Chapter Six

General Pre-Tapering and Tapering Instructions

Despite apparent redundancy, what I am about to say cannot be said too many times, so bear with me.

As you start your road back, I want your journey to be as successful and as smooth as possible. Therefore, I repeat; you cannot simply quit your medications cold turkey.

You must methodically taper off these drugs, giving your body all possible assistance to ensure you fully complete this program and are not driven back onto your prescriptions.

Your program consists of a two-part process: First, the pre-taper, which can be done in one week. If you need more time on the pre-taper go-ahead and spend the time but the final relief may not come until you are reducing the medication or until you are completely off the medication.  This is a journey back to you through steady steps that become more and more certain over time.

Once finished with the pre-taper, you will start the actual taper. You will start to reduce the medication while continuing your supplements. The number of medications you are currently taking, and your speed of progress each step along the way, will determine the length of the tapering process.

This chapter is an overview of the pre-tapering and tapering process, and what you will do no matter which drug or drugs you are taking.

These steps are vitally important to your success. Please study them carefully to ensure confidence when beginning your personal program.

The Purpose of the Pre-Taper

Just as in running a marathon, swimming a mile, buying a house, or having a baby, you have to build up to the ultimate goal. The same applies with The Road Back Program. You need to stretch your muscles, get some correct nutrients into your system and know how your daily schedule will change. The Pre Taper will set you up for a smooth reduction off your medications.

The Pre-Taper Goals

• Elimination, or a drastic reduction, of all existing side effects caused by the medications.

• Determining which supplements created the positive change.

• When you know the exact supplement that eliminated the side effects, you will know how to eliminate that side effect, if it recurs during the reduction phase of your program.

The reasoning: If a withdrawal side effect begins during the taper, odds are that it was one of the existing side effects you had before you started your pre-taper. 

An example of the importance of the pre-taper is found in the Introduction to The Art of War by Sun Tzu, from Thomas Cleary’s translation.

“Plan for what is difficult while it is easy, do what is great while it is small. The most difficult things in the world must be done while they are still easy; the greatest things in the world must be done while they are still small.”

Nutritional Supplements

Review the Chapter “Nutritionals" Used on The Road Back Program and make sure you have the nutritional supplements on hand. The day before you start your pre-taper, review which supplements you will be taking the next day, and the times you will be taking them. If you will be carrying the supplements with you during the day, and need to put those quantities into smaller containers, do so. If you know that you have a busy schedule on the day that you will start, or any day following that, prepare by making a note of when you need to take your supplements and how you can arrange to do so. If you do not usually carry water with you, or have it available where you will be, take some with you.

As stated earlier, this program is a work in progress. We constantly research better ways to eliminate side effects and speed up the tapering process. This new edition is required due to recent breakthroughs. Today a person can taper completely off their medication in half the time previously required. The changes to the program are fewer supplements used and a two third reduction in time that it takes to complete the pre-taper. The pre-taper has been able to change from taking twenty-two days to seven days.

Your Daily Journal:

Every day you will keep a written record of your progress in a journal.

You are free to copy the journal found in the next chapter and put together your own, or you can find pre-made journals at The Road Back website. In your Daily Journal you will note certain information over the course of a 24-hour period. These specific statistics are important because they will help you find your way back to center, if you falter at any point during the program. Before going to bed each night, or during the day as you take each step, write down the following:

• The date.

• The time of all medications you took that day and dosage amount.

• All food and drinks, including coffee, water, alcohol, etc; times you ate or drank, and the amount.

• Rate your own progress as to how you feel.

• Rate your energy, appetite, mood and exercise.

• Include anything that you added or deleted from your daily routine.

Keeping the journal allows you to review changes and determine which changes made positive improvements. However, if a problem occurs, the journal allows you to look back and locate which change may have made a negative impact. Locating such will enable you to quickly fix what changed and get yourself back on track.

