Schaffer: Two antidepressants and alcohol

[Schaffer]

Although I’ve been a member for some time, I’ve only read others’ survival posts, so I guess this is my introduction.

I’ve been taking at least one antidepressant (Prozac when it was first introduced) for over 35 years and more recently, Paxil for about 10 years. I’ve tried all the SSRIs. Also started self-medicating wth alcohol over 35 years ago. Coincidence? Yeah, sure. At the time my doctor attributed my symptoms to PMS. Over the years I have tried to quit or at least control my wine intake, resulting in chronic insomnia. So my new doctor prescribed Remeron as an adjunct to help me sleep. I’ve had my share of stressful jobs and relationships, but I now find myself at a period of my life of low stress and I strongly feel it’s time to get off these chemical dependencies so I can do the things I want in my retirement years (mostly painting in nature).

So two months ago I gave up my daily bottle of wine, and got through the withdrawal. Six weeks ago, I decided to taper myself off Paxil, and now I am off that completely. It hasn’t been easy but tolerable and I am highly motivated. So one month ago, I started to taper off Remeron, and am down to approx. 3.35 mg at bedtime. Here is a list of my withdrawal symptoms in order of appearance: fatigue, vivid dreams and nightmares, brain fog, irritability, brain zaps, and hot flashes. I’ve put up with all these knowing that eventually they will disappear. But my latest symptom is the one that brings me to my knees and that is teariness. It can be brought on by anything, such as a picture of a sad dog. I had this tendency to cry easily when I was a child, and did my best to hide it, so I’m wondering if it’s a withdrawal symptom or just part of my character. I’m reading that if I can’t handle total withdrawal, I should return to lowest dose of a drug with long half-life, such as Prozac. At this stage of withdrawal, it’s probably impossible to untangle what’s responsible for what. Also in this year of great change, my mother died, and that has come with its own kaleidoscope of emotions. I’m so glad to have been reminded recently of this wonderful peer-support forum.

Edited November 14, 2019 by Shep
added username to title

[Schaffer]

Hello moderators,

I realize this is a very busy forum, but I’m suffering here; could really use some feedback.

Thanks.

[Sassenach]

Hello   Schaffer   and welcome to SA.

 

I apologise for the delay but

This site is run entirely by volunteer Administrators and Moderators, all have been through or going through withdrawal.

There are no commercial interests or influences  involved .

 

I am sorry you are having such a rough time but you are now in the right place.

On 11/4/2019 at 10:18 PM, Schaffer said:

So two months ago I gave up my daily bottle of wine, and got through the withdrawal

Congrats a good start.

To begin we need information regarding your drugs.

What dose of Paxil were you taking?

When did you start and finish your taper, dates please as accurate as possible but not relative ie not two weeks ago.

What was your starting dose of Remeron?

Date started?

From the info currently available, you have tapered off both dugs much too quickly and should make no further reductions at present.

why-taper-by-10-of-my-dosage/

You are now experiencing W/D ( withdrawal symptoms ) which are likely to increase.

dr-joseph-glenmullens-withdrawal-symptom-checklist/

The only known way to mitigate W/D symptoms is reinstate a small dose of the A/D.

about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms/

the-windows-and-waves-pattern-of-stabilization/

the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable/

On 11/4/2019 at 10:18 PM, Schaffer said:

I should return to lowest dose of a drug with long half-life, such as Prozac

 

We normally advise reinstateing the original but Paxil is notoriously difficult to cease so Prozac may be an answer.

It is however extremely important that reinstatement dose are much smaller than the original level.

If to decide you wish to reinstate I will ask one of our senior mods to advise on the dose.

We advise reinstatement within one month of ceasing the med so, time is important.

Which drugs do you currently have available?

Do not attempt reinstatement without asking our advice about a suitable dose.

As soon as we recieve the drugs info. we can assess your situation.

In the meantime DO NOT MAKE ANY CHANGE TO YOUR CURRENT MEDS please.

Please feel free to browse the site, it is a wealth of info.

Other members threads will give you an insight and the opportunity to share experiences.

 

Again welcome.

 

Sassenach

 

 

 

 

[Schaffer]

Hi Sassenach,

thank you very much for you response today, and sorry for my impatience which I guess is all part of the withdrawal. BTW, I Love Bonny Scotland; it’s my heritage and in fact we took my mother’s ashes home this year.

Here is my recent history with antidepressants:

Paxil: 15 mg. circa 2001 to 2010; increased to 30 mg. circa 2015 to beginning of taper Sept 17, 2019.

Remeron: 15 mg. circa 2015 to beginning of taper Sept 17, 2019.

Taper history:

Paxil: Sept 17: 30 mg. to 15 mg. Oct 6: 15 mg. to 7.5 mg. Oct. 27: 7.5 mg. to 0

Remeron: Sept 17: 15 mg. to 7.5 mg. Oct 27: 7.5 mg. to 3.75 mg. 

