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  1. See journal articles about PSSD in Papers about Post-SSRI Sexual Disorder (PSSD) Please note that SurvivingAntidepressants is a site for tapering and recovery from withdrawal syndrome. While we see PSSD sometimes as an aspect of withdrawal syndrome (and we see gradual recovery from it as well as withdrawal syndrome), this site is not specifically for discussion of treatment of PSSD or its neurological origins (which at this time are highly speculative). If you wish to discuss symptoms, theories, and treatment of PSSD, please go to these sites: PSSDforum http://www.pssdforum.com/ Yahoo group SSRIsex (log in to http://Yahoo.com to join) Facebook group (log into Facebook.com to join) Various pages on Rxisk.org
  2. Hi all, I've just signed up, have been a member of benzo buddies for last few months as I thought my problems were from benzos, but as I'm improving I've realized it's more antidepressants. Long story short I've been on and off Citalopram for past 15 years, each time reached tolerance and came off, only to have what I now know to be withdrawal and reinstated. I can't believe nobody tells you this. Got diagnosed with fibromyalgia (withdrawal), tried Valium, Xanax, ativan, cymbalta, Prozac all stopped CT. Final wammy was stopping Valium for the 3rd time and trying to up my Citalopram which by this point was only 5mg. (I was on 40mg at 1 point a few years ago and couldn't work out why I couldn't take it anymore.) Had to go to the ER, now unable to tolerate any medication as kindled on both benzos and AD. I've found even eating ginger puts me into a wave as it affects serotonin. I've been in hell for 6 months and desperate for anything that may help. Have tried to reinstate twice, but even 0.5mg is too much and takes a month to return to baseline Anyone else as damaged as me, and found any relief?
  3. AKA 5htp and oxitriptan (INN) [Also see our topic on SAM-e] http://www.5-htp.net/Safety.asp 5-HTP Safety, Side Effects and Dangers Safety and Side Effects 5-HTP appears to be well tolerated with few and relatively mild side effects, the most common being nausea. However, large doses of 5-HTP should be avoided as it can result in the formation of excessively high levels of serotonin in tissues other than the brain, resulting in significant adverse reactions. 5-HTP is generally better tolerated than its SSRI counterparts, such as Prozac®........ Source: 5-HTP The Natural Way to Overcome Depression, Obesity, and Insomnia by Michael Murray, N.D. 5-HTP should not be taken concurrently with anti- depressants except under the supervision of a physician, because 5-HTP increases the activity of these drugs. 5-HTP should be avoided by pregnant women, nursing mothers and those with significant cardiovascular disease. It is also contraindicated in those with carcinoid tumors. Large doses of 5-HTP may significantly increase serum levels of serotonin which, at least theoretically, may result in the serotonin syndrome which can be very serious, although there have been no reports of the syndrome occurring with use of 5-HTP in humans. Do not exceed 900 mg per day. Vitamin B6 taken in doses of 5 milligrams or greater causes 5-HTP to be converted into serotonin before it passes into the brain. Since serotonin does not easily pass the blood-brain barrier as 5-HTP does, this effect is undesirable and can be detrimental. May have additive effects with tryptophan, St John's wort, and SAMe. Be sure to get 5-HTP from a reputable source to ensure purity, such as MedQuest Pharmacy. As with any supplement, 5-HTP can be abused. However, when used wisely, it has proven itself to be a safe and effective supplement........... *The information provided herein should not be used for diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. PROZAC is a registered trademark of Eli Lilly and Company. _______________________________________________________________________ http://www.progressivehealth.com/5-htp-risks.asp Dangers and Benefits of 5-HTP 5-HTP is a supplement used to help with many conditions, including depression, obesity, carbohydrate craving, bulimia, insomnia, narcolepsy, sleep apnea, migraine, headaches, and fibromyalgia. Although there are several conditions, which are helped by, taking 5-HTP there are also dangers when taking it with out know how to take it. Benefits of Taking 5-HTP 5-HTP is an amino acid. The body makes 5-HTP from tryptophan (an essential amino acid) and converts it to an important brain chemical known as serotonin. Tryptophan and 5-HTP dietary supplements help raise serotonin levels in the brain, which may have a positive effect on sleep, mood, anxiety, aggression, appetite, temperature, sexual behavior, and pain sensation. Depression - Low levels of serotonin in the brain can contribute to the development of depression. Many drugs prescribed for depression increase serotonin levels. Some studies indicate that 5-HTP may be as effective as certain antidepressant drugs in treating individuals with mild to moderate depression. Such individuals have shown improvements in mood, anxiety, insomnia, and physical symptoms. Fibromyalgia - 5-HTP has been shown to improve sleep quality and reduce pain, stiffness, anxiety, and depression in individuals with fibromyalgia. Insomnia - Medical research indicates that supplementation with tryptophan before bedtime can induce sleepiness and delay wake times. Studies also suggest that 5-HTP may be useful in treating insomnia associated with depression. Headaches - Some studies suggest that 5-HTP may be effective in children and adults with various types of headaches including migraines. Obesity - There is some evidence that low tryptophan levels may contribute to excess fat and carbohydrate intake. When Not To Take 5-HTP As with any supplement, 5-HTP can be abused. However, when used wisely, it has proven itself to be a safe and effective supplement. While this supplement appears to be safe for most people, 5-HTP danger occurs when people mix 5-HTP with prescription medications and herbal supplements. Taking too much 5-HTP is also dangerous. 5-HTP should not be taken concurrently with anti- depressants except under the supervision of a physician, because 5-HTP increases the activity of these drugs. Mixing SSRI medications and 5-HTP may result in a rare but extremely serious condition called serotonin syndrome. People with serotonin syndrome exhibit a variety of symptoms including confusion, restlessness, hallucinations, fever, nausea, and vomiting. Coma and death follow swiftly after symptoms appear. 5-HTP should be avoided by pregnant women, nursing mothers and those with significant cardiovascular disease. It is also contraindicated in those with carcinoid tumors. Mixing 5 HTP with herbal supplements for depression such as St. John's Wort is also not recommended. Like SSRI medications, St. John's Wort alters the delicate balance of brain chemistry. 5 HTP can tip the balance into dangerous territory. 5-HTP Overdose Individuals who take 5-HTP may expect it to act quickly, altering their mood overnight. Medications, supplements and herbs that act upon neurotransmitters usually need to be taken for several weeks before patients start to feel the effects. Some people take more and more 5 HTP, hoping that taking more will increase the effectiveness more quickly. This can create a dangerous condition called, serotonin syndrome. Many alternate health practitioners recommend starting slowly with 5 HTP and taking it for only short periods of time to avoid dangerous overdoses. 5-HTP Side Effects Reported side effects from taking 5-HTP include nausea, vomiting, and difficulty breathing. Dangerous doses of 5-HTP can cause agitation, fast heart rate, a boost in blood pressure—and in rare cases, coma and even death. Combining it with an antidepressant, any other drug that affects serotonin levels or herbal supplements like St. John's Wort can also cause such side effects. People who have heart disease, peptic ulcers, kidney disease, or clotting disorders should definitely not take this supplement. ____________________________________________________________________________________ http://wellnessletter.com/html/ds/ds5HTP.php 5-HTP Claims, Benefits: Treats or prevents insomnia, depression, and other problems; modifies mood. Bottom Line: In 1989, thousands of people taking tryptophan developed a rare and incurable blood disease, leading the FDA to ban all sales of the pills. 5-HTP, a close relative of tryptophan, is being taken as a substitute for it. Its potential dangers outweigh any possible benefits. Full Article, Wellness Letter, January 2005: Playing with Brain Chemicals For years people took tryptophan pills to treat insomnia and depression and to improve mood. This amino acid is converted in the brain into serotonin, an important neurotransmitter that affects mood and sleep, among other things. But in 1989 the Food and Drug Administration (FDA) banned all sales of tryptophan because of an outbreak of eosinophilic myalgia syndrome (EMS, a rare disorder that affects the skin, blood, muscles, and organs) among thousands of people taking the pills. At least 30 people died. The epidemic was traced to a bad batch of tryptophan from one Japanese manufacturer, which apparently introduced an impurity when it altered its manufacturing process. A cousin steps in Since then 5-HTP (5-hydroxytryptophan), a close relative, has replaced tryptophan in health-food stores and drugstores and on the Internet. The body makes 5-HTP from tryptophan; and like tryptophan, 5-HTP is converted to serotonin in the brain. The supplement is derived from the seeds of an African tree. For decades European doctors have used it to treat depression and several other disorders. Some small studies suggest that 5-HTP may be as effective as standard antidepressants, but most of these studies were not well designed. And other studies have not found a benefit. There’s some preliminary evidence that the supplement may play a role in weight loss and may help against mild insomnia. One problem: when some people take the supplement, their blood levels of 5-HTP do not rise, so there’s little chance of a benefit. Just how safe is it? Reported side effects include nausea, vomiting, and difficulty breathing. High doses of 5-HTP can cause agitation, fast heart rate, a boost in blood pressure—and in rare cases, coma and even death. Combining it with an antidepressant, any other drug that affects serotonin levels (such naratriptan or sumatriptan, used to treat headaches), or “herbal antidepressants” such as St. John’s wort can also cause such side effects. People who have heart disease, peptic ulcers, kidney disease, or clotting disorders should definitely not take this supplement. Even though the manufacture of 5-HTP is very different from that of tryptophan, worries about contamination remain. Researchers from the Mayo Clinic have found an impurity known as “peak X” in commercial samples of 5-HTP; the FDA has also spotted impurities. Substances similar to “peak X” were found in the tryptophan involved in the 1989 outbreak of EMS. So far, however, there have been no confirmed cases of the illness from 5-HTP supplements. Final thoughts: Some dietary supplements, notably 5-HTP, can influence brain chemicals. As the tryptophan story showed, even though they are marketed as “natural,” they can have serious adverse effects—just like traditional antidepressants. The potential dangers of 5-HTP outweigh any possible benefits. UC Berkeley Wellness Letter, January 2005 ____________________________________________________________________________________ http://www.ehow.com/about_5600605_5_htp-dangers-stomach.html 5-HTP & Dangers to the Stomach Tully Grey Tully Grey is a freelance writer living in Chicago who has been writing for 10 years. She attended Columbia College in South Carolina and is currently pursuing a B.A. in history. Her fiction has appeared in The Broadkill Review and will appear in The Dead Mule School of Southern Literature. She has written nonfiction for The Post and Courier and iNeTours.com. By Tully Grey, eHow Contributor 5-HTP, or 5-hydroxytryptophan, is used by your body to produce brain chemicals like serotonin. Serotonin helps regulate your mood, appetite and energy level. 5-HTP helps maintain your serotonin levels, which can alleviate depression, kick-start weight loss and increase your energy. While 5-HTP can be beneficial, it does have side effects that can include mild gastrointestinal problems. Nausea Your digestive system can be sensitive to serotonin, and 5-HTP can lead to some mild nausea. The higher the dose, the more likely this is to happen. Higher doses are generally given to patients who are using 5-HTP to help with weight loss or fight obesity. Standard doses of 50mg to 100mg don't tend to bring on nausea. Diarrhea If your serotonin level becomes too high, you can develop serotonin syndrome. If this happens, you could experience side effects, one of which is diarrhea. The risks of serotonin syndrome increase when you take 5-HTP in combination with MAOIs, or monamine oxidase Inhibitors, as MAOIs prevent serotonin from being chemically broken down. Consult your doctor before beginning or ending any drug program. Empty Stomach If your reason for starting 5-HTP is appetite regulation, you should take it about 20-30 minutes before eating so that it will enter your brain and begin converting to serotonin faster. If you have other reasons for taking 5-HTP, you should be able to take it three times a day in small doses without nausea. You won't have to take it before meals if the purpose for taking it is not to promote weight loss or combat obesity. After Meals If you tend to eat more during the night hours than in the morning or during the day, it may be beneficial to take a 100mg dose of 5-HTP immediately after your last meal. If nausea follows, it should be temporary and subside after a few days. Sipping a ginger ale can be beneficial if nausea occurs after a meal. Avoid caffeinated drinks, as these can keep you awake as well as counteract the effects of 5-HTP. Gastrointestinal Side Effects Other side effects of 5-HTP that occur in the stomach are loss of appetite, diarrhea, cramps, vomiting and gas. Most of these symptoms occur when you take more than 100 ___________________________________________________________________________________ http://vitamins.lovetoknow.com/5_HTP_Danger 5 HTP Danger By Jeanne Grunert If you're concerned about 5 HTP danger, careful consideration of the risks and benefits may allay your fears. What Is 5 HTP? The product known as 5 HTP contains a naturally occurring brain chemical, 5-hydroxytryptophan. Synthesized from proteins containing tryptophan, 5 HTP whirls through the brain with a bevy of chemical compounds called neurotransmitters that affect mood, sleep, and appetite........... 5-HTP works with the neurotransmitter serotonin. Individuals take 5-HTP to combat depression, anxiety, and insomnia. Recently many companies have begun touting 5 HTP as a weight loss product. Both prescription and non-prescription supplements affecting serotonin appear to decrease appetite. Scientists aren't sure of the exact mechanism at work, but preliminary theories suggest that when serotonin levels are low, the body boosts the appetite in a quest to ingest as many foods as possible that provide the building blocks of serotonin. A 5 HTP Danger While this supplement appears to be safe for most people, 5 HTP danger occurs when people mix 5 HTP with prescription medications and herbal supplements. Taking too much 5 HTP is also dangerous. Antidepressants and 5 HTP People suffering from depression frequently take medications known as selective serotonin reuptake inhibitors (SSRI). Medications in this category include brand names such as Prozac, Lexapro, Celexa, Paxil and others. The exact way that these medications improve mood isn't known, but doctors speculate that SSRI drugs block the reuptake of serotonin in the brain, leaving more circulating serotonin for use by the brain itself. This process improves neurotransmission among nerves that affect mood. SSRI medications exert a powerful influence on brain chemistry. It's no surprise then, to learn that taking 5 HTP and a prescription SRRI poses great danger. Remember that 5 HTP itself interacts in complex ways with the entire serotonin reuptake system in the brain. Because the SSRI medications are already altering the delicate symphony of chemicals, adding 5 HTP to the mix creates cacophony. Mixing SSRI medications and 5 HTP may result in a rare but extremely serious condition called serotonin syndrome. People with serotonin syndrome exhibit a variety of symptoms including confusion, restlessness, hallucinations, fever, nausea and vomiting. Coma and death follow swiftly after symptoms appear. Anyone taking antidepressant medications, 5 HTP or a combination of substances who begins exhibiting these symptoms should go to the nearest hospital immediately. Herbal Supplements and 5 HTP Just as mixing prescription medications with 5 HTP is dangerous, mixing 5 HTP with herbal supplements for depression such as St. John's Wort is also not recommended. Like SSRI medications, St. John's Wort alters the delicate balance of brain chemistry. 5 HTP can tip the balance into dangerous territory. If you have any questions about these medications, supplements or herbs, please consult your doctor or another qualified health professional, and always tell your doctor about vitamin and herbal supplements you are taking to avoid dangerous interactions. 5 HTP Overdose Individuals who take 5 HTP may expect it to act like a magic pill, altering their mood overnight. Medications, supplements and herbs that act upon neurotransmitters often need to be taken for several weeks before patients feel the effects. In their rush to feel better, some people take more and more 5 HTP, hoping that "more is better" and the substance will improve their mood faster. This can create the dangerous condition mentioned above, serotonin syndrome. Many alternate health practitioners recommend starting slowly with 5 HTP and taking it for only short periods of time to avoid dangerous overdoses. Other Side Effects People taking 5 HTP also report other side effects, including nausea and stomach upset, irritability, and insomnia. If symptoms worsen or you feel ill taking 5 HTP, discontinue and see a physician immediately. Peak X Dangers No discussion of 5 HTP danger is complete without mentioning "peak X", a term coined in 1994 when a woman came down with a serious and rare condition called eosinophilia-myalgia syndrome (EMS). In this condition, the body overproduces eosinophils. Eosinophils are white blood cells responsible for combating infections. In EMS, high levels of eosinophils cause trembling, extreme muscle pain, and shortness of breath. In 1994, a Canadian woman came down with symptoms of EMS after handling 5 HTP pills intended for her children who required the supplement for medical reasons. Although the children didn't become ill, they also had higher than normal levels of eosinphils. The suspected compound within 5 HTP that created these side effects was named "peak X". Today, most alternate health practitioners feel that the supply of 5 HTP is free from peak X. Dr. Michael T. Murray, a doctor of naturopathy, provides a complete case history on 5 HTP and peak X online, and concludes that it would take massive doses of 5 HTP to cause EMS symptoms. Anyone taking 5 HTP, however, should be aware of the possibility and check with a physician if they experience unusual symptoms.
