Momiki: tapering off paroxetine. Muscle stiffness is no fun.

[Momiki]

Hi all,

 

I have been on paroxetine for about 10 years and am currently on a slow taper. Reading this forum has been a great support at moments where I feel disheartened due to withdrawal symptoms, so I figured I would contribute with my own story.

 

At around 18 years old (2006) I was diagnosed with an anxiety disorder. I refused antidepressants for about a year and a half, but then succumbed under pressure of GP and parents. At around the same time I switched to a new psychologist who made rapid progress with me where others didn't. Within two weeks after starting paroxetine things went much better. Consider the short time period this was likely because of therapy instead of the drugs. I wonder what life would have been like if I had not started paroxetine at all...

 

I didn't want to go back to anxiety, so I kept taking paroxetine (20 mg). About two years later I successfully quit, with a quick taper (about one month?). At this time I knew nothing about the best way to taper and potential withdrawal symptoms. After quitting I seemed to be getting migraines more frequently, and because I knew ADs are sometimes used to prevent migraines, I started paroxetine again. In the years after I attempted to quit a few more times (I don't recall exactly when), but didn't make it past 10 mg. My original anxiety symptoms didn't return, but I developed a sort of general anxiety where I didn't know how I was going to manage to be a normally functioning adult during tough times.

 

About two years ago I started searching online about quitting ADs again and found out about serotonin discontinuation syndrome. I was relieved to know that my previous failed attempts were probably because of the withdrawal difficulties, and that I should be able to live normally without the drugs. I was about to start a new job and move to a new town, so I waited for things to have settled somewhat, before starting the slow taper I'm currently on.

 

My history so far:

 

2006 (18 years old) - Started paroxetine, 20 mg

2008 - Successful quick taper, but started again due to lack of knowledge about withdrawal symptoms

2010 / 2018 - About 3 unsuccessful tapers? Don't remember the specifics. Didn't make it past 10 mg. No knowledge about correct tapering scheme at this time.

 

2019, June 23 - Went from 20 mg to 15 mg paroxetine. No withdrawal symptoms

2019, Dec 2 - Went from 15 mg to 10 mg paroxetine. No withdrawal symptoms

2020, Feb 23 - Switched from 10 mg paroxetine to 10 mg (5 drops) liquid citalopram (to allow for smaller decreases in dosage). No symptoms.

2020, April 9 - Stepped down to 4 drops (8 mg). No symptoms.

2020, June 6 - Stepped down to 3 drops (6 mg). No noticeable symptoms.

2020, July 22 - Down to 2 drops (4 mg). No symptoms I remember, but at this point the first withdrawal symptoms might have occurred.

2020, Sep 9 - Bought a pipette to be able to make smaller decreases in dosage. Went down to 3.2 mg (80 ml). Getting impatient, and not noticing clear withdrawal symptoms, I started tapering more quickly.

2020 - Sep 23 - Down to 3 mg (75 ml). I realised the schema I was using as a guideline (the most precautionary one from the Dutch Association of GPs) didn't talk about taking 6 weeks between decreases, which I thought it did. On Sept 29 I called in sick due to nausea and distressed bowels, but no fever. Didn't make a link with withdrawal.

2020, Oct 10 - Down to 2.8 mg (70 ml). On Oct 14 nausea and distressed bowels again, this time with fever. Fever was gone the next day.

2020, Oct 26 - Down to 2.6 mg (65 ml).

2020, Nov 13 - Seen as the schema I took as a guideline went from 3 mg to 2 mg in one go, I went down to 2 mg (50 ml). Compared to what I read on this forum, I seemed to have no big withdrawal symptoms, so I started taking less time between decreases, but only decreasing 0.16 mg (2 ml) at a time.

2020, Nov 24 - 1.92 mg (48 ml)

2020, Nov 28 - 1.84 mg (46 ml)

2020, Nov 30 - 1.76 mg (44 ml)

2020, Dec 3 - 1.68 mg (42 ml).

 

Dec 7 Realisation: withdrawal symptoms. Nausea, restless, cold, tired, but no fever. Very tight back and neck muscles all weekend (I get that more often, as a prelude to migraine, but that pain responds to sumatriptan (my migraine medication). This pain barely responded to that). Lightheadedness after just 10 min of daily walk. Also realisation that Sept 29 might be the first day of clear withdrawal. I was looking out for brain zaps and the general anxiety symptoms I had during previous tapers, but apparently this time flu-like symptoms are my to-deal-with nastiness.

 

2020, Dec 8 - Upped dosage to 1.80 mg (45 ml). Nausea subsided quickly, followed by restlessness, lightheadedness and tiredness.

 

Dec 31: Muscle stiffness and consequent pain seems to remain. Normal muscle strengthening exercises and cardio for max 30 min lead to several days of pain. It's mostly the long back muscles, right along the spine. Walking and keep moving, as advised for back pain, seems counterproductive. Muscle tension seems high all the time, standing and sitting seems to heighten it.

 

At first I was unsure if the muscle tension is a withdrawal symptom or it's a mix of being inactive/working from home (thanks, covid) and increasing exercise too quickly, but after reading the results on this forum on "muscle tension" and typing down my history, I lean towards withdrawal. It sounds ridiculous to be in pain for several days after simply dancing around the house for 30 min.

