BasicIsland: Feeling trapped

[BasicIsland]

Hi all, I'm new to the forum and would like to provide you with a brief history of my antidepressant use and current situation.

 

When I was in my teenage years (15) in 2003 I was diagnosed by a psychiatrist as having General Anxiety Disorder and Obsessive Compulsive Disorder due to having panic attacks and intrusive thoughts.
I was prescribed Citalopram 10mg and to be honest I do not remember much during this time, all I know is that the medication worked to a certain extent reducing both my OCD and anxiety. (but never completely "curing" the conditions, only making them manageable) The side effects were brutal (weight gain, lack of empathy - turning me into a zombie and sexual disfunction being the main ones) but I continued taking the medication because I was told there was a "chemical imbalance" in my brain and the medication is the only solution.

From 2003 to 2018 my dose was gradually increased from 10mg to 60mg as I had periods of anxiety and panic attacks through the years even when medicated.
I distinctly remember that the medication stopped working for me in 2016 when I suddenly started having anxiety 24/7 with the occasional panic attack. In late 2018 I decided to come off the medication for good as I believed it was not helping me anymore and the side effects were quite debilitating. 

I consulted my general practitioner about stopping the medication in 2018, he suggested I cut the dose in half every 3 days and then stop when I hit 5mg. I did not quite follow his instructions as during my taper I experienced some severe withdrawal symptoms (brain zaps and agitation) so I decided to reduce my dose by 5mg every 2 weeks.

 

My last dose was taken in March 2019 and I took 2 weeks leave from work in anticipation of the withdrawal. 

At first there was only brain zaps and some agitation that in itself was manageable, then came the gastro intestinal issues about 1 month after stopping the meds, mostly heartburn and IBS type symptoms. I did not link these issues with withdrawal and went to a GI specialist that performed multiple tests (Colonoscopy, Gastroscopy, CT scan and blood tests) all tests came back reporting no issues. after about 2 months off the meds I started having severe panic attacks and anxiety as well as pressure in my head (behind my eyes), severe dizziness and a lot more symptoms that I cannot even recall as they disappeared and reappeared seemingly at random. 

 

Due to the anxiety and panic attacks I started to struggle at work and I reasoned that it must be due to me requiring the medication and I probably need to take it for the rest of my life (even though it does not seem to do anything for me anymore). So I went back to the general practitioner explaining to him my situation and symptoms, he reinstated the Citalopram at 20mg (this was at the end of August 2019). After taking my first dose I felt fine but taking my 2nd dose all hell broke loose - intense shaking, vomiting, insomnia, hallucinating and migraines. On the 4th day after reinstating I ended up in the ER unable to sit still and focus on anything I probably looked like I was on hard drugs or something, they gave me some Ativan and sent me on my way advising me to cease my current medication and go see a psychiatrist. Off the Citalopram I was still in hell - could not focus or sleep, randomly crying over nothing. Finally I went to my appointment with the psychiatrist 2 weeks later - he prescribed me Effexor XR 75mg which he said will fix all my problems. Again I managed to make it to day 4 before giving up on the medication, it made me 100x worse. Once again I landed in ER with hallucinating, migraines, muscle spasms all over my body and my face muscles “pulling” downward rendering me unable to speak.

 

The ER sent me to a mental health clinic as they could not assist me with my condition. Booking myself into the clinic I waited to see my psychiatrist, he told me to stop taking the Effexor XR and put me on Zoloft (Can’t remember the dosage) but I refused to take the medication as I was MUCH better off before reinstating and I already knew what will happen to me if I have to take another SSRI. Having refused the Zoloft and sending my psychiatrist a lengthy timeline of my symptoms showing that I get VERY sick every time I try another SSRI - So he puts me on 25mg Valdoxan. It does absolutely nothing for me (stopped taking it 2 weeks in as my psychiatrist refused to send me for liver tests) and my symptoms get better as the Effexor leaves my system.

 

This was approximately 6 weeks ago, currently it feels like I am in hell, I am able to work but I am struggling. I had blood work done today and will get the results back on Monday (just to make sure I don’t have some kind of infection/disease/vitamin deficiency - because it literally feels like I am dying). I am seeing a neurologist in late November so they can do some scans of my brain to further make sure nothing is physically wrong with me and when I get the all clear I feel I will be able to hang on for the duration of this terrible terrible experience.

 

I only started to log my symptoms about 3 weeks ago but in those 3 weeks I have experienced:

 

• Abdominal Pain
• Joint Pan
• Migraines / Headaches
• Feeling of insects crawling under my skin throughout my entire body
• Severe fatigue 
• Body trembling (muscle twitches in legs and arms) When holding arms/legs together can feel a quick repeating “pulse” of muscles
• Pain in hands/wrists muscles feeling “not connected” touching objects feels strange (numb).
• Nausea / Vomiting
• Visual problems feels like the brightness in my eyes was turned up to 11 this produces poor night vision
• Dizziness
• Pain in neck and head (right side) - behind ear to forehead
• Pain in thighs 
• Super brain zaps? - lasts hours instead of seconds (worsens with eye movement / sound) - Pressure/Tingling in skull, sensitive to sound 

 

I do believe all the above mentioned symptoms seem to align with withdrawal perfectly, but I am still very scared. Not knowing when/if I will get better is true torture.

