DrMox: Just stopped prozac with tapering after 10 years

[DrMox]

Hi,

I'm totally new here. I started prozac 10 years ago for anxiety. I was always on 20mg a day. It helped me tremendously at the time but I never expected to be on it for so long.. My life is less stressful (not in grad school any more, job stability etc.) so I decided to go off it. At my doctor's advice I tapered slowly, decreasing roughly like:

2 weeks of: 10mg 3x/week, 20mg 4x/week 

2 weeks of: 10mg 5x/week, 20mg 2x/week

2 weeks of: 10 mg all week

2 weeks of: 10mg 5x/week, 5mg 2x/week

2 weeks of: 10mg 3x/week, 5mg 4x/week

2 weeks of: 5mg all week

2 weeks of: 5mg 3x week, then 5mg 1x and then OFF.

 

NO emotional side effects during this entire process. Just some IBD stuff (which I had with the stress/anxiety before starting the prozac).

 

So I took my last pill 2 weeks ago. Just in the past few days I've had racing in my chest, palpitations, some joint pain, and mild irritability. And last night I had terrible insomnia. Is this finally the withdrawal kicking in?

I'm a teacher and start classes after Labor Day. My goal was to be DONE with all this by the time school started. I figured with the slow tapering, I wouldn't have withdrawal once I stopped. Is there anything I can do to help the withdrawal? I DO NOT want to go back on it. I want to ride this out. Going off it like this has shown me how insidious it is. I know it helped me and helps people, but it's messed up that it's so hard to get off of! 

[baroquep]

Hi  DrMox,

 

Welcome to Surviving Antidepressants (SA), I’m glad you found this site.  

 

The symptoms you describe sound very much like withdrawal and I have a feeling that, yes, withdrawal is just now kicking in for you.  Because Prozac has a long half-life, typically 16 days, it takes longer for withdrawal symptoms to appear.  I don’t want to alarm you, but want you to be aware that your symptoms could get progressively worse down the road because of the nature of withdrawal syndrome. 

 

What is Withdrawal Syndrome?

 

Unfortunately few medical professionals have any idea how to safely taper off of these drugs and often give the wrong advice, which for many people leads to the trouble you are now experiencing.  The schedule that your doctor advised you to follow was far too fast, and the reason you are feeling the way you are.  Once you been on antidepressants long-term, it becomes even more important to taper off at a slow and steady rate.  

 

Surviving Antidepressants recommends tapering by 10% of your current dose with at a hold of at least four weeks before your next decrease.  The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.  Some people may have to taper at an even more conservative rate as they are very sensitive to even the smallest drops.  

 

You’ll find more specific information as to the reasons this approach is recommended when tapering off of psychiatric drugs at the link below.

 

Why taper by 10% of my dosage?

 

We ask all of our members to fill out a withdrawal history signature so that all of your information can be read at a glance.  This helps moderators immensely and we would ask that you follow the instructions at the link below.

 

Instructions:  Withdrawal History Signature

 

I would encourage you to have a look around the site, connect with other members in the introduction forum and familiarize yourself with what options are available to you at this time so that you can make an informed decision about what you can do to help alleviate your symptoms and avoid potential problems down the road.

 

I’m attaching a few links that might help you in the meantime.

 

Non-drug techniques to cope with emotional symptoms

Non-drug techniques for dealing with physical pain

 

Best,

BaroqueP

Edited August 31, 2017 by baroquep

[DrMox]

Thanks that is useful info! Obviously, my doctor thought this was a good, slow, schedule. And since I haven't had an symptoms until now, I thought everything was OK.

 

What's strange is that I'm NOT having emotional withdrawal symptoms. I am actually not anxious emotionally. Emotionally I feel fine. What I feel is like the physical part of panic and anxiety-- the jittery tightness in my chest. And I wasn't up during the night with anxious thoughts. I was just up and wide awake. 

 

Is it possible to have the physical side effects and not emotional ones?

I can start walking and running again. I know that always helped me. And I can take melatonin before going to bed tonight, and see if that staves off insomnia (it works well for my partner).

I don't want to go back on it again. But I hear you that symptoms might get worse before they get better. How do people have time to taper off so slow? I figured the summer break would be enough! 

[AliG]

DrMox. Welcome. I'm sorry that you have been put in this position after undergoing a fast taper but unfortunately it is common due to a lack of knowledge about safe tapering by most doctors.

