Emonda: 26 years on ADs. Tapering from Vortioxetine / Brintellix

[Emonda]

Dear All,

What a relief it was to find this community around 9-months ago! Many thanks to all involved, from the administrators to the moderators and the members. 

 

I’ve written this introduction so many times over the past few months. I’ll confess that I am currently experiencing what I suspect is a wave and finding the journey more unpleasant than it has been. So, it’s time to introduce myself and ask a question at the end.

 

Short story

I developed depression and anxiety at uni, with a subsequent 26-year history of different ADs. I’ve had numerous failed CT attempts. Like everyone else, I was never advised to taper slowly. I got the usual:

·      It must be a relapse, and you need even more of the drug,

·      You have a chemical imbalance and need to take ADs for life, and 

·      Take your dose every second day over two weeks to taper.

 

Last year I stumbled across a newspaper article referring to Dr Mark Horowitz and his prolonged taper approach. After a few google searches, I found the SA website, devoured many posts, and adopted a 10% taper. 

 

After a month or so, I switched to the Brass Monkey method, as the first week of a 10% reduction would knock me around. Usually, most of my WD symptoms are tolerable. Mild insomnia, mild anxiety and tinnitus persist, although they have improved. Some strange things, such as a twitch in my left arm, have gone.

 

As many others have commented, I can’t believe this journey will take years! I’m sitting at 3.95mg, down from 15mg ~12 months ago. Moving from a 15mg tablet to a 5mg tablet was a significant milestone and a confidence booster that ‘I, too, can do this’.

 

Thanks to all for sharing their success stories. Those stories are so encouraging, especially after a few recent cold rushes of panic and some catastrophising when I start thinking, ‘maybe I should up my does’.

 

The positive I can see (care of this site) is that I can recognise that I am probably in a wave and have avoided a kneejerk response…so far…but it’s been a rough three weeks. I’ve experienced some significant triggers in a short period that have unsettled me. Most have now resolved….so here’s hoping the wave subsides. I’ll sit tight at 3.95mg until some stability returns. 

 

Question:

A wave, a relapse or a ‘chemical imbalance’ is the question that keeps going through my mind. I’m confident that it’s a wave. I guess I’m just after some reassurance.

 

How long do I stick it out, feeling off at 3.95mg? I’ve drawn a line in the sand of a fortnight from today. If I still feel fragile in another fortnight, I might go back to the previous dose of 4.06mg. That would be five or six weeks of feeling off at 3.95mg. I don’t want to up-dose too soon, but I also don’t want the collateral damage if things deteriorate further at 3.95mg.

 

Until next time, our respective journeys continue….

[Gridley]

Welcome to SA, Emonda.

 

It sounds like you have a very good handle on the situation.  Congratulation on getting so low.  Yes, it does take a long time, but you're doing a great job.  I used the Brassmonkey Slide for my Lexapro taper and it worked well for me.

 

You probably have all these links, but so you have them in one place--

 

The Brassmonkey Slide Method of Micro-tapering

 

 

Tips for tapering off vortioxetine (Trintellix, previously called Brintellix)
 

What is withdrawal syndrome.

 

Brain Remodelling 

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

The Windows and Waves Pattern of Stabilization

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Regarding your current situation, I'd go with wave.  To bolster you about the hoax of chemical imbalance, here's a link: 

 

Again, chemical imbalance is a myth. Stop the lies, please.

 

Your idea about the updose in a fortnight, that sounds good.  You might feel the updose the same day but more often it can take 7 to 10 days to take effect.

 

This is your introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community.  I hope you’ll find the information in the SA forums helpful for your situation.  I'm sorry that you are in the position that you need the information, but I am glad that you found us.

 

 

 

 

[Emonda]

Many thanks for the reply and reassurance, Gridley.

 

Thanks also for the links to the chemical imbalance myth articles. I'd heard it was a myth but had missed those articles.

[Emonda]

Hi All,

 

I thought I’d post a bit of an update. 

