rickoshea Hi ... and help please

[rickoshea]

Hi everyone, this is my first post so an introduction .... I've been on Citalopram for about 10 or 12 years (not sure!) originally for stress (work related) combined with CFS/ME. It's been a very up and down journey but I've coped as best as possible with what life has thrown at me (and that has been a "lot").

 

Things had been good towards the end of last year and in the middle of October 2013 I decided to try and come off the Citalopram and to try and return to "me". I have only ever taken 10mg and had some terrible experiences of changing brands of generic so have been taking liquid Seropram for about a year at the equivalent 10mg amount.

 

So, mid October I reduced this to roughly 8mg and got hit by w/d symptoms - mainly the expected dizziness, vertigo, stressed feeling and GI problems (I'll not be too graphic!). These I overcame and I actually felt pretty good up until the 17th of December (I think I had lowered the dose a tiny amount again but didn't keep a note of it which was stupid) when I had to raise my dose to 0.2mls (about 10mg) as I just couldn't cope with the sudden anxiety/depression that set in.

 

My work means I simply have to function and concentrate (for my sins I'm a dentist lol) plus I had a lot going on over Christmas that I had to be able to cope with.This worked pretty quickly. I reduced again to about 8mg at the start of January and all was fine for a couple of weeks so I reduced again to about 0.15mls (about 6.4mg) and endured some more GI problems and pain plus feeling freezing cold nearly all the time (especially my feet - lovely!).

 

I stayed at this dose, Then, 2 weeks ago,it was like someone flicking a switch at 10am in the morning and I became very irritable, short tempered and after a few days the anxiety and depression hit me big time. Complete depersonalisation and extreme fatigue preceeded that. Quite simply I couldn't cope and now realise that my taper was probably too fast, I just found it strange that the severe stuff didn't start for a good few weeks after a dose drop (and such a small one 8mg to 6.4mg). So after a lot of soul searching and yes, feeling like a complete failure, 3 days ago I restarted taking 0.2mls (10mg). The depersonalisation has gone but the anxiety/GI probs and pain/depression/tearfulness and feeling so cold all the time are as bad as ever. Sometimes I truly feel like giving up and just ending things (I wouldn't by the way).

 

Can anyone tell me if is this pattern is "normal" withdrawal (considering I reduced such a small amount) and how long roughly will it take for my reinstatement on 10mg to take effect so I can plan to get stable then come off more slowly? I can't figure out if my symptoms now are from withdrawal or reinstatement but things are a long long way from "good". So it would really help me to hear someone else's experiences

 

Please help, I truly feel like I'm losing my mind here

Edited March 2, 2014 by Altostrata
added lines breaks for readability

[Meimeiquest]

Welcome, R! The pros will be along soon, but I will throw out a couple of thoughts.

 

Your profession requires such quick thinking and very precise fine motor and perception skills, that I would expect you to require an extremely slow taper.

 

There is a book about CFS that proposes cortisol as the primary causative agent of the symptoms. Cortisol is also intimately involved in the AD withdrawal process. So, if that hypothesis is true, that puts you in a sort of double jeopardy. The ebook is available on Amazon, entitled Unravelling CFS. Its recommendations eerily resemble those of this forum. An integrative psychiatrist in NYC has a two-part e-seminar one can purchase, it covers a lot of info on depression and some on drug withdrawal, kellybroganmd.com. Or you can get tons of info here for an optional donation .

[Skyler]

Hi Rick... I've found cortisol issues (anxiety, etc.) to be inextricably bound with withdrawal.. The WD Sx you are now having will subside, but from what you describe, you need a very slow taper, around 5% a month, and you should be able to reduce with minimal or no WD Sx.

 

Cortisol is impacted by WD. Do you currently drink anything with caffeine. I've tapered off diazepam, and at my most vulnerable had to restrict.. NO coffee or tea.

 

Skyler

[Zoe]

Welcome Rick-

I'm glad you found this site. It has been a lifesaver for me. The people here are the most knowledgeable around on the subject of these drugs, withdrawal, and their side effects. No harm taken about being a dentist. I was a dental hygienist.  Hang in there - you will get through this. Check out the information on the site. You will learn so much. 

Take care,

Zoe

[rickoshea]

thankyou all so much for your replies, believe me it means a lot. Ive read about cortisol being implicated in CFS/ME and I did wonder if that had an effect on my symptoms. It seems it has. Coffee has dtopped (that was tough!) and tea will stop too. Water and herbal tea it is then!

