kestrel28: on various SSRIs and antipsychotics for 30+ years

[kestrel28]

Hello, everyone, 

 

My name is kestrel28,  and I have been on a huge variety of psych meds since 1991 when I was first diagnosed with panic and OCD and anxiety.  

For many years I was taking 60 mg prozac and klonopin (to dull the edge of the prozac).  

 

After a while, the prozac did not do its job--it was the poop out effect.  So,  I had drs. prescribe other antidepressants (lexapro, paxil, zoloft).  all which did not work with me.  

 

So, I went back on prozac when those did not work, and, I noticed that the prozac did not do the same thing that it did the first time.  So, I was given some antipsychotics to take (zyprexa, seroquel, abilify, and rexulti).  Not all at once.  

 

The only one that seemed to work for me was rexulti.  The only problem I have had after being on this for about five years is the super weight gain (over 40 pounds), carb cravings.  Whenever I did taper and get off of it, I lost a lot of weight, even on the prozac.  

 

So, I am wondering if what I am experiencing here is kindling (the sensitivity) to being on and off two drugs:  prozac and rexulti.  

 

For a long time (from 2020-early 2022),  I was taking 20 mg prozac and .5 mg rexulti and 1.5 mg klonopin.   I  thought I was doing A-OK.   Only, I had so sexual feeling, was emotionally blunted, and I was feeling extremely fatigued.  

 

I told my psychiatrist that I wanted to go off the rexulti for good, because the weight gain was unbearable, and I was afraid of becoming diabetic.  

 

This was AFTER I had discontinued prozac for about a month and a half (february 2022 to late march 2022), because I wanted to have my sexual feelings back.  

 

Long story short, I am off the rexulti for good, BUT,  I am back on the prozac (been on 20 mg for 12 days),  and I am feeling nauseous, and it feels like I can feel my nerves tingling like I had just had 6 cups of coffee.  

 

I need to know if this sensitivity of my nervous system trying to re-establish a medication many times?  

 

Thanks in advance. 

[Shep]

 Hi, Kestrel.

 

Welcome to Surviving Antidepressants. 

 

On 4/8/2022 at 8:34 PM, kestrel28 said:

Long story short, I am off the rexulti for good, BUT,  I am back on the prozac (been on 20 mg for 12 days),  and I am feeling nauseous, and it feels like I can feel my nerves tingling like I had just had 6 cups of coffee.  

 

I need to know if this sensitivity of my nervous system trying to re-establish a medication many times?  

 

Yes, it's likely some of your symptoms are nervous system dysregulation from going on and off various drugs. But it's possible that the antipsychotic was covering up some of the agitation caused by the antidepressant, so some of your symptoms may also be a side effect of the Prozac. You may benefit from reducing the Prozac dose. Reinstatements work best at very small doses. According to your signature, you went off fluoxetine cold turkey in February and then reinstated at the full 20 mg in March. You may want to reduce the Prozac to 10 mg and see how you do. Prozac has a very long half life, so even when you go cold turkey, it stays in your system for several weeks. 

 

On 7/2/2011 at 2:11 PM, Altostrata said:

Prozac has the longest half-life of any SSRI. After you take it for a few days, half-life is about 16 days. Fluoxetine itself has a half-life of 2-4 days, but as it is processed, your body creates an active antidepressant metabolite, norfluoxetine, which has a half-life of 7-15 days. So Prozac keeps on extending its half-life as it is metabolized.

 

 

Here are some links for more information on reinstatement and tapering. 

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

Tips for tapering off fluoxetine (Prozac)

 

Why taper by 10% of my dosage?

 

The Windows and Waves Pattern of Stabilization

 

Please update your signature to include your full drug history. The first post in this thread will show you what we need included:

 

How to Summarize Your Drug History in Your Signature

 

As you provide more information, we can help you set up a taper strategy. I'm concerned that you stopped an antipsychotic after being on that class of drugs for several years. So please let us know more about how you came off Rexulti. 

