Poop out and Treatment Resistant after 28 years

[JayGatsby]

Greetings,

 

My troubles started for me during my freshman year of college in 1994 when I had what I later realized was an extremely severe and traumatic drug induced panic attack from smoking marijuana that may or have not been laced. I was convinced for the next year and a half or so that I was losing my mind, and would constantly ruminate and obsess on thoughts and feelings which I believe were depersonalisation/derealization type feelings and sensations. However, I don't think I was accurately able to describe these symptoms to the psychiatrists on campus, and after a brief (maybe a month or so?) trial on Prozac, they tried various antipsychotics. I don't remember all of the names, but I do remember Haldol and I also remember Stelazine. I remember Stelazine in particular because I had a bad reaction to it where my entire body seized up. At one point, I was also trialed on Lithium as one psychiatrist thought I might be bipolar.

 

Eventually, in the spring of 1995 I was put on effexor and I finally stabilized. I have no idea how many milligrams I was on, but I stayed on it until the fall of 1999. I had been backpacking through Europe, and towards the end, when I got to the last country and the attempt to win over the girl of my dreams I began to feel down. After "confessing" to this girl about my taking antidepressants and how I was feeling down, we both decided that I should stop taking these pills. I had no idea about withdrawal at the time, and of course had no idea about Effexor's short half life or even what a half life was for that matter, and I went through some major withdrawals, including heavy brain zaps and was extremely emotional.

 

I went back home and was doing ok for about a month maybe when my depression came back with a vengeance. I went to my GP who put me on Paxil, which helped me greatly. I had a Paxil prescription from that time (around 2000) until last fall for 30mg. At some point, however, I bought a jewelry scale, and would use a pill cutter and a nail file to adjust my dose of Paxil. My goal was always to take the least amount possible (to minimize side effects) while still getting therapuetic results. This probably wasn't wise, but it seemed to work for close to 20 years. I would imagine that I probably averaged about 20 mg over those years, but sometimes I would take less, and there were long stretches where I took the full 30mg as well.

 

Cut to last summer (2022) and I was taking approximately half a pill (15mg) and feeling very blah. I was fed up with Paxil's side effects, and went to my GP in search of another SSRI that would provide relief from my depression without as many side effects. I was prescribed Lexapro 10mg and after two and a half weeks I had my first panic attack and feelings of depersonalization in over 20 years. I lasted a few more days, and told my doctor I wished to go back to paxil, which I started fairly slow, taking 15 mg to start, and slowly working my way up to 30mg over about a two month stretch.

 

After restarting my Paxil, I began to have panic attacks and derealization feelings within the first week of reinstating, which was horribly heartbreaking as I assumed I could restart the paxil and at least go back to feeling "blah," but without the panic and anxiety, since I never really had the panic and anxiety being on Paxil all those years. This panic and unease lasted for close to six weeks, and then I had about a three week stretch where I generally felt "ok." I then got Covid and my panic and anxiety became worse then ever for a good week or so. I then had another month long period where I felt "ok." Not great, but ok. However, I then had a strange illness involving night sweats and painful swallowing, and my panic and anxiety and depression returned full force for about a month or so and I asked to try Prozac.

 

On Prozac I got very agitated, and only lasted about three weeks. My hands were constantly shaking and I had a constant feeling of anxiety in my stomach and generally felt "cracked out." This is when I decided to seek help from a psychiatric practice, and was connected with Nurse Practitioner who specialized in psychiatry. I saw her, and she thought that Viibryd would be a good fit. I was on Viibryd for 4-5 weeks and would get a headache approximately 2-3 hours taking it each day, had trouble sleeping, my blood pressure increased, and I felt very hopeless and depressed.

 

I then asked her to try clomipramine, and she prescribed me 25mg, which I was on for around 7 weeks. This was better than the Prozac and Viibryd, but I still had some very rough patches, and my sleep was horrible and my blood pressure was very elevated as well.

 

I asked the NP to try effexor again, which I did, but even on a low dose I would feel anxiety in my stomach about two hours after taking it and my blood pressure would increase fairly significantly so I only lasted a few days. This was about a week and a half ago, and I went close to a full week on nothing at all. During this time, the only physical withdrawal was some brain zaps when moving my head from side to side. However, the I felt depressed and derealized for much of this time, but also went through some periods where I felt pretty good. We were at the beach on vacation, so I thought this was a good time to try this experiment of not being on any SSRI's. The only thing I was taking was a small dose of Trazodone for sleep.

