whatshappening: Did I reinstate too late?

[bijay]

@whatshappening  I am so sorry you are suffering through this insomnia. I agree with @getofflex that acceptance is important - it will help take the pressure off and reduce your anxiety over insomnia, which just feeds it more.   From my own experience I think the anxiety over sleep can become more of a factor than the WD itself - maybe that’s why the updosing has not worked for you. 
 

Besides doing good sleep hygiene, consistent bed and wake times, etc. try putting the clock/phone away so you can’t see it and become anxious over the hours you have slept or not slept.  

 
You may also try getting out of bed and doing something boring.  Low-key tv or music, reading (even the phone book), or whatever helps you to calmly distract your mind.  It didn’t always work for me but it was a lot better than lying in bed becoming more and more despondent, and sometimes I would nod off despite myself. 
 

Sending good thoughts your way.

[Artistic1]

@whatshappening I sympathize with your sleep issues. I've been through this same scenario of reaching a state where you're afraid to go to bed or go to sleep. That, of course, creates more problems! I tried melatonin (never worked), different doses of magnesium, (worked sometimes), sleep tapes (worked sometimes), sleep books (informative, but not helpful), sleep therapy (waste of money), and on and on....but nothing helped consistently. Knowing that thinking and worrying about sleep was counterproductive, I decided to try to stop thinking about my poor sleep, and most especially, what might be causing it. That will drive you crazy. I can see in your post that you're trying to figure out if it's your updose, your low dose, if this will ever change, etc. etc.

 

I told myself, I have poor sleep, plain and simple. So what can I do to just DEAL with it rather than FIX it? I changed my thinking to aim for resting rather than sleeping. If I couldn't get the best sleep, I could at least get the best REST possible. That took a lot of pressure off. Resting I could do! It allowed me to do deep breathing, or listen to relaxing tapes, or do progressive muscle relaxation imagery in bed without worrying if it was going to put me to sleep. If I did drifted off and woke up and couldn't go back to sleep, I just started again with the same things....focusing on relaxing rather than sleeping.

 

At the same time, I had to deal with feeling tired the next day, because I wasn't sleeping well. So I switched my focus on my daytime activities, too. Instead of fretting about how tired I was, my philosophy was: "First, do what is necessary. Then do what is possible. Soon, you can do the impossible." I cut myself some slack about how crappy my sleep was the night before and how I was dragging during the day. I did what I could, and I also made sure to do a 15 minute quiet meditation during the day, just to get my brain and body used to being still.

 

 All this really took the pressure off, and I am now actually sleeping much better! It took quite a while, and my sleep isn't perfect, but it's much, much better. I'm happy with being able to get into bed and not working myself up about whether or not I will sleep, because I know that all I have to do is rest. My brain is now in the habit of focusing on plain relaxation, and as a result, the sleep just seems to take care of itself.

 

Hope this is helpful.

[whatshappening]

28 minutes ago, Artistic1 said:

@whatshappening I sympathize with your sleep issues. I've been through this same scenario of reaching a state where you're afraid to go to bed or go to sleep. That, of course, creates more problems! I tried melatonin (never worked), different doses of magnesium, (worked sometimes), sleep tapes (worked sometimes), sleep books (informative, but not helpful), sleep therapy (waste of money), and on and on....but nothing helped consistently. Knowing that thinking and worrying about sleep was counterproductive, I decided to try to stop thinking about my poor sleep, and most especially, what might be causing it. That will drive you crazy. I can see in your post that you're trying to figure out if it's your updose, your low dose, if this will ever change, etc. etc.

 

I told myself, I have poor sleep, plain and simple. So what can I do to just DEAL with it rather than FIX it? I changed my thinking to aim for resting rather than sleeping. If I couldn't get the best sleep, I could at least get the best REST possible. That took a lot of pressure off. Resting I could do! It allowed me to do deep breathing, or listen to relaxing tapes, or do progressive muscle relaxation imagery in bed without worrying if it was going to put me to sleep. If I did drifted off and woke up and couldn't go back to sleep, I just started again with the same things....focusing on relaxing rather than sleeping.

 

At the same time, I had to deal with feeling tired the next day, because I wasn't sleeping well. So I switched my focus on my daytime activities, too. Instead of fretting about how tired I was, my philosophy was: "First, do what is necessary. Then do what is possible. Soon, you can do the impossible." I cut myself some slack about how crappy my sleep was the night before and how I was dragging during the day. I did what I could, and I also made sure to do a 15 minute quiet meditation during the day, just to get my brain and body used to being still.

