Kat66: should I reinstate or plough on drug free?

[Kat66]

Thank you @Jakeblack14 I appreciate your reply. You would think after two and a half years of this I would know not to do certain things like introduce lots of supplements and jump off my meds even at such a low dose. 
 

We get battle fatigued though and just want it to end. 
 

Clearly I needed reminding that withdrawal doesn’t do things predictably. For example; I read positive reviews of 5htp therefore assume I will have the same reaction to it. Instead the wave I’m in gets exponentially worse. Sounds like you experienced something similar when you started on 5htp and L-Theanine while reducing, ie; a horrible wave.

 

What is the thinking behind advising magnesium and omega3? Keeping it simple? In all honesty I was going to stop all the supplements and just give my system time to recover.

 

Thanks again for taking the time to reply x

[Jakeblack14]

On 11/3/2023 at 6:22 PM, Kat66 said:

You would think after two and a half years of this I would know not to do certain things like introduce lots of supplements and jump off my meds even at such a low dose.

 Totally get it, I was the same way. When we are in Windows and functioning fairly normal the optimism to do normal stuff or make changes slightly can be strong. 

Here are some resources posted by one of the moderators. It has some good links on Magnesium and Omega 3. Basically there are tons of functions magnesium plays on the body and brain as well as its calming effect compared to supplements like B12.

Good luck and take care of yourself. 

[jon1]

On 11/3/2023 at 11:22 PM, Kat66 said:

Thank you @Jakeblack14 I appreciate your reply. You would think after two and a half years of this I would know not to do certain things like introduce lots of supplements and jump off my meds even at such a low dose. 
 

We get battle fatigued though and just want it to end. 
 

Clearly I needed reminding that withdrawal doesn’t do things predictably. For example; I read positive reviews of 5htp therefore assume I will have the same reaction to it. Instead the wave I’m in gets exponentially worse. Sounds like you experienced something similar when you started on 5htp and L-Theanine while reducing, ie; a horrible wave.

 

What is the thinking behind advising magnesium and omega3? Keeping it simple? In all honesty I was going to stop all the supplements and just give my system time to recover.

 

Thanks again for taking the time to reply x

I’ve found I can’t take any supplements whatsoever, so I’ve gone the food route as much as possible.

 

For B12 and Omega 3, I eat one can of wild salmon and a couple of cans of sardines a week. They’re really easy to consume, even as a quick snack, and provide high amounts of naturally bioavailable B12 and omegas, without side effects.

[Kat66]

On 11/12/2023 at 7:22 PM, jon1 said:

I’ve found I can’t take any supplements whatsoever, so I’ve gone the food route as much as possible.

 

For B12 and Omega 3, I eat one can of wild salmon and a couple of cans of sardines a week. They’re really easy to consume, even as a quick snack, and provide high amounts of naturally bioavailable B12 and omegas, without side effects.

Hi @jon1 I've noticed you've been off meds since Jan 22, how are you getting on in general now you've been off for some time?

 

Do you feel being off all supplements and just doing everything through food has helped you?

 

I've now been off everything (supps and meds) for three weeks. My mental health is still poor.

 

Looking forward to hearing how you're getting on!

[jon1]

17 hours ago, Kat66 said:

Hi @jon1 I've noticed you've been off meds since Jan 22, how are you getting on in general now you've been off for some time?

 

Do you feel being off all supplements and just doing everything through food has helped you?

 

I've now been off everything (supps and meds) for three weeks. My mental health is still poor.

 

Looking forward to hearing how you're getting on!

 

Hey @Kat66, thanks for asking!

 

It's been a roller coaster for sure, and not an enjoyable one. It's been a relentless cycle of anxiety and depression, I can't say I've had any windows yet, certainly nothing more than a day or so in between waves.

 

That said, there are a few extra factors at play. I'm aware now that I stopped completely at a very high dose. 2mg of Escitalopram. I didn't know at the time that it's a much stronger SSRI than others, so 2mg was the equivalent of 6-10mg in alternatives. So while I thought I was jumping off at a relatively small dose, I wasn't. Lesson learned!

