ryan1982: my journey

[ChessieCat]

21 minutes ago, ryan1982 said:

I’m on day 4 of my increase to 12.5 and each day has been somewhat better from an anxiety standpoint but far from perfect. Anyone who knows more than I do, should I give it a couple weeks before thinking about going up again?  Also, is it normal to have an increased anxiety when trying to reinstate? I’ve read all the articles, I’d just love to hear from someone who has lived through this. 

 

The idea of reinstating/updosing isn't to get rid of withdrawal symptoms completely but to bring them to a tolerable level.  Then you hold at that dose for a while to ensure that you are stabilised before making a further reduction.

 

If you are noticing symptoms which have improved it means that updosing is working.  It takes about 4 days for a dose change to get to full state in the blood and a bit longer for it to register in the brain.  Because you have noticed improvement it would be better to give it 2 weeks and a chance for your brain to adapt to the new dose.  If after 2 weeks some of your symptoms are unbearable then a very tiny updose, even 0.25mg or 0.50mg might be enough.  It is better to make small increases than to updose too high a dose and destabilise yourself.  Some members have taken too much and destabilised themselves and haven't been able to stabilise again.

[ryan1982]

11 hours ago, ChessieCat said:

 

The idea of reinstating/updosing isn't to get rid of withdrawal symptoms completely but to bring them to a tolerable level.  Then you hold at that dose for a while to ensure that you are stabilised before making a further reduction.

 

If you are noticing symptoms which have improved it means that updosing is working.  It takes about 4 days for a dose change to get to full state in the blood and a bit longer for it to register in the brain.  Because you have noticed improvement it would be better to give it 2 weeks and a chance for your brain to adapt to the new dose.  If after 2 weeks some of your symptoms are unbearable then a very tiny updose, even 0.25mg or 0.50mg might be enough.  It is better to make small increases than to updose too high a dose and destabilise yourself.  Some members have taken too much and destabilised themselves and haven't been able to stabilise again.

Thank you @ChessieCat. Since I was on 

9 MG for just two weeks before going back to 12.5, do you think 12.5 is the correct does to updosing to?

[ChessieCat]

8 hours ago, ryan1982 said:

do you think 12.5 is the correct does to updosing to?

 

This is something only you can decide.  It's important to keep daily notes of when you take you drug/s and when you notice symptoms worsen or improve.

 

You have made a lot of Luvox dose changes since the end of October 2017

 

Your brain likes consistency.  You need to choose a dose and stick to it:  Keep it Simple, Slow and Stable

 

 

Edited March 11, 2018 by ChessieCat

[ryan1982]

31 minutes ago, ChessieCat said:

 

This is something only you can decide.  It's important to keep daily notes of when you take you drug/s and when you notice symptoms worsen or improve.

 

You have made a lot of Luvox dose changes since the end of October 2017

 

Your brain likes consistency.  You need to choose a dose and stick to it:  Keep it Simple, Slow and Stable

 

 

I’m so grateful for your guidance. I’ll be sure to keep you updated as I go. God bless you. 

[ryan1982]

Anxiety is much, much better.  My head feels like a balloon and I almost have a sort of fog over my brain.  Is that normal? Is there anything other than time that I can use to combat this?  Seems like the morning is the worst.  

[Gridley]

It takes 4 days for your nervous system to register a change and and a bit longer for it to register in the brain, then several weeks to stabilize, especially after so many changes. The fact that you were feeling better at 12.5 mg was a sign that you were on the right dose and were you on your way to stabilizing. Keep in mind how withdrawal works:  it's non-linear with lots of window and wave activity.

 

The Windows and Waves Pattern of Stabilization

 

I emphasize that it takes several weeks to stabilize.  Your brain craves stability, which means not bouncing around in dosage.  

 

The rule of 3KIS: Keep it simple. Keep it slow. Keep it stable.

 

You said the anxiety is better but not perfect.  "Better" is good. It's great.   We're not shooting for "perfect" in withdrawal.  Slow and steady is what we're after.

 

 

[ChessieCat]

7 hours ago, ryan1982 said:

My head feels like a balloon and I almost have a sort of fog over my brain.  Is that normal? Is there anything other than time that I can use to combat this?  Seems like the morning is the worst. 

 

If you are taking your dose in the morning it may be because the dose has dropped and you are due for your next dose.  It is then after the new dose has kicked in that you feel improvement.  It's called interdose withdrawal.

 

Luvox's half-life is the shortest of all SSRIs and it is well known to incur withdrawal symptoms.

