I have been taking 50mg of Luvox (fluvoxamine) for about 9 years (once
per night).  It has helped me with my OCD (obsessive-compulsive
disorder) and anxiety.  Lately, I have been having memory
difficulties. I know this could be a side effect of luvox.   I would
like to taper off luvox now.  But I want to do this very, very slowly
so I do not cause bad withdrawl symtoms.  I haven't had anyone
monitoring me for these 9 years.  I've just renewed my prescriptions
with reuglar doctors.  I would like to find a psychiatrist in New York
City.. who is a "top" psychiatrist.  I only want to go to a very good
psychiatrist who has a good reputation and has a history of success
with patients tapering off psychiatric drugs (specifically SSRIs).
Where can I find a Manhattan Doctor with these credentials?  Thanks,

Rob

in my opinion the regular doctors who prescribed the medication should
be competent to taper the ssri. i do not believe there is any truly
special method, though i'm sure you could find a specialist to tell
you otherwise. if i were your doctor and the ocd was in excellent
control, given the circumstaances which you described, i would
diminish the dose by enough to see if the side effects resolved, but
not so much as to remove reasonable effect of the medication. i.e.
taper too quickly and possibly get ocd worsening ( although there is
no true way to know at this point the exact role of the ssri in
treating the ocd) and taper inadequately might not test your
reasonable hypothesis that your memory is decreased by the ssri

in conclusion, you might just ask your doctor to decrease your dose by
fifty percent and then to see you again in six weeks ( or sooner if
you feel you are doing poorly).  please do not take this to diminish
the value of a good psychiatrist -  if you wish to establish an
ongoing relationship.  i am just saying that the specific  issue of
tapering an ssri is not particularly tricky. one would change the dose
then watch closely for signs of ocd worsening and/or side effect
improvement.  further adjustment could be made down the road.


best of luck

When going off SSRIs there is more than the risk of old symptoms
returning; the effects of coming off these drugs too quickly can lead
to violent behavior, as is evidenced by most of the school shootings
in the USA. Other possible side effects include seizure, depression,
and mania.

I'm afraid I'm unaware of a psychiatrist that specializes in this type
of thing, but I have seen SSRI patients very, very gradually taper
themsleves off the drug. Nonetheless, I would let your physician (even
an MD) know what you're up to. But I wouldn't go back to the
prescribing physician. It's unconscionable that he or she hasn't seen
you in so long a time, but allowed your prescription to go on and on.

This article, about weaning yourself off SSRI antidpressants, may help:
http://www.antidepressantsfacts.com/taper.htm

Kriswrite