Today’s article is based on a question I am seeing more and more on the blog: How do I taper from my antidepressant with tryptophan and can I safely use the other amino acids?
I find my clients do better when tapering off an antidepressant (which is often prescribed for anxiety and panic attacks) when their nutritional status is solid. Incorporating diet changes and adding amino acids and other nutrients first can result in a more successful taper with less side-effects. This would mean starting with the basics – eating real whole food, incorporating quality animal protein, eating to balance blood sugar, and removing gluten, caffeine and sugar.
If needed and based on testing results, it’s important to address any other nutritional deficiencies such as low iron, low vitamin D, low stomach acid, low total cholesterol, low B12 (and whatever else is an issue), plus support the adrenals/sex hormones/thyroid if needed and addressing gut health like leaky gut and dysbiosis.
Adding a good copper free multivitamin and often the addition of zinc and vitamin B6, evening primrose oil and possibly fish oil – the latter based on each person’s unique needs.
With antidepressants such as selective serotonin-reuptake inhibitors (SSRIs), I have my clients work with their prescribing doctor and get the approval to add tryptophan (or 5-HTP) 6 hours apart from the SSRI. If they are taking the medication at night they get the approval from their doctor to switch it to the morning, and will take tryptophan (or 5-HTP) at least 6 hours later, mid-afternoon and evening.
If they decide to do both the medication and tryptophan (or 5-HTP), they get a protocol for the SSRI taper for the future. This is important. If you are in too big a rush to start right away, it often causes more issues. It’s also important to make sure you get a very slow taper protocol from your doctor. Some antidepressants are harder to taper (Paxil is notoriously difficult) and they all should be tapered really slowly.
The plan is to start to taper the SSRI once you have been using the tryptophan (or 5-HTP) for at least 4 to 8 weeks and are seeing real benefits by using it. This translates to much much less or none of the following symptoms: anxiety, depression, insomnia, rumination, worry, negative-self-talk, perfectionism, afternoon and evening carbohydrate cravings, PMS, rage or anger.
For some of my clients it’s 3 months before they feel they are ready to taper. This may be because of feedback they have provided based on prior taper attempts and how they are feeling this time. It may also be based on what else is going on in their lives like a stressful work situation. It may also be based on the time of the year: winter is generally not a good time to taper and definitely not if you suffer from increased depression or anxiety in winter.
The tryptophan (or 5-HTP) is adjusted up as needed while continuing to taper the SSRI.
The doctor is always kept informed and monitors for the possibility of serotonin syndrome. I learned about the potential concerns about serotonin syndrome when using tryptophan or 5-HTP with an SSRI from Julia Ross, author of The Mood Cure, and so I continue to caution my clients about this.
When I interviewed Dr. Peter Bongiorno in season 4 of the Anxiety Summit (Serotonin and anxiety: tryptophan, 5-HTP, serotonin syndrome and medication tapers), he shared that he is not concerned about serotonin syndrome being an issue with tryptophan or 5-HTP dosed with an SSRI, even if taken at the same time. He cited research that found the combination of tryptophan and SSRI did not result in serotonin syndrome in any of the participants.
Dr. Bongiorno also uses the same approach to address the basics:
the most important thing is that we really establish all the basics and that they’re in the healthiest place possible. Because if those aren’t there, if a patient just gets off the medication and we haven’t really done anything to change the underlying reasons why they got to the place where they had the mood issue, in most cases they’re going to go back there again.
Some people need amino acid support in more than just the low serotonin area so we review the amino acid questionnaire and consider trials of GABA and other amino acids too. All this only applies for SSRIs and tryptophan or 5-HTP. The other amino acids can safely be used with SSRIs, and it’s not uncommon to also have low GABA, low endorphins, low catecholamines and low blood sugar and need them all, but it’s still best to discuss them with the prescribing doctor.
We also review all the amino acid precautions.
Some people choose to work with their doctor to taper the SSRI and then add the tryptophan (or 5-HTP) once they have quit the medication. I have found that this makes it much harder to do and more side-effects are seen. With the amino acids you start to get some relief right away and have hope on the first day! They also make it so much easier to quit the sugar, gluten and caffeine without having to use will-power.
In summary, these are my recommendations for doing an SSRI taper with amino acids:
- doctor’s approval to taper the SSRI and use amino acids
- address diet and nutritional deficiencies first – before starting to taper
- work with someone knowledgeable in amino acid use
- OR educate yourself by
- reading my book The Antianxiety Food Solution , Julia’s book The Mood Cure and Dr. Kelly Brogan’s new book A Mind of Your Own
- listening to the Anxiety Summit interviews
(please don’t simply read one or two blogs and jump in to this)
- use the amino acids from day one to start addressing low levels of all the brain chemicals
- use the tryptophan or 5-HTP at least 6 hours away from the SSRI
I would like to add that Dr. Brogan shares that coffee enemas help her patients who are doing medication tapers.
If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. It’s an opportunity to interact with me and other practitioners who are also using the amino acids and helping their clients/patients to taper from antidepressants (always working with the prescribing doctor).
Have you used a similar SSRI taper protocol? And how did it work for you? What would you have done differently? And what advice would you give someone contemplating an SSRI taper?
Have you found that coffee enemas have helped?
If you are a practitioner, has the above approach been helpful for your clients/patients?
Your post said:
“When I interviewed Dr. Peter Bongiorno in season 4 of the Anxiety Summit (Serotonin and anxiety: tryptophan, 5-HTP, serotonin syndrome and medication tapers), he shared that he is not concerned about serotonin syndrome being an issue with tryptophan or 5-HTP dosed with an SSRI, even if taken at the same time. He cited research that found the combination of tryptophan and SSRI did not result in serotonin syndrome in any of the participants.”
Yes, I too can attest to having never had a hint of anything bad happening when taking 5-HTTP at the same time as an SSRI (and I have done so many times). It may be different for everyone, but personally, I have had zero negative impact (at least nothing I have ever remotely detected) from doing so.
Thanks for sharing. Can you please let us know why you have taken both? and how much 5-HTP and which SSRI (and how much of that)? May I also ask what benefits you saw being on both?
Hello, I thought I’d add my comment in here, because its on topic!
Just wanted to share that I have had what I believe must have been serotonin sydrome from taking escitalopram 5mg, and 5htp at the same time. I was also using st johns wort. I didn’t use huge amounts of any of them but it seems that the 3 must have badly combined. st johns wort is also contraindicated with ssri’s (for anyone not aware) so it makes sense taking two things which both affect serotonin with an ssri at the same time could cause issues.
I have also had what i can only assume was serotonin sydrome as a result of taking a migraine medication, sumatriptan, alongside escitalopram 10mg. I had taken the sumatriptan without issue at 25mg, then one day i took 50 mg in a day and was affected by the SS. So I’m quite wary of SS now.
Catherine
Thanks for sharing. May I ask what symptoms you experienced and if your doctor diagnosed you with serotonin syndrome? And how quickly it took for symptoms to resolve?
May I ask how much 5-HTP and St Johns Wort were you taking and how long did you use these after starting the escitalopram?
And yes sumatriptan has been reported to cause serotonin syndrome when used with escitalopram.
I have taken 100 mg of Pristiq for the last 8 years. Other SSRIs before that for a total of 26 years. I have been off Klonopin for 29 months and believe I am still healing from the damage it caused after 8 years. My diet is good and no gluten, sugar, milk. My question is, is it safe to use Tryptophan to help me during a taper off Pristiq? Is it ok to use Gaba with having come off of a benzo? There are so many mixed reviews and I am just not sure how to proceed. Thank u for any help.
Dana
Since Pristiq is an SRNI there is a potential for serotonin syndrome with tryptophan. I’d work with a practitioner well versed in what I share about in this blog.
There are no documented issues with using GABA during a benzo taper or after having tapered. It is very helpful for most folks but there is sometimes an issue with down-regulated GABA receptors.
Apologies for the delay in your comment approval and my response. We had a computer glitch where a large number of comments were hidden from view in a spam folder. It mostly affected new folks who were commenting for the first time but it’s hopefully resolved now.
Hi I am on 5mg escitalopram(lexapro generic) and I found this article very interesting. I am on zinc, magnesium, l theanine, gaba, fish oil, cod liver oil, dairy free, vegan, soy free, wheat free, vitamin b d e, probiotic, maca, ashwaghanda and any other supplement haha I will try 5 htp in morning ssri 5mg at night and see if I feel ok. I want to taper off the Ssri due to the side effects. I feel like an old woman in a young body on ssri. My dr doesn’t seem to think any natural supplements will do the trick for my anxiety and I disagree I know there is a supplement out there. I won’t stay on ssri my whole life so thank you for this article I am going to try.