 

I think I'll up my dosage a bit more tomorrow, and really hope that the tension will subside. :(

 

[Momiki]

Forgot to include, but I'm no longer allowed to edit my post:

 

My supplement stack contains omega-3, a multivitamin and a pill containing magnesium, B6 and L-tryptofaan. I used to take the first two daily since Jan 2019, but I stopped for a while. Currently I have no clear schedule of which one I take when. Bit confused about time of day, empty stomach yes/no, competition with other nutrients. I'm thinking about sticking to the omega-3 and magnesium one on a daily basis.

 

Regarding muscle tension I'm well acquainted with triggerpoints. My neck used to have many, and I have a lot less tension-headaches-leading-to-migraine since I used a peanut massage ball to massage the area. It does bring relief for my back, but with the high muscle tension unresolved it is treating symptoms rather than causes. I hope that the massage ball in combination with a percussion massage tool (Theragun)  and meditation (plus increasing the dosage and waiting at least 6 weeks if not more before decreasing) will bring relieve and enable me to exercise again. I'm getting fat being immobile. 😕

[Altostrata]

Welcome, Momiki.

 

Paroxetine can be a very difficult drug to go off, particularly as the dosage gets lower. It is possible that if you updose a bit, you may find a plateau where your withdrawal symptoms are relieved. You might stabilize at this dosage for some weeks or months to let your nervous system settle down, then taper with micro-tapering.

 

For more information about fish oil and magnesium supplements, see
https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/
https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

Please let us know how you're doing.

[Momiki]

Thanks!

 

I've quickly read the beginning of the magnesium one, and the advice of taking smaller amounts of magnesium over the day sounds like a really good one. My tablets contain 400 mg, where apparently 300 mg is the recommended maximum daily intake for a healthy female. Magnesium seems to relieve my muscle tension, but taking 2 supplements seemed like a bad idea. I'll read both threads later in more detail.

 

I increased my dosage yesterday at 6 am (unplanned awakening), to 2.2 mg (55 ml). The muscle tension had lowered the night before after lots of time with a warm water pad. I went back to sleep after, and woke up a few hours later. Tension wasn't completely gone, but was minimal. I used the Theragun on my back, but that seemed to slightly irritate more than do good.

 

Later in the day I took the magnesium-B3-L-tryptophan supplement and about half an hour, 45 min later the tension was much better. I did feel really tired, but was able to take a 20 min walk outside and felt better afterwards.

 

I had occasional sharp twinges of pain at random places (arms, legs, back, etc) throughout the day, but they were short and didn't limit me. Muscle tension increased a bit again at the end of the day, but wasn't nearly as bad as before. Perhaps I sat on a chair for too long. In the evening, before meditation, I noticed my upper legs and especially my calves were cold. I'm guessing lack of circulation. Massaging them helped.

 

Mentally I'm in a good place. Early December I was bummed about having to increase my dosage, but now I'm proud with the progress I've made. Looking back at my tapering chart I somewhat think "Yeah, that could cause problems", but I hadn't encountered limiting withdrawal symptoms during this taper before. You can only find out what your pace is by taking steps. :)

 

 

 

 

 

 

[Momiki]

Muscle tension has gradually been decreasing, and no symptoms from increasing the dose have manifested. The most noticeable reduction in pain came after the first day of working (I had 2 weeks off). I was afraid the symptoms would worsen, seen as working requires a lot of sitting, but apparently I actually take breaks more frequently (every time I'm switching between tasks, video calls, when procrastinating on something) compared to when I sit behind my computer in my free time (we're in lockdown currently, so it has been quite a bit of my time).

 

The end of the week things worsened, though. It started the night from Wednesday to Thursday. I woke at night with a slight tension headache and some stiff muscles. I stretched and massaged my neck, which made me feel better. Went back to sleep afterwards. When I awoke it felt as though I might get migraine that day. During lunch I didn't go for a walk, due to bad weather, and I stopped wearing my Fitbit, because the hourly goal of 250 steps added stress. I figured today would be a rest day. The stress built up in the afternoon, because I really wanted to finish some work as quickly as possible. I had been wanting to do that all week. When the work day was over, my head was spinning. It calmed down after some down time on the couch and some meditation. The expected migraine didn't occur that day.

 

During the night from Thursday to Friday I again awoke with stiff muscles. In the morning I had quite some pain and felt nauseated. I grabbed my hot water bottle and went back to sleep (I don't work on Fridays). When I woke again I took my temperature and found out I had a fever: 38.3 C. The nausea was gone and most of my muscles had relaxed, except for my neck. The resulting tension headache was no fun. I took sumatriptan, but it didn't relieve the pain. The fever rose to 38.6, but dropped to 38.0 at the end of the day. By that time I was okay with taking paracetamol (didn't want to take it earlier as it lowers fever, which as I understood is a way of fighting invaders, not just a byproduct). I put on a knitted hat to keep my head warm and went to sleep early. The tension headache quickly lessened.

 

Today the fever is gone. There's still some tension-related pain in my face, but it's minor. I've had several of these one-day fever occurrences, although I can't remember how many and if they've only occurred once I started tapering or had occurred before that as well.

 

 

Lessons (re)learned at the moment: Take enough breaks while working. Don't go into "want-to-finish-something-quickly" mode.

 

 

 

[Momiki]

Muscle pain wise, the last two weeks have been quite alright. My lower back has been almost problem-free. My upper back is annoying me somewhat, but it's not painful and it's not leading to headaches. I've noticed it's important to move regularly over the day, and not have prolonged periods of sitting. My Fitbit is a great tool for this, it reminds me every hour if I haven't set 250 steps in an hour yet. Having my yoga mat permanently on the floor makes it easy to randomly do some mobilization exercises during the day as well. I should pay more attention to posture, I'm leaning forward (with tilted head) too often.

