Shmalan: serotonin sensitivity vs SSRI withdrawal

[Shmalan]

Hi, I have been reading the forum for a few days now about tapering off SSRI. Have been on AD since 1989. Around 2017 began to taper from 40mg Fluoxetine to 10mg every other day in 2019. Stayed there until October 2021 when I started to get brain zaps after illness. Started taking roughly 5mg on off day so that I am up to 10mg and 5 mg on alternate days. However, soon after the increase. I began to experience withdrawal type symptoms like insomnia, shakiness mood swings. This surprised me since the dose was increased which makes me wonder if I am experiencing a new sensitivity to SSRI or serotonin or if my metabolism had changed and now the drug does less than it used to in which case I would be having withdrawal due to lower S levels from metabolism change. This makes it difficult to know whether to continue taper down or to increase dose to reach a stable level I previously had. Thanks 

[Shmalan]

After reading more on this site (great resource) I have learned that with sensitive or sensitized CNS down OR going up on a AD can lead to problems/symptoms. Once in some turmoil the idea is to reach a steady state and stay there for a while before tapering ( as I understand).

 

With that in mind I will add a little more detail and the risk of some repitition. I was at a somewhat steady state of 10mg fluoxetine one day and 0 mg the next day. Was doing ok except thought maybe I had a relapse of depression. This brings me to October 12 2021 during illness got brain zaps on a 0mg day, so I took approximately 3mg guesstimate dose which seemed to do ok. Next day back to 10mg.  Between October 12 and December 28 was very inconsistent dosing of (usually) 10mg day 1 and 3 to 5 mg day 2 depending on whim and symptoms. At thus time I had some “withdrawal type symptoms” including restlessness and off and on sleep maintenance problems. I know now that changing dosage every day is a mistake but at the time was just trying to find an ideal position and didn’t know if I was withdrawing or if I had developed a sensitivity to increased dosage.

 

december 28 I decided to stick with 10 mg day 1 and 5mg day 2 alternating which I have done. Still have withdrawal/sensitivity windows on this dose. Furthermore, if I told these symptoms to a Doc it would probably be considered a relapse with a order to increase dosage to “ therapeutic levels” . I am hoping not to do this and after reading in this site that going back to some original dose ( from month or years ago) will not bring you back to that place (“you can’t go home again” as that dying goes). Right now I don’t no if I should go back to 10mg/0mg alternating, stay where I am at 10mg/5mg alternating or begin taper down.

 

Additional twist: around Nov-8 my PCP prescribed Zolpidem 10mg per night for insomnia and Ativan 0.5mg as needed. I have taken the Zolpidem a few times (with unsatisfactory results) and Ativan 3 times over a month and decided to stop both about 3 weeks ago before I became habituated.

 

thanks. I appreciate this site and any suggestions.

 

[Shmalan]

I decided to go ahead with the next comment based on typical questions I see asked regarding time of day taking meds, symptoms. Hopefully I am not jumping the gun.

January 16, 2022

215 AM wake from vivid dream.

215-500 lay in bed possibly dozed a couple times. Early morning shakiness and slight anxiety (typical every morning)

5:00: 3 cups coffee (1/2 caffeine) shakiness increased, some anxiety. (Typical every morning coffee increased stimulation to un pleasant levels)

6:30 shower 

7:00 AM breakfast 3 eggs  and one toast (Appetite not great). Give cat insulin shot and food

7-10 AM slow decrease in anxiety and shakiness

10 AM pre lunch 1/2 sandwich- cheese , pastrami and turkey ham (Appetite OK)

10:20 AM 10mg fluoxetine 

10:20-1PM more improvement of symptoms 

1PM lunch proper: remaining half of sandwich and bowl of soup ( appetite fairly good)

1:20 PM 20mg Atorvastatin, Vit D3, Vit C

1:20-4PM continued improvement of symptoms (anxiety) really no shakiness or weakness at this point

