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“You can get past the dead end. You can break through the ceiling. I did and so have countless others.”

Clinical Pearl Wednesday #167

Female doctor recommends medication to senior patient

One of the most challenging medication changes for most of us is helping patients wean off their SSRIs.  Reducing by half doses is often too big of a change, resulting in worsening of symptoms and frustrations that impact patients’ willingness to keep decreasing doses.  

The 2 things I use to help reduce SSRI or even SNRI doses: 

  1.  Reduce tablet doses by “slivers,” not halves.  
  2. Start GABA, magnesium L-threonate, and L-theanine BID a couple weeks prior to reducing the first dose. 

Reducing by slivers can definitely be challenging, but it really is effective, and patients LOVE being able to use less medication.  This method can ONLY be used with tablets that are scored.  The first step is to have the patient use the score to halve the tablet.  Using a pill-splitter is much preferred over a knife b/c the blade is much thinner, and easier to slice crumbly tablets.  Once the tablet is sliced in half, have the patient slice a thin sliver off the middle, straight line of the tablet.  Instruct the patient to take all of the tablets EXCEPT the sliver.  Keep the sliver approximately the same size for 2-4 weeks, and then increase the size of that sliver.  Continue taking less medication over time as the sliver size is increased and discarded.  

Starting GABA, mag, and L-theanine and continuing it while decreasing medication doses is extremely helpful for patients, improving their ability to wean off the meds safely and effectively since these 3 ingredients are vital for optimal brain chemistry and many neurotransmitter functions.  The doses of these 3 supplements can vary widely; sometimes, I recommend individual products to get higher doses of each, but for milder symptoms, a combination product like Cerenity by OrthoMolecular can be quite effective.  

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