Grad74: Reinstatement of Prozac not working

[Grad74]

Hi all , I have heard about this site for awhile and have been struggling this past year with my prozac medication. I was originally prescribed it for very bad anxiety episodes after my mother's passing in 2015. Last year I had decided to come off completely but apparently went off way to quick. I reinstated my prozac soon as per my doctor but did not receive much relief, if at all . I was still experiencing what people refer to here as "windows and waves"..... I had really wanted to stick it out but after almost 8 months after reinstating I am not sure what to do. I am afraid of touching any other medication but at the same time these waves feel absolutely awful. A local support group I was attending had someone going through something similar and they had mentioned this site among a few others. I watched a documentary featuring the creator of this site and she seemed very knowledgeable about the subject and I had wanted to ask for some kind of take on my situation.

 

Is this a common occurence to reinstate the drug but it having little to no effect? I'm really at a loss right now, any response would be greatly appreciated! I want to get through this for my cat and two beautiful nieces 

[Grad74]

Hi, I am posting this again due to a name change as per Altostrata's request. I am fine with my name either way as I do not care too much if someone finds me here, besides the fact I share my name with a famous SNL alumni 

 

I have been taking Prozac 30mg for about 7 years after my mother's passing in 2015. Last year I had completely come off of the medication and a short while after I started experiencing horrible withdrawals. I reinstated the Prozac as per my doctor's orders but it did not seem to have any effect unfortunately, I had really just wanted to stick it out hoping to adjust to it again but 8 months out I am still experiencing very intense windows and waves and I am in a very bad sitatuation . I was reffered to this site by a friend in a support group and had watched a documentary with the founder of this site and wanted to ask for help here because I am not sure what to do at this point. This is the only psychiatric medication I have taken in my life and I have been almost non functioning this entire year. Thankfully I have a very supportive family but I would really like to get back to my job. 

 

I don't know if it is a common occurence for drug reinstatement to not work but I was really hoping that it would. The windows and waves have lessened but are still so intense to the point of having suicidal thoughts. Any response would be greatly appreciated 

[Go2zero]

Welcome to this support site. Before we can answer your questions, please give us more information first. 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.

 

Can you please give us specific information about your drug history for all drugs you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise list (no symptoms), only drug names, specific dates (as best you can say for example early March if you don't recall the day) and dosages of each medication decrease or increase.  Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

https://www.survivingantidepressants.org/topic/28240-how-to-summarize-your-drug-history-in-your-signature/

[Grad74]

1 hour ago, Go2zero said:

 

Welcome to this support site. Before we can answer your questions, please give us more information first. 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.

 

Can you please give us specific information about your drug history for all drugs you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise list (no symptoms), only drug names, specific dates (as best you can say for example early March if you don't recall the day) and dosages of each medication decrease or increase.  Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

https://www.survivingantidepressants.org/topic/28240-how-to-summarize-your-drug-history-in-your-signature/

 

Ok, I have made a drug summary, thank you for the link

[Go2zero]

Thank you for making the signature.

 

Your signature show that you stopped prozac by going off 10 mg without tapering. This may cause severe withdrawal symptoms, which probably happened to you. 

 

Reinstatement may help then, but often our body and nervous system react different to these drugs after a reinstatement than in periods before the reinstatement.  Going up and down in dosages may sensitise our nervous system.  I see that you went up to 30 mg again.

 

Since you are still experiencing symptoms (most probably because of a sensitised nervous system) the only good advise is to stay on this dose until you stabilise. It cannot be said how long this may take unfortunately. This is different for everyone.

 

Here is some specific info about tapering Prozaz

https://www.survivingantidepressants.org/topic/759-tips-for-tapering-off-prozac-fluoxetine/

 

Here is more info about wave, windows and stabilising,

https://www.survivingantidepressants.org/topic/82-the-windows-and-waves-pattern-of-stabilization/

 

Have you been or are you using other medication?

 

Do you take alcohol, drugs, coffee?

 

[Grad74]

2 hours ago, Go2zero said:

Have you been or are you using other medication?

 

Do you take alcohol, drugs, coffee?