4:45 PM small surge of anxiety + warm flash

4:45 - 6PM resolution of symptoms

6:30 PM dinner Salmon and potatoes (very good appetite) Give cat insulin shot and food

7-8 PM watch TV stupid sitcom that I find comforting 

8PM to 8:30 PM relaxed doze off in chair watching more stupid sitcoms

8:30PM -9:30PM doze off and on

9:30 get ready for bed. More food for cat

10Pm bed

10:20 PM sleep

 

The above is fairly typical mood and symptoms worst 1st thing in morning made worse by caffeine

I feel “serotoniny” and would like to plan a med reduction unless this is already withdrawal and I need to stabilize.

[Kiasofia]

Welcome @Shmalan

Thank you for creating a drug signature. It is likely that what you have experienced since adding in an extra 5mg Fluoxetine is a reaction to increased drug amount for a brain that had adjusted to taking a lower dose. Alternating doses can also be a causing problems. It is very important to take the same dose every day:

NEVER SKIP DOSES TO TAPER

How Psychiatric Drugs Remodel Your Brain 

 

Since your current dose may be to high, I suggest a slight reduction. So rather than 7.5mg daily, you can consider 7mg daily from now on. Monitor symptoms for at least four weeks and then plan a taper from there.

Tips for tapering off fluoxetine (Prozac)

 

Did you ever have a long stretch of time where you weren't on an antidepressant? Or was quitting one always followed by starting another?

 

I suggest weaning yourself off caffeine if possible. Vitamin D is also known to be activating.

Important topics about tests, supplements, treatments, diet

 

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

Please stay in touch and let us know how you are doing.

Edited January 17, 2022 by Kiasofia

[Shmalan]

Thanks Kiasofia

 I think that is a good suggestions. I suspected alternate doses were not good but liked having one day I could take 10mg pill on one day without dividing or measuring. Will try 7mg/day and stay for a while before successful taper. I will read through the links you provide.

 

Yes, I had a stretch from roughly 1992-1995 where I was not on the meds and doing well for a while.  But since then have been mostly on, trying different Meds SSRI/SNRI and combination until I settled back with Fluoxetine as the best option. I have a lot of the dates and sequence of meds over 3 different states and 7 or 8 different prescribers. 

I think it is a new sensitivity to caffeine unfortunately. ☹️ Maybe a slow switch to decaf, so I can still have the ritual of coffee. 
 

Thanks  for your response. Appreciate the time you all put in to help others.

[Kiasofia]

It is very common to react badly to caffeine while tapering. We become sensitive to a lot of things. I've had to give it up completely, as it triggers anxiety for me. I'm reacting to sugar too, which I never noticed before. Good to hear you will start taking the same dose each day. 

 

Please stay in touch and let us know how you are doing.

[Shmalan]

 Late December through early January have been fairly good. Sometimes a challenge with sleep. I gave a script for Zolpidem which I have not used since Dec 30th and one for lorazepam which I have not used since mid December. I have used both infrequently since prescription in November. This week have  used both once for sleep. Probably a mistake since one or twice a month use of these meds upset the equilibrium I am trying to establish and confuse the nervous system. 
 

January 17

436 AM Wake

500 AM out of bed 3 cups of coffee

6:30 breakfast

10:30 to 11:00 snack then 5mg Fluoxetine 

good day thru afternoon at home for MLK holiday, housework and reading

Around 645PM unpleasant dinner (dry and overcooked) annoyed by TV shows waves of negative energy

10:30PM bed not sleepy

1AM 5mg Zolpidem and sleep within a few minutes Note have not taken this med since Dec 30 limited effectivity but 10mg dose too high. PCP has told me to take every night for “chronic insomnia” I have only used a few times since prescribed in November

January 18

3:45 AM wake

4:30 out of bed 2 1/2 cups coffee

6:30 Breakfast

feeling slight brain fog and slightly 

10:15 some food and 7mg Fluoxetine

(started dose of 7mg/day instead of 10mg day 1 and 5mg day 2 alternating

1230 lunch 40mg Atorvastatin 

Afternoon Less brain fog

Evening: Not relaxed anxiety

10:30 PM sit in dark to unwind

1100PM wide awake but feeling good and energetic, however no sleep in sight.