 

Assuming that you are taking your dose in the morning, if it causing issues you could move 1/2 of your dose 1 hour later each day until you are taking your doses 12 hours apart. 

[ryan1982]

Thanks @ChessieCat. I actually take my dose at noon. Should I try and split it take it 9 AM and 9 PM instead?  

[ChessieCat]

Well that might explain why the mornings are the worst.  There are several ways you could get your dose 12 hours apart.

 

1/2 dose 30 mins earlier and 1/2 dose 30 mins each day until they are 12 hours apart

 

1/2 dose 1 hour earlier each day + noon until (eg) 8am,  then 1/2 dose (noon dose) 1 hour later  each day until (eg) 8pm

 

alternate between 1/2 dose 1 hour earlier, next day 1/2 dose 1 hour later, and repeat

 

Whichever way you do it I suggest you set an alarm.

 

Please keep daily notes on paper of when you take your doses and when symptoms worsen or lessen.  

 

Keep notes on paper about your drug dosages and daily symptom pattern

 

A symptom pattern that occurs regularly over several days could mean the symptoms are from withdrawal, other adverse effects of drugs, or something else you do on a daily schedule.

 

In the course of discussion in your Introductions forum topic, you may be asked to keep notes on paper of your daily symptom pattern, including when you take your drugs, their dosages, and any symptoms.

 

What we need to see for every individual day over several days is:

- Time and dosage for drugs taken in morning
- Time and description of any symptoms in the morning
 
- Time and dosage for drugs taken in afternoon
- Time and description of any symptoms in the afternoon
 
- Time and dosage for drugs taken in evening
- Time and description of any symptoms in the evening
 
- Time and dosage for drugs taken in middle of the night
- Time and description of any symptoms in the middle of the night (such as waking)
 
And so forth. A diary, in chronological order, such as:
 
6 a.m. Woke and vomited
8 a.m. Took 2.5mg Lexapro
10 a.m. Had diarrhea
10:30 a.m. Ate breakfast
11:35 a.m. Got a headache, lasted one hour
12:35 p.m. Ate lunch
4 p.m. Stomachache
5 p.m. Took 2.5mg Lexapro
6 p.m. Ate dinner
9:20 p.m. Headache
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Headache got worse
10:30 p.m. Fell asleep
2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")
2:45 a.m. Fell asleep
4:30 a.m. Woke with headache

 

An appointments diary is perfect for this and can be bought at stationery stores. 

They have a page for each day with times for appointments which can be filled in with doses, symptoms etc as shown by Alto.

[ryan1982]

Thanks so much- very helpful!

[ryan1982]

I'm doing better.  Excited about that. I've been getting really dizzy and almost nauseous, regardless of when I take my dose.  Any ideas on things that can help with dizziness?  Would an OTC nausea pill help with the dizziness?

[ChessieCat]

Have you started moving your doses to 12 hours apart?

 

It would be better to complete this process and hold for a while instead of introducing anything new into the mix.  If you start something new you will not be able to work out if it is the new thing working/not working or the dose changes.

[ryan1982]

@ChessieCat- I haven’t done that just yet because it doesn’t seem to matter when I take my dose, I always get dizzy. Had a wave of anxiety today. 

[ChessieCat]

The reason for suggesting moving the doses so you take them 12 hours apart is because you may be experiencing interdose withdrawal because of the short half life of Luvox (from wiki:  12–13 hours (single dose), 22 hours (repeated dosing)^[1]).  Taking the dose twice a day would mean that you would have a more constant level of drug in your system.  It may be the interdose withdrawal causing the dizziness and the anxiety.

[ryan1982]

@ChessieCat I'm having intermittent panic attacks and I'm having a lot of trouble working. I have an appointment with a psych tomorrow and I'm considering trying a new med with the intention of eventually weaning off, but going very slow this time.  I would start the new med at the lowest possible dose.  This anxiety is crushing and I can't maintain any semblance of my life like this and I certainly can't lose my job.  Thoughts on that plan?  It's been a week and half since I went back up to 12.5 and I don't feel like I'm stabilizing at all.  

[ryan1982]

Slight edit- it's been 2 weeks tomorrow since I increased my dose to 12.5 MG.  I don't want to jump ship but this last couple weeks has been awful.  

[ryan1982]

I've done some research on SA this afternoon and it sounds like staying the course, not switching meds and breaking my dose up into two equal parts is my best play.  At what point should I consider updosing if 12.5 doesn't control my anxiety?

[ChessieCat]

1 hour ago, ryan1982 said:

I've done some research on SA this afternoon and it sounds like staying the course, not switching meds and breaking my dose up into two equal parts is my best play. 

