Eva: struggling after 20+ years Prozac and now without.

[btdt]

Probiotic?  have you tried them?

[eva]

No, I'm not taking the antibiotics anymore, had to take them ten days. It seems the one they gave me is neurotoxic if you take it for longer then 10 days.. had i known what I now now about this drug (clioquinol) I would not have taken it.

Do you have an advice for a good, gentle probiotic? There are so many different kinds...

[Altostrata]

I don't know what's available in the Netherlands.

 

I like one called Goodbelly here in the US.

 

You might look for a refrigerated liquid one for children.

[eva]

Hello everyone, just wanted to let you know how i am doing. I was so sick, i had to do something. I reinstated the st. Johnswort at a full dose ( 3 x 300 mg.) and am much better now. The stomach issues are much better to, not as nauseous anymore. I will keep taking the sjw for a while. Also I will be going to see an acupuncturist tomorrow, to see if that can help.

For me I think it was the right thing to do right now, and anyway, much better then reinstating prozac. After some time I will try to lower the dose of sjw very gradually and see what happens. But for now I am mainly very glad that my body feels better and my spirit too!

[Altostrata]

Good to hear you're doing better.

 

St. Johns Wort is a mild MAO inhibitor (MAOI). Look up the diet restrictions for MAOIs. You will want to be careful with this.

[Fitby50]

Eva, so glad to hear that your stomach is doing better and your mood.  It is nice when trying something actually has the effect we are looking for.

[eva]

Hello Fit by 50,

I was feeling better but now am in a very bad way again... stomach is better but mood is much worse. Also very much peri-menopause i think, terrible mood swings, anger, crying spells. Periods are becoming irregular. Sometimes afraid I will hurt my kids or myself. If this continues I will go back on a low dose of prozac or maybe even HRT although that really frightens me.

Alto, you must be getting tired of me, but do you have any suggestions what to to in case of a mixture of withdrawal and menopause symptoms? I freaked out in front of my kids yesterday, crying and yelling at them and feel so bad about that yet can't stop myself. It happened on and off over the last year since I quit prozac but is getting worse along with my other peri-menopausal symptoms.

[eva]

Ok, a little better, did some yoga and had an acupuncture session. From a very kind female acupunctirist who is treating me for free as i can't afford it. A really nice woman that is goin to treat me for the next few months and hopefully this can bring some relief. Feeling a little hopefull.

[Fitby50]

Eva,  It's hard to know what is WD and what is menopause, because both give us the same symptoms. I struggled a lot last summer wanting to know what was causing so much of my symptoms. I had tests done for my female hormones and nothing really jumped out, like wow this really needs fixed.  My hormone internist did put me on a low dose of Progesterone and high dose of Vitamin D.  I take 5000mg of Vit. D every day and I think it has helped with depression, that is what  she told me it should do.  Low Vit. D can cause low mood in women our age.  I don't know if the progesterone is helping or not. I have thought about stopping it, to see if it makes a difference.  I think my anger and irritablitlity spells might be slightly better.  I still have them, but a little less intense.  I sure don't have the patience I need.  I get so agitated and that is not really like me.  I was having more crying spells last summer.  I still get teary over little things, but not crying jags that I cannot control.  If our female hormones are out of wack and on top the WD, its no wonder we are a mess.  I have not had a period since August, so maybe things have leveled out for me some or it could be the Vit. D and progesterone, who knows.  My 3 sisters and my mother did not have problems with menopause.  Do you know history of your family?  I think that can give a clue to how it will be for us.  I hope you can get relief from your acupunt.  Maybe try the Vit. D.  When you find yourself short with your kids, try to distract yourself with something.  Figure out ahead of time what that distraction is going to be, so you can go to it right away.  Like sweeping or doing dishes, or organizing a junk drawer.  Maybe if you can get yourself distracted quick enough, you can difuse the situation before you can yell at the kids.  I know what that is like and how guilty it makes you feel later.  Also, try to be less critical of how things are.  Ask yourself in the big scheme of things if this "thing" upsetting you is really that BIG of a deal.  During these trying times of WD, we have to lessen our standards about some things.  If they are not putting themselves in danger, or burning down the house, etc. You get what I mean.  Some days it just seems that everything is overwhelming and those are the days we need to really chill and let some things just go.

[Altostrata]

I agree with Fitby. eva, please see http://survivingantidepressants.org/index.php?/topic/1112-non-drug-techniques-to-cope-with-emotional-symptoms/

[eva]

Thanks Fitby 50. It's good to know that I am not alone in this. And you are right, I have to try and let things go a little, and find ways to make it doable for me and for my family. I will try to up my vitamine d dose, see if that helps.

