tamu1876: Psych meds journey

[tamu1876]

Hi all - I'm Jon (42 M) and this is my first post here. I'm hoping to get some insight into what I've been going through the last 3.5 years. I have a sense that I am probably a case study in what NOT to do but I am trying to understand my situation more fully. I also felt like I wanted to write it down so that I have the timeline. Even now my memory of what I went through over just the past couple years is getting fuzzy.

 

For background, my history with psychiatric drugs started mid-2012. In Jan 2012, a month or two after my 30^th birthday I smoked pot for maybe just the 4^th or 5^th time in my life (I never really liked how it made me feel) and I guess had way too much and had a horrible nightmarish evening.  I remember sitting on the couch watching a tv show and feeling a sudden intense panic wash over me. It was worse than anything I had ever felt. I thought I was dying and - worse than that, going to hell. I had had religious anxiety as a child but hadn’t really struggled with it since 8^th or 9^th grade. That night brought it back intensely. For a few weeks after that night I was mostly okay I think. Then one morning, driving to work I felt a sudden chill in my body similar to what I had felt the night I smoked too much. I thought I was having a heart attack and pulled over. Over the next three months (it seemed like a lifetime) I felt intensely troubled and weird – almost like a haunted feeling. I spent a lot of time at my parents’ house.

 

I had never seen a psychiatrist before. But I went to an internist and she prescribed Zoloft 100 mg (I think I tried beta blockers for a week but they didn’t do anything). I had a suspicion of psychiatric drugs and so the prescription sat in the bathroom for a couple months. I went to therapy for a few months but it didn’t give any relief. So at a certain point I just decided to give the Zoloft a try. I had friends who were on it and they said it had worked for them. After I started (at 100 mg) I remember feeling a bit odd (in a different way than I had been) for a few weeks, and then one evening as I drove to my parents’ house, I felt a sudden lifting of my spirits – like “okay everything is actually fine.” And so I stayed on the Zoloft for around 8 years and kind of forgot I had ever had any problems. Occasionally, nice spring weather would remind me of those bad months and I would kind of shudder internally and calculate the number of years that had gone by but couldn’t really remember what it felt like. During this time, my dad went through a horrible mental crisis of his own (including a planned suicide and several commitments). He ended up on antipsychotics and spent his last years in a chemical daze. I’m one of six kids and other than my dad I’m the only one in my immediate family to have these types of issues. He had a heart attack in 2017 and even during this time – while I felt heartbroken and cried a lot for several weeks, I felt like it was a healthy emotional response to something like that. So anyway, despite different tragedies and stressful circumstances life, seemed pretty good.

 

Through most of 2020 I was fine as well. The pandemic year was weird and stressful but mentally I felt fine. Sometime in the middle of that year, I ran out of my Zoloft prescription. I had not been taking it every day but hadn’t noticed any issues at all. When I ran out I kept thinking ugh okay I need to call the doctor and get it refilled, but I was busy and stressed and work and I just kept forgetting. Then in late October 2020 my younger brother (he was 33) had a stroke. He was living in my house and came into my bedroom at around 5 am with half his face frozen. I called the ambulance and all that. It was a relatively minor stroke from which he eventually fully recovered but a couple weeks after it happened I had a full-blown panic attack thinking that I was having a stroke. My brother’s stroke was caused by a genetic protein deficiency that all the siblings ended up having (I just have to take a baby aspirin every day). After the panic attack I immediately called the doctor and got the Zoloft prescription renewed and started taking it again. But nothing happened. I was on it until mid-February 2021 but was still dealing with panic, derealization, a sinking feeling (it’s hard to remember the symptoms). I had another doctor’s appointment (a different GP by now) and after saying she didn’t like to put people on over 100 mg of Zoloft she told me to take Welbutrin. I took that for one week and then woke up one Sunday (I admit, after drinking the night before) and had one of those headline bad days that I still remember. I felt like a different person, or like I was in a dream. Horrible, horrible day. I made an appointment with my doctor and she said to stop the Welbutrin and started me on Lexapro.

 

Lexapro went “okay” for a couple weeks I think, then I started feeling worse and worse – intense derealization etc. In April I drove from Dallas to see my sister in Tulsa and remember feeling panicky the entire drive. When I got there I remember feeling like I couldn’t sit still – not really a physical thing, more like just mental agitation. I talked to my sister, who is a doctor, and she said I could try seeing a psychiatrist. I looked one up and made an appointment.

