Kristinhopes: completely lost, what to do now - taper, reinstate, switch

[Kristinhopes]

1 hour ago, Altostrata said:

Hello, Kristin. 5.5 hours of sleep may not feel like enough but it's not too bad for antidepressant withdrawal syndrome. Waking early in the morning is very common, it's due to the normal morning cortisol surge.

 

When you threw up, did you throw up your Prozac dose? Otherwise, did you accidentally skip a dose or take one off schedule? Are you using a liquid to take 8mg? How are you measuring your dose? Are you taking any other drugs or vitamins?

 

How do you feel before and after taking Prozac each day?

 

Many women find their symptoms get worse around their periods. Did you used to have insomnia at times in your menstrual cycle?

I never had insomnia except a couple times when not on meds. I slept heavily and was always tired when I took Zoloft for over 10 years and also when I stopped it. This all started when the lexapro got to 2.5 on sept. I feel about the same before and after prizac but in general I get a little better as the day progresses, although during this most recent relapse not too much better. I take my prizac 8 mg with a syringe via liquid at noon each day. I take magnesium. I stopped taking it during my last wave to see if it was a cause but had not been taking it during this wave so I restarted taking it during this wave since I don’t think it was a contributing factor and I have low magnesium. and occasionally .5 mg melatonin. No, I did not throw up the Prozac dose . It had been 9 hours. 

[Altostrata]

In what ways do you feel better after taking Prozac at noon? How long is it before you feel better?

 

Why did you stop moving Prozac earlier in the day?

 

What is your sleep schedule?

 

On 11/11/2020 at 3:25 PM, Kristinhopes said:

So 10/27 is when I began the 8 mg Prozac

 

You seemed to feel better after you decreased to 8mg. When was it you began to feel worse?

[Kristinhopes]

In what ways do you feel better after taking Prozac at noon? How long is it before you feel better? I don’t feel a lot better this time and not sure that it’s the Prozac since in general even with the 2.5 mg lexapro I saw a relief of some inner restlessness and akathisia towards the afternoon and more clarity in the brain, but this time the depression and that symptom only slightly improves.

 

Why did you stop moving Prozac earlier in the day? I just found it easier to remember to take at this time. 

 

What is your sleep schedule? Try to sleep at 9 but can’t fall asleep til midnight lately ( before this wave was able to fall asleep easier) wake a couple times through the night but able to fall back asleep typically until between 4 and 530. At that point akathisia begins, my body is buzzing, sever depression and tickling body and brain, inner tremor despite being very sleepy. 

 

 

You seemed to feel better after you decreased to 8mg. When was it you began to feel worse? I had 1 wee wave 2 weeks after decreasing but had attributed it to drinking alcohol. Then I had a pretty good 2 weeks and then 1 week ago everything got horrible again, so two weeks after decreasing I got bad again, and then two weeks of decent, and then so far 1 week if bad. This most recent wave had been 5 weeks out, but I had one at two weeks out as well. This time no alcohol was involved and this one is the worse yet because it’s severe depression and akathisia that is more relentless in that the afternoon windows are pretty bad too, I am averaging 4 hours instead of 6, and having more trouble going to sleep, and it’s been a week now and not suddenly let up unlike last time. 

 

Edited December 7, 2020 by ChessieCat
extracted response from quote and formatted for easier reading

[Shep]

21 hours ago, Kristinhopes said:

No, I have had some pins and needles around my lips here and there but trying to tell myself it’s just anxiety and stress, some eye twitches here and there and leg twitches here and there but nothing too unusual that I had not had prior to lexapro and Prozac. I have had a little burning feeling on my tongue and keep checking to see if it’s twitching because I’m scared but I think I am biting my tongue and overthinking every feeling due to stress and being scared . So the actual near constant right eye buzz I had when first start Prozac 10 mg for two weeks has subsided and the tinguevtwitcges I had for a few days when I went up to 20 mg for two days have also not returned. I have had a couple jerks when laying in bed but I think it’s more a panic or stress thing. 

 

Thanks for writing this out and fixing your signature. I know you're dealing with upticks in insomnia right now so you're understandably tired of this, but what you just posted is a sign of healing. The dose you were on was too high and the reduction has brought some relief. 

 

Please note I edited your last post with highlighting to make it easier to see your answers to Alto's questions, since they are contained within the quote-box.  (CC's removed them from the quote box so that they can be seen in full)

 

 

Edited December 7, 2020 by ChessieCat
added CC note

[Altostrata]

@Kristinhopesyou take 8mg Prozac at noon, correct? What time of day do the symptoms intensify after you take it?

 

You decreased Prozac to 8mg on 10/27/20. Was it about 4 weeks later that the symptoms got worse? Around the end of November?

 

Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms throughout the day. Post 24 hours of notes at a time in this topic, in a simple list format with time of day on the left and notation (symptom or drug and dosage) on the right. This can show if your symptoms are adverse effects from one of your drugs.

 

[Kristinhopes]

3 hours ago, Altostrata said:

@Kristinhopesyou take 8mg Prozac at noon, correct? What time of day do the symptoms intensify after you take it?

 

You decreased Prozac to 8mg on 10/27/20. Was it about 4 weeks later that the symptoms got worse? Around the end of November?

 

Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms throughout the day. Post 24 hours of notes at a time in this topic, in a simple list format with time of day on the left and notation (symptom or drug and dosage) on the right. This can show if your symptoms are adverse effects from one of your drugs.

