How to Taper Off
Anti-Psychotics,
Antidepressants and ADHD Medications
(Abilify, Adderall,
Anafranil, Adapin, Celexa, Concerta, Cymbalta, Effexor,
Elavil, Haldol, Lexapro, Luvox, Paxil, Prozac, Remeron, Risperdal, Ritalin, Serzone,
Strattera, Thorazine, Wellbutrin, Zoloft, Zyprexa)
Amit Dhingra, Pharma
D., is now assisting The Road Back program to reduce medications. Many
medications do not allow a 10% reduction and The Road Back is continuing to work
on bring you, your physician and pharmacist our most current information.
If you are taking these
medications, click on their name and print out the reduction schedule:
Adderall XR 5mg, Effexor,
Paxil,
Risperdal 2mg B.I.D.,
Seroquel 25mg B.I.D.
Strattera 40mg 25mg 18mg,
Trazadone 50mg 100mg,
Wellbutrin XL 150mg,
Zoloft 50mg or 25mg.
Pharmaca Integrative pharmacy,
www.pharmaca.com, with locations in CA, NM, CO, WA,
and OR can now compound medications that are not available in favorable
reduction dosages. When you require a 2% or 3% exact reduction, compounding is
the method used.
If you are taking a benzodiazepine,
anti-anxiety or sleep medication along with an antidepressant, anti-psychotic or
ADHD medication, deciding which medication to taper off of first is important.
Most of the time the antidepressant,
anti-psychotic or ADHD medication will not have a drug-drug interaction but
there are instances where they will have interactions and selecting the proper
medication to taper off of first is vital.
The most common reason these medications
have a drug/drug interaction will be their sharing of the same metabolizing
route. Two medications trying to go through the same pathway will create an
increase of the medications and usually one or both medications will take longer
to clear the body.
Sometimes one medication will
greatly increase another medication.
Example: Zoloft and Ambien
– Ambien is increased by 43% with concurrent Zoloft usage. You will need to
taper off the Ambien first or you will go into withdrawal on the Ambien even
though it was not reduced.
Check with your physician or
pharmacist for drug-drug interactions as noted above. A way to tell if the
pharmacist or physician really understands drug/drug interaction is to ask them
if Zoloft and Ambien have an interaction. If they say there is no interaction,
they are not using the latest drug/drug interaction database.
The tapering method to reduce
antidepressants, anti-psychotics and ADHD medication are identical.
If you are
taking a benzodiazepine, anti-anxiety or sleep medication with the
antidepressant,
anti-psychotic or ADHD medication, we do need to address the pre-taper a little
differently.
It is important to address
the benzodiazepine, anti-anxiety
or sleep medication first before tapering off the other medication.
Pre-Taper Program if Also Using a
Benzodiazepine, Anti-anxiety or Sleep
Medication
The goal of this stage of
the taper is to handle daytime anxiety and sleep problems as needed and to get
into your body the needed nutrients to help avoid interactions caused by the
benzodiazepine, anti-anxiety or sleep medication before reducing the
antidepressant, anti-psychotic or ADHD medication.
Day 1 – Begin with the cherry. Take 1 teaspoon of cherry liquid
or 1 cherry capsule at bedtime. Put cherry liquid into ½ cup of
water and drink.
Day 2 –
Take ½
teaspoon of cherry liquid or 1 cherry capsule every 4 hours during the day. Mix
the cherry liquid in ½ cup of water. Take 1 teaspoon of the cherry liquid or 1 cherry capsule at bedtime.
You are finished with this stage of
the pre-taper. Keep taking the cherry every day from this point forward.
Next – Begin
taking the Ultimate Omega 3.
Day 3 -
Ultimate Omega 3 – Take two softgel capsules in the morning on an empty
stomach.
Day 4 -
Ultimate Omega 3 – Take two softgel capsules in the morning and two softgel
capsules at noon on an empty stomach.
Remain at this level of
Ultimate Omega 3 and continue taking as described in day 4.
Note:
Try to never take Omega 3 after 4 PM.
Once in awhile it is ok to take after 4 PM if
you forgot the noon supplements but taking Omega 3 late in the day for a
prolonged period is not advisable. Omega 3 needs time to breakdown in the body.
Next – Begin
taking the Power Barley Formula.
Note: While taking the Power Barley Formula: If you feel a very
nice change at a certain amount of the Power Barley Formula, remain at that
level and do not increase the Power Barley Formula further. It is not
mandatory to increase the Power Barley Formula to three teaspoons, three times a
day.
Example: If
Day 7 you experienced a major relief of fatigue or an overall feeling of
well-being, you would not increase the Power Barley Formula beyond this level.