 

 

No, I do not take anything else. I do not drink or do drugs and I have stopped drinking coffee years ago. If this is the case then stabilizing seems like a truly scary prospect to consider.  I still did not expect it to be so intense after so many months after reinstating. On a couple of occasions my doctor suggested trying out Effexor in order to mitigate symptoms and see if that helps but I am not sure, also I don't think that is what is advised on this site, I am no sure. Reading on the half life of Effexor I am scared to try it and then come off of it and get withdrawals from that too! Do you know of any individuals who tried a different antidepressant and recovered from their symptoms? I am suffering a lot from headaches, fatigue and nausea. I had my vitamin levels tested and everything came back fine. Thank you for your response.

[Altostrata]

Hello, @Grad74

 

You reinstated 30mg Prozac? What is your current symptom pattern? How does it compare to when you were off Prozac in January?

[Grad74]

14 hours ago, Altostrata said:

Hello, @Grad74

 

You reinstated 30mg Prozac? What is your current symptom pattern? How does it compare to when you were off Prozac in January?

 

Yes, I was on 10mg for about a month and then went up to 30mg. In January it was a huge wave of anxiety, dread and doom that I could not describe, very bad headaches, brain fog and fatigue, I was doing so bad I was thinking about going to the hospital but did not want to be put on anything else. Restlessness as well, could not lie down for long periods of time without having to get up or change positions, just a constant feeling of dread the entire time. I then upped it to 30mg in February as things were not improving and was still experiencing those symptoms. 

Currently the dread, doom and overall anxiety is gone but I still don't feel comfortable most of the time and cannot focus on complex tasks for long periods of time. Have a constant headache and I am doing "better" but still in a place where my quality of life is nearly unbearable. I don't know what to do at this point.

[Altostrata]

4 hours ago, Grad74 said:

In January it was a huge wave of anxiety, dread and doom that I could not describe, very bad headaches, brain fog and fatigue, I was doing so bad I was thinking about going to the hospital but did not want to be put on anything else. Restlessness as well, could not lie down for long periods of time without having to get up or change positions, just a constant feeling of dread the entire time.

 

You have described acute withdrawal from Prozac.

 

4 hours ago, Grad74 said:

I still don't feel comfortable most of the time and cannot focus on complex tasks for long periods of time. Have a constant headache

 

What times of day are these symptoms better or worse?

 

What times o'clock do you take your drugs, with their dosages? Do you feel better or worse after a dose?

[Grad74]

5 hours ago, Altostrata said:

What times of day are these symptoms better or worse?

 

What times o'clock do you take your drugs, with their dosages? Do you feel better or worse after a dose?

 

It's starts in the morning and gets to its worst in the afternoon. Around evening it eases up a little bit and by night I feel the most calm. 

 

I take 30mg Prozac at 9am every morning. I don't really feel better or worse after taking it, though on one occasion I forgot to take it and I got sniffles a couple of hours later, I don't know if that was connected.

[Altostrata]

1 hour ago, Grad74 said:

It's starts in the morning and gets to its worst in the afternoon.

 

The bad symptoms start in the morning? What are they? Do they start before or after you take Prozac? 

 

Do you have a bad spell at the same time each afternoon? When does this occur? What are the symptoms? What time do they ease up?

[Grad74]

16 hours ago, Altostrata said:

 

The bad symptoms start in the morning? What are they? Do they start before or after you take Prozac? 

 

Do you have a bad spell at the same time each afternoon? When does this occur? What are the symptoms? What time do they ease up?

 

Yes, I have a minute where everything is normal and then the headache sets in, palpitations, fatigue. They start before taking Prozac. 

 

It can vary, sometimes it's noon and sometimes it can start around 4. Headache reaches a fever pitch and it's painful to do anything. Starting around 7 or 9 pm things begin to ease up to the point I can concentrate on basic things again

[Altostrata]

2 hours ago, Grad74 said:

I have a minute where everything is normal

 

What time o'clock does this minute occur?

 

Please keep daily notes of times o’clock you take your drugs, their dosages, and your symptoms throughout the day. We need to know how you feel before and after taking each drug, and any significant symptoms in between. Post 24 hours of notes at a time in this topic, in a simple list format with time o’clock on the left and notation (symptom or drug and dosage) on the right.

[Grad74]

4 hours ago, Altostrata said:

 

What time o'clock does this minute occur?

 

Please keep daily notes of times o’clock you take your drugs, their dosages, and your symptoms throughout the day.

 

My sleep schedule has been a bit unorganized but always the minute after waking up. Usually around 9:30am. Ok, I will take daily notes. Based on what you have heard so far, are there any ideas you may have about what is going on? I want to get back to work again which I know will not happen in the near future but eventually I will have to either way. Have you seen individuals try out other medications and see improvement or has it made things worse? 

