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starquake: how long will Prozac withdrawal last?

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starquake

Hi all, I'm a 24-year-old female who has been on some kind of antidepressant since I was 17.

 

1. Zoloft, 1 year (2011)

2. Wellbutrin, 2-3 months (end of 2011 in conjunction with Zoloft)

3. Viibryd, 6 months (2012)

4. Buspar, 2-3 months (2012)

5. Lexapro, 1 year (late 2012 to late 2013)

5. Prozac, 3ish years (late 2013 to mid 2017)

 

I started tapering off of Prozac this April, going down by 10mg a month for 7 months.

I was on an 80mg per day dose for at least 2.5 years.

I finished tapering at the end of October 2017.

 

I didn't have any particularly bothersome symptoms until the last 10mg and these have persisted or gotten worse in the last two months. My biggest issue right now seems to be irritability. I feel like I go through multiple mood swings per day and sometimes I can't even describe how I'm feeling. My anxiety has also increased - fears about my loved ones dying or that I'm going to get into a car accident on the highway, that kind of thing. 

 

I know it's still soon, being only 2 months since I completely stopped taking Prozac, but are these all withdrawal symptoms and if so, how long can I expect them to last? Sometimes I wonder if I even remember was normal feels like anymore, since I've been on antidepressants since before I was even an adult. I felt pretty good on Prozac moodwise, but disliked the weight gain that resulted (65 pounds!) and I worried about the long term effects on being on it.

Edited by Altostrata
added screen name to title

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Altostrata

Welcome, starquake.

 

80mg Prozac is a very large dosage.

 

Yes, you have withdrawal symptoms. How are you sleeping?

 

Do you have any Prozac left?

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starquake
3 hours ago, Altostrata said:

Welcome, starquake.

 

80mg Prozac is a very large dosage.

 

Yes, you have withdrawal symptoms. How are you sleeping?

 

Do you have any Prozac left?

 

My sleeping seems okay. 

 

I do not have any Prozac left. My last doctor would not issue me the 10mg pills that I needed in order to taper down slowly so I ended up buying them online in bulk and bought only enough to complete my taper.

 

I almost feel like I'm perpetually PMSing. 

 

When I first started tapering down, I felt like I was getting back my control over my appetite, but over the last few months it seems like my cravings have come back with a vengeance. I'm trying to count calories and failing miserably because I just want to eat everything starchy or sugary. 

 

I feel hopeless and empty and have zero motivation to go out and do anything. 

 

I know some of what I'm feeling is related to other circumstances, like the fact that I'm currently jobless, just made a big move, and haven't seen my counselor in a long time. 

 

But I just want to feel okay. I'm scared that being put on antidepressants from a young age completely screwed me over. Everything feels really hopeless.

 

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Altostrata

It's very possible you have withdrawal syndrome. 

 

Do the symptoms follow any daily pattern?

 

Taking a very low dose of Prozac, such as 2mg, might take the edge off those withdrawal symptoms. You'd stabilize on that for a good while, then taper off by tiny amounts later.

 

This topic explains how to make a liquid so you can take 2mg  Tips for tapering off Prozac (fluoxetine

 

Also see About reinstating and stabilizing to reduce withdrawal symptoms 

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BilboBaggins

Hi! Just wanted to drop in to wish you the best, starquake. I have been on prozac since I was 22, and I recognize so much of what you're talking about. The mood swings especially, I switch from feeling okay to suddenly feeling a hot rage and fury and disgust for everyone around me, including my loved ones. Lately, the apathy of not wanting to do anything has hit me as well. It's like I just want to sit and do as little as possible all day. My motivation for being active is zero.

When I think about it, a big issue that I have with these drugs is that because (at least for me) they make your brain foggy, tired, and "sick", it's so much easier to get caught up in spirals of bad routines and tiredness. I feel like I become more of a slave to my current moods than I was when I was drug-free. Right now I'm caught up in procrastination and apathy, but hopefully that will change.

