NONE79, Switch Prozac following 15 years Deroxat... Need Help

[None79]

Hello everyone, My name is Franck and I am French. I started Deroxat 20 MG in 01/2008 for anxiety disorders...Since then I have never been able to get rid of it despite several reduction attempts, admittedly too rapid, by my doctor. 2023 has been a dramatic year for me and I'm heading into 2024 with a new antidepressant. I have many side effects: memory loss, intense fatigue, irritability, insomnia... I stopped deroxat 20mg in 08/2008 as planned by my doctor, reducing it in less than a month... in 01/2009 I fell into severe depression and lost 25 kg before the doctor didn't realize I had Crohn's disease. I took deroxat again in 07/2009 but still with a lot of fatigue, 0 emotions, 0 libido, irritability, non-restorative sleep... We tried again to stop deroxat 20MG in 03/2014 while reducing the dose by 1/4 every 15 days... in 05/2014 it's hell.... My last stop took place on 11/2022 when I suddenly stopped taking deroxat in the middle of Covid, a month and a half with very good windows and some side effects... Mid-January 2023, impossible to get out of bed, feed myself, wash myself... my doctor decided to reintroduce 10 mg until March 2023... without effect... he then changed to Effexor 75MG then 150 MG...it got me out of bed but the sensations aren't great... In November 2023, effexor no longer works... I sleep 20 hours a day, I no longer eat, I no longer drink, a real zombie... they change my treatment and put me on Prozac 20MG in the morning and Diazepam 30MG in three doses. Today I am very slowly stopping the diazepam. 2 mg in the morning and 10 mg in the evening remain manageable. What do you advise me based on my experience, I would like to try magnesium and reduce this Prozac when the time comes but with a real withdrawal protocol... Thank you in advance for your answers and support. Edited January 1 by KenA
Format

[KenA]

Welcome to SurvivingAntidepressants None79.  Here is some information for you to read over and give you more information about what you may be going through.

 

TAPERING

Why taper by 10% of my dosage?

Dropping 1mg a months sounds like a nice slow taper, and if you were on a much higher dose it would work well.  10mgs is a very tricky dose to start tapering from.  It's right at the top of the most sensitive part of the taper. Something like 85% of the drugs effectiveness happens in the first 10 mg, so making even a small change can have a big effect symptom wise. Decreasing by a straight 1mg also accelerates the amount that you  would be decreasing each time making it rougher and rougher with each drop. Decreasing by a percentage however decelerates the amount of each drop and makes things gentler on your system

The Brassmonkey Slide is a way of making micro-taper reductions weekly, as opposed to a larger reduction once a month. 

The Brassmonkey Slide Method of Micro-tapering

Taking multiple psych drugs? Which drug to taper first

 Important topics in the Tapering forum and FAQ  

 

WITHDRAWAL

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

REINSTATEMENT

Reinstatement of a very small dose of the original drug is the only known way to help alleviate withdrawal syndrome.  It isn’t a guarantee of diminished symptoms but it’s the best tactic available. The only alternative is to try and wait out the symptoms and manage as best you can until your central nervous system returns to homeostasis.  Unfortunately no one can give you an exact timeline as to when you will start feeling better and while some do recover relatively easily, for others it can take many months or longer.  

 Reinstatement predictably works up to 3 months after last dose.  It is best to reinstate as soon as possible after withdrawal symptoms occur. We usually suggest a much smaller reinstatement dose than your last dose.  These drugs are strong, and when reinstating it is better to start with a small amount and increase if symptoms remain unbearable. Your system has become sensitized and If you take too much it may be too much for your brain and can cause you become unstable.  Sometimes it can be hard to regain stability after this happens.  Then, once you've stabilized on that dosage, which can take several months,  you can begin a 10% per month taper down to zero.   Please read:

About reinstating and stabilizing to reduce withdrawal symptoms. -- at least the first page of the topic

 It takes about 4 days for a dose change to get to get to full state in the blood and a bit longer for it to register in the brain.    

SUPPLEMENTS

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium (glycinate is a good form) and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

Magnesium, nature's calcium channel blocker 

Omega-3 fatty acids (fish oil) 

Add in one at a time and at a low dose in case you do experience problems.

 

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.

