This image illustrates why initially every small increase in the drug in your system has large effects, swamping receptors at very low doses then flattening out very quickly. This is the original SSRI and ALL psychiatric drugs have the same kind of receptor occupancy profile.
This image illustrates the MUCH larger changes at lower dosages, which directly correlates with what people experience in terms of withdrawal:
First, tapering must be done gradually: sometimes tapering over months, or even years, especially if the drug has been taken for long periods — and certainly not weeks. This allows the brain to adapt to the changes. Stopping too quickly is a bit like jumping off the tenth floor of a building. Coming down step by step over a longer period of time causes much less disruption to the system.
Second, the rate must be adjusted to the individual. Everyone is different so it is hard to determine ahead of time. The best way to work this out is through a test reduction to see how someone responds to determine further steps.
Lastly, extra care must be taken on reaching the last few milligrams of the drug. This is because very small doses have much larger effects than one would expect, because when there is little drug about every extra milligram has a large effect, but when it is more crowded with drug every extra milligram has less and less additive effect.
We’ll be using the best possible information to structure your tapering program, specifically the Maudsley Deprescribing Guidelines, and sharing detailed knowledge about what to expect, and how we will handle the process.
