Leyla: journey to quit SSRIs

[Leyla]

Hello, 

My name is Leyla, I'm a 27 year old from Saudi Arabia. When I was 20 I went through a depressive anxious period during college and I started therapy then was referred to psychiatrist and started Lexapro. At the time, it helped me very overcome the crippling anxiety and at a point I was taking 20 mg which made me overly sleepy and low energy ,but also less anxious so I was happy with the result. 7 years went by and I was unaware that I have become fully dependent on the medication I forgot how it feels not to be on it. I decreased my dose gradually to 5 mg and was continuously advised not to quit whenever I tried because of how withdrawal was so bad it felt like a relapse. My doctor advised me in November 2022 to cross taper to 20 mg Prozac since it has a longer half life and so I did. I really want to quit medication and start following a holistic approach in dealing with anxiety and so I started taking the 20 mg dose every other day this month April 2023. So far my withdrawal symptoms are headaches, anxiety and seeing weird dreams. 

I am tapering on my own as my psychiatrist thinks that 20 mg Prozac is so low I can just stop taking it overnight, but I don't want to risk it so i reduced it by taking it every other day as I don't have access to 10 mg or liquid form where I live.

I read some forums here that 10% taper is the safest way to quit, should I invest in a scale and start measuring the powder in capsules or would my current approach of gradually spacing my doses work?

 

Also if you know any trustworthy psychiatrists I could contact online or any resources that could support me during my journey that would help. 

thank you,

[Go2zero]

Hello Leyla,

 

Welcome to this support site. Good that you came to this website. There is a lot of knowledge to be found and shared here. Also the members can support each other here. Thank you for already making your signature. 

 

Lexapro is a very powerful drug which can be difficult to taper, especially in the lower dosages. I understand you made a switch from 5mg Lexapro to 20mg Prozac. Better would have been 10 mg Prozac, since that is the equivalent to 5 mg Lexapro. 

 

So effectively you doubled the dosage with the switch to Prozac. But this is something you cannot change anymore, so let's see how you can go further from here.

 

First of all, 20mg Prozac is NOT a low dose. It is the standard dose most people take when on Prozac. Whereas 10mg would be the standard dose of Lexapro. Please understand that you ALWAYS should taper Prozac. If you would just stop it, you would probably be OK for several weeks (given the long half life). But then a BIG BANG will come nearly for sure. It is a big mistake to think that Prozac is easy to stop or taper. It only lasts longer before the withdrawal symptoms kick in.

 

It is far from advisable to skip dosages. This may sensitise your nervous system. Please read this info https://www.survivingantidepressants.org/topic/22958-never-skip-doses-to-taper/

 

Going down from 20mg to 10mg Prozac is far too fast. We advise to go down maximum 10% of the last taken dosage every month.

Here is more info on that: https://www.survivingantidepressants.org/topic/1024-why-taper-by-10-of-my-dosage/

 

You can open the 20mg capsules and take out part of the powder. In this way you can adapt your dosage every month. Here is explained how:

https://www.survivingantidepressants.org/topic/1596-using-a-scale-to-weigh-and-measure-doses/

 

Here is some more useful info:

https://www.survivingantidepressants.org/topic/6632-the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable/?tab=comments#comment-525233

 

 

 

[LostInCanada]

@Leyla welcome to SA. You asked  if you know any trustworthy psychiatrists I could contact online or any resources that could support me during my journey that would help 

This site has so much information to help you understand anxiety and depression. Get familiar with it and all it has to offer.  Read as much as you can. There are many areas speaking about CBT and other non drug ways of coping. How these drugs really work is also scientifically exposed here. You have a great moderator to help you and this active supportive community. 👍

 

[Leyla]

Thank you both for the input and resources. I am very grateful to have stumbled upon this gold mine community after watching many youtube videos about tapering medication desperate for some guidance. 

