vincent: prescribed Prozac with no prior history of mental illness

[vincent]

Hi All

May I first thank whoever started and maintains this excellent forum, without it I would still be under the misconception that without SSRIs I have serious and disabling mental illness

I was prescribed Prozac at 56 with no prior history of mental illness. It was only about a year or two ago that I realised that the 'mental illness' I later suffered was SSRI Withdrawal

With the help of this forum I have started a 5% taper of 20mgs Prozac, using mini scales.

Here is my brief and approximate history of SSRIs

 

 

2007 (at age 56) Prozac 20mg. For chronic fatigue syndrome.

2010/11                Stopped taking Prozac and suffered severe withdrawal

2010                       Prescribed Citalopram 10mg ? For ‘ Anxiety and depression and panic attacks

2014                       Discontinued Citalopram over a month

2014/15                Suffered severe withdrawal and was prescribed Prozac 20mg

2017/18                After research I decided that I have never had mental illness, only withdrawal

2017/20                Various failed attempts to ‘taper’ (missing doses)

2020 Sept            Took advice from this Excellent forum and started a 5% taper using mini scales

Withdrawal symptoms.

Took to my bed. Flu-like symptoms, Thought I had all forms of cancer, Zaps, Inexplicable fear, Limbs shaking, Insomnia, Constant ‘stress’ Headache, Panic attacks

Edited September 25, 2020 by Gridley

[Gridley]

Welcome to SA, vincent.  I'm glad you had this realization.

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.  Using the link below, you can just copy or paste the history in your post and press "save."

 

Account Settings – Create or Edit a signature.

 

You might already have read some of these threads, but in case you haven't here's information on withdrawal and the healing process.

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

These explain the healing process really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

Brain Remodelling 

 

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

 

 

Edited September 25, 2020 by Gridley

[vincent]

Thanks Gridley. I will have a look at some of the links and well done on your taper

[vincent]

Here is how I calculated the dose.

 

I weigh and collect the powder from 10 capsules in a container and fill new capsules with the reduced amount'

I assume not all drug companies use the same concentration of drug in the bulk, so I may have to repeat this with a new prescription.

Keeps me busy

 

 

[Gridley]

@vincent That's the way to do it.  If your new prescription is from a different drug company, you're correct that you'd have to re-calculate.

[vincent]

I would appreciate the opinion of experienced members.

 

My prosac prescription this month is from a different company, tho the capsules look the same. I almost based my 5% reduction on my old calculation but when I weighed the powder of 10 capsules it was 2366mg making a mean of 236.6.

 

Should I recalculate my 5% on this new mean or assume this drug company is being generous?

[manymoretodays]

On 9/26/2020 at 9:26 AM, Gridley said:

@vincent That's the way to do it.  If your new prescription is from a different drug company, you're correct that you'd have to re-calculate.

 

On 10/2/2020 at 9:54 AM, vincent said:

My prosac prescription this month is from a different company, tho the capsules look the same. I almost based my 5% reduction on my old calculation but when I weighed the powder of 10 capsules it was 2366mg making a mean of 236.6.

 

Should I recalculate my 5% on this new mean or assume this drug company is being generous?

 

Yes, and no they are not being generous......that's funny!

 

So you now have a 20 mgai(the ai is for active ingrediant or dose strength) that weighs .237 grams on your scale.  I rounded up from the .6 mg in your 236.6.

Now multiply that weight by   0 .95:

And you get:  .237 X 0.95 = .0225 mg in weight, for your first 5 % taper.  I'd go with the .022 gm on your scale with this one.

I'm redoing this in my next post as I made an error in not only the multiplication but too confusing for member switching from mg to grams!!!

 

 

The chart you are using doesn't have the dose in mgai and so:

 

Also 20 mgai X 0.95= 19 mgai, so this is what you are taking in dose strength.  And it's important that you don't get the weight mixed up with your dose.  Even though they are both in mg(milligrams). 

 

Using digital scales to measure doses

Am I correct in assuming that you are using a Gemini20 scale?

 

Yah, I also sometimes do this to busy my sometimes squirrelly, quirky brain.

 

And here is the: Tips for tapering off Prozac(fluoxetine) topic.  Good to have that here to refer to.  I might, if I were you, and given Prozac's longer half life.......stay with this first reduction, for at least a month, if not 6 weeks.

 

And keep us updated here, along the way, or ask questions, when needed.

 

Love, peace, healing, and growth,

manymoretodays

Edited October 4, 2020 by manymoretodays
further spacing, redo math and explanation next post

[vincent]

Thanks for your contribution manymoretodays

I use 'homegeek' scales .001g. They seem accurate and stable.

I realise I should recalculate but the difference was that small.........

