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Chapter Twelve
How to Taper Off
Antidepressants, Antipsychotics,
and ADHD Medications
Now that you have completed your pre-taper program, you are
ready to start the reduction of your medication. Not knowing what each of you
may have experienced personally, I do know that the vast majority of people who
are ready for this step tell me that they have some trepidation starting the
taper, as they have had terrible side effects when they have tried to quit
before.
You might have experienced the “electrical zaps” in the head
that is very common with stopping antidepressants, a return of depression,
anxiety, fatigue, extreme ache and pain, or even wound up in a mental hospital.
Now, as incredible as this might seem, this step should be the easy part
of The Road Back Program!
Note: If you are taking Cogentin along with another
medication, you will need to rotate the reduction of the Cogentin and the other
medication.
Example: If you are taking Cogentin and Haldol, you
would reduce the Haldol first, wait 14-days and then reduce the Cogentin, wait
14-days and then reduce the Haldol once again, wait 14-days and then reduce the
Cogentin again. Repeat this process until off both medications. Reduce the
Haldol and Cogentin by the same percentage with each reduction.
The Taper
The safest method to reduce medication:
If you have tried to taper off these medications before and
suffered withdrawal side effects, I suggest that you at least start the taper
slowly.Reduce the medication by 5% every 14-days for three reductions
and have success, and then move to the next method for reducing the medication.
I have been told by people that the 5% reduction every 14-days
is far too long. When I asked them, “How long have you been trying to get off
the medication?” the answer was usually a few years without success. This is
where, slow, and steady wins the race
every time.
Again, if you had a problem in the past with tapering off the
medication, use the 5% reduction schedule. Have success reducing the medication
at least 3 times, see for yourself that you can do this and still feel well, and
then you and your physician should decide if you should reduce the medication.
Make sure you work with the prescribing physician before
changing the dosage of your medication.
* Ask your physician to write a prescription to
accommodate a 5% reduction.You will
need to use a compounding pharmacy to fill this prescription.
* It is important that the compounded drug be identical to the drug you are
currently taking.
* Changing to a generic drug may not act the same and withdrawal side effects
can begin.
* Switching from one drug to another because it has a longer half-life will
create withdrawal side effects from the drug abruptly stopped.
* Do not switch from a tablet or capsule form of the drug to a liquid.
* Do not switch from a time release to a tablet form or liquid form of the drug.
* Unless the pharmacist can assure you the medication is
exactly the same, avoid this method.
* Only reduce the medication 5% every
fourteen days.
The 5% reduction is based on the original dosage of the medication. The 5%
reduction is based on milligrams.
* Never skip any
days taking your medication.
* Always take your medication at the same time each day.
* If you take your medication more than once each day, make
sure the total reduction of the medication is no more than 5%.
* Take each supplement at least ½ hour apart from the drug,
but ideally, 1 hour apart. It is much better to take the supplements 1 hour
after taking the drug, instead of before the drug.
* Continue with your supplements and “super foods” at the same
times and amounts established during the pre-taper.
* Take each supplement at the same time each day.
* Continue taking your “super foods” and supplements at
least 45 days after you take the last dosage of your
medication.
* Remember to keep your Daily Journal filled out each day and
keep taking all of the supplements exactly as you were at the end of the
pre-taper.
The next method to reduce medication:
Until now, the problems encountered by most people attempting
to get off any of the medications have been withdrawal side effects and the
availability of the medication in a dosage that would allow a gradual reduction.
Several of the drug inserts will suggest reducing the
medication gradually.
What is gradual? Gradual is defined here as “A slow and steady
reduction that reduces to a minimum, the chance of feeling a dip, bump or
turbulence.”
To survive in this world, sometimes we need to change the
environment or change ourselves to live in the environment. The environment we
have been dealt regarding available dosages has been a constant problem with
tapering in the past.
Either the drug manufacturers needed to make their medication
in dosages that would accommodate a gradual reduction or a solution needed to be
found that would allow for the large reduction while averting withdrawal side
effects.