 

Things stabilised since my first post, so after holding for five weeks at 3.95mg, I dropped to 3.85mg. Things were ok (not great, but doing all the things I needed to do in my daily life with mild WD symptoms). 

 

Two weeks later, I dropped to 3.75mg. Things were okay-ish and improved over time.

 

One week later, I dropped to 3.65mg and have held here for two weeks. I’ll hold a little longer.

 

Since the last reduction, I’ve again poured over various SA posts for reassurance, as I’ve had a few bad days. Anxiety hits me occasionally for the most minor and insignificant reasons. I ruminate over past events and conversations, reliving the trauma/interaction. Sometimes I catastrophise over the future, and other times I can’t even identify a cause for the anxiety. Although, when I review my mood diary, it doesn’t seem as bad as I think it has been. 

 

The positive I can see is that the anxiety spike doesn’t last as long as it did years ago…it hits me, lingers for hours, and then subsides. I also don’t wake up early in the morning anxious like I used to. Because this anxiety experience differs from what it has been in the past, I’m still thinking (hoping) it’s waves that come and go rather than a relapse. If only the windows were as frequent as the waves! 

 

A relapse is my greatest fear. I keep replaying a comment from my doctor in my head, “Some people just need to take ADs for life, like a diabetic taking insulin”.

 

Reading the entire ‘introduction’ of Asjf from 8 years ago last night was encouraging. Asjf describes what I feel I experience….2 steps forwards and ten steps backwards at times. Frustration at seemingly doing things right: slow taper, eating well, exercising, communicating with my wife about my feelings. I love this quote from Asjf, “seriously, in the year 2016, my best option is just ride it out”? Hearing and identifying with the quote and reading Asjf’s subsequent success story was so encouraging. Thanks for posting, Asjf; you’ve given me some much-needed reassurance.

 

I’ve never been much of a drinker (alcohol), maybe one or two standard drinks on a Friday night. Over the past month, I’ve noticed a spike in anxiety the morning after one drink….so I have cut out alcohol completely. Have others noticed they were OK with alcohol, then suddenly, you’re not? Yes, I had read on this site that alcohol was not recommended, but I was ok with it…until I wasn’t!

 

Funny/embarrassing comment: I initially thought I had this taper 100% under control. I thought I was going to make my first post in the ‘success’ stories section; I was that confident in my slow, steady and stable progress. At least I can laugh at that now!

 

Until next time, one foot in front of the other, repeat…

[LostInCanada]

@Emonda hi and welcome back. Sounds like you are hitting those waves. You are doing great. Just listen to your body...that may mean holding a dose a little longer than you want to. 

I have read examples of something being fine and then all of a sudden it was a problem. It can happen with food, supplements, and like you, alcohol. The body tolerates our behaviours until it has had enough. The lesson for me was cut out caffeine, alcohol, chocolate before it caused an issue.

Glad you are maintaining your sense of humour as well. 👍

[Emonda]

Thanks so much, @LostInCanada (am I meant to put the @ sign at the front of your name so you get the reply, or is it unnecessary? I'm new to online forums).

 

There is something very reassuring in receiving a reply from the other side of the world from someone travelling down the same road. It can be a lonely path.

 

Caffeine and chocolate: I had been considering cutting those, as well. I'll starve!

 

I've just read your introduction and seen a few of your posts on others' introductions. You are an encouragement! Thank you, and wishing you well with your taper.

[LostInCanada]

@Emonda yes the @ tags the person. I do miss a good caramel macchiato and some chocolate but hey I am eating healthier than ever. I ordered some decaf tea but haven't had the courage to chance it yet since I am in a window at the moment. Apparently decaf coffee can still be a trigger... it's not just the caffeine that is a problem. It's definitely a learning curve. It can be lonely even when we cheer each other on from the sidelines. The journey still is very much our own but this forum is an amazing help. You are really doing great, one day at a time.

