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  1. Hello everyone. I'll try to organize this as best as I can. There is a lot going on. I was on benzos from age 17 to 36 and on Cymbalta from age 35 to 36. Went off both together for a 2 year nightmare. Absolute pure hell. I wont get into the details and symptoms of that withdrawal in this post as it is it's own little novel. Some things improved during those 2 years and I feel I've beat the benzo part of the nightmare even still, but at age 38 I was still suffering enough that I agreed to go on Lexapro to see if I'd improve. I did improve hugely but it stopped working as well after 3 years and I was switched to Prozac. I have taken the Prozac ever since and it felt like it was failing around 4 months ago. I missed a lot of doses around 3 months ago and just tried to stop CT for just over a week around a month and a half ago. I started feeling withdrawals so I went back on and the withdrawal feeling is still getting worse. My memory and focus went first, then the inner restlessness and anxiety started and dizziness. I am also having the disconnected dream like feeling 24-7. I am so depressed and fearful all of the time. I've been taking the Prozac without missing a dose for over a month again and this is still happening to me. It's as if the combo of Prozac tolerance and coming off for the short time has started a withdrawal that even going back on can't stop. My doctor wants to take me off the Prozac after a slow taper and start me back on the Lexapro. The hope is that since it worked before and I've been off of it for almost 3 years that it could pick me back up and end this nightmare I'm back in. I am really considering just tapering the Prozac and staying off all ssris; so no going back on Lexapro in that case. I am so afraid of entering back into a nightmare like a was in coming off benzos and Cymbalta. My current state is terrible but the previous experience was truly worse; being benzos and Cymbalta together. It is really hard t say what withdrawal symptoms were coming from which pill. There were so many. I am so terrified of how I am feeling right now, but mostly for the days to come. If I come off the Prozac entirely I know my current state will worsen. I will be thrown back into a situation similar to the first nightmare. If I taper the Prozac and go back on Lexapro and it actually works, I'll still be doomed because I'll be back on another pill waiting for it to stop working again and most likely going through it all again. If I go back on the Lexapro and it doesn't work I will just aggravate my current symptoms with throwing more chemicals on my already hurting brain. The first time around withdrawal I had terrible akathisia and I am already feeling it brewing and I am still on the Prozac. I don't want to go through this again! Also from what I've been experiencing this month it seems a lot of what I assumed were due to the benzos were possibly due to the Cymbalta withdrawal as it's so similar. Also, I forgot to mention that I am on 500 mg of Depakote XR as well. I was put on this a couple of months after the Prozac as I felt a bit agitated. It helped but I got worried about my liver and quit it after 4 or five months and had a mild withdrawal from that but it passed. Just a couple of weeks ago after my current situation started I went back on the Depakote to see if it would help and it hasn't. I'll most likely be stopping it again as well. I had an account on Benzo Buddies during that ordeal and it gave me an outlet and some hope. I've set this account up here and got my story out in advance as I am leaning towards just stopping the meds and I'll be needing all of the support I can get! I'm seeing my doctor on January 3 so whatever I decide to do it will be starting then.
  2. Hi Everyone, I am just going to jump right into this. I developed anxiety 4 years ago after having several life crisis in a months time. My mom was diagnosed w Dementia. My little sister was diagnosed with stage 3 lung cancer. I was diagnosed with squamous cell carcinoma.A childhood friend died in his sleep from heart failure. I tipped over from the stress. I went to my GP and she started throwing AD's at me to help silence the anxiety. The AD's only made me worse. I went to the ER one night after experiencing my first panic attack The ER Dr gave me a script for Ativan. I took it for four weeks and then stopped because I was feeling much better. A few days later my world turned on it's axis. I didn't know what was happening. My anxiety was worse, I was pacing, heart racing, Panic attacks daily.... I went to my GP and she said I needed to see a Psychiatrist. To get in to see anyone was 3 months. I started to spiral. I had no idea I was in withdrawal! I ended up in the hospital to get help for my anxiety. I was put on Effexor (75mg)and Klonopin (.25mg). I stabilized and was sent home. I did really well on Effexor. After 4 months on Klonopin I started to slowly taper off. I tapered over 3 months. The taper went pretty well. I was cutting and weighing my pills. 