How long........

does it take, on average (assuming a nice slow taper), for the brain to heal completely once off SSRIs?

I have been on them for 13 years, and plan to taper for almost the next 2 years.

While I know that I won't be the same person I was pre-med (since nobody, meds or no meds, is the same exact person in adulthood as they were as a teenager), I just want to know a ballpark estimation.

Will my brain--receptors, neurotransmitters, etc--be able to heal fully? How long am I looking at?

[jheaney1]

It varies. There are a lot of factors that play into the amount of time it takes to wean off SSRI. The brain has a remarkable ability to regenerate and compensate for changes that have been made by drugs. When I first started weaning off Paxil, it seemed like it would take forever, too long. It gets better and easier to deal with. I'm still about a year away from being off Paxil at my current schedule, but it doesn't seem too bad to me, anymore. Especially compared to the consequences of weaning too quickly.

Gotcha--what about after the tapering is completed though?

[jheaney1]

I'm not sure about the post weaning time frame. I'm still in the middle of my taper. I would say that a slow taper will protect you better once you're completely finished. It takes some time for symptoms to manifest themselves after each taper, and the effects seem to be cumulative. Taking a Paxil example, say I drop from 10mg/day to 9mg/day. I have both short term and long term symptoms to deal with. The immediate symptoms of my last drop are low grade headaches, increased agitation, anger and frustration. There are also longer term symptoms that may not appear for some time. If I make another drop to 8.1mg/day before I've consolidated the 10-9mg/day taper, I will have both long term and new short term symptoms to deal with. Once I'm finished tapering, there will be some long term symptoms that persist, but I can hopefully minimize those by doing a slower taper now.

[slappyintheface]

It took me about a year after I finished tapering to start feeling like myself again. I have heard a lot of people say that the one year mark usually means quite a bit of relief from the withdrawal symptoms.

[aberdeen]

Originally Posted by slappyintheface

It took me about a year after I finished tapering to start feeling like myself again. I have heard a lot of people say that the one year mark usually means quite a bit of relief from the withdrawal symptoms.

To feel like yourself again took a year even after a slow taper? What intensity level was that year for you, like are we talking major anxiety and other symptoms, or just feeling "off"? I'm curious because I've been on and off basketcase for 2 years now, and just started a slow taper and the idea of yet ANOTHER year after these next two....OMG I'm hoping the next two years for me are a lot more manageable than the previous two.

[obliviousjo]

Don't Freak yourself all out hun....Every day gets better in different ways I think...Looking at things in YEARS is not how we need to think of it...One day at a time works for a reason...I'm no longer keeping track of days like a hawk...Thank God...But I totally did for the first month or so after completly stopping my effexor...The first month was by far the worst..Its now been 3 months since ive been off and I'm grateful everyday that I DONT have to take that stupid pill just to not go into immediate wd...That sucked....Yeah I'm still going thru alot of junk but I also now have half a life so I have zero regrets about going off Ad's...ZERO!!! So yeah, we don't snap back immediately, that would be just too easy....grrr...but we will eventually snap the heck back....Most of us our lil old dried out rubber bands...takes a lil olive oil to get us to loosen back up...hehehe.... Oh but how I wish I was a snappy teen again

[jr1985]

Originally Posted by aberdeen

To feel like yourself again took a year even after a slow taper? What intensity level was that year for you, like are we talking major anxiety and other symptoms, or just feeling "off"? I'm curious because I've been on and off basketcase for 2 years now, and just started a slow taper and the idea of yet ANOTHER year after these next two....OMG I'm hoping the next two years for me are a lot more manageable than the previous two.

Well, for what it's worth, from slappy's sig it looks like she tapered faster than 10% every 3-6 weeks.

[Bilo76]

There is no way to tell. The only rule is that a slow taper is better then a quick. But thats about it as far as certainties go. It depends on so much factors. for instance:
- how long you took the ssri.
- your age
- you diet and exercise habbits before and during the wd.
- how ressiliant your brain is
- if you are a optimistic person by nature
- etc etc.

there are little to no rule of thumb is my experience. My neighbour is 55 years old and she is taking paxil for 18 years. Last year here in holland we got the generic pills and we had to pay more for seroxat. She..and i quote.."thought it was a nice timing to lower the dosage now with this new generic pill". She dropped in 1 day from 30 mg paxil to 10 mg and is on that amount for a year now. She felt no symptoms at all besides some small headaches.

when i heard that story i knew there are no certainties when it comes to an ssri.

however, but this is my personal opinion, there are ways to fasten the healing. Good diet, sleeping, mild exercise, cbt, positive outlook on life, magnesium and fish oil caps, do new stuff every day to train your brain, lots of water, social agenda

[aberdeen]

Originally Posted by jr1985

Well, for what it's worth, from slappy's sig it looks like she tapered faster than 10% every 3-6 weeks.