 

Additionally, I also gave up alcohol and caffeine completely. Doing this set my recovery back significantly, with a return of all the worst symptoms. I don't regret this though, as it proves they clearly affected my neurotransmitters in some way, so better to be rid of them. Health measures like my blood pressure, heart rate and baseline anxiety levels have all fallen considerably since giving them up, so it's been worth it from a health perspective.

 

My most debilitating symptoms have been extreme fatigue and exercise intolerance. I've been to my doctor, had lots of blood tests, and checked out, and I'm 'healthy'. The doctor says the symptoms are similar to CFS (although not exactly the same), and have probably been caused by the SSRI.

 

This was a bit of a shock, as I didn't know SSRIs could affect the body in that way, and also that a doctor actually acknowledged that it could be caused by the drug.

 

One thing I've definitely learned is to avoid all supplements. The truth is, unless we have a specific diagnosis of deficiency, we don't need them at all. At best they are wasted money, at worst they do us physical harm. Herbal remedies are even worse than synthetic vitamins, as they are often unregulated and peddled by people who just want to make money.

 

Put simply, if any single vitamin or supplement genuinely worked, we'd know about it. We'd all be talking about it, and everyone would be taking it.

 

If I were paid for the amount of times I've done 'research' on Reddit, and spotted a thread where someone claims some supplement made them feel great, then a few comments down the same person said it either didn't work, or made them worse, I'd be very rich!

 

It also makes me angry when I see threads where a person has said 'I took X and it made me feel bad', and most of the replies are people telling them they need to take more supplements as a 'cofactor'. It's nonsense, unproven pseudoscience. And for people like us, with a very sensitive CNS, potentially dangerous.

 

It's really easy to get sucked down the internet rabbit hole of 'health' supplements when you're suffering and just want relief, I get it. But it's not worth it.

 

It's actually really very easy to get all the nutrition we need from food. Just eat fruit, vegetables, and whole foods, with a balanced diet. You don't need to do anything out of the ordinary.

 

Just as an example, the sardines, and salmon I mentioned before, just that amount each week will give you all the B12 and Omega's you need for the week, along with many, many other very healthy nutrients (selenium, Vit D) that are much more easily and naturally absorbed than those from supplements.

 

I've rambled on a bit here, but I hope my experience helps!

 

[Kat66]

On 11/15/2023 at 8:30 AM, jon1 said:

Additionally, I also gave up alcohol and caffeine completely. Doing this set my recovery back significantly, with a return of all the worst symptoms.

Hey @jon1 this sums up the whole SSRI WD experience perfectly IMO. After 2.5 years of this BS I'm now fully realising that coming off SSRIs destabilises our CNSs and what works for people not on psych meds simply doesn't work for those of us WDing from, or off (but once on) meds. For instance, I recently jumped off at .7mg citalopram and started on 5HTP and L tyrosine and L theanine in the hope this would somehow help to rebalance my serotonin/dopamine levels. It made me so much worse. I have now come off ALL supps to give my system chance to calm down. I worry my brain has been permanently restructured by these drugs.

 

[Jakeblack14]

I would be interested in hearing more about if supplements, especially calming ones like Magnesium or Fish Oil or Omega3's are not beneficial. From what I have read, those supplements like mentioned above, are easily found in food, while also our bodies use Magnesium for so so many things. Do you guys have any resources or information about if we can become dependent on supplements like those? 

[jon1]

15 hours ago, Kat66 said:

Hey @jon1 this sums up the whole SSRI WD experience perfectly IMO. After 2.5 years of this BS I'm now fully realising that coming off SSRIs destabilises our CNSs and what works for people not on psych meds simply doesn't work for those of us WDing from, or off (but once on) meds. For instance, I recently jumped off at .7mg citalopram and started on 5HTP and L tyrosine and L theanine in the hope this would somehow help to rebalance my serotonin/dopamine levels. It made me so much worse. I have now come off ALL supps to give my system chance to calm down. I worry my brain has been permanently restructured by these drugs.

 

 

Indeed. It feels like the CNS is an open wound that - when left alone - (very) slowly heals. But if anything touches it, like taking a supplement, or going through stress, it’s like poking it with a stick and it flares up all over again.

 

14 hours ago, Jakeblack14 said:

I would be interested in hearing more about if supplements, especially calming ones like Magnesium or Fish Oil or Omega3's are not beneficial. From what I have read, those supplements like mentioned above, are easily found in food, while also our bodies use Magnesium for so so many things. Do you guys have any resources or information about if we can become dependent on supplements like those? 

