Roxanne13: Tapering off of fluoxetine

[Roxanne13]

I’m new to the site and looking for some guidance and insight into my taper. I started taking fluoxetine in July of 2018 for depression and anxiety. I started at 10mg a day and over a 6 month period worked up to 40mg. Over the course of the pandemic i continued to up my dosage until I got to 80mg a day in January of 2021. I also take propranolol as a migraine preventative 10mg twice a day and as needed for anxiety/panic attacks which is usually once a week. And I take dextroamphetamine XR as needed for focus, but I avoid it if I feel my anxiety is kicking back in. Sometimes I’ll take it for 4 days in a row and sometimes I won’t take it for a month. I also cut caffeine out of my diet. I’ve been in therapy since February and have developed a bunch of good coping mechanisms and lifestyle changes that made me feel like I could try going off of the SSRI’s. I’ve been going down 10mg each week since mid July, but after reading a few posts I’m wondering if that’s too fast. I’m currently down to 30mg a day. Some days are totally fine and I feel really good about the taper and some days I wake up in a totally nebulous depression. I’m currently in a sort of an emotional haze. I can’t really say I’m depressed about anything in particular which is typical of my depression. I just stop caring. Unfortunately one of my coping mechanisms for depression in the past has been to self medicate with alcohol and I feel myself slipping back into that. I’ve been so up and down though the last few weeks I don’t know if maybe this current feeling of apathy will fade away tomorrow. Right now I feel like I could just stare at a wall all day or sleep for a week. Thanks for reading.

Edited August 31, 2021 by getofflex
Added other meds I take

[getofflex]

Hello, and welcome to SA.  We are a peer owned and run forum of people who have been or are getting off of psychiatric drugs.  Congratulations for getting off of fluoxetine!  This is a significant accomplishment.  Thank you for giving us your drug signature. 

 

Here is some information about how these drugs actually work.  This will help you understand why you are having the symptoms.  

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

 Video on Recovery from Psych Drugs

 

What is Happening in Your Brain

 

 

Tapering is best done extremely slowly, and we generally taper by 10% of the current dose no more than once every 4 weeks, so that the taper becomes exponentially smaller.  You are having symptoms because you are reducing the drug at too fast of a rate.  What other symptoms are you having besides depression? 

 

 Why Taper by 10% of my Dosage  

 

Tips for Tapering Fluoxetine

 

 

Also, as we are recovering, we suggest keeping things slow, simple, and stable. This is extremely important. 

 

Keep it Simple, Slow, and Stable

 

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

 

Omega 3 Fish Oil

 

I strongly suggest you avoid alcohol (and any other mind altering substances) completely.  This is likely to aggravate your withdrawal symptoms by further destabilizing your system more than it already is by the tapering.  I also suggest that you stay on your current dose of fluoxetine, and your other drugs for a long time, to allow your system time to heal, stabilize, and settle down.  Give it at least 3 or 4 months.  Be careful about taking the precise same dose at the same time each day, and don't miss or skip doses.  Your system needs as much stability as you can give it, to allow it to heal.  Then, when you feel stable, you can resume your tapering.  

 

I see there is a major drug interaction between fluoxetine and dextroamphetamine, so I would quit taking the dextroamphetamine altogether if I were you.  Here is what drugs.com says about this interaction: 

 

FLUoxetine with dextroamphetamine

Applies to: fluoxetine, dextroamphetamine

Talk to your doctor before using FLUoxetine together with dextroamphetamine. FLUoxetine may increase the effects of dextroamphetamine, and side effects such as jitteriness, nervousness, anxiety, restlessness, and racing thoughts have been reported. Combining these medications can also increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. 

 

There is a moderate interaction between fluoxetine and propranolol.  Drugs.com says: 

propranolol  FLUoxetine

Applies to: propranolol, fluoxetine

Using propranolol together with FLUoxetine may increase the effects of propranolol. Contact your doctor if you experience uneven heartbeats, shortness of breath, bluish-colored fingernails, dizziness, weakness, fainting, or seizure (convulsions). If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs.