 

 

 

[None79]

Thank you for your reply.  I'm going to go to the pharmacy tomorrow to buy some magnesium glycinate.  Prozac is in tablet form, can I reduce it by 1 mg per month with a scale?  My doctor still gave me a protocol to reduce the Diazepam.  I also have zopiclone at bedtime 7.5mg which I need to reduce.  Normally at the end of January no more benzodiazepine... I try to compensate by running but it's not easy to manage the waves during the day.  The hardest part being the lack of concentration and memory loss, fatigue unfortunately we get used to.  Good evening

[None79]

Up

[None79]

Hello, I bought a jewelry scale to weigh my prozac and I am going to start reducing it by 10% per month.  Necessary to dilute the tablet in water from what weight?  Advices ?  Good evening

[FireflyFyte]

16 hours ago, None79 said:

Hello, I bought a jewelry scale to weigh my prozac and I am going to start reducing it by 10% per month.  Necessary to dilute the tablet in water from what weight?  Advices ?  Good evening

 

Do you have tablets or capsules of Prozac?

[None79]

Tablets

[KenA]

@None79 This topic has great information for making a liquid solution

 

Also this one as well.

 

 

[None79]

Hello everyone, I have just received my scale in order to very gradually stop fluoxetine.  But to my great surprise, the manufacturer's tablets are 32 mg!  I am well aware that there is 20 mg of fluoxetine and excipients but how should I go about reducing it by 10% every 4 weeks, knowing that I would have liked to try less than 10  % if there was a need.  Thank you in advance for your answers.  Good evening

[brassmonkey]

The ratio of pill weight to active ingredient is a constant. So, if you reduce the pill weight by 10% the dose strength automatically reduces by the same 10%. This also applies to any other percentage reduction. To do say a 5% reduction you would multiply the current pill weight by 0.95 to get the weight of the desired dose. For a 2% reduction you would use 0.98 for the multiplier.

 

If you are wanting to do 10% every 4 weeks, I would highly recommend you look into doing a Brassmonkey Slide. It yields 10% in six weeks and is much gentler on you system. There are full directions in the Tapering forum.

[None79]

Thank you for the response, I obviously intend to base myself on your method and I understand that it is necessary to be stabilized before considering weaning.  From what dosage is it interesting to create your own fluoxetine liquid?  My tablets are orodispersible... The scale will have these limits at a certain mg, this one spanning 0.01mg minimum.  THANKS

[brassmonkey]

I would just start right off using the liquid.

[None79]

Thank you for the advice, does the quantity of water in which my tablet dissolves matter?  2-5cl?  My tablet is orodispersible.  THANKS

[None79]

Thanks for the advice, does it matter how much water my tablet dissolves in?  For example, should I respect 18cl for 18mg of fluoxetine for my first reduction or if there is more water it doesn't matter?  My tablet is easily dispersible.  THANK YOU

[None79]

Good evening, I am currently experiencing a terrible wave for 5 days... Valium went from 10 mg at bedtime from January 1 to January 15, 2024, then 5 mg from January 15 to January 23 then 2 mg from January 23 to February 1 and  I was supposed to do 2 mg every other day from February 1 to February 8 then stop completely.  If I take 4 mg again at bedtime, does that seem consistent to you?  The reduction seems to have been too rapid... I saw my psychiatrist again on February 19th. Thanks

[None79]

Nobody for help me? Thx@brassmonkey

@KenA

I have taken 5 mg again at bedtime since February 1st but the wave is still intense...

[KenA]

@None79 I CT quit everything so I don't have any experience with tapering. However, we do only recommend a 10 percent reduction each month, so it sounds like you reduced too quickly. A 5 day wave isn't out of the ordinary when it comes to WD. I had waves that lasted 17-18 days sometimes. Especially in the beginning of WD. There were times it seemed like I never got a break. You just have to realize that this is what healing feels like. It won't always be this way, just a temporary part until you are healed. 

[None79]

Thank you @KenA for the answer, I didn't think that the rule of 10% per month applied to anxiolitics... The Ashton method recommends 10% every 15 days.  I have been on Valium since the end of November 2023, starting at 30 mg then decreasing... But my body is visibly in tolerance at low doses... I will fight to stop Valium and then I will tackle Prozac.

[LotusRising]

On 2/1/2024 at 3:02 PM, None79 said:

The reduction seems to have been too rapid... I saw my psychiatrist again on February 19th.

We do not follow Ashton on this site, since her taper schedules can still be too fast for some people. Valium also has a very long half-life, so it could really take up to two weeks to feel the full effects of each reduction. You might want to hold at your dose until symptoms settle out. 

