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How to talk to a doctor about tapering and withdrawal? What to expect.


Altostrata

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ADMIN NOTE You might want to talk with your doctor about your withdrawal experience, but do not expect validation from your doctors. 

 

You may wish to take or send the following papers to your doctor. All may be downloaded at the links.

 

Horowitz, M. A., & Taylor, D. (2019). Tapering of SSRI treatment to mitigate withdrawal symptoms. The Lancet Psychiatry, 6(6), 538–546. https://doi.org/10.1016/S2215-0366(19)30032-X full text https://markhorowitz.org/academic-papers/

 

Royal College of Psychiatrists. (2020). Stopping antidepressants. Royal Colllege of Psychiatrists (UK). 
 
Hengartner, M. P., Schulthess, L., Sorensen, A., & Framer, A. (2020). Protracted withdrawal syndrome after stopping antidepressants: A descriptive quantitative analysis of consumer narratives from a large internet forum. Therapeutic Advances in Psychopharmacology. https://doi.org/10.1177/2045125320980573

 

Framer, A. (2021). What I have learnt from helping thousands of people to taper off antidepressants and other psychotropic medications. Therapeutic Advances in Psychopharmacology. https://doi.org/10.1177/2045125321991274
 
Palmer, Emilia G., Sornalingam, Sornalingam, Page, Lisa, Cooper, Maxwell. (2023). Withdrawing from SSRI antidepressants: advice for primary care. British Journal of General Practice. Full text: Withdrawing from SSRI antidepressants: advice for primary care.

 

Background of the UK's "Stopping antidepressants" leaflet:

  

On 9/28/2020 at 6:53 PM, Shep said:

 

From CEPUK, 9/24/2020:

 

Major milestone: Royal College releases new guidance on stopping antidepressants

 

And here is the leaflet from Royal College of Psychiatry website: 

 

Stopping antidepressants

 

Might be useful to print out and take to doctors ignorant of withdrawal. May also be helpful for helping family members understand. 

 

 

 

You can mention the following new DSM-5 diagnosis code.  See this link for further information:

 

On 9/8/2018 at 6:17 PM, Altostrata said:

 

Antidepressant Discontinuation Syndrome DSM-5 995.29 (T43.205A)
Initial encounter 995.29 (T43.205A)
Subsequent encounter 995.29 (T43.205D)
Sequelae 995.29 (T43.205S)
 

Antidepressant discontinuation syndrome is a set of symptoms that can occur after an abrupt cessation (or marked reduction in dose) of an antidepressant medication that was taken continuously for at least 1 month. Symptoms generally begin within 2-4 days and typically include specific sensory, somatic, and cognitive-emotional manifestations. Frequently reported sensory and somatic symptoms include flashes of lights, "electric shock" sensations, nausea, and hyperresponsivity to noises or lights. Nonspecific anxiety and feelings of dread may also be reported. Symptoms are alleviated by restarting the same medication or starting a different medication that has a similar mechanism of action - for example, discontinuation symptoms after withdrawal from a serotonin-norepinephrine reuptake inhibitor may be alleviated by starting a tricyclic antidepressant. To qualify as antidepressant discontinuation syndrome, the symptoms should not have been present before the antidepressant dosage was reduced and are not better explained by another mental disorder (e.g., manic or hypomanic episode, substance intoxication, substance withdrawal, somatic symptom disorder).

 


 

Doctors are unaware of how bad withdrawal syndromes can be. Doctors who understand psychiatric drug withdrawal syndromes are few and far between, even among psychiatrists.

 

Myths about withdrawal symptoms you might hear from your doctor

  • "You'll get over it."
    Doctors tend to believe that all withdrawal symptoms are trivial and transitory and will tell you to just wait and they'll go away. This is not true.

    Withdrawal symptoms of any type show your nervous system is in distress. If they go on for any length of time, they cause neurological dysregulation -- neurological damage that can last many months. There's no way to fix this, your nervous system will need to repair itself over time.

    If you are suffering from significant withdrawal symptoms, the official advice included in most antidepressant drug package inserts is to to reinstate a partial dose of the medication and taper more slowly.

    If you are in the midst of tapering and you get withdrawal symptoms that last more than a couple of days, you're reducing too fast. (NEVER alternate doses to taper.) Increase your dosage a bit, wait until symptoms pass, and then reduce in smaller amounts at a slower rate. Some people can reduce by only a fraction of a milligram per month.

    You have significant withdrawal symptoms that need attention if any of these apply:
    • You immediately suffer severe symptoms while reducing or after quitting.
    • Your symptoms increase over a week or two.
    • Your symptoms don't decrease over a couple of weeks.
    • You find your symptoms interfere with your daily functioning.
    • You experience brain zaps, insomnia, depersonalization, mania, hypomania, or unusually dire thoughts.

 

  • "What you're experiencing is relapse."
    Many doctors do not know about withdrawal symptoms at all, call whatever you're experiencing "relapse," tell you it's evidence you will need to be on an antidepressant permanently, and prescribe some other antidepressant that's struck their fancy. Those antidepressants will themselves incur dependency.

    A second antidepressant may not resolve your withdrawal symptoms. You can have withdrawal symptoms from one drug while you're taking another.

    If after quitting, you get symptoms you've never felt before ("I don't feel like me") or they're more intense than anything you've felt before ("I can't seem to get out of this fog"), it's likely you have withdrawal symptoms.

    Not all withdrawal symptoms happen immediately after you discontinue the drug. They can become evident weeks later. It can take the nervous system some time to lose normal regulatory function.

 

  • "You have bipolar disorder."
    Possibly under influence of the drug companies to deny the difficulty of withdrawal, some psychiatrists have applied a convoluted, misguided logic to explain antidepressant withdrawal syndrome, calling it an "unmasking" of bipolar disorder.

    Withdrawal symptoms are not bipolar disorder of any variety, not bipolar II, bipolar III, or bipolar R2D2. See Disease Mongering in a Top Psychiatry Journal by Dr. David M. Allen:
     
    Quote

    23.2 percent of their subjects who had experienced episodes of elevated or irritable mood triggered by antidepressants were also defined as bipolar. This is almost comical. Irritibility is a common side effect of drugs like prozac and has absolutely nothing to do with bipolar disorder....


    and his article Bipolar or Borderline? A rampant case of diagnonsense

    Agitation, akathisia, insomnia, mania, hypomania etc. that you've never had before are well-known withdrawal symptoms that your doctor may attribute to bipolar disorder. This is incorrect. They are adverse effects of medication.

    Withdrawal symptoms come in waves, usually several times a day but possibly lasting several days. A misinformed doctor might call this "bipolar cycling."

    If your doctor diagnoses your withdrawal symptoms as bipolar disorder (or another severe psychiatric disorder), most likely the prescription with be for an atypical antipsychotic (Zyprexa, Abilify, Seroquel). These drugs do not resolve withdrawal syndrome, have serious side effects, and over time cause a degradation in general health (stroke, cardiac problems, diabetes).

 

  • "A benzo will cure your symptoms."
    Some doctors will prescribe a benzodiazepine for withdrawal symptoms. This poses its own problems as, used frequently, benzos incur dependencies of their own and also need careful tapering.

    Benzos are technically addictive. Often Klonopin (clonazepam) is the prescribed benzo, and is very, very difficult to quit should you become dependent on it.

    Another medical myth is that some benzos are less addictive than others. This is not true. Addiction cannot be predicted on an individual basis. You can become addicted very quickly to any benzo. It's the luck of the draw.

    A benzo may indeed help with some withdrawal symptoms, but only while you're taking the benzo. Since withdrawal symptoms tend to resolve over time (sometimes many months), the benzo is a baby sitter for your nervous system while it does the job of recovery.

    And then you'll have to taper off the benzo, which may take quite a while itself, and may cause similar withdrawal symptoms.

 

  • "There are supplements to fix withdrawal symptoms."

  • No supplement can compensate for a too-fast taper.

    It's always best to control the taper rather than assume you can fix withdrawal symptoms with a supplement or other treatment. Psychiatric medications are much stronger than any supplement, and the neurological damage of withdrawal is something you want definitely want to avoid.

    While fish oil, magnesium, and some other supplements might improve general health and reduce the intensity of symptoms for some people, only time can cure withdrawal symptoms.

 

What should I ask from my doctor?
Tapering off the original medication is preferable to adding any new drug that may cause dependency. You'll want help from your doctor in writing prescriptions to support your taper, or your taking very low doses that will not cause kindling in a nervous system made hypersensitive by drug adverse events.