 

Mentally, the year didn't start well. Quite some work-related frustration, a friend made me rather agitated, and at the beginning of this week very little motivation to work. I noticed I'm more productive after I've walked during lunch time, so I wondered whether a daylight therapy lamp might help. My apartment doesn't have a lot of natural daylight. I ordered one online and received it yesterday. Man, that thing is bright. :p

 

Current plan is to wait until at least February 1st before decreasing to 2 mg, but perhaps longer, if the agitation and lack of motivation return. Winter might not be a great time for tapering.

[PerAsperaAdAstra]

Hi Momiki! Welcome to this forum. Just read your story and we're tapering the same difficult antidepressant. 

Seems that you're doing pretty well since much of your problems only started when dipping below 6 mgs. 

 

Then again, I've totally misread in that you've transitioned to citalopram. Did the transition go well? You just asked your GP for another AD?

 

I have quite a long while to go still, so I'm curious to your results!

Edited July 19, 2022 by Shep
edited with member's new username

[Momiki]

Hi PerAsperaAdAstra,

 

Thanks for stopping by!

 

Yes, I feel lucky that I've been able to take relatively big steps in the beginning without much problems. During previous taper attempts I sometimes experienced that feeling when you sit and start to fall asleep, and your head drops, when I was still at 15 or 10 mg, but I didn't have that this time. I started taking omega-3 supplements daily 6 months before I started my current taper, perhaps that has helped. My drug history is also simpler than most others on this forum: only paroxetine, no other ADs (except the switch to citalopram, to be able to taper slowly) and no benzos. Perhaps less confusion for the central nervous system.

I switched from paroxetine to citalopram when I was at 10 mg. I made the jump from 15 mg to 10 mg paroxetine on December 2nd and then went from 10 mg paroxetine (solid pill) to the equivalent dose (5 drops) of liquid citalopram on February 23rd. I waited until April 9th before going down to 4 drops (8 mg). The transition went well, I had no symptoms.
I originally asked my GP to be switched to a different AD, which had a reputation of being easier to taper. However, apparently citalopram was the only drug available in liquid form, so he prescribed me that one.

How is your taper going? Did you lower your dose since your last update in your introduction topic? I read you weren't looking forward to talking to your GP about tapering. I'll send you the link to the guideline from het Nederlandse Huisartsengenootschap, that I've been using. Perhaps this 'proof' makes it easier to convince him/her that tapering slowly is important.

[PerAsperaAdAstra]

Hi Momiki! I hope your tapering has been uneventful this weekend? 

 

How many times have you tried tapering by the way between 2008 and 2018? Did those attempts fail (miserably) and cause you to hit rock bottom? Or could you cushion much of the blow before the **** hit the proverbial fan? 
I think that definitely might have also attributed to the fact you're in a relatively stable state now. Anyway, count your blessings that you haven't run in some of the problems we come across here on the forum.

 

And about your GP being asked to prescribe a totally different AD: did it take you much effort to make him/her provide the script for citalopram? Or did you have to sorta like bargain with him/her, providing several proof of the fact that Seroxat is so much more difficult to come off of? 

 

About my taper: I'm doing the Brassmonkey Slide and it's going pretty well. Had some dizziness in the beginning. Then came slight cortisol surges in the morning. Now a form of dizziness has returned again, paired with very brief episodes of depersonalization. But it's really very very minor. I am blessed in comparison to some of the stories here. Some even have a hard time when knocking off less than 10% each month. That must really suck. :-(.

Edited July 19, 2022 by Shep
edited with member's new username

[Yesyes123]

On 12/31/2020 at 12:12 PM, Momiki said:

I wonder what life would have been like if I had not started paroxetine at all...

I think we all go there. It's useless. Don't let this type of thinking influence you or grow on you.

 

It won't help you at all. It will only make you angry, and make you waste your time and energy.

 

It seems now that you would much rather have never taken the meds - but that is impossible. It cannot be done.

If you had never taken the meds, you wouldn't be you. It would be an entirely different timeline. You might not even be alive today.

 

It doesn't help ruminating about those things.

 

If you focus on what can be done now, the way will open up for you. It's quite amazing.

 

Peace, love and healing!

Edited July 19, 2022 by Shep
edited with member's new username

[Sebas]

Hi Joline,

I came to visit your thread while looking for possible relation between paxil and triggerpoints.

Didnt read everything but i can tell you one thing from experience. Do not take tryptofaan with ssri. Your stepping down from paxil seems amazingly easy by the way as someone had already noticed. Current withdrawl is possible backfire from period before but still seems RELATIVELY smooth. Avoid stress and stay safe,

Sebas 👍

[Momiki]

So, last week has been crap. I'm restless, quickly agitated, angry, frustrated, and muscle stiffness has increased again. I can, however, entirely chalk this up to the current events going on around me (e.g. riots and media sensationalism on that and on other topics), it doesn't have to be withdrawal-related. It could also be seen positively, that I'm becoming less emotionally flat. I hadn't noticed that as a clear side-effect of using SSRI's, but I guess it did stump my feelings to some degree.

Sleep has been fine, and no dizziness, nausea, lack of appetite etc occurred. I haven't changed my dose since January 1st, so I'm still on 2.2 mg (55 ml) citalopram. I don't plan on lowering for at least the coming week, I'll wait until the thing that's making me so angry at the moment has blown over. I should reinstate meditation in the morning, but I dislike waking up earlier.

