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irritatedtortoise: On SSRIs since I was 11 and feeling stuck


irritatedtortoise

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Hi everyone, I wish I had found this community sooner. Just wanted to introduce my situation and ask a few questions.

 

My overall SSRI timeline:

  • 2008–2019: Paxil 40mg
  • Sept–Nov 2019: Paxil taper/Prozac titration: 10mg/month until 0mg Paxil and 40mg Prozac
  • Nov–Dec 2019: 40mg Prozac --> 20mg Prozac (stabilized)
  • Jan 2020–Jan 2024: 20mg Prozac
  • Feb 2, 2024– March 11, 2024: 10mg Prozac
  • March 11, 2024–April 11, 2024: 10mg Prozac every other day
  • April 11, 2024–now: 0mg Prozac

More details:

 

When I was 11 years old I was diagnosed with OCD, sensory integration dysfunction, depression, and generalized anxiety disorder. I was also starting to have suicidal ideation. My parents were desperate. A psychiatrist put me on 40mg of Paxil. (A few years later, he also put me on 50mg of Quetiapine for insomnia, which I didn't manage to come off until October 2023.)

 

I stayed on this dose of Paxil until 2019 (age 22) when I decided to bridge over to Prozac to make it easier to eventually come off SSRIs when I felt ready. The psychiatrist reduced the Paxil by 10mg and increased the Prozac by the same amount every 2 weeks until I was at 40mg Prozac. This had an emotion-deadening effect so we went down to 30mg and then 20mg, where I felt about as stable as I did on the Paxil.

 

Fast-forward to 2024, I'm 27 and, despite still grieving one of my best friends who I lost to a violent event 2 years ago, I'm in a more stable place in my life with a great support network. I thought I would be ready to try coming off the Prozac. Unfortunately, I think I tapered off the Prozac too quickly (see timeline above) following advice from my PCP who said the medication is "self tapering" and that going down by 10mg each month would be "an extremely safe bet." My insurance doesn't cover the liquid, so she had me take 10mg every other day for the final month. (I'm very much trying to find a competent psychiatrist instead of relying on my PCP for this, but everybody in my area has a 6+ month waitlist. My past experiences with psychs has been pretty negative so it's also a bit difficult to get up the motivation. I DO have an amazing psychotherapist who I see weekly.)

 

First few weeks off Prozac, I didn't feel any difference. Then 3-4 weeks in, I felt pretty great. Emotions were coming back to me with a deepness that I haven't felt since elementary school. I was crying a lot, which isn't like me, but it felt good, like things were moving through me, particularly my grief for my friend, which I think had been numbed by my medication. I did feel extra irritable, however, and it's taken a lot of self control not to take it out on my partner. She has been amazing BTW.

 

Something shifted at about 5-6 weeks in, which is where I'm at now, where I feel INCREDIBLY hopeless and miserable. All of my childhood woes, save for the suicidal ideation, are coming back in force. I haven't dealt with sensory integration issues since I was a kid but I'm again experiencing bad sound and touch sensitivity. My anxiety is through the roof---I wake up every morning with my heart racing like my life is in danger. My depression is also back with a vengeance and I'm finding it very difficult to work and do things around the house. I'm having extreme mood swings:  I'm more irritable than I've ever been in my life, especially with sounds setting me off. I'll go from being filled with rage, to apathy, to hopelessness, to having the giggles, all in the span of an hour. (The giggles part is weird. I'll just suddenly start laughing out of nowhere at nothing in particular.)

 

This is all making me feel like my brain is broken and like I'll be stuck on SSRIs forever.

 

I guess my questions are:

- Clearly I made the jump from 10mg -> 0mg too fast. Would it be advisable to reinstate a small dose of Prozac again? I can't get the liquid covered by my insurance, but I've seen a post here about a DIY liquid. Considering I've been at 0mg for about 6 weeks, if I were to make this liquid, would a very small dose like 1mg daily be advisable to start?

- Let's say I go to a 1mg/daily dose of DIY liquid Prozac. How long do I stay on that dose before I can accurately assess whether to increase/decrease again? 

- Is there any reason at all I might want to keep trying to power through this and not reinstate? Like is it possible to "get this over with" if I can just manage to tolerate these mood swings for some amount of time... say 6 more months?

- Could I have permanently screwed my brain up by coming off too fast :( 

 

Any words of support/encouragement/advice are much appreciated. I just feel so alone, even though I know that I'm not. And I can't help but feel shame that I've "failed" at this so far.

  • 2008–2019: Paxil 40mg, Quetiapine 50mg
  • Sept–Nov 2019: Paxil taper/Prozac titration: 10mg/month until 0mg Paxil and 40mg Prozac
  • Nov–Dec 2019: 40mg Prozac --> 20mg Prozac (stabilized)
  • Jan 2020–Jan 2024: 20mg Prozac
  • Oct 2023: 50mg Quetiapine -> 25mg Quetiapine
  • Nov 2023: 25mg Quetiapine -> 0mg Quetiapine
  • Feb 2, 2024– March 11, 2024: 10mg Prozac
  • March 11, 2024–April 11, 2024: 10mg Prozac every other day
  • April 11, 2024–May 22, 2024: 0mg Prozac
  • May 23, 2024: reinstate 1mg Prozac
Link to comment
  • Moderator

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.