Luella
Please be sure to discuss with your prescribing doctor even if he/she doesn’t seem to think any natural supplements will do the trick for your anxiety. He/she can at least monitor you
And do keep us posted on how you do
Dear Trudy,
I take 30 mg of mertazipane at night before bed with GABA. Can I also take 5 H T P along with the GABA? I read that
5 HTP can have the opposite effect.
I have been taking 5htp for several years and am just now learning it isn’t meant to be taken indefinitely, but when I run out of it for a few days I get very depressed. I think I may be having side effects from it however. Twitching muscles, sexual problems. I’m wondering how I could taper off 5htp and how and what I could introduce as a substitute to address my anxiety, depression, ADHD symptoms, and SAD
Leila
I’m not aware of twitching muscles and sexual problems from long-term 5-HTP use and would want to confirm this continues when 5-HTP is stopped. And also rule out other factors like hormone changes, low b12/low magnesium and medication side-effects.
Other ways to support serotonin include exercise, full spectrum light, tryptophan, saffron, theanine and curcumin. Using precursors such as zinc, vitamin B6, magnesium help with serotonin production too.
I’d also focus on diet – real foods, no gluten/caffeine/sugar, quality animal protein, organic veggies/fruit, healthy fats etc. My book “The Antianxiety Food Solution” is a great place for this foundational change. More here https://www.everywomanover29.com/blog/the-antianxiety-food-solution-by-trudy-scott/
I am very confused about the role of neurotransmittors in depression, anxiety, and OCD. Dr. Brogan thinks they do not play a role, but you seem to disagree. I have been on anti-depressants for over 20 years, and have gradually tapered – from 150 mg of Zoloft down to 15 (which is a minucule amount and way below the therapeutic dose) but started having such bad side effects I couldn’t go lower. I am now following Dr. Brogan’s book and hope to get off it completely in time, but it is rough going.
My naturopath put me on Dr. Hinz’ protocol. He uses massive amounts of 5 HTP and tyrosine. The theory is that the brain has been so wrecked by drugs, that it has stopped making serotonin and dopamine and needs tons of the precursors in order to function properly. Have you heard of this approach? Any opinion on it? I am curious if you would consider interviewing him and his approach.
I am caught between thinking my serotonin is wrecked, and that it doesn’t make any difference at all (Dr. Brogan). Can you please clarify????
Many thanks
Susan
I’m sorry to hear you’re having a rough time of it.
Neurotransmitters absolutely play a role in anxiety and depression and I think you’ll find Dr. Brogan agrees. She just feels that dietary changes and addressing the microbiome and inflammation is more important as a first step – and later addressing other nutritional deficiencies. She does also use amino acids when tapering medications (I think to a limited extent). I have just found that my clients need all the support they can get to make the taper less painful – hence my use of amino acids from day 1.
I don’t use the Hinz protocol as each person is unique and I have not found a one-size fits all approach for anything for any one person. Also many of my anxious clients cannot tolerate tyrosine until we have the anxiety under control with GABA or tryptophan. I also start with tryptophan because 5-HTP can raise cortisol and not help for the wired-tired anxiety/depression. I would never say the brain is so wreaked but the meds can cause havoc and be more problematic with some people. Others seems to do fine on them and tapering. Again that uniqueness.
And yes I’d love to interview him but would like to first attend his training so I have a better feel for the rationale. I have heard that practitioners have very good results with this type of approach for Parkinson’s disease.
It is unfortunate there are all these differing approaches but that’s good because we have to question and learn from each other. And clearly people do benefit from each of them or else we wouldn’t be doing it the way we do. It’s a matter of finding your solution.
Thanks, Trudy
The part about the brain being so wrecked from drugs is my inpterpretation of things – not Dr. Hinz’. But after being on AD for so long, I think my brain is far from normal in it’s ability to produce and balance any sort of neurotchemicals.
Dr. Hinz addresses a lot of different issues – anxiety, depression, bipolar, etc. I am using it to help stabilize after a long history with AD.
His approach isn’t a one-size-fits-all approach. The initial starting dose is the same for everyone, and it often works to resolve symptoms. But if this is not the case, you do urine testing. It is different from the urine testing for neurotransmittors that others do – he has developed something called Organic Cation Transporter testing, which I don’t quite understand, but apparently provides an accurate indication of what is going on.
Following the testing, dose adjustments are made. Dr. Hinz will review the lab reports himself, and offer recommendations to the naturopath as to what changes need to be made.
Once again, if the dose adjustment doesn’t resolve symptoms the process is repeated – another test, then another dose adjustment. This can be quite costly and time consuming, but after a series of tests and does adjustments, you get to the optimum dose for each individual. It is different for everyone, based on your ow unique needs. The goal isn’t just to raise the level of neurotransmittors, but to achieve the correct balance between them.
I don’t understand a lot of the science behind this approach, but he has been doing this for over 20 years, and has published a lot on the subject.
Thanks Susan. I have seen some of his work and heard some good results from folks, also some not so good results. I have had colleagues rave about this approach and others not like it at all
But it is an area that is one my list to look into as we can all learn from each other.
Regarding Susan’s comments about K.Brogan’s views on neurotransmitters: If I understood her book properly, she was just making the point that she doesn’t believe that deficiencies are the primary cause of depression, but rather inflammation from malnutrition, poor gut health, stress etc. And thus, treating with SSRIs for instance, has no benefits and only negative consequences of desensitising the synapses and also reducing the amount of serotonin available in the brain – actually causing a serotonin deficiency.
Does this protocol apply also to tapering off lamotrigene? I am in the middle of a taper from 100 mg per day and have made it to 52 mg tapering only 10% dose reductions. I am supporting myself with methylated B12, Omega 3 F.A., D3 and other supplements under advisement from a professional who uses energy/muscle testing. I do get breakthrough anxiety and anger issues sometimes. Would amino acids help with this?
Thank you for all the knowledge you are providing to those of us who are recovering from medication damage. I also had to taper off Klonopin and oxcarbezapine. It has taken 13 years to to achieve this with no help from the traditional psychiatrist who prescribed them to me in 2002.
Valerie
You are so welcome! Sorry to hear you have been on your own with this. Lamotrigene/Lamictal is not an SSRI so there are not the same tryptophan/5-HTP precautions to be followed.
For anyone with anxiety/anger issues I have them do the amino acid questionnaire and a trial of the respective amino acids
https://www.everywomanover29.com/blog/anxiety-amino-acids-overview/. Anxiety can be low serotonin and low GABA, anger is typically low serotonin or low blood sugar – and so yes the amino acids are often very helpful for this.
Of course diet and lifestyle changes too – real food, quality animal protein, eat to control blood sugar, no gluten/sugar/caffeine, address gut health, exercise, sleep etc
A neurologist prescribed Prozac for me in 2012. By day 5 I could barely walk. It was frightening how fast it came on. I’ve always had weak, heavy legs, but push on. This time I was out shopping at the mall and I really thought I was going to need a wheel chair to get out. Stopping every five minutes to gather strength. Scary. Stopped taking immediately. Neurologist wanted me to try Paxil, I said no. I had previously been taking 5HTP at night since 2009.
Trudy, am I correct understanding that seratonin is made in the gut and in the brain. If your low in one, is the other automatically low? Or can one be low and other high?
Jaci
Wow, sorry to hear this! But the advantage of this is that you weren’t on it for years only to discover challenges with tapering.
Does the 5-HTP help you? and how?
Most serotonin is made in the gut and there is a bidirectional connection between the gut and brain via the vagus nerve. Testing is not sophisticated enough (yet!) to measure it in both places but from my work I’d say they could both be low, both high or one low and one high.
I never felt any benefit from 5HTP. Was up to 4 a night. Nothing. I may have even been taking it when I tried Prozac, but can’t remember for sure. I stopped taking it 2013. It’s in my supplement graveyard box under the sink I took multiple blood and urine tests in 2009 (metametrix and another I can’t remember name of) and it shows my serotonin levels ok. So looking back I’m not sure why functional doc still had me taking 5HTP. This has me wondering re:gut/brain serotonin. I will tell you what has helped recently… 9000mg of omega 3 daily. I heard it on one of the talks (I really should make note of these talks, so many I get lost who said what). But it was a neuro specialist talking about flooding the brain with omegas to heal damage, along with dampening inflammation and increasing blood flow. Since an ultrasound of my brain blood flow showed slowing (no clots) I thought I’d try it. And I will admit I feel a bit perkier.