 

As you provide a complete drug history, we'll be able to help you set up a game plan for coming off these drugs. For now, you may want to go ahead and reduce the Prozac to 10 mg and see if that helps. 

[kestrel28]

Well, I did decide to go off rexulti somewhat gradually.  Not from .5 mg, but then .25 mg for two weeks and then stopping it.  

 

Rexulti is the only one antipsychotic I have used in the past 5 years, and at relatively smaller doses.  

 

 

[kestrel28]

15 days in, on 20 mg prozac, and my nerves feel on edge, like I drank a pot of coffee.  I made sure that I didn't have any caffeine today.   

 

I called up my dr., and he wanted to take me off prozac again!  Without tapering.  I told him I would stay on until our next meeting.  He then snapped at me and said "Well why did you call me in the first place?" I said "because I am feeling very shaky".   He said "Well, please don't call me from now until the appointment".   

 

He then suggested that since I was running out of options regarding other medications,  he decided that next time we talk I would maybe try tricyclic antidepressants or MAOIs.  

 

I don't want to take any of those!  

 

One of the only reasons I am staying on the prozac is this: I heard that it is extremely beneficial if you are on a benzo, (I am on Klonopin) 1.5 mg per day, and they say to have an SSRI in your system helps if you are going to taper off of klonopin. 

 

I am so sick and tired of the shell games that drs. play with meds!  

 

 

[ChessieCat]

18 hours ago, Shep said:

You may want to reduce the Prozac to 10 mg and see how you do.

 

[kestrel28]

Thanks ChessieCat. 

 

I was just thinking about that today.   I think it would be to my advantage to try 20 mg every other day, since I cannot get a hold of 10 mg capsules right now.  

 

 

[ChessieCat]

Even with a long half life drug like Prozac see:

 

NEVER SKIP DOSES TO TAPER

 

And you do not have to skip days.  Please see Post #1 of this topic about how to get non standard doses:

 

Tips for tapering off fluoxetine (Prozac)

 

If you decide to make a liquid from your capsules/tablets it is suggested to:

 

cross-over-changing-form-eg-tablet-to-liquid-of-drug-or-changing-brand-of-same-drug

 

[Altostrata]

7 hours ago, kestrel28 said:

One of the only reasons I am staying on the prozac is this: I heard that it is extremely beneficial if you are on a benzo, (I am on Klonopin) 1.5 mg per day, and they say to have an SSRI in your system helps if you are going to taper off of klonopin. 

 

I have never heard of this, nor do I put much credence in it. 

 

8 hours ago, kestrel28 said:

15 days in, on 20 mg prozac, and my nerves feel on edge, like I drank a pot of coffee.  I made sure that I didn't have any caffeine today.   

 

Too much Prozac. Any doctor can prescribe these drugs. Suggest you get a new doctor. 

 

Even 5mg or less might stop the withdrawal symptoms.

[Shep]

15 hours ago, kestrel28 said:

One of the only reasons I am staying on the prozac is this: I heard that it is extremely beneficial if you are on a benzo, (I am on Klonopin) 1.5 mg per day, and they say to have an SSRI in your system helps if you are going to taper off of klonopin. 

 

That's been messaged by some of the benzo forums that began before a lot was known about SSRI withdrawal. It's out of date information. As Alto wrote, we don't put much credence into that here. 

 

This thread explains more:

 

Taking multiple psych drugs? Which drug to taper first?

 

Note the concepts of "brakes and accelerators."  Benzos are brakes and Prozac is an accelerator. In order to preserve your sleep, it's best to come off the accelerator first and leave the brake for last. 

 

On 4/11/2022 at 6:09 AM, Shep said:

Please update your signature to include your full drug history. The first post in this thread will show you what we need included:

 

How to Summarize Your Drug History in Your Signature

 

Please update your signature so the mods don't have to re-read your thread to catch up. Having an up-to-date signature prevents mistakes being given as we help you set up a game plan for coming off your drugs. 

