Yisus: I need counselling / tapering advice

[Yisus]

Can someone help me to withdrawal Trazodone and Fluoxetine? I’m also in protracted Benzo WD. (22 months off after 4.5 yeras on Lorazepam). I’ve also been 5 months withdrawing pregabaline (225 mg) since march to august,  and I have also been able to reduce Trazodone from 50 mg to 22.5 in 5 months (extremely difficult) . I’m also taking 1 capsule (20 mg) fluoxetine every 10 days because I can’t afford WD symptoms. I need a proper plan. Even if it’s 1 or 2 years. I’m exhausted and suffering. I find it hard even to write. I feel I can’t do this anymore. My sleep is fractured and poor (no REM sleep). I can’t even calculate dosages or plan tapering methods. At this stage I’m too sensitive to any cut. 

 

Many thanks in advance.

[Gridley]

Welcome to SA, Yisus.

 

Let me see if I understand your drug history.  Please correct any errors.and supply any information I request.

 

Lorazepam DOSE? 22 months off after 4.5 years, protracted withdrawal WHAT DATE DID YOU TAKE YOUR LAST DOSE?

Pregabalin 225mg tapering March to August, 2020   QUESTIONS: AT WHAT RATE DID YOU TAPER AND ARE YOU NOW AT ZERO?

Trazodone 225mg  tapered from May 1 to Oct. 1 22.5mg  QUESTION: AT WHAT RATE DID YOU TAPER?

Fluoxetine 20mg every 10 days   QUESTION HOW LONG HAVE YOU BEEN DOING THIS?

 

Once you've supplied the requested information and corrected any errors, please enter the information using the following link, then press "save.  You will need to do this on a computer rather than a phone.

 

Account Settings – Create or Edit a signature.

 

This will be your drug signature, which is important for the moderators to be able to help you.

 

What method are you using to taper the Trazodone and Pregabalin--are you using liquid or a digital scale?

 

Regarding the Prozac, skipping doses is a bad way to taper.  Even with a drug with a long half life like Prozac, skipping doses makes the amount of the drug in your bloodstream go up and down, battering your nervous system and making withdrawal worse.    Once you've told me how long you've been taking the Prozac every 10 days, we can arrive at a dose for you to take every day.  At that point we can begin to talk about tapering the Fluoxetine.

 

We recommend tapering by no more than 10% of your current dose (not original dose) every 4 weeks.

 

Why taper by 10% of my dosage?

 

This link is specifically about tapering Fluoxetine, including how to get the nonstandard doses you'll need for a 10% taper.  If prescription liquid Prozac is available in Spain, that's the easiest way to taper.  Other choices are a compounding pharmacy to make your doses, making your own liquid or measuring powder from tablets using a digital scale such as the Gemini-20 scale available on Amazon.

 

Tips for tapering off fluoxetine (Prozac)

 

We recommend tapering only one drug at a time.  Otherwise, if problems appear, you won't know the cause.  We recommend tapering the more activating (stimulating) drug first, leaving the sedating or neutral drug(s)in place to preserve sleep to be tapered later.  Prozac, like all SSRI's, is an activating drug.  Trazodone and Pregabalin are sedating.  So you should taper the Prozac first and stop tapering the Pregabalin and Trazodone at this point until you have finished your Prozac taper.

 

Taking multiple psych drugs? Which drug to taper first?

 

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 complete your drug signature, answer my questions, ask your own questions and connect with other members.  We're glad you found your way here.

 

 

 

 

 

 

 

 

 

 

 

 

[Yisus]

Hi Gridley! Many thanks for your response! I will try to answer you back appropriately tomorrow morning as I can't really be very concentrated at night times.

 

Regards!

[Yisus]

22 hours ago, Yisus said:

Hi Gridley! Many thanks for your response! I will try to answer you back appropriately tomorrow morning as I can't really be very concentrated at night times.

 

Regards!

Hi gridley. 

 

Sorry if soemthing is missing.  I find it difficult to think straight  at the moment. 

 

Well, first of all I’m 41 and been on Psych Meds since I was 25 (16 years). I’ve been on many drugs (20-21) but the main ones are the ones in my signature.

 

Now I know that during 3 of the 4.5 years I was on Lorazepam I was paradoxical to the drug: very high anxiety, depersonalization, derealization and anterograde amnesia. I was able to tapper 1 mg during 2018 crossing over to diazepam. I quitted on December 7^th 2018 and the hell began as you can imagine. Still protracted. At month 13 after 7 times in ER with severe insomnia and akathisia I finally accepted new medication (I was suicidal): Trazodone (50 mg) & Pregabalin (225 mg) and reinstated Fluoxetine 40 mg. This was on January this year. I took it for 10 weeks and since march I started tapering the 3 drugs.

