ElaineM: Need advice on fluxotine withdrawal

[ElaineM]

I have been on fluxotine for around 11 years of my life with a short break at some point. I started at age 13. The first time I went off I was very moddy so went back on. About three months ago I took my last tapered dose of fluxotine. I have been struggling with insomnia so my doctor put me on setraline. I am on. my second night is taking it but wondered if J should have held out longer if this is only withdrawal affects. At least some of my insomnia seems to be anxiety related but I don’t think all of it is. Any tips?! Should I stop setraline before I have to deal with its withdrawals?! thank you!

[Shep]

Hi, @ElaineM Welcome to Surviving Antidepressants.

 

I would stop the sertraline. You've only taken it for two days, so it's safe to simply stop taking it. 

 

By "fluxotine," do you mean "fluoxetine"? If not, please let me know. 

 

Since you've been off fluoxetine for 3 months, you may want to reinstate a small amount. Here is the information on reinstatements:

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

As the first post in that thread states, you'll want to pick a very low dose to reinstate. Here is how to get to those low doses:

 

Tips for tapering off fluoxetine (Prozac)

 

Before we can recommend a dose to reinstate, we'll need to know:

• What dose were you prescribed?
• What was your taper rate and how long did you taper?
• What dose did you stop three months ago?

Are you taking any other psychiatric drugs? Are you taking any supplements? If so, please list the name of the drugs or supplements, the dose, and the start date. 

 

Please set up a signature. Here is what we need:

 

How to Summarize Your Drug History in Your Signature

 

Please continue to use this thread to document your taper and to ask questions. As you answer our questions and provide more information, we'll be able to help you set up a safe reinstatement and taper plan. 

[zma1]

Stop the sertraline! You traded one ssri for another this will not help at all if you want to get off meds. Also just the switch could give you worse insomnia. Try magnesium, warm baths instead and if you still suffer from insomnia after a few weeks try cbt techniques. Insomnia can cause a feedback loop where you get so stressed that you won’t sleep, you don’t sleep. Seriously tho unless you want to stick w meds stop the sertraline. If you want to be on meds stick w the fluoxine. Also you may feel uncomfortable while your body adjusts to being without fluoxine so expect that and know that it’s temporary. Don’t ask doc for more meds to relieve withdrawal symptoms it just adds more to your nervous system. If it becomes unbearable then talk to doc or read further through this website for help❤️

[ElaineM]

The reason I was switching to setraline quad because I wanted a safer ssri for pregnancy. I also slowly came off of fluoxetine (yes sorry I meant fluoxetine). I’m not sure if I’m experiencing withdrawal or just a return to my pre state dealing with anxiety.
 

 

I was on 80 mg and I started by skipping one dose a week till I was down to none! 

[ElaineM]

I guess I’m curious…. Do you think it’s bad to be on ssri’s lifelong. I feel like it’s not good…but I did do really good on fluoxetine! 

[LostInCanada]

@ElaineM you are experiencing withdrawal. It takes much longer for a "relapse". These drugs were never intended to be on for more than 28 or so months. The problem is trying to get off them The doctors don't know about withdrawal and think it's relapse so it's easier for them to keep you on them indefinitely. They are not safe in the long term. Definitely cease the sertaline. Reinstating a very small dose of fluoxetine- 1mg is usually recommended - will help with withdrawal. You can slowly taper from there once stable. Learning non drug methods of coping is preferred to drug therapy which basically just numbs the brain, body, emotions. If you wish to reinstate, ask for the specific recommended dosage and help in this thread. ♥️

[ElaineM]

How do I get 1 mg fluxotine capsules?? I only have the 20?

[LostInCanada]

How to make a liquid from tablets or capsules@ElaineM to do 1mg you need to get a prescription for the liquid and use a 1ml syringe. If the liquid is 10mg fluoxetine- per 10ml liquid you would take 1ml if liquid to get 1mg of the drug. Some on here have also made there own liquid.

Search "How to make a liquid from tablets or capsules" using the search icon.

It is easy to find what you need to do this on Amazon. 