8 months after that I felt good and talked to my Psychiatrist about tapering off of the Effexor. She strongly recommended to go slow and we did. I tapered for almost 7 months. To be honest, the Klonopin was easier to come off of than the Effexor. She put me on Prozac before my last cut of Effexor. Tapered off of the Prozac over 3/ months. I still had some anxiety but it was tolerable. It felt AMAZING to be free of AD'S and the Benzo....then COVID hit and my mom passed away. Anxiety came back w a vengeance. I ended up back in the hospital after a very bad reaction to Zoloft. My new psychiatrist kept telling me to "push through," the first 3 months. I was back on Klonopin but now it was.50mg twice a day.The hospital took me cold turkey off of Zoloft and started me on Remeron and Trazadone. The next day they added clonidine. The klonodine didn't agree w my system at all and I was taken off of that in two days. They released me from the hospital 5 days later. I lasted two weeks on Remeron. I was so disoriented, confused, high anxiety and felt like I could become violent on them so they weaned me off of that over 4 days and put me back on Prozac. Prozac didn't help my anxiety, I had constant headaches for months! I did get an MRI and it was normal. I started to feel more and more depressed on it. I was on Prozac for maybe two months when my psychiatrist took me off of that (tapered over 6 weeks) and put me on Lexapro. I had to have back surgery during this. I did NOT take a single pain med out of fear of making my WD worse. At first I thought the Lexapro was helping? I was still having breakthrough anxiety so he bumped it up. My Psychiatrist retired and a new woman came in to take his place until they could find a new one. She bumped my Lexapro up to 25mg when I told her I was having major anxiety rushes, my face would get bright red, I wasn't sleeping very well. That increased dosage was the worst! I was like a zombie but w heightened anxiety. I couldn't work, I would sit at my desk and space off for hours! I felt awful. So, she told me to start tapering off of the Lexapro (4 weeks total! I knew better...) and she wanted to cross taper me onto Effexor. I started that and boy....the depression was BRUTAL! I was not sleeping well, could hardly focus, anxiety was high, my legs felt like jelly, my head would burn, I felt my brain tingle all the time... I was nearing the end of my rope. I was desperate for a Psychiatrist that CARED. The interim Psych left and a new one came in. She wanted me off of the Effexor because she felt it was too hard to come off of and if it didn't work for me, I would be in for hell. I told her I was scared to switch AGAIN and she assured me that switching to Duoloxetine was it's "sister drug," and I shouldn't have an issue. I trusted her. The last 3 months have been.... (How do describe this hell?!) a daily battle to push through hell on earth. I am still working, I can still function, I take care of myself, my home, my dog. I am a divorced woman with a 22 year old son. I live by myself with my Rottweiler. Life is so friggin' hard when you are trying to get thorough this mess. I now have a WONDERFUL and caring Psychiatric nurse practitioner who truly cares. She is holding me on the last 10mg of Lexapro until the Effexor/Lexapro WD calms down...IF it calms down. I should tell you that I can't believe I have pushed through the last year. My symptoms have been Burning in my head, headaches, tingling in my head, mood fluctuations, burning on my skin, bloodshot eyes, pressure on my chest, sensitivity to heat, depression, sweat easily, joint pain, ringing in my ears, no motivation, grinding my teeth, feeling mentally off at times, at the beginning I couldn't sit still, short tempered, at times in the beginning of the Lexapro taper, I didn't want to talk at times...like I almost couldn't, buzzing in my body, feel like I'm going crazy sometimes, anxiety rushes...etc I am interested in this group for support and the combined knowledge from it's members. I know that NO ONE can tell me when this is going to end. What I am hoping is that someone can tell me what I am going through is normal for all of the med changes? I am honestly concerned if I am still having problems because of the Duoloxetine? My anxiety IS better since I have been on it. I get 8 hours of sleep. I don't drink. I don't use illegal drugs, don't smoke. I eat pretty healthy. I don't exercise. It's tough to get out for walks when you feel like hell and I guess I save my mental energy to work. I know I have rambled on. My mind feels like it's in a vice and also these drugs affect how well I put my thoughts into words. For the most part I am a happy and well adjusted person. I feel like the last few years have been stolen from me because I faithfully followed Dr's instructions and thought they knew best...I was so wrong. Thank you for your time. Blessings to all of you.
  3. Hi, I have been struggling with hearing sensitivity and eye issues ever since I made the mistake of listening to my neurologist and trying Effexor, and then upon recommendation of a psychiatrist, Prozac. Both were for short time periods. I am a little more than 4 months out of my last prozac dose. Ears/Hearing: hypersensitive to certain sounds - sudden sounds, sharp impact sounds, crinkling plastic wrappers etc. High pitched tinnitus that is generally not too instrusive and can be better or worse but always there. No hearing loss as of post-Effexor, pre-prozac. Eyes: “tight” feeling that is somewhat better than a few months ago but still not normal. I probably have some visual snow, and my night vision is worse because it’s like my eyes are amplifying light that’s not even there. Constantly bloodshot and dry eyes - taking restasis but opthamologist didn’t see any other eye issues. Balance: generally ok but occasional unsteadiness. Other: Mild constipation: gastroenterologist didn’t see anything wrong. Some TMJ pain and minor random muscle twitches. Occasional facial tremors that are better than a few months ago but not gone. Frequent trouble sleeping- falling asleep, getting enough sleep or deep sleep. Basically I believe that these drugs hypersensitized me. I sincerely hope that this hypersensitivity will decrease over time. I have seen some improvement vs say 2 months ago, but I have a long way to go. I have read on this site that it can take a long time for the nervous system to calm down. I believe that I am generally improved on magnitude of sensitivity vs say 2 months ago, but I am clearly not on a “some people take as much as a month to recover” timeframe.