 

My tapering down does indeed seem to be less problematic than most other's on this forum. I should be thankful for it, but it also gives me the feeling I don't belong here. My rational mind knows that's nonsense, but my bad mood isn't keen on listening.

 

@Sebas What was your experience with tryptophan? Using a combined pill of magnesium/B3/tryptophan wasn't a conscious choice, I bought the wrong bottle last time I went to buy magnesium citrate. Considering the biochemistry, though, I didn't think it was harmful, and might perhaps be beneficial as tryptophan is a precursor to serotonin.

 

@PerAsperaAdAstra I don't accurately recall the amount of times I tried to taper. The first time (about 2 to 3 years after I started on paroxetine) I made it to 0 mg, but I reinstated because I had an increase in migraine headaches. I didn't notice the negative side-effects of paroxetine at the time. There have been at least 2 to 3 attempts after that one, with withdrawal being more noticeable at each successive attempt. I didn't go lower than 10 mg at those points. Several family members are on antidepressants, and I was told the 'some people need insulin, we need this stuff' reasoning. I never fully bought into that, but I was also afraid of returning to anxiety. The attempts didn't fail miserably, I stopped before things got bad.

 

Regarding the GP, I didn't have to convince him at all. I simply told him I wanted to switch to a different antidepressant for easier tapering, he told me liquid citalopram was the best option. It wasn't the same GP that got me on paroxetine originally, I've moved several times since then. It's also not the same GP I have now, I have yet to meet that one (switched recently). I'm not concerned about having to convince GPs, as I have a master's degree in neuroscience. I don't know more about general medicine than they do, but I do know more about brain chemistry. I'll bring out the scientific literature if I have to.

 

 

 

[Sebas]

Hi Momiki,

I read about tryptofaan and ssri when i was faced with sudden enhanced withdrawl symptoms after using a protein product. 

 

If you feel crap right now then first take enough time to return stable again, all withdrawl symptoms should be gone, then take 2 weeks to give CNS rest after tapering and only then go down again. If you taper again too soon when balance has not completely set in, then you'll be asking for system overload. DONT RUSH THINGS is best advice I can give you. Let your body and mind heal first until anxiety, feeling crap, aggitation levels are completely normal. General stress circumstances such as Covid can definitely have negativ effect on withdrawl but its still withdrawl. Textcolour has suddenly turned red dont know why.

 

Stay safe and be wise,

Sebas 👍

Edited July 19, 2022 by Shep
edited with member's new username

[PerAsperaAdAstra]

Hi Momiki! Sorry to hear about the fact that you seem to wonder if you really belong here. Although a part of you also knows that probably isn't correct. And the rioting and other societal problems plaguing The Netherlands now definitely affect one's taper process.

 

I'm happy that you're sharing your progress though. Your story counts just as well, as tapering has many faces. Heck, I might even dare to claim your taper might offer hope to some that a taper can be relatively "smooth". (of course I'm not dismissing your physical discomfort during your taper since it definitely sounds troublesome).

 

About the tryptophan. For what I've heard caution should be exercised with any serotonin precursor (be it 5-HTP or tryptophan) because of the potential for serotonin syndrome. I've used some serotonergics myself whilst also using Paxil. It didn't do that much for me though. Most of the topics here about serotonergics generally advise against using it as it might negatively influence an already destabilized CNS.

 

Thanks for your explanations about your taper attempts and your GP. Great to know some of your background.

Edited July 19, 2022 by Shep
edited with member's new username

[Sebas]

Zie bijlage, wist niet dat je Nederlands was 😊😁😉. Magnesium citraat en omega 3 visolie zijn goed aan te bevelen.

 

Voorzichtigheid is o.a. geboden bij gebruik van b- of multi-vitamines, caffeine (ook theine), chocolade, cola, grapefruit, karamel. Tijdens afbouwperiodes vermijd ik deze produkten.

 

Fijn weekend,

Sebas

[PerAsperaAdAstra]

How are you doing now Momiki

Edited July 19, 2022 by Shep
edited with member's new username

[Momiki]

Five months have past already? Time flies!

 

Steps I've taken this year:

 

2021-01-01: 2.2 mg (55 ml)

2021-02-08: 2 mg (50 ml)

2021-03-21: 1.92 mg (48 ml)

2021-04-02: 1.8 mg (45 ml)

2021-04-25: 1.68 mg (42 ml)

2021-06-06: 1.56 mg (39 ml)

 

Tapering has gotten more difficult since I've gotten below 2 mg. My pattern of WD symptoms have become clearer to me. About two to three weeks after lowering a dose I can expect nausea and diarrhea on the physical side. On the mental side there's mostly feelings of overwhelm and agitation. Old feelings of insecurity have resurfaced at my latest dosage drop. The gastrointestinal symptoms seem to resolve in about a week time. The mental ones last longer. I had a particularly nasty combination of withdrawal symptoms and menstruation (felt like a very bad case of stomach flu: nausea, diarrhea, abdominal cramp, sweating, feelings of possibly fainting). I've since started taking birth control pills again (last time I took those was several months before I started tapering), now I no longer have problematic periods.

 

At this time a 10% reduction per month seems too fast. I will probably wait until at least mid August, perhaps somewhere in September before I will continue tapering. It took me a while to come to terms with the fact that this process will likely still take more than a year, perhaps two, but rationally I think it's the better way to go.

