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logicalscout: Delayed SSRI withdrawal symptoms triggered by stressful event


logicalscout

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Hi all,

 

I could really use anyone's experience or advice here as i'm in a very fragile mental state.


My history

I was diagnosed with OCD and severe anxiety in 2011. I was put on SSRI's and they did eliminate my symptoms but it also resulted in several other symptoms such as chronic fatigue and motivation and emotional blunting. I tried cycling through the SSRI's (see history below) to see if I could do better but none of them ended up removing the side effects. In the past I had tried tapering off the antidepressants (usually over the course of a month with no success, I used to get severe brain zaps and anxiety).

 

My history of SSRI/SNRI's are below:

2011-2013 (Lexapro 20mg)
2013-2014 (Sertraline 200mg, Prozac 20mg, Luvox 50mg, cycled through with help of psychiatrist, stopped due to other side effects such as sleep issues or anxiety)
2014-2016 (Lexapro 20mg then Prozac 20mg)
2017 June (Pristiq 50mg)
2017 June - Now (Not medicated)

 

My Journey Getting of SSRI/SNRI

I have been on SSRI's and SNRI's for a total of 7 years when I decided to go see a wholistic doctor who said he could help me get off anti-depressants using high dose vitamins (Pfieffer technique) (I can provide doses of the vitamins if interested, some of the doses are very high Vitamin b6 250mg, Zinc 75mg etc.)

 

I started the vitamins in May 2017 and was able to slowly stop Pristiq. It did help blocking the withdrawal symptoms (brain zaps). After stopping (and still taking the vitamins) I still felt the effects of the anti depressants (emotional numbing, no sex drive) but I also had no anxiety and no suicidal thoughts (I was unhappy but stable). The anti depressant effects had persisted after I stopped taking them.

 

I thought all was fixed and I had to wait months for the negative side effects to reverse (no sex drive, fatigue). 

 

The event that triggered severe symptoms and relapse

In July, I went overseas and had several very stressful events (breaking up with girlfriend, anxiety of being in a new country, a death in the family) and it is as if my brain delayed the withdrawal symptoms. It changed me.

 

I now have severe general anxiety and depression (including suicidal thoughts and intense feelings of loneliness). The main symptom that is worrying me is a constant feeling that my perception is restricted/blurred and constantly feel disoriented, it is as if i'm feeling drunk all day and it is hard to process anything, people will talk to me and sometimes nothing registers. This is really worrying me (has anyone heard of anything like this? Is it withdrawal?) It is very hard to get through a day of work. It is okay in the morning and gets progressively worse as the day goes on.

 

I'm not getting brain zaps so i'm not sure if it is withdrawal symptoms but I'm very worried right now. The only thing I can think of is to go back on 10mg Lexapro to see if the anxiety/depression and disorientation disappear. I have tried Omega 3 and it has not resolved the disorientation, I am already taking high dose Magnesium as well.

 

Can anyone provide any information regarding these symptoms and if they have experienced it before? (Especially the drunk and disoriented feeling)? Has anyone had a stressful life event completely change the symptoms they were feeling? I don't know what to do.

 

Thank you,

LogicalScout from Sydney

 

 

2011-2013  (Lexapro 20mg);
2013-2014 (Sertraline 200mg, Prozac 20mg, Luvox 50mg, cycled through with help of psychiatrist)
2014-2016 Lexapro 20mg then 2-week prozac bridge (Prozac 20mg) to taper off
2017 January start Pristiq 50mg; June tapered off 50mg -> 25mg - 12.5mg - 6mg (Stop) over a 4 week period
2017 June - Aug (Not medicated) Was stable for a while until stressful life events triggered anxiety/depression symtpoms
2017 Aug 1 - Now Lexapro reinstated 10 mg, Reduced to 5mg due to increased anxiety/panic
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  • ChessieCat changed the title to logicalscout: Delayed SSRI withdrawal symptoms triggered by stressful event
  • Moderator Emeritus

logicalscout -- Welcome to Surviving Antidepressants (SA)

 

Sadly no supplements will prevent withdrawal symptoms, despite what holistic practitioners say.  Most holistic professionals, like western medical providers, believe that the effect of the medications lasts only as long as the drug is in your body at a significant level.

