success Anonymous784: Effexor withdrawal is nearly killing me

[SquirrellyGirl]

Anonymous784, it is wonderful to see that you are more stable now and are sounding very sensible in your philosophy about all of this :-)  Grounded, I should say.  Your self-care is commendable!

 

You described exactly how this drug affected me:

 

On 8/14/2016 at 8:19 PM, Anonymous784 said:

 The difference seems to be that before I would go numb and shut down in the face of extreme feelings, whereas now they are closer to the surface.  I am getting used to living alongside them, but it is often hard.

 

Extreme stress induced SI in me as well before, but now I am handling things much more evenly, though I am still up at around 20.5 mg..  I am so glad that has passed for you, and that you are faring well on such a small reinstatement dosage!

 

Are you on 3-4 mg still?  I think it is very wise to hold with that for a good long time to let your system truly heal to that level before any further challenges.  

 

Cheers!

SG

Edited January 6, 2021 by Karma
Name edit

[ChessieCat]

Hi Anonymous784,

 

"... I think I am feeeeeling my emotions more (meaning I am aware of them in the body).  Not sure how much of the latter is due to reduction vs a daily meditation practice I started 4 months ago, but I am glad it is there either way. ..."

 

It's probably a bit of both, but it doesn't really matter, because as you say you are glad of it and that is good.

 

Please remember to update your signature with the date and dose of your reinstatement.  This way your signature will remain current and information can be seen at a glance.  Thank you.

Edited January 6, 2021 by Karma
name edit

[Anonymous784]

SG - whoops, no, I think I am on 10mg.  I have a weird reversal issue with the 30 beads and 3-4 beads per mg...  And hey, after how horrible withdrawal was, reinstatement to whatever level is necessary to cope is a good thing.

 

CC - again whoops, have updated now.

 

Thanks to you both for the encouragement!  It is a relief to see how far I have come since that first post. 

[Anonymous784]

Hello all

 

I'm back! To update again. Since I last updated in early 2021 I experienced a severe and complex depressive episode in late 2021 and re-entered the medication world. I am now doing really well again (for the context of someone with complex PTSD and now chronic fatigue) and with a much higher baseline than before. The big reason for that is that I was diagnosed with Pre Menstrual Dysphoric Disorder (PMDD), and had it treated. (For anyone managing PMDD as part of their psych drugs picture, my heart is with you and it is not hopeless, even though the state of women's healthcare is a bit hopeless.)

 

I have probably always had sensitivity to menstrual hormones in some form, but it got lost in the maelstrom of other psychiatric and physical symptoms. PMDD is a hormonal disorder where your brain is hypersensitive to the changes in menstrual hormone levels, particularly progesterone. This means that you can suffer moderate to severe to disabling to life-threatening psych and physical symptoms in the luteal phase of your menstrual cycle (for me 2.5 weeks of the month). It is an unbearable and life-threatening illness, and it often goes undetected or untreated because we don't know it exists, don't notice the pattern among other psych symptoms, or don't have appropriate medical care (or are not believed - I am lucky I was).

 

Part of the suggested treatment protocol for PMDD is hormonal birth control (made my symptoms worse though), SSRIs, including taking SSRIs only in the luteal phase (I refused that as quick changes seemed crazy given my history of sensitivity to drug changes), and then treatments that stop your cycle altogether. (Extreme treatment is removal of your internal reproductive organs, but that's extreme and most won't do it unless another treatment works first and you're late 30s or older.) Stopping my cycle is what eventually worked for me: cyproterone to shut down the ovaries, progynova to reintroduce stable levels of oestrogen and progesterone. It was rocky going onto it but now I am on it I have no significant side effects, and maybe 60% of my mood symptoms are gone (especially the more intense ones!). It is essentially a kind of chemical menopause, but can be reversed at any time by stopping the medication, so there is no risk to pre-existing fertility as far as I am aware (other than the usual risks of aging). It is, to me, a medical miracle. 

 

So back to late 2021 - I was experiencing horrific PMDD episodes and felt hopeless that treatment was possible, and so entered a profound depressive state. I was incredibly reluctant to go back on any psych meds after my earlier experiences, but eventually went onto 10 and then 20mg of fluoxetine. That did a lot to curb the intensity and danger of the depressive episode and I'm glad I did it. Side effects are there but not too intrusive. I am MORE glad that I then was able to see the appropriate specialist for my PMDD (a gynaecological endocrinologist, fyi), and she told me some interesting things.