[manymoretodays]

Hi ElaineM, and thank you LostInCanada.......I was just compiling a response too,

And I have some Questions for ElaineM too,

 

Did you stop the sertraline?  If not, stop that first, prior to trying a reinstatement.  Also scroll up and read the link you were given on reinstatement earlier today please so you learn a bit more about what to expect.

 

The link in what I quoted below will tell you your options to getting a 1 mg dose of fluoxetine(Prozac)

7 hours ago, Shep said:

As the first post in that thread states, you'll want to pick a very low dose to reinstate. Here is how to get to those low doses:

 

Tips for tapering off fluoxetine (Prozac)

Do look at the links given.  Here is more on if you wish to make your own, from that topic:

Making your own fluoxetine liquid

 

how-to-make-a-liquid-from-tablets-or-capsules

 

Fluoxetine is one of the few psychiatric medications with a long history of do-it-yourself dilution in water or juice. Mixed in cranberry juice, it's been called "Cranzac."

My own personal preference would be to dilute it with water, to avoid any degradation that might be caused by sugar or acid in the juice. Also, it will be easier to see how well the fluoxetine is dissolved in water. (There may be particles swirling around, that's the filler in the capsule that doesn't dissolve.)

Your fluoxetine liquid may be a little bitter -- just swallow it quickly. You might want to chase it with a little fruit juice.

---------------------------- (end of partial copy from tapering link)

 

You could for example, put a 20 mg capsule into 20 mL of water, and then just take 1 mL of that to get a 1 mg dosage.  Do read the whole link please, and go through the how to make a liquid link as well.  You'd need to get a mixing vessel, and oral syringes to do this.  You have other options as well, to get a prescription for a liquid from any doctor.

 

What kind of WD(withdrawal) symptoms have developed?  And when did they develop in relation to when you took your final dose of fluoxetine?

You can refer to the PDF in this link to get an idea of some of the WD symptoms.

Dr. Glenmullen's withdrawal symptom list

 

1 hour ago, ElaineM said:

I was on 80 mg and I started by skipping one dose a week till I was down to none! 

 

That is.....a huge dose!  Wowser.

 

Can you also add into your signature a date, year, month, day if remembered or approximate, as to when you took your last dose of fluoxetine(Prozac)?

To edit your signature or update, here is the direct link:  AccountSetting/direct link to your signature

I did read it was 3 months ago I think, but to save us time when you have questions.......ever so nice to have that in your signature, and easily found.

 

By the way I think I read you were doing alternate doses or skipping doses prior to stopping your Prozac, and we do not recommend that.

Never Skip Doses to Taper

 

Welcome aboard, sorry you had such poor management of your drug and also withdrawing from it.  You may wish to use a PC to read links and topics, rather than attempt to do that from a mini screen phone device.  That might help you to get familiar with this site.  It's a forum, not Instagram, not FB, and there are large amounts of information here to look at. 

All my best in your healing.

 

L, P, H, and G,

mmt

 

[ElaineM]

thank you so much! I really appreciate your response! It’s so nice to be able to find help!

 

That was the way my doctor told me to go off of medication’s by skipping doses. Basically the first week I skipped one dose, the second week two, and so on. I really do appreciate my doctor, and she’s very sweet, go to the same church as us, and says I’m like one of her grandkids, however, I’m not sure she fully understand all this withdrawal stuff. she does not think it is withdrawal that I’m dealing with, she thinks it’s a return to pre-symptoms. i’m struggling to know who to believe honestly.😂

 

honestly, I’m surprised I haven’t had more withdrawal symptoms. My main thing is really insomnia. I really struggle to get a good nights sleep. It’s very hard to cope when I’m a mom and a wife and just want to feel good. 

 

I guess I forgot that my fluoxetine capsules are 40 mg. So I would just mix that with 40 mg of water and take 1 mg correct? And then, how long should I do that before I taper off of 1 mg? And how do I taper off of that 1 mg? 

 

once again, thank you so much for your help, sorry for all the typos in the messages🙈

[ElaineM]

I added this info but I took my last dose on 1/25/23. 