 

I also agree on the part of fear towards having started prozac (and mianzerin for me) at an early age. The prefrontal cortex is apparently not fully developed until 25ish (or so the scientists seem to think nowadays at least), and the fact that I've been drugged down for my final years of prefrontal cortex-development worries me. In the end though, the way I look at it, is that I can't make the choice to start taking these drugs undone, so no matter if it has screwed up my brain or not, I can worry about it as much as I want, it still won't change anything. All that is left is to just accept the situation that I am in, and then try to pick up the pieces and move along (easier said than done.......).


Also, the feeling you're describing of no longer knowing what it feels like to have a normal brain with normal emotions and moods and functions, is another great worry that I have. That worry seems to be very common around here, from what I can tell.


Anyway, good luck! :)

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BilboBaggins

Just wanted to add: To try to calm your worries of having a messed up brain, one suggestion would be to do some research on neuroplasticity, either on this forum, on other internet pages, or in books. The brain has a very great ability for change and recovery. A healthy, fullfilled, happy lifestyle with regular physical exercise for example, has been shown to make you're brain better and stronger (i.e stronger connections between braincells and so on), and to improve the most important parts of your brain. So the brain is very open for change, is my point. :) I've read a lot about it lately and it has given me a more positive feeling that my brain can become fully functioning again, with time.

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starquake

Finished my slow taper off Prozac in November of last year. Had ZERO negative affects until the last 10mgs (started at 80). At first I was just a bit irritable from time to time. In the last month, however, particularly the last few weeks, things have deteriorated rapidly. 

 

I no longer have any tolerance for alcohol. If I have one drink, I feel absolutely horrendous for days. Easy enough to deal with, I haven't been drinking.

 

I've been focusing on eating more protein and eating regularly to control blood sugar crashes and whatnot (following the Potatoes not Prozac "diet" so to speak).

 

I am horribly depressed and anxious all the time. I have no motivation. Everything is empty and meaningless.

 

I haven't experienced a window in at least a couple weeks now.

 

I'm a recovered self-harmer, and last weekend I self-harmed for the first time in at least a year.

 

I have a regular therapist who I see every two weeks, but this feels far more biochemical than behavioral.

 

I don't know what to do. I feel like I'm in a full-on depressive episode. My life is going to fall apart if I continue like this. I don't know where I'm supposed to go for help. If I go see a psychiatrist, they will just put me back on meds and all of this will have been for nothing. 

 

I am starting to take vitamins again (Vitamin B Complex, fish oil, and magnesium) but it hasn't been long enough to see if there's a difference.

 

If it's just going to get worse like this it seems like antidepressants are my only option unless I want my life to completely implode. 

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RealMe

 

21 minutes ago, starquake said:

If it's just going to get worse like this it seems like antidepressants are my only option unless I want my life to completely implode. 

How long did you stay on the last 10 mg of prozac?  Did you slowly taper off the last 10 mg. in 10% increments?  I'm on 9 mg. of prozac since the end of December and do not know when I will be ready to make another reduction.  I hope a moderator will be able to help you.  Please hang on until you speak to someone who is experienced in prozac wd.  I read about PAWS which I believe is protracted or postponed withdrawals that sometimes happens but is not permanent nor is it a reason to return to ADs, but of course I'm in the same boat as you and don't know how to help.  I am on your team though.  My thoughts are with you.  I am suffering from terrible tinnitus, anxiety, depression, dystonia and tremors which I can only hope to habituate to.  There's no way I'm going to go back to psychiatry land for further damage if I can possibly avoid it.

Best wishes,

RM

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JamesF

Hello Starquake,

It's pretty clear to me what's happened here. 

What you need to understand is that you've tapered in a linear way (10mg per month), while doses of SSRIs do not have a linear effect. 

I had the same issues before I learned the biology behind these drugs.

