Wilsonnn: trying to reach stability

[Wilsonnn]

So I started Zoloft 100mg (Sertraline) in high school (2012) after going through a course of Accutane (which I did not realize had serotonin modifying properties until recently) and coming out somewhat depressed (assuming diet and other factors had effects as well). I was completely against taking this medication as I did not think that I needed it, but my psychiatrist ended up persuading me with the idea that I could stop it at any time and that it wouldn't hurt to try. I started my regimen of sertraline and was on my way.

 

Around 2015 I ended up having some side effects that were not clear to me until I entered a relationship and was reduced down to 50 mg and Wellbutrin 150mg XL was added. At the beginning with Wellbutrin I noticed some brain fog or spaciness but that went away and I ended up stabilizing. This lineup was fine and I felt that I was in a great spot, I wanted to try life without antidepressants. I had taken AD's for 5 years and wanted to know if I could go without them, they couldn't be good for you (who knew what they were doing to your body everyday).

 

So in December 2017 I CTed Wellbutrin and started taking Sertraline every other day and then every three days, etc. I really had no system to tapering but I did it over a few weeks (without doctor's overview). January of 2018 I thought I caught the flu, but later on realized that this was withdrawal. I had all the acute symptoms but got through it. After my "flu" I seemed to stabilize but noticed that I was more withdrawn and not as outgoing, whatever maybe this was the real me without drugs.

 

April of 2018 I began having panic attacks, I hadn't had one of these for a LONG time. I realized that I may need to take medication again but pushed through, maybe I would get better. After a night of heavy drinking with friends, the next morning was hell, I had some of the worst anxiety attacks I had ever had, my vision was spacey, I could barely move, this was not a normal hangover lol. This apparently was my crash. Almost like clockwork with everyone else on the website (3-4 months after stopping meds).

 

I went to see my Primary Care Doctor and he said it was best to start Sertraline 100mg again which I did, but regardless of starting it I still had brain fog, vision issues, trouble concentrating, and anxiety through the roof. I didn't want to leave the house.

 

It seemed that I had started to stabilize over the summer (2018) but I still had traces of anxiety and had brain fog, spaciness and vision issues intermittently (couple of times a day). Around fall 2018 (around September?) I noticed that I was tired all the time (sleeping 14 hrs if I could) and my spaciness/brain fog was almost all day now. I was still on Sertraline 100mg at this point so the Primary Care Doctor decided to add Wellbutrin XL 150mg and drop the Sertraline to 50mg (same regimen I took before stopping). 

 

This DID NOT help I was either tired or angry all of the time and my brain fog/spaciness did not improve in the least. Primary Care Doctor tapered me off Sertraline over two weeks and I was left with Wellbutrin. Wellbutrin alone ended up not working for me, (still aggressive, tired and spacey) so we decided to stop that as well.

 

January 2019 I was back to taking nothing. I had already done this once a year earlier and wondered if supplements could help alleviate the problem and make the anxiety bearable. I went to a psychiatrist and told him that I did not want any medications if I could help it. He prescribed omega 3 and lavender oil (Silexan) which is apparently used in Germany for anxiety cases. The anxiety seemed to be slightly better than the previous year with no supplementation but I was still just surviving (barely) and not thriving and living life like I wanted to. I've stayed away from alcohol, gone to the gym daily (cardio and weights), drank only water and even tried to change my diet. Nothing seemed to work well enough. One positive though: my spaciness and brain fog was completely gone, only anxiety was left.

 

May of 2019 I gave in and decided to go back onto meds. I told the doctor to put me on the smallest dose possible and he chose Lexapro 5mg (escitalopram). I did notice that my anxiety was going away slightly, but around August I was back to being anxious and my brain fog was back (barely).

 

September 5th 2019 went to see ANOTHER psychiatrist supposedly with a love for psychopharmacology and she immediately gave me a DNA test (Genomind) and told me that I may be a candidate for l-methlyfolate (the activated form of folate). She also prescribed Trintellix 10mg (5mg the first week) and gave me some free samples to try over the course of a month. I started taking it and no brain fog was apparent. I actually seemed to be improving slightly.

 

I found out how much it was and was astounded. $400 per 30 day supply and after insurance it was still $180. Im still in college and apparently I could get it for $15 a month if I were to use the Student insurance plan, but I graduate soon so I will still be paying that ridiculous price later on. 

 

I notified the psychiatrist of this and we reduced down to 5mg with the notion that we would taper down to zero and try something else. Right around this time (October 20th 2019) I started the l-methylfolate that she prescribed and after a week (Oct 27th) I seemed to improve more. I don't know if this was the Trintellix finally kicking in ( I was at the 7 or 8 week mark at that point) or the l-methylfolate. I seemed to be stabilizing at this point and waited to get off the Trintellix 5mg because I didn't want to destabilize. 

