Locut0s: off medication again after years - feeling scared

[Locut0s]

Original topic title before shortening:  Off medication again after years. Feeling kind of scared at the feelings that are here now.

 

I've been on and off SSRIs for many many years. To be honest I'd need to dig through records to know just how many but it must be a good 15 years or more now. Most of this time I was on, with the occasional period where I would taper off. I typically would do ok for some period of time then hit  a road block in life and go back on

 

I think over the years I've gone from a belief that I needed the medication to a belief that at least it helped supported me to now more of a belief that it's part of the cycle of my whole struggle. I had a very unhappy childhood and my solution to most of life was to isolate, live in my head, numb myself, deny and run from problems. I can see next to no strong correlation between the times I was at my best and worst and when I was on and off medication. I chose to be an alcoholic for many years while still taking medication for example and have been sober for 3 or 4 years now. What I will say is that I do believe that medication does act to dull my emotions but long term I'm seeing this more as a bandaid over a wound that I'm not addressing the trying to heal. I've done a LOT of self work over the past 7 to 8 years and I believe I've made a lot of progress in that time. One of the most transformative changes has been taking up a very dedicated meditation routine. 

 

I've now been off Prozac, the last medication I was on for a while, for well over a month from the time I last took my last tapered dose. I tapered from it over a period of several months. I never felt a lot of bad physical withdrawal but I did notice some pronounced mood swings. Those seem to have settled more but what I feel left with is quite a prolonged period of nervous system activation. A persistent sense of wrongness, doom etc. I suspect though this is even more connected with recent experiences I've had with someone that my brain has labeled a dates lol. I laugh because I don't know if we just have a friendship or if it's something more. But intimacy in general has often been one of my huge triggers for emotional struggle. So I think the panicked mood I'm in is to be expected even without the change in medication. 

 

I'm wondering though if others have experienced resurgences in fear, depression etc. I think the difficulty is that the societal narrative is such that this is taken as diffinitive proof that I need to be on them for good. I have a couple of friends who have said they thing I'm sabotaging myself and it can be difficult for me to know if that's what I'm doing or not. I would like to say that I want to learn to live without medication and that it's likely that the feelings I'm having are a natural result of both just going off them but also moving through this world with unhealed trauma, pain, attachment wounds and much else. We seem to be living in a society for so long where that simply = medicate. But I'd really like to learn to build the skills and muscles to lift these heavy and painful weights. Does that mean though that I should or should not go back on medication while I work on things I don't know and find myself rather lost with. 

 

Edited May 30, 2022 by ChessieCat
shortened title

[Onmyway]

Dear @Locut0s, 

welcome to SA. I am sorry you are struggling with life after coming off of the medications with a fast taper. The resultant activation is very likely a symptom of withdrawal. Many of us feel extra anxiety, hypervigilance, insomnia, intrusive thoughts, dread. It is likely that right now you are not yet feeling the full effects of the withdrawal as prozac is known to stay in the body for a long time after you stop taking it and as such its withdrawal effects are often confused as 'return of the original condition'. Withdrawal symptom after a long period of taking these drugs and switching multiple drugs and/or tapering fast from them can be hard and go on for a long time period (months and more likely years). We can't predict how long it will take for any individual or how severe it can get. One option for you is to reinstate your drug (at a lower dose) before the symptoms get bad and then lower your dose at no more than 10% of your previous dose every month. If you can please tell us about your drug history, we can advise better. Here is how to do it. 

How to List Drug History in Signature - Introductions and updates - Surviving Antidepressants

 

Here is the general advice on reinstatement. Have a look and see how you feel about reinstating a small dose. Small doses are very potent -see the SERT studies below. We can help decide if you have question once you fill in your drug signature. 

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

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

 

This is what you can expect during withdrawal: 

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

 

I am glad that you are addressing deep seated trauma - many of us come from very traumatic childhoods and end up being retraumatized by psychiatry. There are now more effective therapies to heal trauma - if you haven't yet read it I highly recommend the book The Body Keeps The Score by Bassel van der Kolk. I personally have benefitted from EMDR and IFS therapy though trauma therapy can be difficult and may not be the best thing during withdrawal unless you are so triggered there is no other way (which is the case for me and for a few other people here). If you decide to do trauma therapy, please find a therapist who is trained in those and trauma aware so that they know how to keep you safe. 

