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sleepylex: Changes to tiredness after stopping antidepressant


sleepylex

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Hello, I was wondering whether anyone had experienced a significant change in their levels of tiredness/sleepiness after tapering off their SSRI/SNRI?

 

I cannot remember the exact sequence of events but I was started on an SSRI (escitalopram) in 2003 and in the same year diagnosed with narcolepsy (type 2). Narcolepsy type 2 lacks some of the neurological symptoms (falling attacks (cataplexy), hallucinations on waking/falling alseep) of type 1 narcolepsy and therefore is considered by some a less clear diagnosis. 

 

I have been tapering off escitalopram from the last few months, and have gone from 20mg to 0.5mg. I had the sense that my tiredness was resolving as I got down lower in dose and had the idea that perhaps my 'narcolepsy' might have been an SSRI side effect rather than true narcoelpsy. However, I am now mired in rather unpleasant withdrawal symptoms, which for me include tiredness and fatigue. I am therefore increasingly uncertain whether my hypothesis that my long-standing tiredness might be due to antidepressants

 

I wondered whether others had experienced a significant change to their levels of tiredness after stopping antidepressants? Whether anyone had received a diagnosis of narcolepsy or perhaps chronic fatigue syndrome that resolved after stopping antidepressants? 

 

It may be that I am simply wishing upon a star for a change to come but wondered what others experience had been?


2003  various trials of SSRIs/SNRIs
2004-2016  escitalopram 5mg
2016-2018 Escitalopram 5-20mg, mirtazapine 7.5-30mg, Zolpidem CR 12.5mg, Xyrem 2-9gm (GHB)

2018 August pre-taper Escitalopram 20mg, mirtazapine 15mg, Zolpidem CR 12.5mg, Xyrem 2gm

 

2018 escitalopram Aug 5mg Sep 2.5mg Oct 1.5mg Nov 0.95mg (also mirt from 15mg to 7.5mg) Dec 0.3mg BD 

 

2019 escitalopram Feb 0.2mg BD March 0.16mg BD 3rd April 0mg esc, 9th April reduce mirt to 3.75 7th May increase esc to 0.18mg nocte 14th May increase mirt to 7.5mg 19th May increase esc to 0.5mg nocte


 

 

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  • ChessieCat changed the title to sleepylex: Changes to tiredness after stopping antidepressant
  • Moderator

Welcome to SA, sleepylex.

 

There's considerable discussion on SA on the possible links between CFS and antidepressants.  Here are two links.  You can also Google "SurvivingAntidepressants.org CFS" for more information.  See also the initial post of new member starryskies    

 

http://mentalhealthdaily.com/2015/02/13/can-antidepressants-cause-chronic-fatigue-syndrome/

 

Chronic Fatigue Syndrome, ME, CFS - Surviving Antidepressants

 

As you noted, the situation is muddied now by your withdrawal symptoms of fatigue.  Your taper of escitalopram over the last few months was very fast.  We recommend tapering no faster than 10% of current dose every four weeks.


Why taper by 10% of my dosage?

 

Here is some information on the withdrawal symptoms you're experiencing.

 

 
 
I would suggest you stop tapering at this point and let your system stabilize, which can take several months.  Depending on the severity of your symptoms, you might consider an updose of an additional 1mg Escitalopram.  Though updosing/reinstatement doesn't always work, it's the only known way to reduce withdrawal symptoms.  
Please read:
 
About reinstating and stabilizing to reduce withdrawal symptoms. -- at least the first page of the topic
 
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.
 
This is your Introduction topic, where you can post updates, ask questions and connect with other members.  
 
 
 
 
Edited by Gridley

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 1986-1991 CT, soon reinstated.  CT 2000. RI 1 mg 2011-2016.  Sept. 2016  0.625mg X 3

Nov.27, 2020, 7-week Ativan-Valium crossover + change to one 18.75mg dose, w/1 month hold.

Feb. 9, 2021, begin 10% every 4 weeks taper.  Current dose as of March 22: 14.4mgai.

 

Imipramine 75 mg daily since 1986.  Jan. 2016 began every 3-weeks 10% taper, down to 16mgai (0.44mgpw).  Aug 2016, discovered SA, holding at 16mg.  Taper is 78% complete.  

  

Supplements: omega, 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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puthappinessfirst

SSRIs can 10000% make you ridiculously tired. While stable on mine, I could sleep at LEAST 8 hrs a night. And if I had nothing to do midday, could take a 2 hour nap. I would nod off at my desk at work as well.  Ridiculous!

Celexa 10mg: 2007 to June 2018, stopped CT

No meds: June 2018 to December 2018

PROTRACTED WD-- major depressive episode for 2+ weeks

Lexapro 10mg: December 12, 2018 to January 19, 2019, severe adverse reaction

Celexa 10mg: January 20, 2019

June 24, 2019: 9mg

July 22, 2019: 8.5mg

Jan 8, 2020: 8mg

Aug 25, 2020: 7.2mg

 

Supplements: Magnesium, Fish Oil

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I've developed chronic fatigue in withdrawal. There have been many days where I could barely move from my bed. Not sure what causes it. 

