Addax: 30 years with Fluoxetine and tapering

[j1290]

53 minutes ago, Addax said:

Sometimes I get on my own nerves. 🙃

LOLLLLLL 😅 I resemble that remark!   Am I really getting so cranky I annoy myself?!?  Well, kinda...

 

[Addax]

On 1/18/2023 at 1:16 AM, j1290 said:

LOLLLLLL 😅 I resemble that remark!   Am I really getting so cranky I annoy myself?!?  Well, kinda...

 Right? Ha! I saw a meme or something recently that talked about how much it would suck to meet yourself only to find out you’re a jackass.  I think given that possibility, if offered the opportunity, I would refuse to meet myself and just live knowing I’m mildly annoying to myself, and not knowing for sure whether I annoy others. 😄

Edited January 21, 2023 by Addax

[Addax]

One of the wonky things that happens with the whole kerfuffle of withdrawal is the compulsion to play the game, “what’s ‘normal’ and what’s withdrawal?” Dumbest game ever. I hate it but I‘m compelled to play. I also play “did I hurt my back or is it just how middle age is?” which I actually prefer.

Today’s game is “Is it depression or is it withdrawal?” I am blue an irritable and have been for a few days. I was attributing the blueness to a serious back strain that left in a lot of pain and essentially immobile for several days. But it morphed today to include irritability. Depression and irritability are common bedfellows, so maybe not a big surprise the irritability eventually showed up.

I know depression and irritability are things people with no history of a depressive disorder experience at various times, and without an identifiable cause. It happens. It’s part of being human. I wasn’t depressed when I started Prozac, so this funk is not a return of depressive symptoms.  My options? I’m just feeling down like regular people do sometimes, it’s a wave and withdrawal symptoms, or it’s iatrogenic depression and I’ll feel this way for eternity. Of course, the game is rigged because it’s extremely difficult to make an unbiased and rational assessment when you’re wearing glasses with the dark gray lenses of depression. I mean, we only believe the most likely explanation is worst possible scenario when these dumb dark glasses are on. The kicker is, I’ll believe it’s the worst scenario despite the fact that I’ve been wrong SO many times in the past and really have no evidence to back up my belief. 
Ugh!! The game isn’t just dumb, it completely pointless! - yet, here I am. 🙄😖😠😞

Edited January 27, 2023 by Addax

[Addax]

It passed. Thank goodness! As of yesterday my low mood and irritability lifted.  I'm going to attribute most of this smallish wave to my recent injury and the pain because it seems that the improvement in my mood coincided with the decrease in pain and frustration from my injury.  Maybe a coincidence, but pain that sticks around has a negative impact on mood, so I can't separate the two.  

It's been 6 weeks since my drop to 9mg.  I have been planning to drop to 8 and with the passing of the blue mood, I'm planning on starting the 8mg capsules tomorrow.  A 10% drop = 8.1 mg, however, I have not gotten the liquid yet, and having weighed out the powder from some of my capsules there are some minor fluctuations in weight between the content of the capsules I've emptied, that I'm thinking the 0.1 difference may not have a large impact at 8mg.  That doesn't mean I'm not a bit nervous and won't spend at least 4 weeks waiting for the other shoe to drop.  If it mimics how I felt at 9mg, even with some bumpy moments, I'll be fine.  The bumps are uncomfortable but tolerable and I functioned at work just fine.  No one was the wiser - except my partner, who I tell (warn?) when I'm feeling down and irritable. 

I'm repeatedly reminding myself that I'm doing this without the kerfuffle caused by Wellbutrin.  It's not providing the reassurance I keep hoping it will, but... here I am doing this without Wellbutrin mucking things up this time ☺️.

 

I read that 1990 research article that talked about withdrawal symptoms experienced from discontinuing fluoxetine.  I have no idea why I re-read - maybe to anger myself all over again that the info has been out there and ignored since then.  

 

I should have the liquid fluoxetine by the time it's time to taper again.  I will do what Alto recommended and split my dose between capsule and liquid to improve precision and taper by smaller but more frequent steps.  Again, I plan to hold at 5mg for an extended period, if for no other reason than to take a breather.  I hope when I get there it will be the only reason I'm holding.

 

I hate the uncertainty that accompanies tapering but am oddly optimistic while still being nervous.   

[Edub26]

Addax, 

Reading your story has been beneficial to me through these difficult times. I was on Prozac 60mg for about 2 years. I was still having OCD and anxiety and I didn’t want to up my dose so I began going to counseling. Counseling really started helping and I decided I didn’t want to be on Prozac anymore. My doctor then tapered me off within a month. I began have withdrawal symptoms that were manageable until they weren’t. I started having extreme anxiety, it was and still is terrifying. 
 

I went to a psych doctor and she reinstated 30mg of Prozac. It’s been a rollercoaster. I’m just now on week 7 of taking Prozac again and I’m starting to feel better, but I still feel the heaviness of anxiety. I’m so scared I’m going to feel this forever.. I feel like I’ll never be myself again. I haven’t been to work since December 5th. All I want is to be able to function without feeling this constant fog/anxiety cloud over me. 
your story has given me hope. Do you have any advice or encouraging words? 
I plan on tapering off VERY slow once I’m stabilized for a while.
 

thank you so much. 

[Addax]

@Edub26

I am only just seeing that you foster to my thread. I'm glad you took the step to connect. I wish I’d seen your post sooner and been able to responded here. I think the kind of conversation we had is valuable within thread because people who “stop by” are often doing so for the reason you did but don’t end up interacting or asking questions even when they want to. I’m glad you started a thread. 

[Addax]

Just finished day five at 8mg. I’m nervous that it’s slightly more than the 8.1mg that would be 10%, but so far so good. Since I didn’t experience the irritability I did during the week I dropped to 9mg, I’m thinking that the episode may not have been related or was only partially related to the drop. Maybe I would have been irritated that week anyway. So hard for me to know sometimes. 

I’m particularly nervous about the next couple of months. Several significant stressors on the horizon beginning next week. In the past my ability to tolerate stress has been lower during tapering. Much lower. So this is causing me some anticipatory anxiety. I am anxious about being anxious! Sounds a bit silly, but such a loop is not at all unusual. The difference this time will be that if my tolerance is tested, I’ll know what’s going on and I’ll know it’s time limited, which is pretty damn empowering. 
 

