ClueyGirly: about to start trying to taper off fluoxetine

[ClueyGirly]

Hi, I’ve been on fluoxetine for about two years but the longer I take it, the less it seems to be working. In fact it feels like the depression is worsening. I only found out a couple of months ago that it’s actually Prozac which I refused to take about 20 years ago because of the potential side effects (including suicidal thoughts, what’s THAT all about?!). I’ve decided that I want to taper off it with the view to maybe feeling better (the pills aren’t helping so what’s the point?).

 

I have researched the possible side effects of coming off it, so know that cold turkey is definitely not the way to go, so I want to start reducing the dose and taking my time with it. 
 

the reason I’m here is because not many of my friends know I’m taking anti-depressants and so to ask for support while coming off them would be a bit of a shock to them. My family know, but many of them are so far away it’s unfeasible to get support there. As for my partner, having told him very recently  how I’m feeling, his response was a one line conversation ended. So, that’s what I’m hoping to find here, people who are potentially going through the same thing, know what I’m on about and hopefully can help. Me understand what’s going on with me. Maybe.

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  I'm very glad you came to us before you started your taper.  If you do it as suggested here, it should minimize or eliminate any major withdrawal effects. 

 

Can you please give us specific information about your drug history for all drugs you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise vertical list (no symptoms), only drug names, specific dates (as best you can say for example early March if you don't recall the day) and dosages of each medication decrease or increase.  Use this format:

 

Drug name: date, dose, date, dose, date, dose…

Drug name: date, dose, date, dose, date, dose…

Etcetera

 

Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Drug History in Signature

 

Here is some information about how these drugs actually work.   This explains why it's so important to taper slowly and carefully, and be very cautious about changing our doses: 

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is.  We hope to avoid/minimize this with a slow and careful taper. 

 

Video on Recovery from Psych Drugs

 

What is Happening in Your Brain

 

Windows and Waves Pattern of Stabilization

 

 

Tapering is best done extremely slowly, and we generally taper by 10% of the current dose no more than once every 4 weeks, so that the taper becomes exponentially smaller.

 

 Why Taper by 10% of my Dosage  

 

Tips for Tapering Fluoxetine/Prozac

 

 

Also, as we are recovering, we suggest keeping things slow, simple, and stable. 

 

Keep it Simple, Slow, and Stable

 

Here is a link with checklists of common WD symptoms.  Hopefully you won't have these with a proper taper.  

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

 

Here are some techniques to cope with symptoms, just in case some should develop: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

 

Omega 3 Fish Oil

 

Here is a link that explains about tachyphylaxis, which means the drug is no longer working (poop-out).  

 

Tachyphylaxis, or Poop-Out

 

I've given you quite a bit of information here.  Please read through it, and feel free to ask any questions.  Good luck, and let us know how it goes.  

Edited December 17, 2021 by getofflex

[ClueyGirly]

Hi,

 

Thanks for the welcome and all the thread links.. I’ve gone through them and found some really helpful info.

I do have a question - before I decided to taper off Prozac I was taking 40mg (2x20mg capsules) a day. I was going to drop that to 30mg daily by taking 1x20mg one day, then 2x 20mg capsules the next and keep alternating like that. But, the last few days have been such a rollercoaster  and I didn’t manage to take 2x20mg twice, so effectively all I’ve had is. 40mg over 4 days instead of what should have been 120mg.  I’m a bit concerned that if I get back on track with my original plan I might screw up by system more than it already is. Also, I know it has the longest half life so I know I won’t feel any withdrawals yet which is obviously good, but I wanted to get some advice. Do you think I’ll be buggering everything up if I DO go back to the 20mg, 40mg, 20mg etc?

I hope that makes sense!

[ChessieCat]

Hello ClueyGirly

 

Alternating doses is NOT recommended even with a long half life drug like Prozac.  The brain likes consistency.  Post #1 of the Tips for Tapering Prozac (link provided above) gives information about how to get non standard doses.

 

I think you could try taking 30mg every day.  Then after you stabilise, follow SA's tapering protocol.

 

@getofflex What do you think?

[ClueyGirly]

The problem I have is that I only have capsules so dividing one into a half dose although isn’t impossible, is difficult as I don’t have any empty capsules. Do you reckon I should stick to 40mg daily until I can get some empty capsules to make half doses?

[ChessieCat]

18 minutes ago, ChessieCat said:

 

Post #1 of the Tips for Tapering Prozac (link provided above) gives information about how to get non standard doses.

 

 

Did you read the above post?

 

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

 

Making your own fluoxetine liquid
Fluoxetine is one of the few psychiatric medications with a long history of do-it-yourself dilution in water or juice. Mixed in cranberry juice, it's been called "Cranzac."

My own personal preference would be to dilute it with water, to avoid any degradation that might be caused by sugar or acid in the juice. Also, it will be easier to see how well the fluoxetine is dissolved in water. (There may be particles swirling around, that's the filler in the capsule that doesn't dissolve.)

Your fluoxetine liquid may be a little bitter -- just swallow it quickly. You might want to chase it with a little fruit juice.

...

For very gradual tapering, for example, you can dissolve a 10mg capsule or orally dispersible tablet in 10mL of water to make a solution with 1mg Prozac in 1mL of water. To take 1mg Prozac, use an oral syringe to take out 1mL.

Refrigerated, it's supposed to be stable for 14 days. From a pharmaceutical technician manual

 

[ClueyGirly]

I did! Then totally forgot about making a liquid from capsules, thank you very much for the reminder! 😙

[getofflex]

14 hours ago, ChessieCat said:

Alternating doses is NOT recommended even with a long half life drug like Prozac.  The brain likes consistency.  Post #1 of the Tips for Tapering Prozac (link provided above) gives information about how to get non standard doses.

 

I think you could try taking 30mg every day.  Then after you stabilise, follow SA's tapering protocol.

 

@getofflex What do you think?

I agree that alternating doses is not a good idea.  However, dropping from 40 mg to 30 mg is a 25% reduction, and this could cause withdrawal symptoms.  I would suggest instead reducing to 36 mg, which is a 10% reduction.  Then, I would stick with that dose for a while, a bare minimum of a month, but preferably longer, to allow the nervous system to get used to that dose and stabilize.  

[ChessieCat]

6 minutes ago, getofflex said:

I would suggest instead reducing to 36 mg, which is a 10% reduction.

 

I was tossing up between 30mg and 36mg.

[getofflex]

1 minute ago, ChessieCat said:

I was tossing up between 30mg and 36mg.

Gotcha.  I tend to err on the side of caution.