Turkey: Question about Prozac taper

[Turkey]

Hello,

 

Someone told me to ask a moderator on this site about my Prozac taper.  I hope you have access to the information about my drug history that I gave when I signed up to become a member of this site just now. 

 

To recap:

Took Prozac 20 years, 10 mg.  Tried stopping in 2017 CT for 2 months, then reinstated.  This was the only medication I was taking.  Stopped again CT in August 2020.  It took until November 2020 before I started having WD symptoms, but didn't know that's what it was.  I thought it was anxiety over Covid and the vaccine.  Started taking low lose (1-2 mg Valium 1-2 times a day) in November 2020 through end of February 2021, WD getting worse the whole time.  ER doctor switched me from Valium to Ativan beginning of March 2021.  Paradoxical reaction to Ativan, which I think I was also having with Valium.  (Had taken Valium for flights, dental and medical procedures for about 15 years, maybe once or 2 times a year, but never more than 4 mg a day and never two days in a row.)  Reinstated Prozac 10 mg mid-March 2021 in preparation for stopping Ativan, to "help" with benzo withdrawal, supposedly.    CT Ativan (stupid at home detox service) April 3, 2021.  Now a little over seven months later and seven months off benzo, I started tapering Prozac at 10% every 4-6 weeks.  I have only done one Prozac cut so far, 5 weeks ago.  Why?   It has never helped, and I am afraid it could be making me worse.  Just learning about kindling and about how reinstatement often does not work.  But now I don't know if my symptoms are from benzo withdrawal only or also from reducing the Prozac.    

 

Here are my questions:  I now think that my reinstatement of Prozac at the exact dose of 10 mg that I cold turkeyed from was not a good idea.  I have been back on Prozac for eight months, so it it were going to help my benzo withdrawal I should know by now.  Or, if it were going to help me stabilize from Prozac withdrawal, I should also know by now.  So I am left with the conclusion that I should have reinstated Prozac at a lower dose (actually, I should not have reinstated at all).  But it is too late now.  So, Prozac is not helping me in any detectable way.  And, it might actually be hurting my benzo recovery.   Could I still be experiencing Prozac withdrawal despite the reinstatement  (on top of my benzo withdrawal)?  If so, should I continue tapering Prozac now?  I understand that if Prozac were helping my benzo withdrawal, then starting to taper Prozac in the middle of benzo withdrawal (well, I am past withdrawal, let's say "recovery"), then the Prozac taper will heighten my symptoms overall.  But if Prozac isn't helping, and I have not stabilized on Prozac since reinstating, and I am still in Prozac withdrawal despite the reinstatement, then maybe I should continue to taper.  

 

Perhaps you would be so kind as to offer me some observations based on your experience.  I realize you cannot offer medical advice, and I would not expect you to do so.  I will not go to another doctor about this because no one I have seen recognizes that withdrawal even exists.  They have been no help.  That's another reason I want to get off Prozac too, so I don't have to keep seeing a doctor to get refills!

 

Please respond.  And thank you so very much.

 

 

[Kiasofia]

Welcome @Turkey

I understand your wish to get off Prozac and from what you are saying it doesn't seem to be helping you deal with any withdrawal. The general advice is to not start a taper until one is feeling stable and withdrawal symptoms are manageable. And then taper by 10% of current dose, as you have begun.

Preparing to taper

Why taper by 10% of my dosage?

Tips for tapering off fluoxetine (Prozac)

 

Even though Prozac is not of any use to you, coming off a third time can cause even more withdrawal. In addition you are possibly dealing with withdrawal from Valium and Ativan. Every time we start and stop a psychiatric drug, our brain gets more sensitized. So this taper needs to happen at the right time, and the right speed, for your body and brain to handle.

How Psychiatric Drugs Remodel Your Brain

 

What withdrawal symptoms were you having before you did the  10% Prozac reduction?

Dr. Joseph Glenmullen's withdrawal symptom checklist

 

Do you feel any different now after your first 10% reduction? What date was the reduction?