Quick run through of how I’ve done and will do my taper.

I did a slow linear taper from 2021 until now. Beginning at 20mg I dropped 1mg every three months. It might have been overkill, but I wanted to ensure a couple things. 1) that I would avoid withdrawals symptoms to the extent possibly 2) I wanted to insure my NS was stable and emotional regulation solid as hell befor dropping below 10mg and off the occupancy “knee.”
 

From 10mg, I switched to a hyperbolic taper. The last two drops to 8mg appear linear, but are inline with a hyperbolic taper. 
 

I will next be dropping 5% every 2-3 weeks and switch to 5mg capsules and use the fluoxetine solution to make up the difference for at least a month, then just switch over to liquid entirely. The liquid will make things easier in that i can adjust based on how I’m feeling and now how long it takes to get a new prescription. 
 

Because I’m feeling so good I’m finding myself fighting the urge to taper more aggressively.
 

Outdoor activities typically have the effect of improving mood, right? But it’s only been this fall and winter that I have come to fully realize just how much of an impact spending several active hours outdoors has. It’s been kind of mind blowing. That sounds extreme, but ”mind blowing” is really the best description I can come up with right now.  Of course, it helps that I’m not feeling held down by that horrible 1000lb blanket of iatrogenic depression or anhedonia, and able to get my ass outside. 

 

[Thorin]

Hi @Addax,

Thought I’d drop over to your thread to say hello. You’ve done amazingly well with your taper. How old were you when you started meds? I was 16 (43 now). It’s a big thing to come off meds when you’ve relied on them your whole life. Takes a lot of courage to take the plunge and do it I think.Hope you’re feeling well and chat soon. Cheers

[Addax]

Hey @Thorin! So nice to see your note. 
Yes, this taper is going well. It’s not been without its bumps, but yeah, it’s going well. What sometimes steals my appreciation is worrying that I’ll end where I did the last time I tried to taper off. So The fact that I am where I am and feeling okay is great but also a bit nerve wracking.  Also, Because fluoxetine has such a long half life it will be a least a month after a drop before I can feel confident that it went okay.

 

I was 17 when I was prescribed Prozac for an eating disorder, maybe almost 18. I am 52 now. Prozac had just been approved by the Food and Drug Administration here in the states, or was in the last stages of approval. It freaks me out to think about how long I’ve been on Prozac/ Fluoxetine. There were short breaks in there very early on, but I ended up back on it.  The first time because of a significant flare up of my eating disorder when I was in college, then later because of bouts of depression or anxiety when I went off it - which I now know wasn’t depression or anxiety, but withdrawal mimicking their symptoms.  

It is a huge plunge to take the leap to taper. I wasn’t sure I would ever do it again after my last attempt that landed me in a horrific place. It took me several years to build up the courage to try again. I am much more conservative and cautious this time and it seems to be paying off.  

 

[Thorin]

6 minutes ago, Addax said:

Hey @Thorin! So nice to see your note. 
Yes, this taper is going well. It’s not been without its bumps, but yeah, it’s going well. What sometimes steals my appreciation is worrying that I’ll end where I did the last time I tried to taper off. So The fact that I am where I am and feeling okay is great but also a bit nerve wracking.  Also, Because fluoxetine has such a long half life it will be a least a month after a drop before I can feel confident that it went okay.

 

I was 17 when I was prescribed Prozac for an eating disorder, maybe almost 18. I am 52 now. Prozac had just been approved by the Food and Drug Administration here in the states, or was in the last stages of approval. It freaks me out to think about how long I’ve been on Prozac/ Fluoxetine. There were short breaks in there very early on, but I ended up back on it.  The first time because of a significant flare up of my eating disorder when I was in college, then later because of bouts of depression or anxiety when I went off it - which I now know wasn’t depression or anxiety, but withdrawal mimicking their symptoms.  

It is a huge plunge to take the leap to taper. I wasn’t sure I would ever do it again after my last attempt that landed me in a horrific place. It took me several years to build up the courage to try again. I am much more conservative and cautious this time and it seems to be paying off.  

 

That’s great that you’re succeeding in your taper! Slow and steady wins the race. It seems like most people get off eventually, it’s just a difficult and uncomfortable (understatement) process getting there. It is terrifying though isn’t it. I think this experience has scared me more than anything I’ve ever done in life and I’ve done a lot! Do you ever get glimpses of what it will be like once you’re off? I occasionally get them and it feels GOOD. Usually, not long after I remember how far I have to go and I go back to looking at one day at a time. I think it’s harder for people like you and me that started at such a young age. We’ve been reliant on these drugs to be the scaffolding of who we are in the world for a very long time. Now we’re taking the scaffolding away and hoping the structure won’t fall. I don’t think it will. But I don’t think it will be comfortable all the time either. I’m glad you’re doing this and I’m glad you’re succeeding. It’s an honour to witness it. You’ve got this!

[Addax]

1 minute ago, Thorin said:

It is terrifying though isn’t it. I think this experience has scared me more than anything I’ve ever done in life and I’ve done a lot!

It is absolutely terrifying. I would have to say that my last go round is the scariest thing I have ever experienced. That experience has this weird affect of keeping me scared now, but also allows me to know to question my thoughts and feelings because they’d been so wrong and irrational last time. 
Of course I am now curious about what all you have done! 

 

15 minutes ago, Thorin said:

Do you ever get glimpses of what it will be like once you’re off? I occasionally get them and it feels GOOD. Usually, not long after I remember how far I have to go and I go back to looking at one day at a time.

 
Yes.  Even though I don’t necessarily feel bad right now I’ll have these moments where I feel good… clear… it’s something different, and I have a sense of “This is it.”  It’s like a window or a cloud lifting that I might not even known was there. I don’t always notice when it fades or even remember what it was like exactly, but just that it was different and good.  
 

Some days it does feel like it’s going to take forever. I try to keep it to one refill at a time and something akin to radical acceptance. 
 

36 minutes ago, Thorin said:

I think it’s harder for people like you and me that started at such a young age. We’ve been reliant on these drugs to be the scaffolding of who we are in the world for a very long time. Now we’re taking the scaffolding away and hoping the structure won’t fall. I don’t think it will. But I don’t think it will be comfortable all the time either.

