Ladybird: trying to reinstate Lovan / fluoxetine to stabilize

[Ladybird]

Hi

Thanks for this forum, so much care shown and wisdom and sense making.

I have been on 10 mg of Lovan per day for 10 years. I have been trying to taper (incorrectly I can now see) for 3 years, by skipping doses from alternate days to every 3 day.

12/10/20 I stopped taking meds. 

17/10/20 extreme fatigue, increasing nausea, dizzy spells, mood flatline...etc

22/10/20 cant do this so started up on 10mg lovan for 4days. For 3 of those days I couldnt get off the bed, migraines, nausea, cant eat, acid reflux needing to sleep upright. On day 4 mood improved but still real sick. Have totally cancelled my life.

24/10/20 found this forum and realize my mistakes.

26/10/20 reduced my dose to 5mg each morning, my symptoms have eased somewhat but my mood is very low again and not able to leave home.

Stuck here trying to weigh it up and I feel like rolling the dice or phone a stranger.

I m trying to re instate and stabilize but even tho I get the main gist of reinstating and stabilizing and proper tapering, need help to decide how to proceed. 

Thanks

[Gridley]

Welcome to SA, Ladybird.

 

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.

 

Account Settings – Create or Edit a signature.

 

Reinstatement of a very small dose of the original drug is the only known way to help alleviate withdrawal syndrome.   We usually suggest a much smaller reinstatement dose than your last dose.  What happened was that you reinstated too high a dose.  Your system was accustomed to much less than 10mg due to your skipping doses, and the 10mg overwhelmed your brain.  It's good that you reduced your dose, and that as a result you're feeling better,  but 5mg is also likely too high.  Please read:

 

About reinstating and stabilizing to reduce withdrawal symptoms. -- at least the first page of the topic

 

I'd suggest reinstating 1mg fluoxetine.  This link tells you how to get small  nonstandard doses.  The easiest way would be to use liquid fluoxetine if this is available in Australia.  The link also explains how to make your own liquid, which is also is recommended.  

 

Tips for tapering off fluoxetine (Prozac)

 

It takes about 4 days for a dose change to get to get to full state in the blood and a few days longer for it to register in the brain. We need to see how 1mg affects you.  If it's not enough, if you're using a liquid, it will be very easy to increase the dose.  Keep in mind that the purpose of reinstatements isn't to eliminate withdrawal symptoms (though it does for some) but rather to bring symptoms down to a tolerable level.  It still may take some weeks or months for your nervous system to settle down. You probably will continue to have waves and windows, but symptoms won't be as intense. 

 

Once you've stabilized on the reinstated dosage, which can take several months,  you can begin a 10% per month taper down to zero.

 

Why taper by 10% of my dosage?

 

 

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. Get supplements that ae single ingredient (not mixed with other types of supplements).

 

10 hours ago, Ladybird said:

I get the main gist of reinstating and stabilizing and proper tapering, need help to decide how to proceed. 

 

We'll be happy to help you any way we can.

 

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

 

 

 

[Ladybird]

Thanks Gridley

Really really good to get your help.

I decreased from 5mg to 2mg this morn. W.Symptoms etc felt pretty similar to yesterday. I am Starting to identitify the 'waves n windows' your site describes.

Nausea, indigestion, acid reflux, hardly able to eat a thing, and very low mood are my most intense symptoms atm.

Regardless of the decreases in dosage over the last week (since i dosed too high to reinstate) the 'acid reflux symptom' has stayed the same intensity (bad) and starts up around 230/3pm and goes thru night. I am only eating chicken broth at lunch and yoghurt for breakfast, so not irritating foods. 

So my question is ....

Would it be a good idea to try splitting my 2mg morn dose into 2 doses ie 1mg in morn and 1mg after lunch?

[ChessieCat]

32 minutes ago, Ladybird said:

Would it be a good idea to try splitting my 2mg morn dose into 2 doses ie 1mg in morn and 1mg after lunch?

 

No, that's not necessary with fluoxetine.  It has a long half life.

 

19 hours ago, Gridley said:

It takes about 4 days for a dose change to get to get to full state in the blood and a few days longer for it to register in the brain.

 

This is correct for most ADs.  However because of fluoxetine's long half life in can take 1 week or a bit longer for the dose to get to full level in the blood and a bit longer for it to register in the brain.

 

Because you've been on a higher dose it might take a while for things to improve, so please be patient, try not to panic and don't keep changing your dose.  The brain likes consistency.

[Ladybird]

Thanks Chessiecat

I was advised yesterday to drop my dosage so thats what Ive done. But yes I understand the consistency thing. I am not panicked just slowly getting my head around the amazing information here and how to apply to my situation. 

The  last consideration (before holding to hopefully stabilize )  I am deciding on is whether to split the dose morn and noon. I guess I am wondering if the morning dose is running out by mid afternoon hence more intense withdrawal symptoms. 

 

[ChessieCat]

 

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

Prozac has the longest half-life of any SSRI. After you take it for a few days, half-life is about 16 days. Fluoxetine itself has a half-life of 2-4 days, but as it is processed, your body creates an active antidepressant metabolite, norfluoxetine, which has a half-life of 7-15 days. So Prozac keeps on extending its half-life as it is metabolized.

 

Most ADs have a half life of about 24 hours; some a little bit shorter, some a bit longer.  The shortest one is Cymbalta which is only about 12 hours depending on whether a person is a slow or fast metaboliser.

[ChessieCat]

9 minutes ago, Ladybird said:

I was advised yesterday to drop my dosage so thats what Ive done.

 

Yes, I saw that.  You were on too high a dose.  But that was not what I was referring to.  I made the statement because we have members who panic when they don't think that things are changing/improving and then they start increasing/decreasing their dose.  In your case, with fluoxetine's long half life, you need to be patient for longer than for most other ADs before the dose gets to full effect.