[Emonda]

Hi All,

The wheels fell off a bit yesterday. I was hit with a wave of emotions whilst driving. I had to pull over, burst into tears and started shaking. I’ve experienced one panic attack in my life, and it wasn’t like that. I’m not sure what to make of it. Fortunately, my wife was with me, and I regrouped after 30 minutes.

 

It’s been 3.5 weeks since the most recent 2.5% reduction. I feel fragile at times and perfectly fine at other times. Once stable, I’ll go even slower than the BrassMonkey, say 1.25% per week.

 

However, the little voice of doubt in my head keeps saying that maybe some people need to take ADs for life.

 

That little voice is purely the WD symptoms talking, right?

 

[LostInCanada]

@Emonda it is the withdrawal.  We can do this without drugs. It's just about learning new skills. Like you, I have been medicated so long it terrifies me. But I think about Claire Weekes advice 'face, accept, float and let time pass'. Slow is good, the longer we have been on affects the process for sure. Glad your wife was with you for support. 👍

[Emonda]

Thanks for the reply @LostInCanada. I really appreciate the encouragement. It was a much better day today 😃

 

I just took a peek at your drug signature. Yep, you’re a long-termer, too, so you can relate to self-doubt.

 

I hope you are doing ok on your side of the world.

[LostInCanada]

@Emonda I am so happy you are in a window…may many more come your way! It is so wonderful to get that feeling of normal. Imagine the day when that will be our reality 24/7. 

[Emonda]

Thanks, @LostInCanada. I was starting to think these 'windows' were mythical! I've felt 'normal' with a real sense of clarity over the past week. 

 

I'll hold at the current does until June and make the next cut 1.25% rather than my typical 2.5%. Hopefully, that will be less disruptive.

 

It's counterintuitive; we all want to get these ADs out of our system, but SLOW is the way to go.

 

I look forward to reading your next update when you are in a window, too!

[LostInCanada]

@Emonda hope you are still in that beautiful window 🌻

[Emonda]

Hey @LostInCanada,

Good to hear from you, and thanks for checking in.

 

It's been eight weeks since I last made a reduction, and today I was brave enough to drop 2%. I'm a little nervous, but that's normal. Usually day 2 or 3, I get a feel for how it'll go. I have very much appreciated the window and opportunity to stabilise.

 

I've just read " Anatomy of an Epidemic". Wow, what a read. It seems criminal, but it seriously motivated me to keep tapering.

 

How are you doing? Is that wave abating? Wishing you well and stability 🙏

[LostInCanada]

@Emonda I have been in a window since Friday .. longest one yet! I wrote myself a note last night when the next wave hits, to encourage myself, that it won't last forever.

[LostInCanada]

@Emonda how did this last cut work out? Have you thought about doing the brass monkey slide? Do you cut your own pills or use liquid? It’s always good to hear from you. Give your wife a big hello from me. We are very fortunate to have supportive spouses. Not all are so lucky on here. 

[Emonda]

Hey @LostInCanada,

Thanks for checking in.

 

Yeah, I do the brass monkey slide. My last cut was 2% rather than the brass monkey's 2.5%. I timed the reduction so I'd have the predictable day 2/3/4 wobbles on the weekend. They arrived on time as expected 😜

 

I got the usual restlessness, irritability, anxiousness, and dizziness. Those symptoms are abating now, so I'll drop another 2% tomorrow.

 

I have to crush the pill into fine particles and create a liquid. There is no liquid version in my country unfortunately. I've got it down to a fine art now.

 

100% re supportive spouses! I'm glad your hubby is right there by your side.

 

I look forward to reading you are in a window again sometime soon.

[LostInCanada]

@Emondahow have you been? Hope all is going well. Any more windows? 

[Emonda]

Hey @LostInCanada, It's always lovely to hear from you, and thanks for checking in.

 

I'm currently on a two-week hold after four weekly reductions of 2%. I'm not in a wave, but I wouldn't call it a window. I think that's what they refer to as WD normal.

