jjwarf: struggling with post acute withdrawal

[Shep]

@jjwarf In my last post, I forgot to ask where you're at in your taper. Are you still at 7.2 mg Prozac? Have you added in any new drugs or supplements? If your current signature is out of date, please update it. A direct link is here:

 

Account Settings – Create or Edit a signature

[Alexmember]

15 hours ago, jjwarf said:

Has anyone struggled with their feelings being all over the place? I have had a pretty good period of stability but the last few weeks have been a rollercoaster. I'll be perfectly fine, happy even, in the mornings and then almost unable to function in the evenings because I am so sad or just numb. Earlier today I felt so happy, almost elated, and then bam! I feel intense anxiety and sadness. I had to lay down and still feel like I am shaking.

 

Anybody?

 

yes definitely.

 

I'm currently at 3 weeks of reinstatement on effexor and it's an overall improvement but still very up and down. Like yourself, I am often better in the morning and early afternoon and this is when I get most of my windows. However, come evening and night I tend to crash and can get sudden panic, feelings of intense terror/doom, and a lot of intrusive thoughts.

I've went from feeling back to normal to lying on my bathroom floor shaking and sobbing in the space of 10 hours.

 

All part of the brain trying to stabilise itself again. I try to keep reminding myself this and it helps. 

[Kelsears]

@jjwarf

checking in to see how you are doing? 

[jjwarf]

@Kelsears you are so sweet! I am feeling better today. I had a couple of waves of intense anxiety but I made it through them. I keep telling myself that this isn't forever. One day we are going to feel ok again.

 

How are you?

[jjwarf]

@Shep As always, thank you for taking the time to respond. I am going through the links you sent. I like what you said about seeing this as an opportunity to practice mindfulness skills.

 

I haven't tapered anymore or added anymore supplements. I am still at 7.2mgs Prozac and 10mg Trintellix. I wanted to start tapering but then the symptoms have returned over the last few weeks. I am just thankful they are not as severe as they have been in the past. So, I think that is progress. How long should I wait before tapering? I was thinking that once I am stable enough to taper again, I only want to taper in 0.2mg increments. I am so sensitive to change and also just scared.

[jjwarf]

@Alexmember I am sorry that you are experiencing that. I am glad we have this forum where we can share our experiences and know that we are not alone. That's so strange. I have the same thing happen: great windows in the morning and then the evenings can be awful! Thank you for sharing

[Shep]

10 hours ago, jjwarf said:

@Shep As always, thank you for taking the time to respond. I am going through the links you sent. I like what you said about seeing this as an opportunity to practice mindfulness skills.

 

I haven't tapered anymore or added anymore supplements. I am still at 7.2mgs Prozac and 10mg Trintellix. I wanted to start tapering but then the symptoms have returned over the last few weeks. I am just thankful they are not as severe as they have been in the past. So, I think that is progress. How long should I wait before tapering? I was thinking that once I am stable enough to taper again, I only want to taper in 0.2mg increments. I am so sensitive to change and also just scared.

 

Yes, I think what you're going through is progress, too. This is where it's best to look at your *overall* symptoms going back in time. If the waves are not as severe, than you are, overall, doing better. That means you're going in the right direction.

 

You may want to check this post out, as it's a very good description of when it's a good time to taper - it's what Brassmonkey calls WD Normal (Withdrawal Normal):

 

WD Normal

[Kelsears]

@jjwarf

im doing ok. Busy with back to school. But the body keeps my mine occupied so that’s a good thing. 
still taking my 2 walks a day which seems to help a lot as well. 

[jjwarf]

@Shep I read through the link you sent me for withdrawal normal. Thank you! I honestly think that is where I am at. Most days I do feel better. I still get waves but they are manageable and not nearly as bad as they were.

 

I really want to continue with the taper. I am scared though! I only want to taper 0.2 mgs of Prozac. I am nervous because I am in the middle of a semester of school but also I'm not so sure that there will ever be a time in my life where I don't have stuff going on that I need to deal with.

[Shep]

Very true, @jjwarf. It is hard to find that *perfect* time to get off these drugs. Perhaps sticking to a micro-taper will help. You'll make slow progress, but you'll be more functional, which is really the goal during this stage. Please let us know how you do. 

[Kelsears]

@jjwarf

That read about the withdrawal normal was sooo helpful.  I was reaching for before med normal not know I just needed to find my stable withdrawal normal. Don’t beat yourself up over tapering. Slow wins the race. Just remember every cut is a step towards the finish line. No matter how small it is. Celebrate those cuts even it it’s .0001 mg. It counts! Stay stable and stay strong! 