 

Did you experience side effects when reinstating Prozac in March? Any side effects now?

 

On 11/5/2021 at 9:01 PM, Turkey said:

Could I still be experiencing Prozac withdrawal despite the reinstatement  (on top of my benzo withdrawal)? 

 Withdrawal can last a long time, so it's possible you are still in withdrawal from August 2020. But it can also be limited to withdrawal from the benzos. Or a combination. It's hard to say for sure.

 

Even though we have access to drug history in the profile, we ask all members to put an overview in their signature so we can quickly see their situation. Please create one following these instructions:

How to List Drug History in Signature

 

When we have a few more details, we will be in a better position to offer support and suggestions.

 

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

 

 

[Turkey]

I went to settings and updated my signature to include drug history as you advised but it is not appearing I don't think.

[Turkey]

[Turkey]

Sorry for the hard to read text.  I lost my original post that I typed online, so I decided to write it in Word then copy and paste, and this is how it came out.  Can't figure out why the font looks like that.

[Altostrata]

Hello, @Turkey How long have you been alternating doses of Prozac?

 

What are the new symptoms you have since you started alternating doses of Prozac?

 

Please stop alternating doses of Prozac immediately. This could be causing the symptoms you're concerned about. You can take the average dose (9mg, or 62.5mg/7) at the same time daily. Prozac is available as a prescription liquid so you can take this custom dose, or you can make your own liquid, explained in Tips for tapering off fluoxetine (Prozac)

[Turkey]

I will ask for the liquid, but the liquid contains alcohol and I was afraid that might cause even more problems.  So I might have to dissolve the tablets in water.  But, as I said, I have only made one cut and that was when I started alternating doses.  I have not had any new symptoms since then.  The symptoms I am having I was having before the cut, and I attribute them all to benzo withdrawal.  So I am a little confused.

[Turkey]

The tablets dissolve completely in water, so I will start taking regular daily doses of this liquid.  Thank you.  But can you please address my original concerns also about continuing a Prozac taper during benzo recovery (I am 7-1/2 months off benzos CT).  I am not sure if you read the other parts of all my answers.  Would appreciate your experience.

[Altostrata]

What are the symptoms you attribute to benzo withdrawal?

[Turkey]

I attribute all the symptoms that I listed in my previous replies to your questions as attributable to benzo withdrawal.  Please see my reply above to your question:  "What symptoms were you having before you did the 10% Prozac withdrawal?"  I have been experiencing the exact same symptoms since I stopped benzos CT.  I have not noticed any significant worsening of symptoms since I did my first Prozac cut 5 weeks ago.  I am not sure you saw my previous answers.

 

[Altostrata]

Generally, we advise people not to taper another drug when they've got significant withdrawal symptoms from a prior drug. 

 

After you had an adverse reaction to 5mg Prozac, why did you go back on an even higher dose in March? What was the effect of Prozac that time?

[Turkey]

I was already out of my when I took the 5 mg Prozac thinking that maybe it would help be.  I didn't know what I was doing.  I thought I would try a little to see.  Then when I reinstated at 10 mg, I was again thinking maybe it would help me but maybe I should have gone back to my full 10 mg dose the first time I tried.  Remember, I was having interdose tolerance and very bad reactions to Valium and Ativan.  

[Turkey]

I meant to say I was already out of my mind…

[Altostrata]

So you did not have an adverse reaction to the higher dose of Prozac you started in March?

[Turkey]

12 hours ago, Altostrata said:

So you did not have an adverse reaction to the higher dose of Prozac you started in March?

Not that I was aware of, but I was already suffering so much from the Ativan, I am not sure if I would have known.  I have a question about making a liquid suspension of Prozac from my 10 mg tablets.  The instructions on this website say to dissolve a 10mg tablet in 10mL of water to make a solution with 1mg Prozac in 1 mg of water.  IS THIS CORRECT?  SHOULDN'T THAT READ "to make a solution with 1mg Prozac in 1 mL (not 1mg) of water"?  So, if I need to take 9 mg of Prozac I would take 9mL of water?  Could you please clarify?