So many pieces to this huge puzzle …
I successfully did this with Zoloft, thanks to you, Trudy, and Julia Ross. I’m two months past my last dose of Zoloft and doing pretty well. I still take Lidtke tryptophan, GABA, and l-theanine daily as well as other things, like C, B complex, fish oil etc. What I would do differently: follow the advice to clean up my diet FIRST. I was a clean eater but hadn’t given up important things like dairy and coffee. (which I am now doing) My advice to others: hang in there through the weaning/withdrawal process. It will pass and it will be worth it. Be gentle with yourself, too. My doctor has been very supportive, also, throughout this process. In fact, in between two of my visits she had looked up both this website and Julia Ross’s, and was giving me advice based on both! So don’t be afraid to discuss these methods with your doctor and get their assistance, also.
Abby
This is wonderful to hear! I’m so happy for you! Thanks for sharing here – this will inspire others and give them hope! I’m also glad to hear your lovely advice about being gentle with yourself and working with your doctor (who sounds wonderful!). I agree the diet and caffeine is a big one that many people skip.
Hello!
My name is Rossi,
and I had in the past ,depression for a lot of years…
I am taking the last 4 years,in order to get out of antidepressants and benzodiazepins ,3000 milligrams a day of niacine (B3) plus vitamine C ( same amound)
I want to stop the niacine and replace with other vitamins or acids
Can you recommend me with what can i substitute?
For example, tryptophan, gaba ,5htp,(etc)?
And in which doses? ( about..)
Thank you very much
Is it important to be gluten free for anxiety? Is it for the everyone with anxiety or it vary from person to person. My main diet is made of Wheat. Should I change.
Suresh
I have all my anxious clients go gluten-free and the majority of them benefit dramatically.
Can you use this taper protocol with tricyclics?
Lesley
They work on both serotonin and norepinephrine http://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20046983. And yes you can but as always be sure to work with your doctor.
Trudy – I’m getting ready to start a taper from 50 mg of Zoloft. My doctor has me going down to 37mg. Do you have any articles on that? I have been looking on your website and can’t seem to find one.
I’m also still breastfeeding three times per day. Do you recommend the amino acids while breastfeeding. My doctor had no idea. When I took the quizes in the book – I scored high on the GABA supplement.
I love all your stuff — just frustrating I can’t find someone local with this kind of knowledge
While I’m asking — Are there an sample meal plans on your blog?
Thanks so much!
Desirae
This blog post explains just this and you may want to share it with your doctor. The amino acids have not been tested in breastfeeding but with the doctor’s ok I have my clients use them right after feeding and then not feeding for another 3-4 hours. Also monitoring baby is advised.
I’m afraid I don’t have sample meal plans on the blog
Great. Thank you. Now the article is mostly on tapering with 5-HTP. Since I scored in need of GABA would I just do the above protocol with GABA instead of the 5HTP?
Thanks.
There is no issue with taking GABA at the same time as an SSRI (this precaution is only for tryptophan and 5-HTP). The same breastfeeding precautions do apply
Hi Trudy
I’m having a bit of an issue getting started. I have been under extreme stress for a very prolonged time and I am on many many medications for various issues but the majority being anxiety, depression, PTSD and insomnia. My psychiatrist had me on 3 antidepressants to cover all these issues but I am having serious side effects from at least one or two of the meds. My neurologist noticed breakthrough anxiety and prescribed xanax which helps some of the major anxiety but made my psych very angry. Another issue that came up is obvious tardic discanesea which he said could be caused by 1 of 2 of the antidepressants and he stopped one cold turkey. I tried to bring up to him that I wanted to get off meds and on a more natural protocol with GABA and Tryptophan and he was very negative toward the idea. I could tell he had no idea of what I was trying to explain but instead through out flimsy reasons not to do it. So now I’m left floating and not sure how to proceed. How do I get off the remaining antidepressants and the xanax so that I can safely use the Tryptophan and GABA? And I’m not even sure if there are any other supplements I may need.
Sorry for the extra long note. Just a lot going on. Thank you for your help
Curious about withdrawals with SSRI brain zaps ..tried even at 25 mg ..any way some recommended a supplement online called sunny mood 2 kinds one had htp and other had fish oil as replacement instead ? So I think the bottle says 100mg htp. So is it safe to take either together at regular dosage 2 a day with 25 mg Zoloft and wean off? Or take just one htp not at same time as Zoloft to start..? I was at 50 mg Zoloft now 25mg.. a small amount of zaps now. Then I guess I’ll cut in half..but never have been able to get off ever because of that weird brain whoosh.. thanks guys
Hello Susan,
In regard to your post on Nov. 18 about the Hinz protocol and using large amounts of 5-HTP and Tyrosine…. Have you been using both and how did it affect your anxiety? I had a Dr. (that I was doing neurofeedback with) who wanted me to take a product called NeuroReplete that has 5-HTP and large amounts of Tyrosine. I was totally afraid to try it because of what Trudy mentioned about the possibility of it making anxiety worse.
Margaret
Hi Margaret
There are a couple of follow up comments to my post on Dr. Hinz’ protocol (above) that you may be interested in looking at.
He has developed a whole system, with quite a bit of research behind it. You start by taking 4 Neuroreplete twice a day. If symptoms aren’t resolved, you add 4 Replete Extra the following week. Then, if necessary, you add another 4 Repelte Extra in week three.
Apparently a lot of people have resolution of symptoms within the first three weeks – at either the first, second, or third dosage level. My naturopath has seen this happen quite a bit.
If there is not a resolution of symptoms, you are given a urine test, and dose adjustments are made based on the results.
For me, it was a long and expensive process. I needed about 8 tests and adjustments, and didn’t see results for many months.
This was partly because I was a complicated case and have a lot of issues. (depression, OCD, Tourettes, anxiety). OCD is apparently one of the hardest things to treat. I also had a lot of “paradoxical” reactions, where I would feel worse on a certain dose, rather then better. But I think I have finally found the right dose.
This link explains the protocol in more detail.
http://www.healthyselfnow.com/MTOprotocol.php
I tried this protocol because I was desperate. Tapering off of antidepressats was a horrendous experience for me. I tried using individual amino acids, since so many people have success with this – but could never find the right combination or amount on my own. This was prrobably because my case was was so complicated and because (at least this protocol) I need very high amounts.
Good luck with your decision. I hope you will repost if you decide to try it, and what your results are.
Cheers
Susan
Susan
Glad to hear you got resolution finally. As you know I like my clients to see results on day one – but it can be more challenging for some people to find that sweet spot.
I have been taking 75 mgs. of venlafaxine for about 5 years. My memory, both short and long term has become so bad, it was effecting my daily living. Being 71 years old I thought I may be getting dementia. I recently married, yes, that the good old age of 71! I felt I had a good support system to taper off my med, which I was taking for severe anxiety and depression. I did research and found a book titled, How to get off Psychoactive Drugs Safely. It is tThe Road Back Program, authored by James Harper N.C.and Jayson Austin N.C. I used all his supplements and followed his protocol, and am now off my med, still with small amount of side effects, still using his protocol. It absolutely helped me through this nightmare. The book is free, and covers all types of melds. Very well explained. I highly recommend it. God bless all who who are tapering.
Carolyn
Thanks for sharing this for others here – so glad to hear you had this support! and congrats on your recent marriage!
Thank you for providing such an amazing resource, first of all!
My wife is currently weaning herself of 50 mg Pristiq (Desvenlafaxine), which is an SNRI not SSRI. I suggested she taper based on the schedule found at SA and go to a compounding pharmacy to accurately do so, but she preferred to follow the Dr’s advice and alternate days. She is now taking one 50 mg pill every 3rd day, soon to be every 4th day. As you can imagine, she is suffering from the withdrawal and it is impacting her work and home life.
Is it possible for her to use the 5-HTP and L-Tyrosine at the same time as still taking her medication, or is it better for her to wait until she is completely off the medication first?
I am concerned that if she takes 5-HTP whilst still having Pristiq in her system, it may cause Serotonin Syndrome or something like this.
Unfortunately, her prescribing doctor (psychiatrist) has not been very helpful in discussing alternative remedies or supplements to aid in coming off Pristiq.
Any advice most appreciated – with thanks!
Dawood
I can’t give specific advice via the blog (only to clients). I would follow the guidelines I’ve outlined in this blog and ideally find a supportive prescribing doctor or/or add a functional medicine practitioners to her team. The key with all tapers is super slow with plenty of nutritional support – best before starting any taper.
You mention eliminating gluten and caffeine, but not dairy. Is dairy okay for some/ most people??
Dagwood, if you are taking a tablet, I think it is better to take it every day, cutting down a little, say, every two weeks or longer as your body adjusts. However, if you are taking capsules, you can’t cut them,so your only choice is every other day. Take your time. I know from experience that you will have side effects, some of us worse then others and depending on the med.DON’T give in to the side effects! Those drugs will destroy your brain. God bless.
Hi Trudy,
I’m on Celexa 20mg and Effexor 75mg. I had been on SSRI’s for about 20 years and the SNRI for about 2 years.