 

This video explains antidepressant withdrawal quite well. 

https://www.youtube.com/watch?v=PSjYH044-2Q

 

Welcome again to our community. We will help you come off of your drugs in the safest way possible and you can find kindred souls here who can support you on that journey! 
 

OMW

 

Edited May 31, 2022 by Onmyway

[Locut0s]

So I reinstated an extremely small dose of Prozac after continuing to struggle and for a bit that does seem to have helped. I have these 20mg capsules and basically I've been opening them and emptying them until there's almost just dust in them lol. That did seem to reduce some of the worst of the doom feelings. I've noticed though that in situations where I would have been activated in the past anyway that I'm still really badly triggered and on edge right now. For me these are social situations regarding romance or intimacy or the perception of that, areas where I need to work on my mental health and attachment wounds etc. 

 

It's difficult to know if this is the withdrawal still or just how I normally am and need to do nervous system work here. I'm doing better than I used to with sitting with these feelings and continuing with my life as I normally would. But it's on the edge of bareable right now. I'm fine if nothing activates me lol, but if a social trigger comes along I'm just crawling to get out of my skin. I feel like I CAN sit with this... it's just a fear if it could get worse or not. The good news is that I haven't gone back on a significant dose so I assume my nervous system is adapting to things?

 

Are there ways to measure small doses for something like Prozac? Prozac comes in capsules so it's not easy to easily measure. 

[ChessieCat]

1 hour ago, Locut0s said:

Are there ways to measure small doses for something like Prozac? Prozac comes in capsules so it's not easy to easily measure. 

 

You can make your own liquid from the capsule contents.  See Post #1 of this topic:

 

Tips for tapering off fluoxetine (Prozac)

[Locut0s]

So 1 month later roughly and I’ve been off Prozac now entirely, even the shavings of a dose I was mentioning above. I think I stopped taking even those not long after posting the above post. I’ve noticed a lot of stress of late but I’ve also been doing new things and taking on a lot of different things so the stress makes sense. Today I had a panic attack at work and it’s been a long time since I’ve had one, I am not really prone to them normally. Nothing I can’t handle but difficult day. My main question regards sleep, I’ve noticed it’s been difficult to get deep good quality sleep. Is this a side effect of Prozac and or SSRI withdrawal in general? An analogy I have is that it’s like skipping a stone off a pond. I find I just touch deep sleep barely then vaguely wake with some stress, needing to use the washroom or some such. I wake more tired than I normally would for the number of hours slept. How long does this last? I am hesitant to take sleep aids but don’t mind for some short period. 

[Locut0s]

How many times can you reinstate very small doses without causing problems?

 

I tapered off Prozac over a period of a month or two reducing dosage on a weekly basis. About 2 months ago I started to really feel some withdrawal symptoms, anxiety, agitation, doom, some depression. I decided to go back on a really really small micro dose, just powder in the capsules lol. That definitely stabilized things and I remained on that for a while then decided to stop that. I actually had forgotten that withdrawal was likely to come back again lol. About a week ago I had a panic attack and since then the last week my nervous system has been in a pretty prolonged state of fight or flight. Plus feeling physically ill at times. This isn’t at a point where I can’t handle things but it is on the edge and I was wondering if I were to reinstate an extremely small dosage again is that something wise to do or am I playing with kindling by doing that off and on, or is that only going off and on larger doses and cold turkey etc? 

 

Edited July 26, 2022 by ChessieCat
added Intro topic title before merging with intro topic

[Altostrata]

Hello, @Locut0s

 

Your sleep problems suggest some amount of withdrawal syndrome. Suggest you follow instructions in Tips for tapering off fluoxetine (Prozac) to make your own liquid and reinstate 1mg as soon as possible. You'd stay on this for some time to let your sleep recover, then taper by tiny amounts later. Please let us know how you're doing.

