June 3, 2025 • 38 mins
You've been gaslit into believing medication tapering means cutting pills in half and taking them every other day until you're done. The reality? Your brain requires a much more sophisticated approach.
In this final installment of our medication tapering series, we reveal the neurological science behind why standard tapering methods fail so many patients. Discover what's actually happening as your brain's receptors adjust when medication levels change, and why those challenging symptoms aren't a "return of your condition" but genuine withdrawal effects your prescriber may never have warned you about.
We dive deep into the hyperbolic tapering method, explaining why initial reductions often feel deceptively easy while those final milligrams can be the most challenging. Learn to identify withdrawal symptoms beyond the obvious brain zaps—from headaches and vivid dreams to digestive issues—that signal when your taper is moving too quickly for your unique neural adaptation.
The most crucial factor in successful tapering? Individualization. Your withdrawal timeline might look nothing like someone else's, even on the same medication. Some experience effects within days, while others don't notice symptoms until weeks after a reduction. Understanding your personal pattern becomes your most powerful tool.
Whether you're contemplating a medication reduction or currently struggling through withdrawal, this episode provides both scientific understanding and practical guidance to navigate the journey with greater confidence and fewer setbacks. Connect with us directly if you're ready to create your personalized tapering plan with evidence-based support.
Are you tired of being gaslit and want to DEEP THROAT some more truth? We want to hear from you! Message us your gaslit stories at thegaslittruthpodcast@gmail.com
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Dr. Teralyn:
Therapist Jenn:
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Therapist Jenn (00:01):
Well, hey, everyone, you have been gaslit
into believing that you aregoing to be on these
antidepressants forever.
This is now a three-partepisode.
It was supposed to be two, butgaslit.
Dr. Teralyn (00:11):
You're gaslit into believing it was only two parts,
when it's really going to bethree.
We lied.
Therapist Jenn (00:16):
So now it's a three-part episode and we're
going to talk to you about howto taper your medications.
We are your whistleblowingshrinks Dr Teralyn , and
therapist Jen.
And hey, you found us on theGaslit Truth Podcast.
Dr. Teralyn (00:26):
Woohoo.
So, if you haven't already, goback and listen to episode one,
or, I'm sorry, not episode one,but part one and part two of the
Medication Taper.
We were only going to do twoparts, but Jen and I get a
little geeked up and we end uptalking a little too much, and
(00:50):
so this turns into threeepisodes for the same thing,
which I although it's importantbecause I think people need to
understand, also not to dissuadeyou into doing this, but to
understand, like, the detail ofwhat it means to taper, because
so many people come in and likewhat supplements can I take to
help me feel better, tapering,and how do I taper?
And I don't have a two sentenceanswer to that.
(01:11):
Um, because everyone is sobio-individual how long you've
been on a medication mattersimmensely.
What medication you've been onmatters, um, all these things.
Your nutrient depletions matter.
How you take care of your bodymatters, it matters, it all
matters, yep.
So it's not easy, in the sensethat it's a little bit more
(01:36):
complicated than you probablythought, but I like to believe
that Jen and I make it lesscomplicated and we offer you
some real solutions that willhelp make you feel better faster
.
So this episode we're going totalk about the actual taper part
.
So I'm going to say again don'tjust listen to this episode and
start your taper.
(01:57):
Go back and listen to part oneand part two.
Okay, cannot stress that enough.
Therapist Jenn (02:03):
We'll put them all in order for you guys.
Dr. Teralyn (02:04):
We'll make it real easy you just flow from the
first one to the second one tonow the meat of the third one.
Therapist Jenn (02:11):
So let's start talking about this taper.
Something that Terry and I dois called a hyperbolic taper.
Dr. Teralyn (02:19):
I'm going to put hyperbolic taper-ish.
Therapist Jenn (02:22):
Ish, okay, this would be an ish.
And before we, before we gofarther with that, we have to
give a shout out to MarkHorowitz.
Dr. Teralyn (02:30):
Mark.
Therapist Jenn (02:30):
Horowitz is the gentleman that wrote the
Moudsley deprescribingguidelines.
Um, he is going to be coming onthe show.
Dr. Teralyn (02:37):
He's coming on guys , we've got him scheduled, but
he is in.
Therapist Jenn (02:39):
France right now and he's fucking busy, okay,
right now, and he's fucking busy, okay.
So we all just have to bepatient, okay, and so we can get
him on the show in a few months, but he's coming, guys, so it's
going to be super cool to talkto the man that I don't know.
Change the entire, my entirepractice, like it made me like,
actually change how I see all ofthe world within deprescribing
Um, so he, um, he wrote a, a guy, a deprescribing guideline
(03:03):
that's about getting offantidepressants and benzos, z
drugs, things like that.
So Terry and I use this as aguide when we are working with
our clients and doing consulting, but I can speak for both of us
when I say this is just reallytruly nothing but a guide,
because this process is soindividual.
I am walking proof of thisprocess being extremely
(03:27):
individualized and I'll give afew little things along the way,
as Terry and I talked todayabout how this had to shape and
change, and it does for many ofour clients too.
Dr. Teralyn (03:36):
Well, this is why this conversation is important,
because this is also why thereisn't a standardized
evidence-based practice fordeprescribing, because of the
individuality andbio-individuality that is
required within it.
So if you only had you do this,this and this, that would be
(03:58):
great if everybody respondedthat way, which is why a lot of
prescribers who are trying todeprescribe people don't take in
the individual nature.
They're like cut it in half andthen do every other day and
it's just.
It's not an individual processenough to account for all the
withdrawals that people gothrough and the debilitation and
all those things.
So this Mousley deprescribingguideline is like the next best
(04:22):
thing to that, but we also haveto make sure that we account for
bio individuality within that.
Therapist Jenn (04:29):
So the real layman's easiest way to talk
about the idea of hyperbolictapering is we are not most.
We're going to talk a lot aboutantidepressants today Not that
there aren't other drugs that wehelp deprescribe individuals
off.
But when we're talking about ahyperbolic fashion, it's about
(04:53):
looking at how it is that thedrug actually interacts with the
brain and these receptors ofthe brain as you slowly start to
deplete this drug out of thebody.
These drugs use a hyperbolicfashion.
The law of mass action comesinto play with this.
(05:14):
So we're really looking atneurologically how our brains
have adapted from being on thesedrugs and what we have to do,
in a very low and slow fashion,to take them out of the body.
Dr. Teralyn (05:29):
Okay, so that they can readapt to that.
It's that exercise and kind ofhomeostasis that we're talking
about.
Therapist Jenn (05:34):
It is so so to give you just just a little bit
of like the nerd part of me thatI like to explain to my clients
which, for some people, this istoo much information.
For others, they take this andrun and they're people, this is
too much information For others,they take this and run and
they're like this is so fuckingfascinating and I'm like, yeah,
thank you, mr Mark Horowitz, andother people too.
There are people out there, drYosef, they put some really
(05:56):
great videos out guys, which I'mlike at some point I need to do
one of these Melissa Pistillohas one out there too where they
draw the graphs for you andthey explain what's actually
happening.
The part I'm going to explainnow without a graph for you guys
, okay, but it's aboutneuroadaption to antidepressants
and what happens when youreduce the antidepressants or
you stop them.
So in the brain, serotonin isreleased from neurons,
(06:20):
essentially right thesepresynaptic neurons, and it gets
released into the synapse andit activates the receptors right
On the postsynaptic neurons.
So they go from one to the nextright the serotonin.
There's something called aserotonin transporter, okay, and
it re-uptakes your serotoninright, and it gives you
basically some level ofequilibrium.
(06:41):
That's what's happening beforea medication.
Okay, that's your healthy brainneuron action, yay, okay.
Then we introduce a medicationinto the brain, okay, and fuck
it all up and we God damn it wecreate.
I know you don't want to hearthis, but for those of you who
are already met, harmed and arelistening to us because you're
like, I'm ready to startdeprescribing.
(07:02):
You have a synthetic braininjury and here's the start of
the synthetic brain injury, guys, okay, so we introduce like an
antidepressant, and thatantidepressant blocks like 60,
70, 80, 90% of the serotoninactivity, this transporting
activity.
That happens.
So what happens is there's lessreuptake of that serotonin
that's going into thatpresynaptic space.
(07:24):
There's less of it, okay,essentially.
So then what does this do?
It leads to an increase in ourlevels of serotonin, which
increases the activation of thepost-receptor, the thing where
it's supposed to receive it,right.
So this is once this drug isgoing in there, so we're
actually increasing it.
Here we go Then, when drugs arein the body long term and
(07:47):
they're in the brain long termdue to homeostasis, which is
what Terry just said before,basically our body space of like
, we have to even it out.
We got to just feel, got tofeel good because something's
changing right Due to that, theexcess activation that's
happening in the post.
I got to make sure I get thisright now.
