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AbbyElfie

AbbyEffie: 3 months into Prozac withdrawal

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AbbyElfie

Hey everyone,

 

My name is Abby and I have been off Prozac for 3.5 months now. I'm currently experiencing intense withdrawal and the return of mental states I never thought I'd have to experience again, and I would really like to connect with others who are going through similar during this long, difficult process.

 

Background info: I always had tendencies towards anxiety, depression and obsessive compulsive disorder (the Pure-Obsessional variety) since childhood. At 16 these symptoms very rapidly became so severe my whole life fell apart within a matter of days (Going on the contraceptive pill at this time may have been a contributing factor). I didn't have a full breakdown until I was 18, at which point I was taken to the doctor, put on Sertraline, and referred to psychiatry. The following 8 years consisted of several psychiatric admissions, different drugs including clomipramine, seroquel, mirtazipine, prozac, and possibly a few others for shorter periods. I lost pretty much everything, my obsessional fears were so strong that I attempted suicide more than once, developed a bad cocaine/mephadrone habit, was a constant worry to my family. There were times, however, where the medication would help a lot. At 60mg of Prozac I went through some periods of being functional - I went to work, got into a relationship etc. These were a great relief but I can't say I was truly happy as the fears were never properly dealt with.

 

My last hospital admission was in 2014 when I was 24. I had attempted to come off medication as I believed I had to deal with the underlying problems, and I hated the weight gain side effects. Looking back, this was doomed to fail as I was still using cocaine regularly, drinking a lot, and didn't have any proper support mechanisms in place. I was fine for 6 months then crashed, was borderline psychotic with the OCD symptoms, depressed and anxious beyond belief and desperately wanted to die (and believed I deserved to). I was in a psych ward for just over 2 months before new meds kicked in - clompipramine and (randomly, I don't know why) Epilum, as I was told it 'balanced moods'. A year later I went back on to old faithful Prozac and also came off the contraceptive pill. I had always been told the same about it, that it leveled out moods, and don;t think it's a coincidence that my symptoms became much more manageable a few months after stopping it.

 

I then managed to stay at 40mg for 2 years and my life changed drastically for the better. to myself and everyone around me it was like a miraculous recovery - I stopped taking drugs, began volunteering at a Buddhist meditation centre, got my dream job, published a novel, did newspaper interviews about my experiences, ...I pretty much had my dream life. It was like being reborn after thinking everything was all over...forever. It was in January 2017 that I decided to gradually wean off Prozac. Over the following 10 months I reduced until stopping completely in October.

 

In these past 2 years I have done extensive mind training and spiritual exploration, which has probably been the main factor in this recovery. My life is pretty much dedicated to this practice now - I still volunteer at the meditation centre, go on meditation retreats throughout the year, and have also completed a Reiki Mastership. It was always potentially on the cards after exploring my mind with psychedelic drugs in the past, doing past life regressions and also taking Ayahuasca twice in ceremonies. It was around the time of the reiki mastership that I was weaning off the last of the Prozac. Things became challenging - but at first I welcomed it. I was in a strong place mentally, and my mental health hadn't plagued me intensely for a few years. I was made aware that the Reiki energy can churn things up to be healed, but I think that the combination of this, a massive flare up of a back issue that left me not able to walk for weeks, family pressures and intensive mind exploration during retreat that has led me to my current situation.

 

Since December just passed things have been incredibly difficult. I have experienced a return of old OCD obsessions, to the point where I've had panic attacks for days that made my vision blur, heavy depression, crying all the time, existential fears and experiences which medically would look similar to psychosis (although I believe that term can pathologize important and natural inner processes), identity confusion etc. I knew it would be hard, I just never expected to feel this level of horror ever again. Having said that, I know things are different this time round - I have a level of insight gained through spiritual practice that is keeping me going. Energetically, I'm aware that I am creating this reality on various levels, and that I need to relax as much as possible to allow it to pass through the way it's supposed to. I'm no stranger to facing the darkest parts of the psyche, but it's still terrifying and I'm struggling to cope day to day. To make matters worse, my Mum has gone abroad for cancer treatment and I'm now caring for my little brother and sister 4 days a week which is incredibly stressful (I'm used to having my own space and being able to retreat when I need to).

