Quickcharge: Should I increase and then taper slowly, or wait where I'm at?

[Quickcharge]

If anyone can offer me some tapering advice I'd be so grateful, I'm really struggling here.

 

I had severe OCD and Tourette's as a child, I was HEAVILY over medicated (Haldol and a bunch of other toxic ****) and then refused meds for 20+ years but smoked pot daily (so I was self medicating).

 

3 1/2 years ago my son was born and my OCD got significantly worse. I went to a doctor who put me on Sertraline. I was SO SENSITIVE to it - 2 weeks horrible side effects, 2 weeks lessening side effects, 2 weeks the worst side effects, 1 month lessening, 6 weeks feeling really good (better than before the meds it felt like), then wake up one day and over the next week would start to feel more and more depressed with SI that I'd never had before in my life. Then go up again. This was with 12.5 mg increases. I tried liquid but even a .5 increase would cause the same pattern so I just muscled through on the 12.5 increases. 

 

Once I got to 200 mg, the same pooping out would happen after 3 months, and the doctor started talking about 300 or 400 mg. I decided I had to do something else. I started Ketamine IV. The initial round of 6 helped with the mood and OCD a TON. However, in the week following, every day I woke up feeling like my sertraline does had doubled. I was drowning in serotonin (or whatever it was that was happening!). 

 

I very quickly dropped down to 150 and then 125 and felt better for a month or two, while getting ketamine IV every 3 weeks. I had 0 side effects from the quick drop, but that probably has something to do with the ketamine. But 3 months later, the same crapping out happened. Just one day I'm sobbing and hitting my head and thinking I don't deserve to be alive. 

 

Got a new doctor who thought Prozac might be better with the longer half life. Switched to 40 prozac, barely had any side effects. For 5 weeks thought answers were solved.!Then one day I woke up and it was like I was drowning in serotonin again, worse every day. Eventually it was much worse than even post the ketamine IV.

 

So I went down to 30, but I got pretty sick, felt really bad. In retrospect, this was my first time where lowering ***** with my system. I went back to 40 but I was immediately (well, within 48 hours) snowed again. 

 

Talked to doctor who said let's try lexapro. I said, can I switch to lowest dose possible and go up if I need it? She said "sure!" Went to 5 lexapro, tapering VERY fast off the prozac over 3 weeks. That was 6 weeks ago, when hell really started. On 5 lexapro alone I started having horrible side effects after 2-3 weeks. Went up to 7.5 but had INCREASE side effects, went back to 5. At this point every dose change was making me have SI and sobbing, feeling insane, ecetera. 

 

Decided, can't do the SSRI this is madness. Found a really wonderful place that does microdosing psylocibin, started that 3 weeks ago. It for sure helps, a lot, especially on the non break days. Switched back to 5 of prozac, I had the smoothest experience on the prozac of the 3, honestly felt like Lexapro was poison to me and I was only on it for 6 weeks, half of which was on prozac. So just went back. 

 

Debated going to 5 vs 10, but I really wanted to be on the lower dose, so I did 5. My mood is more stable by the day, but I'm having severe brain zaps pretty much all day long. I found this forum, watched all the suggested videos. I now know to do a liquid tape, 5 to 2.5 to 1.25 to .6 to 0, a month at a time, and I won't even start that taper till I'm a month out from these brain zaps. 

 

My question is, given how bad my brain zaps currently are, at 2 weeks on the 5 mg of prozac, should I INCREASE the prozac until the brain zaps stop? If I did this I was thinking maybe go to 10 mg, wait 3 days to see if they stop, if they don't go up to 15, so on and so forth, then once they've stopped, at THAT POINT being the 10% taper per month?

 

OR should I just wait at the 5mg of the prozac and once I'm a month past side effects continue. Overall I wish I could just stay at the 5mg, because I'm already here. But if the zaps could be here a LONG TIME, I just can't take that. And maybe it's too late to go back up? I just don't know.

 

Any advice anyone could offer on the best plan, given where I'm currently at, I'd be so so grateful. 

 

 

[Quickcharge]

Today, the day after this message, my zaps were so bad and I was feeling so low and crazy that I went up to 10 on the prozac. Hoping beyond hope that I can even out at this dose. 

