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Ashelado: Mild SS or Withdrawal? Catch 22


Ashelado

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Hello everyone.

 

I have been on antidepressants for 8 years now, with almost no break. I have tried over 10 and found some to work for a while, some never worked, and some had bad side effects so I stopped taking them. In the Summer of 2018, I started taking Nardil. It helped me the most. For about a year I felt amazing. After it stopped working I switched to Parnate 40mg. I have been on that for 8 months. I decided to see how I would feel without antidepressants so on July 12th I started tapering from Parnate. I went from 40mg to 0 in 3 weeks. As I was tapering, there weren't many withdrawal symptoms that I experienced. After I fully tapered I started feeling fatigued throughout the day, lost my appetite, was nauseous, low motivation, etc. It wasn't unbearable, but after 2 weeks of not being on anything I decided to ask my Psychiatrist to try Nardil again. We started on 30mg for a week and then went up to 60mg. 2 days after taking 60mg I woke up feeling like a completely different person. My heartrate was beating extremely fast (120), I felt a loss of sensation in my body in terms of temperature, higher pain threshold, like I was physically and emotionally numb, I am unable to feel tired at all. My depression and anxiety are at an all time high, I can barely function. I went to the ER and thought I had serotonin syndrome. They told me to stop taking Nardil for 3 days and see if symptoms improve. I stopped taking it for a week but nothing changed. I thought it might be the Parnate withdrawal. A week ago I started taking Parnate again. I took 20mg for a week, and today I went up to 30mg. I am feeling slightly better, but the insomnia, numbness, anxiety, tachycardia is still present. I am not sure if this is mild serotonin syndrome or if I am experiencing withdrawal.

Was on various SSRI from 2013 to 2018

Nardil: June 2018 - October 2020 (60mg)

Parnate: October 2020 - July 2021 (Tapered from 40mg in 3 weeks)

Nardil: August 15th - August 27th (30mg 1st week, 60mg 2nd week, discontinued due to adverse reaction)

Reinstated Parnate: 9/4/21 (30mg)

                                  9/20/21 (27.5mg)

                                  10/18/21 (25mg)

                                  11/15/21 (22.5mg)

                                  12/13/21 (20mg)

Levothyroxine: 2017 (25mcg)

 

 

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  • Moderator

Dear @Ashelado,

Welcome to SA.  

To get you started, and to be able to give you pertinent information, we ask members to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements in a vertical list format.  This link can help you with that:

Account Settings – Create or Edit a signature.

 

I'm glad you're feeling slightly better, though the remaining symptoms suggest your nervous system is in turmoil.  In my experience, it is possible to experience serotonin syndrome and withdrawal symptoms simultaneously.  Are you taking any other drugs or supplements?   These can also add to both conditions.   I recommend readin:

What is Withdrawal Syndrome?

Serotonin Syndrome or Serotonin Toxicity - 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 

Melatonin 

 

 

To cope with your symptoms, I recommend browsing under:

symptoms and self care   

Non Drug Ways to Cope with Withdrawal Symptoms

 

Please keep us informed about how you're doing as stabilizing your system is a crucial priority right now.  These links address this issue:

About reinstating and stabilizing to reduce withdrawal symptoms

Considerations About Stability Stop Jumping Around  

Keep it Simple, Slow, and Stable

 

This is your Introduction site where you can ask questions, record your experience, and connect with other members.

I'm glad you've found us. 

Arbor

 

 

 

Zoloft: 1995 - 2015

Prozac: 2015 - 2018 (tapered from 40mg x day on July 31 to 30mg on August 31 to 20mg on September 31 to 10mg October 31 to 0mg on  December 15, 2018

Gabapentin: 2016 to 2019  (tapered from 300mg x day to 150mg on August 31, 2019 to 75mg on September 15 to 50mg on September 31 to 25ishmg on October 15 to 0mg on December 1, 2019

Enalapril: 2010 - 2019

Lipitor: 2017 -2017

Metformin: 2000 - 2020

Liothyronine: 2007 - 2019

Levothyroxine: 2000 - 

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Thank you @arborfor the introduction and all the links. I've gone through them and have been lurking the forums for the past week now. My current situation is described in my signature. I am confused as to what my issue currently is. Withdrawal from Parnate, serotonin syndrome from Nardil, or both? If its serotonin syndrome wouldn't that mean I can't stabilize at 30mg Parnate? But If I go down too fast then SS symptoms might get replaced by WD symptoms. I'm not sure what to do at this point. I've been on 30mg for 5 days now.