11:30take 1/2 Lorazapam pill (0.25mg) last time I took Lorazepam was mid December however this dose was probably a mistake. 
Sleep 12 or AM or after

January 19

345 wake

5:00 out of bed 2 1/2 cups coffee

6:30 Breakfast

feeling dopey and slightly agitated

7:15 to work

10:15 some food and 7mg Fluoxetine

1230 lunch 40mg Atorvastatin 

Mood improvement

2:30 break from working and 1/2 bowl of soup

Afternoon increasing uneasiness (revved up)

5:46 home from work

6:45 dinner appetite great

Evening: Doing well relaxed

10PM bed no meds

1020 sleep

January 20:

Wake 430 2 cups coffee

5:45 Shower

6:30 Breakfast

715 to work feeling good

10:15 some food and 7mg Fluoxetine

1230 lunch 40mg Atorvastatin and VitC

Afternoon increasing uneasiness, revved ip feeling anxiety continuing through evening

1 PM 1/2 cup coffee to warm up (!)

6:00 home from work

6:45 dinner appetite ok

Evening not sleepy increasing worry about sleep. Tormenting self about upcoming night of sleep or lack og

10PM bed no meds

1020 sleep

Unpleasant dream

January 21:

12:35 am wake

12:35-2:00 AM doze for maybe 30 minutes 

4:45 AM out of bed

 

[Kiasofia]

Good to see you are taking the same dose each day. It may take a few weeks to stabilize and to assess if the dose is causing side effects. I would continue avoiding zolpidem and lorazepam. Using them also makes it harder to assess the effects of Prozac.

 

Vitamin D3 (cholecalciferol or calcitriol)

Quote

NOTE: Vitamin D is a daytime vitamin. Even if you take it in the morning, it can keep you awake at night. Be sure to start low and don't take too much.

 

Tips to help sleep -- so many of us have that awful withdrawal insomnia

 

Melatonin for sleep: Many people find it helpful

 

Quote

In summary, if you take too high a dose -- we suggest 0.25mg or 0.33mg to start -- you may get headache, dizziness, nausea, drowsiness, or it may not help you sleep.

 

[Shmalan]

Kiasofia,

I hope you are doing well.

Thanks for reading, and I appreciate the links on melatonin, D3 and sleep. I agree on the meds.  I had a good night last night with no Meds. Having a 1/2 caff coffee now and watching the sunrise.

Takk for hjelpen! I appreciate all the assistance provided by the mods on this site. I hope you have a good day.

 

 

[Kiasofia]

8 minutes ago, Shmalan said:

Takk for hjelpen!

Værsågod🙂 (You're welcome) Wishing you a good day too!

[Shmalan]

summary
Update. sorry maybe it is not exciting. I can’t wait to quit the SSRI but still maintaining at 7mg. Have not taken any sleep med and had 2 good nights of sleep then one not so good. Need to take up activity or volunteer. Thinking about “symptoms” all day is not beneficial. Re-starting counseling on Tuesday with former counselor. Maybe grief and coping with recent loss/deaths in the last few years. Or at least a way to be proactive with mental health

 
Friday January 21:

12:35 am wake

12:35-2:00 AM doze for maybe 30 minutes 

4:45 AM out of bed 2 1/2 cups of coffee

~6am breakfast

~7am off to work Don’t want to go. Feeling very fatigued and uninterested. A good day drink herbal tea and stare out the window

