DeedlesTheMoose: Third time's the charm?

[DeedlesTheMoose]

Hey there! My name is Deanna. I'm 26 years old, and I live in Canada. 

 

Besides having depression, I'm an artist and graphic design student. I've always been a visual learner and a creative person, and now on my second run through college, I'm hoping to make art my career. I also enjoy video games and movies. I love animals; my parents have six cats that I love very much, and I look forward to adopting a dog one day. Now to get down to business. I apologize in advance for how long this is going to be. In my defence though, this is more than 15 years of mental illness history here.

 

I've been on some form of antidepressants since the age of 9 (~2001). I was started on Effexor (which is definitely not recommended for children...) and stayed on that for several years. My first experience with tapering happened within a few years of that, under the supervision of my psychiatrist. It was great to be medication free! Most kids don't have to worry about medications, and for a while, I didn't either. After about one year though, my depression seemed to be back. So back on the medication I went. I went back to seeing that same psychiatrist for a few more years, until I was no longer considered a child, since he was a psychiatrist for kids. I didn't question the medication for a long time after that. It helped me be functional. It wasn't perfect, no, but I could get through my days.

 

It might sound obvious now, but it took me a while to realize that a fascination with violence and serial killers wasn't normal. For several years at least, I read nothing but true crime and fictional serial killer stories. I was fascinated by them. Disturbingly, I also realized that I wanted to be like them. I would think a lot about violence, and kind of came to accept that one day, I would be a killer, and that I'd either end up dead or in prison. Not only that, but I experienced intrusive violent thoughts. I'd be standing behind my sister as she bent down to take laundry from the dryer, notice a pair of scissors on the counter, and see myself using them to hurt her. I didn't want to. But I couldn't stop that thought from happening if I tried. I remember another time one of my cats jumped onto my bed, and I noticed that from the side, a cat's eye looks a lot like a bubble. I couldn't help but picture what it might look like if I tried to pop that bubble. That one really bothered me. Of course I didn't want to hurt my sister or any other person either, but that image of hurting an animal felt especially intrusive, because I know I would never hurt an animal. 

 

After realizing how harmful thoughts like those were, I told my psychiatrist. (It's worth mentioning that between 2010 and 2013 or so, I had two different psychiatrists. Neither felt helpful, and they spent our (very quick) appointments asking a couple of questions, then prescribing a new dosage or different medication altogether, and hurrying me out of the office. One of them left the hospital where I saw him, and didn't refer me to anyone else. He basically just said he was leaving, goodbye. The other psychiatrist seemed to be open to the idea of me trying to taper off the medication again around 2013, but then did more or less the same thing; he said goodbye and went on with his life.) Over the period of a year or two, I was prescribed a few different anti-psychotics and other medications that I'm really not sure of, to try and deal with the violent thoughts. None of them seemed to help, and some of them had some awful side effects. Most of those medications did not last longer than a few doses. I was taking Risperdal for a year or so, but then that one starting having negative side effects too, so I stopped with the help of my family doctor. Thankfully, that seemed to end the intrusive violent thoughts. After this point, I had no psychiatrist.

 

In 2013, I had a suicide attempt. Besides the homicidal thoughts, I would also experience suicidal thoughts. Most of the time I was able to resist those in much the same way as the others; I didn't want to die, so they stayed as thoughts only. I think it might've been a really bad combination of depression and my intrusive thoughts that made me actually consider hurting myself. I'd have intrusive images of stabbing myself in the stomach, and my parents finding me. It was like my depression saw those images and said "wow, good idea". One night I was feeling very low, and my dad had to physically stop me from using the knife in my hand. After that, my parents took me to the hospital and I stayed in the Mental Health Inpatient Unit for one week. That's the worst my depression has ever been. Besides this one incident, I would occasionally have passive suicidal thoughts such as "I don't deserve to be alive" or "there's no future for me", but not actually want to act on them. 

 

My dad helped me do some research on Effexor, and we didn't like the side effects we were seeing. We thought my violent thoughts might even be caused (or worsened) by the medication, so I started seeing a naturopathic doctor to begin tapering again. I used a natural supplement called TrueHope EmpowerPlus. I made it down to 0 medication, and felt pretty good for about a year before I started experiencing an eating disorder. I've always had anxiety, but over a period of a few months, I lost at least 70 lbs (I was overweight to begin with, but still) because of some serious anxiety around food. Deciding what to eat made me very uncomfortable. Not eating was easier. I also had some trust issues with food. If a food I normally enjoyed was gross one time I had it, I would decide not to eat it again. I ended up with a very limited diet.

 

In mid-2014 I was at a point where I'd feel physically ill from being so hungry. I was weak. My parents were (understandably) very worried. I started seeing a psychiatrist at CAMH (the Centre for Addiction and Mental Health). She suggested that I go back on medication so that, at the very least, I could start eating again. She prescribed 80mg of Prozac. She also referred me to a month long inpatient program for anxiety. I did the program, which included CBT and group therapy, and made a lot of improvements with my eating disorder. After leaving the hospital, my medication and depression have since been monitored by my family doctor.

