Edmunds: prolonged Wellbutrin withdrawal

[manymoretodays]

((((((Edmunds)))))))

Me too......on the continuing quest for just the right glasses.  I've got readers AND progressives now(the bifocals without a line)........yet have to switch to readers for any lengthy reading.

My night vision is really not the greatest either.........astigmatism too now!

So back to the optometrist again and I'm all scheduled to see an opthamologist for the first time in early October.

 

And I know some of it, is due to my drug/medication history.......I know that.......I do and it irks me! 

 

Wishing you significant lengthy windows..........coming soon!

 

And hey, what's going great! .................................................................yep, all that and more so.  The best is yet to come.

 

L, P, H, and G,

mmt

[Edmunds]

I’m holding at 1.8 mg of fluoxetine. Last Saturday evening we had guests come to our house for dinner for the first time in 7 months. We dined on our patio while social distancing. I got through the entire evening with minimal anxiety, though derealization and fatigue were the same. It was good to see dear friends again. I was encouraged. But yesterday and today the anxiety has been on the offensive. The derealization is so bad coupled with blurry vision that I can’t drive a car except for very short distances. Had a crying session with my loving wife. I don’t know what I would do without out SA and the support of wonderful moderators. Some days it’s so easy to think I’m simply mentally ill and that it’s not going to get better. Without SA I would have nowhere to turn  except to a psychiatrist eager to prescribe ADs. I do have a good therapist, though. 

[Hanna72]

@Edmunds

5 minutes ago, Edmunds said:

Last Saturday evening we had guests come to our house for dinner for the first time in 7 months. We dined on our patio while social distancing. I got through the entire evening with minimal anxiety,

Wow that’s great news. Keep those positive improvements close to your heart. 
 

 

7 minutes ago, Edmunds said:

I’m holding at 1.8 mg of fluoxetine

That’s a huge accomplishment, well done. 
 

 

11 minutes ago, Edmunds said:

But yesterday and today the anxiety has been on the offensive. The derealization is so bad coupled with blurry vision

This is unfortunately what many of us experience in withdrawals. A ride that is filled with windows and  waves. 
 Don’t be discouraged, you already know the feeling how a lovely window feels and they will become more frequent as time goes by and more healing happens.

18 minutes ago, Edmunds said:

Some days it’s so easy to think I’m simply mentally ill and that it’s not going to get better.

You are not mentally ill and you will reach your destination before you know it.

All the best to you.

 

 

[Edmunds]

Thanks to @Hanna72 for encouragement earlier this week. The past three days I've noticed a softening of anxiety feelings, though pronounced mental fatigue, derealization,  blurry vision, and annoying-level cortisol spikes when I first wake up. As I've remarked before, I don't seem to have distinct waves and windows, just changes in the dominant symptoms. In the meantime I'm holding at 1.8 mg Prozac and getting on with my work as best I can. As many have observed,, COVID isolation together with fear of a perpetuation of the current political regime in the US takes a toll, even though we may not understand the connection.

[Colonial]

Just stopping by to say hello.

My last Wellbutrin dose was June of 2018.

Took Me over 3 years to successfully get off a med I was on for 6 months.

I still get symptoms from it every spring and Autumn, but they are not as bad this Autumn as they were last, so You will get there slow but sure like the rest of us!

Take care!

[Edmunds]

Thanks @Colonial for checking in with me. I went off both Wellbutrin and Effexor within two months, both with fast tapers. I don’t know which AD caused me more trouble in the ensuing months, but I’m pretty sure it was the Effexor. Right now I’m aiming to get off Prozac, the last of them. 

[Edmunds]

I'm checking in to report that I'm holding at 1.8 mg of fluoxetine. Not much change in the past several weeks. I noticed that over the past couple of days the moderate cortisol spikes in the early morning have gone away. We'll see if that trend continues and if it's a sign of windows opening that alleviate other symptoms--the very unpleasant derealization, low level anxiety that goes up and down, blurred vision, and fatigue. Yesterday was my birthday. I spent part of the morning sobbing (not moaning and screaming!) over the protracted nature of this wd recovery. Fortunately, my dear wife was on hand, and a daughter and granddaughter brought us lunch and cupcakes.

[Colonial]

Happy Birthday, Friend!

Glad the spikes are starting to even a little.

And happy you have family around you as well.

[Edmunds]

Thanks @Colonial!