I will start a taper with my Doctor’s approval. But when you take 2 different antideppresants, do you taper off one first and then the other one? Or both at the same time?
I will really appreciate your orientation. Thanks! 🙂
Trudy,
I’m reading that many people benefit from taking 5-HTP with SSRI’s. I am on Remeron which is in a class all it’s own. Have you effectively used amino acids with others coming off of this drug?? Is it safe, as far as you can tell, to use amino acids with this drug?? It has been recommended to me to use Sam-E, and also 5-HTP, but I have been very frightened to try either of these.
I would appreciate any thought.
Thank you.
Jill
I don’t have experience with anyone on Remeron (Mirtazapine). Per this site http://medical-dictionary.thefreedictionary.com/mirtazapine “is not structurally related to any of the classes of antidepressants” and “Potentiates effects of norepinephrine and serotonin by blocking their synaptic reuptake.” So I’d assume the same tryptophan/5-HTP rules would apply. Tyrosine may also be a problem. GABA, glutamine and DPA would likely be ok to use but I’d have my client check with their prescribing doctor.
Hello Jill,
I am not a doctor, but I took SAM-e after I stopped my antidepressant, thinking it would be a safer way but I regret it so much. At first it gives a lot of energy by rising dopamine level in the brain. But after I had very bad palpitations. Can’t cut the pill because it’s enteric and passes through the stomach. So no, don’t do that!
Can Carolyn Volger who spoke about the road back program be reach to give some more information on her journey with these supplements and what ones she is still using though off the meds
I am on anti depressants and my daily dose of medicines are 2.5mg olanzapine and 15mg. mirtazepine since 3 months.I want to wean off these drugs and wish to replace/uitilize natural amino acids for fighting my depression/anxiety panic attacks with the guidance of some expert in the field.
Hi. I heard your talk with the Headache & Migraine Summit. How do I get my Dr to agree to bring me off Prozac so I can take either 5-HTP or Tryptophan?
Marla
Hello. I stopped taking Prozac a week ago after only taking it for 3 weeks. I had horrible side effects that I could not handle. And I really couldn’t handle them because it was adding to the anxiety and insomnia problems I already was having. Unfortunately I still only sleep an hour or two a night, and when I do I have crazy dreams. My question is, do you think adding 500 mg of l-tryptophan to my diet every other night would hurt considering I’ve only been off Prozac a week? My doctor doesn’t seem to specialize in mental health at all and I’m currently seeking a psychiatrist. Thank you
Corey
I would always suggest checking with the prescribing psychiatrist. The dosing is typically 6 hours from the SSRI so I would feel comfortable with a client trialing tryptophan knowing their doctor is ok with it.
My md would like me to get off Zoloft and on to tryptophan instead but says I can’t do it until I am off the Zoloft completely because of serotonin syndrome. So I am reading this correctly that if taken 6 or more hours apart, tryptophan can actually help get off the Zoloft and I needn’t be concerned about the syndrome? This would be wonderful news
Janet
There is a potential for serotonin syndrome which is why the doctor needs to be on board
Hi Trudy,
Reading these posts has really brought me hope! I have tried to go off of Cipralex twice in the last four years, and was unsuccessful. My taper was slow, over a year and a half, but I realize now that the drop was too large (from 20mg to 10mg to 5mg, then 5mg every other day to off). I went back up to 10mg until stable in the withdrawal in August, but I was not defeated! I do not need this medication anymore, so I am very determined to come off of it.
Since then, I have done a great deal of reading and have made huge changes to my diet, exercise and sleep habits to prepare for my next attempt. I’m down to 9mg and doing fine, of course, I didn’t run into much trouble in my past attempts until I got to 5mg very second day (I can’t believe this is the recommended approach to going off this medication!). This time is different. I am working with my GP and a pharmacist at a compounding pharmacy on tapering in small increments (as low as 1% if necessary) to get off of the last 9mg. I’ve stopped eating anything with sugar or wheat for two weeks and started taking supplements (fish oils, etc that I read about in Julia Ross’s book). That alone has made a huge difference. I’ve ordered your book since coming across your presentation on amino acids. After going through the lists you presented, I am interested in starting the amino acids as soon as I can! I have a Dr appt next week and plan to discuss starting with tryptophan.
I’m still learning about the other amino acids. My question is, did I read correctly that they can be taken while on an SSRI?
Victoria
I’m so glad you’re finding answers and yes a super slow taper is key for so many people. I do use tryptophan with clients who are tapering off a SSRI as I mention in the article – and with their doctor’s approval and monitoring.
Thank you, I am full of hope now that I will be able to come off Cipralex and heal my system.
Victoria
Hi Trudy,
I had an appointment with my GP this morning. We worked out a plan to taper off Cipralex in small increments (9mg to 8.5mg, then down to 8.0mg and so on down), remaining at each dose for at least 4 weeks, but as long as needed. Luckily, the pharmacist I am working with on this is very understanding and I am able to stay at each dose as long as needed. I can switch up the amount that I drop as needed, which is what I think will happen as I get closer to 5mg. I had severe withdrawals at 5mg, but I got there way too quickly in my previous attempts.
My GP supports the use of L-tryptophan taken in the late afternoon along with the Cipralex taken in the morning. He does not believe it will result in serotonin syndrome, but agreed that monitoring is necessary just in case. He also said he has never had a patient have this much difficulty coming if Cipralex or anyone requiring l-tryptophan or 5htp to come off Cipralex, so he was not able to really say how much to take, but to start with a minimal amount.
I checked at my healthfood store on the way home from my appt and they carry L-tryptophan (“Now”)(220mg). I have ordered your and Julia Ross’s books. Are there guidelines in the books on how much l-tryptophan to start with? The pharmacist helping with my taper suggested to start with 1/4 amount of one capsule and see if there are any negative effects, but I’m a bit nervous about it!
Current dose of Cipralex is 9mg and this is day 13 at that dose. Only a few minor withdrawals so far (slight burning feeling and tingling sensation under my arms and down my right side-I’ve had this before while in withdrawal). I took sugar out of my diet completely when I started on the 9mg. Thirteen days “clean” 😉 and feeling pretty good simply from that. I want to do this right, it’s my third attempt to come off Cipralex.
Thank you,
Victoria
Victoria
I’m glad you have the support of your doctor. My book and Julia’s book lists 500mg as the starting dose and less for sensitive people. I always use the trial method to find the ideal dose https://www.everywomanover29.com/blog/how-to-do-an-amino-acid-trial-for-anxiety/ and adjust up or down during a taper only recommend Lidtke tryptophan. The Now tryptophan is less effective.
Hi Trudy,
I appreciate your advice very much. I am really looking forward to reading your book!
Thank you,
Victoria
Wow! What a powerful article full of all kinds of nuggets of knowledge. I am on an SSRI and a Benzodiazepine for General Anxiety Disorder. I recognize the place to start is diet and exercise. After reading this article I want to speak to my psychiatrist about tapering with 5-HTP. I also have your book on order. Is it best to taper off the SSRI first or can both medications be tapered at once? Any insight is appreciated!! Thank you for your work!
Alana
I have found that having my clients do one taper at a time is easiest. It also depends on the medication, how long they’ve been taking each one and prior history of tapers – together with the support of the prescribing doctor. The season can make a difference too – with many doing better tapering SSRIs in summer due to increased winter depression and anxiety. With any taper, super slow is key (often slower than some doctors advise) as is being nutritionally sound. Many of my clients have to educate their doctors about the amino acids, taper process and nutritional psychiatry so having a supporting doctor makes a big difference.
Trudy, what if you have one of those well meaning but highly resistant practitioners that won’t listen to the explanation and refuses to acknowledge the benefits of opting out of the traditional medications in favor of a natural path to treat these conditions?
Julie
Julie
This is a great question! Some people take longer to come around and it often happens when they experience the benefits of natural health approaches first hand or with a family member. Unfortunately some people will never change.
As long as it’s not impacting our health/treatment plan I would stick with them and keep plugging away. If it is having an impact on our health/treatment but we have a good relationship with them I say stay with them for medical emergencies and find someone else for the nutritional support. I believe it’s good to have a team on our side anyway so we get varied expertise. An MD, a ND, a nutritionist, a herbalist etc all bring something of value to the table.
Am currently tapering off Prozac 20mg. Am using omega 3, B complex, vit D3, magnesium. Also addressing gut health by taking glutamine and probiotics. Can you please list the amino acids that are helpful for tapering
Hi Trudy! First of all – thank you so much for all of the work you do. Your website has literally been an absolute saving grace for me. Two years ago I tried to come off of lexparo after being on it for nine years. little did I know the hell and almost death I was going to face from the horrific withdrawal. I was down below 4mg and got myself back up to 7mg (had tapered from 10mg) to get myself stable. I added in fish oils, b vitamins, vitamin d, and recently had an iron infusion because I have big issues absorbing nutrients from foods (low stomach acid, candida issues, etc). I should also mention I do not eat gluten, dairy, grains or soy. On top of all that – my emotional issues these past two years have been HORRIFIC – come to find out, caused by the clear as day amino acid imbalance that’s occurring in my brain/body. I could be your “I have all these symptoms” poster child for your amino acid questionaire!!