 

I've been trying tea with ginger to help with the nausea last week. It seemed to help. I've also picked up the compassion side of mindfulness training again, am working on connecting with others and try to write down around 3 things I'm happy with, proud of or thankful for that day. That last one is surprisingly effective.

 

 

[Momiki]

I was reading a very nice thread on this forum, https://www.survivingantidepressants.org/topic/23081-are-we-there-yet-how-long-is-withdrawal-going-to-take

 

In it there is a section on drug interactions, with a link to a site where you can check for interactions yourself. I checked both paroxetine (my initial AD) and citalopram (the one I switched to for easier tapering, since it's available in liquid form) with sumatriptan, the medication I take when I suffer from migraine-like headaches. I was surprised to find that both combinations have major interactions. In hindsight perhaps somewhat foolish, I discovered not so long ago that sumatriptan works by affecting a serotonin receptor. It was a different receptor type than paroxetine/citalopram, though, so I figured that perhaps that's why my doctor subscribed it anyway / that it was safe. Realizing that they have a major interaction and can lead to serotonin syndrome made me realize that perhaps the reaction I get when taking sumatriptan isn't so normal at all. I used to always feel worse before feeling better, which led to me only taking sumatriptan when I'm at home, can lay down and don't have to go anywhere for a while.

 

I haven't taken sumatriptan that often in a while. Recently the initial feeling worse hadn't really occurred. Perhaps that's because my AD dosage is now lower...

 

Man, mind is blown. I can't believe I've been risking serious problems by taking these two drugs simultaneously for such a long time. 😐 Or actually have experienced the adverse effects, but didn't recognize them as a serious drug interaction.

[Momiki]

I can expand my list of "functions serotonin has that I have experienced" with an additional entry: involvement in balance. Out of the blue, while working behind the computer, I became unsteady. Walked around a bit, felt like a drunkard. I've been lying on my bed for a bit now, still feeling somewhat unsteady. I wonder how long this will last and if it'll become recurrent. Sure hope not, this feels quite debilitating.

 

Yesterday night I had trouble falling asleep, somewhere in the morning I woke up and think I mostly only had light sleep after that. Felt quite tired this morning, like I would fall asleep shortly after laying down. After walking for 40 minutes during my lunch break I felt better, though. Only other thing of potential interest I can think of is I've eaten bits of dark chocolate the last few days. I eat that occasionally, but normally a different brand and a smaller quantity.

 

Edit: Other thing I can think of is an unhappy muscle in neck or face somewhere. I've been having muscle pain again recently, and am already quite familiar with muscle knots leading to pain and nausea. I'll check my triggerpoint book for possible culprits.

[Momiki]

I realized something else that's new that may have an impact. I started using a shakti acupressure mat a week ago. Initially only on my back and neck, but yesterday morning I stood on it (with socks) for about a minute and the evening before a bit longer with no socks (ouch). I'm a bit afraid to use it now, which is a pity, because I bought it as a gift to myself, wishing myself relaxed muscles. There were several hours between standing on it in the morning and the balance problems in the afternoon, so I wonder how strong the connection between the two is (whereas I was eating some chocolate 2 minutes before it happened), but withdrawal is weird... Perhaps it is the culmination of things.

 

I'll take a break from the mat for a while and possibly use it on my back and neck again eventually, but I will no longer use it on my feet.

[Sebas]

It's definitely the chocolate, it's containing cafein. Avoid it during WD.

Many people also avoid coffee (i'm taking decaf) and tea. Green tea also holds cafein. You can drink Rooisbos tea. I would loose the ginger tea. Ginger is a spice and spices are also known for possibly influencing WD.

If you like icecream, then choose vanilla or strawberry for example. Also be careful with products containing 'cookies', cacao, white chocolate toppings etc. No Mars, Snickers etc. No cookies with chocolate topping.

At least this goes up during withdrawal. When stabilisation is back, then try after a few weeks with small dose. 

 

Bij stijfheid in specifieke spiergroepen kan ik je shockwave therapie aanbevelen. 

 

Ciao ciao

[Momiki]

The balance problems haven't returned, luckily. I remained dizzy for a week after, but that didn't make me bedridden. I've switched to caffeine free types of tea and stayed away from chocolate for a while. I've taken some bits of good quality chocolate recently, which went well.

 

After (/next to? Don't remember..) the dizziness I've experienced gastrointestinal problems (nausea, diarrhea), muscle pain, lack of stamina and fatigue (got tired just walking 15 min), but those seem to have resolved by now. I've also had another episode of waking up in the middle of the night with abdominal cramp, diarrhea and nausea, along with dizziness, heart palpitations and sweating. I don't know if those last three are part of the original problem, or whether they arise because of my great dislike of vomiting and fear of passing out. This has been the third time, and the severity was less than the second, which was less than the first. Here's hoping for a non-existent fourth episode. I'm not sure if it's a monthly thing (I'm bad at keeping daily observations of anything), or whether it's junk food induced. I ate a bag of crisps the evening before the third episode, and too many sugar-glazed cookies before the second. Quite a good motivator to not binge on the bad stuff.

 

Remaining are problems with anger and higher tendency to cry. I've never been an angry person, and crying was never my thing either, so they are quite easy to chalk up to withdrawal. They still suck, though. I'm mentally not in a great place now. I would like to go out and make new friends, but my hobbies require a decent physical condition, and I don't feel like a pleasant person at the moment. I feel rather stuck. The thing that would help me is also the thing I don't feel that capable of doing.

