Ruby22: severe pain - need advice about reinstating

[Ruby22]

Hi all. I really need some advice about reinstating. I was on Prozac for about 5 years (started at 20mg and was at 60mg for the last 1.5 years) for seasonal affective disorder and anxiety. A couple years ago, I started Adderall for suspected narcolepsy. My narcolepsy got much worse the following year and another stimulant, armodafinil, was added. I finally got approved for a treatment that treats the root problem by normalizing the sleep cycle and started Xywav in September 2021. A few weeks in, I woke up feeling rested for the first time in my life, but with some very unusual symptoms atypical for Xywav. Going down on the Xywav did not get rid of it. I did stop armodafinil which helped a bit. I was referred to a psychiatrist (scheduled 3 months out) and neurologist (scheduled 7 months out). I went 3 months with these symptoms (SEVERE anxiety, dizziness, tremor, muscle twitching and stiffness, feeling agitated by noise and light, and sensory overloads) and was finally diagnosed with serotonin toxicity from the psychiatrist. I did a rapid taper from 60mg to 20mg over 3 months. Each drop I made, I had withdrawal, then stabilized quickly and had the toxicity come back. My psychiatrist and I decided to try holding at 20mg because of a longer withdrawal period, but then I started to feel like the toxicity was coming back. I kept going and taking the pill because I didn't see how it could be toxicity at that point, but I kept getting worse each time I took it. I started having spasms and burning sensations on my skin and was very hyper-reflexive. I was eventually instructed to CT at 20mg. I immediately felt better the next day, pain and spasms were gone within 3 days and I improved dramatically over the next couple months with only mild withdrawal symptoms. I did treat the mild withdrawal by taking 0.25-0.5mg microdoses of Prozac as needed (which I realize now was probably a bad idea, but it worked at the time). At 4 weeks, I started to have mild tingling in my legs but didn't think much of it. At 6-7 weeks out I felt almost completely recovered and back to normal and then week 8 everything started going downhill with the burning and tingling sensations in my legs amping up. I tried my last microdose of 1mg on June 6 and didn't have much change in symptoms.

 

Over the next several weeks, I developed burning and tingling in my arms, back/spine, chest, neck, face, and now stomach. Along with this, I also have had severe muscle spasms in various areas, stiffness/tightness, cramping, and general muscle/joint pain. Posting this, I have now been off for 4 months and am going through wave and window episodes of severe pain and less pain. Each wave I seem to have burning/tingling neuropathic type pain, muscle pain, spasm, or stiffness developing in a new area of my body, so it’s now widespread. The pain is milder during the day, but gets so much worse at night and is causing lots of fear and anxiety. Since starting 5-htp, curcumin, and modified cictrus pectin (recommend by a naturopath) I seem to be having a few more windows through the day of a lot less pain and even 1-2 nights a week where the pain does not become severe at night. My mental symptoms are anxiety/fear, detachment (happens 6-8pm everyday) and some mood swings/low mood. The intense fear caused by the pain is the worst one. Most of my other symptoms are physical (blurred vision, dizziness, nausea, fatigue, loss of appetite). I know reinstating can be a bit risky this far out, but I am a grad student and the semester will be starting soon. I would like to be more functional than I am... and in less pain. So is it worth trying a reinstatement at this point to see if the pain will go away or should I just try to wait this out? If I do choose to reinstate, my psychiatrist suggested reinstating 5mg, but would it be better to start at 1-2mg and work up?  

 

4 months off at end of July and primary symptoms are pain (burning/tingling neuropathic pain, spasms, stiffness, aches bodywide), blurred vision, dizziness, detachment, nausea, loss of appetite, dry mouth and eyes, mood swings, and a lot of anxiety and fear.

 

A couple other things.  One thing I have working for me in withdrawal is my Xywav. I always get 8 hours of quality sleep a night with no insomnia, so maybe that will help me to stabilize just a bit faster than normal (or maybe its wistful thinking...). I also don't think I have a chemical sensitivity. I have started supplements, an antiviral (acyclovir), and lowered the adderall without any obvious worsening of symptoms. 