 

Yes, the symptoms are worse upon waking around 530 to afternoon, so before I take it. I don’t know that taking the med makes it better it just seems I get a little better as the day progresses (cortisol perhaps?)
 

yes, I vomited from a night of nausea approximately 4 weeks after dose decrease and a week later had this wave.  I am at day 42 since the reduction to 8mg. It started getting real bad again with the akathisia  around day 34. I have thought it could be a delayed withdrawal from the dose reduction but since I had waves at 10 mg as well I can’t be sure. Should I updose or continue to try to stabilize at 8mg? 10 mg initially gave me a constant eye twitch and tricep twitch (I’ve had that twitch before but it seemed more consistent upon starting Prozac) but those twitches did go away within a couple weeks of starting the Prozac . I also felt a little overactivated on the 10 mg when I had a window on it. That’s why I decreased to 8 mg after 5 weeks at 10mg. I have had waves and windows at both doses that I have attributed to different things, but this one can only be attributed to either a wave from the lexapro still that was just bound to happen, the Prozac decrease, the klonopin ceasing a month earlier (I feel this is  less likely), or an adverse reaction to Prozac in general. If this wave continues much longer I may consider updosing 1 mg but not sure. My pattern so far has been waves that last a week and then 10-14 decent to good days . and I am at the one week mark of this wave, so we will see how I go the next few days.   I will take the daily notes again. I end up stopping them in my windows. 

[Kristinhopes]

Sigh.. day9..  longest wave yet, most panic attacks yet (especially when going to sleep and waking), worse insomnia yet (only averaging four hours as opposed to 6), depression is relentless 

[Kristinhopes]

Also just wanted to mention progressive panic feeling, maybe a bit of walking on a boat feeling, and inner burning in muscles, stomach, chest. I read a couple posts on benzo buddies from people who did not experience withdrawal symptoms until 1 or 2 months out, so I suppose it could be from stopping the klonopin as well even though I was only on it for six weeks, twice a week ( and Ativan twice a week a couple weeks before that). So who knows anymore. I am suffering beyond comprehension and no longer no what to do. Just suffer , hope to survive in time and not miss out on too much of my toddlers life . :,( but this new constant panic is pushing my limits on what my body and brain can handle

[Altostrata]

20 hours ago, Kristinhopes said:

I don’t know that taking the med makes it better it just seems I get a little better as the day progresses (cortisol perhaps?)

 

I need to see those daily notes.

 

Something is going on that might involve when you take your drugs.

[Shep]

On 12/7/2020 at 9:19 PM, Kristinhopes said:

 I will take the daily notes again. I end up stopping them in my windows. 

 

It's possible the Prozac dose is still too high or the last reduction was too abrupt, but without daily notes, we can't help you. The ball is in your court. 

Edited December 9, 2020 by Shep
add more info

[ChessieCat]

Providing daily symptom notes is usually only short term.  To begin with the mods need to you to post 3 consecutive days of symptoms notes.  However you might be asked to provide them for a bit longer.

This is explains why daily symptoms notes are requested and how they might help the mods to assess your situation:

  

On 9/28/2016 at 4:49 AM, Altostrata said:

 

Keep notes on paper about your daily symptom pattern and drug dosing

 

Are your symptoms worse at any particular times of day? A symptom pattern that occurs regularly over several days could mean the symptoms are from withdrawal, other adverse effects of drugs, or something else you do on a daily schedule.

 

In the course of discussion in your Introductions forum topic, you may be asked to keep notes on paper of your daily symptom pattern, including when you take your drugs, their dosages, and any symptoms. We ask this because there may be something we can do to reduce the symptoms.

 

What we need to see for every single day over several days is what symptoms you get before and after you take your drugs.

 

 

[Kristinhopes]

 

okay. So here are my daily

notes.the first few

are from past waves in October and November in case you wanted to

compare... scroll down to 12-9 for my Current notes. Everything is pretty much the same.

think I may go up to 8.8 mg Prozac to see if it either helps me or if it

causes worsening then i

know it’s probably an adverse reaction to Prozac rather thawitbdrawal from the 2 mg cut. my other fear isit being delayed withdrawal from the klonopin. I’d say the main Difference with this

wave is that it has been longer, I have way more body twitching, and not as much afternoon or evening window, the depression is always there rather than a little window.  Is severe twitching and possibly some dystonia or myoclonus especially upon waking seen in withdrawal? I am worried about dyskinesia especially since my tongue twitches at 20 mg Prozac. It has not twitches since but feel like it’s adverse in that sense. I have some possible mild tongue burning sensation too. 
 

10/27 2 hours of sleep (jolted awake at 1115) panic and nervousness

7-8 less panic and nervousness

8 -1140 Akathisia and stomach nervousness.. 

1140 Akathisia began to settle from 8 to 6 level

Feeling a little energized and level 8 depression 

1230: took Prozac immediately felt a bit jittery and maybe nauseas nausea and odd feeling within 15 minutes.. while eating lunch. A bit of inner tremor 

145:took two magnesium supplements 

2:00- weird weakness off feeling and some jittery ness / anxiety

2:20- heartburn and a bit of tongue twitching 

2;56 restless legs, depression 

600: depression worsening a little and severe muscle neck throat tension tic. No jitters

8-post dinner, got emotional . Have heart burn and a little stomach burn and noise sensitivity no restlessness

815: heart burn and a couple palpitations, couple negative thoughts, slight inner tremble

1110 panic awake inner trembles

140 panic and unease sleeplessness awake

Multiple awakening going to sleep shortly thereafter awake at 510 unable to go back to sleep severe anxiety and restlessness unable to settle despite meditations . 5.5 to 6 hours total probably

 

 

11/14:

 

845. Up , so anywhere from 545-715 hours of sleep. But very little akathisia and inner shaking all night ! Main issue is waking and not being able to go back to sleep, or get comfy or have to pee a bunch of times when I wake up in middle of night. Mild to moderate depression so far this morning

930-breakfast yogurt and gluten free muffin

1030- increasing depersonalization and depression. Nervous throat tic

1215- diarrheah and more depression

1230- 8 mg Prozac 

230- Popeyes spicy chicken sandwich and half apple fritter, mild depression -nervous throat tic

Feeling good with mild to moderate depression rest of day 

8- cauliflower pizza and s’more and anxiety about if I am going to get poisoned since husband put two twigs from azalea bush in fire pit that we roasted marshmallow on

1am- went to bed , stayed up watching tv after son went to bed, good night

7ish- woke up, no akathisia but difficulty falling back asleep , possibly went to bed another light 45 minutes or so. Between 6 and 7 hours

939- breakfast if yogurt and gf muffin. Mild depression, nervous throat tic 

12- started feeling some overwhelm, increasing depression And depersonalization. 

