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Reinstatement: About reinstating and stabilizing to reduce withdrawal symptoms


Altostrata

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  • Moderator Emeritus

@Manati

 

Please ask questions about your own situation in your Introduction topic.  This way your history will all be in one place and it is easier for the mods to access previous history.  Thank you.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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2 hours ago, ChessieCat said:

@Manati

 

Please ask questions about your own situation in your Introduction topic.  This way your history will all be in one place and it is easier for the mods to access previous history.  Thank you.

 

Oh sorry -  I didn't mean to hijack the thread for my own concerns, and will stick to my intro topic with those questions! 🙈

Fluoxetine (Prozac) (25mg?) from December 2002 - November 2005 for anxiety/depression

Effexor (Venlafaxine) Retard (75mg) due to Panic attacks from November 2005 until around May 2020 when I started tapering off from 75mg to about 33mg in September. Accidentially missed a dose and naively went cold turkey from around 33mg to zero on 26th of September. Hell broke loose in early December.

25th December: Reinstated Venlafaxine with one bead (0.3/0.4mg) in the evening, proceeding with two beads (0.7/0.8mg)

since 5th January: 3 beads of Venlafaxine daily and nothing else except fish oil and magnesium. No changes in daily routine

15th January - 17th January: 4 beads of Venlafaxine

since 18th January: back to 3 beads of Venlafaxine due to extreme agitation, introduced Ashwaghanda supplement.

Since 23. January: introduced Lyrica to help with sleep/jerks keeping me awake: updosed from 4mg to 8mg.

Since February: 700mg Valerian and 2mg Melatonin for sleep

March: tapering Lyrica again due to side effects.

April: down to 2 beads of Venlafaxine

17th October: Off everything. Braindead, apathetic/anhedonic Zombie.

 

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  • 2 months later...

Anyone felt even worse when reinstating after 2 1/2 months? I was finally doing better but took the path of reistating and I got so bad and depressed . My depression wasn t even back. Why is my brain reacting so bad at this? Anyone felt worse? 

JUNE 2019 Tried Coaxil ,wellbutrin, cipralex, mirtazapine, effexor, sertraline, benzoS for 5 months.November 2019 started prozac 30 mg, took till May 2020 and started tapering 5 mg at a time till reached 2.5mg once every 2 3 days.January 2020 stopped benzos (tapered for 2 months).27 December 2020 stopped Prozac, 2 bad weeks.January and  february was feeling well.I am taking 2 mg of lorazepam /year.Tried 5Htp 100mg Febr 2020 for a copule of days, vomited non stop. Stopped right away.No supplements, possibly allergic to excipients now. 30 mg of Ulipristil acetate on 25th of febr.

Reinstated 0.4 mg of prozac 12 march  , had 0.2mg 13 march. Stopped reinstatement, feeling better.

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14 hours ago, Melany said:

Anyone felt even worse when reinstating after 2 1/2 months? I was finally doing better but took the path of reistating and I got so bad and depressed . My depression wasn t even back. Why is my brain reacting so bad at this? Anyone felt worse? 

Yup!! I think alot of people on here have, that's part of the risk of reinstating. 

How long have you reinstated for? You could go back to your regular dose if you haven't been reinstated for too long. Either way, it's going to be a matter of patience waiting for your brain to regulate itself.

10 years on various anti-depressants

5 years Effexor xr

tappered of 150mg in 6 months

nothing for two weeks

Reinstated 15 beads for 50 days

Tappered off then clean 2-3months

gradually went back up to 13 mg 3 years

bridged fluoxetine 10mg

2 week tapper

1 year clean

reinstated 5ml dispersed fluroxatine for 6months

 

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How can we tell if it s the reinstatement that makes us feel worse or the WD that got worse?

Should I pause for 2 3 days? See if I get better?

JUNE 2019 Tried Coaxil ,wellbutrin, cipralex, mirtazapine, effexor, sertraline, benzoS for 5 months.November 2019 started prozac 30 mg, took till May 2020 and started tapering 5 mg at a time till reached 2.5mg once every 2 3 days.January 2020 stopped benzos (tapered for 2 months).27 December 2020 stopped Prozac, 2 bad weeks.January and  february was feeling well.I am taking 2 mg of lorazepam /year.Tried 5Htp 100mg Febr 2020 for a copule of days, vomited non stop. Stopped right away.No supplements, possibly allergic to excipients now. 30 mg of Ulipristil acetate on 25th of febr.

Reinstated 0.4 mg of prozac 12 march  , had 0.2mg 13 march. Stopped reinstatement, feeling better.

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5 hours ago, Melany said:

How can we tell if it s the reinstatement that makes us feel worse or the WD that got worse?

Should I pause for 2 3 days? See if I get better?

Usually, for me, if the reinstatement works I feel better very quickly. 

 

You will feel better eventually either way, it's a matter of whether its worth upping your dose if your going to have to go through withdrawal symptoms until your brain levels out anyway. 