 

Your first task is to create a drug signature, with the following:

 

  • All current medication you take, the dose you take, when you started the drug, and when you made dose changes
  • All current supplements you take
  • An accurate history of recent drugs, taken in the last 12-24 months
  • Dates for recent should be written as 7 Oct 2023, or Oct 7 2023, or early Oct 2023, or mid Oct 2023
  • A history of drugs taken 24 months ago and beyond - if applicable
  • Dates for historical drugs can simply be listed as start and stop years
  • Please do not use 07/10/23 // 10/07/23 as this is intepreted differently around the world

 

  • Please leave out symptoms and diagnoses. See my signature for example of clear and concise information.

 

Active Monday-Friday UK time

 

Taper calculator spreadsheet

 

MEDICATION:

1) Sertraline:

50mg - Oct 2020, 100mg - Dec 2020, 50mg - April 2021, 75mg - May 2021, 50mg - Sep 2021, 55mg - 23 Feb 2024, 60mg - 20 March 2024, Start tapering - 24 April 2024

Current dose: 55.09mg  (1 July 2024)

2) Mirtazapine:

15mg - Nov 2020

SUPPLEMENTS:

Cod liver oil, Magnesium, Vitamin C

Link to comment
  • Moderator

You have tapered off Prozac too quickly, at no fault of your own, and are now experiencing withdrawal syndrome. The good news is, with prozac's long half-life, you still have a good opportunity to reinstate and minimise withdrawal symptoms.

 

Yes, a reintroduction of 1mg is a sensible starting point. Do you have the capsules of prozac that are filled with powder?

 

Here are some important topics for you to read:

 

--------Important topics in the Tapering forum and FAQ--------

 

Micro tapering

 

Why taper by 10% of my dosage?

 

Tips for tapering off fluoxetine (Prozac)

 

How to make a liquid from tablets or capsules

 

Using a scale to weigh and measure doses

Active Monday-Friday UK time

 

Taper calculator spreadsheet

 

MEDICATION:

1) Sertraline:

50mg - Oct 2020, 100mg - Dec 2020, 50mg - April 2021, 75mg - May 2021, 50mg - Sep 2021, 55mg - 23 Feb 2024, 60mg - 20 March 2024, Start tapering - 24 April 2024

Current dose: 55.09mg  (1 July 2024)

2) Mirtazapine:

15mg - Nov 2020

SUPPLEMENTS:

Cod liver oil, Magnesium, Vitamin C

Link to comment

Thank you for your reply and the useful links! I think I will try reinstating 1mg starting tomorrow. I have 10mg powder-filled capsules. 

  • 2008–2019: Paxil 40mg, Quetiapine 50mg
  • Sept–Nov 2019: Paxil taper/Prozac titration: 10mg/month until 0mg Paxil and 40mg Prozac
  • Nov–Dec 2019: 40mg Prozac --> 20mg Prozac (stabilized)
  • Jan 2020–Jan 2024: 20mg Prozac
  • Oct 2023: 50mg Quetiapine -> 25mg Quetiapine
  • Nov 2023: 25mg Quetiapine -> 0mg Quetiapine
  • Feb 2, 2024– March 11, 2024: 10mg Prozac
  • March 11, 2024–April 11, 2024: 10mg Prozac every other day
  • April 11, 2024–May 22, 2024: 0mg Prozac
  • May 23, 2024: reinstate 1mg Prozac
Link to comment
  • Moderator
Posted (edited)
56 minutes ago, irritatedtortoise said:

Thank you for your reply and the useful links! I think I will try reinstating 1mg starting tomorrow. I have 10mg powder-filled capsules. 

Easiest way would be to open the capsules and tip into a volume of water that you have measured. If you don't have any containers that measure small volumes then 100ml is easy enough. Add all the powder to 100ml of water, give it a stir, and use a syringe to draw up 10ml. Your suspension is 10mg/100ml = 0.1mg/ml.

 

You can buy oral syringes from pharmacies.

Edited by Erimus

Active Monday-Friday UK time

 

Taper calculator spreadsheet

 

MEDICATION:

1) Sertraline:

50mg - Oct 2020, 100mg - Dec 2020, 50mg - April 2021, 75mg - May 2021, 50mg - Sep 2021, 55mg - 23 Feb 2024, 60mg - 20 March 2024, Start tapering - 24 April 2024

Current dose: 55.09mg  (1 July 2024)

2) Mirtazapine:

15mg - Nov 2020

SUPPLEMENTS:

Cod liver oil, Magnesium, Vitamin C

Link to comment
  • Erimus changed the title to irritatedtortoise: On SSRIs since I was 11 and feeling stuck
  • 3 weeks later...

Hi again. I reinstated 1mg of the DIY liquid Prozac on 5/23, so it's been just about 3 weeks. After about 5 days of reinstatement, I started feeling much better. Not completely normal again--still extra emotional--but able to function again, work my job, take care of chores. This lasted a week and a half. But since this weekend, the severe withdrawal symptoms are back, and I feel like I did before reinstatement. Is this a normal part of the windows/waves pattern, or is it a sign I should go up on my reinstatement dose? If so, should I go up to 2mg, or a smaller increase? 