 

Also is there anybody here who can relate to this and has developed a lot of pain in withdrawal? I’m 24 and never had pain before. I have had a full autoimmune and blood work up as well as a brain mri. All normal, so hopefully it's just withdrawal. Sorry for the long post, but thank you for reading and any advice you can offer.

 

Edited August 2, 2022 by getofflex

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  It sounds like you are dealing with issues from being on the drugs (adverse reaction/serotonin toxicity) as well as withdrawal syndrome from going off the Prozac 20 mg abruptly.  It is not uncommon for it to take several months for withdrawal symptoms to show up.  

 

You were on a very high dose of Prozac, so I can see why you developed an adverse reaction/serotonin syndrome.  

 

Can you please make your drug signature more concise, listing only drug names, specific dates (as best you can say for example early March if you don't recall the day) and dosages of each medication decrease or increase?  That will really help me to see what drug you were taking when, and what you are still taking. Please delete descriptions of symptoms, diagnoses, etc. (I've moved your current symptoms to your intro post)  Use this format:

 

Drug name: date, dose, date, dose, date, dose…

Drug name: date, dose, date, dose, date, dose…

Drug name: date, dose, date, dose, date, dose…

Etcetera

 

Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Drug History in Signature

 

Here is some important information about how these drugs actually work.  This explains why we get symptoms from going off of these medications, and why it's so important to taper slowly and carefully, and be very cautious about changing our doses: 

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

Video on Recovery from Psych Drugs

 

Windows and Waves Pattern of Stabilization

 

 

Here is a link with checklists of common WD symptoms: 

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

Stability is really important when we are tapering off psych meds.  Please read the link about stability:

 

Keep It Simple, Slow, and Stable

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

Omega 3 Fish Oil

 

Finally, going back on a small dose of your drug, or increasing your dose, which we call reinstatement, is best done very carefully.  This is temporary, and after stabilizing you would then taper gradually off of this.  There is some risk involved.  When I see your updated drug signature, I can give a suggested reinstatement dose. Here is some information about reinstatement.  

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

We look forward to hearing from you soon.  Please keep in touch.  

[getofflex]

On 7/30/2022 at 2:33 PM, Ruby22 said:

lowered the adderall without any obvious worsening of symptoms. 

I would not make any other changes to my drugs if I were you.  If you do a prozac reinstatement, and have problems, you won't know if it's from the reinstatement, or lowering the Adderall.  

 

On 7/30/2022 at 2:33 PM, Ruby22 said:

Also is there anybody here who can relate to this and has developed a lot of pain in withdrawal?

I personally have not had this symptom, but many people have.   

 

Pain and Stiffness in WD

 

Body Pain

 

Pain from Psych Med WD

 

 

[Ruby22]

Out of desperation, I did reinstate 1mg of Prozac with my psychiatrist's approval. I noticed a decrease in anxiety after taking it and I had less pain these last 2 nights. However, today I am having more symptoms. Worse tremor, this buzzing originating in my back and traveling through my body, some head pressure, worse blurred vision and dizziness. But this could be because I made too many changes too quickly. I am noticing I am much more sensitive to the Adderall even though I'm only taking 5mg doses. If I just sit at 1mg, and don't change anything else, should these symptoms eventually stabilize? 

 

All I want at this point is to get out of withdrawal. If I thought it was safe for me, I would just go back on a therapeutic dose and do this at another time. I have grad school starting soon and just want to get back to my life. 

[ChessieCat]

July 30 - Reinstated 1mg of Prozac, Went down to 50mg 5-htp

 

You also made a 50% reduction of the 5-htp.  The reduction in anxiety might have been due to this and not the reinstatement of the Prozac.

 

When making changes, SA suggests only making one change at a time.  When there is more than one variable it is very difficult to know what might have caused any worsening/improvement.

 

Also, please note that Prozac has a very long half life and it can take 3 weeks before a dose change is registered in the brain.

 

 

 

[getofflex]

15 hours ago, Ruby22 said:

Out of desperation, I did reinstate 1mg of Prozac with my psychiatrist's approval. I noticed a decrease in anxiety after taking it and I had less pain these last 2 nights. However, today I am having more symptoms.

