ScottishLass: hello and some help please

[ScottishLass]

Hi @altostrata, thank u

On reflection I’m not sure I did ever feel ‘normal’ on Duloxetine.  It gave me an awful sense of ‘urgency’ most of the time.  Paradoxically I also had anhedonia and reduced motivation. I think I was also less filtered, a little assertive/aggressive and it was not maintaining my mood. In fact the anhedonia in my opinion from the drug fuelled depressive thinking. I also felt quite disconnected from everything a lot. 

 

When I took the zopiclone I slept- kind of. Very heavy head in the mornings and I think pulled down mood more. Some depersonalisation type feelings. Metallic taste in mouth. Rebound insomnia when stopped. 

 

Terror/panic has been mostly at night but have had some surges in day time. 

 

Thanks

 

 

[Altostrata]

It's possible that what you've had all along is withdrawal syndrome from Prozac, incompletely masked by duloxetine, which was too stimulating for you. 

It's possible a little Prozac, say 0.5mg, might help more than the duloxetine.

[ScottishLass]

 

23 minutes ago, Altostrata said:

It's possible that what you've had all along is withdrawal syndrome from Prozac, incompletely masked by duloxetine, which was too stimulating for you. 

It's possible a little Prozac, say 0.5mg, might help more than the duloxetine.

@Altostrata

Wow, I’d never thought of that possibility but makes sense given the lengthy time I was on Prozac. So, would it be ok then to just stop the  2mg Duloxetine and switch over to Prozac?  There was a suggestion at my last meeting of switching to Prozac as its easier to taper. No counting out beads with tweezers.  I was scared that would be another thing to get used to so agreed to stick with Duloxetine.  Unfortunately I don’t see the psych until July for new prescription........unless GP would agree. 
Thank you very much for your time

SL

 

[Altostrata]

If I were you, I might add 0.5mg fluoxetine in liquid form for a week. If that seems beneficial, then go off duloxetine, as it doesn't seem to help.

[ScottishLass]

Well GP refuses to prescribe Prozac until psych r/v. So now have to wait till July to even discuss. Excuse my French but **** these services that throw out drugs like sweeties. Then suddenly can’t help. Slam the door. 2mths to wait for a potential prescription. Meantime continue....with Duloxetine. Well, it’s not working. Its a fecking nightmare....2mths??..an hour is too long atm.  Why don’t they realise. What is the ******* point. 

 

 

[Rosetta]

Maybe someone else from the U.K. can chime in about what to do.  See a private doctor? Go to Emergency because of the insomnia and try to get Prozac that way?  Or put in a request for an earlier appointment with the psych due to the insomnia?

[ScottishLass]

22 minutes ago, Rosetta said:

Maybe someone else from the U.K. can chime in about what to do.  See a private doctor? Go to Emergency because of the insomnia and try to get Prozac that way?  Or put in a request for an earlier appointment with the psych due to the insomnia?

@Rosetta thank you.

NHS doesn’t really work like that. Chance of an earlier appt prob close to zero.  

Sorry for outburst yet again. I need to stop posting. 

SL

 

[Rosetta]

Someone might have an idea.  There are ways through bureaucracy, or ways around it.   You are sleeping 3 hours per night or possibly 4?  On the one hand, trust your body that you are getting enough, but I would not just accept that you have to wait two months.  That’s not reasonable.  

[Rosetta]

You could look at this.  Sometimes filing complaints is worse than not doing so but you could merely talk to an advocate to see if that person had ideas for you.
 

https://www.voiceability.org/about-advocacy/types-of-advocacy/nhs-complaints-advocacy

[ScottishLass]

8 minutes ago, Rosetta said:

Someone might have an idea.  There are ways through bureaucracy, or ways around it.   You are sleeping 3 hours per night or possibly 4?  On the one hand, trust your body that you are getting enough, but I would not just accept that you have to wait two months.  That’s not reasonable.  

