determinedToMakeIt: Prozac WD again after 10 years off and on

[determinedToMakeIt]

Hi All,

I've been on Prozac off and on for the last 10 years:

• Nov 2007 - 20 mg after severe anxiety/PTSD/depression after abusive relationship and bad alcohol binge. 
• Summer 2008 - went off bc i 'felt good' 
• Fall 2008 - WD and all original symptoms back: extreme anxiety, etc
• Fall 2008 - back on 20 mg until
• Summer 2009 - went off bc i 'felt good'
• ... note, prozac was always prescribed by an internal med doctor, not a specialist. took me about 10 mins each time to get a prozac diagnosis, from different docs ...
• ... note, always used Xanax for the symptoms until the prozac kicked in, 0.25mg - 0.5 mg several times a day ...
• ... repeat this process, same seasons, each year until ...
• Nov 2015 - severe anxiety and WD symptoms brought about by bad romantic experience (i see the pattern now..)
• Nov 2015 ri 20 mg of prozac by integrative psychiatrist who tested me for & determined i had: MTHFR mutation, pyroluria, copper toxicity, zinc deficiency, and put me on 

the Walsh protocol to treat: Zinc, Selenium, 5-HTP, B6, B12, EPO, Vit C, Vit D, Biotin. I stayed on Prozac at 20 mg for a year. I expressed my desire to not be on it, he agreed to help me wean.

He never ever said a thing about WD. Honestly, i don't think he must know much about it or else he would have said. He is an open-minded doctor. 

• July 2016 reduced to 10mg under supervision by doctor. Did not taper from 20mg to 10mg, just jumped. Was perfectly fine for one year
• May/June 2017 began to taper according to doctor: 10 mg every other day for a month - i did about 6 weeks
• Sept 23 2017 - panic attack and full-blown WD from hell symptoms. Still at this point had never heard of WD from SSRI. Had no idea it was a thing. Assumed my symptoms

were my 'depression and anxiety just coming back'.  Struggle for one week thinking i'll make it out. Did not go back on Prozac, wanted to try and fight it. 

• Sept 29 spoke with dr, expressed i did not want to begin prozac, he suggested Inositol 4g x 3 each day and up 5-htp from 150mg to 200 mg per day
• Oct 2 after severely worsening symptoms finally crack and call my dr asking for a prescription for Prozac and Xanax. Pick up prescription but still try to tough it out a few days. 
• Oct 5 finally cave and RI at 10mg. He is telling me RI at 10 mg for the first 7 days and then up to 20mg after that.
• Today - Oct 10 - discover that Prozac WD is a thing. Discover this forum, discover Rxisk.org. Feel like it makes sense that i am experience WD and not just 'anxiety and depression'. Why on Earth would my brain need fluorine molecules in it to function properly (fluoxetine). That is complete garbage. I can only infer that my nervous system has in fact become dependent on it in some way. 

 

I meet with my doctor in one week and will bring this up with him. I am unsure what to do, but feel from reading here a bit that i should RI at a lower dose, stabilize, than try to taper more slowly. I hope to god that 10mg will help me stabilize bc i feel absolutely awful.  The only relief i have is a window of time from about 6pm - 10pm when i can relax and feel calm if i do some guided meditations. I sleep OK until about 530AM then wake up with extreme nervousness and can't sleep. Tossing and turning, having bad dreams for another hour or so. It's awful. It's totally unbearable. Even taking 0.75mg of Xanax does not fully relieve the anxiety. 

 

Was tapering at 10 mg every other day too slow? I would appreciate any feedback you all have on this.

I need some hope - can this really be down to get off this stuff? 

Will I feel better again? 

Thanks for your feedback. I wish you all the best.

