theskul: Should I reinstate?

[theskul]

I got Akathisia this summer from Prozac+Olanzapine

It went away with lower dosages.

 

Now here are my recent Prozac changes

 

I have been taking Prozac since April.

To recap my prozac changes:

• I have been taking Prozac since April, at most 40mg for a short time
• 10mg since September
• Then 4 or 5 days of 20mg Prozac
• Then I quit CT 5 or 6 days ago because I was feeling a little Akathisia.

Then my Akathisia and anxiety got really bad. I was sometimes pacing alot, and, yeah, it was just really bad.

I was at the same time fast tapering off a benzo medisine that I had been taking for a few days.
Then I gave up on stopping on the Benzo because the Akathisia and anxiety was so bad. So now I have been on Valium(5mg/day) for a few days.
 

Now my symptoms are:

• Akathisia
• difficulty sleeping
• memory/concentration problems
• less need for human contact.

The symptom can come from

• a possible SSRI withdrawal
• a possibly too fast tapering off the Benzo
• my form(I have been spending a lot of energy on the internet and on facebook groups what to do)
• Valium.

 

I've heard people sometimes reinstate. Maybe I am in SSRI withdrawal. But I have no idea if I should reinstate or not and how much I should take then. Sometimes it helps, sometimes it is a horribe failure.

 

What would you advice me to do? I feel like so much is on the line.

 

Edit:

[Sassenach]

Hello    Skul    and welcome to SA.

 

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.

 

The site is currently extremely busy so please ensure you answer any requests from staff fully.

 

 

un-August 2019
• Olanzapine lowered to 5mg in a few steps
• Prozac lowered to 20mg
• Akathisia got better, but I felt my mind wasn't really working well
• A 2 week interval 20-30mg Oxazepam tried. Then I went back down to occasional use(5-10mg a few times a week) quite fast.
• Lamictal tried again for a month but failed
Sep 2019
• Olanzapine changed from 5 mg to 2.5mg CT
• Prozac chaged from 20mg to 10mg CT
• Melatonin 0.75mg added to aid sleep.Nov 2019
• Olanzapine tapererd from 2.5mg - 1mg22. Nov - 27. Nov
• 1-2x0.5mg Tafil Retard(like Xanax Extended Release 0,5mg) for anxiety
• Olanzapine 0,9mg
• Prozac 10mg
• Melatonin 0,75 (I think)

28.Nov-7. Des
• 5mg-10mg Oxazepam to taper off Tafil Retard cause I didn't like it• Prozac to 20mg to battle anxiety, then stopped CT because of Akathisia
• Melatonin upped to 1.5mg cause I was having trouble sleeping
• Akathisia and anxiety gets really bad.

Current meds (Dec 10, 2019)
• Valium 5mg for Anxity (and i believe Akathisia and to stabilize)
• Olanzpine 0.9mg
• Melatonin 1.5mg-2.25mg
• Akathisia gets somewhat better. But fear of the future is high and feeling stuck on meds is crippling

 

You are experiencing W/D (withdrawal symptoms) from so many changes of medication.

The only known way to mitigate symptoms is to reinstate a small dose of the drug.

Under no circumstances attempt reinstatement without asking us for a suggested dose.

Please see;

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

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

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

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

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

Your continual change of meds and doses will have to stop if you want to stabilise.

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

20 hours ago, theskul said:

• I have been taking Prozac since April, at most 40mg for a short time
• 10mg since September
• Then 4 or 5 days of 20mg Prozac
• Then I quit CT 5 or 6 days ago because I was feeling a little Akathisia.

I was at the same time fast tapering off a benzo medisine that I had been taking for a few days.
Then I gave up on stopping on the Benzo because the Akathisia and anxiety was so bad. So now I have been on Valium(5mg/day) for a few days.

Olanzapine tapererd from 2.5mg - 1mg22. Nov - 27. Nov

 

Edited December 11, 2019 by Sassenach
thread locked

[theskul]

How should I reinstate Prozac?

 

This section seems to apply: If you have symptoms of hyper-reactivity or alerting (anxiety, panic, sleeplessness), you may be too sensitive for reinstatement. If you want to try it anyway, you might wish to try reinstating at a very low dosage, such as 0.5m-1mg if you had been taking 20mg Celexa, for example.