  4. 9 years ago, I was prescribed 10mg of generic Prozac after a traumatic incident in my life that left me nearly catatonic. I continued on that dose for 7 years. Approximately 2 years ago, after a stressful work situation, my primary care doctor suggested I switch my antidepressant as he thought it became ineffective after so many years. He switched me to a dosage equivalent of generic Lexapro for a short time. I complained about a spike in anxiety so he then switched me to 50 mg of generic Zoloft. Shortly thereafter, I experienced major depersonalization and brain fog. I eventually went down to 25 mg of Zoloft and, somewhere in the midst of this, I experienced some other obscure health symptoms (pressure in head, tinnitus, dizziness, fatigue, neck and head pain, etc). I saw many specialists who all said my health checked out. I ultimately decided I wanted off of my antidepressant and my doctor recommended halving my dose for a week, and another, then stopping. I experienced some peculiar insomnia/hypomania, agitation and flatness the first few weeks, but, overall, I faired well. It wasn’t until about 2-3 months later, I would know literal hell. I have been imploding with anxiety, trembling, not eating, experiencing an avalanche of panic attacks, and not sleeping for 24 hours at a time- during which time I have rapid, intrusive thoughts teetering on hallucinations. I can feel my nervous system destabilizing and have an overwhelming feeling of dread. It has felt as if I’m on the precipice of permanent insanity. Sunday, I went to urgent care where I was prescribed Hydroxyzine for sleep and I was told I could not experience withdrawals 2-3 months after discontinuation; I was told I was experiencing a relapse. I have never experienced this kind of insomnia and anxiety prior to antidepressants. Yesterday, I started back on 25 mg of Zoloft. Today, I was prescribed 7.5 of Mirtazapine for sleep until the Zoloft takes effect. I will eventually address tapering again, but it won’t be through the suggestions of healthcare providers. Hopefully, I can rely on another’s experience for a successful taper. For now, I feel highly skeptical and disappointed in modern practitioners. I am hoping to stabilize my nervous system soon.
  5. Medication HIstory: Prozac 1993 to 2016 for anxiety and depression (actually have Complex PTSD) Switched to Celexa in 2016 and took until Feb 2022 Switched to Lexapro in Feb 2022 then Zoloft in June. Switches were due to bad anxiety and now tapering off because SSRIs seem to be causing anxiety rather than reducing it. At 25 mg Zoloft presently for 3 weeks. Symptoms include nausea, loss of appetite, stomach ache, anxiety. Also taking Lorazepam 1 mg and Zolpidem 10 mg. Just started Accel for nausea and it's helping.
  6. Hi. I've been on SSRI meds for a long time. I'm currently tapering from Zoloft. I'm at 26 mg. I'm reducing at 2.5% every 2-4 weeks. My CNS is a mess and I can feel every taper. I'm so tired all the time and have no energy. I'm taking cal-mag citrate, Barleans Omega fish oil, Vitamin D3/K2, and an iron supplement for anemia. Sometimes I take Coq10. I'd like to know what has helped others with the inability to focus and with fatigue.
  7. I will keep this short as I can. I gave up fluoxetine in my early 60s when I had the opportunity to retire, having been taking ADs for previous 15 years or so. I didn’t taper having tried it before, and with my personality type I was keen just to turn my back on the whole lot of it and see what happened. At the same time, this is 2018, my friend tried to give up by tapering. Now 4 years later having tried cutting down many times she has just been prescribed yet another type of AD this time stronger than ever. I went through hell giving up but you do come out of the other and I feel sorry for my friend who is still stuck and suffering. First six months. Pure unadulterated hell. I spent a lot of time crying. The psychological pain found a focus in the state of the world and the intense cruelty of humans towards animals (even thought of all the farm creatures penned up with no freedom felt like a hideous knife twisting into my heart). Everything was unbearable, I didn’t sleep well and woke hideously early.I could barely go out, would try having coffee with sympathetic friends and would end up just sitting in silence with tears running down my cheeks. 6 months to one year. Still a hellish existence, those close to me started losing patience and sympathy. I started getting comments like ‘maybe you’re just one of those people who always need to take them’, or ‘have you tried mindfulness/etc’ while putting on a why isn’t she pulling herself together by now face. The second year of withdrawal. At this point I realised it is all about the brain chemicals. There is not a thing you can do until your brain has had time to heal and recover and find its own balance and that will take as long as it takes, so don’t give up, nothing external really seems to help you just need time. I was still trying all sorts of things, eg cold swimming when I could, but it’s not a miracle cure nothing is. You just need to keep fighting it for another day, day after day. Realise that 99%of the advice and suggestions, both medical and ‘alternative’ are bullsh*t. People confuse their journey battling low mood where it worked for them to take that supplement and do that meditation with people like you and I who are suffering a chemical depression where every home grown good feeling the body can create has fled and won’t be coming back for a good long while. Hang in there! After about 18 months it was starting to ease in that by mid to late afternoon my mood was starting to lift and I was even getting some prolonged moments of inner peace from the tortured thoughts that continually plagued me. But really for the first two years there was a pattern; wake up (too early) and feel normal for about 30 seconds then countdown to the plunge into the abyss as the cortisol kicked in. And I really do mean the abyss. Third year. Generally started actually feeling I was on the road to recovery. The daily cortisol plunge was being shaken off earlier as each month went by. I still had terribly sensitive emotions related to my pain focus of choice (world/animals) and just hearing about the wrong thing would do the trick. My courage started to return in lots of little ways and life started to get back to normal although everything had changed at the same time. Looking back, some things that provided temporary relief: being outdoors, taking a walk, doing some gardening, cold swimming or showering, repeating a mantra to crowd out the repetitive negative thoughts - pick your own. I chose the Vedic spiritual mantra Hare Krishna, Hare Krishna… etc find it on the internet. This is with the greatest respect to that great Indian tradition from which the mantra comes, I followed transcendental meditation for many years so it had a spiritual meaning for me. A practical tip the mantra should be soothing, easy to repeat over and over. Late afternoons I started to look forward to a strong cocktail sipped in the garden with a little puff of homegrown (also the only reason why I was able to sleep at all). Obvious warning - if you have an addictive personality you will be particularly vulnerable during withdrawal so watch out. Now four years later. I am definitely 100% over it and have been for a while, now getting psychologically stronger all the time and better than ever before. if you are suffering at the start or in the middle of your journey that sounds like an awfully long time, almost too much to bear. But you must bear it for your long term benefit and when you are free you will finally have your life back in a way that you never truly had been able to perceive it before. You will have been through hell and survived. The great statesman Winston Churchill kept me going, I repeated a quote to myself all the time ‘if you find yourself in hell, keep going’. If you are young and have been prescribed these medications for anxiety and depression the one thing that will help you terminate your trajectory into lifelong suffering is the one thing in this modern world that is kept in short supply - peace and healing nature. This will be so difficult for you as the modern consuming lifestyle by which we are all tethered and controlled relies on providing constant dopamine hits from clicks and thrills, it is ultra addictive poison - avoid if you have any desire and hope of building a peaceful and meaningful life, and spend as much time in nature and with pets and other animals as you can. (IMHO of course!). For the first 18 months I scoured this website multiple times a day because the one thing that helped was hearing about other people’s experiences and knowing there were others like me suffering on this awful journey that we can only travel alone. As I started to get better I promised myself I would thank this website and the good people who run it for the support and for keeping hope alive that there is actually something worthwhile at the end of the long dark tunnel we’ve had to travel. I hope my experience is of benefit to you. Just keep going, if you do I promise you that the outcome will be unavoidable - freedom and relief.