[Altostrata]

You may have protracted withdrawal from Prozac or you may have adverse effects from 30mg Prozac.

[Grad74]

19 hours ago, Altostrata said:

You may have protracted withdrawal from Prozac or you may have adverse effects from 30mg Prozac.

 

Interesting. While this far out taking 30mg Prozac did not know it could still hurt you this bad, not sure of the alternative or if it really is just better to wait it out.

[Altostrata]

If you're getting adverse effects from the drug after 8 months, they're going to continue. You can't wait them out.

[WeLiveInHope]

Is it possible for you to change brands? Sometimes that can help.

[Grad74]

On 8/29/2023 at 5:49 AM, WeLiveInHope said:

Is it possible for you to change brands? Sometimes that can help.

 

Change brands? What do you mean?

 

On 8/29/2023 at 1:25 AM, Altostrata said:

If you're getting adverse effects from the drug after 8 months, they're going to continue. You can't wait them out.

 

would this mean slow tapering it off again? Worried about still getting protracted withdrawals

[Altostrata]

It means carefully reducing your Prozac dosage until you don't have the adverse drug effects. Adverse drug effects tend to be related to dosage.

[Grad74]

On 9/3/2023 at 5:58 PM, Altostrata said:

It means carefully reducing your Prozac dosage until you don't have the adverse drug effects. Adverse drug effects tend to be related to dosage.

 

I see...... If I were to taper off again how would I go about it this time? Sorry for not keeping daily logs, I have really not been feeling well this past week. I feel maybe this could be what's contributing to the headaches but I'm not sure.

[WeLiveInHope]

On 9/3/2023 at 2:52 AM, Grad74 said:

 

Change brands? What do you mean?

 

 

would this mean slow tapering it off again? Worried about still getting protracted withdrawals

To put simply, Fluoxetine is made by different manufacturers, Prozac by Eli Lilly being just one of them. There are named generics and non named generics. We call all of these brands. Each brand of these may have expedites or fillers that you are sensitive to or get on better with.
 

Has the Fluoxetine you taken changed, or have you been taking the same brand throughout your recent withdrawal and reinstatement experience? 
 

If it has changed, it maybe, just maybe, be the brand you are taking that is causing all these issues.
 

As @Altostrata had also mentioned, it could be protracted withdrawal, or an adverse reaction also. Either way, whatever step you take next, you’ll have to be very careful as a rapid taper from fluoxetine can be extremely dangerous. And, I think your previous taper which was quite rapid has desensitised your body as it is.
 

Finally, long term use of any psychotropics typically cause all sorts of other health issues which may be having an influence on your body, and possibly then how you are experiencing the reinstatement. It may be worth speaking to a medical professional about your symptoms to investigate in case there is something else going on with you. 
 

Hope that helps. Take care.

 

Edited - some edits due to grammar and spelling and format.
 

 

[Altostrata]

Tips for tapering off fluoxetine (Prozac)
 

 

[Grad74]

Hi, I apologize for not posting, have not been feeling good at all these past few weeks. I am unsure how much longer I can continue living like this and have still maintained 30mg dose because I am incapacitated for most of the day and don't know how long I could keep up making custom doses before I mess up at some point. Doctor denied liquid doses and I feel that if I continue taking it I will continue to be in this state. Very difficult times right now

[Grad74]

I am feeling great agitation but I don't know at what and am feeling very antsy, I have not felt this way prior. I am worried it might be mild serotonin syndrome as I do not metabolize things as well and maybe there is a build up in my body. Very scared right now.

[Altostrata]

If you're having an adverse effect from your Prozac dose, gradually reducing the dose is the way to reduce the adverse effect while minimizing risk of withdrawal.

 

Using the liquid is a good way to gradually reduce your dosage in a controlled, systematic way.

 

Any doctor can prescribe these drugs. Do you have another doctor who would be more understanding?

 

In a pinch, you can make your own liquid Prozac. Many, many people have done this.

 

If you don't care to reduce the dose, you'll have to cope with the adverse effects. No one can do this for you but you.

[mstimc]

On 9/30/2023 at 6:40 AM, Grad74 said:

Hi, I apologize for not posting, have not been feeling good at all these past few weeks. I am unsure how much longer I can continue living like this and have still maintained 30mg dose because I am incapacitated for most of the day and don't know how long I could keep up making custom doses before I mess up at some point. Doctor denied liquid doses and I feel that if I continue taking it I will continue to be in this state. Very difficult times right now

Hi Grad

I did a quick review of your thread, but I don't see where you've tried any non-drug coping strategies to help manage your thoughts and feelings.  Have you looked into any tools like CBT or ERP?

