Lighthouse: 6 months post Doxepin-reemergence of symptoms

[Lighthouse]

Good afternoon and a heartfelt thank you to the moderators and volunteers for this forum. I would like to introduce myself. My name is Lisa and I am six months into completely stopping Doxepin which was originally taken at 10 milligrams nightly. I began taking this medication, with little understanding of its' powerful aspects to include its’ very addictive nature, as well as the dependance upon a medication for coping with anxiety, stress, insomnia, and depression. I began taking Doxepin somewhere around 2016, possibly earlier, after I went back to school to get my masters (CRNP). It is good for me to note here, and for you to understand, I am no longer in what I call the government health care system, having left about a year and a half ago to work in cash based practice in wellness and hormone replacement. I was an older student, I am now 58 years old, and was very distressed and fearful of the inability to stop my brain after writing papers for hours daily. I was in school for a total of five years with no break, even for summer, during that five year time frame. Oh, and the covid time was 2020, my last year of school/precepting. Doxepin answered the call! Yippee, right?   

 

I did not have knowledge of this forum, but as a healthcare practitioner and limited in my knowledge of psychiatric medications, I felt that I should taper this medication very slowly and so over the next two years starting in 2022, I began tapering initially to 5 milligrams and then taking medication, every other day, every third day, etc… until June 2024 taking once every 7 to 9 days. June 2, 2024, was the day I pushed to 10 days and haven’t had a pill since. Had I had this information on this forum, I would have done it differently, however, when I found the forum it was well into the summer and I decided from the information it was not worth going back on the medication as it had been too long since I had taken the last dose. 

 

Since the initial withdrawal, which was extremely difficult and challenging, I have leveled out very well until several weeks ago; sleeping well, anxiety was basically nonexistent, and I felt that even though I didn't consider myself depressed, I had nevertheless felt depressed coming off the medication and that also had leveled out. I was asked to give a public testimony, and at that time I began having some return of symptoms. I stopped drinking alcohol, which I only drink one to two drinks several times a week after I came off the doxepin. I had resumed this and wondered if this is not causing some of my trouble presently. I am a very high energy person but have not regained my previous quality of life since coming off the Doxepin. Sometimes, I presently suffer from a strange shortness of breath that seems anxiety related;  I also seem to be extremely sensitive to medications to include motrin, for my back pain, which has knotted up recently along with the other symptoms relayed. I had none of these symptoms pre doxepin or during. I am hoping to find some information on longer withdrawal. I only take a couple of supplements,  and am very blessed with good health. One has to wonder when you feel so bad if those days are behind you !! I see that theme here and relate to it. My apologies for the length and blessings to all that are here.

 

Of note: I have not been in a setting to prescribe these meds, as I was in urology, but can attest to the ignorance, ineptness, and substandard care that is given in the medical setting regarding these drugs. I balance hormones so men and women and so many then don’t need them, thank God, oh but the doctors answer is more, more and more drugs for the customer for life….Cudos to all here for your bravery, commitment, and perseverance….dont give up!

 

Sincerely, Lisa

[Jane318]

Greetings @Lighthouse, 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. You indicate in your narrative that you tapered down to 5 mg before beginning to skip doses, but this is not reflected in your drug signature.  In your signature, it looks like you were still at 10 mg when you started to skip doses.  Can you please edit your signature to reflect this? When did you get down to 5 mg?  The more detail you can provide, the better.  Please add any supplements and other meds you take on a regular basis. 

On 12/4/2024 at 2:33 PM, Lighthouse said:

I felt that I should taper this medication very slowly and so over the next two years starting in 2022, I began tapering initially to 5 milligrams and then taking medication, every other day, every third day, etc… until June 2024 taking once every 7 to 9 days. June 2, 2024, was the day I pushed to 10 days and haven’t had a pill since. Had I had this information on this forum, I would have done it differently,

 

Yes, SA strongly urges to NEVER SKIP DOSES TO TAPER.   Also, we recommend a slow hyperbolic taper, which you can read about here:  Why taper by 10% of my dosage?  For you, it would have taken about three years to taper to 0.4 mg.  Unfortunately, many (most) healthcare providers are ignorant of how these powerful drugs affect our brains and how to go about getting off of them safely.

 

On 12/4/2024 at 2:33 PM, Lighthouse said:

Since the initial withdrawal, which was extremely difficult and challenging, I have leveled out very well until several weeks ago; sleeping well

I am sorry for all you are suffering right now. We have seen that it is often about six months after a cold turkey or too-fast/improper taper that symptoms worsen.  In your case, you are likely experiencing severe withdrawal due to a too-fast taper and skipping dose.  Both throws the central nervous system into chaos as it scrambles to try to stabilize.  