Go to a doctor with whom you can communicate. Any MD can write a prescription for a psychiatric drug. As calmly as possible, explain you've gone off your medication too fast and you have withdrawal symptoms.

 

When working with doctors, you'll have to be very definite that you are hypersensitive to drugs and want to work with only very small dosages, probably in liquid form. Most will start talking about therapeutic dose blah blah blah. This is not relevant to tapering. If you can't get them to grasp your request, just request they order a prescription liquid or compounded liquid (if you can afford it) so you can "gradually titrate dosage" to a therapeutic level.

 

If prescription or compounded liquid is not available, requesting the lowest dose tablet or capsule "to start" will enable you to split tablets or make your own liquid in order to take a very small dose. (You cannot make a liquid from extended-release drugs and splitting XR tablets will make them into immediate-release. Capsules of venlafaxine XR and duloxetine contain tiny beads you may count out for tapering. For tips on tapering your drug, see Important Topics in the Tapering Forum and FAQ)


If at all possible, do one of the following:

  • Get a prescription for the liquid form of the medication (if it is available) so you can taper or reinstate at a partial dose, stabilize for a few weeks, and taper more slowly.
  • If the liquid form of the medication is not available, get a prescription for a liquid made by a compounding pharmacy. This may be more expensive, check with a compounding pharmacy first to see if the liquid can be made up, how much it will cost, and if your insurance covers it. If your insurance does not cover it, it may be worth it to you to pay out of pocket for a compounded liquid. Most likely, as you taper, a bottle of liquid will last you more than a month.

    (Extended-release medications such as Effexor XR, Cymbalta, and Pristiq cannot be made into liquids.)
  • Get a prescription for a low dose of the medication, preferably in tablets. You can cut up most tablets. (When split, extended-release tablets revert to immediate-release and may need to be dosed more than once a day.)
  • For tips on tapering your drug, see Important Topics in the Tapering Forum and FAQ)

 

_______

How to tell if a doctor is knowledgeable about tapering and withdrawal symptoms

 

Edited by Shep
Added link - Withdrawing from SSRI antidepressants. . .

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Unless you are a patient who has a physician who truly understand WD, don't have expectations.

 

Just keeping looking for a doctor who 'gets it". Some of them do.

Intro: http://survivingantidepressants.org/index.php?/topic/1902-nikki-hi-my-rundown-with-ads/

 

Paxil 1997-2004

Crossed over to Lexapro Paxil not available

at Pharmacies GSK halted deliveries

Lexapro 40mgs

Lexapro taper (2years)

Imipramine

Imipramine and Celexa

Now Nefazadone/Imipramine 50mgs. each

45mgs. Serzone  50mgs. Imipramine

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And if you find a doctor who "gets it," please let us know!

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • 10 months later...

 

Useful Excerpts from a previous thread

 

Alto

 

When speaking to a doctor, do not yell, scream, beg, cry, whimper, or weep. It confuses them and they start thinking of psychiatric drugs to give you. 

 

Speak clearly, firmly, and insistently -- but politely. Make a specific "request" that is actually a direction.

 

On 6/14/2018 at 12:53 PM, Altostrata said:

Like other people, some doctors, are resistant to learning new things. If your doctor or psychiatrist absolutely refuses to assist you in tapering, and you cannot get prescriptions from anyone else but this doctor, you might stop talking about tapering during your visits and report you're doing fine on the dose you're taking. See Important topics in the Tapering forum and FAQ for information about how to taper specific drugs.

 

Rhi 
There are a few tricks that I've found that sometimes help when dealing with doctors.

 

One is, instead of saying "I want off my meds" say "I want to see how I do at a lower dose." Because all doctors know that the lowest effective dose is what you want to shoot for. So "let's find out my lowest effective dose" doesn't set off their alarms as much as "I want to stop taking the drug."

 

Also, they believe these drugs actually are beneficial, and you can use that. Maybe your doc will continue to give you prescriptions and not rush you so much if you say, “Hm, I want to see how I do staying on this dose for a while. I sure don't want that doggone depression to come back, so I want to just hold here for a while and make sure it doesn't come back because golly gee willikers, maybe this drug is good for me.” (At the lowest possible effective dose.)

 

You know, basically, just kind of speak their language so you can get them to give you what you need to do the taper at a speed that works for you. Having that pressure of "I have to get off before I run out" usually leads to trouble, and/or disaster, for people. Much better to have the freedom to taper at the pace your body is telling you is right for you.

 

 

Alto

 

Take the official instructions from the drug package insert to your doctor.

Jump to this post on the Patient Package Insert here

^ How to find the information.

Also drug package information can now be found online .  Guidelines and instructions  to getting the Patient Package Insert(PPI) information, online are here. 

FDA Learn About Your Medicines.

Scroll about 1/2 way down the article for instructions, and then go to Drugs@ FDA to get the PPI .  The FDA article will link you there too!

Or just google your med and Patient Package Information.

 


 

This site is so full of information and clinical studies. I read quite a few in the journals section, but none really acknowledge withdrawal syndrome and the fact that it can last past the 2 weeks commonly believed by most psychiatrists.  Including mine, who recently told me that withdrawal lasts 7-16 days and after that it's considered a recurrence.

 

How do I educate my psychiatrist without her being offended or dismissing this information.  What would be the most helpful studies, write ups from this site or elsewhere to print out and give to her?

 

I'm overwhelmed by all this information and all this reading.  It would be helpful if there was a topic that compiled the most recent studies or links that would be the most effective in getting her over to my side?

 

It's hard enough to deal with reality while going through withdrawal and/or severe depression, than to also have to fight your own doctor and their pharmaceutical brainwashed beliefs.

 

I just don't have the energy to keep searching and reading over and over, wondering if an article is credible enough for my psych to consider it.

 

Is there proof of withdrawal syndrome? And what is the best literature on that?

 

The same with taperin.  Psychiatrists idea of tapering is pretty ridiculous.  Out of all the topics an studies on this site, what would be the most helpful one to give to my doc?

Thanks!

 

Edited by manymoretodays
duplicate info removed, new links added, spelling, removed content no longer available box

2005-2008: Effexor; 1/2008 Tapered 3 months, then quit. 7/2008-2009 Reinstated Effexor (crying spells at start of new job.)
2009-3/2013: Switched to Pristiq 50 mg then 100 mg
3/2013: Switched to Lexapro 10mg. Cut down to 5 mg. CT for 2 weeks then reinstated for 6 weeks
8/2013-8/2014: Tapering Lexapro (Lots of withdrawal symptoms)
11/2014 -8/2015: Developed severe insomnia and uncontrollable daily crying spells
12/2014-6/2015: Tried Ambien, Klonopin, Ativan, Lunesta, Sonata, Trazadone, Seroquel, Rameron, Gabapentin - Developed Anxiety disorder, PTSD, and Psychogenic Myoclonus
7/2015-1/2016: Reinstated Lexapro 2 mg (mild improvement, but crying spells still present)

1/2016-5/2017: Lexapro 5 mg ( helped a lot, but poor stress tolerance & depressive episodes)

5/20/2017 - Raised dose to Lexapro 10 mg due to lingering depression(Total of 2 failed tapers & severe PAWS)

9/11/2018 - Present: Still on 10 mg Lexapro and mostly recovered.(Anxiety still triggers Myoclonus.)

10/7/2022 - 20 mg Lexapro (brand only) Plus occasional Klonopin for anxiety and Ambien for insomnia.

 

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Hi sweetie, this is harder than you thought, isn't it. I have been watching you try to follow my suggestion and you've run with it admirably. Sites like SA are amassing a large body of 'anectodal' evidence in favor of tapering AD's to reduce the amount of disruption on sensitive nervous systems. The studies posted by Alto and others give weight to what is suggested here.

 

Look what I found when I took the title of your post, changed it a bit, and typed it into a search engine:

 

https://startpage.com/do/search?language=english&cat=web&query=How+do+you+introduce+your+psychiatrist+to+the+concept+of+antidepressant+withdrawal+syndrome

 

Just a quick look at the summaries below the links shows me that there are many links on credible sites, and SA comes up in the top 10.

 

Until you are able to show your doc your MD license, you will have trouble 'convincing' him of the 'rightness' of your position. The people on these boards are pushing ahead in spite of their Dr's reluctance and many are coming out the other side successfully.