The psych told me to get off the Lexapro (By this point I had been on for 6-8 weeks) and start with Prozac. I was on Prozac for two weeks I think but ended up getting withdrawal from the Lexapro. He had me test it by taking a dose of Lexapro one morning when I felt really bad and those symptoms cleared up within 20 minutes. He told me to stop taking the Prozac and go back on the Lexapro and come off slower (take alternate days for two weeks and then every three days for a couple more weeks). The psych than asked me how I felt about going back on Zoloft. I said I was willing to try it.

 

So between May and October of 2021 I titrated up from 25 mg all the way to 150 mg. For a while I felt like I was doing better then I started feeling worse and worse. Just felt weird, not myself, I’d wake up feeling strange. It would get better. After not drinking since February I started drinking again here and there and found it eased the anxiety (obviously until the next morning when it had worn off). In October I couldn’t take it anymore and started taking less Zoloft. Thought I was reducing slowly and got down to I think 25 mg per day in March. Still unsatisfied, my doctor put me on Cymbalta. I was on that for maybe a month but once again I found my anxiety increasing and he told me to stop and said I hadn’t been on it long enough to get withdrawals. After I came off that I didn’t take anything for maybe 6 weeks. Then I had another horrible panic and lingering severe anxiety that lasted for several days. I emailed my doctor and he said to start on the Zoloft again. (It was around this time that alcohol started becoming very unpleasant and even the thought of alcohol would make me anxious so I stopped drinking entirely). So once again I started cycling up on that, starting at 25 mg. This time was even worse than the last time. At every dose increase I would have a really rough month then things would level out. But in retrospect I feel like I was getting worse and worse, and then getting used to the new normal in a way. It was a couple weeks before Christmas 2022 that I realized there seemed to be very little left of ME in there. Everything seemed weird, I had very little emotion – just anxiety. I cut down to 50 mg (without consulting doctor) immediately and felt better for a few weeks. I remember feeling pretty good on Christmas and thinking maybe it was all behind me. Of course from Jan – March was very bad. My psych started me on gabapentin 100 mg per night and eventually up to 600 mg a day. I got down to 25 mg of Zoloft. Then, I found out that during my dad’s crisis, the med that had helped him the most was Effexor. I spoke to the psych about that and he said we should try Pristiq because it’s similar but has a lower side effect profile. I was on Pristiq for a month or so and ended up in a terrible way – basically stayed on the couch for a week. After that I went back on the Zoloft 25 mg and 600 gabapentin. Also, my psych put me on 2.5 mg of Olanzapine for “short-term relief.”

 

In July or so, still having a rough time, my doctor said I was treatment resistant and that I should try TMS therapy. I was transitioning out of my job and was planning to take a few months off so the timing worked out. The problem was they said I had to basically get off the gabapentin before I could do TMS. So over the course of 5-6 weeks I went from 600 mg a day to 100 mg. I ended up hating the TMS but I did like 40 sessions of it. I almost quit maybe a week into it but they convinced me to stick it out. During this time I began to feel almost OCD – no compulsions but I had repetitive thoughts. My doctor put me on Prozac 10 mg. After the TMS ended I started a new job in October 2023 but found myself basically unable to do it. My creativity was gone, if I faced some kind of problem I would just melt in the face of it and find a way to take a nap. My ability to carry on a conversation or be witty or even think of the right words was gone. My psych told me to come off the Olanzapine because it’s so sedating and he thought that might be causing my lack of sharpness. He told me to try Abilify. For a few days I felt extremely, weirdly libidinous and had weird thoughts and that was the end of Abilify. But we didn’t restart the Olanzapine. From around Thanksgiving 2023 (when I took my last dose of Olanzapine) through probably February 2024 I felt very anhedonic – like I didn’t enjoy anything and couldn’t imagine every enjoying anything ever again. Definitely felt suicidal at several points. I started going on crying jags. I would wake up in the middle of the night with anxiety and take half a Benadryl to go back to sleep (Benadryl is the only thing I’ve ever been able to use for acute anxiety. Benzos have an paradoxical effect on me). By February 2024 I was up to 40 mg of Prozac and 600 mg of gabapentin again and I kind of decided I was giving up – or at least giving up medication changes. I wanted to do at least 6 months without adjusting anything.