Agreed. Our brains were still developing when the drugs were introduced and were integrated into our brain’s development. The idea of that used to cause me a lot of anxiety. SO much anxiety. I was worried that my brain wouldn’t be able to fill the holes left by the drug.  Like there’d been some kind of irreparable brain damage. I would do the doom scrolling I’ve seen you talk about. Confirmation bias was hard at work so I would dismiss everything that didn’t align with my fear, and honed in hard on the things that confirmed my fears. I, of course, didn’t realize I was doing that at the time, but see it clear as day now. 😄

 

But neuroscience is clear on brain plasticity, and that it’s still hard at work at my age. Plus, the fact that I’ve eliminated 52mg of the drug so far and am okay, tells me the structure is  of reinforcing itself as the scaffolding is being pulled away - as neuroscience said it would.  The lag between taking away the drug and rebuilding is where the discomfort and withdrawal symptoms emerge.  I despise the lag and wish my brain would work faster! But I know that’s the reason tapering slowly is so important to managing symptoms. 
 

1 hour ago, Thorin said:

I’m glad you’re doing this and I’m glad you’re succeeding. It’s an honour to witness it. You’ve got this!

Thank you for this. Your words came at exactly the right time. 😊

 

 

[Thorin]

6 minutes ago, Addax said:

absolutely terrifying. I would have to say that my last go round is the scariest thing I have ever experienced. That experience has this weird affect of keeping me scared now, but also allows me to know to question my thoughts and feelings because they’d been so wrong and irrational last

I can relate. There have been times I have been completely irrational and not realised at the time. I’m surprised my partner has stayed with me. Just last night we were walking the dog and I had a moment of clarity where I realised how irritable I’d been with her at times. I was able to see the difference between how I had felt/acted in the past and the reality of the situation. I am very lucky she is so loyal and she stood by me. The irritability is rarer now and I’m better at keeping it in. I know I go quiet and surly when I feel it though. Makes me feel bad for my loved ones.

 

9 minutes ago, Addax said:

Of course I am now curious about what all you have done! 

Haha that would be telling. I’ll just say it has been a big life and at 43 I’m enjoying a quieter one. Tbh in hindsight I believe that I was seeking sensation, stimulation and novelty as I was very numb from medication. I just didn’t know that’s what was going on. Now that I’m not so numb there’s more than enough internal stimulation lol. Now I seek out more peaceful things. Breathwork, cold exposure (not sure if that’s ‘peaceful’ but it’s powerful). Therapy. Connection with people.

 

12 minutes ago, Addax said:

Yes.  Even though I don’t necessarily feel bad right now I’ll have these moments where I feel good… clear… it’s something different, and I have a sense of “This is it.”  It’s like a window or a cloud lifting that I might not even known was there. I don’t always notice when it fades or even remember what it was like exactly, but just that it was different and good.  

I truly believe this is a sign of what is to come.

 

13 minutes ago, Addax said:

Some days it does feel like it’s going to take forever. I try to keep it to one refill at a time and something akin to radical acceptance. 

I hate radical acceptance but how else do you get through? One day at a time and I’m trying to take the good days at face value and enjoy them without overthinking everything. Still working on this one lol.

 

14 minutes ago, Addax said:

Confirmation bias was hard at work so I would dismiss everything that didn’t align with my fear, and honed in hard on the things that confirmed my fears. I, of course, didn’t realize I was doing that at the time, but see it clear as day now. 😄

Right, I have definitely done this without realising what I was doing. I am now getting better at reading someone’s story and saying, my story has been different, that’s not my story. Still freak myself on occasion when I start doomscrolling. Having said that I ONLY doomscroll when I’m not feeling great….. something for me to think about….

 

16 minutes ago, Addax said:

But neuroscience is clear on brain plasticity, and that it’s still hard at work at my age. Plus, the fact that I’ve eliminated 52mg of the drug so far and am okay, tells me the structure is  of reinforcing itself as the scaffolding is being pulled away - as neuroscience said it would.  

That’s very true and it’s incredible that you’ve reduced by 52mg when you thought it wasn’t possible. I would say it IS possible and this proves it. It may be non linear and slow, but it’s possible. I am most of the way off a reasonably high benzo dose (basically microdosing) and my anxiety is manageable. I am down from 40mg Lurasidone to 14mg and am managing. I actually feel MUCH better on this lower dose. My emotions are hard work but my mental health is MUCH better.

 

19 minutes ago, Addax said:

I despise the lag and wish my brain would work faster! But I know that’s the reason tapering slowly is so important to managing symptoms. 

I can see how this would be very difficult. Do you reduce your dose every month and trust you’ll be fine? Or do you reduce every 2-3 months to make sure you’re ok. Difficult situation. I feel for you!

 

20 minutes ago, Addax said:

Thank you for this. Your words came at exactly the right time

Thank you. I needed the conversation too ☺️

[Addax]

14 hours ago, Thorin said:

Tbh in hindsight I believe that I was seeking sensation, stimulation and novelty as I was very numb from medication.

I feel this. I for sure was sensation seeking. It wasn’t all bad, but I also acted reckless and selfish, which was unlike the me I thought myself to be. As I tapered I began to experience some  guilt and remorse for some things. It was when the guilt kicked in that I realized that the drug had blunted EVERYTHING, not just sadness and happiness.  
 

14 hours ago, Thorin said:

I am most of the way off a reasonably high benzo dose (basically microdosing) and my anxiety is manageable. I am down from 40mg Lurasidone to 14mg and am managing. I actually feel MUCH better on this lower dose. My emotions are hard work but my mental health is MUCH better.

Wew! Yeah. You’re well on your way, for sure. Right on!  That’s a significant drop. Glad you’re feeling better. The emotional work is tough when the emotions feel bigger and drugs managed them for us for so long.  

 

14 hours ago, Thorin said:

Do you reduce your dose every month and trust you’ll be fine? Or do you reduce every 2-3 months to make sure you’re ok.

I did a linear taper for two years; 1 mg every 2-3 months. It was probably not necessary to go quite that slow, but the fear of experiencing symptoms that would interfere with my professional life drove my trepidation. I’ve now shifted to a hyperbolic taper and will do 5 - 6% drops every 2-3 weeks, or 2.5% every 1-2 weeks.   The smaller steps will hopefully allow my brain to keep up with the pace and avoid that lag I fear. I will slow down and/or hold at any hint of a symptom becoming uncomfortable enough to interfere in my ability to manage in my work life. My personal life is much more forgiving… I could probably get by in my personal life being a hot mess for awhile. My husband is understanding and I’m pretty quirky and engage in jackassery frequently enough that he might not even notice a change 😄.

