About tapering strips
Taperingstrips solve the most important practical problem patients and doctors face when attempting to taper: the lack of lower (in certain cases very low) dosages.
To taper antidepressants or other psychiatric drugs successfully, it is important to be able to taper the dose gradually and ‘hyperbolically’. This means that the dose is reduced in small steps, becoming smaller and smaller as the daily dose gets lower and lower - similar to going down a slide. Gradual dose reduction gives the body time to adapt. This is extremely important to prevent withdrawal symptoms, especially if you have used these drugs for a long time.
Whether you will be experiencing withdrawal symptoms, how strong they will be and how long they will last, can differ strongly. It depends, among other things, on the person doing the taper, on the drug being tapered, how fast it is tapered, how long the drug has been taken and at which dose. It also depends on other drugs you may be using. There are so many factors that it is impossible to predict how gradual a given patient should taper.
Taper as slowly as you need to
Taperingstrips are made according to a personalized tapering schedule and they can easily be adapted at any time. This is done based on proper (self)monitoring and shared decision making.
Once you and your doctor have decided what is most likely the best tempo for you, given your personal situation, you can get started. The flexibility offered by the use of tapering strips reduces the danger of serious withdrawal symptoms to a minimum.
Taking a tapering break
If you feel the taper is going too fast, you can take a tapering break: you stay on the same dose for 28 days, while your body adjusts and adapts to the new situation. When you feel better, you can continue your taper. This is called ‘stabilizing’.
To take a tapering break, you can either order a so-called ‘stabilisation strip’, or create the right dose yourself, using the extra tablets in varying dosages that you are provided with when you order your first tapering strip. For the next strip, your doctor can prescribe a slower tempo of tapering.
If you don’t feel well during your taper, it is important to contact your prescriber to determine if the dose should be adjusted or if stabilization is needed. The faster you react, the easier it will be to relieve your symptoms and prevent further worsening of the withdrawal symptoms.
While tapering, these is NO SUCH THING as gritting your teeth and saying: I will get through this on sheer willpower.
This will only make withdrawal symptoms worse. Be gentle with yourself: it will help you feel better.
Taperingstrips, stabilisation strips
A taperingstrip or stabilization strip contains medication in a plastic strip with medication for 28 days. Each strip consists of 28 sachets with one daily dose each. Each daily dose consists of one or multiple tablets with very precisely defined doses. For tapering strips, compounded lower doses are especially made to measure by the pharmacy.
Each new taperingstrip is ordered separately, every month
This because you may want the new strip to taper more slowly than the previous one. This ensures that you always get the taper that suits you best.
Three large observational studies have been conducted examining the efficacy of taperingstrips in daily clinical practice.
More than 2000 patients, using mostly antidepressants, participated in these studies. About 60% had taken the medication for a long time and had tried to come off it once or several times in the past. They were very unhappy with these previous attempts, having suffered severe withdrawal symptoms that caused them to give up the taper.
When these patients tapered again, this time using tapering strips, they suffered much less withdrawal symptoms and generally felt much better. About 70% was now able to complete the taper. When these patients were asked 1-5 years later how they were doing, 70% of them indicated that they were still off medication.
These studies show that many people (actually the majority) who have been taking antidepressants over a long time, having tried to stop taking them once or several times before, may still be able to stop if they taper very gradually and slowly.
Getting a prescription
To order taperingstrips, you need a prescription from a licensed physician. In the UK (100% sure) and Denmark (almost certainly) a doctor can prescribe whatever he wants. Keep that in mind and, if necessary, remind your doctor of this. Check to find out what is the law in the country where you live.
Reimbursement of the cost
Whether the cost will be reimbursed is another matter. Taperingstrips are not yet automatically part of the insurance package. Purely according to the letter of the law (EU), the preparations should be reimbursed. However, this is very difficult to explain to the health insurer, but you can always try. If the cost of the tapering strips is not covered by your health insurance (or, in the UK, the NHS) you will have to pay for the taperingstrips yourself.
Certification and production
Taperingstrips are prepared by a fully licenced and certified online pharmacy in the Netherlands. The Regenboog Apotheek is officially registered and permitted to prepare custom-made/made-to-measure medication, sell it online and send it to customers, with the exception of taperingstrips for opioids.
Getting your prescription to the pharmacy
Your doctor can email it for you, but you can also do it yourself, as long as it is valid prescription, signed by your doctor. Make a scan of the filled in prescription document and email it to the Regenboog Apotheek in the Netherlands.
To order taperingstrips, you need a valid prescription that is signed by your doctor.
Taperingstrips can be ordered from and shipped to all over the world, with the exception of opioids.
Groot, P. C., & van Os, J. (2021). Successful use of tapering strips for hyperbolic reduction of antidepressant dose - a cohort study. Ther. Adv. Psychopharmacol., 27 August. https://doi.org/10.1177/20451253211039327
Groot, P. C., & van Os, J. (2020). Outcome of Antidepressant Drug Discontinuation with Taperingstrips after 1-5 Years. Ther. Adv. Psychopharmacol., 10, 2045125320954609. https://doi.org/10.1177/2045125320954609
Review describing the development of tapering medication
Groot, P. C., & van Os, J. (2020). How user knowledge of
psychotropic drug withdrawal resulted in the development of
person-specific tapering medication. Ther Adv Psychopharmacol, 10.