I also am getting back to my yoga practice, which i sort of 'forgot' the past year. And am trying to meditate for a short while every day and do some breathing exercises. And i hope the acupucture will bring some relief. Still, it's hard, both withdrawal and menopause together. Might have been better to quit prozac before or after menopause but this is where I am right now and I will try to make the best of it. And hope the menopause stuff will be better in a year or so as I have been having symptoms of menopause for a few years now, getting much worse the last few months.

I just hope my husband can put up with it for as long as it takes. I can see that he sometimes really has had enough of all my moods and my lack of interest in being intimate etc. And I don't know if he will be able to wait as long as it might take for me to get better. But there's not much more i can do about it.

[Fitby50]

I meant to say 5000IU of Vitamin D, not mg.  I really think it has helped me.  I thought the same thing about doing the WD discontinue the AD meds at my age, when I am hitting menopause too. But it is what it is, like you said, we can't go back and do it when we were younger, and I sure don't want to wait more years being on the meds, so I guess it is toughing it out all at once. I hope your husband can be more understanding. Have you told him much about this site and how it is common for us to have such bad waves and we need our family to be patient????  I know my husband sure has his moments where he wants to just say, Why don't you go back on your meds?  He does not really get why I want off of them.  He thinks I did ok on them for 20 years, so why change what wasn't broken.  So its bad enough we have to feel like TOTAL crap, physically and mentally and then we have to worry about how our husbands are affected. Maybe you could show your husband some other peoples threads that have similar issues and he would see its common for you to have such moods, etc.  I tired it on my husband bcuz I thought he was thinking it was all in my head, no pun intended.     It helped for him to read about others and then I could say, Yea, that is exactly what is happening to me.

[eva]

Just a quick update: things have gotten much worse. I am in a state of anxiety, near panic, almost all of the day. I can't sleep anymore because of strange muscle twitches (not restless legs) at the moment I fall asleep. This has been going on for three weeks now. I take oxazapam to sleep on some nights, but the anxiety in the daytime is getting worse and I can hardly function anymore. Could this still be withdrawal, after a year? Or is it a new 'disorder', partly due to stressed out hormones or whatever? I am thinking very hard of starting a small dose of fluoxetine, but am also very scared it will make things worse. In the past I have stopped fluoxetine for half a year or three quarters of a year and started it agian without problems. But I didn't have the panic and anxiety then, only a little but not like this. What shall I do? I am so scared, dizzy, hyperventilating etc.

[Rhiannon]

Eva, I don't have much time this morning so I haven't read over your whole thread so I can't advise about reinstatement or whatever, but just a few thoughts: 

 

Oxazepam is a fairly short acting benzo. It peaks out in your bloodstream in less than three hours and then begins to fall. We find that with short acting benzos people can then get withdrawal symptoms as blood levels fall (anxiety, tremulousness, panic). This is called "interdose withdrawal." So this may be part of your problem, you may actually be inducing some symptoms by your intermittent use of oxazepam. I don't know for sure, but benzos are tricky that way, so if you're taking it more than twice a week, you may want to consider talking to your doctor about trying a longer-acting benzo like diazepam or clonazepam and taking it regularly to keep blood levels even, or tapering down off it (which might be tricky at this point.) I don't know for sure what to advise but this is something to be aware of.

 

The other thing I would say is that Prozac is considered one of the more activating SSRIs and is known to cause akathisia, anxiety, restlessness etc. so keep that in mind if you're looking at reinstating a medication. Like I say, I haven't read over your thread so I don't know all your information.

 

I'm so sorry you're suffering like this.

[Rhiannon]

Oh and yes, people do have withdrawal after as long as a year or longer--we get people in that state here on this forum quite often.

[Addax]

Oh Eva! I'm very sorry to hear that you're struggling! I've been going through a rough patch myself...

 

In my own experience with benzos for sleep, I was prescribed Ativan to help with sleep and if I felt I was walking into a panic attack. I found that my anxiety and Akathisia were worse the next day if I took the Ativan to help sleep. It was like some kind of rebound after the Ativan left my system. It was helpful in the moment, but I stopped taking it because of that rebound thing.

 

Have you tried the magnesium supplements for the anxiety? I've never tried them, but I've seen people on here find them helpful, whether in pill form or an Epsom soak. Melatonin for sleep is another one I've seen mentioned here.

 

From what you wrote it sounds very much like what I went through after the last time I discontinued Prozac. I was hit with horrible anxiety and Akathisia 4 months after my last pill. I ended up reinstating Prozac at around the 5 month mark. It worked for me, but Rhi has seen more cases so is probably a better resource where that's concerned.

