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About reinstating and stabilizing to reduce withdrawal symptoms


Altostrata

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  • Administrator

VJ, didn't you take a big dose instead of the low dose we suggested?

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

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  • 3 weeks later...

Yes alto I did- I jumped up to 20- I did what my doc told me to do- mistake - huge mistake

 

*Currently at 8.2-8.5 mg of my 10mg pill of Paxil (they actually weigh 12.5mg) 

january 2023 I began reducing my med again. I was a 9mg weight for years, I went to 8.9 in January, went to 8.6mg in February, and in March 2023 I went down to 8.5-8.2 mg ( my scale varies, so I stick within that .3 range because of that) 

*No other supplements or vitamins 

*Taper schedule in the pdf 

Blank.pdf

 

https://docs.google.com/document/d/1-5vShtJtwAOGA30OxIP87steLmMdFzD29F0fzAPD564

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  • Administrator

I understand you were following your doctor's orders. The reason we suggest a very low dose as reinstatement is to avoid adverse effects from a powerful dose, which can delay stabilization or make someone worse.

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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  • 1 month later...

I'm on day 6 of Lexapro reinstatement and actually felt OK for a couple hours minus the exhaustion from insomnia. I hope to build on that amount of time tomorrow.

Lexapro: started in 2002 at 10 mgs.

Ambien: started as a as needed sleep aid in 2010.

Quit Lexapro cold turkey in June 20015 due to contributing to low sodium issues.

Restarted Lexapro in late November for a week (only 5 mgs) but quit due to dizziness side effects. Side effects worsened for 3 weeks until

12/24/15: Protracted WD hit, experienced extreme anxiety, insomnia lack of full concentration and social challenges.

Reinstated Lexapro on 1/1/16 at 5 mgs. Increased per Dr to 7.5 MG. Tapered off Lexapro in March 2016.

Started 50MG of Seroquel in late January 2016 for bedtime to help in eliminate Ambien. Tapered off both Seroquel and Ambien in March 2016.

2/14/16: Prescribed both Remeron (15 MG) and Temazapam (15 MG) for sleep. Also use Klonopin and Ambien again in place of Temazapam to avoid addiction. However I did take Temazapam 60 straight days

6/15/16: Stopped use of all benzo's and now use Belsomra 1-2 times a week. Still on 15 MG of Remeron

10/11/16: Off all psych medications

 

After kindling, trying to regain my strength suffering from severe mental and physical fatigue.

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  • 2 weeks later...

Hey guys I always re-read this thread during a wave. And I am in a bad one. Bedridden for 2 days and counting due to a myriad of intense symptoms. I usually read the forum and talk myself out of reinstating. My gut says no but I dont know foresure. I am 17 months off and although Ive seen some improvements, I am not functional yet. Could a 1mg reinstatement make me much worse? I guess in tough times I need to know that by not reinstating im doing the best thing for my recovery or am I making a mistake by not trying reinstatement? Any advice is appreciated. Thanks

 

Mort

Was on 30mg (Lexapro) for 7-8yrs20mg for 3 months (This was my choice my Doc wanted me to drop much faster)15 mg 2week10mg 2 weeks 5 mg 1 week0 since August 24th . PPI Dexlant  30 mg taper has begun. Cutting 20% currently.  using zantac as needed.  Benzo is currently 0.10mg 

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Mort, For me updosining made me sooo much worse and it took at least a month to stabilize somewhat. I only updosed from 4mg to 5mg and felt like my brain was exploding...  I developed new symptoms like andehonia and insomnia and akathisia. It was really traumatising. I think that in your case when you have been off meds for so long reinstatement would be really like russian roulette.

Citalopram 40mg from 2003-2015

Jan 2015 started tapering first dropped to 35mgFeb 30mg, March 25mgApril 20mg, May 17,5mg, June 15mgJuly 12,5mg, Aug 12,5mg,

Sep 0mg for 5 days because of stomac flu and after I raised to 7,5mg. All the symptoms of acute WD shaking, diarrhea, vomiting, barely could walk ect. Still didn't realize that it wasn't only stomac flu but I was also going through WD.

Oct 2,5mg and crashed again badly and quickly raised to 4mg. It was then when I knew my symptoms were due to WD.

Then in November after a month holding on 4mg raised to 5mg due to muscle weakness and had a VERY BAD reaction to reinstatement: akathisia(lasted for one or two weeks), insomnia, anhedonia... Drop quicly back to 4mg, Dec 3mg

Jan 2016 2,6mg( in the middle of Jan after I had been on 2,6mg for a week I tried to updose to 2,8mg and immediately had bad reaction to it: akathisia for a day, andehonia got worse. The next day dropped back to 2,6mg), Feb 2,4mg( a new symptom PGAD lasted 24/7 for 2 months after that on and off), March 2,4mg, April 2,3mg, May 2,2mg, June 2,1mg, July 2,0mg( Pgad almost nonexisting, sleeping pretty good, still some anhedonia but there has been a lot of gradual progress), Aug 1,97mg-1,89mg, Sep 1,88mg-1,49mg, Oct 1,48mg- 1,70mg,

Nov 0,65mg- current dose 0,5mg

 

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  • 4 months later...
  • Administrator

Prior to about 4 days, there are variations of the drug level in your bloodstream, your body does not get the full dose consistently 24 hours a day until around the 4th day. You may still feel effects of the drug, though.

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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  • 3 months later...

Alto, have you gotten your emotions back after your reinstatement? You wrote in some thread that you were on Paxil first few years and then you were off for an year and then you started Paxil again and on the second time on Paxil it blunted your emotions. I wanted to ask this bc you have been off Paxil after you CT'ed for so long and bc so so many experience anhedonia after reinstatement. 

Citalopram 40mg from 2003-2015

Jan 2015 started tapering first dropped to 35mgFeb 30mg, March 25mgApril 20mg, May 17,5mg, June 15mgJuly 12,5mg, Aug 12,5mg,

Sep 0mg for 5 days because of stomac flu and after I raised to 7,5mg. All the symptoms of acute WD shaking, diarrhea, vomiting, barely could walk ect. Still didn't realize that it wasn't only stomac flu but I was also going through WD.

Oct 2,5mg and crashed again badly and quickly raised to 4mg. It was then when I knew my symptoms were due to WD.