The post synaptic receptor itleads to down-regulating of
(08:09):
these receptors.
Dr. Teralyn (08:10):
Okay, and it actually there's too much going
in.
Therapist Jenn (08:13):
So you have only so many receptors for the
serotonin molecules, and so it'stoo much Down-regulates
down-regulates, right, and weknow this because there's
imaging that has been done ofthe brain to see that this is
happening.
This is how we know.
Okay, so this can happen forquite a long period of time.
So then we move to the verylast part of this, which is when
we decide that we're going tostop the medication.
(08:34):
Okay, so when theantidepressant gets removed, or
even reduced okay, after along-term use, that serotonin
transporter starts to beunblocked and now the serotonin
becomes removed from thesynaptic area and it tries to
return to these basicphysiological levels.
It's trying to get back there,that down regulation right.
Dr. Teralyn (08:58):
The sleepy receptor .
Therapist Jenn (09:00):
The receptors are sleepy, they are sleepy, yes
you always say that that's agood way to say it.
I got to use that more becauseI'm just too like in the stupid
words I need to use simple wordsSleepier.
Dr. Teralyn (09:11):
It's a sleep.
We need to wake it up.
Therapist Jenn (09:13):
Sleepy night night.
So they're all sleepy nightnighting here.
That down regulation of thatreceptor goes on for some time,
even after the antidepressantguys is starting to be removed,
and then the system starts toregister these physiological
levels of the serotonin and it'slike what the fuck is going on?
And that is what leads towithdrawal guys.
(09:36):
That is then when we start toexperience withdrawal and these
symptoms.
They're going to keep happening, guys, until the body and the
brain gets back to a space thatwas like, as mark horowitz puts
it in his book he calls itpre-drug configuration, meaning
where we were before wesynthetically injured our brains
.
Dr. Teralyn (09:55):
so there's your five minutes of like.
Therapist Jenn (09:58):
No, that was channel 10.
Yes, I liked it, ross, he canpaint and I'm just going to be
there talking about the brain.
Dr. Teralyn (10:07):
Well done, jen, well done, thank you.
There's two parts in here thatI want to talk about just
briefly.
The one is in the withdrawal,so when your receptors are
sleepy, and that's when you'regoing to experience the
withdrawal.
And that's when most people sayI must need the medication
because I'm experiencing thisheightened state of anxiety or
(10:29):
depression, whatever it is, andthere's a truth in that.
Yeah, you do need thatmedication to keep the previous
homeostasis in place.
You're right, but that is not areturn of symptoms, and this is
what we've been taught to saythat, yep, that's a return of
your symptoms.
There's one way to understandhow it's not a return of
(10:52):
symptoms by a simple questionthe symptomology that you have
right now, was it exactly thesame as the symptomology you had
25 years ago when you started?
And 100% of the time, I canguarantee you the answer is no.
It's way worse, it's waydifferent.
Or maybe I started as adepressed patient and now I have
got this immense anxiety, soit's different.
(11:15):
So that's how you know thatit's not a return of symptoms.
I also want to address the verybeginning stage of when you
start taking a medication.
Address the very beginningstage of when you start taking a
medication.
As you said, it blocks thereuptake of serotonin, leaving
more serotonin out there playingaround building up, right?
So when I say the chemicalimbalance hypothesis has been
(11:37):
long disputed and debunked andall the things and so I'll get
this pushback of, then why doesit work?
I'm like, well, because yourneurons now are flooded, in the
beginning, with serotonin.
What does that feel like?
Anytime you have flooded yoursystem with a neurochemical, it
(11:58):
feels different, right, like yes, you're going to get sometimes
a manic response to that whichfeels good, like it does feel
better than some depression.
Therapist Jenn (12:09):
Yeah, you were so damn low.
Yes, that's like when peopleare like a stimulant really
helped.
Well, fuck, yeah, yes.
Dr. Teralyn (12:16):
I would probably enjoy a stimulant too much.
Therapist Jenn (12:19):
I'll just love that for a hot second.
Yeah, not for more than alittle bit.
Dr. Teralyn (12:24):
Right, because then , the longer you go, the more
downregulated those receptorsare, and that's the place where
you end up getting moremedication, because you start
feeling low, or an additionalmedication on top, or a new
diagnosis.
All these things starthappening.
So I've never said that anantidepressant doesn't quote
(12:46):
unquote work in the beginning,because it does, because it
floods you with all those happychemicals.
Right, it works until itdoesn't.
It works until it turns on you,and those are the people that
we're hoping to catch here,because that's when you know
your mental status is goingdownhill.
So, anyway, those are the twoimportant pieces, parts of this
(13:09):
process that I think most peoplehave experienced.
Therapist Jenn (13:14):
Yeah.
So, knowing that these, like wewere giving a very specific
example and what I was goingthrough is talking a lot about
serotonin, okay, antidepressants, they show this hyperbolic
pattern between, like the doseand the clinical like symptoms,
that's happening, okay.
So here's how we get towithdrawal.
So the next part I'm from thebrain right, which is what Terry
(13:36):
and I were talking about here.
So then the next part of thisis what actually is withdrawal.
I think we should touch on that, because people's perceptions
of withdrawal at least for a lotof my clients that I've worked
with, some of them, it's like asplit.
Some of them know what it isbecause they've been trying this
two ways from.
Sunday and have tried so manytimes to get off of their
medication and they know theobvious withdrawal symptoms they
(14:03):
know really well.
Dr. Teralyn (14:04):
Like the dizziness, the brain zaps.
The dyscalibrium, the akathisia.
Anybody who has ever went offof?
Therapist Jenn (14:12):
a medication and had akathisia, which is
essentially there is just thisrestlessness in your body.
It's like.
For me it was like there waslike bugs crawling all the way
through me, had to move, had tomove, had to move, had to move.
Ok, impending doom often comeswith akathisia bugs crawling all
the way through me, had to move, had to move, had to move, had
to move.
Dr. Teralyn (14:28):
Okay.
Impending doom often comes withakathisia.
I still think, jen, thatsometimes akathisia is looked at
it like a return of symptoms.
That stuff is the anxiety andthe akathisia, with the low mood
and the wanting to off yourself.
That's a return of depressionmood and the wanting to off
yourself, that's a return ofdepression.
Therapist Jenn (14:46):
But the obvious ones are I know I'm in
withdrawal because I'm dizzy orI have a bobblehead or I have
brain zaps.
Those are obvious.
Those are obvious, but thereare.
When I say a lot of clients, Ihave already been through those.
But something that I find veryinteresting is that there were
many other.
As they learn about withdrawal.
(15:07):
There are many other symptomsof withdrawal that they had
prior to those that they didn'tknow were withdrawal.
Dr. Teralyn (15:13):
Right, yeah, so, in the vein of us helping you with
your hyperbolic taper, we tracksymptoms with people Like.
Symptom tracking is a hugething, data collection is a
giant thing, and the reason wedo that is especially, I think,
about the first time.
Like, let's say, you're goingto come in and you're going to
do your first reduction, right,okay, I will say, we're going to
(15:37):
do your first reduction.
The first one is going to takethe longest, because I want to
make sure that you're notexperiencing any withdrawal
symptoms at all for weeks beforewe go again.
In order to do that, though, weneed to collect data for a
little bit of time.
Okay, on this first one, and soI want to give.
I'm going to throw Jen underthe bus here, because I think it
(15:58):
was one of your first tapers,and then it was going well for a
few weeks, and then, suddenly,you were complaining to me that
you had a headache, and I saidyou need to track that as a
thing, and you were kind of likeit's been a few weeks, so
whatever.
Therapist Jenn (16:11):
And here's where it comes from, and I know a lot
of people listening right noware going to go through this.
Well, the first couple ofreductions, I was fine.
And here's the deal, guys.
Yes, if you're on 20 milligramsof of, say, lexapro, right For
most, tapering like guides okay,you actually go down like five
(16:32):
milligrams right away or down to10 milligrams.
That's very common and that'swhere that's where this is
important to know.
Dr. Teralyn (16:39):
It's a false sense of security.
Therapist Jenn (16:42):
And there's a little science to back it right.
Again, guys, there's thishyperbolic fashion that's
happening and in that, thiscurve that's occurring the
farther you get in the taper,the more difficult it gets
because of all of that obnoxiousPBS special I just gave you
about the brain.
Okay, about 10 minutes ago.
That's the why.
So typically for most taperswe're looking at the occupancy
(17:08):
of serotonin on these receptors.
Over time that changes, so whatit looks like when you go in
the beginning is very markedlydifferent from the middle versus
the end, which is why in thebeginning you can take a five or
even a 10 milligram cut andyou're like oh, I'm fucking fine
.
Dr. Teralyn (17:25):
Or I want to say people that are on like Zoloft
and they're at 200 milligramsand they don't feel anything in
their taper for a long time.