Zoe... thanks and you understand the work too which is great. It can be tough but the focus needed at least helps a bit by taking my mind off the hell I'm going through. I think I'll need to drastically reassess my withdrawal programme in light of the cortisol issue. I really cant afford to get ill again with CFS, my financial responsibilities just don't allow that. I just cant cope with feeling like this for too much longer.

[Altostrata]

Welcome, rick.

 

You seem to be very sensitive to dosage reductions. Please read these topics

 

http://survivingantidepressants.org/index.php?/topic/1024-why-taper-by-10-of-my-dosage/

 

http://survivingantidepressants.org/index.php?/topic/2878-micro-taper-instead-of-10-or-5-decreases/

 

our topic for tapering citalopram http://survivingantidepressants.org/index.php?/topic/2023-tips-for-tapering-off-celexa-citalopram/

[rickoshea]

many thanks for the links, once I (hopefully) get stable I think the micro taper is my way to go. Not much change at the minute ... just have to take each day as it comes. I have friends who are GP's ... time to educate them! My thoughts truly go out to all of us who are going through this

[Rhiannon]

Hi--Only thing I would add is that you've made some changes up and down and up over the past few months, so I'd expect you'll do best with your taper if you can take a month or two to get nice and stable before starting to taper again.

 

Then try starting with a small cut, like half a mg or less, and then hold that cut for six weeks to allow the full pattern of withdrawal symptoms to play out.

 

As you've discovered, it's typical in AD withdrawal for there to be some initial acute withdrawal that then settles down, and then people think they're done, only to get hit again further out. It's not unusual to be hit a few weeks out. There also seems to be a common pattern of getting through all of that and then being hit with a "relapse" of symptoms at three to six months out, at which point most people are told they "need" the drug for life. This is actually just more withdrawal and goes away eventually.

 

So it's a good idea to take it slow even if you're initially feeling well. I have learned this the hard way. If you start your taper slow and wait a good long while after your cuts, you'll learn how the pattern plays out for you and be able to work around it.

 

Good luck to you. Sounds like you'll do fine with a slower taper.

[Altostrata]

Yes, please educate those GPs!!!!!!! That would help so many people.

[ladybug]

Even though it seems like your drops were small, they were actually both 20% drops which would throw most of us for a loop! It's recommended that your drops are 10% or less and you give yourself a good amount of time between drops to stabilize, usually at least 4 weeks if not more. Some of us have to go even slower than that. I hope you start to feel better soon!

[rickoshea]

thanks again for the replies and advice. The pattern of withdrawal is difficult to understand for me and my scientific mind but then the human body, especially the neurological system/endocrine system interaction is ultimately poorly understood. I thought I was doing well but this crash, probably compounded by a relapse in CFS symptoms is difficult to handle (to put it mildly). I'll try to stabilise on 0.2mls (about 10mg) then start again. Ladybug ... yup, overconfidence on my part and a touch of impatience. I've learnt my lesson! I find it tragic that patients are not better educated about w/d effects when the prescription is handed out - they're so much worse than the original symptoms (or at least my w/d effects are) The medical profession has a lot to learn about patient care sadly. I'll do my best Alto in that respect!

 

I think things may be settling a bit this morning, I get moments of "near normaility" then feel like I'm under severe stress again with the associated symptoms ... delightful. Anyone reading this please take the great advice on this site and don't make my mistakes with dose reduction, after all, there's no rush!

[Altostrata]

It may take a while for your system to adjust to the dosage change.

 

Typically, symptoms come in waves. This is because your autonomic nervous system, a complex web system, gains control, then loses it again.

 

See these topics http://survivingantidepressants.org/index.php?/topic/603-what-is-antidepressant-withdrawal-syndrome/

 

http://survivingantidepressants.org/index.php?/topic/82-the-windows-and-waves-pattern-of-recovery/

[rickoshea]

Hi all ... I just thought I'd give a bit of an update and maybe seek some advice from those of you that have been through this (thanks for the links Alto by the way)

 

After suffering with my probably too fast taper from 10mg to 6mg I decided to reinstate to my original dose of 10mg Citalopram. From what I have read this should mediate the w/d symptoms if not immediately pretty quickly (a few days?). This is definitely not the case with me unfortunately. I still have crippling anxiety/depression and many symptoms of withdrawal such as shivers, headaches, nausea, IBS, feeling under extreme stress, tremors, weakness, aching muscles, feeling too "switched on" (if that makes sense), waking early in the morning - the list goes on. The problem is that I can't differentiate between withdrawal symptoms, the side effects of reinstating, or my symptoms of CFS. All I know is that this is becoming unmanageable.