 

My CBT therapist has discharged me as she feels I cannot engage with therapy under this amount of stress, but encouraged me to come back when my Mum gets back. To be fair, she never taught me anything I didn't naturally learn in meditation and I was only seeing her regularly to comply with services. I have however started going for reiki treatments with the person who facilitated the course I was on last year - he is exceptionally intuitive, knowledgeable and takes an all round, individual approach. One session with him last week was worth a year of 'traditional' therapy. So I'm hoping that continuing with this will help.

 

Anyway, sorry for the essay. I don't have many people to talk to about all this. It's also weird for me to ask for help now as I haven't needed it in so long - I'm usually now the one that helps everyone else. It's a scary and heartbreaking thing to go back to a place you thought you'd left long in the past, but I do believe deep down that I have done so in order to face my demons fully and emerge stronger in the long run.

 

Thank you if you made it this far, I'm looking forward to connecting with others on this site. You are all incredibly strong to be doing what you're doing, no matter what stage you're at. Much love x

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Altostrata

Welcome, Abbie.

 

How much Prozac were you taking? How did you go off? Do you have any Prozac left?

 

What are your symptoms? Do they follow any daily pattern?

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AbbyElfie

Hi Altostrata, 

 

Thanks for your reply. I was taking 40mg for two years, then 20mg for around 5 months. The last few months I went from 20mg daily to every other say fairly quickly (around 3 months). Due to lack of info and non compliance with doctors, I wasn't able to get lower doses than that and probably did it too fast looking back. 

 

My symptoms in the last few weeks are intense anxiety, the return of my OCD including obsession all fears, mental checking compulsions, depression, crying a lot, and lots of fear. The kind of fear that really terrifies me, it's like existential, falling into the abyss type panic. I'm wondering if it's too late to try and reinstate at 20mg and reduce much more slowly from there? 

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Altostrata

Even 2mg - 5mg might be sufficient for a reinstatement. If I were you, I would try 2mg Prozac to start and see what that does.

 

This topic explains how to make a liquid from Prozac so you can take a very small amount Tips for tapering off Prozac (fluoxetine)

 

Please let us know how you're doing.

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AbbyElfie

Thank you, I'm glad to hear that as I was thinking a lower dose might be ok to start at. My doctor has agreed to give me it is liquid for so I will be starting from tomorrow. Will definitely keep you updated!

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AbbyElfie

Hi, I'm wondering if someone can advise me on ml doses. I've read a few threads and googled but I have always had a problem with maths (I call it dyslexia, but with numbers lol). I'm confused - I have 70ml of Prozac solution, which it says is 20mg/5ml. If I wanted to start taking 2mg, how much would that be in ml? The syringe takes 5ml with 5 little gaps between each one, I just want to make sure I get the right amount.

 

Many thanks

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brassmonkey

Hi Abby-- dyslexia with numbers is called dyscalculia.  I've suffered with it all my life yet I managed a career as a research engineer, go figure.  Anyway to answer your question you want to take .5ml to get a dose of 2mgai. (mg active ingredient)

 

Strength of medication as stated on bottle 20mgai per 5ml

20mgai divided by 5ml = 4mgai.  This means that for every 1ml of liquid there will be 4mgai of active ingredient. This is referred to as the Active Ingredient Concentration and is very helpful with figuring out future doses.  But it only applies to bottles that are marked  20mg/5ml

You are looking for a dose of 2mgai which is half of 4mgai, so you would take half of 1ml. On your syringe that would be two and a half gaps.

 

Hope that helps.

 

Brassmonkey

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AbbyElfie

brassmonkey - I can't believe it has a name! I always wondered why I was so good with words yet struggled with basics maths haha.

