panphyni: roller-coastering around

[panphyni]

Hello everybody, 

 

I'm new to this forum and very excited to have found a community of people, who understand. Usually I'm not the best with posting, but I'll try my best to keep this thread updated. Sorry if this will be a bit longer. 

My journey begins back in 2011 when I was 16 and was brought to some sort of mental hospital, for I was bulimic for 1,5 years and couldn't really "live" anymore. There, we had no choice but take the meds they gave us, which was Adjuvin (i think eventually 50mgs) and Mirtabene - no idea about the dosage, I just found out last week that this is an antidepressant as well, and not a sleeping pill like they told us.

 

After those 6 weeks and coming back home, I still struggled with bulimia, depression and self-harm into my 20s. Mirtabene I think I just quit at one point, because I thought I can just stop sleeping pills, and also I sometimes misused the drug and took a couple to not have to make it through another day. From 2012 to 2017 I don't remember much, I think I just took Adjuvin 50mgs throughout. 

 

In 2017 I tried to quit Adjuvin - which of course failed miserably, as I was not under supervision or anything (also, the mental hospital didn't prepare us for the future - how to proceed with the meds? etc., so my parents just where happy I took it and that things were okay-ish). I saw my first psychiatrist ever, who then put me on Escitalopram (5mg) and upped to (10mg), which I took for a while. 

 

In 2018 I wanted to quit again, for I was in a relationship and the sexual side-effects were really annoying. I cannot remember if I went CT or not. However, this was the first time I thought I discovered my sexuality, for I had not been able to experience it before due to Adjuvin. And this picture got stuck in my head - this sexual liberty is what I was deprived of. After a couple of months, a bad goa-festival with drugs in between, I had to go back to my medication, it was just hell. My psychiatrist then reccommended adding Bupropion (150mg) to dodge the sexual side-effects, which we did and to me it seems this was the best combination for me so far. I went to NZ for a while etc and had good days! So good, that in May 2021 I decided to taper down Escitalopram to 2,5mg. I was still driven by the sexual experience I had back then, feeling like my libido being caged by the medication. This time I was in touch with my psychiatrist and he said, I can just stop the meds (!!!), don't need to go down slowly. I, however, didn't listen and stuck with the 2,5mg, which eventually also turned out not to be the optimum. Back to 5mg in October. 

In October 2021 I saw a new psychiatrist, asking again for a possible solution to have no sexual side effects. He said I should drop the escitalopram and double the Bupropion to 300mg - which I didn't do, it seemed very risky to me. I saw another psychiatrist: on December 3rd, she made me exchange my Escitalopram(5mg) with Duloxetin (30mg), upping the dosage to 60mg after one week. I was super irritable and aggressive, told her it didn't feel quite right. She then wanted to stop Duloxetin within ONE WEEK, I said "hey wait that seems super super fast", so she reccommended I go down to 30mg for a week, and then start taking it on alternating days. I trusted her on that one, and then had a complete crash on December 30th, where I smashed my head into the floor and had the full range of WD symptoms for 2,5 weeks. I could neither walk, talk nor look at things properly, brain  zaps, etc. you name it. I saw her again, asking for help - she said we're gonna stick to this regimen, as we are seeing some improval. Another 2 weeks go by, I tell her that I'm not okay - and I'm desperately looking for solutions. 

I asked if she had any experience with Microdosing - and then the whole conversation changed, she got very personal, loud and unfriendly, I felt treated like a junky (please excuse), just trying to get access to mushrooms. I had told her that I used to smoke pot before all that rollercoaster ride, so in her eyes I was already depraved in that sense. I don't care if it's considered a drug - if it was pickle-water, I would take it! She prescribed me Venlafaxin, saying: "let's just hope there are no side-effects" and left me in this state. After the Duloxetin CT and now this session I had lost all my trust in her. 

