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lithiumnomore: Withdrawal from Lithium, Prozac after 20-years on lithium, others

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lithiumnomore

Hello. Details below but I think I'm experiencing withdrawal symptoms, mainly intense anxiety and insomnia. Both seem to be geting better following the windows and waves pattern, but it's exhausting. Looking to make sense of what I'm going through and support. 

 

Brief med and treatment history

2002-2019 Lithium 900-1200 mg (0.6-9.0 mEq/L blood serum levels), 2018-2019 Prozac 20 mg. After trying various mood stabilizers following manic episode precipitated by Zoloft (very high 100mg+ dosage), I was prescribed lithium, which I took most of the period from 2002 until I stopped it in 2019. During that time I tried various other mood stabilizers, including depakote, lamictal, carbemazepine, and abilify in addition or instead of lithium. 2008-2010 became dependent and withdrew from benzodiazipes. Underwent ~20 ECT treatments in 2010 following hospitalization for depression which marked a turning point in course of "illness." Significant improvement in my life from 2010-2020 but some anxiety and depression symptoms remained. 
 

Tapering


Started Prozac in early 2018 to help with continued chronic anxiety and mild depression. Prozac did help...most notably with the anxiety. I recall it seeming to lift a huge weight off my shoulders, allowing me to let go of the indecision, rumination and general anxiety. While on the prozac, I stopped lithium, tapering fairly rapidly, going from 900 mg/day to 600 mg, to 300 mg, dropping down after a couple months each step. In late 2019, I then went off the prozac, going from 20 mg to 10 mg for about 2 months, then to 0. I was not aware of this website or procedures to taper even more slowly.

 

Current State - Withdrawal? 


Beginning in 2020 after being off prozac a couple months and lithium over a year, I began experiencing bouts of intense disabling anxiety, insomnia and intense emotions (crying for hours on occasion). All of these seem to be of a different quality than the anxiety symptoms that led me to take the Prozac and very different from anything before then. At the same time, I have also been experiencing periods of clarity and heightened consciousness, which feel like my brain and mind waking up after many many years. Also, have had some periods of calmness. Its hard to make sense of the mix of feelings and sensations, but for the closest experience to the clear periods, I have to go back to my teenage years before the diagnosis and before the pills.
  
After reading the New Yorker profile on Laura Delano, I learned more about antidepressant withdrawal through this website and some of her work. I think it's probably the best explanation of what I am dealing with and am looking for help getting through this. I feel like I am on the precipice of regaining a full mind and life after 20 years in varying degrees of darkness. But this is also scary, hard, and it's difficult to keep things together. I am continuing to juggle a demanding career, parenting a two year old and five year old, and being a good husband....while caring for myself and trying to practice self-compassion as I go through what I view as a major life event. Looking for support and to hear more about others experience, hopefully to give me some confirmation that there's an end to what I'm going through. Up typing this in the middle of a stretch of anxiety and insomnia. 

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Gridley

Welcome to SA, lithiumnomore.

 

You are experiencing withdrawal from your fast taper of Prozac.  The symptoms you describe are very typical of antidepressant withdrawal, including the fact that the anxiety you're experiencing is of a different character than your pre-drug anxiety.   It is not uncommon for withdrawal symptoms to show up at the 2-3 month mark after cessation of the drug.

 

What is withdrawal syndrome.

 

Glenmullen’s withdrawal symptom list.

 

The mix of emotions you're feeling, good alternating with bad, is part of the windows and waves pattern of stabilization.

 

The Windows and Waves Pattern of Stabilization

 

When we take psychiatric medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

 

This explains the healing process you're now undergoing. 

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Add in one at a time and at a low dose in case you do experience problems.

 

This restorative yoga pose helped me a lot with anxiety.

 

10 minute Restorative Yoga for Relaxation | Up the wall

 

You mentioned the need to care for yourself during this process.  We recommend non-drug techniques to cope with withdrawal.  Take a look at the links in the following link and see which techniques you think might be helpful to you.