With these medications, it is not always possible to compound
them to exact dosages without altering the drug structure, and with some of the
medications being prescribed as a time release, large reductions are the only
option. Therefore, for survival, we need to change the environment and change
ourselves as well. In this case, it was improve The Road Back Program to
accommodate medications that could not be gradually reduced by a small
percentage.
The Road Back Program has and always will be a work in
progress. However, at the writing of this book, that work has made a giant
stride in handling the environment or better stated, the problem of available
dosages supplied by the drug manufacturer.
This breakthrough includes benzodiazepines, antidepressants,
antipsychotics, sleep medications, ADHD medications, and even medications
prescribed in a time release form.
With your pre-taper complete and the Daily Journal kept up to
date throughout, you will know which supplement caused each positive change and
handled which side effect.
You will be using that information during the taper phase of
the program to handle any withdrawal side effect, if one begins.
Taper Procedure:
Keep taking all supplements exactly as you did at the
end of the pre-taper throughout the taper process.
Keep your Daily Journal up-to-date each day.
Compound medication for a 5% reduction.
Reduce medication by 5% every 14-days, at least during
the first 3 reductions.
Reduce the medication at the lowest possible amount,
using the drug manufacturer’s available tablet or capsule.
Reduce the medication every 14-days.
Make sure you have at least 7 consecutive days of
feeling very well before reducing the medication again. If this requires you
to reduce the medication every 21-days, do that.
Never skip any
days of taking medication.
Tapering can be this simple.
What to Do If Side Effects Begin
It is important to know what to do if side effects begin while
tapering off the medication. Withdrawal side effects can happen, but addressing
them early and knowing what to do will usually make them short lived and keep
them mild as well.
In this book, mentioned several times is, “With little to no
side effects,” but if you were to purchase a $250,000 automobile, it would still
come with a spare tire, just in case!
Use the following steps if side effects take place while
tapering.
If a withdrawal side effect turns on during the taper:
Do not reduce the medication again until the symptom goes
away. This usually only takes a few days, or less, and then you can resume the
taper.
Do not start making wholesale changes to your daily
routine.
Proceed with the following steps, in the order presented.
Once the withdrawal side effect is eliminated, give yourself 7-days, and then
continue with the taper.
Review your Daily Journal and look for changes you
might have made to your routine. If you located a change, go back to exactly
what you were doing before the change and all should be well shortly. Give
the withdrawal side effect 7 days to go away. If nothing is found, move to
number 2.
Usually, the withdrawal side effect will be a side
effect you had before doing the pre-taper. Review the Daily Journal and
locate the exact step of the pre-taper that eliminated the side effect.
* The exception to this is with antidepressants. The “electrical
zaps” tend to only happen when an antidepressant is reduced. Increase the
Ultimate Omega 3 immediately at the first sign of a head symptom or the
“electrical zap.” Increase the Ultimate Omega 3 to 5 softgels in the morning
and 5 softgels at noon immediately, if this side effect begins.
Usually, the side effect will subside the same day or the next day with the
increase of the Ultimate Omega 3.
If the head side effect remains mild, but is still present, continue taking
the 5 Ultimate Omega 3 until the symptom abates and then return to your
previous amount of Ultimate Omega 3. Wait 7 full days and then continue with
the taper.
If the head side effects are severe and you find it difficult to function in
life due to the pain of the symptom, go back to the last dosage of the
antidepressant you were at before this reduction and remain there for
14-days. Going back to the last dosage you were at should get rid of the
“electrical zaps” quickly.
The next time you reduce the antidepressant, and each reduction thereafter,
increase the Ultimate Omega 3 to 5 softgels in the morning and 5 softgels at
noon 2 days before you reduce the medication, and remain at this level for 5
days after reducing the medication. This approach should avert the
occurrence of the “electrical zaps.”
If the “electrical zaps” continue with this approach, you will need to lower
the medication at a slower reduction. Talk to your physician and have your
pharmacist find a way to fill the prescription to allow for a more gradual
reduction. This will handle the taper for you.
* End of antidepressant exception.
* Antipsychotic drug exception: Antipsychotics can have as a side effect
when tapering psychosis, hearing voices, seeing things that are not there or
episodes extreme aggression.