 

Thank you so much for the info, that makes it really straight forward. Will take this dose tonight :)

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AbbyElfie

Hey,

 

I thought I'd give an update on things and also provide some information that might be relevant for future advice!

 

I have reinstated Prozac at 2mg as of three days ago. On Monday and Tuesday I experienced one of the worst things...well, ever lol. It began with some stuff that triggered stress, then the OCD fears became suddenly very real and terrifying, followed by a panic attack the next morning (I never usually get full blown ones like that, more like serious anxiety attacks) where I hyperventilated and was so utterly depressed and despairing I cried non stop all day. Weirdly, by the evening, things lifted. Or else I was so traumatized that I went numb or went into shock. The 2 days since I have still had anxiety and some depression but I have been able to use my meditation techniques and some other practices to distance myself from it, and actually do things around the house, babysit, laugh at funny videos etc. These immense swings in mood are extreme beyond words, yet they don't last more than a few days. This time it was only really a day. I can't get my head around it and don't intend to try.

 

I also remembered that when I first stopped the Prozac completely in October, I then suffered a serious back problem which left me unable to walk for weeks. It was really intense, I thought I might not walk again, and had just come off a meditation retreat which left me in an existential crisis (normal for me after retreat, but made worse by my back injury).

I also was completing my Reiki Master level at this point, which churned things up psychologically and spiritually, as expected. On top of all this, I then developed horrific fever, then Bronchitis just after the Master level attunement (sickness is quite common as the body is clearing out old energy), which lasted for a couple of weeks. I experienced brain zaps when I was sick too, which I hadn't had at all up to that point.

 

So looking back, all of this probably contributed to the intense emotional symptoms that were to come later. Despite how tough those months were, they were nothing compared to the recent stuff and the return of the OCD fears.

 

It also might be helpful to state for others who may be on some form of contraception that when I was 16, my OCD tendencies turned into full blown severe mental illness a few months after going on the pill. I stayed on it for 10 years as I was always told it leveled out moods, only to come off it 2.5years ago and have pretty much most of my symptoms disappear. (That is one of the reasons I felt I was now able to come off Prozac). There is a large body of growing evidence to suggest that the pill can cause serious mental illness in women - so this might be something to consider.

 

I have now looked at the (super helpful) tapering calculator thread and taken note of the 10% reductions down from 2mg. Of course, I'm going to stabilize on this for around 6 weeks at least before I begin to taper further, but I'm wondering if anyone could advise me on a couple things:

 

1) Is there an easy way of figuring out what all the mg doses are in milliliters online? There's an awful lot of decimal points and about 28 different doses, which brings me to my next question...

2) It says on the calculator that it is ok to round up the decimal points if you can't get an accurate amount (in a syringe, for example). Does this mean I could reduce the number of tapers, or do I have to stay at each one for 4-6 weeks? For example, there's 0.6974, then 0.6276, then 0.5649, 0.5084 etc. Do I need to stay at each of those doses for the stabilizing period or is it ok to try going from 0.6 to 0.5, to 0.4 etc and see how I feel?

 

Many thanks! x

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AbbyElfie

Anybody?

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brassmonkey

Hi Abby-- as far as I know there is not an online calculator to translate mg into ml.  It sounds like a job for our spreadsheet wizards.  A big problem is that there is no universal conversion as each liquid medication is sold at a different concentration.  On the bottle it will state something like 20mg per 5ml.  From that you can calculate the volume of what ever dose you need.

 

Rounding the strength of a dose is only used to make the dose size more manageable when you measure them out.  It does not mean that you can reduce the number of tapers and you do have to stay at each level for the suggested 4-6 weeks.  With the numbers that you posted above it is very important have the unit of measurement associated with them and if you are talking about the weight of the active ingredient or the weight of the powdered (crushed) tablet.  The weight of the active ingredient is expressed as mgai while the weight of the powder is referred to as mgpw.

