This is a very good article. I’m a retired psychiatrist. You didn’t cover the benzos, which I am much interested in learning your persprcted. I am also so glad
Thanks Cherryl. Means a lot coming from a psychiatrist:) I was focusing on SSRI meds in this article but much of what was learned in tapering them well came from the understanding of tapering benzos safely. Very related in practice but also as you know tapering benzos comes with even greater care.
Sorry. Perspective on withdrawal of the anti anxiety meds. I am glad there are integrative psychiatrists around now. I’m in IN, and I don’t think we have any.
Currently, I have tapered my with my provider's knowledge to 1/4 of my initial dose. However, when I have tried to go lower the sensory withdrawal symptoms described in the chart send me back to this level. I am going to try a slower hyperbolic approach as you described. Those shock type sensations with visual disturbance and vertigo are the worst. For me, it feels like a dog is shaking my brain like a toy.
Where’s the series? Good to know! Love that these people are spreading the knowledge. I will look for Dr. Horowitz on podcasts, have only heard him speak at a conference.
I took Effexor in lieu of hormones to combat menopausal symptoms from hormone blockers and forced menopause due to estrogen fueled breast cancer. Coming off Effexor, under my oncologist’s care, was so incredibly hard and DARK. Whew. It was actually pretty scary the way my mind went so so dark. It made me very hesitant to start Zoloft for my increased anxiety in these current times that have kicked up some long sleepy triggers. I am back in therapy and taking a very low dose of it to see if it takes the edge off. Thankfully my oncology psych nurse practitioner is soooo well versed. I trust her implicitly. I wish ketamine therapy was not so cost prohibitive because that’s what I really want to do. And I wish I could get micro dosing psilocybin down but can’t get it right. * Sigh *
I am open to trying this low dose to see. And as always, thank you for always educating me!!
Amy, that sounded so hard. But It sounds like you have a great provider who can walk you through this. That is very fortunate. I do hope the anxiety and sleep improve.
Thank you for this information. What about cross tapering? And when you are trying to find the right medication? I have a psych consult approaching and I’m pretty sure there will be a recommendation for a new medication as I don’t feel Zoloft is helping me. In your experience and practice what do you do with patients trialing new antidepressant medications?
This is an art form in of itself. Depending on how long you've been on the medication and your particular situation, sometimes providers will decrease one as they increase another and other times fully come off one before starting one.
Hi Tanmeet. This is a fantastically helpful article thankyou. As herbalists we come across this quite a lot and if you don’t mind, I’d like to add that the support of a herbalist can be very helpful here. We have a number of very effective herbs to support in the process of weaning off SSRIs and the other benefit of seeing a herbalist is the ongoing support that’s offered which can be very helpful in this long healing process. To stress though that it’s vital to see a qualified medical herbalist who understands the mechanisms and can work with you personally (and your doctor) to adjust your herbs as needed along the way.
Personally I experienced the numbing effects of SSRIs many years ago and decided to find my own way out of the blackness. It took time and effort but ultimately my life is in an infinitely better place that it would have been had I relied solely on the medication for my recovery. In fact on reflection I may not have ever properly healed. So like you I do believe they have a place when used consciously, but there are many many other options and every person is unique so the prescription will be different for everyone. 🌱
Thank you for this article. It is timely. While I am still actively taking mine, my daughter has made note of starting to taper. This is wonderful information. Thanks again. 💜
Thank you so much for this incredibly informative post, Tanmeet! I have been on a combination of Pristiq, Klonopin, Risperidone, and Nortriptyline since 2016 to treat acute PTSD, generalized anxiety disorder, and major depressive disorder. Iʻm at a fairly high dosage for most of these medications. Iʻve been trying to taper off for years (as I donʻt enjoy the side effects and I donʻt want to be dependent on the drugs forever), but have had very little success. I usually end up back on the medications due to what appears to be a relapse but may just be withdrawal.
I donʻt think right now is the best time for me to attempt to taper off my meds or even decrease the dosage, but thanks to you, I have new information in my toolkit to bring to my conversations with my psychiatrist the next time we discuss tapering off.