  • 2008–2019: Paxil 40mg, Quetiapine 50mg
  • Sept–Nov 2019: Paxil taper/Prozac titration: 10mg/month until 0mg Paxil and 40mg Prozac
  • Nov–Dec 2019: 40mg Prozac --> 20mg Prozac (stabilized)
  • Jan 2020–Jan 2024: 20mg Prozac
  • Oct 2023: 50mg Quetiapine -> 25mg Quetiapine
  • Nov 2023: 25mg Quetiapine -> 0mg Quetiapine
  • Feb 2, 2024– March 11, 2024: 10mg Prozac
  • March 11, 2024–April 11, 2024: 10mg Prozac every other day
  • April 11, 2024–May 22, 2024: 0mg Prozac
  • May 23, 2024: reinstate 1mg Prozac
Link to comment
  • Moderator
11 minutes ago, irritatedtortoise said:

Hi again. I reinstated 1mg of the DIY liquid Prozac on 5/23, so it's been just about 3 weeks. After about 5 days of reinstatement, I started feeling much better. Not completely normal again--still extra emotional--but able to function again, work my job, take care of chores. This lasted a week and a half. But since this weekend, the severe withdrawal symptoms are back, and I feel like I did before reinstatement. Is this a normal part of the windows/waves pattern, or is it a sign I should go up on my reinstatement dose? If so, should I go up to 2mg, or a smaller increase? 

I would wait until you've reached a month before going up again, the signs are there that stabilisation is beginning to happen. You are going to experience windows and waves, it's important not to act too hastily when they happen.

Active Monday-Friday UK time

 

Taper calculator spreadsheet

 

MEDICATION:

1) Sertraline:

50mg - Oct 2020, 100mg - Dec 2020, 50mg - April 2021, 75mg - May 2021, 50mg - Sep 2021, 55mg - 23 Feb 2024, 60mg - 20 March 2024, Start tapering - 24 April 2024

Current dose: 55.09mg  (1 July 2024)

2) Mirtazapine:

15mg - Nov 2020

SUPPLEMENTS:

Cod liver oil, Magnesium, Vitamin C

Link to comment

Thank you for the guidance. I will wait at least a month.

 

If after a month has passed I still feel very destabilized and haven't had any more windows, would I only increase my dose by 10%, so 1.1mg, the way we do when tapering properly? Or would it be a larger increase, like 2mg?

  • 2008–2019: Paxil 40mg, Quetiapine 50mg
  • Sept–Nov 2019: Paxil taper/Prozac titration: 10mg/month until 0mg Paxil and 40mg Prozac
  • Nov–Dec 2019: 40mg Prozac --> 20mg Prozac (stabilized)
  • Jan 2020–Jan 2024: 20mg Prozac
  • Oct 2023: 50mg Quetiapine -> 25mg Quetiapine
  • Nov 2023: 25mg Quetiapine -> 0mg Quetiapine
  • Feb 2, 2024– March 11, 2024: 10mg Prozac
  • March 11, 2024–April 11, 2024: 10mg Prozac every other day
  • April 11, 2024–May 22, 2024: 0mg Prozac
  • May 23, 2024: reinstate 1mg Prozac
Link to comment
  • Moderator
7 minutes ago, irritatedtortoise said:

Thank you for the guidance. I will wait at least a month.

 

If after a month has passed I still feel very destabilized and haven't had any more windows, would I only increase my dose by 10%, so 1.1mg, the way we do when tapering properly? Or would it be a larger increase, like 2mg?

I would say increases of 0.5mg are acceptable, unless you feel it is too much.

Active Monday-Friday UK time

 

Taper calculator spreadsheet

 

MEDICATION:

1) Sertraline:

50mg - Oct 2020, 100mg - Dec 2020, 50mg - April 2021, 75mg - May 2021, 50mg - Sep 2021, 55mg - 23 Feb 2024, 60mg - 20 March 2024, Start tapering - 24 April 2024

Current dose: 55.09mg  (1 July 2024)

2) Mirtazapine:

15mg - Nov 2020

SUPPLEMENTS:

Cod liver oil, Magnesium, Vitamin C

Link to comment

Thank you for your help! 

  • 2008–2019: Paxil 40mg, Quetiapine 50mg
  • Sept–Nov 2019: Paxil taper/Prozac titration: 10mg/month until 0mg Paxil and 40mg Prozac
  • Nov–Dec 2019: 40mg Prozac --> 20mg Prozac (stabilized)
  • Jan 2020–Jan 2024: 20mg Prozac
  • Oct 2023: 50mg Quetiapine -> 25mg Quetiapine
  • Nov 2023: 25mg Quetiapine -> 0mg Quetiapine
  • Feb 2, 2024– March 11, 2024: 10mg Prozac
  • March 11, 2024–April 11, 2024: 10mg Prozac every other day
  • April 11, 2024–May 22, 2024: 0mg Prozac
  • May 23, 2024: reinstate 1mg Prozac
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