Magsie: Prozac withdrawal i need advice

[Magsie]

Prozac started middle of March. 20 mg daily. Started taking it every other day and that worked better for me. Did that for a few months. Began to taper end of may. Tapered from 20 every other day to 10 kinda fast but did fine with that and held there for a while. Then tapered to 7mg every other day. For a while. Got down to 5mg every other day for a few weeks and then stopped. Was fine other than emotionally for 2 weeks and then completely stopped sleeping. Heart palps and electric feeling throughout body. Yesterday I panicked and reinstated at took 2 mg and now I dont know what to do. I can’t not sleep all night. I feel sick and my bad thoughts start screaming. I’m terrified. I feel sick and depressed and I can’t sleep during the day. At this point idk if I should just go back on, maybe to 5mg in hopes I can stabilize? And whether I should go back to every other day or if I should stay lower or if I should just stay off of it. It was such a low dose to jump from, I can’t believe this is the reaction my body is having. I would appreciate support so much. Thank you. 

Edited September 8 by Emonda
Name to title

[Catwoman73]

Hi @Magsie, 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'm so very sorry for your struggles.  With your lengthy history of going on and off various psychiatric medications, and your dosing schedule for prozac even before tapering, you have unfortunately set yourself up for a challenging withdrawal experience.  Here at SA, we recommend tapering by no more than 10% of your current dose, no more often than every four weeks.  This is known as hyperbolic tapering, and is designed to release the receptors in the brain from the drug at a slow pace that is well tolerated by most, thereby minimizing withdrawal symptoms.  We also strongly advise against skipping doses, as this simply sends the body in and out of a withdrawal state every second day, keeping the nervous system destabilized.  If you felt you couldn't take prozac every day because of symptoms, your dose was probably too high in the first place.  You can read more about these things in the following links:

 

Why taper by 10% of my dosage?

Never skip doses to taper

 

5mg is not a stopping dose from Prozac.  These drugs have disproportionately large effects at very low doses, so stopping from 5mg is like jumping off a cliff.  Read more about this here (and do check out the links contained within the first post to understand this further):

 

SERT Occupancy Studies

 

The question is, what to do now.  Well, you have two options.  One- you can tough it out.  You will heal eventually.  If you give your body and mind what it needs (more on that soon), you absolutely will heal.  Your second option is reinstatement.  You would have to find a dose that you can tolerate taking every day, so as not to destabilize your nervous system further.  When reinstating, it is best to start at a VERY low dose, as overshooting your optimal dose can lead to a hypersensitivity reaction, making you feel significantly worse, rather than better.  By a low dose, I mean less than 1mg- probably around 0.5mg.  The idea with reinstatement is to find a dose that minimizes your withdrawal symptoms to allow you to stabilize, and then doing a hyperbolic taper someday down the road.  I can help you with creating these very low doses at home.  Read more about restatement and hypersensitivity here:

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 How long does it take to stabilize after reinstating or updosing?

 Hypersensitivity and kindling

 

Regardless of which option you choose, there are a few things you can do to help yourself heal.  Eat a balanced, whole foods diet, stay adequately hydrated, get adequate rest/sleep, engage in gentle exercise.  It is best to avoid neurologically active substances, such as nicotine, caffeine, alcohol, and recreational drugs, as these will destabilize you further.  Do not add any new psychiatric drugs to deal with the withdrawal effects from psychiatric drugs.  The results are not predictable, and may make you feel worse rather than better.  Not to mention, taking other medications just creates a situation where you have to taper from something else down the road, thereby prolonging your withdrawal journey.  We only recommend two supplements here at SA- magnesium and omega-3 fatty acids.  Do be aware, though- it is common for those in withdrawal to develop hypersensitivities to all sorts of things- medications, supplements and even foods.  So if you try to take anything, including our recommended supplements, start with a very low dose.  You can always increase slowly over time if you tolerate it well. 