 

Brassmonkey

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AbbyElfie

Thank you brassmonkey. I'll be continuing to get the 20mg per 5ml bottles of liquid fluoxetine. I've done the taper calculator, 2mg down to 0.1mg and there's 29 tapers, which would be just over two years if I did one a month. More if I do 6 week tapers/stabilize etc. Is that right?

I can also figure out the ml values given the example you gave previously. One other thing I'm wondering...given Prozac's long half life, I usually only experience symptoms 3 or 4 months down the line. Do you think this will affect tapers and should they be done more slowly? After 6 weeks of a drop I don't think I'd be having much withdrawal given past experience, so I'm not sure if it's wise to then continue to drop every 4 to 6 weeks if I feel ok. Again, apologies for all the questions. If this is something that should be asked in another part of the site please let me know.

 

Many thanks x

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AbbyElfie

Also, on the tapering schedule, once the doses get down to below 1mg a few of them round up to the same amount. For eg. 0.4 and 0.5 for several different 'drops', I don't think I could get the specifics accurate on the syringe if it's say, 0.487 and the next one is 0.468?) Would I hold longer at this point? Is rounding up to one decimal point too much?

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brassmonkey

Hi Abby-- it's disconcerting just how long a taper will take once you crunch the numbers. Two years sound about right though.  With your past tapers you were going very fast and skipping doses, that would account for the problems you were having several months down the road.  With a slow taper in small changes your body will have more time to adapt and there should not be the build up of symptoms that would result in a crash. 

 

The official stance for SA is that 4 weeks in the minimum time to old between drops, my personal findings is that 6 weeks works a lot better for most people. The key is to not rely on a set schedule, but rather to listen to your body and see how you are feeling at the end of each time period and adjust accordingly. Just don't go faster than the 4 weeks.

 

When using the liquid it is possible to refine a dose to a ridiculously small amount.  Syringes are made in such a way that they can be controlled to make a single drop of liquid that is consistent in volume.  By using one drop and controlling the dilution of the liquid in theory you can get a dose of 0.0001mgai or smaller. So rounding at the smaller doses isn't really a factor, it all comes down to syringe control and the amount of active ingredient in one drop of liquid.  Rounding is more frequently used when working with scales and powdered tablets because you have to work with in the limitations of the scales. It can get very fiddly but once you have figured out the dilution of the liquid and how to work with various syringes it's possible to hit almost any dose size you're looking for.

 

Please ask all the question you need to in order to feel comfortable with what you're doing.  We fully understand the consequences of misjudging something and really want to help you avoid them. I have been told many times by many different professors "the only stupid question is the one that doesn't get asked".

 

Brassmonkey

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AbbyElfie

Thank you! That's really helpful. I think I might get a better syringe, the little one from the chemist is OK but I'm sure there's better ones for more accuracy. Two years isn't that bad if it means doing it right, with as little impact on the CNS as possible. I'm going to listen to my body and see how it goes, maybe holding at six weeks now and then to stabilize. I'll have to make up a table with dates and dosages so I don't get confused! 

 

Will update on progress with the aim of coming back with a success story. I've already recovered pretty quickly from that horrible wobble last week, the 2mg dose is working well and haven't had any major issues since. My aim these next few weeks is to focus on healthy activities and not withdrawal or symptoms etc. Have a great week, and thanks again for the info 😊 

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Altostrata

Hello, Abby. How are you doing?

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AbbyElfie

Hi @Altostrata , thanks for asking. I was doing better with the small reinstatement, but then I reduced from 2mg to 1.8mg at end of Feb (ish). I now believe this was way too soon. I drank alcohol once in March (2-3 drinks), had a severe reaction and ended up extremely mentally and physically ill for around three weeks. It turns out I'm now intolerant to EVERYTHING. I had tests done and had to completely overhall my diet...my liver wasn't functioning well, my gut was imbalanced and my adrenal glands exhausted.