  4. Hi--I'm so glad this site exists. I took my last dose of Prozac on December 15, 2018. 3 days later, what I call the Horror, began. I had been on ssri's for over 20 years during which time I had become constantly sick. It never occurred to any doctor that my illnesses were medication related. Eventually I began to link studies of the ssri's to my problems. I tapered over a 6 month span, and now realize with the discovery of SA that it was probably too quick. I'm frightened because I still don't sleep well, suffer from akinesia, bone-crunching depression, suicidal ideation, especially in the night and mornings, tinnitus, extreme weight loss, blurred vision, and obsessive ruminations. This mental state is a million times worse than anything I experienced before starting on Zoloft. At that time, my husband had been diagnosed with Huntington's Disease, and during the first 2 years Zoloft did seem to help me cope. After that, it never worked the same, though the dose was consistently increased. Eventually my doctor had read that Zoloft was associated with an increased risk of stroke in those over 60, and he switched me to Prozac. Over these years I lost my hair, had an oophorectomy for cysts on my ovaries, had appendix removed, two heart attacks, and was put on Enalapril for HBP, Metformin for diabetes. I always had digestive problems during this time--including hiccups! And terrible sweating-- Three days after my last dose of Prozac, I was admitted to ER with BP of 250/150ish. Administered clonidine. Back to ER again about a week later with same high BP which had never gone down. My urine was pink. My body and mind could barely function. I was given a diagnosis of Serotonin Syndrome by the ER toxicologist. Since then I have tapered off the Ace inhibitor in 2019, and Metformin, the last dose being in March 2020. About 8 months in, it seemed I might be improving somewhat, but the final withdrawal from Metformin has set me back again. A couple of months ago, the mental nightmare had become so unrelenting I considered reinstating, but haven't. I still can't watch movies, read novels, or enjoy music the way I did. But the good news is that my blood pressure is now normal. This month I've slowly returned to my job part time after nearly a year away. Thank you for all that you all contribute here. I hope I can offer support as well. Your journeys mean a ton to me--life rafts, in fact. Zoloft: 1995 - 2015 Prozac: 2015 - 2018 (tapered from July to December) Gabapentin: 2016 to 2019 Enalapril: 2010 - 2019 Lipitor: 2017 -2017 Metformin: 2000 - 2020 Liothyronine: 2007 - 2019 Levothyroxine: 2000 - Happy to be here, Arbor
  5. Hi folks, Just looking for a bit of advice. I'd been on Prozac, 25mg a day, for 9 months, for depression and wanted to come off them. I was advised by my doctor to take a 25mg tablet on alternating days for 1 month and then stop completely. I did this and have now been off for 4 weeks. Asides from some rather severe depression symptoms my main withdrawal issue has been PGAD (Persistent Genital Arousal Disorder), something which I suffered with 2 years ago. What I'm wondering is, does this mean I tapered off too quickly? I should also mention I have M.E. and tend to respond strongly to drugs. Is the best plan of action to just ride this out and hope the symptoms go or to go back on the Prozac and taper off again much slower? (my doctor did tell me if I go back on the Prozac I'd have to stay on for 2 years but I really don't want to do that.) Any advice appreciated, Thanks
  6. Hello to all. Thank you for this site. I'm sorry to all who are suffering through this. Back in August I was down to 112.5 mg of effexor from 187.5 when my doctor put me on 30 mg of prozac to help with my taper. Over a few weeks I developed seratonin syndrome and had to stop both at once on Sept 19th. I've been going through withdrawal ever since with it getting worse every morning. It is extreme in the mornings now. I found a fb group and started reintroducing effexor starting with 8 beads on Thursday Oct 15th. My main most disabling symptoms are extreme nausea, vomiting, dry heaving, diarrhea, and feeling extremely hot and prickly electric type shocks to my body. Any advice that anyone can offer would be greatly appreciated. I plan to hold at this dose for a week and then go up if not stable.
  7. ADMIN NOTE: Read this entire topic before attempting a switch to fluoxetine. Be sure to read details and cautions below . Consult a knowledgeable medical practitioner before changing medications. Also see Tips for tapering off fluoxetine (Prozac) Switching or bridging with another related drug, usually of a longer half-life, is a medically recognized way to get off psychiatric drugs, particularly if you find tapering your original drug to be intolerable. Many people with failed tapers from venlafaxine (Effexor), desvenlafaxine (Pristiq), paroxetine (Paxil), and duloxetine (Cymbalta) find they need to bridge in order to go off the drug. For many doctors, a switch to Prozac to go off a different antidepressant is routine. Because of the risks of switching drugs -- see below -- we recommend attempting a very gradual direct taper from your drug, with bridging with a different drug only a last resort. There are a lot of unknowns in bridging. Fluoxetine (Prozac) has the longest half-life of any of the modern antidepressants. Because it takes more than a week for a dose to be metabolized completely, a careful taper off fluoxetine is easier for many people -- see information about Tapering off Prozac. And, at least fluoxetine comes in a liquid. (Do not assume fluoxetine is "self-tapering"! We have many people here with Prozac withdrawal syndrome. While going off fluoxetine usually has less risk, one might still develop withdrawal symptoms going off fluoxetine. No bridging strategy is risk-free.) Citalopram (Celexa )and its sibling escilatopram (Lexapro) have half-lives of about 35 hours, a relatively long half-life among SSRIs, and are other candidates for a bridging strategy. They also come in a liquid form. You must find a knowledgeable doctor to help you to with a bridging strategy. The cross-taper method discussed below is probably the safest way to make a change in drugs. You might wish to print this post out to discuss it with your doctor. For most people the switch goes smoothly but for some it doesn't. The drawbacks of switching to another drug to get off the first drug, described below, apply to ALL bridging strategies for ALL drugs, including benzodiazepines (where people often want to bridge with diazepam per the Ashton method). Risks of bridging A bridging strategy has the following drawbacks for a minority of those who try it: Dropping the first antidepressant in the switch may cause withdrawal symptoms even though you're taking a bridge drug. Adverse reaction to the bridge drug, such as Prozac. Serotonin toxicity or adverse effects of a drug combination. If withdrawal symptoms are already underway, switching to a bridge drug may not help. A cross-taper requires a number of careful steps. Difficulty tapering off the bridge drug. All of the bridge drugs can be difficult to taper themselves. So, like anything else, a drug switch is not guaranteed to work. When to switch or bridge "The devil you know is better than the devil you don't know". A direct taper from the drug to which your nervous system is accustomed carries less risk than a switch to a new drug. You may have a bad reaction to the substitute drug, or the substitution may not work to forestall withdrawal symptoms. The risk of a switch is justified if you find a taper from the original drug is simply too difficult. Usually people will do a switch when they find reducing the original antidepressant by even a small amount -- 10% or even 5% -- causes intolerable withdrawal symptoms. (I have heard doctors say they don't even try tapering off paroxetine (Paxil) or venlafaxine (Effexor ), they switch to Prozac at the beginning of the tapering process.) If you are having intolerable withdrawal or adverse effects from an antidepressant, it may be worth risking the worst case, which is that a switch to a bridge drug doesn't help and you have withdrawal syndrome anyway. If you're thinking of switching simply as a matter of convenience, you need to weigh the risks against the amount of convenience you would gain. Generally, switching for convenience is a bad idea. CAUTION: A switch to a bridge drug is not guaranteed to work. It's safer to slow down a taper than count on a switch. A switch really should be used only when a taper becomes unbearable or there are other serious adverse effects from the medication. You must work with a doctor who is familiar with bridging, in case you develop severe symptoms. Overview of cross-tapering method For drug switches, many doctors prefer cross-tapering, where a low dose of one drug is added and gradually increased while the first drug is reduced. For a period, both drugs are taken at the same time. Here is a graphic representation of cross-tapering: If you are making a switch to Prozac, the second antidepressant is fluoxetine (Prozac). Given fluoxetine's long half-life, it may take a couple of weeks to reach full effect. The effect of the amount you add at each stage of the cross-taper will build throughout the process. As it is possible to overshoot Prozac dosage, it's best to be very conservative about increasing fluoxetine throughout the cross-taper, you could end up with serotonin toxicity from too much fluoxetine (see below). Also see this discussion about cross-tapering with Prozac: Serotonin toxicity and serotonin syndrome You run the risk of serotonin toxicity if you are taking too much serotonergic. Most antidepressants (and some other drugs, such as triptans and MDMA) are serotonergics. Serotonergic effects of antidepressants are added when you take more than one of them, particularly if you add an SSRI (such as Prozac, Celexa, or Lexapro) to an SNRI (such as desvenlafaxine (Pristiq), duloxetine (Cymbalta), venlafaxine (Effexor), venlafaxine XR (Effexor XR), milnacipran (Savella), and levomilnacipran (Fetzima)). (Other types of antidepressants should not be combined with tricyclics or MAOIs.) Symptoms of too much serotonergic can be: Nervousness, anxiety, akathisia, sleeplessness, fast heartbeat. Symptoms of serotonin toxicity can be these plus disorientation, sweating, and others. Serotonin syndrome is even more serious. See Serotonin Syndrome or Serotonin Toxicity Reduction of the drug dose should resolve serotonin toxicity. Note that if you cross-taper, you will be taking 2 drugs at once for part of the time. Because of the potential of serotonin toxicity by overdosing SSRIs as well as in combination with SNRIs, it's safest to err on the lower side of a Prozac dose "equivalent" -- such as 5mg -- to your original drug. This is why doctors familiar with the Prozac switch will cross-taper by adding an initial LOW DOSE of Prozac to an SNRI. Start low, the effect of fluoxetine will increase over several weeks. Another concern: Escilatopram (Lexapro) is several times stronger, milligram for milligram, than the other SSRIs. If you add 10mg escilatopram to the high dose of 60mg duloxetine (Cymbalta), for example, you run the risk of serotonergic toxicity -- 10mg escilatopram is equal to approximately 20mg-30mg duloxetine. How much fluoxetine (Prozac) to substitute for my drug? Since fluoxetine's half-life is so much longer than those of other antdepressants, its effect is a little different. It's not a stronger antidepressant, but the effect of each dose lasts much longer. This may be the reason a lower dose of fluoxetine often seems to adequately substitute for other antidepressants. For an idea of equivalent doses of your medication to fluoxetine (Prozac) read this post (January 7, 2018) in this topic. It compares fluoxetine 40mg/day (a fairly high dose of Prozac) to other antidepressants. Source of that data: https://www.ncbi.nlm.nih.gov/pubmed/25911132 If you have tapered to a lower dose of an antidepressant, an even lower dose of Prozac may be more tolerable. If you are about half-way down, you might want to try 10mg Prozac. If you have decreased further, you may wish to try 5mg Prozac. If you have substituted fluoxetine for your drug and after two weeks, you feel you have withdrawal symptoms, you may wish to gradually the fluoxetine dosage. After each change in fluoxetine, wait at least 2 weeks to see the effect before deciding on another increase. More is not better for nervous systems sensitized by withdrawal. EXAMPLES OF THE PROZAC SWITCH Below is information I've gathered from doctors about how to do the Prozac switch. You will see there is no standard protocol. Healy 2009 method for the Prozac switch From Healy 2009 Halting SSRIs withdrawal guidelines: Phelps-Kelly 2010 method for Prozac switch From Clinicians share information about slow tapering (2010) Jim Phelps, one of the