I am writing all of this to you because I want my life back! I am at my wits end with all of this stuff! I am switching my lexapro from the evening to the morning – I am looking for guidance on how to start these aminos. 6 hours after — can I take them twice a day? And is it alright if I start with the GABA calm first? (I am constantly overwhelmed and stressed out to a point where performing normal small tasks seem mountainous). Thank you in advance for reading all of this, and I am open to any feedback you may have. Also – I am located in upstate NY & if you know of anyone in New York (Aside from Kelly Brogan) who is familiar with this process – I am more than willing to meet with them! I of course signed up to be on your list of new clients when you start taking them again!!
From the bottom of my heart, thank you for putting out this content. I hope someday to empower others as you do — I have to get through this last big step first!
Much love and namaste
– Gabriella B.
Withdrawal Update – this post is a bit long!
I just wanted to put a bit of an update on here – thought it might help someone else going through the same issues I am while tapering from Cipralex (a.k.a Lexapro).
I began tapering off 10 mg of Cipralex in November 2017. I have my little “Support Team” that includes a compounding pharmacist and my GP. Feeling very fortunate that I have these people as my taper has not exactly gone as planned (although far better than my last two attempts) Originally, the plan was to go down by 10% of the dose and stay at that dose for 4 weeks. That didn’t work for me. I was fine when I dropped from 10mg to 9, but after my next 10% drop I experience that familiar withdrawal hell. I got a little scared, but stuck with it, and decided to stay at that dose for a bit longer. While I leveled out, I did a lot of reading about how SSRIs work. I learned about the 1/2 life of Cipralex (all SSRIs have a different 1/2 life) and what was actually happening physiologically as my body adjusts to the lower dose. It’s a recovery process. With that new knowledge, I decided to try another approach. I knew I couldn’t handle a drop of 10%. So, I started to taper at a rate of .1mg once a week (far less than 10%!). By day three at the new dose, I could feel the withdrawal, but it was far less severe. Small drops=small “withdrawal wave”. I discovered that I am able to manage a 2% drop of the current dose and I have been able to drop that % each week. So, I’m still reducing by 8% a month, which means I am close to the original plan of dropping by 10% a month. At this time I am at 6.24mg. Yes, it is a very slow process and I have a long way to go, but it’s working. I have read that some people have to reduce by 1% of their current dose and remain at that dose for 4 weeks to allow their body the time to heal and adjust to life on the lower dose. Having the liquid compound has made such a difference! You sure would have difficulty accurately shaving off a pill by 2%!! If anyone is trying to come off of this drug, do your best to find a compounding pharmacist!
I find that I must stick to a very healthy diet. I eat a lot of fresh, raw and cooked vegetables. I mean a LOT of vegetables. I eat good sources of protein and walk for at least 45 min almost every day. I steer clear of sugar and caffeine. Both make my withdrawal much worse.
Every day I take omega 3, vitamin C, vitamin D, vitamin B complex. I take the supplements for pyroluria, b6, evening primrose oil and zinc. I take magnesium at night. I took Trudy’s amino acids course online and did all of the amino acid trials. I discovered all I really need is tryptophan. It has made a huge difference for me. Yes, I take Lidke tryptophan. For us Canadians, it can be ordered online.
I practice mindfulness. I’ve read a lot about the anxious brain (the reason I took Cipralex in the first place) so I understand what is happening now, what is real and what is just noise in my head. Not sure if I’m allowed to recommend any specific books on here, but there are many great books that have given me so much insight into the workings of the mind.
As I said, I’m not out of the woods yet, but so far, this attempt at withdrawal has gone relatively well. The recommended way to withdraw from Cipralex is to cut the dose by 1/2 and then 1/2 again, then go every second day. I tried that approach twice and failed miserably both times. Both times I was advised to go back to 10mg and of course, that’s what I did. Not this time. I will hold firm should I feel the withdrawal as now I know what is happening and how long it will likely last. I have surrounded myself with a support team including my husband, my sister, two wonderful women who have become friends who are also coming off an SSRI, my Naturopath and the awesome leaders in this field like Trudy, Julia Ross and Kelly Brogan. As I said, I took Cipralex for anxiety, so Reid Wilson is my go to for retraining my beautiful Brain. Meditation is very important and there are many great leaders out there to guide everyone in that process. It’s a matter of discovering who resonates with you!
Anyway, that’s my update for now. I’ll check back in after a few more months. I hope that everyone has great success in their taper. My unsolicited advice here is to take it slow and embrace the healing process.
Victoria
Somehow I missed this update of yours! Thanks for sharing and checking in to see how you’re doing now!
Hi Trudy,
My phsyciatrist as advised me to not to tryptophan while still on Prozac 20mg. She wants me to wait until I am completely weaned off of Prozac to start taking tryptophan. I am going to follow her guidance, but are there any other supplements you recommend that are safe to take with Prozac while tapering off the Prozac that could help with the withdrawal side effects?
Thank you!
Megan
I have my clients make all the dietary changes BEFORE starting any taper, plus address guy health, adrenals, low zinc, low B6 etc (based on what is going on with them). I have found that tryptophan or 5-HTP does make the taper much easier but the prescribing doctor needs to be on board with this.
How do you address all those issues if you don’t have a local practitioner that understands any of that?
Desirae
There are a few options – many folks manage DIY with my book “The Antianxiety Food Solution” (https://www.everywomanover29.com/store/aafsbook.html), some folks like more guidance and do my Amazing Aminos group program (https://www.everywomanover29.com/aminosforanxietyhs/index.html) and some folks work one-on-one with me or another practitioner via phone.
How can one go about working with you on this subject via phone or Skype trudy. V
Yes how can i work with someone
Carol
Please reach out to support@everywomanover29.com
Hi Trudy, is 500mg tryptophan at night time likely to cause serotonin syndrome if I have taken only 3.3mg of Lexapro in the morning? My long term doctor is very pro anti-depressants so I know she will not be supportive of me trying the natural approach. As mentioned in another of my comments, I can’t stand the thought of being pregnant while on Lexapro – hoping to fall pregnant at the end of the year
Nicole
I’m afraid can’t provide consulting advice via the blog. I can provide general feedback – the advice is to use tryptophan 6 hours away from SSRIs and use it while being monitored by the prescribing doctor. I also encourage my clients to find a supportive doctor or educate their doctor (my book is often well-received). If the doctor is not supportive of tryptophan use they are still required to monitor the safety of their patient.
I want to wean off of SSRIs for good. These I use for my obsessive behaviors related to my autism spectrum disorder. Am just starting N-acetylcysteine (started this yesterday at 1 scoop of powder or 1200 mg). I heard tryptophan can do the exact same thing. I also know anything that modifies serotonin carries with it the risk of serotonin syndrome and want to avoid it. Is there a safe way to supplement tryptophan and get off of SSRIs for good? It would also save me money. I will plan to get your book in a future month; my budget is limited and I’m trying to get my IBS-C under control right now. Just coming out of a flare-up of it. I have watched your talks on few summits recently. I will appreciate whatever advice you can give.
Crystal
This blog explains what I do with my clients. If you are new to the amino acids (and other anxiety nutrition solutions like gluten/sugar/caffeine removal, blood sugar control, gut health, pyroluria etc) my book “The Antianxiety Food Solution” is a great place to start. Do much of the dietary advice is key. More here https://www.everywomanover29.com/store/aafsbook.html
Julie Matthews autism work is also invaluable https://www.everywomanover29.com/blog/nutritional-and-dietary-intervention-for-autism-spectrum-disorder-a-new-study/
Apologies for the delay in your comment approval and my response. We had a computer glitch where a large number of comments were hidden from view in a spam folder. It mostly affected new folks who were commenting for the first time but it’s hopefully resolved now.
11 years ago I began taking a low dose of xanax. It took me 2 years to get off of it.
But for 9 years withdrawal symptoms haunted me: dizziness at unforeseen times, vertigo, terrible episodes
while driving, becoming ice cold and shaking, and feeling a terrible squeezing sensation. In a phrase, quite unbearable and impossible to fully describe.
I had to get on it again 2 years ago now, due to a terrible withdrawal episode
while driving that necessitated a 911 call. I was diagnosed with Panic Disorder at the time.
But I now believe it was one of these terrible withdrawal episodes. It took me a long time to
figure this all out.