So at present i am taking no Paxil and 3.75 mg. Remeron. I take a multivitamin and started supplementing with 4000 mg. Omega 3. My sleep seems to have stabilized. Some days are better than others, the best being a little sluggish with mild flu-like symptoms. I am not curtailing activities, except for things that are stress-inducing such as city driving. Of all the symptoms, i have not once felt depressed or anxious. So far i have no interest in reinstating, and certainly not Paxil. I do have both Paxil and Remeron on hand. I have an appointment to see my GP on nov. 19. She is not aware of my intention to taper, and i am still waiting after 7 months for an appointment with a physician specializing in addictions and psychotropics. Such is the state of our medical system in Canada.

i think that’s all the info you need from me at present. Thank you for the links you have identified for me; i will spend the rest of the evening with them.

thanks again for your warm welcome to SA and for caring to help others. It feels good to be here.

Schaffer

[Sassenach]

Hi Schaffer

 

Thank you for the drugs info.

You tapered very quickly and two drugs at once, neither of which we would recommend on this site.

However some people do manage to do this with minimal symptoms, I hope you are one of them.

If however you experience an uptick in symptoms please contact us sooner rather than later.

15 hours ago, Schaffer said:

i am still waiting after 7 months for an appointment with a physician specializing in addictions and psychotropics.

To be honest this will probably be a total waste of time anyway, they may claim to specialise, but few if any really understand withdrawal from these meds.

Good luck, you know where we are if you need us.

 

Sassenach

 

 

 

[Schaffer]

Thanks Sassenach.

I realize I tapered too quickly and I expect to experience waves of withdrawal. I’m now monitoring daily with Dr. Glennmullen’s spreadsheet.

I appreciate the support.

schaffer

[Schaffer]

Hi Sassenach,

I'm finding it difficult to give myself an accurate appraisal of my symptoms. When I’m home resting, I feel they are not too bad, but when I go out even for groceries, I feel more of an impact. If I were still working, I don’t think I’d be able to cope. And at times I think I may have to reinstate. I see my doctor nine days from today, and I’d like to be prepared for that possibility. Could you or another moderator please advise on reinstatement for me? As I mentioned, I started in Prozac when it first came on the market, and had no problem with it. I’ve just discovered there is a brand new compounding pharmacy in my community, so I’d like to ask their advice as well. To be honest, I don’t think my doctor will be very knowledgeable in this area.

thanks again.

Schaffer

[Sassenach]

Hi Schaffer

 

Having re-read your thread.

As you have not completely stopped Remeron reinstatement is not involved and there is no issue with timeframe.

It is possible that a small updose could help but would only really be necessary if your symptoms are unbearable.

It is only two weeks since you halved the Remeron dose.

I suggest you hold as you are for the present and keep track of your symptoms in a diary as follows

keep-daily-notes-of-drug-schedule-and-symptoms-to-track-patterns-and-progress/

Your doctor will almost certainly tell you to updose, they always believe that is the answer.

If you decide to do so you should not go beyond 7.5mgs, it could cause unwelcome symptoms.

Keep us advised of your progress.

 

Sassenach

 

[Schaffer]

Thanks again Sassenach; you have bolstered my courage. My symptoms are not unbearable, so I will take your advice and stay the course with the Remeron. I have enough of my cut-up pills for another 54 days, that is until week of Jan 6, 2020. The compounding pharmacy has assured me that they can produce to order small doses for me. I had originally intended taking these 3.35mg bits until I run out, but I suspect you’ll recommend going even smaller before I quit outright. So my question is whether to cut these even smaller and if so, when to go down to this next cut, which would be 1.7mg, more or less. Or whether to continue until January on 3.35, and then get a prescription for the smaller dose. I have a feeling I know what you’ll recommend. I have been keeping a journal on my symptoms, but not on the appointment-book style, so I’ll start that tomorrow. However, since I take the Remeron at bedtime, I don’t think we’ll see much correlation to time of day for symptoms. All I can say is that the morning grogginess is getting better and the fatigue starts about 2pm. I fall asleep readily about 10pm, however I have many overnight ‘bathroom breaks’ from drinking so much tea. I will start not having any after dinner, but it is such a comfort! I don’t let myself stay in bed beyond 7-7:30 am for fear of not getting to sleep at night.

 I’m curious about my doctor’s reaction. You could be right, but she is very young and proactive and I think she might be pleased I’ve taken this step. Will let you know next week.

[Sassenach]

Hi Schaffer

 

You are getting the hang of this.

I would not consider further reductions until you at least a couple of months of stability.

You should then get the componded liquid and swithch to that at the same dose.

Even switching to a compouded formula of the same drug can have an effect which then needs to stabilise.

10 hours ago, Schaffer said:

when to go down to this next cut, which would be 1.7mg, more or less.

