Estman: reducing Anafranil, withdrawal symptoms

[Estman]

It is usually recommended to reduce by 10% every 4 weeks
For example, when I started four months ago, does it look like this:
Starting dose 75mg
In early January, the dose was 67.5 mg
In early February, the dose was 60.75 mg
In early March, the dose was 54.7 mg
In early April, the dose was 49.2 mg
And in early May should be 44.3mg?

Currently, the dose is 35mg .44.3mg and 35mg is not a big difference
In practice, however, the symptoms have been severe and have been reduced too quickly for me.
Does this 10% still apply to every person?

[Altostrata]

If you have withdrawal symptoms now, you should not reduce further until the withdrawal symptoms go away.

 

When you started Anafranil in August 2019, what effect did it have on you? Did you always take it several times a day?

[Estman]

Now on the 13. day sleep has improved
The level of anxiety is slightly lower, but the mood once better then worse
I started Anafranil in August 2019.
It was put on while I was in the hospital 
In addition, I took valproic acid in August-October
Valproic acid made me very sleepy and weak
In addition, the weight increased a lot,I gave it up
I remember when I started Anafranil I was very tired for the first 3-4 weeks.
For the first month I took Anafranil 3 times a day (25mg three times)
Next, I started taking long-acting Anafranil (75mg) in the morning.
When I started taking Anafranil wihdrawal, I had to go back to the short-acting tablet
The long-acting 75 mg tablet could not have been accurately dosed
So I thought I should take it several times a day
To keep the level of the drug in the blood more or less the same

[Altostrata]

Well, it's still making you tired.

 

Good to hear your last reduction is evening out.

 

There is no need to take Anafranil more than once a day. You might gradually move the morning dose to merge it with the nighttime dose by taking it an hour later each day.

[Estman]

On 4/26/2020 at 4:02 PM, Estman said:

My mood is worse today
Somehow apathetic and lacking in interest
Does it still show a withdrawal symptom?
Today 15 days after the reduction

 

[Estman]

On 4/26/2020 at 4:02 PM, Estman said:

The mood changes,now depression
Two days ago it was better mood, yesterday the depression started again and remained so until now
Even at night I got a little sleep and bad dreams
How to cope with such days when a very bad mood?
Does it last for a period of time and then heal again?
What to think of these days that would give hope?

 

[Estman]

Is compulsive worrying a withdrawal symptom?
I get like compulsions and can't get rid of them, they become very disturbing
Yesterday I could not sleep again before 3-4 o'clock at night
This raises fears that this will remain the case
I have an emotional spiral.
What to do and how to think?
It's like a constant worry in your head, everything keeps spinning

[Altostrata]

Whether your worrying is a withdrawal symptom or not, you will have to manage it to get past this rough spot.

 

What do you mean by "depression"? Emotional anesthesia and demotivation are common adverse effects of psychiatric drugs, or they can be withdrawal symptoms. They are not the worst withdrawal symptoms you can get. Either way, you need to cope with them while you adjust your Anafranil dosage.

 

See

 

Non-drug techniques to cope with emotional symptoms

 

Easing your way into meditation for a stressed-out nervous system

 

Music for self-care: calms hyperalertness, anxiety, aids relaxation and sleep

 

Ways to cope with daily anxiety

 

Dealing With Emotional Spirals

 

Shame, guilt, regret, and self-criticism

 

Health anxiety, hypochondria, and obsession with symptoms

 

Have you started moving the morning dose towards nighttime?

[Estman]

For me, depression is a condition that usually occurs in the second week of drug reduction.
It usually starts with fatigue or severe weakness
This is usually accompanied by anxiety
Weakness makes me fear that I will die or not recover
It's so all-encompassing and scares me
This usually takes a few days
After that, the mood is very depressed
Unable to find motivation to do something or joy in life
Depression also usually lasts for several days.
Sometimes I'm afraid that maybe I can't get rid of the drug
However, I want it and can't wait to see when it happens
Compulsive thoughts bother me a lot.
For example, if unable to fall asleep, it is the usual fear that recurs like last year
I was an exemplary sleeper
I was often able to sleep during the day (when I took Cymbalta)
I came from work and slept for 2 hours
Later I slept at night and there was no problem
Problems with insomnia began with amitriptyline
At first 4-5 months it helped me sleep well
Then restless legs syndrome (before going to bed)
When I gave up Amitriptyline (within 2 months) I became insomnia
I couldn't sleep for several days
I was tired but not asleep
It caused a lot of stress and fear
Then different drugs were consumed
The worst was Olanzapine
It caused me a lot of akathisia, I had to go crazy
In addition, there was a lot of confusion and no orientation
If I still can't fall asleep, I'm afraid that maybe I won't get better anymore

 

I've taken the dose for lunch a little later

 

[Altostrata]

I am sorry you feel poorly for a few days after making a reduction in Anafranil. This is normal for tapering, it may take a few days for the change to settle down.