 

It took me 20 weeks to quit pregabalin at a rate of 25 mg every 10-15 days.  Finished on July 24^th

 

I started tapering Trazodone using a jewellery scale on May 7^th. I make cuts when I ever I feel I can. I’ve managed to get down to 23 mg after 5 months. I’ve stopped. I can’t even tolerate the smallest percentage.

 

 Regarding Fluoxetine. I’m very confused. I’ve been taking this drug for 3 years. And at one point in march this year I just started to make my own reduction plan:

 

May: 1 capsule every 5 days = 4 mg per day

June: 1 capsule every 6 days: 3,33 mg per day = - 16.66 %

July: 1 capsule every 7 days:  2,857 mg per day = - 14.20 %

And…

To get to October: 1 capsule every 10 days = 2 mg.

 

The thing is that I don’t get any WD symptoms but, at the contrary, just a minimum cut of Trazodone is hell for 7-10 days. In top of that my sleep is broken from benzos. I wake up at 4-5 and sometimes sleep 1-2 hours but never feel rested. I can’t nap either ever I’m shattered.

 

So, as I hate depending on drugs to sleep, I was trying to get off Trazodone first. But now you say it’s best to get off Fluoxetine first. I’m very confused. Because I’m in appoint that my brain and body can’t tolerate any more. Still not recovered from benzos and I don’t know how I’m going to deal with fluoxetine WD and I’m aware that it can be as hard as benzos once the drug is removed from the system after 15 days.  In top of this I’m still on trazodone and I have chronic insomnia.

[Gridley]

47 minutes ago, Yisus said:

 

So, as I hate depending on drugs to sleep, I was trying to get off Trazodone first. But now you say it’s best to get off Fluoxetine first. I’m very confused. Because I’m in appoint that my brain and body can’t tolerate any more. Still not recovered from benzos and I don’t know how I’m going to deal with fluoxetine WD and I’m aware that it can be as hard as benzos once the drug is removed from the system after 15 days.  In top of this I’m still on trazodone and I have chronic insomnia.

The reason we recommend tapering the sedating drugs like trazodone last is to preserve sleep while you're tapering the more activating drug (Fluoxetine).    

 

 

47 minutes ago, Yisus said:

 

May: 1 capsule every 5 days = 4 mg per day

June: 1 capsule every 6 days: 3,33 mg per day = - 16.66 %

July: 1 capsule every 7 days:  2,857 mg per day = - 14.20 %

And…

To get to October: 1 capsule every 10 days = 2 mg.

 

Thanks for providing your Fluoxetine schedule.   Skipping doses is very hard on your system. I'm going to bring your situation to the attention of the other moderators and administrators to get their their thoughts on what would be a good daily dose given your previous schedule.

 

You said you reinstated 40mg Fluoxetine in January.  How did you get to 20mg when you started tapering in May?  Did you taper or just drop from 40mg to 20mg?

 

 

 

 

Edited October 2, 2020 by Gridley

[Yisus]

Hello Gridley. 

Thanks again for your response. Yes. I just dropped from 40 mg to 20 mg. I just don't understand why I never have withdrawal symptoms with this drug. I can't say the same regarding trazodone or benzos or pregabalin. 

I've been thinking about it and after two years stuck in a house not even able to work or be functional, I can't go on this way anymore. I understand this is long process and I can't tolerate more extreme suffering. I'm not recovered form benzos. I feel my brain very damaged. So, this time I want to do it the proper way. Going slowly, so that my brain can recover. My main worry is sleep. It's broken form benzos. Even though I take 22.9 mg trazodone I wake up at 4-5 am and sometimes sleep perhaps 1-2 hours more after eating something. But it’s not the same.  I never feel rested. 

 

I’m opened to hear from your advice.

 

Many thanks

[Gridley]

@Yisus

 

I still haven't heard from the other moderators regarding what to do about your Fluoxetine.  Because of its long half-life, withdrawal symptoms can be delayed.  Or maybe you're going to be lucky with it.  I hope so.  I wouldn't make any more changes for now with anything.  I'd hold steady with what you're doing with the Fluoxetine for now and also the Trazodone.  It would be good to rest a bit and make no changes.  

 

 

 

 

 

 

[manymoretodays]

Hi Yisus,

You might be having WD(withdrawal) from Prozac, it's hard to say, as you've been reducing other drugs as well.

Both the pregablin and Trazodone.

 

When was the last day you took a dose of Prozac, and what was the dose?  What time do you usually take the Prozac?