For example, you may have increased your supplements and “super foods” too quickly or too much, and now you need to reduce them to the quantity you were taking when you last felt good. Or possibly you felt so good from the pre-taper that you added exercise into your day, which created a negative change. Whatever the case, it could be a small and seemingly insignificant change, or it could be a major change that you did not realize you had made. Using your Daily Journal, you will be able to find your way back. The Daily Journal will act like a positive voice sitting on your shoulder reminding you of what works for you, and what does not.

By noting the exact quantity of each supplement you have taken daily, you will know the positive changes are a direct result of the exact amounts and times you took your supplements.

Recreational Drugs and Alcohol

There might not be a lot to say on this subject that you do not already know. Firstly, either of these items, recreational drugs and/or alcohol, can create or bring on unwanted physical symptoms during your tapering process. Use of either could also cause or contribute to existing problems, mask potential problems, or aggravate problems that already exist. While I have said do not change anything you are doing in your life, this is one area where that adage does not apply. Completing The Road Back Program is not about “having your cake and eating it too.”

Becoming medication-and-symptom-free is your goal. Give yourself the chance to accomplish your goal.

Do Not Change Anything

Since I just told you to stop taking recreational drugs and alcohol, I might now seem to be contradicting myself, but not so.

For example: If you are already on some form of exercise program, and starting The Road Back Program, you would not stop exercising. It is great for your body, and your body is accustom to this routine.

If not on an exercise program, do not suddenly start because it seems like a good idea in combination with the tapering process. Your body is not ready for both of these changes at the same time and there could be hell to pay. However, you can go for a slow, casual walk daily if you wish. That is fine and recommended.

Also note the following:

• Do not start a liver-cleansing process, colon cleanse, etc. and the taper at the same time.

• Do not stop drinking coffee, smoking or abruptly change your diet and start this program at the same time.

Each one of these dos and don’ts: a) has its own chemical response in your system and b) any of these can either speed up or slow down the flow of medication you are taking through your body, and could create withdrawal side effects.

While some supplements are good for you and some supplements may not be as beneficial, it will be too hard to sort out what causes what, therefore you may find it difficult to keep yourself on a steady path gaining momentum and success. You get the point – use your head. Examine the options and choose the one that adheres as closely to The Road Back Program as possible.

Deviation from The Road Back Program

You might think deviating from the program would be obvious and easy to detect. Not always.

The Road Back Program usually works quickly with the person quickly experiencing a vast improvement. This blessing can also be a curse. In the first years of the program, a person would typically feel a major positive change about halfway through the tapering portion. Now they frequently experience major positive change after a few days on the pre-taper. The creation of the supplements and the time of day each is taken have greatly sped up the program. Imagine feeling as though you had never taken a drug only one week after starting the pre-taper part of The Road Back Program.

However, when this major positive change occurs, a person can feel so good that he or she begins doing things they have wanted to do for years, such as quitting smoking, giving up coffee or starting a major exercise program.

Then they suddenly crash and wonder why!

I first experienced this curse in 1999 when a woman called who was tapering off her medication. After first doing well, suddenly she was not. She had tried to taper off an antidepressant medication several times over the years before starting The Road Back Program, never reducing the drug without extreme withdrawal and always returning to her original dosage. This time she had been halfway off her medication and feeling great.

It took two weeks to figure out what changed. I asked every question I could think of; there was something she was doing differently. I finally found out that typically, every six months, she went onto an all-protein diet. This was so “normal” for her she never thought to mention, or view it, as a major change in her lifestyle. However, this diet change hugely impacted her progress, and was the major deviation from the program. Once the change was discovered, she re-started her tapering program from square one and successfully completed tapering off the antidepressant.

I cannot over stress looking for and finding obvious as well as subtle changes if you experience a negative change during this program.