[kestrel28]

4 hours ago, Shep said:

 

That's been messaged by some of the benzo forums that began before a lot was known about SSRI withdrawal. It's out of date information. As Alto wrote, we don't put much credence into that here. 

 

This thread explains more:

 

Taking multiple psych drugs? Which drug to taper first?

 

Note the concepts of "brakes and accelerators."  Benzos are brakes and Prozac is an accelerator. In order to preserve your sleep, it's best to come off the accelerator first and leave the brake for last. 

 

 

Please update your signature so the mods don't have to re-read your thread to catch up. Having an up-to-date signature prevents mistakes being given as we help you set up a game plan for coming off your drugs. 

Good points.  Thanks.  

 

I got to my PCP today and he prescribed me the 10 mg capsules.  

I am very interested in learning how to liquefy the prozac at home.  

I will follow those links.  

 

Again, thank you.  

[kestrel28]

19 hours ago, ChessieCat said:

 

Thanks, Chessie Cat.  

 

I just started on 10 mg today, and I feel much better!  

Thank you all for the guidelines, help, suggestions, etc.

Since I've only reinstated the drug two 16 days ago,  I am confused as what to do next.  

I read the 10 percent taper rule.   Should I stay on 10 mg for a while to see how I feel?  

I am a little confused on the putting prozac in liquid form.   If I want to do it myself, where would I get the syringe? 

 

I am very new to this, so I am really eager to learn, and hope I move slowly enough to have minimal withdrawal (if any).  

 

Again, thanks, and if I do decide to dilute the prozac in water, when would be a good time to start? 

 

 

[Shep]

10 hours ago, kestrel28 said:

I read the 10 percent taper rule.   Should I stay on 10 mg for a while to see how I feel?  

I am a little confused on the putting prozac in liquid form.   If I want to do it myself, where would I get the syringe? 

 

Yes, I would hold for a few weeks and give yourself time to stabilize. 

 

You can order syringes online, including Amazon. Members have reported being able to obtain syringes for free from pharmacies. 

 

10 hours ago, kestrel28 said:

Again, thanks, and if I do decide to dilute the prozac in water, when would be a good time to start? 

 

I wouldn't make any changes until you're at what moderator Brassmonkey calls "withdrawal normal." Here is his description:

 

WD Normal

 

 

[Altostrata]

Using an oral syringe and other tapering techniques

[kestrel28]

On 4/13/2022 at 3:32 PM, Altostrata said:

Using an oral syringe and other tapering techniques

thanks AltoStrata.  

 

Day 3: feeling better,  but flat, and very tired.  Having to take many naps.  Day 4 without caffeine.  

[Altostrata]

It's only been 4 days since you reinstated fluoxetine. How have the drug effects changed over these 4 days?

 

Did you quit caffeine at the same time? How many cups a day were you drinking?

[kestrel28]

1 hour ago, Altostrata said:

It's only been 4 days since you reinstated fluoxetine. How have the drug effects changed over these 4 days?

 

Did you quit caffeine at the same time? How many cups a day were you drinking?

It's been since last Tuesday since I cut from 20 mg to 10 mg.  I feel less shaky, but I feel really tired,  devoid of energy.  

I was so amped up from the 20 mg a few days ago that I decided to temporarily stop coffee (since this past Monday).  

I was drinking two to three mugs per day (when I was also on Rexulti), and before I got back on the 20 mg (on 3/27).  

I realize now that that was really a nervous system overload with all that caffeine on board.  

 

Still dealing with the very tired feeling in the mornings to afternoons (since cutting to 10 mg).  

 

 

[Altostrata]

If you quit caffeine, you might also get caffeine withdrawal symptoms.

 

When were you taking Result? Please update your signature.

[kestrel28]

On 4/17/2022 at 3:54 PM, Altostrata said:

If you quit caffeine, you might also get caffeine withdrawal symptoms.

 

When were you taking Result? Please update your signature.

I did stop caffeine for six days, but started back easily this past week with 1/2 a cup, which I can tolerate. 