 

Non-drug techniques to cope

 

This is your Introduction topic, where you can ask questions and connect with other members.  We're glad you found your way here.

 

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lithiumnomore

Thank you, Gridley. I ordered Magnesium last night and got it today (Thanks Amazon). They had 250 mg and 500 mg tablets available, but I'm seeing now people doing much lower doses in the Magnesium thread. I guess I'll start with the 250 mg and see how I tolerate it. I also restarted a multivitamin that contains magnesium so maybe I just need that. As I'm in pretty bad shape I'm just going to try the multivitamin plus magnesium supplement. And I took fish oil last night and again this morning 3 1200 mg pills containing 360 EPA/240 DHA at each dose. I think there are studies showing the greatest effects at higher doses and it seems benign otherwise. I realize I should probably limit changes to one thing at a time but need some immediate relief so am going to try all three. If I have problems, I'll try adding one in at a time. How long does it usually take to see an effect from fish oil or magnesium?

 

Also going to collect my recent medical history and nail down when I tapered, will update my sig with that when I have it.

 

Two questions:

1) How long will this last? I know it's impossible to know but does anyone have a sense of what's typical with prozac? 

 

2) You mentioned just the prozac and I know this board is focused on antidepressants. How is the thinking on lithium? I was on it for much longer, though did not seem to have much withdrawal when I came off of it while taking the prozac. Previous attempts to come off the lithium had thrown me into bouts of depression. Do the accounts suggest lithium is easier to say goodbye to?

 

 

 

 

 

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Gridley
1 hour ago, lithiumnomore said:

I guess I'll start with the 250 mg and see how I tolerate it.

It's better to start low and see how it goes.  Magnesium can have a laxative effect.  If 250mg is too much, if it's a tablet you can cut it in half.  

 

1 hour ago, lithiumnomore said:

As I'm in pretty bad shape I'm just going to try the multivitamin plus magnesium supplement.

If you haven't already taken the magnesium, I would stick with the omegas only for a few days.  That's because if there's a problem, you won't know the cause if you're starting more than one supplement at a time.  We advise against multivitamins for the same reason: if there's a problem you won't know which ingredient is the cause.  So I'd introduce one and a time and consider not taking the multivitamin.  If you do take it, wait until you've introduced the other two before starting.  

 

1 hour ago, lithiumnomore said:

How long does it usually take to see an effect from fish oil or magnesium?

I found the effect of the magnesium to be pretty immediate, within a few hours.  Omega levels build up quickly in the body, but some reports indicate it can take 6 weeks to 6 months to see significant improvement. 

 

1 hour ago, lithiumnomore said:

 

1) How long will this last? I know it's impossible to know but does anyone have a sense of what's typical with prozac? 

There is no typical time for any psychiatric drug, and unfortunately it's impossible to predict how long withdrawal will last.  

 

1 hour ago, lithiumnomore said:

Do the accounts suggest lithium is easier to say goodbye to?

 

The tapering schedule for Lithium is the same as for other psychiatric drugs.  It's not one of the hardest to taper, but I've read accounts of difficult lithium tapers.  It's great you got off it without much withdrawal.  

 

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lithiumnomore

Thanks. I'll avoid the multivitamin. It's quite a shift in thinking to realize all the things that could affect your state of mind. 

 

Another part to my story...I had been taking b12 vitamin around the beginning of year. Made anxiety and insomnia so much worse. Shoukd have learned a lesson there.

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Gridley
3 minutes ago, lithiumnomore said:

b12 vitamin

B vitamins can really be overstimulating in WD.  Another reason to avoid the multivitamin.

 

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lithiumnomore

Thanks for the advice. I wanted to write an update. This is mostly just to write but then have a few more constructive thoughts at the end. 