As Chessie Cat said, it takes time for a reinstatement to register in the brain, and take effect.  Please give it time.  The worse thing we can do is react whenever we have an uptick and symptoms, and keep changing our drugs.  That is a recipe for major problems.  There is no quick fix for withdrawal.  Please don't make any more changes to your drugs or supplements for a while.  Remember, windows and waves are part of the healing process.  Please read this: 

 

Stability - Stop Jumping Around

 

 

[Ruby22]

Well after reading the thing about stability, I’m kicking myself for making so many changes. I’ve been getting bad advice about experimenting to see what works. I am now highly suspecting that I’m having adverse effects from the adderall, but since I just reinstated the Prozac, I can’t try coming off of it yet, right? Will having adverse effects from Adderall affect the reinstatement? What advice would you give in a situation like this? Also, how long do I wait to see if the reinstatement is successful and what happens if it is not? 

[Ruby22]

Really nervous. Barely slept on my Xywav which has never happened before and had extreme anxiety this morning. My heart is pounding like crazy. I’m afraid to take my adderall and afraid not to. I think the problem is I’m taking medication around the clock. I take the adderall in 5mg doses 4x a day, the Prozac 1mg in the evening, and 2 doses of Xywav at night, and 5-htp in morning. How do I go about fixing this? Please advise. 

[getofflex]

23 hours ago, Ruby22 said:

I am now highly suspecting that I’m having adverse effects from the adderall, but since I just reinstated the Prozac, I can’t try coming off of it yet, right?

Here is what you can do:  keep a daily journal, and see how you feel in the 3 hours after you take the adderall.  Adderall reaches peak plasma level in the bloodstream 3 hours after you take it.   If you feel consistently worse after you take it, you can assume you are having an adverse reaction to it. Please post your journal notes in here, and we can help you see what is going on.  If you are having an adverse reaction to it, you might be able to slowly and carefully taper off, while holding on your 1 mg reinstatement dose of the prozac.  Please pay especially close attention to how you feel before you take the adderall, and after you take it.  Here is an example of the daily journal:  

 

6 AM woke with anxiety

8 am took 2.5 mg lexapro

10 am stomach is upset

10:30 am ate breakfast

11:35 am got a headache, lasted one hour

12:35 ate lunch

4 pm feel a bit better

5 pm took 2.5 mg lexapro

6 pm ate dinner

9:20 pm headache 

10:00 pm took 50 mg Seroquel

10:30 pm feeling dizzy

10:30 pm fell asleep 

2:30 am woke, took 3 mg Ambien

2:45 am fell asleep

4:30 am woke, but got back to sleep 

 

23 hours ago, Ruby22 said:

Also, how long do I wait to see if the reinstatement is successful and what happens if it is not? 

Prozac has a long half life, and reinstating it takes several (about 3) weeks to fully register in your system. Unless you feel significantly worse, and it's not an adverse reaction to the Adderall (we will know by your notes above), then please stay on the 1 mg prozac for a while.  It takes a couple of months for a reinstatement to reach it's full effect.  

 

1 hour ago, Ruby22 said:

Really nervous. Barely slept on my Xywav which has never happened before and had extreme anxiety this morning. My heart is pounding like crazy. I’m afraid to take my adderall and afraid not to.

If it were me, I would not abruptly stop taking adderall at this time.  I know this is scary, but we will help you get through this.  Insomnia can make everything feel worse.  Stopping another drug at this time will confound things, and we won't know what is causing what.  I suggest you please go ahead and take it just as you have been, and see if you feel worse in the 3 hours after you take it.  How many hours apart do you take your adderall doses - 4 hours?  6 hours?  

 

Your drug signature says  

 

July 7 - 12 - Trial off of the Adderall

July 13 - Resumed Adderall at 20mg/day taken in 4 5mg doses;"  

 

What happened when you went off the Adderall July 7 - 12?  What happened when you resumed your adderall on July 13?  Were you taking it in 4 doses prior to this? 

 

 

 

Edited August 4, 2022 by getofflex

[getofflex]

Another thing is, multivitamins often have high amounts of B vitamins in them, which can be activating, and cause insomnia and anxiety, especially in destabilized nervous systems.  You could try stopping that right away, it may help.  