 

 

Edited October 12, 2017 by baroquep
Remove real name

[baroquep]

Hi DeterminedtoMakeIt, 

 

Welcome to Surviving Antidepressants (SA).  Am certainly glad that you found the site before going any further.  Unfortunately few medical professionals have any idea how to safely taper off of these drugs and often give the wrong advice to their patients; which for many people leads to the trouble you are now experiencing.  The schedule that your doctor advised you to follow was far too fast and it is never recommended to skip doses.  While I'm not surprised, it's very discouraging to hear that doctors are still using this ineffective method of "tapering" off of antidepressants which in my experience is not only unsuccessful, it is highly irresponsible.  Basically by alternating doses, your central nervous system is now getting an inconsistent dose of the drug and this basically puts you in perpetual withdrawal until you are able to get a steady dose back into your system.  Once you been on antidepressants long-term, it becomes even more important to taper off at a slow and steady rate.  We are not sure why, but when a person has been on and off antidepressants in the past, it puts them at a much higher risk for suffering from withdrawal syndrome (see link below).  

 

I am including a link on our reinstatement topic so that you have a better understanding of what it means to stabilize after reinstatement and what you can expect.  I would encourage you to read all of the information regarding reinstatement before making any changes to your dose of Prozac.  I would probably not increase the dose of Prozac beyond the 10mg for the time being and because you have been taking 10mg for over a week now, it is probably best if you just try and stabilize on the 10mg rather than make any changes at this time.

 

A few questions:

What are your symptoms since reinstating Prozac on October 5th? 

Have you been feeling better or worse since you reinstated?

How often do you take Xanax?  

 

About reinstating and stabilizing to reduce withdrawal symptoms
What to Expect in Reinstatement (James Heaney article)

 

Am a little concerned regarding your use of Xanax as it is highly addictive and I'm not sure if you are aware or not but you can become addicted to this medication in as little as two weeks of continued use.  Surviving Antidepressants does not recommend using benzodiazepines to withdrawal from antidepressants as usually what ends up happening is the person ends up dependant on two drugs rather than getting off the antidepressant safely.  

 

SA recommends tapering by no more than 10% of your current dose followed by a hold of about 4 weeks to allow the brain to adapt to the changes in the central nervous system (CNS).  When changes are made too quickly, doses are alternated/skipped or the drug is discontinued abruptly, the brain is unable to adapt to the changes and this results in uncomfortable withdrawal symptoms.  I am attaching a few links so that you can familiarize yourself with the recommendations made by Surviving Antidepressants.  

 

What is Withdrawal Syndrome?

Before you begin tapering what you need to know
Why taper by 10% of my dosage?
Recommendations for Tapering off Prozac/Fluoxetine

 

Before being able to provide you with any specific information with respect to your current situation, we would ask that you summarize your withdrawal/drug history in a signature - ALL drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months in particular?   We ask all members to provide their drug history as a signature.  This will be a permanent part of your introduction and It helps moderators to be able to see all of your details at a glance.  You can find the information on how to complete your signature at the link below:
 
Instructions:  Withdrawal History Signature
 
    •    Please leave out symptoms and diagnoses.
    •    A list is easier to understand than one or multiple paragraphs. 
    •    Any drugs prior to 24 months ago can just be listed with start and stop years.
    •    Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago)
    •    Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016.

 

Because you've mentioned that you will be seeing your doctor, I am including a couple of links that you may find useful in order to help him understand that there are protocols available to safely withdrawal patients from antidepressants.  Hoping that you are able to find the support of your doctor as you taper off of Prozac safely and successfully.    
   

How do you talk to a doctor about tapering and withdrawal?
What should I expect from my doctor about withdrawal symptoms?

 

Please feel free to connect with other members of the Surviving Antidepressants Community by posting in their introduction topics, they are a supportive group, know what you are going through and are here to help.

 

I know I have given you a lot of information to digest but feel that an informed decision is the best decision when it comes to our health and wellbeing.  If you have any questions, or need clarification please do not hesitate to post back here in your introduction thread and one of the moderators will get back to you.

Edited October 12, 2017 by baroquep

[determinedToMakeIt]

Hi baroquep,

Thank you so much for your response. 