What do you think of this method.  Empty 10 capsules in a container, weigh the powder and divide by ten to obtain the mean? Then fill capsules with with 95% of the mean. Do this every 10.

I intend to remain on the reduction at least 4 weeks or even more, as my experience shows that withdrawal from fluoxetine can take months to appear.

No obvious withdrawal symptoms after 17 days on 5% reduction

[manymoretodays]

Hey vincent,

 

On 10/3/2020 at 4:35 AM, vincent said:

I use 'homegeek' scales .001g. They seem accurate and stable.

I realise I should recalculate but the difference was that small.........

What do you think of this method.  Empty 10 capsules in a container, weigh the powder and divide by ten to obtain the mean? Then fill capsules with with 95% of the mean. Do this every 10.

I intend to remain on the reduction at least 4 weeks or even more, as my experience shows that withdrawal from fluoxetine can take months to appear.

No obvious withdrawal symptoms after 17 days on 5% reduction

 

Awesome, and good, good to remain on reductions for at least 4 weeks!

And, I think if you are using some of the old capsules or capsule contents, just go with the old calculations until you get to your new batch.

If you haven't already, don't mix the old capsule contents with the new.  

And doing a mean, on every 10 capsules is excellent!

 

You did recalculate though.   Correctly.

 

I think I confused you going from mg to gram.  And I also see an error in my multiplication.

(and apologies, I wanted you to understand the difference between the weight and the dose, as well as rounding up or down, what the readout on the scale would look like, etc........I may have made it even more confusing and to top it off.......I made a math error!)

 

And so here is the redo.

For when you begin to use your new capsules. 

 

 

On 10/2/2020 at 9:54 AM, vincent said:

My prosac prescription this month is from a different company, tho the capsules look the same. I almost based my 5% reduction on my old calculation but when I weighed the powder of 10 capsules it was 2366mg making a mean of 236.6.

 

 

You now have a mean from 10 capsules(20 mg dose) of 236.6 mg. 

Each 20 mg dose weighs 236.6 mg

0.95(236.6)=  224.7 mg(this represents your 5% taper by weight) with this new batch of Prozac/fluoxetine

 

I think your 5% taper weight used to be 216.9 mg, with your old batch.  With a mean for the 20 mg dose of 228.3 mg.    I'm referring to your chart posted here: https://www.survivingantidepressants.org/topic/23434-vincent-prescribed-prozac-with-no-prior-history-of-mental-illness/?do=findComment&comment=502830

 

So there is a difference.

Your scale measures in grams and so:

you would want to see .225 on your scale readout for the amount to fill each capsule with.  Rather than .217. 

Do you follow?

 

I hope that makes it clearer.

 

0.95(236.6)=  224.7 mg(this represents your 5% taper) with this new batch of Prozac/fluoxetine

 

And yes, your method also sounds very sound vincent.

 

You'll base your next taper % on the previous weight, not the starting weight.

 

And your first taper brings you to a dose of 19 mg of Prozac/fluoxetine.

We do like to know the dose when you report your tapers or put them in your signature.

 

Okay.....I hope we both feel clearer now.

 

L, P, H, and G,

mmt

 

 

Edited October 4, 2020 by manymoretodays

[vincent]

Thank you ! 

great stuff!

[vincent]

19 days on 5% reduction

 

Not sure if these symptoms are related as I drink alcohol and prescription pain killers. I feel OK otherwise.

 

1. Feeling hot and sweaty but no temperature (not had this for a while)
2. Mildly Agitated for no good reason
3. Sore eyes

 

[manymoretodays]

Hi vincent,

If you would, please put ALL your drugs, including the alcohol into the interaction checker here:  Drugs.com- Drug Interactions

And then, copy and paste the results right here in a reply box.

The alcohol and prescription pain killers also effect your CNS(central nervous system) and from our standpoint, would require some form of tapering as well, for best outcomes.

Are you using the alcohol and pain killers on a regular schedule? 

And, I'm sure you know that alcohol and pain killers taken together are not a great idea. 

I'm not judging here, either........and thank you for disclosing.

 

L, P, H, and G,

mmt

 

[vincent]

Hi Manymoretodays

 

Thanks for your comments. I see the interactions from these drugs

 

At the moment I average 6 units of alcohol a day and 2x30mg dihydrocodeine a day for pain. As you can imagine, these drugs make me feel better (addiction? I don't know)

 

What would be a good taper regime?

[manymoretodays]

You saw the interactions, right?

You're citalopram may be limiting the effectiveness of your codeine.  The CYP450 system in the liver.

Were you on the codeine before the other drugs?

 

I would think the codeine and alcohol make you feel worse, or just blah.  They certainly aren't real motivating substances.

