xyz12310: Kindling worse with PMS

[xyz12310]

Hello, all. I am looking for advice about a potential kindling reaction.

 

I was started on SSRIs as a 10 year old  in 1999 for anxiety and trouble sleeping. Was briefly on Zoloft, and then switched to paxil. I was on this for many years before quitting cold turkey in 2016. I had some flu like symptoms in the immediate withdrawal period. Then I developed some mild anxiety about 6 months after stopping and started Prozac 10 mg daily with good effect. Increased to 20 mg daily due to depression in the immediate postpartum period in 2018.

 

I was feeling very stable and wanted to try tapering in winter 2024. I tapered for 3 months and stopped Prozac in April 2024. Initially, I felt ok. Some mild muscle twitches but that was it. In September 2024, I began to feel depressed. I restarted Prozac 10 mg daily x 3 days and developed insomnia, palpitations, anxiety, nausea like I had never experienced before. Also started the day before my period came. I ultimately took trazodone for sleep and symptoms abated a bit. I have since had some periods of feeling depressed or anxious with nausea and jitteriness, but it passes. Alcohol worsens things so I have stopped drinking and cut down on caffeine.

 

Now I am a day or 2 out from starting my menstrual cycle and had another episode of insomnia and severe anxiety. I am not sure what is kindling, what is hormonal and what is just depression and anxiety. Anyone go through something like this?

 

Part of me wants to go back on SSRI but I am very worried about making the symptoms worse.

[xyz12310]

Hello, all. I am looking for advice about a potential kindling reaction.

 

I was started on SSRIs as a 10 year old  in 1999 for anxiety and trouble sleeping. Was briefly on Zoloft, and then switched to paxil. I was on this for many years before quitting cold turkey in 2016. I had some flu like symptoms in the immediate withdrawal period. Then I developed some mild anxiety about 6 months after stopping and started Prozac 10 mg daily with good effect. Increased to 20 mg daily due to depression in the immediate postpartum period in 2018.

 

I was feeling very stable and wanted to try tapering in winter 2024. I tapered for 3 months and stopped Prozac in April 2024. Initially, I felt ok. Some mild muscle twitches but that was it. In September 2024, I began to feel depressed and teary right before my period. I restarted Prozac 10 mg daily x 3 days and developed insomnia, palpitations, anxiety, nausea like I had never experienced before. I ultimately took trazodone for sleep and symptoms abated a bit. I have since had some periods of feeling depressed or anxious with nausea and jitteriness, but it passes. Alcohol worsens things so I have stopped drinking and cut down on caffeine.

 

Now I am a day or 2 out from starting my menstrual cycle and had another episode of insomnia, nausea and severe anxiety. I am not sure what is kindling, what is hormonal and what is just depression and anxiety. Anyone go through something like this?

 

Part of me wants to go back on SSRI but I am very worried about making the symptoms worse.

 

 

   

1999-2000- Zoloft 25 mg

2000- 2003- paxil 10 mg

2003-2016- paxil 20 mg

2016- quit cold turkey 

2016-2018- Prozac 10 mg

2018-2024- Prozac 20 mg

 

Edited December 3, 2024 by Emonda
Name to title

[FireflyFyte]

Hello xyz12310,

 

Welcome to SA. Please summarize your drug history in your signature by following the instructions at How to Summarize Your Drug History in Your Signature. You may need to be on a computer to complete this.

 

We have had a lot of members, myself included, that experience a worsening of withdrawal symptoms during pre-menstrual or menstrual cycles. You can read more at PMS, PMDD, and menstrual cycle issues during withdrawal and after

 

For clarification, are you still taking the Prozac and/or Trazadone?

 

Thanks,

 

Firefly

[Sebas]

👋 Hi, here's for some guidance.

You tapered prozac rather quick, then reinstated at 10 mgai and then your cns became volatile.

 

Prozac has a long halflife so it reacts delayed. Thats why you gotten wd symptoms in september. In these situations we normally recommend small updoses not to upset cns even more. A big updose was too much for cns to process at the time.

 

Trazodone is not recommended although it may seem to cover up withdrawal in fact it is troubling stability. Both prozac and trazodone work on serotonine levels so cns has trouble figuring out how to manage serotonine levels with 2 different sources.

 

Please also read: https://www.drugs.com/drug-interactions/prozac-with-trazodone-1115-648-2228-0.html

 

Given cns is struggling for stability any new sources like flu, supplements, menstrual cycle, caffein, alcohol, chocolate, powerful herbs are likely to disturb stabilisation process.

 

Stop taking trazodone and let cns first sort out prozac stability. It may take a while but let it run it's course. From there on once cns becomes stabile for a longer period of time resume a slow taper, step by step and you'll be fine eventually. 

 

Bye Sebas

[xyz12310]

On 12/3/2024 at 1:32 PM, FireflyFyte said:

Hello xyz12310,

 

Welcome to SA. Please summarize your drug history in your signature by following the instructions at How to Summarize Your Drug History in Your Signature. You may need to be on a computer to complete this.

 

We have had a lot of members, myself included, that experience a worsening of withdrawal symptoms during pre-menstrual or menstrual cycles. You can read more at PMS, PMDD, and menstrual cycle issues during withdrawal and after

 

For clarification, are you still taking the Prozac and/or Trazadone?

 

Thanks,

 

Firefly

Hi Firefly,

 

I am no longer taking Prozac or trazodone. I did take lorazepam this week which helped with sleep.

 

My psych NP thinks I should start a low dose Lexapro after a couple more menstrual cycles. Hopefully I am feeling more stable by then.

 

 

XYZ

[FireflyFyte]

15 hours ago, xyz12310 said:

I am no longer taking Prozac or trazodone. I did take lorazepam this week which helped with sleep.

 

Would advise caution in taking lorazepam as it is a powerful drug with which a dependency can develop quickly.

 

[xyz12310]

Firefly,

 

Yes I have stopped the lorazepam. Hoping not to have to use it again.

 

Xyz

[Sebas]

20 hours ago, xyz12310 said:

My psych NP thinks I should start a low dose Lexapro after a couple more menstrual cycles

Bad advice to introduce anything new since your complaints are prozac withdrawal and need time to stabilise. Any new sources will only make things more difficult.