Nelly: coming off fluoxetine / Prozac

[Nelly]

Hi just a little about me! I have been taking fluoxetine for approx 20 years! Throughout which time I have continued to struggle with coping and mood! I have made adjustments in my life to help me cope better: not overloading myself, mindfulness, taking it easy and trying to manage my reaction to situations and life better! I am now weening myself off Prozac! I have always taken 20mg. At the moment I am down to taking the tablet just 5 days per week. As for symptoms, I never felt well while taking them, tired moody, highs and lows, generally feeling unwell. Noticeably more recently foggy head, poor long and short term memory and a feeling that my head is full and confusion at times! So, I am thinking, yes there will be withdrawal symptoms, but I am hopeful that I can handle it! I have been taking 5 per week for 3 weeks now, and I am wondering when I could reduce to 4 per week? I would really appreciate your advice and thoughts on this. Many thanks x

Edited May 27, 2017 by scallywag
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[mammaP]

Hi Nelly, welcome to SA .  We don't recommend skipping doses, it doesn't work and eventually you will start to have withdrawal symptoms! 

Sadly some doctors recommend skipping doses than when the patient has withdrawal they are told they need the medicine for the mental illness and they are relapsing.  

 

We recommend tapering no more than 10% of the current dose  with 4 weeks between cuts. If there are any withdrawal symptoms, hold until they have subsided and never make a cut while feeling withdrawal as it will build up and become a problem.  It takes time to taper and you are in a great place to get off prozac now, well done for tackling things.  The side effects will lessen as the dose gets lower, so it won't be long before you are feeling better. It takes time but is well worth it, so many people taper too fast and come here in terrible withdrawal, have to reinstate and taper properly (myself included).  By tapering slowly you get there with little discomfort and prozac is one of the easier ones because of it's long half life. 

 

As you have been skipping 2 days a week, you could make your first reduction now but take it every day.  The tapering prozac topic tells you how to get the lower doses. 

 

I will post some links for you to read. 

 

http://survivingantidepressants.org/index.php?/topic/759-tips-for-tapering-off-prozac-fluoxetine/

 

http://survivingantidepressants.org/index.php?/topic/1024-why-taper-by-10-of-my-dosage/

 

http://survivingantidepressants.org/index.php?/topic/6632-the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable/

 

It would help us if you can put your drug history in your signature strip, include all meds and supplements. Reductions should be noted there too. That way we can see at a glance what you are tapering without having to go back through your thread.  This topic can be your journal where you chart your progress and ask any questions you have.  We all understand here because we are all in varying stages of tapering or withdrawal! 

[Addax]

Welcome to SA Nelly. I'm at 27 years with Fluoxetine/Prozac. I took 60 mg for the majority of those years and am now relatively stable at 20 mg. Adhereing to the recommendations MammP provided will serve you well. Bumbling around with trial and error has had me (and others) ending up feeling pretty horrible... Even when following Dr.'s advice. Being the expert on how we each feel, you may find you'll need or want to make some adjustment along the way. Some people are more conservative in their reductions, hold longer ( I've held for over a year), and the like. It can depend on what's going on in a person's life. This year has had enormous changes for me, including a stressful job ( that I really enjoy btw) which is whim holding for so long.

 

Taking care of yourself, as you seem to already be aware of is of utmost importance. I got a little over confident recently and ignored some signals that I was getting over stressed and was feeling some WD like symptoms I had felt for most of this year. I'm on day #2 of 5 days off and the symptoms ( or whatever they are) have subsided. I have to remind myself that stress can throw us for a loop.

 

Glad you found this site. You're going to find lots of support here. :-)

[scallywag]

Welcome Nelly.  I started my taper of Cymbalta at 20 mg, so have a look at my "homework".  (No marks deducted for borrowing another person's work. I promise! )

 

10% x 20 = 2, 20 - 2 = 18 mg

10% x 18 = 1.8, 18 - 1.8 = 16.2 mg

10% x 16.2 = 1.6, 16.2 - 1.6 = 14.6 mg

 

Just a note, I also started with skipping days.  For reasons of stability, I decided to go back up to taking a daily dose of 20 mg for about 4 weeks before making the first 10% cut.

 

There are topics in the tapering forum about making a liquid from tablets and capsules. Lots of people do this to adjust doses rather than best-guesses to get close to a taper dose.