  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. Hello, my name is Sturm! I am from Austria and am looking for someone to read over my story about getting off of Effexor, since, quite frankly, I am terrified that it will last a few weeks more, or that I could get addicted to benzos (see more about that later) in the process (as the worst side effect I have atm is very bad insomnia). I hope I am posting this in the correct place. So, this is a bit of a long story. I have been taken Venlafaxine / Effexor for around 7 months (since January 2022). Around two months ago I decided to taper it (I was at 150mg). We tapered to 75mg. I don’t recall any psychological side effects from this, but I did notice muscle pain (especially from my left leg). I stayed on this for around two weeks, when I tapered again to 37,5mg. I stayed at this dosage for two weeks, and didn’t notice any psychological change besides muscle pain. I was then told I could get off Effexor, or I could take it every other day. I took it every day for a week. By this time, I noticed brain fog, but nothing extremely strong. At this point, after a week of this, I asked the psychiatrist about a prozac bridge, knowing the withdrawal effects would undoubtedly be terrible. The next day (Friday 21.07.2022) I was off Effexor and took 10mg prozac. At this point, I had a decent amount of nausea and akathisia, a reduced appetite, as well as chills, but never experienced brain zaps. The 5th day had the worst nausea. By day 7, the nausea was seemingly gone, and I thought the withdrawal was over, so I stopped taking prozac a few days later (31.07). The next few days were pretty recent, little to no nausea. By August 5th, (roughly two weeks since being off of the Effexor), I had some mild nausea, chills were back, and worst of all, I started having really bad insomnia. Despite bot having taken any prozac in 8 days, I took it again on August 7th, thinking the insomnia happened due to stopping prozac and being off of it long enough for its half life to expire, therefore allowing more of Effexor’s withdrawal effects to occur (since prozac normally suppresses most of the nasty ones). This, however, doesn’t seem to be the case, as of today, August 10th (day 19), I still am having sleep problems. I am also concerned that I could have become dependent on prozac for taking it for around 14 days. Could dependence on prozac be attained that early, or does it normally take around a month to occur? It has been nearly three weeks since I am off of Effexor. When should I expect the rest of the withdrawal to end? When should my insomnia end (before yesterday and the day before (I was proscribed lorazepam, I hadn’t gotten any sleep in three days due to the insomnia). I was proscribed lorazepam 2,5mg to help me sleep at night. Is this safe to take, or will I get addicted? The psychiatrist and nurses at the hospital where I was given this prescription said it shouldn’t be an issue unless I take this dosage for months. Do I believe them?
  10. Hi everyone this is my first post so please excuse any errors or things I don’t do correctly. I see a lot about inserting signatures but I am not sure how to do this… So this year after 3 years on Prozac (swapping from Seroxat from June 2018) I decided to taper off very slowly because I was in a good place in myself. This was equivalent to one every other day for 1 month and then 1 every two days for another month and so on. This started in June 2021. By September 2021, I felt at the point that the tapering was perhaps enough so stopped approx Sept 15th. I felt I was doing ok but then on 15th November I got Corona and for some reason my system completely got messed up with severe anxiety and on 28th November I reinstated my on the advice of the doctor the Prozac at my usual 20mg - Big mistake. The doctor then gave me 20mg Temazepam for sleep and Oxazepam 10mg for the anxiety and upped me to 30mg Prozac. I stuck this for 2 weeks and the side effects were so bad I dropped back down to 20mg and continued but I had such extreme nausea that I lost 9kg in 6 weeks and this Monday just gone the Psychiatrist has taken me off the Prozac immediately and told me that he will try me on something else after two weeks!!! I’m really scared for more side effects but he said he is not worried about that because it takes such a long time to leave the system. I am in general anxious so worrying about this is also not helping. Do I need to re-add my drug history as I already did this when I registered? I hope for some good advice or reassurance. Thank you
  11. Hi. I have been reading different posts on here for about a month. I want to taper off Lexapro, but I've been on it for over 10 years. In 2005, I was put on a very short, and ended up with brains apps and went back on it because I was super agitated. When I told my doctor I wanted to Lexapro, her idea was to switch me to Prozac. Initially, she was going to help me switch to 20 mg, but I knew that the equivalent was 40 mg, so I asked if we can do that and she said yes. I am on day two of switching from 20 mg of Lexapro to 40 mg of Prozac. I feel dizzy and have a UTI. I don't know if that can be caused by this medication switch. It kind of creeps me out. The test only showed barely any evidence of the UTI, but the doctor said I was experiencing symptoms so gave me an antibiotic. I am thinking about a post I read on here that suggested people try wean off their current drug rather than bridging to Prozac. So now I am kind of freaking out thinking that I should just go back on Lexapro and when I see my doctor in a week and a half ask if she will prescribe the liquid. I think I asked that in A message, but she suggested Prozac. I have wanted to wean off the drugs for a long time, but actually had resigned myself to staying on it for life. I felt like I was stuck. But then it was getting migraines, and my family doctor wanted to add another antidepressant Pamelor, for the migraines. At that point, I did not want to add any more, and so now I decided it was time to try to taper down. I have seen that on some sites it says Lexapro can cause migraines.