I ordered a scale to start micro-tapering, I'd like to start reducing my dose by 10% every month. According to my excel sheet calculation, it'd take almost 3 years to reduce by 98%. I'm a little discouraged by this fact as I was excited to quit but I'm aware it'd be safer and more sustainable so hopefully will stick with it. 

I started taking supplements a while ago to support the process including GABA, L-theanine, Magnesium and Vitamin D.

 

I also got Mentat on my hand from an ayurvedic clinic and Ginkgo supplements ,but I'm afraid of interactions and not sure if I should incorporate them if anyone has any experience with these. 

 

 

[LostInCanada]

@Leyla make sure to look under Symptoms and Self-care. There is a section called Important topics about.... supplements. When dealing with withdrawal the body can be overtaxed by taking things that normally would have help. Lots of good info there. ❤️

[Leyla]

Any recommendations to combat sleepiness during tapering? I've been feeling very drowsy lately and experiencing body aches making me want to sleep all day. Not to mention the many dreams I have during one sleep, mostly ordinary and very close to everyday reality it feels like I'm continuing my day while asleep.

Currently switched from taking 20mg every other day to 10 mg prozac everyday and will begin tapering by 10% after one month.

[LostInCanada]

@Leyla sleep is good...the body wants to heal. Try to practice a good sleep routine, maybe going to bed a bit earlier. Try to go to bed at the same time and rise at the same time.  That might help you feel more rested. Can you fit in a relaxing walk in the morning sunshine? 

[Leyla]

Moving definitely helps ,but getting out of bed has been a challenge. I started taking iron due to iron storage deficiency which could be a contributor to the low energy levels.

Since I've started 10mg one month ago, I've been feeling elevated anxiety and shortness of breath. I'm trying to incorporate mindful breathing to bring my anxiety down. I am going to decrease my dose to 8.02 mg today. I honestly can't wait to be off and get rid of the horrible side effects of brain fog, forgetfulness, fatigue, nausea and loss of appetite I've been enduring.

[LostInCanada]

@Leyla looks like you are still destabilized and dropping more than the recommended max of 10%. Slow and steady will get you there faster with the least damage. Reversing issues is not a quick fix. I have been holding my reinstatement for 6 months and am still not ready to taper. The withdrawal symptoms stack on top of each other unfortunately. Because of prozac's long half life you can think all is well and then crash months later. That is why no more than 10% is so important.

[Leyla]

Thank you @LostInCanada. I realize I'm not feeling my best in terms of anxiety and mood ,but the medicine side effects are becoming quite unbearable. When I was on escitalopram it did cause me to have low energy and fatigue similar to prozac, but prozac is giving me horrible nausea and weight loss so I'm constantly feeling weak and sick. I am also concerned for long term side effects that's why I'm aiming to quit within one year. I will attempt to decrease my dose to 8.5 mg and see how it goes.

[LostInCanada]

@Leyla it definitely isn't an easy road. We will get there. Just listen to your body to minimize the impact.

[Patient2022]

@Leyla hey just wanted to check in and see how your journey is going? Hoping all is well

[Leyla]

Hello @Patient2022

I hope you're doing well too, thanks for checking. I've been okay, I'm at 1.5mg dose currently. I realize it's a faster taper than the 10% every month ,but I just want to end this soon as the med is making me feel horrible in my body. I've lost weight and I always want to sleep.. I've had more downs than ups recently, my corporate job drains my mental and physical body and I feel a lot of anxiety during the day and always wake up with a cortisol spike. One thing that's been helping is exercise, I'm also taking Magnesium and Omega 3 almost daily. Will keep trying 🙏 How about you, how's your taper going?