10 years on various anti-depressants

5 years Effexor xr

tappered of 150mg in 6 months

nothing for two weeks

Reinstated 15 beads for 50 days

Tappered off then clean 2-3months

gradually went back up to 13 mg 3 years

bridged fluoxetine 10mg

2 week tapper

1 year clean

reinstated 5ml dispersed fluroxatine for 6months

 

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Thanks ! I ve delayed my dose and feeling ok so far. We ll see in a few days what happends and then tough it up and deal with it  whatever it is.

JUNE 2019 Tried Coaxil ,wellbutrin, cipralex, mirtazapine, effexor, sertraline, benzoS for 5 months.November 2019 started prozac 30 mg, took till May 2020 and started tapering 5 mg at a time till reached 2.5mg once every 2 3 days.January 2020 stopped benzos (tapered for 2 months).27 December 2020 stopped Prozac, 2 bad weeks.January and  february was feeling well.I am taking 2 mg of lorazepam /year.Tried 5Htp 100mg Febr 2020 for a copule of days, vomited non stop. Stopped right away.No supplements, possibly allergic to excipients now. 30 mg of Ulipristil acetate on 25th of febr.

Reinstated 0.4 mg of prozac 12 march  , had 0.2mg 13 march. Stopped reinstatement, feeling better.

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  • 2 weeks later...

I have read through this entire topic again.  My impression when I first read it was that reinstatement is not recommended after being several months off.  This time it seems that any time reinstatement occurs, it should be at a very minimum dose to start and that amount of time off does not always mean you should not try reinstatement.  Is that correct?

I also want to clarify if you reinstate at say.5 and it creates problems, do you still taper off @10% or just stop.


My situation is dire at 18 months off, so trying to figure this out. I did post my specifics on my own thread, but have not received a response.  I addressed that post to @Altostrata but I know all of you are very busy, so thought I would go back through this thread.  I do appreciate all this information and the time you spend creating and monitoring it.  

 

 

 

 

 

 

Mid and late 1990s various antidepressants including Prozac, Pamelor, Zoloft, Trazadone for brief periods of time  Usually one month or less with no taper.

1998 to August 2020   .5 mg lorazepam, first PRN then daily. CTed Jan 2015 RI March 2015 (6 wks): CTed October 2016 RI Nov 2016 (3 wks (October 2016). 10 month taper begin Oct 2019 finished Aug 10, 2020. 2000 to Sept 2015 periodic use Escitalopram 10 mg.  Brief periods, 3-6 months, with rapid tapers or cold turkeys.Oct 2016 Cymbalta and Remeron for a period of about 2 weeks. Stopped cold turkey.Nov 2016 to October 2017 10 mg escitalopram.  One month taper

Last 2 ½ years:

Ongoing daily .5 lorazepam originally began in 1998 PRN, then daily 2008.  March 2019 to August 2019 10 mg escitalopram; rapid taper about 3 weeks. Sept 2019 to Sept 2019 Pristiq 25mg, taken 2 weeks then a every other day taper for one week.  25 mg trazadone for one week, no taper.  Zoloft 25 mg for 5 days, no taper. October 2019 -August 2020 10 month taper from .5 lorazepam.

Currently taking Valsartan 40 mg daily and Preservision AREDS2 one capsule daily.

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  • Moderator Emeritus

@JustBella

 

Post #1 of this topic explains what to do if you start to feel worse after reinstating.

 

Reinstatement is basically a gamble whether you reinstate after a few months or many months.  We have seen it work/fail for both time spans.  It seems that the sooner you reinstate/updose (usually starting with a small amount) after experiencing withdrawal symptoms the better chance there is of it being successful.

 

Generally SA suggests reinstating the last drug that you took.  However if you have been off a drug for longer than a few months, or the drug you stopped is one that is difficult to taper (either because of the physical difficulty of getting doses OR side effects), changing to a different drug like Prozac or citalopram is an option that might work.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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i went back on prozac after struggling for 2 years with crippling ocd and anxiety. i started at a tiny dose and gradually increased over a year with very little benefit. eventually i bit the bullet and went back on 40mg, the dose i originally took. it took a long time to work - over 3 months before i saw a difference but now 4 years later i'm feeling a whole lot better and i can see the sunshine again. i wish i'd bitten the bullet sooner and gone back to my original dose. 

Took prozac 40 mg for 20 years.

January 2017 started cutting down prozac by 12.5% a week. End of February 2017 completely off prozac and withdrawals began.

Currently taking Levothyroxine 75 mcg, Magnesium citrate 200mg,Sage leaf 50mg daily

Amlodipine: October 2017 , discontinued 26 Feb 2019; Candesartan:  26 Feb 2019, 4mg.

Discontinued magnesium citrate 200mg Apr 3rd 2019

Reinstated prozac:  14 Jan 2019, 1mg; 26 Jan, 1.5mg; 4 Feb, 2mg; 16 Feb, 2.5mg; 2 Mar, 3mg; 5 Mar, 2.5mg, 23 Mar, 3 mg; 6 Apr, 3.5mg, 14 Apr 4mg, 23 Apr 5mg, 10 Jul 8mg, 1 Dec 20mg, 1 Apr 2020 40mg 

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  • Moderator Emeritus

@thecowisback

Please update your drug signature.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • 5 months later...