[brassmonkey]

It appears to be a typo on Alto's part and really should read 1mL. But by definition it's the same thing, 1mL of water weights 1mg. With water being a very common and consistent material they used it as a base of reference when developing the metric system.

[Turkey]

Oh wow, thanks so much brassmonkey!  I actually got it from your website page "Tips for Tapering Off Prozac."  

[Altostrata]

I fixed the typo. It's 1mg in 1mL

[Turkey]

I have been dissolving the 10 mg tablet in 10 ml of water, then removing 1 ml with a dropper and discarding it, then drinking the rest (9 ml).  My question is:  if the remaining 9 ml of water with the diluted tablet is diluted with more water, does it make a difference?  I would still be getting 9 mg of Prozac, right?  Because after drinking the solution I swish the cup with a little more water to get any residue that stuck on the side.

 

Also, are other people able to view and respond to this post?  

Thanks.

[Altostrata]

4 hours ago, Turkey said:

My question is:  if the remaining 9 ml of water with the diluted tablet is diluted with more water, does it make a difference?

 

No, it doesn't make a difference.

 

Everyone can see your posts. Members can respond.

[Turkey]

Do you always eventually stabilize symptoms on a hold if you hold long enough?  I know some people just keep cutting at a predetermined schedule.  But I am in Benzo WD, 8 months off, and starting to taper 10 mg Prozac after reinstating didn't help.  I will want to hold the taper if symptoms become too bad because I am still in bad benzo wd.  Would like to hear your experiences.  Holding seems to prolong this inevitably.  I don't want to go through a benzo WD only to have to face a completely new AD withdrawal.

[manymoretodays]

Hi there Turkey and welcome aboard,

I moved your recent topic on back here to your Introduction page.  It's good to do a search, prior to starting any new topics.  I usually just type in my main browser, e.g.:  survivingantidepressants.org stabilizing after a hold.

I did find a topic we have, that you could take a look at and contribute to:

Stabilizing, what does that mean?

 

2 hours ago, Turkey said:

I will want to hold the taper if symptoms become too bad because I am still in bad benzo wd.  Would like to hear your experiences.  Holding seems to prolong this inevitably.  I don't want to go through a benzo WD only to have to face a completely new AD withdrawal.

I'm not exactly sure what your question is but I'll tell you how my story has gone.  When and while I tapered off my final medication, I still had some tolerable symptoms of WD.  I had become very aware of the patterns that occurred after a tapering drop and when by that point.  Once I recognized my own WD stability, that really helped. 

 

Here's another topic, which you will also find very helpful I think to reach some peace of mind:

Stability  from- Are We There Yet?  How Long is Withdrawal Going to Take?

2 hours ago, Turkey said:

I don't want to go through a benzo WD only to have to face a completely new AD withdrawal.

 

You may sail through your Prozac taper, who knows?  It's hard to predict.  I would recommend a taper for sure, and then pay attention, keep notes.  It may take longer after each reduction of Prozac, until you notice the WD, if you do, due to it's longer half life.

 

You may also find during any HOLD periods, or longer HOLDS, that your WD stability is improving.  And that's always nice too.

 

Hope that helps.

L, P, H, and G,

mmt

 

Edited November 17, 2021 by manymoretodays

[Turkey]

I still wonder if I understand the right way to taper.  What I was planning to do was cut my dosage by 10% and take that 10% reduced dose every day for at least 4-6 weeks before cutting again.  In other words, I cut from 10 mg Prozac daily to 9 mg Prozac daily and hold at that daily dose for at lest 4-6 weeks.  However, I just read brassmonkey say this:  "Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks."  In other words, brassmonkey cut dosage by 2.5% weekly, each week, for 4 weeks equalling 10% per month.  Which is the correct way?  I think it makes a huge difference because brassmonkey's way makes continual small cuts every week for 4 weeks, totalling 10% per month.  Whereas I make one bigger cut  all at once, 10%, then hold for 4-6 weeks.  