[jjwarf]

@Kelsears

 

omg same here! I was waiting until I felt normal like I did before meds or withdrawal! That article was so helpful!

 

Today I reduced my dose to 7mg of Prozac. I am nervous but determined. It is going to be ok!

 

Also, I’m wondering if anyone else has experienced extreme daily nausea? I’m not sure if it’s from the Prozac and Trintellix combo or if the vitamin E and fish oil supplements are the culprits since I started them around the same time.

I feel nauseous constantly! I can’t eat a whole lot or I get nauseous and a terrible headache. Any info would be greatly appreciated!

[Kelsears]

At the beginning of my cold Turkey I felt nauseous all the time. But I’m sure someone else would be better at answering that. 
 

I hope your cut goes well. Thinking of ya! 

[Shep]

12 hours ago, jjwarf said:

 

Also, I’m wondering if anyone else has experienced extreme daily nausea? I’m not sure if it’s from the Prozac and Trintellix combo or if the vitamin E and fish oil supplements are the culprits since I started them around the same time.

I feel nauseous constantly! I can’t eat a whole lot or I get nauseous and a terrible headache. Any info would be greatly appreciated!

 

You may want to start a daily journal (you can do that here on the site or on a Word doc or notebook) to see if the nausea hits at any particular time(s) of the day, especially around the time you take your drugs and supplements. 

 

Here are a couple of threads we have for this symptom:

 

Digestive problems: nausea, diarrhoea, bloating, GERD

 

What to do for dizziness, queasiness, nausea

 

Please update your signature to reflect your reduced Prozac dose. 

 

Has nausea been a withdrawal symptom for you in the past? 

[jjwarf]

@Shep

 

I updated my signature and am checking out the links you sent me. I am also going to start keeping a journal to keep track of the nausea and meds.

Nausea hasn't been a withdrawal symptom for me before. 

 

I started feeling weird about an hour ago. I thought it would take longer to notice the taper since the half life on Prozac is longer than a lot of the other SSRI's, but nope. I felt anxious and detached. I did go for a walk and that helped. I had made dinner plans with friends for tonight which I may cancel in lieu of some self care but we shall see.

I am scared but hopeful.

[Shep]

16 hours ago, jjwarf said:

Nausea hasn't been a withdrawal symptom for me before. 

 

I started feeling weird about an hour ago. I thought it would take longer to notice the taper since the half life on Prozac is longer than a lot of the other SSRI's, but nope. I felt anxious and detached.

 

I'm not sure the nausea is a withdrawal symptom from the Prozac, either. Your reduction before this latest one was back in May, so that's a really long time if it's a delayed withdrawal symptom from that past reduction. 

 

On 9/19/2023 at 6:15 PM, jjwarf said:

Also, I’m wondering if anyone else has experienced extreme daily nausea? I’m not sure if it’s from the Prozac and Trintellix combo or if the vitamin E and fish oil supplements are the culprits since I started them around the same time.

I feel nauseous constantly! I can’t eat a whole lot or I get nauseous and a terrible headache. Any info would be greatly appreciated!

 

Do you mean you started the vitamin E and fish oil supplements this week when you reduced the Prozac? If so, I would suspect it's these additional supplements causing the problem and recommend stopping them for now. If you google the side effects of fish oil, you'll see that stomach problems are one of the most common. You may want to eat foods high in these nutrients instead of taking supplements, at least for now. 

 

It's best to avoid adding in supplements around the time you make drug reductions. Please see:

 

The rule of 3KIS: Keep it simple. Keep it slow. Keep it stable.

 

[jjwarf]

@Shep

 

I added the Vitamin E and Fish Oil supplements back in late May or early June. It was a couple of weeks after I made the switch from Zoloft to Prozac. I have been nauseas ever since. Yesterday I didn't take the fish oil supplement and my nausea seemed quite a bit better. Do you think it would be ok to stop taking it and see how things go?
 

So far the Prozac taper seems to be going well. I am able to function for the most part. Usually later in the evenings I get a weird wave of...well, I don't really know what. I feel kind of detached and anxious. I am getting through it though.

[Shep]

21 hours ago, jjwarf said:

Yesterday I didn't take the fish oil supplement and my nausea seemed quite a bit better. Do you think it would be ok to stop taking it and see how things go?

 

That's is great to read, jjwarf. Yes, I think it's okay to just stop. Some folks like to taper supplements, and you may find that you don't have nausea on a lower dose, so you may decide to decrease the dose and see how you do. 

 

Glad to read the Prozac taper is going well, even with a few bumps in the road, you're making your way through. 