Another major deviation from the program can occur – you feel so good, you forget to take your medication(s). This is a no-no, but happens. Lower the medication only at specific amounts and make that gradual reduction. Numerous people over the years have begun a pre-taper while suffering from widely varying side effects. Taking psychiatric medications for years, they had tried to get off the drugs countless times. After beginning the pre-taper and finally sleeping through the night for the first time in months, their daytime anxiety vanished. Three days later, they forgot to take their medication at bedtime. The next day, they went into full withdrawal and began to question whether The Road Back Program was right for them. The only problem was forgetting to take their medication.

These variations or deviations from the program can also be extremely troubling for a doctor. He or she can only help guide you through the steps with all the information on hand. Again, it is imperative that: a) you write everything down in your Daily Journal, including things you might think have no bearing whatsoever, and b) bring your Daily Journal to your doctor visits, so that together you can chart your progress and get back to square one if needed.

 â€œSuper Foods”

A deviation from The Road Back Program can also take place with the “super foods” used on the program. Once you feel a positive change with the Power Barley Formula, do not increase it further during the pre-taper.

I often make this joke about Texans and Power Barley Formula. Big, or better yet bigger, is better in Texas. On a trip to Texas I described how to use the Power Barley Formula, what to look for regarding positive changes and to not increase that product once positive change is achieved.

Two weeks later, a Texan called raving about her positive changes. One week later, the same person called again, saying they did not feel as well and were wondering what could have happened. This was not too difficult to solve. Texans and Power Barley Formula? The person had doubled the Power Barley Formula amount that brought on the positive changes. If one teaspoon three times a day made you feel that good, 2 teaspoons 3 times a day should make you feel twice as good, was the thought process.

Once the Texan went back to the right amount for her body, she felt good again.

Major Improvement

The Texan story leads us to the definition of major change - a major improvement. A major improvement is what you are going for with the pre-taper.

If you have extreme daytime anxiety and are able to reduce it to a point where you have to stop and look for anxiety to even see or feel any, you have had a major improvement.

If you could not sleep more than two hours a night and are now able to sleep four to five hours, wake up and then go back to sleep, that is a major improvement.

If every joint in your body ached, and now you have only a little ache in the morning when you awake that goes away within the first few minutes, you have experienced a major improvement.

If you felt a major depression every day and now you feel a little depressed occasionally, you have had a major improvement.

If you feel like you are not even taking a medication now, you have had a major improvement.

Major changes are what you are going for during the pre-taper. The goal is to alleviate major complaints or reduce them to the point of being very acceptable and not in the way of day-to-day life, so that you can fully taper off the medication and “live life.”

Once a “super food” or supplement provides relief or a major improvement, there is no need to keep increasing that product.

Steady State: The term “steady state” has special definitions in biochemistry, chemistry, electronics and even macroeconomics.

In The Road Back Program “steady state” is defined as: A constant level or a level of action that allows a balance between two or more substances.

A constant level would be maintaining a level of a supplement in the body to a degree where it never drops below a certain point. Much like the half-life of medication, keeping enough of a substance in the body at a specific strength gives a result. If you skip a dosage of medication, withdrawal begins. If you skip a serving of a supplement, withdrawal does not take place, but you do lose the steady or constant state of the supplement.

A level of action that allows a balance between two or more substances is different from a constant level. Psychiatric medications alter hormones and the adrenals. When a “steady state” occurs with the nutritionals at a constant level, the cells will use the nutrients to begin working with each other, balancing each other, allowing the cells to receive energy and exchange back to other cells desired substances for optimum survival.

During the pre-taper, one goal is finding the “steady state” of each nutritional for your body. Age, height, weight, gender, how long you have been using a medication or the type of medication you might be using cannot be used to predict the correct amount of a nutritional in this program. This takes trial and success.

If You Have Anxiety or Insomnia, What to Expect

The following chart is the result of a double-blind randomized controlled trial of the benzodiazepine Oxazepam compared to the type of passion flower used in this program. Oxazepam is also marketed under the names Alepam, Murelax, Oxascand, Serax, Serepax, Seresta and Sobril.