 

Day 2 & 3, after each reduction, I get the usual heightened dizziness, irritability, anxiety and insomnia.

 

The reduction at week 4 seems harder in terms of anxiety and irritability. That's probably the accumulation of the 4th weekly reduction. I really appreciate that hold!

 

This community continues to be a fantastic support. Just reading the accounts of others, reassuring me that what I am experiencing is 'normal', is a blessing. I've been rereading the success stories again lately for some encouragement. It is wonderful that people take the time to come back and share their success with us all.

 

I have so much admiration for the significant contributors to this site. They have such a heart for people. I jump on a few introductions I can relate to try and offer encouragement, but the moderators/administrators and yourself are so proactive. You all make such a positive impact on the lives of many!

[LostInCanada]

@Emondadon't sell yourself short. I've read some of your encouraging posts. Every one that contributes positively is a blessing. Glad you are holding and it is going well. 👍

[Emonda]

Thanks, @LostInCanada. You are very kind 😃

[Emonda]

Just a bit of an update and a question at the end:

 

I’ve noticed the timing and type of WD seem to have changed. Originally, it would take 2 or 3 days after a reduction for me to see WD, such as dizziness, irritability, anxiety, and sleep issues.

 

For the last two weekly reductions (2% each time), I noticed WD later the same day of that reduction. It just seems too fast to impact me. Maybe it’s the combination of work stress and ongoing WD.

 

The WD has been different, too. I checked the Joseph Glenmullen WD checklist, and the first two items below are on the checklist, so they must be real. It’s just the super-fast timing that I’ve been surprised by.

 

I’ve noticed the following ~6 hours after a reduction:

1. Significant stomach bloating and discomfort, as though I am so full of air, I’ll float away (slight exaggeration, obviously).  
2. Agitation rather than irritability. I want to yell and have so much nervous energy. I go for a run to get that out of the system.
3. Lastly, I’ve noticed the feeling that I am about to have a fit/spasm down my neck and spine - an uncontrollable muscle spasm. I don’t have epilepsy, and I’ve never had a fit. I have noticed small muscle/arm ticks before, but never this.

Can anyone relate to item number three? Has anyone else noticed WD later the same day of a reduction?

 

Many thanks to you all.

[LostInCanada]

@Emonda never a dull moment is there. I have the feeling you are getting delayed withdrawal symptoms. The half life is 66 hours so it seems unlikely the immediate reduction would even be felt for a couple weeks. Could that be possible?

[Emonda]

Ah, that makes sense, @LostInCanada! I was too busy being cross and cranky that I didn't consider a delayed WD response. Each weekly reduction gets a little harder, and by week 4, I'm ready for that 2-week hold. I think that adds to the argument for a delayed WD.

 

As to the neck/spine muscle spasm...just another one of the joys of WD, I guess.

 

I hope you're doing ok with your latest reduction. 

[LostInCanada]

@Emonda I am doing good for me. Ready to do a drop again on Friday. I get so in my head but pushing through.👍

[LostInCanada]

@Emondaare you thinking you might want to hold after this reduction till things settle?

[Emonda]

9 hours ago, LostInCanada said:

you might want to hold after this reduction till things settle?

 

The thought has crossed my mind @LostInCanada.

 

Next Wednesday is my 4th weekly drop before holding...will reassess before that drop.

 

It's a fine line. You want to keep crawling along but not push yourself too far/fast.

 

Thanks for the appropriate suggestion to consider holding. I always appreciate hearing from you. All the best for your drop tomorrow.

[LostInCanada]

@Emonda hope you are enjoying your hold. No one said it would be easy...lol. Take care.

 

[Emonda]

Ah, lovely as always to hear from you @LostInCanada.

 

I wish I listened to you on 28 July...I should've held my dose rather than make the 4th 2% drop. I was stubborn and pushed on. I got an extra dose of fear, panic, anxiety, insomnia and tinnitus. My own fault...I should have known better....lesson learnt...again. 

