Monmonster: trying to live without fluoxetine / Prozac

[Monmonster]

Hello everyone,

 

I am very thankful to be here. I am completely new to the site and looking for advice and guidance. I quit 20 mg of fluoxetine cold turkey about 7 weeks ago. I had been told by both my PCP and psych nurse practitioner that is was "such a low dose" that I would probably do fine. The first thing I noticed was irritability, followed by depressed mood, insomnia, and now anxiety/worry/fear.

 

History:
2009 (age 27)-2019: Start 20 mg of escitalopram for eating disorder and major depressive disorder. Sxs alleviated.

2016-2019: Slow, gradual taper off of escitalopram with final dose July 2019. 3 months later: insomnia, fear/doom, excessive anxiety to the point of not functioning in life.

2020: Started 30 mg fluoxetine for anxiety sxs. 

2021: Reduce to 20 mg, no problems

June of 2022: Quit 20 mg of fluoxetine, cold turkey. 

 

Current complaints after 6-7 weeks: quickly noticed high irritability. Now bad insomnia. Also return of depressed mood, anxiety/fear/doom about things that are very much under control and okay, worse on days that I get very bad sleep. Occasionally able to sleep a solid night. 

 

In hindsight, I really wish I would've tapered off of the 20 mg despite it being a "small dose." Small dose but a world of difference.

Motivation for getting off: I just want to see if I really need drugs to live or can my coping tools be enough. Potential future pregnancy. Worries about staying on a drug indefinitely.

Experience while on Prozac: it works. No side effects that were bothersome, no emotional numbing like when I was on escitalopram. Life is good.

 

Questions to you all:

Aside from the insomnia, I'm not convinced I'm experiencing withdrawal sxs. It really just seems like a return of the emotional sxs that brought me to meds in the first place. No brainzaps, physiological oddities, etc. Just the insomnia. What is your take?

 

Considering I quit cold turkey and shouldn't have, what are best next steps? Things are starting to get to the point where I'm getting desperate to get back on medication just to feel like my happy old self (prozac self) again. I do all the right things: good bedtime routine, regular exercise, good nutrition, no drugs, rare glass of alcohol, regular meditation, and back to seeing my therapist regularly. Could I be doing more harm by getting back on prozac rather than just waiting it out longer?

 

Any insight is appreciated. I want to live my life free of SSRI's but I have serious doubts it's possible. Thanks for being here.

 

[Frogie]

@Monmonster

 

Welcome to SA. We are a volunteer ran site helping people taper off psychiatric medications, or have tapered off and are now healing.

 

This is your introduction page where you will receive information, ask questions and meet other members. We ask that you only have one introduction page so we can keep all your information in one place.

 

First can you please create a signature.

 

How to List Drug History in Signature

 

 

Unfortunately, dr's don't know much about these drugs and think it is ok to just stop taking them. We don't suggest more than a 10% a month taper.

 

Why taper by 10% of my dosage?

Tips for tapering off fluoxetine (Prozac)

 

 

 

Here is some important information about how these drugs actually work.  This explains why we get symptoms from going off of these medications:

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

Video on Recovery from Psych Drugs

 

 

Here are some links you might find useful.

How do you talk to a doctor about tapering and withdrawal?

Dr. Joseph Glenmullen's withdrawal symptom checklist

 

Irritability, Anger, Rage

 

Sleep problems - that awful withdrawal insomnia

 

 

You could try a small amount of melatonin for sleep.

 

Melatonin

 

 

You could try a reinstatement of 2 mg of Prozac and see if that would help since you haven't been off too long. You would hold this dose for 7-10 days for it reach full stability in your system. It could be adjusted if necessary. Then a nice long hold before tapering off again.

About reinstating and stabilizing to reduce withdrawal symptoms

 

What is withdrawal syndrome?

 

The Windows and Waves Pattern of Stabilization

 

 

We don't suggest supplements on here as they can be stimulating to the CNS (central nervous system) but 2. If you want to try one try a small amount and wait a few days before introducing the other.

 

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

 

After reading the provided links please reach out with any questions.

 

 

 

 

 

[UserMan1775]

You have over 10 years of SSRI use plus are at that weird spot where you are past a month for reinstatement, getting back on could kindle you and make it worse. After 6 weeks, you actually still have prozac in your system due to the long half life, cold turkey is never a good way to get off and what you are experiencing now is definitely withdrawal, i would not touch anything deal with the unconformatableness and just know it may get worse as it leaves your system more, you already chose to get off it.