 

 All this really took the pressure off, and I am now actually sleeping much better! It took quite a while, and my sleep isn't perfect, but it's much, much better. I'm happy with being able to get into bed and not working myself up about whether or not I will sleep, because I know that all I have to do is rest. My brain is now in the habit of focusing on plain relaxation, and as a result, the sleep just seems to take care of itself.

 

Hope this is helpful.

 

Hi Artistic,

 

I want to thank you for all your comforting advice. I totally understand what you are saying and 100% agree. I've told myself the same things lately regarding focusing on REST instead and definitely ACCEPTANCE of my current situation. I get hopeful with these new mantras and psych myself out with them throughout the day. I do meditate and exercise (whatever energy permits) and do my best to stay productive during the day. Then the dreaded and tiring night time regime sets arrives and it takes the fun out of my new outlook. I'm getting irritated with things that help one night that don't help another night - especially being the sleep meditation, music and hypnosis that I plug into when I just want to lay still. I also have the added pressures of trying to get my body stabilized so that I can attend to some responsibilities towards the end of this month. So i guess you can say it's a race to get better by a certain date. But now 4 weeks in I can see that I may be stuck with this new sleep pattern for a while and life must go on right? I like what you said about "First, do what is necessary. Then do what is possible. Soon, you can do the impossible.". That's definitely something I will include in my daily mantra.

 

I want to stay the course of a direct taper especially when I have those nights where I get a couple hours of sleep. But not sure at this point if it'll get only harder when finally tapering down again or if I should just cut my loses and cross taper to a medication that will be kinder to my body to get off. 

 

May I ask what part of the tapering journey are you on yourself? Did your sleep issues begin at a lower dose of your taper or are you now completely off medication?

 

 

 

 

 

 

 

 

 

 

[whatshappening]

1 hour ago, bijay said:

@whatshappening  I am so sorry you are suffering through this insomnia. I agree with @getofflex that acceptance is important - it will help take the pressure off and reduce your anxiety over insomnia, which just feeds it more.   From my own experience I think the anxiety over sleep can become more of a factor than the WD itself - maybe that’s why the updosing has not worked for you. 
 

Besides doing good sleep hygiene, consistent bed and wake times, etc. try putting the clock/phone away so you can’t see it and become anxious over the hours you have slept or not slept.  

 
You may also try getting out of bed and doing something boring.  Low-key tv or music, reading (even the phone book), or whatever helps you to calmly distract your mind.  It didn’t always work for me but it was a lot better than lying in bed becoming more and more despondent, and sometimes I would nod off despite myself. 
 

Sending good thoughts your way.

 

Hi Bijay,

Thank you for responding and for your advice. I agree with what you are saying about the anxiety over sleep becoming more of a factor rather than the WD its self. I think I'm getting scared that this experience is becoming all to familiar to what I faced in 2016 when trying to initially taper off and then getting hit with chronic insomnia at the very same dose of 3mg. I swear I didn't sleep for weeks and the doc tried so many different medications until landing on Klonopin first then later Rameron. 

 

As I've mentioned to @Artistic1, I told myself to focus on REST instead and definitely ACCEPTANCE of my current situation. I get hopeful with these new mantras and psych myself out with them throughout the day. I do meditate and exercise (whatever energy permits) and do my best to stay productive during the day. Then the dreaded and tiring night time regime arrives and it takes the fun out of my new outlook. As sleepy as I make myself I get jolted up a few minutes later. I play some meditation tracks or sleepy hynosis from my phone to just lay still (sometimes works to drift off and other times not) if that doesn't help I get out of bed to do something else which then I tend to go on this SA site to look for answers and comfort when I do get really restless. I know that's probably not productive. I typically don't stay on the computer long before turning it off and trying to go back lay down and close my eyes.

 

It's just been a circus of pre-night time regimens (a glass of wine earlier, nighty tea, lavender oil, melatonin etc) and then anywhere during the middle of the night hours of 12am- 6am sleep (meditation, getting up, laying back down etc.)

[bijay]

@whatshappening  I was just looking at your signature - congrats on your perseverance,  you really have come so far on your taper.  It does look as though the last few times you’ve been going down more quickly, and the last drop from 3.5 to 3.0 mg was larger than the previous ones. Could this have been too much too fast?  If so, staying at your current updose will help, but may take some time.

[Artistic1]

@whatshappening Hi again. You had this question for me: 

May I ask what part of the tapering journey are you on yourself? Did your sleep issues begin at a lower dose of your taper or are you now completely off medication?

 

I had sleep issues starting in 2015 when Generalized Anxiety Disorder hit me out of the blue. This was aggravated in 2017 when I went on Zoloft, which totally ruined my sleep. In 2018-2019, I did a taper down from 25 mg that was inconsistent and unsuccessful, and at 12.5 mg, I had to go back up to 25 mg. During that time, sleep was hit and miss, but generally bad.