[Onmyway]

On 7/29/2022 at 5:33 PM, Quickcharge said:

If anyone can offer me some tapering advice I'd be so grateful, I'm really struggling here.

 

I had severe OCD and Tourette's as a child, I was HEAVILY over medicated (Haldol and a bunch of other toxic ****) and then refused meds for 20+ years but smoked pot daily (so I was self medicating).

 

3 1/2 years ago my son was born and my OCD got significantly worse. I went to a doctor who put me on Sertraline. I was SO SENSITIVE to it - 2 weeks horrible side effects, 2 weeks lessening side effects, 2 weeks the worst side effects, 1 month lessening, 6 weeks feeling really good (better than before the meds it felt like), then wake up one day and over the next week would start to feel more and more depressed with SI that I'd never had before in my life. Then go up again. This was with 12.5 mg increases. I tried liquid but even a .5 increase would cause the same pattern so I just muscled through on the 12.5 increases. 

 

Once I got to 200 mg, the same pooping out would happen after 3 months, and the doctor started talking about 300 or 400 mg. I decided I had to do something else. I started Ketamine IV. The initial round of 6 helped with the mood and OCD a TON. However, in the week following, every day I woke up feeling like my sertraline does had doubled. I was drowning in serotonin (or whatever it was that was happening!). 

 

I very quickly dropped down to 150 and then 125 and felt better for a month or two, while getting ketamine IV every 3 weeks. I had 0 side effects from the quick drop, but that probably has something to do with the ketamine. But 3 months later, the same crapping out happened. Just one day I'm sobbing and hitting my head and thinking I don't deserve to be alive. 

 

Got a new doctor who thought Prozac might be better with the longer half life. Switched to 40 prozac, barely had any side effects. For 5 weeks thought answers were solved.!Then one day I woke up and it was like I was drowning in serotonin again, worse every day. Eventually it was much worse than even post the ketamine IV.

 

So I went down to 30, but I got pretty sick, felt really bad. In retrospect, this was my first time where lowering ***** with my system. I went back to 40 but I was immediately (well, within 48 hours) snowed again. 

 

Talked to doctor who said let's try lexapro. I said, can I switch to lowest dose possible and go up if I need it? She said "sure!" Went to 5 lexapro, tapering VERY fast off the prozac over 3 weeks. That was 6 weeks ago, when hell really started. On 5 lexapro alone I started having horrible side effects after 2-3 weeks. Went up to 7.5 but had INCREASE side effects, went back to 5. At this point every dose change was making me have SI and sobbing, feeling insane, ecetera. 

 

Decided, can't do the SSRI this is madness. Found a really wonderful place that does microdosing psylocibin, started that 3 weeks ago. It for sure helps, a lot, especially on the non break days. Switched back to 5 of prozac, I had the smoothest experience on the prozac of the 3, honestly felt like Lexapro was poison to me and I was only on it for 6 weeks, half of which was on prozac. So just went back. 

 

Debated going to 5 vs 10, but I really wanted to be on the lower dose, so I did 5. My mood is more stable by the day, but I'm having severe brain zaps pretty much all day long. I found this forum, watched all the suggested videos. I now know to do a liquid tape, 5 to 2.5 to 1.25 to .6 to 0, a month at a time, and I won't even start that taper till I'm a month out from these brain zaps. 

 

My question is, given how bad my brain zaps currently are, at 2 weeks on the 5 mg of prozac, should I INCREASE the prozac until the brain zaps stop? If I did this I was thinking maybe go to 10 mg, wait 3 days to see if they stop, if they don't go up to 15, so on and so forth, then once they've stopped, at THAT POINT being the 10% taper per month?

 

OR should I just wait at the 5mg of the prozac and once I'm a month past side effects continue. Overall I wish I could just stay at the 5mg, because I'm already here. But if the zaps could be here a LONG TIME, I just can't take that. And maybe it's too late to go back up? I just don't know.

 

Any advice anyone could offer on the best plan, given where I'm currently at, I'd be so so grateful. 

 

 

Hi @Quickcharge

Welcome to SA. I am unclear what your ultimate goal is? Is it to come off of these drugs altogether or is it too find the 'right cocktail' or dose? If it is the first, we are definitely here to help. If it is the latter, you will need to work with your doctor.