 

For now, I think many of us are in this fight alone. It may be many years before the studies are formed, tested, then published in peer-reviewed journals before the tide of medicating 'psychological' discomforts turns the other way.

 

Keep up the good work!

What happened and how I arrived here: http://survivingantidepressants.org/index.php?/topic/4243-cymbaltawithdrawal5600-introduction/#entry50878

 

July 2016 I have decided to leave my story here at SA unfinished. I have left my contact information in my profile for anyone who wishes to talk to me. I have a posting history spanning nearly 4 years and 3000+ posts all over the site.

 

Thank you to all who participated in my recovery. I'll miss talking to you but know that I'll be cheering you on from the sidelines, suffering and rejoicing with you in spirit, as you go on in your journey.

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This might help lend credibility by showing the respect given by researchers to this site:

 

http://survivingantidepressants.org/index.php?/topic/4021-alarming-report-on-persistent-side-effects-of-antidepressant-drugs/?fromsearch=1

 

There is also an article comparing SSRI and benzodiazepine withdrawal. Many doctors agree that benzos are problematic and this article draws parallels.

Pristiq tapered over 8 months ending Spring 2011 after 18 years of polydrugging that began w/Zoloft for fatigue/general malaise (not mood). CURRENT: 1mg Klonopin qhs (SSRI bruxism), 75mg trazodone qhs, various hormonesLitigation for 11 years for Work-related injury, settled 2004. Involuntary medical retirement in 2001 (age 39). 2012 - brain MRI showing diffuse, chronic cerebrovascular damage/demyelination possibly vasculitis/cerebritis. Dx w/autoimmune polyendocrine failure.<p>2013 - Dx w/CNS Sjogren's Lupus (FANA antibodies first appeared in 1997 but missed by doc).

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I have found only tepid interest in the topic from a number of psychiatrists. I have my theories for this but I think the luke warm reaction is largely due to simple human motivations which effect doctors. Doctors make a nice living "doing good" and are rather invested in maintaining this self-perception. I don't think most psychiatrists are willing to retool their practices as would be ethically necessary if they acknowledged problems with their Rx interventions so they therefore are reflexively uninterested in considering protracted withdrawal.

 

The positive is that since your doctor will no nothing about withdrawal except what you teach them, then you are actually very much in charge of your treatment, something I found very rewarding to consider.

 

So if your doctor isn't interested in learning about withdrawal simply inform him or her of your desire to reduce your medication by a small amount and let them follow along on your journey... Maybe she'll learn something too!

"Well my ship's been split to splinters and it's sinking fast
I'm drowning in the poison, got no future, got no past
But my heart is not weary, it's light and it's free
I've got nothing but affection for all those who sailed with me.

Everybody's moving, if they ain't already there
Everybody's got to move somewhere
Stick with me baby, stick with me anyhow
Things should start to get interesting right about now."

- Zimmerman

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After several tries, trying to convince someone else of something that they refuse to believe is a waste of time in my opinion. Look how long it took to get the "church" to accept the fact that the planets revolved around the sun & not the sun around the planets? Especially when you are trying to change the minds of people who almost consider themselves "Gods" .... well you might just as well piss in the wind.

 

RU

Fall 1995 xanax, zoloft. switched to Serzone

1996- spring 2003serzone/ xanax/ lightbox.

b]Fall 2003- Fall 2004? Lexapro 10 mg. Light box /4 mg. xanax.[/b]

2004 - Fall of 2009 10 mg Lex, 150 mg Wellbutrin XL % 4 mg xanax

November 2009- Sept. 2011 10 mg lex., 300 Well. XL, 4 mg Xanax [/b

Sept.2012- July 2012 20 mg Lex 300 Well. XL, 4 mg Xanax

My mantra " go slow & with the flow "

3/2/13.. Began equal dosing 5 Xs /day xanax, while simultaneously incorporating a 2.5 % drop ( from 3.5 mg/day to 3.4 mg/day)

4/6/13 dropped from 300 mg. Wellbutrin XL to 150 mg. Difficult but DONE! Down to 3.3 mg xanax/ day / 6/10/13 3 mg xanax/day; 7/15/2013 2.88mg xanax/day.

10/ 1/2013...... 2.5 mg xanax… ( switched to tablets again) WOO HOO!!!!!! Holding here… cont. with Lexapro.

1/ 2/2014.. tapered to 18mg ( by weight) of a 26 mg ( by weight) pill of 20 mg tab. lexapro. goal is 13mg (by weight OR 10 mg by ingredient content) and STOPPED. Feeling very down with unbalanced, unpredictable WD symptoms.

1/2/2014- ??? Taking a brain-healing break from tapering anything after actively tapering something for 1.5 years. So… daily doses as of 2/2/2014: 18 mg by weight Lex, 150 mg Well. XL, 2.5 mg xanax, down from 26 mg by weight Lex., 300 mg well. XL, 4 mg xanax in August, 2012. I'll take it. :) 5/8/14 started equivalent dose liquid./ tabs. 5/13/14 1.5 % cut.

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After several tries, trying to convince someone else of something that they refuse to believe is a waste of time in my opinion. Look how long it took to get the "church" to accept the fact that the planets revolved around the sun & not the sun around the planets? Especially when you are trying to change the minds of people who almost consider themselves "Gods" .... well you might just as well piss in the wind.

 

RU

 

I have the same feeling...and yet I've always been one of those people who just tries and tries and tries to convince someone of MY truth, THE truth...with plenty of evidence behind it...BUT they just revert back to their thinking. I've been trying to do this with my own mother for over a decade.  She just doesn't get it.  Doesn't WANT to get it.  Maybe just like Alex suggested above, that to admit the truth to themselves would be to admit their own failure.  She just wants to believe that she gave birth to a perfectly healthy child - not one who's prone to depression!

2005-2008: Effexor; 1/2008 Tapered 3 months, then quit. 7/2008-2009 Reinstated Effexor (crying spells at start of new job.)
2009-3/2013: Switched to Pristiq 50 mg then 100 mg
3/2013: Switched to Lexapro 10mg. Cut down to 5 mg. CT for 2 weeks then reinstated for 6 weeks
8/2013-8/2014: Tapering Lexapro (Lots of withdrawal symptoms)
11/2014 -8/2015: Developed severe insomnia and uncontrollable daily crying spells
12/2014-6/2015: Tried Ambien, Klonopin, Ativan, Lunesta, Sonata, Trazadone, Seroquel, Rameron, Gabapentin - Developed Anxiety disorder, PTSD, and Psychogenic Myoclonus
7/2015-1/2016: Reinstated Lexapro 2 mg (mild improvement, but crying spells still present)

1/2016-5/2017: Lexapro 5 mg ( helped a lot, but poor stress tolerance & depressive episodes)

5/20/2017 - Raised dose to Lexapro 10 mg due to lingering depression(Total of 2 failed tapers & severe PAWS)

9/11/2018 - Present: Still on 10 mg Lexapro and mostly recovered.(Anxiety still triggers Myoclonus.)

10/7/2022 - 20 mg Lexapro (brand only) Plus occasional Klonopin for anxiety and Ambien for insomnia.

 

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The 'why' and 'why not' sidetracks you from your primary goal which is to get better. Your results may or may not ever be a convincing enough example for them. And all you want to do is have a better life from here on in, right?

What happened and how I arrived here: http://survivingantidepressants.org/index.php?/topic/4243-cymbaltawithdrawal5600-introduction/#entry50878

 

July 2016 I have decided to leave my story here at SA unfinished. I have left my contact information in my profile for anyone who wishes to talk to me. I have a posting history spanning nearly 4 years and 3000+ posts all over the site.

 

Thank you to all who participated in my recovery. I'll miss talking to you but know that I'll be cheering you on from the sidelines, suffering and rejoicing with you in spirit, as you go on in your journey.

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Also, I feel that villifying the psychs, pharma, the Media, etc. is a waste of my precious energy right now. I'll have to leave that to others such as Alto. And is too seductively a distraction from the real work I need to to on myself to keep from needing help from meds. Ascribing to them all nefarious motives just won't help me recover and have a better future.

What happened and how I arrived here: http://survivingantidepressants.org/index.php?/topic/4243-cymbaltawithdrawal5600-introduction/#entry50878

 

July 2016 I have decided to leave my story here at SA unfinished. I have left my contact information in my profile for anyone who wishes to talk to me. I have a posting history spanning nearly 4 years and 3000+ posts all over the site.