authors of the above, posted in 2005 in some detail about the so-called "Prozac bridging" strategy. He said it is described in Joseph Glenmullen's book, Prozac Backlash, maybe in the chapter titled of "Held Hostage." The technique Dr. Phelps described in this post skips doses and finishes with alternating dosages, which we do not recommend for people who are sensitive to withdrawal symptoms. Given that fluoxetine liquid is available, this is completely unnecessary. Foster 2012 method for Prozac switch Dr. Mark Foster, a GP whose mission is to get people safely off psychiatric drugs includes this in a presentation he gives to doctors. http://www.gobhi.org/spring_conference_powerpoints/safewithdrawal_of_psychotropics%5Bautosaved%5D.ppt. His method involves overlapping Prozac with the other antidepressant -- cross-tapering. Prey 2012 method for Prozac switch Another knowledgeable doctor (whom I trust) explained his technique to me (this is the technique I personally would prefer if I had to do it, it seems much gentler) For a "normal" dose of Effexor (150mg per day or more) or Paxil (20mg) or Cymbalta (20mg), he would switch to 10mg Prozac with a week of overlap. In other words, take both medications for a week and then drop the Effexor. Lower doses of Effexor or other antidepressant require lower doses of Prozac as a "bridge." The lower dose of Prozac reduces the risk of excessive serotonergic stimulation (serotonin toxicity) from the combination of the two antidepressants during the overlap period. Do not stay on the combination of the first antidepressant and Prozac for more than 2 weeks, or you run the risk of your nervous system accommodating to the combination and having difficulty tapering off both antidepressants. Later, taper off Prozac. He acknowledged Prozac can have its withdrawal problems, but given Prozac's long half-life, gradual tapering should be easier than tapering off Effexor. Smoothing out a transition to fluoxetine Even with a cross-taper, your system might feel a jolt after you finally drop the initial antidepressant, particularly if it is an SNRI, such as Effexor, Pristiq, or Cymbalta, or other drug that is not an SSRI like fluoxetine. (Other SSRIs include Paxil, Zoloft, Luvox, Celexa, Lexapro). If you go through a rough patch after the transition, patients find they can take a tiny chip of the original drug (or a bead or two, if it's a capsule containing beads) for a week or two to smooth out the transition. Eventually, you'd take a chip as needed only when you feel a wave of withdrawal from the original drug, and then finally leave the original drug entirely behind. (A gelatin capsule might make a tablet fragment easier to get down, but it is not necessary if you can wash it down with a good swallow of water. The gelatin capsule quickly dissolves in your stomach.) Here's an example. There is no shame in doing this. Whatever works, works.
  8. Hi All, Firstly thanks for the excellent site and taking the time to review my post. History is long, so in the interest of time, 20 yrs on SSRI's (i've tried virtually all but had most luck with prozac and lexapro) with a 4 month bout of Remeron (awful w/d not helped by cross taper) and benzo's on/off for 8 years or so. Benzo: I've successfully switched from .5mg of clonazepam/day to 10mg valium and i'm now at 2mg per day. A bit more about this below. SSRI: Was on 20 mg for celexa for the last several months but completely zombified so decided it's finally time to be done with this sh1t I dropped relatively quickly per docs orders with really no impact down to 5mg celexa completely stopping the celexa and valium on May 1. Started 10 mg prozac only May 1, by May 4 really awful DR with anxiety, inability to focus, sleeplesness, headaches. Reinstated 1-2 mg valium which helped a little bit. Yesterday i tested the waters and dropped the prozac down to 5 mg to see if agitation was from that which resulted in bad anxiety, chills,and shaking. Took the other 5 g prozac and an additional 1mg valium which helped a bit. Today slightly better back at 10mg prozac and 2mg valium in the morning. I have a pdoc appointment tomorrow and really don't know what to do and not sure i trust his opinion frankly but do believe he will be fine with what i recommend. I consider these the following my options: 1.) Reinstate celexa at last dose (5mg?), drop prozac entirely after a week or 2, and keep valium, then micro taper off at 10% per 3 weeks or so. 2.) Hold steady on prozac and valium for awhile (how long?) then micro taper 3.) Something else? Any thoughts are much appreciated and i apologize for any incoherence in this post but just got back from work trip and wanted to get this out there for the educated folks to review asap. Many thanks for any input and your time!!! methuselah
  9. Took and stopped prozac and abilify with not much problem. Following ocd depression and a panic attack took them again. After a week constant panic attack and insomnia. Doctor gives lexapro(10) and zyprexa(5). A Week later i decide i have to stop. Tried tapering zyprexa but because of the ocd coming back failed badly. Took 3 months.Some kindling in the stopping process hurt me. Quit after like a 1 mg a week and at 0.6 mg. After 2 days at 0 mg i had very good energy just breathing made me smile. Then the energy decreased and 4 days later sleep problems started so i took zyprexa again 0.6 mg maybe. After two days sleep kinda stabilised so i stopped. 10 days later im worse than i started but not taking the drug is helping me cope. I pray i didnt do damage. Should i reinstate? Also currently trying to lower lexapro.
  10. Hey Warriors! I’m approaching 3 months tapering off Pregabalin, reducing 1-2mg/day using water titration. Today marks -80mg, or 520mg down from 600mg/day. And the day I found this forum. Feeling constant sadness most days, with some energy and a few happy moments here and there. Sleep has been erratic, it affects me badly to be so tired all the time. I’ve got appointments next week: - Julia Ross Nutritional Consultant for Amino acid therapy - New GP To get referral to Psychiatrist Three other meds to come off after this. The order I’m hoping to follow is: 1. Pregabalin 2. Lamotrigine 3. Fluoxetine 4. Moclobemide I’d love to be blessed with a quick and easy tapering journey but I know it’s not always possible. But I’ll do my best to have the best possible outcome. Thank you for sharing in the good and the challenging times xxx
  11. Hi everyone, After many months of reading and gaining some hope and encouragement from the stories here I decided to join your great forum. Sorry, but this is a very long story. Im a 39 year old male from Australia and I have been taking ssri’s for GAD for the last 10 years. I started on Paxil 20mg for around 18 months and was switched to lexapro 10mg due to weight gain, sexual dysfunction and fatigue. Lexapro was a little better but I really didn’t feel like it was doing much apart from keeping the weight up and the motivation down. I am 6’2 and was always skinny, I never could bulk up. Paxil took me from 78kg and healthy to 100kg and always sweaty in around 12 months. I tried a few times to simply stop the meds but had no idea about withdrawal or tapering and always ended up reinstating due to awful side effects (rage, crying spells etc). The drs always said thats just how you are off the meds...... keep taking them for the rest of your life. They also upped my dosage a few times but I quickly went back to 10mg. In 2017 I felt lexapro wasn’t being effective so the dr straight swapped me to Valdoxan for a few weeks and I felt awful. They then straight swapped me to Prozac and around 4 days into taking that I woke in the middle of the night to terrible ringing in my ears. This was my first introduction to tinnitus. I freaked out and asked to be put back on lexapro. I reinstated at 10mg again and everything calmed down after about 7-8 weeks of hell. The tinnitus that was in both ears and the middle of my head reduced to a tiny amount only in my left ear. I now know this was likely my last chance at reinstatement working for me..... more on that soon. So another few years went past and the side effects of weight gain, heat intolerance, sexual dysfunction and the general feeling of “blah” were just too much for me to handle. I began a taper in January of 2019 and went from 10mg to 7.5mg for 4 weeks. I then went to 5mg for 4 weeks and finally 2.5mg for 4 weeks. I felt okay during the taper, my tinnitus was a little bit louder but not enough to bother me, I was more irritable and I had brain zaps. The real “fun” began around 12 weeks after the taper off the medication...... I had a panic attack and fell into one of the episodes that put me on meds in the first place. These were purely anxiety driven and I never felt depressed. I’ve had them since about 13 years of age and I always recovered from them and they lasted from 1 to 3 months usually. They would encompass intrusive thoughts, shakes and shivers, anxiety and panic only. So I decided to jump straight back on the lexapro 10mg thinking all these drs are right and I’m doomed to be on meds for the rest of my life. But something happened that didn’t happen before..... they didn’t work. After a few weeks I felt worse and my ears started to really scream, I had awful insomnia and a really bad eczema rash appeared on my chest and legs. I now know this as a severe reaction to the meds after too fast a taper and too fast of a reinstatement. If I had not jumped straight back on the meds I likely would have had to deal with wd symptoms only and not so many physical ones as well. So after 6 weeks of hell my dr upped my dose to 20mg and I waited another 5 weeks. That didn’t work either, just got worse. My dr referred me to a psychiatrist at this point and things got really bad. He upped my dose to 40mg lexapro, I stuck this out for another 5-6 weeks and it made me no better, actually worse. He then said ssri’s don’t seem to work for you now so let’s try Effexor. We cross tapered that with the lexapro over only a two week period and then all the way to 150mg of Effexor in only 3 weeks. I was desperate and wanted the pain and suffering to just stop. I did consider suicide a lot during this period and I had never been like this before when taking medication. My beautiful partner kept me here with her love and grace. I stuck with the Effexor for 7 weeks and it was just hell, dizziness, insomnia and mini seizure type things were a daily occurrence. I was couch bound and I still had tinnitus screaming away every day. He wanted to up the dose more but by this stage I knew that my body was not accepting any of these meds, I even said to him I think I am having a reaction to these meds. His answer was always that they just make you feel worse before better and that we can keep upping the dose...... That was the last time I saw him, I went back to my GP and asked to try Zoloft in a last ditch attempt to gain some stability and sanity. She cross tapered me to Zoloft and it seemed to calm things down a tiny bit but I was still so, so sick. I made it up to 100mg and was on Zoloft for 3 months before massive amounts of diarrhoea hit me (colitis) plus I was still struggling with SI, tinnitus and now bad depression for the first time in my life. All the fun stuff that comes along with bad reactions to these meds. My Dr CT’d me off the Zoloft and started me on Remeron 30mg..... this one was ok for my sleep issues but made me irritable as hell and didn’t have any effect on the SI, depression and tinnitus. I lasted 6 weeks on it before breaking down again and seeing the Dr. She mentioned Paxil...... like I said, I was desperate and since it worked 10 years ago maybe it would pull me out of this living hell I was in. Since the first episode after WD in June of 2019 and the living hell my life has been, I started Paxil 20mg in April 2020..... this lasted all of 12 weeks and I CT’d the Paxil in July 2020 due to all the above still happening. I happened to come across the SA website in June this year After desperately searching for answers. I’ve read and learnt a lot from everyone and now understand what has happened to me the last 12 months. How I should have tapered waaayyyy slower, how I should have reinstated waaayyy slower and how screwed up our medical system and the makers of these drugs are. I have been med free for 9 weeks and even though I still have loud tinnitus, depression and a host of other Awful symptoms, I have improved more then any time I was on meds. I’m bloody scared of what’s ahead but I will NEVER touch another psych med again in my life. I assume reinstatement is beyond my body now after what it has endured. I hope to be able to vent a little here on my bad days and keep reading the encouraging stories of success whilst pushing on with my life and the healing process. Thanks for taking the time to read my book.... 😂 And thanks to the creators of such a great site.