 

So I saw another psychiatrist (and goddamn, how to afford all that?). He then asked if I ever got diagnosed with borderline or adhd, which I declined. Since this was the time I had taken 2 capsules of St. Johns wort, he was upset and said "Now we have to wait for 2 weeks until I can prescribe something". So he gave me a prescription for Seroquel - which I just dont want to take, I am afraid by now of taking new meds since the last experience of WD. I've seen 4 psychiatrists within the past 7 months, all of them seemed so reckless and insensitive - have they never heard of withdrawal? Do they simply not care? Are they listening to my needs/questions? 

 

Last saturday (19th february) I started taking microdoses of truffles (1mg), because I just feel lost and don't want to go back to an SSRI. Ever since the Duloxetin CT, I've felt weird, uneasy and like things are just "off".  I've been trying my very best to help my healing - I go running/hiking 3 times a week, meditate, talk a lot about my thoughts, write down some stuff etc - with little success. At the moment I have this sensation of feelin "ill" in my head, whereas my body is just fine, and of course I'm left with million questions: 

- Is it still withdrawal? (New shrink says nope!)

- Is it the 300mg Bupropion my body cannot handle?

- Will it get better if I just hold on for another week or 2?

- Is this the right path?

- What happens if I really pick up the Escitalopram again? Will it work the same way? How long will I be out, starting an SSRI again now after 3 monthts?

- What role do the truffles play now? should I stop?

.... 

 

All questions that have no answer for me - but finding this forum and reading through it, however, I feel like I found an answer to my first question: I feel confirmed in my assumption of still fighting the withdrawal symptoms. As of yesterday, I am considering going back to my Escitalopram on a low low dosage (even if it feels like a big step backwards), coming back to a normal situation and then try a properly done taper in the future. Of course I'd still wait, as I have taken those truffles. But I'm still not sure, I'm just considering it right now. 

My "suffering"-tolerance is very low at the moment, and each hour spent in bed feels like a nightmare - so I am just really sucking on my last resources of patience, and I am looking for solutions everywhere. I'm even considering going down with Bupropion to 150mg, cause the 300mg didn't seem to do much. ButI know I should consider this reasonable approach of reinstating the Escitalopram, even if it means that I might be out again for 2 weeks. 

 

I feel super lost and lonely on this ride, since everywhere I turn to doesn't seem like a safe place. Even my best friend said stuff like "how long have you been dealing with this now? 11 years? shouldnt you come off it? what have you done to make it possible?" "you dont even manage to not drink for a month" "i will not visit you in case you might land in a hospital" "why do you need external (meaning meds/truffles) things to heal you?" blabla bla. 

 

Thank you so much for giving me the space to write down my thoughts here, it feels good to get them out of my head. I'm looking into my future with hopes, I know that I just need to be patient with myself. Thank you. 

 

[Onmyway]

Dear @panphyni, 

welcome to SA. I am so sorry you have been suffering on this rollercoaster of drug changes and switches and CTs. 

From what I am reading it seems like your nervous system is very sensitized and the addition of any new drugs may cause things to get worse. On top of that, it seems like you are having adverse reactions to bupropion. How do you feel after you take the bupropion (within a couple of hours)? Do any symptoms ramp up? 

 

I am not clear if you are taking 300mg bupropion right now. In the text you say you refused but in the signature you say that's your dosage. 

 

What we find is that people who stop and start psychotropic drugs, switch, skip doses or forget to take them end up with a sensitized nervous systems esp after withdrawal. This makes reinstatements hard as well. Sometimes they are also very sensitive to other psychoactive substances esp alcohol, pot, street drugs, supplements and antibiotics. Some usually calming medicine may end up having paradoxical effects on them. 

 

If I were you, I would not make any changes, would stop all alcohol/microdising even vitamin D/coffee/ St John's Wort etc and try to stabilize. If we find out that the bupropion ramps up your symptoms, we may need to cut it faster than we would usually recommend. 

 

I am linking some more info on reinstatement. If you do decide to reinstate, we'd recommend a more 'benign' drug than escitalopram. Perhaps citalopram or prozac and a very low dose (0.5-1mg). We find that sometimes a dose that low will take away symptoms while also minimizing the risk of things going bad with reinstatement as in your case it might be risky. 