[Locut0s]

1 hour ago, Altostrata said:

Hello, @Locut0s

 

Your sleep problems suggest some amount of withdrawal syndrome. Suggest you follow instructions in Tips for tapering off fluoxetine (Prozac) to make your own liquid and reinstate 1mg as soon as possible. You'd stay on this for some time to let your sleep recover, then taper by tiny amounts later. Please let us know how you're doing.

 

Thank you. I was seriously thinking of this actually. I was thinking actually of doing 0.5mg. Would this still be in danger of kindling issues though since I've been off and on a few times?

[Altostrata]

You could start with 0.5mg if you feel safer with that. Unlikely this would cause kindling. The effect would ramp up over a few weeks.

[Locut0s]

So I started taking the 0.5mg reinstated via my own liquid creation. That seemed to help a tiny bit. But I’m stuck now in a difficult place with some worry. Last night I found I couldn’t sleep well and thought it was a one off. Then today was pretty anxiety filled and tonight to my dismay I can’t sleep again. And much worse tomorrow im set to get on a plane at 6am to fly to start a vacation. That will mean very little if any sleep the next 24 hrs and I was hoping tonight I’d at least be able to sleep. I think im going to reinstate going back up to a full 1mg instead of the 0.5 in the hopes that my sleep will stabilize and return. I worry I’m the short term this forced period of insomnia and how I’m going to do flying and experiencing this period of short stress. I will try my best to get rest when I can.

[ChessieCat]

It might not be the reinstatement causing the sleeping problem, but the anxiety about your plane trip and/or whatever the reason you are travelling.

[Onmyway]

1 hour ago, Locut0s said:

So I started taking the 0.5mg reinstated via my own liquid creation. That seemed to help a tiny bit. But I’m stuck now in a difficult place with some worry. Last night I found I couldn’t sleep well and thought it was a one off. Then today was pretty anxiety filled and tonight to my dismay I can’t sleep again. And much worse tomorrow im set to get on a plane at 6am to fly to start a vacation. That will mean very little if any sleep the next 24 hrs and I was hoping tonight I’d at least be able to sleep. I think im going to reinstate going back up to a full 1mg instead of the 0.5 in the hopes that my sleep will stabilize and return. I worry I’m the short term this forced period of insomnia and how I’m going to do flying and experiencing this period of short stress. I will try my best to get rest when I can.

@Locut0s

If you want to get through withdrawal you will need to tolerate a lot more than a few nights of insomnia. 

 

If you panic and play with your dose up or down you may create worse problems, the brain likes stability. This insomnia seems situational so if I were you, I'd wait for a few more days without worrying that it means anything. Some insomnia is not very dangerous to your health unless you're driving etc. (My biggest learning from withdrawal - I ended up making my situation worse in the beginning by treating insomnia aggressively and adding more drugs). Once I let go of the expectation that I would sleep normally for a while things got better.

 

OMW

 

 

[Locut0s]

1 hour ago, ChessieCat said:

It might not be the reinstatement causing the sleeping problem, but the anxiety about your plane trip and/or whatever the reason you are travelling.

 

14 minutes ago, Onmyway said:

@Locut0s

If you want to get through withdrawal you will need to tolerate a lot more than a few nights of insomnia. 

 

If you panic and play with your dose up or down you may create worse problems, the brain likes stability. This insomnia seems situational so if I were you, I'd wait for a few more days without worrying that it means anything. Some insomnia is not very dangerous to your health unless you're driving etc. (My biggest learning from withdrawal - I ended up making my situation worse in the beginning by treating insomnia aggressively and adding more drugs). Once I let go of the expectation that I would sleep normally for a while things got better.

 

OMW

 

 

Good points to both. I did however already take a 1mg dose instead of my usual 0.5 just now that I had been. Lol. Would you now keep this as your dose? 

[ChessieCat]

It's up to you what dose you decide to take. 

 

Be aware that Prozac has a very long half life and it can take 3 weeks before the dose registers in the brain.

[Locut0s]

5 minutes ago, ChessieCat said:

It's up to you what dose you decide to take. 

 

Be aware that Prozac has a very long half life and it can take 3 weeks before the dose registers in the brain.

