music321: arresting withdrawal by reinstating medication

[music321]

i am experiencing horrific symptoms as a result of a rapid withdrawal from 30mg prozac. it is my understanding that symptoms that have begun during withdrawal can remain with us for ever. it is also my understanding that the acute withdrawal phase can last for 2 months (give or take). In my situation, while in withdrawal, i reinstated prozac (under MDs guidance; 20 mg). She said that normalization should occur in about 2 weeks (and it's been two weeks). however, after this period of time, little has changed. another doctor said that it likely would take the amount of time that is normally required for prozac to reach a therapeutic dose for me to fully arrest withdrawal (about 6 weeks). emotional lability as a result of withdrawal has ended (with regard to being "depressed"). i still have other symptomes (buring pain, waking at 3:00 am, impotence, etc). my gut feeling is that i've probably arrested acute withdrawal, and that my symptoms are going to be a little more lasting. has anyone else experienced arresting withdrawal who can offer some feedback on this? thanks.

Edited October 3, 2016 by scallywag
tags added

[dalsaan]

Hi music

 

It's hard to tell everyone is different You may need to increase your dose up a bit more and that could resolve or your may still be left with some withdrawal that could take some time to heal

 

We generally recommend reductions of 10 percent. So considering your original dose was 30. 10 percent would take you down to 27mg. That's why I say 20 might. Not be enough, particularly if you have been on Prozac for a long time. Can you give us some details about your medication history

[music321]

i was on 30mg for about 2 yrs. In june, i forgot to take my meds on a regular basis. i've been under extreme stress the past few months. i intended to resume, and had decided to take 10 mg for a few days, then 20, then back to 30. after a few attempts, I would forget. on one occasion, i took 30 (about a month ago). during the summer, more often than not, i took nothing. everything was fine. i didn't think this was a big deal. about a month ago, i started to go into withdrawal. i didn't realize what was happening until it was too late. libido started to go 20 days ago. it was completely gone and impotence was complete by 15 days ago. as i mentioned, i have burning pain all over (mainly in face), the aforementioned sexual problems, restlessness, extreme anxiety, fuzzy thinking. i think i really damaged my brain badly.

 

i have read horror stories about people that, at best, have partial recovery of sexuality years later. many never get it back.

Has anyone lost sexuality during withdrawal, and regained it shortly thereafter?

 

can anyone offer any hope? i've read so many dreadful things about what i'm going through. i had no idea that i was risking such damage to my brain. Thanks.

[strawberry17]

I have a fair bit of experience with Prozac, I've been tapering off it a long time. People think Prozac is more benign and harmless because of it's long washout time but that's not my experience and I know others who've suffered with coming off Prozac too fast.

 

I think as you know you've messed about with the dose a lot, different doses, sometimes taking it sometimes not and I'm sure this has caused your current problems, I think Dalsaan is right, you do need to stabilize yourself over as long a time as it takes to feel well, and maybe you do need to up your dose to do this. I always ended up reinstating the full dose. When you think about it 30mg to 20mg is a 33% cut in what your body is used to when as Dalsaan says we normally recommend no more than 10%.

 

I did some terrible withdrawals more than once years ago, cold turkeys that kind of thing (before I found out what I should have been doing) and made myself really really ill, but I have come out the other side, but it has taken a lot of time and patience and discipline to stick to a slow taper. So yes there is hope you can get over this and get better.

 

With regard to libido, I used to lose it totally while on the drug, then it would come back when I came off and it did come back quite soon into my taper as well, guess I was quite lucky on that front, it's quite a difficult thing for people to talk about so it might be hard to get answers from others on that one.

[strawberry17]

Forgot to say, if you can try and get hold of liquid Prozac it will be so much easier for you to control the dose accurately.

[Altostrata]

music, it's a good sign, at least, that the emotional lability has abated.

Here is what is known about reinstatement, from my reading and from patient experience as posted on online support sites:

• According to medical knowledge, reinstatement is the only way to alleviate withdrawal symptoms.
• Reinstatement is best done immediately upon appearance of symptoms. The more time that passes, the less likely it is to work.
• The length of this window of opportunity varies according to the individual. Sometimes people can reinstate successfully months after quitting.
• After reinstatement, the amount of time needed to alleviate withdrawal symptoms varies according to the individual. Relief can be felt immediately, after some weeks, or after some months.
• The dose needed for effective reinstatement varies according to the individual.
• Sometimes reinstatement does not work. The nervous system has taken such a hard hit from withdrawal, it's destabilized beyond whatever effect the drug might have had.
• Sometimes reinstatement not only does not work, it causes an adverse reaction from a nervous system sensitized by withdrawal.

