On 3mg Seroquel tapered from 600mg

Hi @ang123 Amazing work! I'm tapering from 800mg and down to 400 at the moment, while I don't have experience in the final step to actually stopping, I would love to hear how your taper has progressed so far. Is your current dose compounded by a pharmacy? How long has the taper timeframe been to date? I see my doctor in 2 weeks, we are going to go through the receptors affected at certain doses, so maybe I can ask what happens at the lowest levels.

Hi Ang! Some general thoughts. The core principle: the final step to zero should produce roughly the same drop in D2 occupancy as previous steps, not a sudden cliff. Because the dose–occupancy curve is hyperbolic, this means the final dose has to be much smaller than people intuitively expect. Horowitz et al. suggest that final doses before complete cessation may need to be as small as roughly 1/40th of a therapeutic dose to prevent a large drop in D2 blockade when stopped. 3mg is already deep in the tail, but the framework would say: don’t jump from here. Continue with proportional reductions (commonly ~10% of the most recent dose, held 4–6 weeks each — longer if any symptoms appear), down to roughly 0.5mg or lower before stopping. This is obviously generic info, you and your clinician will be able to tell based on how you feel going forward. Let us know how it goes!

"@Catina great idea!" — @Based Psychiatrist

Surviving Antidepressants had a topic thread called Managing the End-Game Taper with advice about how to handle the very end of a taper. 👍