I was taking Rexulti for two years, but stopped due to weight gain and cravings.  

[Shep]

@kestrel28How is your sleep? Has it gotten better or worse? 

[kestrel28]

6 hours ago, Shep said:

@kestrel28How is your sleep? Has it gotten better or worse? 

I find it very hard to get to sleep.   I often wake up unrefreshed, and end up feeling very fatigued the next morning.  Unlike before (like a few months ago), where my sleep was not interrupted and I woke up feeling refreshed.  

[Shep]

@kestrel28Are you still taking clonazepam at .5 mg 3 times a day? 

[kestrel28]

17 hours ago, Shep said:

@kestrel28Are you still taking clonazepam at .5 mg 3 times a day? 

Yes.

[kestrel28]

Since reinstating the prozac, I have had irritable bowels and frequent diarrhea.  It usually occurs in the AM.  I take acidophilus and am on meds (mesalamine) to keep my colitis in check.  Could it be that my body is rejecting the prozac?  

 

I am having my annual colonoscopy on Tuesday.  

[Shep]

5 hours ago, kestrel28 said:

Since reinstating the prozac, I have had irritable bowels and frequent diarrhea.  It usually occurs in the AM.  I take acidophilus and am on meds (mesalamine) to keep my colitis in check.  Could it be that my body is rejecting the prozac?  

 

You were on 20 mg in March and then reduced to 10 mg about 10 days ago. Did this symptom change for better or worse when you decreased the dose? Or is it the same? 

 

GI issues are really common with these drugs. Here is more information:

 

Digestive problems: nausea, diarrhoea, bloating, GERD

[kestrel28]

4 hours ago, Shep said:

 

You were on 20 mg in March and then reduced to 10 mg about 10 days ago. Did this symptom change for better or worse when you decreased the dose? Or is it the same? 

 

GI issues are really common with these drugs. Here is more information:

 

Digestive problems: nausea, diarrhoea, bloating, GERD

I think it's been increasingly more problematic.  When I was off of prozac for 6 weeks, my bowels were normal.   

[Shep]

8 hours ago, kestrel28 said:

I think it's been increasingly more problematic.  When I was off of prozac for 6 weeks, my bowels were normal.   

 

How did your bowels feel when you reduced from 20 mg to 10 mg? Just trying to see if you're dealing with a side effect or a withdrawal symptom and if you may benefit from reducing more.

 

What are your other symptoms? How intense are they on a scale of 1 - 10, with 1 being mild and 10 being severe? 

 

It may come down to figuring out which is worse - the side effects or the withdrawal symptoms and going from there. It looks like symptom such as crying and panic improved with the reinstatement, so it may be a matter of managing the upticks in GI symptoms through diet and see if they settle down as your body adjusts to the changed dose.

 

Please post your thoughts. 

 

 

[kestrel28]

12 hours ago, Shep said:

 

How did your bowels feel when you reduced from 20 mg to 10 mg? Just trying to see if you're dealing with a side effect or a withdrawal symptom and if you may benefit from reducing more.

 

What are your other symptoms? How intense are they on a scale of 1 - 10, with 1 being mild and 10 being severe? 

 

It may come down to figuring out which is worse - the side effects or the withdrawal symptoms and going from there. It looks like symptom such as crying and panic improved with the reinstatement, so it may be a matter of managing the upticks in GI symptoms through diet and see if they settle down as your body adjusts to the changed dose.

 

Please post your thoughts. 

 

 

My bowels felt only slightly better, going from 20 to 10 mg.  I'd say my biggest symptom right now is morning lethargy--feeling unrested--having absolutely no energy whatsoever.  This is the worst part of the day for me from 8 am til about noon.   If I take a 1/2 cup of coffee, then that usually gives me a little push, without it being too harsh.   

 

My fatigue/lethargy  is pretty bad  i'd say it's a 7 out of 10.  I can get up and have breakfast, but I am extremely tired.   