 

Withdrawal symptoms can be delayed; many people experience a "honeymoon" of several weeks ... the BAM! It's entirely possible that would have happened without the additional stress that came from circumstances out of your control. Your symptoms are altogether consistent with what we see all over this site. For more information, please read:

What is withdrawal syndrome.

Glenmullen’s withdrawal symptom list -- downloads available in the first post.

 

12 hours ago, logicalscout said:

2014-2016 (Lexapro 20mg then Prozac 20mg)
2017 June (Pristiq 50mg)
2017 June - Now (Not medicated)

Before we can make suggestions about a next step, please post more detail about the last 18 months:

  • In what month of 2016 did you discontinue Lexapro? How did you discontinue? Why did you discontinue?
  • In what month of 2016 did you discontinue Prozac? How did you discontinue? Why did you discontinue?
  • When did you start taking Pristiq?
  • On what day was your last dose of Pristiq? How did you stop taking Pristiq -- "cold-turkey" from 50 mg, cut tablets, something else?

 

Please add those details to your history of SSRI/SNRI's and then post those as a signature: Account Settings – Create or Edit a signature. 

 

The symptom that concerns you most sounds like a description "Depersonalization/Derealization" or DP/DR. Here's our discussion topic where members share about coping with it: DP/DR.

 

This is YOUR introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community.

 

I hope you'll find the information in the SA forums helpful for your situation. I'm sorry that you are in the position that you need the information, but am glad that you found us.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results

Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to  0.0 mg  Aug. 12; details here


scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet

Link to comment
On 8/2/2017 at 8:28 AM, scallywag said:

logicalscout -- Welcome to Surviving Antidepressants (SA)

 

Sadly no supplements will prevent withdrawal symptoms, despite what holistic practitioners say.  Most holistic professionals, like western medical providers, believe that the effect of the medications lasts only as long as the drug is in your body at a significant level.

 

Withdrawal symptoms can be delayed; many people experience a "honeymoon" of several weeks ... the BAM! It's entirely possible that would have happened without the additional stress that came from circumstances out of your control. Your symptoms are altogether consistent with what we see all over this site. For more information, please read:

What is withdrawal syndrome.

Glenmullen’s withdrawal symptom list -- downloads available in the first post.

 

Before we can make suggestions about a next step, please post more detail about the last 18 months:

  • In what month of 2016 did you discontinue Lexapro? How did you discontinue? Why did you discontinue?

 

Thank you for your response scallywag, As the anxiety was unbearable, I began 10mg Lexapro yesterday night and experienced a panic attack (elevated heart rate, increased anxiety and shortness of breath). I cut down to 5mg today but still increased anxiety. Is that expected after starting an SSRI after a long time?

 

Unfortunately I don't have/remember the actual months on when I discontinued Lexapro. The reason I discontinued it was due to the motivation issues and chronic fatigue (I had zero anxiety though). The doctor suggested I switch to a SNRI (Pristiq) as it may be more energizing. The reason Prozac was involved in the middle was he suggested to use a technique called a Prozac bridge. I then began the Pristiq in January 2017 (Sorry i made a typo in my original post).

 

On 8/2/2017 at 8:28 AM, scallywag said:
  • In what month of 2016 did you discontinue Prozac? How did you discontinue? Why did you discontinue?

 

It was only used for the purpose of a Prozac bridge which lasted 1-2 weeks

 

On 8/2/2017 at 8:28 AM, scallywag said:
  • When did you start taking Pristiq?

 

January 2017

 

On 8/2/2017 at 8:28 AM, scallywag said:
  • On what day was your last dose of Pristiq? How did you stop taking Pristiq -- "cold-turkey" from 50 mg, cut tablets, something else?

 

Beginning of June 2017. I used a pill cutter and did a quick taper over a month 50mg -> 25mg - 12.5mg - 6mg (Stop) over a 4 week period.

