Monk3yl0ve: failed SSRI discontinuation multiple times

[m0nk3yl0ve]

Greetings everyone!

 

Just want to say I am so happy to have found this forum and website. Have been drifting along with no oars for a decade, looking for answers. Was beginning to believe this would be a lonely journey, and was not seeing any light at the end of the tunnel. A little personal history, had often struggled with anxiety (and to a lesser degree depression) for most of my life. Initially took the form of public speaking fears, and social anxiety, around the age of eleven. Of course, was unable to recognize it for what it was and later sought help for panic attacks in my early twenties, after believing I was having a heart attack following a bad breakup from my girlfriend. Was soon turned onto Cognitive Behavioral Therapy by a wonderful psychologist that helped immensely. CBT served me well over the next 15 years, including talk therapy with several psychologists and the occasional Xanax spot treatment when things got really rough.

 

Unfortunately fell into the SSRI trap in late 2008, after moving cross country to a depressing weather climate in Seattle, WA. Had accepted a high stress corporate sales position with a manager I was not fond of (feeling was likely mutual) and had also just gotten married earlier that year. Needless to say, it was a confluence of stressors that rendered me an insomniac for the first time in my life. Heavy depression had also settled in, and I feared for the health of my marriage. After taking medical leave from work, I began to meet with a neuro psychologist that prescribed a daily dose of 20mg Lexapro, with 50mg of Trazadone for sleep.

 

Immediately began to feel alive again, like the shackles of my despondency were thrown off. Started to excel at the office, repaired my teetering marriage, began an exercise routine, and just generally had a zeal for living again. For that I am eternally grateful. Also continued to meet with the psychologist and practice CBT. I'm not fond of taking prescription meds long term however, and as I began to ask questions about the duration of my treatment, was told I needed to be patient as structural changes to the brain often take at least a year or longer. I took her word for it obviously, and believe she had my best interests at heart. However, looking back on it now, I feel many in the medical profession on see the improvements on the front end, and take the word of medical journals and "research" regarding the discontinuation of these drugs. Most will never experience the horror of attempting to quit these compounds, believing only that they are "non-addictive" and conquered with an easy taper. 

 

In the years since, have attempted to come off at least three times now (maybe four?) with little success. If I remember, my first attempt was a "self ween" over the course of a month that failed spectacularly. A couple years later, I attempted a three month "ween" off of Lexpro that was also unsuccessful under medical supervision. Last attempt in 2015-2016 was a five month slow taper off of Lexapro and a conversion to Prozac with the extended half-life. Did not win that battle either. In all cases, I would describe the classic discontinuation symptoms I've seen noted here and elsewhere...the return of my anxiety at greater levels than before I began to medicate, often without any "triggers", trouble getting a solid night's sleep (waking early), general dizziness, the attendant brain zaps with falling asleep, trouble focusing on tasks, short term memory issues, etc etc. 

 

Am still fighting the good fight here, but have come to this forum for help. This is easily the scariest time of my life...have a son I don't feel like I'm always present for because of my preoccupation with getting through this. Constantly wonder if I am "brain damaged" after having ingested these compounds for over a decade. Can't say I have half the drive or motivation to succeed I used to, my creativity has bottomed out, and it just feels like something has been lost. Also happen to believe that SSRI Discontinuation Syndrome will be the single greatest mental health crisis in the future, if it is ever acknowledged! Seems to be a lot of suppression over truth as I talk to more and more medical doctors across the country. 

 

Again, I am so grateful for having found this forum and would appreciate any help and support! Am willing to do the heavy lifting on my own, but a little encouragement and education goes a long way...

 

Peace,

Monk3yl0ve

 

 

 

 

 

Edited November 13, 2020 by Gridley

[Gridley]

Welcome to SA, Monk3yl0ve.  We are a site for helping people to  taper off psychiatric drugs and to deal with withdrawal, and we're happy to help you.  Thank you for completing your drug signature.

 

Doctors almost invariably taper their patients too fast, increasing the likelihood that the taper will fail due to withdrawal symptoms.  We recommend tapering by no more than 10% of your current dose every four weeks.  

 

Why taper by 10% of my dosage?

 

We recommend tapering only one drug at a time.  Otherwise, if problems arise, you won't know the cause.  Unless there are other issues involved, we recommend tapering the more activating drug, known as an accelerator, first, leaving to the more sedating drug, known as a brake, in place to help with sleep to be tapered later.  SSRI's like Prozac are accelerators; trazodone is a brake.  Unless there are issues with the trazodone, likely you'd want to taper the Prozac first.

 

Taking multiple psych drugs? Which drug to taper first?

 

Prozac comes in a prescription liquid, and that would be the easiest and most accurate way to taper it.  If you're taking Prozac in tablet form, you'd want to do a gradual crossover from tablet to liquid before beginning tapering.  This link is specifically about tapering Prozac.

 

Tips for tapering off fluoxetine (Prozac)

 

So that you have a better idea about problems you may have experienced previously, here is some information about withdrawal and the healing process.

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

The Windows and Waves Pattern of Stabilization

 

When we take psychiatric medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

 

These explain the healing process really well.

 

Brain Remodelling 

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Add in one at a time and at a low dose in case you do experience problems. Get supplements that are single ingredient (not mixed with other types of supplements).

 

This is your Introduction topic, where you can ask questions and connect with other members.  We're glad you found your way here.

Edited November 13, 2020 by Gridley

[m0nk3yl0ve]

Thanks so much for this information Gridley, you give me hope! Will definitely review all of the information provided in the coming days...