1230 are some ribs 

220- Prozac 8 mg and some applesauce and tortilla chips and guacamole

3- feeling better with moderate depression 

 

11-15 6 1/2 hours of sleep last night

Mild depression and otherwise great day 

1230- 8 mg Prozac

Ham sandwich tortilla chips guacamole, cookies, peanut butter cup, orange, protein shake for food. Body pump exercise 1 hour at 4. 

 

12/9

 

6- awake with panic and akathisia and burning in body

9- more burning and akathisia

11- burning let’s up some 

12- short windowish

1230-8 mg Prozac and ham sandwich and applesauce 

130- begins ruminating and obsessing over how I feel , panicy, burning, glued to phone and message boards , depressed

4- window 

530- muscle aches and burning but continued semi window especially stomach back chest and arms

6- window seems to be closing . Muscle twitches throughout the day mostly legs. Could just be stress and anxiety, it’s been doing that more since this last wave

7-dinner

With some depression and continuing muscle burning, depression and twitching, but better than am 

11- fell asleep for approximately 6 hours of somewhat restless sleep . Woke up briefly a couple times

 

12-10

5 am awake with restlessness, mental and physical akathisia, inner tremor , mild burning, and muscle twitching. Meditated the next couple hours . Helped slightly.

8 am - Greek yogurt for breakfast . Mental akathisia (like a tickler depression and anxiety that makes you have severe dread and depression and want to cry and scream), lots of muscle twitches in body, mild inner tremor 

930- a bit of a window starting

1240- lunch and 8 mg Prozac

1-40- increasing akathisia / inner tremor and muscle pain ...took 240 mg magnesium 

3 heartburn or body burn 

4: increasing inner tremors Ike I had way too much caffeine and lots of muscle twitches 

6- less tremor but still a lot of body twitching..especially legs 

7-9- some twitching and some window 

11- finally doze off wake a few times for a little and fully awake at

530- awake: lots of twitching all over, jumps around.. a twitch on lip, then back, then thigh, then butt, the calf, then arm ..  some tremor and anxiety tried to meditate but was not possible with the tremor and twitching

830- still twitching some but not as much tremor but increasing dread and horrible akathisia like depression

11- muscle twitching but not as severe as am, no inner tremor or akathisia , normal depression

3- slight increase of akathisia like thickly depression and throat spasm tic increasing

330-225 mg magnesium 

430- worsening akathisia depression, snapped at son and felt like I was slipping into worse akathisia depression ever

515- a little better but also have been noticing possibly burning tongue tip and not sure if in my head or if real. Past week

7- even better- window, had dinner . Wanted to add I’ve been having horrible itching eczema on knees recently but I’ve had it before and I think is due to seasonal changes. Also, twitches and tremors gone or minimal right now

11 ish- asleep

230- awake somecrestlessness and lots of twitching maybe a bit if dystopia soasming too

330- asleep

 

12-11

6- awake for good.. severe twitches , some spasms or dystonia maybe, racing heart , mild tremor, restlessness 

7- out of bed. Less twitching and tremor and racing heart when out of bed and standing but still there. More prevalent sitting and laying. Not too much akathisia . I’d say regular severe depression rather than akathisia depression this morning 

Edited December 12, 2020 by Shep
reduced font

[Kristinhopes]

To add to the above, I went ahead and updosed to the 8.8 an hour ago after lunch, within ten minutes I felt panicy, off, more disoriented, and more jittery and had two eye twitches. Can an adverse reaction happen that fast (10 minutes) or maybe it’s just all in my head. Not sure if updosing is the answer now and instead thinking about tapering off, which will mean I will be tapering off something without ever being stabilized 

[Kristinhopes]

Three hours since updose.. getting more detached, panicy, out of touch, disoriented feeling.. can’t think straight at all. I am scared. Think I’m losing my mind. I should have waited for your advice and probably a smaller updose if going to try. Now I gotta ride this out.  Starting tomorrow should I begin tapering perhaps to like 7.2 (from 8 , which I had been at except for today) . What if I want to reinstate lexapro? I mean ideally tapering off meds is best but at this point my brain is not in a good place for a taper already and I have akathisia that will probably worsen so terrified. It  be would be better for me by to immediately go from no one ad to Another than come off for months and then end up on another a few months later? I mean is there one that’s worse than the other for your nervous system? I mean hopefully I’d stay off forever but I have to be realistic with myself too. I am a teacher with a toddler and feeling like I’m not going to get through this. I can’t think straight at all. Akathisia. Insomnia

[Shep]

17 hours ago, Kristinhopes said:

Not sure if updosing is the answer now and instead thinking about tapering off, which will mean I will be tapering off something without ever being stabilized 

 

Kristin, you were on your way to stabilizing before you updosed. Please note the below windows prior to this updose:

 

20 hours ago, Kristinhopes said:

12/9

12- short windowish

4- window 

530- muscle aches and burning but continued semi window especially stomach back chest and arms

 

12-10

930- a bit of a window starting

7-9- some twitching and some window 

7- even better- window, had dinner .

 

Please go back to the 8 mg and hold for a few more days. Let the moderators have a chance to read through your notes before you make the decision to change your drugs. It looks like Prozac is an activating drug for you, so updosing is moving in the wrong direction. 

 

Your sleep is great for someone going through withdrawal, so please work on your non-drug coping skills to get through the day. You may want to clean up your diet a bit, as food from Popeyes and tortilla chips may cause problems for someone with a destabilized nervous system.

 

But again, you're sleeping at least 6 hours most nights, which is excellent, plus you saw some windows. You just need to be more patient before panicking and making drug changes when your nervous system isn't ready. 