 

Thank you to all who participated in my recovery. I'll miss talking to you but know that I'll be cheering you on from the sidelines, suffering and rejoicing with you in spirit, as you go on in your journey.

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Also, I feel that villifying the psychs, pharma, the Media, etc. is a waste of my precious energy right now. I'll have to leave that to others such as Alto. And is too seductively a distraction from the real work I need to to on myself to keep from needing help from meds. Ascribing to them all nefarious motives just won't help me recover and have a better future.

What can I say, you're right... But I've always had a bit of an activist/missionary streak in me.  I know i should just leave it alone, but I'm obsessed with wanting my psychiatrist to "see the truth".  Why do I need so badly for her to do that? I'm obsessed with collecting evidence that just might convince her to believe what we all know already.  And i'm doing this at the expense of neglecting my other responsibilities and chores.

 

Every time I hear something preposterous from a psychiatrist, I go on a clinical study "Quest" to prove them wrong!  Their ignorant statements make me so mad!

2005-2008: Effexor; 1/2008 Tapered 3 months, then quit. 7/2008-2009 Reinstated Effexor (crying spells at start of new job.)
2009-3/2013: Switched to Pristiq 50 mg then 100 mg
3/2013: Switched to Lexapro 10mg. Cut down to 5 mg. CT for 2 weeks then reinstated for 6 weeks
8/2013-8/2014: Tapering Lexapro (Lots of withdrawal symptoms)
11/2014 -8/2015: Developed severe insomnia and uncontrollable daily crying spells
12/2014-6/2015: Tried Ambien, Klonopin, Ativan, Lunesta, Sonata, Trazadone, Seroquel, Rameron, Gabapentin - Developed Anxiety disorder, PTSD, and Psychogenic Myoclonus
7/2015-1/2016: Reinstated Lexapro 2 mg (mild improvement, but crying spells still present)

1/2016-5/2017: Lexapro 5 mg ( helped a lot, but poor stress tolerance & depressive episodes)

5/20/2017 - Raised dose to Lexapro 10 mg due to lingering depression(Total of 2 failed tapers & severe PAWS)

9/11/2018 - Present: Still on 10 mg Lexapro and mostly recovered.(Anxiety still triggers Myoclonus.)

10/7/2022 - 20 mg Lexapro (brand only) Plus occasional Klonopin for anxiety and Ambien for insomnia.

 

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Why do I need so badly for her to do that?

 

Getting an answer to the 'why' just leaves you with the answer. It won't change anything. This is the single most important thing I have ever learned in my life. Think about it. You will eventually have to stop answering the 'why' questions and get down to the business of recovery. There are far more productive distractions than questing for validation.

 

And just how is following your 'obsession' helping your recovery? Like I said, seduction....... For me recovery is 'self-centered' not 'other-centered'.

 

I always have to look at where my energy is going. What you are describing is not a part of my recovery and maybe never will be. Yours? Who knows. Recovery takes work and honest self-assessment. Plus the day to day grind of just doing it. Take my supplements, drink my water, get my exercise, control ruminative thoughts, get proper sleep, the list goes on. There is not enough time for me to be mindful of all this and carry on a work schedule AND fight to convince psychs. So I won't try to fight the nebulous 'them'. I am my own worst adversary. I am a fussy master and require a firm hand because I will defeat myself every step of the way if I'm not careful.

 

We lead best by example.

What happened and how I arrived here: http://survivingantidepressants.org/index.php?/topic/4243-cymbaltawithdrawal5600-introduction/#entry50878

 

July 2016 I have decided to leave my story here at SA unfinished. I have left my contact information in my profile for anyone who wishes to talk to me. I have a posting history spanning nearly 4 years and 3000+ posts all over the site.

 

Thank you to all who participated in my recovery. I'll miss talking to you but know that I'll be cheering you on from the sidelines, suffering and rejoicing with you in spirit, as you go on in your journey.

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Here's something that might be helpful:
 
http://www.aafp.org/afp/2006/0801/p449.html
 
DIFFERENTIATION FROM RELAPSE
The symptoms of antidepressant discontinuation syndrome that are associated with most antidepressants share features of major depression, including dysphoria, appetite changes, sleep problems, cognitive problems, and fatigue. By focusing on symptoms that distinguish antidepressant discontinuation syndrome from depressive illness relapse (e.g., dizziness, “electric shock” sensations, “rushing” sensations in the head, headache, and nausea) and observing for rapid (i.e., within a few days) reversal of symptoms after restarting the antidepressant or complete resolution of symptoms in one to two weeks (highly uncharacteristic of a depressive relapse), a definitive diagnosis is fairly easy to make.19,27 Depressive relapses or recurrences typically occur after at least two to three weeks or longer after cessation of medication and are most often marked by gradual worsening of depression, insomnia, and psychomotor symptoms.28

2005-2008: Effexor; 1/2008 Tapered 3 months, then quit. 7/2008-2009 Reinstated Effexor (crying spells at start of new job.)
2009-3/2013: Switched to Pristiq 50 mg then 100 mg
3/2013: Switched to Lexapro 10mg. Cut down to 5 mg. CT for 2 weeks then reinstated for 6 weeks
8/2013-8/2014: Tapering Lexapro (Lots of withdrawal symptoms)
11/2014 -8/2015: Developed severe insomnia and uncontrollable daily crying spells
12/2014-6/2015: Tried Ambien, Klonopin, Ativan, Lunesta, Sonata, Trazadone, Seroquel, Rameron, Gabapentin - Developed Anxiety disorder, PTSD, and Psychogenic Myoclonus
7/2015-1/2016: Reinstated Lexapro 2 mg (mild improvement, but crying spells still present)

1/2016-5/2017: Lexapro 5 mg ( helped a lot, but poor stress tolerance & depressive episodes)

5/20/2017 - Raised dose to Lexapro 10 mg due to lingering depression(Total of 2 failed tapers & severe PAWS)

9/11/2018 - Present: Still on 10 mg Lexapro and mostly recovered.(Anxiety still triggers Myoclonus.)

10/7/2022 - 20 mg Lexapro (brand only) Plus occasional Klonopin for anxiety and Ambien for insomnia.

 

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I also feel the desire to protect others from going down this horrible road... learn from my mistakes, so to speak. I haven't attempted to convince doctors about withdrawal although I have been able to show a few how poor the "science" behind these drugs is. When they think about the brevity of the FDA studies (several weeks) for treatment that is often prescribed for life, it makes them think.

 

There are many parallels between steroids and SSRIs also. That tends to get attention.

Pristiq tapered over 8 months ending Spring 2011 after 18 years of polydrugging that began w/Zoloft for fatigue/general malaise (not mood). CURRENT: 1mg Klonopin qhs (SSRI bruxism), 75mg trazodone qhs, various hormonesLitigation for 11 years for Work-related injury, settled 2004. Involuntary medical retirement in 2001 (age 39). 2012 - brain MRI showing diffuse, chronic cerebrovascular damage/demyelination possibly vasculitis/cerebritis. Dx w/autoimmune polyendocrine failure.<p>2013 - Dx w/CNS Sjogren's Lupus (FANA antibodies first appeared in 1997 but missed by doc).

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I recently made a conscious decision to never discuss my withdrawal/taper with a doctor in my practise again unless I absolutely have to, it seems like a complete waste of time, I've shared a book and my blog with them and it feels like banging my head on a brick wall and is too upsetting. I make my own decisions and do my own research, I think they don't want to know, it's just too much trouble.

*** Please note this is not medical advice,discuss any decisions about your medical care with a knowledgeable medical practitioner***





http://prozacwithdrawal.blogspot.com/
Original drug was sertraline/Zoloft, switched to Prozac in 2007.
Tapering from 5mls liquid prozac since Feb 2008, got down to 0.85ml 23/09/2012, reinstated back to 1ml(4mg) 07/11/2012, didn't appear to work, upped to 1.05ml 17/11/2012, back down to 1ml 12/12/2012 didn't work, up to 1.30ml 16/3/2013 didn't work, bumped up to 2ml (8mg) 4/4/2013 didn't work, in July 2013 I reinstated Sertraline (Zoloft) 50mg, feeling better now. 

A few months down the line I switched to 5ml liquid Prozac and tapered down to a compromise dose of 3ml liquid Prozac and have stayed there ever since, no withdrawals and no emotional blunting/loss of libido.

 

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Lilu,

 

I empathise with your feelings and don't think they are at all unusual. To want acknowledgement, an apology, vindication... very natural but also very unlikely as this would be admitting that they did something wrong and possibly set them up for legal action.