When I say a long time, like150, 100, and then suddenly you
hit that cert occupancy pointand it goes.
Oh my God.
Therapist Jenn (17:45):
And that's where there's some brain mind fuckery
that happens with this and Iwill be yes, you can call me out
all day long in this episodebecause I did it multiple times
because I wasn't payingattention to withdrawal symptoms
that I didn't.
I knew they were withdrawalbecause you know I've read about
them, I was educated on them,right Like Joseph Glenn Mullen
(18:07):
wrote this great book called theAntidepressant Solution, and in
there there's these charts thatI still give to my clients as a
reference right and I usemyself.
Dr. Teralyn (18:15):
There's like a hundred, there's around like a
hundred symptoms or something.
Therapist Jenn (18:17):
Well, the one he put out has about 60.
It's got about 60 differentwithdrawal symptoms in it.
And some of these are ones wewould never chalk up to
withdrawal guys, which is why westart to.
This is like my Bible thesesheets I have.
They are laminated and they'rein my bathroom cabinet.
I look at them every day Greatidea.
Dr. Teralyn (18:39):
It's a great idea, I do.
Therapist Jenn (18:41):
Because here's the deal.
Did you know that slightheadaches are a symptom of
withdrawal?
Stomach bloating and abdominalcramps diarrhea, okay are
symptoms of withdrawal.
Let's say you got a cold andthere are symptoms that are
mimicking like flu-like symptoms, right, Like you've got aches
(19:03):
or pains, or my nose keepsrunning, Okay.
Dr. Teralyn (19:07):
Yep Runny nose is on the list.
Oh my God.
Therapist Jenn (19:09):
Nightmares, guys .
All of a sudden I'm notsleeping as good.
I'm having these kind of crazy,like intense dreams maybe not
super nightmares, but all of asudden my dreams are vivid and
they're really intense.
Okay, intense dreams maybe notsuper nightmares, but all of a
sudden my dreams are vivid andthey're really intense.
Okay, these, these are symptomsof withdrawal.
Now most people are like mybrain's not zapping.
Dr. Teralyn (19:27):
I'm not.
Therapist Jenn (19:27):
I don't have suicidal thoughts.
Dr. Teralyn (19:29):
Okay, guys, these are the things.
Therapist Jenn (19:31):
Yeah, you're not going to hurt myself or others.
These are the things that yourprescribers will say to you to
pay attention to, but they aremissing the other hundred
symptoms that people go through.
Well, you have trouble sleeping.
What's that about?
That's actually a symptom ofwithdrawal.
Dr. Teralyn (19:47):
This is the exercise in curiosity and not
dismissing anything.
So if you have it, you check itoff because it might be really
important for your next one.
It might have an establishedpattern of when it emerges.
Yeah, because here's the thing,and this is where the
deprescribing guideline is veryimportant, because it maps it
(20:11):
out.
But this is the individualitypiece.
So if you know that on weekthree you get a headache, Week
three after your taper, you'redefinitely not going to want to
be tapering in week four or evenin week three.
Therapist Jenn (20:25):
So that's what we do, guys, is we look at the
symptoms you have and you haveto be very honest with yourself
on this.
I was not many times, which ledme to some pretty extreme
akathisia and spaces of like.
I could have been inpatient, nodoubt in my mind.
Okay.
So I laugh about these things,but it's part of my story and
that's just kind of how I amsometimes.
(20:45):
But I didn't pay attention,right, and so here I was, going
from headaches to so muchakathisia that I couldn't walk
around my kitchen and be aroundknives.
Okay, that's reality for me,all right.
Now what we do and we look at iswhen you have these symptoms
even if it's diarrhea, even ifit's like the headaches or my
nose won't stop running or mysleep is changing then what we
(21:08):
do is when you have thosesymptoms of withdrawal, you note
them and we do not look attapering you down until you've
went at least a couple of weekswithout those symptoms.
Everyone's different.
For me, it takes about 21 to 25days between each dose
(21:29):
reduction for me to have awithdrawal symptom.
I don't go down a dose and feelit within four or five days.
I'm about two to three weekslater and then I get it.
Dr. Teralyn (21:38):
So for me, I got to wait like a month between every
single dose reduction.
Right, because so many peoplewill miss a dose, like when I
was on Zoloft.
I know I would miss a doseRight, and then the next day I'd
be like you know.
So that's what I'm.
Most people are looking for,those immediate responses to
(22:00):
withdrawal, and they might notexist.
Okay, well, and that's.
Therapist Jenn (22:05):
I don't mean to interrupt you here, terry, but I
and I didn't want to.
I'm not going to go far intothis, but it's one of the
reasons that we educate ourclients also on, like, the
half-life of a medication.
Okay, yeah, and I was like,before we prepped here, I was
like we could talk abouthalf-life, just really.
Oh, yes, flexatine, it's reallylong, okay, and so, as compared
to some other drugs, right,it's longer.
Right, versus a benzodiazepine,your half-life is a matter of
(22:45):
hours for some of them.
Okay, so your prescribers aregoing to tell you that's how
long it takes for you to thedrugs out of your body.
If you haven't experiencedwithdrawal within that half-life
period, you're good to go Right, but we already did the PBS
special and I talked to you allabout how this actually works in
the brain, so it's a misnomer.
(23:07):
Your half-life is important toknow, though, because you might
notice some of those withdrawaleffects that can happen right
around that, which is why, likefor me, okay, I can't go more, I
can go a day and miss myLexapro, I'm okay.
It has a little bit longer of ahalf-life, and that's me.
Personally, I don't experiencethat Right, and I can miss a
dose and I'm okay and I'll justtake the dose the next day.
(23:28):
But so half-life does matterfor that reason.
Okay, so it's something to knowfor the drug that you're taking
.
But where half-life doesn'tmatter is what's told to you by
your prescribers, which is, hey,you've made it, the half-life's
done, you don't have withdrawal.
Dr. Teralyn (23:43):
It's out of your body.
You're good to go.
Therapist Jenn (23:44):
You're good to go.
When in reality, that justmeans the drug has been expelled
from the body, but now we waitfor the brain to do its thing.
Dr. Teralyn (23:51):
Yes, so getting the drug out of your body is only a
smidgen of the battle.
The recuperation of your brainis the biggest piece that you're
going to be dealing with.
Therapist Jenn (24:03):
My example I give people is alcohol.
Dr. Teralyn (24:05):
Yes, huge example Use alcohol as an example.
Therapist Jenn (24:08):
You can go ahead and you can drink too much,
right, and within how many hoursyou know that the alcohol
itself is out of the body.
But what happens for the nextcouple of days?
You're a piece of shit becauseyou're hungover, right.
The brain, right, the half-life,it's out of the body.
But now the brain and the bodyhave to do the work from the
damage that was done.
It's the same thing as theseguys.
(24:29):
So half-life matters, but itdoesn't matter in the way that I
think it's been educated to us,sometimes by prescribers,
because we're like Same thing,yep, and also when we were
talking about that cert occupant, we should have put up that
little graph on the screen.
Dr. Teralyn (24:49):
Too bad, anyway, sorry guys, we didn't do it.
Yeah, that graph part of thescreen is, I think, one of the
most important.
I might have it here.
Hang on, oh, she might be ableto pull it up here.
I mean, I have the book here soI can just grab it.
Oh, you could.
Yeah, you can just throw it upthere.
Therapist Jenn (25:03):
Okay, hang on, I'm going to try to make this
work, guys.
Dr. Teralyn (25:06):
Oh, there it is.
Yep, there it is.
You can see it Like there'slike this plateau across the top
and then the occupancy levelstarts decreasing and decreasing
and decreasing.
Once you hit that curve, okay,going down.
Okay, good, you're good.
Yep, there you go, yeah, whichis why, in the hyperbolic taper,
we go slower and slower andslower toward the end.
(25:27):
So the ending.
Here's the caveat for everybodythe ending is the hardest part.
So those last little, what isit like?
10% or something is the hardest.
Therapist Jenn (25:38):
Man.
Dr. Teralyn (25:40):
Yeah, maybe I would have that.
But this is like you know youget down to Jen's on four
milligrams or something.
I'm four, four milligrams orsomething, and she's just
chomping at the bit to be done,Like I can I just be done.
And it is so for some peoplenot all, obviously but the last
(26:01):
little bit is the hardest partand you're just aching to get
off of this entirely.
But know that you're going toprobably go slower in the end
than you did in the beginning.
Like I said, that beginningdrop, like when you saw the
curve was pretty well plateaued.
So really anything over, like,let's just say, your sort of
occupancy, is 100 milligrams,meaning if you're below 100, you
start experiencing withdrawal.
(26:21):
If you're 100 to 200, you don'texperience anything.
That just means that that'sjust extra shit rolling around
in your brain.
That extra stuff didn't reallyeven do much for you, right,
it's just all the extra stuff.