[Patient2022]

1 hour ago, Leyla said:

Hello @Patient2022

I hope you're doing well too, thanks for checking. I've been okay, I'm at 1.5mg dose currently. I realize it's a faster taper than the 10% every month ,but I just want to end this soon as the med is making me feel horrible in my body. I've lost weight and I always want to sleep.. I've had more downs than ups recently, my corporate job drains my mental and physical body and I feel a lot of anxiety during the day and always wake up with a cortisol spike. One thing that's been helping is exercise, I'm also taking Magnesium and Omega 3 almost daily. Will keep trying 🙏 How about you, how's your taper going?

ahh quite similar dose to me again, I’m on 1.2mg and I’ve done few faster tapers with only 2 weeks hold between. But I’ve slowed down now, because the withdrawal symptoms are meant to get worse nearer  the end so I was advised to hold. That may be the reason your symptoms are a lot right now? Ie if you’ve been going fast your body may not have had enough time to stabilise. 
 

it’s always hard to distinguish if it withdrawal or something else. I’ve had a lot of domestic stress recently and had surgery 2 weeks ago. I was saying I’m ok for a few weeks. But I’ve had a wave today (some others too) just cried, but the situation is one that makes me sad so I guess there’s some normality in it. I think I just have to hold and adopt other coping mechanisms. 
 

I’m so sorry that the job is draining you! It’s tough to tackle tapering with other responsibilities. Good though that you’re finding some support with the supplements and exercise.

[Leyla]

23 hours ago, Patient2022 said:

ahh quite similar dose to me again, I’m on 1.2mg and I’ve done few faster tapers with only 2 weeks hold between. But I’ve slowed down now, because the withdrawal symptoms are meant to get worse nearer  the end so I was advised to hold. That may be the reason your symptoms are a lot right now? Ie if you’ve been going fast your body may not have had enough time to stabilise. 
 

it’s always hard to distinguish if it withdrawal or something else. I’ve had a lot of domestic stress recently and had surgery 2 weeks ago. I was saying I’m ok for a few weeks. But I’ve had a wave today (some others too) just cried, but the situation is one that makes me sad so I guess there’s some normality in it. I think I just have to hold and adopt other coping mechanisms. 
 

I’m so sorry that the job is draining you! It’s tough to tackle tapering with other responsibilities. Good though that you’re finding some support with the supplements and exercise.

Yes I’ve been tapering almost every three weeks ,but I think I’ll hold for now to stabilize. I got too excited to start a new year off meds however I might have a long way ahead.

 

I hope you’re recovering well from your surgery and sorry to hear you’re going through tough times. It’s good that you cried as letting the feelings go is healthier than holding them and piling up your emotions. I’ve felt quite numb on my meds but since I started tapering I’ve been feeling lots more emotions and crying more. It’s hard but I hope it’s temporary and part of the healing process. May you feel peace and happiness very soon❤️‍🩹

[Patient2022]

On 1/27/2024 at 8:09 PM, Leyla said:

Yes I’ve been tapering almost every three weeks ,but I think I’ll hold for now to stabilize. I got too excited to start a new year off meds however I might have a long way ahead.

 

I hope you’re recovering well from your surgery and sorry to hear you’re going through tough times. It’s good that you cried as letting the feelings go is healthier than holding them and piling up your emotions. I’ve felt quite numb on my meds but since I started tapering I’ve been feeling lots more emotions and crying more. It’s hard but I hope it’s temporary and part of the healing process. May you feel peace and happiness very soon❤️‍🩹

Thank you and for you too

 

Slow and steady for us both and hopefully that helps us win the race. 

[Leyla]

I'd like to share an update and ask for advice.

Around one month ago I went into a depressed state, it was really intense and my thoughts went to a dark place which isn't something I often encounter even if I'm very sad. I just felt like there isn't so much to live for and that life is all suffering. I felt very isolated and disassociated when observing my surrounding family and colleagues living life with so much will. 
During that period I was extremely stressed at work, I was experiencing night sweats and so much insecurity, anxiety in my gut and of course ugly crying spells occurring often at inconvenient time and place.
Symptoms has now improved, I am feeling bit better but not the best. I am kind of confused if these are withdrawl symptoms suddenly catching up to me. 

Any advice how to deal with this? 

 

I would love to continue my taper journey without having to show up to a demanding job everyday. My energy is always drained lately, I struggle to leave bed even after 8 hours and wake up with a spike of anxiety and dread to commute and face my responsibilities at work. I do also genuinely feel that my cognitive abilities have declined, I have bad memory and I struggle to do basic tasks and this makes me very sad. 