 

When I started my current taper in January, 2020, I had some terrible nights. Mostly, I think it was me psyching myself out over whether I was doing the right thing. Once I committed to getting off the drugs, and doing it correctly, I felt more in control. The thought that helped the most: I figured if I was going to be miserable without good sleep, I'd rather be that way OFF of drugs rather than on them. I used to sleep well before Zoloft and GAD, so I knew it was in me to get back to that place. I just have to ride it out to the end. The success stories on this group helped so much.

 

I am now down to 13.15 mg Zoloft from a basic starting point of 25 mg. Took me 10 months to get there. But I now know that the med was affecting my sleep since I'm doing so much better as I get lower. Just a combination of that and the practices I mentioned before. Also, I had a GREAT CBT therapist who made a huge difference for me. We didn't do any sleep therapy, but everything else I learned from her had a domino effect.

 

Good luck to you. I know you will get where you want to be. Just one step at a time. First, do what is possible......!!

[whatshappening]

2 hours ago, bijay said:

@whatshappening  I was just looking at your signature - congrats on your perseverance,  you really have come so far on your taper.  It does look as though the last few times you’ve been going down more quickly, and the last drop from 3.5 to 3.0 mg was larger than the previous ones. Could this have been too much too fast?  If so, staying at your current updose will help, but may take some time.

Hi Bijay, thank you for recognizing my efforts. I guess that’s why I’m so hard on myself feeling like all this way and now this??? 

I would agree with you about possibly go down a little quicker at the tail end. I just couldn’t see how 1 measly bead (that’s the dose difference) could make much impact. Plus it’s not possible at this low dose to even drop 10% of current dose as the individual bead weight is much greater. 

 

I got some maybe 2 hours of sleep (light) last night but it was separated by a good 3.5 hours Of being awake in between with a series of getting up, laying down, rolling over, meditating, going on the computer, laying down, going to the bathroom...lol.

 

ughh...I now struggle with a decision on whether I’d be better off crossing over to Prozac as that might be a likely option to getting off effexor. 

[bijay]

@whatshappening  We are always toughest on ourselves, much tougher than we would be with anyone else.  But you have come a very long way and need to give yourself a lot of credit for that.  

 

I can understand what you say about a single pellet.  I look at the extra tidbit of powder I shave off these tablets and can’t believe my body can tell the difference.  
 

I’m sure you have probably read the information on SA about making a liquid for easier dose reductions, although you would probably need to dose twice a day if you are switching from a time released version.  Maybe you can get some first hand experience from others here to see if that works better than the crossover to Prozac.  

[Artistic1]

@whatshappening Hello again. I just read through more of your thread, and I see a BIG focus on the number of hours you're sleeping or not sleeping. My recommendation is to forget about keeping track of the number of  the hours of sleep you're getting. It's actually not helpful.  I used to do that, too. Every morning, I wrote down how many hours I got so I could see if something I had done the day before or taken the night before was a solution. All it did was make things worse because I was focused on a negative behavior and a negative outcome.  

 

Then I found this out that sleep research indicates two things:

1.we usually get more sleep than we think we do.

2. we generally don't need as much sleep as we think.

 

Note the word "THINK" in those statements, because that's a big part of the problem.

1. We can't possibly know the exact amount of sleep we're getting because unless you're watching a clock and falling asleep at the same time (which is impossible), you can only estimate that. Chances are, what you THINK is inaccurate. Also, sometimes we are in a light sleep phase, but when you wake from it, you THINK you were awake the whole time, but it's not true. It was sleep, but just not deep restful sleep. 

2. We THINK we need 8 hours because that has always been the "recommended" amount, but that's not true for everyone.The fact is, some people do perfectly fine on anywhere from 4 - 8 hours of sleep. 

 

When I learned these two things, I used them to change my behavior and my thinking.

1. I quit tracking the amount of sleep I was getting because I realized I couldn't really measure it accurately, and it was one more negative thing I was focusing on.

2. I threw out the 8 hour sleep recommendation. Maybe I was one of those people who did just fine on less than that, and that has turned out to be true. After all, the number of hours mattered less than how I was actually functioning during the day. Of course, I could tell if I hadn't had a good night's sleep because I'd be dragging along. But then I employed the "do what's necessary...possible....impossible" philosophy, and with practice, my day became less stressful. 

 

In the early practice of this, I set different goals. There were nights when I estimated I THINK I only got 2-3 hours of sleep. But if that happened, I changed my thinking and said, "Hey, I THINK I got 2-3 hours last night, but it could have been more. I don't know. At least it wasn't zero! I'll just work with that today...do what's necessary....possible....impossible." What else was I going to do? This was at least better than counting hours and worrying over them and creating more insomnia.