 

Here's the first one: Making a liquid from a tablet or capsules

[Nelly]

Thank you for your messages, they are really helpful. I have been feeling a bit out of sorts but accept that as being "me"!! I think I will go back to the doctor and ask for 10mg capsules instead of 20mg that way I can taper more accurately I think! I want this to work for me and after reading others posts it is very encouraging. I now realise how careful I need to be which I hadn't given enough thought to before. When your well you forget why you are taking them in the first place, then you get a "wobble" and realise why!? I need to read up more on the site. Great to have found this many thanks

[scallywag]

I think I will go back to the doctor and ask for 10mg capsules instead of 20mg that way I can taper more accurately I think!

 

Something to consider: You're at 20 mg now and are cutting from there; the 20 mg might make more sense. Also, you get more milligrams for your money with the 20 mg capsules.  If you're going to go with a liquid solution, you'll have fewer capsules to open.

 

How many 20 mg capsules do you have on hand?

 

The simplest way to get an 18 mg dose from 20 mg capsules is to put the contents of 5 capsules (100 mg) in 100 ml of water. The solution/suspension is 1 mg floxetine/ml. You then use a syringe and withdraw 18 ml and take the 18 ml by mouth. 

 

After 5 days (5 * 18 = 90), you'll be left with 10 ml or 10 mg of fluoxetine. For the 6th dose, I would probably

- take 8 ml of the old solution, discard the remaining 2 ml.

- make a new 5-capsule batch with 5 capsules

- take 10 ml of the new solution for a total of 18 ml (or 18 mg fluoxetine).

- then each day following take 18 ml, until I ran out (after 5 x 18 ml).

 

That covers 10 days.  Then repeat with 2 more batches for 20 days.  And again for 30 days. Then depending on how you're feeling, it **might** be time for another dose reduction and set of calculations.

[sparklypickle]

Hello Nelly,

 

A fellow prozac Withdrawee here. If you ask your doctor you should be able to get a liquid form of prozac such as prozep, that has 4mg in every 1ml, so you can use a syringe to gradually reduce the dose. I found I could not tolerate skipping doses and in fact in the UK 10mg prozac tablets are weirdly massively expensive and basically never prescribed. I absolutely agree about taking it slow. I've been on prozac for about 17 years and have gone from 60mg down to 1.6 mg now but it has taken me years! When I taper too fast I get withdrawal and have to stabilise for longer before I can taper again.

[Nelly]

Thank you for all your replies, it really is helpful and I am reading through everything. I am sorry if I am misunderstanding,but do you think the following would be OK to try; Over 7 days I am taking 100mg (5 X 20mg). In a couple of weeks or more depending on how I am feeling and all being well, do you think it would be OK to start reducing 10%; so 90mg divided into 7 days = 13mg per day? Many thanks

[mammaP]

That sounds ok, but you would need to take the 13mg every day for a month, then reduce by 10% of 13mg, or 10% of 90 then divide by 7  

You could do that right away and take it every day because skipping 2 days means you are going into withdrawal those days.

[bubble]

Hello Nelly,

 

It seems to ne that 13 mg per day would already be a reduction on what you are taking now. I would much rather do my best to stabilise on the dose you are taking right now by taking the same dose at the same time every day before considering further tapering.

 

Withdrawal symptoms can be really nasty and they have a tendency to get worse before they get any better.

 

Ask as many questions as you need to to make sure you take the right dose. Doctors don't know about the possibility to use a liquid. That's why their only idea of tapering is skipping doses. I compare this to dieting in which you eat your regular meals 5 days in a week and then nothing for 2 days in your case. Who would ever agree to such dieting plan?

[Nelly]

That's great thank you. Do you think this is why some days I feel worse than others because I am missing two days? Obvious I suppose, but hadn't thought of that. thank you.

[Nelly]

Thank you a great reminder to slow down on this, I agree. I'm so glad I found this forum; others who understand first hand of what it's like x

[bubble]

For sure! When you start seeing how these drugs can mess you up it's hard to believe how we once blamed everything so readily on ourselves

 

But it's not you, it's not your condition, it's the drug. You will see a proof of this once you start dealing with them in the right way. Depending on how destabilised your brain got you will very soon or a bit later see that 'you' which is actually a withdrawal symptom disappear.

 

Symptoms are the way in which your brain is telling you it doesn't like the way it's being treated. Keeping everything steady and stable is all that it takes for it to recover and symptoms to disappear. This might take time in the same way a bone doesn't heal in a matter of days.