@Rosetta once again thanks for support. The psych don’t care about the insomnia.  She’s aware of it and just said wait it out. I actually dont care about it either. I care about feeling so frightened and shockingly low with persistent, constant intrusive thoughts. I’m scared this won’t change. That I can’t withdraw or ever be normal again. 

[ScottishLass]

Sorry. I’ll stop posting this **** now. 

[Rosetta]

Oh, of course you are worried about that.  It’s not at all likely that you will continue to have these problems indefinitely, but feeling worried is normal when dealing with this syndrome.  It’s new to you, it’s strange, and it involves a lot of mental distress that you will learn to manage.  You are new at this.  Even when you are not, there will be times of doubt.  It’s considered one of symptoms by some people.  
 

Hold on, feed yourself well today, check out Claire Weeks anxiety stuff here, and try to get your mind off of the future.  You can do something about now, but not the future.   Here’s the Claire Weekes thread 

 

 

Edited May 19, 2021 by Rosetta
Added Claire Weekes link

[Rosetta]

I posted the video that had been lost earlier.  It’s on page 2

[Altostrata]

Perhaps you need a new doctor.

 

On 5/18/2021 at 7:41 AM, ScottishLass said:

Saturday 15/05

10.30am - Duloxetine (1mg) with food

1200 - black mood, tears, nausea + (no vomiting but sat at toilet bowl). 

1700 - Eat dinner

o/n - insomnia- slept 4-7am

Sunday 16/05

11am - Duloxetine (2mg) with food. Black mood

1200 - spontaneous crying. 

1300 - Ate lunch

Pm generalised nausea throughout. 

1800 - Ate dinner

2300 - Go to bed. Insomnia

1330 - 15.30 - increased RLS 

0400 - sleep

0700 - wake

Monday 19/05

10.45am Duloxetine 2mg with food. Black mood, spontaneous crying. 

11.45 Nausea

1300 Eat Lunch

1400 Stiff muscles and joints most of afternoon.

1600 Spontaneous crying

1800 Eat dinner

2300 Go to bed, insomnia 

1200 RLS but for short time (30 mins)

0300 nausea+ 

04.15 sleep

wake at 0500, 0615, 0630. 

0715 Awake

 

You said the nausea stopped but this does not appear in your notes. When did this stop? Please keep posting daily notes, 24 hours at a time.

[ScottishLass]

@Altostrata @Rosetta.....anyone with advice.

 

Is the suggestion of reinstating 20mg Duloxetine  with the view of then tapering more slowly a bad idea? Will it leave me with symptoms forever? Does that work for some?  Might it give me a period of reprieve or relative stability to be able to survive this then start reduction again? I’m desperate to get out of this current state. It’s kiling me. I’m lost in this and all ways out of it are scaring me. 

 

I am not myself.......at all......in any way.  I need some hope. This state is not manageable for much longer. 

Please don’t be angry at my question. 

[wantrelief]

Hello SL - I am so sorry you are suffering so much.  

 

Were you ever stable on duloxetine?  

 

2 hours ago, ScottishLass said:

Is the suggestion of reinstating 20mg Duloxetine  with the view of then tapering more slowly a bad idea?

Please keep in mind I am not a moderator and what I am saying is only from personal experience.  My sister discontinued duloxetine cold turkey and tried several other drugs to stop the withdrawal symptoms that eventually arose.  Not surprisingly, none of the other ADs would work to stabilize her. After several months (maybe 10 months - it was while ago so I don't remember exact details), she did reinstate duloxetine and stabilized on a higher dose than she was originally prescribed.  You have to be careful though as some people don't react well to reinstating a higher amount so that is why you've been cautioned to reinstate small amounts.  This is all so terribly frustrating and difficult as we all react differently to these drugs. I did want to let you know, however, my sister's experience as it did work for her.

[ScottishLass]

@@wantrelief

thank u so much for posting that.  I understand everyone is different. I am so glad your sister stabilised. I absolutely want off of these poisonous drugs but have to look at every angle.  I NEVER expected to be in this frightening place which is not sustainable unless maybe I knew it would be over....next week..next month. Thanks again for a different perspective. That is helpful. 