 

 

[Thorin]

9 hours ago, Addax said:

Wew! Yeah. You’re well on your way, for sure. Right on!  That’s a significant drop. Glad you’re feeling better. The emotional work is tough when the emotions feel bigger and drugs managed them for us for so long.  

Thanks. It feels bizarre that I may do better off the drugs after being told I have a chemical imbalance and that I need medication like a diabetic needs insulin. Keep waiting for the other foot to drop. The emotions are HARD. There’s a lot of suppressed stuff from when I was a kid that I’ve never dealt with. And now it wants to come up. But my therapist is great and I’ve been able to work though a lot of stuff already on the last 12 months. Plenty more to come though 🙄😬😂

 

9 hours ago, Addax said:

feel this. I for sure was sensation seeking. It wasn’t all bad, but I also acted reckless and selfish, which was unlike the me I thought myself to be. As I tapered I began to experience some  guilt and remorse for some things. It was when the guilt kicked in that I realized that the drug had blunted EVERYTHING, not just sadness and happiness.  

I can relate to this. It’s not something I seem to do anymore since I’ve tapered down. There’s an element of ‘who am I now’. There was definitely some recklessness and selfishness on my part also but that’s much better now. I have many nuanced emotions now that I haven’t had since I was a kid. Much more difficult to navigate but much more fulfilling.

 

9 hours ago, Addax said:

did a linear taper for two years; 1 mg every 2-3 months. It was probably not necessary to go quite that slow, but the fear of experiencing symptoms that would interfere with my professional life drove my trepidation

I can understand going slow and taking care. Particularly when you’ve had a previous bad experience 

 

9 hours ago, Addax said:

I’ve now shifted to a hyperbolic taper and will do 5 - 6% drops every 2-3 weeks, or 2.5% every 1-2 weeks.   The smaller steps will hopefully allow my brain to keep up with the pace and avoid that lag I fear.

That’s much faster! I hope this works for you! I will be trying something similar. Thinking of trying the brass monkey slide rather than just dropping 10% in one go. Will wait and see how I react though 

 

9 hours ago, Addax said:

fear. I will slow down and/or hold at any hint of a symptom becoming uncomfortable enough to interfere in my ability to manage in my work life

This has been my fear too. Apart from about 1.5 weeks near Christmas and the odd day here and there I have been able to push though. And now that my taper will be a bit more appropriate hopefully it won’t effect my work life as much.

 

9 hours ago, Addax said:

I could probably get by in my personal life being a hot mess for awhile. My husband is understanding and I’m pretty quirky and engage in jackassery frequently enough that he might not even notice a change 😄.

Sounds like you have a great personal social life! And your husband sounds great. Every house needs quirkiness and jackassery! My partner is a hairdresser and I say this with love, hairdressers are a bit nutty. So there’s plenty of quirkiness in my house (obviously from me also!)

[Addax]

On 2/11/2023 at 11:57 PM, Thorin said:

That’s much faster! I hope this works for you! I will be trying something similar. Thinking of trying the brass monkey slide rather than just dropping 10% in one go.

 It looks faster in writing, but it’s much brass monkey’s slide. Maybe a wee bit slower.

 

On 2/11/2023 at 11:57 PM, Thorin said:

Sounds like you have a great personal social life! And your husband sounds great. Every house needs quirkiness and jackassery! My partner is a hairdresser and I say this with love, hairdressers are a bit nutty. So there’s plenty of quirkiness in my house (obviously from me also!)

My “social life” is probably not much of one. I’m a funky mix or introvert and extrovert.  I love people and being around them when I’m around them, but I generally chose not to be around them 😄.  That sounds much more brutal than it is, but I can’t think of a better way to say it. My husband is pretty great and luckily is social appetite is a lot like mine.

 

Hairdressers are nutty! Ha! I’m glad to hear you have that in your house. Every house should have that. 
 

 

[Thorin]

8 hours ago, Addax said:

I’m a funky mix or introvert and extrovert.  I love people and being around them when I’m around them,

Ha. Can relate. May partner says I am an extroverted introvert. I need to be around people at times but also need to be away from people a lot…… confusing at times but it works

 

8 hours ago, Addax said:

My husband is pretty great and luckily is social appetite is a lot like mine.

Oh that works well. My partner will get peopled out with work and then it’ll hit the weekend and I’ll want to see people and she says ‘no thanks!’

8 hours ago, Addax said:

Hairdressers are nutty! Ha! I’m glad to hear you have that in your house. Every house should have that. 

It can be great much if the time….

[Addax]

Looks like it's time for a hold.  Some work-related stressors have kept my anxiety heightened and I've had a few instances of waking up in the morning to pretty intense surges of anxiety/near panic, and the feeling has taken a little longer to shake.  I've had these surges now and then, particularly on Monday mornings, but they have not been nearly as intense or frequent as they have been in recent days.  They shake off by the time I start my work day, but the combination of the general heightened anxiety and the intense panic feeling upon waking ends up leaving me tired, generally blah, and struggling to focus for a good part of the day, which I absolutely hate.   I will say, other than waking to the panicked feeling, the other stuff is more irksome than interfering. However, I made a conscious decision to hold at any sign of a new or worsening symptom. After July I may not have to be so hypervigilant, but from now until then I simply cannot have symptoms mucking things up or the combination of withdrawal stress and work stress setting me back. 

 

Now, are there things I can do that would help? Yes. Number one is to attend to my sleep habits. That is by far the most important for me. I have a bad habit of staying up too late just to extend and enjoy the quiet downtime of the evening.  It's tough to give up, but 100% doable.  Reminding myself of the consequences of staying up, or how much better I feel when I go to sleep early doesn't seem to help, but maybe the panic surges and increased fatigue will up the anti enough to force me to put down my tablet.  It's this kind of thing that gets me so annoyed with myself. I mean, I know better, why the hell don't I do better? - Well, Addax, you're a jackass, that's why.... and now I'm more annoying for referring to myself in the 3rd person. 🙄

 

I could cut down on coffee. - Maybe? - I just talked about this in someone else thread.  I am physically dependent on caffeine - Sure, it might be psychosomatic, but regardless, the four or five days of gawdawful headaches and drowsiness that follows cutting back of cessation is not something I want to put myself through, especially right now.  Also, drinking my morning coffee is not followed by any increase in anxiety or shakiness or the like. The anxiety I feel in the morning precedes the coffee and doesn't get worse afterward.  Would the anxiety subside if not for the coffee? I suppose - but I'll wait until July to experiment with that... maybe.