[Edmunds]

My waves and windows fluctuate throughout the day, though the main symptom of dense derealization does not change much. This morning I experienced an unusually sharp surge of anxiety lasting about an hour. There was no triggering event. I was able to manage it pretty well by remembering that this episode is my brain working  hard this morning to heal a particular patch, and that's a good thing. I'm into 4.5 weeks of holding at 1.8 mgs fluoxetine.

[ChessieCat]

53 minutes ago, Edmunds said:

I was able to manage it pretty well by remembering that this episode is my brain working  hard this morning to heal a particular patch, and that's a good thing.

 

That is a really good way of looking at it.  It takes the "it is what it is" self talk a step further and puts a positive spin on it.

[Colonial]

3 hours ago, Edmunds said:

. I was able to manage it pretty well by remembering that this episode is my brain working  hard this morning to heal a particular patch, and that's a good thing.

 

That's wonderful, Edmunds! Keep holding on! 💖

[Edmunds]

Thanks to @ChessieCat and @Colonial for the encouragement.

[Edmunds]

This is Sunday and from Thursday through Saturday I had the most encouraging stretch of windows in a very long time. Anxiety was down, and I had tiny feelings of hope and muted exuberance. I also forgot all about meditating or doing my moderate weight lifts. Instead I worked harder at my desk and completed a few home projects. Then this morning I woke up anxious, sad, and discouraged, had an anxiety surge, and have been experiencing particularly heavy derealization. I'm so grateful to SA for teaching me about waves and windows. I'm looking forward to the next window!

 

Question: Since my 40s I've had occasional (once every several months) ocular migraines. For me that means a ziggy-zaggy visual disturbance that starts small and in the center of my eyes, the gets bigger and moves outward until it disappears in 10-20 minutes. I sometimes have a minor headache afterward. Since experiencing WD starting 15 months ago, the ocular migraines have become much more frequent, about once a week recently. Neurologists have told me not to worry about them. Are these disturbances, especially occurring more often, one of the many possible symptoms of WD? The one I had today coincided with an anxiety spike.

[Colonial]

How wonderful You had such a great window! That's so encouraging to hear! 😎

 

It's not unlikely for WD to make any underlining condition worse or make it pop up more frequently. They may or may not coincide exactly with another symptom or wave. This can sometimes make one wonder if it is the WD or the original condition getting worse or a little of both.  If Your migraine pattern was stable for an extended period and has become more frequent during WD and the neurologist has looked you over and said not to worry it could very well be the WD. It may be discouraging but it's a reminder that Our brains are still healing even if we don't "think" we are having, what for us, would be exclusive WD symptoms and be a good reminder to take Our taper slow and steady.

[Edmunds]

Thanks @Colonial for you last reply.

 

I wonder if you or another moderator could tell something. I watched the excellent film on WD a month or two ago. I can't remember the name of it now. One of the featured participants was a psychiatrist at UCLA. Could someone remind me of his name. Thanks!

[Colonial]

46 minutes ago, Edmunds said:

psychiatrist at UCLA

Could in be David Cohen?

 

[Edmunds]

Thanks @Colonial.  Yes, you are right. The UCLA professor in "Medicating Normal" is David Cohen.

 

What Next? I have now been on 1.8 mgs of fluoxetine/Prozac for just over 6 weeks. Last week I had a 3 day period that I would definitely call a partially open window. But since then I have experienced a more aggravating wave of dense derealization and gnawing anxiety (no panic attacks). This morning I was crying my eyes out and going through boxes of tissues! This current wave is about as difficult to bear as the continuous wave I had for 4 months last year following withdrawal from Effexor. Moderators have told me that the taper I made from 4 to 2 mgs of fluoxetine a few months ago was not a good idea. Would you advise me to stay on 1.8 mgs for as long as it takes to feel some sustained improvement? 

[Colonial]

While it is true to say that we don't have to be completely symptom free before we can restart Our taper I think it might be a little too soon for you.

I don't see in your signature your med chart for this drug or when You dropped from 4 to 2, if it was all at once, etc., but I wouldn't be surprised if these symptoms were from that larger drop or the cumulative drops of going from 20 mgs down to 2 mgs in only 19 months. You also have to take into account the plethora of other meds over the years that may be making it harder to adjust. Until out brains have adjusted, even seemingly tiny drops make it harder for us. So 6 weeks may not be enough time at this level if Your still dealing with the fallout out from a 50% drop in the recent past. 

