Sharkmouth: 12 Years Tapered in 5 Weeks

[Sharkmouth]

First, I hope you all had a wonderful Christmas.

 

I’ve been spinning my wheels not knowing when I’ll be back in purgatory. Lately I’ve been there more than I’d like and was particularly deep yesterday. I’ll circle back to this.

 

I had a panic attack 12 years ago and went to the ER. They ran tests and my potassium was at a 1. They gave me iv lorazepam and sent me home with a few to hold me over til I could see a go. In my appointment my doctor just assumed the diagnosis of the ER and told me I would need to be on an antidepressant. I told him that didn’t make sense to me as I had never been depressed and have always been sensitive to meds. He assured me using them off label was common practice and that I’d be fine. After our discussion he said “So would you like Prozac or Zoloft?” To which I of course told him, “Isn’t that more your area of expertise?”. We settled on Zoloft. We started immediately the same day at 100mg. I took this for months without any change (minus exponential weight gain and total disregard for my gf. Didn’t fix anything but Ativan was helping still and I was being extorted (for lack of a better term) to keep taking them or lose the Ativan. After 5 years I at least got them to lower to the dose to 50 mg.

 

After still having daily panic attacks and facing that they were going to keep me on this medication, I started researching that perhaps an SNRI would work as the mechanism of action included norepinephrine. I was on that for 5 years. In the throes of my worst panic attacks after taking Duloxetine, my thoughts of “what if I lose control of my sanity” became “what if I lose control and kill myself” however fleeting, were still very jarring. I brushed it off to the panic attacks evolving. 

 

Fast forward to May of this year, I told them if they wanted to take the Ativan they could, but I was getting off the medication. Was still crescendoing into a panic attack everyday for 12 years. Only change? 30 pounds from Zoloft and a bonus 40 pounds from Cymbalta. I eat and have eaten for the past 5 years like fitness gurus could only dream of. Still, no weight loss.

 

May 12 I started 30mg of Cymbalta down from 5 years at 60mg. 7 days later I was at 20 my. 7 days later I was alternating 20 every other day and then every 2 days til I was out. Taper was just around 5 weeks. I felt the zaps, however not only in my head but throughout my chest. As well as what I can only explain as jolts. As if someone has attached a TENS unit inside my chest. Also upon beginning the taper I had elevated anxiety, muscle pain and severe impairment to my cognition. I also experienced memory loss, irritability, dizziness and fatigue. All of this I was able to handle as I’m a bit of a brute. However, midway through I started getting intrusive thoughts in regards to suicide. As I decreased in dose they increased in frequency.

 

On June 18th I had my final dose. Thoughts were gone for the most part. Full body shocks had become infrequent. I almost immediately started becoming obsessed that anything I eat could make me sick. I forced myself to eat and the thoughts would move the goalposts as these types of thoughts tend to. Then if I were trying a new restaurant, that restaurant was going to make me sick. I faced it all down through what I now realize was some sort of built in exposure luckily I have built in. Other thoughts would come up and I’d do well with them. July 3rd I had a thought of committing suicide that it triggered the “freeze” response to which I had previously thought was only “fight or flight”. This thought stuck and there was nothing fleeting about it. Again, I’ll spare more details unless they’re asked of me but, suffice to say, I still have suicidal intrusive thoughts. Sometimes I wish I had compulsions to find myself some sort of respite, but alas, that would be terrible as well. Throughout all of my appointments while on these meds I never scored anywhere near depression during diagnostic testing. I was also on antidepressants purely for panic attacks with no comorbidity, so “relapse” is completely off the table as the panic never even went away haha. Yesterday at Christmas dinner I was at the table and had the thought of killing myself, with no specificity. Followed by a thought of “Bet I would’ve killed myself if I were back home.” 

 

So I’ve posted here for a slew of reasons, the selfish being that I’d love to know if you have any advice. I.e starting an SSRI for a full course of 9+ months and then slowly tapering or if there are other options. I have zero desire to kill myself and these thoughts are absolutely not my conscious thoughts. A therapist I just hired believes I have OCD and he just can’t find the compulsion. Regardless of a diagnosis, these thoughts are distressing and therapy alone I fear is not going to be enough to quell these anytime soon. Especially if like in the case of the creator of this community, it lingers for 11 years. I’m 36 and aside from being overweight from those meds, I’m actually incredibly fit and physically healthy. I’ll be adamant in this again, I do not wish to harm myself and have no plan to. I’ll be relaxing and will get crushed with those thoughts. It feels like an uncontrollable urge and my brain has me worried I’ll eventually be overridden.