 

Well....sorry for the long post, but maybe this will help.

 

 

 

 

 

 

[Onmyway]

@whatshappening

I noticed in one of your previous posts that you are drinking alcohol. Lots of people here have discovered that it can really exacerbate withdrawal and set people back. Alcohol also interferes with sleep in a serious way and while you may not have thought it impacted you before, in this sensitized state it can have profound effects. 

 

I'd consider cutting it.

 

I personally would not make more changes like bridges as it can confuse things - it's hard to know what the equivalent dose of SSRI is in another medicine. You could try it but I've learned that keeping things stable is good in WD. 

 

I still have sleeping issues, they get worse in waves and when things are not going well in my life but the initial insomnia right after cutting improved significantly over a few months for me. 

 

Not sleeping one night actually doesn't bother me much as I've done that regularly in school. Also deprivation can actually increase mood paradoxically.

[whatshappening]

1 hour ago, Artistic1 said:

@whatshappening Hello again. I just read through more of your thread, and I see a BIG focus on the number of hours you're sleeping or not sleeping. My recommendation is to forget about keeping track of the number of  the hours of sleep you're getting. It's actually not helpful.  I used to do that, too. Every morning, I wrote down how many hours I got so I could see if something I had done the day before or taken the night before was a solution. All it did was make things worse because I was focused on a negative behavior and a negative outcome.  

 

Then I found this out that sleep research indicates two things:

1.we usually get more sleep than we think we do.

2. we generally don't need as much sleep as we think.

 

Note the word "THINK" in those statements, because that's a big part of the problem.

1. We can't possibly know the exact amount of sleep we're getting because unless you're watching a clock and falling asleep at the same time (which is impossible), you can only estimate that. Chances are, what you THINK is inaccurate. Also, sometimes we are in a light sleep phase, but when you wake from it, you THINK you were awake the whole time, but it's not true. It was sleep, but just not deep restful sleep. 

2. We THINK we need 8 hours because that has always been the "recommended" amount, but that's not true for everyone.The fact is, some people do perfectly fine on anywhere from 4 - 8 hours of sleep. 

 

When I learned these two things, I used them to change my behavior and my thinking.

1. I quit tracking the amount of sleep I was getting because I realized I couldn't really measure it accurately, and it was one more negative thing I was focusing on.

2. I threw out the 8 hour sleep recommendation. Maybe I was one of those people who did just fine on less than that, and that has turned out to be true. After all, the number of hours mattered less than how I was actually functioning during the day. Of course, I could tell if I hadn't had a good night's sleep because I'd be dragging along. But then I employed the "do what's necessary...possible....impossible" philosophy, and with practice, my day became less stressful. 

 

In the early practice of this, I set different goals. There were nights when I estimated I THINK I only got 2-3 hours of sleep. But if that happened, I changed my thinking and said, "Hey, I THINK I got 2-3 hours last night, but it could have been more. I don't know. At least it wasn't zero! I'll just work with that today...do what's necessary....possible....impossible." What else was I going to do? This was at least better than counting hours and worrying over them and creating more insomnia.

 

Well....sorry for the long post, but maybe this will help.

 

 

 

 

 

 

Hi Artistic1,

 

I will throw the sleep tracker away...lol. It actually is my symptom tracker though and I use it correlate against my tapering cuts and to see which symptoms got better. But yes I should maybe not putting so much emphasis on what happens on one day versus the next day otherwise it just turns it into one big messy sea of red ink. I need to change my behavior and thought processes to make this work and I like your approach and seems to be one that I can definitely implement. 

 

My doctor wants me to stay the course in my tapering without crossing over to another medication. However just mentioned Doxepin for sleep so that I can continue to taper effexor. He said it doesn't bind to the receptors as much as effexor does or even mirtazapine. I'd need to find out more about that.

[whatshappening]

1 hour ago, Onmyway said:

@whatshappening

I noticed in one of your previous posts that you are drinking alcohol. Lots of people here have discovered that it can really exacerbate withdrawal and set people back. Alcohol also interferes with sleep in a serious way and while you may not have thought it impacted you before, in this sensitized state it can have profound effects. 

 

I'd consider cutting it.

 

I personally would not make more changes like bridges as it can confuse things - it's hard to know what the equivalent dose of SSRI is in another medicine. You could try it but I've learned that keeping things stable is good in WD. 

 

I still have sleeping issues, they get worse in waves and when things are not going well in my life but the initial insomnia right after cutting improved significantly over a few months for me. 

 

Not sleeping one night actually doesn't bother me much as I've done that regularly in school. Also deprivation can actually increase mood paradoxically.