 

It suggests I might even not reinstate. I stopped 6 or 7 days ago. Should I reinstate maybe 0.25mg of Prozac? Could that make things even worse? I was on 10mg Prozac for a long time, and then 20mg for a few days. The window is closing. How long will I be like this?

[theskul]

I'm so desperate that I might even try 0.25mg Prozac this night. Where can I ask for reinstating advice? Just in this thread?

[theskul]

How can I measure suck small doses? My scale is maybe 0.01g accurate. Can I titrate with powder?

And are there any questions I haven't andswered?

Am I right that I can only get advice on how much to reinstate in the threat?

 

Thank you so much

[Altostrata]

Hello, theskul.

 

On 12/10/2019 at 2:34 PM, theskul said:

• I have been taking Prozac since April, at most 40mg for a short time
• 10mg since September
• Then 4 or 5 days of 20mg Prozac
• Then I quit CT 5 or 6 days ago because I was feeling a little Akathisia.

Then my Akathisia and anxiety got really bad. I was sometimes pacing alot, and, yeah, it was just really bad.

I was at the same time fast tapering off a benzo medisine that I had been taking for a few days.
Then I gave up on stopping on the Benzo because the Akathisia and anxiety was so bad. So now I have been on Valium(5mg/day) for a few days.

 

It looks like when you were taking 10mg Prozac, you were already in a sensitized state. When you jumped up again to 20mg Prozac, you got a kindling reaction.

 

On 12/10/2019 at 2:34 PM, theskul said:

I was at the same time fast tapering off a benzo medisine that I had been taking for a few days.

 

You situation is complicated by your changes in the benzo at the same time you were making changes in Prozac. Any of your symptoms might be from benzo reduction rather than Prozac.

 

What benzo were you taking, at what times of day and dosage? When did you switch to Valium? How did you accomplish this switch?

 

What times of day do you take Valium, at what dosages?

 

What effect do you feel from Valium? I'll ask @Shep to review this information, too.

[theskul]

8 hours ago, Altostrata said:

What benzo were you taking, at what times of day and dosage?

 

I was taking Talif Retard 0,5mg (like Xanax extended release 0,5mg) for a few days like this. This is the history of the whole usage:

22. Nov 14:25 tafil
24. Nov 15:30 tafil
25. Nov 9:50 tafil 1740
26. Nov 9:25 tafil 1715
27. Nov kl 17:30 tafil

Then I switched to Oxazepam in one go.

I broke a 10mg tablet into roughtly 4 parts. So I was taking 2,5mg each time.

28. Nov
2,5mg 16:40
2,5mg 23:00
29. Nov
2,5mg 1104
2,5mg 1521
2,5mg 2120

 

and so on. I was basically taking 2,5mg Oxazepam 2-4 times each day, during the day. Sometimes I pushed myself quite alot.

 

 

8 hours ago, Altostrata said:

When did you switch to Valium? How did you accomplish this switch?

I just switched from 5mg-10mg/day Oxazepam(short acting Benzo med) to 5mg/day Valium(Diazepam) 5mg. I just did it in one go 8. December. Here is a conversion table between Benzos.

 

 

 

 

8 hours ago, Altostrata said:

What times of day do you take Valium, at what dosages?

 

I take Valium like this:

11:00 1,25mg

17:00 2,25mg

23:00 2,5mg

 

8 hours ago, Altostrata said:

What effect do you feel from Valium? I'll ask @Shep to review this information, too.

 

From the Valium I feel much calmer. The Akathisia/anxiety gets much better, sometimes I don't feel it. I'm also less interested in my family. My memory is worse. Harder to follow converstations. Sometimes I loose the thread if I'm saying something a little complex. My attention is worse.

 

I had extreme anxiety/Akathisia just after I stopped the Prozac, but I was also taking a little less Oxazepam.

It is getting much better with Valium. But I sometimes feel anxiety/Akathisia.

