Racandimo: fluoxetine withdrawal

[Racandimo]

Hi, 

Newbie just starting out my taper. 
I changed to liquid fluoxetine (Prozep) 3 weeks ago and it’s been ok. I got acid reflux and headaches but have managed that well with anti-inflammatory diet, yoga and meditation rests. 
Tomorrow I start to lower the dose. I am trying the Slide Method of Microtapering by Brassmonkey. So 18 mg should be 4.5ml instead of my usual 5ml. 🤩

Slow and steady: 10% with a 4 week hold. 
 

Wish me luck!!!

[Erell]

Hello Racandimo !

 

And welcome on SA.

 

I'm so glad that you found SA before starting your taper, now you have all the infos to treat gently your CNS and move on your path to a drug free life

 

I see that you've made some reading, but just to be sure I will put some links here :

 

1. why-taper-by-10-of-my-dosage

 

2. the-brassmonkey-slide-method-of-micro-tapering

 

3. tips-for-tapering-off-prozac-fluoxetine

 

Feel free to ask questions after you read these links 

 

My best wishes !

 

 

 

[Toast]

Hi Racandimo, Best of luck on your taper -- I hope things go well for you! Fluoxetine is no joke and it is great that you are looking at a conservative tapering strategy. I CT'd off of fluoxetine because my doctors were not knowledgable and suffered horribly for it. You are on the right track! 

[Racandimo]

It’s going very well. Nothing above very mild symptoms of acid reflux, the odd headache and some down feelings - very mild. 
I’m ready for the next drop - down to 16 mg on Thursday then holding for a month again. 

[Altostrata]

Thanks for the good news, @Racandimo

[Racandimo]

Hello, fellow-taperers!

A wee update for you. 
I have now dropped to 14.5mgs, which I started on 18th March. 
I’ve been a bit lax in keeping track of symptoms but the main one I’ve struggled with has been fatigue. I’m receiving treatment for chronic fatigue and have no idea if it is related to the Prozac or if it’s a withdrawal symptom. But it could also be caused by work stress/exhaustion or perimenopause. 
It’s been hard going and the fatigue has been particularly bad the past week alongside muscle and joint aches (not COVID - I get tested twice a week for my job). 
I’ve noticed that tears have been easier to come too. Today I watched ‘Coco’ and had a wee cry. I cried talking to my sister telling her how much I loved our mum. So, my emotions are more available and raw. 
Anyway, We go on until we win! 
Next drop is planned for 15 April, but maybe I should  take longer to settle - thoughts welcome if anyone who knows this stuff is reading! 
Thanks for the encouragement! 


 

 

[Toast]

So glad things seem to be going relatively well and that you are able to stay in good spirits. I did not experience fatigue as a symptom myself but it definitely seems possible it could be related to the taper. Hopefully it will go away as your CNS adjusts to being without the drugs. 

 

For me, my main symptoms hit after I dropped below 10 mg Prozac. Based on the dose-response curve for Prozac, you may be fine until then, or hopefully, you will have minimal to no symptoms throughout your whole taper. I will cross my fingers that the second will be true for you!

 

Sending my best. ❤️

[Racandimo]

Hi humans,

It’s the ninth month of tapering and going well. I really don’t know which things are withdrawal symptoms or post-viral syndrome but either way the summer was good and I got my energy and spark back. It’s Autumn, nights getting longer here (it gets DARK in Scotland! in winter) and energy is waning a little and work is picking up (I’m a teacher) so I need to be vigilant to look after myself. Really happy that I’ve not experienced a horrible kickback - following the slow method seems to be working great. Thanks to all who have posted - I would not have known how to do it safely otherwise. 

[PsychologicalSafe15]

@Racandimo Are you getting bloating or some sorts of gastrointestinal issues like gas accumulated in stomach ??

[Racandimo]

No bloating but I am v careful with what I eat so I avoid that. For me, sugar, too much wheat, and alcohol are things to avoid. 

[Racandimo]

Off the stuff now but maybe in WD?

 

I’ve been tapering off Prozac since the start of 2021. If you read my updates I’ve been poster girl for a good taper. I continued to follow advice up until July 2022 when I was down to a few ml of the liquid. I was abroad and having a good time and kept forgetting to take it with no real side effects. I then thought “this must be a sign that I should just stop - after all, Doctors suggest a much quicker taper, I’d put in 18 months and not had any symptoms of WD. Maybe the forum is too extreme in its advice or I don’t really need it”. There WAS a tiny voice saying ‘but the last tapers are the roughest from what I remember’ but I didn’t listen. 

