Aroha16: Scared and alone

[Aroha16]

Hi. Im early 50s female. 

I started fluoxe 20mg back in 2010 for PMDD. My symptoms back then were rage during Pmt. It worked wonders. I was also diagnosed with Rheumatoid disease the same year. 

Fast foward to 2020 and officially in menopause so figured I didn't need the fluox anymore.  I tapered slowly over 2021 without discussing it with a dr. I got to taking 20mg once  a week for a month or so then stopped.  I felt good. I didn't need an afternoon nap anymore.  That was September 2021. Beginning of 2022 brought multiple significant life stressors. I started having intense palpitations,  nausea anxiety sweating.  Couple hospital visits,  heart ok.  Deemed menopause so started tibolone HRT, symptoms went away. A month later symptoms creeping back to changed HRT to eostrgen patch and progesterone tablet. Again symptoms improved then regressed.  Uped eostrgen patch and told to restart 20mg fluox as this was thought to be helping my menopause symptoms.  Im now 3 weeks since reinstating and no change. I wake with intense nausea palpitations and anxiety every morning.  Im basically bed bound by anxiety until mid afternoon after I've had some lorazepam (various doses, sometimes .25, sometimes. 5 or more).  Anxiety was never something I had experienced before,  this is completely new and terrifying.  So I've been in a holding pattern waiting for the fluox to kick in and now I've discovered its maybe not my menopause but protracted withdrawal and that restarting the fluox 6 months after stopping might not even help? My husband cant handle me be "sick all the time" and is not at all empathetic.  Hes basically disgusted in my lack of "resilience ".  Ive told him today that it could be this protracted withdrawal and he just wants to know how long its going take.

 

I know now that I completely stuffed up coming off the fluox  

Where do I go from here. My life is on hold, I'm unable to look after my grandchild which negatively impacts my daughters work. 

I dont want to keep taking lorazepam because then I'll have problems getting of that but I cannot cope with this anxiety. 

 

Help please. Do I stay on the fluox or come off? Is there dr in South Australia who can help or an interstate dr via telehealth 

[Aroha16]

Any suggestions please

[Aroha16]

Also. I feel I need to be on anti anxiety meds for a while. Currently Lorazepam  1mg per day in divided doses.  I have read that it is better to be on diazapam as this stay in the body longer and therefore easier to taper.   Iam am seeing my GP next week so wanted to ask to switch to diazapam if that will be better for me in the long run.

[Onmyway]

Hi @Aroha16, 

welcome to SA. I am so sorry you are going through a hard time. Can you help me understand - when exactly did you take your final dose of fluoxetine and how did you taper to get to that dose. 

 

It is possible that you have delayed withdrawal from fluoxetine - it takes a long time to get out of your body. However, it is also possible that you are having adverse reactions to it. The two can go together. Did the morning anxiety issue start before you reinstated fluoxetine or after reinstatement? When we advise reinstatement we usually advise a very low dose as our nervous system is sensitive from withdrawal. If you tapered fluoxetine by alternating doses it may be even worse as that makes the nervous system even more sensitive.

 

Can you give us more info on how you tapered? Over what time period? 

Can you tell us what time you take your drugs and how your symptoms change during the day.

If you can provide daily notes like this, it would really help us help you. 

 

7 am wake up - anxious, restless, sweaty, nausea

8 am took citalopram 1mg 

9 am anxiety is worse 

10 am breakfast (eggs etc)

10-12 distracting myself walking the dog

12 lunch 

2 pm anxiety much better 

3 pm xanax 1mg 

4 pm work, foggy 

7 pm dinner 

10 pm sleep

 

I would advise to lower your dose of fluoxetine down. Let me check with the other mods how quickly this should happen. 

 

How long have you taken lorazepam. It is a very addictive drug - a benzodiazepine - and you will need years to taper it slowly once you have been on it for a while. I would advise to not continue taking it. We don't recommend starting any new drugs or take psychoactive substances (alcohol, pot, street drugs, even some vitamins) during withdrawal. 

 

Hope you start feeling better soon, 

 

OMW

 

 

 

 

[ChessieCat]

Welcome from me too.

 

It would also be good for us to know a timeline of your HRT treatment.

 

We need to know how many changes have been made (drugs and doses) since you started it and the date that the last change made.  Also are you still in the process of getting these drug/s sorted out?

 

Thank you.

[Altostrata]

Welcome, @Aroha16

 

It appears you might be at the start of a psychiatric drug spiral due to very typical misdiagnosis of withdrawal symptoms, endocrinological symptoms, the widespread belief that antidepressants are good for everything, and widespread ignorance of their adverse effects. It makes no sense at all for you to get dependent on a benzodiazepine to manage the adverse effects of an antidepressant.

 

It may be that you are taking TOO MUCH fluoxetine. You might want to reduce to 10mg and see if that helps. As we do not treat symptoms of menopause here, I cannot say whether this will resolve your menopause-related symptoms, if you have any. But reinstatement typically will reduce withdrawal symptoms, if you don't take too much. We often suggest a very low-dose reinstatement for withdrawal; in your case, this might be 5mg.

 

Please let us know if dosage reduction helps.