 

I have increased my Omega-3 intake and Magnesium does seem to take the edge up, so I keep that around. Holding at 8mg for another week or more, sleep hygiene, Omega-3s, Magnesium, getting in my exercise... and keeping my focus away from thinking about how I'm feeling and why.  That's going to be my gig - a big part of it, anyway.  

 

 

[Addax]

Putting this here so I don’t forget about it and don’t forget where it was and start looking for it all over again.

 

[Addax]

Entry for my records… 
I was hoping to make my first drop into The Brassmonkey slide method… that funky monkey… 

I Had intended to drop to 7.8mg two days ago but it wasn’t meant to be.
My PCP became overwhelmed by my request for a divide prescription ( 5mg capsules & 20mg/5ml solution) and decided he was no longer comfortable writing prescriptions to support my taper w/o a psychiatrist’s oversight. I actually blame the office manager of the clinic who called me out of the blue to ask me who had authorized my taper and prescriptions. She sounded pretty irritated and unconvinced by my explanation, and was quite condescending.  I came back with a research informed explanation, and explained what the current best practice looked like, after which she stepped down. But, Unfortunately, asking for the divided prescription seemed to have worked against me and I’m now a month away from my first appointment with a new prescriber (a PsychNP) with only 8mg capsules.  I had planned to use them to make a liquid, but when I weighed the contents it came to 12 mg.  After an  angry and panicked call to the compound pharmacy, the pharmacist assured me it was just 8 mg of Fluoxetine, and the other 4mg was filler. I’m very skeptical of his explanation. 4mg of filler just sounds wonky. But what am I going to do?

 

Anyway, now I’m unsure whether I can make a liquid from it and know I’m getting 7.8mg. The contents of the 20mg capsules from the local pharmacy weighed 20mg or within .00x of it, so I might use them to make a liquid in the meantime.  The whole thing brings me to the edge of tears.  I’m scared that some small mishap will send me cascading into 2014.

 

but wait, there’s more… a mishap…

 

I must have not been paying attention when I filled my little weekly pill container and noticed this morning that I forgot to include the fluoxetine capsules. So I went two days without any. I’m thankful for Fluoxetine’s long half-life, but it seems I’m a tad sensitive at this lower dose. I felt off on the second day- irritable, blue but funkier, and last night I experienced the swishing/stop motion thing when I turned my head. Something that I have experienced in the past after missing a couple days, but something I have not experienced in a VERY long time.  I thought it was strange because I hadn’t missed any pills (so I thought at the time). Then this morning I was a bit weepy over something really benign… Then I went to take my pills and vitamins and noticed there was just one white capsule (my vitamin D3 looks nearly identical to the fluox capsule). I of course added the fluoxetine to the rest of the days. Hopefully, my funk will clear in short order, but… yeah. I’m pretty anxious about what might come next.

 

The rub? It’s game time! Are the symptoms explained by perimenopause? PMS? Withdrawal/missed doses? All of the above?  FFS!! 

 

Last thing… I’d forgotten that tapering/withdrawal kicks up some skin issues for me.  👎

I try not to marinate in my anger at Eli Lily, and those that came after, or the psychiatrists who I’ve tried to accept were mostly ignorant ( hopefully none willfully so), but iatrogenic hiccups in my quality of life make it hard not to be so angry sometimes. 

 

[Hanna72]

Dear @Addax

1 hour ago, Addax said:

I actually blame the office manager of the clinic who called me out of the blue to ask me who had authorized my taper and prescriptions.

Huh…well it’s nobody’s business but your own if you want to taper. I bet most of us in here have all kinds of stories about doctors, or physiatrists. 
Please don’t let their attitude bother you. It’s your life and your decision, try to stay calm and collective and don’t give them the power to change your beliefs and action. Their opinion is not your problem. No matter what they do or say, never doubt your own truth You always know what’s best for you.

I can understand it’s frustrating and you have every right to feel angry. It’s not like you need more obstacles then what you already have.

1 hour ago, Addax said:

must have not been paying attention when I filled my little weekly pill container and noticed this morning that I forgot to include the fluoxetine capsules. So I went two days without any

It’s going to be ok, I have missed dosage too, we are only human and nothing is perfect in this journey. I would erase this mistake out of your mind, and keep on going like nothing happened. 

 

1 hour ago, Addax said:

I’m scared that some small mishap will send me cascading into 2014.

You have been doing such a slow consistent taper, I bet your body will catch up and keep going in the right direction. I mean look at where you are now, 8 mg is huge success. 
Never loose hope, because even if things don’t go your way today, anything can happen tomorrow.

 

[j1290]

3 hours ago, Addax said:

The Brassmonkey slide method… that funky monkey… 

So I'm not the only one that hears that whenever I read Brassmonkey Slide?   hah!  

 

Sorry to hear this all happened to you, Addax!   This sounds like a particularly grueling day in the life of tapering.   For me, actually reducing the drug monthly has been the easy part.  The hard part was getting everything coordinated to put me in a place to do it.  

 

Hearing you talk about that swishing feeling...that one word takes me right back.  

 

Nowadays I have a pretty elaborate system of checks and balances for taking pills, alarms/apps/photos/notes...and my heart still sinks when I look in my pill tray and see one left in there that shouldn't be there, because I know what it can mean to miss one darn pill.   

 

Usually I grabbed a pill out of the wrong tray or forgot that I took a dose while I was at work or in my car or something, but that's why I take photos of each dose, so I can walk it back and confirm.   Even after all that once in a while I still have to play  that game of risk mitigation...do I take the dose I think I accidently skipped?  Half a dose?  Get me off this ride.  

 

I go to therapy weekly.  I did an EMDR session about tapering and various frustrations.  It actually really helped me a lot.   

 

Hang in there, Addax.  You're doing great!