Medicine wants to believe the acute phase of withdrawal lasts only a few weeks. From what people have posted on the Web, it can last many months.

You cannot go off medication assuming that reinstatement is a safety net. This is one of the reasons we advocate gradual tapering to minimize withdrawal symptoms. Once the nervous system is destabilized by withdrawal, all bets are off.

[music321]

I'm seeing my psychiatrist again in 2 weeks. she's willing to adjust dosages as i'd like. we both agreed that in the interm (from 2 weeks ago until 2 weeks from now) i should stay on the 20mg. going to 30mg would not be my preference, as i'd eventually like to get off this stuff. however, the health of my nervous system is of primary importance.

 

my gut feeling is that i should remain on 20mg for at least 6 months after i start to feel normal, then taper down. however, there is something to be said for going to 30. thoughts? thanks.

[dalsaan]

You could go a mid way point and try 25 now. I know it feels like a backward step to take more and perhaps reinstate to original dose but if it allows you to

stabalize and then do it the right way, believe me you will be way out in front.

[music321]

25mg. hmm... my prozac-withdrawal addled brain wouldn't have thought of that. thanks.

[music321]

i'm getting burning pain and loss of libido during withdrawal. my understanding is that these are very unusual symptoms. does/did anyone else have these problems during withdrawal?

[strawberry17]

What Dalsaan said. It's not a backward step really, it feels like it but you're going back to enable you to go forwards in the future.

[Rhiannon]

I'm no expert on AD withdrawal, so don't give my advice too much weight, but I think if you're willing to ride out the withdrawal for a long time and hold for a long time (and it sounds like you are, from what you say) it might not be the worst plan ever to hang with the 20 mg for as long as it takes to stabilize. Although I also think 25 sounds like a good option. That way you'll feel like at least it's a partial "win" and I find that the psychological self-encouraging aspect of tapering is important, for me.

 

You might not need to wait a full six months after stabilizing to begin a taper. If you're really stable you could probably begin a safe, slow taper sooner than that.

 

Also want to add that taking meds and skipping meds and taking them again and going up and down on doses is just as destabilizing as cold turkey quitting them. (I speak from sad experience of doing that for many years with my AD, thinking it was better than taking the full dose. I was miserable and suicidal much of that time.) So it's possible a lot of what you're getting right now is the aftermath of all that bouncing around as much as it is of the cut from 30 to 20.

 

You seem to understand that time is the only healer when it comes to a chemically destabilized CNS. Don't worry that your withdrawal isn't fitting the doctor's idea of how it should look. It sounds pretty normal to me given the history you've described.

[Jemima]

i'm getting burning pain and loss of libido during withdrawal. my understanding is that these are very unusual symptoms. does/did anyone else have these problems during withdrawal?

 

music321,

 

I've moved some of your posts here to the 'Introductions and updates' section after noticing that you didn't have an introductory post. This will help you and other forum members track your history and progress, somewhat like a journal. When you want to add a comment or question, just click on the Add Reply button at the bottom of the page.

 

Here's a topic on the burning sensation from the 'Symptoms and what helps' section:

 

http://survivingantidepressants.org/index.php?/topic/2154-burning-skin-important-question/

 

It takes some digging, but often you can find a lot of information in that section on what seems to be an obscure symptom. As for sexual dysfunction, I think that's a fairly common side effect of antidepressants and the subsequent withdrawal. As a woman in her middle sixties it isn't a big concern of mine, but I hope some younger members will jump in and share their experiences.

[music321]

I stopped taking prozac (30mg/day) cold turkey and felt fine until 3 months later, when I experienced horrific withdrawal side effects. At this point, I was reinstated at 20mg/day to arrest withdrawal. This worked to some degree, but I'm still experiencing post acute withdrawal. It has been 6 months since I reinstated (so, 9 months since I stopped originally). I would like the symptoms to end. I don't know if, at this point, I should consider taking more (bringing myself closer to the original 30mg/day), stay where I am, or start slowly tapering. The psychiatrist's input on this is next to worthless. Suggestions, please?