And then when you start goingdown, that's when you know that
was your most impactfulmilligram, really up to like I'm
just making numbers up 100,right.
(26:43):
So it gives you that falsesense of security off the
beginning.
But it also gives you a reallylarge sense of hope, right, Like
oh, but sometimes the hope isthis was really easy, right.
And then you start going okay,this is okay.
Whoa, that hit me hard, I gotto pull back a little bit.
Then you get to that little bitand you're like oh man, this is
(27:03):
so psychologically hard to keepgoing.
Therapist Jenn (27:07):
Part of what we work with people on our
consulting is the psychologicalpiece behind this.
Dr. Teralyn (27:14):
That is a very- and to not lose motivation, because
I do.
There's some people that I'veworked with and they get down to
that last little bit andthey're like maybe I'll just
stay on this little bit becauseit's so hard, and it's like,
okay, we got to get going again.
Or you know, I do tell peoplelike sometimes the working with
me isn't about a full taperAgain.
(27:35):
I want to make sure that myclients have that own personal
agency again where they can sayI'm just going to hold here for
a while and I'll contact you inthe future when I'm ready to
finish it off, and that's fine.
So, even like, just a reductionin medication for some people,
that's enough, right For somepeople.
(27:55):
I can't push my agenda on you,but I want them to know that
it's either you know, less ismore, or we're going to do the
full thing, or we're going totake you off of you know one or
two medications and leave you onthe other.
You know, whatever you want todo, I'm there for it, you know
so.
Therapist Jenn (28:11):
I think that's important too, because people
will like consult with me andthey will.
They'll do a you know, a quickconsultation and they well, I
heard you on on your socialmedia, right, I've listened to
you on the gas literature and,like I know you're over a year
and a half into doing this andit's not feasible for me to sit
and see you once or twice amonth, right, for a year and a
(28:38):
half.
Like that's like cost-wiseright, Like that is not a thing
I can do, right, and so I thinkit's important.
That's one of the first thingsI tell people is well, first of
all, this is my journey, notyours, so everybody is going to
be really different than this.
And second, we're going tobuild you up.
At least I tell people this I'mgoing to resource the shit out
of you, give you everything youneed.
I'm going to teach you how tolisten to yourself and as you
start to go through this taper,you're going to know and learn
(29:00):
and have that agency.
You're going to know what to do.
You don't have to stay with meforever.
I've got people that come backthree, four months later and do
a check-in and tell me wherethings are at and ask a couple
questions.
And that's it.
You do not need to.
Once we get you built andresourced, you'll have the
things that you need.
To keep moving forward in this,you learn.
I've got life events going onright now.
(29:22):
For me, that was a big one.
I went three months and Ididn't touch anything.
I didn't even touch the taperand I knew what I wasn't going
to because I had so many thingsgoing on in my life that I knew
weren't going to be optimal.
It was the middle of winter.
In this godforsaken state welive in, I don't know why I'm
still here.
That doesn't help.
So I paused, and you learn whento pause, when to go.
(29:49):
You learn if you went too fastand if you have to reinstate,
which is going back up to whereyou were.
We try hard, not to do that.
We try not to do that.
There's this thing called thekindling effect you can look
that up, guys which can be adangerous space.
However, for some people, I'vehad to do it a couple of times
because the withdrawal was sobad and it was two solid weeks
of it and it was too much for me, so I went back up.
Of course, I got better withinlike 24 hours.
Dr. Teralyn (30:10):
That's another way.
You know it's withdrawal.
You instantly get better andyou're like oh, Within like a
day or two, you're back, butit's very individualized.
Therapist Jenn (30:19):
So we teach you how to get to that space,
because I don't know about you,terri, but I'm not in the
business of creating foreverconsumers.
That's just not my shit, couldwe be Hell yeah, you want to
stay with me for three years andsee me every two, three weeks
and pay out of pocket for thatand do that.
Fine, but guess what I find?
maybe some people do, but formost of us I don't want that.
(30:42):
We want to teach people how toreally listen to yourself and do
this yourself.
We'll get you there and youjust check in.
Dr. Teralyn (30:50):
Yeah, and I like to tell people too.
When I'm working with you, Ilike to keep communication open,
because if I'm not seeing youfor four more weeks or even
longer, because, like Jen, sheheld for three months or
whatever, I'm not going to seeyou while you're holding, let's
set that appointment for Aprilthen.
But if you're doing somethingand you have a question that's
(31:14):
small, just ask it.
Do not wait for April to rollaround to ask should I take this
B complex, like what the fuck?
Just ask me the question, youknow.
Um, so I I like to be able tohave that type of touch point,
support as needed.
Uh, and I will tell you thatyou know there's people like, oh
(31:36):
, you shouldn't do that,whatever, and I'm like I have
yet to have somebody abuse thatwith me, um, cause I think most
people are conditioned to notunless it's really important.
So I'm not really worried aboutthat stuff because I want to
know that you're also being verysupported by me.
Therapist Jenn (31:55):
And most people don't.
They're not right and left likegoing through things, asking
crazy questions.
They're not.
It's usually like legitimatethings that they just want to
know something about.
I get a lot of people whocommunicate just to go hey, I
just found this article youmight want to read this Like.
I get more of that.
I get memes sent to meconstantly.
I know I'm constantly gettingmore of that kind of stuff.
(32:18):
Like hey, I was on JAMA and Iread this article have you seen
this?
And I'm like, oh my God.
Dr. Teralyn (32:22):
And then I'll take that and give it to other
clients.
Therapist Jenn (32:24):
It's so fantastic because it's this
community of sharing resourceswhich ends up happening too,
which is pretty damn cool.
Dr. Teralyn (32:31):
And I will tell you that I think, Jen and I, every
time we work with someone welearn something new, because no
one person is the same.
And also I've had an influx ofpeople coming in very
complicated psychiatricmedication stacking and stuff
like that.
Therapist Jenn (32:51):
A lot of polypharmacy.
Dr. Teralyn (32:52):
Polypharmacy is a huge thing and a lot of
health-related concerns on topof it.
So I'm learning, sometimes atthe same pace as my clients are,
and I'm constantly having torelearn what I thought I knew
already, because it's never thesame thing twice.
So people will have questionslike, well, is this normal?
(33:16):
Is that normal?
I'm like, well, if it'shappening to you, then it's
normal for you.
Yep, I'm like I don't know, noteverybody's going to experience
that, but if you are, yep, I'mlike I don't know, not
everybody's going to experiencethat, but if you are, that is
your normal.
So that's where we're at andthat's that individual piece of
all of this that I think can bemissing, and it is kind of
(33:37):
missing in the book.
There's no way you can accountin this book for
bio-individuality and just lifeexperiences and things like that
.
So this book is a great guide.
Like Jen said in the beginning,it's a tool, it's a guide, it's
great education to give to yourprescriber.
Therapist Jenn (33:55):
They love it when you bring it to the
appointment and you tap on thebook and you show them the
charts.
Dr. Teralyn (34:00):
And then they ignore it.
Therapist Jenn (34:02):
They love that, I know I'll tell Mark all about
that when he comes on the show.
I'm just like you have no idea.
I brought that book right inthere with all my tabs and all
my notes and everything, 100%.
Dr. Teralyn (34:12):
Jen has exchanged her DSM for the Mouselini
prescribing guidelines.
Therapist Jenn (34:16):
I know Well, but if you guys have stayed this
far with us, this was the end ofwhat was supposed to be a two
but a three-part series.
I swear to God, we're not goingto do part four, I mean unless
we get a bunch of people thatlike if we get feedback that
like, because anytime you guysgive us feedback of like topics
that you're interested in usdoing or talking more about, we
take that into account and so ifit makes sense for us, well,
(34:38):
we'll add it in and we canresource and add it in.
But this I think, I think wecan say this is three parts.
Dr. Teralyn (34:44):
We are done.
Here's the end of ourthree-part series.
If you need more, just workwith us individually and we'll
give you all the things youcould shoot us an email.
Therapist Jenn (34:53):
I'm looking to deprescribe and, yes, we will
work with you and help youthrough this.
But this is the end of athree-part series.
If you haven't catch the wholething as we wrap, we wrap up our
first.
The first piece of deepprescribing is that 90 day
warmup eat, sleep, move,meditate, get your fricking
lifestyle dialed in before weget going.
Then you actually move into thesecond part of deep prescribing
(35:15):
, which is you've got your taperteam, you're you're maybe doing
some functional lab work.
We're looking at nutrientdepletions.
Maybe there's some amino acidsor supplements that we need to
bring into the game.
Okay.
And then we move our way to theactual part of looking at what
could we do for deprescribing.
How could it look?
What types of guides can we use?
What could your actualhyperbolic taper look like?
(35:37):
And that's our hustle.