 

I've started taking both fish oil and magnesium regularly now. I noticed a slight calming effect when I first took the magnesium and the fish oil seems to be having an effect over time. It could also just be time. Overall, the course of my healing seems to be on an upward trajectory. I look back at the state I was in a few months ago, and I can see a ton of progress. But there are still ups and downs sometimes with a day, day to day or between weeks. It seems consistent with the windows and waves idea, but I can't help but worry it's some mood disorder. I want to believe I'm just healing, but it's hard. I had believed there was something wrong with me for years, and it's difficult to let go of that.

 

To give an example of the windows and waves, I had manageable week last week, coming off a bad weekend around my birthday. By the end of the week I was looking forward to a trip to a nearby state park that's still open with my wife and two children we had planned for Saturday. I woke up feeling good and excited about the trip--went to the store, then we headed out there. As the day went on spending more and more time outside, I began to feel better and better. There's a calmness that I feel and a freeing of clutter in my mind. The park was positioned in the foothils and after lunch, we went on a hike up road to a look out, overlooking a mix of woodland and farm lands. I hiked up the road carrying my two-year old who was also excited and looking at the wonders of nature. Going up, I had a big problem I had been working on in my work start to clear up, and all the pieces began to fall into place. I felt alive and in the moment. By the end of the day, I told my wife that I had a "great day" and that it had been a long time since I had a day like this. At home, we had dinner, Indian food and I had a beer (more on that later.)

 

Sleep was okay, though I woke up a couple times with the 5-year old getting into bed with us and the dog needing to go out in the middle of the night. I woke up today in a dramatically different place. Trouble deciding what to do with myself, planning for the day, mind scattered, feeling exhausted.  Look in the mirror and I look physically exhausted, dark dircles under my eyes. Suddenly, everything seems overwhelming again. The clarity I had with my work problem is gone, replaced by pessimism and self-doubt. Rumination and catastrophizing take root, and it's hard to take initiative with anything. I've tried taking it easy---not reacting--but it's hard to let the negative thoughts go. Buying into the windows and waves framing, I give myself some comfort by remembering that this will pass as other waves have passed. 

 

So here I am. One lesson learned is that I need to be absolutely strict on my avoidance of alcohol. It adds a variable, and more often than not, any amount of alcohol leads to poor sleep and a bad day the following day. Maybe some day I can enjoy a nice glass of wine with dinner or beers with friends. I can't right now.

 

Learning more about the difficulties of withdrawing after long-term use of psychopharmaceuticals has helped me undrerstand the last year or two better--since I started coming off the lithium. I'm pretty sure I started having lithium withdrawal while on the prozac and then dropping the prozac produced its own withdrawal symptoms. Still, the lack of certainty is difficult. I appreciate this forum and the confirmaiton it can give, but it's hard not having more certainty. What if I am bipolar? What if I'm just in denial? What if this never ends? What's really going on? I want it to be over. 

 

Sorry, for the rambiling update. Tl;dr: making progress, fish oil and magnesium are good, having windows and waves, alcohol is bad, struggling with lack of certaintiy. 

 

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Gridley
8 minutes ago, lithiumnomore said:

What if I am bipolar? What if I'm just in denial? What if this never ends? What's really going on? I

You are catastrophizing.  From your report, you are doing very, very well.  

 

9 minutes ago, lithiumnomore said:

I want to believe I'm just healing, but it's hard. I had believed there was something wrong with me for years, and it's difficult to let go of that.

 

We call it unpatienting ourselves, learning that we are not defined by often arbitrary and incorrect psychiatric labels.  

 

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lithiumnomore

Thank you. I appreciate the quick response. Besides just pouring some thoughts on a bad day, also just wanted a reality check.

 

I am doing better. The bad days are less bad, and day's like yesterday are amazing. It's this feeling of "Oh, this is what life is supposed to feel like...wow, how I've missed this." 