 

I've been thinking a lot about my experiences over the past year or two on Citalopram. I never had severe anxiety or depression before I started it but this past 18 months or so I have had episodes of that and other symptoms that could be related to the drug (sinusitis, sneezing, constant congestion) which I didn't have during the years previously taking it. This makes me think that maybe it was losing its effectiveness? When I started the taper I actually felt better than I had in years than crashed a bit (nowhere near like I feel now) but stabilised pretty well on just under 10mg just managing the slight symptoms myself (nausea, stomach pain, slight headache) but mentally feeling more positive and sharp. I believe this is not uncommon during the early phase of withdrawal though. However it does make me think that the small taper I did actually may have helped me in a way. Strangely the congestion/sneezing etc have completely disappeared. To be replaced by this dreadful anxiety and depression. It does come in waves Alto - occasionally I get a window (a very short one) but I seem to be at a constant at the minute and feel very isolated and alone (not much support sadly)

 

Can anyone give me some advice/wisdom on what path I could/should take. My reinstatement is at the 2 week mark now with little improvement, in fact the anxiety may be slightly worse. I know originally we need to wait at least 3 to 4 weeks in general before the benefits are felt but is this the same on reinstatement? If so should I keep going on my 10mg dose for a few more weeks to see if things improve? or maybe reduce a very small amount and risk destabilising again? ... or should I think of a cross taper to Fluoxetine if what I've experienced the past year and a half really was the Citalopram losing efficacy? I've read much about the pros and cons of switching so I'm very uncertain if this would be a wise move.

 

If anyone has been in this situation I'd really appreciate your thoughts. I'm probably being impatient with the reinstatement but really thought I'd see some results by now.

 

Thanks again all and I truly hope everyone is coping as well as possible

 

Rick

[Altostrata]

Have your symptoms gotten worse since you increased to 10mg?

[rickoshea]

it seems very up and down but I would say little difference or maybe very slightly better. The DP/DR is somewhat better but I still have many other symptoms - the anxiety being the worst. I've been keeping a diary and had 4 bad days after reinstating, then 2 days slightly better then back again to the anxiety/hopelessness/tearfulness etc. I'm still waking up with tremors every morning or if I take a nap during the day. Basically ... I'm a long long way from stable

 

thanks for the reply Alto.

[Altostrata]

It's only been 2 weeks since you went up to 10mg, correct?

 

Please give the increase more time.

 

Have you tried fish oil and magnesium supplements, see

http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/

[rickoshea]

thanks again Alto ... yes only 2 weeks since the reinstatement to 10mg. It was just that I thought when doing that I would feel the beneficial effects sooner? It does seem to be slightly improving and my gut feeling is to give it at least a couple of months on 10mg to stabilise then a very slow taper? I have tried fish oil which actually seemed to worsen things for me (it did that before this crash - maybe something to do with the CFS) and am supplementing with Mg transdermal which is a better route and less likely to cause GI problems (MgCl powder mixed with a water based cream and just rubbed into the skin). I've used that on and off for a while for my CFS. I think my ANS is completely unstable, that plus unstable cortisol levels. Amazing how such a small dose increase/decrease can cause such bodily chaos.

[Altostrata]

Yes, give the reinstatement more time. Sometimes it takes quite a while to take effect. Your ANS needs more time to stabilize.

[bubble]

Just to share my experience, the longer you waited to reinstate and the more chnages up and down you made before, the longer it will take to stabilise. And they often say: we are talking about months here, not weeks, let alone days...

 

I was off for 40 days and after reinstating I felt a slight relief after 2 weeks but symptoms were very gradually retreating and now 5 months later I feel a lot better but still not where I was before I CT. (It definitely wasn't: bang, you take the medication and all the symptoms are gone). 