 

I went back to my previous psychiatrist because I couldn't afford the visits for the other (out of network- insurance doesn't cover). He suggested trying out Prozac 10mg and take the Trintellix every other day for a two weeks and quit (Half life = 66 hrs). I started this on November 3rd 2019 and immediately after taking Prozac I was spacey (derealization), couldn't concentrate and just felt high. Is this my body trying to reject SSRIs? It seems like I have had issues with Sertraline, Lexapro and now Prozac; they have all caused this spacey feeling. With Trintellix I seem to be sharp and not have this issue. Of course Trintellix was a small sample size of only two months.

 

So my question as of right now is should go ahead and bite the bullet and take Trintellix and pay the amount (I will be able to afford it with a job, but all else equal I would rather not have to if something else works just as well) or should I keep with Prozac or possibly try something else? Has something worked for someone else in a similar situation?

 

My ultimate goal here is to stabilize on a certain medication and then initiate a proper slow taper that has been proven to work (although I know it isn't easy).

 

Also if anyone has any comments they wish to share about a certain route that I should possibly try, feel free to comment.

 

Thanks guys!

 

 

Edited November 13, 2019 by Altostrata
removed spaces

[Altostrata]

Welcome, Wilson.

 

I am sorry you have gotten caught up in this drug merry-go-round.

 

On 11/9/2019 at 8:21 PM, Wilsonnn said:

It seems like I have had issues with Sertraline, Lexapro and now Prozac; they have all caused this spacey feeling.

 

You have this consistent adverse effect from SSRIs. SSRIs do not agree with you at the dosages you've been taking.

 

On 11/9/2019 at 8:21 PM, Wilsonnn said:

So I started Zoloft 100mg (Sertraline) in high school (2012) after going through a course of Accutane (which I did not realize had serotonin modifying properties until recently) and coming out somewhat depressed

 

Treating adverse effects of Accutane with an antidepressant is inappropriate. That psychiatrist should have known better.

 

In my opinion, you never needed antidepressants in the first place and have been enduring side effects and drug switches for years for no good reason. Anything you've heard about having a "chronic brain disease" or "serotonin imbalance" is nonsense.

 

As I read your account, you have seen at least two psychiatrists. Both of these specialists should have known that you did not need to continue on antidepressants, singly or in combination.

 

On 11/9/2019 at 8:21 PM, Wilsonnn said:

So my question as of right now is should go ahead and bite the bullet and take Trintellix and pay the amount (I will be able to afford it with a job, but all else equal I would rather not have to if something else works just as well) or should I keep with Prozac or possibly try something else? Has something worked for someone else in a similar situation?

 

I don't know what you mean by "works" in this situation. You're taking any of these drug unnecessarily. If I were you, I wouldn't get hooked on Trintellix again, why pay more for a drug that has no benefit?

 

As I understand it, you're taking 10mg Prozac for 10 days? To reduce the side effects, I would immediately reduce the dosage to 7.5mg and in a week, to 5mg. This topic explains how to reduce Tips for tapering off Prozac (fluoxetine)

 

This is in preparation for finally going off Prozac.

 

Any doctor can prescribe these drugs, it doesn't have to be those ignorant, highly paid psychiatrists you've seen. If I were you, I'd send them stiff notes with copies to your state medical board about the long-term misdiagnosis and misprescription.

 

Please let us know how you're doing. There is a small chance you will experience withdrawal from Trintelllix, which has a very long half-life, and we'll have to address that.

[Wilsonnn]

Hey guys and gals, 

 

I'm back.

 

So at this point I have been off of any AD's for a little less than 11 months. I took my last dose of Trintellix November 8, 2019 and only took Prozac for a single day if I remember correctly. I have noticed recently that my anxiety is through the roof so to speak. This has been the case since around the 10 month mark. Would there be any reason for this uptick in anxiety?  I have had panic attacks through out the year, but not as plentiful as they have recently been (some are bad enough that I am shaking). I know with this Covid-19 mess going around, that the thought of having it is always in the back of my mind; and of course your mind also has a funny way of playing tricks on you. But recently I have been sleeping 12 hours a night if allowable and have gotten tired a lot easier. I also am unable to workout much at all, due to increased anxiety or whatever the issue seems to be. I have also seemed to have a lot of hot flashes in the past couple of weeks. But all of these symptoms seem to be intermittent, which leads me to believe that they are anxiety/withdrawal related.

 

Would anyone have some incite on this? Is this just a massive wave for me?

 

Also I was wondering if there was a generalized "withdrawal road map" where there are certain milestones I can look for while recovering. I read a lot of success stories on here, and while they do give me hope, it is difficult to be optimistic sometimes.