 

You won’t become dependant (at least not physically) on regular supplements like vitamins and minerals. The only risk would probably be taking too much, in too high a dose, or taking one that agitates the nervous system. There is also a possibility that very high doses of one vitamin or mineral, can cause an imbalance in others.

 

All nutrition can be found in food, and the body deals with that naturally, keeping itself in balance, absorbing only what it needs. Take a look at the nutritional content of what you’re already eating, and see if there are any gaps.

 

Other supplements that mess around with neurotransmitters in the brain should be avoided in my opinion. Evidence is very sketchy on how much harm they cause.

 

For example, for the last few years GABA has been pushed by supplement companies as being calming, but now research is showing that taking it can causes changes to the brain, and leads to withdrawal if stopped.

 

So really, the safest way is to simply eat healthy food.

[Jakeblack14]

6 hours ago, jon1 said:

You won’t become dependant (at least not physically) on regular supplements like vitamins and minerals. The only risk would probably be taking too much, in too high a dose, or taking one that agitates the nervous system. There is also a possibility that very high doses of one vitamin or mineral, can cause an imbalance in others.

I agree with everything you have mentioned. 

Related, but not the same, alchohol and caffiene (coffee). Alchohol is’nt an option. It spirals into the worst of withdrawal. 
I dont expect anyone to give advise, but I would appreciate thoughts on a single cup of coffee a day. I have found it seems level out the racing thoughts in waves. I think it has something to do with inflamation, as I can do the same with ibuprohen, but I am avoiding medication in general.

I would also be interested in if you have been able to exercise at all? I personally have been extremely fatiuged and flu like daily. I have read some places that things like Yoga and Walking are beneficial, but other places suggest no exercise at all. 

Would appreciate any suggestions as our stories and symtoms sound fairly similar. 

[jon1]

35 minutes ago, Jakeblack14 said:

I agree with everything you have mentioned. 

Related, but not the same, alchohol and caffiene (coffee). Alchohol is’nt an option. It spirals into the worst of withdrawal. 
I dont expect anyone to give advise, but I would appreciate thoughts on a single cup of coffee a day. I have found it seems level out the racing thoughts in waves. I think it has something to do with inflamation, as I can do the same with ibuprohen, but I am avoiding medication in general.

I would also be interested in if you have been able to exercise at all? I personally have been extremely fatiuged and flu like daily. I have read some places that things like Yoga and Walking are beneficial, but other places suggest no exercise at all. 

Would appreciate any suggestions as our stories and symtoms sound fairly similar. 

 

Coffee/Caffeine is a difficult one and varies from person to person. It does have beneficial effects initially, by raising levels of dopamine and serotonin for a short period ( an hour or two) after digestion. It is known to have mild antidepressant effects for that reason.

 

Unfortunately, like any drug, there is a sting in the tail. In this case it's that caffeine doubles the amount of stress hormones such as cortisol and adrenaline in the blood, this lasts for many hours and can elevate anxiety and stress levels for up to 24 hours. However, some people process caffeine quickly and easily, barely feeling any negative effects, others much more slowly, and so experience much worse side effects. This is down to the individual, and our tolerance of caffeine does fall as we get older. So if you feel caffeine is not causing you any side effects, there isn't any particular harm. But if you do suffer from anxiety, even one cup in the morning can affect you for up to 24 hours.

 

I've now been off caffeine for four months, and it was very difficult in the beginning. Pretty horrible withdrawal effects. However, now I'm very glad I did it. My sleep is 1000 times better, and my anxiety has improved. I tried just one cup of weak coffee a few weeks ago, and my anxiety and agitation shot through the roof. I was horrified to think I had been putting that into my body every day!

 

Exercise is difficult. I can manage short walks, but I have to be careful about doing too much. I've found if I walk any more than around 5000 steps at a time, the next day I'll feel it. Usually with very, very high agitation and irritability. I used to manage the gym four times a week, but I had to stop that within two months of my last dose.

 

Some exercise, no matter how little, is beneficial, even just a very short walk outside. It's a case of paying attention to how much is too much, and keeping within those limits. Maybe trying a little more now and again to see how it goes.