 

I did quite a bit of CBT over the years and found it to be ineffective because it didn't address the roots of my problems. I've only recently recognized some very serious issues and losses in my life that have created bad patterns and perpetuated further problems. Skyler has posted great info on psychodynamic / depth therapy vs. CBT:

 

http://survivingantidepressants.org/index.php?/topic/2042-cbt-vs-psychodynamic-pros-and-cons/?fromsearch=1

Pristiq tapered over 8 months ending Spring 2011 after 18 years of polydrugging that began w/Zoloft for fatigue/general malaise (not mood). CURRENT: 1mg Klonopin qhs (SSRI bruxism), 75mg trazodone qhs, various hormonesLitigation for 11 years for Work-related injury, settled 2004. Involuntary medical retirement in 2001 (age 39). 2012 - brain MRI showing diffuse, chronic cerebrovascular damage/demyelination possibly vasculitis/cerebritis. Dx w/autoimmune polyendocrine failure.<p>2013 - Dx w/CNS Sjogren's Lupus (FANA antibodies first appeared in 1997 but missed by doc).

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4 days.  That's how long it took for me to come back to "normal" and for most of the withdrawal symptoms to disappear.   4 days.  

 

How can educated experienced psychiatrists insist that my symptoms are a result of my "depression returning"?  

 

It makes me so angry!  I want to throw every bit of evidence into my psychiatrist's face and "make her see the truth"!!!

 

I am obsessed with it.  But at the same time, I'm afraid of ruining my relationship with her.  Afraid that she will react the way all the others did.  Afraid that I'll wind up just feeling hurt and demeaned, without having been heard.

 

She did give me permission to email her.  Should I do it?

2005-2008: Effexor; 1/2008 Tapered 3 months, then quit. 7/2008-2009 Reinstated Effexor (crying spells at start of new job.)
2009-3/2013: Switched to Pristiq 50 mg then 100 mg
3/2013: Switched to Lexapro 10mg. Cut down to 5 mg. CT for 2 weeks then reinstated for 6 weeks
8/2013-8/2014: Tapering Lexapro (Lots of withdrawal symptoms)
11/2014 -8/2015: Developed severe insomnia and uncontrollable daily crying spells
12/2014-6/2015: Tried Ambien, Klonopin, Ativan, Lunesta, Sonata, Trazadone, Seroquel, Rameron, Gabapentin - Developed Anxiety disorder, PTSD, and Psychogenic Myoclonus
7/2015-1/2016: Reinstated Lexapro 2 mg (mild improvement, but crying spells still present)

1/2016-5/2017: Lexapro 5 mg ( helped a lot, but poor stress tolerance & depressive episodes)

5/20/2017 - Raised dose to Lexapro 10 mg due to lingering depression(Total of 2 failed tapers & severe PAWS)

9/11/2018 - Present: Still on 10 mg Lexapro and mostly recovered.(Anxiety still triggers Myoclonus.)

10/7/2022 - 20 mg Lexapro (brand only) Plus occasional Klonopin for anxiety and Ambien for insomnia.

 

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Lilu, I'd recommend that at some point you read Anatomy of an Epidemic by Robert Whitaker, to get a sense of the how the profession of psychiatry got to where it is today, and what kinds of pressures and miseducation psychiatrists are experiencing, pushing them to believe the claims of pharmaceutical companies over the reported experiences of their patients.

 

There are a lot of studies referred to in the book as well that you can probably follow up. But mostly I think it will give you a context for what you're experiencing with your own psych that may help you in your journey.

Started on Prozac and Xanax in 1992 for PTSD after an assault. One drug led to more, the usual story. Got sicker and sicker, but believed I needed the drugs for my "underlying disease". Long story...lost everything. Life savings, home, physical and mental health, relationships, friendships, ability to work, everything. Amitryptiline, Prozac, bupropion, buspirone, flurazepam, diazepam, alprazolam, Paxil, citalopram, lamotrigine, gabapentin...probably more I've forgotten. 

Started multidrug taper in Feb 2010.  Doing a very slow microtaper, down to low doses now and feeling SO much better, getting my old personality and my brain back! Able to work full time, have a full social life, and cope with stress better than ever. Not perfect, but much better. After 23 lost years. Big Pharma has a lot to answer for. And "medicine for profit" is just not a great idea.

 

Feb 15 2010:  300 mg Neurontin  200 Lamictal   10 Celexa      0.65 Xanax   and 5 mg Ambien 

Feb 10 2014:   62 Lamictal    1.1 Celexa         0.135 Xanax    1.8 Valium

Feb 10 2015:   50 Lamictal      0.875 Celexa    0.11 Xanax      1.5 Valium

Feb 15 2016:   47.5 Lamictal   0.75 Celexa      0.0875 Xanax    1.42 Valium    

2/12/20             12                       0.045               0.007                   1 

May 2021            7                       0.01                  0.0037                1

Feb 2022            6                      0!!!                     0.00167               0.98                2.5 mg Ambien

Oct 2022       4.5 mg Lamictal    (off Celexa, off Xanax)   0.95 Valium    Ambien, 1/4 to 1/2 of a 5 mg tablet 

 

I'm not a doctor. Any advice I give is just my civilian opinion.

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On 6/16/2013 at 12:46 PM, kaza31 said:

hi there lulu, I know how you feel when it comes to doctors listening.. It use to really annoy me that because I have a history of having had depression five years ago, any time I went to a doctor with a sickness complaint it always would revert back to my depression being the problem.. in my first withdrawal from Effexor, when I managed to get to zero I felt really ill six weeks later and my doc put me straight back on the 150mg tablet, she obviously had no clue about withdrawal (as apparently it would have been better and safer to be put back on a low dosage)

 

luckily  this time around I have changed doctors, my doctor is same age as me 31 and is very helpful.. He seemed to understand withdrawal, said "if it takes me a year or even two years to get off it, that's ok, do it slowly with as little symptoms as you can".. Luckily last time around I kept a very thorough diary of all my symptoms, dosage reduces etc and was able to show him how bad it was.. I have a diary for this time around too and even though I have only withdrew down to 120mg from 150mg over four months period, he has been able to see how the symptoms still occur on even a small reduction at a time.. he even said its important for me to keep coming back for regularly check ups, because withdrawal can affect your body in lots of ways and he will keep an eye on it to make sure its withdrawal symptoms and nothing else im going through.. I swear I felt like hugging him lol because he was so understanding... I could be totally wrong, but maybe the younger doctors are becoming more aware of anti depressant withdrawal  through their medical training who knows, I just felt listened to for the first time in a long time..

 

another thing he did say is " when I told him about the tiredness, and how I wanted to go to the gym, socialising, shopping etc but some days I just felt so tired I didn't have the energy even tho I really want to. straightaway most doctors would say this is your depression coming back.. but he said" the fact that your even thinking of the gym and really wanted to go to the gym etc you can see the benefits of it but you just felt  physically exhausted through the withdrawal symptoms lack of sleep etc,, tells me its not your depression, because most people who are getting depression again couldn't care less if they never did anything they have no desire to, they want to do very little, they rarely even want to leave the house and very little gets them motivated to do anything"

 

Hopefully through this withdrawal I will be luck enough that the doctor stays the same and continues to listen to me.. I will continue to keep my recovery in my diary of proof of withdrawal symptoms as evidence of how hard it really is..

 

I wish you all luck in your recovery

god bless x

 

If your doctor is willing, please add him to our list of doctors who understand antidepressant withdrawal:

 

recommended-doctors-therapists-or-clinics/

 

I'm very impressed with what you've said about this man.  He's head and shoulders above the mainstream medical crowd!

Edited by manymoretodays
updated link

Psychotropic drug history: Pristiq 50 mg. (mid-September 2010 through February 2011), Remeron (mid-September 2010 through January 2011), Lexapro 10 mg. (mid-February 2011 through mid-December 2011), Lorazepam (Ativan) 1 mg. as needed mid-September 2010 through early March 2012

"Never attribute to malice that which is adequately explained by stupidity." -Hanlon's Razor


Introduction: http://survivingantidepressants.org/index.php?/topic/1588-introducing-jemima/

 

Success Story: http://survivingantidepressants.org/index.php?/topic/6263-success-jemima-survives-lexapro-and-dr-dickhead-too/

Please note that I am not a medical professional and my advice is based on personal experience, reading, and anecdotal information posted by other sufferers.