To answer you questions:

 

What are my symptoms since RI prozac on October 5th?
First 3 days, no symptoms, 4th through 6th day some
headaches, today, the 7th day I am starting to feel that
'flat' feeling. And feel a very tiny bit less reactive
to things. But my anxiety is still high. I am feeling more
depressed though, meaning that flat feeling. It feels stronger
than it has in the past when going back on.

 

Have I been feeling better/worse since RI?
Honestly, about the same. It's only been 6 full days though on the 10mg.

How often do I take Xanax?
Generally, once per day, either 0.5mg-0.75mg in the early morning
hours. Around 4:30AM I wake up with an intense feeling of nervousness in my heart, 
and upper chest area. I toss and turn and cannot get back to sleep. Every time i drift off, i wake

up in about 10 minutes in a state of fear. So I take the Xanax
and it helps me get back to sleep but does not actually work well to alleviate the nervous feeling
in my body. During the day I have not been taking it. I can get through the day at work and deal with the 
anxiety by keeping myself busy and in the evenings i start to feel better after I do about 2 hours of a guided body scan
meditation that calms me very much. Then I go to bed without any Xanax. I have been trying to take it as 
little as possible as I know it is addictive. In the past 7 or so WD episodes I've had over the last
10 years, I've used it as a crutch until the Prozac kicked in and was careful to slowly reduce my dose.
I've never had any problems with WD from Xanax in the past. But yes, I do agree with you that it is not
good to take. I waited two weeks to start it, but honestly I had hit an absolute wall with my anxiety and
could not make it further on my own. I had reached my absolute limit. 

Thank you very much for the links, I am going to read through them all.  

 

Right now my main question is really, i guess just an expression of fear: What if the 10mg RI doesn't
help? I know that i was on that dose for 1 year before the WD. But, is it possible that the 10mg just won't
work this time? I've never started on such a low dose before. I'm really afraid that these feelings just won't
go away.  

 

Does anyone else know this nervous, early-morning half-awake/half-asleep feeling I'm talking about? Where your heart and chest

are just full of nervousness? This is the worst of it. I dread going to sleep bc i know i will wake up feeling this way. 

Will this go away, even with RI at 10 mg?

 

Also, I cannot eat anything. Each bite of food makes me want to gag. I've lost 6 lbs in 2 weeks.  I have to force myself

to eat and can barely get 800 calories in a day. Is this something anyone else has dealt with? When i wake up in the morning

I am so nervous i just gag for no reason. It's horrible. I am racked with anxiety almost all the time. Will this every end???

 

Thanks anyone and everyone for your help, and thank you baroquep.  

Edited October 12, 2017 by determinedToMakeIt
wanted to add lose of appetite symptoms

[determinedToMakeIt]

Hi All, 

 

I really need some encouragement and information here. I've RI on fluoxetine, it's been a total of 12 days: the first 10 days at 10 mg and yesterday and today at 20mg.

 

My mornings are really rough. I wake up between 3:30-4:30 with anxiety and nervousness, bad dreams. I understand from reading the posts about the cortisol spike 

that is is what is going on. I have read most of this information. 

 

The info i couldn't find is - when might this stop? It's been 11 full days since my RI and this has not gotten any better at all. 

 

Can someone who has experienced this, and has reinstated and stablized successfully, please tell me how long it took them for this to go away?

 

Please, i'm desperate for some encouragement. 

 

Thank you

 

[ChessieCat]

On 12/10/2017 at 0:17 PM, baroquep said:

I would encourage you to read all of the information regarding reinstatement before making any changes to your dose of Prozac.  I would probably not increase the dose of Prozac beyond the 10mg for the time being and because you have been taking 10mg for over a week now, it is probably best if you just try and stabilize on the 10mg rather than make any changes at this time.

