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Psychology Today: Antidepressant Withdrawal and Scientific Consensus


anacleta
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thanks for posting this. 

anybody who still sees a shrink should be sure said doctor reads at least this short article to help them become aware that there are downsides to AD prescription that are not presented to the patient at Rx time.  I certainly don't mean to totally dis ADs, but had I been told of long term effects and withdrawal issues, I may well have chosen to suffer through the anxiety period that prompted my current addiction to Rx drugs.  

20090810 Dx GeneralAnxietyDisorder & PanicDisorder.  Rx Pristiq (desvenlafaxine) 50mg.  stable, side effects minor but blurry vision, impotence, others. http://survivingantidepressants.org/index.php?/topic/5418-ktp-weaning-from-4yrs-50mg-pristiq/ for more details.  

20140210 switch Pristiq50mg (can't cut them!) to Effexor (venlafaxine, V) same drug but easier dose reduction (and mfr TEVA's beads are handily ~= 1mg ea).  20140218 125mgV  0309 112mg 0401:100mg, 410:75, 0506:70, 0512:65, 0525:56, 0614:37.5, 0620:30, 0624:27, 0630:26, 0706:24, 0724:22, 0801:20, 0804:19, 0808:18, 0813:17, 0818:16, 0819:15, 0821:13, 0903:12, 0911:11, 0918:10, 0921:9, 0927:8, 1001:6, 1021:5, missed a day?, darn, it was going so well, or so I thought.  SEVERE ANXIETY, INSOMNIA. WAY TOO QUICK REDUCTIONS! hindsight: 0813:5%/5days, 0818:6%/5days, 0819:6%/1day, 0821:13%/2days, 0903: 7%/14days, 0911:8%/8days, 0918:9%/7days; 0921:10%/3days, 0927:11%/6days, 1001:25%/3days (still okay!) 1021:16%20days.  guideline is 10%/30days =  i am a self-diagnosed idiot

20141103 back to 6mgV, xanax next several days. 1111 insomnia bad, 10mgAmbien slept well. 1112 8mgV no Ambien; miserable. 1113 Ambien+xanax, tough night. 1114 Very Tired. 0.125Xanax, 25mgV at 10, better 10min later. 20141115 37.5mg V +Ambien. miserable month, still insomnia & anxiety. 1214 upped to 75mg V, ate .125Xanax. 1215 37.5mg mornings; force sleep for one week and come back". 20150115 lots of appts lots of chat but we never get to MY agenda = meds discussion.  Upping to 47.5mg mornings (no more xanax-, lunesta-forced sleep) but still anxious.  PAYING BIGTIME FOR TOO-FAST WEANING in OCTOBER 2014!  20150220 50mg V. 20150330 still anxy each am let's try reducing: 45mg V 1/day mornings. 20150511:42mg, 0611:40, 0626:39, 0710:38, 0717:37, 0731:33, 0813:32, 0915:29, 0927:28, 1004:27, 1015:26, 1101:25, 1116:22mg/day.  Still anxiety every morning, this sucks.  20151124 found a shrink who seems to get weaning: 20151125 add 10mg/day Prozac aka fluoxetine F, continue taper V to zero, then taper the F, "easier".  20151203:10mg Prozac=P 19mg V, 1213:10mgP17mgV, daily anx quieter but lurking. 1227:10mgP15mgV, 20160108:10mgP14mgV, 0124:10P13V, 0131:P10,V12. 0215 P10,V11.  0223:P10V10.  0314:P10V9. enjoying relatively quiet brain.  0407 P10V8, 0427P10V7, 0517P10V6, 0611P10V5, 0706P10V4, 0818P10V3, 0921P10V2,  1021P10V1, 20161128Prozac10mgVenlafaxine ZERO, 20170115 still anxious upped Prozac to 20mg/day, better anxiety control... 

20190301 finally stable enough to consider weaning again, started skipping one day / week.

20190501 started skipping every 3rd day so 13.3mg/day average.  several days long 1/2life must be why the docs think of prozac as 'self-tapering' i think it just means longer time between upsetting the cart and seeing apples all over the road.  skipping is bad practice, even with longlife prozac: let's do liquid: 20190902 first day of 13mg via 5ml liquid made from 13 20mg caps in 100ml water.  20190921 12mg same way(7.7%/20days).  20191010 11mg (8.3%/20days) 20191031 10mg (9.1%/20days) 20191124 9mg (10.0%/24 days) 20191213 8.5mg (5.6%/20 days) 20191231 8mg (5.9%/20days) 20200120 hit a wall?  going another 20 days at 8mg, just started Lisinopril for hypertension (caused by prozac withdrawal creating less-than-panic-grade anxiety??) and doubled atorvastatin to 40mg.  Minimizing changes in general and had a semi-panic 4am 1/20... BP still wild. 20200208 back to 9mg daily anxiety starting about 1/18.  

20200212 increase to 10mg prozac cap daily.  anxiety still there but clears within hour of drugs.  20200222 still anxy 2 hrs after 10mg, added another 1mg and mucho better.  20200223 11mg early.  anxious enough to be glad i can actually sit.  will wait another 5 days before adding another milligram. 20200229 12mg prozac still anxious.  20200317 13mgProzac still anxious.  20200610 15mgProzac.  bp under control with Losartan50mg (lisinopril cough dictates change)  