 

I am wondering if the reintroduction of the prozac has affected my sleep cycle (not getting to sleep at a good hour), and having to nap.  

 

Another thing is that I cannot focus as well as I was doing before--I used to be able to sit down and read a few chapters of a book just to calm my mind--now, I cannot do that.  

I'd say it's a 5 out of 10.  

 

On a positive note, my weight has gone down since stopping rexulti (I was above 220 and now I am 213). 

 

I do note that when I exercise I have to have plenty of electrolytes on hand--water alone will not work, as I sweat profusely on prozac and klonopin.  

 

 

[Shep]

10 hours ago, kestrel28 said:

I'd say my biggest symptom right now is morning lethargy--feeling unrested--having absolutely no energy whatsoever.  This is the worst part of the day for me from 8 am til about noon. 

 

You're also taking clonazepam 3 times a day.  Please note that drug is a central nervous system depressant and can be vey sedating, so you may be getting side effects from the benzo. Since you're dosing three times a day, you're being sedated all day. And now being on a lower dose of a stimulating drug like Prozac, you may be over-medicated with the benzo. 

 

How many hours are you sleeping at night? I'm wondering if you might benefit from moving more of the benzo from daytime use to nighttime or even tapering off a bit of the morning dose. You'll want to stay on some of the benzo throughout your Prozac taper to preserve sleep, but you may want to reduce it a bit before you start tapering Prozac.

 

Please post your thoughts. 

[Altostrata]

Quote

 

Jan 2020-March 2022: Rexulti .5 mg, then .25 mg for last two weeks of march, then stopped.  

Feb 2022: went off fluoxetine 20 mg without tapering

Late March 2022: bawling, crying, irritability, panic, irritability 6 weeks after withdrawing

 

 

How have you determined that your symptoms are not withdrawal from Rexulti?

[kestrel28]

Update:

 

after getting very irritable on 30 mg fluoxetine, my doctor took me off without tapering it.  This is the 2nd time he has done this.  I am in a real bind here.  I haven't taken my dosage in 4 days, and I know I have to reinstate it at a lower level to prevent what I had experienced many months ago.  Not feeling edgy as before, but I am starting to feel down and empty.  Should I insist that I be tapered with liquid prozac?  I have a compounding pharmacy one mile down the road from my house, and they can make up anything the dr. orders. 

 

Truly am dumbfounded as what to do.   I am limited as what doctor/nurse practitioner I can trust, as I have medicare, and am limited to what my insurance can pay for. 

Any ideas where I can look for drs. that help with tapering? 

 

Thanks in advance. 

 

[Shep]

6 hours ago, kestrel28 said:

after getting very irritable on 30 mg fluoxetine, my doctor took me off without tapering it. This is the 2nd time he has done this.  I am in a real bind here.  I haven't taken my dosage in 4 days, and I know I have to reinstate it at a lower level to prevent what I had experienced many months ago. 

 

Kestrel, do you have any flouxetine pills left? If so, take your dose. You've only been off it for 4 days so it's okay to reinstate it at the dose you were on.

 

 

6 hours ago, kestrel28 said:

Any ideas where I can look for drs. that help with tapering? 

 

Any doctor can prescribe fluoxetine.  I would just tell them the drug was extremely helpful for you and you'd like to continue taking it.

 

Then you can taper it in peace.  You may find that you can't be honest with doctors who've been lying to you and are ignorant about withdrawal. 

 

6 hours ago, kestrel28 said:

Should I insist that I be tapered with liquid prozac?

 

If you can find a doctor that will prescribe liquid Prozac, that would be great. But you can also make up your own liquid. 

 

Tips for tapering off fluoxetine (Prozac)

 

Scroll down in the first post on the thread where it says Making your own fluoxetine liquid.

