Satori: help needed a year after adverse reaction

[Satori]

I hope you can help.

 

I’m currently in a state of overwhelming confusion, terror and despair.

 

This began in September 2019. Feeling despondent after difficulties in my personal life, I visited my GP. At the time I was on 20mg of Escitalopram. He prescribed 40mg of Prozac - and life has been hell ever since.

 

Depersonalisation, derealisation, anxiety like I’ve never experienced before, tinnitus, visual snow, deep confusion, and the most awful, ‘unnatural’ sensations coursing through me - and with it all despair like I’ve never felt, and thoughts of suicide (again new) as the only hope for peace. It’s all terrifying. That I'm not able to be the person I truly am for those around me is deeply painful. Any thoughts I have about things to do are attended by awful emotional pain and feelings of futility.

 

There have been short windows when I’ve felt relatively comfortable and my mood has improved, though the dissociation and other symptoms continued. At these times it has felt possible I’ll get through this. But most of the time it has felt impossible. I don't quite understand how I've been able to get through the last 13 months.

 

After calling my surgery a few days into the prozac last year, I was advised to halve the dose, which I did for a few weeks. There was some lessening of the immediate horrors but I remained depersonalised, distressed and far from ‘right’.

 

I then moved to 10mg of Citalopram (which I had been on previously for a number of years). I have been on that dose until beginning tapering at 10percent four weeks ago. I went two weeks at the reduced dose, then in despair, two days back at 10mg. I’ve been back on reduced dose again since.

 

My history with antidepressants:

 

Paroxetine - approx 2000 until 2006

Citalopram (varying at times from 10 to 20mg, and occasional, short lived attempts to come off cold turkey) - 2009 - January 2019

Escitalopram 20mg January 2019 - September 2019

 

I’m a male in my early 40s. I have a child. I live with my partner and her son. I've desperately tried to shield them from all this and have been able to function to a reasonable level but nothing like I should be. 

 

Something had clearly gone very wrong a few days after starting the prozac on September 24 2019. I have had experiences of anxiety, bouts of depression, and two episodes of depersonalisation/ derealisation previously, but nothing like this.

 

I was getting little to no understanding or help from my GP after this happened so battled on on my own for several months, hoping it would fix itself. I was thoroughly miserable, scared and researching dp/dr and trying techniques I found but to no avail. I knew initially that the prozac had caused this. My thinking then moved and I thought perhaps it had triggered a dp/dr - perhaps a psychological reaction that could be overcome and might fade in time, that the effects of prozac would not last long after it was 'out of my system'. 

 

I think it was around May this year that I began to despair. I think around this time, more awful unfamiliar sensations began to appear.

 

Despondent, I called my GP surgery and spoke to a new GP who has greater sympathy and knowledge, and an understanding of the effects of antidepressants. He recommended someone to me, who I am speaking to regularly and who is guiding me through a new practice.

 

I’ve come to understand how dangerous these drugs are. I believe I’m developing a practice and approach to life I’ve always needed but am not yet able to counter the horrifyingly awful impact of these drugs. I’ve had short windows in recent months when things seem clearer and more hopeful , but have been followed by awful crashes.

 

I’ve battled hard over the last 13 months to keep my life together - job, relationships but it really is now hanging by a thread.

 

I’ve been in an awful state since beginning the tapering, though a painful difficulty emerged in my personal life just a few days into tapering. It’s hard to tell if my state since beginning tapering is any worse than it was before.

 

I believe that in time I may be able to overcome this - but I feel like I don’t have time left to keep my life together, and I don’t know if I can bear the months and perhaps years of suffering ahead. I’ve had suicidal episodes and recently researched methods in desperate hope for a way out of this excruciating agony. I desperately want to live. If this would just clear I can make everything ok. For the last 13 months I have been almost continually in a state of what feels like pure suffering.

 

I’d very much appreciate any help in better understanding what might have happened to me, what is happening, what I may need to do to get out of this, and what I may need to face to overcome this.

 

Thank you

 

 

[Gridley]

Welcome to SA, Satori.  I'm sorry you're feeling so bad.  Thank you for doing your drug signature. Could you add the date you halved the Prozac dose?  Here is the link to add this information:

 

Account Settings – Create or Edit a signature.

 

If I understand you correctly, You tried a 10% taper of the Citalopram four weeks ago, but had to reinstate back to 10mg after 2 weeks due to symptoms.

It appears that 10% is too much of a taper for your sensitized system, and once you stabilize, you might try a much smaller taper, perhaps 2% to see how that works.  Also you could consider a micro-taper, which is the gentlest way to come off these drugs.  

 

Micro-taper instead of 10% or 5% decreases

 

However, it may well be that you need to heal more from your adverse reaction to Prozac before thinking about tapering.  Has the Citalopram helped at all?

 

We have a number of members who have had adverse reactions to psychiatric drugs.  An adverse reaction basically means that the drug was poison to your system and threw your system into chaos.  The following is from a post by one of our moderators, Brassmonkey, about adverse reactions:

 

 

"I think that some of the most unfortunate members we have are the ones who only took the drug for a short time and had a severe Adverse Reaction. ... They suffer acute symptoms that hit immediately and hard.  

