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James Heaney article on what to expect in restatement


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The following exerpt is scarily accurate:


"...Once withdrawal symptoms have appeared, the nature of SSRI use has changed. There is a point where you put yourself on a track to wean off the drug and can’t really get back to the previous state of SSRI use. You can take your original dose, but the effect will be different. Instead of creating the mental environment that you experienced before, it’s now a mix of withdrawal and the SSRI numbness. Once you’ve experienced a mental state without an SSRI, it’s very hard to go back. Just as you’re very aware of the effects of withdrawal, restarting an SSRI makes you very aware of the effects of the drug. Reinstating an SSRI is a mixed bag. Deciding to start back on an SSRI should be done carefully. Be prepared to experience some form of withdrawal symptoms as well as the general slowing of mental functions that accompanies SSRI use."


In my case, I traded severe WD symptoms for a fierce level of apathy and anhedonia upon reinstatement of a much lower dose of Paxil --- the likes of which I never experienced in the ten years of continuous use of a much higher dosage. Clearly, something changes. On a positive note, these reinstatement symptoms - which would surely lead me to suicide if they were permanent - are forcing me to taper and ultimately be free of the effects of SSRIs on my brain. I'd much rather be anxious and have OCD with a full complement of emotions, pleasures, and energy then continue to be the walking dead.


Edited by ChessieCat
bolded link to article

Medication before problems: Took Paxil 60-100mg from 2003 to 2014 for OCD.
1) Last pill taken November 2014, horrendous withdrawal started six weeks later.

2) Re-instated successfully @ 20mg May 2015, but accompanied by severe anhedonia, loss of emotion, apathy, and fatigue

3) Switched to Prozac, Viibyrd, Zoloft, Nefazadone, Cymbalta, Nardil in attempt at abating WD symptoms while not re-introducing anhedonia. Each one either failed to relieve WD or brought back anhedonia. So re-stabilized on Paxil at 15mg

4) Tapered down to 7.5mg as of October 2016. More energy, anhedonia/loss of emotions remains apart from short windows.

5) May 2017 - down to 3.5mg of Paxil (no other meds)
6) Early 2018 - added 8mg of Prozac
7) January 2019 - down to 1.05 Paxil / 5mg Prozac and continuing

8) October 2019 - down to 0.2mg Paxil / 3mg Prozac

9) November 2019 - down to 0.1mg Paxil / 3mg Prozac 

10) March 2020 - done with Paxil, 2.5mg Prozac

11) April 2021 - 0.03mg Prozac

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Thanks so much for finding and posting this very important article!

After being hit badly several times increasing dose myself, and reading others being severely harmed by reinstating, I tried to spread the word of the danger of reinstating. I'm so glad this has been acknowledged by experts and I believe this very important knowledge will save many from suffering.


I actually read it many years ago before my wrong doing increasing doses, unfortunately I didn't quite understand it well. Hard lessons learned for me but hopefully others won't have to go through the same route.

Drug free Sep. 23 2017

2009 Mar.: lexapro 10mg for headache for 2 weeks.

2009-2012: on and off 1/4 to 1/3 of 10mg

2012 June--2013 Jan,: 1/4-1/3 of 10mg generic, bad jaw pain

2013 Jan-Mar: 10 mg generic. severe jaw and head pain;

2013 Mar--Aug. started tapering (liquid ever since) from 10 to 5 (one step) then gradually down to 2.25 mg by July. first ever panic attack, severe head/jaw pain

2013 Aug.: back to 2.75 mg; Nov: back to Brand Lex. 2.75mg -- 3mg,

2014 June: stopped PPI, head pressure/numbness. up-dosed 4.5mg, severe reaction mental symptoms added on

2014 Aug--2015 Aug: Micro taper down to 3.2mg, .025mg (<1%) cut holding 2-3 weeks.

2015 Aug 15th, Accidental one dose of 4.2mg. worsening brain non-functional, swollen head, body, coma like, DR

2016 Feb., started dosing 10am through 11 pm everyday 2/13--3.2mg, 3/15-- 2.9mg, 4/19-- 2.6mg, 6/26--2.2mg, 7/22 --1.9mg, 8/16--1.8mg,8/31--1.7m g, 9/13--1.6mg, 9/27--1.5mg, 10/8--1.4mg, 10/14--1.3mg, 11/1--1.2mg, 11/29--1.1mg, 12/12--1mg, 12/22--0.9mg

2017: 1/7--0.8mg, 1/15--0.7mg, 1/17--0.6mg, 1/20--0.52, 1/21--0.4mg, 1/22--0.26, 1/23--0.2, 2/13--0.13mg, 2/20--0.06mg, 3/18--0.13mg, 6/1--0.12mg, 7/6--0.1mg, 7/14--0.08mg, 8/17--0.04mg, 8/20--0.03mg, 8/28--0.02mg, 9/6--0.0205mg, 9/8--0.02mg, 9/17--0.015mg, 9/20--0.01mg, 9/21--0.0048mg, 9/22--0.0001mg,

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  • 5 weeks later...

Wow.this is me.question is after 1 month of reinstating at regular dose and getting terrible w/d,when is the right time to start a slow taper? ?

Reinstating 75mgs effexor w/d symptoms after alternating days of 37.5.still suffering after amonth.updosed Aug.6.1 brief window 2 hours in early August. Hypertension.taking lasartan and water pill . feeling drugged up with dizziness and nauseous.low energy

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  • Moderator Emeritus

Zaz - your question is a good one.  Please ask it in your introduction topic so that all your information and suggestions from moderators and other members are in place.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results

Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to  0.0 mg  Aug. 12; details here

scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet

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