SL 🙏🏻

[Altostrata]

@ScottishLass I understand you are very frustrated and would like an immediate, definite solution. However, you need to stop convincing yourself that your current state is unbearable. You are experiencing moderate withdrawal syndrome.

 

It is odd your doctor would prescribe diazepam but not fluoxetine. You might contact him or her again and in a calm, level, reasonable voice, say you want to try Prozac again, by titrating up with the liquid. I would not mention withdrawal or tapering.

 

Further, I really really really need concise answers to my questions, or I can't even guess which way to go with your drugs. Without the information I request, your guess is as good as mine about taking 20mg duloxetine.

 

 

[ScottishLass]

Thanks and I thoroughly appreciate any responses. However,  I really don’t need to be judged on the ‘level’ of my withdrawal.  I also think I am the only one who can decide if this is ‘unbearable’ or not.   Spending every day trying to get through the next minute, feeling physically unwell, not sleeping, being unable to control rage, stop crying, having constant suicidal thoughts, struggling to function in any meaningful way and not knowing in any way when this will end to me IS unbearable.  I was in a FT job, living a mostly normal life prior to this ****. I am all too aware an ‘immediate’ solution is not possible but I am just trying to stop the current descent, save my job/home by being able to get back to work and survive. I am not ‘convincing’ myself of anything.  I am where I am.  If to you that is poor coping or not being positive enough...then I’m sorry, but you are very wrong. 

 

Re: the doctor.  As you know services are very different here.  The psychiatrist may well prescribe fluoxetine but my GP won’t.  The GP is the only contact until next Psych appt in July and they will not prescribe at this point.  I also did speak to them both in a ‘calm’ voice. 

 

I am unsure as to what questions you are asking that I’m not answering concisely? 

 

I thoroughly appreciate what this site does and am desperately trying to get information to make the right choice.  

 

Obviously I need to deny my current feelings, keep any despair and emotions to myself, beat myself up further that it should be  easy for me to manage and that my current struggle is my own fault and if I was stronger, clearer, more together I would be fine.  

I find this damaging. 

I understand. I don’t want this either.   

 

Heard clearly.  

Apologies for wasting your time. 

SL

 

 

 

 

 

 

[Rosetta]

Hi SL,

 

This is not the ideal form of communication for these sorts of things, but it’s all we have.

 

To answer your question about 20 mg of duloxetine: As for me, I wouldn’t risk a big dose like that of anything, of course.  It’s a mystery to me how some people get away with that.  There are “occupancy graphs” that show how powerful these drugs are at low doses.  They are quite powerful at 20 mg. I will edit this post to show one of them to you.
 

I would rather be the same than take the risk of feeling worse, but I have been through years and years of taking what a doctor told me to take and that resulted in me becoming completely incapacitated.  If you did get worse, there would be nothing anyone could do to fix it.  If you stay the same by avoiding risks, at least you continue to have recovery as slow as it may be.  
 

Having suicidal thoughts become more difficult to ignore is a real possibility.  If a person is highly sensitized because of WD, a normal dose of the drug is an overdose to that person.  This is why addicts die from drugs that can kill people, but with ADs, the toxicity has other effects — physical effects and mental.
 

At the very least you would want to extremely slowly work your way up to a higher dose.  Every time my doctor raised the dose of Zoloft, I became sicker and sicker because she raised it by 25 or 50 mg.
 

You are alone with no support — no one to catch you if you fall deeper into dysautonomia.  That is a very important aspect of the risk equation, to me.
 

You are not in a frame of mind that let’s you work logically or methodically through the responses you get to your posts.  Panic prevents our minds from even seeing the questions the Mods ask.  WD increases the effect of panic.  Anyone who thinks she will lose her job is going to feel panic until that possibility is removed.  It’s going to color every thought you have about what you should do next.  That can’t be helped.