 

Hope this helps

 

Do you know how you will get at the same dose every day and how much will that be?

[Nelly]

I am thinking 100mg ( 5 x 20mg capsules) mix with water and take 14 1/2 mg daily for some time until I'm ready ........how much liquid should I dilute it in and is it ok to mix 100g and keep ready mixed for the rest of the week?

[Nelly]

Hello when I read about people's struggling with withdrawal symptoms this scares me and I feel that maybe I should just continue with the prescribed medication! It is awful what people go through. It has made me realise more about the importance of a graduall withdrawal process.

[scallywag]

15 mg would be easier to calculate than 14.5:  3 x 20 mg = 60 mg = 4 x 15 mg.

 

To do 14.5 mg: 5 x 20 mg = 100 mg = (6 x 14.5 mg) + 13 mg.  Put 5 capsules in 100 ml water, take 14.5 ml water every day, you'll have 13 ml (13 mg) left at the end.

[sparklypickle]

Don't be scared of withdrawal effects. Everyone reacts differently and if you take it slow it's shouldn't be too bad. I only had withdrawal effects really when I skipped doses (every morning that I skipped a dose at ~4pm I got dizzy and sweaty) or went faster than 10% per month because I thought I knew better (doh!). The worst is if you stop suddenly because it is a shock to the system and takes your brain a while to rebalance.

 

I agree with bubble that you want to stabilise on your current dose for a few weeks before you drop again.

 

As a word of warning, prozac in liquid form tastes revolting, they try to flavour prozit and prozep with mint and sweeteners but its still unpalatable. I think some people mix the powder up with cranberry juice.

[Nelly]

Thank you this is so helpful and reassuring best wishes to you x

[sparklypickle]

Well Nelly, I have been in your position and the lovely folks here encouraged me to continue and it was the right thing for me to do...only 1.8mg to go then I'm free!!

[Nelly]

I have been free from Prozac since December 2016 and this has at times been difficult. I recently reached breaking point and have been off work for 3 weeks. I realise now it was building up for a while. Contributory factors were trying to support others who were struggling and an overpowering new partner. Both have now had to take a back seat in order for me to get well.

Since tapering and coming off Prozac I have been sad and tried to remain peaceful to avoid over stimulation. I have been seeing the plant spirit therapist I mentioned in a previous post, irregular but still seeing her. Her nurturing, loving and kind approach, her therapy, her medicine a combination of St. John's wort, rosemary, oats and lemon balm, her guidance, her understanding have all contributed to my ongoing recovery. I was swimming but stopped due to the cost and the "other" things going on in my life. I have asked my doctor for a prescription for exercise; this gives me a certain amount of time for a reduced cost of exercise. I think the fact that I stopped swimming contributed to my recent "wobble". I take biofood magnesium, omega 3 and a "food state" multivitamin and mineral. I have changed my eating habits to rid of candida in the body. I drink plenty of water. I walk every day. I burn sweet smelling oil and take dead sea salt baths occasionally. I listen to relaxing music in the background all night. I do sleep. I attempt to avoid being overwhelmed. However I am not able to deal with unexpected upsetting occasions.

I think this is me and how I will always be. I want to ride the storm without turning to antidepressants. But will I get there? A contributory factor to my current negative time is loneliness. I think this is one of the worst things; The lack of a loving supportive network of family and friends. I have never felt I had this ever in my life, which I suspect is part of my depression and lack of self esteem and insecurity. So I have to create my own haven, but it's still lonely. When I do spend time with others I can get tired and a sense of overwhelmness.

I isolate myself to protect myself. But I am so trying to do everything right.

I want to get back to work as I am worried about losing my job, I'm just not sure I'm there yet. I don't have a supportive family.

I remind myself that I had these struggles while taking Prozac which were sometimes worse than what I am experiencing now. I remind myself to be kind to myself, take it easy on myself. I think I need to adapt this approach for the rest of my life. When I'm well I forget that I am vulnerable to depression and lack the ability to cope. I think I have done well to get this far. I will have to continue to do what I am doing and take one day at a time and hope that I will feel better soon.

[Altostrata]

Hello, Nelly. I merged your post with your Intro topic as an update.

 

It sounds like you went off Prozac and haven't had significant withdrawal symptoms. That is good.