NOOO not the wine...lol. It's my one thing that helps me to forget about this whole cracker mess for just a while. How about 1/2 glass ????

[Onmyway]

On 10/23/2020 at 2:40 PM, whatshappening said:

NOOO not the wine...lol. It's my one thing that helps me to forget about this whole cracker mess for just a while. How about 1/2 glass ????

It's obviously up to you what you do, I had a reaction to fresh squeezed orange juice which ferments so had a tiny amount of alcohol but I drank a liter of it which would have been equivalent to about half to a glass of wine. This would cause drunken feeling, balance issues, dizziness.

 

Giving it up may improve your sleep, you could try for a week or two.

 

 

 

 

Edited October 26, 2020 by ChessieCat
removed name

[whatshappening]

Hey guys thoughts please:

 

since I’ve hit a wall in my tapering which has led to unmanageable withdrawal symptoms particularly with sleep my options I’m thinking are:

 

- take an additional med to help with occasional sleep while I continue to taper off effexor.

- don’t take additional med, wait to stabilize and then start a cross over to prozac

- don’t wait to stabilize and Just start cross over to Prozac. 

 

although my best ideal choice is to do the direct taper as I have been I don’t want to prolong any unnecessary misery should any of the above options be a better route.

[bijay]

@whatshappening  I have no personal experience with drug crossover, but I would not consider crossing over to Prozac until you feel stabilized at your current updose of Effexor.  
 

Recently you have also been going as little as two weeks between tapers, and the last taper was larger than previous ones.  Being more conservative as you go forward may be more important than anything else you do.

[whatshappening]

UPDATE:

 

As much as I wanted to wait it out for things to get stable, Because the relentlessness of Insomnia did not let up and got worse even after updosing and holding for a few weeks, the anxiety of sleep was getting too much and my OCDs were becoming exacerbated. So it was time to make a change.

 

I ended up seeking the help of professionals. Most all agreed to just jump from the low dose I was on and cross over to something else. If I didn't try then I won't know if it'll work since everyone is different. So now it's been 5 days since my last dose of effexor and I am currently on Fluoxetine 10mg as a buffer and potentially something I am considering staying on long term due to OCDs and Panic Disorder. Hoping the withdrawal symptoms that may or may not occur off effexor will be minimal and tolerable. But I've been suffering with protracted withdrawal for 1 1/2 years now so hoping I've endured it all already. I know the fluoxetine will take time to settle in but hopefully this med will work well with my body and psychiatric needs going forward.

 

As for sleep and still deprived many weeks out, the prescriptions that were provided have been hit and miss. Tried Duoxepine and diazepam. Now trying Mirtazipine at 3.75mg which worked one night but not so much on the next two. So doc said try go up a little more to 7.5mg hopefully this sticks cause I certainly don't want to do an antipsychotic pill. 

 

Interesting how I got here. I worked so hard for 3 years to come to a low dose of Effexor at the recommended SA tapering rate only for it to bite me in the butt anyway and now resorting to even more new drugs....ugghhh. If I am able to share any success right now is that I am no longer taking Effexor which was a big goal of mines. 

 

I hope to report back in the next few weeks to let everyone know how things are going.

[whatshappening]

NEED SOME HELP AND ADVICE PLEASE!

 

I stopped effexor at 4mg about 1 week ago (Everything okay so far) cause  Doctor did a direct switch to 10 mg fluoxetine which he wants me to do for 10 days only as a buffer and then stop. Okay..... so that's it I asked? He said that's it! What are thoughts on staying longer or just stop before CNS gets used to 2nd drug. 

 

To help with sleep (the only major withdrawal issue to begin with) , Doc gave me mirtazipine. I've taken 3.75mg for the past 5 nights and it's a mixed bag of results. I don't know whether to continue to take it going forward for sleep or just drop it since I'm early in and don't want to find myself doing a long tapering journey again.

Edited November 13, 2020 by ChessieCat
reduced font size of help request

[ChessieCat]

I've asked the other mods to assist.

[whatshappening]

Thank you ChessieCat,

 

I know I strayed from my original plan to do a direct taper but sleep deprivation just became so unbearable (0-1.5 hrs light sleep stage 1 majority of the nights for 4 weeks). My suspicion is that my down regulated serotonin levels is what is causing sleep issues of course and in addition made worse by the obsession to find remedies that will work thus leading to ruminations and song ear worms at night that also keep me up. I drown them out with sleep audios etc but with that playing in my ear it's hard to totally drift off completely. 