 

 

[Kristinhopes]

38 minutes ago, Shep said:

 

Kristin, you were on your way to stabilizing before you updosed. Please note the below windows prior to this updose:

 

 

Please go back to the 8 mg and hold for a few more days. Let the moderators have a chance to read through your notes before you make the decision to change your drugs. It looks like Prozac is an activating drug for you, so updosing is moving in the wrong direction. 

 

Your sleep is great for someone going through withdrawal, so please work on your non-drug coping skills to get through the day. You may want to clean up your diet a bit, as food from Popeyes and tortilla chips may cause problems for someone with a destabilized nervous system.

 

But again, you're sleeping at least 6 hours most nights, which is excellent, plus you saw some windows. You just need to be more patient before panicking and making drug changes when your nervous system isn't ready. 

 

 

I was thinking about going to 7.5 today to help counteract the updose (if that is even a thing) and because I don’t think Prozac is right for me . I had less inner tremors and twitches this morning upon waking at 5, although still there ... but I’ve had very bad anxiety on verge of panic all morning.laid there with a heavy weighted blanket on my chest to help but nope and meditating to no avail. Trying not to take a klonopin since I have been off it 7 weeks as well and don’t want to risk kindling or feeling bad about taking it . I don’t know if the fear of the updose did it and kindling or if the actual updose did. Either way I’m scared to even take Prozac today but I will, just thinking about 7.5 maybe. 

[Kristinhopes]

33 minutes ago, Kristinhopes said:

I was thinking about going to 7.5 today to help counteract the updose (if that is even a thing) and because I don’t think Prozac is right for me . I had maybe slightly less inner tremors and twitches this morning upon waking at 5, (approx. 6 hours again) although still there ... but I’ve had very bad anxiety on verge of panic all morning and still tremor. laid there with a heavy weighted blanket on my chest to help but nope and meditating to no avail. Also weird rhythmic stomach growl for a while this morning. Trying not to take a klonopin since I have been off it 7 weeks as well and don’t want to risk kindling or feeling bad about taking it . I don’t know if the fear of the updose did it and kindling or if the actual updose did. Either way I’m scared to even take Prozac today but I will, just thinking about 7.5 maybe. 
 

Uodated an hour later: I’m calming down a little from panic. After reading a couple other threads I will take the 8 mg today, not 7.5 mg I was thinking unless suggested otherwise
 

 

[Shep]

20 minutes ago, Kristinhopes said:

I was thinking about going to 7.5 today to help counteract the updose (if that is even a thing) and because I don’t think Prozac is right for me

 

 

You posted your drug and symptom notes and then just a few hours later, without giving the staff time to respond, increased your dose.  And now you're advocating yet another change that contradicts the advice that was given (to go back to 8 mg and hold and to work on improving your diet). 

 

Kristin, if you aren't interested in the advice being given here, please let us know. I spent a lot of time going through your recent drug and symptom notes and gave the best advice I knew to give only to be ignored yet again. You were having windows and sleeping around 6 hours most nights at that 8 mg dose, which was a sign that your nervous system was starting to stabilize, not only on that dose of Prozac, but on your recent benzo withdrawal. Making another drug change is not advised right now.

 

You can't keep bumping this drug around and expect your nervous system to keep up with all of these changes. It's not just about the amount of the drug in your system, but also your system's ability to handle these constant drug changes. Prozac has a very long half-life, so these changes can take days if not weeks to fully manifest. 

 

It's okay if you wish to come up with your own withdrawal strategy. But please don't continue to waste staff time if you really aren't interested in taking our advice. 

 

[Kristinhopes]

1 hour ago, Shep said:

 

 

You posted your drug and symptom notes and then just a few hours later, without giving the staff time to respond, increased your dose.  And now you're advocating yet another change that contradicts the advice that was given (to go back to 8 mg and hold and to work on improving your diet). 

 

Kristin, if you aren't interested in the advice being given here, please let us know. I spent a lot of time going through your recent drug and symptom notes and gave the best advice I knew to give only to be ignored yet again. You were having windows and sleeping around 6 hours most nights at that 8 mg dose, which was a sign that your nervous system was starting to stabilize, not only on that dose of Prozac, but on your recent benzo withdrawal. Making another drug change is not advised right now.

 

You can't keep bumping this drug around and expect your nervous system to keep up with all of these changes. It's not just about the amount of the drug in your system, but also your system's ability to handle these constant drug changes. Prozac has a very long half-life, so these changes can take days if not weeks to fully manifest. 

 

It's okay if you wish to come up with your own withdrawal strategy. But please don't continue to waste staff time if you really aren't interested in taking our advice. 

 

Sorry, I added to the post an hour later prior to your response that I was going to stay at the 8 like you suggested. I apologize. I was in the middle of a panic state when I suggested maybe 7.5. I am going to take the 8 today. My only other concern is that maybe this panic about the updose is in my mind and I should hold at the updose, but I think maybe you are right regardless about 8 because even if it is in my mind, maybe I will feel better at the 8 in terms of stability in my mind , not just cns. I should eventually stabilize at 8, right? Just may take a little longer than an updose? I was just worried that my depression was not going away like it had been. This had been the longest wave and I had new increasing amounts of tremor and twitching. So I paniced. I don’t know y I did not wait for advice yesterday after posting symptom notes. It was stupid and I regret it and hope it does not set me back too far. Based on those notes would everyone have advised a hold. I guess I was thinking the tremors were a withdrawal things paniced and went up. Now I am panicking that I caused a huge setback and kindling based on my 1 day updose 

 

it’s also scary to know that if I made a slight measurement error in the future it could also destabilize me. It feels like having a gun to your head having such a destabilized system that one false move could cause a huge setback or kindling. Like in the past if I missed a dose or accidentally took too much I would not freak out, but now I am freaking out over this time updose and it’s repercussions and I have a lot of anxiety now about measuring my doses and stuff. 
 