You would disregard the increases beyond day 7.
Day 5 – Take
one teaspoon of Power Barley Formula in the morning.
Day 6 – Take
one teaspoon of Power Barley Formula in the morning and one teaspoon around 3
PM.
Day 7 – Take
one teaspoon of Power Barley Formula in the morning, noon and around 3 PM.
Day 8 - Take two teaspoons of Power
Barley Formula in the morning, noon and around 3 PM.
Day 9 - Take two
teaspoons of Power Barley Formula in the
morning, noon and around 3 PM.
Day 10 - Take three
teaspoons of Power Barley Formula in the
morning, noon and around 3 PM.
Day 11 - Take three
teaspoons of Power Barley Formula in the
morning, noon and around 3 PM.
There is no need to use more than the
three teaspoons, three times each day, of the Power Barley Formula.
You will be looking for increased
energy, mental clarity, the brain fog to leave or an overall feeling of
well-being.
Note: The measuring spoon supplied inside the Power Barley Formula
is 1 tablespoon. You should use a kitchen teaspoon to measure the Power Barley
Formula. Use a level teaspoon amount.
Day 12 –
Begin taking 1 softgel capsule of 200 i.u.
vitamin E with the morning drink of Power Barley Formula.
If all or nearly all of the
side effects you were experiencing no longer exist, you are ready to taper.
If you are still
experiencing nagging side effects at this stage, send an e-mail to The Road Back
and state: Medications you are taking, what happened during the pre-taper and
what nagging side effect is persisting.
Pre-Taper Program if
Only
Taking an
Antidepressant, Anti-Psychotic or
ADHD Medication
You will be starting with the Power
Barley Formula. More is not better with most supplements and the Power barley
Formula is the same. Increase it only to the point of feeling a positive change
and then remain at that level.
You will be looking for increased
energy, mental clarity, the brain fog to leave or an overall feeling of
well-being with the Power Barley Formula.
Once you feel those changes as
described above, do not increase the Power Barley Formula any further at this
time.
Note: The measuring spoon supplied inside the Power Barley Formula
is 1 tablespoon. You should use a kitchen teaspoon to measure the Power Barley
Formula. Use a level teaspoon amount.
Day 1 – Take
one teaspoon of Power Barley Formula in the morning.
Day 2 – Take
one teaspoon of Power Barley Formula in the morning and one teaspoon around 3
PM.
Day 3 – Take
one teaspoon of Power Barley Formula in the morning, noon and around 3 PM.
Day 4 - Take two teaspoons of Power
Barley Formula in the morning, noon and around 3 PM.
Day 5 - Take two
teaspoons of Power Barley Formula in the
morning, noon and around 3 PM.
Day 6 - Take three
teaspoons of Power Barley Formula in the
morning, noon and around 3 PM.
Day 7 - Take three
teaspoons of Power Barley Formula in the
morning, noon and around 3 PM
There is no need to use more than the
three teaspoons, three times each day, of the Power Barley Formula.
If you have not reached the goal at
this stage, you probably will once the other supplements are added.
Next – Begin
taking the Ultimate Omega 3.
Day 8 -
Ultimate Omega 3 – Take two softgel capsules in the morning with the Power
Barley Formula.
Day 9 -
Ultimate Omega 3 – Take two softgel capsules in the morning with the Power
Barley Formula and two softgel capsules with the noon Power Barley Formula.
Remain at this level of
Ultimate Omega 3.
Day 10 –
Begin taking one softgel capsule of 200 i.u.
vitamin E with the morning drink of Power Barley Formula.
Next –
Begin taking the cherry.
Day 11 Cherry – Begin with the cherry. Take one teaspoon of
cherry concentrate or one cherry capsule at bedtime. Put cherry concentrate into
½ cup of water and drink.
Day 12 Cherry – Take ½ teaspoon of cherry concentrate or
one cherry capsule extract every four hours during the day. Mix the cherry
concentrate in ½ cup of water. Take one teaspoon of the cherry concentrate or
one cherry capsule extract at bedtime.
Remain at these levels for 2 full days then you are ready to taper
the medication.
Note: If you have not experienced a major reduction of side
effects or at the least a major improvement of how you feel, please do not
reduce the medication yet. Please read the chapter, The Importance of the
Pre-taper.
After the Pre-Taper is Complete
-
You should have a routine in place now with the supplements.
-
You should have your Daily Journal up to date.
-
As close as possible, reduce the
medication by 10% or less each week. The 10% is based on your
current dosage. If you are at 20 mg a day you would reduce the medication to
18 mg a day, then to 16 mg a day, then to 14 mg a day and so on.