Then in November after a month holding on 4mg raised to 5mg due to muscle weakness and had a VERY BAD reaction to reinstatement: akathisia(lasted for one or two weeks), insomnia, anhedonia... Drop quicly back to 4mg, Dec 3mg

Jan 2016 2,6mg( in the middle of Jan after I had been on 2,6mg for a week I tried to updose to 2,8mg and immediately had bad reaction to it: akathisia for a day, andehonia got worse. The next day dropped back to 2,6mg), Feb 2,4mg( a new symptom PGAD lasted 24/7 for 2 months after that on and off), March 2,4mg, April 2,3mg, May 2,2mg, June 2,1mg, July 2,0mg( Pgad almost nonexisting, sleeping pretty good, still some anhedonia but there has been a lot of gradual progress), Aug 1,97mg-1,89mg, Sep 1,88mg-1,49mg, Oct 1,48mg- 1,70mg,

Nov 0,65mg- current dose 0,5mg

 

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Just throwing in my experience...

 

- re-instated Paxil ~15mg approx FIVE months after severe withdrawal started (itself taking 6 weeks after my last pill). Sounds like I was lucky considering this is on the far end of successful reinstatement delays.

 

- reinstatement quickly cleared up the withdrawal insanity (panic attacks, cognitive dysfunction/memory loss, de-realization, worst OCD of my life)

 

- unfortunately, reinstatement also brought a *fierce* anhedonia, apathy, and loss of motivation - The likes of which I hadn't experienced in ten years of 60mg+ Paxil. This hasn't gone away yet, I'm on 8mg and still tapering slowly. In some ways, this is much worse than withdrawal since I could still enjoy music, sex, sunshine, socializing etc during withdrawal.

 

- muscle pain, digestive issues, general spaciness still lingered after reinstatement.

Medication before problems: Took Paxil 60-100mg from 2003 to 2014 for OCD.
1) Last pill taken November 2014, horrendous withdrawal started six weeks later.

2) Re-instated successfully @ 20mg May 2015, but accompanied by severe anhedonia, loss of emotion, apathy, and fatigue

3) Switched to Prozac, Viibyrd, Zoloft, Nefazadone, Cymbalta, Nardil in attempt at abating WD symptoms while not re-introducing anhedonia. Each one either failed to relieve WD or brought back anhedonia. So re-stabilized on Paxil at 15mg

4) Tapered down to 7.5mg as of October 2016. More energy, anhedonia/loss of emotions remains apart from short windows.

5) May 2017 - down to 3.5mg of Paxil (no other meds)
6) Early 2018 - added 8mg of Prozac
7) January 2019 - down to 1.05 Paxil / 5mg Prozac and continuing

8) October 2019 - down to 0.2mg Paxil / 3mg Prozac

9) November 2019 - down to 0.1mg Paxil / 3mg Prozac 

10) March 2020 - done with Paxil, 2.5mg Prozac

11) April 2021 - 0.03mg Prozac

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Alto, have you gotten your emotions back after your reinstatement? You wrote in some thread that you were on Paxil first few years and then you were off for an year and then you started Paxil again and on the second time on Paxil it blunted your emotions. I wanted to ask this bc you have been off Paxil after you CT'ed for so long and bc so so many experience anhedonia after reinstatement.

This was my exact experience.. Never had anhedonia until reinstatement. Didn't realize this was a common thing?!

Medication before problems: Took Paxil 60-100mg from 2003 to 2014 for OCD.
1) Last pill taken November 2014, horrendous withdrawal started six weeks later.

2) Re-instated successfully @ 20mg May 2015, but accompanied by severe anhedonia, loss of emotion, apathy, and fatigue

3) Switched to Prozac, Viibyrd, Zoloft, Nefazadone, Cymbalta, Nardil in attempt at abating WD symptoms while not re-introducing anhedonia. Each one either failed to relieve WD or brought back anhedonia. So re-stabilized on Paxil at 15mg

4) Tapered down to 7.5mg as of October 2016. More energy, anhedonia/loss of emotions remains apart from short windows.

5) May 2017 - down to 3.5mg of Paxil (no other meds)
6) Early 2018 - added 8mg of Prozac
7) January 2019 - down to 1.05 Paxil / 5mg Prozac and continuing

8) October 2019 - down to 0.2mg Paxil / 3mg Prozac

9) November 2019 - down to 0.1mg Paxil / 3mg Prozac 

10) March 2020 - done with Paxil, 2.5mg Prozac

11) April 2021 - 0.03mg Prozac

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  • Administrator

Alto, have you gotten your emotions back after your reinstatement? You wrote in some thread that you were on Paxil first few years and then you were off for an year and then you started Paxil again and on the second time on Paxil it blunted your emotions. I wanted to ask this bc you have been off Paxil after you CT'ed for so long and bc so so many experience anhedonia after reinstatement.

 

This is incorrect. I never reinstated Paxil myself. After going off Paxil in October 2004, I suffered acute withdrawal syndrome for about 11 months and post-acute withdrawal syndrome for another 10 years. My emotions gradually came back in the last half of that period.

 

Please take discussions of drug-induced symptoms to such topics as these:

 

Did antidepressant reinstatement work for you?

 

Anhedonia, apathy, demotivation, emotional numbness

 

Disconnect between interest and action/motivation

 

Derealization or Depersonalization

 

Personality changes during withdrawal, who's had them?

 

"Change the channel" -- dealing with cognitive symptoms...

 

"Is it always going to be like this?"

 

What does healing from withdrawal syndrome feel like?

 

Inactivity may make sympathetic nervous system hypersensitive...

 

Non-drug techniques to cope with emotional symptoms

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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  • 4 weeks later...

YMMV, but I reinstated at 4/5 months to keep my job. And I did it in a terrible way (tried all kinds of other drugs before going back on the original) and it "worked" for me. 90% of the symptoms went away or were greatly improved, saved for adding fatigue and anhedonia.

Medication before problems: Took Paxil 60-100mg from 2003 to 2014 for OCD.
1) Last pill taken November 2014, horrendous withdrawal started six weeks later.

2) Re-instated successfully @ 20mg May 2015, but accompanied by severe anhedonia, loss of emotion, apathy, and fatigue

3) Switched to Prozac, Viibyrd, Zoloft, Nefazadone, Cymbalta, Nardil in attempt at abating WD symptoms while not re-introducing anhedonia. Each one either failed to relieve WD or brought back anhedonia. So re-stabilized on Paxil at 15mg

4) Tapered down to 7.5mg as of October 2016. More energy, anhedonia/loss of emotions remains apart from short windows.