 

I wear an Apple Watch, and have for several years, so a couple of months ago I took a look at the readings from it when I was still taking Lexapro, and the readings now.

 

The big difference I noticed was in my HRV (Heart Rate Variability), which is an indicator of the CNS being under stress. When I was still on Lexapro, after a workout my HRV stayed the same, or went up (higher is better) after a workout or exercise.

 

But within a couple of weeks of quitting Lexapro, my HRV dropped dramatically after a workout, and stayed low for a few days afterwards.

 

This seems to indicate that even small amounts of exercise cause stress on the CNS, resulting in fatigue and other symptoms that follow. It's possible SSRIs alter the way the body processes energy in some way. But I've no idea how.

 

[Kat66]

5 hours ago, Jakeblack14 said:

I would also be interested in if you have been able to exercise at all? I personally have been extremely fatiuged and flu like daily. I have read some places that things like Yoga and Walking are beneficial, but other places suggest no exercise at all. 

I exercise every day except the weekends. Depending on how I feel that could be a light walk, a short yoga stretching workout, HIIT or weights. Exercise is one of my biggest weapons against mental illness so under no circumstances would I ever give it up. Even on bad days I'll try and do something, even of it's 10 mins. That said, I appreciate when you're feeling really bad, it's almost impossible to get your body to move. When I'm like that I know rest is the only option.

 

11 hours ago, jon1 said:

The only risk would probably be taking too much, in too high a dose, or taking one that agitates the nervous system. There is also a possibility that very high doses of one vitamin or mineral, can cause an imbalance in others.

Re magnesium, it's hard to find a low dose supplement. I'd been taking 300mg/day until recently!

[jon1]

10 minutes ago, Kat66 said:

I exercise every day except the weekends. Depending on how I feel that could be a light walk, a short yoga stretching workout, HIIT or weights. Exercise is one of my biggest weapons against mental illness so under no circumstances would I ever give it up. Even on bad days I'll try and do something, even of it's 10 mins. That said, I appreciate when you're feeling really bad, it's almost impossible to get your body to move. When I'm like that I know rest is the only option.

 

Re magnesium, it's hard to find a low dose supplement. I'd been taking 300mg/day until recently!

It’s surprising how much can be on gained from daily foods. It’s interesting that the daily recommended intake, is the maximum we should take, not the amount we need.

 

https://my.clevelandclinic.org/health/articles/15650-magnesium-rich-food

 

I tried magnesium supplements in the very early days, but they made me horrifically depressed and tired. I tried all forms and dosages. I think I reacted that way even before I took SSRIs though.

[Kat66]

18 minutes ago, jon1 said:

It’s surprising how much can be on gained from daily foods. It’s interesting that the daily recommended intake, is the maximum we should take, not the amount we need.

 

https://my.clevelandclinic.org/health/articles/15650-magnesium-rich-food

 

 

Thanks for the link @jon1 looking at it, I get a ton of mag with what I eat, no need to supplement lol. Interesting about the RDAs, I didn't know that.

 

 

20 minutes ago, jon1 said:

I tried magnesium supplements in the very early days, but they made me horrifically depressed and tired. I tried all forms and dosages. I think I reacted that way even before I took SSRIs though.

This WD journey is a bl**dy minefield!!! 

[Kat66]

So I'm wondering if taking HRT is something which could affect recovery from ADWD? I have just changed my HRT prescription from patches to oestrogen gel and progesterone tablets (a week ago) and my symptoms are suddenly off the scale HORRENDOUS. Could this be a form of kindling? I'm really struggling and have even wondered about going back on an antidepressant, it's that bad!

 

If anyone has any thoughts on this I'd be most grateful!

 

#HRT #kindling

[Greatful]

@Kat66  Oh man Kath, what next😒 Can you go back to what you were taking before the change in how you take the hormones?  If they are anything like the disruption you can get when making changes from pill to liquid or  from on manufacture to another manufacture on physics drugs...... maybe going back will help?  It seems we are so sensitive to any changes of any kind😓  May someone who is more knowledgeable with hormone replacement can help you out more.

