TaperCareby FeelGround
Integrative mental health

The method

Why slower, smaller steps work

Psychiatric drugs have a curved relationship between dose and effect. Halving a low dose changes far more in the brain than halving a high one — so steady, proportionate reductions feel gentler.
1. Dose and effect aren't a straight line

How much of the brain's serotonin transporter an SSRI blocks at each dose. The curve flattens: going from 40 to 20 mg barely changes the effect, but 5 to 0 mg removes half of it.

0%20%40%60%80%100%051020304020 mg ≈ 80%5 mg ≈ 50%Daily dose (mg, citalopram-like)
2a. Equal mg cuts (linear)

Same 5 mg each time — but the last step removes 50% of the effect at once.

02550520→15815→101710→5505→0.0Dose step (mg)Effect lost per step (%)
2b. Proportional cuts (hyperbolic)

Doses shrink each time, so every step removes a similar ~10%.

025501020→121012→8108→5105→3103→2102→1.3101.3→0.6100.6→0.0Dose step (mg)Effect lost per step (%)

Illustrative model based on PET imaging data for SSRIs (Horowitz & Taylor, Lancet Psychiatry 2019). Exact doses and timing differ per drug and person — not a prescription.

  1. 1

    Talk to your prescriber

    Bring this information and agree a plan together, including how you'll check in.

  2. 2

    Choose a starting reduction

    Often around 10% of the current dose (some people need less), held for 2–4 weeks.

  3. 3

    Listen to your body

    If symptoms become hard to manage, hold the dose or return to the last comfortable step.

  4. 4

    Make steps smaller over time

    Each reduction is a percentage of the current dose, so the final steps are tiny.

  5. 5

    Finish gently

    The last few milligrams often matter most. Liquids or tapering strips can help.

Sources

  1. 01
    Tapering of SSRI treatment to mitigate withdrawal symptoms

    Horowitz & Taylor, The Lancet Psychiatry, 2019

  2. 02
    Tapering medication: the role of tapering strips

    Groot & van Os, Therapeutic Advances in Psychopharmacology, 2018

  3. 03
  4. 04
    The Maudsley Deprescribing Guidelines

    Horowitz & Taylor, Wiley-Blackwell, 2024