About reinstating and stabilizing to reduce withdrawal symptoms - Symptoms and self-care - Surviving Antidepressants

 

Pls let me know how how bupropion makes you feel and what you think about my suggestions above. 

OMW

Edited February 23, 2022 by Onmyway

[panphyni]

Hello @Onmyway,

 

thank you for this thorough answer. I'm sorry if this is going to be long, too. 

It might be sensitized, it is of course hard to tell for me. And surely I don't want to do any further harm. Yes, my current dosage is 300mg of Bupropion, sorry, it is unclear in my text. I refused to do it the first time it was recommended, since it was just a one-time appointment with this doc. 

The past 3 months I've had alcohol 4 times, so I keep it on the lowlow already - only one time I felt like a glass, and all the bottles I opened tasted bad to me (I took a glass of wine which i then diluted with syrup so it would taste okay-ish). 

In the beginning, when we started the 300mg bupropion only, I couldn't stand coffee (which I loooooooooved) and my appetite was gone, I think I lost 3kgs, which are back on my hips by now for sure, though. But I'm back to liking it right now. 

 

I looked up adverse-effects of Bupropion, could only find one study, however. I don't have most of the symptoms, mainly that weird "ill" feeling in my head - last time I tried to explain it as if there were 2 internal tubes on each side that are pumped with water, but have no release on the end and therefore there is this constant pressure with the feeling like I'd have 38°C of fever (but yeah, the body is fine) and something right in the front of my forehead, like a square that is "activated" and puts some sort of small pressure. It mostly comes sometime in the afternoon and lasts into the evening. In the mornings I'm kind of okay, I have to study a lot atm and therefore I can tell immediately when there's a switch. But my focus is bad in general. Also, I'm avoiding all social contacts outside the house. I'm living in a flatshare with 3 other people, 2 of them know about my situation very well and I get full support. But I realize very soon that sometimes those conversations get too much for me and I'm exhausted and impaired by this ill-feeling, last time we had dinner I also had this sudden instinct of wanting to flee the situation.

Sometimes I feel like I kind of hear things (don't know if this counts as hallucination)- like I think I hear somebody coming home, but then there's nobody. It's very subtle, but irritating - especially when I meditate I seem to feel a lot of the vibrations in the floor when people walk (but how could I verify that one?...). Naturally, everything in my perception now is scrutinized, so maybe I just pay more attention to things now... 

 

I do feel some time pressure on myself - in a month it's my good friends 30th, in May my flat and friends will go to Czech Republic for a concert, in June to the Netherlands, in August there's a festival and another 2-days festival. Also, there are many exams I have to write, and I'm working 20hours in a store. So I feel like "I have to and absolutely want to function as soon as possible".  (which is not the right approach, I know)

Regarding the reduction of bupropion: I was really considering it - however, last May when I was on 150mg Bupropion and 5mg Escitalopram, I tried to reduce the latter - and it didn't work out well. So if I now reduce the Bupropion to 150mg without any SSRI, I feel like this solution is also doomed to fail. 

So basically I don't have many options: 

- I either wait and don't do nothing to see how things will turn out further 

- I wait, don't change nothing and keep on microdosing

- I reduce Bupropion to 150mg

- I reduce Bupropion to 150mg (or keep it at 300mg) and reinstate Escitalopram on a low dose, or Citalopram on a low dose

 

I'll try to analyse my body and disposition today in detail, to see if I can make out any other effects the 300mg Bupropion might have and post in case I realize something. 

Thank you very much 

 

 

[Onmyway]

Hi @panphyni

from your description, it seems like your symptoms are bearable and you can keep your daily activities. In that case, I would suggest that you stay on the current dose until you stabilize (you haven't given me information to help decide whether it causes adverse drug reactions in you). You don't need to look up the recorded side effects of bupropion, just need to observe whether anything changes within an hour or so after taking bupropion - it could be nausea, more pronounced anxiety, more rumination etc. It is also possible that nothing changes. 

