ncst: fluoxetine taper

[ncst]

I’m hoping I can get some assistance or some words of guidance. I had to start taking 20 mg of fluoxetine 2 years ago in my junior year at college. Came out of nowhere and had never experienced it, although I was always an anxious, uptight person. Had to go up to 30, and then went back to 20 and 10. Took the 10 every other day and every third day until I hit zero. I was fine on zero for a month until I started my first real job out of college. I crashed and was forced to go back on 20mg again. My doctor says just take it and don’t experiment, but I want to get off for me. I really just think I was retriggered by a life event. I know there is a never a good time but I wanna do this. I am working and finishing up my masters online, but I was thinking about dropping down to 10mg in a few weeks as spring approaches. Does anyone have anything that can help me make sure this second attempt is a successful one?

[ChessieCat]

Hi ncst and welcome to SA,

 

I am really pleased that you have found SA before you started trying to get off fluoxetine again.  You will understand why when you read the information I provide below.

 

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?  The dose we reduce by gets smaller.  Why taper paper: dose-occupancy curves

 

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

 

Before you begin tapering what you need to know

 

Please note that skipping days is not recommended.  This topic explains how to get the dose you need:  Tips for tapering off Prozac (fluoxetine)

 

Not many medical professionals understand psychiatric drug withdrawal and tapering which is why this site exists.

 

How do you talk to a doctor about tapering and withdrawal?

What should I expect from my doctor about withdrawal symptoms?

 

 

Please create your drug signature.  The preferred format for your drug signature is as follows. 

 

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

as an example:

Drug name:  date, dose; date, dose; date, dose;

 

Account Settings – Create or Edit a signature

 

 

I will provide more information in the following 2 posts.  This is your own introductions topic where your can ask questions about your own situation and journal your progress.

[ChessieCat]

Getting off a psychiatric drug has nothing to do with how strong / determined / disciplined we are as a person.  It has to do with the brain adapting to not getting as much of the drug.  We can only go as quickly as our brain lets us if we are to get off the drug with minimal discomfort.  It is important to listen to your body and your symptoms and to hold for longer and/or reduce less if symptoms become more than minimal.  Withdrawal symptoms mean that your brain is trying to adapt to not getting as much of the drug.

 

Here's some additional information which you might find helpful:

 

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.

 

 

[ChessieCat]

The chemical imbalance is a myth was debunked at least 20 years ago. Again, chemical imbalance is a myth.  Stop the lies, please.

 

I've been tapering my Pristiq following SA's protocol and only experience mild withdrawal symptoms, which do increase at times of stress (good and bad) and sickness.  I was taking 100mg in October 2015 and I'm now down to 4.25mg.

 

As my dose got lower I started to feel like my pre AD self (25 years).  There are links in my drug signature to my story.

Edited February 18, 2019 by ChessieCat

[Carmie]

Hi ncst, 

 

How are you doing?💚