Dr. Teralyn (35:41):
It's what we do, yeah, and so the next part would
be setting your freeconsultation.
So there you go Shamelessself-promotion.
Therapist Jenn (35:50):
You know what?
You could send us your GaslitTruth stories.
Or you can email us and justsay hey, I want to deep
prescribe with you.
At thegaslittruthpodcasts atgmailcom, you can find Terri and
I anywhere that you go at anyof our socials.
We're there.
You can listen to this podcastanywhere that you listen to your
podcasts and give us five starsbecause you know what we're
trying to save the world.
Dr. Teralyn (36:09):
We deserve every star.
Therapist Jenn (36:11):
Yes, Damn yeah.
So thank you everybody forstaying with us and listening to
three-part series and staycurious How's that?
Dr. Teralyn (36:20):
All right, have a good one.
Well, hey, everyone, you have been gaslit
into believing that you aregoing to be on these
antidepressants forever.
This is now a three-partepisode.
It was supposed to be two, butgaslit.
Dr. Teralyn (00:11):
You're gaslit into believing it was only two parts,
when it's really going to bethree.
We lied.
Therapist Jenn (00:16):
So now it's a three-part episode and we're
going to talk to you about howto taper your medications.
We are your whistleblowingshrinks Dr Teralyn , and
therapist Jen.
And hey, you found us on theGaslit Truth Podcast.
Dr. Teralyn (00:26):
Woohoo.
So, if you haven't already, goback and listen to episode one,
or, I'm sorry, not episode one,but part one and part two of the
Medication Taper.
We were only going to do twoparts, but Jen and I get a
little geeked up and we end uptalking a little too much, and
(00:50):
so this turns into threeepisodes for the same thing,
which I although it's importantbecause I think people need to
understand, also not to dissuadeyou into doing this, but to
understand, like, the detail ofwhat it means to taper, because
so many people come in and likewhat supplements can I take to
help me feel better, tapering,and how do I taper?
And I don't have a two sentenceanswer to that.
(01:11):
Um, because everyone is sobio-individual how long you've
been on a medication mattersimmensely.
What medication you've been onmatters, um, all these things.
Your nutrient depletions matter.
How you take care of your bodymatters, it matters, it all
matters, yep.
So it's not easy, in the sensethat it's a little bit more
(01:36):
complicated than you probablythought, but I like to believe
that Jen and I make it lesscomplicated and we offer you
some real solutions that willhelp make you feel better faster
.
So this episode we're going totalk about the actual taper part
.
So I'm going to say again don'tjust listen to this episode and
start your taper.
(01:57):
Go back and listen to part oneand part two.
Okay, cannot stress that enough.
Therapist Jenn (02:03):
We'll put them all in order for you guys.
Dr. Teralyn (02:04):
We'll make it real easy you just flow from the
first one to the second one tonow the meat of the third one.
Therapist Jenn (02:11):
So let's start talking about this taper.
Something that Terry and I dois called a hyperbolic taper.
Dr. Teralyn (02:19):
I'm going to put hyperbolic taper-ish.
Therapist Jenn (02:22):
Ish, okay, this would be an ish.
And before we, before we gofarther with that, we have to
give a shout out to MarkHorowitz.
Dr. Teralyn (02:30):
Mark.
Therapist Jenn (02:30):
Horowitz is the gentleman that wrote the
Moudsley deprescribingguidelines.
Um, he is going to be coming onthe show.
Dr. Teralyn (02:37):
He's coming on guys , we've got him scheduled, but
he is in.
Therapist Jenn (02:39):
France right now and he's fucking busy, okay,
right now, and he's fucking busy, okay.
So we all just have to bepatient, okay, and so we can get
him on the show in a few months, but he's coming, guys, so it's
going to be super cool to talkto the man that I don't know.
Change the entire, my entirepractice, like it made me like,
actually change how I see all ofthe world within deprescribing
Um, so he, um, he wrote a, a guy, a deprescribing guideline
(03:03):
that's about getting offantidepressants and benzos, z
drugs, things like that.
So Terry and I use this as aguide when we are working with
our clients and doing consulting, but I can speak for both of us
when I say this is just reallytruly nothing but a guide,
because this process is soindividual.
I am walking proof of thisprocess being extremely
(03:27):
individualized and I'll give afew little things along the way,
as Terry and I talked todayabout how this had to shape and
change, and it does for many ofour clients too.
Dr. Teralyn (03:36):
Well, this is why this conversation is important,
because this is also why thereisn't a standardized
evidence-based practice fordeprescribing, because of the
individuality andbio-individuality that is
required within it.
So if you only had you do this,this and this, that would be
(03:58):
great if everybody respondedthat way, which is why a lot of
prescribers who are trying todeprescribe people don't take in
the individual nature.
They're like cut it in half andthen do every other day and
it's just.
It's not an individual processenough to account for all the
withdrawals that people gothrough and the debilitation and
all those things.
So this Mousley deprescribingguideline is like the next best
(04:22):
thing to that, but we also haveto make sure that we account for
bio individuality within that.
Therapist Jenn (04:29):
So the real layman's easiest way to talk
about the idea of hyperbolictapering is we are not most.
We're going to talk a lot aboutantidepressants today Not that
there aren't other drugs that wehelp deprescribe individuals
off.
But when we're talking about ahyperbolic fashion, it's about
(04:53):
looking at how it is that thedrug actually interacts with the
brain and these receptors ofthe brain as you slowly start to
deplete this drug out of thebody.
These drugs use a hyperbolicfashion.
The law of mass action comesinto play with this.
(05:14):
So we're really looking atneurologically how our brains
have adapted from being on thesedrugs and what we have to do,
in a very low and slow fashion,to take them out of the body.
Dr. Teralyn (05:29):
Okay, so that they can readapt to that.
It's that exercise and kind ofhomeostasis that we're talking
about.
Therapist Jenn (05:34):
It is so so to give you just just a little bit
of like the nerd part of me thatI like to explain to my clients
which, for some people, this istoo much information.
For others, they take this andrun and they're people, this is
too much information For others,they take this and run and
they're like this is so fuckingfascinating and I'm like, yeah,
thank you, mr Mark Horowitz, andother people too.
There are people out there, drYosef, they put some really
(05:56):
great videos out guys, which I'mlike at some point I need to do
one of these Melissa Pistillohas one out there too where they
draw the graphs for you andthey explain what's actually
happening.
The part I'm going to explainnow without a graph for you guys
, okay, but it's aboutneuroadaption to antidepressants
and what happens when youreduce the antidepressants or
you stop them.
So in the brain, serotonin isreleased from neurons,
(06:20):
essentially right thesepresynaptic neurons, and it gets
released into the synapse andit activates the receptors right
On the postsynaptic neurons.
So they go from one to the nextright the serotonin.
There's something called aserotonin transporter, okay, and
it re-uptakes your serotoninright, and it gives you
basically some level ofequilibrium.
(06:41):
That's what's happening beforea medication.
Okay, that's your healthy brainneuron action, yay, okay.
Then we introduce a medicationinto the brain, okay, and fuck
it all up and we God damn it wecreate.
I know you don't want to hearthis, but for those of you who
are already met, harmed and arelistening to us because you're
like, I'm ready to startdeprescribing.
(07:02):
You have a synthetic braininjury and here's the start of
the synthetic brain injury, guys, okay, so we introduce like an
antidepressant, and thatantidepressant blocks like 60,
70, 80, 90% of the serotoninactivity, this transporting
activity.
That happens.
So what happens is there's lessreuptake of that serotonin
that's going into thatpresynaptic space.
(07:24):
There's less of it, okay,essentially.
So then what does this do?
It leads to an increase in ourlevels of serotonin, which
increases the activation of thepost-receptor, the thing where
it's supposed to receive it,right.
So this is once this drug isgoing in there, so we're
actually increasing it.
Here we go Then, when drugs arein the body long term and
(07:47):
they're in the brain long termdue to homeostasis, which is
what Terry just said before,basically our body space of like
, we have to even it out.
We got to just feel, got tofeel good because something's
changing right Due to that, theexcess activation that's
happening in the post.
I got to make sure I get thisright now.
The post synaptic receptor itleads to down-regulating of
(08:09):
these receptors.
Dr. Teralyn (08:10):
Okay, and it actually there's too much going
in.
Therapist Jenn (08:13):
So you have only so many receptors for the
serotonin molecules, and so it'stoo much Down-regulates
down-regulates, right, and weknow this because there's
imaging that has been done ofthe brain to see that this is
happening.
This is how we know.
Okay, so this can happen forquite a long period of time.
So then we move to the verylast part of this, which is when
we decide that we're going tostop the medication.
(08:34):
Okay, so when theantidepressant gets removed, or
even reduced okay, after along-term use, that serotonin
transporter starts to beunblocked and now the serotonin
becomes removed from thesynaptic area and it tries to
return to these basicphysiological levels.