 

any idea how long do symptoms of insomnia will last? (Also dealing with anxiety. my whole body just feels achy and tense with anxiety)I know it’s different for everyone but even an approximate?

[manymoretodays]

23 minutes ago, ElaineM said:

I guess I forgot that my fluoxetine capsules are 40 mg. So I would just mix that with 40 mg of water and take 1 mg correct? And then, how long should I do that before I taper off of 1 mg? And how do I taper off of that 1 mg? 

 

That would be fine.  As fluoxetine has that long half life we'd want to wait and see.......a week, and then maybe a little longer to see if it helped.  No rush to get off if it helped with your symptoms.  And after week one or longer......it might be worth a little updose too, like maybe to 2 mg.  Once you've had a couple of months feeling stable and like it is all manageable then you would taper off that reinstatement dose.

 

26 minutes ago, ElaineM said:

That was the way my doctor told me to go off of medication’s by skipping doses. Basically the first week I skipped one dose, the second week two, and so on. I really do appreciate my doctor, and she’s very sweet, go to the same church as us, and says I’m like one of her grandkids, however, I’m not sure she fully understand all this withdrawal stuff. she does not think it is withdrawal that I’m dealing with, she thinks it’s a return to pre-symptoms. i’m struggling to know who to believe honestly.😂

 

honestly, I’m surprised I haven’t had more withdrawal symptoms. My main thing is really insomnia. I really struggle to get a good nights sleep. It’s very hard to cope when I’m a mom and a wife and just want to feel good. 

 

Oh, definitely keep the relationship with your doctor and not many do know.......honestly, less likely a general doctor would know than a psychiatrist.......but thankfully.......most are beginning to get the gist of how poorly these drugs work, and then that some do really have symptoms and WD beyond the first week or two, and then that...... it may be worth it.......for them to begin to be more prone to harm reduction for all.  Or de-prescribing more slowly than what a lot of their literature tells them.

At some point.....you can be this doctors educator if you hang around here long enough.  Most of them, doctors and especially general practitioners are so pushed to the max to see so many patients per day.........so many are burning out, and/or their own mental health suffers.  They don't get much extra time anymore to be totally holistic.  So definitely don't lose the friendship.

 

Many in WD, do opt for just non-drug coping to get through, or reinstatement(of the small dose) and non-drug coping.

Some ideas for non-drug things you can do or try:

 

Tips to help sleep: so many of us have that awful withdrawal insomnia

Ways to cope with daily anxiety

 

So more to look at.  And a ton of hope for you too ElaineM.  Your youth, your just one drug trialed, and that you ARE managing now fair in spite of WD.  Keep us update, as to what you do, and how you are doing.  And thank you for your membership here.

 

L, P, H, and G,

mmt

[LostInCanada]

@ElaineM getting stable with minimal symptoms is best before tapering off. If you read the threads on tapering, it is no more than 10% of the current dose per month. It is not a quick process but it works and minimizes damage to your central nervous system. These SSRIs are very potent at small doses and therefore the slow taper is so important. ❤️

[ElaineM]

Curious what makes everyone so sure this isn’t symptoms returning and is only withdrawal?! I mean it seems like it is possible for stuff to return. Not saying it isn’t withdrawal but curious! Also if it is withdrawal any idea how long it will last?! Basically just dealing with insomnia and anxiety! Thank you!

[ElaineM]

It makes me really nervous when I read about those suffering from insomnia for years but maybe that’s due to being on worse medications as well as more than one!

[LostInCanada]

@ElaineM relapse takes much longer to present according to Harvard Health and they develop more gradually. Withdrawal symptoms occur within days to weeks.

Hopefully with a small reinstatement the insomnia can get dealt with sooner than later. Following the advice of the moderators and educating yourself about sleep hygiene will help in this regard.  There is a lot of good info to search under Self care. 

[ElaineM]

hmm ok. My insomnia actually did not start right away. It started around the month and a half off mark, then I went back to sleeping ok, and then it has been bad for around a month and I am currently at three months off. However maybe that is still considered to fast for return of symptoms! Thank you again for responding!