I was fine for the rest of the summer holidays. When it came to work starting up again (I’m a teacher and it’s a v stressful job but I do love it and have nice classes except for one) I started to feel very anxious. It’s not really stopped. Not had a panic attack yet but come close. I wake every morning with horrible anxiety. I’ve been more and more tearful. I fell like I am falling apart mentally and have had some dark thoughts about ending my life (but not made plans and have good support in my husband who is aware). I’m also in therapy but can only get it every two weeks. 

I thought I’d share this. Not sure if this is delayed WD. Or if it’s perimenopause (just upped my HRT). Or a new thing. 

Looking for reassurance / advice / thoughts. 

 

Edited September 12, 2022 by ChessieCat
added Intro topic title before merging with intro topic

[ChessieCat]

Q:  What was the lowest dose you were taking before you stopped?

 

Q:  Have you been drinking alcohol, been sick, taken antibiotics, any stressful events occur?

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

Fluoxetine has a very long half life and it can take 2-3 weeks for withdrawal symptoms to be felt.  If you were tapering 10% every 3 weeks then you might have been getting a build up of withdrawal symptoms.

 

 

[Racandimo]

Hi chessiecat,

I was on 0.3 mls of the liquid when I stopped at the start of July. Symptoms got bad from mid August.
R 

[Racandimo]

I drink very little (one unit / small drink perhaps once a month or at most once a week depending on what is happening). 
 

I’ve not been on antibiotics. 
 

Stress - wise return to work after 6 week holidays is always stressful but I do a four day week now to help with Post-Viral fatigue that I’ve struggled with for years. 

[ChessieCat]

14 hours ago, Racandimo said:

I was on 0.3 mls of the liquid when I stopped at the start of July. Symptoms got bad from mid August.

 

If 1mL = 1mg fluoxetine that means that your last dose was 0.3mg which is more than SA recommends jumping off at.  And the fact that you got withdrawal symptoms mid August seems to indicate that it was stopping at too high a dose and possibly (as I stated before) that because you were tapering every 3 weeks your symptoms caught up with you.  I suspect that you might have been getting symptoms during the few reductions made prior to you stopping but either ignored them and continued to taper anyway or you didn't recognise them and it wasn't till you still that it all accumulated and made itself know.

 

HOWEVER if you were taking prescription fluoxetine then it may be that 1mL = 4mg so 0.3mL = 1.2mg which is much higher a jump off dose than SA's recommendation.

 

  

On 7/3/2011 at 4:11 AM, Altostrata said:

If your fluoxetine liquid contains 20mg fluoxetine in 5mL of liquid:

•    1 mL= 4mg
•    0.5mL = 2mg
•    0.25mL = 1mg
•    0.2ml = 0.8mg

 

 

14 hours ago, Racandimo said:

I drink very little (one unit / small drink perhaps once a month or at most once a week depending on what is happening). 

 

  Please see the 2 following lots of information about alcohol:

 

alcohol-wine-and-beer

 

On 7/6/2020 at 5:50 AM, brassmonkey said:

Some months after going off, some people report a serious wave of bad symptoms.  This is about the time that people are feeling very comfortable with their recovery, not realizing their nervous systems are still very sensitive.  This can cause them to get careless in their actions.  Drinking alcohol is a major factor in excellent recoveries getting derailed.  We just had a case of a member who has been drug free for several years with an excellent recovery underway.  They had a couple of drinks over the weekend and tripped off their symptoms all over again.  Luckily, it cleared in a few days, but that is not always the case.

 

[Racandimo]

Thanks! 
So I was on prescription Liquid Fluoxetine (Prozep) and 5ml = 20mg. so looks like the jump was too big. 
i wasn’t aware of breakthrough symptoms but I am going through perimenopause so there are a lot of things happening which cause similar things. I guess I will never know. 
 

The main question is - what to do now to help? Go back on the liquid at my last dose? My Dr is not v helpful - she gave me the liquid but her advice on ending AD was the usual thing about taking one tablet every two days and then just stopping. When I told her how I wanted to do it she pretty much said (paraphrased) “ do what you want and I don’t need to see you now. “

i still have medication left and can get the medicine if that’s the thing to do. 

[ChessieCat]

You have been off for at least 6 weeks, possibly 10, depending on when in July you stopped taking the fluoxetine (please add the date to your signature).  I suggest that you DO NOT return to the last dose you took, it might possibly make things worse because your brain will have made adaptations to the lower dose since you have been off and going back to the last dose might be too much.

