vincent: prescribed Prozac with no prior history of mental illness

[vincent]

Vivid dreams over last few days

[vincent]

Due to move on to next monthly taper. However, I have become tired and sleepy last 4-5 days, legs achy and not motivated to go for daily walk.

No more vivid dreams, or zaps and my mood and emotions feel normal

Could be other causes?

I think I will leave my next taper for now and see what develops, or should I reinstate 1mg?

[ChessieCat]

I don't think increasing the dose is a good idea.  The symptoms sound like they are bearable and you have also noticed improvement.

 

Because of the long half life of Prozac yoyoing doses of it can be a nightmare simply because it takes so long before you see the result of the dose change.  If you updose and 2 weeks later you find that it was too much, and then you reduce the dose it will then take another 2 weeks for the reduction to fully impact you.  So I imagine that for at least 2 of those 4 weeks, or possibly longer, you would be having to deal with the result of the dose changes.

 

A longer hold would be a better idea.

[vincent]

Hi chessiecat

 

Your comments are much appreciated. I think I will hold as you suggest.

 

I don't think I have felt any improvement. I am just trying to get off the drug and I hope to go  slow enough to prevent withdrawals. I really don't fancy two years of 'tolerable side effects🤕.  I want to feel well, well enough to be motivated for exercise.

 

Do you think it sounds like withdrawal? I hope the symptoms are related to something else.  I will have t wait and see.

[vincent]

If Withdrawal appears 2 months into a 5% monthly taper of 20mg Prozac is it safe to to go back to 20mg? I ask this because of the long half life. It could be the first 5% that is causing the symptoms. 

I know some believe that Prozac is the best SSRI to taper but I have to disagree because of the above

[ChessieCat]

Going back up to 20mg after being on a lower dose for 2 months would most likely be too much.  This is because during the time on the lower dose/s your brain will have made some adaptations to not getting as much of the drug.  If unbearable withdrawal symptoms appear and you wanted to updose, then you make a small updose.  Here is an example of an updose I did whilst tapering Pristiq.  This was a 4 day period and I did not go back to the "original" dose.

 

29/12/15	75
30/12/15	67.5
31/12/15	67.5
01/01/16	70

 

Q:  Why are you asking about 5% monthly?  Is this a question you are asking about what happened back in 2020?  If yes, then I don't think it really is worth being too concerned about now.  There may have been other things at play which you haven't mentioned and/or you haven't remembered and/or you didn't think might have impacted your withdrawal/taper.  Prior to 2020 you had cold turkeyed citalopram and then gone back on and then started Prozac and then tried tapering by skipping doses (not recommended even with a long half life drug like Prozac).  The good thing is that you seem to be on the right track now, doing a slow taper.

 

Your drug signature says you are reduction by 1mg per month.

 

Reducing from 20mg to 19mg is a 5% reduction, however reducing from 19mg to 18mg is a 5.26316% decrease, and the next reduction from 18mg to 17mg is a 5.55556% decrease.  This is not really an issue because it is below 10% of the current dose, however once you get below 10mg it will be a larger than 10% reduction.

 

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

 

Looking at the above from your signature it appears that the taper you started in November 2021 was from 20mg, yet the previous entry states you had started a 5% taper (apparently off 20mg).  Q:  Did you go back up to 20mg at the end of 2020 or in 2021.  If you, please add the date and the dose so that we can easily see what changes you made.  Thank you.

 

If my interpretation is incorrect and you were at a lower dose in November 2021 when you started reducing by 1mg per month, state the dose you were taking just before November 2021 (not the original starting dose).

 

Please also add "current dose:  date, dose" so that we can easily see what you are taking now.  It saves the mods a lot of time and effort when we can see your drug history at a glance and not have read back through posts to get the information.  Thank you.

 

Edited February 5, 2022 by ChessieCat

[vincent]

Hi ChessieCat

 

You raise a few issues.

 

My current signature needs updating.   The Sep 2020 Taper was abandoned fairly quickly;  "Even a slow 5% withdrawal has brought on withdrawal symptoms and reinstatement after 6 weeks." (Jan 7th 2021). 

 

I am concerned with, and only referring to,  my Prozac taper from Nov 2021; previous tapers, most of which occurred before I came across this remarkable site were based on ignorance and I acknowledge that.