 

If you have only been taking the 5-HTP since July 22, then I would stop that, too.  Throwing too much stuff at your nervous system will tend to confuse and worsen things rather than help.   

[Ruby22]

I will work on the journal. I noticed when I did the trial off of the adderall I was more fatigued, had more blurred vision, but slightly less pain and anxiety. Before the trial I was doing 10mg doses 4x a day. Right now I take the adderall every 2.5 hours because that’s when the 5mg dose starts to wear off. Maybe it’s too close together. I just notice that I have bad affects when it’s increasing or decreasing, not so much in a steady state. The reason I’m a little concerned about the Prozac reinstatement is when I was serotonin toxic, I would wake up with extreme anxiety, so it feels similar to that. 
 

Regarding the multivitamin and htp, I kind of figured I shouldn’t be stopping anything yet. 

[Altostrata]

Hello, @Ruby22

 

When you started Prozac in 2017, did it make you tired? After you increased Prozac to 60mg, did you become more tired?

 

Quote

Jan 2022 - Diagnosed with serotonin toxicity (had mild/moderate case for 3 months)

 

Which drugs, at what dosages, were you taking September-January 2022, before you went off in January?

 

We will need to see those daily notes before we can distinguish potential adverse effects of your current drugs from withdrawal syndrome.

[getofflex]

39 minutes ago, Ruby22 said:

Right now I take the adderall every 2.5 hours because that’s when the 5mg dose starts to wear off. Maybe it’s too close together.

At what times each day o'clock do you take these addreall doses? 

 

40 minutes ago, Ruby22 said:

I just notice that I have bad affects when it’s increasing or decreasing, not so much in a steady state

I'm not sure what you mean by this.  

 

41 minutes ago, Ruby22 said:

The reason I’m a little concerned about the Prozac reinstatement is when I was serotonin toxic, I would wake up with extreme anxiety, so it feels similar to that. 

But remember, you are only on 1 mg of Prozac, which is a very low dose so I wouldn't think serotonin toxicity would be a high probability.  High anxiety is also a hallmark symptom of destabilization from psychiatric drugs, be that caused by withdrawal, adverse reaction, etc.  Not only that, but all humans have a cortisol spike in the early morning hours, starting at about 4 AM.  In people with a healthy nervous system, this serves to give them energy to start the day.  But, in people like us, with destabilized nervous systems, this cortisol spike makes us anxious, sometimes very anxious in the morning hours.  This is a very common symptom of withdrawal.  

 

Also, adderall is a stimulant, so that could cause anxiety, hence the request for a daily journal.  

[Ruby22]

I normally take the adderall 9:15am, 12pm, 2:30, 4:45. It takes a half hour for the dose to kick and I feel really awful at the half hour mark (anxiety, fast heartbeat, tremor, spasms). And I feel really awful at 6:30-8 when it’s wearing off. I honestly don’t know if I can tolerate another dose. I’m shaking like crazy and feel completely overstimulated

[Altostrata]

57 minutes ago, Ruby22 said:

I feel really awful at the half hour mark (anxiety, fast heartbeat, tremor, spasms)

 

This indicates you're taking Adderall too often. Why are you taking it on this schedule? 9:15am, 12pm, 2:30, 4:45 

 

Are you taking Adderall XR or immediate-release Adderall? Please specify in your signature.

 

57 minutes ago, Ruby22 said:

And I feel really awful at 6:30-8 when it’s wearing off.

 

This indicates you are getting withdrawal symptoms from Adderall because you have established a physiological adaptation with your daily dosing schedule.

 

Since you've been taking Adderall on this schedule only since July 13, suggest you take only 3 5mg doses per day, spaced 4 hours apart: 9 a.m. 1 p.m., 5 p.m.

 

I would not increase Prozac. Please put ALL your drugs in this Interactions Checker and post the report or a link to it in this topic.