Was on various SSRI from 2013 to 2018

Nardil: June 2018 - October 2020 (60mg)

Parnate: October 2020 - July 2021 (Tapered from 40mg in 3 weeks)

Nardil: August 15th - August 27th (30mg 1st week, 60mg 2nd week, discontinued due to adverse reaction)

Reinstated Parnate: 9/4/21 (30mg)

                                  9/20/21 (27.5mg)

                                  10/18/21 (25mg)

                                  11/15/21 (22.5mg)

                                  12/13/21 (20mg)

Levothyroxine: 2017 (25mcg)

 

 

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  • Moderator

Thank you, @Ashelado--I'm going to send your questions to the moderators right now.  In the meantime, could you please redo your signature so that it only includes dates, pscyho-drugs, dosages in a vertical list.  No symptoms or reactions.  You can use mine as an example.  This is to make it immediately accessible for others reading it.  Here's the link again:   

Account Settings – Create or Edit a signature.

 

 

Do what you can to avoid stress, as you figure out your next step.

Zoloft: 1995 - 2015

Prozac: 2015 - 2018 (tapered from 40mg x day on July 31 to 30mg on August 31 to 20mg on September 31 to 10mg October 31 to 0mg on  December 15, 2018

Gabapentin: 2016 to 2019  (tapered from 300mg x day to 150mg on August 31, 2019 to 75mg on September 15 to 50mg on September 31 to 25ishmg on October 15 to 0mg on December 1, 2019

Enalapril: 2010 - 2019

Lipitor: 2017 -2017

Metformin: 2000 - 2020

Liothyronine: 2007 - 2019

Levothyroxine: 2000 - 

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Thanks, I've fixed up my signature.

Was on various SSRI from 2013 to 2018

Nardil: June 2018 - October 2020 (60mg)

Parnate: October 2020 - July 2021 (Tapered from 40mg in 3 weeks)

Nardil: August 15th - August 27th (30mg 1st week, 60mg 2nd week, discontinued due to adverse reaction)

Reinstated Parnate: 9/4/21 (30mg)

                                  9/20/21 (27.5mg)

                                  10/18/21 (25mg)

                                  11/15/21 (22.5mg)

                                  12/13/21 (20mg)

Levothyroxine: 2017 (25mcg)

 

 

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  • Moderator

Thank you, @Ashelado,

Someone will be able to look at what you're going through and help you decide where you're at.  As you know, the medical establishment isn't currently interested in helping people get off these drugs with any reliable sudies.  We're here to assist as fellow sufferers of the situation.  From my experience, and not as a doctor, I would suggest you're feeling the effects of too rapid a taper, combined with too high a reinstatement.  These are protocols your doctor should know, and should've known before ever prescribing you medications.  

You may find this recent publication by Alto interesting:

What I have learnt from helping thousands of people taper off antidepressants and other psychotropic medications

****** FramerSurvivingAntidepressants.org, San Francisco, California, USA

First Published March 16, 2021 Review Article

Abstract

Although psychiatric drug withdrawal syndromes have been recognized since the 1950s – recent studies confirm antidepressant withdrawal syndrome incidence upwards of 40% – medical information about how to safely go off the drugs has been lacking. To fill this gap, over the last 25 years, patients have developed a robust Internet-based subculture of peer support for tapering off psychiatric drugs and recovering from withdrawal syndrome. This account from the founder of such an online community covers lessons learned from thousands of patients regarding common experiences with medical providers, identification of adverse drug reactions, risk factors for withdrawal, tapering techniques, withdrawal symptoms, protracted withdrawal syndrome, and strategies to cope with symptoms, in the context of the existing scientific literature.