 

Starting from 20mg per day Prozac I selected a 1mg per month reduction because it is a less sever start than 10%.  I would have started 10% when I reached 10mg if all went well but it hasn't 

 

My concern with tapering Prozac is based on the assumption that it takes 3 months to leave the system and therefore withdrawal symptoms could take 3 months to appear.  Based on this assumption  then my first 1mg reduction  could bring on  withdrawal anytime  to up to  late Feb 2022,  so how do I know that if I hadn't taken the  second month reduction I wouldn't still be having withdrawal from the first reduction?   This seems to suggest that by continuing to reduce could lead to a 'build up' of withdrawal requiring a larger reinstatement. A bit convoluted but difficult to explain.

 

It has been suggested elsewhere that Prozac should be tapered every 3 months! I already know that a 10% reduction would bring on withdrawal and a 5% reduction every 3 months is a long taper. I hate these drugs but fear I am stuck with them   Even so,  I consider myself lucky when reading about other members' suffering  and I wish them all the best.

 

In the meantime my withdrawal has become more apparent - spending more time in bed, tinnitus, nausea, dizziness and little anxiety - and I have gone back to a 1mg reduction of a 20mg Prozac.

 

Thanks for your input

 

 

[ChessieCat]

I can understand your concerns which I think might be due to a combination of your previous experience of withdrawal symptoms (once bitten, twice as shy) and also the conflicting information that you have read.

 

It is not unusual to experience some withdrawal symptoms after making a reduction.  But the aim is to keep them to a minimum and at a bearable level that you can live with and not reducing again until you are at WDnormal:

 

Stability

 

WDnormal

 

And Brassmonkey talks more about it here:

 

tao-of-the-brassmonkey

 

The taper rate is only a guide and each member needs to listen to their body/symptoms and taper according to those.

 

5 hours ago, vincent said:

My concern with tapering Prozac is based on the assumption that it takes 3 months to leave the system and therefore withdrawal symptoms could take 3 months to appear. 

 

It's not about the drug "leaving your system" which I interpret as getting the drug out of your body.  When we take a psychiatric drug the brain adapts to getting that dose of the drug.  When we take away a small amount the brain's automatic reaction is to adapt to not getting as much of the drug, which is called regaining homeostasis.  This is what causes the withdrawal symptoms.  Take away the drug too quickly and generally you experience worse symptoms because the brain is trying to make a lot of changes all at once.  So it's about how quickly the brain adapts after a reduction and not how much drug is in your system.  And the easiest way to assess this is by keeping note of your symptoms.

 

Any reduction is going in the right direction of getting off the drug.

 

The aim is to get off the drug at the rate which allows you to live your life as normally as possible.

[vincent]

Hi ChessieCat

 

I really appreciate your expertise and your patience in explaining this to me,  and thanks for the links. I have decided to stay on 18mg Prozac for an extra month ( i only went to 19mg for a couple of days).

 

The withdrawal is tolerable - nowhere near as bad as I have suffered in the past - and I need to know where this reduction takes me if I am ever to get off Fluoxetine. If I stabilize then that will offer hope. Perhaps a 5% reduction every 2 months may avoid withdrawal 

 

I have updated my signature and hope it is more clear to the mods

 

Thanks again

[vincent]

I have been fine the past week; good mood and more energy. I am glad I stayed on 18mg rather than go back to 19 or 20 as it has given me a lot more confidence in my taper. 

If it was mild withdrawal I was suffering then it has past and I feel 'stable'

Onwards and upwards :)

 

[vincent]

I have been reading a thread by a forum member Moment19 who says serious withdrawals appeared 4 months after cessation of Prozac. This adds to my concerns that withdrawal from reductions will also take 4 months to appear because of its long half-life. This is very disconcerting for me.  I will remain on 18mg for 3/4 months and test this hypothesis.

 

[ChessieCat]

10 hours ago, vincent said:

I have been reading a thread by a forum member Moment19 who says serious withdrawals appeared 4 months after cessation of Prozac. This adds to my concerns that withdrawal from reductions will also take 4 months to appear because of its long half-life. This is very disconcerting for me.  I will remain on 18mg for 3/4 months and test this hypothesis.

 

 

You are comparing apples with oranges.

 

Moment19's drug history is very different to your own:

 

Fluoxetine 10 mg for 2 months

Fluoxetine 25mg for 4 years

Fluoxetine 10 mg for a few months

Fluoxetine zero

Brain zaps

Back up to Fluoxetine 10mg

Zero Fluoxetine for 4 months - After 4 months extreme withdrawal symptoms surfaced

Sertraline 25 mg for 4 weeks - couldn't stabilize. 