10:15 Food (1/2 sandwich) 7mg fluoxetine

12:30 lunch (earlier than I prefer) 40mg Atorvastatin 

Afternoon: restless and agitated

2:30 leave work for home (Fridays are short days) 3:15 home

315-6:00 less restless

6:30 dinner good appetite

~8 very relaxed and tired fall asleep in chair. Nap off and on till 1030

-1045 to bed asleep in a couple of minutes 

 

Sat January 22

5:30 wake

6am 2 1/2 cups of coffee

7:30 breakfast

Doing well, no unpleasant symptoms

10:30Food 7mg fluoxetine

Late am early pm. Sending messages to friends reading having a great time

1:30lunch40mg Atorvastatin

2:30 grocery store

3:30 -430 pm a couple of waves of anxiety. Seems typical for afternoon 

4:30-5:00 cleaning car 

6:45  pm dinner appetite pretty good

8:45 fall asleep in chair (boring guy)

~8:45 Nap off and on till 10:40

-1045 to bed minor wave of sleep anxiety comes and goes

~11pm to sleep

 

SunJanuary 23

5:00 wake in middle of vivid dream

Unpleasant way to wake up. Some anxiety 

5:30 2 1/2 cups of coffee (will reduce to 2 cups tomorrow)

7:00 breakfast

Restless: trying to plan day

9:15 30 minute walk in the park

10:10am food and 7mg fluoxetine

10:30-11:30 driving around to avoid going home (and chores). Drank gatorade sports drink (sugary)

11:45 home still restless and anxious I have energy to do house and yard work but no motivation 

12:45 lunch 40mg Atorvastatin, Vit C

1:45 happy birthday from sister in-law and brother. I realize I forgot one of my niece’s birthday earlier in month, sadness over that. The nieces and nephew are growing up fast! I don’t want to loose the relationships

2:00-3:30 a little shaky and restless/agitated. Doing housework and bills 

4:30 break from housework

6:45 Dinner salmon potatoes

8:00-10:00 on and off waves unpleasant energy (adrenaline?) strong heartbeat 

10:00-30 sit in dark breathing

10:30 to bed fall asleep quickly 

10:30pm- 3:10 AM light sleep with dreams wake 2 times 

 

Mon Jan 24

3:10 wake

3:10 -4:45 possibly dozed off for some minutes

4:45 up start coffee

[Shmalan]

Summary:

generally mood and symptoms are worse at work than at home (stressful job) have had many good days at home. Anxiety and restlessness seem to increase in afternoon a few hours after med then get better in the evening (at home)
Monday Jan 24

3:10 wake

3:10-4:45 possible sleep for a few minutes

anxious and restless at work

breakfast ok appetite

1015 am food and 7mg fluoxetine

lunch not too hungry

afternoon increasing  restlessness some anxiety

6:00 at home improvements in restlessness and anxiety

6:45 dinner good appetite

10:30 pm to bed 10:45 sleep (est)

one wake up for barthoom

4:10 am wake

 Tues Jan 25

4:10 wake-

2 1/2 cups coffee (forgot to limit to 2 cups)

kind of weak and shaken

to work

restless and anxious

10am food and 7mg fluoxetine 

11 am to therapist given “assignment”

Afternoon at work restless, nervous anxiety 

6pm home symptoms improve 6:40 dinner very good appetite

10:00 to bed no sleep

11:30 sit in chair no sleep

12:45 am ~3.3mg of Zolpidem ( approx 1/3 of 10mg pill)

(May have to throw these Zolp pills away or give to trusted friend for safe keeping otherwise will want to take  a small dose on

bad nights or argue with myself about taking some gonna buy melatonin and try small dose)

pills

1am sleep

4:15 wake

[Shmalan]

One trouble with SSRI seems to be some side effects and withdrawal symptoms ( eg anxiety and sleep issues) are the same or similar. Then some propose (psychs drs etc) etc propose the 3rd theory of relapse of depression. I prefer to (eventually) get off the meds and deal with depression with CBT and talk therapy.

[Frogie]

@Shmalan

 

You will get off your medications. You have a the right mentality and you will succeed. 