 

Full text: https://journals.sagepub.com/doi/full/10.1177/2045125321991274

 

No matter what, self care is going to be very important for you.  It's really all we have, plus the wisdom of wiser moderators, and fellow members.  You want to keep your system as calm as possible.  Eat well and gentle exercise.  I imagine you know these things.  The brain can become very negative and panicky during this phase.  Try to remember it's not "you".  I like this link on Neuro-emotions.

 

I will check in with you again💜

Arbor

Zoloft: 1995 - 2015

Prozac: 2015 - 2018 (tapered from 40mg x day on July 31 to 30mg on August 31 to 20mg on September 31 to 10mg October 31 to 0mg on  December 15, 2018

Gabapentin: 2016 to 2019  (tapered from 300mg x day to 150mg on August 31, 2019 to 75mg on September 15 to 50mg on September 31 to 25ishmg on October 15 to 0mg on December 1, 2019

Enalapril: 2010 - 2019

Lipitor: 2017 -2017

Metformin: 2000 - 2020

Liothyronine: 2007 - 2019

Levothyroxine: 2000 - 

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  • Administrator

Welcome, @Ashelado

 

On 9/11/2021 at 11:09 PM, Ashelado said:

after 2 weeks of not being on anything I decided to ask my Psychiatrist to try Nardil again. We started on 30mg for a week and then went up to 60mg. 2 days after taking 60mg I woke up feeling like a completely different person. My heartrate was beating extremely fast (120), I felt a loss of sensation in my body in terms of temperature, higher pain threshold, like I was physically and emotionally numb, I am unable to feel

tired at all. My depression and anxiety are at an all time high, I can barely function.

 

The MAOIs such as Nardil or Parnate are rarely prescribed because of their adverse effects and complexities in switching from one drug to another. You are under the care of a psychiatrist. Did you report your reaction to your psychiatrist? What did your psychiatrist do?

 

Rather than withdrawal, your symptoms indicate excessive stimulation from too-high dosage of an antidepressant. This is not serotonin syndrome but serotonin toxicity. Probably, Parnate had not completely washed out of your system when you started Nardil. Your doctor raised it to too high a dose and failed to adequately monitor what happened. The combination caused an adverse reaction that in their training, psychiatrists are exhorted to avoid.

 

This part was probably Parnate withdrawal:

On 9/11/2021 at 11:09 PM, Ashelado said:

After I fully tapered I started feeling fatigued throughout the day, lost my appetite, was nauseous, low motivation, etc. It wasn't unbearable,

 

It appears this has resolved by your reinstating Parnate. Otherwise, it may take you some months to recover from the bout of serotonin toxicity.

 

As this is a site for going off drugs and your situation is a bad psychiatrist-directed switch, I don't know what we can do for you except to advise you your psychiatrist made a very dumb medical error and you probably should find another psychiatrist who better understands MAOIs.

 

Please let us know if you would like help tapering off a psychiatric drug.

 

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • 3 months later...

Hey. I've been weaning off of Parnate after reinstating, going down 2.5mg every 4 weeks. That whole Nardil ordeal I had has gotten better symptom wise, but I'm still not myself. Insomnia, paranoia, depersonalization have passed, but the extremely high anxiety, depression, and tachycardia have persisted. Anhedonia has gotten somewhat better as well. The biggest hurdle is the anxiety and depression which prevent me from interacting with anyone, including my family. I can't even do my internship the way I am now and had to drop out of it. Don't have any questions, I'm just venting.

Was on various SSRI from 2013 to 2018

Nardil: June 2018 - October 2020 (60mg)

Parnate: October 2020 - July 2021 (Tapered from 40mg in 3 weeks)

Nardil: August 15th - August 27th (30mg 1st week, 60mg 2nd week, discontinued due to adverse reaction)

Reinstated Parnate: 9/4/21 (30mg)

                                  9/20/21 (27.5mg)

                                  10/18/21 (25mg)

                                  11/15/21 (22.5mg)

                                  12/13/21 (20mg)

Levothyroxine: 2017 (25mcg)

 

 

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