 

So, let’s think about what you would do if the job wasn’t important.  If you didn’t need the income which risks would you take?  Would you let yourself heal as best you can until July and then ask for P?  Would you ask for a new GP?  Would you call the advocate office?  How would you handle this if you were to get your paycheck indefinitely whether or not you could work?  Compare your decisions about your options in that sort of world to the decisions you are making in reality.  This is just an exercise to let you imagine life without excessive panic.  I understand it’s not reality, but does it put things in perspective at all?
 

It doesn’t matter to you how sick you are compared to others.  If this is as confused and miserable as you have ever been, then it seems like a 10 out of 10.  However, I want you to know you are not lost; you are not so far gone — so sick — that you can’t make it through this.  You disagree.  That’s ok, but please consider my point of view and give the idea that you are able to stay in control a fair hearing.  
 

Unfortunately, when one is alone, one  will feel much more panicked about withdrawal.  You probably didn’t actually see two questions that Alto asked you.  It is easy to get fixated on one question when our brains are so scrambled.  So, maybe I can help:

 

I think answers to these two questions might help:
 

1. Please explain more about how you feel this terror. Does it occur at any specific times of day?

 

2. What happened when you took zopiclone?

 

No 1. I think Alto is hoping to determine whether D is possibly causing the feeling of terror.  If it is, then she will have different suggestions.

 

No 2. Alto is trying to determine whether Z is harmful to you.  Exactly how she figures out how to make these suggestions, I don’t know.  What the considerations are I can guess.  That’s it.  Guess.  She’s the only one who has the expertise to make these educated, experienced guesses.

 

Maybe if you had an option to reduce your fear right now — while you wait to see the psych — you would feel more in control.  It’s possible that the answers to these two questions will open up an option.

 

Rosetta

[ScottishLass]

@Rosetta

Thank you,  really.

I need to get my head together to read and think. 

P

 

[rubywednesday]

@ScottishLass, so sorry that things are not improving for you.  Where I live the advocacy service is CAPS, not sure about your neck of the woods. Alternatively there's the out of hours emergency service at the royal ed.  They may put in a request for an earlier appointment with the psychiatrist.  Do you have or could you get a CPN or is there one at your GP practice?  

 

I hope some of these suggestions get you the help you need.  Feel free to pm me if I can be of any more help.  I saw a private psychiatrist, bloody expensive but if you're desperate.

 

Ruby

 

[ScottishLass]

@rubywednesday thanks 🙏🏻 

@Rosetta thank you too for your post and sorry I haven’t responded.

Today was better.  I don’t know why, but woke up feeling ok, still only 3hrs sleep but fear less and black thoughts diminished.  Almost don’t want to say it or tempt fate.  Praying it continues.  Not sure if it’s due to increase in Reinstatement (10 days) or natural window?? 

Now that I can process, react more logically I will post notes if appropriate.  

Apologies for previous outburst. 

Hope everyone is doing well. 

Thanks again 🙏🏻

SL

[Rosetta]

Good. To wake up feeling ok is fabulous! A very good sign.
 

I think you should post notes.

[Rosetta]

Are you doing all right?  I hope so. -Rosetta

[hayduke]

Hey @ScottishLass, wishing you more stabilisation as you get used to your updose.

 

Cheers

[ScottishLass]

@Rosetta

On 5/28/2021 at 1:13 PM, Rosetta said:

Are you doing all right?  I hope so. -Rosetta

Hi Rosetta, Thanks for dropping by.