 

On the drive home from the beach, and after a night of very poor sleep, I was feeling very very down. Because of this, when I got home, I decided to take a dose of my 30mg paxil I had leftover. Stupid, I know. Two hours after taking this, I had an extreme amount of anxiety in my stomach and my blood pressure spiked close to 20 points. I didn't take anything yesterday or anything today, and am thinking I will try to continue to ride it out on nothing and try to let my brain heal. It seems that I may have become resistant to SSRI type medications, and I'm pretty scared not to be on anything. However, I felt pretty bad on them for most of this past year, so my thinking is that if I feel bad off of them, at least I'll be giving myself a chance to heal. However, I've also toyed with the idea of asking the NP if she'd consider an MAOI for me..

 

I'm pretty lost right now.. Like I said, surprisingly, I don't have much in the way of physical withdrawal. It's more the mental effects.. The stomach anxiety is no longer really there at least, but the depression and ruminating on derealization type feelings are fairly strong, though. And I'm worried that after so many years, that my brain will not revert to making serotonin on my own.

 

Another thing that confuses me is that I feel the SSRI's were still providing serotonin to my brain. Perhaps this is too much information, but the reason I feel this is true is because since going off the SSRIs entirely last week, my time to orgasm was significantly shorter than while on the Paxil, Prozac, Clomipramine, etc., and I know that levels of serotonin play a significant role in length of time to orgasm. Since it seems the serotonin was raised, I just don't know why I had positive effects all those years and now nothing.. In fact, if anything, now, I think I feel worse on these medications than without..

 

Also, reading through some of this forum, it seems that I may have developed "serotonin toxicity" with many of these medications. This confuses me again, because I had all those years of success where paxil made me feel more or less calm.. Now, the serotonin increase seems to put me on edge..

 

Thanks for any thoughts on how you feel I should proceed.. As of now, I'm feeling I should try to ride things out a bit without SSRIs to see if can heal..

 

With Love,

 

Jay

[Onmyway]

Hi @JayGatsby

Welcome to SA. Believe he or not your story is not at all unusual here.  Lots of people are started on ADs, they have side effects or for some other reason want to stop or  then change medicines. The doctors tell them to switch to the new meds in a few weeks.  They go into withdrawal.  The new medicine is slightly different from the old one so it doesn't cover the withdrawal effects (these drugs affect many more things than just serotonin,  it's a complex system we know very little about). They are then suffering from withdrawal (which can go for months) but after a few switches the brain becomes hypersensitive and reacts to new drugs with (usually) severe agitation and more side effects. Please look up 'hypersensitivity and kindling' in the Symptoms and Self Care forum (I'm on a mobile so hard to link). The doctors do not recognise this as iatrogenic harm and label the patient as treatment resistant.  

 

Good news is the this it's temporary and you will get better but it may take years to get back to normal.

 

Bad news is it will be quite unpleasant in the meantime and you have to brave that without the help of other drugs - they're likely to make things worse.  In the process you will learn how strong of a person you are and how you didn't need these drugs in the first place.  

 

In the meantime please do not take any psychoactive substances such as alcohol,  other drugs,  massive doses of suppleness- they will likely set you back and make you worse. 

 

This will pass if you let your brain/body figure it out itself. 

 

Omw

 

 

[JayGatsby]

Thank you so much for your response onmyway!

 

I am struggling with feelings of depersonalization/derealization the past couple of days. It's really scary, and it worries me especially because these were the symptoms I had after my bad panic attack on marijuana all those years ago and the only thing that helped me was SSRIs.

 

Now that they don't help me at all anymore, and in fact make my anxiety worse and blood pressure rise, I'm kind of at a loss..

[Onmyway]

Hi @JayGatsby what helped at the time was probably the placebo effect and passage of time. If it were the serotonin, the first drug would have helped you not the 5th or 6th. 

 

Have a look at this article: 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/

 

The current DP/DR will go away as well slowly. Be gentle with your system. 

 

Can you pls fill in your drug signature? The instructions are in the email that was sent to you when you registered on the site. 

 

This will help us advise you better. Did you have a look at the hypersensitivity and kindling thread?

[Cheeky]

Hey @JayGatsby

welcome to this community . 
my story is similar to yours . 
paxil is so hard to get off , I reinstated after many drug chance like what you had . 
Don’t take any other drug as it won’t cover the withdrawal symptoms from the Paxil . 
I ended up reinstating it and held for 6 months until I felt stable again . 
Good luck with your decision .

[Altostrata]

Welcome, @JayGatsby

 

To help us out, follow these instructions Please summarize your drug and withdrawal history in your signature You may need to use a computer to do this.

 

When was the last time you took an antidepressant, and what was it? What is your current symptom pattern now? How's your sleep?