 

You are going to be okay.....We got your back

 

 

 

 

 

[LotusRising]

22 hours ago, Kat66 said:

I have just changed my HRT prescription from patches to oestrogen gel and progesterone tablets (a week ago)

 

Can you clarify what you mean here? You were on both estrogen and progesterone and changed forms? Or you were on estrogen only and then added progesterone tablets.

 

It could be the difference in absorption rates, or it could be due to a change in dosage amounts.

 

According to your signature, you're off all meds, is that correct?

[getofflex]

According to your signature:  11/11/23 jumped off @0.7mg

 

I assume this is citalopram?  It is quite possible you jumped off at too high of a dose.  These drugs are extremely powerful, especially at the very low doses.  I know it's hard to believe.  I jumped off my Lexapro at 0.005 mg!  This was at the advice of Brass Monkey, one of our senior staff members.  Lexapro is at least twice as powerful as citalopram, so that would be like jumping off Lexapro at 0.35.  

 

Chessie Cat was another of our mods, and here is what she did: 

 

On 9/9/2021 at 4:15 AM, ChessieCat said:

I forgot to include my planned last dose: 

 

0.0025mg Pristiq

 

 

Here is some more information:  

 

When to End Taper and Jump to Zero

 

 

If these horrendous symptoms continue, you might consider doing an extremely small reinstatement of citalopram - perhaps 0.35 mg.  I assume you were using the liquid to taper at the very end?  

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

 

 

 

[Kat66]

On 12/21/2023 at 7:05 PM, LotusRising said:

 

Can you clarify what you mean here? You were on both estrogen and progesterone and changed forms? Or you were on estrogen only and then added progesterone tablets.

 

It could be the difference in absorption rates, or it could be due to a change in dosage amounts.

 

According to your signature, you're off all meds, is that correct?

Hi @LotusRising I was on a combined patch with oestrogen and progesterone and swapped to estrogel and utrogestan tablets. 
 

I WAS off all meds, but on Christmas Eve I started on 7.5mg mirtazapine as I had had enough and couldn’t bear the symptoms any longer.
 

 

@getofflex yes I jumped at possibly too high a dose (yes, citalopram). I’d just had enough and thought it was low enough. Do you think jumping off at 0.7mg might explain these symptoms?

 

 

[getofflex]

1 hour ago, Kat66 said:

@getofflex yes I jumped at possibly too high a dose (yes, citalopram). I’d just had enough and thought it was low enough. Do you think jumping off at 0.7mg might explain these symptoms?

Yes, I do.  Now that you started mirtazapine, I'm more reluctant to see you also reinstate celexa.  We only suggest one drug change at a time.   

Edited December 26, 2023 by getofflex

[Kat66]

10 minutes ago, getofflex said:

Yes, I do.  Now that you started mirtazapine, I'm more reluctant to see you also reinstate celexa.  We only suggest one drug change at a time.   

Should I just carry on with the mirtazapine at the current dose of 7.5mg?

 

I’ve messed everything up haven’t I? What an idiot! I didn’t see that you’d suggested a tiny reinstatement, no.

[getofflex]

It's up to you what you want to do.  

 

Personally, if it were me, I would discontinue the Mirtazapine now, because once you get dependent on that, you have another long taper to do with another drug.  

 

You can stop abruptly, as you have only been on it 2 days.  Then I would reinstate citalopram 0.35 mg.  Please read the topic on reinstatement.  

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

Edited December 26, 2023 by getofflex

[getofflex]

Please put the mirtazapine you just started in your drug signature, even if you decide to stop it.  We need detailed drug history - thank you.  

[Kat66]

1 hour ago, getofflex said:

It's up to you what you want to do.  

 

Personally, if it were me, I would discontinue the Mirtazapine now, because once you get dependent on that, you have another long taper to do with another drug.  

 

You can stop abruptly, as you have only been on it 2 days.  Then I would reinstate citalopram 0.35 mg.  Please read the topic on reinstatement.  

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

I appreciate what you’re saying, but Im so tired of feeling horrible. This is the worst I’ve ever been. I’ve been in a wave/depression for months on end. Everything is so dark, I thought if I go on something else I’ll get relief within weeks and this darkness is gone. Honestly do you think such a small reinstatement would make a difference to this bleakness? 