[strawberry17]

Hi music321 I merged you post in tapering with your original topic so people can see the whole story when responding. I am tapering Prozac, I wish I knew what to suggest for you, it's been 6 months at the same dose and still feeling rough. I'm hoping Alto might see this and have a suggestion, it's so hard to know what to do for the best isn't it?

[Altostrata]

What are your current symptoms, music321?

[music321]

Here's an update.  To recap:  In 2010, I developed problems related to Lyrica.  These went away to some degree by the time I stopped taking prozac in June of '12.  Things were fine until september of '12, when withdrawal hit me hard.  After a couple of weeks, I reinstated at 20 mg, which prevented things from getting worse, but didn't improve things.  

 

I have regained sexual desire, to pre-withdrawal levels, but this has come in waves in the past, so I don't know if it's here to stay. But, this level is still far lower than pre-prozac levels, and is "good enough" if it remains at this level.  This was accomplished by taking 2 capsules of "nordic naturals" fish oil every day.  In about 10 days, sexual function returned (a few weeks ago).   I am on 20 mg Prozac, soon to go to 19mg (packaged by a compounding pharmacist).  I can't take melatonin without problems.  Early on, I couldn't exercise without problems, but I forced myself to push through.  Now, exercise has a temporary calming affect, and problems aren't made worse by it.

 

I have occasional difficulty thinking, but it's not nearly as bad as it was.  I also have anxiety, but this is due somewhat to life circumstances.  A huge problem is face pain.  Well, not the pain itself, but what it represents.  I'm forcing myself not to attempt some difficult life-goals, since I know the stress will be too much.  And my life just slips by...

 

I can't stress how great the fish oil is.  I use the brand that I do since they remove mercury.  

 

I saw a neurologist early on who was of little help.  I have an appointment with a GP on wed. to recommend a neurologist.  The neurologist obviously can't fix things, my brain has to fix itself.  I am going for two reasons:  to gain insight into my problem (how do others in our position fare over time?), and to get dietary/supplement advice.  I don't want to play a guessing game at this point.

 

Good luck to everyone.  As a reminder, I hope to continue to update this until I am recovered, so as to give others hope.  My greatest hope rests on the thought that once my life becomes more manageable, I'll have less stress, which will lead to complete healing.

[Altostrata]

Thanks for checking in, music.

 

Have you tried taking even more fish oil? Often it takes 6 capsules a day to reach 3000mg EPA + DHA, the omega-3s in fish oil.

[music321]

It had not even occurred to take higher doses of fish oil.  Thanks for the suggestion.

[music321]

I suffered many symptoms that lasted for months as a result of a rapid withdrawal from 30mg prozac last summer.   I reinstated at a lower dose (20 mg) to arrest the withdrawal.  It was too little too late.  I normalized (pretty much) about 2 months ago with the help of omega-3 supplements.

 

Four weeks ago, I went from 20 mg to 19 (as packaged by a compounding pharmacist).  I started having body-wide burning pain yesterday morning.  I'm thinking of going back to 20 mg.  On the other hand, I might try to ride this out over a few weeks, but don't want to damage myself again.

 

I've heard of others experiencing withdrawal for a few weeks, and then normalizing when doing tapers.

 

Does anyone have any insight?  thanks.

[Altostrata]

This indicates the 1mg decrease was too much. I would go back up to 19.5mg and stay there for a couple of months.

 

Please put further updates and questions in your Intro topic.

[music321]

thanks.

 

I agree, that remaining on 19 was not the way to go.  I wanted to go onto 19.5.  My psych told me that it was impossible that any of my withdrawal symptoms were caused by going from 20 to 19 mg.  She agreed to let me go back to 20, but would not hear of 19.5, as she thought the idea was ridiculous.

 

I have had very poor luck with all three psychiatrists that I've seen over the course of my multi-year treatment.  Frankly, I don't know what to do.  I'm trying to get an appointment with a locally respected neurologist, and I'll go from there.

[Rhiannon]

Hi Music, I merged these posts into your Intro topic and hopefully now it has been bumped up so you can see it.

