stubbornasf: Introduction to my past and need help regarding SSRI tapering and withdrawal effects.

[stubbornasf]

Hey,
I wish you all are doing good. I am 23 years old male. I left SSRI but in cold turkey and I am currently going through withdrawal effects. I was 4 years on fluvoxamine since 2020 and at start of 2024 because of side effects my dr. changed it to fluoxetine. Later after 6 months June/July this year it also started showing side effects and these SSRI was not working even when I took them. So, I started tapering it slowly form dose of 80mg a day to 50 mg a day I had no problem at all. But when I tapered further the effects started coming up. But I continued to taper to 40mg but then I met a Bike accident, and I broke my collar bone (I think it was because of withdrawal effects as I was feeling very dizzy that morning, and I did the mistake of driving the bike myself. No one got hurt except me and my bike as I fell from a bad turn on a clear road). Underwent surgery and I decided to leave fluoxetine at 40mg. For a month I did not feel a lot because I was also suffering the pain of surgery. Now after 2.5 months I am having all sorts of withdrawal effects like extreme pressure in my head, brain fog/block, memory and concentration problems, mood swings etc. I was considering of starting fluoxetine again and start tapering off as it should be. But a good man (not in this forum) advised me not to start it as it will prolong my pain and suggested I should do changes in my lifestyle and do dry fasting. I need some guidance from you and what should be done in my case, I am trying to read more but currently it is difficult for me even to read for long. I need help from you.

 

Regards

Edited December 18, 2024 by Emonda
Name to title

[Jane318]

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

 

So the moderators can best help you, please complete your drug signature by following these instructions. Adding a signature ensures your drug history appears at the bottom of every post, making it more efficient for those trying to assist. This link should go directly to your own signature: Account Settings – Create or Edit a signature.  If you are taking any other medication or supplement on a regular basis, please list it also.

 

I am sorry for the terrible bike accident and for the severe withdrawal you are suffering now as a result of stopping fluoxetine suddenly.

 

Reinstatement of a very small dose of the original drug is the only known way to help alleviate withdrawal syndrome.  It isn’t a guarantee of diminished symptoms but it’s the best tactic available. 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.  

 

Reinstatement predictably works up to 3 months after last dose.  It is best to reinstate as soon as possible after withdrawal symptoms occur. We usually suggest a much smaller reinstatement dose than your last dose.  These drugs are strong, and when reinstating it is better to start with a small amount and increase if symptoms remain unbearable. Your system has become sensitized and if you take too much it may be too much for your brain and can cause you become unstable.  Sometimes it can be hard to regain stability after this happens.  Then, once you've stabilized on that dosage, which can take several months, you can begin a 10% per month taper down to zero.  

 

Please read:

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

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

Hypersensitivity and kindling

 

If you decide to try reinstating fluoxetine and want our help on choosing a dose to try, please let us know.  We would not recommend reinstating at the full dose you were last on, 40 mg, as this could trigger kindling.

 

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

 

Again, welcome to SA and let us know what you decide.  Best wishes.

 

 

[stubbornasf]

Hi @Jane318,

Happy new year!! I updated my signature. Severity of my withdrawal symptom does not seem to improve and it got bad the last time I left message. I get mood changes in every 15 minutes or so. Its like for a time I could feel positive motivated and hopeful for my life after fighting my thoughts for 2 hour and after just 15 min I again start feeling depressed, gloomy and start having obsessive thoughts. From previous week I also started feeling disassociated even sometimes if I am with my friends, feel sad all day and also started having suicidal thoughts. I am so consumed currently that it literally took me days to prepare myself to write this.

 

I am also suffering from Post-grad depression as its called but I don't know how much it is because of withdrawal. As when I was in grad school my health was improving so much and was feeling livingly again. I think this is not the big problem currently, but this is helping make things worse. Currently I am surfing excessive from mood issues, increased obsessive thoughts, disassociation and depression. I am also having very bad head pressure. I have had a bad history with OCD which i had worked on it. Reduced Obsession and Compulsion to almost to none. But now I am facing Severe obsessiveness which is clung to my mood changes, depression and insecurities. All this is also making me insecure and increasing it. At this stage I have to start my career and its very hard to read and learn anything.