Fluoxetine 10mg then 5mg 2 weeks couldn't stabilize

Fluoxetine zero - Experiencing severe withdrawal symptoms since 4/2021

 

Edited February 22, 2022 by ChessieCat

[vincent]

Since converting to liquid fluoxetine  I experience a 'high' shortly after my dose at mid morning. Anyone else experienced this? Should I attach any significance to it?

[ChessieCat]

It's most probably related to the body accessing the drug a bit faster bit it is liquid.

[vincent]

I have been feeling well, with no obvious withdrawal, so i have decide to reduce my dose by 1mg (5.56%) from 18 t0 17mg Fuoxitine having been on 18mg for 8w

 

 

[Shmalan]

Hi Vincent,

Regarding liquid fluoxetine: I use the pill capsule form with powder . I don’t get a high but side effects (revved up, restlessness etc like way too much coffee) which peak about 5-6 hours after dosage. When I tried liquid the “peak” was sooner and stronger which is why I went back to capsules and powder. Glad you are able to reduce dosage again.

[vincent]

Hi shmalan

 

Sorry to hear about your side effects I guess I am just lucky as I don't mind the slight 'high' I receive.

Keep well and good luck with tapering.

[vincent]

On 2/27/2022 at 2:04 PM, vincent said:

......... i have decide to reduce my dose by 1mg (5.56%) from 18 t0 17mg Fuoxitine having been on 18mg for 8w

 

 

Correction  -  Reduced to 17.2mg Prozac (4.65% reduction) easier to read on oral syringe

[vincent]

* 4.44%  reduction

Can't edit last post

[vincent]

Due for my next taper soon. What are the risks of me trying 10%? 

[ChessieCat]

It's up to you what sized reduction you make.  If you are at all concerned about a 10% reduction then this can add stress/anxiety.  When this happens then if you get symptoms it will be difficult to know if it is related the the reduction or the anxiety or both.

 

Instead of reducing by 10% you could try reducing anywhere between 5% and 10%.

 

If it was me, because of the long half life of Prozac, I would be cautious and making a <10%.  For example you could try a 7.5% reduction this time and if that goes okay then next time you might try the full 10%.  Or you could try a 6% reduction and then next time make a 7% reduction.

 

Please note that these are just my thoughts about this and giving you some options to consider.

[ChessieCat]

On 2/2/2022 at 9:53 AM, ChessieCat said:

Because of the long half life of Prozac yoyoing doses of it can be a nightmare simply because it takes so long before you see the result of the dose change.  If you updose and 2 weeks later you find that it was too much, and then you reduce the dose it will then take another 2 weeks for the reduction to fully impact you.  So I imagine that for at least 2 of those 4 weeks, or possibly longer, you would be having to deal with the result of the dose changes.

 

Just wanted to remind you of the above.

 

The aim is to get off our drug with minimal discomfort so that we can live our life as normally as possible.

 

Every reduction, however small, is heading in the direction of getting off the drug.

[vincent]

Update

Thanks for your advice Chessiecat

 

added to my signature today (minor blip hopefully)

2022 Mar 12th            Reduced to 16.8mg Easier to read on Syringe 

2022 Mar 30th           Increased to 17.1mg After Symptoms  Drop of 6.7mg too much?

I seem to be OK around 5% drop and no more. The drop to 16.8 was only 2 weeks after my last reduction.  Symptoms: low mood, impatience, irritability insomnia but sleeping during the day. Loss of motivation. fatigue 

[Shmalan]

On 2/5/2022 at 4:47 PM, ChessieCat said:If unbearable withdrawal symptoms appear and you wanted to updose, then you make a small updose.  Here is an example of an updose I did whilst tapering Pristiq.  This was a 4 day period and I did not go back to the "original" dose.

 

29/12/15	75
30/12/15	67.5
31/12/15	67.5
01/01/16	70

 

@ChessieCat Thanks for this example, do you remember and mind sharing why, in this case you chose to increase to 70mg and not closer to the 75mg dose? Did the withdrawal of symptoms improve? 
 

@vincent Hi Vincent, how are you doing? I hope that your recent increase in dose helped the WD symptoms.

[vincent]

I have been meaning to post an update.

