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CatMan: Horrible morning anxiety / derealization


CatMan

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Hi everyone, this is my first time posting here, hope that I am doing everything correctly. I am recovering from fluoxetine (Prozac), I took it for about 8 months and I have been off it for about 3 months now. I have searched a lot on the internet and this forum but I was not able to find anyone who suffers from similar issues, so I was hoping for some kind of support from here :) Every morning, I wake up with horrible anxiety and a feeling of "depersonalization", it is kind of like sitting in the back of your head and having some kind of tunnel vision. Apathy is a big part of it and there is a weird feeling of having to supress a panic attack at any moment. The weird thing about it is that this feeling goes away in the afternoon and I feel completely fine the entire evening until I wake up the next day. I think this might be related to cortisol levels rising in the morning but I am not sure. Does anyone have similar experiences or tips to share with me? Thank you so much :D

Prozac 20mg (July 2018-Feburary 2019 CT)

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  • Moderator

Hello, Catman, and welcome to SA. The symptoms you describe are very typical withdrawal symptoms.  They often accompany a too-fast taper off psychiatric drugs.  What dosage of Prozac were you on and how fast did you taper off it?

 

Please add a signature.  Include drugs, doses, dates, and discontinuations & reinstatements in the last 12-24 months. Also include supplements. This will help us give you the most accurate advice we can.  Please include the information about your Prozac dosage and taper, including dates you started and stopped.
  • Any drugs and supplements prior to 24 months ago can just be listed with start and stop years. 
  • Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago) 
  • Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016. 
  • Please leave out symptoms and diagnoses. 
  • A list is easier to understand than one or multiple paragraphs. 
  • This is a direct link to your signature:  Account Settings – Create or Edit a signature.

So that you have an understanding of what you're experiencing, here is some information on antidepressant withdrawal.  Doctors know very little if anything about protracted antidepressant withdrawal and in fact don't believe it exists.

 

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

 

 

   On 8/30/2011 at 2:28 PM,  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.

Here are some links dealing with the symptoms you described.  Waking with anxiety or panic and having the symptoms fade throughout the day is generally associated with the fact that the body has elevated cortisol in the morning.  I had this symptom for several months but it gradually faded away.  The other symptoms will too, but it is impossible to predict how long it will take.

Waking with panic or anxiety - managing cortisol spikes - Page 4 ...

Derealization or Depersonalization - Surviving Antidepressants

Anhedonia, apathy, demotivation, emotional numbness - Symptoms ...

The only known way to reduce withdrawal symptoms is with a very small reinstatement of the drug you were taking, in your case Prozac.  Reinstatement doesn't always work and works most dependably within 3 months of your last dose.  The other alternative is to wait it out until your system returns to homeostasis.  Again, there is no way to predict how long this will take.  While some recover fairly quickly, for others it can take months or longer.  Please read:

 

 

About reinstating and stabilizing to reduce withdrawal symptoms. -- at least the first page of the topic

 

If you are interested in reinstating, please let us know and, after you've completed your signature, we can suggest a reinstatement dose.

Then, after you've stabilized on that dose, you can begin on a slow taper to zero of 10% of current dose every four weeks.  


Why taper by 10% of my dosage?

 

Please don't reinstate without letting us suggest a dosage.  Reinstating a too-high dosage can result in further destabilization.

 

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

 

 

 

Please research all supplements first and only add in one at a time and at a low dose in case you do experience problems.
Please continue to use this thread to document your taper and to ask questions.  After you've completed your signature, we'll be in a better position to help you.

Gridley Introduction

 

Lexapro 20 mg since 2004.  Begin Brassmonkey Slide Taper Jan. 2017.   

End 2017 year 1 of taper at 9.25mg 

End 2018 year 2 of taper at 4.1mg

End 2019 year 3 of taper at 1.0mg  

Oct. 30, 2020  Jump to zero from 0.025mg.  Current dose: 0.000mg

3 year, 10 month taper is 100% complete.

 

Ativan 1 mg to 1.875mg 1986-2020, two CT's and reinstatements

Nov. 2020, 7-week Ativan-Valium crossover to 18.75mg 

Feb. 2021, begin 10%/4 week taper.  Current dose as of Sept 13: 9mg 

Taper is 52% complete.

 

Imipramine 75 mg daily since 1986.  Jan-Sept 2016 tapered to 16mg.  

Held until Aug 2021, tapered for 4 weeks to 14.4mg and holding.  

Taper is 80% complete.  

  

Supplements: omega-3, vitamins C, E and D3, magnesium glycinate, probiotic, zinc, melatonin .3mg


I am not a medical professional and this is not medical advice, but simply information based on my own experience, as well as other members who have survived these drugs.

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intothewoods
4 hours ago, CatMan said:

Every morning, I wake up with horrible anxiety and a feeling of "depersonalization", it is kind of like sitting in the back of your head and having some kind of tunnel vision. Apathy is a big part of it and there is a weird feeling of having to supress a panic attack at any moment. The weird thing about it is that this feeling goes away in the afternoon and I feel completely fine the entire evening until I wake up the next day. I think this might be related to cortisol levels rising in the morning but I am not sure. Does anyone have similar experiences or tips to share with me?