QUESTION: Would you suggest tapering off medications one at a time or in concert?
Yes for sure wait until you are ready. I am glad the info feels empowering. And only one at a time is my reasoning to be gentle as well as because if there are symptoms of withdrawal or relapse, it gets too confusing with two at once.
I’m trying to wean of desvenlafaxine. It’s one of the hardest! I’ve been on it awhile - only 50mg. They put me on 25mg and I’m irritable as ever. Is there anything that helps the symptoms that’s holistic? Herbs, foods, etc? I am exercising and eating Whole Foods. Still feel angry. I don’t like it.
Michelle, I would see if you can go down to 37.5 mg first and see if that helps. As well, it can help to eat a ton of vegetables to support your liver detoxification systems, exercise/move regularly and I like passionflower and lemon balm teas as well to support your nervous system.
Thank you for this. I will pass this article over to my son. He tried unsuccessfully to taper and the doctors he worked with were horrible. He is back at a reduced doses, and staying where he is for now. Especially, with everything going on in the world. We are all struggling right now.
Karen, I think it's very valid to stay where you need to in such hard times. I encourage patients to not wean when life is hard and this is such a time. Sending your son good energy for the taper when it's right.
With the help of my doctor I was able to taper off my SSRI meds during my electromagnetic treatment for depression. I am truly grateful for how they kept me surviving during certain times of my life but I’m also grateful to be off of them.
This is a very good article. I’m a retired psychiatrist. You didn’t cover the benzos, which I am much interested in learning your persprcted. I am also so glad
Thanks Cherryl. Means a lot coming from a psychiatrist:) I was focusing on SSRI meds in this article but much of what was learned in tapering them well came from the understanding of tapering benzos safely. Very related in practice but also as you know tapering benzos comes with even greater care.
Sorry. Perspective on withdrawal of the anti anxiety meds. I am glad there are integrative psychiatrists around now. I’m in IN, and I don’t think we have any.
I would like to subscribe to your Substack. Frankly, I’ve never figured that out. If I get emails, it’s easy. Thanks!
Cheryl, if you got this article in your emails, you are subscribed. Let me know. If not, I can subscribe you so you get the weekly Friday articles.
Currently, I have tapered my with my provider's knowledge to 1/4 of my initial dose. However, when I have tried to go lower the sensory withdrawal symptoms described in the chart send me back to this level. I am going to try a slower hyperbolic approach as you described. Those shock type sensations with visual disturbance and vertigo are the worst. For me, it feels like a dog is shaking my brain like a toy.
Good job so far! Yes, go much slower. It can work but your brain needs time to adapt.
Horowitz has been a guest on several podcasts, kesser did a whole series on ssri tapering. Very informative.
Where’s the series? Good to know! Love that these people are spreading the knowledge. I will look for Dr. Horowitz on podcasts, have only heard him speak at a conference.
The podcast is called revolution health radio. It’s hosted by an ND - Chris Kesser. He did a few shows back in 2023 covering this topic.
I took Effexor in lieu of hormones to combat menopausal symptoms from hormone blockers and forced menopause due to estrogen fueled breast cancer. Coming off Effexor, under my oncologist’s care, was so incredibly hard and DARK. Whew. It was actually pretty scary the way my mind went so so dark. It made me very hesitant to start Zoloft for my increased anxiety in these current times that have kicked up some long sleepy triggers. I am back in therapy and taking a very low dose of it to see if it takes the edge off. Thankfully my oncology psych nurse practitioner is soooo well versed. I trust her implicitly. I wish ketamine therapy was not so cost prohibitive because that’s what I really want to do. And I wish I could get micro dosing psilocybin down but can’t get it right. * Sigh *
I am open to trying this low dose to see. And as always, thank you for always educating me!!
Amy, that sounded so hard. But It sounds like you have a great provider who can walk you through this. That is very fortunate. I do hope the anxiety and sleep improve.
