Bertie: 8 years on fluoxetine, inc last 2 years trazadone

[Bertie]

Hello,

Recent online articles have brought me to this site, and after reading several topics I now realize that I experienced Withdrawal Syndrome when I tried to quit Fluoxetine a couple of years ago. My doctor and I had accepted at the time that I needed to go back on Fluox for the rest of my life, but now I see that it's possible to slow taper and eventually my body will heal. In a way, it's a relief to know the truth and if I had known then, it may have helped greatly with my anxiety.

 

Here's a short summary of my AD history:

Prescribed 20 mg Fluoxetine in 2011 (age 35) for symptoms of insomnia, depression and anxiety (I always considered insomnia to be the worst symptom, causing the others to rear up)

Quickly tapered off Fluoxetine in spring 0f 2016 at the suggestion of my primary doctor (who was not the original prescribing doctor).

Felt great over the summer, started to feel uneasy in the fall. Reinstated 20mg of Fluoxetine.

Crashed in December, upped Fluoxetine to 40 mg and started 100mg of Trazadone for severe insomnia

Withdrawal continued to be severe in early 2017, but I started seeing a therapist, going to a support group, MIND diet, light exercise, positive cognitive behaviors, etc.

I also accepted the condition I was in and that it would be hard, long work to get better.

Spring of 2017 I started to feel stabilized. A consistent, day-to-day "blah" feeling since then.

This year I decreased the Trazadone to 20 mg with no detriment to my sleep so far. I informed my doctor, and she accepted that but cautioned me not to decrease anything further.

 

I would like to slow taper the Fluoxetine. My to-do list: inform my husband, my doctor (possibly find a specialist), gather supplies for tapering if I have to make my own doses.

 

[Gridley]

Welcome, Bertie.  Yes, it is possible to slow taper and heal.  I'm going to give you several links that will be helpful to you in your upcoming taper.

 

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.

  

Before you begin tapering what you need to know

Why taper by 10% of my dosage?

 

Brain Remodelling

 

The following link gives specific information about tapering fluoxetine.  Basically, to make your own doses you have a choice of using liquid fluoxetine, making your own liquid, cutting and weighing pills or a compounding pharmacy.

 

Tips for tapering off Prozac (fluoxetine)

 

To help you understand the symptoms you are experiencing, here is some information on withdrawal.  The withdrawal time doesn't necessarily correlate with the time you were on the drug.  These drugs alter the architecture of the brain, and the time necessary to heal the brain and return to homeostasis is, unfortunately, impossible to predict.  

 

What is withdrawal syndrome.

 

Glenmullen’s withdrawal symptom list.

 

 The Windows and Waves Pattern of Stabilization

 

When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

 

Youtube video, 4 minutes: Healing from antidepressants

 

Unfortunately, very few doctors know anything about slow tapering or withdrawal.  They will usually suggest a far-too-fast taper.  Here are some tips for taking with your doctor.

 

How do you talk to a doctor about tapering and withdrawal?
 
What should I expect from my doctor about withdrawal symptoms?

 

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.

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.

 

 

 

 

 

 

 

 

[Bertie]

Thank you, Gridley.

 

 

[Bertie]

I was taking the multi-vitamin off and on to treat anemia, but I’m concerned about constipation I’ve been experiencing, so I stopped as of 10/21/18, to see if that will help. I’ve also decided to follow Drs. Phelps and Kelly’s advice for tapering fluoxetine, which is to begin by skipping a daily dose once a week for 6-8 weeks, and monitoring the effects closely (my husband can help me with that and he’s very supportive about this journey, and accepts that the drugs haven’t been  helping.) If I make it 6-8 weeks, I will go on from there, but at some point I imagine that I will switch to microdosing the fluox. So my first skipped dose was 10/21/18.

 

I will separately try the magnesium and fish oil for a few weeks each to see if I can tolerate them.

 

The oral contraceptive (Sprintec) is actually to treat the anemia as well, because otherwise I bleed too much and too often. I realize that my hormones are affected by it, but I feel that I’ll do better if I continue    to stabilize that aspect. Eventually, nature and time will eliminate the need for that... I hope... 🤷🏻‍♀️

 

 

[ChessieCat]

4 hours ago, Bertie said:

skipping a daily dose once a week for 6-8 weeks

 

The brain likes consistency.  Skipping days is NOT recommended, even with a drug which has a long half life, it is better to take the same dose at about the same time EVERY DAY.  Keep it Simple, Slow and Stable

 

It is possible to make your own liquid from Prozac tablets, using water or cranberry juice.

 

This post is by Altostrata, this site's owner, which she made in response to another member who needed to get a 5mg dose of Prozac/fluoxetine:

 

 

[Bertie]

Ok, thanks Chessiecat. I will try the 10% taper from 40 mg daily and see how it goes.

[Bertie]

Just wanted to confirm if this is correct: I should empty a 40mg capsule of fluoxetine into 40ml water, dissolve and then measure the tapered dosage out of the liquid. The first taper of 10% would be 36ml. Correct?