 

Over the last six months I have gone through many many “phases” where I will literally wake up and feel like a new person, which is always very disconcerting. I will have vivid dreams and then wake up and feel like my life over the last several years has been a bad dream. This odd feeling lasts for a few days and then I kind of stabilize again and can’t remember what I felt like a few days earlier. There have been some concrete improvements – I am exercising regularly for the first time in a few years, for the first time in several years I am playing my guitar again, and I’ve read 12-13 books this year after averaging maybe 2-3 a year between 2021 and 2023. Haven’t thought about suicide in a while. I sometimes feel goosebumps when I listen to music. I still don’t feel quite as sharp as I used to, but I am able to get through a day of work productively (usually). I still have a sense that I’m not quite myself and there’s more ground to make up but I am able to sit at dinner with friends (or at a bar drinking NA beer) and make conversations and tell jokes and stuff. I’m not sure whether the Prozac is actually helping or whether I’m just stabilizing. My psychiatrist retired a few months ago and so far I haven’t made an appointment with a new one. He wanted me to increase to 60 mg before he retired but I stuck with the 40 mg.  

 

Believe it or not I’m leaving some stuff out – the weekly therapy, the intensive outpatient counseling, the expensive brain scan, the time I spent on MAOI and ketamine forums, the books, the podcasts, etc etc. I don’t know what my plans are going forward. I’m very hesitant to make any changes for now. I’m not sure when I’ll feel good enough to start tapering off the Prozac.

 

 

 

 

 

 

[Catwoman73]

Hello, @tamu1876, and welcome to SA!  We are a community of volunteers providing peer support in the tapering of psychiatric medications, and their associated withdrawal syndromes. 

 

Thank you for completing your drug signature.  I am so very sorry for all you've been through- and it's been a LOT!  Yes, lol, you are absolutely a case study in what NOT to do.  Sadly, the majority of psychiatrists do not seem to understand that these drugs can't be swapped out at random, stopped cold turkey or rapidly tapered without serious consequences.  All the mental weirdness you are experiencing is because of polydrugging and improper tapering, probably resulting in some degree of hypersensitivity to these drugs.  I want to assure you that your story is not a unique one.  There are many on this site who have had very similar experiences.  

 

It sounds to me like you are currently relatively stable, though experiencing some derealization/depersonalization, brain fog.  These are  pretty standard psych drug withdrawal symptoms.  Please see this list of typical withdrawal symptoms.  I expect a lot of this will look very familiar to you.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

My suspicion is that the prozac and gabapentin are not doing much for you at all, but you will likely need to stay on them for a while longer in order to allow for a bit more stabilization.  I have a few things I would recommend for you to assist with this.  First of all, start a symptom journal.  You can use the above list as a template.  Rate your symptoms daily on a scale of 1-10.  It is absolutely normal as you stabilize to have days/weeks where you feel decent, and days/weeks where you feel terrible.  This is known as the windows and waves pattern of stabilization, and is a good sign that healing is occurring.  Keeping this journal can help you identify your windows and waves.  Read more here on this:

 

The Windows and Waves Pattern of Stabilization

 

While trying to stabilize (and in during tapering of psych meds), there are a few things you can do to assist with healing.  Eat a well balanced, whole foods diet, stay adequately hydrated, get adequate rest/sleep, get gentle exercise (overdoing it can make you feel worse), and avoid all neurologically active substances, such as alcohol, nicotine, caffeine, and recreational drugs.  These only serve to keep you destabilized.  Also avoid adding any further psychiatric drugs to your cocktail.  As you have already figured out, when you are destabilized, they often don't work as they should, and even work paradoxically at times.  And, they just create another physiologic dependence- another drug you will have to taper from in the future, thereby prolonging your withdrawal journey.  I know none of this is easy to hear, and can be a massive lifestyle change for many people.  But I can promise you, giving up things like alcohol and caffeine is well worth it in the long run!

 

It sounds like you have some wonderful non-drug coping mechanisms in place already- this is wonderful.  Music is great medicine, and exercise helps release feel-good hormones (as long as it's not too intense and causing you to crash).  We have a variety of threads on coping with these symptoms that I will link below.  I find intensely practicing mindfulness to be very helpful, along with using mantras, such as 'this isn't me, it's just the drugs.'  Particularly on the bad days.  Meditation, and distraction are great tools- I like to swim and do art projects to keep my mind active.  It's worth it to get a while toolbox in place to help you learn to cope with symptoms without drugs even before you start to taper.  It's much easier to create these habits when you are relatively stable then while tapering, when things can be unpredictable. 

 

Apathy, anhedonia, emotional numbness, emotional anesthesia

 Derealization or Depersonalization

 Non-drug techniques to cope with emotional symptoms

 Easing your way into meditation for a stressed-out nervous system

Music for self-care: calms hyperalertness, anxiety, aids relaxation and sleep

Ways to cope with daily anxiety

"Change the channel" - dealing with cognitive symptoms

Dealing With Emotional Spirals

 

Once you are ready to taper, you will have to choose which med to taper first.  In your case, I would recommend tapering the Prozac, as it is the more stimulating of the two meds you are currently taking.  More here on choosing which drug to taper first:

 

Taking multiple psych drugs? Which drug to taper first?

