Ruth29 Posted April 8, 2022 Share Posted April 8, 2022 Hi everyone- not sure if this is the correct way to do it but I wanted to introduce myself. I've been relying on stories and advice here as I taper (with help from my doctor) desvenlafaxine, and now feel ready to engage in this community myself. I've also been experiencing quite a lot of ups and downs emotionally (windows and waves?) and am wondering if I've gone off my meds too quickly. Currently looking at options for reinstating low does venlafaxine or fluoxetine (see below for tapering- I used the fluoxetine method for weaning). Feeling hopeful that having a space away from my doc, with people who actually get it, will help! Ruth tapering schedule: Jan 26: reduced the pristiq dose to 25mg Feb 2: after 1 week on pristiq 25mg, started fluoxetine 10mg and continued pristiq Feb 9: after 1 week on step 2, stopped pristiq, and continued fluoxetine for an additional 3 weeks March 3: Last day on fluoxetine April 8th: 5 weeks off all meds, 8 weeks off pristiq tapering schedule: (began pristiq 50mg in Sept 2016) Jan 26: reduced the pristiq dose to 25mg Feb 2: after 1 week on pristiq 25mg, started fluoxetine 10mg and continued pristiq Feb 9: after 1 week on step 2, stopped pristiq, and continued fluoxetine for an additional 3 weeks March 3: Last day on fluoxetine April 8th: 5 weeks off all meds, 8 weeks off pristiq Link to comment
Moderator Onmyway Posted April 10, 2022 Moderator Share Posted April 10, 2022 Dear @Ruth29, welcome to SA. Thank you for creating your signature. It helps us advise you much faster. You have come off your drugs in a very fast way and we would encourage a reinstatement and a very slow wean if you are struggling. The prozac bridge was a good idea with desvenlafaxine as it is a very hard drug to come off of, but we would have had you come off of it at no more than 10% of your previous dose every 4 weeks. I will post some links below to help you understand where we are coming from and what we would recommend. It is likely that the withdrawal symptoms will get worse. The reason is that prozac stays in body for a month or more (some of its metabolites do) so it is likely that you haven't felt its full effects yet. You might try to reinstate a small amount (1-2 mg or half of your previous dose) and see how you react to it. The small amount may be enough to make your symptoms bearable. WIth prozac you wouldn't know the full effects of reinstatement for a week or more. About reinstating and stabilizing to reduce withdrawal symptoms - Symptoms and self-care - Surviving Antidepressants Why taper by 10% of my dosage? - Tapering - Surviving Antidepressants Why taper? SERT transporter occupancy studies show importance of gradual change in plasma concentration - Tapering - Surviving Antidepressants Important topics in the Tapering forum and FAQ - Tapering - Surviving Antidepressants The Prozac switch or "bridging" with fluoxetine - Tapering - Surviving Antidepressants Tips for tapering off Pristiq (desvenlafaxine) - Tapering - Surviving Antidepressants Tips for tapering off Prozac (fluoxetine) - Tapering - Surviving Antidepressants Once you have read through these topics you can decide if you want to reinstate and which drug go reinstate (here I would not suggest reinstating desvenlafaxine after having read just the first post in that thread but I have no experience with it myself). Below are also some other threads to help you understand where you are. If you haven't seen them, I'd highly recommend the 'What is happening in your brain... ' post specifically. Non-drug techniques to cope with emotional symptoms - Symptoms and self-care - Surviving Antidepressants The Windows and Waves Pattern of Stabilization - Symptoms and self-care - Surviving Antidepressants What is happening in your brain? - Symptoms and self-care - Surviving Antidepressants How psychiatric drugs remodel your brain - Symptoms and self-care - Surviving Antidepressants Success stories: Recovery from psychiatric drug withdrawal - Surviving Antidepressants We recommend that members do not take other supplements (some can be activating to a sensitized nervous system) but we have found magnesium and Omega-3 to be beneficial but even they can make some members worse so try them one at a time when no other changes are being made and see how they affect you. https://www.survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/ King of supplements: Omega-3 fatty acids (fish oil) - Symptoms and self-care - Surviving Antidepressants Hope things get a bit better soon, OMW "Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. Aug 2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg, xanax prn, wellbutrin for a few months, trazodone prn Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used) Aug 2018 - citalopram 40 mg (self titrated up) September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0 Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering) citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg, 7/27/19 -1.5 mg, 8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg Supplements: magnesium citrate and bi-glycinate Link to comment
Ruth29 Posted April 10, 2022 Author Share Posted April 10, 2022 @Onmyway Thank you for your advice and support. It's already been so helpful in understanding what's going on in my body. I'm still taking my time to review the links you attached, but in the meantime, a couple questions have come up. Although I worked with a psychiatrist on my tapering schedule, clearly I didn't get the advice and guidance I needed. I'm concerned now that having tapered so fast things will be that much harder for me now. It's a bit scary, but I'm trying to stay calm, hopeful and optimistic. Some of these links are really helping with that. Most of the "ups and downs" I mentioned are now just emotional. During the 5 weeks I had only mild physical side effects. Is that a good sign? Probably the most obvious side effect has waking up in a panic or with immediate anxiety and elevated heart rate. This continues still, although it is sometimes not as bad now. I've also been prone to this in my life (morning is usually when I feel the most anxious). I've read this is a pretty common side effect. I also had morning nausea, and stomach upset. This has mostly passed now. Of the emotional side effects, they are: -irritability, frustration, often followed by sadness and grief -extreme sensitivity emotionally (to all