 

Here is my very recent med history

22. Nov - 27. Nov

• 1-2x0.5mg Tafil Retard(like Xanax Extended Release 0,5mg) for anxiety
• Olanzapine 0,9mg
• Prozac 10mg
• Melatonin 0,75 (I think)

28.Nov-7. Des

• 5mg-10mg Oxazepam to taper off Tafil Retard cause I didn't like it

• Prozac increased to 20mg(1. or 2. Des) to battle anxiety, then stopped CT (4. or 5. Des) because of Akathisia/Anxiety

• Melatonin upped to 1.5mg cause I was having trouble sleeping
• Akathisia and anxiety gets really bad.

Current meds (8. Des - Dec 10, 2019)
• Valium 5mg for Anxity (and i believe Akathisia and to stabilize)
• Olanzpine 0.9mg
• Melatonin 1.5mg-2.25mg
• Akathisia gets somewhat better. But fear of the future is high and feeling stuck on meds is crippling.

 

 

[Shep]

2 hours ago, theskul said:

From the Valium I feel much calmer. The Akathisia/anxiety gets much better, sometimes I don't feel it. I'm also less interested in my family. My memory is worse. Harder to follow converstations. Sometimes I loose the thread if I'm saying something a little complex. My attention is worse.

 

I had extreme anxiety/Akathisia just after I stopped the Prozac, but I was also taking a little less Oxazepam.

It is getting much better with Valium. But I sometimes feel anxiety/Akathisia.

 

How many hours are you sleeping? 

 

Since you just started Valium on December 8, it's still building up in your system due to its long half-life. So some of the overly sedating side effects may diminish over the coming days as your nervous system adjusts to it. 

 

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[theskul]

I will.

 

But I feel like the window to reinstate prozac is closing.

Prozac:

I was taking 10mg from September. More before that.

Prozac increased to 20mg 1. or 2. Des.

Prozac stopped CT 4. or 5. Des

 

I need to know if I should reinstate. I felt quite horrible after I stopped CT but I was also taking less Benzos then, but I had done that before and never felt that bad anxiety/akathisia.

 

[theskul]

I'm also having problems with taking accurate doses of my medicine because my scale isn't accurate enough. It should be a milligram scale but the measurement jumps around quite ab lot. I would like to look into ways to blend it to other substances, like water, alcohol or something dry so I don't need so accurate scales.

[theskul]

I added signature. If I should change it to clarify please give me advice

[theskul]

54 minutes ago, Shep said:

How many hours are you sleeping? 

I'm sleeping 4 to 6 hours each night. It's hard.

[theskul]

1 hour ago, theskul said:

I will.

 

But I feel like the window to reinstate prozac is closing.

Prozac:

I was taking 10mg from September. More before that.

Prozac increased to 20mg 1. or 2. Des.

Prozac stopped CT 4. or 5. Des

 

I need to know if I should reinstate. I felt quite horrible after I stopped CT but I was also taking less Benzos then, but I had done that before and never felt that bad anxiety/akathisia.

I need to correct this. I felt horrible after I stopped taking prozac, but I had already recently changed my Benzo intake, and was varying doses between days according to how I felt. And I had been having a very difficult time with tapering Benzos for the last weak or so.

 

Shoud I reinstate 0.25mg/day Prozac and see if it helps?

[theskul]

Tonight I slept better than the nights before.

I was quite calm this morning but I get very stressed very easily. I had some personal difficulties and my calmness just went out of the window. Also trying to write a decent signature really stresses me out. I start pacing and feel a little uneasy in my skin. There is a hint of Akathisia which really makes me so scared. But things may be stabilizing.

 

Still I am wondering if I should try 0,25mg Prozac and see. But I did stop 4. or 5. Desember, a few days ago. And I had an extreme reaction(which could also be a Benzo reaction). So maybe it is too late.

[theskul]

I'm also on a Keto diet since 1. Desember. Maybe that is bad. Does that mess up how the medicine works in the body? Maybe I should stop it.

[Shep]

On 12/12/2019 at 7:55 AM, theskul said:

I'm also having problems with taking accurate doses of my medicine because my scale isn't accurate enough. It should be a milligram scale but the measurement jumps around quite ab lot. I would like to look into ways to blend it to other substances, like water, alcohol or something dry so I don't need so accurate scales.

 

Please see these tips for using a scale: 

 

More Tips for Using a Scale

 

What type of scale to you have? Please list the brand name. 

 

22 hours ago, theskul said:

There is a hint of Akathisia which really makes me so scared. But things may be stabilizing.

