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Dr_Anderson, Doctor
Category: Mental Health
Satisfied Customers: 335
Experience:  Psychiatrist
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Hi Dr Anderson: Seems like you were right! My worst anxiety

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Hi Dr Anderson: Seems like you were right! My worst anxiety was yesterday (day 3) after I took the next dosage (.50mg) I was fine!
Is it safe to reduce now another .25mg (in the same week)
Will I have peak anxiety within 72 hrs again? or should I wait the week out.
Will the new anxiety be worse than what I just had or similiar?
Has my body now adjusted to this new level? blood pressure and heart rates have remained constant. I just felt depressed and nervous...Love your take on if I should go for the next reduction now...and PS - your kind words have really really helped me through the hard time.

Dr_Anderson : Greetings, and thank you for the follow-on questions. Glad to hear you are feeling better already! Certainly you can decrease now if you wish to, or wait 1-2 more days just to make sure that you are really "in the clear." It is hard to say if you will have another peak, as some people do not, but I'd expect one. This way, if it does not happen, you can be pleasantly surprised, but if it does, you're not caught off-guard. If it does happen, it should be similar to what you have already experienced, it ought not to be worse.
Dr_Anderson : Glad to be of service! I'm thankful that these words are providing you with comfort during this challenging time.
Dr_Anderson : Regards,
Dr_Anderson : Dr. Anderson
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Customer: replied 4 years ago.

Hi Dr Andersen: This new peak withdrawal was different....not during the 1 to 7pm timetable


Went on 1/2 hr walk at 12:30pm

At 12pm --- I was 117/90 p 66.

On the return I had pains above my left breast.
came home and it was 109/93 p94

5 min later 115/91 p74. Did I overdo the walk or is this still withdrawals?

I just took the .25mg tablet. Chest pain is gone. Usually stuff starts after 2 hrs

As ready as I think I was-for morning reduction I am now scared.

QUESTION---If I am fine the rest of today, should I do the reduction tomorrow 7AM?

Will it make the withdrawals from the 1pm worse?

My morning #s were

113/85 p69

126/87 p64

113/84 p 72

110/82 p69

123/91 p65

117/90 p66

Greetings - with respect to the pains, that sounds more like overdoing the exercise, possibly coupled with not being hydrated enough (water loss increases during the summer months, even for moderate exercise). The elevated pulse and DBP further lend evidence to the exercise.

The chest pain going away after the 0.25 mg may just be coincidence - that it was going to go away anyway. You may have also been anxious about the chest pain, and so the little dose of medication relieved the anxiety, which in turn had a beneficial effect on the chest discomfort.

Given the trepidation you have over going down further, instead why not wait 1 more day to prepare yourself for the decrease, as well as to allow your body another day to equilibrate to the new dose?


Dr. Anderson
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Customer: replied 4 years ago.

Do you think exercising before the next dosage also triggered the pain.

Perhaps I should exercise mid-dosage?

What are your thoughts on that?

Greetings - I don't think the exercise timing triggered the pain, so you can exercise at any time. But, I would try to time your exercise to when you think your anxiety will peak, so the exercise will distract you from the anxiety.
Customer: replied 4 years ago.

Good Evening Dr Anderson: I did not decrease the dosage this AM as you suggested.

I was told maybe tomorrow since this AM I was dizzy. I am confused because idizziness is a withdrawal symptom but also a symptom of the medication. Is my diziness caused because I take 2 nighly dosages of .50mg -and then the same first thing in the morning, only followed by .25mg in the afternoon? I am not anxious but scared of what I face with this next reduction.

QUESTION 2 Plse remind me again now that I am at 1.75mg for the past 5 days if I reduce tomorrow by .25mg - will the withdrawal symptoms be severe since I didn't wait a week? QUESTION 3- MOST IMPORTANTLY When will the peak withdrawal symptoms be for this next reduction? in 3 to 5 days or sooner?. Last go day I was sleepy with 50 like pulses, next day ok, third rebound anxiety and depression, yesterday dizzy and today a little higher but normal bp and heart rates with numbness in legs and left arm aches.

I really hate that I've been on this med for over a month now. Is it true that since I will still be taking this med for awhile - the withdrawal symptoms will continue to be this severe???? Your spirit and info has been so are a gem.


Optional Information:
Person's Gender: Female
Person's Age: 54

Good evening!

(1) You are correct in that some of these things may be withdrawal symptoms. To be sure we're speaking the same language, dizziness is a sense of feeling unsteady when everything else seems steady. Vertigo is when one seems steady but everything around them seems unsteady. Light-headedness is a faint feeling, and may present with dizziness, vertigo, or both. Typically, the mediation side effect is dizziness or light-headedness but not vertigo. Withdrawal, on the other hand, usually feels more like vertigo. So, the experience of dizziness you have in the morning could be withdrawal since presumably you have not had any for 10 hours or so. On a good (if we can call it that!) note, the experience of dizziness, though persistent, should not worsen.

(2) If you go down by 0.25 mg, it is hard to say how severe they will be, if present at all, but on the bright side they should not be any worse! And the waiting of a week is only a guideline - it is more important to gauge a person's withdrawal symptoms than the amount of time on a dose per se.

(3) Yes, the peak for each is usually 3-5 days following the dose reduction, although in rare cases it can last for or can peak up to 2 weeks later.

(4) They will continue to cause discomfort and annoyance, yes, but that should improve very much with time. And, as you go, the symptoms won't necessarily continue to be this severe. On that note, some of my patients who are very aggressive about wanting to get off of the medication make bigger cuts in it sooner. Why? heir rationale is that they are already miserable, and it can't get much more so, so why not go faster getting off and not deal with the withdrawal as long as a slow taper might have. Food for thought. :)

Hang in there! You WILL get through this ok! Glad to be of service. :)


Dr. Anderson
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Customer: replied 4 years ago.

Hi Dr Anderson: I will try another cut down by .25mg tomorrow morning. Hope the severity of the withdrawals won't increase...Yes, you read my mind. I want to get this over with as soon as possible. Just can't take an increase in the severity of the withdrawals. Will try a cutback tomorrow and pray for the best. Keep you posted.

Thanks again for all your help.

My pleasure - keep up the great work, and hang in there! You're a lot closer to being done with this ordeal than when you started.

~ Dr. Anderson

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