 

It seems when you have a withdrawal symptom or have a bad day or night, you enlarge this to be a disaster. It is not a disaster. You will have ups and downs. See The Windows and Waves Pattern of Stabilization

 

If you want to go off Anafranil, you will need to learn to cope with ups and downs. We can't do that for you. If you cannot cope, perhaps you should not go off Anafranil?

[Estman]

Yes, I definitely want to leave Anafranil
Yes, you are right, I must learn to cope with the ups and downs
Since I have no experience in particular, I hope you will support me
It is important to me that I get guidance from people who have done it themselves
I'm trying to change my mind
I didn't have such problems before I started taking antidepressants

[Estman]

Hello,

I understand that withdrawal symptoms go in waves?
Today is 21 days after dose reduction
Some days have already been better, the mood more or less stable
The strange thing is that I have been able to sleep for 2-3 nights in the meantime, but yesterday I could not again
I thought this symptom was over
Can insomnia go like waves?
Yesterday I was very tired during the day and slept several times
Last night I was able to sleep for a couple of hours (around 4-5 in the morning)
I've been trying to sleep after a sleepless night
But it doesn't work and I can't fall asleep
As if some kind of alertness is on
It bothers me when I can't fall asleep and I start to worry
Otherwise, it is returning to normal

[Estman]

Hello !

 

Do the days of the full moon affect how you feel?
Does it affect sleep, anxiety?
Does anyone have any observations ?

[Estman]

Hi ,

I hope someone answers.

I've been on the same dose for a month
It has generally been more stable, while the symptoms have changed
I did physical work for half a day yesterday and I felt good
Unfortunately, after that, weakness and great fatigue began
It kept getting worse and caused headaches, great anxiety
I was able to sleep for 2-3 hours a night, I sweated a lot
There is a lot of anxiety today
Does exercise affect the drug?
Why is the situation getting worse?
I called the doctor and he doesn't think it's medicine
He says you can stop taking the medicine during the day
Isn't that true?

 

[Erell]

Hello Estman, 

 

1 hour ago, Estman said:

I've been on the same dose for a month

 

Unfortunately, 1 month is still early time in the stabilisation process. After all the changes you made recently, your CNS may need time to heal and stabilise with the new dose.

I know how hard it can be, but you can go through this  With time, it really does get better. It just goes very slowly.

 

2 hours ago, Estman said:

Why is the situation getting worse?

 

It feels like it's getting worse because you probably are going through a waves an windows pattern : 

 

https://www.survivingantidepressants.org/topic/82-the-windows-and-waves-pattern-of-stabilization/

 

 

 

2 hours ago, Estman said:

Does exercise affect the drug?

 

Exercise can affect your body : your body is actually doing a lot of work of adjustments, and maybe physical work is too much for now. Take it easy

 

2 hours ago, Estman said:

called the doctor and he doesn't think it's medicine
He says you can stop taking the medicine during the day
Isn't that true?

 

Doctors don't believe in withdrawal : this website wouldn't exist if it was so easy to quit these drugs. 

 

Take care ❤️

 

[Estman]

Hello Erell!

It also seems to me that physical exertion caused the symptoms to worsen
And 2 days ago it was more or less normal
Now great anxiety and despair
I do have diazepam, but I haven't taken it in six months.
The only hope is that the anxiety will pass
Thank you very much for your support!

[Erell]

22 minutes ago, Estman said:

And 2 days ago it was more or less normal

 

Yes, stabilisation process is all about ups and downs. Ups are sooo good, we are always kind of surprised when they end. But they come, back, always.