 

I know that you don't want to go back on the Prozac understandably but after only 2 weeks off you could possibly find a very small reinstatement of perhaps somewhere between 1- 5mg may help. Reinstatement is the only known way to alleviate withdrawal symptoms and is best done immediately on appearance of withdrawal symptoms. The more time that passes the less likely it is to work.

 

I wish I had known early on about reinstating a small dose as it would have made a very positive difference in my recovery but I discovered SA too late. I was already 9 months into a cold turkey and was advised that it was perhaps too late. Three years on and it has been an extremely difficult and challenging time. I have had major improvements but it has been slow going and an exercise in patience.

 

I would encourage you to at least have a think about the possibility and read the information provided. You can then make an informed decision armed with the facts about reinstatement. It is totally up to you what decision you make but knowledge is power and I wanted you to be well aware of your options at this point.

About reinstating and stabilizing to reduce withdrawal symptoms

 

Some find that they may have predominantly either physical or emotional symptoms but often it's a mixed bag and it can be variable throughout. If you do decide to try Melatonin it's always best to start at the lowest dose and work your way up a little until you find the lowest effective dose. It really doesn't take much and often 0.5 mg is enough. Less is more with Melatonin. I found it very helpful at certain times and others have also experienced some level of success with it's use.

Melatonin for sleep

 

We also recommend Magnesium and Omega-3 fatty acids( fish oil) as both can have very beneficial effects during withdrawal:

Magnesium, nature's calcium channel blocker

King of supplements: Omega-3 fatty acids (fish oil)

 

To answer your last question most successful taperers establish a routine whereby they can keep their symptoms to a minimum by going slowly and doing holds when necessary all the while carrying on with their life. There can be unforeseen glitches occasionally but mostly they remain relatively symptom free.

 

Please have a read of the reinstatement link. If you do decide to reinstate, we can then suggest an exact starting dose.

Edited August 31, 2017 by AliG

[nz11]

DrMox welcome to sa.

I also dont want to scare you, however i'd take ALiGs advise and give serious consideration to a reinstatement.

Your doctor has been misinformed on how to taper.

After such a long term exposure following sa's rec you would be tapering off 20 mg over at least 2.5 years. Many are having to taper longer.

You may not be having emotional symptoms just yet...but they will arrive. Often beginning with crying spells. Please be careful and be gentle with the exercise.

As baroq pointed out the long half life of prozac means withdrawal reactions can typically take several weeks or more to manifest.

 

I fear that full blown delayed ssri wdl will soon bite and it will be extremely rough to cope with.

Did your doctor inform you that withdrawal can be a life threatening medical emergency?

Things will get worse before they get better.

Doctors sadly do not know or want to know how severe withdrawal is. Seeking their help often results in another drug or drugs being prescribed and trust me withdrawal reactions will not be the diagnosis.

 

So glad you found sa

nz11

[ChessieCat]

Hi DrMox and welcome from me too.

 

What a lot of people don't realise is that the psychiatric drug we take changes our brain.

 

I will tell you my own experience.  I am a professional typist of 40+ years, with high speed and accuracy.  Just before finding SA I decided to reduce my Pristiq from 100mg to 50mg.  Over the next 3 weeks I was suffering very bad brain fog.  At the end of the 3 weeks I could not type.  Thanks to the information I received here I updosed and within 4 hours the brain fog was clearing and I was able to type again.  There was no way that this could have been placebo.  I have since been tapering successfully and am currently taking 20mg.

 

Here's a symptom list.  You may be experiencing symptoms which you aren't connecting to AD WD.  Dr Joseph Glenmullen's WD Symptoms Checklist

 

These really helped me to understand SA's recommendations:

 

Brain Remodelling

Video:  Healing From Antidepressants - Patterns of Recovery

 

Please read Post #1 in the Reinstatement topic so that you can make an informed decision.

[baroquep]

Hi again, I don’t think it is anyone's intention to frighten you, and will have to concur with AliG, NZ11 and ChessieCat that a reinstatement may save you from a lot of misery down the road.  Our experiences are based on years of dealing with people that have gotten into trouble after tapering too quickly.  The intention is to inform you of what can and will most likely happen and to help you avoid crashing.  

 

Because it has only been two weeks since your last dose, as AIG mentioned, it is best to reinstate as soon as withdrawal symptoms appear.  Because of the long half-life of Prozac, I am very worried that this is just the beginning for you and that reinstatement will help you to stabilized now so that you don’t have to go through the horror of experiencing the impact of these drugs when they have been taken long-term and the brain has has far too much time to adapt to their presence.  The withdrawal symptom list is long and emotional symptoms are just one of many many physical and emotional difficulties that you could face down the road.