There's a good paper that makes this easy to understand: https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.161.5.826 

But if you're not up for reading, the most important graph in the paper for you is this one: 

 image.thumb.png.f4d5a101b7369d2dcae8f195d09a909a.png

This shows the relationship between dose and effect on the brain. 

Following each dosage level upward, you can see that for Prozac:
 

  • 10mg corresponds to about 75% effect
  • 20mg corresponds to about 80% effect
  • 30mg corresponds to about 83% effect
  • 40mg corresponds to about 85% effect
  • 50mg upward levels off at about 86%, where there is strongly diminishing returns. 

So call 86% the total effect you had.


This is the reason for your suffering. While you jumped down in what seems like even steps of 10mg. What you actually did is this:
 

  • 80 to 70 = 0.5% jump
  • 70 to 60 = 0.5% jump
  • 60 to 50 = 1% jump
  • 50 to 40 = 1% jump
  • 40 to 30 = 2% jump
  • 30 to 20 = 3% jump
  • 20 to 10 = 5% jump
  • 10 to 0 = MASSIVE JUMP of 87% (75%/86%)

 

It's absolutely no wonder that you didn't have symptoms until the last 10mg.

You were making tiny jumps until then.

 

But after this, the last 10mg composes about 87% of the effect of 80mg, your highest dose. 

 

 

You essentially when down a very smooth and barely perceptible slope to 10mg, then abruptly went into a rollercoaster vertical drop to reach the bottom. 

 


I think the right strategy for suffering reduction here is reinstatement.

 


I would strongly advise you to consider reinstating at a low dose, since that jump is far too big to recover from and will cause a lot of needless suffering. It's simply a huge bridge for the brain to cross in healing, and it's much more effective to go slower both for long term healing and to maintain your functioning and happiness. 

 


I think your brains probably "expecting" something in the range of 8mg, since you will have healed slightly from the time you took 10mg, and from the experience of members here, healing seems to occur at about 10% per month. But this is definitely not a precise science and it's more important to be sensitive to the rate at which you personally can stabilize after dosage reductions. 


Moderators might advise a reinstatement of a low dose e.g. 2.5mg. Then holding for a few weeks to stabilize and assess your level of symptoms, after which you might increase to say 5mg if you still have intense symptoms, then hold to stabilize once more. The advantage of this is that it minimizes any onset effects and prevents you from "overshooting the mark" and taking more than you might need. But I think it's far more important to be healthy and functional than to overshoot the mark a little bit. 

 


My experience was that reinstatement worked after a much longer time off, but that stabilization took about as long as I was ill. That is to say, if you had 2 months off destabilizing withdrawal symptoms, it might take another 1-2 months for them to diminish after reinstatement. In this regard, it's important to do sooner than later. 

The good news is: 1) you have done extremely well to reduce your dosage to such a low level and should never need to go above 10mg again. 2) reinstatement will hopefully reduce your suffering and put you back where you were a few months ago. 

The slightly frustrating news is: tapering that last 10mg should be done very slowly and carefully. With no fixed timeline (possibly a year or two) of how long it will take outside of how long it takes you to stabilize. 10% reductions per month seems like a good guide that is often suggested here. E.g. 10mg -> 9mg - 8.1mg, etc. But the better guide is to be internally sensitive to how long as it takes to feel stable.

 


The upside of this of course is that you will minimize suffering, carry on with life and hopefully never go back to the place you find yourself currently.

A bit of measuring and weighing daily beats withdrawal symptoms any day.

Wishing you all the best, Jay


(Bear in mind that I am just a human who has gone through this and researched it, so this is not official medical advice. )

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starquake

How do you go about splitting a 10mg pill into a 2.5mg dose, or even accurately measure 8mg from a 10mg pill?

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starquake

I really don't know what to do anymore. I feel so lost and hopeless, and like I have to choose between two really undesirable futures for myself.