  12. Hey guys, My past medications: these were most recent, from the age of 15 onward: - Pristiq - 100 mg - Abilify - 15 mg - Fluoxetine - 20 mg - L-methyl folate (supplement) - Adderrall XR (in morning) - forget dosage - Adderrall , 2 throughout day - forget dosage When I was 10, I was dealing with a lot of anxiety due to an unstable home life at my Mom’s. I was diagnosed with anxiety and began taking Fluoxetine after an initial meeting with a psychologist followed by a psychiatrist. At age 15, I attempted suicide and was admitted to a teen unit at a local hospital. There, I was placed on many of the medications that would later be incredibly difficult to discontinue. By age 20, I had erectile dysfunction, weighed ≈285 pounds at 6’, couldn’t concentrate on anything, was diagnosed with type 2 diabetes, had severely limited vision in both eyes, slept 12 hours per night, had a constant feeling of emptiness, and had an overall feeling of not being present in my life (just kind of floating around). On March 12th, 2020 (yes, at the beginning of the pandemic), I stopped everything Cold Turkey. It probably wasn’t the smartest move, but I’m so glad I did it. I went through about 4 months of what I can only describe as hell. Vomiting, diarrhea, alternating between sleeping for 12 hours and 3 hours per night, and a rollercoaster of emotions I’d never felt before. I’m currently 185 pounds, diabetes free, updated my license yesterday to remove my vision restriction (my vision corrected), have a pretty good running/ weightlifting habit / Nutrition approach going, I just finished 2 years at a local Community College with a 3.2 overall GPA in a transfer program to a B.S. in Chemistry, and life is fantastic. Everything works well, I’m feeling real, genuine emotions for the first time in my life, and I’m thrilled to be alive. The only drawback from this whole discontinuation process is that I now can’t stay in bed for more than 6-7 hours. There is a light at the end of the tunnel, getting the vision restriction from my license removed yesterday prompted me to speak about my story (I guess you could call it a personal milestone). I’m still navigating the whole relationship, being human, and experiencing emotions part of everything but I can say that for once in my life, I’m very happy. Feel free to ask me anything. Thanks everyone, Connor
  13. Overall question i have is:Are these side effects of this new med desvenlafaxine xr(brand name pristiq)25mg or is it withdrawal from my old one paxil 20 mg that I have been on for 30 years ?? And i need help. Thinking of going back on the paxil 20 mg and forget the pristiq. History and introduction of me:all started in 1992 having difficulty coping, little things would set me off, or crying. (Looking back now, think it was postpartum depression had baby April 1991)Dr. Prescribed Prozac 20 mg. Worked great in the really helped my mood, however, felt like having out of body experience, like I was up in the air looking down at myself and watching me do whatever, ie: work and had extreme muscle weakness. Was on about 1 month. Dr switched me to zoloft 20 mg, not good from the start extreme headaches. Dr stopped that after a week and prescribed paxil 20 Mg once a day and have been on ever since. So have been on for 30 years. It has worked well for me, mood stabilized. Did have weight gain with and no matter what I do unable to lose the weight. 15 years ago Also tried low dose wellbutrin to it smoking. Had extreme heart palpitations ( i have since quit smoking) 10 yrs ago, Didn't know anything about tapering and went cold turkey off pax. Did not take 2 weeks and Didn't go well. Ended up with flu like symptoms that wouldn't go Away, and ringing in tears. Started back on 20 mg and was better again. 5 years ago tried tapering 10% every 4 weeks. By 8th week flu like symptoms back felt like crap, ringing in ears. Started back on 20 mg paxil every day and all good again. 4 years ago. GP Dr. Had me to genesis testing to see what meds would be good fit for me.. paxil was not on the list( I think since I have been on this med for so long it squed the results for that med.. any thoughts on this) anyways. Gp prescribed on 7/29/2022 desvenlafaxine xr(brand name pristq)25mg once a day. Do a direct switch from the paxil 20 mg i was taking to 25mg desvenlafaxine. First day no noticeable side effects. Day 2 and forward( 07/31/2022 thru 8/8/2022) you know how your head feels congested when have a cold..that's how my ears feel. Loose stools, not diarrhea, but mushy like, excessive sweating, waking up soaking wet from a night's sleep, and occurring sporadically throughout day out of no where. EXTREME FLUShing(does not occur when excessively sweating. Dizzy, muscle heaviness. Lack of appetite(i have lost 3 lbs but not the way i would like to loose the weight) drinking lots of water. Also my liver and kidney numbers are slightly elevated prior to this switch. Is the 25mg of desvenlafaxine even equivalent to 20 mg paxil? Any direction would be most appreciated. Thank you
  14. Hi, I'm new, thanks for letting me join. I started Prozac 7 years ago after having severe anxiety after my daughter was born. My anxiety particularly revolved around sleep. 7 years later and after CBT I felt ready to taper off them which I did slowly over months. I had the usual withdrawal symptoms tiredness, highly irritable, brain fog, sadness and a little anxiety. And some weird symptoms - Im hungry all the time for sweet things and constantly want an alcoholic drink. And the sensation of my eyes wanting to cry when I don't feel sad. Also all my emotions that had been numbed came flooding back - I cry at sad movies and have empathy again. The positive side is that my terrible drug induced sweating problem is gone which is so wonderful! I didn't revert to the sleep anxiety or panic attacks I had before so I thought hey, I'm succeeding, I'm doing ok. I'm now 6 weeks on but I have suddenly started feeling very sad and tearful and I'm worrying I'm going backwards. Is this normal? I didn't actually start the antidepressants for depression but that's how I'm starting to feel.