[Grad74]

On 10/1/2023 at 12:17 AM, Altostrata said:

If you're having an adverse effect from your Prozac dose, gradually reducing the dose is the way to reduce the adverse effect while minimizing risk of withdrawal.

 

Using the liquid is a good way to gradually reduce your dosage in a controlled, systematic way.

 

Any doctor can prescribe these drugs. Do you have another doctor who would be more understanding?

 

In a pinch, you can make your own liquid Prozac. Many, many people have done this.

 

If you don't care to reduce the dose, you'll have to cope with the adverse effects. No one can do this for you but you.

 

What happens if I get down to zero and this all happens over again? 

[mstimc]

Hi Grad. 

1 hour ago, Grad74 said:

 

What happens if I get down to zero and this all happens over again? 

Hi Grad

This is your anxious mind talking.  It loves to play "what if" games with your thoughts to keep you trapped in negative thinking.  That's why having coping tools is so important; they keep the "what-ifs" from trapping you into inaction.  Focus on recovery and how to get there, and you'll be surprised how weak the anxious thought cycle really is. 

[Grad74]

Today my doctor suggested switching from prozac to lexapro, he says there is no need to cross taper and that I can just switch that day. He really wants me help me with this and says it could promising for this anxiety that I've been having lately but I'm scared of making such a big change

[Addax]

On 10/16/2023 at 10:26 AM, Grad74 said:

What happens if I get down to zero and this all happens over again? 

Try to take it one day at a time. I’ve had similar thoughts along the way. They are scary, for sure, and these kinds of thoughts are pretty typical of withdrawal, particularly when you’ve had a very negative withdrawal or reinstatement experience.  
 

Tapering is a marathon not a sprint to the end. Follow the links and guidance offered earlier. Those things will get you where you need to be.  It’s not a quick process, but, ultimately, the guidelines are meant to get you through this with as little discomfort as possible. There will still be waves and windows along the way - recovering and healing won’t be linear, but following the guidelines and keeping tabs on your response to decreases will minimize the risk of things going sideways.
 

Another important part of all this is doing what you can to draw your attention away from the scary thoughts. Whether it’s finding a coloring book and coloring in it, walking, or using methods like Attentional Training Techniques (Like this: https://youtu.be/kbTkwMJExCc?si=mqukPeYvI24fK4o_)- focusing your attention away from your symptoms and your thoughts about your symptoms is an important to finding relief from anxiety. 

 

Edited October 22, 2023 by Addax

[Grad74]

My doctor is a caring person but at the same time would like me to get my life in order and see some kind of change if this isn't working. Is doing the switch from 30mg Prozac to 20mg Lexapro, scared but hopeful hoping to find relief from restlessness and then taper slowly from there as suggested by others here

[Go2zero]

2 hours ago, Grad74 said:

My doctor is a caring person but at the same time would like me to get my life in order and see some kind of change if this isn't working. Is doing the switch from 30mg Prozac to 20mg Lexapro, scared but hopeful hoping to find relief from restlessness and then taper slowly from there as suggested by others here

 

Switching from Prozac to Lexapro may give you withdrawal symptoms from Prozac. Even after switching to another SSRI.

 

Lexapro is MUCH harder to taper than Prozac. Why don't you follow the advise of Altostrata? 30 mg Prozac is most probably a much too high dosage for you, which may give an adverse reaction. Tapering Prozac down to 20 mg is much safer than switching to another AD. Tapering from 30 mg to 20 mg Prozac may give relief from the problems you experience right now.