 

Please let me know if any of you have any ideas. I’ve gone full Malcolm Gladwell on this topic and could help anyone dealing with most of this stuff. Mine is just slightly a bit out of my depth. I’ve seen 5 psychiatrists and they’re all not worth their salt. I’m seeing a brilliant Neuro that I adore on Wednesday and am going to bounce some ideas off her but she hasn’t the experience you actually do in the trenches. 

 

Sorry for the run on sentences, ill-formatted paragraphs, and typos I’m sure I missed. I just wanted to get the words down. 

 

I appreciate your time whether you’re able to respond or not. And thank you so much for advocating for the voiceless.

 

Edited December 28, 2021 by ChessieCat
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[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  You have come to the right place.  Your doctor certainly sounds pretty glib and flippant.  I'm sorry to hear of the shoddy treatment you've received from the medical community.  You are not alone - many of us here feel the same way.  

 

It sounds to me as though you may have had a paradoxical reaction or adverse reaction to the antidepressant drugs, but that the benzos (Ativan) was helping you.  You were forced to take the AD's, to keep your Rx for the benzo.  Sheesh.  (smh). 

 

Would you say the panic attacks while you were on the Cymbalta, and the Zoloft, were worse than they were before the drugs, or the same, or less severe?  I'm trying to determine if you had an adverse reaction, or if the drugs just didn't work.  

 

To make sure I'm understanding correctly, you are altogether off antidepressants?  Do you still take any benzos, or any other psychiatric drugs? 

 

Can you please give us specific information about your drug history for all drugs you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise vertical list (no symptoms), only drug names, specific dates (as best you can say for example early March if you don't recall the day) and dosages of each medication decrease or increase.  Use this format:

 

Drug name: date, dose, date, dose, date, dose…

Drug name: date, dose, date, dose, date, dose…

Etcetera

 

Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Drug History in Signature

 

Here is some information about how these drugs actually work.   This explains why we get symptoms from going off of these medications.

 

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

 

Windows and Waves Pattern of Stabilization

 

 

Also, as we are recovering, we suggest keeping things slow, simple, and stable. 

 

Keep it Simple, Slow, and Stable

 

 

Here is a link with checklists of common WD symptoms: 

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

 

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

 

Finally, going back on a small dose of your drug, or increasing your dose, which we call reinstatement, is best done very carefully.  This is temporary, and after stabilizing you would then taper gradually off of this.  There is some risk involved, and we need more specifics about your drug history before we can suggest a good dose at which to reinstate.  We don't suggest reinstating at a full dose, due to the danger of kindling.  Here is some information about reinstatement.  

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

There is quite a bit of information here.  Take you time to go through it.  Hang in there, and eventually, we will help you get through this.  The key to recovery from this is lots of patience, and time.  Keep us posted. 

Edited December 27, 2021 by getofflex

[getofflex]

PS. the suicidal thoughts are not uncommon during withdrawal.  The trick is to realize they are just thoughts, you don't have to act upon them, and to let them float on by.  

 

Acknowledge, Accept, Float

 

Suicidal Thoughts in Withdrawal

[Sharkmouth]

Hey GetOffLex,

 

Thank you so much for reaching out. I fixed my signature to have my schedule. 
 

I still had to take Ativan everyday throughout my course of the SSRI’s and still do. Luckily I’m on the lowest dose of Ativan and ONLY take it to intervene a panic attack, so although taken daily, it’s never at a specific time of day. However I’m optimistic, I’m sure that has the potential to be an issue all it’s own down the line. I certainly don’t enjoy taking them. 
 

You’ll see in my amended signature that I started another run of SSRI’s as I was in crisis and being plagued by intrusive suicidal thoughts. This was their best course of action, none of them even acknowledged that “Discontinuation Syndrome” was a possibility. However a relapse would be impossible as all I had was panic disorder. Even the current therapist I’m with for the intrusive thoughts can’t for the life of him figure out why I have panic. And he’s a specialist… Anyways, I had to stop the Lexapro as I developed uncontrollable twitching in my lower extremities that eventually made its way to my elbows, forearms and on occasion, my temples and eyebrows. Thankfully a neurologist just recently diagnosed it as Benign Fasciculation Syndrome and is positive it will resolve one day. After coming off the Lexapro In early October I hadn’t had the horrible suicidal IT’s until December 10th. Now it’s been a nice little two week run of them daily til Yesterday I finally got a day off. Today’s been a bit rough.