 

One last question: I have read here and elsewhere that magnesium seems to help with anxiety as well as other bodily functions. Is magnesium better to take alone or should it be supplemented with other minerals so that an imbalance does not occur? (Thorne Research sells a mineral supplement that I was looking at)

[ChessieCat]

The only supplements which SA recommends are Magnesium and Omega-3 Fish Oil.  Only try a small amount, one at a time to test it.  I take magnesium and it definitely helps my anxiety.  Several times I've run out and then re-started it and have noticed the difference.  Be aware that some magesium contains calcium.  Calcium cancels out the calming effect of magnesium and needes to be taken 2 hours apart.  Also some contains Vitamin B6 which can be activating.  It's better to things separately than in complex.

 

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

 

Since the beginning of 2020 we have members posting that they have been experiencing unexpected and/or worse waves.  The stress of the covid situation is possibly having an impact.  For example, changed working situation, job loss or worry about job loss, isolation/close living with household, financial stress, general anxiety over the worldwide issues, relationship/s strain.

 

Since the beginning of this year have you:

 

Been sick?

Taken a course of antibiotics?

Drinking alcohol?

Consuming caffeine, coffee, cola, energy drinks?

Introduced new supplements/drugs (prescription/OTC/illicit)?

 

Please check out the sub-topics linked in Post #1 of this topic, especially the Post 0 topic:

 

are-we-there-yet-how-long-is-withdrawal-going-to-take

 

Also check out:  Success stories: Recovery from withdrawal

 

[ChessieCat]

1 hour ago, Wilsonnn said:

I have had panic attacks through out the year,

 

Audio:  First Aid for Panic (4 minutes) Female voice - getselfhelp.co.uk
 

Audio:  First Aid for Panic (4 minutes) Male voice - getselfhelp.co.uk
 

Audio:  How to Recover from Anxiety - Dr Claire Weekes

 

the-dr-claire-weekes-method-of-recovering-from-a-sensitized-nervous-system
 

Anxiety Self Help - getselfhelp.co.uk
 

Cognitive Behaviour Therapy Self Help - getselfhelp.co.uk
 

Mindfulness - getselfhelp.co.uk
 

Stress Self Help - getselfhelp.co.uk
 

Relaxation - getselfhelp.co.uk
 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help ...

 

  

On 4/28/2017 at 4:03 AM, brassmonkey said:

 

AAF: Acknowledge, Accept, Float.  It's what you have to do when nothing else works, and can be a very powerful tool in coping with anxiety.  The neuroemotional anxiety many of us feel during WD is directly caused by the drugs and their chemical reactions in the brain.  Making it so there is nothing we can do about them.  They won't respond to other drugs, relaxation techniques and the like.  They do, however, react very well to being ignored.  That's the concept behind AAF.  Acknowledge, get to know the feeling involved, explore them.  Accept, These feelings are a part of you and they aren't going anywhere fast. Float, let the feeling float off as you get on with your life as best as you can.  It's a well documented fact that the more you feed in to anxiety the worse it gets.  What starts as generalized neuroemotinal anxiety can be easily blown into a full fledged panic attack just by thinking about it.

 

I often liken it to an unwanted house guest.  At first you talk to them, have conversations, communicate with them.  After a while you figure out that they aren't leaving and there is nothing you can do to get rid of them.  So you go on about your day, working around them until they get bored and leave.

 

It can take some practice, but AAF really does work.  I hope you give it a try.

 

 

 

[Scotty]

Hello Chessie Cat. 
I have a question about magnesium supplementation.  I’d like to try it to alleviate my anxiety - which by the way has become much worse since Covid.  However my doctor says it’s not necessary because a recent blood test shows that my magnesium blood levels are normal. In your view do people in withdrawal benefit from extra magnesium?
As always thanks for your great contribution to this site.  Cheers.

[ChessieCat]

We have members here taking it and they find it helps.  A few members find that it either doesn't do anything or they find that it makes them worse.

 

The only way to find out whether it helps you is to try it.  Start with a tiny amount and build up the dose.  Just make sure that it is "only" magnesium with nothing else added.

 

It also works better if taken throughout the day.  I take mine twice a day.  Sometimes when I have felt more anxious I've taken an extra dose.

 

The sign of taking too much magnesium is getting an upset stomach.

 

Edited September 25, 2020 by ChessieCat

[Scotty]

Belated thanks for this advice Chessie....cheers

[Wilsonnn]

Hello again,

 

I ended up getting through to May of 2021 before really going downhill and needing to be hospitalized. I was under a lot of stress at the time and it seems that through the process of withdrawal I have really taxed my adrenals. I lost the ability to exercise and even longer walks were a trail to get through (this coming from a 27 yo lifelong athlete). In retrospect it seems that my previous post on my 11th month off of SSRIs was possibly adrenal fatigue setting in.