[ChessieCat]

Yes, 40mg in 40mL water means each 1mL liquid = 1mg dose.  40mg x 0.90 = 36mg.  So you can remove and discard 4mL liquid and drink the rest.

 

Remember to do everything the same way and use the same equipment each time.

[Bertie]

Thanks, Chessie!

[Altostrata]

DO NOT SKIP DOSES TO TAPER.

 

I have since informed Dr. Phelps of ways to titrate fluoxetine. Tapers do not have to be dependent on the capsules dosages supplied by the manufacturer.

[Bertie]

Thank you for the clarification, Alto.

 

I'm thinking the Estarylla oral contraceptive may have been causing some anxiety as well, after reading more about it. There is some indication that it may act a "mood stabilizer," which means it's affecting my brain, and I actually have three meds affecting my brain. I'm thinking that I'm stupid-lucky to have dropped from 100mg trazodone to 50mg without experiencing intolerable side effects, but I'm glad to have at least done that.

[Bertie]

Upon further reflection, I’m going to hold off tapering the fluoxetine until January, just to make sure I’m stabilized from the 50% trazodone drop. I remember having dropped it by May 2018, informing my GP at my last exam, but also I went back up to 100mg for a few days in June when I visited NYC and then my mother died. The instructions on the bottle have always said “take 1 or 2 tablets when needed” which misled me, of course.

 

I’ve had some abnormal symptoms since about August, which I didn’t connect to withdrawal at the time, but may be the case. Irritability, headaches, the worst allergies in about 15 years that don’t seem to be abating with cooler weather, as they would normally. I bumped my head hard, and twice within the span of 5 minutes, when putting my daughter’s bike into a storage crawl space, and I’ve never done that before. I’ve also had the feeling of losing time, checking the clock and finding that it’s a couple of hours ahead of what I would have guessed. I wanted to include all of these symptoms in my thread so that I don’t mislead anyone into thinking that Trazodone withdrawal isn’t ocurring. I don’t know for sure, but I’ll wait a couple of months before tapering anything else just In case.

 

Meanwhile, I plan to slowly try magnesium and fish oil to see if they help me at all.

[Bertie]

Added 300 mg DHA-EPA capsules (vegan alternative to fish oil) that I have on hand to my daily meds. It may be a coincidence, but on days that I take it, my sinus headaches don't occur.

[Bertie]

I’m getting over a difficult week; had to take my 80 year old father to a blood draw one day, and doctor appointment the next; the third time this month, probably hundreds of times over the years.  In order to do this I have to get up at 5am and drive my husband to work so that I can have the car for the day, and my sleep is so out of whack. I compensated with too much caffeine and now I can only sleep a couple of hours even with 50 mg Trazodone. Skipping the coffee today, and expecting a big headache. I only have to take my cat to the vet for shots, which itself sucks, but at least I’m able to fulfill these small responsibilities. With lack of sleep I’ve been having some anxiety about my teenage daughter, her safety, emotional well- being, and my ability as a mother - my inadequacies, I feel.

 

Thanksgiving holiday and  visiting siblings loom next week. I have such resentful feelings for my bio family, and always feel like no contact with them would be such a blessed relief, regretting that I never moved far away and am now obligated to take care of my father, who I equally resent. It may be the “thick skin” of Prozac/fluoxetine causing this, yet I feel love toward my husband and daughter and our little family I chose and helped to create. Such a contrast to my painful, anti-social dysfunctional bio family. I just want to spend all my time with my real family, and feel like too many sad years were spent with the other. I literally just say “I’m doing the best I can” when they criticize me or request that I do more.

 

I’ve also missed yoga this week after a tetanus shot on Monday made my arm too sore. Not a good start to the week. But I have time today to try it, so maybe it will help my mood.

[Survivor1]

Hello Bertie,

 

I wanted to connect with you especially as you are a fellow trazodone traveller.  Not many of us out there.  I see that you had make a huge drop in traz. I agree that you should hold before tapering because WD will catch up with you eventually.  

 

The symptoms you mention do seem to square with traz WD, as I have had them too:  allergies, klutzy behavior, etc.  You have a good plan, just keep steady and stability will come.  

 

Take care.

[Bertie]

Thank you for your post, Survivor. It helps to have some confirmation on my hunches.

 

I upped Trazodone back to 100mg in December because at 50mg I began waking up after about 3 or 4 hours every night and wasn’t able to get back to sleep. The 100mg dose helps me stay asleep for 8 hours, even when some little disturbance wakes me up briefly (cat, husband). Then, worried about Serotonin Syndrome, I tapered down to 36mg of Fluoxetine for a few weeks and because that felt very stable, I recently went down to 30mg and I’m feeling even better. I have a feeling that true withdrawal may not happen until I get down to minuscule doses. In anticipation of that I’ll be more strict about 10% tapers and holding for at least a month.