 

I have this, too @CatMan. It started two years ago and has morphed in and out of severity as I dropped too much or was given med trials by p-docs before finding SA in December 2018. Until March, I believed it was withdrawal from one of my morning meds that has a half short-life. In fact, I wrote this in my thread in January: 

 

Every morning  I wake in full-blown withdrawal from Provigil. It's so violent I can't hold a glass of water until lots of deep breaths and determination. My one goal for an hour is to calm to a state of being able to get out of bed (vs falling out... LOL). As well, I feel like I'm vibrating from the inside out, those infamous akathesia electric shocks, in near perpetuity along with the dyskinesia daily. I just shudder always. Some seems from WD. Some seems from the meds. 

 

Now after what I've learned on SA, I believe it's primarily cortisol gone-crazy as described in the link that Gridley gave you. Plus years of iatrogenic harm that simply has to heal. The whole fiesta (my loving term for it ) starts just like you said, with horrible anxiety, depersonalization, panic implosion. As morning dawns, feelings of terror and dread seep in, like poison in an IV line I've suddenly been hooked up to. As long as I stay hidden under the covers with a mask in pitch-black room, the physical symptoms hold off. The minute I move, they kick in. In the cortisol thread, you'll see advice to keep a dark, cool bedroom and wear a sleep mask. This has helped tremendously.

 

I've been on Prozac since 1999 and last year dropped too fast, had to reinstate a bit. This is when the mornings reached full intensity. Since yours is for sure sparked by Prozac WD, I suppose there could be a common factor but there are many of us with this symptom but who took meds other than Prozac. 

 

It will subside and resolve, for you I would think sooner than later because you only took it for 8 months. It might subside some if you reinstated a small amount; Gridley gave you the link for that too.

 

Whatever you decide to do, you've come to the best place. SA is an amazing encyclopedic resource for WD that's unmatched online. Mainlly, Altostrata and the mods are very skilled at helping members stabilize. They've been through every symptom -- including the morning fiesta. 😊

 

All the best to you.

* Fluoxetine: 40 mg 1999-2012; 60 mg 2012-March 2018;  49 mg at present.

* Provigil: 25-100 mg PRN 2005 to mid-2015; 200-300 mg mid-2015 to early 2016; tapered from 300 mg in early 2016 to 100 mg early 2017; tapered from 100 mg early 2017 to 31 mg June 15, 2019; 22 mg at present.

* Amitriptyline: 10-15 mg 2002-2013; 25 mg 2014 to December 5, 2018; December 15, 2018 converted to water suspension and tapered to 21 1/2 mg at present

* Diazepam: 5 mg at night 2002-present

 Supplements: Iron for anemia

 

Back Story: From 2012 thru early 2017, relocated and cycled through over 20 primary and psych docs (supposedly for severe Chronic Fatigue Syndrome) who prescribed two dozen different psych meds in search of the "perfect therapeutic combo." Took most for only a few days, some for a week. Included Wellbutrin, Cymbalta, Lexapro, Seroquel, Lamictal, Klonopin, Lyrica, Gabapentin, Belsomra, Tramadol, Librium, Halcyon, Remeron and -- the last straw, Trintellix. Began in early 2016 when it was still called Brintellix (Pharma's attempt to combine the words "brilliance" and "intelligence" in a pill name), became unable to eat or sleep, lost 25 lbs and the ability to speak. Slowly tapered myself back to Prozac by 2017 but was unable to stop akathisia, cortisol mornings and kindling which continue, actively, through present.

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  • ChessieCat changed the title to CatMan: Horrible morning anxiety / derealization

Hi & Welcome to the Group! Congratulations on getting off these awful drugs! Yes, I too took Prozac for severe chronic pain, I took an average dose of 60MG daily for 11 years as well as Benzo's for 7 years (and Hydrocodone for about 15 years & Gabapentin for 7 years) after an uniformed CT & * 1/2 months of healing by God's grace, I feel great! I haven't felt this much like myself in years- it's truly unbelievable- so Hang in There! It does get better & you will heal!

2 years Drug History Prior to Tapering:

Between 2011 & 2018 I had approximately 58 dose changes between the 4 main medications I took as well as 14 new medications add & taken away.

Prozac (Fluoxetine):(Aug 2016-Dec 2016: 60MG),(June 2017-Nov 2017: 60MG),(Dec 2017: 80MG),(June 2017-Sept 2 2018: 60MG),(Sept 3 2018-Sept 5 2018: 40MG),(Sept 6 2018-Sept 8 2018: 20MG),(Sept 9 2018: 0MG).

Cymbalta:(Jan 2017-May 2017: 60MG).

Cyclobenzaprine: (Aug 2016: 30MG,(Feb 2017: 30MG).