 

fyi https://www.drugs.com/interactions-check.php?drug_list=1115-0,190-1645

 

Quote

 

Interactions between your drugs

Major

FLUoxetine  amphetamine

Applies to: fluoxetine, Adderall (amphetamine / dextroamphetamine)

Talk to your doctor before using FLUoxetine together with amphetamine. FLUoxetine may increase the effects of amphetamine, and side effects such as jitteriness, nervousness, anxiety, restlessness, and racing thoughts have been reported. Combining these medications can also increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should contact your doctor immediately if you experience these symptoms while taking the medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

 

 

 

[Ruby22]

 

FLUoxetine  amphetamine

Applies to: Prozac (fluoxetine), Adderall (amphetamine / dextroamphetamine)

Talk to your doctor before using FLUoxetine together with amphetamine. FLUoxetine may increase the effects of amphetamine, and side effects such as jitteriness, nervousness, anxiety, restlessness, and racing thoughts have been reported. Combining these medications can also increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should contact your doctor immediately if you experience these symptoms while taking the medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

 

FLUoxetine  sodium oxybate

Applies to: Prozac (fluoxetine), Xywav (calcium oxybate / magnesium oxybate / potassium oxybate / sodium oxybate)

Using sodium oxybate together with FLUoxetine may increase side effects such as drowsiness, dizziness, lightheadedness, confusion, depression, low blood pressure, slow or shallow breathing, and impairment in thinking, judgment, and motor coordination. Occasionally, severe reactions may result in coma and even death. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. You should avoid the use of alcohol while being treated with these medications. Also avoid driving, operating machinery, or engaging in potentially hazardous activities requiring mental alertness and motor coordination for at least six hours after taking sodium oxybate and until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

[Ruby22]

Both were listed as major, which is interesting that the Xywav pharmacy told me this combination was perfectly fine. I was originally taking the adderall on an every 3 hours schedule because that's when the 5mg seemed to wear off and I've been very fatigued in withdrawal. I adjusted it slightly to 2.5 hours because I wanted to take my last dose by 4:30pm since I've been taking the prozac at 6:30pm. Now I have no fatigue, which is really odd because I'm not sleeping well at all. By not increasing the prozac, do you mean don't go up from 1mg, or the 1mg was a bad idea? 

 

Thank you so so much for your help. I acted abruptly purely because I wanted to save my semester in graduate school.  I have a couple of questions. Since I seem to have kindled myself, I know I am at risk of developing adverse reactions to things. The only med I absolutely don't want to have to come off of is the Xywav. I haven't messed with that at all, so should that one hopefully be okay? The other question, do you think the nerve pain, spasms, stiffness, twitching, and myofacial pain is likely all part of this withdrawal syndrome. I've noticed flair ups tend to happen a half hour after I take the Adderall, and in the late evening/nighttime. These pains do seem psychosomatic and closely tied to anxiety. 

 

 

[Ruby22]

I’m also concerned about the Prozac reinstatement. I feel exactly how I feel when I had serotonin toxicity. There are others in a serotonin syndrome group who say that the threshold for SS seems to get lower once you’ve had it. Things went wrong when I tried to reinstate, so should I taper off? 

[Altostrata]

I don't know if you've kindled yourself. You appear to be taking TOO MUCH Adderall per day.

 

1 hour ago, Ruby22 said:

Now I have no fatigue, which is really odd because I'm not sleeping well at all.

 

Not the least bit surprising, since you're overusing an amphetamine!

 

As it appears you are already taking TOO MUCH Adderall, and it may interact in a way with Prozac to cause serotonin toxicity, I would not increase Prozac -- unless you want to sample serotonin toxicity again.

[Ruby22]

I am very concerned I am sampling it now. Can I have instructions to safely taper off the Prozac and adderall. 

[Ariel]

Hi @Ruby22

 

I am not a mod but am noticing from your drug signature that you've been taking 50-100 mg 5-HTP for about a month now. 

 

You may want to redo the drug interactions check and include 5-HTP along with Prozac and Adderall. 

 

5 hours ago, Altostrata said:

Please put ALL your drugs in this Interactions Checker and post the report or a link to it in this topic.

 

It is my understanding that 5-HTP is serotonergic and can potentially contribute to serotonin toxicity. 

 

[Ariel]

On 7/4/2011 at 2:35 AM, Altostrata said:

From http://www.rxlist.com/5-htp-page3/supplements.htm#Interactions

 

Are there any interactions with medications?