 

I did a slow taper of Prozac, from 80 milligrams per day to 0 over the course of 7 months. I realized of course after the fact that the last 10mg is the hardest to come off of, but I didn't know that at the time. During the last 10 mg (October 2017) I felt some irritability, but also as though the old me was coming back. It was a mixed bag for a while, but I thought I'd stick it out to see how it went. By February/March I was in full on withdrawal. A GP suggested reinstating at 10 mg. This seemed to help for a few months, but over the last month or so my symptoms have gotten worse and worse, cycling between bouts of extreme anxiety and depression. I have a therapist but no psychiatrist. I have a strong distrust of psychiatrists, who put me on antidepressants at 16 and changed my medication and doses frequently until I was 18 and put on Lexapro and later Prozac. I was on the Prozac successfully for four years but wanted to come off of it due to the extreme weight gain. I lost nearly 40 pounds in coming off of Prozac, and started to FEEL again. Not that I wasn't feeling at all on Prozac, just not as deeply. I felt a bit numb and bored all the time.

 

I'm at an impasse here. Do I increase my Prozac dose? by how much? do I try a different med? I know nutrition and supplements can work wonders on imbalanced brain chemistry but I'm too ****** up to even try. I can barely get myself to swallow the one 10mg pill of Prozac once a day. My weight is creeping back up. I'm eating like **** and the only thing that boosts my mood is high doses of caffeine and sugar (no drugs and no alcohol, they make me feel like **** ever since I came off high dose Prozac). 

 

I am so desperate. I don't know what to do. My insurance is useless and psychiatrists don't ******* listen or know what they're talking about. 

Edited by Dan998
removed swearing

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ChessieCat

Hi starquake,

 

I moved the new topic you created to your Intro topic.  This way your history is all in one place and it makes it easier for the mods to assist you.

 

It may be that you are taking too high a dose of Prozac.  Alto made the following suggestion:

 

On 1/3/2018 at 8:49 PM, Altostrata said:

Taking a very low dose of Prozac, such as 2mg, might take the edge off those withdrawal symptoms. You'd stabilize on that for a good while, then taper off by tiny amounts later.

 

Q:  What is your daily symptom pattern? 

 

Q:  What time of day do you take your dose?

 

Answering these question may help us to see whether increasing or decreasing might help.  I've asked the other mods for their thoughts on this.

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manymoretodays

Hi starquake,

Do attend to the questions that Ccat has asked above. So we can further advise you on dosing.

 

I just wondered if you've had a chance to look at some of the stuff we have collected in symptoms and self care? 

http://survivingantidepressants.org/topic/1112-non-drug-techniques-to-cope-with-emotional-symptoms/

 

And hugs.  Maybe you can find something there for comfort today.

 

I found it interesting that you gained weight on Prozac.  I remember back in the day, early 90's, when it was being touted as a weight neutral, or even weight loss medication.  Sometimes these drugs can have some varying metabolic effects in different people though.  I was only briefly on it personally.  The SSRI's and SSNRI's(AD's) were all pretty weight neutral for me.  Some of the other classes of medications that they use for everything under the sun now........did cause some rapid weight gains for me though.  Tres' bizarre as it rarely had anything to do with the calories I was eating.  

Do you get a general medical physical each year with lab work?  That's always a good idea even though you are young and relatively healthy.

 

Love, peace, healing/inrecovery, and growth,

manymoretodays

 

Edited by manymoretodays
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starquake

My doctor flat out refused to give me anything other than a 10mg pill which is unsplittable. I even requested a liquid version so I could measure a smaller dosage and again he refused. So I don't know how I'm supposed to take 2mg a day instead. 

 

The last few weeks my mood has been VERY erratic throughout the day, moving between a low-level depression I can cope with and severe depression that makes me want to die. I go through this patterns several times a day. I'll be irritable one moment and crying inconsolably the next. The only thing that improves my mood is caffeine and sugar, which provides a temporary relief from symptoms.

 

I take my Prozac in the morning as I always have. Occasionally I'll take it in the afternoon if I forget. The more depressed I get, however, the less likely I am to take my meds consistently. 