 

draw your own conclusions

 

I just found out that there is no right dose but that it is stability and time (and patience of course) that heal... I also found it helpful to look at alternatives to manage my symptoms instead of thinking about meds. I stuck to one dose, forgot about it and focused on what I could do to feel less anxious in the morning, etc. such as what you are doing with magnesium and trying out the fish oil....

 

Your body will tell you when it is time so don't bother about how many months before you start taper...and yes, up and down would mean windows and waves and slightly better might mean reinstating is working 

 

best of luck!

bubble

[rickoshea]

thanks for the advice. Bubble, its actually good to hrar someone with a similar experiebce! . as long as i know it will improve then I can try to manage it. Today has been a dreadful one, very dizzy and detached, weak, anxious, that awdul over stimulated feeling etc etc. i suppose it'll be just up and down until it eventually evens out. Damn its tough though :-(

[mammaP]

Hi Rick. don't lose heart, it will get better. It took me 7 months to stabilise after reinstating effexor.

It wasn't all bad in that time, there were some bad days and some good ones, stress definitely 

made things much worse so if you could limit stress that would help. I know it isn't always possible 

but keeping it to a minimum will be beneficial.  Once I had been stable for a couple of months I knew

I was ready to restart my taper. 

 

It will get better and I hope it is soon for you. 

[bubble]

yes, I understand

 

It is very hard because it's not linear: you can feel ok one moment and then the next moment you feel worse than ever...

 

It helped me a lot in enduring this to see that this happens to everyone because as Alto says, our brains get things under control and then lose it again, then get it again and so on. Have you read the thread about windows and waves pattern of recovery?

 

Understanding what s happening to us is the only thing that helps us to endure. Windows become longer and clearer and waves shorter and milder but they do reappear again...

 

but things definitely do get better so hang in there!

[rickoshea]

thanks for the encouragement Mammap. yes, stress definitely its me harand for me its hard to avoid in my work. i was travelling today so thats part of the problem possibly. I'll keep updating here and hopefully it'll improve soon.

[rickoshea]

thanks too Bubble! sorry, I'm on my phone here which makes replying tricky. yesterday was one of my worst days so far and i feel that i was suffering what seem to me to be some severe over stimulation effects (side effects?) caused possibly by too high a reinstatement? I haven't experienced what was an almost fever like state combined with an unbearable "wired" feeling before. plus the usual culprits of anxiety, weakness, headaches, severe stomach pain etc. i may try a tiny dose reduction. As i said, i use the liquid Citalopram and went back to 0.2mls (a tiny bit above as advised on the pt leaflet) but was forcing the last tiny bit from the syringe. Then I read here that that bit shouldn't be counted in the dose, so I was actually on slightly more than 10mg. I feel that has been to severe a reinstatement for me. Would it be an idea to reduce very very slightly to say exactly 0.2mls and not force that last bit from the syringe? Its early morning here and I woke feeling my usual shakiness and anxiety, we'll see what today brings. Thanks everyone again for the advice and thoughts :-)

[Petunia]

Hi Rick,

I just read through your thread, I'm sorry you are having to go through this, but I think with enough time and patience, you will be able to come off Citalopram, once you stabilize, if you take it slow enough, you should be able to do it with minimal symptoms.

 

If it were me, I would stay on exactly the same amount you have been on the last 2 weeks, no more, no less.  Its not about the dose, but about giving your NS enough time to adjust to the current chemical situation, if you keep changing it, it keeps getting confused.

 

I know its tempting to want to tweak your meds, based on a particular day when you felt slightly better, but I've been here on this site long enough to know that never works and usually makes the situation much worse.

 

It sounds like stress is a big part of your problem, and that can have a significant influence on withdrawal symptoms, withdrawal seems to make us more vulnerable to stress.  Have a look through our section about non-drug methods for dealing with emotional symptoms here:

 

http://survivingantidepressants.org/index.php?/topic/1112-non-drug-techniques-to-cope-with-emotional-symptoms/

 

you may find something which helps. If you can manage it, regular exercise, especially walking is good and many people find that meditation, once you learn how, can really help with accepting uncomfortable feelings.

 

Hang in there Rick, you will get through this, post as often as you like, we are here for support.

 

Petu.

 

 

[Altostrata]

rick, what time of day do you experience these wired feelings, in relation to your dose?

[rickoshea]

thanks Petu for the advice. In my heart I know you're probably right but seeing light at the end of the tunnel is getting increasingly difficult. I'll keep going I don't have much choice!