 

The positive is that when I looked at my mood diary, I knew these heightened feelings tend to last < one week before things settle.

 

Yep, I am now comfortably holding and enjoying some stability.

 

I am glad to read of your progress...keep up the great work, and thanks for your support and encouragement on our respective journeys 😊 

[LostInCanada]

@Emonda checking in to see how you are doing? I hope things are going well. I am still holding... Seems like this wave wants to stick around. Guess waiting is my only option lol.

[Emonda]

You've brightened my day as always, @LostInCanada 😃

 

Today was the day I was meant to finish my two-week hold and drop 2%, but I learned from my impatience a few weeks back. I'll hold for another week. One of my kids is heading to your neck of the woods for a few years. That came out of the blue and unsettled me a little. First one to move out.

 

I'm sorry to hear your wave is lingering. I love the positivity that still comes across in your posts. Waiting is a good option...if in doubt, wait it out. I'm eager to reach my next milestone of 2.5mg (50% of the smallest tablet), but I'm resisting the temptation to rush.

 

Thanks for dropping by to say hi, LostInCanada. Say hi to hubby for me. I hope he's still taking good care of you.

 

Emonda

[LostInCanada]

On 8/24/2023 at 2:32 PM, Emonda said:

One of my kids is heading to your neck of the woods. That came out of the blue and unsettled me a little. First one to move out.

That is very unsettling. We raise them to be solid and responsible and then they are and we just want to turn the clock back. Our youngest lives in England with her hubby. It's hard but I am happy she loves it there. What city are they going to?

I can hardly wait to get to 2.5 mg...so exciting. You have done so well. Enjoy every success.👍

[Emonda]

On 8/25/2023 at 2:38 AM, LostInCanada said:

We raise them to be solid and responsible and then they are and we just want to turn the clock back

 

I agree entirely 👍 It's good progress, much sooner than anticipated.

 

On 8/25/2023 at 2:38 AM, LostInCanada said:

What city are they going to?

 

Ok, this answer will make you laugh. By "your neck of the woods," I meant the USA....but that's "your neck of the woods" from my perspective 😂

[LostInCanada]

On 8/25/2023 at 9:35 AM, Emonda said:

this answer will make you laugh. By "your neck of the woods," I meant the USA....but that's "your neck of the woods"

Hey it is directly south of me, same time zone. Great place to go to school.💯

[Emonda]

It's been a while since I've posted an update...so here goes.

 

It greatly encouraged me when I dropped below 3mg recently from a starting dose of 15mg. There's still a long way to go on my journey, but I'm grateful for the progress to date care of this site's collective wisdom....and the encouragement of my wife.

 

My body gave me a gentle reminder over the past few days that I'm not a young man in my 20s anymore, close to 50, and I need to be kind to myself during this tapering process. I drove 2,500km over a few days. I found myself driving at an hour I'd usually be going to bed. As I was doing this, I thought, I'll pay for this tomorrow...sure enough, I did. The predictable anxiety spiked after the trip, given the fatigue. It'll pass with time and rest.

 

I continue to look at the WD symptom checklist. It helps to be reminded that things I experience are 'normal' WD symptoms. I've had increased tinnitus over the past month. It's been there for years (developed following a CT of Escitalopram and subsequent reinstatement) but much worse of late. I find quite background classical music helpful.

 

I've just gone back to visit Anatomy of an Epidemic, by Robert Whitaker. It was described as the most important book on psychiatry in a generation. It encourages me that the AD pills are the problem, not me, to persevere and keep tapering slowly.

 

Anyway, that's it from me for a while.

 

I wish you all patience and success with your taper.

 

Emonda

[LostInCanada]

Great update my friend. Knowing our limitations is key but so hard when you are feeling good and just want to forget those limits. Almost 50...you are so young still. I am pushing through this taper at 63 lol...life.