[jjwarf]

@Shep

 

wonderful! I’ll stop the fish oil supplement and hopefully that will help. Yesterday I got nauseous around the same time I do every day but it wasn’t as bad. It’s always right before my dose of trintellix and the vitamin e and fish oil supplement I take at 5pm.

 

the evenings seem to be the hardest for me. I’m usually pretty ok during the day but right around 4 or 5 pm things take a turn. But, I am making it through and it’s not as bad as it has been before.

 

how long should I hold on this taper? Today is day 7.

[Shep]

22 hours ago, jjwarf said:

 

wonderful! I’ll stop the fish oil supplement and hopefully that will help.

 

Do you like fish? That can be a good way to get the same nutrients without the side effects. I wasn't able to tolerate fish oil and vitamin E, either, do to GI issues, but I eat fish several times a week, so it was really not as important to supplement. 

 

22 hours ago, jjwarf said:

 

the evenings seem to be the hardest for me. I’m usually pretty ok during the day but right around 4 or 5 pm things take a turn. But, I am making it through and it’s not as bad as it has been before.

 

Is this before you have dinner? Could some of these symptoms be low blood sugar from not having eaten since lunch? Would a small, high protein, low carb and zero-sugar snack help, maybe around 3 PM to prevent this 4 or 5 PM uptick in symptoms? Also, are you drinking plenty of water throughout the day?

 

I'm asking these questions because low blood sugar and dehydration can cause some of the same symptoms as withdrawal.

 

 

22 hours ago, jjwarf said:

how long should I hold on this taper? Today is day 7.

 

What kind of taper are you doing? Are you doing the Brassmonkey Slide with weekly reductions or the standard monthly reduction? 

 

You may want to give yourself at least a couple more weeks of holding to see if you can build up a better baseline now that you've stopped supplements that were causing problems. 

 

How is your sleep? 

[jjwarf]

@Shep

 

I do like fish. I usually eat it a couple of times per week most weeks. I'll do that and maybe add it in an extra night. That's interesting about low-blood pressure and dehydration symptoms mimicking withdrawal. I will try adding in a snack around 3pm. Maybe some beef jerky or nuts. I do drink water during the day. Outside of one cup of 1/2 decaf 1/2 regular coffee in the mornings, it's all I drink.

 

I hadn't made a decision on what kind of taper to do, honestly. I started this one and figured that I could do the 0.2mg reduction and see how symptoms went. Could I do a 2-3 week hold after each reduction? Or should I pick one of the methods you mentioned above?

 

So far, my sleep is pretty good. As long as I go to sleep at a decent time, I usually sleep through the night with no interruptions. 

 

I feel kind of strange this morning. I ate some foods the last couple of days that I normally don't; they had carbs and some sugar in them. I hardly ever eat foods like that because they severely effect me. After today, I am going to try to get back on the wagon. I feel disconnected and have a headache. Slight anxiety. 

[Shep]

20 hours ago, jjwarf said:

I hadn't made a decision on what kind of taper to do, honestly. I started this one and figured that I could do the 0.2mg reduction and see how symptoms went. Could I do a 2-3 week hold after each reduction? Or should I pick one of the methods you mentioned above?

 

 

Feel free to hold as long as you need. This is a great post that Brassmonkey wrote describing when it's a good time to taper, what he calls WD Normal (withdrawal normal):

 

WD (withdrawal) Normal

 

If you haven't already, you may want to check out the Brassmonkey Slide:

 

The Brassmonkey Slide Method of Micro-tapering

 

Smaller weekly reductions, as opposed to a larger monthly reduction, can be less jarring to the nervous system. You can set it up to go as slow as you like. 

 

But as long as you don't go faster than 10% a month (based on the prior month's dose, not the originally prescribed dose) AND your symptoms are tolerable, you'll do just fine. 

 

20 hours ago, jjwarf said:

 

So far, my sleep is pretty good. As long as I go to sleep at a decent time, I usually sleep through the night with no interruptions. 

 

This is great to read, jjwarf. Being able to sleep is key to getting through withdrawal. 

 

20 hours ago, jjwarf said:

I feel kind of strange this morning. I ate some foods the last couple of days that I normally don't; they had carbs and some sugar in them. I hardly ever eat foods like that because they severely effect me. After today, I am going to try to get back on the wagon. I feel disconnected and have a headache. Slight anxiety. 

 

I'm glad you're getting back on the wagon. What we eat and staying hydrated are so important, especially during withdrawal when the body needs all the help and support we can give it. 

 

Please let us know how you do as you taper. 