5) May 2017 - down to 3.5mg of Paxil (no other meds)
6) Early 2018 - added 8mg of Prozac
7) January 2019 - down to 1.05 Paxil / 5mg Prozac and continuing

8) October 2019 - down to 0.2mg Paxil / 3mg Prozac

9) November 2019 - down to 0.1mg Paxil / 3mg Prozac 

10) March 2020 - done with Paxil, 2.5mg Prozac

11) April 2021 - 0.03mg Prozac

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Reinstatements have been a lifesaver for me. I've had to updose a bit at several points in my taper when my body couldn't handle my previous taper schedule.

 

The relief I feel immediately after reinstating (generally the day after) is the only thing that gives me hope to keep going.

 

I've read at benzo forums that one should never reinstate repeatedly because it can cause kindling. I understand how that could happen, and every reinstatement carries risk, but I just couldn't remain minimally functional without reinstating. Neither would I been able to keep cutting, as unstable as I was for weeks and months.

 

So in MY case, reinstatements helped me stabilize, continue tapering, and function.

  • SSRIs 3-4 times in the last 14 years; would take them for 6-8 months and then taper off under dr supervision with no problems.
  • Med history prior to 2015: http://survivingantidepressants.org/index.php?/topic/6012-newbeginning-my-withdrawal-story/?p=267313#entry267313
  • 04/2015: Prozac decreased to 15mg over last 3 months; effexor held steady at 8mg; current effexor XR: 20 beads of a 75mg capsule per day (about 8mg)
  • 06/2015: Prozac: 10mg; effexor XR: 19 beads (about 7.5mg); 07/2015: Prozac: 8.5mg; effexor 18 beads; 08/2015: Prozac: 7.5mg; effexor: 17 beads
  • End of August: withdrawal: depressive symptoms, crying spells. Realized I was measuring prozac dose wrong for the last 2 months. Reinstated Prozac 8.5mg; Kept effexor at 17 beads. Stabilized in 5 weeks.
  • 10/2015: Prozac: 8.5mg; effexor: 17 beads11/2015: Prozac: 1.9ml (7.5mg); effexor: 16 beads12/2015: Prozac: 1.6ml; effexor xr: 16 beads. Withdrawal: neuroemotions
  • 01/2016: prozac: 1.6ml; effexor xr: reinstated 17 beads, withdrawal improved; 02/2016: Prozac 1.5ml; Effexor: 17 beads; 03/2016: Prozac 1.3ml(5mg); Effexor: 17 beads (7mg)-withdrawal (flu-like malaise, lightheaded, drowsy) started end of March. April 15: reinstated Prozac 1.5ml. Stabilized. 2 weeks ok. End of April: Withdrawal (neuroemotions). Eventually stabilized in April-May. Apathy improved.
  • 3 month hold until August. August 2016: apathy came back;

  • October 2016: updosed to Prozac 1.6ml. Bad reaction: anxiety, depression. End of October: went down Prozac 1.5ml. Stabilized over several weeks.

  • Dec 9: tried macca for energy: anxiety/depression. Improved over several weeks, but not completely resolved.

  • Dec 31: cut Effexor 5% to 16 beads. After 9 days: withdrawal anxiety, depression; tried updosing to 17 beads Feb 7 but anxiety got worse; went down to 16 beads

    May 2017: Anxiety improved; severe depression continuesSeptember 2017: finally stabilized!!!!!! 09/07/2017-12/31/2017: hold

  • Stable on Effexor 6mg and Prozac 6mg until around 2019-2020. Side effects (fatigue, anhedonia) continued, but had some long lasting windows thanks to therapy. Windows lasting 5-6 months each year followed by relapses.

  • 2019: bad reaction to melatonin 3 mg. Withdrawal after taking it 2 months. When I tried to stop it developed severe insomnia that lasted 6 months even after I reinstated melatonin. Only slept again because I took hydroxyzine 5 mg 3 times a week for few months. Stopped hydroxyzine with no issues. Sleep normalized.

  • 2020-2021: Holding on Prozac 6mg, Effexor 6mg, Tapered melatonin 1 drop every 2-4 weeks down to 1.5mg. Had to hold because further cuts were causing severe drowsiness. 

  • 2021: Insomnia returned due to caffeine use for few months (only started after months of use). I also had a concussion at this time.

  • 2023: took hydroxyzine 5-100mg for one month (kept increasing dose every 3 days because I developed tolerance). Tapered for 1 week. After 1 month: withdrawal neuroemotions. Reinstated 5mg 2 months after stopping. Gradually increased to 25mg, stabilized, but withdrawal came back after 10 days. Kept increasing dose and withdrawal returning. Currently at 40mg. Not sure how to stabilize. 

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  • 1 month later...

Questions:

 

Does this advice apply the same way to someone who only tapered part way and is still on the med but considering reinstating to the original dose? Especially the advice about being sensitized to the drug.

 

Does the reinstatement advice apply to all psych meds, not just antidepressants? (In my case, Seroquel.)

 

Is it really possible to be symptom-free?

 

Thanks.

 

MN

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  • Administrator

If you are tapering and get withdrawal symptoms that don't go away in a few days, a small updose might help. You may not need to go back all the way to the original dosage to quell withdrawal symptoms.

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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  • Moderator Emeritus

"Is it really possible to be symptom-free?"

 

The idea of reinstatement and updosing isn't to become free of symptoms but to get the withdrawal symptoms to a bearable level.

* 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 month later...

This is cool, very helpful. I was off for a long time, several years. I cold-turkeyed for the most part, and I was on a heavy-duty "cocktail." I believe my brain was damaged by taking the drugs, not from withdrawal. Stopping them any way I could saved my life.

 

I had none of the "brain zaps" people describe. Insomnia resulted from decades on drugs. After five years of barely sleeping at all, I finally decided I couldn't stand constant exhaustion. My mood was not affected, but I tended to be short-tempered because I could barely stay awake. I recall feeling that I would fall asleep while walking and doing ordinary tasks. I also dropped things that were in my hands due to mini-sleeps.

 

I obtained some Seroquel without a prescription (not quite legally) and started back at the lowest possible dose. It was like a miracle. My goal is to get off, but really, I'm so thrilled to sleep that I am less worried about the drug damage from such a low dose than I am about the devastating consequences of sleep deprivation. I think the only way I can taper would be to grind it up (it isn't XR) and dissolve it in water, then drink, and do a very very very slow taper even from this mini-dose.