 

i should also note this is the first morning I have not had the akathisia like depression and feeling since this last wave so now I’m like, huh, maybe the updose was what I needed. Typically every morning and most day I have had it. Like my depression is slightly better at the moment than yesterday or days prior.  Also a little less twitching and inner tremor.. although still there.But I felt worse yesterday upon taking it and panicy and also panicy this morning, so at any rate I will stay at 8. Maybe it’s just me stabilizing in general and this last updose moment does not bit me in the behind in a few days. Fingers crossed. 

[Kristinhopes]

Also. Is there a reason I should stay on the Prozac and not get back on the lexapro to stabilize instead? I have never stabilized on the Prozac, it may be adversely effecting me even (never had tongue twitches before prizac.. I only had them a few days at the 20mg but scary anyway)  and if I am going to eventually taper y not taper off the lexapro rather than the Prozac if the Prozac did not work to stabilize me from the lexapro withdrawal? I don’t want to spend two years on a drug that I can’t stabilize on while tapering, because that means I will be miserable the entire taper plus whatever withdrawal I have when it’s finished. Since I am at a low dose of Prozac is it possible for my brain to be adjusting the receptors to be allowing some of my natural serotonin production to start being made while I’m on it? I don’t know how that works, but I guess I’m saying if this is withdrawal , even if Prozac does not help me, in essence can my brain receptors still be repairing and fixing itself from the lexapro while I am on Prozac? Or does that process only begin when you are no longer on drugs at all? I know that may not be a question anyone can answer but any insight is appreciated. 

[Kristinhopes]

I’ve been sticking with this prizac thinking everything was lexapro and Prozac will balance it out, but I am really thinking the Prozac is causing the extra twitching and dyskinesia type symptoms. Those things did not get better on my one day updose so I still think it’s Prozac causing that, internal tremor, and worsening waves and depression. I want off the Prozac. I am not stabilizing and I think it is further poisoning me. I never had twitches like this before the Prozac ( I have not noticed worsening if anything except panic for a day after the updose and hopefully it stays that way- no improvement either, maybe slightly less tremor). Is 10% reductionstill recommended for medication that you have been on three months that is causing adverse reactions? How much longer would I wait on the 8mg before a taper would be advised? Also what about if I want to reinstate lexapro ? Would I slowly taper off the Prozac before trying a low dose reinstatement of lexapro or would I taper quickly to hurry up and do a low dose reinstatement?

[Shep]

1 hour ago, Kristinhopes said:

Is 10% reductionstill recommended for medication that you have been on three months that is causing adverse reactions?

 

You were seeing windows, Kristin. That doesn't speak to an adverse reaction. But without continuing on with your symptoms notes, it's impossible to advise you. From what you've written so far, holding at 8 mg, improving your diet, and working on non-drug coping skills is the best advice I can offer. You were seeing windows and had gone from 4 hours of sleep to 6 some nights but you still made another drug change. 

 

1 hour ago, Kristinhopes said:

Those things did not get better on my one day updose so I still think it’s Prozac causing that, internal tremor, and worsening waves and depression. I want off the Prozac. I am not stabilizing and I think it is further poisoning me. I never had twitches like this before the Prozac ( I have not noticed worsening if anything except panic for a day after the updose and hopefully it stays that way- no improvement either, maybe slightly less tremor).

 

It takes 4 days for your nervous system to register a change of dose. Many of a drug's actions aren't seen on day one. It's possible that it's not Prozac that's causing the internal tremor, but rather a destabilized nervous system that's hyper-reacting to everything. This would like make you hyper react to Lexapro, as well. We don't know what is causing what. 

 

BUT YOU WERE SEEING WINDOWS. 

 

You'll have to decide how much you want to engage in micro-managing your symptoms with constant drug tweaking instead of learning to distract and stop these spiraling thoughts.

 

Continuing to tweak your drugs looking for immediate relief is only going to lead to more kindling. 

 

Whether you'd be better off reinstating Lexapro at this point is unknown with all of Prozac dose changes, periodic benzo use, briefly adding in GABA, and drinking alcohol. It can take a very long time for these things to sort themselves out. 

 

 

[Kristinhopes]

1 hour ago, Shep said:

 

You were seeing windows, Kristin. That doesn't speak to an adverse reaction. But without continuing on with your symptoms notes, it's impossible to advise you. From what you've written so far, holding at 8 mg, improving your diet, and working on non-drug coping skills is the best advice I can offer. You were seeing windows and had gone from 4 hours of sleep to 6 some nights but you still made another drug change. 

 

 

It takes 4 days for your nervous system to register a change of dose. Many of a drug's actions aren't seen on day one. It's possible that it's not Prozac that's causing the internal tremor, but rather a destabilized nervous system that's hyper-reacting to everything. This would like make you hyper react to Lexapro, as well. We don't know what is causing what. 

 

BUT YOU WERE SEEING WINDOWS. 

 

You'll have to decide how much you want to engage in micro-managing your symptoms with constant drug tweaking instead of learning to distract and stop these spiraling thoughts.

 

Continuing to tweak your drugs looking for immediate relief is only going to lead to more kindling. 

 

Whether you'd be better off reinstating Lexapro at this point is unknown with all of Prozac dose changes, periodic benzo use, briefly adding in GABA, and drinking alcohol. It can take a very long time for these things to sort themselves out. 