 

On 8/2/2017 at 8:28 AM, scallywag said:

Please add those details to your history of SSRI/SNRI's and then post those as a signature: Account Settings – Create or Edit a signature. 

 

The symptom that concerns you most sounds like a description "Depersonalization/Derealization" or DP/DR. Here's our discussion topic where members share about coping with it: DP/DR.

 

I think it is actually more than Depersonalization/Derealization (which I have experienced in the past). I would describe it as a feeling of being drunk or having impaired perception. A feeling or disorientation and lack of mental clarity. It is near constant and gradually worsens during the day. One other thing I have noticed is that eating meals gives me anxiety symptoms, it is as if my body is a in a super sensitive state.

 

On 8/2/2017 at 8:28 AM, scallywag said:

This is YOUR introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community.

 

I hope you'll find the information in the SA forums helpful for your situation. I'm sorry that you are in the position that you need the information, but am glad that you found us.

 

Thank you again for responding Scallywag. The psychiatrist recommended I stay on 5mg for at least one week, however even this dose is causing me anxiety. Any advice would be appreciated.

 

2011-2013  (Lexapro 20mg);
2013-2014 (Sertraline 200mg, Prozac 20mg, Luvox 50mg, cycled through with help of psychiatrist)
2014-2016 Lexapro 20mg then 2-week prozac bridge (Prozac 20mg) to taper off
2017 January start Pristiq 50mg; June tapered off 50mg -> 25mg - 12.5mg - 6mg (Stop) over a 4 week period
2017 June - Aug (Not medicated) Was stable for a while until stressful life events triggered anxiety/depression symtpoms
2017 Aug 1 - Now Lexapro reinstated 10 mg, Reduced to 5mg due to increased anxiety/panic
Link to comment
  • Moderator Emeritus

logicalscout -- your anxiety is almost certainly a withdrawal symptom. Most people do not see improvements after the second reinstated dose. It takes at least 4 days for Lexapro to reach steady state (same daily cycle) in your body and then at least another 7-10 days for your CNS (central nervous system) to "notice" and to settle down its symptom-creating activity.  Give yourself at least 2 weeks at this dose.

 

It can take longer than 2 weeks for symptoms to lighten:

How long to stabilize after reinstating or updosing.

 

Are you comfortable with your psychiatrist's suggestion of 5 mg?

If yes, stay at that dose.

If no, you could reduce to as little as 0.5 mg/day or to 2.5 mg.  Then stick with it.

It may seem counter-intuitive to reduce dose rather than increase it. Our thinking behind this is that your brain has made changes since you discontinued Lexapro last year, in the process of undoing the changes it made since you started taking Lex. Your symptoms are a sign of a destabilized CNS. Returning to a full dose *can* cause further destabilization. Some people's CNSs handle full reinstatement in short order; other people's don't. There's no way of knowing who's going to suffer until they do. To get some other descriptions/explanations about this, please have a look at:

 

 

Here is what you posted previously with a few additions from your post immediately above this one:

 

2011-2013 (Lexapro 20mg); 2013-2014 (Sertraline 200mg, Prozac 20mg, Luvox 50mg, cycled through with help of psychiatrist)

2014-2016
Lexapro
20mg then 2-week prozac bridge (
Prozac
20mg) to taper off

2017 January start
Pristiq
50mg; June tapered off 50mg -> 25mg - 12.5mg - 6mg (Stop) over a 4 week period

2017 June - Now (Not medicated)

2017 Aug 1 - reinstated 10 mg
Lexapro
; Aug 2 - reduced to 5 mg;

 

Please copy and paste these ^ lines in a signature:

 

If/when you change a dose or a medication, please update your signature with the new information.

 

Having your medication and withdrawal history in a signature that appears below every one of your posts helps moderators and other members understand "where" you've been and "where" you are.

 

 

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results

Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to  0.0 mg  Aug. 12; details here


scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet

Link to comment

First of all Scallywag, can I say thank you so much for responding to my posts, your posts are helping me through a very difficult time and you have no idea how much it means to me that you are helping me out (a random person on the internet).