  12. Hi, I thought I would introduce myself. Have joined this forum after experiencing horrendous withdrawals from anti-depressants. I am 34, female. Currently 3 months completely off of Prozac which I took for 6 years at the highest dose I understand is allowed to be prescribed in the UK (60mg daily). I weaned down from 60mg to 0mg over 5 months. Have had 3 months of pure hell since stopping taking Prozac completely - symptoms ranging from suicidal depression, nausea, migraines, loss of appetite, the most debilitating anxiety and panic. Weakness, crying spells, the most excruciating emotional and psychic pain that I have ever had to endure. All the symptoms I have read others have experienced except I haven't had brain zaps - not sure why. Am determined to stay off of Prozac and just go through what I need to. Very grateful to have come across this forum and hopefully to be able to share how I am getting through and to hear how others have managed and hopefully to offer support too. I am aware that there seems to be no other way that through this - keen to connect with others who are finding a way through. Very keen to connect and speak further to anyone else having to go through this. Very determined to get through although very aware it feels like you just don't know what each day will bring or when you really are finally on solid ground. Very keen to hear others experiences. I am using the idea of windows and waves to navigate through currently. Very keen to connect with others. Natalie
  13. Hi all, I am so glad I found this site. I am dealing with what I now know is ssri withdrawal and this place has given me hope, knowledge, and peace of mind. It’s crazy what these drugs can do. To start, I will give you my story. Looking back, I grew up with low self esteem and emotional issues that I never faced. Through school and going into college, I still managed to adjust well, make friends, and didn’t have especially bad anxiety or anything. In high school and college I abused alcohol frequently, probably due to emotional distress. I never was addicted, but was a binge drinker. In my 2nd year of college, even drinking became stressful and not fun. I began to have a lot of social anxiety, and couldn’t handle any alcohol. Depression started to set in, and I was in denial for a long time. Because of this, I let it get worse, I let people hurt me, and I ended up in the ER because I realized I couldn’t function and was suicidal. There they decided to send me to an outpatient treatment facility, and there my medication history began. I first was given seetraline, then Effexor, neither for longer than a week. The side effects were too much. So the doc deicided to try Prozac with me. That one seemed to have me feeling better, so I stayed on that for the time being. Started at 20mg around May 2017, 40mg for a few months, then 60mg for a long duration. I was only at this outpatient thing for a couple months, then I started seeing a new doctor. She basically just kept giving me the Prozac, and I’d just say I’m fine. I guess I felt fine, but I was more or less a zombie that just went to work and slept. The thing is though that Prozac is what lifted me out of the horrible depression I was in, and helped my anxiety. I thought of it as miraculous. The one thing that made it a lot less miraculous was that I gained nearly 100 pounds in a year! This prompted my doctor to lower my dose to 40mg, which made me realize how much Prozac dulled me out. I felt so much more awake and clear headed, so I figured I should get off the meds totally! It’ll only be good news, or so I thought. So I went down to 20mg a couple months later around November 2018. Afterwards is when withdrawal started to hit. I really noticed it while visiting family for Christmas. I just wasn’t myself. The anxiety was back in full force, and that was enough to hinder my social ability. It sucks to think family members see me like that and don’t know what’s going on, that maybe they just think I’m mentally ill. Oh well. I went down to 10mg in February, and jumped clear off in March. I now know this was far to fast of a taper, but I didn’t know this at the time. My doctor obviously didn’t either, but she probably also thinks Prozac doesn’t give people withdrawals. Once at 10mg I started to have the very sever symptoms. Extreme anxiety, irritability, anger, sensitivity to movement light and sounds, depersonalization, tightness in chest and neck, paranoia, numbness, and headaches (sometimes long lasting). Once I went to 0 they got a little worse for a bit, and it was gradually improved since then. I’ve only been totally off the Prozac for about a month right now. My god has it improved since a month ago! I still wouldn’t say I’m doing well by any means but I at least feel kind of normal. I felt like everybody was staring at me when I went outside or drove around at first (still kind of do sometimes), so much so that I just felt overwhelmed and crazy. I quit my job, not super important since it was just a silly job to pay rent. All I can really say about the symptoms is that they are still there, and it feels like they’ve been gradually receding ever so slowly. I seem to have the windows and waves, but mine have been short, maybe only hour long windows sometimes. I just pray that I will not only feel normal again but find real happiness and relief. I’m currently taking D3 and fish oil daily, nothing else. Does anyone have any advice about those supplements and others I could try? That would be great. I’m also just wondering if my story sounds familiar to anyone and what to expect. But most of all, it’s just nice to get this all out. Feel free to ask me questions!
  14. Hi- I am new here and have been on SSRI's since around 1990! Diagnosed with unipolar depression. Diagnosis Depression: Prozac from 1990-1999, Prozac stopped working, then various SSRI's through 2001, several hospitalizations and ECT. Older tricyclics and depakote 2001-2003; Effexor, Cymbalta, Zoloft, Zyprexa, Luvox and others the past 20 years, another few hospitalizations, then back to Prozac, Wellbutrin and Zyprexa, not working very well. Recently was self-medicating with kratom, low doses but quit Aug. 2020. I don't want to be addicted to anything. Never tried to get off these meds, but now (soon) is the time. I fear their long-term damage and am not benefitting from them. I've developed a swallowing disorder the dysphagia specialist suggests (cannot be proven) could be the result of long-term use of psych meds causing neurological damage. I'm 62 and I want to get back to a more functioning self. I exercise daily and have begun meditating, diet and physical fitness are good. I am here to learn from others about tapering and other ways to manage depression besides meds. I am scared to get off the meds, scared I will always be depressed. It's hard to be optimistic and hopeful. Also, how do I get my meds history as part of my signature/profile? Thanks! Rich in Ga.
  15. I have been on Prozac for about 25 years. I tried to taper few times in the past, but it didn't work. So what can be different this time? I am hoping this board will make the difference. I know I can't do it alone. I am now taking 10 mg Prozac daily. I was on 40 mg about 2 years ago, and took it down very slowly, cutting 5 mg every few months. One reason that it took so long was because I was also tapering clonazepam. Another reason was the failed attempts in the past. What I learned from tapering clonazepam I hope to put into use while tapering Prozac. One lesson that I learned is that you need to do it slow. There is just no other way. Another lesson is that you need support. I am looking for my next cut in a few months and my goal is to be completely drug free by the end of the year. I have been on disability during the last couple of years while recovering from clonazepam withdrawal. It's been hell and I'm still not completely recovered. I am looking to get back to work as soon as I can but I know it could still take more time. The biggest challenge will be to deal with withdrawal and setbacks without going back on Prozac. My hope is that I will be able to do that with the help of this board.
  16. Hey, everyone. Here's my introduction (I hope it's not too long): In 1994, at 19, I suffered panic attacks from being bullied in school and having cognitive errors in my thinking (perfectionism, negative self talk, etc.) My parents took me to a psychiatrist who told me I had a "chemical imbalance in my brain," prescribed me 80 mg of Prozac a day, and kicked me out the door. I received no therapy and from that day forward saw myself as a mental health patient. This diagnosis changed the course of my entire life. My Prozac took six weeks to kick in, and it brought with it a slew of side effects: generalized anxiety, hypervigilance (constant surveying the world and my body for signs of panic), stomach cramps, and irritable bowel syndrome. Like the proverbial boiling frog who doesn't notice the raising temperature, the side effects eased in to my life so slowly I thought they were a part of me and my "chemical imbalance." In essence I had a paradoxical reaction to the drug: it amplified my existing struggles but I had no idea my medication was the source. I was never told this was possible, nor was I told about the danger of trying to come off. The side effects made work outside the home, socializing, and dating extremely difficult because I was always afraid of the next wave of anxiety that would send me racing to the washroom. I watched my friends grow up and have careers, partners, and families, while I tried to buoy what was left of my self-esteem with self-help books and different therapists, none of who ever questioned the drug or the dosage. After two years of cognitive behavioral therapy to untwist the errors in my thinking, I tried coming off the drug under the supervision of my doctor in 2006 but the initial reduction of 20 mg every two weeks proved to be far too steep. When I reached zero I had a few days of bliss, then an absolute mental collapse. I developed akathisia and was unable to sit still and paced relentlessly and lost control of my emotions. I felt completely hollow and cried for no reason, all the while suffering from unspeakable anxiety. My parents debated admitting me to a hospital but was told that the doctors would check my medication levels then ask me to leave as there would be nothing they could do. I went to my psychiatrist who misdiagnosed my condition not as withdrawal but as depression and anxiety that the Prozac had been treating. Desperate not to lose my mind, I restarted the drug and lost another ten years to side effects. Two years ago I lowered my dose from 40 mg to 30 mg. Three days later I was to meet friends for dinner for as long as my anxiety would allow. I braced myself during the meal for the inevitable tsunami of mental anguish but what I felt instead was a mere ripple. I was stunned, then perplexed. When I realized what was happening and that the drug had been the cause, I burst into tears. Instead of racing home after the meal as I so often had in the past, my friends and I went to a movie. Over the past few months I've been easing off Prozac at 5 mg every six weeks. My quality of life improves with each reduction. My hypervigilance and anxiety all but vanished at 20 mg. At 15 mg I have become more social than I have ever been, and at 10 mg I feel like myself again - sort of. I've been on 10 mg of Prozac since May 9th, and I'm also on 50 mg of Seroquel. I want to get off the Prozac completely but I'm going to stay at 10 mg for at least three months until I know I'm stable. Though most of my anxiety is gone, I had a panic attack last week. I had an appointment with my psychiatrist yesterday over how much I've missed out on from the medication and cried through the whole thing. Naturally she was concerned that this might be a relapse of depression/anxiety, but I honestly feel better now than I ever did on the higher dose. So...that's me!
  17. I started using Lustral 50 mg & Abilify 5 mg when it was 2012.I stopped taking my medicines for many times and I have never had any withdrawal effects on my body.But when it was 2016 Summer, after I stopped using them again (I didn't even know what tapering was in that time) I got a mania attack.It was like after 3-4 months of stopping my medicines cold turkey.After my first mania attack, my doctor thought that it was bipolar disorder and he wanted me to use Depakine.I refused using that medicine and i continued using Abilify + Lustral at same dosages.But when it was 2017 Summer, I did the same thing as I did when it was 2016 and I got a mania attack one more time.It was much more bad than the first one and I was feeling so anxious and even if I was feeling like there was no problem, I had to continue using my medicines because of my massive anxiety.My dose was always the same.I refused getting higher all the time.I was feeling like it was okay to stop using them abruptly because of the doses of my medicines.But I was completely wrong. After my second mania attack, my doctor asked me to use Depakine one more time because of my second attack.I guess he thought me that I was bipolar but I didn't have any mania history before I started using these medicines. Anyways, when it was 2018 January, after I used them for a while again, I stopped them abruptly one more time and I got withdrawal symptoms for the first time and I didn't even know it was withdrawal.I tried to go on like this for 2 months but I was feeling dizzy.I had to do something and that's why I decided to go to another psychiatrist.I tried to explain the thing I was suffering from but she couldn't understand what I was trying to say.She thought that I was anxious and depressed and she gave me Wellbutrin + Abilify 5 mg.I can't remember dose of Wellbutrin but I guess it was the lowest dose.After Wellbutrin made me angry and furious, she decided to change it to Prozac and I started to use Prozac + Abilify. It has been for 2 months like this and I started to have some jerky movements in my fingers and arms and I realized that there was a problem with my vision.(like blurred vision) I have high myopia and I've been using contact lenses for years maybe it was about it I don't know but my dizziness and light-headedness were gone.I can see now that it was about withdrawal and after she put me on these medicines I was feeling better even if these minor problems.But after 2 months I started to feel uncomfortable again and I stopped my medicines abruptly one more time. Unfortunately, I started to get the withdrawal effects again but I decided to continue like this even if I was suffering.(It was the biggest mistake which I made. ). There was no one who understood what was happening to me and I couldn't understand too.When I realized it was about withdrawal it was too late. I stopped using them when it was July 2018 and now it's April 2020.I couldn't get healed at all.I don't have anxiety or bipolar problems but I have problems with my muscles and my coordination.Jerky movements on my fingers are still on and got worse.My vision got worse too and they got worse gradually. I started to lose my hope about my healing process.What do you think about it? Is there a chance for me to get healed or is it a brain damage which is serious to get rid off? Your opinions are so important for me please let me know what you think about my situation. Thanks.