 

Also, 20mg is not small dose at all, 10mg considered small, 20 is standard therapeutic dose. Doctors are just insane today putting people on 80mg, madness, back when i started prozac 10 was low 20 was standard and 40 was high. I was on 20 for YEARS and felt fine.

 

I would keep riding, you like even though it is rough you are doing okay.

[Monmonster]

Thank you Frogie and UserMan for your responses. This is all very helpful information and very much appreciated. I'm still working on reading through it all.

 

I've decided to plug ahead without reintroducing fluoxetine. Days aren't good, but I'm somehow getting through them, with days obviously worse the nights I don't sleep. Something inside me needs to know if I can do my life without SSRI's. I have healthy coping techniques that I'm putting all my faith in. 

It seems withdrawal sxs can last anywhere from a few weeks to years. I feel like since I first quit cold turkey (last week of May '22), things were noticeably changing, then really bad by week 4-5, now maybe getting slightly better into week 8 ish. Is there any indication that maybe I'm through the worse of it? Or is there really no way to tell? 

[Altostrata]

@Monmonster

 

Insomnia is a very common withdrawal symptom. How much sleep do you get? How has your symptom pattern changed on the last 2 weeks?

[Monmonster]

Thank you Altostrata.

 

I typically sleep very well and get on average 8 hours/night. Good sleep hygiene. 

 

First 4 weeks off prozac:  no sleep change.

Weeks 5-6:  most nights unable to fully fall asleep despite being very sleepy and feeling relaxed at bedtime. If I do manage to fall asleep, I wake up every couple of hours. I seem to enter some level of unconsciousness but then feel like a surge of energy charges through my body/brain telling me to wake up. So I awake with a feeling of fear charging through me. Then I go through a pattern of trying to relax myself again, get to some level of unconsciousness, and the charge of energy runs through me again right before entering full stage of sleep. Go through that cycle most of the night. Don't think I ever reach dream level sleep. It's rather hard to fully explain. 

Last week: getting better. I seem to be in a pattern of alternating: one night sleeping mostly well (not taking me as long to break through pattern of energy surge and sleeping through night) then next night rough sleep, back to night of mostly good sleep. Definitely better than what it was last couple of weeks. 

 

I am familiar with having trouble falling asleep due to worries and stressors around life. This is different. I am able to place my stressors out of my head and not go to bed thinking about worries. I am very relaxed and ready to invite sleep, but then this weird energy surge comes from nowhere and zaps me back to life. It's awful. 

 

I'm hoping that with the little improvement I've seen over the last week, this may be an indication that things are getting better. Of course, not getting sleep causes me to be very overwhelmed, anxious, and fearful the following day. Any ideas around how long it may take sleep to improve or what I else I can be doing to help? 

[Altostrata]

16 hours ago, Monmonster said:

Definitely better than what it was last couple of weeks. 

 

This indicates you are recovering naturally. Full recovery might be very slow and gradual over months.

 

Many people find fish oil and magnesium supplements helpful, see

 

https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

 

https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

You might try a little bit of one at a time to see how it affects you. Please let us know how you’re doing.

 

Please add the date of your last fluoxetine dose to your signature.

[Monmonster]

Something tells me if I could just get a handle on the insomnia and get better sleep, I would probably not be dealing with the panic and anxiety. There are other life stressors that are definitely contributing to anxiety, which certainly doesn't help. But I'm very concerned this sleep pattern has just turned into a psychological game that may not remedy itself without a big intervention. 

 

Any additional tips on managing insomnia are appreciated, and I will continue to look through previous board posts. 

[ChessieCat]

What is the sleep cycle?

 

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

 

Sleep and withdrawal

 

Path to Better Sleep FREE online for everyone from the US Veterans Administration

 

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

 

Melatonin for sleep: Many people find it helpful

 

TV or computer use in evening can disrupt sleep: Bright light signals the brain that it's daytime

[UserMan1775]

You are totally recovering naturally, do not restart it like i did, not knowing what i was about to do and just listening to the "doctors", that is what was happening to me until i ruined it and restarted and kindled myself, making things a million times worse, keep riding it out, i see you continually to get better, those fear rushes are nocturnal panic attacks caused by cortisol spikes , i also got them intermittently in the month prior, not having them every night is a good sign u are recovering, they should get less and you will feel better DO NOT restart the drug, keep on trekking through, you are doing great. really.