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starquake
On 5/27/2018 at 7:07 AM, manymoretodays said:

I found it interesting that you gained weight on Prozac. 

 

I initially started gaining weight on Lexapro. About 30 pounds in a year. And then an additional 30+ on Prozac. Doctors all say it doesn't cause weight gain but I have heard a lot of anecdotal evidence of others gaining weight rapidly on SSRIs, including my sister. It's not that the med itself caused the weight gain, but the Prozac has increased my appetite DRAMATICALLY. At my highest dose my appetite was insatiable. I dropped about 40 pounds when I came off of Prozac and since I've been on it again have gained about 15 pounds back.

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ChessieCat

From Post #1 of this topic Tips for tapering off Prozac (fluoxetine):

 

Making your own Prozac liquid 
Prozac is one of the few psychiatric medications with a long history of do-it-yourself dilution in water or juice. Mixed in cranberry juice, it's been called "Cranzac."

My own personal preference would be to dilute it with water, to avoid any degradation that might be caused by sugar or acid in the juice. Also, it will be easier to see how well the Prozac is dissolved in water. (There may be particles swirling around, that's the filler in the Prozac capsule that doesn't dissolve.)

Your Prozac solution may be a little bitter -- just swallow it quickly. You might want to chase it with a little fruit juice.
 

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bubbles
1 hour ago, starquake said:

I initially started gaining weight on Lexapro. About 30 pounds in a year. And then an additional 30+ on Prozac. Doctors all say it doesn't cause weight gain but I have heard a lot of anecdotal evidence of others gaining weight rapidly on SSRIs, including my sister. It's not that the med itself caused the weight gain, but the Prozac has increased my appetite DRAMATICALLY.

 

Me too, though sertraline. I want to eat, even when I'm not actually hungry.

 

 

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starquake
1 hour ago, bubbles said:

 

Me too, though sertraline. I want to eat, even when I'm not actually hungry.

 

 

I think we get a serotonin boost from eating a lot of carbs and sugar. It may be part of the efficacy of SSRIs. just my two cents.

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starquake
1 hour ago, ChessieCat said:

From Post #1 of this topic Tips for tapering off Prozac (fluoxetine):

 

Making your own Prozac liquid 
Prozac is one of the few psychiatric medications with a long history of do-it-yourself dilution in water or juice. Mixed in cranberry juice, it's been called "Cranzac."

My own personal preference would be to dilute it with water, to avoid any degradation that might be caused by sugar or acid in the juice. Also, it will be easier to see how well the Prozac is dissolved in water. (There may be particles swirling around, that's the filler in the Prozac capsule that doesn't dissolve.)

Your Prozac solution may be a little bitter -- just swallow it quickly. You might want to chase it with a little fruit juice.
 

So do you dissolve one pill and then split that up into five equal amounts of water? can you then store it in the fridge? how does that work?

 

Also, how  do I know that I need LESS Prozac and not more if I'm feeling so badly?

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bubbles
Quote

I think we get a serotonin boost from eating a lot of carbs and sugar. It may be part of the efficacy of SSRIs. just my two cents.

 

Interesting - certainly when I was doing a faster taper previously, I had massive sugar cravings, and actually eating candy was the thing that made me feel better. Shame about the pouds...

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manymoretodays
On 5/30/2018 at 12:25 AM, starquake said:

So do you dissolve one pill and then split that up into five equal amounts of water? can you then store it in the fridge? how does that work?

 

You would dissolve your 10mg pill in enough water to make a 10mg: 10mL solution. 

I don't think you should jump down to a 2 mg dose immediately.   A judicious 10% or less taper is in order now.

If you have an amber jar you can store it in that.  Please read carefully the first couple posts in the link that you have been given above.