 

First, PMDD often arises in patients with trauma backgrounds of some kind. Second, patients who are resistant to SSRIs often respond well to beta blockers, which reduce heart rate and communicate calm to the brain via that biofeedback. Third, PMDD can be helped by talk therapy but requires medical intervention to manage. 

 

She put me on: 50mg cyproterone, later raised to 75mg since I seemed to be especially sensitive even to the tiny remaining hormones; 2mg progynova; 40mg nadolol (beta blocker); calcium and magnesium, both of which have been shown to help a little with PMDD symptoms. I have also been on my 20mg fluoxetine throughout. 

 

It's now been almost a year since I went on the fluoxetine, and more than five months since I settled on the PMDD treatment. I had thought my fatigue all this time was related to mental health, but after having a neutral or positive mood most of the time for a few months, it became clear the fatigue was its own thing (hence a chronic fatigue diagnosis). I still get triggered and have some insomnia and anxiety, but my symptoms are just nothing like they were before. And I have the learning over many years to manage symptoms, too. I have a sense of self and a very kind inner voice, and I can treat myself with dignity even in low spells. The beta blockers really helped remove a layer of anxiety from everything.

 

So I am now gong to try going off the fluoxetine. I want to come off so that I can keep it in my back pocket as a crisis option; I worry about it stopping working if I stay on it indefinitely, as it did in my early 20s. I also want to come off it because it has made me extra sensitive to heat, which I'm finding really difficult coming into summer. Obviously it is the most promising one to come off of with its languid half life, so I am expecting some symptoms and adapting, but hopefully not too much. I've been recommended a stint of going back and forth between 10 and 20 mg for a while, then down to 10, then off. I expect I will do 5mg before I go off. I know to go veeeery slowly, even with a long half life drug. 

 

We'll see what happens! 

 

PS - if you think you could have PMDD, use this form to track your symptoms over a couple of months, and see if a pattern emerges (it doesn't have to be a perfect curve). Tracking is the only way to diagnose, so even if you don't have a doctor that's on the case yet, you can get yourself started that way, and have something to show your doctor once you get to them. There is lots of information on iapmd.org as well. 

 

 

[ChessieCat]

I have moved your new post from your Success Story to your Introduction.  Staff regularly check the Introductions forum for new posts.

 

Please update your drug signature.  Remember to click Save.  Account Settings – Create or Edit a signature

 

 

16 hours ago, Anonymous784 said:

I've been recommended a stint of going back and forth between 10 and 20 mg for a while, then down to 10, then off. I expect I will do 5mg before I go off.

 

NO!  Skipping/alternating doses of any psychiatric drug, including Prozac/fluoxetine is NOT recommended. 

 

Please see this topic:

NEVER SKIP DOSES TO TAPER

And jumping off at 5mg is also not recommended.  It is generally suggested to go to about 0.025mg before stopping a drug.

 

I am truly shocked that you might be considering both of the above.  You have been a member here since May 2016, so 7 1/2 6 1/2 years.  I suggest that you reacquaint yourself with SA's recommended tapering method.

 

SA's tapering protocol is to reduce by no more than 10% of the current dose followed by a hold of at least 4 weeks to allow the brain to adapt to not getting as much of the drug.  For fluoxetine a longer hold might be necessary due to the long half life of the drug.

 

The aim is to taper in such a way to keep withdrawal symptoms to a minimum and be able to live your life as normally as possible.  Due to fluoxetine's long half life, withdrawal symptoms might not be felt for 2-3 weeks after a reduction.  If you then decided to updose it will take about the same amount of time for the drug to reduce in your system, and during that time you will be have to tolerate the symptoms.  Also, many members find that the lower their dose gets the slower they need to go reducing less/holding longer:

 

Why taper paper: dose-occupancy curves

 

When to end the taper and jump to zero?

 

managing-the-endgame-taper

 

It is possible to make a liquid from fluoxetine tablets/capsules so there is no reason not to take the same dose every day.  Please see Post #1 of this topic which explains how to get non standard doses:

 

Tips for tapering off fluoxetine (Prozac)

 

Post #1 of this topic has links to helpful SA topics:

 

Important topics in the Tapering forum and FAQ

 

Edited November 12, 2022 by ChessieCat

[Altostrata]

Hello, @Anonymous784

 

Good to hear hormonal therapy -- not a psychiatric drug -- helped your PMDD.

 

Not sure if we can be of much help. You're under the care of a doctor who should be responsible for your going off psychiatric drugs in a safe way. Your doctor got paid to put you on the drug, your doctor will get paid for taking you off. We do not get paid.

 

Best wishes for your taper.