 

The diet overall made me feel better within a week. I cut out sugar, dairy, all grains. And also began supplements. The difference has been huge, the brain fog cleared within about five days, and my energy increased. I no longer have any physical symptoms from withdrawal.

 

However, in May, I had a few days where I had planned to go away and didn't completely stick to my diet just before leaving. This coincided with the three month mark of my last reduction (I always seem to feel the effects of reduction almost exactly three months after). I still don't know what happened exactly, it's all kind of blurry. But my OCD obsessions suddenly became borderline psychotic. I was convinced I was a sociopath and damned, that I was in hell and rotating round rapidly being tortured. I broke down completley like nothing ever before (and I've had four hospital admissions from past breakdowns). Even those who are against medication (i.e., my reiki teacher) suggested I needed to reinstate asap. Doctors were useless, told me I needed to be on a therapeutic dose of 20mg or above. I ended up reinstating at 5mg. I was vibrating from the inside, panic and terror so extreme I could barely breathe. I would get stuck in this cognitive 'loop' all day, with brief breaks where I suddenly thought I was ok and would try and do simple things like errands or work. The  suddenly it would happen again half an hour later and I'd have to just collapse or lie down. The panic attack I had at the doctors was so severe I wouldn't even call it a panic attack, it was a complete breaking apart of my soul.

 

I felt as though I saw the deep roots of myself at their core, and could not handle it. There was no way out, and for a long time I believed I was completely, permanently broken. I still don't know how I'm functioning given what I saw/felt during this experience. I did a lot of inner 'work' in the years running up to withdrawal, so I know this has had an impact. I'm finally dealing with trauma etc. and in doing so, I've realised the main issue is that I've never had a stable sense of self. Which can be dangerous. I've seen it, and it's not something that will heal quickly, or even in this lifetime. But at least I've seen what 'it' is.

 

Things did balance out, however. The extremes of my 'waves' are crazy fast. I have always had a tendency for extremes, however, and crave balance now. I saw a shaman a month ago and have been incredibly ok since then. He went into trance and saw my mind and what was going on - the accuracy with which he described it almost made me cry. He did a lot of energy clearing and, although I didn't expect anything to help at this point, I've not had an episode since. I've moved house into a nicer place. There is lingering low mood and irritability under stress, as well as my normal OCD, but nothing compared to before. I must have also balanced out well on the 5mg. I plan to hold at this for at least 6 months. I feel like there are way more issues to work through than I realised and this is going to be years, perhaps a lifelong, thing. My father and brother both took their own lives after coming off medication. I've got to stop the cycle of suicide in our family, it's not an option for me. I'm 28, and they both died around a similar age so that may be something I'm aware of unconsciously too. There was absolutely zero choice in reinstatement, I wouldn't have survived otherwise.

 

Weirdly, despite all this, I am incredibly grateful. Withdrawal has taught me so much, it's stripped away so much crap that I have no choice but to really look at myself. Not many get that opportunity. So as of now, I'm taking each day as it comes. Decorating my new house, writing, cooking etc. When the time is right I will taper very slowly again. I can attest that without huge changes in my diet, I would be in a much worse place. Once I accepted that life never promised to bring me happiness, I kind of accepted where I was at more. I believe you have to give up who you 'were' if you want to recover and go through a rebirth of sorts.

 

Thanks for your concern, I hope all's well with you.

 

I try to stay off the forum unless I'm updating, as when I'm super sensitive to everything it's so easy to pick up on all the suffering and symptoms. So I will be back to update in the next month or so :)

 

Much love x

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Altostrata

Good to hear you've found ways to manage some of your symptoms and learn from this experience.

 

Please do tell us how you're doing, and when you're ready to taper again.

 

Please update your signature.

