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Hi All, Yet another member of the OMG SSRI's I thought they were supposed to help me - club. My story. My mother is a schizophrenic - maybe related, maybe not, not sure. In my early 20's I struggled with fairly deep depression with anxiety - no specific reason or cause - again, I think it MIGHT have been inherited something from my mother. Got through that after a few years with help of good diet, reading a lot of self-help books, and finally travel. Had a fantastic childhood, always on the go. Deep interest in technology and IT. Moved from Australia to UK to travel and see world. Met loveliest lady in Victoria in 3 months! Instantly knew we were right. Happy. Never really was a "depressive" personality, fairly introverted and normally interested in lots of things. had some mood dips, took St Johns Wort occassionally - not sure if it did much, but low moods NEVER last long for me. I'd always bounce back. But nothing major. Anyway - flashforward to about 2008. In a job in IT. Had an extremely stressful situation build and build - sought help internally in the company - wasn't really helped much. Finally my wife got me to goto her regular GP doc. She signed me off for 1 month of work, gave me some of tranquilizer which I didn't like at all, and 10mg of Lexapro. She said I might feel MORE anxious starting Lexapro - I was a bit sceptical... but went along with it. Work situation was sorted out, went back to work. Was ok. Wasn't nearly as interested though, felt less "sharp" and less switched on. Thought it was that I was just over the job. After approx 18 months (I really didn't take notice of a lot of the dates back then) I thought right lets stop the tablets. Took 5mg for 2 weeks and stopped. Started getting the brain zaps - they weren't THAT bad, thougth they were weird and interesting more than anything else. What got me was the intense muscle aches and crippling depression and extreme confusion and brain fog. After a few days of suffering with this and being very irritable, my wife said "For god sake, take your med!!" So I swallowed that 10mg tablet and a few hours later, started to feel more human again. Thats when I was like omg I'm stuck on these things. Went to see the doc who put me on them, and she completely dismissed me saying they're not addictive. I didn't see her again, got repeats from other doctors who seemed to understand the situation a bit better. I went on my merry way thinking, I'll deal with coming off them another time - later when things are better. Fast forward a few more years, in 2 newer jobs - again, struggling mentally to learn new things and retain things, and "care" about the job. Started to get dizzy spells - 5-10 seconds, tingling in feet, and growing apathy, slowly losing more and more interest in hobbies and interests, really having to push myself. Felt like I was in a rut... just felt "off", not myself, and constantly like I'm about to come down with the flu or something. Was it my teeth? Something wasn't right. Just notched it up to being in a rut, and "getting older"... not sure why I thought that, but thats how I rationalized it. I started getting SORT of brain zaps, even though I was taking my meds daily. I was doing half of a 20mg tablet for years to save costs (the 20mg cost same as 10mg here in AUS). Eventually something clicked in my brain that I wasn't feeling right, starting googling my symptoms and eventually found people on SSRI's having similar - came to various sites like survivingantidepressants and paxilprogress etc etc etc, and there were literally 10,000's of people in the same boat. Finally an answer! I still couldn't quite work out exactly what was going on with me though. As I felt bad on 10mg, the thought of DROPPING in dose scared me - and I did something very very silly (in hindsight).... and took myself upto 20mg!!!!!!!!!!!!!!!!!!! I know, I know. I started to feel better, but my brain was still "drugged", but I was feeling as if my brain was getting oxygen. I stayed there for about 2-3 weeks, and went down to 15mg - getting quite strong waves of anxiety, but it was still better than the "nothing" I'd been feeling... also got a little "high" with a fair bit of energy - and "windows" of very clear thinking... they didn't last very long though. My aim was to "kick-start my brain" and get back to 10mg to then start tapering properly. I jumped to 20mg in around sept or oct 2014, then 3 weeks later to 15mg. when I got back to 10mg I started getting waves of muscle aches (to me that is the WORST withdrawal symptom - I literally cannot stand that feeling of deep pain in my body - same when I get the flu too). Was taking some codeine and ibuprofen to take edge off, as well as a mouthful of Omega 3, Magnesium, NAC, and Choline supplements - as well as a multivitamin. Overall, I didn't feel TOO bad, some dizziness, whooshy feelings, lightheaded, some concentration issues etc, but nothing I couldn't push through. But I was having some waves of being interested again - which I loved... although I could STILL "feel" the Lexpro suppressing my emotions and perception ability, like things don't really penetrate, like you have cotton wool around you. Anyway - I felt "stable" on 10mg again... and dropped to 7.5mg.... I was at that for about 4 weeks. I was hoping to feel stable on it, but the muscle aches kept coming and going, seeming to get a bit worse with each wave, then I started to get waves of depression along with it, each "wave" seemed to be worse than the last. After 4 weeks I thought I would be over the worst of it, and I als thought I'd be stable for Xmas time with the family. WRONG! I got good news about a new job - and was able to quit current job quickly - and spend 2 weeks at home. Great. wrong. Crashed BIG TIME, on couch - could barely move, felt incredibly depressed, felt like lead in my arms and legs, and couldn't get off couch. ARGH - not now!!! went back to 10mg tablet - started to feel a bit of relief.. but it now seems after 1 week of being on 10mg that the symptoms are getting to me aghain - slowly building muscle aches and depression... So the reason I'm here - I can't seem to get to a stable dose again... so do I need to go UP to 15mg to get "stable" and taper slowly from there? I'm really confused as to what I need to do now. I've got a bottle of liquid Lexapro, although it is 10mg /1ml which is very potent. I've got an oral syringe to help measure out the doses. But I really don't know what I should do now. Any advice??