The trial was for treatment of generalized anxiety.

Anxiety Reduction Chart

                                    Oxazepam plus placebo

                                    Passion Flower plus placebo

Left Column is the Hamilton Anxiety Score.

Notice the gradual reduction of anxiety over 30 days. During your pre-taper the anxiety should begin to lessen and the second week should bring a marked decrease of anxiety. Use the graph located after the “Daily Journal” chapter to chart your own progress.

Calcium-Induced Side Effects With Benzodiazepines and Anti-Convulsants

• When taking benzodiazepines and/or anti-convulsants, do not take a supplement containing ionic calcium.

If you are taking an antidepressant or anti-psychotic medication and anxiety is a major complaint, avoid ionic calcium as well.

If you are going to take calcium, make sure to include 5 grams each day of Calsorption to improve the calcium absorption and ideally use a calcium product like CalesiumD.

Ionic calcium and “plain” or unaltered calcium differ in that ionic calcium is altered into a form the body absorbs instantly versus “plain” or unaltered calcium, which breaks down in the body more slowly. An ionic calcium product either dissolves or fizzes when put into hot or cold liquid.

While either type of calcium supplements a natural, healthy diet, do not use ionic calcium if taking a benzodiazepine or if suffering from anxiety. Calcium is something all bodies require, and one main property is assisting with the correct functioning of nerve impulses. While you want your nerves and their impulses functioning correctly at all times, you do not want or need to increase or “feed” this nerve stimulation while you are taking and/or trying to taper off of benzodiazepines and/or anti-convulsants.

Calcium stimulates electrical discharge of the nerves. The stimulation of nerve impulses is the primary problem associated with using ionic calcium along with a benzodiazepine or anticonvulsant.

Clinical trials have shown that blocking calcium can help protect a person from the worst benzodiazepine withdrawal symptoms.

Calcium-induced side effects while taking a benzodiazepine or anti-convulsant can include:

• Hyperkinesia: an abnormal increase in muscular activity, hyperactivity, especially in children.

• Hyperthermia: unusually high body temperature.

• Hyper aggression.

• Audiogenic seizures: Seizures caused by loud sounds and noises.

• Increased anxiety.

• Psychosis.

• Numbness around the mouth.

• Tingling in the extremities.

• Shortness of breath.

It is vital that you ensure you are not taking an ionic calcium supplement while using a benzodiazepine or anti-convulsant.

Several patients and physicians have contacted The Road Back with questions about using calcium as part of The Road Back Program.

Suggestion: If you are taking a calcium supplement and suffer from anxiety, stop the calcium supplement for three days. See if the anxiety goes away or greatly subsides. If the anxiety subsides, there is nothing left to argue about. If the anxiety stays the same, it is not the calcium. Keep taking the calcium!    

Your Next Step    

• If you are taking a benzodiazepine, anti-convulsant, anti-anxiety or sleep medication, follow the instructions found in the chapter “Pre-Taper for Benzodiazepine, Anti-convulsant, Anti-anxiety, and Sleep Medication” in Chapter 9.

• If you are taking an antidepressant, anti-psychotic or ADHD medication, follow the instructions found in the chapter “Pre-Taper for Antidepressants, Anti-Psychotics, and ADHD Medication” in Chapter 10.

• If you are taking a benzodiazepine, anti-convulsant, anti-anxiety or sleep medication along with an antidepressant, anti-psychotic or ADHD medication follow the instructions found in the chapter “Pre-Taper for Antidepressants, Anti-Psychotics, and ADHD Medication” in Chapter 10. In that chapter, there is a section “If You Have Anxiety or Insomnia.” Follow the pre-taper instructions in that section. 

Two Key Components for Accomplishing a Complete and Successful Taper:

Fully complete your pre-tapering program before starting your medication- reduction tapering program.

Taper off the medication using the correct reduction amount to match your body. Slow and gradual will win this race each and every time.