 

Let me know your thoughts.

 

Best Regards,

 

Chris

[getofflex]

According to your drug history, 

 

"July 15th: Lexapro 5mg, July 30th: Lexapro 10mg, Aug. 12th: Lexapro 15mg, Sept 10th: Lexapro 10mg, Sept 22nd: 5mg, Sept 24th: 25mg Sertraline, Oct 9th: Last Dose".  

 

Q: What day did you stop taking the Lexapro altogether?

 

Q: What was the starting and ending date of Sertraline?  

16 hours ago, Sharkmouth said:

I still had to take Ativan everyday throughout my course of the SSRI’s and still do. Luckily I’m on the lowest dose of Ativa

What dose is that?  Please add the Ativan to your drug history in your signature box - thank you.  We can address the Ativan at a future point.  That can be tapered down the road. 

 

You have had a quite a few changes to your psych meds in the recent past.  You did a fast taper off Duloxetine, then went on Lexapro, then back off in 2 months, then had a brief trial of sertraline. Our nervous systems crave stability, and the more we go on and off drugs, the harder it is on our nervous systems - this tends to destabilize them, and can cause kindling.  Read this link about kindling.  

 

Post Withdrawal Nervous System Hypersensitivity, and Kindling

 

Hopefully, you read my links above about stability. Here is another similar thread: 

 

Considerations About Stability - Stop Jumping Around

 

I believe that if you do some non drug, natural ways of taking care of yourself, you will slowly but surely heal from this condition.  

 

• healthy eating at regular intervals
• gentle walks if you are able, each day as possible
• avoid negative people
• plenty of fluids
• get outside with fresh air and sun 
• get out in nature
• develop a spiritual life
• do activities that your enjoy, that relax you and are not complex or demanding
• practice good sleep hygiene
• stay away from avoidable stress, and try to destress and simplify your life as much as you can
• stay away from alcohol and any mind altering substances altogether

Go ahead and try the magnesium, and the omega-3, as described above.  Please keep us posted, and let us know how you are doing. 

[Sharkmouth]

September 23rd was my last dose of Lexapro before I went over to Sertraline. We stopped the Lexapro cause of the twitching. October 9th was my last dose of Sertraline. The twitching hadn’t stopped so they took me off it all together. 
 

I’ve read all the articles you’ve sent to me, some twice. I’m very thankful for them. 
 

Basically most of the withdrawal symptoms have resolved except for the most unsettling one, the depressive suicidal thoughts. I read the link you sent me, some pretty grim posts on that thread. I’m guessing it’s my serotonin trying to regulate but understanding the mechanism doesn’t help how I end up feeling. It feels so very real. Sometimes it’s a few minutes, sometimes (last night) it’s hours. 
 

That’s the only reason I was asking about re-initiating. NEVER had a single feeling this in my life Til 3 weeks after my last dose of Cymbalta. I was getting intrusive thoughts but I could handle those. These make me feel like I need to check myself into a psych ward. Again, I’m very happy overall. However this happening certainly dampens my mood. 
 

I eat incredibly healthy and exercise. I’ve been trying mediation and mindfulness. Whatever is happening, completely overrides everything. It’s almost like a panic attack how it comes on. 
 

As for my Ativan I wake 1 mg a day. 2 halves throughout the day. Some days i only need one half. About 4 years into this journey I started feeling like I might need more than one, so I started breaking them in half. There have been occasions where I’ve taken more on a certain day than another, but never for multiple days in a row. 
 

I’ll add it to my signature.

 

I read about the kindling, not much that I’ve read mentions my particular issue. Some people who are very upset about their situation and have thought about suicide. That’s not what’s happening with me. I’m not sad, I have no plan, no will to do anything. I’ll be relaxing, or eating dinner, or working out, and then get crushed under this depressive urge. It feels like blinders are being put on my cognition. When it was just thoughts I was able to acknowledge them and accept them. I even did some exposure with them. I feel like it just opened the door wider to this strange phenomena…

 

Thanks for taking interest. More than I can say for the medical “professionals” I work with.