Alto it seems that all references to reinstatement come from the point of view of having come completely off drug. Is my situation still considered reinstatement where I only made 2 10% cuts albeit too quickly?

1996 started Paxil for anxiety 

2012 20mg reduced to 10mg 2 week period went back up to 20

March2021 dropped from 20-15mg held 2 weeks dropped 2.5mg held 4weeks back to 20mg

July 3 2021 dropped 10% 2mg held 2 weeks

July 17 2021 dropped 1.8mg held 2 weeks 

july 31 2021 dropped 1mg

August 3 2021 raised 1mg Held until august 20 2021 raised back to 20mg

current dose 20mg

dr. Raised to 30 mg because of symptoms 

hospital psych took me off Paxil over a week started me on Zoloft 

current Zoloft 100 mg

klonapin 1-2 mg as needed 

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  • Administrator

Your changes would be updosing.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Ok thanks 

1996 started Paxil for anxiety 

2012 20mg reduced to 10mg 2 week period went back up to 20

March2021 dropped from 20-15mg held 2 weeks dropped 2.5mg held 4weeks back to 20mg

July 3 2021 dropped 10% 2mg held 2 weeks

July 17 2021 dropped 1.8mg held 2 weeks 

july 31 2021 dropped 1mg

August 3 2021 raised 1mg Held until august 20 2021 raised back to 20mg

current dose 20mg

dr. Raised to 30 mg because of symptoms 

hospital psych took me off Paxil over a week started me on Zoloft 

current Zoloft 100 mg

klonapin 1-2 mg as needed 

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  • 2 months later...

Looking back, reinstating made everything so much worse for me, so please think thrice about it once you're more than 3 months out!!

Fluoxetine (Prozac) (25mg?) from December 2002 - November 2005 for anxiety/depression

Effexor (Venlafaxine) Retard (75mg) due to Panic attacks from November 2005 until around May 2020 when I started tapering off from 75mg to about 33mg in September. Accidentially missed a dose and naively went cold turkey from around 33mg to zero on 26th of September. Hell broke loose in early December.

25th December: Reinstated Venlafaxine with one bead (0.3/0.4mg) in the evening, proceeding with two beads (0.7/0.8mg)

since 5th January: 3 beads of Venlafaxine daily and nothing else except fish oil and magnesium. No changes in daily routine

15th January - 17th January: 4 beads of Venlafaxine

since 18th January: back to 3 beads of Venlafaxine due to extreme agitation, introduced Ashwaghanda supplement.

Since 23. January: introduced Lyrica to help with sleep/jerks keeping me awake: updosed from 4mg to 8mg.

Since February: 700mg Valerian and 2mg Melatonin for sleep

March: tapering Lyrica again due to side effects.

April: down to 2 beads of Venlafaxine

17th October: Off everything. Braindead, apathetic/anhedonic Zombie.

 

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I have been 13 months off Zoloft. It is not getting any better

 

Thinking of reinstating 13 months off. Anyone did that after so long off? Thoughts?

 

Original dose 50 mg

Zoloft, November 2019.  I worked up to 50 mg and stayed there until 1 year later. I tapered for 3 months, which should consider to be cold turkey.
Tapering schedule:
Month 1: 37.5 mg

Month 2: 25 mg

Month 3: 12.5 mg

Month 4(Half the month): 6.75 mg
Month 4(Other half): 0 mg December 9, 2020

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  • Moderator Emeritus
4 minutes ago, curiousnootropics said:

Thinking of reinstating 13 months off.

 

After such a long time off the drug if you did decide to reinstate it is better to start of with a very tiny tester dose to see how you respond.  The idea of this is not to reduce the withdrawal symptoms but to see how you respond to the drug.

 

Please make sure that you carefully read all of Post #1 of this current topic.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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7 minutes ago, ChessieCat said:

 

After such a long time off the drug if you did decide to reinstate it is better to start of with a very tiny tester dose to see how you respond.  The idea of this is not to reduce the withdrawal symptoms but to see how you respond to the drug.

 

Please make sure that you carefully read all of Post #1 of this current topic.

What would be a dose to consider? Like 1 mg? How fast would you feel improvement?

Zoloft, November 2019.  I worked up to 50 mg and stayed there until 1 year later. I tapered for 3 months, which should consider to be cold turkey.
Tapering schedule:
Month 1: 37.5 mg

Month 2: 25 mg

Month 3: 12.5 mg

Month 4(Half the month): 6.75 mg
Month 4(Other half): 0 mg December 9, 2020

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  • Moderator Emeritus
8 minutes ago, curiousnootropics said:

What would be a dose to consider? Like 1 mg?

 

If it was me I would be testing with 0.25mg.  It is better to start with a small amount than to risk taking too much.  And if you have no issues with the test dose you could increase by small amounts gradually.

 

The idea of reinstating is NOT to get rid of withdrawal symptoms completely but to bring them to a bearable level.