-
Your pharmacist will be the best
one to speak with on ways to reduce the medication dosages. Some of the
medications are very easy to lower dosages by specific amounts while others
can be difficult with how they are manufactured.
If the medication you are taking can only be reduced by larger
reductions, read the section below: How to Reduce Medication With Large
Reductions
- Switching to a
liquid form of the medication makes it easier to reduce by a percentage
but new side effects usually begin when switching. Please do not
switch to a liquid.
How to Reduce Medication With Large Reductions
Scenario:
You are taking 37.5 mg of Paxil CR each day. You have completed the pre-taper.
During the pre-taper the
Power Barley Formula handled your fatigue, agitation and gave you an overall
feeling of well-being. This was accomplished when you reached 2 teaspoons of the
Power Barley Formula taken 3 times a day.
You also felt a nice change
with two Omega 3’s in the morning and two Omega 3’s at noon.
You took 1 teaspoon of the
cherry concentrate every four hours during the daytime and 2 cherry capsules at
bedtime and your daytime anxiety is gone and your sleep has improved a lot.
This was all easy to see
because you kept your daily journal totally up to date.
Three days before you reduce
the Paxil from 37.5 mg a day to the 25 mg a day you would increase the Power
Barley Formula to 2 ½ teaspoons three times each day, the Ultimate Omega 3 would
be increased to three softgels in the morning and three softgels at noon and the
cherry concentrate would be increased to 2 teaspoons every four hours during the
day and three capsules at bedtime.
This gets your body set-up
for the reduction of the Paxil.
Three to four days after you
reduce the Paxil you would decrease each of the supplements back down to where
they were at before the reduction of Paxil.
You would now be taking 2
teaspoons of the Power Barley Formula 3 times a day, two Omega 3’s in the
morning and two Omega 3’s at noon and 1 teaspoon of the cherry concentrate every
four hours during the daytime and 2 cherry capsules at bedtime once again.
You are now back at the
supplement levels before the Zoloft reduction.
Maintain the supplements at
this level and the new dosage of Paxil for the next 14 days.
Before the next reduction of
Paxil from 25 mg to 12.5 mg a day, repeat the same steps again by increasing the
supplements before the reduction of the medication.
When moving from 12.5 mg a
day to the total elimination of Paxil, proceed again as before with increasing
the supplements before the final reduction and then reducing the supplements
again about 4 days after the medication was discontinued.
The above is a guideline to
follow. An adjust may be needed for each individual.
Example:
If reducing the supplements four days after the medication was reduced made the
withdrawal side effects start, go back to the increased amount of supplements
and remain at that level for three additional days. Then reduce the supplements
once again.
The next time you reduce the
medication you should remain at the increased supplement amount for one full
week to help avoid withdrawal side effects.
With your Daily Journal kept
up to date during the pre-taper, you will know which supplement got you relief
for a specific symptom. Keep this in mind during the tapering phase. If the
Power Barley Formula totally handled your fatigue during the pre-taper and you
begin to feel fatigue after reducing a medication, increasing the Power Barley
Formula for about 3 or 4 days will probably handle the fatigue once again. Just
increase the Power Barley Formula a little for about 4 days or until the fatigue
is handled again, then reduce the Power Barley Formula back down again to the
previous amount you were taking at the end of the pre-taper.
Once You Are
Off the Medication
Once you
are off all medication continue taking the supplements at your current amount
for the next 7 days.
On day 8,
after your last dosage of medication, reduce the Power Barley Formula by one
half.
If you
were taking a total of 6 Ultimate Omega 3 each day, reduce to 4 each day by
taking 2 in the morning and 2 at noon.
Reduce
the daytime cherry to one half as much or half as often. Do not reduce the
bedtime cherry.
Stay at these levels for the next 45 days.
It is important you now rebuild your body.
After the 45 days, decide what you want to do with the supplements.
We all need Omega 3 in our body. It needs to come from a food
source or from supplemental Omega 3 oil.
Usually one or two of the Ultimate Omega 3’s each day is plenty for
a maintenance amount.
If you enjoy the Power barley Formula, it is very fine to keep
taking for a prolonged period. It is great for general health.
Once you know your sleep is handled, you might try taking the
cherry on a need to basis.
If you have been off the medication for months and you begin to
feel tired once again, try taking a little of the Power Barley Formula once
again. All of us get fatigue from time to time when we are living life at a
rapid pace. This fatigue does not mean it is a side effect from when you took
the medication.
Send us an e-mail and let us know how you are doing from time to
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information as it becomes available.
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