Diazepam (Valium):(Aug 2016-Sept 15 2016: 30MG),(Sept 16 2016-Oct 2017: 15MG),(Nov 2017-Aug 19 2018: 6MG),(Aug 20 2018: 0MG).

Gabapentin:(Aug 2016-Aug 3 2018: 2400MG),(Aug 4 2018-March 26 2019: 2000MG),(March 27 2019-March 30 2019: 1600MG),(May 1 2019: 2000MG)

Hydrocodone:(Aug 2016-Oct 2016: 10-325/4daily),(Nov 2016-Feb 2017: 10-325/3daily),(March 2017-April 2017: 5-325/4daily),(May 2017-April 2018: 10-325/3daily),(June 2018-Aug 25 2018: 10-325/5daily),(Aug 26 2018-Sept 2 2018: 4.5daily),(Sept 3 2018-Sept 10 2018: 10-325/4daily),(Sept 11 2018-Sept 18 2018: 10-325/3daily),(Sept 19 2018-May 1 2019: 10-325/3.5 daily).

Oxycodone: May 2018: 10-325MG/4daily). 

Please see my Intro for full drug history.

         **Forgive Yourself For Not Knowing What You Didn't Know Before You Knew It!  -Maya Angelou/

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thecowisback

hi and welcome. i came off prozac over 2 years ago and this has been a problem for me too - waking up terrified in the mornings. i'm almost afraid to say it but this symptom has faded quite a bit and it now depends on how much sleep i've had or how stressful the previous day has been. i found the best way for me to deal with it was to get up and carry on with my morning routine despite the feelings of terror. i have to keep telling myself it's 'just' withdrawals and carry on with what i have to do. 

 

Took prozac 40 mg for 20 years.

January 2017 started cutting down prozac by 12.5% a week. End of February 2017 completely off prozac and withdrawals began.

Currently taking Levothyroxine 75 mcg, Magnesium citrate 200mg,Sage leaf 50mg daily

Amlodipine: October 2017 , discontinued 26 Feb 2019; Candesartan:  26 Feb 2019, 4mg.

Discontinued magnesium citrate 200mg Apr 3rd 2019

Reinstated prozac:  14 Jan 2019, 1mg; 26 Jan, 1.5mg; 4 Feb, 2mg; 16 Feb, 2.5mg; 2 Mar, 3mg; 5 Mar, 2.5mg, 23 Mar, 3 mg; 6 Apr, 3.5mg, 14 Apr 4mg, 23 Apr 5mg, 10 Jul 8mg, 1 Dec 20mg, 1 Apr 2020 40mg 

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  • 2 weeks later...

I quit prozac cold turkey back in feburary (bad decision i know) and tried a reinstatement in march (went horrible). I found that using propranolol (20-40mg 1-2x per day) takes off most of my horrible symptoms, i know that it is not recommended to „muddy the waters“ even more, but it is kind of the only hope I have left. The relief I got from it was so great, I literally cried for half an hour. Will it be okay to use this for a couple of months to get me through the roughest patch? 

Prozac 20mg (July 2018-Feburary 2019 CT)

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I quit prozac cold turkey back in feburary (bad decision i know) and tried a reinstatement in march (went horrible). I found that using propranolol (20-40mg 1-2x per day) takes off most of my horrible symptoms, i know that it is not recommended to „muddy the waters“ even more, but it is kind of the only hope I have left. The relief I got from it was so great, I literally cried for half an hour. Will it be okay to use this for a couple of months to get me through the roughest patch? 

Prozac 20mg (July 2018-Feburary 2019 CT)

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  • Moderator Emeritus

Hi CatMan, I moved your question to your intro topic.  Please post updates and questions about your situation here in your intro topic.

 

We have a couple of topics about beta blockers you may like to read:  

Beta Blockers: Propranolol, Metopropol, Atenolol etc

Tapering beta blockers or alpha blockers

 

In general we don't recommend adding in drugs to treat withdrawal symptoms.  With regular use beta blockers need to be tapered.  You might avoid that if you keep it to occasional use.

 

To help deal with the anxiety I highly recommend books and recordings by Dr. Claire Weekes, as well as regular relaxation exercises.  See:

The Dr. Claire Weekes method of recovering from a sensitized nervous system

Relaxation exercises, guided meditations, calming videos, sleep hypnosis

 

2001–2002 paroxetine

2003  citalopram

2004-2008  paroxetine (various failed tapers) 
2008  paroxetine slow taper down to

2016  Aug off paroxetine
2016  citalopram May 20mg  Oct 15mg … slow taper down
2018  citalopram 13 Feb 4.6mg 15 Mar 4.4mg 29 Apr 4.2mg 6 Jul 4.1mg 17 Aug 4.0mg  18 Nov 3.8mg
2019  15 Mar 3.6mg  21 May 3.4mg  26 Dec 3.2mg 

2020  19 Feb 3.0mg 19 Jul 2.9mg 16 Sep 2.8mg 25 Oct 2.7mg 23 Oct 2.6mg 24 Dec 2.5mg

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