 

Still I am wondering if I should try 0,25mg Prozac and see. But I did stop 4. or 5. Desember, a few days ago. And I had an extreme reaction(which could also be a Benzo reaction). So maybe it is too late.

 

15 hours ago, theskul said:

I'm also on a Keto diet since 1. Desember. Maybe that is bad. Does that mess up how the medicine works in the body? Maybe I should stop it.

 

I don't know if you should or shouldn't reinstate the Prozac, either, theskul. 

 

You state you may be stabilizing. So you may wish to give it more time before reinstating and see if you continue to improve.

 

Do you feel the Keto diet has helped? What kinds of food were you eating before this diet? 

[theskul]

22 minutes ago, Shep said:

Do you feel the Keto diet has helped?

Yes. But I worry it influences GABA and thus may mess up my Valium intake. Or that it may be dangerous for me to stop Keto food because it could change the way the medicine is absorved or something.

 

What kinds of food were you eating before this diet? 

Don't remember well. Except I was having KFC. Don't remember the rest well. Some cereals, some rice and chicken. Some veggies. But I may be wrong

[Shep]

1 minute ago, theskul said:

Yes. But I worry it influences GABA and thus may mess up my Valium intake. Or that it may be dangerous for me to stop Keto food because it could change the way the medicine is absorved or something.

 

Since you've only been on the Keto diet since December 1, which is less than 2 weeks, you could transition over to your previous diet if you're concerned about the Keto diet. If  you decide to do so, you may want to do this gradually. 

 

You'll want to avoid sugar, caffeine, processed foods, etc. and stick to healthy proteins, fruits, veggies, and plenty of water throughout the day. 

 

And of course, alcohol is definitely something you'll want to avoid, since that also affects GABA. 

 

Here is some information on Keto and other diets during withdrawal:

 

Diets that may cause problems: Restriction, Ketosis, Raw, Low Carb

 

Ketogenic Diet

 

The important thing during withdrawal is to eat small meals and healthy snacks throughout the day, as many people report drops in blood sugar. So having some meals and snacks that are high in protein and low in sugar and high--glycemic carbs is important. 

 

[theskul]

46 minutes ago, Shep said:

What type of scale to you have? Please list the brand name. 

I have been using Brifit KA61/UF200H. It's a milligram scale. But the numbers jump around a bit.

I also have Brifit Digital Pocket Scales, (500g/ 0.01g)  for when I blend my Olanzapine in water but that one has only 0.01g accuracy, not enough for pills

I just bought American Weigh Scales Gemini Series Precision Digital Milligram Scale, Silver 20G X 0.001G (GEMINI-20) and am waiting for it to arrive.

 

I actually just baougt a very expensive one that I can still turn in: VIBRA AJ-620CEN (its a milligram scale and seems a little more stable than the Brifit KA61/UF200H). Bu it jumps a bit and is so expensive.

 

 

[theskul]

10 minutes ago, Shep said:

Since you've only been on the Keto diet since December 1, which is less than 2 weeks

I've been thinking and I may have been in Keto for a little longer time, or light Keto. Maybe a month. But I started taking it very serious 1. des. I'm sorry but my memory is poor

[theskul]

I'm scared to throw my system off now. I slept well this night. But am super scaref of the future. I want to try to stop Keto but I'm scared to have a horrible reaction since I'm on Valium as well. Like I said above, I started seriously 1.Des in Keto but I suspect I was in Keto before that for maybe a month total or something. It is unclear.

 

Thank you so much for responding

[Shep]

22 hours ago, theskul said:

I have been using Brifit KA61/UF200H. It's a milligram scale. But the numbers jump around a bit.

I also have Brifit Digital Pocket Scales, (500g/ 0.01g)  for when I blend my Olanzapine in water but that one has only 0.01g accuracy, not enough for pills

I just bought American Weigh Scales Gemini Series Precision Digital Milligram Scale, Silver 20G X 0.001G (GEMINI-20) and am waiting for it to arrive.

 

I actually just baougt a very expensive one that I can still turn in: VIBRA AJ-620CEN (its a milligram scale and seems a little more stable than the Brifit KA61/UF200H). Bu it jumps a bit and is so expensive.

 

 

 

 

Many members here use the Gemini scale for their taper and find it works quite well.