 

 

Thanks for your patience in response. I will continue holding at 8 mg. I do have windows here and there . I’m just feeling tired after having had several long windows (mostly after decreasing to 8 mg and stopping the klonopin on oct. 27th) only to feel like I’m back to square one despite not changing anything (and for a much longer wave) . This stuff started before the updose and 5 weeks after the decrease to 8mg. The tremors and twitches are scary (dyskinesia worries) and it’s just hard because I’m scared I’m staying on a med I won’t stabilize on and may be having an adverse reaction to longer than necessary. I’ll take more notes over next week and Not make changes until advice after that week. I won’t bother you guys for the next week unless anyone wants to answer any of the u other questions in moly post above. The one I am most curious about, and don’t know if there is a hypothesis or research into is will my receptors begin healing at a low dose of a med (Prozac) and does it continue healing as you withdraw slowly  or does that not occur until you are completely off all meds? I know that may not be known but any guesses ? Can I still be healing and returning to my own premed brain while I am on a low dose of meds? Like do the receptors start allowing more of your natural seratonin the lower you go or is the reuptaje completely blocking natural seratonin production until completely stopped? Okay so if you guys have answers to that or any other questions, great. If not, I will post in a week with daily notes  take care! ( by the way.. in a bit of a window currently, less tremor and twitching this morning, still some, 6 hours of sleep, but awoke with severe akathisia like dread depression, it’s eased up some. All right.  Thanks for your patience with us panicking folks!

by the way I am getting a brain and cervical spine mri tomorrow. Was already getting the sound so thought I’d mention all my brain stuff to my neuro and he said I could get both. I know they don’t usually find stuff when related to withdraw but figure it wouldn’t hurt (no contrast). Also getting my magnesium and vitamin blood levels rechecked tomorrow. My magnesium had been low and I am kind of hoping it’s even lowe because that could explain the twitching too, but more likely due to meds. 

[Kristinhopes]

By the way. Notice a visible tremor of eyes and lips when smiling .. only visible when smiling but concerning. May have been there before and just now noticing but i know it’s not normal

[Altostrata]

To answer your questions, we need to see those daily notes, Kristin. We ask for them for a good reason. Please post your daily notes or we can't help you.

[Shep]

17 hours ago, Kristinhopes said:

The one I am most curious about, and don’t know if there is a hypothesis or research into is will my receptors begin healing at a low dose of a med (Prozac) and does it continue healing as you withdraw slowly  or does that not occur until you are completely off all meds? I know that may not be known but any guesses ? Can I still be healing and returning to my own premed brain while I am on a low dose of meds? Like do the receptors start allowing more of your natural seratonin the lower you go or is the reuptaje completely blocking natural seratonin production until completely stopped?

 

There's no way of measuring your serotonin and withdrawal isn't just about this neurotransmitter, but rather, the destabilization of the nervous system, as Alto writes about here:

 

On 7/10/2013 at 12:45 PM, Altostrata said:

Rather than damaged receptors, I've found it more accurate to visualize post-acute withdrawal syndrome as autonomic dysregulation. The effects are generalized and when the nervous system is under stress, symptoms can reappear -- and go away again, as is common with autonomic issues.

 

 

These are really great threads for more details, including what goes on with the various neurotransmitters: 

 

How psychiatric drugs remodel your brain (for antidepressants)

 

What is happening in your brain? (for benzos)

 

 

8 hours ago, Kristinhopes said:

By the way. Notice a visible tremor of eyes and lips when smiling .. only visible when smiling but concerning. May have been there before and just now noticing but i know it’s not normal

 

Please do not continue posting your symptoms without your drug and symptoms notes dairy. This takes up staff time to read your posts and we can't offer you anything without knowing when these symptoms occur within the context of when you take your drugs. 

[manymoretodays]

Hi Kristinhopes,

 

I see Notes, and then you stopped midway through on the 11th of December, I think.

So just.....keep.....going......with notes.

 

You can post them daily or a couple days at a time, and then..........once you've done that, at the bottom you can put in more narrative, or personal speculation on further medication changes.  They are just so very helpful.

 

Here's the sample note, from the link :  Keep daily notes of drug schedules and symptoms, to track patterns and progress

- Time and dosage for all drugs taken throughout the day, psychiatric and non-psychiatric.

- Following each dose, note any symptoms. If you are having a reaction to the drug, it may take hours for a symptom to show up -- that's why we ask you to keep notes all day long.

- If you're not taking any drugs, your symptoms throughout the day.

- Your sleep pattern. Since so many drugs disturb sleep, if you find you're waking in the middle of the night, it could be from a drug you took earlier in the evening. If you're not taking any drugs, there may be ways you can improve your sleep.

And so forth. A diary, in chronological order, looking something like this:
 
6 a.m. Woke with anxiety
8 a.m. Took 2.5mg Lexapro
10 a.m. Stomach is upset
10:30 a.m. Ate breakfast
11:35 a.m. Got a headache, lasted one hour
12:35 p.m. Ate lunch
4 p.m. Feel a bit better
5 p.m. Took 2.5mg Lexapro
6 p.m. Ate dinner
9:20 p.m. Headache
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Feeling dizzy
10:30 p.m. Fell asleep
2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")
2:45 a.m. Fell asleep
4:30 a.m. Woke but got back to sleep

6 a.m. Woke with anxiety (but less than yesterday)

 

And then, sometimes noting when you try non-drug coping practices helps too, to distract from symptoms.  Note what you tryed and if it helped, in addition to the rest.

 

We want to see especially how recent drug changes are affecting you, and your symptoms in relation to them.  You won't have to do these forever.  You'll see I think. 

 

I see a lot of intellectual speculation too, in your narratives,  and that's all fine.  We can continue to discuss that stuff in your Introduction too, when you feel a bit more stabilized.  There are lot's of hopeful stories, and maybe we can find hopeful research too.  A lot of things are coming to mind, but it's getting later than I like to be on the internet.

 

You are doing good Kristin, keep plugging along with getting your information out there, when asking questions, and when you feel concerns.  Okay?  You are going to heal and recover.