  18. Hi, all. Thank you so much for providing this site. I’ve been inspired by the stories here, and look forward to my own recovery and hope to help others as I can along the way. It’s been a hellish year… I have a rather long story – 99% of which takes place within the last year – so please bear with me. I’ll write this out in a timeline for organization’s sake. In essence, I have a history of anxiety and depression, and have OCD. I have been suffering from severe postpartum anxiety (PPA) and depression (PPD) since delivering my son in May 2018 – exacerbated by a move out East so I could start my PhD, the decline and death of my dog, dealing with childhood trauma, etc. I was on Prozac and Xanax as needed before I was pregnant and went off without any problems while we were trying to conceive. I had an uncomplicated pregnancy. Here we go… 1999ish – 2005 (6th grade – high school) (Zoloft, Lexapro, Wellbutrin) I was diagnosed with severe academic perfectionism and OCD and put on (I think) Zoloft first (not sure of dosage). In the years that followed, I was on Lexapro and Wellbutrin, all in various combinations. I don’t remember timing or dosages. I don’t remember having a hard time coming on or off any of the meds. I was chronically ill in high school, though, with fatigue, mono, sinusitis, shingles (to be fair, I had immunological issues before going on meds, too, and a complicated family situation). I took the year after high school off to recover, went off all meds. All I remember is feeling tired and my sleep being on a weird schedule. 2005 – 2009 (no meds) I started taking some community college classes, started volunteering, and then working full-time. Started paying more attention to my diet (went off gluten and most dairy after I realized it made me feel better). Was doing very, very well. Summer 2009 – Summer 2017 (40 mg Prozac daily, ? Xanax PRN rarely taken; occasional supplements - multi vitamin, vitamin D, fish oil, probiotics) Started on 40mg Prozac (slow taper to START it), as a ‘preventative’ measure against OCD and perfectionism (I know… probably wasn’t necessary, but I can’t prove a negative) as I was about to start at a university in the fall of 2009; I was pushed by family (also on psych meds) to start. I think it helped somewhat but it’s hard to know. Eventually, I had an Rx of Xanax, which I took maybe 5-10x/year as needed. I did well in college, though, started a great career, went to the UK on scholarship to do my Master’s and then decided to QUICKLY taper off the Prozac when my husband and I (we married in 2014) decided to conceive. I don’t remember having any issues coming off the Prozac. I was on it fairly consistently for 8 years. Summer 2017 – May 2018 (no meds; supplements: prenatal vitamin, 800 mg folic acid, 1,000-2,000 mg vitamin D, ? fish oil) Pregnant, more depressed than usual, especially after moving back home from the UK and being unsure of what was next. Still, did the damn GRE, applied to PhD programs, got into a great program out East, started setting up our life out there. Obsessive compulsive symptoms were worse than usual but not unmanageable. Late May 2018 (no meds; supplements: prenatal vitamin, 800 mg folic acid, 1,000-2,000 mg vitamin D, ? fish oil) Delivered my son. Epidural, long labor. Started breastfeeding. Early June 2018 (no meds; supplements: prenatal vitamin, 800 mg folic acid, 1,000-2,000 mg vitamin D, ? fish oil) Had a week of awful insomnia and anxiety and intrusive thoughts, but it went away. Early June – Mid-July (no meds; supplements: prenatal vitamin, 800 mg folic acid, 1,000-2,000 mg vitamin D, ? fish oil) Doing okay, just exhausted and depressed (I was breastfeeding around the clock). One week in mid-July 2018 (? Xanax, one-time dosage ~6mg Zoloft, and one-time dosage 2mg Ativan, one-time dosage ? Klonopin in hospital; supplements: prenatal vitamin, 800 mg folic acid, 1,000-2,000 mg vitamin D, ? fish oil) Then, at around 7 postpartum weeks - BAM - I was hit with a week of NO SLEEP. I just couldn't sleep and I lost my appetite. I had been given an Rx for Zoloft by my OBGyn and took a very small amount that Friday (I wanted to ease in). That night, all my symptoms were much worse – and I also felt this severe restlessness in my limbs. It was AWFUL. I even tried Xanax to calm me down (I gave to my son pumped breastmilk). My anxiety was so bad that I went to the ER that Sunday. They drew blood and it turned out that my blood sodium was dangerously low (126) - possibly due to not eating enough and drinking too much water. They gave me Ativan (2 mg – which was A LOT for my system), some Klonopin, too, eventually, and fluids overnight and I felt MUCH better the next day. I was given Ativan and Remeron as needed but didn't need to take it for a few weeks. Mid-July to Late Aug 2018 (0.5 – 1mg Ativan daily; supplements: prenatal vitamin, 800 mg folic acid, 1,000-2,000 mg vitamin D, ? fish oil) I was fine for a few weeks, and then my family and I moved out East, where I was attending grad school (I’m now on medical leave). The anxiety and insomnia came back around the move in August. I took Ativan (0.5 – 1 mg) as needed each day and had some rebound anxiety but was able to get through until setting up care there. I was assigned an interim psychiatrist (before being placed with a regular one), who Rxed me 0.5 Ativan to take at night to sleep for 10 days. This worked for sleep, but not the overall anxiety and depression. Due to breastfeeding concerns, they switched me to Trazodone (25-50 mg), which worked ok for sleep. Eventually, I was able to fall asleep on my own for a couple/few nights. That would be the last time I could do that to-date. Late Aug to Late Sept 2018 (0.5 – 1mg Ativan daily, 1-5mg Prozac, 25-50 mg Trazodone; supplements: postnatal vitamin, 800 mg folic acid, 1,000-2,000 mg vitamin D, ? fish oil, started taking some B complex, probiotics?) I started seeing a regular psychiatrist in early September, and we agreed I should go back on the Prozac with 1 mg Ativan/day as needed. We started sloooow on the Prozac - 1mg, then 2, then 5. By week 3, I had lost my appetite completely, and my anxiety was through the roof - just on 5mg (I was on 40 before becoming pregnant, so I couldn’t understand why I was feeling so terribly). The Trazodone was no longer helping me sleep, and was giving me terrible dry mouth. My limbs felt like they were vibrating. My psydoc FINALLY directed me to go off the Prozac and Ativan, and Rxed me just Klonopin 0.75mg/day. In addition to the psychiatrist, I saw a primary care doc, who checked my thyroid, adrenal glands (several tests there), vitamin levels, and other things - all normal. My blood sodium has still been a little low, but they believe it's due to not eating enough. Oct 2018 (Klonopin 0.25 – 0.75mg/day; postnatal vitamin, 800 mg folic acid, 1,000-2,000 mg vitamin D, ? fish oil, started taking some B complex, I might have tried some hormone-balancing herbs – I don’t remember exactly, probiotics?) My appetite returned but it was never the same. I was sleeping better, but not well – maybe 6 hours at most, sometimes waking in a panic. I could only take one class. I was very depressed and frustrated, and deeply confused as to why I wasn’t responding to medications. But I felt BETTER than when I was on the Prozac, and was able to feel like I could sleep on my own again, and on just 0.25mg Klonopin/day – but the plan was to let me ‘settle’ and then try a new AD, sooo… Nov 2-4 2018 (25mg Anafranil at night, 0.25-0.5mg Klonopin/day; postnatal vitamin, 800 mg folic acid, 1,000-2,000 mg vitamin D, ? fish oil, started taking some B complex, I might have tried some hormone-balancing herbs – I don’t remember exactly, probiotics?) The psydoc suggested Anafranil, a TCA. The day I started it, we put my dog down and I stopped breastfeeding (I had been tapering on that for months). It wasn’t a great time to start something. But I did. I took it the night of the 2nd, fell asleep instantly, then woke up feeling SO GOD AWFUL about 3 hours later. I had a tremor, I vomited, I couldn’t eat. My husband had to hold me while I shook in bed. I called the psydoc and she told me to keep taking it, sounding annoyed with me. So I pushed through for three days – but that was all I could do. Until then, that was the worst I have ever felt. Nothing could calm me down. Things start heating up here, so I’ll spare some details and focus more on the med changes… Nov 5-8 2018 I barely remember these days. Sleep was poor, I felt awful. Then on a Thursday night, I was up all night with panic attacks. I called my therapist and made the decision to go into the psych hospital. Nov 9 – 15 2018 (In hospital, put on 0.5mg Klonopin 2x/day and worked up to 100 mg Seroquel at night) I didn’t start sleeping until I was put on a combination of Seroquel and Klonopin. BUT, I remember this creeping feeling of “buzziness” and restlessness when I woke up everyday. That feeling would continue to get worse over the coming weeks and stay with me to the present. Nov 15 – Early Dec 2018 (0.5mg Klonopin 2x/day → 0.25mg Klonopin 2x/day; 100mg Seroquel at night; some supplements – don’t remember) I left the hospital taking 100mg Seroquel at night and 0.5 mg klonopin 2x/day. I officially went on medical leave from grad school. I stuck with this doseage for 2ish weeks, was sleeping well but feeling horribly depressed and anxious, then started to quickly taper the Klonopin. I don’t remember how quickly – but I wasn’t taking anymore than 0.5mg/day by early December. I then tapered on the Seroquel after feeling SO much worse when an IOP psydoc tried bumping the dose to 125mg; I remember not being able to sit still – going outside to pace. No tremor – just pacing, fidgeting, and losing a lot of weight. Early December 2018 – Early Jan 2019 (1mg Ativan at night, 2.5mg Zyprexa at night, 25-100mg Lamictal; postnatal vitamin, 800 mg folic acid, 1,000-2,000 mg vitamin D, ? fish oil, started taking some B complex, I might have tried some hormone-balancing herbs – I don’t remember exactly, probiotics?) I made the decision to move back home to do a program specialized in PPD (we ended by moving back entirely later that winter). In the program, I was put on 0.5-1mg Ativan at night, 2.5 mg Zyprexa at night (for sleep – though it never helped), and titrated up to 100mg Lamictal (the psydoc suspected a bipolar spectrum diagnosis). I was still incredibly restless, unable to sit down and just enjoy a movie. And my sleep was growing worse and worse. It was awful – then my mood grew worse and worse as we went up on the Lamictal; I also had increasingly bad tinnitus and TMJ. I was hospitalized as my thinking became suicidal – just ideations, but I was ready to go back in… Early to Mid-Jan 2019 (0.5mg Klonopin 2x/day, 5mg Paxil/day, 50mg Benadryl at night; 0.25-1mg Risperidone 1-2x/day; some supplements?; THEN back to 150mg Seroquel) In the hospital, I was taken off the Lamictal and put on 5mg Paxil once/day, 0.5 mg Klonopin 2x/day, Benadryl 50mg at night (for sleep), and Risperidone 0.25mg once or twice a day (I don’t remember). I became increasingly orthostatic (low BP, high HR). I stabilized mood-wise – sorta – and left the hospital feeling off, but better… Within days, though, we tried increasing the Risperidone, and my HR went up to 140 (I think we tried 1 mg). I wasn’t sleeping AT ALL. I was taken off the Risperidone, stayed on 5mg Paxil once/day, 0.5 mg Klonopin 2x/day, Benadryl 50mg at night (for sleep). Eventually, as my sleep diminished, the PPD IOP doc put me back on Seroquel (I has actually asked to go back on) – but suggested as much as 150mg. After that, my mood really shifted and became erratic; I was really upset and angry at my husband and suicidal ideation returned. So it was suggested I go back in the hospital... Late Jan to Mid-Feb 2019: 3-week hospital stay (see below for crazy med changes) All the docs agreed I didn’t need to be in there this long (everyone kept asking why I was still there), but there I was so they could keep throwing stuff at me to see if something stuck. I was holding out hope SOMETHING would work this time...: First week: 0.5 mg Klonopin 2x/day, 100 mg Seroquel at night, 300mg XR lithium 2x/day (HORRIBLE stomach reaction, especially when the doc abruptly pulled the Seroquel) Second week: 0.5 mg Klonopin 2x/day, 50mg Seroquel at night, some amount of Depakote (I don’t remember – wasn’t improving, irritable), tried PRNs of 12.5mg Seroquel and became really depressed Third week: 1 mg Klonopin 2x/day, 50mg Seroquel at night, 1200mg gabapentin (taken as 300mg twice during the day, and 600mg at night). That’s how I left the hospital. Mid-Feb to Early-March 2019: (0.75mg Klonopin 2x/day, 50mg Seroquel at night, 300mg Gabapentin 2x daytime and 600mg at night, brief re-trial of lithium – 150mg; multivitamin, 1,000-2,000 mg vitamin D, ? fish oil, 1200mg evening primrose oil, probiotics?) Instantly went down to 0.75mg Klonopin 2x/day (fear of dependence). New trauma-based IOP. Was very constipated. Tried low-dose lithium (150mg) as lithium seemed to be the only med to be helping to-date (along with benzos); was improving somewhat mood-wise, but the stomach issues were SO bad, so we went off. After going off lithium, my restlessness SKYROCKETED, and was particularly bad for 10 days. My stomach was AWFUL; I was taking antacids all the time; seemed to be worse after taking gabapentin, so the new IOP doc cut THAT dosage in half. Developed a tremor. The new IOP psydoc diagnosed me with akathisia – FINALLY. I had NEVER heard of that before (although, in retrospect, I think it has been mentioned to me in the hospital as a possible side-effect of the antipsychotics – but I remember them saying “you can get this, but I don’t see that in you, so…” and so I ignored it (dumb)). When I read about it, I felt so frustrated; this had, no doubt, been plaguing me since at least the one-time Zoloft attempt in July - and in particular since the first Seroquel doseage in November. Doc suggested I reduce my Seroquel from 50 to 25mg; I couldn’t do that for a couple of weeks. Early to Mid-March (→0.25mg Klonopin during day and 0.5-0.75mg/night, 25mg Seroquel at night, 200mg Gabapentin 2x daytime and 300mg at night, brief re-trial of Depakote – don’t remember dosage; multivitamin, 1,000-2,000 mg vitamin D, ? fish oil, 1200mg evening primrose oil, probiotics) Continue reducing my Klonopin down to 0.25mg during the day and 0.5mg at night. We tried XR Depakote as a Hail Mary in the med department. It seemed to help a bit, but also increased some of the restlessness. At this point – and this should have come sooner for me – I was done – just DONE– with med changes. My body needed a break. I haven’t added or taken away and particular meds since (with one exception - the propranolol, see below) – though I have reduced the dosages… Early April (0.25mg Klonopin during day and 0.5-0.75mg/night, 25mg Seroquel at night, 200mg Gabapentin 2x daytime and 300mg at night, up to 70mg propranolol throughout the day; multivitamin, 1,000-2,000 mg vitamin D, ? fish oil, 1200mg evening primrose oil, probiotics) Was diagnosed with thyroiditis (my thyroid had been normal as recently as January) – a relatively common thing postpartum, but it was ‘late’ to