 

Medications for depression (Antidepressant drugs)

Interaction Rating: Major Do not take this combination.

 

5-HTP increases a brain chemical called serotonin. Some medications for depression also increase serotonin. Taking 5-HTP along with these medications for depression might increase serotonin too much and cause serious side effects including heart problems, shivering, and anxiety. Do not take 5-HTP if you are taking medications for depression.

 

Some of these medications for depression include fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), amitriptyline (Elavil), clomipramine (Anafranil), imipramine (Tofranil), and others.

 

Medications for depression (MAOIs)

Interaction Rating: Major Do not take this combination.

 

5-HTP increases a chemical in the brain. This chemical is called serotonin. Some medications used for depression also increase serotonin. Taking 5-HTP with these medications used for depression might cause there to be too much serotonin. This could cause serious side effects including heart problems, shivering, and anxiety.

 

Some of these medications used for depression include phenelzine (Nardil), tranylcypromine (Parnate), and others.

 

 

[Ariel]

On 7/12/2011 at 6:11 PM, Altostrata said:

 

It's not a good idea to take 5-HTP with a serotonergic drug as it could cause excessive elevation of serotonin.

 

 

[NardilTime]

I’ll leave the specific methods to the experts, but on a macro level I’d just like to add that it seems pretty clear that: (1) your doctors have no idea what they’re doing, which is par for the course; and (2) these drugs are killing you and your long term goal should be to get the hell off them and never take any psych drugs again. 
 

The good news is you are 24 and you caught this early. You can get off and recover at a young age. I spent 20 years on this crap. The prognosis for you is very good. You can do this, fully recover, and go about your life. I’m pulling for you. 

[Ruby22]

NardilTime, thank you for the encouragement 🙏

But on the other hand I’m missing this prime time of my life and I have no idea if I’m going to be able to manage grad school dealing with this and what that will mean for my career. My dad (he’s a doctor) says the problem I’m having is not the withdrawal or adverse effects but that I have uncontrollable anxiety that is exasperating these symptoms. Sure I have anxiety, but this feels on a completely different level and it skyrocketed when I made those changes really fast. 
 

So having made a bunch of changes really fast, should I not take the 50mg 5-htp tomorrow or still take it? I don’t think I am toxic after checking my reflexes with my dad but am having VERY similar symptoms that are possibly exacerbated by not sleeping and the extreme anxiety. I just feel incredibly hyper-stimulated. 

[ChessieCat]

2 hours ago, Ruby22 said:

should I not take the 50mg 5-htp tomorrow or still take it?

 

You made a 50% reduction of the 5-htp oly about 1 week ago.  It might be too soon to reduce it again.

 

At this time, please continue to take 50mg 5-htp and wait for Alto to advise about this.

 

Edited August 5, 2022 by ChessieCat

[Ruby22]

19 hours ago, Altostrata said:

Hello, @Ruby22

 

When you started Prozac in 2017, did it make you tired? After you increased Prozac to 60mg, did you become more tired?

 

 

Which drugs, at what dosages, were you taking September-January 2022, before you went off in January?

 

We will need to see those daily notes before we can distinguish potential adverse effects of your current drugs from withdrawal syndrome.

 

I did gradually become more tired in college though I never directly associated it with the Prozac. I had bad fatigue prior to starting the Prozac. After being diagnosed with narcolepsy, I attributed the increasing fatigue to that. I was on 60 mg the summer of 2021 which was the first time being on a high dose during the summer. This was the most tired I felt. I was taking the 60mg when I started the Xywav in September through Jan 2022. 

[Ruby22]

Daily journal 8/5

 

12:30 Xywav dose 1 

3:15 woke up - buzzing through body, couldn’t really fall back asleep 

4:30 Xywav dose 2

7:15 - woke up with bad anxiety and buzzing, had panic attack

9:30 - 5mg Adderall, felt panicked and hot for half hour and had spasms and nerve pain

10:30 - took 5-htp, citrus pectin, protein shake very nauseous, vision is off

11:45 - 5mg Adderall

12:30 - tachycardia, tremor, head pressure, blurred vision 

1-2:30 - severe pressure headache and overstimulated feeling

2:30 - lunch, felt very cold, head pressure stopped 

3 - 5mg adderall

3:30 - head pressure returned

4:30 - citrus pectin 

4-6:30 very bad tremor and internal vibration, spasms and nerve pain, severe anxiety, some confusion/brain fog

7-1mg Prozac, curcumin

8-citrus pectin, felt anxious/detached 

10-12 - felt a little better mentally, but still vibrating internally

12:30am - Xywav

4:30am - Xywav, had spams and increased buzzing after dose, only slept a couple hours on each dose

Had very severe dry mouth through day, muscle stiffness on and off. 