[Shep]

18 hours ago, ElaineM said:

The reason I was switching to setraline quad because I wanted a safer ssri for pregnancy.

 

Are you currently pregnant or are you just planning on becoming pregnant in the future? 

 

A few questions about some things in your signature:

 

• how long were you taking valerian and when did you stop?
• What is neurolink? 
• What are the doses of your current supplements and what time(s) of the day do you take them? 

Also, please update your signature with the year you started fluoxetine ("since 13" doesn't tell us anything). You may also want to add in the doses for your current supplements. 

[ElaineM]

I am not currently pregnant but want to be soon. 

 

Neurolink is something that my doctor had me take while going off of Fluoxotine. It has Vit B6, L Tyrosine, GABA, L-Glutamine, Inositol, Taurine, 5-HTP. 

 

I have not been being consistent in taking my supplements. In fact I have stopped most of them. Nothing really helps sleep.

 

I only took valerian a little over a week and stopped like 3 nights ago.

[ElaineM]

I have already asked this but any estimate on how long this insomnia will last! Sometimes I can’t go to sleep but something I struggle with bad is waking up in the night and not being able to go back to sleep. I certainly don’t want this to last to long!

[LostInCanada]

@ElaineM there is no way to answer that question about insomnia. Fluoxetine builds up and stays in the system a long time so a month and a half is right away for that drug. Three months is not unusual. All you can do is practice good sleep hygiene as mentioned before. Most of all don't stress about it, that only makes it worse. I capitalize on my insomnia by meditating on my blessings and praying. 

[manymoretodays]

15 hours ago, ElaineM said:

Curious what makes everyone so sure this isn’t symptoms returning and is only withdrawal?! I mean it seems like it is possible for stuff to return. Not saying it isn’t withdrawal but curious! Also if it is withdrawal any idea how long it will last?! Basically just dealing with insomnia and anxiety! Thank you!

 

Some topics that speak a bit more to this question:

Horowitz and Taylor(2022)Distinguishing relapse from antidepressant withdrawal: clinical practice and antidepressant discontinuation studies

 

and then from other users perspectives:

Withdrawal or relapse? Or something else?

 

Also Elaine, often times it can be distinguished as WD, if it does respond to reinstatement.  The "it" being your present symptoms. 

Best would have been that we'd have been able to recommend a small amount of Prozac right at the start of your symptoms.

I don't think it would hurt to try a small dose reinstatement of Prozac now though.  It may help.  I would, if it was me.  You get to decide after reading through everything.  Why suffer if there is something that might help.  I think it's pretty low risk that you'd be hypersensitive........yet I'd still start low, why take more than you need?

 

As far as pregnancy goes and SSRI's like Prozac and the Sertraline(your doctor wanted you to try now) go........  It's best to check it all out with a search and I found some things.

Fluoxetine(Prozac)- Mother To Baby

Sertraline(Zoloft)- Mother To Baby

 

And we have a sparse topic here:  Antidepressants/withdrawal during pregnancy

 

You could google and find more I'm sure too, as well as talk with your doctor.

 

I would think though that if a small dose reinstatement of Prozac helped with your symptoms, then the low dose would be less likely to cause harm to a developing baby.......and who knows.......prior to conception you might have already come off of it too.

 

I think that's fine that you've cut your supplements now.  We often just recommend single ingredient supplements too, so you know exactly what is doing what.  I think it's very likely to assume you are in WD. 

The only 2 supplements we recommend are:

BASIC SUPPLEMENT TOOLKIT

King of supplements: Omega-3 fatty acids (fish oil)

Magnesium, nature's calcium channel blocker

 

Many do develop sensitivities during WD and after, and so if you try.......just try one at a time.......start low and go slow and then you'll know for sure what might be causing what or what IS helping too.  Magnesium can be pretty calming......so give that topic a look and then ask here if you have more questions.

 

I don't know how long with the insomnia or feelings of anxiety either.  There are things you can try though.  The reinstatement, a little magnesium, a little melatonin and improved sleep hygiene.  Even anxiousness can be approached without drugs.