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  • 4 weeks later...

If a low-dose reinstatement doesn't seem to be helping after a couple of weeks, is it necessary to taper or can you stop immediately?

  • 1998-2002 - High dose of Luvox for 4.5 years. Rapid taper over a couple of months in early 2002. Not much withdrawal issues, other than increased irritability and mood lability for a few months.
  • 2005 - Brief trial of Wellbutrin. Stopped taking it after a few months with no problems.
  • 2008 - Started fluoxetine (Prozac), 10 mg. Took this dose for several years. At some point upped the dose to 20 mg and maintained until late 2015.
  • November 2015 - Cold turkeyed off of Prozac 20 mg. Experienced low energy, lack of motivation, irritability, but these were symptoms I was experiencing while still on the SSRI (albeit to a lesser degree).
  • May 2016 - 6 months later, late-onset withdrawal symptoms appear. Severe anxiety, insomnia, dread, unprecedented feelings of hopeless depression, suicidal ideation, bouts of crying, nausea, loss of appetite, akathisia (feeling like I'm vibrating internally, but no need to move).
  • June - September 2016 - Symptoms continue. Mostly waves, but some windows. Some recovery.
  • October - November 2016 - Diagnosed with breast cancer. Handled fairly well, but resorted to benzos for sleep in the week prior to surgery. Following surgery, was pretty out of it for 3 weeks on pain pills and antibiotics.
  • December 2106 - Withdrawal symptoms back with a vengeance, especially anxiety, insomnia, suicidal ideation, and depression. Oncologist prescribed 10 mg Lexapro. Took 2.5 mg for 2 weeks, but felt it was making anxiety worse, so stopped. 
  • January 2016 - Restarted 2.5 mg Lexapro after realizing it was the antibiotic I was taking that was making things worse, not the SSRI. Have stabilized to a large degree.

 

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Some (like me) may have never have had any problems with Cymbalta... until I Ct'd off. 

 

So for me, being free of symptoms, was my goal and I was hopeful that reinstatement would do so - It was just going to take longer than I had expected, so I prematurely began to taper after 4 months of a full dose reinstatement.

 

It's now been 6 weeks since my full updose to 20mg/d Cymbalta and this is the best I've felt in over a year. 

 

My only sx now is 2-3/10 tinnitus.

 

I hope this helps,

Woof out

 

 

How long should you give reinstatement?

  • After reinstatement, the amount of time needed to alleviate withdrawal symptoms (stabilizing) varies according to the individual. Relief can be felt immediately, after some weeks, or after some months.
  • Once you feel withdrawal symptoms are reduced after reinstatement, give your nervous system time to stabilize before attempting dosage reduction. Think in terms of months, not days.
  • Be patient after you reinstate. Reinstatement may not immediately eliminate all withdrawal symptoms. You may still experience waves of symptoms, which usually lessen as time goes on.

 

If on a Benzo for a relatively short period of time, such as less than 6-12 months, one may want to consider tapering off their Benzo first (please see Will Hall's book on Harm Reduction)

 

Prior to commencing with an AD taper please consider what problems the AD is causing, as tapering is an extremely serious endeavor.   

If one has been on an AD for more than 10 yrs. please consider the potential long term negative consequences of AD withdrawal prior to tapering. (please see Drs. Healy, Glenmullen and Shipko) 

Prior to re-starting an AD taper, please do not resume tapering until all w/d sx's from any prior taper, especially CT, have resolved. 

 

2004 - Dec. 2015,  Cymbalta 20mg/d  for neck pain - Never had problems with Cymbalta.   Dec 2015, CT 20mg/d Cymbalta.  5 weeks later reinstated 20mg/d Cymbalta - without increase in CT sx's.   

Feb 2016 STARTED VALIUM 25mg/d for CT Cymbalta wd sxs.    Jan-April 2016 Held Cymbalta 20mg/d - doing pretty well (AM 3/10 anxiety and 3/10 tinnitus)

April 2016, CT Cymbalta sx's had not yet resolved and I prematurely tapered 10% q 4 wks x 3 mos.  After 3rd cut developed 10/10 wd sx's of Anxiety, Anhedonia, Anorexia, Panic attacks, dark, incresaed Valium to 28mg/d. 

November 2016, after 3 cuts, UP-DOSED all (41 beads) back up to 20mg (193 beads total) Cymbalta - from , dark to light.

VALIUM TAPER: Jan 2017 28mg to March 2019 Zero   Cymbalta has partially stabilized and helped with the Valium taper.  The only sx I have now is 3/10 Tinnitus, which I only notice when it is quiet.

http://survivingantidepressants.org/index.php?/topic/11900-woof-cymbalta-re-stabilization-after-cold-turkey-withdrawal/  Benzo Posts http://survivingantidepressants.org/index.php?/topic/11951-woof-valium-scheduling-and-dosage-with-cymbalta-wd-symptoms/

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  • Moderator Emeritus

Sorry for the delay in answering Mellie - I wanted to check with the other mods. 

 

If a low-dose reinstatement doesn't seem to be helping after a couple of weeks, is it necessary to taper or can you stop immediately?

 

It would pay to taper, but it can be done at a faster rate than the usual 10% monthly (unless w/d symptoms indicate otherwise).  You could try reducing by 25%, waiting a week and assessing how you are feeling.  If all is good, try another 25% and so on.  If symptoms increase, that is a clear sign to slow the taper. 

 

Of course if you are already suffering from previous drug changes, that is another reason to taper carefully.  A sudden stop can make things much worse. 

2010  Fluoxetine 20mg.  2011  Escitalopram 20mg.  2013 Tapered badly and destabilised CNS.  Effexor 150mg. 

2015 Begin using info at SurvivingAntidepressants.  Cut 10% - bad w/d 2 months, held 1 month. 

Micro-tapering: four weekly 0.4% cuts, hold 4 weeks (struggling with symptoms).

8 month hold.

2017 Micro-tapering: four weekly 1% cuts, hold 4 weeks (symptoms almost non-existent).

2020 Still micro-tapering. Just over 2/3 of the way off effexor. Minimal symptoms, - and sleeping well.
Supplements: Fish oil, vitamin C, iron, oat-straw tea, nettle tea.