arrive to be postpartum thyroiditis, so doctors suspected the lithium. B/c I was hyperthyroid first (usually follows a pattern of a few months in 'hyper'/overactive mode, followed by anywhere from 3 to 18 (or more) months underactive. I was put on propranolol (taking as much as 70mg throughout the day). That seemed to help the tremor, heart palpitations, and restlessness maybe 50-75% of the time. But it crashed my BP. Early-April to Present (see below) We’ve moved into a new, stable house (both good and really stressful). As of early June, I am off the Seroquel. I tapered from 25 to 0mg by reducing by about 6.25mg every two weeks or so. I tried re-starting it to do an every-other-day ending taper, and felt instantly WORSE, so I am done. But it was probably too quick a taper. I NEVER want to take another antipsychotic again, though; I can point to the beginning of the worst parts of this whole cluster to starting Seroquel, and the akathisia that ensues and continues. I reduced the daytime Klonopin to 0 (though I’ve had to take a 0.0625mg to 0.125mg PRN three times in June as things have grown worse). I still take 0.5mg Klonopin at night. In June, I also went off the propranolol – too quickly – and have been having heart palpitations, and have been orthostatic. My BP was just getting to be so, so low. Now, taking any amount of it seems to make me more agitated/restless or, at best, woozy. In June, I also got ambitious and reduced the gabapentin from taking 400 mg during the day (200mg 2x/day) to 0 at the end of June, mostly b/c I thought it was making me feel worse; I’m not sure on this STILL (or if it ever did much of anything). I still take 300mg at night with 0.5 mg Klonopin. May was my best month - not great (I was still constantly restless, struggled with my appetite, and was really disoriented and depressed), but it felt more manageable. I should have done a slower taper on all things when I felt more stable, then – but here I am. June started out okay but, after going off the Seroquel and trying a glass of wine again (out with a friend), it’s been awful; the akathisia is back in full swing. NOW I seem to have reached this point where my body won’t tolerate much of anything again – as if it’s saying “if you’re done with one, then you’re going to be done with them ALL.” I’ve also noticed that the first half of my menstrual cycle is FAR AND AWAY WORSE than the latter half – and am trying to explore ways to (as naturally as possible) balance my hormones. I tried bioidentical progesterone cream that an integrative MD Rxed and it helped somewhat, but caused cramping and spotting and an upset stomach – no go. Currently Taking 0 – 200mg gabapentin during the day; 300mg gabapentin at night 0.5mg Klonopin at night 5mg melatonin (+10mg B6 – combo pill) at night Fish oil (1400mg EPA + 480 DHA) in morning and afternoon 1500mg primrose oil morning and afternoon 200-400mg magnesium glycinate at night, and magnesium oxide throughout day 2000mg vitamin D afternoon Cal+Mag+Potassium supplement afternoon 2 kinds of probiotics morning Multivitamin morning What Makes Things Worse Alcohol; I haven’t been able to tolerate this since sometime early spring – makes me SUPER anxious. Any antihistamine; it used to help me sleep but something in the last 2-4 months has changed my brain so I now feel WORSE the next morning. Some vitamins (I say that b/c I sometimes feel more buzzy after taking a multivitamin; on the other hand, sometimes I feel better) Caffeine (not that I’ve tested this too much; the most I ever drink is a cup of green tea, and I haven’t been able to do that in weeks) Antacids (found that out the hard way) What Helps Epsom salt baths Sweating Crying (when I am able to) Walking (especially in sunshine) Melatonin (at night – for sleep) Klonopin (but I am trying not to go over 0.5mg/day – mostly at night; and want to taper off) Massage Stretching Kombucha (not too much, though b/c caffeine) Apple cider vinegar + lemon water (ahead of meals and when I have an upset stomach – at east once/day) Eating enough (really tough to do right now) Not Sure if it Helps (tried/trying it) Acupuncture (doing this for a few months now) Therapy – CBT, talk Gabapentin (want to taper off anyway) Primrose oil Multivitamin Fish oil Magnesium Calcium CBD oil What I Need Help With I’m here b/c I need to feel like I’m not crazy when the psydoc says this isn’t still akathisia. I KNOW it is – I KNOW it’s protracted withdrawal and the effect of such a brain-altering year. I know this b/c, even in my most anxious moments pre-postpartum medications, I never felt this protracted insatiable restlessness and dread. I was a champ at sleeping (though a night owl). And my appetite was always solid (too much so, at times). This is DIFFERENT. I also want to get off the gabapentin and the Klonopin – but do so in a smart way. I’m not sure the gabapentin is a net evil right now and shouldn’t be taken off altogether? And is the gabapentin the best thing to drop first? And I need help managing the akathisia. I've read some tips here, and will explore those. Any help on the hormone piece would be invaluable. There is something there. I feel the effects of akathisia/withdrawal/autonomic disregulation far more at the start of my cycle. And this whole postpartum period has been inherently hormonally disregulating (compounded by meds like Depakote, which altered my cycle). Anyone else? Anything help? I plan to keep a more focused journal as this site recommends and track my symptoms alongside food, supplement, and med changes. Of course, what sucks THE MOST is the lost time and what's been taken - from the joy of being a new mother, to what was supposed to be a fulfilling career move in pursuing my PhD (I might have to give up my place now b/c I'm so disabled), to feeling defective for not responding to the 'right treatments.' The worst year of your life should not also be the first year of motherhood. To those of you that read this monster of a post – or event 10% - THANK YOU.
  19. HI, I'm new to the community and at this point am very scared. I will give a quick history and then a couple questions that I would love help with, if you don't mind. I have been on and off prozac for around 9 years(as needed). I was diagnosed with PPD after my son was born. I never experienced emotional blunting while just on the prozac. However, in Dec. 2017 I had a breakdown after suffering a big T (trauma). My doctor prescribed me Abilify to go along with my antidepressant. I almost immediately felt emotionally blunted, and asked if it could be the drugs. I never took them extremely regularly. I would go a month and do great then come off for weeks because I hated how they made me feel. After much research I decided to come off of every thing in May 2020. I have just hit a wall of anhedonia. I would have never dreamed it would get this much worse after being off the medicine this long. Here are my questions: 1. Is it common to have anhedonia set in this late in the withdraw process? 2. Will this last forever, or will my full range of emotions come back? Have I done permanent damage? Thank you in advance. Prozac - 20 mg; On and off since Nov. 2010 Abilify - 5mg ; On and off since Feb.2018
  20. A few months ago I suffered two panic attacks in a matterr of two weeks. Mind you, I’ve never really had a history of anxiety or panic attacks (aside from a few encounters in life where I felt claustrophobic; maybe 5 times in my 28 years of life). I think the recent panic attacks stemmed from me staying up until 5-6am for a month straight prior to this occurring and being stressed about all of the COVID stuff going on, furloughed, etc. When I experienced the panic attack I had NO idea what was happening and went to an urgent care because I thought I was dying. I had never experienced that type of anxiousness accompanied by heart palpitations and tingling on my head and right arm. I was so fearful of experiencing that ever again that I made the mistake of requesting anxiety medication whereas now I think if I made lifestyle changes I would’ve been fine. I was taking 10mg of Fluoxetine for 3 weeks and I didn’t like how it made me feel. I struggled to do the smallest tasks everyday and I still experienced being anxious. I spoke with the urgent care doctor who prescribed them and told her I wished to get off of them. She said I could stop cold turkey since the dosage is so low so I did. It’s been 3 weeks since I’ve been off of the medication and I still experience the tingling feeling (not as bad as before) and I experience acid reflux. I also feel like my chest feels a little heavy at times or I feel like I have a lump in my throat even though I don’t. I’m not sure if I’m experiencing withdrawal symptoms or not. This is my first time in life ever really taking medication besides over the counter allergy medicine so I’m freaked out at how weird my body feels. I thought by 3 weeks it’d be out of my system. Has this happened to anyone? How long does it take to go away? Some days I feel completely fine and back to normal and then some days it happens again.
  21. Unsure if I'm posting in the right place but this is somewhat of an introduction. 1.5 years ago I started on 20mg of Prozac for OCD. There was restlessness with starting but it went away. Gradually I tapered down to 10mg of Prozac which I was on for a full year. 2 months ago, I felt the sudden onset of a a very severely agitated feeling. It was very vague but I can pinpoint the exact moment I noticed it -- I was sitting, doing nothing remarkable, and unstressed. I had felt something like this before throughout my treatment but it was very very temporary and felt more like an agitated depression brought on by external circumstances. When this feeling started I could not pinpoint anything else as the cause. Things were good in all parts of my life. I had not messed with the dosage of Prozac at all for a year. Is it still possible that the Prozac is causing this long term agitation/akathisia that I still experience today? A month into the feeling I decided to taper off Prozac completely. I experienced very little withdrawal...just mild headaches and dizziness. The akathisia didn't get worse or better. But it is still quite bad. And the longer it continues the more hopeless I become and probably the more depressed as well because I can't see a life without this agitation anymore. Started on some Klonopin to treat the restlessness and help me sleep. Has anyone else experienced akathisia without a dose change? And also only being on a low dose?
  22. PLEASE READ THIS ENTIRE TOPIC BEFORE GOING OFF PRISTIQ. Pristiq comes in insufficient dosages to taper. Do not alternate doses of Pristiq to taper -- this will cause the levels of this medication in your brain to go up and down and is second only to cold-turkey in causing withdrawal symptoms. AND DON'T COLD-TURKEY EITHER!!!!!!!!! To reduce the risk of withdrawal symptoms and post-discontinuation prolonged withdrawal syndrome, as with other psychiatric drugs we recommend reducing Pristiq by 10% per month, calculated on the last dosage. (The amount of the reduction gets progressively smaller.) See Why taper by 10% of my dosage? The official prescribing information from the FDA contains this: However, Pristiq is difficult to taper "at a more gradual rate" as it comes in only 3 dosages: low, average and excessive -- and officially, the tablets cannot be split. PROTEST THIS DANGEROUS DRUG Phone Pfizer, Pristiq's manufacturer, to make a complaint: (800) 438-1985 in the US Pfizer has not provided any specific information on how to taper from a dosage of 25mg Pristiq, the lowest available dosage. They may suggest alternating dosages to taper Pristiq. Don't do this -- it's like playing ping-pong with your brain. File a complaint about the difficulty of tapering off Pristiq -- the range of dosages is inadequate. Also complain to the FDA 1-800-FDA-1088 Mon–Fri between 8:00 a.m. and 4:30 p.m. EST. Pristiq is Effexor's fancier sibling Pristiq is a drug made of Effexor's (venlafaxine) active metabolite, O-desvenlafaxine. Pristiq is to Effexor as Lexapro is to Celexa -- a tweaked and more powerful isomer molecule. In effect, Pristiq is concentrated Effexor. See http://www.primarypsychiatry.com/aspx/articledetail.aspx?articleid=2464 According to Pfizer http://labeling.pfizer.com/showlabeling.aspx?id=497, Pristiq is available in extended-release tablets of 25mg, 50 mg, and 100 mg; the most common dosage is 50mg. Unlike Effexor, which is metabolized primarily by liver enzyme P450 CYP2D6, Pristiq is metabolized via conjugation and liver enzyme P450 CYP3A4. It attains peak plasma concentrations in about 7.5 hours. As a chemical, before it's put into an extended-release tablet, desvenlafaxine has a half-life of around 11 hours. Pristiq's extended-release formulation According to this paper, the extended-release formulation releases desvenlafaxine over 24 hours. The mean half-life of desvenlafaxine, without the extended-release formulation, is around 11 hours. The extended-release formulation is a monolithic matrix -- it's in the glue that holds the tablet together, not in the coating. I confirmed this in a phone conversation with Pfizer medical information (1-800-438-1985). (Thank you, oaklily, for this information about the matrix formulation.) Rather than a timed-release coating, the coating on the Pristiq tablet is only protective. The extended-release mechanism is part of the tablet matrix, or the glue that holds the tablet together. This is called a monolithic matrix tablet. If the tablet is split, the matrix is damaged and may not reliably be extended-release, depending on the size of the fragments. Larger fragments are more likely to retain some extended-release capability. When the tablet is CRUSHED, the matrix is completely destroyed. The particles should be assumed to have NO extended-release capability. A Pristiq fragment becomes desvenlafaxine, with an 11-hour half life. (Here is a description of the similar matrix formulation for quetiapine XR (Seroquel XR) .) OPTIONS FOR TAPERING PRISTIQ Since medicine knows nothing about tapering Pristiq, the following are all informal suggestions. Try any of them at your own risk. Please let us know how you do by posting in this topic. Cut up Pristiq tablets Despite the warnings not to cut it up, from reports on the Web, cutting up Pristiq tablets does seem to work for some but it makes others ill, possibly because of "dose dumping." According to Pubmed on Desvenlafaxine: "....The extended-release tablet does not dissolve in the stomach after swallowing. It slowly releases the medicine as it passes through your digestive system. You may notice the tablet coating in the stool...." The extended-release mechanism is part of the tablet matrix, or the glue that holds the tablet together. If the matrix is destroyed, the entire dose is released at once or "dumped," instead of being gradually released through the matrix formulation. Without the extended-release matrix, a Pristiq fragment becomes desvenlafaxine, with an 11-hour half life. To avoid "dose dumping" of the entire dose, you might take smaller divided doses of Pristiq, more than once a day, like immediate-release Effexor, to mimic an extended-release