 

I am inclining to reinstate fluoxetine, but I am scared that I may start experiencing all the side effects come with it and it may again stunt my muscle growth and increase weakness. How much of side effects can happen if I do reinstate?, But I am confused should I reinstate or not. Given my state do you recommend? or Should I wait more to see if things improve.

[Jane318]

Thank you for updating your signature.

 

I am so sorry you are continuing to feel so badly.  However, sudden (cold turkey) stops are very hard on our brains and often lead to severe withdrawal such as you are experiencing.  Withdrawal tends to render us even less able to deal with normal life stressors such as "post-grad depression."  

 

Given the severity of your symptoms, I would reinstate at a small dose if I were you.  You were at 40 mg when you stopped, according to your signature.  I would try 5 mg - if no adverse reaction (symptoms do not worsen) - continue at 5 mg for at least a week.  Assess - are your symptoms improving?  If so, I would stay at 5 mg for as long as it takes you to stabilize.  If symptoms do not improve after a week, but do not worsen either, you might do another small increase, perhaps up to 6 mg and repeat.  Once you are at a dose where you symptoms are improving, you want to hold at this dose until you stabilize.  This will likely take several months.

 

We look to find the lowest dose that will help symptoms abate.  You may experience some of the same side effects as before - this is impossible to predict for sure.  Only you can decide if it would be better to cope with the side effects again for a while longer, if they do recur, in order to get back to a stable state, or if you want to wait this out.  Again, I would reinstate if I were you, but this has to be your decision.  

 

If you decide to reinstate, you will want to taper slowly off after you stabilize.  It will be important to do this properly this time or you will end up back up in the same place.

 

If you wish to read about tapering now, recommend:

Important topics in the Tapering forum and FAQ

Tips for tapering off Prozac (fluoxetine)

 

Please keep us posted, best wishes.

 

[stubbornasf]

Thank you for help Jane. 

While acquiring prescription and medication. I went to revisit my Dr to see what he has to say. I told him about the current withdrawal effects but he refers it as relapse and side effects while I was taking fluoxetine. He changed my medication and advised to take Sertraline(Zoloft) this time with dosage 25mg for 5 days and continue for 50mg. He says that it will help me to cure my depression and ocd and it is more tolerated against the side effects.

 

Should I take sertraline? I would really want your opinion from a practical standpoint.

[Jane318]

27 minutes ago, stubbornasf said:

I told him about the current withdrawal effects but he refers it as relapse and side effects while I was taking fluoxetine.

Most doctors are woefully (and dangerously) ignorant of antidepressant withdrawal syndromes - Their automatic response is to blame it on "relapse" and push more pills.  Here is one paper from the Royal College of Psychiatrists that you could share with him if he were open to learning:  https://www.rcpsych.ac.uk/docs/default-source/improving-care/better-mh-policy/position-statements/ps04_19---antidepressants-and-depression.pdf.   Another resource is The Maudsley Deprescribing Guidelines.

 

32 minutes ago, stubbornasf said:

He changed my medication and advised to take Sertraline(Zoloft) this time with dosage 25mg for 5 days and continue for 50mg. He says that it will help me to cure my depression and ocd and it is more tolerated against the side effects.

This is what they do - push pills.  That's how they are trained, and it is lucrative for them.  However, there is no pill that will solve your or my problems.  While the drugs may numb us for a while, which helps dull the pain, it is a temporary solution that comes with many adverse effects.  Robert Whitaker in his book Anatomy of an Epidemic showed conclusively that the long term outcomes of people who do not take psychotropic drugs are better than those who do.

 

38 minutes ago, stubbornasf said:

Should I take sertraline?

My advice - No.  SA is here to help people get off these toxic drugs in a safe and recover their mental, emotional, and physical health.  We never recommend going on these drugs.

 

That said, this is your decision.  If your symptoms are intolerable, you might try reinstating a very small dose of the Fluoxetine as discussed in prior posts.  I would recommend trying this before going on another AD.