Anything can cause the withdrawal reaction: taking too much magnesium, CBD, enzymes,
antihistamines, a supplement that I’d never think would interfere with xanax absorption or metabolism.
I don’t believe I can get off xanax with just a slow taper. My withdrawal symptoms are
too severe and quite unbearable.
I think I need a medication to substitute that may, possibly allow me to finally get off the drug.
Dr. Ashton’s protocol is not enough.
I pray I don’t need hospitalization to get off and I pray that my brain isn’t permanently damaged and so
I may never be able to get off the drug.
I do have a psychiatrist but I think he may only be able to offer the very slow taper plan.
Any thoughts, any hope???
Linda
Sorry to hear about your struggles which sadly are very common. I have my clients get nutritionally stable BEFORE starting any medication taper (with their doctor’s approval of course) and this prevents many of the adverse effects. This means eating real food, no gluten, no caffeine, no sugar, quality animal protein, eating for blood sugar control and addressing gut health, the adrenals etc (everything I cover in my book “The Antianxiety Food Solution” – more here https://www.everywomanover29.com/store/aafsbook.html). And then we use the amino acids during the taper (all with the doctor’s approval and monitoring).
I have found that GABA and/or theanine and tryptophan and/or 5-HTP help a great deal. We may also include melatonin, niacinamide, adrenal supportive nutrients and other protocols based on each person’s unique needs.
However there are a subset of individuals (about 30%) who do have a much more difficult time tapering benzos than others, even with nutritional support. More on this here https://www.everywomanover29.com/blog/world-benzodiazepine-awareness-day-say-no-benzodiazepines-anxiety/
It’s very common for benzos to work less well as the years go by and actually start to cause more severe anxiety and muscle pain (and many other distressing symptoms). Benzo Information Coalition is an excellent resource https://www.benzoinfo.com/
Apologies for the delay in your comment approval and my response. We had a computer glitch where a large number of comments were hidden from view in a spam folder. It mostly affected new folks who were commenting for the first time but it’s hopefully resolved now.
I stopped my SSRI and am interested in using L-tryptophan instead. I was on Luvox 200 mg/day for obsessive behaviors. Am not sure what safety measures I need to take to prevent serotonin syndrome or what symptoms I should watch for. Like Nicole, my doctor is not being supportive of it, but I do plan to buy your book from Walmart.com. Currently their site says only 4 left!, so please send them more copies when they order it. In the meantime, I will put an in-stock alert on it if necessary. Currently am using N-acetylcysteine, 1200 mg/day for my anxiety and obsessive behaviors. My diagnosis is autism spectrum disorder level 1. Can you provide some general advice on using tryptophan safely, please?
Crystal
My book is the best resource for you as I’m sure you found out by now (apologies for the delay in your comment approval and my response. We had a computer glitch where a large number of comments were hidden from view in a spam folder. It mostly affected new folks who were commenting for the first time but it’s hopefully resolved now.)
I like to start with tryptophan and we may also add inositol for obsessive behaviors. NAC is often very helpful too. And don’t forget all the dietary changes I cover in the book.
Thanks for the heads up about Walmart but their buying department handles all that.
Hello,
I recently quit taking celexa I was on 30mg then down to 20 then to 10mg over about 3 months. It has been 2 weeks since my last dose.
I have had brain zaps and insomnia but that has pretty much subsided at this point. Can I start taking 5htp at this point? Worried about the syndrome
Ashley
It’s always best to discuss with the prescribing doctor. For future reference, for this medication, “Half-life is 24 to 48 hours (average: 35 hours); however, half-life significantly increases in patients with hepatic impairment, mild-to-moderate renal impairment, in elderly patients (60 years or older), and poor CYP2C19 metabolizers” https://www.ncbi.nlm.nih.gov/books/NBK482222/
Apologies for the delay in your comment approval and my response. We had a computer glitch where a large number of comments were hidden from view in a spam folder. It mostly affected new folks who were commenting for the first time but it’s hopefully resolved now.
Hi Trudy,
Can you please define any differences in amio acid treatments for SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin, norepinephrine uptake inhibitors).
Thank you for your very helpful information.
Susan
Both have the potential to cause serotonin syndrome when used with tryptophan or 5-HTP
Apologies for the delay in your comment approval and my response. We had a computer glitch where a large number of comments were hidden from view in a spam folder. It mostly affected new folks who were commenting for the first time but it’s hopefully resolved now.
Dear Trudy, Could you possibly tell where to buy the saffrom you mention in your e-mail, please? Also how much to take and how ofte n? I an really interested in your researh and please keep my name on yout mailing list. I have a feeling that it also improves macular degenration. Does your researh cover this?. Should really like to take advantage of your expertise.on this fantastic remedy but am a complete beginner and want to make sure I start off on the right footing. With many thanks. Kind regards.Mary.
Mary
I will be sharing more details in the new saffron blog. Since you are already seeing my newsletter you’ll see the new blog too. And yes research shows that “Daily supplementation with 30 mg of saffron for 6 months may result in a mid-term, significant improvement in retinal function in patients with AMD/age-related macular degeneration.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5342880/ Is this something you are dealing with? Do you also have anxiety and other mood issues?
Hi Trudy,
I listened to your talk on the mental summit recently. I have been on xanax for many many years. I have been tapering and several doctors have recommended supplements. You mentioned that Benzo Buddies doesn’t support supplements. Most of the facebook groups also say that supplements can make you worse. I’m having a lot of problems with the taper and can’t help but wonder if the supplements are making me worse. On the other hand, I have found supplements have helped with the insomnia. I’m writing to ask you why there is so much information out there that says supplements make the taper worse. None of my current doctors really understand tapering and supplements. I had a wonderful doctor who had special training and really understood tapering. Unfortunately, he left the area where I live. I’m wondering if you can provide a resource that explains how to use supplements while tapering. Also, why do you prefer Gaba versus Pharma Gaba? thank you!
Diane
One reason I suspect support groups say no supplements is because they are seeing folks who are having the most difficult time tapering. There are a subset that do not do well on supplements and they are typically in a support group. However there is another group of about 60% who do very well with supplements.
I have had the most success with GABA but some folks find pharmaGABA is better for their needs so in that case I say use it.
I’m wondering if 5-HTP ever causes sleeplessness. I am tapering off Pristiq (on 25mgs now for 6 months) and just started taking 5-HTP a few days ago. I take it in the morning and late afternoon and take my SNRI at 11pm. Last night I didn’t sleep.
Thank you!
Susan
I blog about this here https://www.everywomanover29.com/blog/5-htp-can-raise-salivary-cortisol-does-this-cause-a-wired-tired-feeling/ but it could also be part of the taper process. GABA, melatonin and niacinamide are helpful for some folks.
Hi Trudy, I would love to hear you opinion/advice. I have been on antidepressants, specifically sertraline on and off for about 4 years (first when I was 17), I tried to stopped when i felt better however the first two times I relapsed back into depression so went back on SSRI.
Last year (2020) I cut the dosage to half I was taking just 50mg sertraline and after I felt great and also some bad side effects like tiredness and no sexual desire dissapeared. As I felt really good, I decided to wean off – in about 2 weeks. After a month I started to have sleeping problems and anxiety from not being able to sleep and at the end depression from being unstable from the lack of sleep. I came back to 50mg and everything went back to normal.
This year 2021, I have taken a year off from school, I am having really good social support and generally no stress at all (I am just at home). However after one month I started to have sleeping problems in about february and it has been worstening ever since. I have been off meds now for 4 months – but I have bad insomnia. I do use melatonin and CBD oil which has helped me, however, I do take a long time to fall ssleep, and I generally wake up so many times. It has been ongoing for 3 months and I feel really frustrated and helpless.
I do have to say that before when I tried to wean off I relapsed back to depression, however now I am experiencing sleeping problems, when I do get to sleep I am feeling absolutely amazing during the day. However, I do have a night time anxiety from not being able to sleep.
I agreed with my doctor that I will try melatonin 5mg for 6 weeks and if it does not improve, we would try something else. It did improved a little, but still it is very hard for me to sleep. The doctor ofcourse thinks that it is not because I stopped antidepressants too quickly as he suggested me to lower the dosage for two weeks and then it should be fine.
Today he prescribed me mirtazapine 7.5 mg for sleep and if it does not work and I do not have side effects than I should take 15 mg. I did read studies and it seems like a good drug, however, I also read people’s stories how hard is to wean off of this med / how addictive this one particularly can be. I am considering whether to even start this since I have been off meds for 4 months. Is there something that can ease my sleeping problems and anxiety from it? I do feel like my brain overreacts to certain situations which I normally would not find stressful. However, CBD helps with anxiety. In a way that I still cannot sleep but I do not have panic attack. I am just 24, and I do not want to be on meds for the rest of my life, however I cannot find a professional who would consider taperring of meds more serious. I live in Denmark, and I do not know who to turn to as my doctor obviously does not take this seriously.