 

What I'm struggling with most now, though again its better, is managing life while dealing with this process of continued healing. I'm not sure how to deal with the "lost days" at work or a worse parent or partner. Knowing it will pass provides some comfort but practically it's hard to just lose hours or days. I'm trying to just accept things not being perfect.Acceptance seems key to a lot of this.

 

Is there a good thread on alcohol effect on withdrawal symptoms?

 

Also, are there good summaries of the symptoms of withdrawa somewhere? I've seen the long lists, and have read some accounts of others, but it'd be helpful to just have a little more concise presentation to give me some confirmation. 

 

Thank you for your support. 

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lithiumnomore

Rest of the day yesterday was pretty hard...but I tried to just let myself be and give myself a break on the work I wasn't getting done. It's hard during those moments, because I of course go from the work not being done to it not ever being done to quitting my job or getting fired. Monday morning, I'm still here. Woke up this morning feeling better. 

 

I ran across some mention of kindling in some of the forum discussion. I couldn't run down the term but this recent experience after alcohol on Saturday night made the kindling idea resonate. I feel like my brain is suspectible to these massive waves of withdrawal symtoms, manifesting mainly in anxiety, mood symptoms and disturbed sleep. Like an overgrown forest. Alcohol--and other things--can cause kindling for that fire or a catalyst to set it off. When I'm healed, I can maybe allow some kindling about or have a campfire and know the forest isn't going catch fire.

 

I wrote down my symptoms yesterday with the intention to turn back to them the next time I have a bad day:

- intense anxiety, feeling of sheer panic

- brain fog - just feels like there's cobwebs, brains having trouble making connections

- difficulty concentrating, thoughts cattered

- Difficulty planning or ordering things---everyhting just comes at me at once

- feeling a need to fix everything--from small stuff around the house to major things in my life-- and a seeming inability to take any action

- feeling overwhelemed

-indecisiveness 

-exhaustion, which is apparent in my appearance with dark circles under my eyes

- poor appetite

 

The contrast from feeling all of that yesterday to this morning cannot have been greater. One experience this morning seemed to sum it up. I was looking for a piece to a game that my son had lost and bent down to look under a heating radiator. It hadn't been cleaned in some time and there was lot of dust and other things collected. Yesterday, this would have sparked overwhelming angst. Today, I just kind of observed the dust, as it was, without judgement and thought "oh, we should clean there." 

 

 

 

 

 

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Gridley
21 hours ago, lithiumnomore said:

managing life while dealing with this process of continued healing.

 

We recommend non-drug coping skills to deal with withdrawal and getting on with life during this process.  Take a look at the links in the following link and see which you think might be helpful to you.

 

Non-drug techniques to cope

 

21 hours ago, lithiumnomore said:

.Acceptance seems key to a lot of this.

 

It is very important.  An attitude of acceptance will go along way in helping you to deal with withdrawal.

 

21 hours ago, lithiumnomore said:

alcohol effect on withdrawal symptoms?

 

Google SurvivingAntidepressants.org alcohol 

 

21 hours ago, lithiumnomore said:

are there good summaries of the symptoms of withdrawa

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

4 hours ago, lithiumnomore said:

kindling

Kindling is what happens when the brain and central nervous system become hypersensitized from psychiatric drugs, often caused by repeated going on and off them

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
 
 
 
 
 
 
 

 

 

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lithiumnomore

Coming up on another week in the books. Lot of work stress, working long hours culminating in not much sleep during the end of the week and a really stressful Friday. During the worst of it, I became absolutely convinced I cannot do my work, that I'm a fraud waiting to be found out, and have to figure out a way to afford to quit my job. Got a decent night of sleep last night and woke up feeling much better. 

 

Anyone have any experience dealing with the demands of work? I'm staring down a difficult 3 months working up to a deadline and have to handle knowing that I will have days when I'm about half as productive as normal. I don't really feel like I can be open with my boss or colleagues about this, so I just go through work days feeling a lot of guilt and self loathing. I'm doing my best to manage my symtpoms but expect I'll have the waves for a time to come. Withdrawal's not going away and neither are the demands of life. Feels like quite a bind. 