 

If your withdrawal symptoms are bearable then you might choose to not reinstate.  If, however, you are finding the withdrawal symptoms unbearable then you could try reinstating a very small dose.  You might find that even a tiny 0.1mg (mg NOT mL) might be enough to reduce the symptoms to a bearable level.  I would definitely not take more than 0.5mg to start.  Personally I am very cautious.

 

Please keep in the mind the following.  The idea of reinstating is NOT to get rid of withdrawal symptoms but to bring them to a level that you can live with.  Also remember the long half life of fluoxetine.  It will take several weeks for the dose to get to full level and might take 4 weeks for it to fully register in the brain.  You will need to be patient and use non drug coping to get through any discomfort.  It is also important to try and keep anxiety to a minimum because the symptoms of anxiety can be mistaken for withdrawal/adverse effect of the reinstatement.  When we become impatient we can panic and make bad decisions.  Because of the long half life you don't want to end up taking too much and then having to reduce the dose again because during that time you will be experiencing discomfort as the drug level changes going up and then coming back down.

 

If after 2 weeks you have noticed no improvement in your withdrawal symptoms (and definitely no worsening) then you might increase by a tiny bit more.  If it was me I would only be increasing by 0.25mg and nor more than 0.5mg.  If you have noticed some improvement after 2 weeks then you would hold for 2 more weeks and then reassess.

 

Remember that the aim is to ease the symptoms.  Some members have tried to find the perfect dose (and most of these have been taking a drug with a short half life where it takes about 1 week to register in the brain) and have ended making things worse and some have posted saying that they should have been satisfied with the improvement they had and regretted continuing to adjust their dose.  Sometimes when this happens they have taken a long to for things to improve.

 

Please carefully read Post #1 of this topic:

 

About reinstating and stabilizing to reduce withdrawal symptoms

[Altostrata]

Hello, @Racandimo what is your sleep pattern? Over the last month, have your symptoms gotten better or worse?

[Racandimo]

Hi @Altostrata,

My sleep is regular - I don’t have trouble sleeping. But I do often wake before the alarm feeling anxious. I get up at 5.45 on workdays and often wake at 5am. I just listen to sleep meditations and NEVER look at the clock to see the time - I just pretend it’s 1am so I get back to sleep ok. But the rush of adrenaline/ cortisol is annoying. 
This has been worse over the last month. But even with that I average 7 1/2 hours of sleep a night according to my apps. 

[Altostrata]

Sensitization to the normal early morning cortisol peak is common in withdrawal, see 

 

Waking with panic or anxiety -- managing the morning cortisol spike

 

On 9/12/2022 at 5:46 AM, Racandimo said:

I drink very little (one unit / small drink perhaps once a month or at most once a week depending on what is happening). 

 

No drinks for you, not even a little one. This can set your recovery back over and over.

 

It's up to you whether your withdrawal symptoms are worth a low-dose reinstatement, or if you want to forge ahead without it.

 

Many people find fish oil and magnesium supplements helpful, see

 

https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

 

https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

You might try a little bit of one at a time to see how it affects you. Please let us know how you’re doing.

[Racandimo]

@Altostrata a long overdue thanks for your reply! And for your invitation to update you - really appreciate it. Sometimes this forum, despite being super helpful, feels like a big place and easy to get lost! 

It’s been a rocky few months. Mainly physical stuff -ME/ chronic fatigue syndrome relapse since about November gave me a lot of pain and fatigue and that has taken a toll on my mental health (low level depression with anxiety). Lots of other minor health issues all adding up to a stack of discomfort every day. 
I’ve had passing thoughts of suicide - nothing concrete but still a bit alarming. A general hopelessness and despair. Not constant though - I’m still working (which keeps me steady but also adds a lot to stress) and just about managing to socialise, although groups scare me. 
I’ve been getting therapy - love my therapist / but honestly it’s stirring up so much that I sometimes wonder if it’s actually helping. 
I’m doing lots to keep eating really well, not drinking, sleep hygiene, exercise. Just want to feel like myself again. 

The thought to go back to Prozac does pass through my mind and I sometimes wonder why I am so keen not to do that. But I know I’ll just end up on it indefinitely. Want to try to resolve some of the underlying stuff and get my joy back myself without being numbed. But counter-arguments appear (I take meds every day for asthma so why should this be any different?).
Thanks for your interest again!