2023 Now on 7 micro-beads of Effexor. Minimal symptoms but much more time needed between drops.

 'The possibility of renewal exists so long as life exists.'  Dr Gabor Mate.

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  • 1 month later...

My experience was a good one with reinstatement of an AD.

 

I had done a too fast taper as per my GP and had some really awful debilitating symptoms that made me lose the use of my legs for a while.

I had got down to 10mgs of Citalopram before WD hit and went up to 20mgs and then my full dose of 30mgs before I was fully aquainted with SA.

 

I got some relief from the symptoms straight away and after a few months was feeling a lot better. I still had ups and downs though and held for a year before starting a taper.

 

I tapered successfully for a year until Dec 2016 when something went wrong and I am now struggling again and trying to stabilise.

15 yrs on 20 to 30 mgs CITALOPRAM.  MAY 2014 Increased to 40 mgs per day.SEPT/NOV 2014 tapered in 6 weeks down to 10 mgs as per Dr instructions due to violent nightmares/palpitations.Given Noctamid (lormetazepam) to help with anxiety. On average took 2mg per day for 8 weeks.No taper was advised.DEC 2014 WD severe. Nervous tic in eyes and limbs, muscle pain,fluct  temp, weakness, dep and anxiety, nausea, giddy, unstable when walking. Different Dr suggested taking 20mgs CIT. BROMAZEPAM 3mgs up to 3 x daily for anxiety.DEC 9 2014 Updose CIT to 30mgs. Only taking BROMAZEPAM in emergency.DEC 31 2014 Settling at 30mg CIT - helping with depression. No Brom for 2wks.Found SA.APR 2015 Trying to stabilise on 30mgs CIT.  JAN 2016 Started Cit Taper reducing by 5% per month.  28.5 mgs 
FEB  Taper held bereavement. APR Taper resumed 27mgs . MAY 25.50 mgs .  JUNE 24 mgs .  JULY I stupidly mixed up my BP meds with CIT. Consequently took no CIT for 3 days and doubled my BP meds. Waiting for the fallout....Holding for a while until any chance of repercussions have abated. SEPT taper resumed to  22.5 mgs . OCT 21 mgs .NOV 19.95 mgs DEC crashed. 2017: FEB 3rd updose to 20.5 mgs to try to stabilise.FEB.switched over to 75mgs of Venlafaxine XR for 3 weeks.Too stimulating so switching back to Cit. 12 March 37.5 Ven and 20 Cit. 21 March 18mg Ven 20mg Cit. 4 April 9mg Ven 20mg Cit. Xanax .50mg when needed.  13 April 0 mgs Ven, 20mg Citalopram. Xanax .50 mg per day. 5 May reinstated a small amount of Ven to stabilize  1 mg twice a day. 20 mg Citalopram at night. Xanax .25 mg twice per day.Other Meds: Losartan (BP)Started 1993 at  50 mgs at night.  Seretide (Asthma) Started 1996 at 1 puff twice a day. Jan 2019 Antibiotic Ceclor 500mgs twice a day for bronchitis and  Atrovent 2ml capsules twice a day for asthma. Finished the course of both Jan 17. 

XANAX  Jan 27  - Feb 3 2019 Failed Valium Crossover.   Feb 14 2019  Updosed Xanax by .0625  Feb 17 2019 Decreased Xanax by .0625. Back to .50mg daily.  Update Xanax 28.2.20 tapered to .1250 mg 8am .25 mg midnight. Update Xanax 11.8.21 tapered to .25 mg at night. 

Current Meds 28.2.19: CITALOPRAM  20mg  taken at midnight. VENLAFAXINE  .9 mg twice a day at 8am and 10pm.  XANAX .50 mg split into 4 doses per day. 10am .0625mg / 2pm .1250mg/ 6pm .0625mg / midnight .25mg.Update 10.8.22 .25 mg at night.  LOSARTAN 50 mgs taken at midnight.  SERETIDE 1 puff taken at 8am and 10pm.   7.7.19 VENLAFAXINE UPDATE: Started tapering 10% every 4 weeks. Currently .4 mg twice a day at 8am and 10 pm.  2.9.19 .36 mg x 2. 1.10.19  .32 mg x 2. 26.11.19 .29 mg x2. 26.12.19 .26 mg  x 2. 23.1.20  .23 mg x 2.  20.2.20 .21 mg x2.20.3.20  .19 mg x 2. 21.4.20 .17 mg x 2. 19.5.20 .13 mg x 2.  18.6.20 .11mg  x 2 .18.7.20.10 mg x 2.1.9.20.09 mg x 2. 30.9. 20 .08 mg x 2. 1.11.20 .07 mg x 2.  2.12.20 .06 mg x 2.  8.1.21 .05 mg x 2.  4.2.21 .04 mg x 2. 9.3.21 .03 mgx2.  7.4.21  .02 mg x 2.  9.5.21 .01 mg x 2.  21.6.21 .01 mg x 1.  11.8.21 ZERO!

 

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  • Mentor

I'm curious if anyone knows if reinstatement typically helps or typically makes a person worse.

 

I can only speak for myself, I jumped off at 2.5 and crashed about 5 mos later, and successfully  reinstated.

And by successful, I mean it pulled me out of the worst of things, when I had over 40 symptoms, all severe, for weeks.

 

I think I'd have been a LOT better off if I'd done a proper taper, for me, the reinstatement helped tremendously

 

I also reinstated at an extremely low dose, so that may have something to do with it.

I have been staying more or less stable now at well under 1mg of liquid lexapro

 

  • pysch med history: 1974 @ age 18 to Oct 2017 (approx 43 yrs total) 
  •  Drug list: stelazine, haldol, elavil, lithium, zoloft, celexa, lexapro(doses as high as 40mgs), klonopin, ambien, seroquel(high doses), depakote, zyprexa, lamictal- plus brief trials of dozens of other psych meds over the years
  • started lexapro 2002, dose varied from 20mgs to 40mgs. First attempt to get off it was 2007- WD symptoms were mistaken for "relapse". 
  •  2013 too fast taper down to 5mg but WD forced me back to 20mgs
  •  June of 2105, tapered again too rapidly to 2.5mgs by Dec 2015. Found SA, held at 2.5 mgs til May 2016 when I foolishly "jumped off". felt ok until  Sept, then acute WD hit!!  reinstated at 0.3mgs in Oct. 2106
  • Tapered off to zero by  Oct. 2017 Doing very well. 
  • Nov. 2018 feel 95% healed, age 63 
  • Jan. 2020 feel 100% healed, peaceful and content
  • Dec 2023 Loving life! ❤️ with all it's ups and downs ;) 
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I just wanted to check back in with an update. I CT'd from 20 mg Prozac in November 2015, then started having the horrible hyper-alerting symptoms in May 2016 (insomnia, anxiety, agitation, dread, depersonalization). I whiteknuckled my way through nearly 8 months of these symptoms, with windows and waves. However, I got really bad after I was diagnosed and had surgery for breast cancer in November 2016. By December, I was in a very dark, dangerous place. 