 

 

I've given you quite a bit of information here.  Please read through it, take your time to digest it all.  Feel free to ask any questions.  Hang in there, and let us know how you are doing. 

[Roxanne13]

I so wish I had found this site before I started to taper. I decided to go down 10mg each week just because that’s the dosage of the capsules and when I told my doctor she had no problem with it. She didn’t say anything about withdrawals or bring up tapering with a liquid. It makes me pretty angry actually. If I had known I never would have tried to go off in only 2 months. 

Other than the depression I also have a loss of appetite, foggy brain and almost zero energy. I’m not motivated to do anything and my life is really suffering. I’m at the end of grad school and now my grades are slipping and I’m wondering if I should take a month off to get myself stabilized. I actually feel physical anxiety when I think about school projects that need to get done and I have a severe inferiority complex. Not to mention that the work I’ve been doing for years that I love I now no longer care about. The only way anything in my life gets done anymore is if I force myself to do it. 

I’m currently down to 30mg but maybe I could go up to 40 and hang out there for awhile? I definitely want to write to my doctor and ask for a some other delivery method besides 10mg capsules so I can do smaller reinstatements or tapers as I continue this journey. 

Another thing, and I’m not sure if this is okay to post publicly so I can remove it if I need to, but I forgot to mention in my first post that for the last few months I’ve been microdosing fungi and wondering if I should stop that as well? 

[getofflex]

On 8/31/2021 at 4:48 PM, Roxanne13 said:

I so wish I had found this site before I started to taper. I decided to go down 10mg each week just because that’s the dosage of the capsules and when I told my doctor she had no problem with it. She didn’t say anything about withdrawals or bring up tapering with a liquid. It makes me pretty angry actually.

Oh, this is so typical of what I hear here every day.  These doctors are so clueless about psych meds and proper tapering and withdrawal.  There is no money to be made in going off the drugs, so the health care industry just sweeps this whole dependency and withdrawal issue under the rug.  Many of us are angry about this too.  

 

On 8/31/2021 at 4:48 PM, Roxanne13 said:

’m currently down to 30mg but maybe I could go up to 40 and hang out there for awhile?

How long have you been at 30?  It would help if you could make your drug signature more detailed with respect to dates and dosages of each dosage change, especially with respect to the fluoxetine tapers.  That way, we can give you the best advice on tapering or updosing.  So I assume you have been on the 30 mg dose since the end of July?  That is a little over month.  I wouldn't go up to 40 again, I would try going up to 32 mg.  If you make too big an updose, it could actually make things worse, because it further confuses your nervous system with too big of a drug change.  If you do OK at 32, then you could updose a little bit more.  Get some liquid fluoxetine - that will make it easy to change your dose by these small amounts.  Here isa link with information about reinstating/updosing. 

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms 

 

Edited September 2, 2021 by getofflex

[Roxanne13]

Just updated my signature. I cringe looking at it because I just had no idea what I was doing and now I’m in this WD space. The apathy/anhedonia is the worst part of it now and I can’t really explain it to anyone. I’m asking my dr for liquid Prozac but at the moment I only have 40mg capsules and 10mg capsules. 

[getofflex]

23 hours ago, Roxanne13 said:

I’m asking my dr for liquid Prozac but at the moment I only have 40mg capsules and 10mg capsules. 

Then stay on the 30 mg until you can get the liquid.  Get the liquid as soon as you can.  You don't want to jump around on your dose, as this is likely to make your WD worse by further destabilizing your nervous system.  Then, when you get the liquid, updose to 32 mg.  Give it at least several weeks to give it a chance to settle in your system, and we will take it from there.  

[Roxanne13]

Thank you so much for all this good info! I’m definitely going to hold my dose here for a month. I do not want to make this any worse. Oddly enough when I asked my doctor for liquid she approved it but also put in the notes to taper down by 2.5mg every 4 weeks. Completely different from her original notes which had me going down 10mg every week! I already have a good taper plan now that I’ve found this site, but I just found it interesting that she altered it so drastically.