  15. Hi, I am in crisis right now and desparate for help. I tapered off effexor 1 year ago and have had no psychiatric meds since. The past year has been rough with prolonged withdrawal and bouts of anxiety along with way, but for the past 3 months I have been doing very well (working a stressful job and handling it well, traveling, etc). For the past week, seemingly out of the blue, I am having severe, debilitating anxiety and insomnia. I also have odd physical senstations that I haven't experienced in quite this way before (odd nagging nausea-not the anxiety kind, but the flu kind; extreme muscle pain; periodic cramping of my hands and feet; a buzzing or tingling sensation in my arms and legs; weakness. I saw my doctor, who ran blood tests- everything is normal. I saw her before the anxiety started- at first, I just had the flu-like symptoms, then the anxiety hit. I don't know what to do....I am going to have to resign from my job (a well-established, successful career of 9 years). I aleady took a leave for 1 month 6 months ago when I was having a bout of bad withdrawal. I feel desperate for relief, and am so desperate that I would even go on meds again (although I swore they were the worst thing I ever did to myself and that I would never touch them again). Is there any chance this is still a delayed withdrawal? Please if anyone can offer me advice, I really need help right now. Thank-you.
  16. Hi all. I really need some advice about reinstating. I was on Prozac for about 5 years (started at 20mg and was at 60mg for the last 1.5 years) for seasonal affective disorder and anxiety. A couple years ago, I started Adderall for suspected narcolepsy. My narcolepsy got much worse the following year and another stimulant, armodafinil, was added. I finally got approved for a treatment that treats the root problem by normalizing the sleep cycle and started Xywav in September 2021. A few weeks in, I woke up feeling rested for the first time in my life, but with some very unusual symptoms atypical for Xywav. Going down on the Xywav did not get rid of it. I did stop armodafinil which helped a bit. I was referred to a psychiatrist (scheduled 3 months out) and neurologist (scheduled 7 months out). I went 3 months with these symptoms (SEVERE anxiety, dizziness, tremor, muscle twitching and stiffness, feeling agitated by noise and light, and sensory overloads) and was finally diagnosed with serotonin toxicity from the psychiatrist. I did a rapid taper from 60mg to 20mg over 3 months. Each drop I made, I had withdrawal, then stabilized quickly and had the toxicity come back. My psychiatrist and I decided to try holding at 20mg because of a longer withdrawal period, but then I started to feel like the toxicity was coming back. I kept going and taking the pill because I didn't see how it could be toxicity at that point, but I kept getting worse each time I took it. I started having spasms and burning sensations on my skin and was very hyper-reflexive. I was eventually instructed to CT at 20mg. I immediately felt better the next day, pain and spasms were gone within 3 days and I improved dramatically over the next couple months with only mild withdrawal symptoms. I did treat the mild withdrawal by taking 0.25-0.5mg microdoses of Prozac as needed (which I realize now was probably a bad idea, but it worked at the time). At 4 weeks, I started to have mild tingling in my legs but didn't think much of it. At 6-7 weeks out I felt almost completely recovered and back to normal and then week 8 everything started going downhill with the burning and tingling sensations in my legs amping up. I tried my last microdose of 1mg on June 6 and didn't have much change in symptoms. Over the next several weeks, I developed burning and tingling in my arms, back/spine, chest, neck, face, and now stomach. Along with this, I also have had severe muscle spasms in various areas, stiffness/tightness, cramping, and general muscle/joint pain. Posting this, I have now been off for 4 months and am going through wave and window episodes of severe pain and less pain. Each wave I seem to have burning/tingling neuropathic type pain, muscle pain, spasm, or stiffness developing in a new area of my body, so it’s now widespread. The pain is milder during the day, but gets so much worse at night and is causing lots of fear and anxiety. Since starting 5-htp, curcumin, and modified cictrus pectin (recommend by a naturopath) I seem to be having a few more windows through the day of a lot less pain and even 1-2 nights a week where the pain does not become severe at night. My mental symptoms are anxiety/fear, detachment (happens 6-8pm everyday) and some mood swings/low mood. The intense fear caused by the pain is the worst one. Most of my other symptoms are physical (blurred vision, dizziness, nausea, fatigue, loss of appetite). I know reinstating can be a bit risky this far out, but I am a grad student and the semester will be starting soon. I would like to be more functional than I am... and in less pain. So is it worth trying a reinstatement at this point to see if the pain will go away or should I just try to wait this out? If I do choose to reinstate, my psychiatrist suggested reinstating 5mg, but would it be better to start at 1-2mg and work up? 4 months off at end of July and primary symptoms are pain (burning/tingling neuropathic pain, spasms, stiffness, aches bodywide), blurred vision, dizziness, detachment, nausea, loss of appetite, dry mouth and eyes, mood swings, and a lot of anxiety and fear. A couple other things. One thing I have working for me in withdrawal is my Xywav. I always get 8 hours of quality sleep a night with no insomnia, so maybe that will help me to stabilize just a bit faster than normal (or maybe its wistful thinking...). I also don't think I have a chemical sensitivity. I have started supplements, an antiviral (acyclovir), and lowered the adderall without any obvious worsening of symptoms. Also is there anybody here who can relate to this and has developed a lot of pain in withdrawal? I’m 24 and never had pain before. I have had a full autoimmune and blood work up as well as a brain mri. All normal, so hopefully it's just withdrawal. Sorry for the long post, but thank you for reading and any advice you can offer.