 

As for dealing with emotional symptoms, it's really important to start developing some non-drug coping mechanisms right away.  We have many, many threads on this subject here at SA- I'll link some of them below for you.  Personally, I practice mindfulness every minute of every day, I use guided meditations/yoga Nidra at night to assist with sleep.  I use CBT techniques, like box breathing and challenging negative thoughts.  I stay as active as I can (though with long covid on top of withdrawal, it's not that much lol), and keep myself distracted with things that bring me joy- I love to swim, cook and work on art projects.  Check out these threads:

 

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

 

Which every option you choose, as you stabilize and heal, you will encounter days/weeks when you feel ok, and days/weeks where you feel pretty grim.  This is a normal part of the healing process, which we call the windows and waves pattern of stabilization.  It's a good idea to keep a symptom journal in order to help you identify your windows and waves.  If you choose to track what you eat and your activities as well, you may be able to identify some things that trigger symptoms for you.  For me- intense exercise, coffee (even decaf), chamomile, and magnesium (yes, it has a paradoxical effect in me) are all triggers.  See the links below on windows and waves, and a list of typical withdrawal symptoms that you can use as a template for a journal, if you wish.

 

The Windows and Waves Pattern of Stabilization

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

In summary, you have two options- either continue to tough it out, or reinstate a very low dose of prozac that you can take every day.  Either way you will heal.  I can't tell you how long it will take, but healing will happen.  There are many things you can do to manage your symptoms, and to help facilitate healing.  Keeping a journal will help you see your windows and waves, and see how far you've come over time!  A journal can also help you identify your triggers.

 

Most of all, please don't lose hope.  It is possible for anyone to heal, regardless of age, history, or any other factor.  Treat your brain and body right, and you will get there!

 

This is your introduction topic- each member gets one intro topic.  Please post any updates or questions here, on this thread.  But don't hesitate to explore the rest of the forum- there's a great deal of good info here.  And if you are up to it, do read the intro threads of others, and drop a comment/word of support.  Withdrawal can be a long and lonely journey.  It helps to have a community of people who fully understand what you are going through in your corner.  You will certainly find that here!  

 

Sending you healing vibes! ❤️‍🩹

 

 

[Magsie]

Thank you for such a thorough response. I decided I will reinstate for the time being. I took under 1mg based off weighing it on a jewelry scale with a capsule but I need to figure out another way to measure it out because it doesn't seem to be the most solid way to do it. So the idea is that I stay here for a while, take it daily and then go up if I still feel not stabilized, but slowly? and then once I feel stable there, just chill for a while until I'm ready to go down. I always wonder how people are going down to like .87 mg. Is jumping off from 1mg too extreme in the future? Thank you for your help!

[Catwoman73]

It's very important to get a consistent dose each day when reinstating- otherwise you could destabilize further.  You might be better off making your own suspension at home in order to be able to fine tune your doses as you taper down the road.  I'm happy to help you with that, but I'm heading out to a class momentarily, so for now, I'll just provide this link to get you started with this:

 

How to make a Liquid from Tablets or Capsules

 

1mg is probably too high to jump off.  Some can get away with it, but with your drug history, you will likely want to taper much lower.  Here's a couple of links on how to manage the end of your taper.   Some here have tapered down to thousandths of a mg.

 

Managing the Endgame Taper

Brassmonkey's Tips and Tricks for Tapering

.  

 

 

[Magsie]

Yes if you could help me that would be great! I have 10mg capsules of Prozac. I’ve just been opening them and transferring to capsules but the weight has def not been consistent I’m sure. I assume if I mixed 10mg with 10ml then each ml would be a milligram? So 1/2 ml would be 1/2 mg? And how long will the suspension last? I would hope a couple days at least 😂

[Catwoman73]

You've got that right.  1mg/mL solution is a good place to start.  Sometimes as you taper, further dilution is necessary, but in your position, this is the perfect way to approach it. 

 

The solution is supposed to be stable in the fridge for up to 14 days, according to our guide on tapering prozac, but I would err on the side of caution there, and keep it for 4-5 days max, then discard.  You don't want to risk any degradation of the solution over time.  Prozac is quite bitter, so after you draw up your 1/2mL, you could draw up another 1/2mL of pure maple syrup, or ora-plus (available on amazon) into the syringe to take with it.  That can make it more tolerable.  It is also best to store it in a sealed glass container of some sort.  And when you dissolve prozac in water, there may be a few little floaty bits in there.  That's just the filler- prozac is fully soluble in water.  Be sure to shake/mix well before drawing up your dose. 