 

It also sounds like now you are confronting a life situation that perhaps was always there, but you are feeling fragile -- your nervous system may still be recovering from going off drugs -- and lonely and overwhelmed.

 

But it also sounds like you are taking care of yourself. This may take time, but you will rebuild in a way that is more supportive. Can you join some clubs or other gentle gathering where you might make friends?

[Nelly]

Thank you for your reply.

I have just finished my first day back at work. My boss is allowing me " to take it easy" for a few days. To be honest I have struggled today. I have this brain fog, like there is no room in my head to recieve and retain information. I have experienced this before when I am feeling mentally exhausted. While I was off work it wasn't so bad, as I didn't have to concentrate. I feel like I don't even want to talk to anyone afraid that my head won't cope with it,

It's worrying. I experienced this when I have had melt downs in the past, and when taking antidepressants. It's like I can't cope with too much. Having adapted my lifestyle so as to ensure I maintain my health and not to feel over powered, I am now worried about it significantly affecting my work.

I would appreciate your thoughts on this. Many thanks

[Jaco2016]

Thank you for your reply.

I have just finished my first day back at work. My boss is allowing me " to take it easy" for a few days. To be honest I have struggled today. I have this brain fog, like there is no room in my head to recieve and retain information. I have experienced this before when I am feeling mentally exhausted. While I was off work it wasn't so bad, as I didn't have to concentrate. I feel like I don't even want to talk to anyone afraid that my head won't cope with it,

It's worrying. I experienced this when I have had melt downs in the past, and when taking antidepressants. It's like I can't cope with too much. Having adapted my lifestyle so as to ensure I maintain my health and not to feel over powered, I am now worried about it significantly affecting my work.

I would appreciate your thoughts on this. Many thanks

Hi Nelly can you provide an update on your situation? How are you feeling ? Do you feel like St. John's wort is helping? I'm trying some of that now, for the past few days. It seems to help but wondering if it takes a little while before it really "kicks" in. Doing some therapy is helping too . Anyways all the best to you

[Nelly]

Hello I am really struggling with feelings of dread and fear and unable to focus. I have lost any enjoyment or strength. Over the last 12 months I have tried lots of things to help me overcome this, but sadly I am not getting there. I may have a good hour in a day, then the horrible symptoms re appear. I don't see a way of this getting better other than going to see the doctor for some antidepressants. I can't see a way out of this. I have invested in seeing a therapist, tried alternative remedies, but I'm just not getting there. I don't want to live. It's too difficult. I have lost my ability. I am disappointed that my efforts have not been enough. A lifetime of anxiety eased by antidepressants has masked my illness. I have to decide weather I want at least some quality of life and ability or live my life in this hell. I'm desperate. I have no one to talk to about this. I'm exhausted. I would really value your thoughts many thanks

[KarenB]

You sound very much like myself a few years back.  It's hard to keep going when you feel you've tried everything and exhausted yourself in teh process.  What I found was that it just took more time.  I don't know how, but things just seemed to eventually start to improve (the problem was, it happened well after when I thought it should have). 

 

I think it was due to putting so many tools and supportive things in place, and eventually my soul seemed to trust that it was a solid base, and that we could start to tentatively heal.  You might get a lot from looking at my blog, which details my journey through that time in my life - it has all the details which I can't remember so much now.  The link is in my signature. 

 

Hugs to you Nelly,

Karen

x

[chrona]

you might try googling homeopathy for depression.  it can work,  it's cheap to try and won't hurt you.  Aurum met is for people who want to die.  there are different depression remedies and there is a thread here by a woman who got through w/d using it.   amazon is a source.  I know it's nuts.  I got through a night of extreme dental pain with homeopathy.  it might help.

[KarenB]

It can work for some people - but others have intense reactions to homeopathy.  You'd have to try a small dose first and see how you go.  I can't use it - whereas before w/d I used it for years with no problem.  W/d changes so much...