 

While having a nice 3 day window like that is encouraging, the temptation is to rush things along can just make things worse. If your back in a wave again it's probably a sign to wait. It's prudent to be having longer windows and less severe waves before making our next drop. Since dropping 50% of our doses normally takes a MINIMUM of 6 months, it might be wise to wait 7-8 months from whenever that 50% drop was, since You've made another drop since then, and re-evaluate. I don't know what "a few months ago" means to you and without the signature chart updated with your exact med changes its hard to give a better idea.  Remember Autumn is a hard time to begin with for everyone, so longer holds this time of year may be beneficial to you for that reason as well.

Edited October 7, 2020 by Colonial

[Edmunds]

Thanks again @Colonial for that detailed and very helpful response. I have just cleaned up and updated my signature.

 

I had relief from heavy anxiety surges after way-too-fast tapers from Effexor and Wellbutrin (May and July respectively in 2019) by Jan 2020, I then started taper of fluoxetine/Prozac. I did (unadvisedly) linear 10% drops at about 4 week intervals over the following months. During this time, I had little improvement but few noticeable waves. Then, to eager to get off the Prozac for good, I dropped from 4 to 2 mgs in just over 2 weeks, as my chart shows. At that point I did not understand the consequences of a 50% drop at such low doses. I dropped to 1.8 mgs after another 2 weeks, but then got wise and hit the brakes amid increased anxiety and derealization.

 

I will continue holding at 1.8 mgs fluoxetine.

 

It's been hard for me to grasp how a little squirt of liquid fluoxetine (.45 ml) in a glass of water or orange juice can have such a large effect on my brain! But as you say, I'm also dealing with 33 years of one psychotropic after another.

 

When I did neuro-feedback in 2015, I had to be off ADs for 5 months. I stopped the feedback after experiencing some heavy anxiety attacks. I attributed them to the feedback sessions, but now I think it's much more likely to have been WD from Lexapro and/or Cymbalta, the last two ADs I had been on. After the feedback ended, I started on Effexor.

[Colonial]

 

I still deal with Wellbutrin symptoms occasionally even though my last dose was June of 2018.

So if you only went off the other 2 meds last year and fast  tapering the Fluoxetine now it's easy to see why your brain and body are in difficulty.

 

In actuality, you made 2 two mg drops in less than a month, not one:

 tapered 6 to 4 mgs 6-29-20, 4 to 2 mgs 7-15-20,  2.0 to 1.8 mgs 08-26-20), holding at 1.8 mgs (10-08-20). you dropped 66% in only 16 days

 

So if you extrapolate out how long it should have taken you to drop from 6mgs down to 1.8 dropping at 10% monthly, you'll have a better idea of how long you may need to wait since stabilization times have an eerily strange way of mimicking the amount of time you should, in theory, have taken to drop properly, sometimes even longer.

 

Have a great weekend ahead!

[Edmunds]

@Colonial I calculated as you suggest from the base of 6 mgs. on June 29 2020. According to that, I should taper from 1.8, where I am now, to 1.62 in June 2021! I can only hope that I will get better in the meantime. I will continue all the ways I know to reduce anxiety. I have a good therapist. I must also be grateful that my symptoms are not severely debilitating. I work at home and can do that. I have a wonderfully supportive spouse. Grown children and grandchildren are not far away.

[Colonial]

 

That's wonderful you have so many people so close!

And I'm super excited for you that Your at least starting to notice some windows, that's great!

 

Yes, that was almost an entire year's worth of tapering! So no need to feel bad about where You are, rest, try to enjoy the Holidays and in, say, 6 months time from Your last drop, so around the beginning of March re-evaluate where You are. You may decide for a small drop then or April. But all things considered, your doing really well with trying to keep a positive outlook. You'll get there eventually! 💖

[Edmunds]

Thanks @Colonial, good advice once again

 

Other SA members might be interested in this: I just spoke to my neurologist regarding my more frequent experience of ocular migraines since my AD tapering adventure began. She said that the migraines may very well be connected to my process of tapering from Prozac. Change in any number of medications may produce increased frequency of migraines, including the ocular type.

[brassmonkey]

Very interesting to hear. I noticed a marked increase in them as I was tapering which has continued even after I reached "0".

[Edmunds]

I’ve read much on the site about symptoms varying during WD. I’m trying to see this as a positive thing—the brain moving through different pathways to recovery. In the past couple of weeks, I’ve noticed the near absence of upsurges of anxiety that usually have lasted an hour or so. This has not meant that I feel generally better. Rather the anxiety is nearly ever present and very unpleasant but also flatter. The derealization remains dense and unchanged, along with mental fatigue. But somehow I take hope that my brain continues it’s patching job, causing different symptoms. 