 

I see you are also taking trazodone- do not change the dosage of that right now!  Trazadone is another drug that requires hyperbolic tapering, and that is not something that you would want to start while working to stabilize after reinstating prozac.  When you do start to taper down the road, taper the prozac first, as trazodone may help to mitigate some of your withdrawal symptoms from the prozac.  

 

Good luck, and keep me posted!❤️

 

 

[Magsie]

So 2 nights ago I slept amazing. And last night I was up basically all night with that electric buzzing feeling and pounding heart beat. I’ve been back on around 1mg of Prozac. Idk if I should increase or what that’s a sign of. I believe it’s just been 2 days that I’ve been back on it. Do I give it a week? I feel so sick today.

[Catwoman73]

You can't rush this.  Reinstatement needs to be done in tiny increments, holding for at least a week, preferably two after each change.  All while carefully tracking your symptoms so you can look back on what you have been experiencing to make informed decisions.  If you go up too fast, you are setting yourself up for a hypersensitivity reaction.  It needs to be approached scientifically, and with great care.  Don't make decisions based on feeling crappy for a day- there's not a soul here that doesn't have really crappy days.  You have to be very patient when reinstating.  I know it's hard, but the alternative to demonstrating patience is going to set you up for more trouble.

 

If you slept well two nights ago, that's a window.  That's a sign of healing.  You don't want to mess that up by moving too quickly.  

 

When you say you've been on 'around' 1mg, what do you mean?  You need to be taking a consistent dose- I recommended starting with 0.5mg, but if you want to try 1mg, that's fine.  But you need to be consistent with how you are measuring it,  and what you are taking, otherwise you are going to continue to destabilize further.  I can't emphasize the importance of this enough! 

[Magsie]

My compounding pharmacy made me this. Told me .25ml is 1mg. So I’m not sure if based on me taking anywhere from 1mg-2mg (just because it was based off my jewelry scale and it’s not that precise) for the past 3 days  if I should start tomorrow with 1mg and see how it goes or .5. I feel like it will be too all over the place. Any recommendations?

 

also thank you so much for your help. 
 

Sorry I guess the picture didn’t upload. It’s 20mg per 5ml solution. 

[Catwoman73]

So that would be 4mg/mL.  If you want to start with 1mg, that's definitely 0.25mL.  If you've been taking the 0.25mL for a couple of days, you may as well stick with that.  Give it at least one week, preferably two, and be sure you are recording and rating your symptoms every day.  I know it's hard to be patient- we all want to feel better right away!  But for most of us, it takes time and a bit of experimentation.  Work on those non-drug coping mechanisms- it may not feel like they are helping, but they are helping to retrain your brain to deal with stress and anxiety differently.  These are skills that will help you through withdrawal, and with every crappy thing that happens down the road, when withdrawal is long past!  It's worth doing the hard work! ❤️‍🩹

 

Keep me posted!

[Magsie]

Ok back with an update! Back on 1mg of Prozac since 9/8. I stabilized pretty quick. Probably within 5-6 days. So grateful. I’m sleeping again and the heart palps have been less. Mental state is way better. Not sure where to go from here. Do I hold here a while? Thank you for your help. I’m so glad I reached out here. 

[Catwoman73]

Hold for a couple of months at least.  Take this time to establish some good habits, like I discussed previously- keep a symptom journal, work on your non-drug coping mechanisms, establish a mindfulness practice.  When you feel like you are ready, start tapering again, hyperbolically this time.  I would recommend making smaller cuts than the recommended 10% here- maybe try a 5% cut to 0.95mg, and hold that for a month.  You can always try decreasing by 10% if you tolerate the smaller cut for a couple of months, but taking things slower in the beginning will allow you to really assess just how sensitive you are to cuts. Slow and steady is always best!