Having windows days sounds like a very good sign : you CNS can heal

 

 

23 minutes ago, Estman said:

The only hope is that the anxiety will pass
 

 

And it will. Slowly, gradually, but it will. Chemical anxiety has been my main symptom, I know how hard it is to accept sometimes. But it does fade

24 minutes ago, Estman said:

I do have diazepam, but I haven't taken it in six months.

 

My advice would be : don't add more drug. Your CNS is trying to stabilise, adding another molecule could destabilise it further.

 

Anxiety is hard to accep and ignore : best we can do sometimes is trying to distract ( doing a puzzle, cleaning, walking, ...).

 

Take care ❤️

 

[Estman]

Hello Erell,

 

Today, the mood is depression and despair.
Along with this, there is nausea, probably anxiety
Fortunately, I was able to sleep at night.
How does your experience show how long ups and downs last?
A few days or longer?
How was your experience?
I always try to think that it will pass, but it is still excruciating
This is probably related to brain chemistry
Strange that a month later this will happen again
Currently my daily dose is 35mg Anafranil
I would like to reduce the dose again, but probably now is not the time

[Erell]

Hello Estman, 

 

I'm sorry you're going through a rough time.

Depression and despair are also a quite common symptom. 

Sometimes, when Despair hit me, the only thing I can do is trying to distract, read Success Stories, and remember that this shall pass too.

Your CNS is playing tricks with you, trying to make you believe this will last forever. But it doesn't, it does fade, always

 

17 minutes ago, Estman said:

How does your experience show how long ups and downs last?
A few days or longer?
How was your experience?

 

Unfortunately, even if I would share my experience with you, it would not give you a timeframe for your own sufferings. Everybody's journey is diffferent, everybody's CNS react differently.
I had waves that lasted a few days, others lasted weeks. I know how much we need certainty while suffering, but nobody can predict the future.

 

However, we do have a certainty : testimonies compiled on SA show that symptoms always fade. It takes time, patience, but our CNS do heal ❤️

 

17 minutes ago, Estman said:

Currently my daily dose is 35mg Anafranil
I would like to reduce the dose again, but probably now is not the time

 

As you're suffering from intense symptom, it sounds like your CNS is trying to stabilise : a drop wouldn't be a good idea for now. Cns needs time to heal

 

I'm a bit confused with your signature : 

 

"Anafranil 03.08.19-15.12.19  75mg   15.12.19-  reduced 2,5mg within three weeks   07.04.20  dose 37,5mg"

 

Since 15 December 2019, you dropped 2.5mg every three weeks : is that right ?

 

 

Take care ❤️

 

[Estman]

27 minutes ago, Erell said:

 

 

Since 15 December 2019, you dropped 2.5mg every three weeks : is that right ?

 

I started my medication reduction on December 15 and then the daily dose was 75mg
In the first months, I reduced every 2-3 weeks
In January, I reduced more at once
Even 5mg but it was very severe
In recent months, I have reduced 2.5mg at a time (then after 3-4 weeks)
But, as I saw last time, it is also too much of a reduction
Last I reduced on April 13 and then 2.5mg (current dose 35mg)
A month has passed, but there are ups and downs
Should I reduce, for example, 1 mg at a time and then 1 mg again in 2 weeks?
Usually after a reduction of 4 days it is more or less normal but then come the symptoms
I would like to reduce 2-3mg per month but at the moment it doesn't seem that way

 

 

[Estman]

Sometimes I feel that the worst is 2-3 hours after taking the drug
As if the medicine itself was causing you to feel unwell
 

[Estman]

Are compulsions also symptoms of withdrawal?
I can't seem to think how bad I am
I would like to think about other things as usual, but I can't
It goes with despair.
There is also hopelessness because I do not know when it will start to ease
It was almost normal a few days ago
I wonder if other antidepressants have the same symptoms?
Or is it so hard with Anafranil

[Estman]

Hello Erell,

Why is it that depression is coming back?
Although in the meantime it was much better and a month has passed since the reduction
Otherwise, I take the medicine regularly
Why are these waves happening?

 

[Estman]

Hello,

I'm trying to raise my low zinc levels
My depression alternates with fear
Even when I sleep normally, waking up has an inexplicable feeling of fear
There is no reason for that, my life is otherwise fine
Does anyone experience fear?
Is this a withdrawal symptom that passes?
Can't describe in detail
Fear and bad mood for no reason

[Erell]

Hello Estman, 

 

5 hours ago, Estman said:

I'm trying to raise my low zinc levels

 

How are you trying to do that ? Please, be carefull with supplements. Try one at a time, and low amount to see how you react.