 

[Thorin]

3 hours ago, Addax said:

My PCP became overwhelmed by my request for a divide prescription ( 5mg capsules & 20mg/5ml solution) and decided he was no longer comfortable writing prescriptions to support my taper w/o a psychiatrist’s oversight. I actually blame the office manager of the clinic who called me out of the blue to ask me who had authorized my taper and prescriptions. She sounded pretty irritated and unconvinced by my explanation, and was quite condescending.

I hate these types of people. First of all your request is not inappropriate. It’s also entirely your choice to taper, or refuse any medication you choose unless there’s a court order in place (my basic understanding). You’re hiring them. They work for you!

 

3 hours ago, Addax said:

came back with a research informed explanation, and explained what the current best practice looked like, after which she stepped down

Well done! Standing up for yourself. Excellent!

 

3 hours ago, Addax said:

After an  angry and panicked call to the compound pharmacy, the pharmacist assured me it was just 8 mg of Fluoxetine, and the other 4mg was filler. I’m very skeptical of his explanation. 4mg of filler just sounds wonky. But what am I going to do?

I can’t speak to this but your 8mg capsules should weigh more than 8mg is my understanding. I know that panicked feeling when you think they’ve made a mistake though!

 

3 hours ago, Addax said:

must have not been paying attention when I filled my little weekly pill container and noticed this morning that I forgot to include the fluoxetine capsules. So I went two days without any. I’m thankful for Fluoxetine’s long half-life, but it seems I’m a tad sensitive at this lower dose. I felt off on the second day- irritable, blue but funkier, and last night I experienced the swishing/stop motion thing when I turned my head. Something that I have experienced in the past after missing a couple days, but something I have not experienced in a VERY long time.  I thought it was strange because I hadn’t missed any pills (so I thought at the time). Then this morning I was a bit weepy over something really benign… Then I went to take my pills and vitamins and noticed there was just one white capsule (my vitamin D3 looks nearly identical to the fluox capsule). I of course added the fluoxetine to the rest of the days. Hopefully, my funk will clear in short order, but… yeah. I’m pretty anxious about what might come next.

I’ve done this (different med but I’m very sensitive). There was a little fallout. But nothing massive and it was short lived. I was uncomfortable for a day or two and that was it. Mistakes are temporary when tapering (unless you don’t have ANY meds to take). I think you’ll be ok. At worst a little wobbly for a day or three which I’m sure you’ve worked through before.

 

3 hours ago, Addax said:

The rub? It’s game time! Are the symptoms explained by perimenopause? PMS? Withdrawal/missed doses? All of the above?  FFS!! 

Haha that old chestnut. Is it me or the meds? You helped me out with this recently! Hold at your current dose until things settle….. that’s all you have to do. Hold, and things will settle. Just takes some time.

 

I genuinely think you’ll be ok. Just go slow and steady. Using the 20mg tablets to make a solution may be a good idea. Keep an eye on yourself just in case the pharmacy DID muck up your compounded script. I think you’re probably ok though.

[Thorin]

@Addax my 40mg tablet weighs 166mg….. I think you’re good

[Addax]

9 hours ago, Hanna72 said:

I bet your body will catch up and keep going in the right direction. I mean look at where you are now, 8 mg is huge success. 
Never loose hope, because even if things don’t go your way today, anything can happen tomorrow.

Yes. Thank your for the reminder, and everything else you wrote. I’m actually surprised how kind of shaken I was the whole thing.  Hopefully that “anything” is return to baseline.

 

Thank you for stopping by, Hanna72.  It means a lot to have had you stop by and have your words of support and encouragement to read. 

Edited March 9, 2023 by Addax
grammatical

[Addax]

6 hours ago, j1290 said:

10 hours ago, Addax said:

The Brassmonkey slide method… that funky monkey… 

So I'm not the only one that hears that whenever I read Brassmonkey Slide?   hah!  

 

Every..single..time. Haha! - I actually wondered if there was a way to get that first refrain "Brass monkey, that funky monkey, Brass monkey junkie, that funky monkey" followed by that crazy horn section to play when I open the spreadsheet.   No doubt it might wear on me by the end of a week, but that first week would be so fun!

6 hours ago, j1290 said:

Nowadays I have a pretty elaborate system of checks and balances for taking pills, alarms/apps/photos/notes...and my heart still sinks when I look in my pill tray and see one left in there that shouldn't be there, because I know what it can mean to miss one darn pill.   

 

Usually I grabbed a pill out of the wrong tray or forgot that I took a dose while I was at work or in my car or something, but that's why I take photos of each dose, so I can walk it back and confirm.   Even after all that once in a while I still have to play  that game of risk mitigation...do I take the dose I think I accidently skipped?  Half a dose?  Get me off this ride. 

 

Elaborate indeed! But considering the potential consequences of missing a dose, etc., it's so worth it.   And yeah, my heart sank when I realized what I'd done.  The fear of plummeting into horrific withdrawal symptoms looms on the edge of my awareness anyways, so when something like this happens, I can get pretty shaken up.  That game of risk mitigation, yeah, totally! I've played that game too.  So many mind games and rides in withdrawal! If only they didn't all suck.  I don't think it's unreasonable to want just one to be fun.  At least one.  I have no idea what that would look like, but c'mon brain! Do me a solid!

 

7 hours ago, j1290 said:

I go to therapy weekly.  I did an EMDR session about tapering and various frustrations.  It actually really helped me a lot.   

 

Hang in there, Addax.  You're doing great!

 

Therapy is a great thing, and I hadn't thought about EMDR for tapering.  But it makes sense.  Withdrawal, especially when the symptoms are particularly bad, has all the makings of a trauma... 

 

I'll hang in there. It helps a great deal to hear from others, for sure.  Thank you for that.

 

 

[Addax]

7 hours ago, Thorin said:

I hate these types of people. First of all your request is not inappropriate. It’s also entirely your choice to taper, or refuse any medication you choose unless there’s a court order in place (my basic understanding). You’re hiring them. They work for you!

 

I was really taken aback by her attitude, especially because I've been working with the clinic and doc since I started this taper in 2021.  It was hard for me not to clap back at her. Had I had your encouragement prior to her phone call it would have been harder, haha! 😄.   I'm not sure how she managed to get under the doc's skin.  In all honesty, he never questioned a thing and was content to just write the prescriptions I asked him to. Something about the divided dosing freaked people out I guess.  