 

The doctor who I just recently found to help me and suggested the direct switch to fluoxetine and stop after 10 days I am suspecting is not a tune with slow tapering methods.  He thinks all major symptoms will show up in 10 days and then diminish.  He also mentioned that I might be bipolar because I can still function without sleep. I have never had any bipolar tendencies and I know from reading elsewhere on this site that doctors will typically misdiagnose for the sake of prescribing more stuff. He mentioned my choices were to either up the mirtazipine or next take a antipsychotic med for sleep or just go back on effexor. Therefore, that's why I am asking the moderators here for advice since.

 

As mentioned I am on Fluoxetine now at 10 mg and my hopes now are to stay on it longer than my quacky doctor's recommendation of 10 days so that my serotonin levels increase to induce some regularity in my sleep over the next few months. I decided to not take the mirtazipine anymore and just deal with the sleep deprivation going forward and hoping that fluoxetine will bring me stability. Because if I stopped the fluoxetine after 10 days then what.... just keep dosing with mirtazipine at 3.75mg every night for sleep? The mirtazipine at a low dose 3.75mg was giving me some sleep (2-4 hrs) but it made if feel crappy all morning more than say no sleep if I hadn't taken it. How will I know when I don't need it any longer if I kept taking it?

 

Also If I had to just take only one medication then I'd rather opt for the fluoxetine for stability versus the bandaid of a sleep aid. When and if I go off fluoxetine later then I hope it may not be so difficult to get off of like the effexor had been. 

 

PS.

looking to switch to another doctor

 

 

[Gridley]

22 minutes ago, whatshappening said:

He thinks all major symptoms will show up in 10 days and then diminish. 

Your doctor's methods run counter to what we recommend.  Doctors think that withdrawal symptoms are brief and don't believe in lengthy withdrawal (that's what they're taught and what the pharmaceutical companies tell them).  Sometimes withdrawal is transitory; many times it is not, and there's no way to predict what category you're going to fall in.  Recent findings have shown that the ratio of those who suffer from protracted withdrawal vs. those who don't is around 50/50.  With your doctor's method there's the real  danger that once you stop the Prozac, withdrawal symptoms from the Effexor will start up and they can last quite a while.  

 

Sometimes a switch from a drug that's difficult to taper, like Effexor or Paxil, is done with Prozac, but when it is you stay on the Prozac until you stabilize, which takes several months, then taper by no more than 10% of your current dose every four weeks down to zero.  This is a long process, first to stabilize then to taper.

 

The Prozac switch or "bridging" with fluoxetine

 

Why taper by 10% of my dosage?

 

29 minutes ago, whatshappening said:

 He also mentioned that I might be bipolar because I can still function without sleep. I have never had any bipolar tendencies and I know from reading elsewhere on this site that doctors will typically misdiagnose for the sake of prescribing more stuff. He mentioned my choices were to either up the mirtazipine or next take a antipsychotic med for sleep or just go back on effexor.

Many members here function without great sleep (I'm one of them) and I'm not bi-polar.  We don't put a lot of stock in psychiatric labels here on this site.

 

Drugs and more drugs are what psychiatrists do.  Antipsychotics have very bad long term effects, and prescribing one to let you sleep seems to be overkill and a very bad idea  Reinstating the Effexor is a possibility.  It's a question of what seems best to you, to stick with the Prozac switch for the long term or to reinstate Effexor..   Read the Prozac switch link.  Sometimes it works, sometimes it doesn't.  In your post you seem to be leaning in that direction, and that's fine if that's your choice.  If you want to reinstate the Effexor, let us know and we can help you with that.  

 

About reinstating and stabilizing to reduce withdrawal symptoms. -- at least the first page of the topic

 

As far as the Mirtazapine goes, we're a site for going off drugs, not adding drugs to deal with the problems created by other drugs.  You've only been on the Mirtazapine for 5-6 days.  You are in danger of withdrawal from a psychiatric drug after a month.  You could simply stop the Mirtazapine now.  It's not as if you're getting that great a benefit from it anyway.  Your sleep may suffer but you'll recover.  If you stay with it longer than a month, you're going to have to taper it slowly, and that would give you two drugs (Prozac and Mirtazapine) to taper.

 

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Add in one at a time and at a low dose in case you do experience problems. Get supplements that are single ingredient (not mixed with other types of supplements).

 

 

 

 

 

 

 

[whatshappening]

Thank you Girdley,

 

I completely agree about bringing stability to my nervous system. I am hoping to stick it out with fluoxetine till sleep is no longer an issue and so that eventually when I do decide to taper it will be easier to do liquid tiration. The weighing of the effexor beads especially at the low dose was just too difficult and all too time consuming.

 

I decided to drop the mirtazipine since it's only been 5 days so last night and it was back to the same old toss and turn, meditate and maybe stage 1 light rest for about  1 hour closer to the wee hours of the morning which is what is what like prior. I hope and pray that sleep becomes okay eventually the longer I am on fluoxetine as I am putting off working at the moment.