This isn't easy and the fact that I will probably go through it for multiple years even after tapering is just depressing. 
 

[LostInCanada]

@Leyla good to get an update.♥️ Seems like I say this alot but I think you need a bit of a hold. You have been doing amazing but with these lower doses the effects are more extreme. I would hold about a month and then reassess. It might be a bit easier to do the brass monkey slide method. Smaller drops ( no more than 2.5%) a week for 4 weeks and then hold for 2 weeks. You can even go slower. Remember it is not a race. It is so important to be kind to your body as it works out this taper. Slow and steady is better than having to updose or have extreme symptoms. 💯🙏❤️

[Patient2022]

47 minutes ago, Leyla said:

I'd like to share an update and ask for advice.

Around one month ago I went into a depressed state, it was really intense and my thoughts went to a dark place which isn't something I often encounter even if I'm very sad. I just felt like there isn't so much to live for and that life is all suffering. I felt very isolated and disassociated when observing my surrounding family and colleagues living life with so much will. 
During that period I was extremely stressed at work, I was experiencing night sweats and so much insecurity, anxiety in my gut and of course ugly crying spells occurring often at inconvenient time and place.
Symptoms has now improved, I am feeling bit better but not the best. I am kind of confused if these are withdrawl symptoms suddenly catching up to me. 

Any advice how to deal with this? 

 

I would love to continue my taper journey without having to show up to a demanding job everyday. My energy is always drained lately, I struggle to leave bed even after 8 hours and wake up with a spike of anxiety and dread to commute and face my responsibilities at work. I do also genuinely feel that my cognitive abilities have declined, I have bad memory and I struggle to do basic tasks and this makes me very sad. 

This isn't easy and the fact that I will probably go through it for multiple years even after tapering is just depressing. 
 

I felt like I could have written some of the things you’re experiencing. I wouldn’t say I’m in a deep dark place…yet. But the waking with anxiety and it generally being high. Some crying spells and feeling overwhelmed like everything is exhausting. Usually this low energy is just before my period but it’s continued so I’ve just been allowing myself to feel and try rest as much I can (with responsibilities), I let the house be messy, I didn’t cook and so on. I eventually gather the courage to sort it out a bit because it’s a vicious cycle, I feel crap about to being messy but then don’t have the energy to sort.

 

It is scary, and I’m sorry you’re experiencing this too. I’m planning to hold for a long time. And try to incorporate some coping mechanism. Having people to speak to helps (most the time). When I’m well enough some gentle exercise (going for walks). As for my eating that’s out the window and I’m not going to stress myself about it while feeling like this but I try to be conscious. 
 

My new motto is take one day at a time. But I’m melting down in this period through the day, just earlier today I was feeling so awful. I’ve showered and made it out the house and feel a bit better just staying in the moment. The problem is the anxiety - once it starts the spiral can go on and on.

Hopefully this is just a blip because we’re coming to the end. We have to keep talking. By encouraging one another we’re helping ourselves too. 

[Leyla]

Thank you @LostInCanada , appreciate you getting back to me.
I held 1.6 mg dose for 52 days and just made a cut yesterday since i've been feeling the same way for around 2 weeks. I would like to try the smaller dose method, however it's not possible with the gem scale I'm using. 

My last dose was 1.6 mg which is equal to 0.015 g powder content according to my calculation, and when implementing 10% reduction it will be -0.001g from now on. I'm actually speculating that I was unstable because I'm not weighing my pills with great accuracy because the scale's accuracy +- 0.005g. 
I'm thinking of getting some syringes and to take it as liquid because of this issue.