 

7 hours ago, Thorin said:

I’ve done this (different med but I’m very sensitive). There was a little fallout. But nothing massive and it was short lived. I was uncomfortable for a day or two and that was it. Mistakes are temporary when tapering (unless you don’t have ANY meds to take). I think you’ll be ok. At worst a little wobbly for a day or three which I’m sure you’ve worked through before.

 

I appreciate the reminder of "temporary" and your reassurance.  It does me good to read. Especially this morning as I'm still sort of waiting for the other shoe to drop.  Maybe rather than a big 'ol combat boot dropping it will just be a flip-flop or sock.  Do they call them flip-flops down under?  Is "down under" okay to use?  

 

7 hours ago, Thorin said:

I can’t speak to this but your 8mg capsules should weigh more than 8mg is my understanding.

 

7 hours ago, Thorin said:

@Addax my 40mg tablet weighs 166mg….. I think you’re good

 

Thank you SO MUCH for saying and sharing this! Wew! You have knocked out a chunk of anxiety for me.  I kept thinking, "what if I've been taking 12 mg all this time? I'm going backward!" and "Those f**kers!"  I really thought I might have been set back several months and that my switch to liquid and drop to 7.8mg could mean a 4.2 mg drop, rather than the 0.2 drop I've been planning to make this week.  

 

7 hours ago, Thorin said:

Hold at your current dose until things settle….. that’s all you have to do. Hold, and things will settle. Just takes some time.

 

7 hours ago, Thorin said:

Keep an eye on yourself just in case the pharmacy DID muck up your compounded script. I think you’re probably ok though.

 

This. Yes. Hold will be the name of the game (another freaking game!! Ugh!).  It helps to see it in writing, for sure - I think you're right, I'll be okay. 

[Thorin]

12 hours ago, Addax said:

Had I had your encouragement prior to her phone call it would have been harder, haha! 😄.

I would definitely push back hard in this situation. I’m so sick of arrogant healthcare workers. Having said that it’s often easier to walk away….

 

12 hours ago, Addax said:

Do they call them flip-flops down under?  Is "down under" okay to use?  

Haha no we call them thongs. Yes we know that thing is called something different in most countries, we have a different name for that here. Yep you can say down under 😂

 

12 hours ago, Addax said:

Ugh!).  It helps to see it in writing, for sure - I think you're right, I'll be okay. 

I only know because I had a similar freak out recently but it’s been 30 days nearly and I seem to be ok. Tbh I still keep waiting for the other shoe to drop but it’s just not happening. Hope I can relax into it even more as time goes on. Everything seems to be going well honestly. There’s an overall upwards trend for me but I still have this dread that hangs over things a lot of the time. If I could lose the dread and accept the other symptoms as they are instead of expecting worse I’d be pretty good. Not perfect but ok.

[Addax]

13 minutes ago, Thorin said:

Tbh I still keep waiting for the other shoe to drop but it’s just not happening. Hope I can relax into it even more as time goes on. Everything seems to be going well honestly. There’s an overall upwards trend for me but I still have this dread that hangs over things a lot of the time. If I could lose the dread and accept the other symptoms as they are instead of expecting worse I’d be pretty good. Not perfect but ok.

So great it’s not happening! As time goes on and nothing happens I would imagine you will get used to nothing happening, then expect nothing to happen, and in will slide relaxation. But yeah. In the meantime, that anticipation that some wave will come along and disrupt the relative stability looms large.
 

And I hear you about wanting to accept the symptoms as they enough so that they don’t occupy so much of your thoughts and awareness. I need to be mindful of when i’m assessing for symptoms and thinking about how I’m feeling so I can do something to pull myself out of my head, otherwise I can get stuck there.
Radical acceptance and move on… that would be a decent  place to be.

 

It’s “thongs” down under, and “flip-flops”… up over? Is there a slang for the northern hemisphere?  I have the silliest list of naïve questions about life in Australia… suddenly I have become aware of just how norther hemisphere-centric I am! 
 

[Thorin]

9 minutes ago, Addax said:

So great it’s not happening! As time goes on and nothing happens I would imagine you will get used to nothing happening, then expect nothing to happen, and in will slide relaxation. But yeah. In the meantime, that anticipation that some wave will come along and disrupt the relative stability looms large.

It does indeed. I’m going to try some EMDR for it to see if I can take the sting out of the fear.

i’m planning to start tapering soon so would love to lessen some of the fear about that too.

11 minutes ago, Addax said:

And I hear you about wanting to accept the symptoms as they enough so that they don’t occupy so much of your thoughts and awareness. I need to be mindful of when i’m assessing for symptoms and thinking about how I’m feeling so I can do something to pull myself out of my head, otherwise I can get stuck there.
Radical acceptance and move on… that would be a decent  place to be.

I get stuck there frequently. And the smallest WD symptom sends me straight there. Would love to get out of that mindset. As you said, radical acceptance and move on would be good.

 

12 minutes ago, Addax said:

It’s “thongs” down under, and “flip-flops”… up over? Is there a slang for the northern hemisphere?  I have the silliest list of naïve questions about life in Australia… suddenly I have become aware of just how norther hemisphere-centric I am! 

Up over 😂 I like it. Never heard it before but we should use it 😂.

 

send your questions through! I love answering these sorts of question.

[Addax]

The primary care doc came through in the end.  For the most part, anyway.  I didn't get the 5mg capsules + liquid but he called in the liquid (20mg/5ml solution) to the pharmacy, so I'm good-to-go to slide to 7.8 on my brassmonkey (🎵that funky monkey🎵) slide.  I wonder if he did it on the DL.  Not like illegally, but silently so the office admin didn't fuss.  Or maybe she didn't actually care in the first place and that's just how she is all the time.  

[Thorin]

3 hours ago, Addax said:

The primary care doc came through in the end.  For the most part, anyway.  I didn't get the 5mg capsules + liquid but he called in the liquid (20mg/5ml solution) to the pharmacy, so I'm good-to-go to slide to 7.8 on my brassmonkey (🎵that funky monkey🎵) slide.  I wonder if he did it on the DL.  Not like illegally, but silently so the office admin didn't fuss.  Or maybe she didn't actually care in the first place and that's just how she is all the time.  

Good news!