Thank you for this information. What about cross tapering? And when you are trying to find the right medication? I have a psych consult approaching and I’m pretty sure there will be a recommendation for a new medication as I don’t feel Zoloft is helping me. In your experience and practice what do you do with patients trialing new antidepressant medications?
This is an art form in of itself. Depending on how long you've been on the medication and your particular situation, sometimes providers will decrease one as they increase another and other times fully come off one before starting one.
Are the recommendations the same or similar for SNRIs?
Yes.
Thank you!
Hi Tanmeet. This is a fantastically helpful article thankyou. As herbalists we come across this quite a lot and if you don’t mind, I’d like to add that the support of a herbalist can be very helpful here. We have a number of very effective herbs to support in the process of weaning off SSRIs and the other benefit of seeing a herbalist is the ongoing support that’s offered which can be very helpful in this long healing process. To stress though that it’s vital to see a qualified medical herbalist who understands the mechanisms and can work with you personally (and your doctor) to adjust your herbs as needed along the way.
Personally I experienced the numbing effects of SSRIs many years ago and decided to find my own way out of the blackness. It took time and effort but ultimately my life is in an infinitely better place that it would have been had I relied solely on the medication for my recovery. In fact on reflection I may not have ever properly healed. So like you I do believe they have a place when used consciously, but there are many many other options and every person is unique so the prescription will be different for everyone. 🌱
Thanks Sarah! Yes, for sure herbs can be very supportive.
Thank you for this article. It is timely. While I am still actively taking mine, my daughter has made note of starting to taper. This is wonderful information. Thanks again. 💜
You're welcome Kallai. Good luck to her!
Thank you so much for this incredibly informative post, Tanmeet! I have been on a combination of Pristiq, Klonopin, Risperidone, and Nortriptyline since 2016 to treat acute PTSD, generalized anxiety disorder, and major depressive disorder. Iʻm at a fairly high dosage for most of these medications. Iʻve been trying to taper off for years (as I donʻt enjoy the side effects and I donʻt want to be dependent on the drugs forever), but have had very little success. I usually end up back on the medications due to what appears to be a relapse but may just be withdrawal.
I donʻt think right now is the best time for me to attempt to taper off my meds or even decrease the dosage, but thanks to you, I have new information in my toolkit to bring to my conversations with my psychiatrist the next time we discuss tapering off.
QUESTION: Would you suggest tapering off medications one at a time or in concert?
Thank you so much!
Yes for sure wait until you are ready. I am glad the info feels empowering. And only one at a time is my reasoning to be gentle as well as because if there are symptoms of withdrawal or relapse, it gets too confusing with two at once.
I’m trying to wean of desvenlafaxine. It’s one of the hardest! I’ve been on it awhile - only 50mg. They put me on 25mg and I’m irritable as ever. Is there anything that helps the symptoms that’s holistic? Herbs, foods, etc? I am exercising and eating Whole Foods. Still feel angry. I don’t like it.
Michelle, I would see if you can go down to 37.5 mg first and see if that helps. As well, it can help to eat a ton of vegetables to support your liver detoxification systems, exercise/move regularly and I like passionflower and lemon balm teas as well to support your nervous system.
Such valuable information. Thank you for breaking it down!
You're welcome Deborah! So glad it served you.
I don't take SSRIs but as a psychologist many of my patients do. I'm happy to have this as a resource to share.
Thank you for this. I will pass this article over to my son. He tried unsuccessfully to taper and the doctors he worked with were horrible. He is back at a reduced doses, and staying where he is for now. Especially, with everything going on in the world. We are all struggling right now.
Karen, I think it's very valid to stay where you need to in such hard times. I encourage patients to not wean when life is hard and this is such a time. Sending your son good energy for the taper when it's right.
With the help of my doctor I was able to taper off my SSRI meds during my electromagnetic treatment for depression. I am truly grateful for how they kept me surviving during certain times of my life but I’m also grateful to be off of them.
So good Chanel, both using them as a tool when needed and getting the right support to taper safely when able as well.