 

It takes about 4 days for a dose to get to full level in the blood and a bit longer for it to register in the brain.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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10 hours ago, ChessieCat said:

 

If it was me I would be testing with 0.25mg.  It is better to start with a small amount than to risk taking too much.  And if you have no issues with the test dose you could increase by small amounts gradually.

 

The idea of reinstating is NOT to get rid of withdrawal symptoms completely but to bring them to a bearable level.

 

It takes about 4 days for a dose to get to full level in the blood and a bit longer for it to register in the brain.

 

How long would it take to feel a severe adverse reaction during reinstatement? I possibly had a kindling reaction while trying to go back on Lexapro, but it took about 3 weeks to feel it.

Risperdal 2012

Lexapro 2013-2020

30mg Lexapro from 2016-2020

30mg cold turkey in June 2020 due to issues with APRN

Re-instatement of 10mg of Lexapro in late September 2020 due to panic attack

Cold turkey 10mg Lexapro early October 2020 due to sudden health problems possibly caused by Lexapro

Now taking 20mg of Lisinopril. Stopped iron supplement over the counter for low iron due to feeling sick while taking it. Taking a vitamin D supplement alongside the Lisinopril.

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  • Moderator Emeritus
8 hours ago, rilexapro said:

How long would it take to feel a severe adverse reaction during reinstatement?

 

18 hours ago, ChessieCat said:


Please make sure that you carefully read all of Post #1 of this current topic.

 

 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • 1 year later...
On 4/8/2019 at 11:58 PM, Lloyd said:

This chart is super helpful. What does “rapid improvement” mean? Days, weeks?

2002-2021: 19 yrs on/off psychotropics

2/2022: Wellbutrin 150mg, Lexapro 20mg  3/22: Wellbutrin 150mg xl, Lexapro 10mg    4/22: Wellbutrin 150xl, Lexapro 5mg 

4/2022: Lexa 7.5mg total, Wellbutrin 150mg    5/2022: Wellb 112.5mg xl, Lexa 7.5mg (Stopped Clonazepam & Hydroxyzine- didn't take often)

6/2022: Welbutrin 111mg xl, Lexa 6.8mg          8/2022: Wellbutrin 100mg xl, Lexa 6.8mg            10/9/22: Wellbutrin 100 mg IR, Lexa 6.5 mg

11/3/22: Wellbutrin 96 mg IR, Lexa 6.5 mg       11/30/22: Wellbutrin 96 mg IR, Lexa 6 mg

3/15/23: Wellbutrin 96 mg IR, Lexa 6.2 mg???

Other Daily Meds: Singulair 10mg, Zyrtec 10mg, Spiriva Respimat inhaler.  Rarely taking: OTC pain relievers, Diclofenac, Cyclobenzaprine, anti acids

SupplementsFish oil 1300mg, Nigella oil, Mag Glycinate 200mg, Probiotics 30 billion, 1/5 dose prenatals, Melatonin .38mg, (Reishi, Lion's Mane & psilocybin microdosing by cycles)

 

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  • 1 month later...

I was on 80mg of fluoxetine for roughly 9 years of my life. (I wasn’t on 80 mg the whole time but that’s what I ended up on in the end). A couple months ago I reinstated 1 mg but am still struggling so so bad with insomnia. should I reinstate more. my only long-term withdrawal symptom has been insomnia for which I’m thankful for, but it’s been very very hard and has been so bad recently! 

fluoxetine since 13 (2012) with a break at some. point in there. 

When I came off I was on 80 mg. I cut out one dose a week.

Last dose taken on 1/25/23

Reinstated 1 milligram April 24th, 2023

Dropped to 0.9 around 5/09/24

Dropped to 0.83 on 6/17/24

I have tried all sorts of supplements… innate response formulas adrenal response, neurolink, pro eze, valerian, integrative therapeutics pro-som.

Currently taking fish oil, beef organ capsules, super food, probiotic, varies tinctures, magnesium, melatonin time release (3 mg),

 

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Hi Elaine, I reinstated 0.5mg a few months after fast tapering from 20 of Viorexetine so based on that math, you might consider going up as much as 2mg and stabilizing there? I waited six months before starting a very slow taper back to zero. Glad to hear your symptoms are limited to insomnia. I wish mine had been! Time to catch up on lots of old movies in the middle of the night!

My Introduction thread

2002-2003 Celexa/Lexapro (first ride, very mild withdrawal). 2004-2012 Drug free
2013-2018 Cymbalta 60mg | 2019 Effexor 75mg - 150mg (can't recall specifics)
2020-Apr 2021 Trintellix 20mg | May-Jun 10mg | Jul-Aug 5mg (stopped Aug 12th, 2021)

WD symptoms began 4-6 weeks after last dose, increased severely at the 4 month mark
2021 Oct 9th Propranolol 10mg 2x/day (10am and 7pm) tapered to 5mg. Stopped 2/1/22.
Lorazepam (Ativan) 0.5-1mg as needed

Started a 0.5mg Trintellix reinstatement on 12/17/21 

Tapered to ~0.4mg and 0.3mg by end of May 2022

Stopped Caffeine 1/1/2022 and Nicotine on 4/1/2022.

