Kila14: Trialing and switching antidepressants over a year

[Kila14]

I haven’t done a signature because I don’t have specific dates or a complete list of meds tried.  Basically I went through the entire SSRI/SNRI list plus Buspar.
 

After a very unsettling life event at the beginning of 2021 my PDoc trialed me on several anti-depressants. All of which gave me severe side effects that I couldnt tolerate. They never dissipated and varied from severe muscle pain to dizziness, brain fog, lethargy, akathesia and GI issues. My last Viibryd (the last resort!) was on March 27 of this year.  Even tried starting them all at very low dose. 

Prior to this latest series of failed therapies I had also tried several other anti depressants, I think around 2016-2017.  With the same result. None of them helped. 

I have found diazepam is the only thing that helps when anxiety is bad. I don’t take it often and only in small dose (1-2mgs).  

The doctor said withdrawal shouldn’t last longer than 2-3 weeks because I was never on any medication for more than a couple of months and at a low dose.  But as im still feeling crappy with all the withdrawal symptoms, I don’t believe him.  Wouldn’t the accumulation of a years worth of drugs be causing the symptoms?  Has anyone else experienced this?

[Onmyway]

Hi @Kila14

welcome to SA. I am sorry you have been struggling during the last year and have been subject to a litany of drugs. No wonder you have been having withdrawal effects. 

What psychiatric drugs do to the brain is much more complicated than doctors know and acknowledge. The brain is very adaptive so if you flood it with serotonin or dopamine etc. it adapts to it. It does that by downregulating its receptors, changing other chemicals and hormones, sometimes possibly structures. The brain is plastic. This is why we have withdrawal effects from these drugs. Once we withdraw the drug, it has to re-adapt and ideally return to factory settings. But because of the complexity of the systems, this does require time. You can find out more here. 

How psychiatric drugs remodel your brain - Symptoms and self-care - Surviving Antidepressants 

What is happening in your brain? - Symptoms and self-care - Surviving Antidepressants

The Windows and Waves Pattern of Stabilization - Symptoms and self-care - Surviving Antidepressants

 

In your case every drug change has made the brain try to adapt and readapt and in the end has thrown the whole system is chaos. We find that withdrawal is really destabilization of the nervous system more than anything else. In this destabilized state we end up being more sensitive to psychoactive substances and so every addition makes us worse. What is more, like with alcohol withdrawal, we find that the more times you start and stop these drugs, skip doses etc., the more you are likely to react to new additions and stoppings (kindling). In the end whether you have symptoms from the adaptation and withdrawal or from the starts and stops doesn't really matter - it is all the same - your system is likely destabilized. 

Good news is, it will very slowly get back to normal. 

The one thing that helps with withdrawal is reinstating a small dose of a the medicine but given that all of the meds have made you feel bad, it might not be a good idea. For you the best thing might be stability - no psychoactive substances whatsoever, no alcohol, pot, street drugs. Sometimes even antibiotics (esp. specific classes) and vitamins (D and  tend to make people like us, with sensitized systems, worse. We recommend Omega-3 and magnesium as many people find them helpful but some people react even to those. So start them slow and one at a time. 

 

This article may explain why none of these worked for you - antidepressants are not better than placebo. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/ 

 

I think (but not sure) that it was your last drug that was at first rejected approval by the FDA because the trials were so weak. But then managed to get it because the FDA requires only 2 positive trials even if you ran 98 that were negative. 

 

In the meantime, you can use various coping techniques to help with the symptoms that you may have.

Non-drug techniques to cope with emotional symptoms - Symptoms and self-care - Surviving Antidepressants

Important topics about symptoms, including sleep problems - Symptoms and self-care - Surviving Antidepressants

 

It will be helpful to try to recall at least some of your drug history and list it so that we can refer to it to give you better advice. 

 

Remember, you will get better, it will just take a long time to do it. 

This might help keep your hopes up. 

Success stories: Recovery from psychiatric drug withdrawal - Surviving Antidepressants

 

So glad you found your way to us. We are here to help however we can, 

OMW

 

Edited April 24, 2022 by Onmyway

[Kila14]

@Onmyway  thank you so very much for your thoughtful, thorough and supportive reply. It really consolidated my own thoughts that all the messing around with various drugs was screwing up my brain. No matter how low the dose or short a time I was on them. I would love to discuss this with my PDoc but I’m going to let go of all the anger and negativity and work on healing my brain. 
 

I am a little concerned about not using vitamin D though. My levels have always been low and gene tests indicate I don’t metabolize well. Maybe it’s best to hold off the vitamin d for hopefully the few months it takes to heal. I also have Prozac left (10mgs capsules) and was wondering if a tiny dose of that would be worth my reinstating. I was on it for maybe one month and felt ok for a short while before the weirdness set in. 
 