[jjwarf]

@Shep

 

Thank you for those links! Both were very helpful. I think I will try Brassmonkey's Slide Method but not at the 10% reduction rate. Do you think doing a 0.2mg drop each week for 4 weeks and then holding for two would be ok? I want to do a bigger cut but I am scared. I'm not sure if I should do a bigger reduction since this is going well. I just want to be off of these meds!

I am still in shock that my symptoms aren't completely debilitating! I still have the evening weirdness/not feeling well that comes each day but it usually subsides within a few hours. Thank you for all of your help. This forum has really changed this whole experience for me.

[jjwarf]

Today I decreased again. I went from 7mg of Prozac to 6.8. Here's to hoping this taper continues to go well! 

[Kelsears]

@jjwarf 🤞🏻🤞🏻🤞🏻🤞🏻🤞🏻🤞🏻🤞🏻 I do hope so. 

[jjwarf]

Today has been hard. I felt fine when I woke up this morning but then out of nowhere the anxiety hit me. I can’t focus on anything and am dreading trying to function.

 

I forgot to the trintellix the last 2/3 nights. I fell asleep early when putting my son down. I don’t know if it’s that or the taper or both. I went ahead and took my dose of trintellix for today though. I really hope this passes.

 

I went for a walk earlier and that seemed to help some. I just don’t even want to go to work or school or take care of my kid or anything.

[Kelsears]

@jjwarf

i feel this today. I’ve hit a huge wave and I feel like all my symptoms have come back. 
 

hold strong hun!!!! 

[jjwarf]

@Kelsears I am so sorry! How are you feeling today? We are going to get through this!

[Kelsears]

@jjwarf

little better today but anxiety it soooo high making my body achy. 
 

how are you? 

[jjwarf]

@Kelsears

 

Are you feeling any better? How has this week been for you?

 

Tapered down to 6.6mgs today. Have felt ok the last few days. A bit emotional yesterday but made it through. It's hard to tell how much of it is the taper or my upcoming cycle. I can so relate to being effected by that.

[Kelsears]

@jjwarf

its been an up and down week. Better than last week. But still feeling off. Anxiety higher, head pressure, tension in my shoulders, and muscle weakness. 
 

those damn cycles are hell!! Fingers crossed you breeze through it. 

[jjwarf]

@Kelsears

I'm sorry you're feeling all of that but I'm glad this week has been better than last. Any improvement is something! And god aren't they?! It still blows my mind how much my mental state, among many other things, can vary so much based on where I am in my cycle. Proud of you for hanging in there!

[Kelsears]

@jjwarf

it sooooo true! If these cycles weren’t a factor I could taper steadily and be off these drugs. 
 

im glad we’re strong women!! 

[jjwarf]

I am holding this week and will resume taper next week or maybe the week after. Things are going ok.

 

Has anyone else had horrible headaches? Mine started before the taper but seem to be much worse now. Anytime I eat I get a terrible headache. My doctor doesn't know what is going on and started me on a medication for migraines: Nurtec. She also wants me to eliminate red meat and chocolate from my diet to see if that's the cause. I am just so confused. The headaches didn't start until I switched to Prozac and have gotten progressively worse since then. It's almost every day that I have a debilitating headache. 

[ccloudyrose]

3 hours ago, jjwarf said:

I am holding this week and will resume taper next week or maybe the week after. Things are going ok.

 

Has anyone else had horrible headaches? Mine started before the taper but seem to be much worse now. Anytime I eat I get a terrible headache. My doctor doesn't know what is going on and started me on a medication for migraines: Nurtec. She also wants me to eliminate red meat and chocolate from my diet to see if that's the cause. I am just so confused. The headaches didn't start until I switched to Prozac and have gotten progressively worse since then. It's almost every day that I have a debilitating headache. 

I wanted to give some reassurance! I have had an ongoing headache since May due to what I believe was my Lexapro slowly becoming paradoxial on me after I had my dosage messed with and has stayed with me during medication changes. I feel it in my neck, throat, behind my ears, my scalp, my face, my temples etc. they make me dizzy at times and incredibly nauseous. Some days are better than others. I don't have any medication as of right now to treat it yet because I am obviously avoidant of new medication but I just wanted to let you know you aren't alone ❤️ 

[jjwarf]

@ccloudyrose thank you for responding! I am so sorry you are experiencing that but I am glad that I am not alone. Mine is the back of my head and the front of my face, temples. It makes functioning hard! I am wondering if once I switched to prozac it somehow effected the trintellix. It seems like it gets worse and I get more nauseas after I take it.

 

Best of luck on your journey through these med changes! Thank you again