 

I do and are taking magnesium gylcinate, fish oil, vitamin D3 and B-complex. New to the mix recommended by my naturopath is : L-tryptophan, collagen hydrolysate unflavored protein powder, and progest-E mineral oil (for low progesterone level)

 

I drink probiotics occasionally , still exercise although modified to meet whatever energy level I can muster, meditate, do yoga, swim, gratitude journal etc. I am going to be seeing an Insomnia Therapist next week to help me with tips on sleeping naturally. I am doing what I can to do this naturally (aside from the flouxetine). 

[Gridley]

26 minutes ago, whatshappening said:

L-tryptophan

I wouldn't recommend L-tryptophan while you're taking an SSRI.  Tryptophan raises serotonin levels, as does fluoxetine, posing the danger of Serotonin syndrome.

 

27 minutes ago, whatshappening said:

B-complex

B complex can be too stimulating to someone in withdrawal.

 

Hypersensitive to B Vitamin or B-Complex  

 

29 minutes ago, whatshappening said:

I decided to drop the mirtazipine since it's only been 5 days

 

 A wise decision.

 

 

[whatshappening]

8 minutes ago, Gridley said:

I wouldn't recommend L-tryptophan while you're taking an SSRI.  Tryptophan raises serotonin levels, as does fluoxetine, posing the danger of Serotonin syndrome.

 

Was taking it prior to fluoxetine but makes sense. Will suspend further use for the time being.

 

8 minutes ago, Gridley said:

B complex can be too stimulating to someone in withdrawal.

 

Hypersensitive to B Vitamin or B-Complex  

 

Interesting. Hmmm I've been taking it for 2 years now though. but will eliminate for now.

[whatshappening]

Gridley / Chessiecat,

 

Have you tried or heard anything about Calm Aid? it's lavender pills.

[Gridley]

@whatshappening

 

Here's a link so you can see other members' response to this supplement.

Lavender, for anxiety and digestion - Symptoms and self-care ...

 

 

 

 

 

[bijay]

@whatshappening Just a heads up on the protein powder - collagen is very high in histamine.  When I took collagen powder it caused insomnia for me - and that was when I was healthy, before any drugs.  I tried it on three separate occasions with the same result each time - great looking skin, but could hardly sleep at all.  It may be worth stopping it for awhile just to see if it helps.

 

[whatshappening]

1 hour ago, bijay said:

@whatshappening Just a heads up on the protein powder - collagen is very high in histamine.  When I took collagen powder it caused insomnia for me - and that was when I was healthy, before any drugs.  I tried it on three separate occasions with the same result each time - great looking skin, but could hardly sleep at all.  It may be worth stopping it for awhile just to see if it helps.

 

Honestly it’s hard to tell at this point because I haven’t seen improvements or anything worsen due to what supplements I was taking prior or even now. Hmm I wonder what’s in the collagen powder that might be stimulating? It does say right on the label “more restful sleep”

[bijay]

I think in my case it was due to the histamine.  When I researched it at the time I did see other cases of people who had insomnia as a result of taking collagen powder.  There are histamine receptors through the body, including the brain, and it plays a role in the sleep/wake cycle.  That is why antihistamine drugs make us sleepy.

[whatshappening]

12 minutes ago, bijay said:

I think in my case it was due to the histamine.  When I researched it at the time I did see other cases of people who had insomnia as a result of taking collagen powder.  There are histamine receptors through the body, including the brain, and it plays a role in the sleep/wake cycle.  That is why antihistamine drugs make us sleepy.

 

Interesting. do you have a link that states where to find the histamine ingredient in the label? Here's the ingredients in mines.

 

[bijay]

I don’t think it would be listed as an ingredient, as it is a formed when the histadine amino acid breaks down.

[Gridley]

12 hours ago, whatshappening said:

It does say right on the label “more restful sleep”

What works for the undrugged may have the opposite effect for those of us in withdrawal.

[whatshappening]

Deciding not to take the mirtazipine has made my conscious feel better. However, 2 nights now with 0 hrs of sleep. I wonder how and why this is so and at what point will I resume at least some type of quality sleep on my own. As mentioned if I do get an hour or so it's generally very light. I cling onto hope but my energy level is waning as weeks go by. I've read the site where some people state the same but then their thread never continues and then I'm left wondering if it got better on their own for them or if they ended up caving in to prescriptions. Can anyone point me to a successful and current thread?

 

I am now at 10 days off effexor with fluoxetine 10mg as my current bridge. so far irritability and anxiety have been present but I manage. I do have days where I feel gloomy and low mood but I attribute this in with the fact that I'm still dealing with this sleep issue which occupies my thoughts every day even while I try my best to stay positive and distract myself.