[Shmalan]

@Frogie Thanks! I am looking forward to making more progress (which is hard to notice in rough days. Appreciate all the help you mods provide.

[Shmalan]

Question for the veteran recovering “sleep challenged” (or anyone else) regarding sleep meds like Zolpidem (or benzo) used as needed (Once a week or once every 2-3 weeks.  With respect to sensitized nervous systems is it recommended to not use at all and risk a sleepless night to maintain consistent medication rather than occasional/sporadic weekly/bi- tri weekly use. Note my pcp has prescribed for every night. I am going to try melatonin but this didn’t work in the last (probably too high a dose). I am thinking about disposing of  mine to avoid arguments with self about when/if to take. I also don’t want to take nightly as prescribed so I can avoid having another med to taper. Thanks

[Shmalan]

WedJanuary 26

4:15 wake

5:00 coffee ~ 2 cups

6:30 breakfast

7:00 to work

Restlessness agitation with some anxiety

10:30 food and 7mg fluoxetine

1pm lunch 40mg Atorvastatin

Afternoon restless agitation continues

(similar to am)

5:30 head home

slight improvement in restlessness type feelings

7:00 dinner appetite good

after dinner no television which is annoying

evening relax in chair breathing exercises getting more relaxed

10:15 PM approximate 0.33mg melatonin 

10:30 PM to sleep (is melatonin the “wonder drug”

 

Thurs January 27

4:10wake

(>6 hours sleep 😴 $

5:00 coffee ~ 2 cups

6:45breakfast

7:30to work

Good day Optimistic less stressed at work

10:15 food and 7mg fluoxetine

12:45 lunch 40mg Atorvastatin

Afternoon increase in anxiety - already worried about night and sleep

5:15 to home

7:15 dinner 

8:00 wave of restlessness/adrenaline 

10:15 PM approximate 0.33mg melatonin 

WedJanuary 26

4:15 wake

5:00 coffee ~ 2 cups

6:30 breakfast

7:00 to work

Restlessness agitation with some anxiety

10:30 food and 7mg fluoxetine

1pm lunch 40mg Atorvastatin

Afternoon restless agitation continues

(similar to am)

5:30 head home

slight improvement in restlessness type feelings

7:00 dinner 

after dinner no television which is annoying

evening relax in chair breathing exercises getting more relaxed

10:15 PM approximate .33mg melatonin 

10:30 PM in bed

Approx 11:30 light sleep

Friday Jan 28
Approx 12:45 wake up for a glass of water

1:30 Am back to bed

Approx 2:30 light sleep

4:05 wake

5:10 out of bed

Poor night of sleep maybe increase melatonin (have 1mg pills). @Kiasofia have you tried melatonin? I am avoiding too much at first as per melatonin discussion on this sight.

[Kiasofia]

I haven't taken it for a few years. Not sure if it helped me or not, but was taking a higher dose than what is recommended here.

[Shmalan]

Thanks. I suppose it varies considerably between people. It’s worth a try at small dosage if it improves sleep.

[Shmalan]

Please  disregard the 2nd Wednesday entered in the previous symptom journal entry. Was a copy-paste that wasn’t updated.

 

general: Seem to be alternating between nights of decent sleep and not so good sleep. Also restlessness and anxiety symptoms often tend to me more noticeable right after waking and in the afternoon a few hours after fluoxetine dosing  (?)
 