It's trying to get back there,that down regulation right.
Dr. Teralyn (08:58):
The sleepy receptor .
Therapist Jenn (09:00):
The receptors are sleepy, they are sleepy, yes
you always say that that's agood way to say it.
I got to use that more becauseI'm just too like in the stupid
words I need to use simple wordsSleepier.
Dr. Teralyn (09:11):
It's a sleep.
We need to wake it up.
Therapist Jenn (09:13):
Sleepy night night.
So they're all sleepy nightnighting here.
That down regulation of thatreceptor goes on for some time,
even after the antidepressantguys is starting to be removed,
and then the system starts toregister these physiological
levels of the serotonin and it'slike what the fuck is going on?
And that is what leads towithdrawal guys.
(09:36):
That is then when we start toexperience withdrawal and these
symptoms.
They're going to keep happening, guys, until the body and the
brain gets back to a space thatwas like, as mark horowitz puts
it in his book he calls itpre-drug configuration, meaning
where we were before wesynthetically injured our brains
.
Dr. Teralyn (09:55):
so there's your five minutes of like.
Therapist Jenn (09:58):
No, that was channel 10.
Yes, I liked it, ross, he canpaint and I'm just going to be
there talking about the brain.
Dr. Teralyn (10:07):
Well done, jen, well done, thank you.
There's two parts in here thatI want to talk about just
briefly.
The one is in the withdrawal,so when your receptors are
sleepy, and that's when you'regoing to experience the
withdrawal.
And that's when most people sayI must need the medication
because I'm experiencing thisheightened state of anxiety or
(10:29):
depression, whatever it is, andthere's a truth in that.
Yeah, you do need thatmedication to keep the previous
homeostasis in place.
You're right, but that is not areturn of symptoms, and this is
what we've been taught to saythat, yep, that's a return of
your symptoms.
There's one way to understandhow it's not a return of
(10:52):
symptoms by a simple questionthe symptomology that you have
right now, was it exactly thesame as the symptomology you had
25 years ago when you started?
And 100% of the time, I canguarantee you the answer is no.
It's way worse, it's waydifferent.
Or maybe I started as adepressed patient and now I have
got this immense anxiety, soit's different.
(11:15):
So that's how you know thatit's not a return of symptoms.
I also want to address the verybeginning stage of when you
start taking a medication.
Address the very beginningstage of when you start taking a
medication.
As you said, it blocks thereuptake of serotonin, leaving
more serotonin out there playingaround building up, right?
So when I say the chemicalimbalance hypothesis has been
(11:37):
long disputed and debunked andall the things and so I'll get
this pushback of, then why doesit work?
I'm like, well, because yourneurons now are flooded, in the
beginning, with serotonin.
What does that feel like?
Anytime you have flooded yoursystem with a neurochemical, it
(11:58):
feels different, right, like yes, you're going to get sometimes
a manic response to that whichfeels good, like it does feel
better than some depression.
Therapist Jenn (12:09):
Yeah, you were so damn low.
Yes, that's like when peopleare like a stimulant really
helped.
Well, fuck, yeah, yes.
Dr. Teralyn (12:16):
I would probably enjoy a stimulant too much.
Therapist Jenn (12:19):
I'll just love that for a hot second.
Yeah, not for more than alittle bit.
Dr. Teralyn (12:24):
Right, because then , the longer you go, the more
downregulated those receptorsare, and that's the place where
you end up getting moremedication, because you start
feeling low, or an additionalmedication on top, or a new
diagnosis.
All these things starthappening.
So I've never said that anantidepressant doesn't quote
(12:46):
unquote work in the beginning,because it does, because it
floods you with all those happychemicals.
Right, it works until itdoesn't.
It works until it turns on you,and those are the people that
we're hoping to catch here,because that's when you know
your mental status is goingdownhill.
So, anyway, those are the twoimportant pieces, parts of this
(13:09):
process that I think most peoplehave experienced.
Therapist Jenn (13:14):
Yeah.
So, knowing that these, like wewere giving a very specific
example and what I was goingthrough is talking a lot about
serotonin, okay, antidepressants, they show this hyperbolic
pattern between, like the doseand the clinical like symptoms,
that's happening, okay.
So here's how we get towithdrawal.
So the next part I'm from thebrain right, which is what Terry
(13:36):
and I were talking about here.
So then the next part of thisis what actually is withdrawal.
I think we should touch on that, because people's perceptions
of withdrawal at least for a lotof my clients that I've worked
with, some of them, it's like asplit.
Some of them know what it isbecause they've been trying this
two ways from.
Sunday and have tried so manytimes to get off of their
medication and they know theobvious withdrawal symptoms they
(14:03):
know really well.
Dr. Teralyn (14:04):
Like the dizziness, the brain zaps.
The dyscalibrium, the akathisia.
Anybody who has ever went offof?
Therapist Jenn (14:12):
a medication and had akathisia, which is
essentially there is just thisrestlessness in your body.
It's like.
For me it was like there waslike bugs crawling all the way
through me, had to move, had tomove, had to move, had to move.
Ok, impending doom often comeswith akathisia bugs crawling all
the way through me, had to move, had to move, had to move, had
to move.
Dr. Teralyn (14:28):
Okay.
Impending doom often comes withakathisia.
I still think, jen, thatsometimes akathisia is looked at
it like a return of symptoms.
That stuff is the anxiety andthe akathisia, with the low mood
and the wanting to off yourself.
That's a return of depressionmood and the wanting to off
yourself, that's a return ofdepression.
Therapist Jenn (14:46):
But the obvious ones are I know I'm in
withdrawal because I'm dizzy orI have a bobblehead or I have
brain zaps.
Those are obvious.
Those are obvious, but thereare.
When I say a lot of clients, Ihave already been through those.
But something that I find veryinteresting is that there were
many other.
As they learn about withdrawal.
(15:07):
There are many other symptomsof withdrawal that they had
prior to those that they didn'tknow were withdrawal.
Dr. Teralyn (15:13):
Right, yeah, so, in the vein of us helping you with
your hyperbolic taper, we tracksymptoms with people Like.
Symptom tracking is a hugething, data collection is a
giant thing, and the reason wedo that is especially, I think,
about the first time.
Like, let's say, you're goingto come in and you're going to
do your first reduction, right,okay, I will say, we're going to
(15:37):
do your first reduction.
The first one is going to takethe longest, because I want to
make sure that you're notexperiencing any withdrawal
symptoms at all for weeks beforewe go again.
In order to do that, though, weneed to collect data for a
little bit of time.
Okay, on this first one, and soI want to give.
I'm going to throw Jen underthe bus here, because I think it
(15:58):
was one of your first tapers,and then it was going well for a
few weeks, and then, suddenly,you were complaining to me that
you had a headache, and I saidyou need to track that as a
thing, and you were kind of likeit's been a few weeks, so
whatever.
Therapist Jenn (16:11):
And here's where it comes from, and I know a lot
of people listening right noware going to go through this.
Well, the first couple ofreductions, I was fine.
And here's the deal, guys.
Yes, if you're on 20 milligramsof of, say, lexapro, right For
most, tapering like guides okay,you actually go down like five
(16:32):
milligrams right away or down to10 milligrams.
That's very common and that'swhere that's where this is
important to know.
Dr. Teralyn (16:39):
It's a false sense of security.
Therapist Jenn (16:42):
And there's a little science to back it right.
Again, guys, there's thishyperbolic fashion that's
happening and in that, thiscurve that's occurring the
farther you get in the taper,the more difficult it gets
because of all of that obnoxiousPBS special I just gave you
about the brain.
Okay, about 10 minutes ago.
That's the why.
So typically for most taperswe're looking at the occupancy
(17:08):
of serotonin on these receptors.
Over time that changes, so whatit looks like when you go in
the beginning is very markedlydifferent from the middle versus
the end, which is why in thebeginning you can take a five or
even a 10 milligram cut andyou're like oh, I'm fucking fine
.
Dr. Teralyn (17:25):
Or I want to say people that are on like Zoloft
and they're at 200 milligramsand they don't feel anything in
their taper for a long time.
When I say a long time, like150, 100, and then suddenly you
hit that cert occupancy pointand it goes.
Oh my God.
Therapist Jenn (17:45):
And that's where there's some brain mind fuckery
that happens with this and Iwill be yes, you can call me out
all day long in this episodebecause I did it multiple times
because I wasn't payingattention to withdrawal symptoms
that I didn't.
I knew they were withdrawalbecause you know I've read about
them, I was educated on them,right Like Joseph Glenn Mullen
(18:07):
wrote this great book called theAntidepressant Solution, and in
there there's these charts thatI still give to my clients as a
reference right and I usemyself.
Dr. Teralyn (18:15):
There's like a hundred, there's around like a
hundred symptoms or something.
Therapist Jenn (18:17):
Well, the one he put out has about 60.