 

L, P, H, and G,

mmt

[Kristinhopes]

12-11

6- awake for good.. severe twitches , some spasms or dystonia maybe, racing heart , mild tremor, restlessness 

7- out of bed. Less twitching and tremor and racing heart when out of bed and standing but still there. More prevalent sitting and laying. Not too much akathisia . I’d say regular severe depression rather than akathisia depression this morning 

12- increasing panic / akathisia/depression

1230- 8.8 mg Prozac 

1240- immediate increasing jittery ness and panics did weird feeling? Panic from taking it?  Panic most rest of day 

11- asleep

 

12-12

6 hours sleep awake at 5. Panic tremor and twitches but less than yesterday . Mild akathisia 

8-10 am : 

1030- decaf coffee 

Depression, depersonalization, off balanced, anxious from 11-1 

1- prizac 8 mg and double cheeseburger

140- spacey pressure feeling in brain, disoriented.m, some panic . Brain can’t focus on words or what is on tv

6- window

9- window closing 

6 hours of sleep

 

12-12: 7- severe akathisia type dread and depression

10- window

1215- starting to feel a little off and maybe an urge to twitch neck just kind of jittery

11- decaf coffee 

1230- lunch ham sandwich and 8 mg prizac

1-15- more anxiety and off feeling in brain(confusion and disoriented and worsening depression)  increasing 

internal tremor but not at peak

5- Exercise and window mostly but a little off and a little jerky feeling in neck but maybe in head, twitchy face after workout but maybe just cus intense workout

7- thai basil chicken dinner 

1030- try to sleep but increasing tremor, panic, 

330 ish asleep

6 - awake with panic and tremor and a little twitching 2 1/2 hours sleep

1030- severe depression but not really akathisia, no noticeable tremor in body (maybe face upon smiling some), sone twitches mostly in legs

11:50- depressed but window from most other stuff

1250- Thai leftovers and 8g Prozac

149- increasing disacciacatuon and inability to focus or concentrate (cog fig) so began feeling overwhelmed driving 

3-mri. Falling asleep during it but then muscle jolts awakening me 

7- no evening window.. a ton of head pressure and cog fog, depression, depersonalization, feel brain dead. Dinner - chicken sausages

11- asleep

 

12-15: 

5 am: awake, 6 hours total

Some dread depression and internal akathisia and tremor around 630, but not as constant as other days and not quite as much twitching

8- some akathisia type depression and mild twitching. Ate yogurt for breakfast. Ruminating heavily about meds and what to do which makes everything worse but I don’t feel like I have control over that which is why I needed meds in first place. Don’t know if it’s worse because rod withdrawal and circumstances and current trauma from all this. Magnesium and iron is actually higher than in past..normal range.. despite supplementing less. Weird... akathisia depression increasing 30 minutes later

12- increasing akathisia brain and cog fog

1230- 8 mg Prozac and tuna for lunch

1- 500 mg or mcg b12- b12 was in low normal range 

2- depression but slightly less cogfog

430- yoga and continuing deep depression and cogfog 

7- small semi window for about ten minutes then ate meatloaf dinner 

8- deep depression, head pressure, brain fog, always have blurry vision (prescription glasses) but seems even blurrier and hard to focus 

9- attempt to sleep but can’t, feel activated

3am- asleep .. dreamed I got severe dyskinesia from my prizac.. lovely 

 

8/16

615- awake with depression but not akathisia dread depression.. 3 hours of sleep

 

I think lately some of my depression is in addition to withdrawal depression. It is from obsessing (the reason y I went on meds) on one thing and the overwhelm and fear of it.. in this case the meds. Honestly I just want to stabilize on anything at this point . I don’t care about getting off meds at this point I just want to get better for my son but I know I have to be careful so as to not make things worse.  I’m not going to take the b12 today to see if that helps sleep tonight. My b12 was on the lower side of normal and lower than in the past though. I go back and forth with the Prozac on holding or tapering down or thinking maybe an updose would help. I think I have gotten a little worse as far as depersonalization and stuff since one day updose, but tremor and twitches, though still there are less. It’s just I wish I had given the 10mg a bit more time. When I was at 10 I was having more windows, then I dropped to 8 and had another great even better window but two weeks later a wave but then another great  window then two weeks later this unrelenting wave that is  going on 16 days. So maybe I was beginning to stabilize on 10 and since Prozac had a long half life I attributed the 8 mg to my great weeks, but maybe it was residuals from the 10.. now that I am truly at 8 mg maybe it’s just not enough.. my obsessive worrying and depression are worse than ever, there are no windows, sleep got worse ( even before the one day updose) however I am also torn in my thinking that maybe the 8 is too much since I have worsening depersonalization after I take it lately and after that 1 day updose. I would hate to be so close to a dose of Prozac that works for me though and too scared to try it at the same time. Maybe my panic from the updose was not an adverse reaction maybe it was more the fear. I do not know. Anyways, that’s where I stand right now. We will see how the next couple days goes. My akathisia seems to be lessening some but i am left with insomnia and severe depression and obsessive thoughts. The severe depression is from withdrawal , yes, but also becoming more and more hopeless feeling the longer this wave lasts and from not knowing where to go from here (obsessing over what I should do with meds) and the heartbreak I have from missing this holiday time and last three months with my son. I mean I’m there, but I’m not really there. Ya know? Luckily I still feel love. It’s what keeps me going. I love my friends and family and son so much. I would love my life if it weren’t for my depression.  Aside from love, the only other emotion I feel is utter depression and fear. 

 

Edited December 17, 2020 by ChessieCat
changed font size

[Kristinhopes]

To finish my notes for the day : 

 

1230- 8 mg Prozac

1-30A little disconnected and anxious feeling 

330- a bit energized but decent. Depressed today but not as much as past few days still kinda depersonalize or disconnected , spacey off feeling

5- depressed but not as much as usual and not as much head pressure and depersonalization

630- chik fil a dinner and decent  window . Today has been better but not baseline

 

 

Edited December 17, 2020 by ChessieCat
changed font size

[ChessieCat]

Please post a 24 hour period of notes in one go.  Thank you.