Friday Jan 28

12:45 wake

2:30 sleep

4:05 wake

5:10 out of bed

very tired uninterested in work some nervousness and restlessness.some improvement by 10am

10:30 food and 7mg fluoxetine

12:30 lunch 40mg Atorvastatin 

Afternoon restlessness and agitation increase

6P improvement of symptoms

7PM dinner appetite ok uninteresting microwave dinner

9:30asleep in chair

10 Pm wake

10:15 to bed and sleep (no melatonin)
 

Sat Jan 29

5:45 wake (7+ hours of sleep)

morning a little groggy and light headed

7:30 breakfast

AM doing well 

10:10 food and 7mg fluoxetine

Afternoon some increase in restlessness and anxiety 

3:00 walk in the park 

6:30 dinner

evening decrease in restlessness and anxiety

10:30 to bed ~ 0.3g melatonin 

11:15 no sleep, awake rumination. Had a snack

 Sunday Jan 30
~12:15 sleep

2:20 am wake

2:30 -5:00 am occasional light half sleep

5:00 am wake

 

 

 

[Shmalan]

Have not finished log for last couple days. Still doing 7mg/day. Still trying to figure out side effects vs withdrawal. I know not to skip doses but keep wondering what would happen if I skipped one dose (better sleep reduced restlessness) as an experiment. However, I have read here it is a bad idea (probably even for long half life) still having trouble with patience and look forward to quitting this toxin. 

[Kiasofia]

Hi @Shmalan

If it's side effects they should be appearing at about the same time each day. I see some tendency for that. What is your impression? Skipping a dose is like throwing your brain off a cliff. Less severe with fluoxetines long half life, but still a big "no". If you are going to experiment it is better to reduce the dose consistently than skipping. You could try experimenting with a 10% reduction and see how you do with that.

[Shmalan]

Hi @Kiasofia . I agree about skipping a dose. My impression is that side effects tend to peak in late afternoon a few hours after dosing then , (generally) get somewhat better. Early mornings can be tough also ( similar to others here). I think I may consider 10% reduction experiment in the near future then but  (not today).  I am not sure how long it would take to notice any difference in time to reinstate (now I am nervous about reducing after all my tough talk about skipping one dose 😁) Thanks 

 

[Kiasofia]

It usually takes at least 4 days for symptoms to show and with fluoxetine often longer. Two weeks is often the case, but can take longer too. That is why holding for 4 weeks is advised. An updose should happen ideally within a month of reducing. I understand being nervous. Wait til your ready and you can also reduce by less than 10%.

[Shmalan]

Wednesday Feb 2, reduced to 6.5mg fluoxetine/day. This reduction is <10% from the 7mg I was recently on but >10 of the 7.5mg average I was taking the prior month.

 
Wed. - Fri (Feb 2-5) seems to be slight reduction in afternoon (4-8 hours post dose) side effects of restlessness/nervousness (the Prozac “revved up effect”) effect on sleep too early to say but seems better 2 nights out of 3.

 
WD also too early but noticed Friday possible more light headed effects.

 

To avoid unnecessary trouble. I am considering a two more conservative options in addition to 6.5mg

1) 6.8 mg per day (very small decrease from the 7mg/day and ~10% reduction from the 7.5mg dose of the prior month. Stay at this for 4-6 weeks and/or until more stabilized.

2)Stick with the 7mg dosage I was on for additional 2-3, weeks or longer.

 

Pros: Avoids the common problems that occur with too rapid reduction.

 

cons: longer time on drug (with associated side effect and intolerance)

 

 

[Shmalan]

Hi @Kiasofia. I hope you are still doing well. As mentioned last week I decided on a less than 10% reduction to 6.8mg (from 7mg) had planned on staying at this dose but am now debating on reducing each week down to 6.3mg in 3-4 weeks. Tagged in case you have any comments (or not) thanks 
 

Sat Feb 5,

Wake 5:00 (6 hours sleep)

2 cups 1/2 caff coffee 

ok, some nervousness usual early am spike (probably should reduce caffeine more)

10:00 Food 6.8 mg fluoxetine

1Pm Lunch

Early afternoon increased restlessness

1:45 40mg Atorvastatin 

2:30 -3:30 shoveling snow in driveway

3:30 back inside 

5:30 tv decrease in restlessness and anxiety 

6:30 dinner good appetite

7:00-8:00 pm read book almost no restlessness or anxiety

8:00-9:00 asleep in chair

945 pm bed

 

