MarvinC: Fluoxetine cold turkey, long withdrawal

[MarvinC]

Hi. I took paroxetine for anxiety for about 4 years and a half. Last year i started to reduce my dose from 40 mg to 30mg then to 20 mg. I had withdrawals symptoms during taper, mostly related to nausea, stomach problems and flu like symptoms. Eventually the worst symptoms faded away after a couple of months and i kept taking 20 mg paroxetine for a little while, but considering how difficult it seemed to quit, i suggested a cross taper with fluoxetine to my doctor and he agreed. 

 

This strategy seemed to work alright and last march i stopped taking paroxetine and stayed with 20 mg fluoxetine. At some point i felt like my body wasn´t absorbing the medication well and i had some withdrawals, as if my dose didn't nothing anymore. So at that point i decided to bite the bullet, so to speak, and i just stopped taking the medication, which my doctor said typically "was no problem" because of half life and whatever . First days i had some symptoms but nothing terrible, i was also taking about 1 mg of klonopin 4 times a week, which seemed to help a little bit with the symptoms. 

 

4 weeks after my last 20 mg dose i started to feel weird again, this time with occasional bouts of dizziness, nausea and flu like symptoms, for example i feel very hot in my face without having a fever. Also i started to feel very angry and irritable for certain amounts of time, like waves of anger that came and went. I tought that maybe these were the last symptoms and i decided to toughen up and bear it. What worries me is that almost 5 weeks have passed and while some days are more bothersome than others, there doesn't seem to be a complete remission of my symptoms, which are not completely incapacitating but certainly annoying. Klonopin seems to help a bit but after the effect is gone, the symptoms come back. 2 months have passed since my last dose of fluoxetine and i don´t know if i should try to reinstate at 10 mg or a smaller dose and see if i improve and taper slowly from there. Sadly my doctor doesn't seems to be of much help and he only gives me very generic indications because probably he doesn't have a clue.  

Edited June 25, 2021 by Gridley

[Gridley]

Welcome to SA, Marvin C.  Thank you for completing your drug signature.

 

Regardless of its half-life, Prozac can and does cause withdrawal if not tapered slowly.  The symptoms you're experiencing are typical of withdrawal.  So that you have a better idea of what you're experiencing, here is some information on withdrawal and the healing process.

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

The Windows and Waves Pattern of Stabilization

 

When we take psychiatric medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

 

These explain the healing process really well.

 

Brain Remodelling 

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

You mentioned reinstatement.  Right now you have two basic options:

 

1.  Wait it out.  While some recover fairly quickly from withdrawal, others takes longer and there is no way to predict how long it will take.  Every person is different.

 

2.  Reinstate a very small dosage of your previous drug, in your case Fluoxetine.  Reinstatement is the only known method to mitigate withdrawal symptoms. You're within the time frame (3 months after last dose) that reinstatement most predictably works.  Sometimes reinstatement work and sometimes it doesn't.  Please read:

 

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

 

If you reinstate, I would recommend a dosage of 2mg Fluoxetine--no more.  During the time you've been off the drug since your cold turkey, your system has become somewhat acclimatized to not having the drug.  Reinstating too much can overwhelm your system and destabilize you further, lengthening the time it will take for you to stabilize.

 

Prescription liquid Fluoxetine would be the easiest and most accurate way to reinstate.  There are other methods, including making your own liquid and weighing with a digital scale.  All are described in the following link:

 

Tips for tapering off fluoxetine (Prozac)

 

If you reinstate, it will take 4 days for the reinstatement to reach full strength in your blood steam and a few days longer to register in the brain.  So be patient.  If you need to reinstate more after this time has passed, you can increase by a little.  But keep us informed so we can guide you.  If you feel worse after the reinstatement, stop the reinstatement immediately.

 

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 are single ingredient (not mixed with other types of supplements).

 

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

 

 

 

 

 

 

 

 

 

 

 

[MarvinC]

Thanks for such a detailed response, i really appreciate it. I'll give it a couple more days, i've felt slightly better the last 2 days. I forgot to add that i had a bad experience with a HTP5 supplement last week, it made me feel better but after it washed out of my body the withdrawal symptoms came back stronger. I will consider reinstatement at 2mg only if my symptoms worsen. Again, thanks for the advice. 

[MarvinC]

Update:

 

I think i made a mistake, i want to make an update on my situation to see if someone can offer and opinion. Since i don´t hace access to liquid fluoxetine i started taking 20 mg one day and one day not. About the third day i started to have allergy like synptoms that didn´t resolve with antihistamines so i assumed it was a withdrawal symptom so i started taking 20 mg everyday. The allergy like problems continued, but they started to dissappear gradually, instead of that, my anxiety skyrocketed, i was doing pretty fine before in that regard, aside from the withdrawal symptoms. The strange thing is that the first really bad anxiety attack was in the middle of the night a few hours after taking fluoxetine. Was it too much after quitting it 2 months before or is a relapse in anxiety? it´s very confusing. I know anxiety can be a side effect of fluoxetine but i didn´t get it last time i took it. 

[michael12345]

Very similar story to you Marvin. Quick tapered paroxetine from 50mg - 0 over 3 months and had hellish nausea/ flu like symptoms ever since ( July 2020). I reinstated back to 20mg and for periods it takes the edge off but are still here. My advice is to reinstate to a level where the symptoms were manageable. I'm on the benzo too Clonazepam.. does not work enough to say it works but calms me down a little. 

 

I guess time will heal this or not- its a b***h mate- but you have time to even reinstate to the highest level as usually reinstatement doesn't work from 3 months onwards, i'm a year in. 

 

GL bro!