[Edmunds]

Yesterday, my window opened a crack. Feeling of anxiety/distress dissipated through much of the day. A little sunshine is easy to recognize when you haven't had one in weeks. Today, the window seems to have closed again. But at least I know windows can happen.

 

Early morning cortisol anxiety surges have been moderate but persistent, along with continuing heavy derealization.

 

I'm holding at 1.8 mgs of liquid fluoxetine.

[Altostrata]

Good to hear, Edmunds.

 

How long have you been holding on your fluoxetine dosage?

 

In post-acute withdrawal, I had occasional ocular migraines myself for a while. They went away, fortunately.

 

Have you tried fish oil and magnesium? Many people find fish oil and magnesium supplements helpful, see
https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/
https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

You might try a little bit of one at a time to see how it affects you.

[Edmunds]

Thanks for checking in @Altostrata. I tapered to 1.8 mgs liquid fluoxetine on August 26, 2020, so I've been holding there for nearly 8 weeks. As I wrote, I had this nice little window two days ago, but the past day and a half have been very unpleasant, including two hours of wakefulness last night. On the whole, I've experienced very little insomnia. Because I have not had any sustained improvement in many weeks, @Colonial advised me to keep holding at 1.8 mgs. Admittedly, I also rushed my taper after reaching 4 mgs. on June 29, not clearly understanding the problem of tapering too fast at very low doses. So I'm probably paying the price for that.

 

As my chart shows, I've been taking Omega 3 and Magnesium for a long time, though I recently increased the magnesium from every other day to daily to see if I can avoid diarrhea, which I have previously experienced on a daily dose.

[Altostrata]

Magnesium is best taken in frequent small doses throughout the day. If you're getting diarrhea, you're taking too much at one time.

 

If you feel you can cope with your current symptom pattern, you might try holding for a while more. Or, you might want to updose slightly, to 2mg, and see if that helps. It will take a week or more to take full effect.

[Edmunds]

Thanks @Altostrata for the advice on taking magnesium, which I will follow.

 

I can cope well enough to carry on at 1.8 mgs fluoxetine for a while longer. I realize that some people in WD have a nice window, then get slammed with worse symptoms. I try to be patient.

 

Because my intermittent problems with derealization/anxiety long precede my WD journey, I've made an appointment with a well-regarded doctor who practices integrative psychiatry and who will explore other causes and treatments not involving ADs. The psychiatrists in my HMO are basically meds dispensers. I'll report how this appointment goes next week.

[Edmunds]

Following up on recent exchange with @Altostrata, who suggested that if my symptoms become more aggravated I might updose from 1.8 mgs of liquid Prozac to 2.0. I’ve been at 1.8 for 2 months now, and derealization fog/anxiety are really bad. Can I get reassurance that updosing back to 2.0 mgs could possibly make a difference? I’m taking liquid, and that would be the equivalent of 0.5 mls, right—a few drops?

[Altostrata]

No, we cannot assure you that updosing will make a difference. You'd have to try it and see what happens.

 

Because you tapered too fast, it's likely your symptoms are withdrawal symptoms that may be relieved by an updose.

 

On 10/8/2020 at 9:51 AM, Edmunds said:

I did (unadvisedly) linear 10% drops at about 4 week intervals over the following months. During this time, I had little improvement but few noticeable waves. Then, to eager to get off the Prozac for good, I dropped from 4 to 2 mgs in just over 2 weeks, as my chart shows. At that point I did not understand the consequences of a 50% drop at such low doses. I dropped to 1.8 mgs after another 2 weeks, but then got wise and hit the brakes amid increased anxiety and derealization.

 

On the other hand, if your anxiety is worse after you take your dose of fluoxetine, it's likely the drug that's causing the sensation of anxiety.

 

We very carefully advise people to go gradually with drug changes because we don't have any magic potions to fix them if their experiments go wrong.

[Edmunds]

Thanks @Altostrata  my anxiety does not get worse after taking the fluoxetine dose. On the whole I tend to cope a bit better from afternoon and especially an hour or two before bed. The anxiety is the sharpest right after waking in the morning— cortisol spike I assume. 
 

I’ll think about the updose today. 

[Altostrata]

What times of day do you take your drugs, and their dosages?

[Edmunds]

Thanks @Altostrata  I take 1.8 mgs liquid fluoxetine every morning after eating, between 7:30 and 8:30. In addition to that, I take D 3, B 12, Omega 3, and magnesium chelate. Nothing else. The magnesium is 250 mgs and I’ve started dividing it into 2 or 3 portions a day. 
 

On another subject, I recently made a donation to SA. I would like to know if it was received.