[Leyla]

15 hours ago, Patient2022 said:

I felt like I could have written some of the things you’re experiencing. I wouldn’t say I’m in a deep dark place…yet. But the waking with anxiety and it generally being high. Some crying spells and feeling overwhelmed like everything is exhausting. Usually this low energy is just before my period but it’s continued so I’ve just been allowing myself to feel and try rest as much I can (with responsibilities), I let the house be messy, I didn’t cook and so on. I eventually gather the courage to sort it out a bit because it’s a vicious cycle, I feel crap about to being messy but then don’t have the energy to sort.

 

It is scary, and I’m sorry you’re experiencing this too. I’m planning to hold for a long time. And try to incorporate some coping mechanism. Having people to speak to helps (most the time). When I’m well enough some gentle exercise (going for walks). As for my eating that’s out the window and I’m not going to stress myself about it while feeling like this but I try to be conscious. 
 

My new motto is take one day at a time. But I’m melting down in this period through the day, just earlier today I was feeling so awful. I’ve showered and made it out the house and feel a bit better just staying in the moment. The problem is the anxiety - once it starts the spiral can go on and on.

Hopefully this is just a blip because we’re coming to the end. We have to keep talking. By encouraging one another we’re helping ourselves too. 

I relate to that very much.I hope you continue to find the courage to break the cycle. 
Talking does help, you remind me I need to get back to therapy. And exercise of course, I was going to group classes but I haven't renewed my membership yet.
One thing that helped the anxiety spike upon the advice of a therapist was to breath for five minutes while seated first thing in morning, inhaling for 5 seconds and exhaling from my mouth slowly. Very calming.
Thanks for checking in ❤️ 

[LostInCanada]

6 hours ago, Leyla said:

thinking of getting some syringes and to take it as liquid because of this issue.

That's a good idea. Especially since you have to take a bit of time to transition. I know I will have to eventually too. 

[Leyla]

I got compounded 1mg/1ml fluoxetine recently prescribed from my GP. I'm thankful that she supported me as oppose to the psychiatrist who told me last year that it's safe to just stop taking 20 mg prozac because it's a baby dose 😕

Now I'm taking half of my dose as solid and half as liquid to slowly adjust before switching completely to liquid. 

I'm looking forward to switching because I think lately the measurements of my dosages were not very accurate using the gemini scale, I think I've been taking less than 1.44mg because when I split the 10mg pill contents into empty capsules there is remaining powder left. So it'll probably be a re-instatement now switching to liquid.

 

I also stopped taking magnesium daily because I could hardly wake up to go to work even after 7-8 hours of sleep.

[Leyla]

My current dose is 1.14 mg liquid prozac. Feeling more stable since I switched to liquid, I think the measurement is way more precise now with the syringe compared to weighing powder.

Reflecting back, I kind of regret bridging to prozac. I felt better on Lexapro but there is nothing to do about it now.  

 

I've been watching a lot of YouTube videos around antidepressants in channels like Angie Peacock and Dr. Josef. It has helped a lot listening to interviews while driving to work most of them are hopeful and inspiring, but some are not very happy ending with protracted withdrawal and sexual disfunction. I think I should ease on this and distract more because I tend to obsess over the content.

I recently read the fluoxetine tapering guidelines in The Maudsley Deprescribing Guidelines by Dr. Mark, I'll try to follow the slow tapering schedule which reduces dose by 3% receptor occupancy every 2-4 weeks or 6-8 weeks since fluoxetine taper effects are delayed because of the long half life. I have 13 more steps to go till 0.06 mg

 

I also started journaling my feelings and symptoms this week, trying to make up a pattern of my mood.

 

[AAOffZ]

Hi there! Just wanted to drop a line and say I’m following you and praying for you on this journey! 

[Leyla]

 

On 4/11/2024 at 8:37 PM, AAOffZ said:

Hi there! Just wanted to drop a line and say I’m following you and praying for you on this journey! 

Hi @AAOffZ Thank you! your message made me really happy  

[Leyla]

Been feeling generally better since I switched to liquid formula. However, I've been experiencing sudden excessive hair loss for the past week. Not really sure if it's a withdrawal effect, but it's making me nervous hoping it will not continue falling like this  Anyone experienced something similar? what helps stop it?