Chapter Thirteen

How to Taper Off Antidepressants, Antipsychotics,
and ADHD Medications

(Slow and Gradual Taper)

If you are taking a medication that is a time release or can only be reduced by the pharmaceutical company available dosages, use chapter fourteen, How to Taper Off Antidepressants, Antipsychotics and ADHD Medication (Fast and Gradual Taper). 

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 aches 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 10% 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 10% 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 10% 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 at a larger reduction.

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 10% 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 10% every fourteen days. The 10% reduction is based on the original dosage of the medication. The 10% 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 10%.

▪ 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.

Once you have reduced the medication by 10% 3 times you can increase the reduction for the remaining of the taper to a 20% reduction every fourteen days.

Taper Procedure:

1. Keep taking all supplements exactly as you did at the end of the pre-taper throughout the taper process.

2. Keep your Daily Journal up-to-date each day.

3. Compound medication for a 10% reduction.

4. Reduce medication by 10% every 14-days, at least during the first 3 reductions.

5. Only reduce the medication every 14-days.

6. 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.

7. Never skip any days of taking medication.

8. After 3 successful reductions at 10% and fourteen days have passed begin reducing by 20% every 14 days.

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.

1. 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.

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 you are not already taking the Calsorption and CalesiumD, you should being doing so at this juncture to help avoid any return of the “electrical zaps.” Taking 5 grams of Calsorption daily along with 800 mg of CalesiumD daily is recommended throughout the rest of your taper and for 45-days after the last dosage of medication.

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 of extreme aggression.

Increasing the Body Calm Supreme has proven to be effective for these side effects.

Increase the Body Calm Supreme 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 Calm Supreme 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 Calm Supreme back to the amount you were taking.
  
  Make sure you keep taking all other supplements exactly as established during the pre-taper.

3. 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.

4. 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.

5. 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 is 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.