 

Did you read the reinstatement topic?  About reinstating and stabilizing to reduce withdrawal symptoms

 

It is better to try and stabilise on the lowest dose possible.  You have changed from 10mg alternate days (so 5mg daily).  I can't tell from your signature if you did stop altogether.  Then 6th Oct 10mg (that is only 10 days) and now 20mg.  Because you have only taken 1 dose of 20mg my suggestion would be to return to 10mg from your next dose.

 

When dealing with withdrawal we need to refrain from knee jerk reactions and not panic and rely on the drug.  We need to learn to accept and get through the hard times rather than reacting by taking more of the drug.  You had only been on 10mg for about 10 days and it can take several weeks to stabilise after making changes.

 

There are many unanswerable questions and unfortunately when might the cortisol spikes stop is one of them.

 

It is important to learn Non-drug techniques

 

Many members experience sleep issues:

 

waking-with-panic-or-anxiety-managing-cortisol-spikes

 

Sleep Hypnosis, Guided Meditations, Calming Videos

Sleep problems - that awful withdrawal insomnia

 

Edited October 16, 2017 by ChessieCat

[determinedToMakeIt]

Hi ChessiCat,

 

Thank you for taking the time to reply to me.

 

I have bumped up to 20mg based on my doctors advice. He told me 1 week at 10mg then after that 20mg. So, that's why i"ve bumped up.

To answer your other question about if i had completely stopped - yes i did. I stopped at the end of July, maybe early August, I can't recall exactly.

 

I have found that guided meditations help me tremendously in the evening. I usually do about 1.5hours of them. They calm me and I almost feel 'normal' and can 

get to sleep without a problem.

 

It's that awful, horrid, cortisol, fear spike at 4AM that gets me and basically ruins my day.

 

I'm going to see my doctor tomorrow.  I honestly was afraid the 10mg was not enough to control the cortisol spike. I was hesitant to bump up to the 20mg. But i did partly

bc I want the cortisol spikes to go away faster and it's also what my doctor said.

 

I was just curious to hear from someone, definitively that YES, they WILL go away.  Have they gone away for anyone after successfully reinstating? I still have that question....

 

Again ,thank you for getting back to me

 

 

[baroquep]

10 hours ago, determinedToMakeIt said:

Hi All, 

 

I really need some encouragement and information here. I've RI on fluoxetine, it's been a total of 12 days: the first 10 days at 10 mg and yesterday and today at 20mg.

 

My mornings are really rough. I wake up between 3:30-4:30 with anxiety and nervousness, bad dreams. I understand from reading the posts about the cortisol spike 

that is is what is going on. I have read most of this information. 

 

The info i couldn't find is - when might this stop? It's been 11 full days since my RI and this has not gotten any better at all. 

 

Can someone who has experienced this, and has reinstated and stablized successfully, please tell me how long it took them for this to go away?

 

Please, i'm desperate for some encouragement. 

 

Thank you

 

 

Hi there, I believe that the reason you are experiencing anxiety, nervousness and increased cortisol spikes is related to alternating your doses over the summer.  And by adding an additional 10mg after being off of the drug since July, is likely going to make things worse and the reason I'd recommended that you stick with 10mg which would have likely settled things down a little if you'd given it a bit more time.  

 

2 hours ago, ChessieCat said:

It is better to try and stabilise on the lowest dose possible.  You have changed from 10mg alternate days (so 5mg daily).  I can't tell from your signature if you did stop altogether.  Then 6th Oct 10mg (that is only 10 days) and now 20mg.  Because you have only taken 1 dose of 20mg my suggestion would be to return to 10mg from your next dose.

  

I concur with ChessieCat in that if you have only taken one dose of 20mg, I would return to the 10mg and hold there for a couple of weeks before making any further changes.  Higher is not better in this case as your central nervous system has already been desensitized by alternating doses before you stopped completely and a lower dose would most likely have been sufficient to re-stabilize your central nervous system.

 

Please reread the link on reinstatement which explains the theory behind reinstating at the lowest dose possible in order to help alleviate withdrawal symptoms.