 

Last fall, I decided I wanted to try lowering my dose. My doctor suggested I go from 80mg to 60mg, and that went fine. When I went down to 40mg, however, I started feeling depressed, assumed it was a relapse, and went back up to 60. Now I think it may have just been withdrawal caused by tapering too quickly. So I approached my doctor about tapering again last month, suggesting I go much more slowly this time, after finding survivingantidepressants.org and reading about other peoples' experiences. Right now, I'm alternating between 50mg and 60mg daily, and by the end of this week, I'll be taking 50mg every day. Each month I plan to take another step down (from 50 to 50/40, to 40, to 40/30, etc.).

 

So far, things are going great. Since 2014, I was also taking Dexilant, for heartburn caused by the Prozac. I've managed to stop taking that medication most days (taking it only occasionally) and haven't had any problems. My biggest concern is that I'll experience withdrawal sooner or later, and I might panic and go back on my progress. I don't want that to happen this time. I'm hoping the third time really is the charm for me, and that this time, I'll be able to be medication free and actually dealing with any problems I might have, instead of taking the medication and hoping it solves everything (which it definitely doesn't).

 

In the past, I was very lonely, socially anxious, and I kept to myself. Now, however, I'm engaged, I'm doing well in school and working towards a career that I'm passionate about, and I recently started talking to my sister again after a few years of falling out. I've also realized how toxic my mom is in my life, and I no longer live with my parents. I'm really hoping that this time, a much better environment and a better understanding of withdrawal will help me succeed 🤞

 

If you read all this, thank you for sticking with me until the end, and I look forward to keeping you updated ☺️

Edited June 5, 2019 by DeedlesTheMoose
I Didn’t make it clear that I no longer experience the intrusive violent thoughts

[Gridley]

Welcome to SA, DeedlesTheMoose (love that name).  I'm glad you found your way here.  I'm glad things are going well for you and that you have an improved environment.  This will be a big help in your taper.  Thanks for completing your signature.

 

We recommend tapering by no more than 10% of your current dose every four weeks, and some have to go more slowly. This allows your system to adapt to getting less of the drug. So the taper you've described is faster than what we suggest.  It's best tp err on the side of going too slowly than too fast.  Also, as I'll explain in a minute, we strongly recommend against alternating doses (for example, 50 one day, 40 the next ).  

 

Why taper by 10% of my dosage?

 

These links explain the importance of a slow taper.

 

Brain Remodelling 

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

Regarding alternating doses, this causes the amount of the medication in your bloodstream to go up and down, battering your nervous system, and makes withdrawal worse.
Thus is true even with a drug with a long half-life such as Prozac.  Your brain and central nervous system like stability, to be treated gently.  

 

The rule of 3KIS: Keep it simple. Keep it slow. Keep it stable.

 

What symptoms did you have when you dropped to 40mg?  Did they resolve then you went back up to 60mg?  How have you been feeling since you started the 60/50mg alternate day taper?  If you're feeling okay, since you only have four more days, I'd suggest you go to May 9 as you've been doing, then hold at 50mg for four weeks.  At that time you'll be ready for a 10% taper, which would be 5mg, so your dose for the following four weeks would be 45mg. And no more alternating doses. On the other hand, if you're experiencing significant withdrawal symptoms, it might be best to split the difference and hold at 55mg until they subside.

 

The following link explains how to take the smaller, non-standard doses of Prozac, which basically means cutting tablets and weighing with a scale, making your own liquid or using liquid Prozac.

 

Tips for tapering off Prozac (fluoxetine)

 

What you experienced when you dropped to 40mg was, as you've guessed, withdrawal symptoms.

 

What is withdrawal syndrome.

 

Glenmullen’s withdrawal symptom list.

 

 The Windows and Waves Pattern of Stabilization

 

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.  

 

This explains 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.

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. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

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 ask questions, make updates and connect with other members.  

 

 

 

 

 

 

[laydefish]

Hi @DeedlesTheMoose & Welcome to the Group!  Hi sorry to hear that you're struggling so, In wow how to say that you've been through a lot with definitely be an understatement! I agree with your assessment with regards to the medications most likely causing your  intrusive thoughts so it's really great that you're deciding to get off of them again. as difficult as it is going to be it's going to definitely be worth it try to stay strong and hang in there. Sincerely, Laydefish

[Altostrata]

Welcome, Deedles.

 

You were on extraordinarily high dosages of Prozac. How are you feeling on 50mg per day? That's still a fairly substantial dosage.