Thank you. As OMW was mentioning I do wish to not yo-yo all over the place with my dosage though. Wouldn’t it be best now that I’ve taken 1 dose at 1mg to make this my new taper point? I felt that going up to 1mg might be ok as it’s still very little but am concerned about kindling. I don’t know about the insomnia but interestingly only about 30 mins or so after taking the 1mg I actually felt a fairly large lifting of the brain fog and deep stress and anxiety I’ve been struggling with lately. Is it possible for these withdrawal effects to subside that quickly? Like you said it takes weeks for dosages to stabilize. I have noticed I’m the past though sometimes an almost immediate relief of some withdrawal symptoms 

[Altostrata]

To clarify, though you may feel some effect immediately, a daily dose of fluoxetine will take several weeks to ramp up to full effect.

 

If you thought 0.5mg was interfering with your sleep, 1mg might be worse. However, as @ChessieCat said, it may have been anxiety over your trip causing you to sleep poorly. This may not be a good time to assess the effect of a reinstatement.

 

Also, if you've found fluoxetine to be energizing, you may wish to take it in the morning rather than evening. 

 

13 hours ago, Locut0s said:

I have noticed I’m the past though sometimes an almost immediate relief of some withdrawal symptoms 

 

Please explain this more. Did you have many periods of withdrawal?

[Locut0s]

12 minutes ago, Altostrata said:

To clarify, though you may feel some effect immediately, a daily dose of fluoxetine will take several weeks to ramp up to full effect.

 

If you thought 0.5mg was interfering with your sleep, 1mg might be worse. However, as @ChessieCat said, it may have been anxiety over your trip causing you to sleep poorly. This may not be a good time to assess the effect of a reinstatement.

 

Also, if you've found fluoxetine to be energizing, you may wish to take it in the morning rather than evening. 

 

 

Please explain this more. Did you have many periods of withdrawal?

 

It's difficult to know for what symptoms are withdrawal and which are simply due to my own mental health. I've had quite a lot going on of late emotionally. The one symptom, and one of the worst, that seems more potentially tied to Prozac dosage is this persistent state of stress in my body, sense of doom (more persistent than my usual anxiety) and strong brain fog. 

 

Yes there was one missed dose that day which explained I felt why that day was particularly bad. I noticed when I went back to 0.5mg it helped some with the doom, stress, and brain fog but kind of marginally. The 1mg I took seems to have helped this much more today. The sleep to be honest has been eradic ever since coming off Prozac and it's hard to know if reinstating the 0.5mg helped or not with that or made it worse. It feels like the sleep comes and goes in periods. I think I'm going to stay on 1mg now for 4 to 6 weeks and see how my body feels, maybe even longer if needed. Then very slowly start the 10% logarithmic decrease. 

 

I realized yesterday that I quite likely have sensitized my nervous system through many years of unhealthy coping that I no longer partake in. I used to be a heavy drinker, with pills and everything and I definitely experienced kindling there. I no longer drink but having  ocasionally tried a beer I noticed my nervous system is unusually sensitive to even one beer say. 

[Altostrata]

It can take some time for any reinstatement to reduce withdrawal symptoms. Suggest you take 1mg at the same time each day throughout your trip and check back with us when you return. If you're traveling, your situation won't be consistent enough for us to be of much help.

[Locut0s]

5 minutes ago, Altostrata said:

It can take some time for any reinstatement to reduce withdrawal symptoms. Suggest you take 1mg at the same time each day throughout your trip and check back with us when you return. If you're traveling, your situation won't be consistent enough for us to be of much help.

Thank you. I'll see how this goes and return with updates. Meanwhile off to Hawaii 😀

[Locut0s]

So I’m back from my vacation in Hawaii! It was a little hairy at times being able to not miss a dose because of flights and I forgot another day. What I noticed is that a single missed dose very definitely produces insomnia symptoms and some anxiety. But the good news is I feel like the 1mg keeps me fairly stable if I don’t forget. The week had a number of triggers that would definitely have caused nervous system upset if I was in a bad anxious state like I was. So I’m definitely going to stay on 1mg for another 3 or 4 weeks. A question I have for those who have tapered using their own liquid creations is where did you purchase syringes or measuring tools capable of measuring the very small volumes you guys use accurately? 
 