The only two supplements we recommand here are fish oil and magnesium.

 

5 hours ago, Estman said:

Even when I sleep normally, waking up has an inexplicable feeling of fear

Does anyone experience fear?

Chemical anxiety is a very common WD symptom, and as all symptoms, it fades with time.

 

You're describing cortisol spikes : also a very common symptom.

Please take a look at this topic : 

 

https://www.survivingantidepressants.org/topic/17471-waking-with-panic-or-anxiety-managing-the-morning-cortisol-spike/

 

 

20 hours ago, Estman said:

Why is it that depression is coming back?
Why are these waves happening?

 

Stabilisation process is all about ups and downs : your CNS is trying to adjust, adapt to the new situation (new dose after the drop).

Everytime we change a dose, everytime CNS has to work to find homeostasy again.

Our CNS knows how to work, but it is a very slow and gradual process.

 

Please take a look at this topic, it explains very well the process : 

 

https://www.survivingantidepressants.org/topic/82-the-windows-and-waves-pattern-of-stabilization/

 

and : 

 

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.

 

  On 12/3/2015 at 4:41 PM, apace41 said:

Basically- you have a building where the MAJOR steel structures are trying to be rebuilt at different times - ALL while people are coming and going in the building and attempting to work.

It would be like if the World Trade Center Towers hadn't completely fallen - but had crumbled inside in different places.. Imagine if you were trying to rebuild the tower - WHILE people were coming and going and trying to work in the building!  You'd have to set up a temporary elevator - but when you needed to fix part of that area, you'd have to tear down that elevator and set up a temporary elevator somewhere else. And so on. You'd have to build, work around, then tear down, then build again, then work around, then build... ALL while people are coming and going, ALL while the furniture is being replaced, ALL while the walls are getting repainted... ALL while life is going on INSIDE the building. No doubt it would be chaotic. That is EXACTLY what is happening with windows and waves.  The windows are where the body has "got it right" for a day or so - but then the building shifts and the brain works on something else - and it's chaos again while another temporary pathway is set up to reroute function until repairs are made.  

 

Take care ❤️

 

[Estman]

Thank you, I am very helpful for your information
It surprises me that the withdrawal symptoms came so hard again
I last reduced it a month ago
1.5-2 weeks later there were very bad withdrawal symptoms
Then in the meantime it got better and there were milder symptoms
Now, a month later, after a more physically demanding day, the severe symptoms came back
The last 4-5 days have been very bad.
As if I had just reduced it, I have not done so
There are suicidal thoughts, feeling very unwell and tired
I feel worst a few hours after taking the drug
I don't know why, logically the opposite should be the case
Does weaning at the most difficult time for the body repel the drug?

[Altostrata]

Your nervous system has been upset by all the drug changes and tapering too fast. Now it's sensitive and reactive to stress. You need to let it settle down before tapering more.

[Estman]

Yes, you are right
I mistakenly thought that the waves would come in the first few weeks
I have really moved too fast and I have to take enough time
The ups and downs are very strong and it scared me
But as you say, it always passes, it gives hope

[Estman]

I can't calm down about insomnia yet
I've been asleep for the last 2 nights, maybe a few hours a night
I have a worse wave right now
I still take the medicine in the morning, afternoon and evening
Because of the bad days, I did not want to delay taking the medicine
In recent days, the body reacts strangely
Feeling unwell a few hours after the 14 o'clock dose (around 4 pm to 5 pm)
Then you first experience bad mood apathy, digestive problems and nausea
No such reaction occurs after the morning and evening doses
If I can't fall asleep before 11 o'clock then I know I can't do it until 3-4 in the morning
I have a phobia of insomnia
If I see that I can't sleep in my bed, I move to another room
The later the time goes on the more anxiety occurs, the pulse is fast and difficult to calm down.
Thoughts keep spinning and I can't turn myself off
As if some alertness was on
It makes me desperate to not be able to change things
It's like a compulsion to think about what you don't want
Sometimes there is a lot of anxiety during the day but I can sleep at night
Then it's a better day but can't fall asleep
Sometimes I sleep for 1-2 hours in the afternoon (often fatigue)
And I can sleep the next night
However, I can be active during the day and still can't sleep at night
Yesterday, when I tried to fall asleep, there were flickers
I fell asleep waiting in bed and suddenly startled
The same thing happened when I gave up Amitriptyline
Does insomnia go like waves?
It's like I can't do anything myself to fall asleep
I'm scared by the thought that maybe I can't sleep, not even 2-3 hours
So was last year when I was experimenting with different drugs
I'm afraid it will happen again
I can't handle it yet

[Estman]

On 5/14/2020 at 2:16 PM, Erell said:

 

 

Stabilisation process is all about ups and downs : your CNS is trying to adjust, adapt to the new situation (new dose after the drop).