If nothing changes we would advise you to get stabilized on this dose and then if you decide to come off of it, taper properly at 10% per month. 

We do not give advice on what drugs to add, what drug cocktail to choose etc. those are things that your doctor does. 

 

I would strongly advise against any psychoactive substances incl. alcohol - some people have had severe setbacks for years from just one drink. Note this is not a moralistic recommendation (I personally don't care whether you drink/do mushrooms etc), I am sharing the experience of people who have drunk a glass many months into withdrawal when they were feeling well and then had a severe setback that made left them worse for months. What you do is up to you and you are the only one who is going to bear the consequences. We are only providing what we have learned. If things go terribly wrong we will only be able to say how sorry we are, we have no magic bullets to fix them (neither does your doctor - Antidepressants and the Placebo Effect (nih.gov)). 

 

Hope you feel better soon, 

OMW

[panphyni]

@Onmyway@Onmyway yes, the worst symptoms are definitely gone, the rest are somewhat bearable, its mainly this ill-feeling that makes it hard, I don't know if this is an adverse reaction... and the anxiety accompanying me and keeping me inside, which I hope will fade too and might stem from my brain readjusting. It's just hard to tell: whats the bupropion's effect and what stems from the sort of cold turkey stop? And is it possible to stabilize? Like jn the sense of the anxiety going away, so I can resume some sort of social life? 

 

My next appointment is next week, I'll keep track of my emotions and symptoms and stick to this dose.

I'll stop the truffles for now, maybe in the future or not anymore at all, it was mainly an emergency reaction of me trying to find help in something. 

Thank u very very much for your answer

Edited February 23, 2022 by panphyni

[panphyni]

Getting worse again atm - cannot look people in the eyes anymore.  waiting till the end of march for an improval (then it will be 4 months off of escitalopram and 3 months after the duloxetine ct)- otherwhise I'm going to reinstate, because the way it has been for the past days is just too much and the downwards spiral doesn't seem stop. 
Right now, I just can't wrap my head around how things should become better, when there is no sign of it at all - there is no guarantee it will pay off and I'm too weak to hold on for much longer. 

[panphyni]

So another couple days passed - I was not sure whether my mood stemmed from my period or not. But now a couple days past and I am sure it was not just my period. 
I just don't understand, how 300mg Bupropion just seem to do nothing. 

Yesterday morning was very bad, also today feels like a bad start. Also my nice bike got stolen, which is just one element in life that is super important to me. Uni is starting again next week and I'm just not ready. 

I had another psychiatrist appointment this thursday - we spent 45minutes doing questionnaires, where he added the points in the end just to tell me that it is not clear what my diagnosis might be. 200 euro bill straigt into my email.  We talked again about me not having started the Seroquel (apparently it is likely to make you gain weight and make you tired - what solution is that? I come from an eating disorder, how could this benefit me?). Then he proposed starting a benzo. I asked about reinstatemet and being afraid of an adverse reaction - he said that this is bullsh*t and it doesn't happen. 
Why are there different claims about this topic? "bullsh*t"? 
Whenever I refer to this forum of being my current source of trust and guidance, everybody downgrades it by "... it's the internet" "people start pills for different reasons" "you cannot assume other people's effects are gonna happen to you" "people have to accept their diagnosis "

 

The last 2,5 months I've spent 1100bucks on psychiatrists, and it's been my worst investment - my main reason for switching were the sexual side effects - and yesterday I watched a video where people said duloxetin is used to prevent premature ejaculation (I know effects might differ from person to person) - but it just left me speechless, that she would prescribe this very pill to me for my request of avoiding sexual side effects. 

 

Yesterday my flatmate gave me one drop of his fullspectrum-cannabis oil, which really got me out of the gloomy mood I was in, but it didn't carry me through the day. 
Reinstatement is what I'm considering the most rn, as I seem to have lost my energy to meditate, write and reflect about life, and also sports decreased to a minimum, social contacts as usual non-existent. I just don't know yet when to start again and how to proceed with the 300mg bupropion - I'd want to go down to 150mg. 