Jan 19, 2022 - Added Vitamin D3 (2000iu), Super Omega-3 (2500mg) 

December 2022 - Finished taper of reinstatement dose around 0.03mg

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  • 2 months later...

I am going to start tapering soon. I am just wondering when is it a good idea to reinstate? When symptoms seem too much to handle? 

2017-2021 zoloft 100mg
2021 january fast taper to 0mg
2021 feb 25 mg effexor for 1 week, then stopped due to side effects
2021 march lexapro 10 mg
2021 april lexapro 20 mg + 2.5mg olanazapine
2021 june lexapro 20mg + 1.25mg olanazapine for 1 week (big mistake)
2021 july-september lexapro 30mg + 2.5mg olanzapine
2021 September (after 2 weeks) 25 mg + 2.5mg olanzapine
2021 September (after 2 weeks) 20mg + 2.5mg olanzapine

 

2023 September 20mg lexapro + 2.5mg olanzapine (want to taper olanzapine due to tiredness side effect)

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  • 3 weeks later...

Hi,

 

I recently reinstated a very tiny dose of Cymbalta to cope with what I believe are withdrawal symptoms (see signature). 


Can anyone tell if if may be a good idea or if you can share any reccomendation? Today I am seeing my GP to discuss about this, I am curious to see whether she will advise me a gastroenterology check and / or a psychiatrist evaluation (again) - in which case, I would directly go again to my "old" one, since she knows my AD history (except my last taper).

 

I just highlight that I did not reinstate because of lack of motivation or depression. From a purely mental point of view I have been feeling psychologically stable and, overall, happy.

I decided to reinstate it due to the unbearable physical pain in my digestive system (gastric acid reflux, bloating, facial flushing, irritated bowels, very slow gastric emptying) and fatigue as a consequence.

It's like my body "got stuck" in fight or flight mode, even when I tried to relax and there was objectively nothing to worry about. 

 

The small reinstatement made this a bit better (started 5 days ago) and I am able to digest better. Everything is still slow, but a bit less worse and I can cope with it. As side measures, I have reduced coffee to the minimum (a tiny one in the morning), light meals and drinking lots of water during the day (which I was not really doing before).

2004-2006 Fluoxetine 20 mg. Tapered and got off successfully.

2008 - November 2021 Cymbalta 60 mg

November 2021 - January 2022 cold turkey

Feb 2022 reinstated Cymbalta, 10 mg to cope with withdrawal. Managed to readapt and stabilize well after 3-4 weeks. 

Apr 2022 - August 2023 - Tapered 10 % every 2 weeks, no particular symptoms. In the meantime, I went running 3 times a week and used magnesium supplements.

August 2023 - November 2023 - meds free. No symptoms.

November 2023 - Mentally ok, no depression whatsoever, but lots of fatigue with bowel irritation, pain, constipation, difficulty to rest properly. Possibly (but not only necessarily) triggered by an extremely stressful time at work + home. Reinstated 2 mg to alleviate symptoms, more or less working.

 

 

 

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@getofflex mentioned in a post that if you are experiencing negative symptoms 5-6 hours after taking your med, it is likely that you are having an adverse reaction to it. I am just curious if there is more information or resources about this phenomenon that I can consult? 
 

I take my Effexor at 9 and like clockwork 5-6 hours later my emotional lability is much worse and I usually experience crying spells, worsened mood, rumination, etc.

- Sept 2021-Nov 2021- lamotrigine 

-Dec. 2021 -April 2022- 300 lithium(both for misdiagnosis of bipolar ii reacted badly to lithium) 

-Trintellix July 2022-Oct.30 2022 (bad reaction made me nauseated, etc)

-vyvanse Sept.2022- present. Was on 20mg until this spring/summer was put on 40mg, now on 30mg 

-escitalopram 20mg mid Feb 2023-March (akathisia) 
-duloxetine up to 60mg I believe for about a month in March 2023  

-March- Early May 2023: quetiapine 25mg x 2 daily (morning & evening) ( no perceivable benefit, urinary retention) 

-Intuniv 1mg April 2023-present 

-April 2023-present: clonazepam 0.5 x2 daily (morning and evening)  

-April 15: Effexor got up to 187.5 by May, started discontinuation Jun. 6, doctor wanted to do weekly, changed to every other week until 37.5 where I’ve been stuck now with severe withdrawal for 53 days (since July 21st); Sept. 15 inc. to 75mg Effexor.

-supplements: vitamin D 2000iu; magnesium 200mg x 2 morning and evening; omega-3 (450mg DHA 70 mg DPA); probiotic (HMF intensive) every other day. 

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The thing to do is to do a daily journal. In the left-hand column write the time o’clock, do this for 24 hours. In the right hand column write basic things like when you go to bed when you sleep when you eat when you take your drugs, what your symptoms are and what time those happen.that’s how to determine the symptom pattern and see if you’re having an adverse reaction. Post your notes in this thread and we can help you see what’s going on.  Here is an example: 

 

post an entry in here for each 24 hour period.   