My symptoms have not improved, Low mood, motivation, and painfully tired, spending most of the day in bed. I am beginning to wonder if I have other health problems but I thought the same the last time I was in withdrawal resulting in many visits to the doctor's but nothing was found.

Are the changes I made big enough to cause these symptoms or are they the result of accumulated reductions of a drug with a long half-life?

 

[ChessieCat]

@Shmalan So as not to hijack Vincent's topic, I have responded in your Intro topic. 

 

[ChessieCat]

24 minutes ago, vincent said:

I have been meaning to post an update.

My symptoms have not improved, Low mood, motivation, and painfully tired, spending most of the day in bed. I am beginning to wonder if I have other health problems but I thought the same the last time I was in withdrawal resulting in many visits to the doctor's but nothing was found.

Are the changes I made big enough to cause these symptoms or are they the result of accumulated reductions of a drug with a long half-life?

 

 

It's a good idea to look at other things that might have happened/changes over the few months leading up to this.  Not everything is due to withdrawal (directly).  It is very easy to think first about it being withdrawal when it may be something else.  During my taper I found that I would tend to look for non-withdrawal causes first and if I couldn't think of anything that might be the cause/contributor, then I would think oh it must be withdrawal.

 

There are many other things, stress, sickness, poor sleep, poor diet, MSG, artificial sweeteners, eating different food.  It's 2 years now since Covid started which has been stressful and it still hasn't gone and the world is not the same as it was before it started.  Sometimes stress can build up gradually over time.  Some stress is obvious high level and may be for a short period whereas there other stress can be low level but over a long period of time.

[vincent]

Hi Chessiecat

 

I cannot think of any other contributing factor. My life has been in steady state for some time and with a lot less stress than in my past and I haven't altered my eating habits.

 

There is of course Covid, threat of WW3 and my age but not long ago I was feeling fine. (I keep a log)

 

I don't get any symptoms of dread, rumination  or impending disasters or panics - which I suffered during previous withdrawal -  just tired and low motivation and mood.

 

[ChessieCat]

Q:  Have you had your blood pressure checked recently?

 

If it's been a while, you might consider getting a full blood check done.  Tiredness can be a symptom of other things, eg low Vitamin D, thyroid, diabetes.

 

It is also worth remembering that people who have never taken a psychiatric drug go through periods like you describe: "just tired and low motivation and mood".

[vincent]

Hi Chessiecat,

I take my blood pressure and Blood glucose levels regularly,  both are fine. I eat OK though I should eat more fruit. I like oranges but citrus gives me a sore tongue. 

😝

I take multivitamins and high doses Vit D and C and an omega 3,6, 9 capsule most days.  It has probably been 2 years at most since general bloods

 

So you think these may not be withdrawals? They seem to tally with my reductions.

I am feeling a bit better today I will keep my taper to exactly 17.1 for now and see how it goes

Thank you for your concern

[ChessieCat]

On 4/10/2022 at 8:15 PM, vincent said:

I am beginning to wonder if I have other health problems

 

The reason I was mentioning other possibilities was because of what you said previously, quoted above.

 

It can be very easy to automatically attribute something to withdrawal when it might be something unrelated to withdrawal.  Other health conditions can happen whilst we are tapering so I think it is important to keep that in mind and get a general health check done so that if something else does exist it can be addressed, and if it turns out that nothing else does exist then it is more likely that it might be withdrawal.  But at least you will have more knowledge and can be less stressed (which can add symptoms) when tapering.

[vincent]

I will give it a little longer and if things don’t pick up I will see the Doctor.

[vincent]

I have improved a lot after my last post. More energy and motivation. I don't know what it was but I have made the tiny reduction back to 16.8 (very easy to read on my syringe)

These drugs stink!

[vincent]

2022 Jun 15               16mg  4.76% reduction

 

Note: No obvious withdrawal lately and I haven't reduced for 2mths

[vincent]

Update

 

Feeling a little better today so here’s my update

Day 1 June 15th                4.76%    Prozac drop

Day 1-8                                 Fine

Day 9-14                              Mild to moderate depression/anxiety, dizzy, IBS, tinnitus, tired

Day 15–31                           Fine

Day 32-                                 moderate depression/anxiety, dizzy, IBS, tinnitus, tired

 

I was feeling really good before and shortly after the drop. I didn’t expect the second attack but I guess that is down to long half life of Prozac

[Ariel]

Glad you're feeling a bit better today @vincent

Hang in there! You're doing a great job