It's got about 60 differentwithdrawal symptoms in it.
And some of these are ones wewould never chalk up to
withdrawal guys, which is why westart to.
This is like my Bible thesesheets I have.
They are laminated and they'rein my bathroom cabinet.
I look at them every day Greatidea.
Dr. Teralyn (18:39):
It's a great idea, I do.
Therapist Jenn (18:41):
Because here's the deal.
Did you know that slightheadaches are a symptom of
withdrawal?
Stomach bloating and abdominalcramps diarrhea, okay are
symptoms of withdrawal.
Let's say you got a cold andthere are symptoms that are
mimicking like flu-like symptoms, right, Like you've got aches
(19:03):
or pains, or my nose keepsrunning, Okay.
Dr. Teralyn (19:07):
Yep Runny nose is on the list.
Oh my God.
Therapist Jenn (19:09):
Nightmares, guys .
All of a sudden I'm notsleeping as good.
I'm having these kind of crazy,like intense dreams maybe not
super nightmares, but all of asudden my dreams are vivid and
they're really intense.
Okay, intense dreams maybe notsuper nightmares, but all of a
sudden my dreams are vivid andthey're really intense.
Okay, these, these are symptomsof withdrawal.
Now most people are like mybrain's not zapping.
Dr. Teralyn (19:27):
I'm not.
Therapist Jenn (19:27):
I don't have suicidal thoughts.
Dr. Teralyn (19:29):
Okay, guys, these are the things.
Therapist Jenn (19:31):
Yeah, you're not going to hurt myself or others.
These are the things that yourprescribers will say to you to
pay attention to, but they aremissing the other hundred
symptoms that people go through.
Well, you have trouble sleeping.
What's that about?
That's actually a symptom ofwithdrawal.
Dr. Teralyn (19:47):
This is the exercise in curiosity and not
dismissing anything.
So if you have it, you check itoff because it might be really
important for your next one.
It might have an establishedpattern of when it emerges.
Yeah, because here's the thing,and this is where the
deprescribing guideline is veryimportant, because it maps it
(20:11):
out.
But this is the individualitypiece.
So if you know that on weekthree you get a headache, Week
three after your taper, you'redefinitely not going to want to
be tapering in week four or evenin week three.
Therapist Jenn (20:25):
So that's what we do, guys, is we look at the
symptoms you have and you haveto be very honest with yourself
on this.
I was not many times, which ledme to some pretty extreme
akathisia and spaces of like.
I could have been inpatient, nodoubt in my mind.
Okay.
So I laugh about these things,but it's part of my story and
that's just kind of how I amsometimes.
(20:45):
But I didn't pay attention,right, and so here I was, going
from headaches to so muchakathisia that I couldn't walk
around my kitchen and be aroundknives.
Okay, that's reality for me,all right.
Now what we do and we look at iswhen you have these symptoms
even if it's diarrhea, even ifit's like the headaches or my
nose won't stop running or mysleep is changing then what we
(21:08):
do is when you have thosesymptoms of withdrawal, you note
them and we do not look attapering you down until you've
went at least a couple of weekswithout those symptoms.
Everyone's different.
For me, it takes about 21 to 25days between each dose
(21:29):
reduction for me to have awithdrawal symptom.
I don't go down a dose and feelit within four or five days.
I'm about two to three weekslater and then I get it.
Dr. Teralyn (21:38):
So for me, I got to wait like a month between every
single dose reduction.
Right, because so many peoplewill miss a dose, like when I
was on Zoloft.
I know I would miss a doseRight, and then the next day I'd
be like you know.
So that's what I'm.
Most people are looking for,those immediate responses to
(22:00):
withdrawal, and they might notexist.
Okay, well, and that's.
Therapist Jenn (22:05):
I don't mean to interrupt you here, terry, but I
and I didn't want to.
I'm not going to go far intothis, but it's one of the
reasons that we educate ourclients also on, like, the
half-life of a medication.
Okay, yeah, and I was like,before we prepped here, I was
like we could talk abouthalf-life, just really.
Oh, yes, flexatine, it's reallylong, okay, and so, as compared
to some other drugs, right,it's longer.
Right, versus a benzodiazepine,your half-life is a matter of
(22:45):
hours for some of them.
Okay, so your prescribers aregoing to tell you that's how
long it takes for you to thedrugs out of your body.
If you haven't experiencedwithdrawal within that half-life
period, you're good to go Right, but we already did the PBS
special and I talked to you allabout how this actually works in
the brain, so it's a misnomer.
(23:07):
Your half-life is important toknow, though, because you might
notice some of those withdrawaleffects that can happen right
around that, which is why, likefor me, okay, I can't go more, I
can go a day and miss myLexapro, I'm okay.
It has a little bit longer of ahalf-life, and that's me.
Personally, I don't experiencethat Right, and I can miss a
dose and I'm okay and I'll justtake the dose the next day.
(23:28):
But so half-life does matterfor that reason.
Okay, so it's something to knowfor the drug that you're taking
.
But where half-life doesn'tmatter is what's told to you by
your prescribers, which is, hey,you've made it, the half-life's
done, you don't have withdrawal.
Dr. Teralyn (23:43):
It's out of your body.
You're good to go.
Therapist Jenn (23:44):
You're good to go.
When in reality, that justmeans the drug has been expelled
from the body, but now we waitfor the brain to do its thing.
Dr. Teralyn (23:51):
Yes, so getting the drug out of your body is only a
smidgen of the battle.
The recuperation of your brainis the biggest piece that you're
going to be dealing with.
Therapist Jenn (24:03):
My example I give people is alcohol.
Dr. Teralyn (24:05):
Yes, huge example Use alcohol as an example.
Therapist Jenn (24:08):
You can go ahead and you can drink too much,
right, and within how many hoursyou know that the alcohol
itself is out of the body.
But what happens for the nextcouple of days?
You're a piece of shit becauseyou're hungover, right.
The brain, right, the half-life,it's out of the body.
But now the brain and the bodyhave to do the work from the
damage that was done.
It's the same thing as theseguys.
(24:29):
So half-life matters, but itdoesn't matter in the way that I
think it's been educated to us,sometimes by prescribers,
because we're like Same thing,yep, and also when we were
talking about that cert occupant, we should have put up that
little graph on the screen.
Dr. Teralyn (24:49):
Too bad, anyway, sorry guys, we didn't do it.
Yeah, that graph part of thescreen is, I think, one of the
most important.
I might have it here.
Hang on, oh, she might be ableto pull it up here.
I mean, I have the book here soI can just grab it.
Oh, you could.
Yeah, you can just throw it upthere.
Therapist Jenn (25:03):
Okay, hang on, I'm going to try to make this
work, guys.
Dr. Teralyn (25:06):
Oh, there it is.
Yep, there it is.
You can see it Like there'slike this plateau across the top
and then the occupancy levelstarts decreasing and decreasing
and decreasing.
Once you hit that curve, okay,going down.
Okay, good, you're good.
Yep, there you go, yeah, whichis why, in the hyperbolic taper,
we go slower and slower andslower toward the end.
(25:27):
So the ending.
Here's the caveat for everybodythe ending is the hardest part.
So those last little, what isit like?
10% or something is the hardest.
Therapist Jenn (25:38):
Man.
Dr. Teralyn (25:40):
Yeah, maybe I would have that.
But this is like you know youget down to Jen's on four
milligrams or something.
I'm four, four milligrams orsomething, and she's just
chomping at the bit to be done,Like I can I just be done.
And it is so for some peoplenot all, obviously but the last
(26:01):
little bit is the hardest partand you're just aching to get
off of this entirely.
But know that you're going toprobably go slower in the end
than you did in the beginning.
Like I said, that beginningdrop, like when you saw the
curve was pretty well plateaued.
So really anything over, like,let's just say, your sort of
occupancy, is 100 milligrams,meaning if you're below 100, you
start experiencing withdrawal.
(26:21):
If you're 100 to 200, you don'texperience anything.
That just means that that'sjust extra shit rolling around
in your brain.
That extra stuff didn't reallyeven do much for you, right,
it's just all the extra stuff.
And then when you start goingdown, that's when you know that
was your most impactfulmilligram, really up to like I'm
just making numbers up 100,right.
(26:43):
So it gives you that falsesense of security off the
beginning.
But it also gives you a reallylarge sense of hope, right, Like
oh, but sometimes the hope isthis was really easy, right.
And then you start going okay,this is okay.
Whoa, that hit me hard, I gotto pull back a little bit.
Then you get to that little bitand you're like oh man, this is
(27:03):
so psychologically hard to keepgoing.
Therapist Jenn (27:07):
Part of what we work with people on our
consulting is the psychologicalpiece behind this.
Dr. Teralyn (27:14):
That is a very- and to not lose motivation, because
I do.
