okaydog: 11 years of SSRIs and unsure where to go from here

[okaydog]

Hi all! I am posting here in hopes to gain some insight into my situation, and to hopefully assist others in this community that may have had parallel experiences.  I'm sorry in advance if it gets lengthy, I will do my best to condense everything and keep it brief. 

 

I'm currently 23, and have been on SSRIs since I was 12.  I was put on a small dosage of Celexa (20mg-50mg over the course of a couple years) for migraine headaches and general anxiety at age 12. At age 18, I was weaned off the Celexa over the course of a month or so and placed on Zoloft, since I was having a lot of issues with depression and suicidal thoughts at the time. This ranged from 50mg-150mg during the time in which I took it. 

With both of these medications I can't say if I saw any difference whatsoever. I began developing pretty intense anxiety and panic attacks shortly after being put on the Celexa, though, I can't say if that was a result of the medication or general adolescent angst. I saw no changes at all while on Zoloft. 

 

I was assigned to a new psychiatrist in June of 2018 who implemented the Genesight DNA test, which determined that my body could not properly metabolize both Celexa and Zoloft. I tapered off the Zoloft over the course of a few months, and was placed on Luvox, which had a much stronger and more noticeable effect. I had now been diagnosed with OCD, additionally.

From September of 2018 to September of 2019, my dosage of Luvox was gradually increased from 50 mg to 300 mg.

The early phases of being on Luvox (50mg-250mg) were some of the happiest times in my life. No longer was I plagued by intrusive thoughts, compulsions, mood swings, panic attacks, or any of the other symptoms that made day-to-day life unbearable. I noticed, however, that it had slightly numbed my emotions, and it had a very strong sedative effect. On Luvox I can sleep up to 16 hours, which was unheard of for me prior to changing medications. I will sleep through all my alarms, not noticing any of them. Most days it takes me close to two hours to get out of bed due to how overwhelmingly lethargic I feel. To feel awake/alert whatsoever, I have to consume a lot of Caffeine...which for a time was fine, but it's not how I want to live my life forever.

 

The emotional numbness was a compromise I was willing to make given how unstable I was prior to Luvox. However, when I reached 300 mg, I had lost emotion entirely. My brain would recognize I felt a certain way, but I didn't feel it at all. This was something I was uncomfortable with, but my psychiatrist has continued to push that I continue increasing the dosage up to 500mg, which I am also uncomfortable with. 

 

Another reason I wanted to get off of them is that missing a dose is the most hellish feeling imaginable. The few times this has happened, it feels like every noise and sensation is that of nails on a chalkboard. I am generally very mild and calm nowadays, but when I miss a dosage I find myself literally screaming about the tiniest things...I really wish I could properly put into words how terrible it feels but nothing really does it justice. 

 

I had reached a point of total stability early this year, and told my psychiatrist I would like to taper off the medication. He has been vocally against the idea but has reluctantly assisted. I began tapering down in early January, going from 300mg to 275mg in January, down to 250mg in February, and down to 200mg in March where I have been since. Most of my symptoms are back in full swing, and they'll range from manageable to paralyzing. I find myself getting irrationally angry/anxious about miniscule things, losing hours to compulsive behaviors, and am constantly having to fight a barrage of intrusive thoughts, in addition to the sedation and lethargy associated with the Luvox. No panic attacks or any of the more severe ones yet, thankfully.

 

I have been coping pretty poorly admittedly, incorporating old coping mechanisms such as binge eating and new ones such as excessive drinking. I have quit the latter entirely and am working on stopping the former. Now I am working on getting into better habits such as working out and meditation, in hopes those will assist in this process. 

 

Frankly, I don't want to have to be reliant on any sort of medication. Sometimes I fear I might have to be, given how overwhelming my symptoms are the moment I begin to taper down. On the meds I feel like a zombie, off the meds I get nothing accomplished and am constantly fighting my own brain and body all day. I don't know which one is worse, and it's been so long since I've been off these meds that I don't know what it even feels like to be off them anymore. I hope that with the assistance of all the resources on this forum that I will be able to make this transition smoothly and finally reach a point of stability while off of medication. 

 

I would really appreciate any advice, resources, or anything else you all may have to offer. Thank you for reading, and glad to be here! 

 

 

[Gridley]

Welcome to SA, okaydog.  Thank you for completing your drug signature.

 

We recommend tapering no faster that 10% of your current dose every four weeks, and you're going a bit faster than that.

 

Why taper by 10% of my dosage?

 

This link is specifically about tapering Luvox including how to get the non-standard doses you'll need for a 10% taper.

Tips for tapering off Luvox (fluvoxamine)

 

The symptoms you describe are typical of withdrawal.  I'd suggest you hold where you are at 200mg for at least three months before tapering further.  This will help you stabilize.  

 

So that you have a better idea of what you're experiencing, here is some information on 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 askquestions and connect with other members.  We're glad you found your way here.

 

 

 

 

[okaydog]

Thank you so much for the quick reply, and for all this great information! Looks like I have a lot of reading to do. 

That's crazy to hear I was moving down too fast, that was the rate my psychiatrist had insisted on! Really makes me wonder how much I was misinformed about. 

 

Thank you so much again!

[Gridley]

On 4/28/2021 at 8:19 PM, okaydog said:

that was the rate my psychiatrist had insisted on!

Psychiatrists know very little about safe tapering and almost invariably taper their patients too fast.  Take your time on the reading; it's a lot to absorb.