[UserMan1775]

You are totally recovering naturally, do not restart it like i did, not knowing what i was about to do and just listening to the "doctors", that is what was happening to me until i ruined it and restarted and kindled myself, making things a million times worse, keep riding it out, i see you continually to get better, those fear rushes are nocturnal panic attacks caused by cortisol spikes , i also got them intermittently in the month prior, not having them every night is a good sign u are recovering, they should get less and you will feel better DO NOT restart the drug, keep on trekking through, you are doing great. really.

 

If I could go back in time, i would have just stayed on the god damn drug, 2nd option would be have dealt with WD and just trucked through it, unfortunately did not know what was going on or about this site, instead i listened to the "doctors". by the time i did find it, it was too late and i was still skeptical about what was going on.

[Altostrata]

@Monmonster typically withdrawal symptoms will go up and down and very gradually get better on the average over time. This takes months rather than days or weeks. 

 

On 7/25/2022 at 8:05 PM, Monmonster said:

Definitely better than what it was last couple of weeks. 

 

Are you having a worse time than 4 days ago?

[Monmonster]

On 7/28/2022 at 7:26 PM, Altostrata said:

@Monmonster typically withdrawal symptoms will go up and down and very gradually get better on the average over time. This takes months rather than days or weeks. 

 

 

Are you having a worse time than 4 days ago?

It seems the insomnia is worse again. I continue to feel very sleepy at night. I eagerly go to bed, and as I start to relax and slip into sleep, it seems my brain decides it's "rested" and jolts me back up again. I'll get up, try and get sleepy again, and the pattern starts all over. I'm back to essentially no sleep at all at night the last 3 nights. I'm not sure how I'm alive. 

 

It also feels like I've developed some anxiety-induced insomnia. I'm not worrying at night about life stressors, rather, the fact that I can't sleep, won't sleep, may never sleep again. I'm starting to develop a small fear of the coming night-time. In the middle of the night I feel panic and systems feel on overdrive no matter how many calming techniques I invoke. I've reached a point where I don't feel like this is sustainable. At night, I feel like I'm going crazy and like it might trigger some psychotic episode (no idea it that's possible, but that's what I fear). I can handle the daytime anxiety to an extent. I can't handle the lack of sleep and the amount of panic it induces.

 

Is there a real danger in getting back on the fluoxetine to get my sleep back and return to a normal life? I have reached desperation. 

[Altostrata]

13 hours ago, Monmonster said:

It seems the insomnia is worse again. I continue to feel very sleepy at night. I eagerly go to bed, and as I start to relax and slip into sleep, it seems my brain decides it's "rested" and jolts me back up again. I'll get up, try and get sleepy again, and the pattern starts all over. I'm back to essentially no sleep at all at night the last 3 nights. I'm not sure how I'm alive. 

 

This is something we have seen before, also the anxiety that you're not going to sleep. You might find this helpful:

 

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

 

White noise devices for sleep

 

Sleep recovery will be gradual. You can help it along with these techniques:

 

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

 

Path to Better Sleep FREE online for everyone from the US Veterans Administration

 

Melatonin for sleep: Many people find it helpful

 

TV or computer use in evening can disrupt sleep: Bright light signals the brain that it's daytime

 

Strange sensations while falling asleep -- surges, zaps, jerks

 

 

[UserMan1775]

16 hours ago, Monmonster said:

It seems the insomnia is worse again. I continue to feel very sleepy at night. I eagerly go to bed, and as I start to relax and slip into sleep, it seems my brain decides it's "rested" and jolts me back up again. I'll get up, try and get sleepy again, and the pattern starts all over. I'm back to essentially no sleep at all at night the last 3 nights. I'm not sure how I'm alive. 

 

It also feels like I've developed some anxiety-induced insomnia. I'm not worrying at night about life stressors, rather, the fact that I can't sleep, won't sleep, may never sleep again. I'm starting to develop a small fear of the coming night-time. In the middle of the night I feel panic and systems feel on overdrive no matter how many calming techniques I invoke. I've reached a point where I don't feel like this is sustainable. At night, I feel like I'm going crazy and like it might trigger some psychotic episode (no idea it that's possible, but that's what I fear). I can handle the daytime anxiety to an extent. I can't handle the lack of sleep and the amount of panic it induces.

 

Is there a real danger in getting back on the fluoxetine to get my sleep back and return to a normal life? I have reached desperation. 

If you would like to make your sleep much worse, that is what restarting fluoxetine will do. Yes, there is real danger, that is what happened to me and i went on to sleep 2-3 hours a night either 9-12 or 12-3 and then wide awake for the next 6 months and then i tried to kill myself.

 

You are currently in withdrawal do not turn it into kindle and withdrawal, ride it out, see how you feel a month out.