 

Alto... I take my dose just before going to bed. In the morning I wake usually with tremors and anxious and a rotten headache. The problem is that I have been like this for 20 years with the CFS, a sort of bad hangover feeling (never with anxiety though) , but this is much worse. This then increases through the morning now with times of complete detachment and dizziness and feeling very (very) over stimulated... a much too alert feeling with associated headache, shaking, GI pain and sweating/chills. Very occasionally I get a moment of clarity and calmness. Towards the evening it relents somewhat. I even now get weird symptoms like being almost unable to form words or "process information" may be a good way to put it. Any further advice or thoughts would be very welcome. Its hard to manage at the minute :-(

[Altostrata]

Has this pattern changed since you increased to 10mg?

[Rhiannon]

Rick, I'm going with the "hang in there" advice, although if Alto says otherwise listen to her because she's more knowledgeable about ADs and reinstatement. 

 

But given your history I would have expected what you're experiencing.

 

Bubble, if you see this, can you post for him that stuff I've written about how these drugs change our neuroplastic brains? The drugs actually change our brain chemistry and even the actual cells themselves. The drug creates an artificial chemistry. The body reacts by trying to regain homeostasis, and in doing so genes are turned on and off, cells are destroyed and others grow, proteins are created and receptors put into place and removed--it's incredibly complex, these nanosecond microcircuits that all feed back on each other. If you get a chance to read a bit of neuroscience it's quite interesting but also amazing to imagine that anyone ever thought throwing wrenches into the works could possibly be safe. Anyway, the brain changes itself, like a plant growing on a trellis (the trellis being the new artificial chemistry induced by the drugs). When you change things it's like yanking out a trellis; you can't just shove another trellis back in and expect the plant to be just fine and everything to go right back to normal.

 

I highly recommend getting hold of a copy of Anatomy of an Epidemic.

 

Most doctors--and everyone really-- are operating from the wrong paradigm about these drugs. Once you understand that due to neuroplasticity they actually cause your nervous system to remodel itself, it becomes easier to understand why we experience what we do when the drugs are changed, removed, go up and down, et cetera. It's incredibly disruptive and it takes a lot of time for the body/brain to renormalize.

[bubble]

Can we pin down Rhi's post somewhere so that we can post a link to it as one of recommended reading for new members? Everybody knows I absolutely love it and share it with everyone

 

It gives the whole rationale behind why 10 %, why hold, why avoid the trap of reacting to symptoms...

 

Hope you find it helpful too, Rick.

 

A lot of people, including healthcare practitioners; in fact, I guess, most people-- are operating from entirely the wrong paradigm, or way of thinking, about these meds. They're thinking of them like aspirin--as something that has an effect when it's in your system, and then when it gets out of your system the effect goes away.

That's not what happens with medications that alter neurotransmitter function, we are learning.

What happens when you change the chemistry of the brain is, the brain adjusts its chemistry and structure to try to return to homeostasis, or biochemical and functional balance. It tries to restabilize the chemistry. 

For example: SSRI antidepressants work as "serotonin reuptake inhibitors." That is, they cause serotonin to remain in the space between neurons, rather than being taken back up into the cells to be re-used, like it would be in a normal healthy nondrugged brain.

So the brain, which wants to re-establish normal signaling and function, adapts to the higher level of serotonin between neurons (in the "synapse", the space between neurons where signals get passed along). It does this by removing serotonin receptors, so that the signal is reduced and changed to something closer to normal. It also decreases the amount of serotonin it produces overall. 

To do that, genes have to be turned on and off; new proteins have to be made; whole cascades of chemical reactions have to be changed, which means turning on and off OTHER genes; cells are destroyed, new cells are made; in other words, a complex physiologic remodeling takes place. This takes place over time. The brain does not grow and change rapidly. 

This is a vast oversimplification of the amount of adaptation that takes place in the brain when we change its normal chemistry, but that's the principle.

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay.

When the drug is removed, the remodeling process has to take place in reverse.

SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. 

It's a matter of, as I describe it, having to grow a new brain. 

I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long. 

With multiple drugs and a history of drug changes and cold turkeys, all of this becomes even more complicated. And if a person is started on these kinds of drugs at an early age before the brain has ever completely established normal mature functioning--well, it can't be good. (All of which is why I recommend an extremely slow taper particularly to anyone with a multiple drug history, a history of many years on meds, a history of past cold turkeys or frequent med changes, and a history of being put on drugs at a young age.)