 

 

[Bertie]

It’s been a while... I’ve dutifully reduced Fluoxetine by 10% each month and I’m down to 4mg. It’s been getting tougher starting around 5mg, I have to admit. Not as bad as when I quit cold turkey in 2016 and experienced WS with physical symptoms, extreme anxiety and insomnia. I’ll describe my current state as just “slightly bearable.” I feel a loss of interest in hobbies, entertainment and some days I feel like I have nothing to fill my time. But it helps to push myself to schedule things I’ve been putting off for years, returning to a community college to learn some job skills, a bathroom remodel and other home maintenance projects, simply cleaning and organizing, budgeting, all things I didn’t feel any motivation to do in the past. Using a nutrition app to motivate me to a good diet and exercise. If I don’t have any tasks on the weekend I try to plan a family outing, even just to drive out of the city and walk some trails, even if I don’t really feel like it, but I know the time spent connecting with my family and nature is healing (for all of us). To help with anxiety, I try not to think of the future so much - my daughter will be driving soon and off to college in two years (yikes!) - but focus on one day at a time.
 

I still have issues with sleep and I still use 50mg of Trazodone as a crutch every night. I feel like I couldn’t have reduced Fluoxetine this far without it. It guarantees at least 4- 5 hours of sleep. I typically wake up by 4am; either it’s husband getting up for work (he leaves by 5) or cat drama that wakes me. I try to accept it, and either successfully get back to sleep or give up and read until the sun comes up. I used to take naps last winter but don’t feel a need at the moment. Maybe that’s a seasonal thing. I hope to taper off Trazodone after I’m done with Fluoxetine, and I’ll cross that sleepless bridge when I get to it. 

[Altostrata]

Hello, Bertie. Have you been getting withdrawal symptoms while tapering?

 

If so, we'd advise you to stop tapering -- let your nervous system catch up for a while before you start the last leg down.

 

We definitely do not advise people to soldier on no matter what. You might want to stay at 4mg for some months.

[ChessieCat]

Hi Bertie, great to hear from you.  Thank you for coming back to update us.

 

(Alto just beat me to posting! but I've got some different/extra info.  And I agree with her that a longer hold at this time would be a good idea.)

 

Wow, down to 4mg Prozac.  You've done well.

 

12 minutes ago, Bertie said:

Not as bad as when I quit cold turkey in 2016 and experienced WS with physical symptoms, extreme anxiety and insomnia. I’ll describe my current state as just “slightly bearable.”

 

We have members here who have found that as their dose gets lower then need to go slower, reducing less and/or holding for longer.  It's better to go slower than to go too fast and cause withdrawal.  Some members have tried to go too fast and it has ended up taking them longer than if they had stuck to a nice doable pace.

 

You might consider doing the Brass Monkey Slide which is a gentler tapering method.

[Bertie]

Thank you Alto and Chessie. Yes, with starting classes and a few other major tasks I have to tackle before the end of the year I think it’s a good idea to hold at 4mg. 

[Bertie]

I’m feeling a strong wave right now, to be honest it feels like the beginning of the horrible wave I got 4 years ago when I CT’d fluoxetine. 4 weeks ago I switched from cutting a 10mg fluoxetine tablet down to 4mg by weighing it, to dissolving a 10mg tablet in water and using a syringe to measure out 4mg. And last week I drank way too much alcohol when my husband had a couple of days off work, and after those 2-3 days my emotions started spiraling. Extreme irritability for a couple of days, now it’s awful anxiety. I feel like it’s harder and harder to cope with the stressors in my life. 
 

I don’t even know why I’m sharing this because it’s obvious the drinking was a problem, right? I’ve been ok so far having an occasional beer with food. I just have to will myself to abstain. Hopefully this wave will steady out and not get worse. I’m just really discouraged that my tapering is on hold indefinitely. 

[ChessieCat]

alcohol-and-beer

 

I suggest that you do some of your own research on the internet about:  how alcohol affects the brain

 

https://pubmed.ncbi.nlm.nih.gov/23713737/

 

Quote

Alcohol interacts with the brain receptors, interfering with the communication between nerve cells, and suppressing excitatory nerve pathway activity.

 

[Bertie]

I’ve had severe withdrawal symptoms and insomnia for the past week so I’ve upped my dosage of Fluoxetine from 4mg to 5mg a few days ago. Crossing my fingers that it helps. I feel the same way now that I did 4 years ago after CT’ing off of Fluoxetine, with a similar long time span for the bad symptoms to appear (about 4 months). I don’t plan to taper again for a long time (this has me sufficiently scared), but apparently when I do I will need to have extraordinarily long holds, if I really can’t determine the effect of the cut until about 4 months later. 
 

At least this time I have better knowledge about my situation and some coping skills to deal with this. I certainly won’t be upping my dose to 40mg and kindling, which is what my doctor directed me to do last time. This certainly has a “second time around” feel to it, though. 

 

I also want to deal with the fact that I was self-medicating milder symptoms with alcohol, which obviously came back to bite me. It’s been a discouraging couple of weeks.