 

I've signed up for a meditation class yesterday, will start at the end of the month. I've been meditating to some degree for about 15 years, but I've never been good with regular practice. Hopefully this will help with that, and will also be some support for dealing with difficult times.

 

Dosage-wise I'm still holding. I see the anger and crying as indicators that I haven't stabilized enough.

[PerAsperaAdAstra]

Thanks for the update Momiki! Anger and crying are telltale signs for me too that something is off. Especially if like you noticed it isn't your thing normally.

 

Might the fact that you don't feel like a pleasant person at the moment also be attributable to withdrawal? 

That "being stuck" feeling sucks though. 

Edited July 19, 2022 by Shep
edited with member's new username

[Momiki]

Thanks for stopping by.

 

Not feeling like a pleasant person is definitely an indirect effect of withdrawal. But yes, it could also be a more direct effect. I was reading about neuro-emotions on this forum a while back, it fits the bill quite nicely. Things will be better eventually, I 'just' need to exercise patience and acceptance. 😛

[Shashal]

I’m in a big wave and the only thing I can recall was that I ate an ice cream with dark chocolate one day before, and my last 2 waves were related to the same ice cream… Very sad 😕 

 

And the funny thing was that the waves happened one or two days later and last two or three days, it’s very hard to make the connection with the chocolate and the waves…

[Momiki]

Very sad indeed, Shashal. Hopefully you can enjoy other tasty food without it triggering waves.

 

I've restarted tapering after a 3 month pause. On June 6th I was at 1.56 mg (39 ml). June and July were rough months, but the second half of August I was WD-symptom free, which makes me quite optimistic. I had a small fright when I developed nausea again on my second day of work after a 3 week holiday, fearing that work stress was causing symptoms. I had also switched to a type of bread I hadn't eaten in a while (spelt bread), so I decided to stop eating bread for lunch. The nausea went away and hasn't returned since. It doesn't seem to be gluten-related, as I still eat muesli for breakfast and now whole wheat wraps for lunch.

 

2021-06-06: 1.56 mg (39 ml)

2021-09-06: 1.52 mg (38 ml)

2021-09-15: 1.48 mg (37 ml)

 

Since midway September I've experienced WD symptoms again. The shooting pains in my legs and feet are back and I've been more tired than normal. I also had a very short bout of fever accompanied by hives (never had that before). The leg pain is directly related to how active I've been. At the end of August I was walking about 90 to 120 minutes daily with no problem, now 30 minutes a day already seems too much. I don't like it and it hinders me living a normal life, but it's nice to know that the pain will go away if I rest for a while, or if I hold my dose for a prolonged time. I don't experience nausea, abdominal cramps, diarrhea, dizziness, problems sleeping or any mental problems and feel quite content to outright happy sometimes, so things are going quite alright.

 

I'm currently following a "1 ml reduction per 2 weeks"-scheme. That's a 2.5% reduction at the moment, so rather slow. I'm waiting to see how it goes, I'm a bit fearful of things returning the way they were in June/July. I've started taking magnesium citrate more often again. I'm trying to implement the habit of 200 mg after breakfast and 200 mg after dinner (I read on this forum that smaller doses more often are better. The pills I have are 400 mg, and cutting them in four makes them tougher to swallow, so this routine is easiest).

[Momiki]

2021-10-04: 1.44 mg (36 ml)

2021-10-18: 1.40 mg (35 ml)

 

The leg pain has passed. Next to taking magnesium daily I switched my active-sit chair for a normal one in my 'home office'. Things got better a few days after that. Instead, nausea popped up. After a while, that was replaced by dizziness, and then fatigue came knocking. Occasionally at night I wake up all sweaty.

 

Around October 10th I started taking vitamin D in the morning. This very quickly led to waking up being easier. After establishing that vitamin D didn't seem to upset my nervous system, I added vitamin B12 to my supplement routine.  I was a bit uncertain about it, reading about how B vitamins can be stimulating for many. I did get some instances of fear creeping up during short walks (at times when I felt nauseated and was wondering whether it wouldn't have been better to stay at home), but I'm not sure if that was related to B12. I took a break from walking for a bit and didn't take the B12 daily. The fear has passed now, and I am now taking the B12 daily without problems. Fatigue was still an issue, so I also added co-enzyme C10 to the mix, building it up slowly from 30 mg to 150 mg a day. This addition also seems to have gone well. My energy levels have been up the past few days. I've been able to do 2 daily walks 3 days in a row (half an hour during lunch and 20 min after work). Today my muscles seem to protest a bit, but nothing major.

 

So, right now, most physical symptoms have passed. They have been replaced by mental ones: first irritation, then trouble thinking about strategic big-picture things at work, or planning stuff in my private life. Zen is helping me with those. I notice the feelings, as well as my tendency to set the bar too high and try to let that go. I was trying to keep all balls in the air and keep a high pace with all my projects at work. I'm now trying to perhaps let one or two balls drop and see what happens. My line of work doesn't involve other people's well-being, so no harm will be done if something doesn't go perfect. 😛

 

I plan on reducing to 34 ml (1.36 mg) next Monday, November 1st. Hopefully the easing of symptoms this last 2 to 3 weeks will prevail! The 1 mg seems to come into reach! (even though at the current pace that would take 5 more months. I'm going to ignore that fact :p)

[PerAsperaAdAstra]

And  how are you faring at this point Momiki?

 

How is your energy doing at this point? Do your levels also take a plunge in this time of year?  

