January 29Jan 29 Some of our UK members have had problems getting access to liquid forms of their ADs on the NHS. Unfortunately there is still a disconnect among professionals and the latest research and guidelines. If you have issues with access to liquids it may be useful to take the following information along with you to your appointment: Nice Guidelines on safe de prescribing: Medicines associated with dependence or withdrawal symptoms: safe prescribing and withdrawal management for adults - Nice "Dose reduction 1.5.10 -Consider giving the person additional control over the process of dose reduction (for example, by issuing their usual daily dose in a form that allows them to reduce the amount in small decrements at a pace of their choosing, rather than issuing successive prescriptions for reduced daily doses)" BJGP also have this advice for de prescribing: Withdrawing from SSRI antidepressants: advice for primary care - British Journal of General Practice "HOW SHOULD THE GP STOP SOMEONE’S ANTIDEPRESSANT? Tapering SSRIs exhibit a hyperbolic dose–response relationship, that is, when reducing, decreases to smaller doses cause larger change to serotonin receptor occupancy. Because of this, traditional linear dose reductions (for example, reducing sertraline by 50 mg increments) cause increasingly large (or hyperbolic) changes to serotonin receptor inhibition and therefore more severe symptoms.1,6,7 This explains why some patients may tolerate the early stages of their taper but towards the end, at lower doses, they experience withdrawal symptoms. Instead, a proportionate taper, recommended by NICE and the Royal College of Psychiatrists, should be used to reduce withdrawal symptoms.1,4,9 This involves reductions as a proportion of the previous dose (such as 25%); an example tapering plan is shown in Figure 1. Unfortunately, some doses will not be available in tablet form so liquid preparations should be used. These are routinely available for most SSRIs; however, in rural areas or for less common SSRIs, liquid preparations might need to be ordered in advance. To prevent withdrawal symptoms, tapering should take place over a long period of time, spanning months, or even years.1,9 SSRIs with shorter half-lives, such as paroxetine and venlafaxine, require a longer taper." Maudsley De Prescribing Guidelines. A fantastic text I would highly recommend anyone tapering buy. For those who are not aware you may want to ask your GP to refer you to the National Psychiatric Drug Deprescribing Clinic (PDC) | NELFT NHS Foundation Trust. Their waiting lists might be long, so the sooner the better, but they have been set up to manage psychiatric withdrawal deprescribing and they may be better placed to provide access to more specific, smaller doses. I’m not a medical professional and cannot offer medical advice. I only offer my thoughts as support. Please speak to your health practitioner about your care. This is a peer site where we support each other on our taper/recovery journeys. If you are from the UK please make sure you fill in a 'Yellow Card' report for the MHRA. It is you doing your bit to help make a difference.Please take the time to do it today 🙂 https://yellowcard.mhra.gov.ukFor US members details here.
January 31Jan 31 I really appreciate this help. Thanks I can’t honestly remember but continual since 2000, lustral, Prozac, citalopram and sertraline, occasional diazepam and a brief spell on zopiclone and amitriptyline for back pain.Recent = started amitriptyline in March 2024 10mg for sciatica up to 30mg by April. Reduced down to zero by September. Recent = 2022 Homemade Kefir from milk. 1/2 pint every other day for diverticulitis 2022 Folic acid 1 pill per dayOct 2024 Vitamin D pill 2024 Hrt 2022= oestrogen gel, testosterone and progesterone coil…Swapped from citalopram in about 2019 onto SERTRALINE (all below)February 2024 75mg, 2 weeks later 50mg, felt terrible, back up to 75mg, then 100mgREDUCTION STARTED8-10-24 to 87.5mgDec 31st 2024 81.25mgFeb 6th 2025 75mg March 11th 68.5mgApril 13th 62.5mgMay 21st 56.25mgJuly 11th 50.6mgAugust 50mgSept 13th 45mgNov 40.5mgDec (late) 36.5mgFebruary 12th 36mg28th February 35mg20th March 33mg8th April 32mg14th April 31mg14th May 29.5mg3rd june 27mgon and off prescriptions for diazepam over the years 2mg to use when severe anxiety sets in. Also occasional prescription for zopiclone 7.5mg (14 tablets at a time) which I half or quarter. Have used OTC sleep aid pills but don’t anymore due to the triggering restless limb..Hrt for the past 4 yearsGeneral improvement since becoming a serious cyclist. I also have a strong Christian Faith..
July 28Jul 28 Sorry to bump an old thread, but I remember I had a medication review with my pharmacist/GP the other month and made a point to insist they offer a liquid form and advice to go slow to anyone attempting to taper (especially after years). And honestly she seemed to take it onboard. 2010 - prescribed Lexapro for OCD (10mg). Fatigue, apathy, very dry mouth, anorgasmia, 'blocked emotions'(can't cry, simmering anger). Brain missing drive and motivation since. I used to be consistently creative and practical. 2023-4 attempt to taper to 5mg (alternate 10-5mg pills(!)(terror, panic, disoriented, suicidal). Then 7mg each reduction (0.02mg over 2-3 weeks) after stabilising became exponentially worse than previous reductions. GP and crisis team/psych services had no experience with withdrawal. - Psychiatric pharmacist got GP to give me liquid form. Reductions still difficult and time consuming. 2025 - (7.5mg) Awaiting assistance from new "Deprescribing clinic" since Oct 25. Apathy, burnout. 25.01.26 - 7.44mgSide effects worse: anger, irritation, hard to focus - can't do anything that brings joy - no feelings except rage and anger.08.02.26 - 7.34mg (~2%) now 4 weeks between reducing to stabilise.No adverse effects, or improvement08.03.26 - 6.9mg (5%)Panic attacks/existential terror last 4 days. A week later fine but tired.16.03.26 - 6.5mgIntermittent dread and sadness, holding again. 2+ weeks of misery.20.04.26 - 6.36mg a modest reduction, slight improvement in mood+motivation. Close to crying at TV/shows. Sexual feelings on/off20.5.26 - 6.17mg (3%)Hard but not suicidal19.7.26 - 5.9mg (3%)Redundancy, burnout this year. On /off low mood. Tears at sad song. Irritable.17.08.26 - 5.7mg (3%) - last reduction before vacation abroad. 🇨🇦16.09.26 - 5.5mg (~3%)11.10.26 - 5.3mg (~3%) - gently closing the gap between reducing to 4-3.5 weeks to see what's the minimum for brain to be ready. I can feel a little of the environment, smells and seasons changing.Supplements: Vit D, L-Theanine, Niacin B3.
July 29Jul 29 Author 12 hours ago, PaintingDave said:Sorry to bump an old thread, but I remember I had a medication review with my pharmacist/GP the other month and made a point to insist they offer a liquid form and advice to go slow to anyone attempting to taper (especially after years). And honestly she seemed to take it onboard.Good work! I’m not a medical professional and cannot offer medical advice. I only offer my thoughts as support. Please speak to your health practitioner about your care. This is a peer site where we support each other on our taper/recovery journeys. If you are from the UK please make sure you fill in a 'Yellow Card' report for the MHRA. It is you doing your bit to help make a difference.Please take the time to do it today 🙂 https://yellowcard.mhra.gov.ukFor US members details here.
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