[powerback]

Hello I am really struggling with feelings of dread and fear and unable to focus. I have lost any enjoyment or strength. Over the last 12 months I have tried lots of things to help me overcome this, but sadly I am not getting there. I may have a good hour in a day, then the horrible symptoms re appear. I don't see a way of this getting better other than going to see the doctor for some antidepressants. I can't see a way out of this. I have invested in seeing a therapist, tried alternative remedies, but I'm just not getting there. I don't want to live. It's too difficult. I have lost my ability. I am disappointed that my efforts have not been enough. A lifetime of anxiety eased by antidepressants has masked my illness. I have to decide weather I want at least some quality of life and ability or live my life in this hell. I'm desperate. I have no one to talk to about this. I'm exhausted. I would really value your thoughts many thanks

 

hi nelly my heart goes out to you ,I relate so much to your post  ,I really do get the misery and so much more of the people on this site can relate ,when I turned by back on my doctors lies ,I researched my own past and I always had anxiety ,I just never understood what it was ,so giving me antidepressants was like petrol on a fire, just yesterday the misery I felt because of headaches  was epic ,

I'm learning to have sympathy for my story rather than hate myself ,[a therapist once said I had the strongest self critic they ever seen],its takes time ,but none of us asked to get anxiety or panic disorders ,my learning began when I stopped listening to lies of the diseased brain that doctors believe .

I do a lot of research on anxiety and panic and I recommend this ,it helps loads on how to cope .

 take care 

PB   

[ShadowMan]

Hi Nelly I understand you, know very well what you are feeling! I wanted so much to be able to help!!

[Nelly]

Thank you all for your messages. They have helped me. I was at that moment feeling pretty awful, but yes it does pass. I am taking St. John's wort and have been for approx 5 months. I am seeing a plant spirit therapist. She is nurturing but it doesn't last. At the moment I have the urge to sell me home, and live in a small flat where I will have less responsibility. It is likely that I would need to rent. At times I want to stop working and allow myself time to get better. What I'm thinking is the less I have to think about the better. Do you think this is a good idea? This would allow me time to just adapt and start again. I want to be free of worry that I constantly have, jumping from one thing to another. I don't have children to think about. Many thanks for your encouragement.

[peng]

You sound seriously unwell, Nelly.

 

With my 40 years personal experience only (I am not a doctor), authoritive sources say that St Johns wort may be useful for people with no more than moderate depression, hence your terrible suffering and worry, in my view.

 

Plenty of sympathy and ideas available on here for you, but I would not waste time and suffer so much by straw-clutching at things like herbals and homeopathy.  Rather like tackling a big hayfield with a pair of nail scissors.  I guess they might work if you are not seriously ill, though.

 

I am not against some herbals, as I willingly tried them for chronic sinusitis recently.  However, only the "to be avoided if possible" antibiotics got rid of it.  The fairly costly herbal mixture and consultation would not touch it at all.

 

Good luck, and keep reading, you will find reassuring advice on here, but the decision on how you proceed to turn things around rests with yourself.

 

OX

[Nelly]

Thank you O for your reply. I am starting to think that my hour and half journey for an hour with a therapist is not working and as you say it is costing me. I know what I need to do as far as taking it easy, healthy life style etc. but this is not giving me enough to get through life, work and have any thing near a decent quality of life. I think I am just delaying the inevitable and that is going to ask the doctor for some antidepressants. Perhaps a different one to Prozac, a low dose, as mentioned on this site, may be enough for me to function better than I am now. I may then be able to cope with the changes I need to make. I am dissapounted but I tried.

My illness I know is as a result of neglect and trauma as a child, the effects have been endured all my life. I have been strong and achieved a lot under the circumstances. But I am now tired of struggling. I know I have to be kind to myself and be gentle. Thank you ❤️

[peng]

Yes, if you get onto a platform with some stability, you may become stronger later to ease yourself down from the medication.  Even reducing a bit can give one satisfaction and optimism.

Don't regard it as a failure - it is merely a temporary surrender , and, as you say, you are being kind to yourself, which you have long deserved.

Many of us have been there, and are living for another day with a reasonable quality of life at times.

 

Beautiful part of the country, North Wales, by the way.  Hope you can feel better enough to appreciate it a little!

 

Best wishes.

[Nelly]

Thank you silver star. It's really helpful to recieve words of understanding, as so many people don't understand and don't know how to respond. I cant see me getting any better at this stage without some medication. I also feel like I need total rest away from work. Hopefully in time I will be less anxious and able to see things differently. What will be will be. What can be worse than this!? X

Karen, I read your blog, it is lovely ❤️

[Nelly]

How do others cope with work when feeling so awful?

[KarenB]

There might be something in here:  http://survivingantidepressants.org/index.php?/topic/1941-working-as-in-getting-a-paycheck-through-withdrawal/

or http://survivingantidepressants.org/index.php?/topic/9742-has-anyone-told-their-work-about-their-withdrawal/