Tinychair: health problems in addition to withdrawal

[Tinychair]

Early 2016 -Started fluoxetine 10 mg

Late 2016 -increased to 20 mg 

Aug 2022 -Increased to 40 mg when hormonal birth control caused a worsening of depression. The higher dose significantly improved my mood. 

Jan 27, 2024 -Stopped hormonal birth control. Immediately started experiencing adverse activating effects from fluoxetine: heart palpitations, anxiety, total insomnia. 

Feb 24 -Started taper. Dropped by 10 mg at doctor’s recommendation (taking 30 mg). Adverse reaction began to resolve first week, though insomnia remained. 

March 1 -Started 12.5 mg trazodone to help with insomnia. Finally able to sleep

March 6 -Onset of intense withdrawal symptoms. Restlessness, debilitating anxiety, feelings of doom and dread, agitation. Prescribed limited supply of lorazepam, took .125-.5 mg as needed (March 6, 8, and 10). By the 11th I was feeling a bit better, and withdrawal symptoms continued to gradually stabilize over the next couple weeks. I did my research and resolved to continue my taper at a much slower pace. 

March 19 -diagnosed with mild sleep apnea following a sleep study taken during my bout of insomnia

March 23 -27.5 mg fluoxetine. Depressed and sensitive right away, though difficult to tell if from withdrawal or PMS, as my period started March 26. Mood eventually stabilized. 

April 3 -6.25 mg trazodone, slept without difficulty. Over the next couple days alternated between feeling hypersensitive and emotionally numb. 

April 6 -0 mg trazodone, slept without difficulty 

April 7 -flare-up of withdrawal symptoms: akathisia, intense anxiety and dread. Symptoms resolved with 0.125 mg lorazepam. Planning to reinstate trazodone tonight, as I’m assuming that’s what caused the flare. I’d neglected to think of the trazodone as an antidepressant! 

I am already chronically ill, so I am having to manage additional symptoms on top of withdrawal symptoms. I have been diagnosed with chronic migraine, POTS, and Hypermobile Ehlers Danlos Syndrome. My recent diagnosis of obstructive sleep apnea was a surprise, as I am young and slim— turns out my hypermobility puts me at a higher risk. But I’m hopeful that treating my sleep apnea will take care of many disabling symptoms I had previously associated with my migraines: poor memory, brain fog, fatigue, and never feeling well-rested even after regularly getting 10+ hours of sleep. I will be getting a CPAP machine this week. It may take some getting used to but ultimately I should be getting much better quality sleep and years of damage might be reversed. My question is, do I need to put my taper on pause while acclimating to the CPAP? I recognize that my nervous system is in a hypersensitive state and worry that any change, even a positive change like this, may disrupt things. I just don’t know to approach my other health problems in the context of tapering. 

[Erimus]

Hello, and welcome to Surviving Antidepressants. We are a peer support forum to assist in tapering off psychiatric drugs safely, or recovering from psychiatric drug withdrawal.

 

This topic is for anything relating to you, and any questions you have. Please do not start another topic.

 

We recommend tapering by no more than 10% of your CURRENT dose each month, to limit withdrawal symptoms. E.g. 10mg --> 9mg --> 8.1mg --> 7.29mg

 

All the answers you are looking for regarding tapering and antidepressant withdrawal are on this site. Please search around and continue to read as much as you can manage. Use the site search function to search for specific words or phrases, such as drugs or symptoms.

 

Here are a few of the most useful links:

 

Important topics in the Tapering forum and FAQ

 

Micro tapering

 

Why taper by 10% of my dosage?

 

Taking multiple psych drugs? Which drug to taper first?

 

How to make a liquid from tablets or capsules

 

Using a scale to weigh and measure doses

 

We only recommend two supplements. Omega 3 Fish Oil and Magnesium. Both should be introduced separately and increased slowly.

 

Regards

Erimus

[Erimus]

12 hours ago, Tinychair said:

I am already chronically ill, so I am having to manage additional symptoms on top of withdrawal symptoms. I have been diagnosed with chronic migraine, POTS, and Hypermobile Ehlers Danlos Syndrome. My recent diagnosis of obstructive sleep apnea was a surprise, as I am young and slim— turns out my hypermobility puts me at a higher risk.

Hopefully you will find that some of your health problems improve as you gradually reduce your antidepressant dose. Many of our members have found similar patterns. Regarding your taper and the CPAP machine, I am not sure. I would suggest holding for a few weeks whilst you acclimatise to it. Once you are more familiar you can start tapering again.