dose. Cut-up Pristiq seems to sometimes cause stomach upset, which may be reduced by taking it with food. Now that the 25mg tablet is available, cutting it into quarters gives you the option to taper by 6.25mg per step. If you are taking 100mg Pristiq or 50mg Pristiq, you may wish to request part of your prescription be written for 25mg tablets. (For insurance coverage of multiple dosages, your doctor most likely will have to specify taking Pristiq in "divided doses.") You may find you need a precise way to measure your tablet fragments. See Using a digital scale to measure doses As you get down to a low dose, you may wish to switch to Effexor to more precisely control dosage decreases, see below. Reducing from 100mg Pristiq to 50mg Pristiq Drug switches incur additional risk. Before trying a switch to Effexor or Prozac (fluoxetine) from 100mg Pristiq, it's probably wise to go down to 50mg Pristiq first, or 25mg if possible. Combining whole tablets, with their extended-release qualities, with tablet fragments probably makes "dose dumping" less likely or noticeable. You might use a 50mg tablet plus a 25mg tablet plus 3/4 of a 25mg tablet (18.75mg) to make the first reduction to 93.75mg 2nd reduction: a 50mg tablet plus a 25mg tablet plus 2/4 of a 25mg tablet (12.5mg) to go to 87.5mg 3rd reduction: a 50mg tablet plus a 25mg tablet plus 1/4 of a 25mg tablet (6.25mg) to go to 81.25mg 4th reduction: a 50mg tablet plus a 25mg tablet to go to 75mg 5th reduction: a 50mg tablet plus 3/4 of a 25mg tablet (18.75mg) to go to 68.75mg 6th reduction: a 50mg tablet plus 2/4 of a 25mg tablet (12.5mg) to go to 62.5mg 7th reduction: a 50mg tablet plus 1/4 of a 25mg tablet (6.25mg) to go to 56.25mg 8th reduction: a 50mg tablet If withdrawal symptoms occur, some people have found taking an additional fragment of a tablet can smooth the transition from one dosage to another. Another way to get from 100mg to 50mg or 25mg is to combine Pristiq tablets with a liquid made from immediate-release Effexor (see below). Once at 50mg or 25mg, stabilize for a month at least and consider your plan for the next stage of tapering. Have Pristiq made into smaller dosage capsules or a liquid by a compounding pharmacy Compounding pharmacies can crush the tablets and put the powder into smaller capsules by weight. Like cutting up tablets or crushing, this destroys the time-release quality, but the compounded method is much more exact. In your body, crushed Pristiq is similar to regular immediate-release Effexor, with an 11-hour half-life. You may wish to have your dose compounded to take twice a day. If you are taking 50mg Pristiq, for example, you would have 60 capsules compounded per month. Each capsule would be 1/2 of 45mg (a 10% reduction of 50mg) or 22.5mg. You would take two capsules per day, once in the morning, and once in the evening. The next month, you would have 60 capsules compounded, each capsule being 1/2 of 40.5mg (a 10% reduction of 45mg) or 20.25mg. And so forth, for each reduction. (According to my compounding pharmacy, they can put in a slow-release additive distributing absorption over 8-10 hours. This is not as long as the Pristiq time-release coating, but at least it's something. Check with your compounding pharmacy about this. See getting-custom-dosages-at-compounding-pharmacies-us-uk-and-elsewhere ) If this does not work, you may wish to switch to Effexor XR and use the bead-counting method. Regular Effexor probably wouldn't be an advantage over Pristiq compounded to custom dosages. One of our members had a desvenlafaxine liquid made by a compounding pharmacy. Most likely, this compounder used pure desvenlafaxine succinate powder to make this liquid, as desvenlafaxine tablets contain a glue that might resist being made into a liquid. But he may have a way to grind tablets up to make a suspension. A liquid would have to be immediate-release, with a half-life of around 11 hours. Generally, you'd take a drug with that short a half-life twice a day. Crush Pristiq tablets, weigh powder with a digital scale This is similar to cutting up tablets -- Pristiq is a "do not crush" medication, as it is a time-release drug. The Pristiq powder becomes desvenlafaxine, with an 11-hour half life. If you pulverize the tablet, you might take smaller divided doses of Pristiq, more than once a day, like immediate-release Effexor, to mimic an extended-release dose. In principle, this would be a more precise way of tapering than cutting up tablets: Crush the tablet Make sure the shell fragments are evenly distributed in the powder Weigh the powder for a dose with a digital scale Put the powder into an empty gelatin capsule to make it easier to ingest Peer discussion of this method starts here http://survivingantidepressants.org/index.php?/topic/876-tips-for-tapering-off-pristiq-desvenlafaxine/page__view__findpost__p__27417 Switch to Effexor or Effexor XR Note: If you've had an adverse reaction to Effexor before, do NOT switch from Pristiq to Effexor. "Desvenlafaxine (O-desmethylvenlafaxine) is the major active metabolite of venlafaxine." Since the relationship is so close, switching to regular immediate-release Effexor tablets, which you can cut up or make into a liquid, this may be the best way to taper off Pristiq. Because it has a mean half-life of 5 hours, you'd have to take regular Effexor twice a day. Alternatively, you might substitute Effexor XR, which is released gradually like Pristiq and needs to be taken only once a day. You'd have the difficulty of tapering off Effexor or Effexor XR -- themselves notorious for withdrawal difficulties -- but at least you can do that gradually. See Tips for tapering off Effexor and Effexor XR (venlafaxine). According to FDA Prescribing Information for venlafaxine (Effexor), the usual dose of Effexor is 150mg per day. Since 150mg Effexor and 50mg Pristiq are both "normal" dosages of their respective drugs, they may be roughly equivalent. (If you've just quit Pristiq and are experiencing withdrawal symptoms, you may wish to reinstate a LOWER dose of Effexor XR, such as 37.5mg, to start. This may be enough to stop withdrawal symptoms and avoid a kindling reaction.) The psychiatrist who writes the 1boringoldman.com blog reports success in switching one patient from Pristiq to Effexor, then tapering Effexor, here (see comments) Another psychiatrist said when he tried this, the switch from Pristiq to Effexor was "seamless." Dr. Stuart Shipko posts here: Advice from a psychiatric pharmacist I have been corresponding with a professor at a prominent US university pharmacy department. Here is his best guess at how to taper Pristiq (he does not want his name published): Then taper off fluoxetine (Prozac). See Tips for Tapering Prozac Advice from Dr. Stephen Stahl, author of the manual Essential Psychopharmacology In his widely read psychopharmacology manual, eminent psychopharmacologist Stephen Stahl advises titration by crushing the tablets and mixing in fruit juice, see http://survivingantidepressants.org/index.php?/topic/876-tips-for-tapering-off-pristiq-desvenlafaxine/page__view__findpost__p__14799 According to our member oaklily, Stahl is wrong. Making a liquid from Pristiq does not work, see http://survivingantidepressants.org/index.php?/topic/876-tips-for-tapering-off-pristiq-desvenlafaxine/page__view__findpost__p__24822 Dr. Stahl intends to correct his book, according to this correspondence 09/15-9/16/13 with him: Use a combination of Pristiq tablets and Effexor liquid Pristiq cannot be made into a liquid, but its close relative immediate-release Effexor (not Effexor XR) can. You may be able to go off Pristiq by taking part of your dose in lower-dose tablets and part in liquid Effexor, gradually converting to all-liquid Effexor as you get to lower dosages. This may offer a convenient and gradual path off Pristiq. Only regular immediate-release Effexor can be made into a liquid (see Tips for tapering off Effexor (venlafaxine) ). As immediate-release Effexor has a short half-life and is usually dosed twice a day, you may wish to take the liquid portion of your dosage later in the day. For example, if you are taking 100mg Pristiq, you may wish to take your daily dose as one 50mg tablet and the rest later in the evening as a liquid made from immediate-release Effexor. You can titrate the liquid by 10% of your daily dosage to taper until you get to 50mg. Then you can take a 25mg Pristiq tablet with the rest in a liquid made from immediate-release Effexor. When you get to 25mg Pristiq, you might switch to splitting the tablet and taking the rest in Effexor liquid and so on until you are taking only liquid Effexor. To do this, you will have to request a prescription for Effexor tablets as well as Pristiq from your doctor. "Bridging" with Prozac or another antidepressant Any drug change incurs additional risk. A switch to Prozac from Pristiq may not work -- they are very different drugs -- or you might have adverse reactions to Prozac. Prozac is regularly used to "bridge" off Effexor. Given that Pristiq is a sibling of Effexor and Effexor XR, it is possible that one can, similarly, use Prozac to withdraw from Pristiq. Attributed to Joseph Glenmullen, the "bridging" technique is described by a doctor here http://www.bipolarworld.net/Phelps/ph_2005/ph1354.htm Read this entire topic before attempting a switch to Prozac: The Prozac switch or "bridging" with Prozac Later, taper off Prozac. At least Prozac comes in a liquid. To do this, consult a doctor knowledgeable about this technique.
  23. Hello I am a new member on this website, but I have learned a lot here last 2 years finding lots of answers to my questions. Until now I could do without personal advice. But I am having some specific questions now. Hope you can help me. And also hoping I can help others as well with everything I learned by now. First my background: In 1993 at the age of 34, I had a very heavy burnout, which changed my life completely over the following years. In those days it wasn’t sure that it was a burnout (there was not so much known about that as nowadays). It all started with glandular fever and I was extremely tired. The extreme tiredness did not go away and I was becoming somewhat depressed. I visited a psychiatrist for the first time in my life. He said the cause was from my traumatic childhood. He gave me Anafranil (Clomipramine) as an antidepressant and we talked every 2 weeks. The Anafranil was terrible. It did not do anything good for me and the side effects were terrible. So I stopped. Then he gave me Paxil. That was shortly on the market in Holland then. I used it for a few months, and again the side effects were terrible and no positive effects at all. I decided to stop the medication and I got severe discontinuation effects. My psychiatrist said that was not possible and it would be an illusion between my ears he said. Shortly after the psychiatrist died suddenly and I went from one psychiatrist to another. I did not take any medication anymore. Only talking therapy, which did not bring anything when I look back. I started to find relief on the spiritual and alternative path and that helped me much better than the medical path. Although my burnout problems stayed (extremely tired / lack of energy and somewhat light depressed feelings and anxiety now and then). In 2004 I became a father of a beautiful daughter, but the relationship with her mother was very bad unfortunately. I decided to stay in this relationship because I was afraid of hurting my daughter emotionally when we would split up. Later I learned that this was not the best decision. In 2006 I could not handle the stressful situation at home anymore and I started to develop severe panic attacks. Again I wanted to protect my daughter emotionally and I went again to another psychiatrist who was very specialized in medication. During a period of 6-12 months I was given all kinds of SSRI’s. On nearly all I reacted very badly with severe side effects and hardly or no good results. Then I was given Lexapro (escitalopram) which helped nearly instantly on my panic attacks. The psychiatrist told me that Lexapro would hardly give any side effects and that stopping the medication in future would not give serious problems. I was so happy that the panic attacks were under control and that I could handle the situation at home better then. But I became even more tired than before, because a side effect of Lexapro. Also my sexual life went almost to zero because of this SSRI. Then the psychiatrist came up with Wellbutrin (bupropion). That could give me more energy and might also solve the sexual problems. The combination of Escitalopram (10mg) and Wellbutrin XR (150 mg) would do the trick, he thought. I was not keen on taking more than 1 medication, but he convinced me that I could stop any moment with Wellbutrin and that it would not give any problem to discontinue. I believed him (unfortunately) After a while I went from 10mg to 5mg Lexapro, which still did the trick, but without less tiredness. After using this combination for 1½ until 2 years, I wanted to quit. I was doing quite OK and did not wanted to use such medication for an extreme long period of time. This is where the roller coaster started….. By then (end of 2009) without having the information I have now about quitting these drugs, unfortunately. I started to have strange feelings and my psychiatrist let me go up and down with dosages of Lexapro between 5 and 10mg, to see what the results would be. Also, he put me on and off the Wellbutrin to see what worked (that was not a problem I was told, since no continuation problems…) End of 2009 I quit completely (Lexapro in some small steps to zero over several weeks and Wellbutrin cold turkey (both according to advice psychiatrist). It went well, but after 3 months I was feeling worse than ever. Panic attacks and terrible feelings that made me wanting to die! My psychiatrist and house doctor both said that I obviously needed the medication and that I should start it again. Which I believed and did. Real relief wasn’t there for a long period. I could not find the balance again. My psychiatrist let me change doses of both drugs to find a new balance. Spring 2011 After nearly 1 year looking for the right dosage I found some balance again. Which resulted in 5mg Lexapro and 150 mg Wellbutrin XR. Spring 2012 – end of 2013 I tried again to quit medications. This time taking 18 months to quit the 5mg Lexapro in small steps. Later in year decreasing Wellbutrin 150mg every other day (as I was advised….!) and end of 2013 cold turkey with the Wellbutrin (since I was still believing that was without any risk as I was told…) Spring/summer 2014 I felt OK for several months without medication and I got suddenly more energy. I woke up much earlier automatically. I really thought I was OK now and also totally off the medication. But suddenly I hardly could not sleep again. Slowly I was feeling worse and worse. And then I developed psychoses at night (which I never had before in my life). My life became a hell! I did not want to start medication again, but my doctor told me I really had to start again. I was feeling so terrible and I was not myself anymore in any way… I had to fight against unknown forces in me that wanted me death. So