 

Glad you realised this because you've saved me having to explain it.

 

1 hour ago, ryan1982 said:

At what point should I consider updosing if 12.5 doesn't control my anxiety?

 

One step at a time.  I know you want a solution and answer now, but it is going to take about 1 week to get your doses 12 hours apart.  However, because of the short 1/2 life of Luvox you might start to feel some improvement in a couple of days once your dose is "covering" 24 hours.  Keep notes on paper of your dose times and when symptoms improving/worsening.  After your doses are 12 hours apart it may be better to wait a few more days before even considering increasing your dose.

 

For the time being put increasing to one side and work on splitting your doses.  You may not even have to consider increasing.

[ryan1982]

Thanks @ChessieCat  I’m so appreciative of your support and guidance. 

 

This all all makes sense to me. I’ll start by spacing my dose +/- 1 hour from noon tomorrow. I pray tomorrow is better from and anxiety perspective. I can handle the physical but the mental side effects are downright scary. 

 

God bless. 

RR

[ryan1982]

Rough day today; I almost passed out at work.  It was a crazy feeling but I pulled it together.  I met with my psych this morning and she said to a) space the doses out and if that doesn't work try to then try and go up to 25 MG Luvox and normalize.  As a last resort she said to try 12.5 MG of Zoloft instead.  I know, I know, I know how bad these last two options are but I'm desperate to not get fired.  I literally will not be able to take care of my family if I lose my job.  Part of me wants to suck it up and go back to 25 MG and start over and wean very slowly or switch to Zoloft, hopefully stabilize and wean from there. 

 

Is it normal to start back over?  25 MG worked like a charm mentally for me (not physically) and maybe that's my best play?

[ChessieCat]

4 hours ago, ryan1982 said:

25 MG Luvox

 

much too high a dose to increase to

[ChessieCat]

4 hours ago, ryan1982 said:

I almost passed out at work.

 

Are you breathing?  I don't mean have you stopped breathing but are you breathing normally or shallowly?  I find that when I'm stressed, in pain or concentrating that I don't breathe as deeply as I usually do.  I even hold my breathe when waiting for a program to load on the computer, and some of the computers I use are slow so I find myself all of a sudden taking a huge breath.

 

Are you able to keep your phone in your pocket and set a vibrate reminder every 20 mins to remind you to do some mindfulness.  It doesn't take long.  Just take a few concentrated deep breaths and focus on relaxing and calming yourself.

[ryan1982]

Thanks @ChessieCat  

 

What is the harm in going to 25 MG? It worked for me not 2 months ago. I’m honestly curious because I’m confused about what to do. 

[ChessieCat]

Because your system may have become sensitised.  We have some members here who have increased too much and have never been able to stabilise.  It is better to increase by a small amount if needed than to risk taking too much.  Just because something worked previously doesn't mean it will again.  Some members have had no difficulty going on and off and on and off and on a drug but then find they have difficulty getting off that same drug.  It is because the effect on the CNS is cumulative.

 

You may be believing that there is a "therapeutic dose".

 

On 04/05/2016 at 9:32 AM, Altostrata said:

"Therapeutic dose" means absolutely nothing. It's an arbitrary (random) number from the drug companies.

 

 

Please read through Post #1 of the reinstatement topic.  It is also relevant to updosing.  About reinstating and stabilizing to reduce withdrawal symptoms

 

Here are several points I have quoted from Post #1:

 

On 09/10/2012 at 10:17 AM, Altostrata said:

Experiencing withdrawal may have sensitized you to drugs and a larger dose will cause an adverse reaction.

 

On 09/10/2012 at 10:17 AM, Altostrata said:

These drugs are vastly more powerful than they need to be; often reinstatement at half dosage AT MOST is sufficient and many people do well with a lot less. You want to be taking only the lowest EFFECTIVE dose.

 

On 09/10/2012 at 10:17 AM, Altostrata said:

If you can stabilize on a lower dose, you have less to taper when you finally do go off.

 

[ryan1982]

Thanks for the info @ChessieCat.  I’m trying to gut this out and stabilize. I’m doing my best but it’s really tough- I know I don’t need to to tell you that. 

 

Taking doses at 10AM and 2 PM today. Dizziness is better than yesterday and no anxiety but I feel like I have a new one to me, akathisia. My muscles are quivering and my back is so tight. Is that fairly normal? I stand up at my desk a lot and my legs have felt so weak the past couple weeks that I can’t really do like I used to. 

 

Overall, better day today and I could even handle life like this if I knew I were going to stabilize. I can’t handle 2 more weeks like yesterday...I’ll lose my job and my family deserves better. 