There's some people that I'veworked with and they get down to
that last little bit andthey're like maybe I'll just
stay on this little bit becauseit's so hard, and it's like,
okay, we got to get going again.
Or you know, I do tell peoplelike sometimes the working with
me isn't about a full taperAgain.
(27:35):
I want to make sure that myclients have that own personal
agency again where they can sayI'm just going to hold here for
a while and I'll contact you inthe future when I'm ready to
finish it off, and that's fine.
So, even like, just a reductionin medication for some people,
that's enough, right For somepeople.
(27:55):
I can't push my agenda on you,but I want them to know that
it's either you know, less ismore, or we're going to do the
full thing, or we're going totake you off of you know one or
two medications and leave you onthe other.
You know, whatever you want todo, I'm there for it, you know
so.
Therapist Jenn (28:11):
I think that's important too, because people
will like consult with me andthey will.
They'll do a you know, a quickconsultation and they well, I
heard you on on your socialmedia, right, I've listened to
you on the gas literature and,like I know you're over a year
and a half into doing this andit's not feasible for me to sit
and see you once or twice amonth, right, for a year and a
(28:38):
half.
Like that's like cost-wiseright, Like that is not a thing
I can do, right, and so I thinkit's important.
That's one of the first thingsI tell people is well, first of
all, this is my journey, notyours, so everybody is going to
be really different than this.
And second, we're going tobuild you up.
At least I tell people this I'mgoing to resource the shit out
of you, give you everything youneed.
I'm going to teach you how tolisten to yourself and as you
start to go through this taper,you're going to know and learn
(29:00):
and have that agency.
You're going to know what to do.
You don't have to stay with meforever.
I've got people that come backthree, four months later and do
a check-in and tell me wherethings are at and ask a couple
questions.
And that's it.
You do not need to.
Once we get you built andresourced, you'll have the
things that you need.
To keep moving forward in this,you learn.
I've got life events going onright now.
(29:22):
For me, that was a big one.
I went three months and Ididn't touch anything.
I didn't even touch the taperand I knew what I wasn't going
to because I had so many thingsgoing on in my life that I knew
weren't going to be optimal.
It was the middle of winter.
In this godforsaken state welive in, I don't know why I'm
still here.
That doesn't help.
So I paused, and you learn whento pause, when to go.
(29:49):
You learn if you went too fastand if you have to reinstate,
which is going back up to whereyou were.
We try hard, not to do that.
We try not to do that.
There's this thing called thekindling effect you can look
that up, guys which can be adangerous space.
However, for some people, I'vehad to do it a couple of times
because the withdrawal was sobad and it was two solid weeks
of it and it was too much for me, so I went back up.
Of course, I got better withinlike 24 hours.
Dr. Teralyn (30:10):
That's another way.
You know it's withdrawal.
You instantly get better andyou're like oh, Within like a
day or two, you're back, butit's very individualized.
Therapist Jenn (30:19):
So we teach you how to get to that space,
because I don't know about you,terri, but I'm not in the
business of creating foreverconsumers.
That's just not my shit, couldwe be Hell yeah, you want to
stay with me for three years andsee me every two, three weeks
and pay out of pocket for thatand do that.
Fine, but guess what I find?
maybe some people do, but formost of us I don't want that.
(30:42):
We want to teach people how toreally listen to yourself and do
this yourself.
We'll get you there and youjust check in.
Dr. Teralyn (30:50):
Yeah, and I like to tell people too.
When I'm working with you, Ilike to keep communication open,
because if I'm not seeing youfor four more weeks or even
longer, because, like Jen, sheheld for three months or
whatever, I'm not going to seeyou while you're holding, let's
set that appointment for Aprilthen.
But if you're doing somethingand you have a question that's
(31:14):
small, just ask it.
Do not wait for April to rollaround to ask should I take this
B complex, like what the fuck?
Just ask me the question, youknow.
Um, so I I like to be able tohave that type of touch point,
support as needed.
Uh, and I will tell you thatyou know there's people like, oh
(31:36):
, you shouldn't do that,whatever, and I'm like I have
yet to have somebody abuse thatwith me, um, cause I think most
people are conditioned to notunless it's really important.
So I'm not really worried aboutthat stuff because I want to
know that you're also being verysupported by me.
Therapist Jenn (31:55):
And most people don't.
They're not right and left likegoing through things, asking
crazy questions.
They're not.
It's usually like legitimatethings that they just want to
know something about.
I get a lot of people whocommunicate just to go hey, I
just found this article youmight want to read this Like.
I get more of that.
I get memes sent to meconstantly.
I know I'm constantly gettingmore of that kind of stuff.
(32:18):
Like hey, I was on JAMA and Iread this article have you seen
this?
And I'm like, oh my God.
Dr. Teralyn (32:22):
And then I'll take that and give it to other
clients.
Therapist Jenn (32:24):
It's so fantastic because it's this
community of sharing resourceswhich ends up happening too,
which is pretty damn cool.
Dr. Teralyn (32:31):
And I will tell you that I think, Jen and I, every
time we work with someone welearn something new, because no
one person is the same.
And also I've had an influx ofpeople coming in very
complicated psychiatricmedication stacking and stuff
like that.
Therapist Jenn (32:51):
A lot of polypharmacy.
Dr. Teralyn (32:52):
Polypharmacy is a huge thing and a lot of
health-related concerns on topof it.
So I'm learning, sometimes atthe same pace as my clients are,
and I'm constantly having torelearn what I thought I knew
already, because it's never thesame thing twice.
So people will have questionslike, well, is this normal?
(33:16):
Is that normal?
I'm like, well, if it'shappening to you, then it's
normal for you.
Yep, I'm like I don't know, noteverybody's going to experience
that, but if you are, yep, I'mlike I don't know, not
everybody's going to experiencethat, but if you are, that is
your normal.
So that's where we're at andthat's that individual piece of
all of this that I think can bemissing, and it is kind of
(33:37):
missing in the book.
There's no way you can accountin this book for
bio-individuality and just lifeexperiences and things like that
.
So this book is a great guide.
Like Jen said in the beginning,it's a tool, it's a guide, it's
great education to give to yourprescriber.
Therapist Jenn (33:55):
They love it when you bring it to the
appointment and you tap on thebook and you show them the
charts.
Dr. Teralyn (34:00):
And then they ignore it.
Therapist Jenn (34:02):
They love that, I know I'll tell Mark all about
that when he comes on the show.
I'm just like you have no idea.
I brought that book right inthere with all my tabs and all
my notes and everything, 100%.
Dr. Teralyn (34:12):
Jen has exchanged her DSM for the Mouselini
prescribing guidelines.
Therapist Jenn (34:16):
I know Well, but if you guys have stayed this
far with us, this was the end ofwhat was supposed to be a two
but a three-part series.
I swear to God, we're not goingto do part four, I mean unless
we get a bunch of people thatlike if we get feedback that
like, because anytime you guysgive us feedback of like topics
that you're interested in usdoing or talking more about, we
take that into account and so ifit makes sense for us, well,
(34:38):
we'll add it in and we canresource and add it in.
But this I think, I think wecan say this is three parts.
Dr. Teralyn (34:44):
We are done.
Here's the end of ourthree-part series.
If you need more, just workwith us individually and we'll
give you all the things youcould shoot us an email.
Therapist Jenn (34:53):
I'm looking to deprescribe and, yes, we will
work with you and help youthrough this.
But this is the end of athree-part series.
If you haven't catch the wholething as we wrap, we wrap up our
first.
The first piece of deepprescribing is that 90 day
warmup eat, sleep, move,meditate, get your fricking
lifestyle dialed in before weget going.
Then you actually move into thesecond part of deep prescribing
(35:15):
, which is you've got your taperteam, you're you're maybe doing
some functional lab work.
We're looking at nutrientdepletions.
Maybe there's some amino acidsor supplements that we need to
bring into the game.
Okay.
And then we move our way to theactual part of looking at what
could we do for deprescribing.
How could it look?
What types of guides can we use?
What could your actualhyperbolic taper look like?
(35:37):
And that's our hustle.
Dr. Teralyn (35:41):
It's what we do, yeah, and so the next part would
be setting your freeconsultation.
So there you go Shamelessself-promotion.
Therapist Jenn (35:50):
You know what?
You could send us your GaslitTruth stories.
Or you can email us and justsay hey, I want to deep
prescribe with you.
At thegaslittruthpodcasts atgmailcom, you can find Terri and
I anywhere that you go at anyof our socials.
We're there.
You can listen to this podcastanywhere that you listen to your
podcasts and give us five starsbecause you know what we're
trying to save the world.
Dr. Teralyn (36:09):
We deserve every star.
Therapist Jenn (36:11):
Yes, Damn yeah.
So thank you everybody forstaying with us and listening to
three-part series and staycurious How's that?
Dr. Teralyn (36:20):
All right, have a good one.
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