 

Anyway......6 units of alcohol........is that like 100 proof or a near beer unit?  LOL. 

You really might be okay doing with less.  Just use the principles here though.......taper, rather than CT off either of them.  The outcomes are better.

 

[vincent]

Hi Manymoretodays

 

It is prozac not citalopram I take and  'units of alcohol' just refers to the commonly held view of a unit of alcohol in the UK.  A unit is a single whiskey, small glass of wine or half a beer. So 6 units refers to either half bottle of wine or three double whiskeys😉

 

https://www.nhs.uk/live-well/alcohol-support/calculating-alcohol-units/

 

 

[manymoretodays]

Okay.  Well, same with Prozac and codeine......at least I lucked out there.  CYP450 D6 inhibitor.  Drug Interactions Report-Drugs.com

(I usually switch on over to the professional information)

Edited October 9, 2020 by manymoretodays

[manymoretodays]

How are you doing vincent?  Update?

[vincent]

On SSRIs for about 13 years with a number of unsuccessful withdrawal attempts. Even a slow 5% withdrawal has brought on withdrawal symptoms and reinstatement after 6 weeks. At 69 is it worth going through years of withdrawal ?

[Toast]

Wanted to send some support your way. I would not feel qualified to encourage you one way or another (and also I'm pretty new here ). I think it's a very personal decision whether to try to come off or not if you are having such problems. I'm in the process of coming off after 15 years on SSRIs and I've faced some pretty horrific withdrawal symptoms as well. However, I'm much younger than you, so for me the prospect of potentially years of withdrawal-related suffering in order to avoid further potential long-term problems associated with long-term SSRI use (many of which probably haven't been fully documented) is worth it. But it may not be worth it to you, and that's okay too! Either way, I'll be thinking of you and I'm sorry that you find yourself in this mess. 

[vincent]

I have decided to get back in the ring for another swing. I contacted my doctor to request liquefied Prozac to aid my taper now that it is available in the UK.

Despite the fact that I sent him a report suggesting a long slow taper, he suggested a 6 week taper🙁

Rather than a 10% monthly taper, I have decided to reduce by 1mg per month for 10 months (keeping it simple) and see how I progress. I will update

 

[ChessieCat]

4 hours ago, vincent said:

Rather than a 10% monthly taper, I have decided to reduce by 1mg per month for 10 months

 

Q:  What is your starting dose?

 

If your starting dose is less than 10mg then 1mg would be more than 10% of the current dose.  If your starting dose is 20mg, then a 1mg every month will be okay until you get below 10mg.

 

Please update your drug signature with the date and dose you are currently taking so that it can be seen easily.  And remember to add in the new dates and doses whenever you make a change so it remains current.  This allows your drug history to be seen at a glance and we do not have to read through your posts to get the information.  Thank you.

 

Account Settings – Create or Edit a signature

[ChessieCat]

4 hours ago, vincent said:

Despite the fact that I sent him a report suggesting a long slow taper, he suggested a 6 week taper🙁

 

I am very glad that you have the knowledge to know that this is not a good idea.

 

It seems that many in the medical profession think the following about Prozac (from Post #1 in the Tips for Tapering Prozac topic):

  

On 7/3/2011 at 4:11 AM, Altostrata said:

Is Prozac "self-tapering"?
Because of its very long half-life, Prozac has the reputation of being "self-tapering," meaning it requires only a short taper. However, some people do suffer withdrawal from Prozac, just as severe as other SSRIs. Because of the long half-life, withdrawal symptoms simply take longer to appear.

 

[vincent]

Hi chessiecat

my starting dose is 20mg. I knew this doctor hadn’t a clue - he had originally told me to go ct - but I needed a liquidised Prozac prescription 😉

[ChessieCat]

Thanks for updating your drug signature.

 

One way of talking to a doctor who wants you to go faster is to say that you have experienced withdrawal before (of course only if you have) or that you have heard that other people have and just say that you would prefer to try doing it more slowly so that you lessen the likelihood of getting withdrawal symptoms.

 

When I saw my doctor for the results of my blood test and my cholesterol and blood glucose was high she started talking about drugs.  And I said no, no statins.  And I told her that it does not make sense to change two things at the same time (ie diet and drug) because if things improve there is no knowing which has helped.  I already knew some of the side effects of statins but I have since done more research and statins can increase the risk of diabetes! and Metformin (for the Type 2 diabetes) can increase weight!  I'm now on a low carb diet (dietician said not enough carbs!) and my blood pressure has come down a lot.  I've managed to lose 1/16th of my weight and just overall I am feeling improvement.  Next blood test is middle of January.  I'm keen to see what the results will be.