And do your best in not setting the bar too high. With tapering life can be hard enough in and of itself, even without you expecting much of yourself. 😉

 

Ah, and now I read you reduced some more! How is it going at 1.36 mg?

Edited July 19, 2022 by Shep
edited with member's new username

[Momiki]

Hmm, I'm not doing that well. I think it might have been better to not make that drop to 1.36, but to have a short break instead. I had considered doing so, but it would have meant a longer break than I wanted to take. I had some outings planned around which time I didn't want to taper.

 

Symptoms of the last two weeks include tension headaches/migraines (lasting 48 hours is no exception. Sumatriptan doesn't always work resolving it), hair loss, increased skin rash, at the start an inability to relax (after which I stopped taking B12 and Q10, haven't reinstated yet) and an increasing inability to think. Normally I can think several steps ahead, now I don't get further than one step. Looking back at my post of 28 Oct I already had that at that time too, but it has now come to a point where it really affects me at work. I tend to have a lot of time sitting behind the computer with a blank mind, trying to break down what I have to do into small steps. That one small step can feel like a pretty big task. I've tried making my problem clear to my colleagues, but I don't feel like the message is really coming across. I have a lot of stuff to do, but many things don't have deadlines, so no harm has been done yet.

 

At the same time I'm positive, because I feel like there's personal growth happening. I've tried summarizing what exactly, but I can't seem to formulate it clearly. If anything, it's realizing unconscious behavioral patterns and consciously responding differently to them. One such response is not trying to give it everything I have to ensure work still gets done, or to make sure my colleagues grasp that I am not functioning fully at the moment. I did my part. It's up to them to do theirs. I'm going with the flow at the moment: if I manage to get something done, then great. If not, then that's how it is.

 

I do really hope this is a phase and not something that will last for the remainder of my taper. I don't like the idea of having another two years of not functioning, both at work and private life.

 

 

Edit: forgot a symptom -> Problems with appetite. I don't feel like eating, yet want to eat at the same time. I usually have to force myself to make food and take a first bite. In case of lunch and dinner things are usually okay after that first bite. Breakfast usually does take effort to continue.

[Mamgu]

Hi Momiki, sorry to hear about your struggles but good to see that you have some positive news as well :-).

 

I just wanted to mention about the work-related issues regarding brain fog, I really hope your colleagues are supportive and adjust the way they communicate with you.  I've had the exact same experience and it wasn't until I mentioned I was struggling to come off anti-depressants that their attitude towards me changed.  I'm not sure about employment law in The Netherlands but in the UK it's unlawful to discriminate against someone with mental ill-health, I would have thought this applies in the Netherlands as I'm sure it's driven by EU law.  Anyway, I explained how my cognitive function is well below my normal levels and I could see a 'rolling of eyes' attitude from some but others were more sympathetic.  More importantly, my manager is very supportive so if you haven't already done so, could you talk to your manager and ask for 'reasonable adjustments' during your withdrawal?  This all depends on a trusting relationship with your manager and the culture of your organisation but if they are inclusive then you might get some positive support.

 

 

Edited July 19, 2022 by Shep
edited with member's new username

[Momiki]

The team I work in is self-organizing, so I don't have a day-to-day manager. I told our 2 team coordinators about my issues with AD withdrawal several months back, I guess more than six already? They didn't respond negatively. I told the rest of the team in July, after I broke into tears for something minor during an online meeting. No rolling of eyes, fortunately. One colleague actually has friends who had trouble coming off their meds as well.

 

We're working from home full time, so they are likely not aware of how much withdrawal is impacting me, though. Until recently I had no problems doing the stuff I'm supposed to do, so I guess they might have forgotten it somewhat. And it's not the first time in my life that I feel like I've been clear on something, where others don't seem to get the message. I'll probably need to be patient and keep repeating my message (even though that annoys me). And I need to stop trying to do everything in my power to ensure things go well (which I realized I do often). I'm trying to lower my way-to-high bar. Hence the new "I did my part, now you do yours" attitude.

 

Regarding employment law: I'm indeed protected. I have a contract without an end date, so I don't have to worry about it not being renewed. I don't know the exact details of the sector I'm currently working in, but you can be on sick leave for a long time (a year and a half? Two?) before a company is allowed to lay you off.

[UkDave]

Hi Momiki, I'm sorry to hear about your struggles with the withdrawal! having a read a few success stories on this site 1 of the things I picked on was a cold showers they stimulate your vegas nerve which helps control the sympathetic nervous system "the body's rapid involuntary response to dangerous or stressful situations"

Quote

Exposing your body to acute cold conditions, such as taking a cold shower or splashing cold water on your face, increases stimulation of the vagus nerve. While your body adjusts to the cold, sympathetic activity declines, while parasympathetic activity increases.

 

If you try a cold shower don't jump straight in on the cold setting gradually turn down the temperature so that your body adjusts other wise you'll shock yourself and not want to try it again.

 

There is also certain breathing techniques you can do that will help calm you as well in any situation regardless of the effects of withdrawal 

 

 

I hope you can take away a few pointers, these techniques have helped me get over barriers I've had for years with anxiety.

 

All the best 😄 

Edited July 19, 2022 by Shep
edited with member's new username

[Mamgu]

Ah yes, patience - something we're having to embrace.  Sounds as though you have this nailed by educating your colleagues 🙂.  I guess it's the irritating waiting game now and keeping on dropping it into the conversation when required.  Working from home can a blessing in these situations but as you say your colleagues might have forgotten. 