 

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I realized pretty that I couldn't introduce the concept of withdrawal symptom to my psychiatrist.  Fortunately, he was willing to cooperate with my tapering plan even I know he thought it was a bunch of BS.  But I really didn't care as my only goal was to get off of the meds and out from his care.

 

CS

Drug cocktail 1995 - 2010
Started taper of Adderall, Wellbutrin XL, Remeron, and Doxepin in 2006
Finished taper on June 10, 2010

Temazepam on a PRN basis approximately twice a month - 2014 to 2016

Beginning in 2017 - Consumption increased to about two times per week

April 2017 - Increased to taking it full time for insomnia

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I am unable to educate my shrink as well.  The problem is that they're not neurologists, and they believe everything big pharma tells them.  I cannot convince my doc that withdrawal exists nor will she educate herself.  Their blatant ignore is staggering and deadly for their patients.  Neurologists would never even prescribe these death pills.  Eugenics at its best.  I'm doing an excrutiatingly slow taper and then plan to RUN!

 

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It can be very, very difficult to change a doctor's mind. It can be easier to find a new doctor with better listening skills, if not more knowledge about withdrawal.

 

But....even though a doctor might put up a wall of denial to you, you can bet the next time someone has a similar complaint, the doctor will remember what you said. So don't be shy about letting your doctor know what you think -- in a firm, calm voice. (Any emotion will be construed as mental imbalance.)

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Doctors are probably afraid of opening themselves up to litigation as well so denial is the best policy, I think that's why mine never makes a fuss about prescribing the liquid Prozac.

*** Please note this is not medical advice,discuss any decisions about your medical care with a knowledgeable medical practitioner***





http://prozacwithdrawal.blogspot.com/
Original drug was sertraline/Zoloft, switched to Prozac in 2007.
Tapering from 5mls liquid prozac since Feb 2008, got down to 0.85ml 23/09/2012, reinstated back to 1ml(4mg) 07/11/2012, didn't appear to work, upped to 1.05ml 17/11/2012, back down to 1ml 12/12/2012 didn't work, up to 1.30ml 16/3/2013 didn't work, bumped up to 2ml (8mg) 4/4/2013 didn't work, in July 2013 I reinstated Sertraline (Zoloft) 50mg, feeling better now. 

A few months down the line I switched to 5ml liquid Prozac and tapered down to a compromise dose of 3ml liquid Prozac and have stayed there ever since, no withdrawals and no emotional blunting/loss of libido.

 

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  • 2 weeks later...

Try a respectful "you may be interested in this" approach.

 

I am too passionate and enraged about this topic, for the non-chalant  "you may be interested in this" approach. But after thinking about this for a month, I finally did it.  I wrote my doctor a letter, and presented her with lots of information, both anecdotal and clinical.  We'll see what her reaction will be. I see her on Wed. I included the article on Psychology Today which references your story and this website. It's a great article and you should PIN it somewhere, since most of us have no idea about how you got to know so much and what your case history is.

http://www.psychologytoday.com/blog/side-effects/201107/antidepressant-withdrawal-syndrome

2005-2008: Effexor; 1/2008 Tapered 3 months, then quit. 7/2008-2009 Reinstated Effexor (crying spells at start of new job.)
2009-3/2013: Switched to Pristiq 50 mg then 100 mg
3/2013: Switched to Lexapro 10mg. Cut down to 5 mg. CT for 2 weeks then reinstated for 6 weeks
8/2013-8/2014: Tapering Lexapro (Lots of withdrawal symptoms)
11/2014 -8/2015: Developed severe insomnia and uncontrollable daily crying spells
12/2014-6/2015: Tried Ambien, Klonopin, Ativan, Lunesta, Sonata, Trazadone, Seroquel, Rameron, Gabapentin - Developed Anxiety disorder, PTSD, and Psychogenic Myoclonus
7/2015-1/2016: Reinstated Lexapro 2 mg (mild improvement, but crying spells still present)

1/2016-5/2017: Lexapro 5 mg ( helped a lot, but poor stress tolerance & depressive episodes)

5/20/2017 - Raised dose to Lexapro 10 mg due to lingering depression(Total of 2 failed tapers & severe PAWS)

9/11/2018 - Present: Still on 10 mg Lexapro and mostly recovered.(Anxiety still triggers Myoclonus.)

10/7/2022 - 20 mg Lexapro (brand only) Plus occasional Klonopin for anxiety and Ambien for insomnia.

 

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I tend to think of it like I'd been onboard a sinking ocean liner that the crew adamently insists is not sinking. Included in the crew are the custodians od the life vests. At first I tried to persuade the custodians that the boat was sinking because I wanted everyone to know what I know so they wouldn't thinkk I was nuts and also so they could save themselves but I could not convince them.

 

Later on, having acquired a more natural sense of my own value, I returned to the custodians and asked them for a lifevest because I told them I thought I'd feel safer with a life vest. Since I had stopped trying to prove them wrong they were not invested in winning the argument and they gave me a lifevest and sent me on my way. I'd also realized I didn't need anyone's permission to save my life.

 

And while I am upset at the circumstance that made me dependent on the custodians, I am grateful enough to have gotten my lifevest and gotten off of the ship before I drowned to death.

 

The end.

 

That is an excellent analogy Alex.  I guess I am not at that point yet.  Or maybe I just have a different personality.  I've spent 30 years of my life trying to get my mother to really understand me...only to recently realize that she is not an understanding person.  And unless she can personally relate to something, she just cannot understand it.  But I still keep on trying... Maybe I will eventually stop.  Unfortunately, with all my knowledge and experience, I still have no credibility - not with  my  mother, and certainly not with the doctors.  How can we convince doctors of what we know is true, when their own peers, who speak out against the mainstream, the ones that have the MD or PhD or both behind their names, cannot convince them either?

2005-2008: Effexor; 1/2008 Tapered 3 months, then quit. 7/2008-2009 Reinstated Effexor (crying spells at start of new job.)
2009-3/2013: Switched to Pristiq 50 mg then 100 mg
3/2013: Switched to Lexapro 10mg. Cut down to 5 mg. CT for 2 weeks then reinstated for 6 weeks
8/2013-8/2014: Tapering Lexapro (Lots of withdrawal symptoms)
11/2014 -8/2015: Developed severe insomnia and uncontrollable daily crying spells
12/2014-6/2015: Tried Ambien, Klonopin, Ativan, Lunesta, Sonata, Trazadone, Seroquel, Rameron, Gabapentin - Developed Anxiety disorder, PTSD, and Psychogenic Myoclonus
7/2015-1/2016: Reinstated Lexapro 2 mg (mild improvement, but crying spells still present)

1/2016-5/2017: Lexapro 5 mg ( helped a lot, but poor stress tolerance & depressive episodes)

5/20/2017 - Raised dose to Lexapro 10 mg due to lingering depression(Total of 2 failed tapers & severe PAWS)

9/11/2018 - Present: Still on 10 mg Lexapro and mostly recovered.(Anxiety still triggers Myoclonus.)

10/7/2022 - 20 mg Lexapro (brand only) Plus occasional Klonopin for anxiety and Ambien for insomnia.

 

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Thanks, Lilu. Feel free to start a topic in the Media forum.Can you list here the items you sent to your doctor? Others might find that helpful.

 

First I wrote my doctor a letter with evidence from my own experience. Having kept a diary since I was 15, I went back to the time when I was severely depressed, and yet had not started medication.  I was shocked to find that my tone and state of mind, was very different than in my diaries post drugs.  Rereading that diary showed me that even during a major depression I was able to cope, function, and live life, far better than when on antidepressants or post antidepressants.   There is no question that these drugs have affected my ability to cope and function! ( I think I'll start a separate topic on this, as reading my past was quite revealing.)

 

Then I included excerpts from Chapter 9 of Dr. Breggin's book "Your drug may be your problem", as well as excerpts from Robert Whitaker's article about antidepressants causing chronic depression.  And then excerpts from the article on Psych Today, about your case with all the links in it.

Since most doctors won't give you their email address, I would have to alter the document so that it can be printed, with references at the end.  I'll work on it.  

 

The thing is that when I saw my doctor  yesterday, she hadn't had a chance to read my email and all the documents attached to it.  And I'm not sure if she ever will or if she will take it seriously. But she is definitely different from all the other psychiatrist that I have encountered.  Very laid back. No ego. No feeling of superiority.  She readily agreed to prescribe liquid lexapro and said that it would have been her suggestion as well.  She also suggested that I try taking fish oil, that she takes it herself and finds it that it makes her feel happier.   She is not super educated about withdrawal syndrome, but at least she was in agreement that a slow taper is the best way to go since I've been taking these drugs for so long.