 

Here at SA, we recommend tapering by no more than 10% of your current dose, no more often than every four weeks.  So as an example: 10mg- 9mg- 8.1mg- 7.3mg and so on.  This is known as hyperbolic tapering, and is designed to release the receptors in the brain from the medication at a very slow rate, allowing you to adapt as you proceed, and minimizing withdrawal symptoms.  If you try to discuss this plan with most psychiatrists, they will think you've lost the plot lol, but I can assure you that it is highly effective, and very gentle.  There are even slower methods of tapering that we can discuss if you are particularly nervous.  Read more on hyperbolic tapering here:

 

Why taper by 10% of my dosage?

 

In terms of supplements, we only recommend two around here: magnesium and omega-3 fatty acids.  Do be mindful though- it is very common for those with destabilized nervous systems to become hypersensitive to all sorts of things, including other medications (like antihistamines, pain relievers etc), supplements, and even foods.  This is where you journal comes in- tracking what you are eating and doing day to day can help you identify symptom triggers.  If you decide to try any supplements, even those recommended here, start with a very low dose to see how you fare.  You can slowly increase the dose over time if you tolerate them. 

 

In summary, I think holding your current doses of your meds for a while longer is probably a good, prudent decision.  This will allow you some time to start a symptom journal, and figure out what makes you feel better, and what makes you feel worse.  When you start to taper, we are happy to help you come up with a tapering plan following the hyperbolic guidelines. 

 

Most of all, I want to say that you won't be dealing with this forever.  The human brain and body do heal- we see it all the time around here!  You can live a happy life without drugs, feeling more like your authentic self than ever.  It's going to take some time and patience, but it is possible.  So don't give up hope- we are always healing, whether it feels like we are or not! ❤️‍🩹

 

This is your introduction topic- each member gets one intro topic.  Please post updates, questions and concerns here, on this thread.  But don't hesitate to explore the rest of the forum- there is tons of good info here!  And if you're up to it, do read the intro threads of others, and drop a word of support.  It really is helpful while on this journey to build a community of people who truly understand what you are going through.  Otherwise, it can feel a bit lonely.

 

I look forward to following your journey, and assisting in any way I can!

[tamu1876]

Hi @Catwoman73 - thank you so much for the response. It took me a long time to figure out what was actually happening to me. I knew that somewhere in mid-2022 (around my final ramp up on zoloft) things really seemed to change and I felt "different." Like I would have preferred having one of my actual panic attacks over the lingering weirdness and the sense of having totally lost myself. And I guess for a long time I felt like I couldn't be in withdrawal because going back on the Zoloft didn't help and actually seemed to make things worse so that was confusing as well. 

 

One thing I wonder is how do you define stabilization. Like would stabilization mean I stop having these waves? I've read enough here to know that the timeframe can be very different depending on the person but what would be the signs be that a person has stabilized? 

 

Thanks!

[Catwoman73]

 

 

4 hours ago, tamu1876 said:

t took me a long time to figure out what was actually happening to me.

 

Do I ever understand this lol!  I have been on and off these meds for 30 years, and it's only in the last year that I came to understand that every time I went back on these medications, it wasn't because I was 'relapsing,' it was because I was in withdrawal!  It's like my entire life suddenly became crystal clear when I figured it all out. All those years that I thought I was just nuts, I was actually just experiencing the long term protracted withdrawal that can happen to some of us.  It really blows my mind sometimes!

 

4 hours ago, tamu1876 said:

One thing I wonder is how do you define stabilization. Like would stabilization mean I stop having these waves? I've read enough here to know that the timeframe can be very different depending on the person but what would be the signs be that a person has stabilized? 

 

Stable is a very hard term to define, and I think it means different things to different people.  For me, I know I'm stable when my windows and waves are relatively predictable (i.e. I have no random new symptoms coming out of no where, and I have a good understanding of my baseline and my triggers), and I am able to live my life in spite of my withdrawal.  So I still have windows and waves when I'm stable, but the waves are less extreme, and I can still go to the grocery store, answer my phone without feeling panicked and laugh at my husband's jokes.  When I'm stable, life is pretty good... not perfect, as I still feel like there is something going on in my nervous system, but at least take some deep breaths and function relatively normally. 

 

I hope that helps a bit!