 

I couldn't reinstate Prozac, because it interferes with an important cancer drug, tamoxifen, that I'll be taking for the next 5-10 years. So I tried a small dose of Lexapro: 2.5 mg. This was a little more than 13 months after my CT. After two weeks, I stopped, because I feared it was making my anxiety and insomnia worse. But since then, I've figured out it was the fluoroquinolone antibiotic I was taking that was making things worse (I was on it for a month).

 

I went back on 2.5 mg of Lexapro on January 16. Since, then my symptoms have gotten much better. Suicidal ideation, dread, and depersonalization are gone. Anxiety is much better. And sleep has improved. This despite the huge stress of dealing with cancer and also having gone on another antibiotic for two weeks (azithromycin -- which also caused increasing anxiety and agitation while I was on it).

 

So reinstatement worked for me -- even with a different medication after a long SSRI-free gap. I don't plan on upping my dose. I just want to stabilize while I get through my medical crisis, and so far it is definitely helping.

  • 1998-2002 - High dose of Luvox for 4.5 years. Rapid taper over a couple of months in early 2002. Not much withdrawal issues, other than increased irritability and mood lability for a few months.
  • 2005 - Brief trial of Wellbutrin. Stopped taking it after a few months with no problems.
  • 2008 - Started fluoxetine (Prozac), 10 mg. Took this dose for several years. At some point upped the dose to 20 mg and maintained until late 2015.
  • November 2015 - Cold turkeyed off of Prozac 20 mg. Experienced low energy, lack of motivation, irritability, but these were symptoms I was experiencing while still on the SSRI (albeit to a lesser degree).
  • May 2016 - 6 months later, late-onset withdrawal symptoms appear. Severe anxiety, insomnia, dread, unprecedented feelings of hopeless depression, suicidal ideation, bouts of crying, nausea, loss of appetite, akathisia (feeling like I'm vibrating internally, but no need to move).
  • June - September 2016 - Symptoms continue. Mostly waves, but some windows. Some recovery.
  • October - November 2016 - Diagnosed with breast cancer. Handled fairly well, but resorted to benzos for sleep in the week prior to surgery. Following surgery, was pretty out of it for 3 weeks on pain pills and antibiotics.
  • December 2106 - Withdrawal symptoms back with a vengeance, especially anxiety, insomnia, suicidal ideation, and depression. Oncologist prescribed 10 mg Lexapro. Took 2.5 mg for 2 weeks, but felt it was making anxiety worse, so stopped. 
  • January 2016 - Restarted 2.5 mg Lexapro after realizing it was the antibiotic I was taking that was making things worse, not the SSRI. Have stabilized to a large degree.

 

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So good to hear that RI lex worked for you Mellie!

This confirmed my guess about a greater chance of success in RI a different ssri as opposed to RI the same drug. For reasons we don't know, RI the same drug has greater probability of getting a reaction. I know it can't be generalized for 100% assurance, but many people changed ssri by their doctors when the old one is poopout, and many got severe reaction going back to their original ssri even at significantly smaller dose.

 

It's possible that even different SSirs block the same receptors, the molecular binding mechanism can be different so a different ssri can still work while the old one is fully exhausted.

 

Of course, this is nothing proved, only statistics from the uncontrolled random but massive incidences.

 

Don't know if agreeable by others, in case this is true, it can help with a less risky RI for those CTed and those got severe reaction being forced to CT.

Drug free Sep. 23 2017

2009 Mar.: lexapro 10mg for headache for 2 weeks.

2009-2012: on and off 1/4 to 1/3 of 10mg

2012 June--2013 Jan,: 1/4-1/3 of 10mg generic, bad jaw pain

2013 Jan-Mar: 10 mg generic. severe jaw and head pain;

2013 Mar--Aug. started tapering (liquid ever since) from 10 to 5 (one step) then gradually down to 2.25 mg by July. first ever panic attack, severe head/jaw pain

2013 Aug.: back to 2.75 mg; Nov: back to Brand Lex. 2.75mg -- 3mg,

2014 June: stopped PPI, head pressure/numbness. up-dosed 4.5mg, severe reaction mental symptoms added on

2014 Aug--2015 Aug: Micro taper down to 3.2mg, .025mg (<1%) cut holding 2-3 weeks.

2015 Aug 15th, Accidental one dose of 4.2mg. worsening brain non-functional, swollen head, body, coma like, DR

2016 Feb., started dosing 10am through 11 pm everyday 2/13--3.2mg, 3/15-- 2.9mg, 4/19-- 2.6mg, 6/26--2.2mg, 7/22 --1.9mg, 8/16--1.8mg,8/31--1.7m g, 9/13--1.6mg, 9/27--1.5mg, 10/8--1.4mg, 10/14--1.3mg, 11/1--1.2mg, 11/29--1.1mg, 12/12--1mg, 12/22--0.9mg

2017: 1/7--0.8mg, 1/15--0.7mg, 1/17--0.6mg, 1/20--0.52, 1/21--0.4mg, 1/22--0.26, 1/23--0.2, 2/13--0.13mg, 2/20--0.06mg, 3/18--0.13mg, 6/1--0.12mg, 7/6--0.1mg, 7/14--0.08mg, 8/17--0.04mg, 8/20--0.03mg, 8/28--0.02mg, 9/6--0.0205mg, 9/8--0.02mg, 9/17--0.015mg, 9/20--0.01mg, 9/21--0.0048mg, 9/22--0.0001mg,

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That's good to hear, Mellie.

 

LexAnger, I don't believe it's true that a different SSRI is more effective as a reinstatement. There's so much variability among people, it's impossible to predict exactly what will happen, so we look to the history as a guide. Generally, it's best to reinstate a drug that was well tolerated before rather than to introduce a new drug that may cause adverse reactions, which will complicate the situation greatly.