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AbbyElfie

Hi guys,

 

I'm going to try and update here more, as an online journal of sorts. It's been around 6 weeks since one of the most horrific experiences of my life with withdrawal, and since I reinstated from 1.8mg of Prozac to 5mg. For about 5 of those weeks I've been pretty good, which is nothing short of a miracle. There's been tough moments, but they passed very quickly and I experienced hope, peace, even joy. A few days ago I went on a camping trip, which may have been a bit much to take on right now. I'm still aware of how sensitive I am, and the OCD obsessions and depression are still there to varying degrees. That first night I experienced a really awful episode, and spent a lot of the time hiding in the tent crying, obsessing etc. Just total grief and despair. It felt like the end of the world (again lol).

 

Three days later and I had a pretty good day. I did normal stuff and managed to enjoy things. It's crazy how fast things change, I've always been prone to being changeable and have mood swings, but this is another level. I'm sure if I went to the psychiatrist now they'd diagnose me with bipolar or BPD, as I have all the hallmark symptoms.

 

The thing that I am most conflicted about is knowing how much is withdrawal, my natural state, or a process of healing. After years of severe OCD and hospitalisations over terrifying irrational fears.intrusive thoughts, I stopped taking the contraceptive pill, balanced out on 40mg Prozac, and made many lifestyle changes. I began looking more deeply within myself and begin healing, found Buddhist meditation, and spent 2 years having what I would consider my 'best life'. I had great friends, a great job, and was experiencing incredible peace and transformation internally through spiritual practice. My life really was blissful. After the initial high, however, I began reducing the medication at the same time as going deeper with my meditation practice at retreats etc. I knew I had to deal with my 'shadow' self and had been, for the most part, enjoying seeing my life in new ways and dealing with all the false beliefs I'd built up. Going deeper into my mind, more and more 'stuff' came up, I had some trippy and difficult experiences, which have evolved to full blown spiritual crisis during withdrawal. I often feel like I looked into this idea of 'self' and uncovered nothing but fragments, repressed trauma, fear of damnation and truths that were just too painful. I know that withdrawal has immensely affected this process, but it's hard to know where to draw the line between spiritual crisis and chemical imbalance. Especially since I have always had an over-analytical, OCD mind that skews everything, including turning the idea of 'enlightenment' into an obsession too.

 

I wonder if anyone else here had begun the process of exploring a spiritual path prior to or during withdrawal? I'm sure there is, and I'd love to hear about your experience.

 

It turns out my ego is much bigger than I first believed. For the past 9 months or so I have had to face the darkest corners of my mind - my narcissism, my manipulation of things, my neediness, my anger and deep fear. But my mind is automatically in a certain mode having become more aware through meditation. Instead of my usual past coping mechanisms (drugs, drink, people, self destruction), I instinctively don't run to external stuff as much because I know I need to face things. This is great in that I'm healthier, but it's also much more terrifying. Especially as, in the throws of a withdrawal wave, it's almost impossible to do any real 'healing' work, you just have to survive it whatever way you can.

 

Anyway, that's sort of where I'm at right now. As horrendous as the (almost) year has been, I'm sort of getting more used to the waves. One thing I do know is that they change so fast, and they're teaching me to surrender everything I thought I knew, which is the only way to be truly reborn. Whether that's in this life, I don't know. I plan on staying at the 5mg and reevaluating at Christmas, so I can see how much I can stabilize. Trying to reduce now would or even in the next few months would be a suicidal move I think, I'm trying to learn from the last times I reduced too fast.

 

Wishing you all the love and light you need to see you through this.

 

Abby x

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Tarheel109
7 hours ago, AbbyElfie said:

Instead of my usual past coping mechanisms (drugs, drink, people, self destruction), I instinctively don't run to external stuff as much because I know I need to face things. This is great in that I'm healthier, but it's also much more terrifying. Especially as, in the throws of a withdrawal wave, it's almost impossible to do any real 'healing' work, you just have to survive it whatever way you can.

 

This is truly poignant. Facing the world without the mask of ADs definitely scares me. I’m really impressed with your outlook.

 

Thank you for sharing your journey!

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AbbyElfie

Thanks Tarheel109, happy to share. That has always been the scariest part for me...what if this is just me without meds? etc. Hope you're doing ok.

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