 

I am currently in a position where I am constantly tired or having anxiety. I was four months off of Citalopram (was recently put on in hospital, not a great reaction to it) when I noticed a serious uptick in anxiety. This is around the time (4 months after stopping) where I have had a nervous system crash. I knew that my adrenal system (HPA Axis) was not functioning correctly and did not want to risk another crash. I took a 10mg Prozac and split it (5mg) in order to hopefully mitigate another crash. 
 

Basically, I know this is not really a proven way to do this, but I am stuck between a rock and a hard place. If adrenal issues were not present I know that I could have completed the withdrawal process. My questions include:

 

Is there a way that another person on here has recovered from adrenal fatigue while in the constant presence of stress from withdrawal?

 

My plan was to possibly start a very small amount of Prozac to reduce withdrawal stresses and then wean from that later. Is there an issue with either doing that or should I abandon that idea (I have only taken one dose) in the hopes that the extremely long half-life will help me through this process?
 

Again I do know that this is not a proven way to get through this but I am not sure what to do based on the shape my body is in. 
 

Thanks,

Wilson

[Wilsonnn]

Hi,

 

What is the general rule for reinstatement after years of being off? I have been off of drugs for over 2 years but have been severely hurting. Unfortunately I am not only dealing with withdrawal issues but also chronic fatigue (adrenal fatigue/HPA axis dysfunction) to the point of being in bed for the most, if not all of the day. The chronic fatigue seems to be from the constant stress that I have gone through over the years. I have pushed my body to the point of exhaustion and have not been able to recover. I have had this fatigue and been in bed for almost 3 years at this point (starting since May '21). I am unable to work and have family taking care of me now. I still have anxiety daily, but I know that I will be able to recover if I can have calm/no anxiety for an extended period of time. This is where I am looking to reintroduce a very small dose of an SSRI (more than likely would be Sertaline, based on my history).

There is too much to go into as to why I came to this conclusion, as I doubt people will have the time to read all of that. But I can write it up if needed. However, the general consensus here seems to be either to reinstate a medication or to wait it out. I have had no improvement over these few years that I can quantify (other than what I can attribute to supplementation) and I know that my fatigue will not get better if I am constantly under stress.

 

Again I can go into more detail if needed, but generally all I need to know is: what has been the outcome of someone reinstating after a few years off of the drug? I am looking at 0.5-1mg of Sertraline to start with.

 

I know you guys have probably heard this a lot, but what I am going through right now is not sustainable (for various reasons) and I just need enough of a boost to not have anxiety on a daily basis, so that I can begin the process of healing. This is why I am asking about reinstatement.

 

Thanks,

Wilson

[Wilsonnn]

Maybe I missed where this was asked, but how many of you are using a compounding pharmacy to make your liquids? Is it more common to use a compounding pharmacy or do you guys make the solutions yourselves?

 

I also would like to know the concentration that you guys usually use. Is it 1mg/mL? 0.1mg/mL?

 

It would be awesome to have a poll feature on here to allow us the ability to collect some data, although I know you moderators are already working too hard!

 

I am asking, because I am REALLY thinking about reinstatement and I want to be able to hold at 0.5-1mg of Sertraline. I hope that is not a mistake, but that is a different topic. I would gladly discuss this on my introduction thread.

 

I want to be able to hold with great precision because I know at a low dose, tiny fluctuations in a dose can have dramatic changes in SERT occupancy. This is of course something you don't have to worry about at a high dose because you are on the flat part of the hyperbolic curve.

 

It makes sense to me that having a less concentrated solution at lower doses would help mitigate some of these fluctuations a bit. For instance if your solution is 0.1mg/mL and you want 1mg of medication you would need to dispense 10mL of the solution. The human error aspect may be minimized because the larger dilution has a smaller effect on the change in drug that is actually dispensed. For example, if you accidentally dispensed 10.1mL you would theoretically be dispensed 1.01mg, which is a much more trivial error than if you had used a 1mg/mL solution. In the 1mg/mL solution, a 0.1mL error would yield 0.1mg more than you want, which could cause more of an effect, especially if you are making these errors daily. 

 

If you are making these errors daily, it would almost be impossible to stabilize because you are causing so much fluctuation.

 

Does this make any sense to anyone? Or am I just out there with this type of thinking?

 

Look forward to hearing from you all,

Wilson

[Emonda]

Hi Wilsonnn,

May I ask if your drug signature is up to date?

 

You mention reinstating above. I just want to confirm that you last took 5mg Fluoxetine in 2021? How did you stop it?

[Wilsonnn]

Sorry I just saw this, for some reason I didn't get a notification about this? But yes, my signature is up to date. I CT'd it. I only used it for a 3 days I believe. It caused pretty bad depersonalization.