 

58 minutes ago, getofflex said:

Please put the mirtazapine you just started in your drug signature, even if you decide to stop it.  We need detailed drug history - thank you.  

Done.

[Kat66]

@getofflex the other thing to consider is, I have no citalopram left. The earliest I could get some would be the middle to end of next week, meaning I would have been off the drug since 11/11, well over a month. It’s no exaggeration to say I am desperate.

[getofflex]

I understand you are feeling really badly, and I'm sorry you are dealing with this.   As I said, it is your choice to make. I'm just making you aware of your options. 

4 hours ago, Kat66 said:

Honestly do you think such a small reinstatement would make a difference to this bleakness? 

It could help significantly.  These drugs are very powerful, especially at the low doses.  But there is no way to know for sure what is causing your symptoms.  It could very well be the change in the HRT, or something else.  It is probably a combination of factors.  It could also be that we just had winter solstice, and the lack of light is causing you to have SADS (seasonal affective disorder), or stress from the holidays.  

 

4 hours ago, Kat66 said:

Done.

Thank you.  

[Kat66]

@getofflex thanks for that. And you don’t think too much time has gone by since I jumped off to reinstate (I came off 11/11)?

[getofflex]

6 hours ago, Kat66 said:

And you don’t think too much time has gone by since I jumped off to reinstate (I came off 11/11)?

No, I don't but I wouldn't wait much longer.  The sooner you do a reinstatement, the more likely it is to work.  

[Kat66]

23 minutes ago, getofflex said:

No, I don't but I wouldn't wait much longer.  The sooner you do a reinstatement, the more likely it is to work.  

Thanks. As I said, I won’t be able to get my hands on any citalopram until next week as I threw all my bottles, pills etc away when I jumped and it’s the holidays etc. Worried that would be nearly two months off.  
 

The alternative is carrying on with mirtazapine. Would that be like a reinstatement in itself? I could start with a very small dose of mirt? Less than the 7.5mg I’m taking?

[Kat66]

I’ve decided to reinstate Mirtazapine at 0.5mg as that’s the only drug I have to hand. I’ll just have to hope it works.

[getofflex]

1 hour ago, Kat66 said:

The alternative is carrying on with mirtazapine. Would that be like a reinstatement in itself? I could start with a very small dose of mirt? Less than the 7.5mg I’m taking?

No, it wouldn't.  Your brain is used to the citalopram, which is why I suggested reinstating that.  I doubt that taking mirtazapine 0.5 mg would do much for you.  You've only been on mirtazapine a few days, and your brain is not adjusted to that particular drug.  If you decide to reinstate citalopram, I would suggest getting the liquid, since you will be dosing such a small amount.  

 

I still think there is a chance reinstating citalopram can help you, even if you can't do it until next week.  We have had people reinstate 3 or 4 months after they jumped off, and it helped them.  

 

 

[Kat66]

Ok well thanks @getofflex I’ll sort the cit out. Thanks for your advice is much appreciated as always.

 

 Quick question though; why did you suggest going back on at .35 and not .7?

[getofflex]

20 hours ago, Kat66 said:

why did you suggest going back on at .35 and not .7?

Because after a period of time, our brains very slowly adjust to being off the drug.  Please read this link carefully, it is very important.  

 

How Psychiatric Drugs Remodel Your Brain

Edited December 28, 2023 by getofflex

[Kat66]

1 hour ago, getofflex said:

Because after a period of time, our brains very slowly adjust to being off the drug.  Please read this link carefully, it is very important.  

 

How Psychiatric Drugs Remodel Your Brain

Ah right. Thanks @getofflex I’ll take another look.

[getofflex]

Hello Kat66, please refrain from tagging me frequently.  I'm already following your thread, so I'll see when you post on your thread.  There are very few of us mods, and many people on here to help.  Thanks for understanding.  

[Kat66]

2 hours ago, getofflex said:

Hello Kat66, please refrain from tagging me frequently.  I'm already following your thread, so I'll see when you post on your thread.  There are very few of us mods, and many people on here to help.  Thanks for understanding.  

Apologies 

[Kat66]

Help! I’ve accidentally taken 100mg citalopram instead of .35mg as I’ve misunderstood my new weighing scales. Any advice as to what to expect and what to do about subsequent doses? Thanks.