 

Best,

 

Chris

[getofflex]

On 12/28/2021 at 6:41 PM, Sharkmouth said:

I’m not sad, I have no plan, no will to do anything. I’ll be relaxing, or eating dinner, or working out, and then get crushed under this depressive urge. It feels like blinders are being put on my cognition

You have had a lot of drug changes to your psych meds in the past year, I'm counting about 14.  This is a lot for your nervous system to handle.  If you read the links above on what these drugs do to our brain, and about withdrawal, you will see that our brains become dependent on them, and it takes a long time for the brain to adjust each time a drug change is made.  There are probably billions of nerve cells whose receptors become downregulated when we are on the drugs, and now must up regulate as we reduce the dosages, and get off of them.  This take a lot of time, as the nervous system is very complex.  When we make drug changes too fast, the nervous system can't keep up, and we get symptoms.  You mention suicidal thoughts, and cognition issues.  Both of these are common WD symptoms.  I'm glad you have no plan for suicide.   Please realize that thoughts are only thoughts, and a brain in WD can certainly create bizarre and disturbing thoughts.  One of our main coping strategies for negative withdrawal thoughts is to not listen to them.  Here is a technique that can help: 

 

APPLE Technique

 

I just came across a very nice technique that really helps me.  It's called APPLE. I have printed it and have it where I can see it every day and be reminded of it so I internalize this technique. 

 

A - Acknowledge Notice and acknowledge the thought or uncertainty as it comes to mind. 

 

P - Pause Don't react as you normally do.  Don't react at all.  Just pause and breathe.   

 

P - Pull Back Tell yourself this is just the thought or worry talking, and this apparent need for worry or analysis or certainty is not helpful and not necessary.  It is only a thought or feeling.  Don't believe everything you think.  Thoughts are not statements or facts.   

 

L - Let Go Let go of the thought or feeling.  It will pass.  You don't have to respond to it.  You might imagine the thought floating away in a bubble or cloud.   

 

E - Explore Explore the present moment, because right now, in this moment, you are OK.  Notice your breathing and the sensations of your breathing.  Notice the ground beneath you.  Look around and notice what you see, what you hear, what you can touch, what you can smell.  Right now.  Then shift your focus of attention to something else - on what you need to do, on what you were doing before you noticed the thought or worry, or do something else - mindfully - with your full attention.  

[Sharkmouth]

It feels like so much more than thoughts when it’s happening. The intrusive thoughts I’ve gotten a handle of. This is the thoughts accompanied by complete demoralization. My neurologist thinks it’s Dysphoria. That, compounded with the thoughts I’m having is the single most terrifying thing I’ve ever faced in my life. It’s hard to even type right now without sobbing. I’ll have symptoms from WD I can handle all day. The extra pyramidal symptoms, fine. I feel like my only choices are roulette. I feel like I risk something happening with the Dysphoria takes over and I’m not strong enough to fight it off or go back on and even then. Who knows?! I didn’t have any adverse effects on Zoloft, it just didn’t work and I gained weight and my libido took a hit. I know nothing on here is meant to be taken as direct medical advice but I have no idea what I’m supposed to do. The weird sensations, lightheadedness, cramps, erratic vision stuff, bring it on… but this ailment absolutely terrifying. Any help would be much appreciated.

 

Best Regards,

 

C

[getofflex]

On 12/31/2021 at 6:51 AM, Sharkmouth said:

It feels like so much more than thoughts when it’s happening. The intrusive thoughts I’ve gotten a handle of. This is the thoughts accompanied by complete demoralization. My neurologist thinks it’s Dysphoria. That, compounded with the thoughts I’m having is the single most terrifying thing I’ve ever faced in my life.

 

I can just tell you what helped me.  I, too, have had depression/dysphoria.  What helped me, is to have a very strong faith in God and in Jesus.  I've had a lot of bad things happen to me throughout my life (trauma and abuse).  However, I believe that God has a purpose for my life, and that gives me hope and optimism.  I also believe that there is an afterlife that will be so much better than life on this earth.  Why not try reading our forum "Finding Meaning" that talks about spiritual things?  I personally believe that I need a bigger purpose in my life besides just myself to be happy and fulfilled.  Many, many people have been demoralized by all the stuff going on with COVID.  Our society is still in chaos from this.  

 

I tend to get depressed in winter, but I accept that.  I tell myself that spring is only a few months away, and when spring and summer come, I tend to feel better.  I get outside and enjoy nature a lot with walks and hikes.  By the way, I take walks almost everyday outside.  This can help a lot with dysphoria/depression.  

 

On 12/31/2021 at 6:51 AM, Sharkmouth said:

The weird sensations, lightheadedness, cramps, erratic vision stuff, bring it on

This stuff is just your brain being in withdrawal.  Eventually, these symptoms will gradually decrease in time, and resolve.  

Edited January 6, 2022 by getofflex