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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Alto, I believe you know the best. Only after reading so many who got severe reaction after RI the original drug, myself included by one increased dose, and many people on SSirs switching From one to another for decades not getting reactions, I can't help but thinking that something mysterious in the play of the RI. You are absolutely right about the incredible variabilities not just across individuals but also within. I feel it will never be clear even with so called controlled studies, as the whole thing is super dynamic moment by moment beyond the most complicated mathematic modeling.

 

Like all statistics, there will be always a probably of error when dealing with individual cases. So a guessing game with higher chances is all we can do.

Drug free Sep. 23 2017

2009 Mar.: lexapro 10mg for headache for 2 weeks.

2009-2012: on and off 1/4 to 1/3 of 10mg

2012 June--2013 Jan,: 1/4-1/3 of 10mg generic, bad jaw pain

2013 Jan-Mar: 10 mg generic. severe jaw and head pain;

2013 Mar--Aug. started tapering (liquid ever since) from 10 to 5 (one step) then gradually down to 2.25 mg by July. first ever panic attack, severe head/jaw pain

2013 Aug.: back to 2.75 mg; Nov: back to Brand Lex. 2.75mg -- 3mg,

2014 June: stopped PPI, head pressure/numbness. up-dosed 4.5mg, severe reaction mental symptoms added on

2014 Aug--2015 Aug: Micro taper down to 3.2mg, .025mg (<1%) cut holding 2-3 weeks.

2015 Aug 15th, Accidental one dose of 4.2mg. worsening brain non-functional, swollen head, body, coma like, DR

2016 Feb., started dosing 10am through 11 pm everyday 2/13--3.2mg, 3/15-- 2.9mg, 4/19-- 2.6mg, 6/26--2.2mg, 7/22 --1.9mg, 8/16--1.8mg,8/31--1.7m g, 9/13--1.6mg, 9/27--1.5mg, 10/8--1.4mg, 10/14--1.3mg, 11/1--1.2mg, 11/29--1.1mg, 12/12--1mg, 12/22--0.9mg

2017: 1/7--0.8mg, 1/15--0.7mg, 1/17--0.6mg, 1/20--0.52, 1/21--0.4mg, 1/22--0.26, 1/23--0.2, 2/13--0.13mg, 2/20--0.06mg, 3/18--0.13mg, 6/1--0.12mg, 7/6--0.1mg, 7/14--0.08mg, 8/17--0.04mg, 8/20--0.03mg, 8/28--0.02mg, 9/6--0.0205mg, 9/8--0.02mg, 9/17--0.015mg, 9/20--0.01mg, 9/21--0.0048mg, 9/22--0.0001mg,

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  • 1 month later...

With regards to the 2 month window period suggested, where there's a chance reinstatement might not work, is this 2 months after discontinuation of a drug or 2 months after the onset of WD symptoms?

1989:   Started taking Anafranil for OCD; 1991: stopped abruptly, no problems

1992/3: started taking again; 1993: stopped abruptly, no problems

1993: started taking again, 50 mg Anafranil

Nov. 2014: started tapering, cutting 6.25 mg every 3-4 months; doses 50 mg, 43.75, 31.25, 25, 18.75, 12,50, 6.25, 0

 

Last dose of Anafranil: 6.25 mg, on 2 Feb 2017

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I'm fairly sure that it is 2 months from quitting the drug.

* 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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  • 3 weeks later...

What is considered an immediate bad reaction upon reinstatement?

May 2015-October 2015-Lexapro 20 mg fast taper due to pregnancy-no issues

Feb 2017-Zoloft 25 mg, too anxious/digestive issues (on for 3 weeks), switched to Lexapro 10mg, Mild serotonin syndrome from mixing lex with trazodone 2 weeks into Lexapro, body could no longer handle 10mg. Reduced to 5mg, then to 2.5, then stopped all together after 2 weeks on lex as I couldn't handle the agitation. 

March 2017-Seroquel-1 dose for sleep-panic and heart racing-discontinued

March 2017-Put back on 2.5 mg of Lex to titrate up slowly. 2.5 for 10 days, up to 5 for 5 days, dark thoughts, agitation, insomnia, reduced back down to 2.5mg and dr added remeron 7.5mg for sleep. Could not tolerate the two together (felt like ants in my head), so stopped Lexapro. Was good for 10 days then wd set in....nausea, shakiness, anxiety, complete insomnia.

 

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  • 3 weeks later...

HI,

 

My reinstatement experience:

 

Tapered off 40mg Celexa over 3 months. Over the next 3 months, felt increasing symptoms of irritability, self-consciousness, vulnerability to stress, low mood and anxiety, intrusive thoughts, emptiness and hopelessness. Was taking small amounts of Valium and Oxazepam for anxiety.

 

On reinstatement, anxiety went through the roof, extreme nausea and vomiting, waking really early with cortisol/ adrenalin spikes, felt desperate, didn't think meds would work again. Taking Lorazepam, valium, oxazepam to get though the day and sleep. Panic attacks.

Went up slowly 10mg for 2 weeks, 20mg for 1 week, 30mg for 3 1/2 weeks. Lost 4kg. Vomited a lot in the morning.

 

After 7 weeks, clouds parted and the sun came out and I felt safe again. 

 

SO: 3 months taper, 3 months off, nearly 2 months of HELL to get well again on ADs

Celexa (Citalopram)    40mg  - 60mg - 40mg for 7 years          Tapered (over 3 months) drug-free Aug–Nov 2013 CRASH

40mg    Dec 2013 – Jan 2017 (7 weeks reinstatement hell then relief)

2017:    20mg    30 Jan       18mg   19 April          16mg   6 May          14mg   20 May      12mg  10 Jun

              10mg   7 July          9mg    7 Aug               8mg     16 Oct          7.5mg  27 Nov         

2018:    7mg      8 Jan          6.5mg  12 Feb          6mg  17 Mar            5.2mg  14 Apr      5mg  28 Apr

             4.8mg  4 Jun           4.6mg   23 Jun         4.4mg   24 Jul          4.2mg 13 Aug      4mg  20 Aug

             3.8mg  1 Sep           3.6mg  28 Sep          3.4mg  14 Oct          3.2mg  11 Nov     3mg  5 Dec

             5mg    26 Dec          10mg  28 Dec

Added Valdoxan 25mg   12 Dec 2018      stopped 24 Jan 2019

Wellbutrin 150mg     25 Jan

 

 

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An immediate bad reaction would be a sudden worsening of any of the symptoms associated with withdrawal.  Tikki Tikki above has given a good example.  It might happen any time in those first 4 or so days. 