[None79]

Good evening, so I stabilized the wave with a return to 5 mg in the evening.  My psychiatrist, whom I saw again on February 19, suggested that I switch to valium drops and began to tell me the following reductions: Diazepam: 10% reduction every 16 days

 5% decrease every 8 days, decrease the percentage to 3% towards the end of taper every 7 days.  Does this seem coherent to you?  Valium consumption started at 30 mg on November 22.  Otherwise the psychiatrist offers me Lyrica... @Shepany advice from you who are a specialist?  thank you good night

[LotusRising]

Unfortunately, Shep is no longer on the site.

 

On 2/4/2024 at 2:57 PM, None79 said:

I have taken 5 mg again at bedtime since February 1st but the wave is still intense...

You mentioned this, have your symptoms settled? I would only move ahead with a reduction if you are stable.

 

On 2/8/2024 at 3:14 PM, None79 said:

Diazepam: 10% reduction every 16 days

 5% decrease every 8 days, decrease the percentage to 3% towards the end of taper every 7 days.

You may be able to get away with a taper this quick if you've only been on it for 2 months, but if it were me, I would do a 10% reduction first and wait it out for 2 weeks to see if I could handle it. Please remember the long half-life of diazepam, meaning it could take as long as 2 weeks to feel the full effects of a reduction. 

 

 

[None79]

@LotusRising

this is my withdrawal protocol prescribed by my psychiatrist below: 12/22/23-01/02/24: 5mg morning 10 mg at bedtime / 01/03/24-01/07/24: 2mg morning 10 mg  at bedtime / 01/08-01/12: 10 mg at bedtime / 01/13-01/17: 7 mg at bedtime 01/18-01/22: 5 mg at bedtime 01/23-01/28: 2 mg  at bedtime CRASH on 01/29 restored to 5 mg at bedtime.  The continuation of the withdrawal which was planned and which I did not do by reintroducing 5 mg at bedtime: 01/29-04/02: 2mg every other day then stopping.  .  I decided to stabilize on 5 mg of Valium until my February 19th appointment with my psychiatrist to switch to the drops and do a 5% reduction every 8 days and not start stopping the Prozac for  the moment.  I have been stable since yesterday!  Mood OK, energy ok, diarrhea stopped, very slight tremors THANK YOU

[LotusRising]

Ok, good to hear! So you will hold the valium until Feb 19?

[None79]

@LotusRisingYes, I will keep it until my next appointment in 8 days and I will reduce it to 4.75mg from 02/20.

[savinggrace]

None79,

I replied on the "multiple drugs" thread but then I came here to your thread.  I am inclined to agree with Lotus and certainly acquiesce to his/her experience as a moderator.  Reading on this thread it sounds like your doctor is very aggressive and does not recognize the severity of withdrawal, especially when done too aggressively.  Meanwhile,  I agree you should not do anything until the 19th.  What I am concerned about it starting too soon with a 10% cut and not holding long enough...the half-life is very long and the effects of withdrawal take quite some time to accumulate.  If you pile on too many cuts, the accumulation of the cuts eventually catches up with you.  I don't know how much latitude your doctor will give you, but seeing how you handle a 5% cut of the valium first (to prevent de-stabilization) MIGHT be the route to take.  I know many start with 10% but you have been through a lot of changes very quickly.  Just food for thought...cut according to how you feel and not by the calendar.

 

Grace

[None79]

@savinggrace@LotusRising

 

My psychiatrist is very aggressive in withdrawal for fear that the nervous system becomes dependent... Except that now it's too late I am now... I'm waiting for him to prescribe the diazepam drops and I was planning to proceed  thus: from 02/20 to 02/28: 4.75 mg.  from 02/29 to March 7: 4.5mg.  from March 8 to March 16: 4.3 mg.  From March 17 to March 25: 4 mg...... And I was thinking of making 3% cuts if withdrawal becomes too hard.  Does this seem consistent to you based on your experiences?  thx

[LotusRising]

@None79

 

It's a little quicker than we would recommend, but again, you've only been on it short-term. I know many people do it this who've been on it much longer and still fare well. I would just pay attention to what your body is telling you.

[None79]

@LotusRisingThank you for your kindness, I will see what my psychiatrist thinks, I would extend it to 10 days at a 5% reduction and see what that gives.  I will keep you informed in any case because you are my support and your experience is valuable to me!  Psychiatrists know how to prescribe but not wean, including in a hospital environment...