 

Question right off the top, regarding the liquid form of Fluoxetine. Had to go in for a med check a couple weeks ago, and saw a new doctor I'd never seen before (my old doc retired). I asked about the liquid, and his reply was something to the effect of "well we have to pay to prescribe that form" and told me we'd cross that bridge when we come to it. Then proceeded to cut my dosage in half from 20mg to 10mg. Are you familiar with how pharma bills a practice for liquid forms that are not "standard" so to speak? 

 

Any info would be appreciated, and thanks do much!

[Gridley]

17 minutes ago, m0nk3yl0ve said:

Then proceeded to cut my dosage in half from 20mg to 10mg.

That is radically too fast.

 

18 minutes ago, m0nk3yl0ve said:

Are you familiar with how pharma bills a practice for liquid forms that are not "standard" so to speak? 

 

I'm sorry, I'm  not familiar with that.  I'd call your provider.

[Krisseyb]

@m0nk3yl0ve when I asked my first Dr. to switch me to liquid Lexapro, she said she doesn't prescribe liquid. Oooookay....?? Don't know why. 

So I asked my local pharmacy if I got someone to prescribe it, how much it would cost. She said $150/month. I thought holy cow!!! Didn't want to spend the money...but thought it was worth it if it was my only option.

So I called Caremark, (where I can get 3 month supply) and asked how much it would be...if I could  get Dr. to prescribe. Check this  out. Free. Yes. Free. My insurance covers 3 month supply, but not one month!!!!

I ended up going to my gyno (who I have a great relationship with) and explained to her my story. She prescribed the 3 month supply, for a years worth...all for FREE!!! Do you have someone like Caremark in your area that your insurance uses?

 

[m0nk3yl0ve]

@Krisseyb Not sure about the Caremark, I'll have to do some digging. Thanks for the idea! Hopefully we'll be able to come to some sort of resolution, I certainly can't afford the high out-of-pocket costs you've mentioned...

[Krisseyb]

@m0nk3yl0ve hope you find some free medicine!

 

[m0nk3yl0ve]

OK, I'm back to report I'm not doing as well on 10mg Fluoxetine (after GP's reduction down from 20mg) as I thought I might. Am having trouble sleeping for more than 5 hours, often waking early around 4am with a racing mind. Seem to have a general level of stress (cortisol) most mornings, for no apparent reason. If I am confronted with a fairly stressful situation, do feel like adrenals are kicking into high gear, racing heartbeat, brain feels like it's on fire, etc. Also noticed my short term memory is suffering, as is my focus and concentration.

 

So, I'm considering going back to my GP and asking to reinstate me back to 20mg Fluoxetine to level out.

 

Issue I have though...when I was on 20mg (before the cut down to 10mg), almost felt like the drug was starting to poop out on me. Was having some of the same issues I am experiencing now, but just not at the same level I guess. Didn't have the sleep issues, for instance, but still had bouts of unwarranted anxiety at work, mainly.

 

Guess my question is, does it make more sense to reinstate in 5mg increments...say from 10mg to 15mg...and then later to 20mg and then see how I'm feeling? Or just go straight back up to 20mg (my original baseline dose)? And if I do get back to 20mg, and do not feel "normal" per se, or continue to have sleep issues...would I need to go even higher to see where the leveling out occurs? How about crossing over to a different medication if the "poop out" is real?

 

I'd hate to have to start my taper again from 30mg-40mg Fluoxetine, but would consider it if absolutely necessary.

 

Anyway, thanks again for listening and any advice would be greatly appreciated. I don't trust my GP to guide me through this, he just doesn't seem to have the knowledge around these withdrawal issues...after all, he cut my dose in half back in November!

 

 

[ChessieCat]

You have been on 10mg fluoxetine since November 2020 according to your drug signature.

 

Over the last few months (up to 3 if you reduced at the start of November) your brain has been adapting to not getting as much of the drug.  If you return to 20mg you could end up making things worse.

 

When updosing it is better to increase by a small amount at a time.  Because fluoxetine has a long half life it is better to wait for at least 2 weeks after an updose before increasing again.  You might find that increasing to 11mg might be enough to reduce your withdrawal symptoms.  You would need to keep notes for yourself to see how the increase is affecting your symptoms.  Keeping notes helps you to be more objective about your symptoms and you might see something in writing which you don't notice otherwise.  The idea of updosing is not to get rid of withdrawal symptoms completely but to bring them to a bearable level.

 

It important to also use Non-drug techniques to cope and stay as calm as possible otherwise you might have anxiety/fear/stress symptoms which are not related to withdrawal but be misinterpreted as ADWD.

 

Many aspects of updosing are the same reinstating (starting the drug again after having stopped it completely).

 

Please carefully read Post #1 of this topic:

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

Also see Post #1 of this topic about how to get the dose you need:

 

Tips for tapering off fluoxetine (Prozac)

[m0nk3yl0ve]

@ChessieCat Appreciate the feedback, that's some sound advice. Although, admittedly I have not done any kind of actually pill "shaving" to updose at those 1mg levels, am currently taking 10mg tablet that looks like can be split in half. Is there a good thread about how to accomplish that type of thing?

 

Will have a look at the other links provided as well, thanks a bunch!

[ChessieCat]

On 2/7/2021 at 9:36 AM, ChessieCat said:

Also see Post #1 of this topic about how to get the dose you need:

 

Tips for tapering off fluoxetine (Prozac)