 

It would be really great if she takes the info that I presented her with, and decides to learn more.  She is an associate professor at UMDNJ - how great would it be if she can start teaching the truth about antidepressant withdrawal syndrome to her students?  

Alto, this makes me wonder - have you ever been invited to any speaking engagements?  What if you requested to speak to Psych students at UCSF, do you think they would be interested?

 

I will keep you all posted on my further dialog about withdrawal with my doc.  I also plan on presenting this information to my primary care doctor who, while being very nice and caring, was the one who started me on antidepressants, and kept convincing me to stay on them.

2005-2008: Effexor; 1/2008 Tapered 3 months, then quit. 7/2008-2009 Reinstated Effexor (crying spells at start of new job.)
2009-3/2013: Switched to Pristiq 50 mg then 100 mg
3/2013: Switched to Lexapro 10mg. Cut down to 5 mg. CT for 2 weeks then reinstated for 6 weeks
8/2013-8/2014: Tapering Lexapro (Lots of withdrawal symptoms)
11/2014 -8/2015: Developed severe insomnia and uncontrollable daily crying spells
12/2014-6/2015: Tried Ambien, Klonopin, Ativan, Lunesta, Sonata, Trazadone, Seroquel, Rameron, Gabapentin - Developed Anxiety disorder, PTSD, and Psychogenic Myoclonus
7/2015-1/2016: Reinstated Lexapro 2 mg (mild improvement, but crying spells still present)

1/2016-5/2017: Lexapro 5 mg ( helped a lot, but poor stress tolerance & depressive episodes)

5/20/2017 - Raised dose to Lexapro 10 mg due to lingering depression(Total of 2 failed tapers & severe PAWS)

9/11/2018 - Present: Still on 10 mg Lexapro and mostly recovered.(Anxiety still triggers Myoclonus.)

10/7/2022 - 20 mg Lexapro (brand only) Plus occasional Klonopin for anxiety and Ambien for insomnia.

 

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When I'm up to speaking, those are avenues I'd like to try. I'm in discussions with faculty at UCSF now.

 

Everyone should take a shot at educating psychiatrists in the ways you have, Lilu. Good job.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Well, I went to see my gp and he was NOT HAPPY! Was quite annoyed that I am tapering slowly 

and said that isn't the way that is recommended. I reminded him that I tried that way and was in hell with

withdrawal. I didn't say I was down to 5 beads, just that I was under 37.5 and couldn't calculate exactly in

mgs. He said he was reluctant to prescribe the liquid because, he said at that dose it is not needed. 

I kept my cool and said no, he was right I don't need it for the depression

, and that it stopped working for me years ago but I want off it because of the side effects.

Said I had no life and couldn't feel anything, just dead inside with no motivation or energy.  

 . I told him that I had shocking withdrawal his way  but that this way it was steady and gentle.. 

 

He showed that he wasn't listening and didn't get it because he said that I'm having problems because

it's too slow and I should just stop it, there wouldn't be any problems after the first week. The point I was making was that I felt BETTER after each tiny drop, not worse with withdrawal. ( Bangs head on wall)  I kept to myself the last few weeks of hell because without the extremely stressful situation I'd been in I would probably have been fine.

 

Then I explained that although people do manage to stop without problems, I am so 

sensitive that it just didn't work for me. I then told him I'd spoken to the pharmacist who had recommended the

liquid and slow titration. After several minutes of reasoning I GOT MY SCRIPT! 

RESULT !  1ml 4x daily is what's prescribed, which is way too much but I will work out what I should be taking

when I can get my head clear enough. I don't think I've convinced him really, just fought my corner but it's a start. 

**I am not a medical professional, if in doubt please consult a doctor with withdrawal knowledge.

 

 

Different drugs occasionally (mostly benzos) 1976 - 1981 (no problem)

1993 - 2002 in and out of hospital. every type of drug + ECT. Staring with seroxat

2002  effexor. 

Tapered  March 2012 to March 2013, ending with 5 beads.

Withdrawal April 2013 . Reinstated 5 beads reduced to 4 beads May 2013

Restarted taper  Nov 2013  

OFF EFFEXOR Feb 2015    :D 

Tapered atenolol and omeprazole Dec 2013 - May 2014

 

Tapering tramadol, Feb 2015 100mg , March 2015 50mg  

 July 2017 30mg.  May 15 2018 25mg

Taking fish oil, magnesium, B12, folic acid, bilberry eyebright for eye pressure. 

 

My story http://survivingantidepressants.org/index.php?/topic/4199-hello-mammap-checking-in/page-33

 

Lesson learned, slow down taper at lower doses. Taper no more than 10% of CURRENT dose if possible

 

 

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Well at least you got your script even though you will have convert it to the right dose. But as I am reading your post, I am going WTF?  I want to say to your doctor, "WTF don't you understand?"  I mean, you're telling him that you are suffering and he is denying your reality.

 

Sadly, I had a similar experience with my psychiatrist when I told him I wanted a compound prescription for Wellbutrin XL since I didn't see an easy way to taper the convention way. His response was that no one does it that way.

 

But unlike your doctor, his attitude was even though he thought what I was doing was the stupidest thing on earth, his attitude was that as long as it wasn't dangerous, he would do whatever I wanted.  I actually think near the end of my visits, he grudgingly accepted that tapering slowly might be a viable alternative.

 

By the way, unlike the pharmacist you dealt with, the guy who made the Wellbutrin prescription also thought I wasn tapering too slowly. So I asked him if there was anything dangerous about what I was doing.  He hemmed and hawed and said no but still stuck to his position.

 

I just think these guys get so arrogant that if a patient challenges the conventional way of doing something, even though they obviously get worse doing it that way, they perceive it as a threat. All rational thought goes out the window.

 

CS

Drug cocktail 1995 - 2010
Started taper of Adderall, Wellbutrin XL, Remeron, and Doxepin in 2006
Finished taper on June 10, 2010

Temazepam on a PRN basis approximately twice a month - 2014 to 2016

Beginning in 2017 - Consumption increased to about two times per week

April 2017 - Increased to taking it full time for insomnia

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  • Moderator Emeritus

He was visibly very annoyed that I refused to stop right now, and I am so so glad that I didn't

speak to him when I was suffering and suicidal, he would have been worse than useless and

would have made things much much worse. I'm glad the folk here helped me through and helped

me see it would not be a wise move at the time. He has been very understanding in the past 

and I hoped he might be on my side because he was agreeable to my coming off the AD's and

didn't try and get me to stay on them.  I don't know how long my 100ml bottle will last but am hoping

it might see me through to the end because I don't fancy going back for more! 

**I am not a medical professional, if in doubt please consult a doctor with withdrawal knowledge.

 

 

Different drugs occasionally (mostly benzos) 1976 - 1981 (no problem)

1993 - 2002 in and out of hospital. every type of drug + ECT. Staring with seroxat

2002  effexor. 

Tapered  March 2012 to March 2013, ending with 5 beads.

Withdrawal April 2013 . Reinstated 5 beads reduced to 4 beads May 2013

Restarted taper  Nov 2013  

OFF EFFEXOR Feb 2015    :D 

Tapered atenolol and omeprazole Dec 2013 - May 2014

 

Tapering tramadol, Feb 2015 100mg , March 2015 50mg  

 July 2017 30mg.  May 15 2018 25mg

Taking fish oil, magnesium, B12, folic acid, bilberry eyebright for eye pressure. 

 

My story http://survivingantidepressants.org/index.php?/topic/4199-hello-mammap-checking-in/page-33

 

Lesson learned, slow down taper at lower doses. Taper no more than 10% of CURRENT dose if possible

 

 

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Another thing that really annoyed me was that I said how sensitive I am to drugs after 40 years of psychiatric medications,

and that I also have to watch what I eat because of additives, and that I can't even have more that 1 cup of coffee a day

without being affected by the caffeine. He stifled a laugh and shook his head like I was a paranoid hypochondriac.   :angry:

**I am not a medical professional, if in doubt please consult a doctor with withdrawal knowledge.

 

 

Different drugs occasionally (mostly benzos) 1976 - 1981 (no problem)

1993 - 2002 in and out of hospital. every type of drug + ECT. Staring with seroxat

2002  effexor. 