[NardilTime]

14 hours ago, Ruby22 said:

My dad (he’s a doctor) says the problem I’m having is not the withdrawal or adverse effects but that I have uncontrollable anxiety that is exasperating these symptoms. Sure I have anxiety, but this feels on a completely different level and it skyrocketed when I made those changes really fast. 

Unfortunately your dad is 100% wrong. Doctors simply don’t understand or are unwilling to understand the truth about the reactions people have on these drugs. You sound exactly like me. It’s on another level. That’s because it’s not real natural anxiety. It’s chemically induced anxiety. I’m sorry you don’t have his support. But know this, you are right. What you are feeling is real. I got gaslit too and it’s the worst feeling ever. I wish I had come in contact with somebody who had validated what I knew to be true. Took me a lot longer to find the recovery community. But you’ve found it. Keep pushing and listen to the mods, especially alto. 

[getofflex]

Ruby from your first journal it looks like you are having an adverse reaction to the adderall.  Please keep posting your daily journals in here.  Do you feel worse after you take your adderall? 

Edited August 5, 2022 by getofflex

[Ruby22]

1 hour ago, getofflex said:

Ruby from your first journal it looks like you are having an adverse reaction to the adderall.  Please keep posting your daily journals in here.  Do you feel worse after you take your adderall? 

I took 5mg this morning and felt awful for several hours. I could not bring myself to take anymore for the rest of the day. I also did not take the 5-htp. I am feeling quite a bit better now.

[Ruby22]

Update: just spoke with my psychiatrist. She thinks I am serotonin sensitive and am having a reaction to too much neurotransmitters/too much meds and is having me discontinue the Prozac. I feel like this is the right choice. 

[getofflex]

I'm glad you are feeling better.  But if you have a wave and start feeling worse, I suggest you don't jump back on right away, as this is like playing ping pong with your brain.  Hopefully, you've read my earlier links about stability.  Please update your signature box with your latest drug changes. 

Edited August 6, 2022 by getofflex

[Altostrata]

Your psychiatrist didn't notice the excessive Adderall?

[Ruby22]

1 hour ago, Altostrata said:

Your psychiatrist didn't notice the excessive Adderall?

She wants me to lay off that too for a bit and we’ll reassess after the weekend.  The buzzing is calming down a bit. She thinks many of my symptoms are from too much psychotropic med activity and that I have been negatively impacted by them. 20mg of Adderall a day is not necessarily excessive (40mg a day is more typical), but splitting it in 4 doses was probably not the way to go. I will talk to her about that on Monday. I am noticing less pain since I had reinstated but I also don’t want to risk SS again. Should I talk to her about trying 0.5mg or commit to discontinuing completely? The other concerning thing is, at the end of the day, I still have narcolepsy. But if I had an adverse effect to the stimulant, I think it’s likely I’ll probably have an adverse effect if I try to go back on later. So I won’t have anything for the excess sleepiness unless I try a different drug or risk going back on, and idk if it’s safe to try either of those things now. 
This all really sucks. 

[Ruby22]

I have a question. The new symptoms I’ve been experiencing since the adverse reaction, feeling wide awake, restless, and overstimulated, vibration through body, worsened dizziness, worsened vision/vibrating vision, sensation of brain burning, feeling very hot or very cold, shivering, tremor, fast heart rate, worse anxiety, but also much less pain. I’ve been instructed to take cyproheptadine as needed. I wanted to know if these symptoms could be just from kindling or if serotonin toxicity is more likely. The cyproheptadine does seem to help, but I am not sure if I’m making matters worse in the long run by taking it.