I’ve also started low dose magnesium and omega-3 so hopefully that will help. I will try and get a list together of drugs taken and approximate times.

 

interesting about the Viibryd and the 98/2 trials and they still put it in the market. It cost me $350. I was actually praying it wouldn’t work!!

[Onmyway]

Hi @Kila14

 

I am glad this helped. It took me a while to come to terms with what had happened to me and a lot of education. Talking to the doctor will probably not give you the closure that you want because he will deny that this is happening - that is the usual course. Though my GP later apologized for not believing me. You can try the tips here if you want to talk to him. I would wait until you 

How to talk to a doctor about tapering and withdrawal? What to expect. - Tapering - Surviving Antidepressants

 

Vitamin D can be activating. If you are deficient you can keep taking it but may want to take it in the morning. It will likely make you feel more on edge which can be misinterpreted as anxiety. If it is hard for you to metabolize vit D anyway, you may want to get yours from the sun? You need very little sun exposure to get enough. Up to you. You can stop it and see if it makes a difference. However, if you are reinstating, the effects may be hard to distinguish from those of the reinstatement and confound our conclusions about both. 

 

Regarding prozac, you are welcome to try reinstatement. The reason why I didn't suggest it was that I thought you had adverse reactions to all of the drugs. If that is not the case, it might be a possibility. The upside of reinstatement is that you might get relief after a period of stabilization. The downside is that if your system is very sensitized it may make things worse. You don't know ahead of time. To minimize the risk you would take a very small dose 0.5mg or so for a few days and track your symptoms. The links below will help you get the right dosage and track your symptoms and post your notes here. Based on your notes we can try to guess if it is making a positive or negative difference. After a week or so of consistent dosing you should feel the full effect and we can decide whether it makes sense to continue. If you continue, you would taper it very slowly (10% of previous dose a month). We ask for these notes in order to be able to help you. They are very important esp if we worry about adverse drug effects so make sure to post them for every day. 

 

https://www.survivingantidepressants.org/topic/759-tips-for-tapering-off-prozac-fluoxetine/

Recording drug schedule and symptoms to track patterns and progress - Tapering - Surviving Antidepressants

About reinstating and stabilizing to reduce withdrawal symptoms - Symptoms and self-care - Surviving Antidepressants

o

I don't want to scare you but withdrawal for many of us lasts for more than a few months. Some people get away with no or little withdrawal the first or second time but the more you start and stop the harder it gets. At least that's our experience here. The good thing you have going for you is that you have only been on these drugs for short periods of time. We do see improvement in the windows/waves pattern that I posted about above. 

 

Glad you have started the magnesium and Omega-3. Please let us know if they are helping.

 

Please let me know if you need more help on the reinstatement. Keeping my fingers crossed that it works. Remember - a very low dose - 0.5mg. 

 

OMW

 

[ChessieCat]

Keep in mind that Prozac has a very long half life so it takes a lot longer than most other types of antidepressants to build up in the body.  Please click on EXPAND and read the whole of this quote below.

 

  

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

 

Prozac has the longest half-life of any SSRI. After you take it for a few days, half-life is about 16 days. Fluoxetine itself has a half-life of 2-4 days, but as it is processed, your body creates an active antidepressant metabolite, norfluoxetine, which has a half-life of 7-15 days. So Prozac keeps on extending its half-life as it is metabolized.

According to http://en.wikipedia.org/wiki/Fluoxetine , fluoxetine and norfluoxetine inhibit each other's metabolism, extending the half-life of the drug. Because the half-lives are so long, the full effect of Prozac on the brain may not be felt for several weeks.

 

 

Edited April 25, 2022 by ChessieCat

[Kila14]

@Onmyway thank you so much for all the useful information and links. I’m going to work on reading all the links and decide whether I want to reinstate or not. It’s really hard for me to focus on how my body feels and make daily notes as I am still responsible for watching grandkids a few days a week (it’s the only thing that stops me focusing on myself all the time!).   
If I need further one on one help I will get back to you but as for now knowing I’m not the only one going through this and there IS a way out will keep me optimistic!

again thank you for taking the time to help me out and provide so much useful information!

[Altostrata]

Welcome, @Kila14

 

We have a small number of people here who have had severe adverse reactions to antidepressants within a short amount of time on each one, sometimes just one dose. These people have symptoms very much like protracted withdrawal syndrome -- but it is not withdrawal syndrome, it shares symptoms of nervous system destabilization with withdrawal syndrome. It appears you might be one of these people, but your "immediate ADR" was repeated over and over with other drugs. 

 

See Adverse reactions to an antidepressant within a few doses -- how long for recovery?