That is 50% cut and definitely not a good idea as your dose reduces.

Dose accuracy is even more important at lower than higher levels.

It will take time to be totally drug free, but by taking time and remaining stable you can get on with your life.

To sum up.

As long as symptoms are bearable stay at current dose.

As you reach end of current meds contact us and we will guide you through the changeover and subsequent taper.

Keep in touch.

 

Sassenach

[PoetJester]

Hi Schaffer

 

I had a lot of crying spells, too, although it was when i had stopped zoloft and zyprexa back in 2014.  Uncontrollable weeping is actually pretty common when stopping an anti depressant or other psychiatric medications and I have spoken with others on other online forums who have had the same weeping after stopping or tapering a med.  If you go around on this site long enough you will find others who have posted of the symptom.   I just recently chatted on a Zoloft support group with a woman who was having spells of weeping during her zoloft taper and had even had to leave work in tears one day recently......My crying would also usually be brought on by memories or sometimes also day to day occurences in my life.   

 

   It's a hellish world at times.  I also cried after seeing my little niece after not seeing her for several months and once when i stopped to talk to a woman on a walking path near my apartment complex who was walking her dog.  I had knelt down to pet her dog while i was talking to her and i guess, just the thought of what a dog goes through, living life on a leash, made me sad and i had to hold back the tears.   

 

Part of the crying for me is because of the sleep deprivation caused by quitting the medications, which is totally debilitating and pure misery.  For about two years, i was crying so much that i was filling up hankerchiefs and dish towels with tears and snot daily and having to do loads of laundry pretty regularly when all my towels/hankerchiefs were soaked with tears.   The crying spells usually made me feel better afterwards, because i felt so ill from not sleeping well for so long.  They were purgative or cathartic moments for me and for my heart, too, to be able to weep.    I would say they are definitely wd related. 

 

Sorry, for the formal tone of this letter, but i saw your post and just wanted to say "yes.  tapering an anti depressant can definitely cause crying spells and teariness." 

 

Poetjester (Derek)

Edited November 18, 2019 by Sassenach
upsetting material

[Schaffer]

Thank you for your reply. Although I’m sure well-intentioned, please do not share stories of animal cruelty. That is in no way helpful to someone in drug withdrawal.

[Altostrata]

Welcome, Schaffer.

 

On 11/4/2019 at 2:18 PM, Schaffer said:

Six weeks ago, I decided to taper myself off Paxil, and now I am off that completely. It hasn’t been easy but tolerable and I am highly motivated. So one month ago, I started to taper off Remeron, and am down to approx. 3.35 mg at bedtime. Here is a list of my withdrawal symptoms in order of appearance: fatigue, vivid dreams and nightmares, brain fog, irritability, brain zaps, and hot flashes. I’ve put up with all these knowing that eventually they will disappear. But my latest symptom is the one that brings me to my knees and that is teariness.

 

At what point in your Remeron taper did these symptoms appear?

 

Does 3.35mg Remeron help you sleep effectively? Do you still drink alcohol?

 

I suspect you are experiencing Paxil withdrawal syndrome rather than Remeron withdrawal. As your sleep is improving, you may get through this without SSRI reinstatement.

 

As you've noticed, @PoetJester was trying to be helpful. He cares about you. He will be more sensitive to others' vulnerabilities in the future.

 

Spells of weeping are indeed common in antidepressant withdrawal, see Deep emotional pain and crying spells, spontaneous weeping

[Schaffer]

Hello Altostrata. I started tapering both drugs Sept. 18, and took my last Paxil Oct. 27 according to my journal. I don’t have an accurate account of my symptoms, but I would say they started to become troublesome around mid-Oct. Although I’ve had the brain zaps for several years, I didn’t think much of them until recent weeks. They never really bothered me because they felt more like a camera shutter release than an electrical charge and I always attributed them to alcohol. Not very rational thinking, I know. Anyway, I was getting several a day mid-Oct, which started to worry me. After doing some reading, I started taking Omega 3 and they have now practically disappeared.

The daytime fatigue is getting better, but not yet gone. My sleep is almost back to normal. I still remember lots of dreams, but the nightmares are gone. The hot flashes also are not as bad as they were a few weeks ago. Which leaves the brain fog and crying spells. As I said, this tendency to cry easily has always been a part of me, but it is certainly easily triggered now. As for alcohol, I have to be honest that I still drink 750ml per month (consumed at once), down from 750ml per day. It’s been triggered by a series of small frustrations or stresses, but the latest (yesterday) simply by being tired of this whole SSRI withdrawal. I never expected it and started ‘thinking’ it was the lesser of the two evils. My sleep last night was not as good as the two previous, nor do I have the stress of caring for an elderly parent, so I am not tempted to return to daily drinking.

i hope this gives you a clearer picture of where I am. I am very grateful for the level of caring and support from this group. I know I can get through this withdrawal without reinstatement.