 

21 hours ago, theskul said:

I'm scared to throw my system off now. I slept well this night. But am super scaref of the future. I want to try to stop Keto but I'm scared to have a horrible reaction since I'm on Valium as well. Like I said above, I started seriously 1.Des in Keto but I suspect I was in Keto before that for maybe a month total or something. It is unclear.

 

If the Keto diet is helping or at least isn't hurting, you could stay on the diet. 

 

I'm glad to read you slept well last night. Hopefully you are stabilizing. 

 

Let us know how you like the Gemini scale once you have a chance to use it. 

[theskul]

Ok. Thank you so much for your help.

[theskul]

I'm thinking about starting to taper off Valium soon. Is it possibly a better idea for me to wait a little bit, maybe a week, because there is so short time since I stabilized? This is my 7th day on a stable dose of Valium.

[Sassenach]

On 12/12/2019 at 12:39 PM, Shep said:

Since you just started Valium on December 8, it's still building up in your system due to its long half-life. So some of the overly sedating side effects may diminish over the coming days as your nervous system adjusts to it. 

Hi Skul

 

Sheps comment above was made on 12/12/19 and is still relevant.

I understand the need to quit Valium but if you try too soon you experience W/D again.

I suggest you wait at least a further week to ensure you are stable before beginning another taper.

 

Sassenach

[Shep]

Sassenach is giving you wish advice, theskul.

 

Here is a post that describes something called "withdrawal normal." Withdrawal normal describes where you need to be before you taper again:

 

Withdrawal Normal

[theskul]

Thank you so much for the advice. Should I also maybe wait with changing my diet? Keto diet can influence GABA in some I think.

[Gridley]

 

35 minutes ago, theskul said:

Should I also maybe wait with changing my diet? Keto diet can influence GABA in some I think.

 

Altostrata, founder of this site, wrote: "Ketosis also increases adrenaline. A ketogenic diet is probably not a good idea when one is struggling with withdrawal symptoms."

[theskul]

Im worried stopping keto will throw me into withdrawal because maybe keto has effects on Gaba receptors or something. Im also worried to continue because maybe it will make me more dependent on Valium. Don't know what to do.

 

I am feeling relatively stable. Im not running around in agony and can enjoy some of the day. But I worry it is short lived.

[Gridley]

10 minutes ago, theskul said:

maybe keto has effects on Gaba receptors

I don't know about this.  

 

Why would it make you more dependent on valium?  Because of the adrenaline that Alto mentioned?

[theskul]

Just now, Gridley said:

Why would it make you more dependent on valium?

If it influences Gaba receptors or how Valium is processed by the brain. I'm just basing this on something I have heard, not at all hard science, althoughgood science may well exist.

 

Sassenach adviced me that I should maybe wait another weak before starting a taper. Maybe the same is true about slowly going out of keto. I have no idea honestly.

[Gridley]

 

1 minute ago, theskul said:

 

Sassenach adviced me that I should maybe wait another weak before starting a taper. Maybe the same is true about slowly going out of keto. I have no idea honestly.

 

That sounds like a good idea to me, also going out of kept slowly to avoid an abrupt change.

[theskul]

Yes. So maybe keep things as they are diet wise for now?

 

Here is another article , that talks about how Ketosis can change how drugs are processed in the body:

Quote

Ketogenic diets cause profound shifts in brain and body chemistry rather quickly. These changes are almost always positive and healthy, but they can have a major impact on medication levels, dosages, and side effects that require close medical supervision, particularly in the first month or two while your metabolism adjusts to your new healthy way of eating.

 

On the other hand, I don't think the full effect of the keto diet are in effect(I only started full on keto diet 1. desember, but have been in some ketosis for a little longer, not sure how long), so maybe I should start to slowly change my diet now. But my system may not be able to handle it right now.

 

Decisions, decisions.

Edited December 15, 2019 by theskul

[theskul]

I did a mistake in my keto diet. I'm out of keto now and am feeling the extra stress and uneasiness. Pacing a lot. I'm so close to panicking. I don't know what to do.

[Gridley]

3 minutes ago, theskul said:

I'm out of keto now

 

Can you buy some more food and get back on it?  

[theskul]

I can, yes. But not sure if it is the right move. So confused.