Yes thank you.  I’m hanging In there.  Still taking the 2mg Duloxetine.  I did unfortunately take diazepam a couple of times due to panic in the night and insomnia, which I was annoyed and quite scared about but I did get a few more hours sleep and got through a bad night.  Haven’t taken again though. 🤞🤞🤞
I feel something has eased over the last 5 days and things feel more manageable.  Whether that is due to reinstatement up-dose or a ‘window’....not sure.  Still up and down no doubt, but ok.  Insomnia still there but I’m almost used to it now.  Still tummy issues and some sickness.  Still emotional etc but  mostly feels currently manageable.  Saying that, I have isolated myself a lot and rarely leaving the house which I know is unhealthy.  I guess worried that I won’t manage ‘normal’ interaction, work etc.  I will have to I know and soon, but I’m just not going there in my head at the moment.  Other than that I think ‘ok’ is positive given where I was and where I thought I was going.  Sorry, I’m waffling. 
I hope you are good.  Thanks so much for your kind, intelligent posts.  I don’t think you realise how appreciative I am of them. ☺️

SL

[Rosetta]

You are welcome.  I’m passing along what was done for me to help me survive this awful experience.  I’m glad you are feeling better!
 

Rosetta

[ScottishLass]

@hayduke

On 5/28/2021 at 2:02 PM, hayduke said:

Hey @ScottishLass, wishing you more stabilisation as you get used to your updose.

 

Cheers

Thanks so much for your kind post. Really appreciated. 

SL

[Kris73]

On 5/24/2021 at 12:04 AM, rubywednesday said:

@ScottishLass, so sorry that things are not improving for you.  Where I live the advocacy service is CAPS, not sure about your neck of the woods. Alternatively there's the out of hours emergency service at the royal ed.  They may put in a request for an earlier appointment with the psychiatrist.  Do you have or could you get a CPN or is there one at your GP practice?  

 

I hope some of these suggestions get you the help you need.  Feel free to pm me if I can be of any more help.  I saw a private psychiatrist, bloody expensive but if you're desperate.

 

Ruby

 

Hi Ruby. 

Sorry to butt in, but I was interested to read you saw a private psychiatrist. Were they helpful? Were they more amenable to the idea of withdrawal symptoms in antidepressant withdrawal? Id be interested to know, because the NHS is so resistant to the idea.... I've already encountered it with a GP and a pharmacist....

Have a lovely day, best wishes

Kris73

 

 

 

[rubywednesday]

Hi Kris, I didn't go to the private psychiatrist to reduce the medication but she wasn't very helpful anyway.

 

Ruby

[Kris73]

1 hour ago, rubywednesday said:

Hi Kris, I didn't go to the private psychiatrist to reduce the medication but she wasn't very helpful anyway.

 

Ruby

Thanks, just curious. Think they're all cut from the same cloth....

[ScottishLass]

Bad, bad day today. So sad.  Feels like back to square 1. Is this what it's going to be like.  I feel like I'm supposed to feel grateful that I had some ok days but I can't.  When it crashes it feels like a sick joke.  Like your being taunted.  Wow.  

I am angry again. I want to track down every fecking dr that put me on, left me on these disgusting pills and I want them to hurt.  You absolute ****ers. I had the most shocking terror and panic today.   Where has this come from. Your ******* drugs because I never had this before.  However, it's starting to play games in my head.  What if this is me.  Not drugs.  Or if this is what I've become.  I don't recognise this person. I don't want this person. I'm scared of this. 

[Mark88]

I’m going though exactly the same thing it’s a nightmare,

but I do believe there is an end to it, I just don’t know when that will be. Please try to hang in there and try not to get angry, I find it just makes it worse 

[ScottishLass]