Increasing the Body CalmSupreme has proven to be effective for these side
effects.
Increase the Body CalmSupreme to 1 capsule every 2 hours during the daytime
and 1 to 2 capsules at bedtime for sleep. Continue taking all other
supplements as established in the pre-taper.
* End of antipsychotic exception.
Continued #2 -
Usually, the withdrawal side effect will be a side effect you had before
doing the pre-taper. Review the Daily Journal and locate the exact step of
the pre-taper that eliminated the side effect.
Increase that supplement slightly when you take it during the daytime or at
bedtime, and this should handle the side effect quickly.
Once the side effect is gone, wait 7 days before reducing the medication
again.
If the side effect is not eliminated, this needs to be looked at a few ways
before taking any new action.
Do you still rate yourself at a 7 or higher on the 1-10 scale for anxiety,
sleep and other feelings? If so, keep taking the slight increase of the
supplement that handled the side effect earlier for the next 7 days and then
continue with the taper as long as you remain at a 7 or higher rating.
If you have fallen below a 7 rating, proceed to number 3.
Each supplement used with The Road Back Program has a
specific purpose.
Using a supplement a little differently is sometimes needed to overcome
withdrawal side effects.
Begin taking the Body CalmSupreme every 4 hours during the day if you are
not already doing that.
Once the side effect is eliminated or reduced to the point of you rating
yourself at a 7 or higher once again, wait 3 days and then reduce the Body
CalmSupreme back to no more than 1 capsule every 4 hours.
Make sure you keep taking all other supplements exactly as established
during the pre-taper.
If you found that number 2 handled the side effect,
and the same side effect begins again with the next reduction, 1 day before
you reduce the medication, increase that supplement slightly and stay on the
increased amount for 4 days after you lowered the dosage.
This approach should help stop the side effect from ever being present with
all future reductions.
If number 2 did not fully eliminate the side effect,
you will need to give yourself a little additional time. Stay at the
increased amount of the supplement that you increased doing number 2, and
relief should come within 7 days.
Sometimes there is just a bump in the road as you
taper off a medication. There is no rhyme or reason for withdrawal side
effects to begin. You might have decreased the medication 6 times with ease
and at the seventh reduction, a withdrawal side effect begins.
This usually goes away using the steps above, but sometimes it just
persists.
There are two solutions. Reduce the medication once again or increase the
medication back up to the last dosage you were doing well with are the two
options.
If you are going to increase the medication, give yourself at least 14-days
before doing this. Give your body a chance to adjust. If the withdrawal side
effect is unbearable, do not wait the 14-days but complete all steps above
and then proceed with this option.
Increasing the medication back to the last dosage should be the first choice
from these two options.
There are those times when reducing the dosage does handle the withdrawal
side effect. For whatever reason, your body is reacting to that certain
amount of medication and nothing you do will get rid of the side effect
except to be on a different dosage, whether a higher or lower dosage.
If you went back up on the dosage of the medication to get relief, and
withdrawal side effects started again when you returned to this level, the
answer us usually to reduce the medication again rather quickly and get to a
new lower level.
Make sure you talk to your physician about this and keep him or her well
informed as to how you are doing and
what you are doing.
Once you are off the medication, make sure you keep taking the
supplements for 45-days.
Read the chapter, “Once Off All Medication” and follow the
ending program completely.
The claims, information and products mentioned through this site or within the
book, How to Get Off psychiatric Drugs Safely have not been evaluated by the
United States Food and Drug Administration and are not approved to diagnose,
treat, cure or prevent disease. The information provided on this site or within
the book, How to Get Off Psychiatric Drugs Safely is for informational purposes
only and is not intended as a substitute for advice from your physician or other
healthcare professional. You should not use the information on this site for
diagnosis or treatment of any health problem or for prescription of any
medication or other treatment. You should consult with a healthcare professional
before starting any diet, exercise or supplementation program, before taking any
medication, or if you have or suspect you might have a health problem.
Copyright 2006 The Road Back. All rights reserved. No part of this Web Site may
be reprinted or distributed without permission.
Copyright 2006 - How to Get Off Psychiatric Drugs Safely by James L.
Harper used with permission.