 

January 31, 2023

6 AM woke with anxiety

8 am took 2.5 mg lexapro

10 am stomach is upset

10:30 am ate breakfast

11:35 am got a headache, lasted one hour

12:35 ate lunch

4 pm feel a bit better

5 pm took 2.5 mg lexapro

6 pm ate dinner

9:20 pm headache 

10:00 pm took 50 mg Seroquel

10:30 pm feeling dizzy

10:30 pm fell asleep 

2:30 am woke, took 3 mg Ambien

2:45 am fell asleep

4:30 am woke, but got back to sleep 

Edited by getofflex

Please do not private message me.  Only tag me for urgent questions about tapering and reinstating - thank you.  

 

***Please note this is not medical advice.  Discuss any decisions about your medical care with a doctor who understands psych meds and how to withdraw from them, if you can find one.

 

Lexapro   Started Apr 15 2010 - 10 mg;  started taper August 2017, recent taper info: Apr 2 '20  0.18 mg; Jul 16  0.17 mg, Aug 23  0.16 mg, Oct 7  0.15 mg, Nov 8 - 0.14, Jan 16 '21 - 0.13, Feb 7 - 0.12, Feb 22 - 0.11, Mar 26 - 0.10, May 21 - 0.09, June 15 - 0.08 Aug 16 - 0.07, Oct 6 - 0.06, Nov 21 0.05, Dec. 17 0.04, Jan 14 '22 0.03, Feb 19 0.02, Apr 18 0.01, May 15 0.005,  Jul 8, 0.00.  Psych Drug Free as of July 8, 2022!!  Woohoo!!!

other meds: Levothyroxine 75 mg

magnesium in small amounts at 4 AM, before bed

suppl AM: fish oil, flax oil, vit C, vit E, multivitamin, zinc

suppl 8 PM: magnesium 350 mg, extended release vitamin C, melatonin 2 mg

 

Paxil 2002 - 2010, switched to Lexapro 2010 

Trazodone 50 mg. 2002 - 2019, fast tapered in 2019 

Xanax 0.5 mg as needed 2002 - 2019, up to 3x weekly 

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  • 4 weeks later...

I kept looking around this site, but couldn't find anything. When do we take into consideration reinstatement? Are we supposed to be okay with little WD symptoms? Should this only be done when WD symptoms are more serious? Thanks

Feb 21 50mg Zoloft - 1mg Rispridone - 200mg Depakine; Mar 21 CT; Aug 21 5mg Olanzapine, 50mg Zoloft, 1 mg Ativan*; Mar 22 Zoloft some days*; Aug 22 Paroxetine 10mg; Jan 23 CT; Mar 23 25mg Zoloft; Apr 23 Tianeptine & Trazadone; Jun 23 Mirtazapine; Jul 23 Trintellix 10mg; Aug 23 5mg trintellix, 300mg gabapentine. Dec 23: 4.5 mg trintellix liquid, 300mg gabapentine; 13 Dec 23: 5mg trintellix, 300mg gabap; 17 Jan 24: ↘️ 4.5 mg Trintellix, 300 mg gaba, 17 Feb ↘️ 4.05 mg Trintellix, 300mg gabap,  17 Mar ↘️ 3.65 mg Trintellix, 300mg gabap, 15 Apr ↘️ 3.28 mg Trintellix, 300mg gabap

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  • 3 weeks later...

Hi all, I have been off amitriptyline for about 3 and half - 4 weeks now and the withdrawal symptoms are awful. Am I still in the window where I could reinstate a lower dose? If so, what should that be? (I was originally taking 20mg a night for insomnia for 3-4 months). 
 

Every day is a living hell and I don’t know what to do for the best. I have so much pain, nausea, GI symptoms, hot/cold flashes, wheezing and anxiety as well as prickly skin in my cheeks, itching and new food intolerances (I’m guessing from the sudden rush of histamine in my system). Is there a risk that I reintroduce and the symptoms don’t go away? I’m terrified to be honest and, as I already have awful health anxiety, am convinced I have something irreparable wrong with me. Any help you can give me would be greatly appreciated. Many thanks in advance. 

January 2023: 1.25mg Ramipril, upped to 5mg, for high blood pressure. 
August 2023: Amitriptyline 20mg per night for insomnia; GP told me I could stop taking at any time. 

December 2023: Stopped taking amitriptyline without taper per GP’s advice.

December 2023 - now: horrible, scary symptoms, possibly withdrawal? 

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Hi! I am looking for some guidance on a reinstated dosage for Trintellix. Its now day 10 of discontinued use after a fast taper. I need to get back on something asap because the withdrawal is really uncomfortable but not sure what dosage. Trintellix only comes in 5,10,15,20 tablets. 

What do you think if I crush up the 5mg tablets and take half so 2.5 daily starting today and see how I feel? and assess from there?

 

Thank you!! 