Edited October 23, 2023 by Go2zero

[Grad74]

This will be some musings that I have had recently in light of some changes made. Have not been as active and unfortunately had not read @Go2zero's post in lieu of starting this new medication. I was absolutely terrified and truly at my wits end but somehow things have seemed to be getting.... better? I won't hold my breath until at least being a couple of weeks into it but against all odds of what I had thought would transpire I have gotten relief I had not seen in months and have immediately begun trying to get my affairs in order. I really don't know what to say, at the advice of several experienced members here versus the pressures of seeking immediate relief in any way shape or form particularly because I feel especially susceptible to pain sensitivty, which would make it against all reason to have gone through with it, but truth be told, I do not believe I am truly here nor do I care what happens as this point. I am hardly living, and with these windows of opportunity given now I try to make the most of it. What if 2 months down the line I get some kind of sudden new onset withdrawal from switching from prozac? I truly don't know. Holding on at this point I put it to stupid luck but a near absolute apathy to the situation when any other time in my life I would fight pragmatically tooth inch and nail to make the best decisions for myself. It is not in my character to be like this, and I truly feel these months have taken a toll on my awareness of the world in ways I cannot really convey. I apologize for doing this and I hope to see my way out of this. It deeply pains me what this year has become and another year of my life lost to medication and with what incredible support I have been given throughout the whole ordeal only to be able to lie down in a near catatonic state, not being able to think or feel, just exist. Black moods setting in not because of the depression but the sheer physical state my body is in and how carrying out any task feels like death. I wish I could find some semblance of normalcy and I thought I was a positive person but deep deep inside I feel I will never be the same way again. The fact that lexapro is much harder to taper off than prozac seems even more foreboding but doesn't add much more to the neuroticism I experience currently. 

 

When I had reinstated prozac too high, I had really tried to hold out, months and months with no improvement whatsoever, and now it seems either it was the cause to begin with or that I had not given it enough time despite those tortuous months. Upon changing to what my doctor deemed a "equivalent" dose of 20mg lexapro something began to change and I can't describe what. It feels like an anomaly on top of the anomaly that was experiencing withdrawals 2 months after stopping the medication to begin with, feeling like I was nearly in the clear, just barely keeping on. In this community I have seen the pragmatism and steps taken to ensure that any decision made based on the advice of experienced members are as safe as possible and I fear I have made some error in taking a chance, whereas I feel more powerless than ever and am completely putting my trust in my new doctor, because I cannot think for myself. I had tried lowering my dose to 20mg once prior but amidst all the chaos it only seemed to worsen things so I desperately got back up to 30 and vowed to hold for as long as I could. If I had held longer, if I had the strength, could I have seen relief? Or to ask my doctor for liquid doses and have him scoff at me? I know that in this state if I attempted to make my own liquid I would screw up. If I could pay for one on one constant support from one of the users here I would, but they are the only ones I can call to and inquire to even though they may ultimately make things worse. It would be so nice to have prescription liquid doses, I screw up things easily.

 

The effects of high reinstatement seem to vary a lot between individuals and that if some cases were showcased and symptoms described as accurately as possible it may dissuade others better from attempting it to begin with to prevent this ordeal to begin with. I had experienced unrelenting restlessness, dull headaches, ideation, extreme fatigue and a black mood that is admittedly much harder to make clear on here. 

 

I see so many new users and individuals joining and I have read their threads until the end, many abruptly stopping, perhaps they had found some kind of relief and did not need the site anymore? A crisis where they eventually were able to recover offsite and we never knew? Or something far worse. What I ask is how do you manage it all? With each new individual that comes in, some highly unstable, you provide in depth responses in hopes they can get some order back into their lives but it seems their ultimate fate is unknown, or at least that is what is seems like it is to me. Among them I have read some success stories and you hold onto these with all possible hope, knowing someone else navigated these waters just as alone and in the dark. Even with outside help uncertainty permeates their every waking hour. 

 

I am looking into this too much and I am ruminating too much about this and ranting/venting, anything out into the void. It frustrates me greatly that I cannot get out the words the way I want them too and it all seems like a big mess of words no matter how much you try and tidy it up. I do not know what I am saying and I am just speaking. Sorry, thank you thus far up until this point and the unwavering support of staff for the many souls who come on here selflessly giving their time and expecting nothing in return except for the chance to see some kind of recovery for them. Sorry for the wall of text

[Grad74]

I am in a severely agitated state while simultaneously being very tired at the same time. I do not feel well

[WeLiveInHope]

I just want to share that I am deeply sorry you are having such an awful time with it all. 

It is hard to know what to suggest by anyone with 100% conclusively. It’s still trial and error, so it comes down to what you wish to trial. You’ve now trialed lexapro. Coming off this may add further problems to your ordeal, or it may not. 
 

it could still be an idea to return to 20mg Prozac. With that said, I wonder if your body would benefit from some stability. Too many major changes eg large change dose or medication, in quick succession is a recipe for disaster in my view. 

I hope the admin come along soon to assist. 
 

Hang in there.