 

And then, if you could just note when you take the pregablin and Trazodone each day, the time on the left, the drug name and dose on the right.

 

Put that right here in your narratives  in reply.

 

Later we may ask you to try something more extensive, to be able to follow up on changes in doses, and dosing patterns but for now that will be great.

 

Thank you.  Hang in there.

L, P, H, and G,

mmt

 

I went ahead and ran a Drug Interaction report for you, with your 3 drugs. 

Here that is:  Drug Interaction Report- Drugs.com

Edited October 4, 2020 by manymoretodays
interaction report, another ? asked

[Yisus]

@manymoretodays

 

Hello! 

 

Many thanks for ypur response. I hope the following informations is enough. 

 

 

I don't take pregabalin anymore. (Finished in July). 

 

11:45 pm Trazodone 22.9 mg

(Last cut: 21/09 - 0.3225 mg)

 

Last dose of Prozac 20 mg: 01/10 (mornings). I was trying just to take one capsule every 10 days to avoid WD symptoms once the drug is removed from the system. I'm aware that even if I don't feel anything at the moment WD can be severe after 15-20 days. 

 

 I don't know what to do with Prozac. In one hand I don't feel anything in comparison to the other drugs while reducing but in the other it's the drug I've been taking for a longer time (since May 2017) In top of that I've been taking ADs for 16 years. It could take me a year to quit trazodone and I'm still recovering from benzos. And in top of that there is a history of 16 years on ADs. I really think it's impossible. 

 

At the same time, I have pelvic floor disfunction due to these drugs (constant urgency and frequency. Horrible) So I'm even more invalidated. 

 

At the moment It's trazodone the hardest one to cut. I take 2 full weeks to stabilize from the minimum cut I can make with a jewellery scale. 

Edited October 6, 2020 by Gridley
added @manymoretodays

[manymoretodays]

Hi Yisus,

And thank you for answering questions.  I'm happy to see that you dose Prozac in the morning and then the Trazodone in the evening.  Sometimes, that's the best one can do when taking two drugs with major interactions.

 

I also think that you are in some pretty de-stabilized times right now, given all the changes you have made prior to arrival here.

What is Withdrawal Syndrome

The Rule of 5 KI's

 

I think you should just HOLD right now, with any further Trazodone tapering.

And get on a daily schedule with your Prozac again.

 

I'd suggest 5 mg/day of the Prozac taken in the morning. 

You'll find ways to get a 5 mg dose of Prozac here:  Tips for tapering off Prozac(fluoxetine)

 

It may be 4-6 weeks from now until you start to feel some stabilization of symptoms.  Hopefully sooner, as the flucuations in your drug levels get a chance to level out.

Keep daily notes of drug schedule and symptoms to track patterns and progress

^ do take a look and then try some, when you are having your clearest moments in the days ahead.

 

Do keep us updated Yisus.

And Yisus,  it's never impossible.  You'll see improvement soon.  And hugs.

 

L, P, H, and G,

mmt

Edited October 6, 2020 by manymoretodays

[Yisus]

Many thanks for the encouragement! This is my 3rd week without reducing Trazodone and I can notice the difference. I will also try to get liquid Prozac from the doctor.

 

So, I understand that it's not the same to take a 20 mg capsule every 4 days than taking 5 mg a day. Is that correct?

 

In the other hand which are the best calculators to tapper liquid Prozac and trazodone using a Jewellery scale? I think I need to do micro-tapering for Trazodone. 

 

The difference between normal 10% reduction plan and micro tapering is that you need to hold two weeks after 4 weeks doing reductions. (2.5% x 4 weeks) Is that correct?

 

Is there any chance to finish tapering both drugs in a year and a half?

 

May thanks again!

[Altostrata]

13 minutes ago, Yisus said:

So, I understand that it's not the same to take a 20 mg capsule every 4 days than taking 5 mg a day. Is that correct?

 

Hello, Yisus. No, it's not the same. Taking Prozac inconsistently causes a fluctuation of the drug in your bloodstream. You are throwing yourself into withdrawal on a regular schedule.

 

Since you're taking 20mg Prozac every 10 days -- I presume that's when you feel withdrawal symptoms -- if I were you, I'd try taking 2mg every morning with the liquid. This should even out over a week or so.

 

We do not advise changing more than one drug at a time. If you make a change, you need to observe the effects for a while, generally around a week. And you should never taper drugs when you already have withdrawal symptoms, that will only add to your withdrawal symptoms.

 

Please get your drugs on a regular schedule and let us know how you're doing.

[Manny78]

Hi Yisus.How are you? I am not tapering Prozac or trazodone, but I am from Spain.If you need help with something,I am here. 

 

Manny78