Pharmacol Res. 2018 Oct 29. pii: S1043-6618(18)31201-5. doi: 10.1016/j.phrs.2018.10.025. [Epub ahead of print] The Emergence of loss of efficacy during Antidepressant Drug Treatment for Major Depressive Disorder: An Integrative Review of Evidence, Mechanisms, and Clinical Implications. Fornaro M1, Anastasia A2, Novello S3, Fusco A4, Pariano R5, De Berardis D6, Solmi M7, Veronese N8, Stubbs B9, Vieta E10, Berk M11, de Bartolomeis A12, Carvalho AF13. Abstract at https://www.ncbi.nlm.nih.gov/pubmed/30385364 The re-emergence (i.e. 'breakthrough') of depressive symptoms despite maintenance treatment of depression with antidepressant drugs is a complex clinical phenomenon referred to as tolerance. Herein we critically appraise evidence from both pre-clinical and clinical studies, focusing on putative mechanisms as well as clinical correlates and implications of the emergence tolerance during antidepressant treatment for major depressive disorder (MDD). It is firstly unclear to what extent this phenotype reflects a pharmacological effect of an antidepressant, is driven by non-adherence, is a marker of latent bipolarity or another comorbidity, a marker of neuroprogression of the underlying disorder or the intrusion of the impact of psychosocial variables into the clinical course. The operational definitions of tolerance and its related phenomena have also been largely inconsistent. Several protective clinical indicators have been proposed, including a rapid-cycling course and comorbid chronic anxiety, whilst poor treatment adherence, proneness to emotional blunting and sub-threshold bipolarity have been identified as possible correlates of tolerance to antidepressant treatment in MDD. Putative neurobiological underpinnings include adaptations in the hypothalamic-pituitary-adrenal (HPA) axis and the serotonergic system. Due to the clinical and diagnostic challenges imposed by the emergence of tolerance to antidepressants, there is an urgent need for upcoming international guidelines to reach a consensus on operational definitions for this complex clinical phenomenon, thus enabling a more precise appreciation of the incidence and correlates of tolerance to antidepressants. Taken together, the present review underscores the need to cautiously weight benefits and risks prior to considering long-term antidepressant treatment for patients with MDD as tolerance may emerge in a subset of patients.
From: verywell.com What is "Prozac poop-out"? If it seems like your Prozac (or another SSRI such as Zoloft, Paxil, or Celexa) stopped working, why might that be, and what can you do? What Exactly is Prozac Poop-Out? When we talk about the phenomenon of Prozac (fluoxetine) poop-out, what we mean is that a person's antidepressant has simply stopped working as well as it once did, causing a relapse of depression symptoms. Although this phenomenon is most commonly referred to as "Prozac poop-out," it can actually occur with any SSRI. An selective serotonin reuptake inhibitor or SSRI is a type of antidepressant medication which is able to prevent nerve cells from taking back up a mood-regulating neurotransmitter called serotonin. This allows more serotonin to be available in the spaces between nerve cells where it can be used, possibly helping depression. Other SSRI's which may cause Prozac poop-out include: Zoloft (sertraline) Paxil (paroxetine) Celexa (citalopram) Lexapro (escitalopram) To read the rest of the article, click on this link to the source web page: https://www.verywell.com/what-is-prozac-poop-out-1067022 .