[manymoretodays]

Hi Turkey, @Turkey

And yes, there are a couple of different ways that one can do the 10% from each previous dose taper each month.

One would be just a straight 10% off your current dose, continue for 4-6 weeks, with the reduction, before the next taper.

 

To calculate a 10% taper, you just multiply the current dose by 0.90 to find out what, your next dose strength will be.

 

On 11/17/2021 at 4:51 PM, Turkey said:

However, I just read brassmonkey say this:  "Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks."  In other words, brassmonkey cut dosage by 2.5% weekly, each week, for 4 weeks equalling 10% per month.  Which is the correct way?  I think it makes a huge difference because brassmonkey's way makes continual small cuts every week for 4 weeks, totalling 10% per month.  Whereas I make one bigger cut  all at once, 10%, then hold for 4-6 weeks.  

 

And then there is the brassmonkey slide method of microtapering.  That's what you were reading about above ^

 

It's entirely up to you.  Both ways are correct.  You just base your taper plan on your body and mind and how you respond to tapers.  Good to keep records and notes, even for yourself, so you learn as you go, how you respond, and then plan accordingly.

 

Some will, and especially towards the end of the taper, taper by even less than 10% each month.

 

The Brassmonkey Slide Method of Micro-Tapering

Micro-taper instead of 10% or 5% decreases

 

Recording drug schedule and symptoms to track patterns and progress

 

I keep to a block calendar, to track what helps, what hinders in living a healthy psychoactive drug free life, even now.  I'm almost 5 years off!!!

And I journal regularly. 

 

To health,

L, P, H, and G,

mmt

[Turkey]

If I prolong my Prozac taper will my recovery post-jump be more difficult?  I did one 10% cut of 10 mg Prozac three months ago, then I got scared because I am in a difficult stage of benzo recovery (9 months off benzo) so I haven't made any more cuts in Prozac.  If I do long holds between Prozac cuts will it make it more difficult for me to eventually get off?  I cannot tell if my first Prozac cut has had any symptoms associated with it because I am so symptomatic from my benzo WD.

 

I was on ADs for 20 years - 5 years Paxil, abut 15 years 10 mg Prozac.  Stopped Prozac CT in 2017 but reinstated after 1 month.  Stopped again in 2020 for 7 months, then reinstated right before CT from benzos.  

[Kiasofia]

1 hour ago, Turkey said:

If I do long holds between Prozac cuts will it make it more difficult for me to eventually get off?

I would think the brain appreciates the long holds to adapt. Why do you think it would be more difficult?

 

How Psychiatric Drugs Remodel Your Brain

[Turkey]

I guess because the longer I am on it the more dependent I get?  I should never have gone back on Prozac after being off for 7 months.  Now I have been back on it for 9 more months.

[Kiasofia]

13 minutes ago, Turkey said:

I guess because the longer I am on it the more dependent I get?

This is a common concern, and understandable, but a faster taper that triggers withdrawal does more damage than a slow taper. Even if it means taking the drug longer.

[Turkey]

Even if it takes years to taper off 10 mg?

[Kiasofia]

Yes, because a fast taper that triggers withdrawal can mean years spent recovering from withdrawal. It is better for the brain to spend that time safely getting off the drug, rather than getting off fast and spending years in recovery. If it were possible to predict who would not get withdrawal and get those people to taper fast, then that would be ideal. But it's not possible to predict. 10% is the standard guideline. Some people can taper faster, and some must go slower.

[Turkey]

Thank you.  Your response makes sense now.  I went CT off Ativan after short term use, but I guess, like you say, once withdrawal is triggered we're screwed.  I was already in interdose withdrawal on Ativan, so I guess I was screwed even before my CT.  I get it now.  No wonder I am in dire straights.

 

[Turkey]

Is it possible not to feel any withdrawal effects after making a 10% Prozac cut until 3-4 months later?  I am going through benzo recovery now and I am terrified about trying to taper Prozac during this time.  