 

I would not make a habit out of benzo use if you have only taken a hanful of them. It is not something you want to become dependent on, and you will probably still be able to escape unscathed if your use has been very limited.

[Tinychair]

4 hours ago, Erimus said:

Hopefully you will find that some of your health problems improve as you gradually reduce your antidepressant dose. Many of our members have found similar patterns. Regarding your taper and the CPAP machine, I am not sure. I would suggest holding for a few weeks whilst you acclimatise to it. Once you are more familiar you can start tapering again.

 

I would not make a habit out of benzo use if you have only taken a hanful of them. It is not something you want to become dependent on, and you will probably still be able to escape unscathed if your use has been very limited.

Thank you for your reply! As for the trazodone, would you recommend reinstating my full dose? I’d starting tapering in hopes that I could sleep without it, but I’d neglected to remember that trazodone itself is an antidepressant and that I shouldn’t add an additional antidepressant taper on top of my fluoxetine taper. My mood was significantly lower for my few days on the half dose (6.25 mg). Yesterday was my first day without any trazodone and it caused a significant flare-up of my withdrawal symptoms, including anxiety and akathisia. Once I realized the lack of trazodone had disrupted my nervous system and was the cause for the flare, I decided to take 6.25 mg trazodone last night before bed. Today I’ve felt better than I did yesterday, but I still have felt quite anxious and depressed. I realize now that the trazodone was likely also helping with the severity of my withdrawal symptoms. I wonder if returning to my original dose of trazodone (12.5 mg), that I was taking less than a week ago, would warrant better results? 

[Tinychair]

Also, up until a couple months ago, I had been taking caffeine 200 mg and adderall 5 mg daily for fatigue and brain fog for years. Once I started experiencing activating effects from my fluoxetine, I dropped to caffeine 100-150 mg and adderall 2.5-5 mg daily. I would like to eventually stop taking both. I have stopped adderall cold turkey in the past due to a pharmacy shortage, and did not experience adderall withdrawal symptoms then. I am assuming that as both are very activating, they are contributing to my fluoxetine withdrawal symptoms (which tend to look more like anxiety, insomnia, hyperactivity, etc). Would coming off of those now aid in my fluoxetine withdrawal? How would I go about doing that? Would I need to pause my fluoxetine taper? Or since I’ve already started my fluoxetine taper, do I need to wait to stop the caffeine and adderall until I am entirely done tapering the fluoxetine? 

[Erimus]

On 4/9/2024 at 9:54 PM, Tinychair said:

Also, up until a couple months ago, I had been taking caffeine 200 mg and adderall 5 mg daily for fatigue and brain fog for years. Once I started experiencing activating effects from my fluoxetine, I dropped to caffeine 100-150 mg and adderall 2.5-5 mg daily. I would like to eventually stop taking both. I have stopped adderall cold turkey in the past due to a pharmacy shortage, and did not experience adderall withdrawal symptoms then. I am assuming that as both are very activating, they are contributing to my fluoxetine withdrawal symptoms (which tend to look more like anxiety, insomnia, hyperactivity, etc). Would coming off of those now aid in my fluoxetine withdrawal? How would I go about doing that? Would I need to pause my fluoxetine taper? Or since I’ve already started my fluoxetine taper, do I need to wait to stop the caffeine and adderall until I am entirely done tapering the fluoxetine? 

Please put adderall in your signature. You can only change one thing at a time. If you want to taper fluoxetine, everything else needs to stay the same. Caffeine is best tapered if you want to avoid headaches.

[Tinychair]

13 hours ago, Erimus said:

Please put adderall in your signature. You can only change one thing at a time. If you want to taper fluoxetine, everything else needs to stay the same. Caffeine is best tapered if you want to avoid headaches.

Got it, thank you! My doctor recommended I start taking creatine to support methylation while tapering. Does that seem advisable? 

[Erimus]

8 hours ago, Tinychair said:

Got it, thank you! My doctor recommended I start taking creatine to support methylation while tapering. Does that seem advisable? 

I've no idea. That's a decision you'll have to make yourself.

[Tinychair]

After stabilizing from the previous taper, how long is it recommended to hold before starting the next taper? I’m struggling to find the answer, though that may be the fault of my brain fog oops

[Erimus]

Wait until symptoms are consistent every day. When you reach that point wait another week or two, and then start tapering again. One change at a time.