I’ve got an oral syringe that has gradations that are fine for 1mg but it gets inaccurate below that. 

[ChessieCat]

You can get syringes and graduated cylinders online, eg Amazon and eBay.

 

If you are making your own liquid you can make a weaker dilution which means you have to measure more liquid.  For one of my liquid I put a 2mg dose into 1 litre (approx 2 pints) of water which meant that each 1mL of liquid had 0.002mg dose.  I didn't keep the whole 1 litre of made up liquid, but just kept a bit more than what I needed and threw out the rest.

 

Generally if you are taking a prescription liquid it can also be diluted.

 

how-to-make-a-liquid-from-tablets-or-capsules   do a topic search for syringes, and also "graduated cylinder".

 

using-an-oral-syringe-and-other-tapering-techniques

 

If you cannot get the very small 0.5mg syringes online you could try a vet because they use them for small animals like mice, rats, rabbits.

 

[Locut0s]

Could this possibly be SSRI discontinuation syndrome coming from storage of my home made prescription liquid for too long?

 

So the last week or two I've been experiencing some pretty disconcerting symptoms. Some of these seem like the same SSRI withdrawal as before but the rapid heart, blood pressure and dizziness stuff is new. Rapid and irregular heart rates, some palpitations, often feeling short of breath, off sensations in extremities even numbness like or tingling, frequent insomnia, stress in my body but not my mind like I'd drank 10 cups of coffee, accompanied with the insomnia eye jitters where I notice my eyes dancing and jiggling about. I've also gone to my family Dr who prescribed some blood work which only came back with some higher than average cholesterol and an ECG which I'm still awaiting. My blood pressure was also high. During this period I've still managed to keep up a fairly regular running schedule which makes me think it doesn't seem likely that it's heart related. Anxiety and panic comes to mind of course but honest I've been surprisingly calm and pretty good through all of this period. Today was one of the worst periods where I almost felt faint at times and notice my heart rates ranged from the 60s up to 120 at a point.

It occurred to be very recently that this could easily be SSRI withdrawal from the way I've been taking my low dose taper of Prozac. As mentioned above I've been taking 1mg liquid doses that I make up myself since about early August. I found those fairly quickly evened me out and I've been doing well since then. However I have a habit of storing them in the plastic phial I use to keep it in the fridge for probably too long. I think I often keep it in there for 7 days, possibly more, before I make a new dose. I'm wondering if it's possible that all of the viable Prozac in the mixture has degraded during this time and what I'm seeing now is the delayed effect of withdrawal from this habit? It's difficult with prozac because of the long 1/2 life to know for sure. Also have others experienced strong withdrawal symptoms like this from even something as small as 1mg? My initial dose before all the tapering was 10 and even 20 before that. At any rate I'm going to start making a new mixture every day from today forward and see if this stabilizes things. Given this may be withdrawal should I go back to the 1mg? Mainly touching base to see if any others have had similar experience?

[ChessieCat]

3 hours ago, Locut0s said:

However I have a habit of storing them in the plastic phial I use to keep it in the fridge for probably too long. I think I often keep it in there for 7 days, possibly more, before I make a new dose. I'm wondering if it's possible that all of the viable Prozac in the mixture has degraded during this time and what I'm seeing now is the delayed effect of withdrawal from this habit?

 

Some drugs might be absorbed by the plastic.  And SA suggests only keeping the liquid for 3-4 days stored in the fridge in a sealed/covered container.

 

The sensible thing to do would be to change what you do.

 

HOWEVER, you may be tapering too quickly, too large a reduction or too soon after the reinstatement OR all 3.

 

PLEASE put the date of the reinstatement in your drug signature and put the dose of 1mg and then the dates and doses for the reductions.  It helps if we can see what you have done.  It means that we don't have to guess and try and answer without having all the information.

 

3 hours ago, Locut0s said:

Given this may be withdrawal should I go back to the 1mg?

 

It depends on what reductions you have made and when.  It is difficult to answer this without the information.

[Locut0s]

1 hour ago, ChessieCat said:

 

Some drugs might be absorbed by the plastic.  And SA suggests only keeping the liquid for 3-4 days stored in the fridge in a sealed/covered container.