Here are a couple more you may find helpful now:

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

http://survivingantidepressants.org/topic/235-using-an-oral-syringe-and-other-tapering-techniques/?_report=1575

 

When crossing over from pill to liquid this is what we suggest you do:

"When changing from tablet to liquid we suggest you keep taking your current dose (in other words do not reduce your dose) and cross over:

by taking 3/4 tablet dose + 1/4 liquid dose for about 3 days,

1/2 tablet dose + 1/2 liquid dose for 3 days,

1/4 tablet dose + 3/4 liquid dose for 3 days, then all liquid.

After changing over to liquid it would be better to hold at that dose for at least 2 months.  3 months would be better.  This is because you have made a lot of changes in the past months  and doing this will give your brain a chance to adapt to all of the changes."

 

You've been on 10 mg. for 4 months now?

 

Initial improvement? 

What happened along the way as you got put up to 80mg?

You could be experiencing "poop out" some time after each dose increase.......which would negate any reason to continue on that tract.

 

If you have been on the 10 mg dose for 4 months now I strongly suggest that you consider a 10% or less decrease once you have stabilized on the liquid version.

 

On 5/29/2018 at 8:44 PM, starquake said:

My doctor flat out refused to give me anything other than a 10mg pill which is unsplittable.

 

I did not see any mention of "unsplittable" pills in the literature I looked at.  Perhaps you could shop around for another splitter?

 

Love, peace, healing/inrecovery, and growth and change,

mmt

 

Edited by manymoretodays
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starquake
On 5/31/2018 at 1:52 PM, manymoretodays said:

You've been on 10 mg. for 4 months now?

 

 

It's been since about March, so around 3 months. But the last month I have NOT been taking my meds consistently (skipping doses, messing up the timing). Depression Brain makes me less likely to take my meds consistently. Which is bad, I know. Maybe I wouldn't be in this boat if I could properly take care of myself. -_- 

 

On 5/31/2018 at 1:52 PM, manymoretodays said:

I did not see any mention of "unsplittable" pills in the literature I looked at.  Perhaps you could shop around for another splitter?

 

I guess I mean it's unsplittable in the sense that it's a plastic capsule with granules inside. I am going to check out the splitting guide right now. 

 

On 5/31/2018 at 1:52 PM, manymoretodays said:

What happened along the way as you got put up to 80mg?

You could be experiencing "poop out" some time after each dose increase.......which would negate any reason to continue on that tract.

it's been so long now that I was on 80mg that I can't even remember why my psychiatrist kept increasing the dosage. I must have still had anxiety and depression symptoms. I know that I held at 80mg/day for at least a year, possibly two. It has been over a year now since I was at the high of a dose.

 

On 5/31/2018 at 1:52 PM, manymoretodays said:

You would dissolve your 10mg pill in enough water to make a 10mg: 10mL solution. 

I don't think you should jump down to a 2 mg dose immediately.   A judicious 10% or less taper is in order now.

Do you think going lower in my dose is a good idea if I'm already dealing with withdrawal symptoms still at 10mg? I've booked an appointment with a recommended psychiatrist and I'm a little worried they might push for a dose increase or medication change. I'm just wondering at what point I can begin to hope for a little relief. Thank you SO MUCH for your patience with me as I bumble my way through this.

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manymoretodays

Work on consistency of dosing.  That's really important.

Definitely read the Tips for Tapering Prozac.  The link is in the post near the top from Alto.

I should have given you this one too:

http://survivingantidepressants.org/topic/2693-how-to-make-a-liquid-from-tablets-or-capsules/?page=5&tab=comments#comment-356973

 

I think you will get some relief sooner than you think.  Once you understand what's going on........really........it helps alot.

Don't expect too much from your shrink.  Most of them aren't too enlightened.

 

Love, peace, healing/inrecovery, and growth,

mmt

 

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Altostrata

If you've been skipping doses, you're likely making yourself sick. Don't skip doses. ever.

 

Prozac comes in 10mg capsules, you shouldn't need to split anything. Do you only have 20mg capsules?

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Carmie

Hi starquake, 

 

How are you doing?💚

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