 

I cling to hope that things will change and I hope and pray for small signs of improvement to tell me so and hope that the fluoxetine will help to stabilize things in the weeks to come. 

[Gridley]

39 minutes ago, whatshappening said:

Can anyone point me to a successful and current thread?

I know it's very hard not getting sleep but it will resolve.  The body will sleep when it has to.  When I can't sleep, and that's plenty of hours of every night, I use the time to rest.  Apace41, one of our moderators, who is a true veteran of the sleep wars, posted the following regarding sleep that I found very helpful.  He is a current sleep success story, and he did it without drugs, using sleep techniques he talks about in his post, and giving it time. Here's his post:

 

There is, unfortunately, no "silver bullet" to withdrawal or any of its symptoms, including insomnia.  If there were, SA would be a much smaller site than it is at this point.  Sadly, it continues to grow as more and more people get caught in the psychiatric medication "web."

 

insomnia and disordered sleeping is a hallmark of psychiatric medication withdrawal.  It starts earlier than that with many studies making it clear that SSRIs (and other psych meds) frequently suppress REM sleep for those who take the meds.  https://www.sleepio.com/articles/sleep-aids/antidepressants-and-sleep/  Given this as a backdrop, it should be no surprise that coming off the meds can wreak havoc on sleep.  The good news, however, is that the brain works hard to achieve homeostasis and, all other things being equal, the brain will return to a place where sleep becomes, as it should be, a matter of routine.  How long that takes for any one person is impossible to predict.  

 

So, what do you do?  In no particular order, some of the things to try:

• Don't place too much significance on sleep.  Rest should be the key and when your body absolutely needs to sleep it will.  The anxiety that comes with lying awake and saying "I must sleep" is far worse than the not sleeping.  It's hard but it can be done.
• Try a journaling practice before bed -- get out the things that are on your mind and add 3 things you are grateful for from the day
• Get a sleep ritual in place so that you do the same thing day after day and start to repair your circadian rhythms
• Take a warm bath with epsom salts few hours before bedtime and add in a cup of chamomile tea
• Use lavender essential oils in a diffuser at bedtime
• Exercise early in the day so that you aren't activated near bedtime
• Get outside and get some sunlight early in the day so that your rhythms are reestablished
• Make sure you have a consistent bedtime 
• Try not to be too activated in the couple of hours before bed and, of course, no caffeine
• Add a meditation practice
• Try yoga
• Go for walks in nature

Most insomnia is the result of the body being "hyperstimulated."  It is very hard to calm down an overstimulated body, especially when it is the result of chemical cascades that come as a result of medication use and withdrawal.  But, it can be done to a certain degree and the skills learned will provide valuable as your body improves over time.  

 

From my own perspective, my sleep is still not great, but it it better than it was.  I went through many stretches of 2 or 3 days with zero or an hour or two a night of sleep.  At this point, I have the occasional sleepless night, but most nights I'm good for at least 5 and usually closer to 6 hours.  By "normal" people standards that's not great, but it feels pretty good when compared to 0 or 2-3 hours a night.  As the saying goes, "in the land of the blind the one-eyed man is king!"

 

Try not to let it become the dominant factor in your life.  Over time, it will get better and you will heal.  Just do your best to continue to live your life what your brain is repairing itself.

[whatshappening]

Awww Gridley thank you for all your help. You are my guiding light. 
 

the thing I don’t know what to do is whether I should just stay in bed and close my eyes and meditate or get up out of bed. All the sleep help guides say to get out of bed if you don’t fall asleep in 15 min and go to another room or read a book etc. If that was the case I’d never get to even rest my eyes because when and if I do drift off it’s because I’m still lying down the whole time even if I am tossing and turning. so I’m just wondering what do you do or others do if hours go by and still no sleep. 

[ChessieCat]

 

[whatshappening]

Sooo......I saw my new provider today (who knows about SA site) and said that the prozac wouldn't of been her choice as a transition off of effexor because prozac can be activating. She is recommending zoloft instead because it is less activating than prozac (Any Thoughts?) She wants to start me on 25mg and just stop the prozac immediately since it's only been 12 days since I've taken it. She also wants me to start taking some natural probiotic capsules as she said 80% of serotonins are made in the gut. 

 

I am just trying to gain some stability in my anxieties, OCD and sleep pattern so if zoloft would be better than prozac then I'm all for it.

 

When there is some stability in prescription and nervous system then hopefully when it resolves a tapering can be done to come down eventually in the future. 

 

Edited November 16, 2020 by ChessieCat
reduced font size