2017-2018 - Ciprelex (highest dosage)

2018 - 2023 - Trintellix (Vortioxetine) - 20mg

11/25/2023 - 15mg

12/09/2023 - 10mg

12/23/2023 - 5mg

12/30/2023 - 5mg every other day

01/03/2024 - 0mg - discontinued

01/12/2023 - 2.5mg reinstated daily dosage

 

 

 

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3 minutes ago, Greenowala said:

Hi! I am looking for some guidance on a reinstated dosage for Trintellix. Its now day 10 of discontinued use after a fast taper. I need to get back on something asap because the withdrawal is really uncomfortable but not sure what dosage. Trintellix only comes in 5,10,15,20 tablets. 

What do you think if I crush up the 5mg tablets and take half so 2.5 daily starting today and see how I feel? and assess from there?

 

I had done a 3 month taper of Trintellix from 20 to 10 to 5 in 2021 and ended up having problems after 6 weeks fully off (I guess small things earlier on that I ignored). Then waited another month before deciding to reinstate at 0.5mg. Yes 1/10th. And I was worried I had waited too long. You can read the details in my intro thread, but even that tiny amount helped. I wanted to be on as little an amount as possible so the slow taper in the end was easier. I spent roughly 6 months on 0.5mg then another 6 tapering until I could no longer measure the right amounts. It took me a few weeks to get the equipment I needed and do the right calculations (and vet them on this forum). With the jewelers scale most people here use, I crushed a 5mg trintellix pill and ended up weighing out 0.015 (15mg) of crushed powder which I believe contained 0.5mg of the drug itself. You are never really sure with the powder and fillers. I made these little pills for a year and kept lowering the weight until I stopped around 0.003 as it seemed like a rounding error.

 

I will say in the first month after reinstatement I really questioned if I should have reinstated a higher dose, but I calculated the slow taper from 2-3mg to take over two years. So I reinstated and suffered mildly another two months. Christmas 2021 sucked. I think the reinstate helped but there is no way to avoid some uncomfortable sensations and dark thoughts in my opinion. All the advice on here about supplements to take and foods to eat are probably helpful, even if you just believe it is. I found myself eating way more avocado because I was convinced it helped. 

 

So to answer your question, if you are able to crush and calculate and weigh and fill your own pills, I might suggest 1mg? The small amounts reallly do work according to the majority of respondents. That is my memory at least. But worst case you could split the pill in half and go 2.5mg. The important part is to pick an amouint and stick to it a while and let yourself stabilize. Don't start tapering again immediately.

 

Hope that helps.

My Introduction thread

2002-2003 Celexa/Lexapro (first ride, very mild withdrawal). 2004-2012 Drug free
2013-2018 Cymbalta 60mg | 2019 Effexor 75mg - 150mg (can't recall specifics)
2020-Apr 2021 Trintellix 20mg | May-Jun 10mg | Jul-Aug 5mg (stopped Aug 12th, 2021)

WD symptoms began 4-6 weeks after last dose, increased severely at the 4 month mark
2021 Oct 9th Propranolol 10mg 2x/day (10am and 7pm) tapered to 5mg. Stopped 2/1/22.
Lorazepam (Ativan) 0.5-1mg as needed

Started a 0.5mg Trintellix reinstatement on 12/17/21 

Tapered to ~0.4mg and 0.3mg by end of May 2022

Stopped Caffeine 1/1/2022 and Nicotine on 4/1/2022.

Jan 19, 2022 - Added Vitamin D3 (2000iu), Super Omega-3 (2500mg) 

December 2022 - Finished taper of reinstatement dose around 0.03mg

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@YachtRockThank you so much for your msg! This is extremely helpful. I realize I tapered really fast - 6 week taper after 6 years of being on 20mg. 

You recommended 1mg to start - do you think that might be too low of a reinstated dosage, given how uncomfortable I feel? or do you still recommend starting with 1mg and assessing higher from there?

How did you make the pills? 

 

Thank you!!!

2017-2018 - Ciprelex (highest dosage)

2018 - 2023 - Trintellix (Vortioxetine) - 20mg

11/25/2023 - 15mg

12/09/2023 - 10mg

12/23/2023 - 5mg

12/30/2023 - 5mg every other day

01/03/2024 - 0mg - discontinued

01/12/2023 - 2.5mg reinstated daily dosage

 

 

 

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4 minutes ago, Greenowala said:

@YachtRockThank you so much for your msg! This is extremely helpful. I realize I tapered really fast - 6 week taper after 6 years of being on 20mg. 

You recommended 1mg to start - do you think that might be too low of a reinstated dosage, given how uncomfortable I feel? or do you still recommend starting with 1mg and assessing higher from there?

How did you make the pills? 

 

Unfortunately there is no way to know what the "right" amount to reinstate is. It seems to me the range is between 5% and 25% of the dose you took the longest. I am using the wisdom shared in the first post of this discussion:

 

Quote
  • Often a very low dose will relieve withdrawal symptoms. We have seen that often reinstating a very low dose of the drug -- such as 1mg fluoxetine or 1mg escitalopram for someone having gone off 20mg -- is enough to reduce withdrawal symptoms and allow the nervous system to gradually settle down. Sometimes it takes a higher dose to address withdrawal symptoms, but going up in dose gradually reduces the risk of kindling from a sudden introduction of a higher dose. If, for example, you were taking 20mg Paxil and quit rapidly or cold-turkeyed only a few days ago, a reinstatement of 5mg may be enough. After trying the lower dose for a week, you can always increase if you feel you need more. If you've been off the drug longer, your nervous system may be sensitized and it may be wiser to try a sample dose, such as 0.5mg-1mg to start, to see how you react.