@Rosetta

Im sorry to tag you but I’m scared about everything and I just wanted to say it to someone.  I can’t interact with people normally because I have such a hair trigger response, my partner left last week to stay with his family.  I was glad as I felt relief that I am alone and at least won’t be feeling so terrible about being out of control and/or have the stress of arguments and bad atmosphere. That pressure is gone. This week I still think that’s a good thing but the ramifications of all of this and where I am is pressing. Work and accommodation could become a nightmare and I can’t think about it.   I still can’t sleep more than 3hrs, feel completely on edge - in my body and mind, Have nausea and diarrhoea.  RLS.  My muscles are stiff beyond anything I’ve known.  I am ruminating about everything, getting really angry with everything and I’m so scared.  I am trying to be mindful, trying to let go and manage the fear but these waves just wash over like a tsunami.  I’ve never had panic like this.  Never been consistently this low.  Had all of these weird physical symptoms.  How do I know what’s what? Is this withdrawal (I think it is mostly) or am I unwell. Sorry I know you can’t answer that for me.  I feel so lost and alone because if I speak to the Dr it will definitely be labelled as relapse...I know it. So I feel there is no support tnere. But I’m stuck, feel trapped in all of this.  I know I had a few ok days and that was such a relief, I cried with thankfulness that first day but even then it was only ok in comparison and now things are as they were. Is this windows and waves.  I feel like the thought of it continuing is too frightening.  I don’t know what to do. Is that because there is nothing I can do.  How do I get through this and keep going. 

[Rosetta]

Scottish Lass,

 

It is withdrawal.  There is no doubt in my mind.  I know that is very hard to understand because I found it hard to understand.  Withdrawal mimics many different illnesses.  
 

Yes, your doctor will probably be unable to understand.  In fact, I think the only doctors who understand have been through it themselves.  Even then, it’s possible the doctor did have a severe case.  Those doctors who do accept that withdrawal is real may not appreciate that the nervous system is incapable of handing normal doses of medications.  They may not accept that reinstatement of the drug that was discontinued can be unsuccessful.  They will find no support from their peers for proceeding cautiously with you, avoiding medications, and prescribing doses that are too low to be “therapeutic.”  
 

It’s true that you are stuck.  It’s NOT true that there is no way out.  The way out is through.  I know that feels unacceptable, and it is!  It’s is utterly unacceptable that a medication that was purported to help you harmed you.  It is unacceptable that a doctor can not help you make your way through the process of withdrawal back to good health.  You can go through this process, you can weather this storm, you can get healthy again.

 

You are right that feeling better and then worse is the windows and waves pattern.  Not everyone experiences it. Some people do not have wide swings.  They very slowly - imperceptibly — improve.  As disheartening as going from window to wave may be, getting that time without particular symptoms helps to convince those of us who get windows that healing is possible.  Some people start to feel less upset about waves as they realize that they signal that progress is being made in re-wiring the brain.  
 

I won’t try to convince you that if you think about this tragedy differently it will not be miserable.  It is only with hindsight that we can see that everything was going to be all right and should not have worried so much. I can tell you that you will heal, that you will be wiser, and that, someday, you will see that your emotions need not control your life.  You will see this with a clarity that would have been unlikely to occur otherwise.  Saying such things do not help you when your mind is literally torturing you.  
 

So, what I will say is this: search this site for strategies to get through your days.  My suggestion is that you Create soothing rituals and do not give up on them if they don’t work.  Establishing a routine takes a couple of months.  Do a sequence of things in order— One for when you wake up, one for when you feel overwhelmed and one for when it is bedtime.  For instance, if you feel overwhelmed, 1. drink some water, 2. eat some protein, 3. go for a walk or do a moving meditation, 4. take an Epsom salt bath,  5. drink more water amd eat a bit more including protein, 6. paint or color or read (whatever you can do).  If you keep doing these things in a particular order you will come to find solace in that ritual.  

 

Do the same when you wake up and at “bedtime” which you could call “evening” if you don’t sleep.  You will start to feel comfort in these rituals.  They will make you feel in control and as if you know what is going to happen for the periods of times you are doing them. Waking up amd going to bed or having your normal bedtime arrive probably cause you a lot of anxiety.  Practice your ritual for anxiety at those times.

I used to play violin when I felt overwhelmed.  I started to realize that I did that at a particular time of day.  However, having some protein and water when one feels anxious and overwhelmed is important.  So, doing that first before you start the activity is a good idea.  Your blood sugar levels will stabilize while you are doing the distracting activity.  Eating after the activity will help to prolong the blood sugar level.

 

I hope this helps you.

 

Rosetta