I started again on medication. First only with Lexapro. Which did not do the trick then and later also Wellbutrin. Very slowly I started to feel better with some ups and more downs. Again it took nearly a year before I really felt better and more or less stable (summer 2015). I was taking 5 mg Lexapro and 150 mg Wellbutrin XR then. Beginning of 2016 I decreased doses Lexapro from 5 to 2,5mg. Which went well. Stayed on 150mg Wellbutrin per day November 2016 Went down to 1 pill of Wellbutrin XR 150mg every other day. Stayed on Lexapro 2,5 mg. Went well also. July 2017 I went to 1 pill of Wellbutrin XR 150mg every 3 days. After a week or so I got the alarming feelings again of waking up early with a lot of energy! To stabilize I went back to 1 Wellbutrin per day (not clever with the knowledge that I have now….) IMPORTANT: This is where I got for the first time the idea that Wellbutrin might play an important role in the discontinuation effects. Until here I really was convinced (told) that Wellbutrin could not give discontinuation problems. November 2017 – February 2018 I decreased the dosage of Lexapro in small steps from 2,5 to 0,6mg. And in the same period I went down with Wellbutrin from 150mg to 66mg. All with little discontinuation problems (or they came months later again perhaps, as often happened when I look back with the knowledge I have now). A problem with weaning off Wellbutrin is that in Europe ONLY the 150mg is on the market. And it is said that these should not be cut. I started to do my own research then as I learned that taking Wellbutrin on alternating days is asking for trouble. I found out that cutting the Wellbutrin XR just changes it to instant release. So I bought myself a scale that can weigh milligrams. I divided my daily dose of Wellbutrin over 4 parts. And that worked. April 2018 I went down from 66 to 56 mg Wellbutrin and shortly after I got discontinuation effects. I was advised by one of the “best” professors in Psychiatry in The Netherlands that it might be better to get away from the Wellbutrin first. And to leave the 0,6mg Lexapro during that weaning off. Which I did. Still thinking that getting off Wellbutrin should not be so difficult (when taking a smaller dose daily instead of alternating days), I went down in small steps of maximum 10% as of here. April – August 2018 I went down in small steps from 56 mg to 37,5mg Wellbutrin. All the time staying on Lexapro 0,6mg. The steps were never more then 10%. Mostly 1 step down every 3-5 weeks. I had sometimes heavy discontinuation effects which lasted most of the times 2-4 weeks. Getting under 50mg Wellbutrin per day, the negative effects became worse and worse and were also taking more time to disappear again. After reaching the 37,5mg I had reached a point where I really could not go further down again. I was feeling so terrible. I was extremely tired, depressed, anxious, negative thoughts (also thoughts of suicide), forgetting things, making lots of mistakes, concentration problems, irritated, no appetite, nausea, hart beating, feeling of burning on the inside skin, blurred vision. This situation remained more or less until March 2019 with several rebounds, so until 7 months after the last dosage change. March 2019 – May 2019 I decided now to try to wean of the Lexapro first. So before stopping Wellbutrin. Since stopping Wellbutrin became more and more difficult I went down in small steps from 0,6mg to 0,3mg Lexapro. I also went down in several small steps with Wellbutrin from 37,5 to 35,3mg (with knowledge of now not clever to do both in same period…) But still it was only 6% down divided over several steps and months… After reaching the 0,3mg level of Lexapro it went wrong again. Extreme problems with sleeping. Comparable with the crisis I had in 2014 where I had the psychoses several times at night. May 2019-December 2019 I learned about the Prozac switch. I discussed it with my doctor and he thought it might be a good idea. So I did. Eventually the problems became worse and worse. I do not know for sure if it had to do with reaching almost the zero point for Lexapro or if it had to do with the small dosage change of Wellbutrin. I guess it had to do with reaching the zero point of Lexapro and then stopping Lexapro completely after the Prozac switch… So maybe it was a sort of “cold turkey” effect om the Lexapro (although only 0,3mg and although the Prozac switch). The sleeping problems were so extreme that I felt that psychoses could come any moment. I tried several sleeping medication, but none helped. In the end I was given Seroquel which helped, at only 12mg per night. I used it only for 4 weeks and weaned it off to zero in another 2 weeks. In the meanwhile I had gone up with the dose of Prozac from 0,6mg (equivalent of 0,3 mg Lexapro when doing the Prozac switch) to 1,2mg Prozac and still 35,3 mg Wellbutrin IMPORTANT: I found information that Wellbutrin slows down the metabolism of SSRI’s. Which means that going down in doses Wellbutrin speeds up the metabolism of the SSRI, which probably has the same effect as lowering the dose of the SSRI. So even if one does not lower the dose of a SSRI, the effect is felt as such after lowering the dose of Wellbutrin….! December 2019 – February 2020 I was having a lot of discontinuation problems from December until February 2020. First With lots of rebounds. Slowly some windows were coming, slowly getting longer and more often. End of February I was feeling better again. February - April 2020 Decreased Prozac from 1,2 mg to 1,05 mg over several small steps. I thought that after being almost 1 year stable on Wellbutrin I could go down there as well (not clever again…). So I went down from 35,3mg to 34,3mg (just 3%). And some weeks later from 34,3 to 33,3mg. That is where it went probably wrong again… About 10 day after the last dosage lowering of Wellbutrin, I started to feel again effects that almost certainly have to do with the Wellbutrin. But still not fully sure since I am also still on a very low dose of Prozac. That might have effects as well. And then there are the possible effects between both drugs… August 31, 2020 Anyhow, It is now 5 months after the last (small) dosage change of Wellbutrin. Still having rebounds from that. I decided that I will remain on the level of the last doses change, i.e. 33,3mg, until I am completely off the Prozac In the meanwhile, I went down extremely slow with the Prozac from 1,05 mg to 0,83mg in steps of only 2-3%. In this current tempo, going down to zero with Prozac, will certainly take me another 6-8 months. If I make that in such a period….. I am dividing 1 pill of 20 mg in 24 daily dosages. One would think that one could stop by at this low dosage, but I am really afraid of doing so, because all my earlier experiences. Plan and Questions OK, this is a very long background story. But I hope it helps with the advice I am looking for. My plan is to leave the dosage of Wellbutrin on 33,3mg as long as I am taking only the smallest dosage of Prozac. This because I have found that Wellbutrin is influencing the metabolism of Prozac. And I have read more then once that stopping Wellbutrin can be very difficult when also taking a SSRI. Hopefully it will be easier (as some say) to quit Wellbutrin after having stopped Prozac. After fully stopping Prozac I want to wait for at least 3 months before doing a dosage lowering of Wellbutrin. This because of possible rebounds after stopping Prozac. When I remain stable, I plan to lower the dose of Wellbutrin with only 3%. Then wait for 4 weeks and then another 3%. If that works out OK, maybe a step of 5% and so on. Questions: 1) What do the moderators think of my plan? Any advice or recommendations? 2) At which dosage level would it be safe to stop completely with Prozac? I was thinking about going down to 0,15mg which is only 1/70 of 1 pill (so 1 pill divided over more then 2 months). But still then I am not sure if that is safe to stop. 3) Is there any experience if it is true that stopping Wellbutrin is easier when one is not taking a SSRI anymore next to it? I hope so, because getting of Wellbutrin seems to be getting more and more difficult at this dosage level I am. And every small step down asks for a heavy recovering period of about 8 months now… Some additive information: I take daily: high doses Fish Oil (3000mg) Magnesium 100 mg Sometimes 2 drops of Lavender Oil when feeling anxiety Sometimes 50mg of L-Theanine when having severe discontinuation effects probably caused by Wellbutrin Fish oil, magnesium , lavender oil
  24. Hello, I was hoping someone could give me some advice about some severe symptoms I've been experiencing since switching from Lexapro to Prozac and back again. Here is my story: Diagnosed with OCD and depression at 18. Prescribed 60 mg Prozac which I eventually manage to reduce to 30 mg. Continue taking this dose of Prozac for about 20 years. At the end of last year Prozac seems to have lost its effectiveness so I speak to my doctor about switching to Lexapro which I've heard has less side effects. As instructed by my doctor I reduce my Prozac dose to 20 mg for two weeks, wait 5 days without medication, and then start on 10 mg Lexapro. Soon after starting Lexapro I develop some very unpleasant side-effects, most notably heart palpitations and tinnitus. I speak with the doctor who tells me not to be concerned because the side effects are caused by "anxiety". Against my better judgment I continue taking the Lexapro for a total of 25 days. At this point the palpitations are so bad I have to stop taking the Lexapro immediately. I wait two days and then reinstate the Prozac at 40 mg. Things seem to be reasonably okay for about 3 weeks before all hell breaks loose. I wake up in the middle of the night with such extreme palpitations and dizziness that I end up in ER. However, the doctors find nothing wrong with my heart, conclude its anxiety and send me home. Two hellish weeks of palpitation induced insomnia and intermittent akathesia follow. During this time I have a number of medical tests but nothing abnormal shows up in the results. The palpitations are worse when I lie down and though they cause some anxiety I am convinced they are not caused by anxiety. It feels like the part of my nervous system responsible for controlling my heart has been physically damaged in some way. When I try to explain this to my psychiatrist and cardiologist they don't understand. The psychiatrist gives me Valium and the cardiologist gives me a beta blocker. None of these seem to make much difference so I'm given some Ambien to help me sleep. I take the Ambien for about 5 nights before I decide I'd rather deal with the insomnia. Eventually I get some kind of sleep, but it is still very fragmented and the palpitations persist. My chest feels really tight as if my heart is being pushed up against my chest bone and the palpitations are worsened by lying down, eating or feeling cold. I lose my appetite and drop from 78 to 69 kgs in weight. I start filming my sleep so that I can show my doctor what happens. The footage shows me suffering from hypnic jerks and muscle twitching. These jerks are accompanied by electric shock like sensations that wake me up. During the day I am still tortured by this uncomfortable feeling in my chest and the ongoing palpitations. It feels like my heart has a mind of its own and has been knocked out of sync with the rest of my body. The tinnitus (a loud, high-pitched ringing) also continues. After 18 years at the same company I have to take sick leave for the first time. I have been off work for a month now and have no idea when I'll be able to go back. I continue to take 30 mg Prozac because I feel things would be even worse without it. During the day I walk because this seems to help with the palpitations. I've started taking Magnesium L Threonate and krill oil supplements. I desperately want my life back.
  25. Hello. Details below but I think I'm experiencing withdrawal symptoms, mainly intense anxiety and insomnia. Both seem to be geting better following the windows and waves pattern, but it's exhausting. Looking to make sense of what I'm going through and support. Brief med and treatment history 2002-2019 Lithium 900-1200 mg (0.6-9.0 mEq/L blood serum levels), 2018-2019 Prozac 20 mg. After trying various mood stabilizers following manic episode precipitated by Zoloft (very high 100mg+ dosage), I was prescribed lithium, which I took most of the period from 2002 until I stopped it in 2019. During that time I tried various other mood stabilizers, including depakote, lamictal, carbemazepine, and abilify in addition or instead of lithium. 2008-2010 became dependent and withdrew from benzodiazipes. Underwent ~20 ECT treatments in 2010 following hospitalization for depression which marked a turning point in course of "illness." Significant improvement in my life from 2010-2020 but some anxiety and depression symptoms remained. Tapering Started Prozac in early 2018 to help with continued chronic anxiety and mild depression. Prozac did help...most notably with the anxiety. I recall it seeming to lift a huge weight off my shoulders, allowing me to let go of the indecision, rumination and general anxiety. While on the prozac, I stopped lithium, tapering fairly rapidly, going from 900 mg/day to 600 mg, to 300 mg, dropping down after a couple months each step. In late 2019, I then went off the prozac, going from 20 mg to 10 mg for about 2 months, then to 0. I was not aware of this website or procedures to taper even more slowly. Current State - Withdrawal? Beginning in 2020 after being off prozac a couple months and lithium over a year, I began experiencing bouts of intense disabling anxiety, insomnia and intense emotions (crying for hours on occasion). All of these seem to be of a different quality than the anxiety symptoms that led me to take the Prozac and very different from anything before then. At the same time, I have also been experiencing periods of clarity and heightened consciousness, which feel like my brain and mind waking up after many many years. Also, have had some periods of calmness. Its hard to make sense of the mix of feelings and sensations, but for the closest experience to the clear periods, I have to go back to my teenage years before the diagnosis and before the pills. After reading the New Yorker profile on Laura Delano, I learned more about antidepressant withdrawal through this website and some of her work. I think it's probably the best explanation of what I am dealing with and am looking for help getting through this. I feel like I am on the precipice of regaining a full mind and life after 20 years in varying degrees of darkness. But this is also scary, hard, and it's difficult to keep things together. I am continuing to juggle a demanding career, parenting a two year old and five year old, and being a good husband....while caring for myself and trying to practice self-compassion as I go through what I view as a major life event. Looking for support and to hear more about others experience, hopefully to give me some confirmation that there's an end to what I'm going through. Up typing this in the middle of a stretch of anxiety and insomnia.
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