[Addax]

Just need to post this - I am kind of astounded by the relief of having the liquid fluoxetine. I knew I have been a bit on edge about dropping below 8mg, but maybe I was more so than I thought.  Of course, trying to calculate the brassmonkey slide for the 20mg:5ml solution nearly brought me to tears. After attempts to work out what the numbers would look like for the next two months, I realized I didn't trust my math abilities enough to leave me in my own hands.  If that even makes sense.  I went to the fluoxetine tapering thread and found this:

 

"Increasing the dilution might make measuring easier. For example, you may wish to make it 1mg = 1mL. To do this, add 10mL (40mg) of the 20:5 solution to 30mL of water. Now you have 40mL of liquid containing 40mg Prozac, or 1mg in 1mL."

 

... And all was nearly right with the world again. my pharmacy gave me the small liquid medication bottle to mix it in, and BAM! 1mg:1ml solution is made and ready to go.  Seems like such a little thing to celebrate, but anything that makes this easier and makes it possible for me to think about tapering and withdrawal less is worth celebrating.   Woot! 

 

The leftover thing to worry about is remembering to dose with the liquid.  Until now I distributed my meds and vitamins in a Monday - Friday dispenser thing and could just dump the day's section into my hand and swallow.  I think my angst over the whole thing will help me remember to take it, but just in case I've put a piece of tape on the pill dispenser so I can mark an 'X' after I take it.  I also put tiny rubberbands in the section to represent the liquid as an extra reminder. Hopefully, I don't absentmindedly pop those in my mouth along with my vitamins.  

 

The "what do I blame the symptoms on" game has temporarily changed up a bit.  Along with Is it withdrawal? Is it perimenopause? or is it just how I am? I am currently including the option of,  Is it because of the switch to the liquid? Oi! 

[Fifree]

On 3/12/2023 at 4:05 AM, Addax said:

"what do I blame the symptoms on" game

Oh I feel this. So very well expressed too. I have irritability but I don't know if it's because I am tapering escitalopram, it's latent menopausal symptoms (I'm 60 but I've been on E since I was around 40), or the fact that I'm also in the process of giving up all my legal drugs (caffeine alcohol and nicotine) to simplify my brain chemistry as much as possible. Also, "is it just how I am?" is a very valid question. I'm struggling with wondering who I am after 30 years on various SSRIs. My kids don't even know me without drugs. Scary.

 

I'm very glad you got your liquid from your dr. I'm celebrating that too and completely get that it's a big deal. I've only just arrived at the even number of 10 mg/day so won't be using my liquid for a while, but I wanted to make sure I had the next step sorted out.

 

Thanks for your article over on rxisk. A really good read. I'm glad you managed to get yourself stabilised again and wish you well for future steps.

[Thorin]

46 minutes ago, Fifree said:

I'm struggling with wondering who I am after 30 years on various SSRIs. My kids don't even know me without drugs. Scary.

Exactly this. It scares the crap out of me.

[Addax]

18 hours ago, Fifree said:

I'm also in the process of giving up all my legal drugs (caffeine alcohol and nicotine) to simplify my brain chemistry as much as possible. Also, "is it just how I am?" is a very valid question. I'm struggling with wondering who I am after 30 years on various SSRIs. My kids don't even know me without drugs. Scary.

I seem to lose patience when I try to give-up coffee.  I know I can tapper it by mixing in decaf, and I know it would be a good idea to kick caffeine to the curb, but for some reason I haven’t found the motivation to do it. If I cold turkey caffeine, the fatigue and headaches overwhelm me.  How great you’re doing it! 
 

I also wonder about what will be when I’m done tapering. It occurred to me yesterday that I had been prescribed Prozac 35 years ago.  Winter of 87/88.  I think I know who am I and I don’t think I’ll be too much different than who I am now, but I guess we can’t really know until we’re there.  I like to think that the positive changes will continue. Like being able to cry, and laugh hard - things I’d been missing at 60 and 40mg… and even still at 20.  There are some other internal experiences that have returned that I don’t love, in part because I experience too late/after the fact. Having them around years ago would have probably helped me make better, less reckless decisions.  
 

I am always curious about what other people experience as they withdrawal. Not just they symptoms. 

 

19 hours ago, Fifree said:

I'm very glad you got your liquid from your dr. I'm celebrating that too and completely get that it's a big deal. I've only just arrived at the even number of 10 mg/day so won't be using my liquid for a while, but I wanted to make sure I had the next step sorted out.

Celebrating as much as we can along the way! Glad you got it too. Having things squared away in anticipation of the next step helps it to feel less stressful.  
 

Because I diluted it to be a 1:1 ratio, 7.8mg of a not so great tasting liquid feels like a lot.  I would have much preferred to divide it between capsule and liquid, but I’ll take what I can get.

 

19 hours ago, Fifree said:

Thanks for your article over on rxisk. A really good read. I'm glad you managed to get yourself stabilised again and wish you well for future steps.

I honestly never thought I would come back from that.  

Thank you for the well wish!
 

 

[Fifree]

9 hours ago, Addax said:

I seem to lose patience when I try to give-up coffee.

If the coffee isn't causing you any issues, I don't think you need to get off it. I could just feel rising anxiety in my chest mid-morning and I thought I could probably attribute it to overusing nicotine or caffeine so decided to wean myself off both. Could not CT off either of them though! Alcohol was no drama as Ive never been much of a drinker.

9 hours ago, Addax said:

I like to think that the positive changes will continue

I'm trying to focus on the positive changes too. I haven't been on these things for quite as long as you have but it is 28 years so a fair old while. Nearly half my life. I'm finding myself with a little more energy and focus... less inclined to sit around playing games on my phone which is a really good thing. I've been wondering wth was wrong with me with that for years and now I realise it was an insidious side effect. I would say I'm a bit less compulsive with a few things like that. So there are definitely wins in this process. At the same time, I'm finding myself a bit less patient with my children's emotional dependence on me. So weird. As I started taking these drugs for PND (PPD in the US I think?) I'm wondering if maybe I just have really low tolerance for children!

 

9 hours ago, Addax said:

7.8mg of a not so great tasting liquid feels like a lot

I've been warned the Lexapro is pretty nasty too. When I was cross tapering to my homemade liquid I was taking 5 ml of it and it was really vile. The pharmacy assistant (who has tapered off Lex herself) recommended diluting it in OJ to mask the taste. That may work for you too!

 

All the best. I'm still at least 3 weeks off my next drop, but let us know how you go.