[Shep]

22 hours ago, Kristinhopes said:

1- 500 mg or mcg b12- b12 was in low normal range 

9- attempt to sleep but can’t, feel activated

 

Kristin, this activated feeling may have been from the B-12. Please see:

 

Vitamin B12: essential for mood, nervous system

 

Note Alto's comment here:

 

On 11/2/2011 at 6:21 PM, Altostrata said:

If you have been tapering psychiatric drugs or have withdrawal syndrome, your nervous system may well be sensitized to B vitamins. You need to be very careful about all B supplements, they may be too strong for you and trigger activation.

 

 

Since you're not a vegetarian and are eating meat regularly, you may want to avoid supplementing B12 until your nervous system is stronger. 

 

22 hours ago, Kristinhopes said:

I’m not going to take the b12 today to see if that helps sleep tonight.

 

This sounds like a good plan.

 

You've gotten some windows mixed in with the waves, so I would hold a bit longer. It's possible the Prozac is still a bit too high (it seems to be activating), but considering you're sleeping about 6 hours (aside from when you took the B12) and experiencing windows, I would hold and see if you can build a more solid baseline. 

 

Also please work on non-drug coping skills to handle the worry and fear and list any you find helpful in your daily notes. You may find Claire Weekes work particularly helpful for this type of worry and fear.

 

On 11/1/2020 at 7:34 PM, ChessieCat said:

Claire Weekes was a doctor who suffered from anxiety and taught ways to overcome it.  Be aware that she does mention using benzos, which is something that SA does not prescribe to, but she was born in 1903 so lived in a time when psychiatric drugs were being touted as the magic solution.
 

Audio:  How to Recover from Anxiety - Dr Claire Weekes

 

the-dr-claire-weekes-method-of-recovering-from-a-sensitized-nervous-system

 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help ...

 

Audio:  First Aid for Panic (4 minutes) Female voice - getselfhelp.co.uk
 

Audio:  First Aid for Panic (4 minutes) Male voice - getselfhelp.co.uk

 

[Altostrata]

Good job on the daily notes, Kristin.

 

As Shep said, it appears 8mg Prozac might still be a little high for you, but your system still seems to be accommodating to it.

 

If you want to take B12, I'd start with a tiny chip of a tablet for a while, working up gradually to a full tablet.

[Kristinhopes]

Thanks for the feedback. Here are yesterday’s notes. I am thinking about decreasing to 7.2 in a couple days to see if it helps with the spacey disoriented feeling, and slight inner tremor and twitching. What do y’all think? 
 

12-17

530 awake: a bit of akathisia depression. Still face tremor if looking closely when smiling or scrunching cheeks, constant right side cheek next to nose pulsating or tremor in one spot since yesterday (update: went away all afternoon came back in evening until bedtime). It’s like my face muscles are weak . Maybe this is normal for someone who hardly smiles? I dunno. Don’t think it’s normal. Going to ask neurologist about this. 

8- depression increasing, hard to focus or concentrate ( disconnected, even when driving to work) 

1230- lunch ham sandwich, 8 mg Prozac, window over next few hours (not following same pattern as past couple days where my windows were later, it’s like it swapped kinda)

530- a bit increasing depression and twitches.. still think I have slight all over tremor. Exercised 

630- increasing spaciness and depersonalization but not peak and weird head pressure disoriented feeling. Also depression is moderate instead of severe . Ate salmon dinner and a couple cookies . Slightly better than yesterday but started off slightly worse than yesterday. Still not baseline. 

8- further disoriented disconnectedness and blurry vision.. been having blurry pressure vision. Don’t have good vision I feel even worse. Also twitching in face

9- window but could not really fall asleep til midnight and woke up a few times during night

6 - awake, around 5 hours total give or take an hour . Awoke with moderate depression , not as much tremor and akathisia and twitching but some 

Edited December 19, 2020 by Shep
reduced font

[Shep]

Kristin, what would you consider to be a good baseline for you? It looks like you're sleeping about 6 hours a night. Is it restful enough that you're not exhausted at work? 

[Kristinhopes]

Yes, 6 hours is fine.. though not my normal and it would be comforting to see I hadvv by the capability of getting more occasionally and sleeping past 6. I’m actually less tired now then I used to get with more sleep on Zoloft, but mentally worse and less energy when deeply depressed of course. Sleeping, that’s not my biggest concern, my bigger concern is the depression, spaciness, depersonalization and confusion, and the tremors. I did have a nice window yesterday afternoon and evening and will update notes tomorrow. 

[Shep]

18 hours ago, Kristinhopes said:

Sleeping, that’s not my biggest concern, my bigger concern is the depression, spaciness, depersonalization and confusion, and the tremors. I did have a nice window yesterday afternoon and evening and will update notes tomorrow. 

 

Your signature is a little confusing because you have "and dropped to 8 mg prozac" underneath your supplements list. 

 

Did you drop to 8 mg Prozac on 10/22/2020? Have you been holding since then? 

 

If so, you may want to make a small reduction in the Prozac. Or you may want to hold a few days and see if you're gaining stability on your current dose - that window is a sign of stabilizing. 

 

The "depression, spaciness, depersonalization, and confusion" can be withdrawal symptoms, so rushing the drug out of your system can make these worse.  It could also be a wave from benzo withdrawal, as well.  So it may be worth waiting a day or two to see if that window continues before making this reduction.

 

On 12/18/2020 at 8:20 AM, Kristinhopes said:

I am thinking about decreasing to 7.2 in a couple days to see if it helps with the spacey disoriented feeling, and slight inner tremor and twitching. What do y’all think? 

 

I would reduce by no more than 5% to start. You may want to go with the Brassmonkey Slide:

 

The Brassmonkey Slide Method of Micro-tapering

 

You can adjust the weekly decreases to do a 5% monthly reduction by decreasing 1.25% each week and then holding at least 2 weeks, as your symptoms allow. Prozac has a very long half life, so you may not even feel the first couple of weekly reductions. So please be mindful that going too quickly thinking you're not getting withdrawal symptoms right away means you can increase your rate. 

 

But again, you may want to wait a few days to see if this window lasts. You could read over the Brassmonkey Slide link and make a gameplan while you're holding.