emotions) -heightened self-doubt and self-criticism -general overwhelm and ability to become stressed even over small and totally manageable things -hopelessness (very common for me in times of depression) -periods of elevated mood, energy & excitement, slight mania (also common for me) Again, all of these I've become somewhat accustomed to in my life having anxiety and depression, but I am concerned, as you said, that they may get worse. I am going to the drop-in mental health centre in my city for a psychiatric opinion on reinstating, and just another opinion. At this moment however, I am seriously considering reinstating a low dose of prozac, as you suggested as an option. I'm very hesitant to reinstate pristiq because it is such a tricky drug. Since there may be prozac still in my system, I'm wondering whether it would be easier to reinstate without causing more harm. I suppose only by trying will I find out. I will talk to the doctor tomorrow about trying 1mg of prozac. If it helps, how long would you suggest I take it for to stabilize before weaning off of it? I will be tree planting in a rather isolated remote bush camp come May 8-end of July. So I want to go out there having compounded what I need. I won't be totally isolated however- the company is very good and wouldn't hesitate to help if I need medication/mental health support. I just don't want to get out there knowing my symptoms could get far worse. I'd rather reinstate now and see how that feels to hopefully be more stable for the season. All that being said- the one thing that has truly helped me feel grounded throughout my weaning, and in my own body, has been exercise. I'm a very active person and tree planting (which is basically a version of an extreme sport) has given me a huge amount of physical and emotional solace in the past while. I'm hoping that will be the case this year, but I of course want to make sure I'm taking care of myself too. Thank you for reading all this! Writing on a forum is very new to me, but it feels right and has already helped so much. -Ruth tapering schedule: (began pristiq 50mg in Sept 2016) Jan 26: reduced the pristiq dose to 25mg Feb 2: after 1 week on pristiq 25mg, started fluoxetine 10mg and continued pristiq Feb 9: after 1 week on step 2, stopped pristiq, and continued fluoxetine for an additional 3 weeks March 3: Last day on fluoxetine April 8th: 5 weeks off all meds, 8 weeks off pristiq Link to comment
Moderator Onmyway Posted April 11, 2022 Moderator Share Posted April 11, 2022 Hi @Ruth29, Glad you're reading through the links. There are many there so take your time. Regarding physical vs emotional symptoms: some members never have physical symptoms, or at least ones that they associate with withdrawal. My only physical symptoms were nausea, dizziness and paraesthesias in the very beginning but they came and went. The morning terror wakings are quite normal in withdrawal. They're the result of cortisol spikes we think. Please search for it in the forums (I'm on a mobile so unable to get the link to you). A few things help with that - best and proven: blackout curtains or eye mask. A baby aspirin the night before may lower cortisol but be careful with that one. Exercise is good, it helps recovery and distraction though not everyone can tolerate intense exercise during withdrawal. Watch your own body. If it makes symptoms worse, pare down. Always listen to your own body. I wouldn't suggest reinstating pristiq either, prozac would be the right one at 0.5 or 1mg. You'd probably stay on that dose for a few months before tapering just to give your body a chance to rebalance. Then drop at 10% of previous dose every 4 weeks. You'd track your symptoms for a week or two to see if there was improvement and whether you need to cut down because of adverse effects or increase if it works and you need more relief. You might get a liquid version and dilute it with syringes. It would be the easiest thing to work with rather than compounding ahead of time which gives you less flexibility if you need to change doses but either is doable. The doctor you see may not be knowledgeable about withdrawal so don't be discouraged if he denies your experience and claims it's all your previous 'condition' returning because you have a chemical imbalance or sth. I had to educate mine with scientific journal articles. It's not possible to know how your withdrawal will progress and whether to reinstate. In general having symptoms means nervous system destabilization and that takes time to heal. The less you have of that the better and prozac is hard to judge because of the long half life. Hope you start feeling better soon Omw "Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. Aug 2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg, xanax prn, wellbutrin for a few months, trazodone prn Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used) Aug 2018 - citalopram 40 mg (self titrated up) September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0 Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering) citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg, 7/27/19 -1.5 mg, 8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg Supplements: magnesium citrate and bi-glycinate Link to comment
Ruth29 Posted April 16, 2022 Author Share Posted April 16, 2022 Hi @Onmyway, this is very helpful, thank you. I've spent he week doing more research, and now have the prozac liquid to help should I need it. You're right, in all this listening to my body has been the best advice and most helpful meter. Especially when talking to doctors and them trying to fit you into a one-size-fits-all diagnosis. I had to educate my doctor as well, and thankfully, they listened are were curious. The vitamins I'm looking into- so interesting! I've taken a women's multi-vitamin and vitamin D since before tapering. I will definitely look into the magnesium and omega. I'll check in if things get worse, but this has already helped so much. I think I'm on a good path now. Thank you!! -Ruth tapering schedule: (began pristiq 50mg in Sept 2016) Jan 26: reduced the pristiq dose to 25mg Feb 2: after 1 week on pristiq 25mg, started fluoxetine 10mg and continued pristiq Feb 9: after 1 week on step 2, stopped pristiq, and continued fluoxetine for an additional 3 weeks March 3: Last day on fluoxetine April 8th: 5 weeks off all meds, 8 weeks off pristiq Link to comment
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