Tapered  March 2012 to March 2013, ending with 5 beads.

Withdrawal April 2013 . Reinstated 5 beads reduced to 4 beads May 2013

Restarted taper  Nov 2013  

OFF EFFEXOR Feb 2015    :D 

Tapered atenolol and omeprazole Dec 2013 - May 2014

 

Tapering tramadol, Feb 2015 100mg , March 2015 50mg  

 July 2017 30mg.  May 15 2018 25mg

Taking fish oil, magnesium, B12, folic acid, bilberry eyebright for eye pressure. 

 

My story http://survivingantidepressants.org/index.php?/topic/4199-hello-mammap-checking-in/page-33

 

Lesson learned, slow down taper at lower doses. Taper no more than 10% of CURRENT dose if possible

 

 

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RESULT !  1ml 4x daily is what's prescribed, which is way too much but I will work out what I should be taking

when I can get my head clear enough. I don't think I've convinced him really, just fought my corner but it's a start. 

 

BINGO!!!!! Well done MammaP! If it's too concentrated, at least it will keep you going a longer time!! Could say it gives you plenty of time for your head to get clear before you go back to your GP for some more!!! I'm in Scotland like you, so this is heartening. I've already broached with my GP the idea of a slower taper with liquid -- rather than crushing/splitting tablets that I posited was so much less reliable than a solution/suspension -- and my GP has cautiously said  that it can be considered. I'm not ready for it quite yet. So YEAH, WELL DONE YOU!!! AND ENJOY!!!

Started citalopram May 12, from 10 to 40 mg/d over 2 months

 

Wanted to come off in May 13 and did it too quickly: decrease from 40 to 0 mg/d over 2 weeks; WD from then onwards, increasing in intensity to be unbearable at 4 weeks later;  reinstated 10 mg/d for 2 days (WD severity halved); reinstated 20 mg/d (initial WD symptoms decreased but not gone entirely until after 8 weeks)

 

Started 5--7% taper: Aug 13: 19 mg/d, mild WD on day 3; thereafter none notable; Nov 13: 18 mg/d, no WD; Dec 13: 17 mg/day, no WD for 3 weeks, then (at Christmas) tearfulness; Jan 14: 16.7 mg/d, Apr 14: 15.7 mg/d, Jun 14: 14.5 mg/d; Jul 14: 13.5 mg/d (6.9% reduction), Aug 14: 12.5 mg/d (7.4% reduction)

 

Sharing experience makes a difference

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My pdoc never responded, addressed, or commented on the email I sent her about Antidepressant Withdrawal Syndrome.  She probably never even read it.  She seems to see it as "your tapering thing"...as if I'm the only one she's encountered...ugh...the story of my life - ignorant people who think that "i'm the only one" who is like this or like that.

 

Anyway, I probably wont bring it up...I need her too much at this point.  At least, she readily agreed about the liquid taper.  Unfortunately, I need to put that off for now.  I desperately need to find work right now.  I'm completely broke. Just can't risk withdrawal right now.

2005-2008: Effexor; 1/2008 Tapered 3 months, then quit. 7/2008-2009 Reinstated Effexor (crying spells at start of new job.)
2009-3/2013: Switched to Pristiq 50 mg then 100 mg
3/2013: Switched to Lexapro 10mg. Cut down to 5 mg. CT for 2 weeks then reinstated for 6 weeks
8/2013-8/2014: Tapering Lexapro (Lots of withdrawal symptoms)
11/2014 -8/2015: Developed severe insomnia and uncontrollable daily crying spells
12/2014-6/2015: Tried Ambien, Klonopin, Ativan, Lunesta, Sonata, Trazadone, Seroquel, Rameron, Gabapentin - Developed Anxiety disorder, PTSD, and Psychogenic Myoclonus
7/2015-1/2016: Reinstated Lexapro 2 mg (mild improvement, but crying spells still present)

1/2016-5/2017: Lexapro 5 mg ( helped a lot, but poor stress tolerance & depressive episodes)

5/20/2017 - Raised dose to Lexapro 10 mg due to lingering depression(Total of 2 failed tapers & severe PAWS)

9/11/2018 - Present: Still on 10 mg Lexapro and mostly recovered.(Anxiety still triggers Myoclonus.)

10/7/2022 - 20 mg Lexapro (brand only) Plus occasional Klonopin for anxiety and Ambien for insomnia.

 

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  • 3 weeks later...

I agree with the pragmatic approach.  It doesn't matter if the psych doc "get's it".  You just need him to institute a slow taper for you.  

 

He'll go on making several hundred thousand dollars a year while harming the community (in addition to some good, that we shouldn't forget, they do also).  Unfortunately, this is just the way it is.  Some battles are larger than we are.

 

Drops of water, over time will erode even the hardest rocks.  We are the drops of water, as long as we all continue the fight, and get the truth out there, eventually we will make "a dent" and psychiatry as we know it, will erode.

 

We might be little ants in the land of giants. No one pays attention to one ant, but thousands of ants all marching together, will always get noticed.  Do your part.  I plan to do mine.

2005-2008: Effexor; 1/2008 Tapered 3 months, then quit. 7/2008-2009 Reinstated Effexor (crying spells at start of new job.)
2009-3/2013: Switched to Pristiq 50 mg then 100 mg
3/2013: Switched to Lexapro 10mg. Cut down to 5 mg. CT for 2 weeks then reinstated for 6 weeks
8/2013-8/2014: Tapering Lexapro (Lots of withdrawal symptoms)
11/2014 -8/2015: Developed severe insomnia and uncontrollable daily crying spells
12/2014-6/2015: Tried Ambien, Klonopin, Ativan, Lunesta, Sonata, Trazadone, Seroquel, Rameron, Gabapentin - Developed Anxiety disorder, PTSD, and Psychogenic Myoclonus
7/2015-1/2016: Reinstated Lexapro 2 mg (mild improvement, but crying spells still present)

1/2016-5/2017: Lexapro 5 mg ( helped a lot, but poor stress tolerance & depressive episodes)

5/20/2017 - Raised dose to Lexapro 10 mg due to lingering depression(Total of 2 failed tapers & severe PAWS)

9/11/2018 - Present: Still on 10 mg Lexapro and mostly recovered.(Anxiety still triggers Myoclonus.)

10/7/2022 - 20 mg Lexapro (brand only) Plus occasional Klonopin for anxiety and Ambien for insomnia.

 

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  • 1 year later...
  • Moderator Emeritus

People's opinions here are based on their own experiences, reading and knowledge that comes from engaging with lots of people in withdrawal. Many people here have experience with Prozac.

 

I am not medically trained. However, I am positive that I have read more research on withdrawal and seen more cases of it that any medical practitioner I have ever engaged. I share an opinion here based on that foundation. It is not medical advice and you need to make your own decisions based on that fact.

 

Re how to know about a Drs understanding of withdrawal.? I would ask them. It is well documented now that ads cause withdrawal and for some protracted wd. If a dr won't acknowledge that, no point going further in my view. In fact I don't ask anymore I tell them and if they can't handle that I won't engage with them.

 

I haven't had a risk report, others might contribute on that point

 

As a final comment, I would say that the gaps in knowledge of the medical profession combined with the power and vested interests of pharmaceutical companies means that we have to become experts of our own conditions and drive our care. That's a very challenging and scary idea but it's true.

Please note - I am not a medical practitioner and I do not give medical advice. I offer an opinion based on my own experiences, reading and discussion with others.On Effexor for 2 months at the start of 2005. Had extreme insomnia as an adverse reaction. Changed to mirtazapine. Have been trying to get off since mid 2008 with numerous failures including CTs and slow (but not slow enough tapers)Have slow tapered at 10 per cent or less for years. I have liquid mirtazapine made at a compounding chemist.

Was on 1.6 ml as at 19 March 2014.

Dropped to 1.5 ml 7 June 2014. Dropped to 1.4 in about September.

Dropped to 1.3 on 20 December 2014. Dropped to 1.2 in mid Jan 2015.

Dropped to 1 ml in late Feb 2015. I think my old medication had run out of puff so I tried 1ml when I got the new stuff and it seems to be going ok. Sleep has been good over the last week (as of 13/3/15).

Dropped to 1/2 ml 14/11/15 Fatigue still there as are memory and cognition problems. Sleep is patchy but liveable compared to what it has been in the past.

 

DRUG FREE - as at 1st May 2017

 

>My intro post is here - http://survivingantidepressants.org/index.php?/topic/2250-dalsaan

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