[Altostrata]

ryan, what dosages are you taking in your 2 doses per day?

 

That does not sound like akathisia. What time of day did that symptom occur?

 

Please keep daily notes on paper about your symptoms, when you take your drugs, and their dosages.

[ryan1982]

@Altostrata

Thanks very much. My doses are 6.3 and 6.2 mg to equal my 12.5 mg. Th dizziness hits hardest in the morning where the rest of the symptoms happen when I’ve taken one or both my doses. I almost kind of shake/quake/shiver. It’s a weird sensation and makes my muscles sore. 

[ryan1982]

Will the dizziness ever end after this increase?

[ryan1982]

I saw a psych yesterday and she did push Zoloft on me. Will that be any easier to taper off of than Luvox? This drug and I simply do not get along, even in the best of times. 

[DrugfreeProf]

OMG Ryan, I am just a civilian here, but IMHO switching to new drug like Zoloft, or doubling your Luvox up to the 25 mg you used to be on, are both really bad ideas. Since you have been off the higher dose of 25 mg. for a couple of months,  your brain may be different than it was back then, having gotten used to the lesser dose of Luvox, so that in effect it is not in the same shape as it was two months ago. That means it might react dramatically differently to 25 mg than it did in the past. Trust me, having seen it with my own eyes, it is very risky to mess around with more drugs or new drugs when you are already experiencing bad withdrawal symptoms. As lousy as you feel now, it could make things even worse. I know you feel terrified, but it WILL get better.   Everyone gets better; it just takes time--how much, no one knows, but it could be soon, if you don't mess with the mix.  I suggest you follow the mods' advice and do everything possible to stabilize before making any big drug changes--meaning increasing, decreasing, or changing drugs.

[ChessieCat]

5 hours ago, ryan1982 said:

Will the dizziness ever end after this increase?

 

You are moving the doses to 12 hours apart because it is possible that the dizziness is caused by interdose withdrawal.  You aren't going to know for at least a few more days so you need to be patient.

[ryan1982]

@DrugfreeProf @ChessieCat

Hey guys-

Thank y’all so much. Today my doses are 9 AM and 4 PM. I’m staying solid at 9 AM and will work my way up to 9 PM. Should be there in 6 days. 

 

Funny enough, I’m experiencing a little bit of euphoria and brain fog. I’m holding strong and just want to thank y’all for your support. This is a battle and the lows are so dark and low but I want y’all to know how much I appreciate you. 

 

God bless. 

[ryan1982]

Crazy question- could the drug be causing my dizziness? Is there a chance I’m on too high a dose?

[ryan1982]

Forgot to tell y’all...my psych is convinced because of the is latest wave that I have Generalized Anxiety Disorder. In her opinion, this is breakthrough anxiety and not withdrawals. She says she can end the suffering with Zoloft. So hard to get conflicting advice but I trust those who have lived it. None of us are here for the fun of it. 

[ChessieCat]

4 hours ago, ryan1982 said:

Crazy question- could the drug be causing my dizziness? Is there a chance I’m on too high a dose?

 

Once you have your doses 12 hours apart and have allowed some time to stabilise, by keeping notes you may be able to work out if it is the drug.  Until that time you will just need to be patient.

 

12 minutes ago, ryan1982 said:

She says she can end the suffering with Zoloft.

 

Did you ask for a guarantee in writing?   And a replacement brain if things get worse?   As for adding in another drug, um ... I think you know the response to that 

[ryan1982]

@ChessieCat @Altostrata

Hi there mods,

I do have a question that I’m hoping I can get an answer for. I went to the grocery store today and brain fog kicked in really hard...and that feeds my anxiety. It has me wondering- what if I DO actually have Generalized Anxiety Disorder and actually need medication?  

 

Do I not have any options if I actually need the meds? I have to stay on this med at this dosage rather than increase and I can’t try to treat my anxiety with another medication?  All the info I’ve gotten here is that I’ve rewritten by brain  I’ll be honest, I wouldn’t have started this process if I knew I wouldn’t have any options other than stabilize and suffer. I certainly didn’t like the side effects of Luvox and Lexapro but they were better than this...I’d get back on them in a heartbeat. I feel like I need to go to a mental institution, it’s gotten so bad. 

 

I’m coming up on 3 weeks on 12.5 and almost 12 hours apart with my doses and I’ve been tracking my symptoms on paper. Still struggling a lot. 

 

I know the answer is “be patient” but I’d rather be on meds the rest of my than deal with this. 

 

I’m sorry, I’m just being honest. 

 

God bless you.