 

Enough from me,

 

L, P, H, and G,

mmt

[ElaineM]

Thank you! I’m fine with being on 1 mg while pregnant. With my first daughter I was in 80 mg so🙈 Prozac is considered relatively safe but setraline is safer I think especially for breastfeeding (it shows up in smaller amounts in the breast milk). 

 

How much magnesium and fish oil should I take?

[ElaineM]

Could one night if doing the reinstatement affect my sleep already! I actually slept pretty good last night!!! probably got 7 1/2 to 8 hours!!

[LostInCanada]

@ElaineM in my drug signature you can see how much magnesium and algae oil I take. (It's the DHA and EPA that is important) The thing with supplements is we need to start at small dosages because when in withdrawal we are very sensitive. I am taking 1/2 the recommended dosage of magnesium and 1/4 of algae oil. But if a small amount doesn't bother you, uping the dose is appropriate.

If a reinstatement has a fast effect on your symptoms it is further proof you were experiencing withdrawal. Glad you got a decent sleep. 👍

[ElaineM]

I haven’t really noticed being sensitive to supplements much. I am taking 1,200 mg fish oil (has 600 mg of Omega-3) and 350 mg of magnesium.

 

As far as the sleep thing, I do get a night here and there of good sleep so I don’t know if it was that or the reinstatement. However I was just curious. If I keep consistently sleeping well we will know it was the reinstatement!

[ElaineM]

hello, I’ve had some rough nights again. I slept good for about two nights, and then I have not been sleeping good however, I also was camping. my first night back at home was bad. should I up my reinstatement does to two mg?

[Altostrata]

How long have you been taking 1mg fluoxetine? Have you skipped any doses?

 

Something like camping might cause poor sleep. It should go back to your usual pattern in a few days.

 

Why would you want to increase fluoxetine to compensate for doing something that might cause poor sleep?

[ElaineM]

I’ve did 1 mg for 6 nights.

 

Well I didn’t sleep good last night here at home either and someone told me on this thread at some point I might need to up it to 2 mg.

[Altostrata]

If you started on 1mg only 6 nights ago and went camping since, that's not enough of a trial period. Suggest you try 1mg for 2 weeks at least.

 

Before you went camping, what effect did you feel from the 1mg?

[ElaineM]

I did sleep pretty good! 

thanks for the input!  I will keep trying 1 mg for now!

[Shep]

@ElaineM Some other things to keep in mind when camping, going on vacation, or doing any activity that's outside your normal routine - many times, our diets change, our bedtime changes, our activity levels change, etc. when we alter our normal day-to-day. These are all things that can ramp up the nervous system and cause symptoms. Even good stress can be triggering to a nervous system that is struggling to adjust to a regular routine. Telling yourself this can be very calming because it communicates to the brain and nervous system that you know you varied your routine, diet, etc. but that was temporary, you're okay, and you'll be feeling better with time. 

[ElaineM]

how long does the adverage person struggle with insomnia? I am so down with it. I can’t even hardly take naps when I don’t sleep at night.

[LostInCanada]

@ElaineM sad to hear you are still dealing with this. I wish there was some average time. These drugs really throw us off balance. I've struggled with sleep for over 7 years on my full dose, now at 5mg I can at least fall asleep fairly quickly but still wake every 90 minutes. It has just been over a month...be patient. Also in a previous post I made a typo about how long anyone should be on these drugs as recommended by the drug companies...not 28 months..max 9 months. They were never to be a long term solution.

[ElaineM]

I actually slept amazing on antidepressant, it’s the coming off that messed me up. 

[ElaineM]

and I forgot to specify, but I’ve actually been off of antidepressants now for close to four months. I did rectory get pregnant…maybe that’s messing it up but it just never has been very consistent… I don’t want to sound complainy but it is hard to plan out activities or go on vacations. Lack of sleep is really hard on me. Makes me feel sick and I get anxious and cry a lot. Hoping it gets better soon… I just don’t get why I can’t take naps either🤷🏻‍♀️ oh well… hopefully it will pass! Thank you and have a good day!