This isn't intended to scare people, but hopefully to give you some idea of what's happening, and to help you respect and understand the process so you can work with it; ALSO, because you are likely to encounter many, many people who still believe these drugs work kind of like aspirin, or a glass of wine, and all you need to do is stop and get it out of your system. 

Now you can explain to them that no, getting it out of your system is not the issue; the issue is, you need to regrow or at least remodel your brain. This is a long, slow, very poorly understood process, and it needs to be respected. 

[rickoshea]

Rhi and Bubbles... thankyou for the info, I had actually read that and it makes sense that this is what is happening anatomically. My neuroanatomy and neuroscience education was based on "no regeneration" and no possibility of neurones respecialising (I dont know about the USA but in the UK we do a lot of medicine alongside dentistry) I would say Rhi yes, you are completely right. I was one of the "aspirin type" believers. I certainly am not now. Its criminal these drugs being basically unleashed on the public without adequate research. Tragic in fact. Thankyou to you both Rhi and Bubble for taking the time to post this.

 

Alto... initially when I reinstated to 10mg I had a couple of bad days then a couple of fairly good ones. Then this started after another few average days but with episodes of what I can only describe as mania... very hyper feeling. This has settled into a constant stream of the symptoms I mentioned before. The GI symptoms are worse (pain mainly) the over stimulation a lot worse but the actual overall depression probably a bit better. The anxiety has changed in that it now manifests as a feeling of complete panic at times with a constsnt underlying

[rickoshea]

sorry, messed up on my phone there. yes... with underlying constant anxiety. its the severe feeling of being too stimulated that has got worse since going up a dose, with the headaches, detachment etc. My wife tells me I'm being weird and seem spaced and just dont talk any more. It's. hit my CFS hard too, but I can deal with that. As everyone seems to think I suppose I may have to just see how this goes? Sometimes I seriously wonder how I can handle this. I really appreciate all of your replies, it helps so much.

[Zoe]

Hi Rick-

 beyondmeds.com is also a great site. It has a great deal of good information on it too. Had a wonderful post on Brain health & neuroplasticity. Hang in there you can do it. Just concentrate on taking a day at a time or a moment at a time if you are going through a rough patch. Remember the deep breathing- this has really helped my very anxious moments.

[Altostrata]

....

Alto... initially when I reinstated to 10mg I had a couple of bad days then a couple of fairly good ones. Then this started after another few average days but with episodes of what I can only describe as mania... very hyper feeling. This has settled into a constant stream of the symptoms I mentioned before. The GI symptoms are worse (pain mainly) the over stimulation a lot worse but the actual overall depression probably a bit better. The anxiety has changed in that it now manifests as a feeling of complete panic at times with a constsnt underlying

 

This indicates 10mg might be too much for you. It takes about 4 days for a dosage adjustment to reach steady-state. The full load of 10mg citalopram took some time to kick in. Overstimulation is a symptom of too-high dosage.

 

Perhaps try 9mg and see if the symptoms are better?

[rickoshea]

thanks Zoe, Im doing my best with getting through the really rough patches with relaxation techniques, its the slowness of the process... tough going.

 

Alto thankyou again for the advice. I have changed my dose by not including the last small amount in the syringe but thats a bit inaccurate and I cant really work out what percentage this represents. Its early morning here but I woke shaking again with the usual severe headache. I read that it takes maybe 4 days for a dose adjustment to stabilise so I'll go to 9mg and see how that goes. Im still feeling "too alert"... if that could subside I may be able to think more clearly about things. I'll post later about how its gone today :-)

[rickoshea]

well maybe a slightly better day today. Still the anxiety persists and the strange hyper feelings but these seem a bit reduced. To be honest this has left me exhausted and traumatised. I've a lot to get through this year including possibly changing job and moving country so it's scaring me that this won't improve sufficiently to enable me to cope with that. I feel pretty hopeless and empty but I would say that you're right Alto, the tiny dose reduction might be helping. I think now I'll need to stay at this dose and just hope over time I make it back to "normal". One thing this is teaching me is that I desperately want to be free of this drug. I'll be seeing my medical friends next week Alto and will be pretty blunt with them if they try to tell me that SSRI W/D is easily managed.