 

From this point, please consider tapering more gradually than you have been. You might have merely dropped the excess before. Please see Why taper? SERT transporter occupancy studies show importance of gradual change in plasma concentration

[DeedlesTheMoose]

@Gridley I'm glad I found this place too. Stopping my medication hasn't worked for me in the past, and I used to think it was hopeless for me, but now I think I was just told to do it in a way that wasn't right. Having a forum full of other people with similar experiences is very encouraging. Seeing other peoples' experiences is what led me to want to try tapering again.

 

Before making my first post, I was lurking around here for a month or two. I've looked briefly at the tapering posts, and Prozac specific things too. I mentioned wanting to try again to my doctor, and she seemed open to it, but when I brought up tapering by 10%, she told me there were no tablets I could cut, and that I'd have to stick to increments of 10 or 20 mg. To be honest, I'm a little scared to try making my own liquid Prozac, but if I can find some ready made liquid stuff, I'd like to try that.

 

When I went down to 40 mg, I had a few days where I felt sad for no apparent reason, and experienced crying spells. It was really only a few days, and maybe I shouldn't have let that discourage me, but it scared me. When I went back to 60 mg, I did feel better. Going back to the safety of the higher dose was just the quick, easy solution at the time. Now that I know I was going way too fast, I'm ready to try again, but much more slowly this time. My doctor is the one who suggested alternating doses. I figured it would end up being about the same as taking 55mg daily, but for now I'm going to stick to 50mg and do some more research on liquid Prozac.

 

Thanks so much for your response.

 

@laydefish Thanks so much for your kind words. I'm very glad that the violent thoughts aren't an issue for me anymore. I've been doing quite well the past couple of years, and I think it's time for me to try again. I plan on taking it more slowly and being more aware of any symptoms I might experience. I plan on succeeding this time!

 

@Altostrata Thank you for the welcome! I'm glad to be here.

 

I had no idea my dose was so high. I'm feeling good taking this dose most of the time. Occasionally, I'll get hit with a wave of sadness. I might cry or feel hopeless, but it doesn't usually last too long. My fiancee is very supportive, so that makes it a lot more tolerable. I do have some issues with procrastination, but I always have, so I don't know if that's related. In general, I'm feeling happy. Now that I think about it, in the past week or two my brain has felt a little... fuzzy. Different, somehow. Not quite brain zaps (I've had those before. They feel awful) but some kind of weird floaty feeling that I don't want worsening.

 

I do plan on slowing down. I don't want to risk the way I've been feeling. I don't want this to affect my school work, if it can be avoided. I'm going to look into liquid prozac and see if I can't get some and use that to taper more slowly.

[Gridley]

5 minutes ago, DeedlesTheMoose said:

that I'd have to stick to increments of 10 or 20 mg. To be honest, I'm a little scared to try making my own liquid Prozac, but if I can find some ready made liquid stuff, I'd like to try that.

Dropping by increments of 10 or 20mg is definitely not advisable.   Liquid Prozac is readily available and any M.D. can prescribe it.  

[DeedlesTheMoose]

Just now, Gridley said:

Dropping by increments of 10 or 20mg is definitely not advisable.   Liquid Prozac is readily available and any M.D. can prescribe it.  

Dropping by 20mg certainly didn’t work for me last time.

 

My doctor didn’t seem to know about the liquid. But I’ll bring it up next time I see her. 

[Gridley]

23 minutes ago, DeedlesTheMoose said:

 

My doctor didn’t seem to know about the liquid

 

If you have a problem getting the liquid, you can weigh the powder on an AWS Gemini-20 scale, available on Amazon, and pour your dose into a capsule.  The following information is from the link in my first post to you, "Tips for Tapering off Prozac."  This is how I'm tapering Lexapro.  The liquid would be preferable if available.

 

"Divide up capsule contents with an electronic scale
If you want to be even more precise, weigh the powder in a capsule with an electronic scale, divide it up, and put it into empty gelatin capsules. The powder is very fluffy, though -- make sure it doesn't blow off the scale.

 

See Using a digital scale to measure doses"

 

Here's another option:

 

"Have a compounding pharmacy make up capsules of smaller dosages
A compounding pharmacy will accurately weigh the doses and put them into capsules for you. See http://survivingantidepressants.org/index.php?/topic/235-tapering-techniques/page__p__3001#entry3001"

Edited December 3, 2018 by Altostrata 

[Gridley]

 

2 hours ago, DeedlesTheMoose said:

 

 

My doctor didn’t seem to know about the liquid. But I’ll bring it up next time I see her. 

 

From Eli Lily drug information July 7, 2016 http://pi.lilly.com/ca/prozac-ca-pmi.pdf

Only mentions for Canada, capsule, no liquid:

 

  Quote

What dosage forms it comes in:  PROZAC Capsules are available in 10mg (green) and 20mg (green and yellow) strengths.

 

But it may be available in Apo generic:

 

From https://www.drugbank.ca/drugs/DB00472

 

You might want to call a pharmacy and ask about the availability of generic Prozac in Canada.