 

The good news is that their body will sort itself out and they will return to normal.  While this is recovery from a severe adverse reaction and not withdrawal syndrome, the bad news is the post-discontinuation symptoms are a lot like post- acute withdrawal syndrome (PAWS), and it’s going to take a long time and there is nothing that will speed up the process.  There are some coping strategies and tools that will help you endure the experience, but time is the only thing that will cure it..

 

These people tend to have a more linear recovery than those with true withdrawal syndrome. The first several months may be more intense.  Then, like PAWS, things start to improve very slowly. Eventually, normal life resumes and get back on track.  All the members I have known with this immediate Adverse Reaction have made full recoveries and gone on to normal lives and careers."

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So, you will heal.  The fact that you're experiencing windows, even though short, is a very encouraging sign that healing is taking place.  

 

The Windows and Waves Pattern of Stabilization

 

This link explains the healing process really well.

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

The symptoms of an adverse reaction are very similar, if not identical, to withdrawal.  This link lists some common adverse realign/withdrawal symptoms.

You symptoms you describe are typical and "normal" and will fade in time.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

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).

 

We recommend non-drug coping skills to deal with adverse reactions symptoms.  Take a look at the links in the following link and see which you think might be helpful to you.

 

Non-drug techniques to cope

 

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.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

[Satori]

Thank you for your reply Gridley. 

 

As I recall I was on 40mg of Prozac for several days, and then 20mg for a few weeks. I'd hoped things would normalise at the lower dose but they didn't. I will check the exact date with my GP. 

 

I began tapering from 10mg of Citalopram four weeks ago. I reinstated but only for two days. I've been back at 10 percent taper since. It is very difficult to tell if I was experiencing withdrawal or a wave like I had previously. I reinstated in desperation - but I've been in equally desperate states over the months I was consistently at 10mg of Citalopram. I'm really not sure if the Citalopram has helped or hindered or neither. I went back onto Citalopram because I had been on it for several years without experiencing anything like I experienced taking Prozac. Once I resumed I felt just as awful as I felt following the adverse reaction. This continued for months while I hoped it would all soon pass. Around May I began to despair - I'm not sure if it was the psychological toll of the months of struggle or something else.

 

Coming to realise and accept over the past months that antidepressants can and do cause such awful suffering for so many people, I really want it all out of me. I've come to realise that antidepressants may have been causing many (much less severe compared to this) issues for me over many years. But I have been weighing whether it might be better - and if it is possible - to recover from the adverse reaction to Prozac while on Citalopram, or whether I need to taper from the Citalopram in order to recover from the adverse reaction. Might the Citalopram be in some way sustaining the effects of Prozac more than a year later?

 

I had a single day window at the weekend (four weeks into tapering) which gave me hope, but the wave overcame me again quickly. It began lying in bed at night and I wondered if I was normal - or close to it - again. I then couldn't sleep. After only 3 hours sleep I felt more alive the following day than I had for some time. I wasn't back to normal, things weren't quite right - but I wasn't in agony, I could think more clearly, I felt able to do things, and I felt more myself.

 

Having gone four weeks at a 10 percent taper (apart from two days in the middle), I'm reluctant to reinstate again. If I were to reinstate is there any indication of how long it might be before I recover from the adverse reaction, or how long until I'm stable again? And also by stable, do you mean a period of feeling consistently the same no matter how awful that is, or a period of feeling consistently better?

All help very much appreciated.

 

Thank you.
 

[Gridley]

31 minutes ago, Satori said:

I've been back at 10 percent taper

Keep in mind that if 10% is too much, you can reduce by 5%. 

 

31 minutes ago, Satori said:

Around May I began to despair - I'm not sure if it was the psychological toll of the months of struggle or something else.

I think we all experience combat fatigue.  But you've had some very encouraging signs of healing (the window) which indicates your brain is working every moment t her and it will get there.  The adverse reaction to Prozac was a knock, I know, but you are healing from that, though when you're in a wave it's hard to believe that.

 

34 minutes ago, Satori said:

I wasn't back to normal, things weren't quite right - but I wasn't in agony, I could think more clearly, I felt able to do things, and I felt more myself.

That is real progress.

 

34 minutes ago, Satori said:

I'm reluctant to reinstate again.

If you don't want to continue the taper, then I would just hold where you are and not reinstate.  When the adverse reaction has faded you'll be in a stronger position.

 

36 minutes ago, Satori said:

any indication of how long it might be before I recover from the adverse reaction,

There's just no way to know.  But you've served one a year in hell and are showing progress.  The progress will continue and increase.

 

37 minutes ago, Satori said:

by stable, do you mean a period of feeling consistently the same no matter how awful that is, or a period of feeling consistently better?

Stable is feeling decent, not tip-top but not awful, with symptoms tolerable (and during the windows much better than tolerable) with no big swings in symptoms.

 

40 minutes ago, Satori said:

But I have been weighing whether it might be better - and if it is possible - to recover from the adverse reaction to Prozac while on Citalopram, or whether I need to taper from the Citalopram in order to recover from the adverse reaction. Might the Citalopram be in some way sustaining the effects of Prozac more than a year later?

 

Unless you're having an adverse reaction to the Citalopram, and from what you've written I don't see any sign of that, being on the Citalopram isn't going stop the brain from healing from the adverse reaction to Prozac.  They're running on two separate tracks.  Your brain is healing from the adverse reaction (there are definite signs of that, as I said above).  It's not all or nothing.  If you can't taper the Citalopram now, you can wait and let the brain do its work on healing without having to fight on two fronts.