 

Have you tried rocking your body? I did that a lot when the Akathisia was bad. I wish I could be more helpful.

[Meimeiquest]

I have been advised to use myo-inositol 2 grams for calming, but I have to admit I don't have symptoms anywhere near yours. My heart goes out to you!

[Rhiannon]

I ended up reinstating Prozac at around the 5 month mark. It worked for me, but Rhi has seen more cases so is probably a better resource where that's concerned.

 

 

No, I'm no Prozac expert, I just know it's reputed to be more activating than some of the other SSRIs.  After a year off I don't know about reinstating. I'd wait for Alto's input on that. I do suspect the oxazepam may be contributing.

[eva]

Thanks everybody for the input and support. It helps, makes me feel less alone in this. My GP doesn't know anything about these things, nor does my psychotherapist.

I really would like to know what triggered all this I was doing well, not good, but okay, and then all of a sudden it started with the jerking awake everytime i drift of to sleep. After a few nights with 30 or 40 jerking episodes, with palpations and dizzyness, I got the oxazepam because Ihave to get some sleep. There are two things that might have contributed, first, I started acupucture a few weeks before the misery started, and second, I was listening to cd's with binaural beats, two times a day. While listening, I also had small jerking movements and a lot of emotions and tears. Maybe too much in a short time?

Anyhow, in a flare of panic, I took 10 mg. of prozac a few hours ago... it seems to calm me a little, though that is not really possible so soon?

[eva]

O ****, the 10 mg. made me calmer and sort of stops the panic but last night the jerks were worse, even with oxazepam. had to take a second pill (10mg) to get 4 hours of sleep. Had a stressful evening because my 8 year old ran a high fever and then suddenly fainted, so we went to the ER. He was okay but that might have contributed to the worsening of the jerks. But I am getting scared that this will not pass and that i will never sleep well again. Made an appointment with my GP and only took 5 mg. of Prozac this morning. Gp will say i should take 20 mg. to have an effect but I won't do that.

Does anyone have any ideas? Or experienced these jerks that go on all night?

[eva]

Have seen my GP, she prescribed diazepam to help me get a good night's sleep and hopefully break the cycle no sleep-panic-even less sleep- more panic etc.

Now I am even afraid to take the diazepam because i don't want to end up with a new addiction. But something has to happen, I am so tired and so scared. So I guess I will take the diazepam tonight but have no idea how thibgs will go after that. I do feel the oxazepam is causing more panic... now that i took two of them last night, my panic today is even bigger.

Don't feel the prozac really doing anything right now... only that i have no appetite and large pupils, which happened every other time I started. Can it take a while before it works? Or does it mean it's not working?

[Addax]

I know your conflicted about reinstating... Or that's what it sounds like, but it seems that's the direction your hesitantly choosing. It was a tough choice for me too. I'm not an expert, but I think the one thing you should think about if you're going to reinstate is to pick one dosage of Prozac and take it regularly everyday at the same time of day. Stablizing at one dose made a BIG difference for me after I had put myself on a schedule where I alternated dose size mistakenly thinking it was a good tapering method. Sticking with one dose was recommended to me and I've seen it recommended by Rhi and Alto and others, repeatedly here. And like I said it was helpful for me.

 

I think it's possible that it's chemically induced by the Prozac. While most SSRIs take some time to reach an effective therapeutic level in our systems, my dog accidentally got a hold of one of my 20mg capsules years ago. I freaked out, but the vet said it would just make him tired... Which is exactly what happened. He was calm and tired for most of the day.

 

The stress of your son being sick may very well have caused an increase in symptoms. Stress does horrible things, and when you've been on meds for as long as you and I have/had been I suspect it takes our bodies and brains sometime to relearn what an appropriate stress response is like. After years of the blunting side effect of Prozac, me and my body's response to stress seems quite elevated and highly reactive. It's gotten slightly better over the last few months which I interpret as "relearning" and a re harmonizing between my mind and my CNS.

 

I know you asked about jerks in the night... I haven't had them beyond the occasion feeling like I'm falling thing, but I don't think that's what you mean. How long after you go to bed does the jerking start?

 

Lastly, I'm not a doctor, but I'm very confident this will pass and that you will definitely sleep again. I know when we are in the throws of these waves, bad spells, or whatever you want to call them, it feels like they'll last forever... That we're stuck with whatever is going on. I just went through that and was sure I would feel like I was feeling forever. It's only been in the las 48hrs that I'm seeing evidence contradicting what I thought.

 

Good luck with your doc!