 

My hope is to get support/advice/hope from this forum that I cannot receive from the medical professionals I have access to (they do not know or seem to care about this very real and very frightening condition) and to help others where I can to the best of my ability.

[Altostrata]

Welcome, BasicIsland.

 

Thank you for that excellent account of how acute antidepressant withdrawal symptoms become post-acute withdrawal syndrome, which is what you have now.

 

What we see is that adverse reactions to psychiatric drugs and withdrawal syndrome tend to make people hypersensitive to reinstatement of "normal" dosages, which you have so clearly recounted here:

 

On 10/17/2019 at 6:32 AM, BasicIsland said:

So I went back to the general practitioner explaining to him my situation and symptoms, he reinstated the Citalopram at 20mg (this was at the end of August 2019). After taking my first dose I felt fine but taking my 2nd dose all hell broke loose - intense shaking, vomiting, insomnia, hallucinating and migraines. On the 4th day after reinstating I ended up in the ER unable to sit still and focus on anything I probably looked like I was on hard drugs or something, they gave me some Ativan and sent me on my way advising me to cease my current medication and go see a psychiatrist. Off the Citalopram I was still in hell - could not focus or sleep, randomly crying over nothing. Finally I went to my appointment with the psychiatrist 2 weeks later - he prescribed me Effexor XR 75mg which he said will fix all my problems. Again I managed to make it to day 4 before giving up on the medication, it made me 100x worse.

 

Recovery from withdrawal syndrome is very gradual and can take many months. You have already experienced some recovery.

 

We have found a very low dose reinstatement, such as 0.5mg citalopram may reduce your current symptoms. If it helps, you'd stabilize on that for some months, then taper off by tiny amounts. Here's some background that may help you decide:

 

What is withdrawal syndrome?
 
About reinstating and stabilizing to reduce withdrawal symptoms
 
The Windows and Waves Pattern of Stabilization

[BasicIsland]

Thanks Altostrata,

 

I have not been posting since my introduction as I have experienced some intense symptoms as of late.

 

There are too many to list but these are the worst for me:

 

• Intense anxiety - I have been an anxious person all my life and I know all about dealing with anxiety and panic attacks, but this? this is not "normal" anxiety this is a new level for me. It feels unnatural, almost synthetic... its very hard to explain and is VERY debilitating.
• Feeling like I am sinking into the floor or falling over - does not quite feel like dizziness/lightheadedness. (this has been a constant issue over the last week)
• Deep dark depression, its at its worst during morning and nighttime. This feels like a dark web covering my mind/emotions constricting me. It is truly terrifying, the feeling of hopelessness and not being able to find a way out of whatever is happening to me. (Never in my life have I felt like this)

I am struggling at work and I am scared that I am going to have to quit/lose my job and lose everything I have worked for over the years and move in back with my parents... Each day feels like an eternity and it is breaking me.

I would not mind reinstating at 0.5mg but I am so scared to take Citalopram at this point - if I have 1 more bad reaction I will most likely lose my job. (I have almost no sick leave left). 

 

At this point I am desperate to hold on to what I have even if it means I have to go back to taking antidepressants just to remain somewhat stable.

 

Would it be a bad idea for me to try a different SSRI at a low dose (maybe 1/4 the normal starting dose?) then go up as I stabilise? Then hold for a year or so then do the extremely slow taper recommended on this forum.

Zoloft is well tolerated by both my mother, father and brother, is there a genetic component to how well an SSRI is tolerated?

 

 

 

 

[Altostrata]

On 10/19/2019 at 1:04 PM, Altostrata said:

We have found a very low dose reinstatement, such as 0.5mg citalopram, may reduce your current symptoms. If it helps, you'd stabilize on that for some months, then taper off by tiny amounts.

 

You might try 0.25mg fluoxetine (Prozac) instead. Please let us know how you're doing.

[Rhiannon]

Hi--

Can I just say, please follow and read the links above before you make any decisions. Everything you are experiencing is classic and quite honestly Alto has seen it hundreds of times and has helped hundreds (maybe into the four digits actually) of people through it.   I don't think you're going to get better advice anywhere than hers.

 

I've followed many dozens of cases like yours myself. Including my own.

 

There are literally only a handful of physicians around the globe whose advice I would recommend to you at this point, and I am pretty sure there's nobody who's better at this than Alto.  I know it's hard to believe that an Internet site could have better information than doctors, but in this case unfortunately it's the truth. There are a few places where they're beginning to admit AD withdrawal exists and to look at it a bit, mostly in the UK, not in the US so much. Hopefully in ten years there will be doctors trained in this. I know Alto is more than ready to pass that baton.

 

Your best bet at this point is a low dose reinstatement.  Your worst bet at this point is listening to doctors who want to put you on full doses of more/better/different drugs. That's usually the path people go down and it doesn't end well.

 

Good luck to you.

[Altostrata]

@BasicIsland, how are you doing?