Sunday February 

6:30 wake 

some coffee 

8:00 breakfast

good morning 

10:20 food and 6.8 mg Flouxetine

1:30pm lunch 40mg Atorvastatin 

Afternoon some anxiety and restlessness 

2:30- 330 grocery shopping

6:15 dinner , still have the slight inner agitation/restlessness. Appetite not bad

9:45 to bed sleep ~ 10:15 sleep

 

Monday Feb 7

4:50 Am wake

6:30 little coffee and breakfast

morning spike in anxiety

 

[Kiasofia]

Hi @Shmalan

Just make sure the total reduction is less than 10% for a month. If you do smaller and more frequent cuts it's important to hold as well.

 

Micro-taper instead of 10% or 5% decreases
Decreasing your dosage by very tiny amounts more often might be more tolerable than 5% or 10% decreases. Know your symptom pattern first so you can estimate how often you can reduce.

 

The Brassmonkey Slide Method of Micro-tapering

One way you can micro-taper.

[Shmalan]

Thanks Kiasofia!

[Shmalan]

RSummary: Since reduction to 6.8mg fluoxetine there seems to be improvement in sleep (most but not all nights), however given the long half life and time to reach steady state it is hard to tell if the reduction to 6.8 over a week ago is the reason or the reduction and equalization to 7mg/day (from 10mg and 5mg on alternate days) is the reason, or possibly unrelated to dosage. Another consideration is the increase or potential increase in side effects (vague mental effects at this point but unknown if med related). For that reason I think I better stay at the current dose for a while or consider going back to 7mg if required.

Mon Feb 7 (off of work personal holiday)

4:50 Am wake

6:30am coffee and breakfast

AM spike in anxiety

10:10 Am food and 6.8mg fluoxetine 

late morning minor brain zap

 12:30 lunch 40mg Atorvastatin 
afternoon some restlessness a little better by eve

6:30 dinner appetite ok

10:30 pm bed

 

Tues (off of work personal holiday)

5:30 wake coffee ( 2 cups)

7:30 breakfast

AM anxiety some shakiness 

10:15 food and 6.8mg Fluoxetine 

1pm lunch 40mg Atorvastatin 

Afternoon increase in restlessness and agitation (less anxiety)

6:30 dinner restlessness and agitation much better great appetite

10:30 late night snack

1130 sleep

 
Wed Feb 9 (Back to work)

5:30 wake coffee (2 cups)

7:00 Breakfast

AM symptoms anxiety, restlessness agitation (back to work)

10:00 Food and 6.8mg fluoxetine 

12:30 lunch 40mg Atorvastatin 

Afternoon increase in anxiety , restlessness hot flushed skin

6:45 dinner still restless less anxiety trouble relaxing

10:15 to light sleep 

 
Thurs Feb 10

3:30 wake from unable to relax

500 coffee ( 2 cups)

6 am breakfast

AM restlessness anxiety 

10:00 food 6.8 mg Fluoxetine 

12:30 meeting with sleep study specialist then lunch 40mg Atorvastatin 

Afternoon some anxiety and restlessness hot flushed skin (better by 4pm)

6:45 dinner

10:15 to bed and sleep

 

 

[Kiasofia]

It's best to avoid changing the dose up and down, so ideally hold where you are.

 

Keep it simple, slow and stable

[Shmalan]

Thanks. I always appreciate the suggestions.

[Shmalan]

Hi @Kiasofia . I hope you are well. I think you are correct and I will

stay at 6:8 mg for a while since frequent dose changes (whether up or down) can cause problems and it is hard to tell if the latest reduction is helping in short period. The strange thing is that symptoms can go away for a day then come back. I would expect windows and waves would be longer. I am hoping after a couple of weeks (at least a month total for 10% reduction) I can continue to the reduction and my reaction or sensitivity to the medication will improve at least by the time I get closer around 5mg per day (which is what I was one, average for a long time) and that the actual side effects will not be too bad. I appreciate the comments; the unbiased suggestion help otherwise I could change my mind every day.

