BALLS IN LIQUID AND
REDUCE GRADUALLY BY REMOVING A PORTION OF THE LIQUID EACH
This will cause an overdose. A time release is designed to
slowly enter the body, not all at once.
Follow the pre-taper precisely for Time
Release Antidepressants. Go to the next available dosage of
the antidepressant when you have felt stable for at least 5
days and 14-days have passed since the last reduction.
How to Adjust Supplements During the Taper
Keeping good notes with your daily Journal during the
pre-taper is worth its weight in gold during the tapering of
A rule of thumb:
The supplement that got rid of a side effect or symptom
during the pre-taper is the supplement to increase during
the taper if that symptom returns while tapering off the
drug. An example of this can be made with the JNK
If all of your anxiety vanished during the pre-taper
after starting the JNK and anxiety creeps back when you
start reducing the medication, increase the JNK to 3
additional capsules at noon. When the anxiety vanishes
again, reduce the JNK back to 3 capsules in the morning
You can increase any of the supplements to eliminate the
side effects again. After the side effect diminishes,
reduce the supplement back down again to the amount you
If you experience withdrawal side
effects every time you reduce the medication
increase the supplements the day before you reduce the
drug, wait 4 days to ensure there is no withdrawal and
then reduce the supplements back down again.
If the information above is not making a smooth and
relative withdrawal free program for you, it is time to
reduce the drug at a slower pace.
Reread and keep in mind the chapter, Nutritionals Used in
Back Program for
tips and how to increase the supplements.
Reducing the medication is actually the easy part of the