Brandon28 13 years on SSRI's/SNRI's CT

[Brandon28]

When I was 15, 2005, I started to have some insomnia and mild depression, it was winter time in Montana so not too much sun, I was diagnosed with SAD. I was started on Lexapro 10 mg and I remember it helped. When summer came around, I think I remember trying to taper off slowly but then having some bad depression. Doctor said I likely had a chemical imbalance and that I would need to stay on the medication for the rest of my life. I was told there weren't long term effects from taking the medication.

 

At some point a few years later, I must have struggled because I was switched to Citalopram 5 mg and after 6 months, went to 10 mg of Citalopram. I don't really remember this point all that well. In 2008 I went on to college and had a successful couple years, grades were good and I had a girlfriend. During the summer I started to experience some major depression and anxiety, I didn't want to get out of bed, I felt scared. After a few days, we decided to go to the doctor and I was switched to Sertraline 50 mg and then a few months later increased to 100 mg. I remained on this dose for almost 7 years.

 

I had graduated college and landed a great job in 2013. I moved away from family for work and when my fiancé finished college in 2014, I moved her down with me, unfortunately, she ended up leaving me suddenly with no warning shortly after and moved away. I was devastated. I remember being hysterical and then very suddenly, felt no emotion at all. At first I was glad that I didn't have to feel the pain, but I didn't feel any joy either. I took two weeks off of work and mainly stayed home alone. The emotions eventually came back and I got better. Since then I have dated a little but nothing serious. I currently live alone

 

In 2017, I started to have some pretty severe depressive episodes, I decided to find a therapist and a psychiatrist and deal with my mental health the 'intelligent' way. Therapy was not too bad, but I really felt like the medication was not working anymore. The psychiatrist decided to start me on bupropion xl 150 mg. I transitioned from Sertraline 100 mg to bupropion xl 300 mg over the course of 2 months. I remember feeling OK, but looking back, I started to feel more and more trapped, afraid of making mistakes, thinking that if I did anything wrong, I was worthless etc.

 

I got my prescription refilled right around Christmas time. I noticed the pills looked different but I wasn't worried about it, I saw it was still the same medication, just a different generic supplier. I started taking that pill Christmas day, within a few days, I started to get very depressed, even though I was working out, eating well and socializing. On that Friday, 5 days later, in the middle of a sprint on my treadmill, I broke down in tears. I was really depressed. I wrote in my journal that night, I was thinking it was all in my head. The next day, I got up early and worked out first thing, I made a list of things to go shopping for and went to the store. I remember taking a long time in the store and feeling very anxious about making the 'wrong' choice on everything. After an hour and a half, I bought what I had and went home. I broke down in tears again. I asked myself what the heck I was thinking about that was making me feel this way. I had been dabbling with journaling and mindfulness. I wrote down a lot of things like "I think I am completely worthless", "I don't know anything", "I'm no good" etc. I wrote down evidence for and against for each item and was able to prove all those negative thoughts false and I felt better. I thought I had found negative core beliefs I held about myself and that challenging them would make me feel better. Unfortunately it didn't turn out that way.

 

The rest of that weekend I was mainly confined to my bed and chair, feeling very anxious and depressed to the extreme. I was talking on the phone with family and my Mom thought the medication wasn't working right. I was thinking it would be weird for the medication to work for months and then suddenly start going haywire. I thought my mood was due to questioning core beliefs I had about myself and my life.

 

After suffering through the New Years weekend and a night of very little sleep, I forced myself to go to work. The morning was awful but as the day went on, I felt better and better. I was able to go and see my psychiatrist that day and explained about the issues and my "mental breakthrough". He was very concerned about my symptoms and prescribed me venlafaxine xr 150 mg and told to switch. As the day went on, I almost felt euphoric. I decided to not switch and just continue the bupropion xl 300 mg. Over the next two weeks, I had some very depressed mornings that lifted to nice afternoons and better evenings. The second weekend, I woke up at 6 am, very anxious and realized something was wrong. I remembered my pills had changed, I researched if people had struggled with supplier changes and found quite a few in fact did. I also found that several years ago, the FDA actually pulled a generic supplier of bupropion off the market due to not being bioequivalent. I was furious. I found a way to report what happened to me to the FDA. I did not take that pill again and switched to the venlafaxine. I took it Sunday, and then Monday but then I thought to myself that I potentially had just gone through cold turkey withdrawal from bupropion and that maybe the worst of it was over. I was thinking maybe I had an opportunity to stay off of antidepressants, so I did not take anymore pills after Monday, January 8th 2018.