leahbean posted a topic in Introductions and updatesHello everyone. I wanted to jump on here and hopefully gain some perspective on my situation. I started Lexapro 10 mg in Oct. 2012 for situational depression. As that situation resolved, I questioned whether I still needed to be on it and began tapering in April 2014. I went down to 7.5 mg for about a month, then discovered I was pregnant. I really wanted to wean off Lexapro for the duration of the pregnancy. Sadly I miscarried at 10 weeks. I was still on 7.5 mg for a little while. Felt I processed the miscarriage as much as I could, then went down to 5 mg for awhile. I was doing okay anxiety-wise, I thought. Went down to 2.5 and discovered I was expecting again! I was overly anxious the whole time, given the outcome of my last pregnancy. I stayed at 2.5 for pretty much the whole pregnancy, went down slowly from 2.5 as time grew closer to delivery. I got down to less than 1 mg with liquid, and then stopped right after I delivered. I was wholly unprepared for what happened next. Three days postpartum, I had an anxious/depressive meltdown, thinking things like, "I shouldn't have had this baby" (even though he was very much wanted), I've ruined my family's life, how am I going to handle caring for two kids instead of one, etc. I was trying to nurse every 2-3 hours, while fighting through unrelenting panic attacks. I would even wake up from sleep in the midst of an attack. It got so that I didn't want to sleep even if someone offered to watch my son because I was so afraid of the panic attacks. Wild mood swings, couldn't stop crying, suicidal thoughts, feeling hopeless, helpless, the whole nine yards. I felt like I was losing my mind and went to the ER. They were pretty much useless, just telling me to go all the way back up to 10 mg of lexapro and everything would eventually be okay. The panic attacks continued. On my husband's birthday, I woke up in the worst panic attack I'd ever had. I knew I couldn't go back to the ER, and checked myself in to a psych ward because I seriously felt like i was going nuts. They were useless as well, only giving me Vistaril and 10 mg Lexapro. My husband busted through h*** to get me out of there less than 24 hours later. The anxiety from there continued. I felt severe DP/DR, and could barely make myself a sandwich to eat. Changing my clothes and showering was a huge accomlishment. Continuing to feel desperate to get back to myself, I did arguably the worst thing I think I could have done: I checked into an inpatient treatment program for perinatal mood disorders. There they proceeded to pump me full of Lexapro, letting me stay at 5 mg for just one night. It was quickly ramped to 10, then 15, then 20, which I was discharged on a mere two weeks later. I was given Klonopin and Benadryl as needed for sleep. I was also advised to take Risperdal, which I adamantly refused. This was about 10 weeks ago. I have since come under the care of a reproductive psychiatrist who has continued me on Lexapro 15 mg, Buspar 10 mg, Lamictal 25 mg, and Vistaril for sleep. She tried augmenting the Lex with Wellbutrin when she wasn't seeing a "quick enough" response. It made my anxiety worse, and gave me a very frightening moment where I was in the midst of a crying fit, and then suddenly felt like laughing for no reason, so I discontinued it. I'm yards better than I was. However, I am having some problems now that I wasn't before and am hoping to taper back off the Lexapro, because I'm thinking (wondering) that I didn't so much have a new episode of depression. Rather I have a theory that while pregnant, the difficulties of coming off Lexapro were masked by my pregnancy hormones, and after delivery, when those dropped, and my body wasn't getting any Lexapro at all, I crashed and burned. You should've seen the look on my pdoc's face when i told her this theory...I though she was going to have a heart attack. Since reinstating lexapro, I've had racing thoughts (sometimes I can't even figure out what I'm thinking about), headaches, vision problems, increased anxiety, difficulty with word finding, lack of concentration (can't even read an easy chapter book with my 9 year old daughter), difficulty focusing on conversations, weight gain, obsessive thinking, songs looping in my head, random movie scenes popping into my head, suicidal thoughts, intrusive thoughts, brain fog, easily triggered by frightening things, etc. I feel like now, somehow, lexapro is too activating for me. I've wondered if I've slipped into hypomania or something. Women can sometimes be misdiagnosed with postpartum depression, when they've really converted to bipolar disorder. those women are at greatest risk for psychosis. I have no family history of bipolar, though my sister was misdiagnosed with it a few years ago. She's way more on that spectrum than I ever have been. So here is my conundrum: I don't want to go back to where i was after I delivered. I CAN'T go back there. however, I feel that with each pill I swallow, I'm giving myself a chemical lobotomy. I can't afford to lose any stability trying to care for my children. I know I can't ask for medical advice here, but I just have two questions: 1. Is my theory about having a really bad reaction to complete withdrawal totally unfounded, or could this have some merit? 2. Should I even think about tapering off Lexapro right now, feeling that it's too activating for me? I've tried to tell my doctor this many times and she feels that if it's helping even a little, it's worth continuing. I feel as though I have to continue the Lamictal for now. Needless to say, these last several months have been extremely traumatizing for my whole family. I just want to do right by everyone, and remember to include myself in that mix. Thanks for reading.