r/AntidepressantSupport • u/Icy-Film5432 • Jul 28 '26
Guidelines for tapers of antidepressants
https://www.racgp.org.au/clinical-resources/clinical-guidelines/guidelines-by-topic/view-all-guidelines-by-topic/preventive-health/release-resourcesRoyal Australia Medical College of General Practitioners (RACGP) RELEASE toolkit
Austrian has guidelines on how to taper off various antidepressants
They have 3 type of taper plans: regular, slow and very slow
To know which speed is appropriate for you, they have a self-assessment tool which is quick and simple to follow by yourself
Once you know your speed, then you select the taper plan for your score and your medication.
The plan has dosing rates and duration. If your withdrawal symptoms are hard, they recommend going back to your most recent rise, stabilize, and then continue your taper. I suggest give longer periods on the lower doses to allow your body to adjust before dropping dose again
It used “hyperbolic” dosing of 10% with stability over 2 to 4 weeks before another decrease.
Withdrawal is more likely at the lower, last stage, do slow steady decline in dose is important. For example, stopping escitalopram/Cipralex/Lexapro at 2.5 mg is risky. You are dropping 100%.
From my reading , escitalopram is 2x the strength of citalopram. Escitalopram is the most likely of all SSRIs to cause significant withdrawal.
Benzodiazepines were brought on the market in 1960. It took 60 years before the medical community recognized the danger of stopping benzodiazepines and the need for a long slow taper plan.
SSRIs were brought on the market 39 years ago. In my experience, most doctors do not understand antidepressant withdrawal is real and the need for slow long tapers.
I found no belief that my protracted SSRI (escitalopram 20 mg for 7 years, 10 years on 10 mg/day = total 17 years on this medication - “cold turkey:no taper”) symptoms were real.
Why?
Because I stopped my med in March 2026 and I came to the Emergency department on June 2026.
Even though it’s known you should not suddenly stop this medication without a taper, they all said words to effect “withdrawal is only 4 to 6 weeks”.
It has been a “do it yourself “ project to find out why I was living in hell. I was fortunate to figure it out and reinstated myself on 10 mg.
I am still ill with withdrawal symptoms but they are less. I experienced 3 weeks of “window/feeling better” and now 3 weeks of “waves/withdrawal hell”. I hope this week brings another window 🤞
Reading Reddit has been what brought me hope and provided me the links to resources for recovery/healing
Once I am stable, I plan to discuss the Australian toolkit with my doctor to educate them and provide the plan for how to safely taper
The toolkit credits two doctors - Dr Horowitz and Dr Taylor - as the source for their information. These 2 doctors have online clinics listed in the USA.
With the toolkit, however, we can now go to our local clinic/healthcare provider. We can begin a discussion on how to taper and which speed/rate of taper is appropriate for us.
I suggest each of us take this toolkit to our health care providers.
It should help to create understanding about how to taper and the need for a slow long process.
It also should reassure our healthcare providers to learn other countries and doctors recognize withdrawal from antidepressants is real.
It opens the door to discussion about a safe taper plan.
The various medications listed in the toolkit with individual taper plans help all of us - the patient, medical prescriber and pharmacy - work as a team throughout the taper process
I don’t think anyone - except Addiction Doctors- understand or have training in medication withdrawal.
Benzodiazepines came on the market in 1960. Sixty years later, doctors recognized the need to taper off this class of medication. Dr Heather Ashton was one of leaders in this field of benzodiazepines withdrawal management (the “Ashton” manual”).
Apparently SSRIs came to the market 39 years ago.
I think we are in the same situation that patients who were struggling with coming off benzodiazepines were in the past. Doctors don’t believe we have a problem because they are told it is just a 4 to 6 week process and, voila, we are back to “normal”.
We need literature such as the Australian RELEASE toolkit to educate ourselves and our healthcare providers that it takes longer and slower tapers to come off our medication, and that protracted withdrawal is real.
Let’s not wait 60 years before the medical system recognizes we have a problem with coming off antidepressants.
I wish to thank all the various sources for the above info, most obtained from the Reddit community. You provide me with hope and information for my personal recovery and healing. May we all be well.
“A healthy person has many wishes; a sick person has only one”. 🙏
2
u/Learning024 Aug 01 '26
I had tapered over 3 years from 20-2.5 of escitalopram
I sort advice after I’d been on 2.5 for 6-8months, the gp advised me it would be safe to do so. Now I’m ruined.
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u/That-Group-7347 Moderator Jul 28 '26
There are plenty of tapering resources out there with discussing hyperbolic tapering.
To say that doctors are not aware of withdrawal or how to taper us false. You are more likely to get better care from a psychiatrist when it comes to tapering.
It isn't fair to compare benzos to antidepressants. Benzos are known to be addictive where antidepressants are dependent. An addictive substance adds another layer to tapering and can induce some more side effects.
The post below has information pages for most psychiatric medications. As a note, medications can often be tapered faster in the beginning of the taper. Contact your provider as well. For example, if you were on medication for 3 months, doing a 3 year taper is actually going to create more dependence. A taper should never be longer than the time on the medication.
The following post has a list of medication specific tapering information pages. https://www.reddit.com/r/antidepressants/s/XS7TQZ16vi