 

The reason I ask is because I am still trying to figure out what happened to me in 2020 when I CT off 10 mg Prozac on August 22, 2020.  I didn't start feeling anything until around November 2020, about 2-12 months later.  Then I got progressively worse, little by little, until January 2021, 4-1/2 months later.  Then I got lots and lots worse very quickly in January and February, which was 4-1/2 to 5-1/2 months after Prozac CT.  Was it even possible that withdrawal symptoms would have shown up like this - not until 2-1/2 months after stopping and having this delayed of a reaction? 

 

In the meantime in 2020 after Prozac CT I  started taking Valium from November - February, then Ativan in March.  I don't know if I needed Valium because I was starting to feel WD from Prozac, or if I was starting a downward spiral because of COVID and isolation.  I got worse, I feel, after I started Valium and progressively worse as I increased my Valium dose.  Then I got horribly worse when I switched to Ativan in March.  I would just like to understand how much stopping Prozac (after 20 year AD use) caused what I went though in late 2020 and early 2021.  Any advice and insight is appreciated.  Thanaks.

[Kiasofia]

1 hour ago, Turkey said:

Was it even possible that withdrawal symptoms would have shown up like this - not until 2-1/2 months after stopping and having this delayed of a reaction? 

Yes. It is very common, but usually misinterpreted as relapse.

 

Delayed onset of withdrawal symptoms

 

Withdrawal or relapse? Or something else?

 

1 hour ago, Turkey said:

Is it possible not to feel any withdrawal effects after making a 10% Prozac cut until 3-4 months later?

Withdrawal symptoms can appear later, but a slow controlled taper will hopefully mean that if these symptoms do show up, they are less severe.

 

1 hour ago, Turkey said:

I am going through benzo recovery now and I am terrified about trying to taper Prozac during this time.  

Ideally wait to taper Prozac until withdrawal from the benzo has settled down.

[Turkey]

Thank you for this information.  I have one followup question:  if I do tend to experience delayed effects from cuts, will I feel the effects of cuts longer when they start or should I expect to stabilize at some point after every cut?  I am worried that if I start to experience symptoms as I continue to cut that the symptoms will not go away before the next cut and prevent me from advancing out of fear.  What I understand is that I should wait for symptoms to subside before making further cuts.  I am just afraid that I will get slammed at some point with the cumulative effect of the cuts, especially because I react to them in this delayed way.  I am not sure if I explained this very well.

 

[ChessieCat]

5 hours ago, Turkey said:

The reason I ask is because I am still trying to figure out what happened to me in 2020 when I CT off 10 mg Prozac on August 22, 2020.  I didn't start feeling anything until around November 2020, about 2-12 months later.  Then I got progressively worse, little by little, until January 2021, 4-1/2 months later.  Then I got lots and lots worse very quickly in January and February, which was 4-1/2 to 5-1/2 months after Prozac CT.  Was it even possible that withdrawal symptoms would have shown up like this - not until 2-1/2 months after stopping and having this delayed of a reaction? 

 

After I cold turkeyed citalopram I felt great for a couple of months and then ended up bedridden for about 2.5 weeks and lost 8kgs because I couldn't eat.  It was similar to the flu but with no fever and it did not seem to be the flu.  It wasn't until I found SA many years later that I realised that it was withdrawal symptoms.  However, my experience of reducing my Pristiq by 50% was almost immediate withdrawal symptoms.

 

And yes the withdrawal was diagnosed as relapse by my counsellor who told me, in 2012 or 2013, that I would need to take an antidepressant for life like a diabetic needs insulin and was given Pristiq.  The chemical imbalance was a theory which was debunked many decades ago.

 

After a 6 year taper I successfully got off the Pristiq mid November 2021 so about 6 weeks ago.

[Turkey]

Thanks for the reply, ChessieCat.  How are you feeling now that you are off Pristiq?  Did you feel bad throughout your taper?  I am so afraid of the delayed reaction.