  17. Hello, my name is Ben from Germany, I am 26 years old. I stopped taking Fluoxetin 20mg After 4 weeks because of the immens problems with the medicine. I had stomache, brain and health problems, lost Libido and nearly no erection and lost feelings in my genitals. Now after 5 months off I still have so many Problems. I feel sick, have Brain/ thinking Problems and I am Always tired and have no power at all. I dont want to do anything... sad :( and I dont have any erection... its like if he‘s dead. So now I am wondering what could/ should I do? My girlfriend is really nice but I think she needs sex :( and I cant. Was the Cold turkey a bad decision? What would u recommend to me? Thanks for your answers, Ben (26)
  18. 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
  19. 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?
  20. Hi! Thank you for including me here ❤️ I have been taking lexapro since April 2021 (went from 5 to 10 in March, then to 15 in September and increased to 20 in October). In December I realized the sedation and headaches I had been having might be due to lexapro, so I tapered off it quite fast (in 10 days from 20 to zero). Inmediately, I had huge GI issues, so I went back to lexapro 7,5 mg. In January I tried to switch to Prozac and cross tapered in 2 weeks. My GI became awful and (sorry for the detail 🙈) I begun burping nonstop, constantly, uncontrollably, every 2 seconds. I thought it was due to Prozac so after a week on Prozac (completely off lex), I quit prozac and returned to lexapro 7,5. However, my GI symptoms continue after a month and especially the burping is horrible. I have read that both lexapro and lexapro withdrawal can cause this symptom, so I don’t know whether it may be caused by having reduced the dose or by being on it… I wonder whether to wait and give my body more time time to adjust to this dose, or to try and lower the dose / taper off. Please, I would really appreciate if someone could help me. THANK YOU SO MUCH IN ADVANCE
  21. Hi all, I've been tapering off cymbalta for, several years, after having taken it on and off for about 15 years. For at least the past year I've taken 5 mg (1 bead from the Lupin generic). I took my last 5 mg dose about six weeks ago. I felt fine for about a week, but then briefly had brain zaps. Twitching in my feet and legs (a minor no big deal thing that happens to my anyhow) got significantly worse, to the point where it is interfering with my sleep. I'm also generally not sleeping well, and so my mood is labile. Or it's just labile because of the withdrawal? My question is does it seem legit that this could be withdrawal even though 5 mg is such a low dose? I'm considering taking a dose to see if the symptoms go away, but I worry that might start the process over. Any ideas, feedback, suggestions are appreciated. Thanks! karla posted this back in 2017 in the PSSD topic (only one post made):
  22. Been on and off antidepressants for the last ten years. Prescribed amiltriptalian 2012 to relief arthritis pain. CT as requested by surgeon pre operation 2013.. PTSD diagnosed by dr after surgery prescribed Dosulapin 2013. Was swapped to another antidepressant after a couple of years think it was duloxetine. CT. Cant remember year swapped to gaberpectin to help with OA!!! CTed. Eventually another antidepressant after a couple of years think it was fluroxetine?? No taper. Tried to come of but didn't understand taper diagnosed paroxetine 2019 30mg also given amiltriptalian to help with sleep again but luckily didn't use it. Been reducing current meds since 2021. Now doing ten percent taper every 4 weeks. Ups and downs!!!! use breathing teckniques, mindfullness,graditude diary,crafting , nature, essential oils, baths, books,support services such as berevement phone line, samartians, therapy of NHS for free or cheep charity counsellors but essentially do it all alone, no support from family limited support from friends
  23. Hope everyone is doing well. I wanted to start with a quick synopsis of my medical background below. I took SSRI antidepressants for 17+ years. I started with Prozac for 5 years from 15-21. Then I took Escitalopram from 22-32. Along the way I was put on Trazodone, Buspar, Ambien and Wellbutrin as well. All in an attempts to control my anxiety/depression and inability to sleep. Also a little mental history - I was bullied from about the age of 9 to the age of 16. It's pretty obvious in hindsight why I was depressed/anxious. I thought the people in this world were mean. I thought everywhere I went was an unsafe place because at this time it was. In response to this I took up boxing and working out so I could become stronger than my bullies. In all honesty it worked. As soon as I became strong and in shape I became popular out of nowhere, which was an interesting transition. Anyways, that's another story for another time. At 15 I visited the doctor because I always held things to myself because I never told my parents I was being bullied or that life outside of my bedroom sucked. They just thought I was sad/depressed. Depression also runs deep in my family. My mother has been on an extreme cocktail of antidepressants since she was about 20. Although this cocktail has been quite a rollercoaster for her as well. She thought this was the only way to help. I had no one to talk to and I felt like the world was an unsafe and scary place so when the doctor prescribed anti depressants and the anxiety disappeared I thought it was a miracle. At this time the extreme side effects didn't matter to me. The fact I lost my ability to feel empathy because I was numb didn't matter because I didn't like people enough to care to empathize with them. I thought I was going to make it in this world on my own come hell