 

On 2017-08-03 at 3:01 PM, scallywag said:

logicalscout -- your anxiety is almost certainly a withdrawal symptom. Most people do not see improvements after the second reinstated dose. It takes at least 4 days for Lexapro to reach steady state (same daily cycle) in your body and then at least another 7-10 days for your CNS (central nervous system) to "notice" and to settle down its symptom-creating activity.  Give yourself at least 2 weeks at this dose.

 

It can take longer than 2 weeks for symptoms to lighten:

How long to stabilize after reinstating or updosing.

 

Are you comfortable with your psychiatrist's suggestion of 5 mg?

If yes, stay at that dose.

If no, you could reduce to as little as 0.5 mg/day or to 2.5 mg.  Then stick with it.

 

I am comfortable staying at 5mg at the moment. The issues I was describing before regarding the drunk feeling or impaired perception have greatly decreased after re-instating the lexapro. The main symptoms i'm experiencing at the moment is high anxiety and and put my sex drive in overdrive (It is quite distracting at this stage and I really hope it settlesv)

 

Quote
It may seem counter-intuitive to reduce dose rather than increase it. Our thinking behind this is that your brain has made changes since you discontinued Lexapro last year, in the process of undoing the changes it made since you started taking Lex. Your symptoms are a sign of a destabilized CNS. Returning to a full dose *can* cause further destabilization. Some people's CNSs handle full reinstatement in short order; other people's don't. There's no way of knowing who's going to suffer until they do. To get some other descriptions/explanations about this, please have a look at:

 

 

 
 
 

 

I can definitely relate to that, I feel that after being on SSRI/SNRI's long term, my brain has made adaptatations and is no longer the same. I did not experience this increased anxiety/sex drive the first time I took lexapro, it is putting me in a state of unease. If you believe dropping to 2.5mg might help, i'm inclined to try that. How often should I increase it from 2.5mg -> 5mg-> 10mg?

 

Quote
Here is what you posted previously with a few additions from your post immediately above this one:
 
2011-2013 (Lexapro 20mg); 2013-2014 (Sertraline 200mg, Prozac 20mg, Luvox 50mg, cycled through with help of psychiatrist)

 

2014-2016 Lexapro 20mg then 2-week prozac bridge (Prozac 20mg) to taper off
 
2017 January start Pristiq 50mg; June tapered off 50mg -> 25mg - 12.5mg - 6mg (Stop) over a 4 week period
2017 June - Now (Not medicated)
2017 Aug 1 - reinstated 10 mg Lexapro; Aug 2 - reduced to 5 mg;
 
Please copy and paste these ^ lines in a signature:

 

Thank you for that, I have added this information for my signature, and thank you again for taking the time to respond to me.

Edited by scallywag
remove extra lines in quoted post
2011-2013  (Lexapro 20mg);
2013-2014 (Sertraline 200mg, Prozac 20mg, Luvox 50mg, cycled through with help of psychiatrist)
2014-2016 Lexapro 20mg then 2-week prozac bridge (Prozac 20mg) to taper off
2017 January start Pristiq 50mg; June tapered off 50mg -> 25mg - 12.5mg - 6mg (Stop) over a 4 week period
2017 June - Aug (Not medicated) Was stable for a while until stressful life events triggered anxiety/depression symtpoms
2017 Aug 1 - Now Lexapro reinstated 10 mg, Reduced to 5mg due to increased anxiety/panic
Link to comment
  • Moderator Emeritus

If you're comfortable at 5 mg, hold there.  Often the most important thing in withdrawal is stability, so the last thing you want to do is stumble around trying to find the "perfect" dose. It may be helpful to read:

3KIS: Keep it slow. Keep it simple. Keep it stable.

 

Monitor your symptoms over the next week. Please keep notes on paper of your symptoms and the times of your dose(s). This post has a useful format for a daily log:

Take notes of doses and symptoms.

 

You're very welcome and it's kind of you to let me know that the information is helpful.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results

Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to  0.0 mg  Aug. 12; details here


scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet

Link to comment

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