[eva]

Thanks Addax, and I so hope you are right! Been feeling panic almost all day but I do it to myself with constant worrying about the medications, how bad they are/could be for me etc.

When you reinstated, did you take a full dose immediately or did you build up to it?

A year ago I started prozac after not taking prozac for a year, with 10 mg which didn't do anything. Now I am also taking 10 mg. and wondering if I should stay on that dose and for how long, or take a regular dose of 20 mg.

The jerking starts as soon as I drift of to sleep, and  then I am awake again and this goes on and happens maybe 30 or 40 times and I get almost no sleep at all if I am not taking oxazepam. And even with the oxazepam i sleep only a few hours. But I hope and think the diazapam will help me sleep longer and maybe by getting some sleep i will also feel less panic.

[Fitby50]

Hey Eva, sorry to hear you are having bad sleepless nights. When I was put on prozac last Spring, I started at 10mg and never increased, and I think at 10mg, for me, I did find some relief, but, like has been stated by Rhi and others, it also can be over-stimulating. Now that I look back, I do think some of my severe anxiety was coming from the Prozac and not just the withdrawl from Effexor.  These leg jerks at night sound really odd.  I would be careful with the sleep meds they are giving you to take, I agree that they can be giving you more problems the next day with mood and anxiety.  Have you tried some hot baths or showers before you go to bed, or anything else that could help you relax??  Drinking some relaxing tea's or warm milk(I have found this one helpful).  Try eating some protein before bed.  Try not to overthink and worry so much, you will end up in the vicious cycle, stressing your system even more than it already is.  Tell yourself that you WILL sleep again and this is just a temporary setback.  It is misery while you are going through it, but it will get better.  The more you obsess about it, the worse it will be.  Did your docs have any explanation for the leg jerks?

[eva]

It's not just the legs, sometimes it's my body, or my hand. And believe me, I tried every thing I could think of, magnesium, herbs, hot milk with proteine powder etc.

Right now i think it is the lack of sleep that is causing alot of my anxiety. I can't make it for weeks without a good night's sleep. GP thinks the jerks are caused by stress and from what i've read, they usually get worse when tired or stressed. So I'm caught in a vicious circle: can't sleep because of the jerks, and my fatigue and stress from not sleeping causes even more jerks.

So I will try the diazepam. And I hope the prozac will help me. I know i shouldn't be overthinking and worrying but that is part of my problem. I get totally obsessed and CAN'T stop thinking about it, however hard I try and even though I KNOW it makes everything much worse. I get obsessed easily and right now can't seem to get out of it. So I hope a low dose of prozac might help me to stop obsessing.

[Addax]

I believe I went to 40 mg when I reinstated, but quickly (too quickly probably) dropped to 20. I think my doc and I picked the initial reinstatement amount based on my history at 60mg combined with my hesitancy to reinstate due to the side effects I'd experienced and generally just not wanting to be back on the drug. If I'd known what I know now I probably would have reinstated at a lower dose since it was more a matter of getting rid of the withdrawal symptoms.  Neither me or my doc had much of a clue about withdrawal and reinstatement.  My doc at the time added 150mg of Wellbutrin because I was reluctant to reinstate because of the yawning and fatigue Prozac caused me (along with numerous other side effects).  It didn't take effect immediately.  I think it took several days before I could begin to feel some of the withdrawal symptoms subside and probably took a couple of weeks or a few weeks to feel "normal" again, which is when I began my much slower taper.  

 

As far as the jerking thing as your falling asleep.  I don't believe it's that uncommon, but maybe it's worth looking up hypnogogic jerk, and hipnic jerk and see what you think.  From what I've read they're not dangerous, but worrying about experiencing hypnic jerks can make them worse, and really, stress in general can exacerbate them. 

[eva]

Thanks for your reply, Addax. I will keep at 10 mg. for now, I have used 40 mg. for years, but the last couple of years I used 20 mg. If the 10 mg. doesn't do anything within a week or so, i will up the dose.

Yes, I already found out about hypnic jerks, I think that si what is happening. And I know now, that they are not dangerous so I don't reallt worry about that. But they keep me awake for most of the night. And I worry that it will never go away, that i will have to take sleep medication forever, or that I will go crazy, or that I am doomed in some way and I obsess about taking meds yes or no, and about my health in general etc.

I hope the diazepam will make me sleep tonight and that I will feel a little less afraid tomorrow.