or high water. This idea set me off on a path of perfectionism, egocentrism, hedonism and drug abuse. This life is not meant to be lived alone. To make sure this story doesn't become a novel I'm going to go ahead and summarize it here. For 16 years I went on a binger of sorts. Chasing all the highs this world has to offer. Whether this be dating multiple women, chasing drugs and festival culture, chasing adrenaline highs in the form of mountain biking, power lifting or cliff diving. I kept chasing thrills to fill the emotional void left by the SSRI. I also had to be perfect at this point. I had to have a straight A's in college. A quick aside (I had a long period of alcohol addiction that ran in parallel with my SSRI usage from about 16-21). This caused me to fall behind in life so I felt like I had to catch-up quick, mixed with the perfectionism created from early bullying it caused an immense amount of anxiety in my day to day life. I wasn't allowed to rest, make a mistake or simply apologize when I was wrong. This caused insane amounts of chaos in my relationships throughout these years. Finally when I hit about 31 I decided I had enough of this chaos. A 6-year relationship and all of my life long friendships finally collapsed on me. They were built on a false human. They were built on a man that didn't exist. I see myself as two people honestly. The person that was on anti-depressants is not the same human I am off them. Honestly in my mind half the withdrawal is realizing you built a life not suitable to the person you are off the medicine. I moved to a new area and started a new life. I also quit my anti-depressants. I began hiking and looking inward. It took about 6 months from the insomnia, brain zaps, panic attacks and extreme social anxiety to subside. I managed these symptoms with extreme self inquiry. I also started walking daily. I'm running out of time to write this so let me summarize this pretty quickly here. I'm not perfectly better now. I think anxiety/depression are a part of existence now. I accept there will be days I'm tired/scared and will have panic attacks, but I've learned to sit with these emotions and understand this too shall pass. Getting of my anti-depressant also gave me my empathy back. I built closer connections with people than I've had in the past 17 years. It was extremely hard to rebuild a social support system and a new life while quitting the SSRI though. I would say overall life feels deeper now though. In summary: 1) Took SSRI's for 17+ years. Felt like a zombie. I won't say it was all bad. If you are suicidal and have no other options I would say these are better than that alternative. If you believe you have any other options though I would urge you to try them all out. 2) Quit SSRI's at 32. Created a new life. 3) Anxiety/depression still exists but I now just believe these to be a part of life as opposed to something to get rid of. 4) Found a social support system that saved me, built around the real me. Sorry for jumping around so much on this post. I was trying to work from home at the same time. So I kept jumping back into it. If anyone has any questions feel free to let me know!
  24. Hi all. I’m writing on behalf of my husband. Bit of background: 2003 was put on Prozac for 3 months- no adverse reaction and subsequently various doses of venlafaxine which he successfully came off of with no issues. 2013 was switched from Venlafaxine to sertraline. Had ‘activation syndrome’ (extreme anxiety) for 8 weeks (always thought it was him) but went away once body used to drug. August 2021 had been on 25mg for years and thought he would taper over 2 months, successfully came off no issues or problems. january 2022- I was having a C section and he was a bit worried, nothing extreme though, just normal worry and decided to reinstate the Sertraline. Within days, ‘activation syndrome’ was back. He stayed on for 5 weeks and then doctor said ‘come off as you weren’t anxious or depressed to start with’ symptoms of withdrawal started but manageable. He thought after 6 weeks that it wasn’t withdrawal as nhs website said it should have gone after 2 weeks! March 2022- started mirtazapine at 15mg going up to 30mg. Fine for 3 weeks, but then developed activation syndrome and quickly came off. GP advised to go back on to sertraline at a bigger dose- ended up in a and e, so agitated! 3 weeks later, he thought that the mirtazapine might be less activating at a smaller dose, so went back on at 15mg… alas, 3 weeks later, activation syndrome is back! june 5th came off and has been battling severe anxiety, but generally, every other day! I am aware of windows and waves but don’t understand this. One day he’s perfect and the next can’t leave the house! He also started propanalol in June which we feel makes it worse as apparently it blocks seritonin to a degree, but makes anxiety a lot worse if he reduces (or maybe he did too big a jump). NHS have left us to it, no help! Have a private appointment on Monday. Questions are: If he is getting windows this early on, is it a good sign?! The only symptom he has is extreme anxiety/agitation which seems more a reaction to lack of seritonin, thus firing out tons of cortisol? Could he go on a low dose of Prozac to see if that helps? Prozac is the only antidepressant he doesn’t think caused activation syndrome?! is there any experiences with propanalol making matters worse? I think there is a slight improvement in the anxiety but considering it’s only been out of his system for 6 weeks I expect takes a lot longer to build new pathways etc/level out. Thanks for reading. Just want my husband back, it’s destroying me and him!
  25. 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.
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