2010  Fluoxetine 20mg.  2011  Escitalopram 20mg.  2013 Tapered badly and destabilised CNS.  Effexor 150mg. 

2015 Begin using info at SurvivingAntidepressants.  Cut 10% - bad w/d 2 months, held 1 month. 

Micro-tapering: four weekly 0.4% cuts, hold 4 weeks (struggling with symptoms).

8 month hold.

2017 Micro-tapering: four weekly 1% cuts, hold 4 weeks (symptoms almost non-existent).

2020 Still micro-tapering. Just over 2/3 of the way off effexor. Minimal symptoms, - and sleeping well.
Supplements: Fish oil, vitamin C, iron, oat-straw tea, nettle tea.

2023 Now on 7 micro-beads of Effexor. Minimal symptoms but much more time needed between drops.

 'The possibility of renewal exists so long as life exists.'  Dr Gabor Mate.

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If I were Tikki, I might have started at a much lower dose of Celexa. But good to hear all has settled now.

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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  • 2 weeks later...

I did a quick taper off 20mg cipralex in 2 months that I had used for six years. Made it through 2 months off the drugs, not worth it I wish I had found this site prior to my taper. I've never felt so bad in my life the last two months. I'm a week into a small dose reinstatement already feel a bit better. Plus the fact I'm out of work it was a bad time go through withdrawal. Make sure you have time and a support system around you before you taper. I thank everyone on this site for Sharing there experiences. This battle with ssri is a tough one. I need to stabilize for awhile and regroup. Good luck

20 mg cipralex for 6 years, did a two months taper roughly 5mg at a time. Then 2 months drug free. Then needed to reinstate 5mg cipralex for one week now. Also take omega 3,Vit c, b12, glucosamine as supplements.

 

-so I've reinstate 5mg cipralex since may.19 till current.

 

-No other drugs being taken

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I am on day 5 of taking citralopam 20mg and I am already experiencing the negative side effects; feeling lethargy on waking and having to drag myself out of bed, less energy, general feeling of nothing! It has reminded me of what I was like on Prozac up to November last year. However, it is starting to ease my anxiety and depression. I felt I couldn't go on with the level of anxiety and depression that I was suffering. I wish I didn't have to take the AD. Physicly i had never felt better while off AD. I hope when I have some stability I will be able to try again and be free of these symptoms.

Prescribed Venlafaxine 150mg ..........

 19 Feb 2019 stopped Venlafaxine 150mg cold turkey. 06 March 2019 restarted Ven 125mg. 04 April 2019 9 mini pills. 02 May 2019 8 mini pills. 01July 2019 7 mini pills. 18 Aug 2019 6 mini pills. 24 Sept 2019 5.50 mini pills. 11 October 2019 5 mini pills. 5th May 2020 Reinstated Ven 125 mg XR 9 pills.

9th Nov 2020 Update Started splitting dose to twice per day

02/02/2021 can’t stabilise without symptoms. 
03/02/21 9 mini pills @ 10am 

Updated.... July 2021 108mg, Sept 2021 107mg, 

tapering steps to be updated

current dose 14 July 2023 80mg

23.07.23 75mg half way ! 

 

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  • 3 weeks later...
  • Moderator Emeritus

This is update from a member who successfully reinstated a small dose of Lexapro after 8 months off:

 

I just wanted to let folks know that I started taking Lexapro in liquid form in July and as soon as I hit .4 mg it was like magic. I had started at just one drop and slowly moved up. I'm still not 100%, but the lions share of symptoms were greatly reduced. I reintroduced 8 months after stopping Lexapro and so much suffering. So just to let people know, there is hope!

 

 

ive managed to find 3 peer-reviewed articles that mention the idea of acute post-withdrawal from ssri's - from a journal called Psychotherapy and Psychosomatics. It's frustrating to be in medical "grey area". There just are no studies done on long-term ssri use and then following the patient for several months. Everythings like "we gave them 6 weeks of Paxil and watched for withdrawal symptoms for a week after"

Current: 9/2022 Xanax 0.08, Lexapro 2

2020 Xanax 0.26 (down from 2 mg in 2013), Lexapro 2.85 mg (down from 5 mg 2013)

Amitriptyline (tricyclic AD) and clonazepam for 3 months to treat headache in 1996 
1999. - present Xanax prn up to 3 mg.
2000-2005 Prozac CT twice, 2005-2010 Zoloft CT 3 times, 2010-2013 Escitalopram 10 mg
went from 2.5 to zero on 7 Aug 2013, bad crash 40 days after
reinstated to 5 mg Escitalopram 4Oct 2013 and holding liquid Xanax every 5 hours
28 Jan 2014 Xanax 1.9, 18 Apr  2015 1 mg,  25 June 2015 Lex 4.8, 6 Aug Lexapro 4.6, 1 Jan 2016 0.64  Xanax     9 month hold

24 Sept 2016 4.5 Lex, 17 Oct 4.4 Lex (Nov 0.63 Xanax, Dec 0.625 Xanax), 1 Jan 2017 4.3 Lex, 24 Jan 4.2, 5 Feb 4.1, 24 Mar 4 mg, 10 Apr 3.9 mg, May 3.85, June 3.8, July 3.75, 22 July 3.7, 15 Aug 3.65, 17 Sept 3.6, 1 Jan 2018 3.55, 19 Jan 3.5, 16 Mar 3.4, 14 Apr 3.3, 23 May 3.2, 16 June 3.15, 15 Jul 3.1, 31 Jul 3, 21 Aug 2.9 26 Sept 2.85, 14 Nov Xan 0.61, 1 Dec 0.59, 19 Dec 0.58, 4 Jan 0.565, 6 Feb 0.55, 20 Feb 0.535, 1 Mar 0.505, 10 Mar 0.475, 14 Mar 0.45, 4 Apr 0.415, 13 Apr 0.37, 21 Apr 0.33, 29 Apr 0.29, 10 May 0.27, 17 May 0.25, 28 May 0.22, 19 June 0.22, 21 Jun updose to 0.24, 24 Jun updose to 0.26

Supplements: Omega 3 + Vit E, Vit C, D, magnesium, Taurine, probiotic 

I'm not a medical professional. Any advice I give is based on my own experience and reading. 

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