[music321]

Well, here's an update.  My condition as mentioned earlier held steady until I dropped from 20mg to 19 (as put together by a compounding pharmacist).  At 19mg, I started to feel withdrawal, so I went back to 20mg.  The withdrawal hasn't gotten better over about the past 6 months.  As a confounding factor, I have been under an extreme amount of stress the past few years.  My psychiatrist said that it is "impossible" that I should experience withdrawal as a result of dropping by 1 mg.  A neurologist believed that the drop caused the problem, but didn't have any answers.  He recommended that I find a psychiatrist with special knowledge in such areas.

 

 

So, any suggestions?  And recommendations of a psychiatrist in the NY area?  thanks. 

[Altostrata]

I hope one of these is nearby http://survivingantidepressants.org/index.php?/topic/988-recommended-doctors-therapists-or-clinics/

 

It's very hard to find a doctor who understands anything about withdrawal and its effect on your nervous system. Your neurologist is a rare gem.

[music321]

well, I wouldn't go so far as to say he's a "rare gem".  He wasn't able to offer me any sort of help.  He did say that it is possible to do an EEG, but said it would likely not show anything.  Has anyone here had an EEG related to these issues?

[mammaP]

I'm sorry you are still struggling, sometimes it seems to go on forever. I wish there was something 

that could be done for withdrawal, time is the healer but sometimes it seems to stand still. 

I hope this wave comes to an end for you very soon and you get a nice long window. 

[Altostrata]

The neurologist was correct, again, in saying an EEG would not show anything for withdrawal syndrome. He is unusually well informed.

[music321]

At this point I'm considering decreasing my dosage by 1mg a month until I'm off in two years.  I'm sure that by doing so, I'll experience quite a bit of discomfort, but I'd like to have the opportunity to eventually go to grad school.  With every year that passes, the window gets smaller.  I'm sure that most of you will all say that this is horrible, but I wonder if any of you have simply pushed through some withdrawal for the sake of getting off the meds.

[Altostrata]

You're taking 20mg Prozac with no change in symptoms?

[Petunia]

Hi Music,

I was about to write what Alto just wrote.

 

Here are the instructions for putting information in your signature:

 

http://survivingantidepressants.org/index.php?/topic/893-please-put-your-withdrawal-history-in-your-signature/

 

Petu.

[Rhiannon]

At this point I'm considering decreasing my dosage by 1mg a month until I'm off in two years.  I'm sure that by doing so, I'll experience quite a bit of discomfort, but I'd like to have the opportunity to eventually go to grad school.  With every year that passes, the window gets smaller.  I'm sure that most of you will all say that this is horrible, but I wonder if any of you have simply pushed through some withdrawal for the sake of getting off the meds.

How about trying a small cut, maybe 0.25 or so, and then holding there to see how tolerable the withdrawal is? "Pushing through" is not usually a good idea, but some people do have to taper in spite of symptoms. Usually even then they do better if they pace themselves, just to keep the symptoms as tolerable as possible.

 

If you make a small cut and after a couple of weeks or so you're not feeling significantly worse, you could then try another small cut. I'd suggest given your condition and your history not cutting more than 2% at once for now.

 

As far as planning to make monthly cuts, it's best not to tie yourself to a calendar plan at this point. Just start with a step or two and see how it goes and then adjust from there.

[music321]

I should have updated.  I was taking 20 mg, and then went to 19.  After about a month, my libido decreased to the point that it's almost non existent.  I reinstated at 20 a month later, and things have not improved.  This was back during the summer.  I've been stable at 20 since then.  If I take too much fish oil or (heaven forbid) a melatonin tablet, I experience a marked increase in burning facial pain.  

 

One factor that differentiates me from those that might recover well is having quite a bit of stress in my life.  I realize that stress, or lack thereof, is a factor in recovery.  I wonder, though, if it could be the MAJOR reason that I'm not recovering.  any thoughts?

[Altostrata]

Stress is a factor in intensifying withdrawal symptoms. Is there a way you can lessen the external stress?

[music321]

To the moderator:

 

Please email me if you combine this with another topic so I can find it.  I did a search of my user name, and nothing came up.  That's why I didn't combine this with a previous post.