 

When changing from tablet to liquid it is a good idea to do a cross over:

 

cross-over-changing-form-eg-tablet-to-liquid-of-drug-or-changing-brand-of-same-drug

 

[vincent]

ChessieCat.  I managed to get the liquid form but at the moment i am removing 5% from the remaining capsules with mini sales - a couple of months supply - and will then move on to liquid. Thanks for the helpful  link

[vincent]

Having problems extracting powder from capsules without loss, making it difficult to remove 5% accurately. Is there an efficient method?

 

[ChessieCat]

You could try using a toothpick.

[ChessieCat]

Holding the capsule with a pair of tweezers might help too.

[vincent]

Doctor has stopped my repeat prescription for Prozac assuming I will be off the drug in 6 weeks😡

 

[ChessieCat]

Any doctor can prescribe an antidepressant.  And if you cannot get in to see one, you could visit the hospital and explain that you are concerned about stopping the drug too quickly because you have experienced withdrawal symptoms before.

 

Definitely sounds like you need a new doctor.

 

how-to-talk-to-a-doctor-about-tapering-and-withdrawal-what-to-expect

 

And I suggest that you print this out and take with you (link is from Post #1 of the above topic, and there is more information there too):

 

Royal College of Psychiatrists. (2020). Stopping antidepressants. Royal Colllege of Psychiatrists (UK).

 

PRINT FORMAT "Stopping antidepressants" leaflet

 

 

Edited December 15, 2021 by ChessieCat

[vincent]

2nd Jan 2022

Started reducing by 2mg (10% of original) after five weeks on 1mg reduction (5% of original)

Prozac

No obvious withdrawal symptoms.

I will review in four weeks

[vincent]

On 9/25/2020 at 4:58 PM, vincent said:

Hi All

May I first thank whoever started and maintains this excellent forum, without it I would still be under the misconception that without SSRIs I have serious and disabling mental illness

I was prescribed Prozac at 56 with no prior history of mental illness. It was only about a year or two ago that I realised that the 'mental illness' I later suffered was SSRI Withdrawal

With the help of this forum I have started a 5% taper of 20mgs Prozac, using mini scales.

Here is my brief and approximate history of SSRIs

 

 

2007 (at age 56) Prozac 20mg. For chronic fatigue syndrome.

2010/11                Stopped taking Prozac and suffered severe withdrawal

2010                       Prescribed Citalopram 10mg ? For ‘ Anxiety and depression and panic attacks

2014                       Discontinued Citalopram over a month

2014/15                Suffered severe withdrawal and was prescribed Prozac 20mg

2017/18                After research I decided that I have never had mental illness, only withdrawal

2017/20                Various failed attempts to ‘taper’ (missing doses)

2020 Sept            Took advice from this Excellent forum and started a 5% taper using mini scales

Withdrawal symptoms.

Took to my bed. Flu-like symptoms, Thought I had all forms of cancer, Zaps, Inexplicable fear, Limbs shaking, Insomnia, Constant ‘stress’ Headache, Panic attacks

 

 

I have managed to acquire a copy of my medical records and need to correct my signature but not sure how to.

 

My long term memory has not served me well! As it turns out the severe withdrawal I suffered 2011 was from a CT of 20mg Citalopram and it continued for months after reinstatement of 10mg

My second noticeable episode was withdrawal from the 10mg Citalopram 2014.

I continue to research my medical records for any reactions to Prozac withdrawal which was around 2007 when I appear to have transferred to citalopram after a gap

[vincent]

Apparently my signature is different when viewed in my account details?

[ChessieCat]

When you join you provide your drug history.  This is only visible to staff, and may be what you see in your profile.  It has the following heading:  My history (visible to staff only)The drug signature is what is visible below every post you make.  This is a copy of your current signature (which we call your drug signature):

 

2003 (at age 52)        Prozac 20mg. For chronic fatigue syndrome.

2007/10                      20mg citalopram 

2010/11                       Cold Turkey citalopram Severe withdrawal

2011                             back on citalopram 10mg

2014                             Discontinued Citalopram over a month period

2014/15                       Suffered severe withdrawal and was prescribed Prozac 20mg

2017/18                       After research I decided that I have never had such severe mental illness, only withdrawal

2017/20                       Various failed attempts to ‘taper’ (missing doses)

2020 Sept 16th           started a 5% taper using mini scales

Nov 24 2021 started a 1mg per month reduction from starting dose of 20mg

 

[vincent]

Thanks for replying Chessiecat 

 

As you can see in my last post my signature is different it is the pervious one (before my last edit). May be a glitch

[ChessieCat]

You might not have saved it after changing it.  The Save Button is below the signature box, similar to how we Submit Reply after creating a post.