 

Since you were last on the forum 4 months ago, you have noted this in your signature:

 

Quote

 

7/2022: started switching over from fluoxetine, taking 10 mg daily, plus 25 mg sertraline (zoloft)

8/2022: stopped taking sertraline as it was causing unwanted adverse side effects

8/2022: increased dosage of fluoxetine to 20 mg; held for three weeks

8/22/2022: increased dosage fluoxetine to 30 mg; on for about five days

8/26/2022: stopped taking fluoxetine; been off since.  Have to reinstate at a lower level. Still on .5 mg clonazepam 3x daily. 

 

 

These types of abrupt changes are very concerning.

 

Please let us know if you'd like targeted help with your taper. Otherwise, I would go back on whatever dose you were on 4 days ago and hold until you stabilize. 

 

[kestrel28]

thank you so much, Shep.

 

Yes, I would really like to have some guidance for tapering.   30 mg was too much, as it made me hostile, aggressive, snappy. 

 

I do have 10s and 20s that my withdrawal ignorant doctor prescribed me. 

 

I definitely do not want to be without a doctor, and then land in an in patient unit, which is the worst. 

 

My primary care physician is someone I've seen decades, and he has been there to prescribe things in the past.  (you mentioned any dr. can prescribe medication). 

 

I am not sure what to do next.

 

Yesterday, seeing that my depression is and has been TRD (Treatment Resistant),  I inquired about TMS for MDD.  I talked with someone about it, and they seemed very helpful and understanding. 

 

However, until I cross that bridge (September 12),  I do not want to have to deal with withdrawal once again or have depression come back.

 

Please advise.

 

Thanks,

Kestrel28

[Altostrata]

10 hours ago, kestrel28 said:

I do have 10s and 20s that my withdrawal ignorant doctor prescribed me. 

 

 

If I were you, I'd start with 10mg, or even half that.

 

10 hours ago, kestrel28 said:

My primary care physician is someone I've seen decades, and he has been there to prescribe things in the past.  (you mentioned any dr. can prescribe medication). 

 

Suggest you cut the psychiatrist from your payroll and ask your GP to prescribe for you as you taper. 

 

10 hours ago, kestrel28 said:

Yesterday, seeing that my depression is and has been TRD (Treatment Resistant),  I inquired about TMS for MDD.

 

If you want to believe that after all these years on antidepressants and other psychiatric drugs that you have TRD, that would be a self-fulfilling prophecy.

 

More likely, you have been suffering from serial adverse drug effects and withdrawal syndrome  as you've gone on and off drugs. The effect of this can accumulate over time. One very common result is an emotional anesthesia; many people here have it from the drugs.

 

This will very slowly dissipate with other withdrawal symptoms if you ever do decide to unpatient yourself.

[kestrel28]

I did take a 20 mg capsule of fluoxetine today. my system cannot tolerate prozac anymore, and it needs to be eradicated out of my system very, very, slowly. 

 

Is there anything that will help with the emotional lability while tapering? 

 

Darn doctors would always add a "Mood stabilizer" to my 20 mg prozac that would make me fat and borderline diabetic. 

 

I have lost 30 pounds since being off rexulti, and I continue to exercise as much as I can, without cravings. 

 

Please, I would like to have some tapering guidance. 

 

As I've read before on here, the antidepressant is the accelerator, and the benzo is the brake. 

 

Again, thanks. 

[Altostrata]

Ordinarily, we urge people to reinstate very low doses. If you find the effect of 20mg gradually becomes too strong over the next couple of weeks, you've taken too much.

[Shep]

10 hours ago, kestrel28 said:

As I've read before on here, the antidepressant is the accelerator, and the benzo is the brake. 

 

 

Are you also taking a benzo? Which one? EDIT: just realized you have clonazepam in your signature. 

 

Please list the drug(s) you are taking, any supplements, and the doses. Also, please let us know what time(s) of the day you are taking them. Also include any drugs you are taking for other health conditions - many times there are drug interactions. Doctors tend to be pretty careless when doling out these drugs, especially to people with psychiatric labels. 

 

You can check yourself for drug interactions here on this drug interaction checker. We recommend folks do this prior to taking any drug. 

 

 

Edited September 1, 2022 by Shep
added an "edit" note