 

That said, it is in your favor that you have taken only one psychotropic drug and you were not on it for many, many years, like many of us (including me).  You will recover, with time and patience.

 

On 12/4/2024 at 2:33 PM, Lighthouse said:

I had none of these symptoms pre doxepin or during.

All the symptoms you describe are common to withdrawal.  Compare to: Daily Checklist of Antidepressant Withdrawal Symptoms (PDF).

 

On 12/4/2024 at 2:33 PM, Lighthouse said:

I am hoping to find some information on longer withdrawal.

Here are some  links to information on withdrawal:

What is withdrawal syndrome.

Brain Remodelling 

Video:  Healing From Antidepressants - Patterns of Recovery

 

In some cases, reinstatement of a small dose of the drug can help alleviate withdrawal symptoms.  However, it is best to reinstate as soon as possible after withdrawal symptoms occur.  The only alternative is to try and wait out the symptoms and manage as best you can until your central nervous system returns to homeostasis.  Unfortunately no one can give you an exact timeline as to when you will start feeling better and while some do recover relatively easily, for others it can take many months or longer.  

 

As you taper, and even in protracted withdrawal, it is very normal to have periods where you feel better, and periods where you feel terrible.  This is what we call the windows and waves pattern of stabilization.  This is actually a good sign of healing!  Read more about windows and waves here:   The Windows and Waves Pattern of Stabilization

 

There are a few things you can do to help your nervous system heal.   Eat a balanced, whole foods diet, stay well hydrated, engage in gentle exercise, and get adequate rest/sleep.  Avoid all neurologically active substances, like caffeine, alcohol, nicotine and recreational drugs- these are like pouring gasoline on a fire for your symptoms.  Avoid adding any further psychiatric medications to deal with your withdrawal from psych meds- the effects of these meds on a destabilized nervous system is unpredictable, and taking something else could make you worse.

 

 

We recommend only two supplements here - magnesium (glycinate is a good form) and omega 3 (fish oil). Many people find these to be calming to the nervous system.

Magnesium, nature's calcium channel blocker 

Omega-3 fatty acids (fish oil) 

 

We have many threads on how to cope with symptoms – I encourage you to check out the various forums / links on the SA.org home page.

 

This is your introduction topic.  Each member gets one intro topic- please post updates and any future questions you may have here, in this thread.

 

Again, welcome to SA and best wishes in your healing.

 

[Lighthouse]

Jane, I wholeheartedly thank you for all fo the wondeerful information. I appreciate all of the feedback as well as direction for more learning. I am unsure, at this point, about the supplements that I am taking. I wonder if I should discontinue some of them as recommended on the forum, but I am not sleeping well as it is, and though I have grown accustomed to less sleep and also less deep sleep, I want to regain my previous activity level before coming off doxepin. Lisa

[Jane318]

@Lighthouse - You are more than welcome!  

 

Many people use a variety of supplements without issue, including melatonin for sleep.  We do usually caution against those that affect neurotransmitters, such as progesterone.  Recommend you do a site search for each one to see if there are any known issues.  If not, and if you have been taking them a while, might be best to not stop them, at least all at once.  Important to keep as many things stable right now as you can. 

 

The best way to search this site for specific information is to use your favorite search engine. Type in survivingantidepressants.org then the symptom, treatment, supplement or information you wish to search for.

[Lighthouse]

Thank you. I was wondering if any of the supplements might be detremental. Since progesterone is a hormone, and is excellent for sleep, anxiety and mood, and I make none of my own, this is likely good for me. I balance hormones for a living so I hadnt thought that this may not be good. I will definitely look into it. 

[Lighthouse]

Thank you! I stopped the progesterone and the anxiety, brain fog, and fatigue has significantly decreased. I started taking the progesterone after I stopped the doxepin to sleep, assuming it would be benign. Also, I have lost a good bit of weight since June, so the dose is likely too high, though labs are ok. I have learned a lot about progesterone that I didnt know and am not planning to resume it. Thank you. *If my posts are not to the group at large, I am fine with that. 

[Jane318]

16 hours ago, Lighthouse said:

Thank you! I stopped the progesterone and the anxiety, brain fog, and fatigue has significantly decreased. I started taking the progesterone after I stopped the doxepin to sleep, assuming it would be benign. Also, I have lost a good bit of weight since June, so the dose is likely too high, though labs are ok. I have learned a lot about progesterone that I didnt know and am not planning to resume it. Thank you. *If my posts are not to the group at large, I am fine with that. 

Thank you for sharing this!  From others here, I've come to see that I am learning that our bodies may react differently when we are tapering / in withdrawal and how important it is to limit substances that affect neurotransmitters - and that includes a lot more things than I realized.  I think it is a very good sign you are seeing improvement already from stopping the progesterone.  You are making progress towards full recovery!