[None79]

 

Hello everyone, to give you some news, I managed to stabilize at 5 mg of diazepam and I still have 20 mg of Prozac, the anxiety is moderate, but what bothers me the most is the muscular tension in the  legs, thighs, calves, buttocks... Which tires me out a lot and limits my standing activities.. I applied for a position as an order picker, which means it's going to be complicated... Has anyone  ever felt these muscular sensations of fatigue, discomfort?  I see my psychiatrist again on Monday the 19th for the diazepam drops... My doctor, whom I saw on Thursday, said that weaning could be done in hospital... Very reassuring. @LotusRising@savinggrace @brassmonkey

[LotusRising]

3 hours ago, None79 said:

what bothers me the most is the muscular tension in the  legs, thighs, calves, buttocks

Yes, this is a very common WD symptom. I had this on and off for my entire taper and still deal with it. It has improved quite a bit though. 

 

Do you do any stretching, or yoga? I find I need to do this really consistently, otherwise the tension gets worse.

[None79]

@LotusRisingYes I started relaxing and stretching, I stopped running for the moment...but very painful on a daily basis.. What do you call "WD"?

[savinggrace]

Hi None79,

 

You sound better...great!

 

i have a lot of chronic pain and have for 20 years, much of it brought on by the meds, some of it brought on by muscular-skeletal problems.

 

I don't take any meds for the muscle tension and never have.  I could not live without heating pads, though.  I have micro-waveable gel filled heating pads that I bought on Amazon and they are my lifeline.  There are times I have 5 or 6 of them on my muscles at once, depending on where the pain is.

 

I don't know what your energy level is but even though I am in pain, I walk nearly every single day for 45-60 minutes.  The pace is whatever my body can handle that day but it does release muscle tension for me.  (It makes my spine pain worse but I have to move my muscles otherwise everything hurts.  I have tried PT many times, but they tend not to do very well with my heightened sensitivity to pain brought on by simple stretches.  How about going on-line and looking at videos (there are tons of them) to help stretch and warm up and relax those tight muscles.  Only you can guage how much, if any of this, your nervous system will tolerate.  I have tried acupuncture, massage therapy, PT,  body work by a highly skilled osteopath (among most other alternative therapies)...none of these things gave me relief but I believe my overly sensitized body and brain "sabotage" these kinds of soothing treatments.   Hot showers/baths (some use epsom salts) can be helpful to soothe muscle pain.

 

The new job may indeed be taxing.  I suppose you will find out.  Distraction and movement just may help the pain.  Distraction, and movement do help me; especially distraction helps.  I have learned to be a master of distraction; it is my only way of coping with unrelenting pain.

 

it will get better...take care.

 

Grace 

[LotusRising]

12 minutes ago, None79 said:

What do you call "WD"?

Sorry, WD is withdrawal.

[None79]

@savinggraceThank you for this message full of hope and solidarity!  I have run 7 marathons in my life but now the tensions are too high to run and the Diazepam does not help things in terms of my heart.  I do sports at home, squats without weights, thigh stretches, this relieves me immediately but I become very sensitive again once I stand up, I will try to find new stretches on YouTube, yoga I am not flexible enough  , I do a lot of meditation during the day, this afternoon I collected leaves in my garden for 3 hours, tensions were low.  I am going to start walking again for 1 hour a day, alternating between walking and running.  My doctor suggests Lyrica... Out of the question.  thx

[None79]

Good evening, following my appointment with my psychiatrist I am switching to diazepam drops, from tomorrow I will be at 14 drops or 4.62mg for 8 days and then 13 drops or 4.3 for 8 days... He wanted to give me levels  of 4 days which I refused.  If the withdrawal becomes too difficult I will go back to the previous level.  What do you think ?!  Stretch out weaning as long as possible or make it shorter.  My anxiety is 5/10, this morning I had a job interview, this afternoon gardening, and then a medical appointment.  I noticed that in the morning I couldn't stand loud or quiet noises and needed calm.  I move forward day by day, I fight!

[littlebird]

11 minutes ago, None79 said:

I will be at 14 drops or 4.62mg for 8 days and then 13 drops or 4.3 for 8 days...

Everyone is different, but a longer hold between dose changes might be useful for helping body/brain get used to this. The recommendation from mods on this site is to not go more than 10% down in a month, so a little more than a week between lowering dose might get tough to handle (especially as it adds up a few weeks in on this schedule). 

 

Glad you're pushing back on doctor's advice (4 days seems way too short) and definitely listen to your body and perhaps wait until any symptoms subside before dropping further. Slower is definitely easier in the long run, especially with something that can make anxiety worse. 

 

17 minutes ago, None79 said:

I move forward day by day, I fight!

You've got this. 😤 You will prevail!