 

I don't know what videos you watched but we do not recommend the tapering schedule you list above. We recommend lowering your dose by no more than 10% of your previous dose every 4 weeks. That would mean that you would taper for over 2 years.

 

Please let us know if that's what you want to do and we can help you do it with the least amount of suffering. Otherwise we wish you good luck.

 

OMW

Edited July 30, 2022 by Onmyway

[Quickcharge]

I watched a video that was posted by a bunch of people on here. https://www.youtube.com/watch?v=PSjYH044-2Q

 

I assumed that was what was suggested here but I now understand the 10% drops. 

 

I want to get off the SSRI I'm looking for support and advice to do that. 10% over 2 years I can handle. I'll do anything. But I don't know if I should be doing that at the 5 mg of prozac I'm currently at, or if I've gone down so far so fast that it's better for me to go up to 10 mg and then taper down from there. I was in so much pain today that I took a 2nd 5mg of the prozac (so I took 10 mg today) and a few hours later it did feel to me like the brain zaps got a little bit more tolerable. 

[ChessieCat]

Yes they do mention a faster taper rate in that video.  However they also mention going slower if you get withdrawal symptoms.

 

BUT it is better to taper slowly and NOT get withdrawal symptoms, or at least keep them to a minimum so that you can live your life as normally as possible.

 

SA's recommended taper rate is no more than 10% of current dose followed by a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.  If you go faster than that you might experience withdrawal symptoms.

 

[Quickcharge]

Got it okay. Yes, I agree, better for no symptoms! Given the extreme symptoms I've been having, which are quite obviously due to all of these switches and lowerings and changes, what would your advice be in order to stablize before starting to taper (a month after stabalization). I went to 5 Prozac from 5 Lexapro this past Monday. I had my truest bottoming out yesterday and today (emotionally plus all the physical side effects). Currently scoring a 23 on the check list I found through this site of symptoms.

 

Today in desperation I took another 5 mg of prozac mid day. Should I stay at the 10mg of Prozac, hoping that it evens me out? Stick with the 5 instead and rough it out (I'd do anything for this not to be the answer but I'll take the route sugessted. or go up even higher to even out? Even just a semblance of a place to get to a place of non-panic will be so helpful at this point. Thank you!

[Onmyway]

@Quickcharge

Can you please summarize your drug and supplement history following the guidelines below?

 

 

 

 

[Quickcharge]

Just done hope I did it okay

[Onmyway]

Hi @Quickcharge, 

thank you for filling in your signature - it helps us understand your history at a glance and advise you better. 

Brain zaps are a common acute withdrawal symptom. Your body has been through a lot of experimentation in the last couple of years and seems to be destabilized from all of it. The reason why you don't have much success with all of these drugs is because they simply don't work better than placebo: Antidepressants and the Placebo Effect - PubMed (nih.gov) Even Ketamine does not have good long term success - it works initially but at 6 months the results don't hold up. I am so sorry you have had to go through all of this. 

 

If you want to come off of your drugs do it very slowly at no more than 10% of your previous dose every month. Here are the reasons why and a compilation of our best advice: 

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

 

In our experience once your nervous system is destabilized, it can take a while for it to get back to homeostasis and further drug/dosage changes can make the whole thing worse. We don't have experience with microdosing but we find that psychoactive drugs make the withdrawal process worse - people are set back by alcohol, supplements, vitamins and even antibiotics and other medicines such as corticosteroids. 

The rule of 3KIS: Keep it simple. Keep it slow. Keep it stable. - Introductions and updates - Surviving Antidepressants

Having said that, if you choose to microdose we would advise you to take the same dose at the same time every day - you are at risk of kindling (look up kindling in relation to addiction/alcohol withdrawal) with any psychoactive substance. 

 

Before you taper off your medicines we would advise you to stabilize on your current dose but what dose is the right one to stabilize on is not clear. Let me consult with the other mods and see what they advise. Can you answer a few questions briefly?

 

Q1: When (date/dose of medicine(s) did the withdrawal effects start? What symptoms were most prominent

Q2: What are your current symptoms beyond brain zaps, if any? How is your mood? Sleep? OCD? 

 

These threads below can help you understand what is going on right now and what to expect. 