 

When the drug is removed so quickly, the brain searches for the drug that it has adapted to, can no longer find it and all hell brakes loose.  I encourage you to read stories posted by other people withdrawing from Prozac to see what they have had to face.  You can find those stories by clicking the links below your name and clicking on the tags.  In my opinion, it would be better for you to reinstate a very small amount of the drug as soon as possible, somewhere between 1-5mg, stabilize at that dose and then slowly taper off of that based on the recommendations of Surviving Antidepressants.

 

Delayed Onset of Withdrawal Symptoms

 

Tips for Tapering off Prozac Fluoxetine

 

 

 

Edited August 31, 2017 by baroquep

[DrMox]

Wow this is all so helpful. My primary care doctor really wanted me off of this. She's more on the "natural" side of medicine (she's a DO). I promised her once I got tenure I'd go off of it, but then this spring when she reminded me of that, I told her that politics was also giving me massive stress (I teach about politics and social movements, so I can't just tune it out-- wish I could!). She insisted I go off it anyway, and did recommend supplementing with 5HTP and going down slowly. But, I bet like most doctors, she just doesn't know all this!

 

I have been randomly tearful about things. And I'm not usually. I've had some brain fog. I did sleep last night (without the melatonin) just fine. It's hard to know what's REGULAR stress, and what's WD. I am stressed about selling our house, and hate seeing all the Harvey news. But, our lives are never truly stress free, are they?

IF I start a reinstatement, how would I do it? I have 10mg pills (6 left, and a refill for 60). Can I start with 5mg? For how long? What would a new taper look like? 

Thanks everyone. I plan to educate my doctor about this as well!

[baroquep]

Yes, I think that 5mg is a good idea.  This will likely calm and/or eliminate what symptoms you are experiencing now and will allow your central nervous system to stabilize.  If you have an immediate adverse reaction, discontinue at once.  I would hold at 5mg for at least two months if not longer to ensure that things have settled.  Once you have stabilized and I mean really stabilized, you can restart your taper.

 

If you are able to manage a 10% taper off of 5mg with few to no withdrawal symptoms, it would take you until approximately 3 1/2 years to safely withdrawal Prozac from your system.  I know that this sounds like a long time, but in the long run it will allow you to carry on with day-to-day life with minimal discomfort.  You may be able to go a little faster or have to go a little slower, it depends on how you manage as you go along.  

 

Once you've made your decision, please let us know and we can provide additional information as you go along.  

 

I'm attaching a worksheet with your numbers plugged in to give you an idea of how the taper would look.  

 

 

DrMox.pdf

[DrMox]

I COULD NOT handle the panicky jitters today (3rd day in a row) so I took 5mg this afternoon. I'll stick to that for 2 months, and then figure out how to back down more slowly. Thank you SO MUCH for the worksheet! I'll check in when I'm not so overwhelmed with everything about making a liquid form etc. My doctor might even be willing to prescribe it in liquid form if she can.

 

I guess I'm stubborn in the way I didn't want to take prozac in the first place-- I should be able to do it myself! Whether that be handling anxiety, or just going off prozac. Sometimes I do need to step back and take a more pragmatic approach.

 

I hope tomorrow I feel a bit less panicked. I remember the prozac worked for me right away, and now I've read on here that sometimes indicates a sensitivity to drugs that makes them harder to go off. So interesting.

 

One reason I wanted to go off was to lose weight. I run etc. and have not been able to lose weight. I did read long term SSRI use leads to a slower metabolism. I'll put the weight loss on the back burner now while I go off of this. Honestly, it isn't that big of an issue.

 

Thanks again. I'll let ya'll know if I start feeling better with this 5mg.

[ChessieCat]

23 hours ago, DrMox said:

How do people have time to taper off so slow? I figured the summer break would be enough! 

 

The idea of tapering slowly is to keep withdrawal symptoms to a minimum so that you can live your life as normally as possible.  I had a few hiccups when I first started my taper because I was trying to reduce my drug quickly because I was experiencing mild serotonin toxicity.  After the first few months of tapering the side effects reduced, I started feeling like my old self and tapering has faded into the background of my life.  I am still experiencing withdrawal symptoms but they are mostly insignificant.

 

You have just posted as I've been typing so I won't continue with what I was going to say.