 

At some point I found this site, and although it was helpful to find I was not alone, I was also terrified of potentially struggling for multiple years! I started taking fish oil, magnesium, turmeric, COQ10, D3,  a multivitamin and eventually added a probiotic. I have had very little physical symptoms, its been mainly mental and emotional. I have experienced windows and waves daily, with a progression to having a couple good days in a row. During the waves, I am depressed, anxious, and cognitive abilities are reduced, my memory is not great, I can't seem to make decisions as quickly or as easily as I used to and I can't seem to be an active participant in most conversations. During the windows, I feel very good. My brain is firing on all cylinders. I am positive and optimistic about the future, I have confidence and good self esteem. I feel like "I can do this".  Recently though, this past week, I have had more lows and deeper lows (not as low as the first two weeks). I am terrified. I know others have had it worse but I don't know what to do. I exercise almost every day. I have been journaling, praying, meditating, seeing a psychologist weekly, I eat well and I sleep well most of the time. I occasionally wake up around 5 am with some anxiety. I have so far been able to keep working full time. Its been 7 weeks since I stopped medications cold turkey, 9 weeks since my last effective pill, and 6 months since my SSRI.

 

I believe I am definitely low on serotonin from the many years of being on SSRI's. I am struggling pretty bad lately with the depression. I am not getting any joy out of anything. I struggle to get out of bed. I am starting to lose hope that it will get better. The thought has crossed my mind to reinstate a low dose of sertraline, but its been out of my system for 6 months and from reading the forums it seems like it may not work or make things worse. The other thing I think I want to try, even though some have recommended not to, is l-tryptophan. If my thinking is correct, it could really help me. At least provide my body the materials it needs to be able to make serotonin on its own. I wish I would have never taken an antidepressant but I just didn't know and I trusted my doctors. I don't want to make my situation worse, but I don't know If I can keep going the way it is. Please, has anyone had success with l-tryptophan. Has anyone had success re-instating an SSRI after 6 months?

[Gridley]

Hello, Brandon28, and welcome to SA.

 

It is a little unclear from your post at what point you went off which medicine.  To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.

• Any drugs prior to 24 months ago can just be listed with start and stop years. 
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago) 
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016. 
• Please leave out symptoms and diagnoses. 
• A list is easier to understand than one or multiple paragraphs. 
• Link to Account Settings – Create or Edit a signature

At Surviving Antidepressants, it is recommended that a person taper by no more than 10% of their current dose with at least a four week hold in-between decreases.  The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.  Some people may have to taper at a more conservative rate as they are sensitive to even the smallest drops. 
To get you started, and familiarized with the protocols followed by SA, I am linking a few topics so that you have a better understanding of what is recommended here. 

What is Withdrawal Syndrome?
Glenmullen’s withdrawal symptom list.

Why taper by 10% of my dosage?

Brain Remodelling

 

At this time, reinstatement of a very small dose of the original drug is the only known way to help alleviate withdrawal syndrome.  The only other alternative is to try and wait out the symptoms and manage as best you can until your central nervous system returns to homeostasis.  Unfortunately no one can give you an exact timeline as to when you will start feeling better and while some do recover relatively easily, for others it can take many months or longer.  

 

Reinstatement isn't a guarantee of diminished symptoms for everyone but it's the best tactic available.  You're still in the time period where reinstatement predictably works, up to 3 months after last dose.  It is best to reinstate as soon as possible after withdrawal symptoms occur. We usually suggest a much smaller reinstatement dose than your last dose.  Then, once you've stabilized on that dosage, you can begin a 10% per month taper down to zero.   

 

It is best to reinstate within three months after the appearance of withdrawal symptoms.  Unfortunately, I can't tell you your chances of success being six months out.
 

Please read the first few post of this topic on reinstatement.:

About reinstating and stabilizing to reduce withdrawal symptoms.

 

Many members have found relief from the techniques in these two links:

The Dr. Claire Weekes Method of Recovering from a Sensitized Nervous System

Non-drug techniques to cope with emotional symptoms.

 

Regarding the inability to feel joy (anhedonia), this is a common withdrawal symptom.  This post on anhedonia may be helpful:

 

"You can't fight against it.  This is a drug induced sensation that we have no control over.  Trying to fight it or over come it just burns a lot of energy and causes a huge amount of frustration and anxiety because it doesn't help anything.  The emotions, feelings of joy, happiness, love and excitement as well as creativity, ambition and a whole lot more are being chemically suppressed and for the time being are just not accessible. Acceptance of the situation is the best path to follow."  

 

"One thing I did learn was to look for and cherish all the little moments of joy.  They actually are popping up all the time, but are very fleeting and easily overlooked.  When you look at a flower, instead of thinking "darn, I can't enjoy this flower", watch for the momentary little flash of joy that that flower brings when you first see it, and acknowledge it when it happens.  Stop and try to see the beauty in things, even if you don't feel it. "Wow, the sun on those clouds is really pretty, one day soon I will feel it again".  Stop and recognize the joy/wonder in the scene, but let your body react in it's own manner.  This exercise will help reestablish the neural pathways and little by little dig out and strengthen the feelings."

 

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

Magnesium, nature's calcium channel blocker 

Omega-3 fatty acids (fish oil) 

Please research all supplements first and only add in one at a time and at a low dose in case you do experience problems. 

 

Here is a link to a discussion of l-tryptophan.  If you reinstate, it would be inadvisable to take it, as the discussion makes clear.

5-HTP (5-hydroxytryptophan) and l-tryptophan - Symptoms and self ...

This is your introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community. I hope you'll find the information in the SA forums helpful for your situation. I'm sorry that you are in the position that you need the information, but I am glad that you found us.