Would you have an advice what could I do/take to help with my sleep and anxiety? Or is there a possibility for an online counselling someone knowledgeable in this area?
Kate
I’m always in favor of finding the root cause and with sleep issues I start with addressing low serotonin and GABA. We also look for high cortisol, parasites, SIBO and always remove sugar, gluten, alcohol and caffeine.
If you are new to the amino acids (and other anxiety nutrition solutions like gluten/sugar/caffeine removal, blood sugar control, gut health, pyroluria etc) my book “The Antianxiety Food Solution” is a great place to start. More here https://www.everywomanover29.com/store/aafsbook.html
Feel free to search on the blog too – it’s a wealth of information.
And you are wise to be concerned about fast tapering – two weeks is considered very fast.
Hi Trudy
In 2019 my anxiety started. I had pressure on my head, ears and nose. My pulse was racing 124bpm. My anxiety was through the roof and obviously my blood pressure was high. I went in and out of hospital probably 5times. They did a head scan, lumbar punch. Everything came back normal. They put me on anti depressants for 3months and I was on anxiety tablets called Alzam for a month i think. I was Ill for 6weeks. I came right for a while but then my anxiety started again then i went on the Alzam again for 7months before I connected with Doctor Murphree and through him and found you.
I’ve been using his supplements since last year October. I started weaning off the Alzam since October 2020 and I took my last the end of April 2021. I’m off it for 39days. The pressure on my head started again 5months ago. I also have pressure on my nose, ears, jaw and neck. I still get anxiety I think its because of the pressure. I’ve seen an ENT a few times he says nothing wrong with my nose. I also found out last year that my TPO & PTH levels was high which I’m using the Th Support. I’m using doctor Murphree jumpstart supplements which consist of the multivitamin, 5htp, adrenal cortex & I also use the th support, digestive enzymes, Gaba plus. I also use omega 3. I suffer from Fibromyalgia.
I just like to know is the pressure because of the withdrawal symptoms or the anxiety. Could it be of low serotonin levels. I really can’t stand it anymore its making me so miserable. I also went gluten free and diary free. I try to be as discipline as i can. I’ve changed my diet completely. I’ve lost 30kg in 9months.
I really need some advise I don’t know what to do. The doctors here want to put me on anti depressants.
Regards Zia
From your home country South Africa, Cape Town.
Zia
Apologies I had missed this question. I do hope you’re doing better now. Since there was pressure before the meds I’d suspect some other root cause but certain meds can contribute to weird symptoms. I’d definately discuss with Dr. Murphree, the prescribing doctor and/or pharmacist.
Hi Trudy,
I’m on 30 mg of cymbalta and I’m very interested in supplementing l-tryptophan in order to both help with my lingering depression and anxiety as well as help me to eventually get off the medication. I’m very worried about serotonin syndrome. I know you recommend doctor supervision but my psychiatrist is very against supplements like these, he also takes my interest in alternative therapies as an insult to his medical advice. I was wondering if any of your clients have had serotonin syndrome problems with l-tryptophan usage along with antidepressants? I specifically am wondering about cases similar to mine such as those who have used cymbalta at 30mg.
Any comments would be appreciated, this blog has such great information!
Emily
I have clients take tryptophan or 5-HTP 6 hours away from the SSRI or SNRI all with the prescribing doctor’s approval and monitoring (as mentioned). If this is not possible I’ve had client’s work with a knowledgeable pharmacist (with the doctor’s monitoring) or find a new doctor or share my book with him.
I have my clients get nutritionally stable BEFORE starting any medication taper and this prevents many of the adverse effects. This means eating real food, no gluten, no caffeine, no sugar, quality animal protein, eating for blood sugar control and addressing gut health, the adrenals etc (everything I cover in my book “The Antianxiety Food Solution” – more here https://www.everywomanover29.com/blog/the-antianxiety-food-solution-by-trudy-scott/). And then we use the amino acids during the taper.
I second the previous question.
I myself am in search of a protocol for the amino acids together with an SNRI (like cymbalta) and mood stabilizer, to avoid any serotonin syndrome.
Also looking for any resources to finding a holistic/functional psychiatrist who can manage tapering, withdrawal etc.
I loved listening to your talks, and really would like to implement some of these wonderful things, but need the guidance/supervision of a qualified expert which is proving very difficult to find.
Anna
I have clients take tryptophan or 5-HTP 6 hours away from the SSRI or SNRI all with the prescribing doctor’s approval and monitoring (as mentioned).
I have my clients get nutritionally stable BEFORE starting any medication taper and this prevents many of the adverse effects. This means eating real food, no gluten, no caffeine, no sugar, quality animal protein, eating for blood sugar control and addressing gut health, the adrenals etc (everything I cover in my book “The Antianxiety Food Solution” – more here https://www.everywomanover29.com/blog/the-antianxiety-food-solution-by-trudy-scott/). And then we use the amino acids during the taper.
It’s advised to use these aminos only when someone is on only 1 prescription psychiatric medication.
Dr. James Greenblatt is an integrative psychiatrist I regard highly.
Hi Trudy,
I have been on 25mgs of sertriline for about a year and decided to taper off – I have come down 1mg a day for the last 8 days and am experiencing quite severe withdrawals which is surprising as I thought that was quite a slow taper. My intention is to get to 12.5mgs and stay there for a few weeks then taper off over another 5 weeks (I have a tapering strip from a dutch company that do them).
How much 5-htp could I take where I am presently at?
Gerard
1mg a day is considered a very fast taper and many folks need to go much slower. Is this what the tapering strip Dutch company recommends?
There is no way to know how much 5-HTP is needed when someone is tapering. We always do a trial and adjust from there (always keeping the prescribing doctor in the loop for monitoring for serotonin syndrome).
Hi Trudy,
I am new to your work and page and am very grateful to have found it! I have been taking Lexapro for nearly 14 years, as a bandaid of sorts, and for a variety of reasons have decided I want to taper off completely and work on my depression and anxiety from a more holistic, integrative approach. Under my psychiatrist’s care I have been slowly tapering down since January of this year. It has been a real struggle and I’ve needed to switch to the liquid form of the drug for an even slower taper. I’m down from 15mg to 4.5mg. I just bumped down from 5mg to 4.5mg a couple of weeks ago and even that small adjustment has really affected me with the typical SSRI withdrawal side effects: insomnia, anxiety, irritability, sadness/low mood, negative thoughts, anger/rage, etc. I’m curious about slowly and carefully introducing L-tryptophan to assist with my taper, particularly my insomnia, taking it about 10 hrs after I take my morning Lexapro. I know that you can’t recommend dosage on this platform and that I need to partner with my psychiatrist on this, but I wondered if you might share what starting dose of L-Tryptophan you’ve successfully used with clients in the past to assist with an SSRI taper? I purchased Lidtke’s 500mg but am considering opening the capsule and pouring out half to lower my starting dose to 250mg or so. I’m on such a low dose of Lexapro now (4.5mg) but do of course still want to be cautious of serotonin syndrome. I really need to sleep and feel that working with amino acids may help. (Right now I’m doing Quicksilver’s liposomal melatonin and GABA-L Theanine formula before bed which helps put me to sleep but I still tend to wake up in the middle of the night and can’t go back to sleep for hours.)
I do not eat dairy or gluten but am going to try cutting out caffeine and refined sugar. I also gave up alcohol for good 2 months ago. Thank you for any comments on what has worked with other patients tapering off of an SSRI! Very grateful to have found your website!
Warmly,
Alison
Alison
Thanks for the kind words and well done on the dietary changes and giving up alcohol. The amino acids can help with caffeine and refined sugar – more on that here https://www.everywomanover29.com/blog/the-individual-amino-acids-glutamine-gaba-tryptophan-or-5-htp-dpa-and-tyrosine-are-powerful-for-eliminating-sugar-cravings-often-within-5-minutes/
It’s good to hear GABA/theanine and melatonin is helping. I do like to capitalize on what is working and increase both to see if more helps before adding something new.
There is no set starting dose for tryptophan in this instance (or any other case). It’s very much based on own unique needs but starting low is always a good idea. And yes, working with the prescribing doctor too.
If you are new to the amino acids (and other anxiety nutrition solutions like sugar/caffeine removal, blood sugar control, gut health, pyroluria etc) my book “The Antianxiety Food Solution” is a great place to start. More here https://www.everywomanover29.com/blog/the-antianxiety-food-solution-by-trudy-scott/
I also encourage you to join my newsletter as I share new information all the time and speak on many summits. Both are great learning opportunities.
Wonderful – thank you so much for your reply Trudy! I appreciate it very much and thank you for the tips! I am reading Julia Ross’s book now and look forward to diving into yours as well! 🙂
I will definitely sign up for your newsletter as well!