You're right.

[markca]

hi, i tapered too fast as can be seen. i remained in what i would call a 'struggling to function' state for about 16-17 months afterwards, im only now seeing improvement. Even this month as im about to get to 20 months drug free i feel im improving a little.
i have developed a lot of opinions on things and one thing i think this drug does is to shrink the cells in the brain. why do i say this...well since tapering ive felt my world was so small just doing dishes was a big effort or even to cook a meal was often just too much...hence i had a sandwhich or fruit or cereal instead...now as time goes by i can feel my world expanding ...im doing dishes and housewwork now etc. i can only assume that the cells in my brain are healing, its taken a long time for this to happen and ive got a long way to go yet.
i love to read the writings of the wonderful voice for the voiceless i.e. Dr David Healey. This man is onto it...he says it can take between 1-4 years.
im sure this will be much less if you taper slowly.
These drugs should be banned...its time America woke up and started protecting its citizens and those of other countries!.

[Backtopaxil]

The slow tapering, it is my understanding, should make the withdrawal livable and with minor symptoms. The real healing starts the day the chemical ( or toxin may I say) leaves your body and your brain is on its own.

[Goosey]

Just wondering: What does "20-30mg" mean? Does that mean you tapered from 30 to 20 mg during the time span listed? Thanks.

Originally Posted by Goosey

Just wondering: What does "20-30mg" mean? Does that mean you tapered from 30 to 20 mg during the time span listed? Thanks.

It means that a times I was on 20mg, and other times 30mg.

[PaxilDream]

Originally Posted by slappyintheface

It took me about a year after I finished tapering to start feeling like myself again. I have heard a lot of people say that the one year mark usually means quite a bit of relief from the withdrawal symptoms.

Oh man I hope this will be the case with me too. I would love to only have 5 months left.

[jr1985]

W/d is caused by your brain, which has decreased serotonin production and downregulated serotonin receptors, in response to the increase serotonin from the drug.

To return to normal, your brain must increase serotonin and up regulate receptors.

By following the 10% rule, every time you drop you are decreasing serotonin, but by such a small amount that the w/d is manageable. By waiting 3-6 weeks you are giving your brain a chance to increase serotonin production and up regulate receptors.

So, in theory, by the time you reach 0mg, your brain should have increased serotonin and upregulated receptors enough that w/d should be minor and short lived at this point. That's why I disagree that "real healing beings once the drug has left your system". You've been allowing healing to happen gradually, every time you drop 10%.

[aberdeen]

Originally Posted by jr1985

W/d is caused by your brain, which has decreased serotonin production and downregulated serotonin receptors, in response to the increase serotonin from the drug.

To return to normal, your brain must increase serotonin and up regulate receptors.

By following the 10% rule, every time you drop you are decreasing serotonin, but by such a small amount that the w/d is manageable. By waiting 3-6 weeks you are giving your brain a chance to increase serotonin production and up regulate receptors.

So, in theory, by the time you reach 0mg, your brain should have increased serotonin and upregulated receptors enough that w/d should be minor and short lived at this point. That's why I disagree that "real healing beings once the drug has left your system". You've been allowing healing to happen gradually, every time you drop 10%.

That's what I'm clinging to!

Originally Posted by jr1985

W/d is caused by your brain, which has decreased serotonin production and downregulated serotonin receptors, in response to the increase serotonin from the drug.

To return to normal, your brain must increase serotonin and up regulate receptors.

By following the 10% rule, every time you drop you are decreasing serotonin, but by such a small amount that the w/d is manageable. By waiting 3-6 weeks you are giving your brain a chance to increase serotonin production and up regulate receptors.

So, in theory, by the time you reach 0mg, your brain should have increased serotonin and upregulated receptors enough that w/d should be minor and short lived at this point. That's why I disagree that "real healing beings once the drug has left your system". You've been allowing healing to happen gradually, every time you drop 10%.

Logically, that makes perfect sense!

[Backtopaxil]

Originally Posted by jr1985

W/d is caused by your brain, which has decreased serotonin production and downregulated serotonin receptors, in response to the increase serotonin from the drug.

To return to normal, your brain must increase serotonin and up regulate receptors.

By following the 10% rule, every time you drop you are decreasing serotonin, but by such a small amount that the w/d is manageable. By waiting 3-6 weeks you are giving your brain a chance to increase serotonin production and up regulate receptors.

So, in theory, by the time you reach 0mg, your brain should have increased serotonin and upregulated receptors enough that w/d should be minor and short lived at this point. That's why I disagree that "real healing beings once the drug has left your system". You've been allowing healing to happen gradually, every time you drop 10%.