Everytime we change a dose, everytime CNS has to work to find homeostasy again.

Our CNS knows how to work, but it is a very slow and gradual process.

 

 

I have wave shells for exactly a week
Started after physical exertion and has persisted to this day.
I feel nonsense, can't feel pleasure or joy, can't start and do simple things
Things that used to interest no arouse enthusiasm, the mood is constantly depressed and hopeless
It feels like you don't want anything or can't do anything, while it causes anxiety
Is it apathy or anhedonia?
If it's been a week, will it go away on its own?
What would give hope?
Looks like I'm having a bad time

[Erell]

8 hours ago, Estman said:

I have a phobia of insomnia

I'm scared by the thought that maybe I can't sleep, not even 2-3 hours

 

There is a symptom : insomnia.

And there is the fear you create about this symptom.

 

You can't control symptoms : as long as your CNS has adjustements work to do, you'll have symptoms. Trying to fight it or overcome it just burns a lot of precious energy and causes a huge amount of frustration and anxiety because it doesn't help anything. Acceptance of the situation is the best path to follow.  : 

 

  On 4/27/2017 at 8:03 PM, brassmonkey said:

 

AAF: Acknowledge, Accept, Float.  It's what you have to do when nothing else works, and can be a very powerful tool in coping with anxiety.  The neuroemotional anxiety many of us feel during WD is directly caused by the drugs and their chemical reactions in the brain.  Making it so there is nothing we can do about them.  They won't respond to other drugs, relaxation techniques and the like.  They do, however, react very well to being ignored.  That's the concept behind AAF.  Acknowledge, get to know the feeling involved, explore them.  Accept, These feelings are a part of you and they aren't going anywhere fast. Float, let the feeling float off as you get on with your life as best as you can.  It's a well documented fact that the more you feed in to anxiety the worse it gets.  What starts as generalized neuroemotinal anxiety can be easily blown into a full fledged panic attack just by thinking about it.

 

I often liken it to an unwanted house guest.  At first you talk to them, have conversations, communicate with them.  After a while you figure out that they aren't leaving and there is nothing you can do to get rid of them.  So you go on about your day, working around them until they get bored and leave.

 

It can take some practice, but AAF really does work.  I hope you give it a try.

 

 

 

8 hours ago, Estman said:

Does insomnia go like waves?
 

 

When we talk about "waves" we mean waves of symptoms. As insomnia is one of your symptoms, yes it will pass

 

Estman, I know how hard these waves can be, and how hard it is to remember that it is only temporary. 

You'll get through this ❤️

 

Edited May 16, 2020 by Erell

[Estman]

Thanks for the support!

Today is extreme weakness and fatigue
This is very excruciating
Hopefully it will pass

[Erell]

17 hours ago, Estman said:

Hopefully it will pass

 

It will eventually

 

[Estman]

Hello,

I was normal for a few weeks and decided a week ago to try to reduce
Since the 2.5mg reduction was too big, I reduced only 1mg this time
At the moment I am currently on a 34mg daily dose
Anxiety and restlessness and fear arose from day 7
This has now lasted for the last 3 days
My plan was to reduce 1mg every 2 weeks
Maybe it's smoother
Unfortunately, even with a small dose change, withdrawal symptoms have occurred

[Estman]

Does a small dose change such as a 2-3% reduction cause withdrawal symptoms or is it a wave?
I was hoping to reduce 1mg every two weeks but that probably isn't the best idea?
Would like to reduce 2mg per month it would be about 6%
Or should I reduce 0.5mg every week?
Then there would probably be constant detoxification and it would not be good

[Estman]

Hi,

Yesterday and today I have felt more confusion
Is this a common withdrawal symptom?
Can a 1mg reduction cause this?