Friday Feb 11

4:45 wake

coffee

7:00 breakfast

AM doing well symptom wise

10:00 am food and 6.8mg fluoxetine 

12:30 lunch 40mg Atorvastatin 

afternoon doing well (very little restlessness and agitation for some reason, not complaining)

later afternoon some sadness and loneliness

6:45 dinner appetite very good

evening read book feeling fairly peaceful only temporary  manageable waves of anxiety 

10:30 to bed and sleep

 

Saturday Feb12

2:00 Am wake

2:30 (approx) back to sleep

5:05  (still at 2 cups 1/2 caff)

restlessness and some agitation 

6:30 coffee and breakfast

continued restlessness ran some errands

9:50 Food and 6.8mg Fluoxetine

12:30 lunch and 40mg Atorvastatin 

Afternoon restlessness slightly better (? Usually peaks afternoon)

6:15 dinner appetite pretty good ate too much

10 PM to bed with at home sleep study equipment 

10-2:30 Sunday dose off and on. Difficult to sleep with attached equipment

 

Sunday Feb 13

3:00 AM take equipment off but still annoyed

3:00-5:00 Am lay in bed (maybe dozed for 10 mins)

5:30 coffee 

7:30 breakfast

 

[Shmalan]

Update: Have had a good week and a half until worse day yesterday. Have been on 6.8mg per day fluoxetine for about 3 1/2 weeks. Side effects are still highest about 4-6 hours post dose. Last week or so side effects have not been bad, usually temporary and pass. Also not many side effects. Yesterday was not as good. I did take an Ibuprofen for minor muscle ache which may have contributed (sensitivity). May have to avoid. Still a little shaken and agitated this am after a less than optimal sleep. Should return to the progress I was experiencing last week and hopefully I can taper after another week or two or three…

[Shmalan]

Correction, I meant “… also not many side effects” I think (not 100%) that I get side effects due to sensitivity to the med, so than WD,after I messed with the dose

[Shmalan]

It’s hard to tell side effects from the med vs withdraw especially when things change daily sometimes. This makes it difficult to determine when and how much dosage to reduce, stay at the same dose, or in some cases increase. I suppose the safest is to remain at the current dose longer since the window/wave pattern seems to be fairly typical throughout the process and does not necessarily indicate a change is required.

[Moment19]

@Shmalan Greeting mate! I am currently almost 8 months of not taking Fluoxetine. When I originally started tapering I got brain zaps pretty and went back to taking 10mg every other day for a month or so. Then I was able to stop taking it. However the withdrawal symptoms really started settling in about 2-4 months after stopping. I had really bad insomnia, headaches, and blurry vision. 

 

I am doing quite a bit better now, but the last 10 months have been extremely difficult. I only take magnesium in the evenings to help with sleep. I got blood work done and found that my iodine and T levels were low. So I am taking some supplements to help with those. I took trazadone for a while to help with sleep. It worked and would knock me out but my head would feel unrested when I would wake up, so I worked on cutting that out as well. 

 

It is so difficult to know how to taper all the way off. Even if you were to get the tablet form of fluoxetine and microdose until you were ready to drop it all together I have noticed that there will be a period of time that will be difficult. I have found it most useful to understand that you will go through some withdrawal, and to support yourself the best you can. Cutting out the ruminating and anxiety around being in the thick of withdrawal has been key to helping my brain recover. 

 

I anticipate I still have another 6-12 months of lingering withdrawal to work through, but building better mental health and fitness has been key to being able to work through the withdrawal as well as become stronger that I am handling the experiences that I took Fluoxetine in the first place to help with. 

 

I hope some of that helps mate. Let me know if you have any questions on what my journey of recovery has looked like so far and if that could be useful for yours!