AD do not regulate serotonin. They modulate receptors in the brain. Noboby has any idea how long it takes for these receptors to either wake up or regenerate. According to Dr Breggin, some actually die early in the process of downregulation by these drugs. Some never recover. In addition, nobody knows how long it takes for the body to start producing serotonin. In some cases this process is faster than receptor recovery, thus you are left with an overload of serotonin ( or an imbalance of neurotransmitters), which can be a neurotoxin in higher than normal levels.


The problem with your theory is that in essence, you should be able to switch to another AD to take over functions. They all work the same and it should be a seamless process. But does not work most of the time. And we see cases here where people taper properly and still have a problems after the last dose. Some even reinstate. Why is that?

Note: I am not debating the 10% rule, I am debating the withdrawal process.

[jr1985]

Originally Posted by Backtopaxil

AD do not regulate serotonin. They modulate receptors in the brain. Noboby has any idea how long it takes for these receptors to either wake up or regenerate. According to Dr Breggin, some actually die early in the process of downregulation by these drugs. Some never recover. In addition, nobody knows how long it takes for the body to start producing serotonin. In some cases this process is faster than receptor recovery, thus you are left with an overload of serotonin ( or an imbalance of neurotransmitters), which can be a neurotoxin in higher than normal levels.


The problem with your theory is that in essence, you should be able to switch to another AD to take over functions. They all work the same and it should be a seamless process. But does not work most of the time. And we see cases here where people taper properly and still have a problems after the last dose. Some even reinstate. Why is that?

Note: I am not debating the 10% rule, I am debating the withdrawal process.

SSRI's block serotonin transporters, prolonging the time serotonin spends in the synaptic cleft. This increases serotonin activity, which causes the brain to downregulate serotonin receptors.

The reason you can't always switch is probably because everyone's biochemistry is slightly different. So while all the SSRI's essentially do the same thing, they are different enough for your body to react differently to them. For instance, some people may metabolise Paxil faster than Prozac, which would make the dose too high/low if they're switched to an equivalent dose.

Also, the only true SSRI is escitalopram (lexapro), as all the others hit other neurotransmitters (Prozac hits noradrenaline, which makes it more stimulating). So switching to a drug that targets different neurotransmitters could cause problems, especially if it's an SNRI -> SSRI switch.

Tapering "properly" (i.e 10% drops) is not always right for everyone. Some people can't handle 10% drops.

Regardless of how SSRI's work, the same principal applies - tapering slowly allows your brain to gradually get used to being without the drug, so once you stop completely you shouldn't have such a hard time.

But I realise none of this is simple, SSRI don't just block serotonin, and some people do just have a hard time once they stop completely.

[aberdeen]

I would like to think that even if some receptors actually "die" that more would regenerate, or be created.

[Backtopaxil]

The SSRi increase may be temporary ( thus increase anxiety, side effects when starting), then the system ( so beautifully created by God), downregulates its production of serotonin and some other neurotransmitters. That is why some experts now say this is all placebo.

But I agree that 10% should be a good standard for those who want quality of life while tapering. The body will be in a mild state of long term withdrawal.
But I insist, the true healing starts once your drug free.

[PaxilDream]

Originally Posted by Backtopaxil

The SSRi increase may be temporary ( thus increase anxiety, side effects when starting), then the system ( so beautifully created by God), downregulates its production of serotonin and some other neurotransmitters. That is why some experts now say this is all placebo.

But I agree that 10% should be a good standard for those who want quality of life while tapering. The body will be in a mild state of long term withdrawal.
But I insist, the true healing starts once your drug free.

I see what you are saying but there is no way it is a placebo effect. I do believe in the test they ran with a short 8-10 week test of course there wasn't much difference from placebo. But there was no doubt the medicine worked and worked good for some time. I was a night and day person and the drug saved me for quite some time.

[aberdeen]

Originally Posted by PaxilDream

I see what you are saying but there is no way it is a placebo effect. I do believe in the test they ran with a short 8-10 week test of course there wasn't much difference from placebo. But there was no doubt the medicine worked and worked good for some time. I was a night and day person and the drug saved me for quite some time.

Totally agree. Besides an 8-10 week study doesn't give those a chance for whom it takes more like 12-16 weeks for full effect to kick in, like me. There is no way on earth the relief I experienced from effexor back in the day was placebo. I was dubious beyond belief about these meds and was practially forced into taking it. I have no regrets, it was the best thing I could have done in the place I was in and wit hthe options I had. My mistake was to stay on too long and to allow my dose to be raised.

[julieannboo]

Originally Posted by Backtopaxil

The slow tapering, it is my understanding, should make the withdrawal livable and with minor symptoms. The real healing starts the day the chemical ( or toxin may I say) leaves your body and your brain is on its own.

do you think it starts healing the day you take the last dose or as you begin to get lower and lower the brain starts healing?