 

 

 

[panphyni]

Ok... So I'm giving up. I'm thinking about puking and hurting myself, feeling the urge to do it... 

I cannot hold on anymore. 

I just took 1,25mg escitalopram and hope to get back on the old track to maybe taper off slowly at some point in the future with a knowledgeable psychiatrist 

[panphyni]

Increased to 2,5mg Escitalopram, feeling some side effects concerning my vision, forehead tingling sensations, tinnitus, but not too impairing. Can go to uni but not focus. 

1,25mg really gave me a booster in my mood, it was not good, but the gloomy mood disappeared and I could even laugh again (1,25mg! I cannot believe docs tell me to just CT 5mg if some amount so small already has such an effect).

Will stay here for a while, until I stabilize a bit and then will try to come back to Bupropion 150mg, like it used to be. 

 

 

 

[panphyni]

Been back on 150mg of Bupropion for a while now, was the best decision - my anxiety levels dropped significantly. I stayed with 2,5mg Escitalopram... And I was doing better, but my flatshare situation worsened extremely , and over the past few months I've been an emotional "scaffold" for 4 people around me with issues too, and 2 other painful experiences + covid left me now in a weird state again. I feel ill all the time, have no energy, for sports and am quickly exhausted by everything... But I'm supposed to study so much and just cannot. 

Immediately I worry again, that 2,5mg might not do the job... But also I'd love to be able to stay here at this amount and make it, but right now it doesn't seem very promising... I don't know how things should just get better without me being able to move much or to meet people much 

[panphyni]

Not getting much better anymore, actually worse. 

How could I know whether I'm experiencing some sort of residue of discontinuation, or if I actually suffer from long covid? I'm really thinking about upping to 5mg again, I can neither do sports nor maintain a stable mood nor focus on my exams nor I don't know... 

[Onmyway]

@panphyni, 

during withdrawal our nervous system is destabilized and, as a result, highly sensitized. Jumping up and down on your medicine can make that much worse. You have just decreased your bupropion by 50% in April (based on your signature). That will have long term effects (months) and you may not feel better for a while. This jumping up and down is hurting you. 

Have a look at these threads if you haven't already. Also have a look at the reinstatement topic I posted earlier. 

 

Important topics in the Tapering forum and FAQ - Tapering - Surviving Antidepressants

Why taper by 10% of my dosage? - Tapering - Surviving Antidepressants

Why taper? SERT transporter occupancy studies show importance of gradual change in plasma concentration - Tapering - Surviving Antidepressants

 

Are We There Yet? How Long Is Withdrawal Going To Take? - Tapering - Surviving Antidepressants

Non-drug techniques to cope with emotional symptoms - Symptoms and self-care - Surviving Antidepressants

 

The Windows and Waves Pattern of Stabilization - Symptoms and self-care - Surviving Antidepressants

What is happening in your brain? - Symptoms and self-care - Surviving Antidepressants

How psychiatric drugs remodel your brain - Symptoms and self-care - Surviving Antidepressants

 

From your reports I am not sure if you are trying to come off of your drugs or if you are trying to find an 'ideal cocktail'. It is up to you which you choose, we have no opinion on the matter. However, if it is the latter, then we can't help you. If it is the former, please look at the links that I have posted above. 

OMW

Edited May 11, 2022 by Onmyway

[Altostrata]

On 5/11/2022 at 10:33 AM, panphyni said:

Not getting much better anymore, actually worse. 

How could I know whether I'm experiencing some sort of residue of discontinuation, or if I actually suffer from long covid? I'm really thinking about upping to 5mg again, I can neither do sports nor maintain a stable mood nor focus on my exams nor I don't know... 

 

It is possible you have both protracted withdrawal from duloxetine and after-effects of covid. If new symptoms arose after you got covid, those symptoms are from covid. 

 

We don't know anything about long covid here. It appears that coping with the symptoms, many of which, like withdrawal, appear to be autonomic, is all you can do.

 

We cannot recommend a drug cocktail to resolve long covid or protracted withdrawal.