[Fitby50]

I have had those jerks before when just about asleep, but not a continual thing like is plaguing you.  Just having them once in awhile is very annoying and never more than once a night normally.  I totally get what you are saying about "obsessing", when I am having a bad wave or more anxiety, I tend to be obsessive, I think it is part of the withdrawl. And the more I say, stop thinking about it, change the channel, it seems to last only a few minutes and then its back to OBSESSING.  Eva, you will get through this.  How is your stomach problem you were having?  Did it resolve?  Not getting sleep is the worst side-effect of all.  Are you able to nap at all during the day, even a cat nap?  Relaxing or meditation is also a good stress relief.  Massage?  Foot massage? Yoga?  Anything you can do to relieve your body and ease your mind. 

[eva]

No, even when lying down for a nap the jerks start happening. The panic is overwhelming and I get no sleep. Gp prescribed Flurazepam for sleep now, and oxazepam if the daytime panic and fear get too much. All of this untill hopefully the prozac will start working.

The stomach trouble got better, but panic and not sleeping is not something i can wait months for it to stop. I don't like to be on all these meds again but right now it has gone to far for massages and all other gentle ways to help or provide relief. I will get of the meds again as soon as I can but I really think I allready waited to long and let the fear etc. build up making it harder now to do something about it. This is not a phase to 'tough out'. I know you are trying to help, but please understand and respect my decision to take meds. It's hard enough for me to accept that I have to at this point...

[btdt]

Good luck Eva I wish you peace. 

[Altostrata]

eva, many people need to use a benzodiazepine to deal with withdrawal symptoms. Please be aware if you use these drugs regularly, you will need to taper them, too.

 

Please let us know how you are doing.

[eva]

Thanks Alto, I try to use the benzo's as little as possible and if I can only at night and when i stop them i will taper them. Tonight with the flurazepam I have slept a whole night, for the first time in a month! And that feels really so much better! I also think the reinstated 10 mg fluoxetine might be beginning to work a little... feel a little less scared and panicky. I never new fear could be such a hell, I knew depression, but not this sickening fear and panic.

I will use the flurazepam for a couple more nights, to give my so overexcited system some (artificial, but right now i don' mind) rest and then consult with my gp what would be the best course of action, taper or go back to a lighter sleeping aid or give it some more time with the flurazepam and see if the prozac 10 mg. will help to calm me or if maybe I need to go back to the 20 mg I used to take a year ago. I hope I don't have to, but right now I am willing to do anything to stop this hell. And I am back on the prozac i will strat tapering of at some moment again, but not too soon. And maybe wait till my very disrupted perimenopause hormones have settled down a bit.

[Altostrata]

It's likely your GP will not know how to do and make a guess to help you. Please consider this, because his or her guess is probably no better than yours. Few doctors know anything about tapering and adverse reactions to psychiatric drugs.

 

See the 22 Netherlands psychiatrists who are at least aware of the need to taper at the end of this paper http://survivingantidepressants.org/index.php?/topic/5195-tapering-packets-to-be-produced-for-paroxetine-and-venlafaxine/?p=66738

 

Switching and adding drugs is likely to cause you more problems. Please be careful.

[eva]

Thanks Alto. Yes. I know my GP doesn't now more then me about all of this, probably even less. I don't mean to add any drugs, will stick with  the prozac,  and for sleep the flurazepam for a couple of nights and after that back to the oxazepam if i stil need it to sleep. Thanks for the list, I didn't know it existed. If the prozac is going to help. I won't start tapering it too soon.

The panic has faded a bit, after 5 days  on 10 mg prozac. So I guess that is a good sign. What worries me most is if I will even be able to sleep again without sleepmeds, because even if i feel quite calm when I go to bed, my body still goes into spasms and panic feelings every time i drift of to sleep. But after 5 days of prozac, I guess it's too soon to tell if it will help with the sleep problem.

[Altostrata]

It sounds to me like your system is still settling down. Please give reinstatement more time.

[eva]

Thanks Alto, I will give it more time. My body is tensed and tired from weeks of panic and no sleep, I guess it's logical that it will need some time to sttle down. And I will try to stop worrying about if it will ever settle down. Could you say anything about how much time I should give it before maybe going to 15 mg or so? A few weeks?

It's more difficult too because it's the school holidays and my three boys are at home and I want to be as 'normal' as possible for them... and we are going on a two week holiday next week and right now that makes me scared too... but maybe it will be a good distraction, being in nature, with no computer to look up all kind of frightening things.

My gp seems to think it would be good if i have at least ten nights of sleep with the flurazepam 30, to give my body some rest. Do you have an opinion on that? And after that, would it then be best to taper the flurazepam (not easy, as they are capsules), or could I also switch to a lighter benzo, like oxazepam? Sorry for all the questions, but so few people know about these things. And thanks for all the time, energy, and kindness you put into this site, Alto.