 

I used a little device that is part of a soda keg and placed half of an empty pill container inside it, tared the scale to zero then filled it carefully to hit the amount of "powder" I needed. It is critical to understand the difference between the weight of the pill and the amount of the drug in the powder. A 5mg Trintellix pill weighed 153mg for me when crushed so I estimated the drug to be roughly 1/30th of the crushed powder. You can read my more on my post here

 

This is the "holder" I put the empty pill into on the scale: https://www.amazon.com/Assemble-Corrosion-Resistant-Accessories-Stainless/dp/B0B2WWT92Y

 

Here is a photo of the setup: https://imgur.com/a/Jby0oKQ

 

You can place one half of an empty "Size 0 (zero)" capsule into the end of that post and weigh it out that way. Here are the empty capsules I used https://www.amazon.com/gp/product/B00PYUZ5UQ

 

My Introduction thread

2002-2003 Celexa/Lexapro (first ride, very mild withdrawal). 2004-2012 Drug free
2013-2018 Cymbalta 60mg | 2019 Effexor 75mg - 150mg (can't recall specifics)
2020-Apr 2021 Trintellix 20mg | May-Jun 10mg | Jul-Aug 5mg (stopped Aug 12th, 2021)

WD symptoms began 4-6 weeks after last dose, increased severely at the 4 month mark
2021 Oct 9th Propranolol 10mg 2x/day (10am and 7pm) tapered to 5mg. Stopped 2/1/22.
Lorazepam (Ativan) 0.5-1mg as needed

Started a 0.5mg Trintellix reinstatement on 12/17/21 

Tapered to ~0.4mg and 0.3mg by end of May 2022

Stopped Caffeine 1/1/2022 and Nicotine on 4/1/2022.

Jan 19, 2022 - Added Vitamin D3 (2000iu), Super Omega-3 (2500mg) 

December 2022 - Finished taper of reinstatement dose around 0.03mg

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@YachtRock You are a SAVIOUR! I cant express my thanks enough!!! 

Given that this is a bit time sensitive and I Cant get all these supplies in place for prob a few days.

Do you think its ok if I crush up a 5mg pill, divide it up into 5 equal portions and place those portions in a glass of water and digest the medication that way? 

 

Thank you! 

2017-2018 - Ciprelex (highest dosage)

2018 - 2023 - Trintellix (Vortioxetine) - 20mg

11/25/2023 - 15mg

12/09/2023 - 10mg

12/23/2023 - 5mg

12/30/2023 - 5mg every other day

01/03/2024 - 0mg - discontinued

01/12/2023 - 2.5mg reinstated daily dosage

 

 

 

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2 minutes ago, Greenowala said:

@YachtRock You are a SAVIOUR! I cant express my thanks enough!!! 

Given that this is a bit time sensitive and I Cant get all these supplies in place for prob a few days.

Do you think its ok if I crush up a 5mg pill, divide it up into 5 equal portions and place those portions in a glass of water and digest the medication that way? 

 

No problem. I don't see any harm in that approach. To make sure I was not missing any powder I might put the powder in my mouth and wash it down with water, since it won't dissolve. You risk leaving some behind?

 

Keep in mind you may not see a difference for a few days or even a week. The 72 hour half-life of Trintellix takes a while to build up. The key is to keep taking that 1mg for a few weeks and let your system even out.

 

I hope others in the community can offer additional thoughts and opinions. I am not regularly on this forum anymore, just happened to notice a post about Trintellix. Good luck, you will get through it. Read everything you can and do a properly slow taper once you are a few months past the withdrawal.

 

My Introduction thread

2002-2003 Celexa/Lexapro (first ride, very mild withdrawal). 2004-2012 Drug free
2013-2018 Cymbalta 60mg | 2019 Effexor 75mg - 150mg (can't recall specifics)
2020-Apr 2021 Trintellix 20mg | May-Jun 10mg | Jul-Aug 5mg (stopped Aug 12th, 2021)

WD symptoms began 4-6 weeks after last dose, increased severely at the 4 month mark
2021 Oct 9th Propranolol 10mg 2x/day (10am and 7pm) tapered to 5mg. Stopped 2/1/22.
Lorazepam (Ativan) 0.5-1mg as needed

Started a 0.5mg Trintellix reinstatement on 12/17/21 

Tapered to ~0.4mg and 0.3mg by end of May 2022

Stopped Caffeine 1/1/2022 and Nicotine on 4/1/2022.

Jan 19, 2022 - Added Vitamin D3 (2000iu), Super Omega-3 (2500mg) 

December 2022 - Finished taper of reinstatement dose around 0.03mg

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