How To Taper Antidepressants
THE FDA HAS
published approved guidelines for tapering off these medications.
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.
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 medication.
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.
antidepressant as close to 10% with each reduction as possible. With
this approach 10 reductions and you are off the antidepressant.
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 medication.
MEDICATION EVERY 14-DAYS
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.
medications being different there is no way for us to describe each one
and your physician and pharmacist should be involved in this process
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.
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 for
measuring reductions. Some medications dissolve well and can be
and put in water and then you pour
out of a flask the reduction amount.
experienced pharmacist will be of great value to you during this
close to 10% reduction as you can do.
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.
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 manner.
DO NOT OPEN THE CAPSUE AND POUR THE
BALLS IN LIQUID AND REDUCE GRADUALLY BY REMOVING A PORTION OF THE LIQUID
EACH DAY. This will cause an overdose. A time
release is designed to slowly enter the body, not all at once.
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 the medication.
A rule of thumb: The supplement that got rid of a
side effect or symptom during the pre-taper is the supplement to adjust
during the taper if that symptom returns while tapering off the drug. An
example of this can be made with the Neuro Day.
time you take the supplement is the key. Negative symptoms tend to start
around the same time each day. So, if you were taking the Neuro Day at
9am and symptoms now tend to begin at 11am, take the Neuro Day at 10am
each day. You are free to adjust the time you take the supplements to
help combat a side effect.
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
Reread and keep in mind Chapter 3, “Nutritionals Used in The Road
Back Program” for tips and how to increase the supplements.
Reducing the medication is actually the easy part of the program
JNK Formula – Only take 1 capsule at a time. No more than 2 capsules in a
day. The second capsule needs to be at least 3 hours after the first.
Only take 1
capsule at a time. No more than 2 capsules in a day. The second capsule
needs to be at least 3 hours after the first.
Neuro Night – Only 1 capsule a day.