LS4284: Prozac withdrawal / reinstatement

[LS4284]

Was on Fluoxetine 20mg for stress induced depression at university. Was having severe elevated cortisol response with difficulty making decisions and memory/ concentration issues prior to the drug.  The drug alleviated the stress and possibly allowed time for sufficient neurogenesis to occur. I took the drug for 13 weeks exactly then went cold turkey under the advice of the GP as I felt like I had healed enough and the drug was affecting cognition. 

 

The first 4 weeks were ok with periods of feeling spaced out and difficulty concentrating/ remembering. I then went on to develop daily sedation and periods of not feeling like myself in waves, accompanied by waking early in the mornings. In terms of stress and anxiety I have nothing. I do however feel like things are improving each day. I have currently been off the drug for 7 weeks now. 

 

I understand this is a very short time to be on the drug then come off and has put the CNS into a bit of a whack.

 

My question is, would the best option be to reinstat a low dose say 7.5 then slowly taper from there or wait it out. I'm not so concerned about the acute WD (say months) because I think I can manage how things are at the moment but rather more concerned about long term implications. 

 

Continuing as is or reinstating, will the long term outcomes be similar ? i.e does the reinstatment help to alleviate the sympto

ms of WD then achieve the same Baseline of functioning as enduring the WD of cold turkey??

Many thanks. 

 

Edited February 8, 2019 by ChessieCat
added space

[ChessieCat]

Hi LS and welcome to SA,

 

Not many medical professionals know about tapering and withdrawal which is why this site exists.

 

SA recommends tapering by no more than 10% of the current dose followed by a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.  Why taper by 10% of my dosage?

 

When the drug is taken away too quickly we can get withdrawal symptoms:  Dr Joseph Glenmullen's Withdrawal Symptoms

 

The only known way to reduce withdrawal symptoms is to take the same drug that the brain has adapted to.

It would depend on how much you last took what dose we would suggest reinstating.  Your brain will have already made some adaptations during the 7 weeks you have been off the drug so please do not go back on the last dose you were taking.  It will be too much and can make things worse.  When reinstating a drug we recommend a smaller dose.  Please read Post #1 of this topic:  About reinstating and stabilizing to reduce withdrawal symptoms

 

It is better to start with a small dose and increase if needed than to risk taking too much.  One we have the information we can make a suggestion about the reinstatement dose.  The idea of reinstating isn't to get rid of withdrawal symptoms completely but to bring them to a bearable level.  You will need to stay as calm and patient as possible and try not to panic.  When we panic we can make bad decisions.  Some members have panicked and increased too much and/or increased too soon and made things much worse.

 

This topic has links to Tips for Tapering various drugs and explains how to get the dose you need:  Important topics in the Tapering forum and FAQ

 

Please create your drug signature using the following format.   Keep it simple.  NO diagnoses or symptoms please - thank you.

• details for last 2 years - dates, ALL drugs, doses
• summary for older than 2 years - just years and drug/s

Account Settings – Create or Edit a signature

 

 

I will provide some more information in the next couple of posts.  This is your own introductions topic where your can ask questions about your own situation and journal your progress.

 

[ChessieCat]

Here's some additional information which might help you to understand what is happening:

 

Recovery isn't linear it happens in a Windows and Waves Pattern

 

Withdrawal Normal Description

When we take a psychiatric drug, we are adding chemical/s to the brain.  The brain then has to change to adapt to getting the chemical/s.  It might have to change something to do with A and then once that change has been made it affects B so another change has to be made and so on down the line.  It is a chain reaction, a domino effect.

 

The same thing happens when we take the drug away.  That's why it's possible to experience such a vast array of withdrawal symptoms, and they can change, and be of different intensity.

 

are-we-there-yet-how-long-is-withdrawal-going-to-take

 

These explain it really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

On 8/31/2011 at 5:28 AM, Rhiannon said:

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.

 

AND

 

On 12/4/2015 at 2:41 AM, apace41 said:

Basically- you have a building where the MAJOR steel structures are trying to be rebuilt at different times - ALL while people are coming and going in the building and attempting to work.

It would be like if the World Trade Center Towers hadn't completely fallen - but had crumbled inside in different places.. Imagine if you were trying to rebuild the tower - WHILE people were coming and going and trying to work in the building!  You'd have to set up a temporary elevator - but when you needed to fix part of that area, you'd have to tear down that elevator and set up a temporary elevator somewhere else. And so on. You'd have to build, work around, then tear down, then build again, then work around, then build... ALL while people are coming and going, ALL while the furniture is being replaced, ALL while the walls are getting repainted... ALL while life is going on INSIDE the building. No doubt it would be chaotic. That is EXACTLY what is happening with windows and waves.  The windows are where the body has "got it right" for a day or so - but then the building shifts and the brain works on something else - and it's chaos again while another temporary pathway is set up to reroute function until repairs are made.  

 

[ChessieCat]

During any taper, there will be times of discomfort.  We strongly encourage members to learn and use non drug coping techniques to help get through tough times.

 

Understanding what is happening helps us to not get caught up with the second fear, or fear of the fear.  This happens when we experience sensations in our body and because we don't understand them we are scared of them and then start to panic.

 

This document has a diagram of the body explaining what happens in the body when we become anxious:

 

https://www.getselfhelp.co.uk/docs/AnxietySelfHelp.pdf

 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help ...

 

Audio FEMALE VOICE:  First Aid for Panic (4 minutes)

 

Audio MALE VOICE:  First Aid for Panic (4 minutes)

 

Non-drug techniques to cope

 

dealing-with-emotional-spirals

 

Dr Claire Weekes suffered from anxiety and learned and taught ways of coping.  There are videos available on YouTube.

 

Claire Weekes' Method of Recovering from a Sensitized Nervous System

 

Audio:  How to Recover from Anxiety - Dr Claire Weekes

 

CBT Course:  An Introductory Self-Help Course in Cognitive Behaviour Therapy

 

Resources:  Centre for Clinical Interventions (PDF modules that you can work through, eg:  Depression, Distress Intolerance, Health Anxiety, Low Self-Esteem, Panic Attacks, Perfectionism, Procrastination, Social Anxiety, Worrying)

 

On 4/28/2017 at 4:03 AM, brassmonkey said:

 

AAF: Acknowledge, Accept, Float.  It's what you have to do when nothing else works, and can be a very powerful tool in coping with anxiety.  The neuroemotional anxiety many of us feel during WD is directly caused by the drugs and their chemical reactions in the brain.  Making it so there is nothing we can do about them.  They won't respond to other drugs, relaxation techniques and the like.  They do, however, react very well to being ignored.  That's the concept behind AAF.  Acknowledge, get to know the feeling involved, explore them.  Accept, These feelings are a part of you and they aren't going anywhere fast. Float, let the feeling float off as you get on with your life as best as you can.  It's a well documented fact that the more you feed in to anxiety the worse it gets.  What starts as generalized neuroemotinal anxiety can be easily blown into a full fledged panic attack just by thinking about it.

 

I often liken it to an unwanted house guest.  At first you talk to them, have conversations, communicate with them.  After a while you figure out that they aren't leaving and there is nothing you can do to get rid of them.  So you go on about your day, working around them until they get bored and leave.

 

It can take some practice, but AAF really does work.  I hope you give it a try.

 

 

[Carmie]

Hi LS, 

 

How are you doing?💚