 

I love your attitude Momiki, I'm impressed that you've the insight to adopt your "I did my part, now you do yours" approach when in the midst of brain fog and all the other debilitating symptoms 🙂.  We may hate the situation we're in but here we are and we just have to deal with it.  And it looks like you're doing incredible well. xx

UKDave's link re the vagus nerve techniques are definitely worth checking out.  I've found the massage techniques helpful (can't bring myself to cold showers though!!).

 

Edited July 19, 2022 by Shep
edited with member's new username

[Momiki]

Thanks for stopping by, Dave! I did the cold showers daily for quite some time about 3 years ago. With the muscle stiffness, though, I switched to indulging in hot showers. Forcing myself under cold water feels like being hard on myself. I'm glad to see in the video that there are other ways of stimulating the vagus nerve! Sucking on candy is no punishment at all. 😛 Massaging would also be a good one, beneficial for the muscles as well.

 

Regarding breathing techniques, I did Wim Hof breathing a couple of times. The feeling of relaxation afterwards is amazing, but the way of breathing is again something I really have to push myself to do. I haven't been able to make it a habit. Pranayama / alternate nostril breathing is an option too. If I remember correctly that stimulates the vagus nerve as well.

 

Update-wise: I'm still holding. The brain fog has passed, and was initially replaced by a feeling of having trouble keeping my head above water (regarding work). Since about this last week that has passed too. I had increased my amount of walking by doing 500 steps instead of 250 every hour (Thanks for helping there, Fitbit), and do at least one, sometimes two 20 min walks. That went well for about two weeks. After that I had pain from my right lower back down to my right ankle and I had to use a pain killer to be able to sleep. I haven't walked much since. I wonder how big the seasonal component is in this, as last winter I had muscle pain as well. I don't recall it being much of a problem during spring (I didn't taper over the summer).

 

Tapering-wise I think I'll be in it for the long haul. I had originally hoped to drop around 5% per month, reach the 1 mg in about half a year and then hopefully have an easier taper. The past few weeks have taught me that 5% is too fast, though. It has also made me wonder if my body functions better on bigger drops with long holds (6 weeks or more), rather than smaller drops in a shorter period of time. Kind of like with the latter as if my body starts repairs at one level (nausea) and goes back to that every time a drop is made and postpones fixing other levels (brain fog), leading to overdue maintenance there. I don't have the courage for bigger drops at the moment, though.

 

I'm now thinking I'll drop 1 ml (currently about 3%) a month at most, with additional breaks in between. The goal would be to be able to function (more) normally, both at work and especially in my private life. One ml a month would mean a time investment of at minimum 34 months, so almost 3 years.. 😕 That sucks, but hopefully my quality of life will be better than it is now.

 

 

[PerAsperaAdAstra]

Hi Momiki. just wanted to say hi! I hope you're doing well. Have you been holding thus far and has it improved your symptoms? For what I've read you dealt with some nuisances after your recent decreases.

Edited July 19, 2022 by Shep
edited with member's new username

[Momiki]

Hi!

 

Yes, I'm still holding at the moment. Last drop was on Nov 1st, to 1.36 mg active ingredient. Things haven't followed the same route as the previous time I was holding. During June-July-August I had a pretty much straight up curve in improvements, and halfway into August I was pretty much back to normal (normal-normal, not WD normal). I was hoping, somewhat expecting, the same pattern this time, but no such luck. This seems to be the first time there is more a waves and windows type of pattern.

 

First, the positive: I no longer have brain fog or other symptoms impairing my thinking, hair loss is back to normal levels and most of my skin rash is gone. I also seem to be remembering things from the past more often, and remembering short bits of dreams. I used to keep a dream journal before I went on anti-depressants, trying to train the ability to become lucid in dreams (knowing you're dreaming during the dream, and having control over what happens). I was able to remember a lot of what I was dreaming at that time. Once I started ADs I hardly remembered anything, and possibly dreamt less (as ADs are known to suppress REM sleep, the stage during which dreams are most vivid). Noticing this increase in remembering dreams and the past made me happy, I felt like a possible numbing effect of ADs might be lifted. I don't know for sure if ADs made me emotionally flat, but I don't seem to experience feeling high from positive things a lot. Could just be my personality, but it would be nice if I experienced this feeling of being passionate or really happy about something more once I'm off ADs.

 

In the less positive department: Muscles continue to be a problem. I seem to tense up unconsciously, which affects not just my back and neck, but also my jaw and abdomen this time. I don't know what's cause and what's effect, but nausea often shows up at the same time. Letting the tension go is difficult. There are days where it's not much of a problem, and days where I feel so crappy I take sumatriptan, regularly on the second day as well, and sometimes even a third. Grateful for working at home during this time.

Sleep-wise I often wake up around 5 am, sometimes feeling normal, sometimes somewhat agitated (thank you, cortisol spike). 

 

I'm somewhat hoping it's a winter thing, and improvements will come now that we're moving towards spring. On the other hand, that might mean next winter will be unpleasant as well. I do have a source of stress in my life at the moment, that probably isn't helpful either.

 

I'm not sure what I'll do regarding tapering at the moment. The original idea was to hold for 3 months, decrease a very small amount (1ml, which is 0.04 mg) and then wait several weeks again. Perhaps I'll wait until the source of stress has resolved somewhat. Either way, I wasn't planning to reduce much until at least June. I booked a holiday full of outdoor activities, so I want to feel well enough during that time. Looking forward to enjoying a holiday again!