 

I suffered a hard withdrawal in the summer of 2012.  I posted of a number of symptoms.  It doesn't make sense to recap here, I'll simply tell you where things are now.  I'm currently taking 20 mg prozac that I was reinstated on after a crash from 30 mg to zero.  I tried withdrawing to 19 15 months ago, but that brought back quite a few problems which are still with me.

 

I currently suffer from major sleep disturbances, profound sugar cravings, tinnitus, minor GI symptoms, tight painful muscles (which were an issue prior to the withdrawal) and most troublesome... anhedonia.

 

The anhedonia robs me of so much of life's value.  Music means nothing.  Sex means very little.  Hugging a loved one means nothing.  Yes, there is a higher "cerebral" appreciation for these things, but it's shallow.  It's if I can say to myself "yes, in theory I can see how this sunset would appear beautiful to someone".  

 

I've read recovery threads here and on paxilprogress.  It's disturbing that there are 29 threads dealing with recovery, and over 1,000 dealing with symptoms.  I understand the phenomenon of "responder bias".  Those that feel better are far less likely to come back and post.

 

What's disturbing is not that I feel that "everyone else will recover, but not me!  I'm cursed!"  No, what's disturbing is that it seems that no one really recovers.  The "success" stories are of people that say "well, four years out and I still suffer from X, Y, and Z.  I'm not in hell the way I was during the first six months, though".  I too feel that I'm not in the hell I was in during the first six months.  I'm still pretty seriously impaired, though.  I don't know of anyone that's made it past the point that I'm at now.  After all, isn't the founder of this site someone that started suffering over six years ago?

 

A doctor recommended a low dose of a tricyclic antidepressant.  No thanks...  I'm going back to a neurologist next week.  Maybe he can tell me something.  Maybe a brain scan can be done.  I don't know.

 

We really don't know the nature of our problems.  Receptors could have down-regulated.  Receptors could have been destroyed.  Neurons could have actually died.

 

Take care.

[cymbaltawithdrawal5600]

Hi music. Here is your intro topic: http://survivingantidepressants.org/index.php?/topic/3070-music321-arresting-withdrawal-by-reinstating-medication/. (A moderator will move these posts to your topic soon.) You can click on the link to get to it and then add it to your browser bookmarks. Putting your username followed by a space then survivingantidepressants.org into google will get you entries that you can click on, one of which will probably be your topic. If you could manage it, fill out your signature.

 

I hear what you are saying. There is this desert that we go through for long periods of time where symptoms are just horrid and seemingly never-ending. In your thread Alto suggested a drop of only .5 mg, did you try that since 1 mg seemed too much?

 

There are people who have recovered, some have told their stories here and elsewhere but very few. Those who have recovered don't seem to stick around to counsel the rest of us. That's just how it is. There is nothing medicine can do for us as for the most part our struggle is not understood. Perhaps if you read some more of the topics on the site you could fill in the gaps in your knowledge and regain some hope.

 

Maybe these links might help understand what might be going on, not 100% but close:

 

http://beyondmeds.com/2010/07/14/gabaglutamate/   and  http://beyondmeds.com/2010/05/24/gabaglutamate-system-benzos-lamictal/

 

It just takes so doggone much time for these things to clear up and it is he11 living in the mean time. I'm in that 3rd phase, and the changes are very minute but they are there. I actually have about 6-7 hours of the day when I am in great despair (about 10 am to 4 pm) and I am usually able to sleep most of the time between 10 pm to 6:30 am, when I am waked up by (cortisol, I presume) and the long day of distracting myself on the computer begins. My desparing hours are awful and I wouldn't wish them on my worst enemy.

 

I hope you can find something here that helps. I know it's not much.

 

One thing that is becoming more and more clear to me when reading entries on this site and others: some of us are absolutely compelled to repeat over and over how bad off we are and will never recover. I do it too, just not in posting but to myself and when talking to some people in my life. I've gotten it a little more under control but it is still there. I am coming to understand that it is a withdrawal symptom and cannot be controlled easily. It just has to go away by itself. I have found it impossible to change my apathy and anhedonia. It just won't budge. I cannot find any activity that I can do long enough that distracts me enough from being able to think and hear my thoughts going round and round in my head. Listening to those horrible thoughts is the source of my despair. It is an awful catch 22: can't do something I don't want to do.

 

I hope someone will give you some better support than I have done.