 

The sensible thing to do would be to change what you do.

 

HOWEVER, you may be tapering too quickly, too large a reduction or too soon after the reinstatement OR all 3.

 

PLEASE put the date of the reinstatement in your drug signature and put the dose of 1mg and then the dates and doses for the reductions.  It helps if we can see what you have done.  It means that we don't have to guess and try and answer without having all the information.

 

 

It depends on what reductions you have made and when.  It is difficult to answer this without the information.

Thank you for the reply. Good to know about the plastic not being the best container. I’ve updated my signature, though to be honest I don’t have more specific details like dates down to the specific day. Though I know I reinstated the 1mg early august. 

[ChessieCat]

If you don't know exact dates, please use early, mid, late so that we have some idea of the amount of time.

 

You asked about whether you should go back up to 1mg.  What dose are you currently taking?  Have you made any reductions?

 

These reductions and increases need to be in your drug signature.  The staff don't have the time or the patience to read back through your posts, and we certainly can't remember everything about a particular member's drug changes.  Thank you.

[Onmyway]

@Locut0s

It's also possible that you're just experiencing the windows and waves of withdrawal. 

Omw

[Locut0s]

42 minutes ago, ChessieCat said:

If you don't know exact dates, please use early, mid, late so that we have some idea of the amount of time.

 

You asked about whether you should go back up to 1mg.  What dose are you currently taking?  Have you made any reductions?

 

These reductions and increases need to be in your drug signature.  The staff don't have the time or the patience to read back through your posts, and we certainly can't remember everything about a particular member's drug changes.  Thank you.

It was early august. I haven’t changed dosage at any point and have hardly missed any dose in those months from early august till now. I’ve been taking 1mg consistently during that time. 

[Locut0s]

23 minutes ago, Onmyway said:

@Locut0s

It's also possible that you're just experiencing the windows and waves of withdrawal. 

Omw

Ahh hadn’t thought of that, thanks. I guess I just assumed if I felt like I’d stabilized at 1mg before that I wouldn’t feel any of this until I started to continue to taper down further. 

[ChessieCat]

6 hours ago, Locut0s said:

Given this may be withdrawal should I go back to the 1mg?

 

So why did you ask this?

[Locut0s]

3 minutes ago, ChessieCat said:

 

So why did you ask this?

Apologies my mistake in how I wrote it. I think I’m not thinking 100% straight with lack of sleep and jitters. Yeah no I never reduced my dose. What I was meaning there was that I’d assumed that the level of the drug might have dropped a lot in my system if it was not being stored properly. So what I meant was I wasn’t sure I was actually taking an effective dose of 1mg anymore because like you said maybe it was being absorbed by plastic or degrading. But I hadn’t actively reduced the strength of the mixture I was making. 

[Locut0s]

I've been considering reinstating back to a regular (10mg) dose of prozac as I continue to have these same symptoms. Insomnia, rapid heart, night sweats, serious agitation, high blood pressure, etc. I was hoping that my symptoms would stabilize after a while of taking the 1mg dose but things seem if anything to have gotten worse. Back in Oct I was wondering if perhaps I was storing the liquid dose I was making for too long so I switched to making a new dose each day I took it, which didn't seem to have any affect. My Dr wasn't very supportive in any of this and doesn't believe that it could even be withdrawal and urged me to go back on prozac. He did however refer me to a specialist in internal medicine that I will be seeing on Tuesday to see if these symptoms could be the result of something else. Despite not wanting to lose the progress I've made I definitely am considering reinstating as I'm concerned the symptoms as they are now pose a serious health risk to me long term, especially with the high blood pressure, agitation, heart stuff. I'm going to see the specialist on Tue before making any decisions. Does anyone here know if there are risks to making things worse if I were to reinstate back to a regular dose?

[Onmyway]

Hi @Locut0s, 

 

you are saying that reinstatement to 1mg has made things worse for you. What makes you think that going higher up will make things better. 

The issue with reinstatement and updosing is that your nervous system is hypersensitive and new additions/increases of dose can cause adverse effects. It is up to you if you want to updose. Here are the risks.