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lithiumnomore

Checking in another week gone by. Have had windows, overall seem to be improving but still having some really bad days. Having trouble keeping up with work and continuing to think about take long term leave. Not sure if I can though. How do you deal with the cognitive symptoms?

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lithiumnomore

Another update. Work and life have become so overwhelming that I'm likely going to talk to my supervisors about reduced work load and/or extended time off. The most difficult part of all this is that while I'm seeing progress in some places and am having wonderful glimpses of clarity, I've noticed some new troubling issues. Have had particularly challenges with cognitive functioning in the last week or so, which is interimittent but seems to be worsening overall. Last couple days have had particular trouble concentrating. I also have had suicidal thoughts in the lat 24 hours, which is something that hasn't happened in a very long time. Just thoughts, no action, and I'm in control but the thoughts alone are frightening.

 

Something I haven't talked about here. Should I be considereding reinstatement? I stopped the Lithium in late 2018, Prozac in late 2019 but then reinstated for one week in February. Sorry, I don't have precise dates with this. I need to do some work to piece them together. My inclination is to just stay the course but I'm worried that might fast taper might have set me up for failure? I'm experiencing a lot of positives, I want more of those but I'm working towards being well in the long-term, not today, not tomorrow, for the rest of my life.

 

 

 

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lithiumnomore

After the awful day yesterday, woke up clear headed this morning. When one of these waves passes, my sleep is suddenly different. It feels restful and deeper. I have the initiative to tackle work and life again. The contrast is striking. Like night and day would be an understatement. The fact that these symptoms pass like this reassures me it's withdrawal and not depression relapse.

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lithiumnomore

After a good 3 days woke up this morning with brain fog. Work has been more manageable but then have to deal with this. Strategy is to get as much done as possible when I'm feeling good and then do what I can when I'm not.

 

One correlation between the window/wave switching I've noticed is if I eat cured meats. Wondering if nitrites might be contributing to symptoms.

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lithiumnomore

I managed the rough day okay yesterday and was feeling better by the end of the day. Slept pretty well and for a long time. Today so far has been better.

 

During the waves lately, the anxiety has been much more mild but feel more depressed. That can be scary as I still worry about just slipping back into depression. It's hard to remember that I don't need the drugs after depending on them for so long.

 

Even on the down days I have little windows of clarity. It feels like I've been away for a long time and am stepping into a life and experience that's unfamiliar. I try to enjoy that. It's all I can do and should do.

 

Anyone else find themselves starting to notice little things in the world after coming off of drugs/out of withdrawal? I think it's just healing and waking up.

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lithiumnomore

I feel really depressed now. Worried getting off meds was a mistake.

 

Took a Zyrtec this afternoon, that's probably just making things worse. But depression is terrifying.

 

I like the narrative of being free from meds and healing but it's hard to let go of the dependency on them and the idea that I'm sick. I'm terrified of slipping back into deep depression like I had when I started long term meds at 18 or had at various times. Scared of losing everything.

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lithiumnomore

Better this morning. Hopeful and feeling less overwhelmed. Starting to formulate a better plan to get through work while going through this.

 

I wish I had a better sense of the windows and waves pattern. I know there're good days and bad, and also good weeks and bad weeks. Overall, I seem to be making progress. And when a wave passes at least, I feel better than before. Going to try to keep track of them more. Maybe seeing the pattern will help remind me that the worst passes and I feel better on the other side.

 

Honestly, it's like  a series of hurricanes lined up and I'm passing through them one by one. Increasing pain and suffering as I start to move through it, eyes of calmness in the middle of each, intense symptoms gradually dissipating as I pass through the other side and then I come upon another hurricane. Repeat. What's hard to tell is if the intensity of each hurricane is lessening. I think they are. I need them to.

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