 

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

 

Many people find Magnesium and Omega-3 help but some people find even those difficult so start at a low dose and one at a time if you want to try them. 

 

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

[Altostrata]

Welcome, @Quickcharge

 

At what point did the brain zaps appear?

 

We don't have any experience with psilocybin combined with an antidepressant (and neither does your doctor). We don't know if the brain zaps could be due to or exacerbated by psilocybin.

 

On 7/29/2022 at 2:33 PM, Quickcharge said:

My question is, given how bad my brain zaps currently are, at 2 weeks on the 5 mg of prozac, should I INCREASE the prozac until the brain zaps stop? If I did this I was thinking maybe go to 10 mg, wait 3 days to see if they stop, if they don't go up to 15, so on and so forth, then once they've stopped, at THAT POINT being the 10% taper per month?

 

Stop playing around with Prozac. Given its long half-life, it takes at least 5 weeks for a dose change fully take effect. You may find 5mg is just right. Your earlier experience indicates that after 5 weeks, 40mg was very much too much for you:

On 7/29/2022 at 2:33 PM, Quickcharge said:

For 5 weeks thought answers were solved.!Then one day I woke up and it was like I was drowning in serotonin again, worse every day.

 

What effect has 5mg Prozac had on your symptom pattern?

[Quickcharge]

My brain zaps started when I went to the low does of the Lexapro, from the 40 of prozac, about 2 weeks after. I went up to 10 mg of the Prozac and I still have the brain zaps but not as bad (60% less). I'm going to wait to stabilize at this dose, and then do the 10% a month over 2 years as suggested here. The symptoms that have been really bad are the suicidal thoughts and mood crashing, which seems to happen when on the very low dose, usually after a few hours of really horrendous brain zaps. 

 

Within 4 hours of adding the 5 mg of the prozac I felt a lessening of the symptoms. It felt like my brain had been atrophied and suddenly had water. I understand it takes 5 weeks, but I don't know how else to explain it. I think going from 40 prozac, all the way down to 5 of Lexapro, and then over to 5 of Prozac, CLEARLY was nuts and sent me into a really bad place. Maybe 5mg is "just right", but I want off. I think 40 down to 10 is still a lot, very fast. If I can even out here and then do the planned taper method then I think i can make it through this. 

 

Thank you so much everyone for your suggestions. Once I'm stabilized I will also try the magnesium to see if it helps in the lowering of the dose. 

[Altostrata]

7 minutes ago, Quickcharge said:

Within 4 hours of adding the 5 mg of the prozac I felt a lessening of the symptoms. It felt like my brain had been atrophied and suddenly had water. I understand it takes 5 weeks, but I don't know how else to explain it.

 

This indicates that a very little amount of fluoxetine -- the amount that got into your system in 4 hours -- was enough to reduce withdrawal symptoms, which probably were from your going off fluoxetine and onto escitalopram. We often see that a very low dose is enough for this, which is why we routinely suggest a very low dose for reinstatement.

 

If you had left the dose at 5mg, you probably would have seen gradual improvement as it ramped up over the next month. It's possible that your escalation to 10mg might prove to be too high a dose for you.

[Quickcharge]

Yeah that does make sense. I went up in desperation before getting feedback on here, and then just stayed with it today.
 

Even if it is too much, I’ll be lowering by 10% in a month, so will the “too much” matter, by that logic, as long as I start the controlled taper down?
 

Regardless, I’m 100% in agreement I will no longer play with the Prozac. Going down to 5 tomorrow frankly really scares me, given that I feel better today at 10 and yesterday was very scary.
 

Given all the above, would you recommend I stay at 10 a month and then start the taper, or drop down to some amount in between tomorrow? I understand the logic as to if I’d waited at 5 could have been okay, but I couldn’t (or didn’t) wait so would like to make the safest decision moving forward as to what to wait at before the next 10% jump down.

 

thank you! 

[Altostrata]

7 minutes ago, Quickcharge said:

Even if it is too much, I’ll be lowering by 10% in a month, so will the “too much” matter, by that logic, as long as I start the controlled taper down?

 

If 10mg is too much, you will have that unpleasant serotonin feeling you had before (serotonin toxicity). I doubt you will want to put up with it.

 

If it starts to feel like too much over the next few weeks, strongly recommend you reduce at least to 7.5mg.