2009-2018: 15mg Celexa

 

June 2018-January 2019: .5mg-1mg Ativan

 

2010-March 2019: Marvelon 21 (Birth Control) 

 

September 2018-Present: Prozac reinstated 1mg (.25ml) April 21st 2019 , updosed to .32ml June 19, 2019 now holding to stabilize.

 

2015-Present: Myers Cocktails 1-2x month 

 

June 2019-Present: B 50 Complex, Magnesium as needed.

 

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Thanks to all for replying and for the links, Gridley.

 

Quick questions first:

 

puthappinessfirst - did your tiredness resolve as you have come down your dose??

 

KMart95 - has your fatigue resolved when you have taken breaks to stabilise?

 

I actually went down to 0mg on escitalopram about 6 weeks ago, meaning I had tapered off over about 8-9 months which may seem very fast but it was made a lot easier I think by being on 7.5mg of mirtazapine at the same time. I know in the past when I was just on escitalopram I could not tolerate anything like that rate of taper - and was quite beside myself with anxiety, insomnia and agitation when I tapered at even slower rate.

 

As a result I am determined to stay on 0.5mg of escitalopram for now because I was OK at this level (along with the mirt)from what I can recall from my (not as complete as it should be) spreadsheet. 

 

Having said that I feel so depressed and depersonalised and derealised and fatigued at times that I am not sure what to do with myself. One of my worst fears (and this may be reality and need to be faced) is that this is not withdrawal but just me, perhaps the narcolepsy that I was diagnosed with. This makes me feel quite hopeless about the future because being tired in the past has made life such a torturous challenge for me.

 

I have people who are telling me I am mistaking the fatigue of withdrawal for the fatigue of narcolepsy, and I really want to believe them but am not sure. The strongest evidence I have for my current experiences being withdrawal-related is the strong depresonalisation/derealisation that I have only experienced in withdrawal before. If it is withdrawal then I really hope that it can't last too much longer because it is sapping my will to keep going. It has been about 3-4 weeks since I re-instated (in fact, I had done a very  unwise thing and not only had I gone down from 0.5mg of escitalopram, I had also halved by mirtazpine to 3.75mg - I think this overzealousness has cost me greatly), although I increased doses over about a week. So I am trying to not catastrophise - but failing badly - and hope that things improve in the next few days or weeks. 

 

I have also been trying to continue as normally and see friends and attend social events, but when people ask me how I am going I often blurt out what is happening, including all sorts of catastrophic predictions and worries. I think my friends are used to me being a neurotic mess of a human but this I think has gone too far and is alienating. I think I will choose to see people less while I am feeling this bad - because it is probably damaging to relationships. It is a bad time for it because I have been seeing a nice girl, but my poor mood and blankness makes me very self-conscious and don't know if I can maintain the upbeat energy required for flirting/courting. Oh brother.

 

Apologies for the rambling. Altogether, it is reassuring to hear both that antidepressants can cause extreme fatigue (puthappinessfirst) and other posters, and that withdrawal can also cause fatigue (KMart95). If the fatigue from withdrawal wears off I will be a very happy fellow (I could tolerate the poor mood, DP/DR but the fatigue - probably because of its profound role in my life, I just cannot handle and makes me totally hopeless and despairing). If getting off the drugs means that I am even a but less tired than I have been the last few years that would also be wonderful. However, given that I have to get off two drugs, (not to mention a small dose of z-drug and xyrem) I will not be through this for a long while. I have never been accused of optimism in my life, and this all makes me even more pessimistic. Insert large doses of why me? this isn't fair, the usual...

 

Anyway, would be interesting (and potentially reassuring) to hear of anyone else who had tiredness/fatigue/sleepiness while on SSRIs improve when they came off them (potentially after the withdrawal resolved)...

 

 


2003  various trials of SSRIs/SNRIs
2004-2016  escitalopram 5mg
2016-2018 Escitalopram 5-20mg, mirtazapine 7.5-30mg, Zolpidem CR 12.5mg, Xyrem 2-9gm (GHB)

2018 August pre-taper Escitalopram 20mg, mirtazapine 15mg, Zolpidem CR 12.5mg, Xyrem 2gm

 

2018 escitalopram Aug 5mg Sep 2.5mg Oct 1.5mg Nov 0.95mg (also mirt from 15mg to 7.5mg) Dec 0.3mg BD 

 

2019 escitalopram Feb 0.2mg BD March 0.16mg BD 3rd April 0mg esc, 9th April reduce mirt to 3.75 7th May increase esc to 0.18mg nocte 14th May increase mirt to 7.5mg 19th May increase esc to 0.5mg nocte


 

 

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  • Moderator Emeritus

Hi Sleepylex,  it would be helpful if you could please create a signature containing a summary of your med history, including all drugs, doses and dates (starting and stopping).  Your signature appears below every post you make, and allows us see your situation easily without having to read your topic from the top every time.   You could look at my signature for an example. 

 

Instructions for creating your signature are here: Please put your withdrawal history in your signature. 

You can edit your signature here: edit your signature in Account Settings

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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