 

It's a good idea to keep notes on paper of the symptoms that improve and the ones that worsen.  That way you will have a better idea of whether reinstatement is working.  However, please throw out the calendar.  Two months is a good time to aim for but please reassess at that time.  It is better to hold for longer so that you stabilise rather than trying to reduce too soon and having to updose.

 

I suggest you read the following before speaking with the medical profession:

 

How do you talk to a doctor about tapering and withdrawal?

What should I expect from my doctor about withdrawal symptoms?

 

Here are some more links which you might find helpful:

 

Keep it Simple, Slow and Stable

Keep Notes on Paper

Rate Symptoms Daily to Check Patterns and Progress

 

Stabilisation is not linear:

 

Windows and Waves Pattern of Stabilization

 

Stabilising After a Reduction - What Does That Mean?

Withdrawal Normal Description

[baroquep]

Hi DrMox, so glad to hear that you reinstated, you have likely saved yourself from a lot of discomfort down the road.  

 

I tried to get off of anti-depressants twice in years past and the anxiety had me back on them pretty quickly.  Unfortunately for me, I hadn't found Surviving Antidepressants at that time and ended up back on the full dose.  It scared me so much that I stayed on the drug for another five years though desperately wanted off.  Since finding Surviving Antidepressants I was able to taper down to 50% of my original dose with only a couple of bumps along the way over the last year.  Am extremely thankful for the help I found here as my family doctor, like far too many others, had no idea how to taper off properly.  I consider myself very lucky indeed.

 

Because you'd only been off Prozac for a couple of weeks and because of it's long half-life, I would doubt that you will have any problems stabilizing so you should be good.  If you have any problems over the next few days, please report back so we can see what's going on.  

 

Like ChessieCat mentioned, it is a good idea to keep track of your symptoms over the course of your taper so you can see your progress, recognize when you are running into trouble, and most importantly have access to the supportive community here as they are a great help.  I use my intro thread as a diary of sorts to keep track of what is going on each time I do a reduction as it's hard to remember what happened month-to-month and that way I can see patterns and progression over the course of many months.

 

A lot of people find once they start taper off anti-depressants, emotions will come back, the mind is sharper/clearer, weight falls off and things you never attributed to long-term antidepressant use improve and you get a new lease on life.  It's not easy, it takes a lot of courage and patience to properly taper off safely but in the long run, it will pay off in spades.

 

Hope the next time we speak, the jitters are history and you are feeling good about your decision to take control of your health and well-being.  So glad you found Surviving Antidepressants when you do and welcome to the community.  I hope you have an uneventful journey off of anti-depressants and good luck with the house.

Best,

BaroqueP

 

 

 

 

Edited September 1, 2017 by baroquep

[nz11]

 

5 hours ago, DrMox said:

I took 5mg this afternoon

Good decision.

 

15 hours ago, DrMox said:

I am stressed about selling our house

In acute wdl I made some very irrational decisions that I went on to regret. 

This for me was only seen in hindsight and with insight. Acting irrationally impulsively and irresponsibly in wdl is very common. It has been documented. 

Of course I'm not suggesting YOU are acting irrationally impulsively or irresponsibly and I'm not saying don't sell the house but I'm wondering what is driving this decision.

If it is something that was planned prior to wdl then great however if it is  something that you have just decided since tapering you might like to revisit the reasons and motives for the sale. 

Either way all the best.

[DrMox]

8 hours ago, nz11 said:

 

Good decision.

 

In acute wdl I made some very irrational decisions that I went on to regret. 

This for me was only seen in hindsight and with insight. Acting irrationally impulsively and irresponsibly in wdl is very common. It has been documented. 

Of course I'm not suggesting YOU are acting irrationally impulsively or irresponsibly and I'm not saying don't sell the house but I'm wondering what is driving this decision.

If it is something that was planned prior to wdl then great however if it is  something that you have just decided since tapering you might like to revisit the reasons and motives for the sale. 

Either way all the best.

Oh, we made the decision to sell the house in the Spring, before I tapered off. It's not the house we live in, so the tenants have been an issue. 

 

I just asked my partner if I made any rash or weird decisions this summer and she quickly answered "you did buy that yucky blueberry pancake bread when we were grocery shopping the other day!" So I guess I've been ok.

I just took a second 5mg, so hopefully today it'll start helping this feeling of constant panic. And I'm decidedly NOT turning on the news, because that doesn't help my panic at all.