Hi,
I have been reading a lot of your information about the pre tapering diet and intro of tryptophan. What do you suggest to someone who has been tapering since May 12th 2021? I started at 20 mg and now down to 10.5mg. Curious about how to implement some of the suggestions mid taper? Very curious about the amino acids. I can add in the vitamin without copper. Currently have calcium, D3, iron, and vitamin C. Saw the one entry about the MegaSpore Biotic and thought that was interesting. Also the GABA Calm. Want to ease up the depression with the taper. Thank you.
Kathy
I’m afraid I can’t offer specific feedback via the blog. I have my clients get nutritionally stable BEFORE starting any medication taper (with their doctor’s approval of course) and this prevents many of the adverse effects. If someone has already started tapering I have them make the changes before continuing with the taper.
This means eating real food, no gluten, no caffeine, no sugar, quality animal protein, eating for blood sugar control and addressing gut health, the adrenals etc (everything I cover in my book “The Antianxiety Food Solution” – more here https://www.everywomanover29.com/blog/the-antianxiety-food-solution-by-trudy-scott/). And then we use the amino acids during the taper (all with the doctor’s approval and monitoring).
We do cover tapering in a new interview on the relaunch of The Anxiety Summit: Gut-Brain Axis, Nov 8-14, 2021. Register here https://anxietysummit5.byhealthmeans.com/?idev_id=739.
Thank you for the information, especially about working on the diet before continuing the taper.
I thought I had bought your book. But now I think it is Kelly’s book.
So I will get your book on the Antianxiety food solution.
Curious about GABA and is that also something that should be instated when the diet is cleaned up?
I just am fighting these lingering lows that come with the tapering.
Thank you again for being so kind and responding.
Kathy
There are no issues using GABA at the same time as antidepressants
During early Covid, I had some difficulty refilling my escitalpram 20mg prescription, so I mistakenly decided to stop taking it cold turkey. I was ok for a month or two, but then began to have anxiety (especially at night/early morning), negative self talk, ruminations, depression, constant worry. I started seeing a naturopath, accupuncture, talk therapist. It’s been eight months and I’m hanging in there, but there are moments that are unbearable and I’m truly suffering. 5htp didn’t seem to help for months and I’m now taking a break. I just heard about l tryptophan, so I’m trying. I try to exercise in some form at least 30 minutes daily. I take fish oil, ashwaghanda, b12, a multi, vit d, coq10. There are some amino acids in the pre-workout powder I use. Just wondering if I should go back on 5mg just to wean the proper way or keep going as it’s been 8 months? Thank you
Rachel
Sorry to hear. Many folks find the nutritional approach helps to ease post-taper symptoms but some folks choose to go back to a small amount of the SSRI and taper slowly.
Being nutritionally stable is key and this means looking at all anxiety nutrition solutions like gluten/sugar/caffeine removal, blood sugar control, gut health, pyroluria, optimal vitamin D etc that I cover in my book “The Antianxiety Food Solution.” More here https://www.everywomanover29.com/blog/the-antianxiety-food-solution-by-trudy-scott/
In the middle of winter, a dip in serotonin needs to be considered too. More here – Increasing tryptophan or 5-HTP temporarily when a winter dip in serotonin causes more severe anxiety, OCD and/or the winter blues https://www.everywomanover29.com/blog/increasing-tryptophan-or-5-htp-temporarily-when-a-winter-dip-in-serotonin-causes-more-severe-anxiety-ocd-and-or-the-winter-blues/
Dear Trudy,
I m here to ask you whether you know anyone in NZ that shares your knowledge about amino acids and can help me with my issue below. My GP is great, but knows nothing about them, and I m struggling to find a good medical practitioner who has knowledge about both antidepressants and amino acids.
I started Loxamine (I live in NZ, I believe elsewhere it’s called Paxil) about a month ago for my suddenly returned Insomnia and bad anxiety related to it (I have a strange type of insomnia, It comes back when I m especially vulnerable, I had a terrible time sleeping during my first pregnancy, felt almost suicidal and I seem to have a PTSD now, with insomnia and anxiety return when I m going through tough time). I’ve been reading your blog for years and over this time learned a lot about amino acids and which ones work for me. So before I went on Loxamine I felt quite balanced, I was taking Tryptophan, Rhodiola, Magnesium, B complex, but unfortunately my anxiety and Insomnia came about after a while of heavy social drinking. I deeply regret it, I felt changes in myself due to drinking and I should’ve not accepted another invitation (from my husband, actually, but I obviously only blame myself), that caused so much grief for me later. When “the problem” came back I accepted that yet again I need to start taking Loxamine, that actually worked wonders for me in the past – it literally brought me my life back. I m a busy mum with full time job, and 2 kids, I felt like I don’t have opportunity to try other solutions and jumped to a solution that always helped. When I started Loxamine this time in the first days I realized I had to drop all my wonderful supplements, as taking them together with Loxamine was giving me hideous serotonin syndrome. I went through hell in the first couple of weeks, adjusting the dose, while amino acids were leaving my system, only survived it with the help of my wonderful husband. This time my Loxamine story wasn’t as successful as previous times – my day anxiety is much better now, but with sleep I had mixed bag results – in the past I would have 4 nights with Lorazepam and the rest is with light sleeping aid, like valerian or Promethazine, until Loxamine settles. This time I still after a month can’t get it right, I resort to Lorazepam more often than I would like to (and I m well aware what class of drag is it, which probably gives me more anxiety), but my main concern is that pretty much anything, including coffee, gives me mild to severe serotonin syndrome – I can’t take magnesium or theanine, or anything else (in the past theanine helped me come off Lorazepam with pretty much no withdrawal symptoms, I felt lucky to have found such solution for myself). I m now stuck with 20 mg of Loxamine, which my body clearly thinks is too much, and I can hardly take anything else to help myself. I regret taking 20 mg, I would prefer 10 mg, and I started taking Theanine to help myself come down to 10 mg, but at this point I can’t even take it. Is 1 month too early to judge? Will serotonin syndrome settle? It might be hard to know.
So I was wondering Trudy if I you might know someone in NZ, or basically anywhere in the world where they speak english, to help me taper off Loxamine down to 10 mg, or help me support myself and my sleep until it settles.
Many many thanks in advance for your help!!
Hey Trudy,
Thanks for writing this article and for all the work that you do, on this subject. I have a question, if I am taking 100mg of 5htp, with no other prescription meds in tandem and not tapering off of anything, and I start to notice negative symptoms from the 5htp within the first 1-2 weeks, should I discontinue use? If I’m on 100mg of 5htp for only 2 weeks, do I need to taper off or can I just stop. Thank you again so much!
Emily
A typical starting dose of 5-HTP is 50mg and 100mg can be too much for some folks. Many individuals also see benefits quickly and then opposite symptoms because it’s too much – although 2 weeks is really fast. I have not found clients need to taper 5-HTP.
Hi Trudy,
Is it okay to taper off faster than others have at 1mg decrease, if one feels no withdrawal side effects or could the side effects be delayed somehow? What is the starting dose for tryptophan if tapering off an SSRI?
Tapering
A very very slow taper is always recommended and yes withdrawal effects when withdrawing too quickly can show up later.
The starting dose of tryptophan differs with each person and is based on symptoms and doing a trial. We typically start at 500mg but use less for sensitive folks.
When you’re new to the amino acids, my book “The Antianxiety Food Solution” has an entire chapter on the aminos with detailed info on doses and times. More here https://www.everywomanover29.com/blog/the-antianxiety-food-solution-by-trudy-scott/ I also cover all the nutritional aspects for helping to ease anxiety – always key to address before starting to taper.
Dear Tracy
I am currently taking Clomiprimine (60mg) which is a TCA . It was prescribed a few years ago to help me come off diazapam. I am now 7 months off diazapam. I am looking to slowly come off the drug as I have read articles about it interfering with my thyroid. I have all the symptoms of euthyroid sick syndrome as a result of HPA axis imbalance due to the diazapam withdrawal.
Do you have any experience of anyone successfully tapering off this class of drug using amino acids?
Thanks
Maggie
Clomiprimine has similar risks of serotonin syndrome as SSRIs so we use similar guidelines when using tryptophan to help taper. And I make sure the prescribing doctor is always on board.
Being nutritionally stable BEFORE doing any medication taper makes things go much better and my book is a great resource for this – “The Antianxiety Food Solution” https://www.everywomanover29.com/blog/the-antianxiety-food-solution-by-trudy-scott/
As always it’s important to do a full nutritional workup and check salivary cortisol, sex hormones, iron, zinc etc too
And yes this medication does affect thyroid function https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-2007-999178. Optimizing thyroid function makes the amino acids more effective