20201028 10am met w Dr S.  to switch back to Venlafaxine XR, "take 10mg prozac + 37mg VenlafaxineXR for a monththen quit prozac." i think i'll taper thanx... 
20201116 9am start 10mgProzac,37Venlafaxine,40Statin,25Losartan,81Aspirin.  20201230 5mgProzac,37Venlafaxine,40Statin,25Losartan,81Aspirin.
20210124 4mgP,37V,40S,25L,81A.  20210213 3.5mgP,37V,40S,25L,81A;  20210306 3mgP,37V,40S,25L,81A  20210328 2.5mgP,37V,40S,25L,81A; 20210501 2.0mgP,37V,40S,25L,81A;20210519 1.5mgP,37V,40S,25L,81A; 20210607 1.5mgP,37V,40S,50L,81A. 
20210614 1.0mgP,37V,40S, 50L,81A. 20210702 0.5mgP,37V,40S,50L,81A; 20210728; 0.0mgProzac,37.5Venlafaxine,40Atorvastatin50Losartan,81Aspirin; 20210917 0915am anxiety started about a week after dropping the last 0.5mg of prozac.  just took 0.10mg xanax.  20210929 1:28 PM I'm anxious after so carefully weaning off prozac - the last 0.5mg may need to come back??  instead, trying an extra cap of 37.5mg venlafaxine, let's see if there's sudden relief?  it seems possible.  fingers x'd.  not sure but 5 minutes later i think i feel better gawd i hope.  20210930 7am anxious out of bed, took drugs early and oops chewed them.  no more drugs 2day.  11:41 AM 10/1/2021 very jagged today, avoiding the shower.   took <1/6 of a .5mg xanax and still anxy at noon.  6:59 PM 10/4/2021 2nd or 3rd day of 75mg Venlafaxine  met w/ shrink 2day he says i'm doing  it right so  20210728 75.0mgVenlafaxine,40Atorvastatin,50Losartan,81Aspirin;10mgCarbidopa-Levodopa; 12/18/2021  112.5mgVenlafaxine, 40Atorvastatin, 50Losartan, 81Aspirin; 0.4mgFlowmax; 3x 25/100mgSinemet aka Carbidopa/Levodopa.    20220308 new neurologist, raising CL:  112.5mgVenlafaxine, 40Atorvastatin, 50Losartan, 81Aspirin; 0.4mgFlowmax; 4x 25/100mgSinemet aka Carbidopa/Levodopa.  possibly need to reduce losartan to avoid fainting.

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  • 2 weeks later...

The article is interesting, and maybe we are seeing a turning point BUT it says " strongly advised not to terminate treatment abruptly, but instead to taper carefully and gradually by microdoses over a course of several months, always in consultation with their doctor, to ensure their own safety. "

 

As we see here, several months to taper is too short and this might end up reinforcing the it's-your-illness-coming-back---see-you-need-the-drugs thing. If you think you can safely get off over several months, you might well assume that issues are the illness.

 

I'll see it as a more positive thing if they talk about tapering over several years, not months, but I guess it's good that it's starting to be talked about.

2005 St John's Wort / 2006-2012 Lexapro 20mg, 2 failed attempts to stop, tapered over 4.5 months in early 2012

January 2013 started Sertraline, over time worked up to 100mg

July 2014 Sertraline dropped from 100mg to 75mg, held for six months, slower tapering until 2019 22 Dec 3.2mg

2020 Sertraline 19 Jan 3.1mg, 26 Jan 3.0mg; 1 Mar 2.9, 7 Mar 2.8, May (some drops here) 24 May 2.5, May 29 2.4, June 21 2.3, June 28 2.2mg,  July 4 2.1mg, July 24 (or maybe a bit before) 2mg, early Nov switched to home made suspension; 29 Nov 1.8mg; approx 25 Dec 1.6mg)

2021 Some time in about Jan/Feb realised probably on more like 1.8mg and poss mixing error in making suspension; doses after 10 Feb accurate; 10 Feb 1.6mg; 7 Mar 1.4, continued monthly

10% drops until 1mg, then dropped 0.1mg monthly.

May 2022,0.1mg, now dropping 0.01mg per week

My thread here at SA: https://www.survivingantidepressants.org/topic/1775-bubbles/page/18/

CurrentSertraline: 0.08mg / Armour Thyroid

 

 

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I'm glad to see this, but I agree, it's not enough. It doesn't talk about the delayed appearance of symptoms after 3-6 months, which is common enough that it really needs to be studied and recognized, because it's usually being called "relapse." It also, as you say, talks about tapers that are much too fast for most people.

 

In other words it is way too little way too late, but it is better than nothing. It's a beginning. It's so much more than we've had before. Hopefully it's the very tiniest beginning of a turn of something that will become a very high tide indeed. I would like to see the widespread use of psychiatric drugs become an appalling memory from a distant past. (Probably not in my own lifetime of course.)

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

 

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

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Yes it's a beginning.

2005 St John's Wort / 2006-2012 Lexapro 20mg, 2 failed attempts to stop, tapered over 4.5 months in early 2012

January 2013 started Sertraline, over time worked up to 100mg

July 2014 Sertraline dropped from 100mg to 75mg, held for six months, slower tapering until 2019 22 Dec 3.2mg

2020 Sertraline 19 Jan 3.1mg, 26 Jan 3.0mg; 1 Mar 2.9, 7 Mar 2.8, May (some drops here) 24 May 2.5, May 29 2.4, June 21 2.3, June 28 2.2mg,  July 4 2.1mg, July 24 (or maybe a bit before) 2mg, early Nov switched to home made suspension; 29 Nov 1.8mg; approx 25 Dec 1.6mg)

2021 Some time in about Jan/Feb realised probably on more like 1.8mg and poss mixing error in making suspension; doses after 10 Feb accurate; 10 Feb 1.6mg; 7 Mar 1.4, continued monthly

10% drops until 1mg, then dropped 0.1mg monthly.

May 2022,0.1mg, now dropping 0.01mg per week

My thread here at SA: https://www.survivingantidepressants.org/topic/1775-bubbles/page/18/

CurrentSertraline: 0.08mg / Armour Thyroid

 

 

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