 

Because it's clear you and antidepressants don't get along, we don't recommend reinstatement of an antidepressant in these situations. We suggest non-drug coping strategies to allow your nervous system to settle down. What are your worst symptoms now? How's your sleep?

 

See 

 

 

 

 

[Kila14]

@Altostrata  Thanks for that additional information!  I had just made a 10ml solution for my 10mg capsules and took two  doses (over 2 days) which may have been a little more than the 0.5mg dose suggested (lack of small syringe). It may have been a nocebo effect as I felt awful all day yesterday. 
My symptoms currently are anxiety related (I’ve never actually been clinically depressed). Similar to when I had my first panic/anxiety attack. Fast heart rate, dizziness and lightheaded, feeling floaty like I’d just disembarked from a boat, headache and tight muscles all over. Sleep is disrupted. I get to sleep ok but wake maybe 3 hours later with the jitters and even deep belly  breathing takes a while to work. Feel fatigued during the day

gene testing revealed slow metabolization of coffee and sensitivity to some medications. I rarely take any other medications and usually always take 1/2 dose of anything prescribed or OTC. 

Anti depressants and I definitely do not get along!  What has always worked for me in the past has been minuscule dose of diazepam. Never more than 2mgs and never for an extended period of time. I think the PDoc was trying to get me off ANY benzo despite minimal use. It doesn’t seem to be working so well this time around. 
oh, and I guess I’m classed as a senior at 65 years old. 
Again, thanks for this additional information. ❤️

[Altostrata]

What symptoms are new since you took two small doses?

[Kila14]

1 hour ago, Altostrata said:

What symptoms are new since you took two small doses?

Extreme anxiety that lasted all day. Did not respond to a small dose of diazepam or self help measures. It felt like a day long panic attack with increased heart rate all day.  I felt this when anxiety attacks first started (about 6 years ago after extreme family issues) but not to the extent I felt yesterday. I do also have a lot of responsibilities for child care that I didn’t have back then so don’t know if that pressure is contributing. Oh and also extreme on and off perspiration. It wasn’t even hot or humid yesterday. 

 

Edited April 27, 2022 by Kila14
Additional info

[Kila14]

1 hour ago, Altostrata said:

What symptoms are new since you took two small doses?

Extreme anxiety that lasted all day. Did not respond to a small dose of diazepam or self help measures. It felt like a day long panic attack with increased heart rate all day.  I felt this when anxiety attacks first started (about 6 years ago after extreme family issues) but not to the extent I felt yesterday. I do also have a lot of responsibilities for child care that I didn’t have back then so don’t know if that pressure is contributing. 

[Altostrata]

No more antidepressants for you. This reaction should fade over the coming days.

[Kila14]

4 hours ago, Altostrata said:

No more antidepressants for you. This reaction should fade over the coming days.

I’ve run the entire list I think so no more options and I will make sure they are a big NO NO in the future!  Thanks for your help!

[Altostrata]

Please let us know how you're doing. 

 

To help us out, follow these instructions Please put your drug and withdrawal history in your signature You may need to use a computer to do this.

[Kila14]

On 4/30/2022 at 6:08 AM, Altostrata said:

Please let us know how you're doing. 

 

To help us out, follow these instructions Please put your drug and withdrawal history in your signature You may need to use a computer to do this.

Working on attempting to out history in signature!!  
I’m doing ok I guess. Adverse Reaction to reinstatement of Prozac has died down. Now I guess I’m dealing with the withdrawal symptoms. Tired aching muscles so just doing gentle yoga every other day. Sleep is ok but waking early.   Still getting the dizzies which I’ve seen described as “water sloshing around in my head”. Almost a perfect description.   Occasional what I can only describe as fizzing in the back of my head. Don’t know if that constitutes a brain zap!  Situational anxiety attacks and I guess generally speaking the anxiety is always there lurking in the background. Working on that with meditation and reframed thinking. 

[Altostrata]

Thanks. Still need to see your signature, enter it from your Settings.

 

As explained, with an immediate adverse drug reaction from an antidepressant, people have symptoms like protracted withdrawal, but it is not protracted withdrawal. Same slow recover, though. Good to hear you've seen a little improvement, that's a good sign, please be patient.

 

You might want to learn techniques to manage that situational anxiety:

 

 

The Windows and Waves Pattern of Stabilization

 

Neuro-emotions

 

Non-drug techniques to cope with emotional symptoms

 

Easing your way into meditation for a stressed-out nervous system

 

Music for self-care: calms hyperalertness, anxiety, aids relaxation and sleep

 

Ways to cope with daily anxiety

 

Dealing With Emotional Spirals 

 

Shame, guilt, regret, and self-criticism