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What is withdrawal syndrome?


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Here is an excellent overview of antidepressant withdrawal, which generally applies to all psychiatric drug withdrawal. The transcript for the video is here https://thedrugclassroom.com/video/antidepressant-withdrawal/

 

 

 

 

Here are some topics that may answer your questions.

Tapering - what you need to know
 
History of the black box warning on antidepressants about "discontinuation syndrome"

 

Click on the links and add to these topics if you wish:

_______________________________________
WHAT CAUSES WITHDRAWAL SYMPTOMS?

One theory of antidepressant withdrawal syndrome

dysautonomia
 

How psychiatric drugs remodel your brain

  

What is happening in your brain?

protracted withdrawal symptoms -- why?

Immediate adverse reactions to SSRIs? How long for recovery?

Brain remodeling
 
_______________________________________
WHAT ARE WITHDRAWAL SYMPTOMS?

Papers on diagnosis of antidepressant withdrawal syndrome

Dr. Joseph Glenmullen's withdrawal symptom checklist (PDF)

 

Is it withdrawal or relapse? Or something else?

 

Bona Fide Emotional Pain or Clinical Depression? Are ANY Psychiatric Conditions Real?

 

Delayed onset of withdrawal symptoms 

 

_______________________________________
HOW DOES HEALING HAPPEN?
 

The Windows and Waves Pattern of Stabilization

 

Are We There Yet? How Long is Withdrawal Going to Take?

 

"Is it always going to be like this?"

 

The importance of recognizing you're feeling good

 

Creating a new self after withdrawal

 

Protracted Withdrawal or PAWS (post-acute withdrawal syndrome)

 

What does healing from withdrawal syndrome feel like?

 

Withdrawal dialogues & encouragement

 

Edited by Altostrata
updated

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Good description of antidepressant withdrawal:   http://npanth.wordpress.com/2012/03/14/phases-of-ssri-withdrawal/ Phases of SSRI WithdrawalMarch 14, 2012 — npanth   Not all people experience wi

This is actually very good, except that for many people (especially people with multidrug histories, long histories on the med, previous attempts to CT or rapid taper, and/or started as teenagers befo

Our esteemed member and moderator Rhi's description of the neurobiology of withdrawal syndrome:  

  • Administrator
Altostrata

The Mayo Clinic describes autonomic dysfunction here, calling it autonomic neuropathy: http://www.mayoclinic.com/health/autonomic-neuropathy/DS00544/DSECTION=symptoms

 

Signs and symptoms of autonomic neuropathy vary, depending on which parts of your autonomic nervous system are affected. They may include:

  • Dizziness and fainting upon standing (orthostatic, or postural, hypotension), caused by a drop in blood pressure
  • Urinary problems, including difficulty starting urination, overflow incontinence and inability to empty your bladder completely, which can lead to urinary tract infections
  • Sexual difficulties, including erectile dysfunction or ejaculation problems in men, and vaginal dryness and difficulties with arousal and orgasm in women
  • Difficulty digesting food, due to abnormal digestive function and slow emptying of the stomach (gastroparesis), which can cause a feeling of fullness after eating little, loss of appetite, diarrhea, constipation, abdominal bloating, nausea, vomiting and heartburn
  • Sweating abnormalities, such as excessive or decreased sweating, which affects the ability to regulate body temperature
  • Sluggish pupil reaction, making it difficult to adjust from light to dark and causing problems with driving at night
  • Exercise intolerance, which may occur if your heart rate remains unchanged instead of appropriately increasing and decreasing in response to your activity level

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • 1 year later...

Good description of antidepressant withdrawal:

 

http://npanth.wordpress.com/2012/03/14/phases-of-ssri-withdrawal/

Phases of SSRI Withdrawal

March 14, 2012 — npanth

 

Not all people experience withdrawal symptoms when trying to stop taking a Selective Serotonin Reuptake Inhibitor. In clinical trials, the percentage is placed between 2 and 10 percent of patients. These studies are sponsored by pharmaceutical companies. In independent research that looked at several different company studies, the percentage of patients who experienced withdrawal symptoms from SSRI was placed between 40 and 60 percent. It’s difficult to ascertain which number is right, most studies are held privately by the drug manufacturers and not available for public scrutiny. The term used by the pharmaceutical companies for withdrawal is “Discontinuation Syndrome”. SSRI work by blocking receptors that absorb Serotonin between neurons, thereby increasing the available Serotonin in the brain. The theory is that depression, obsessive behavior, anxiety, and psychotic behavior are caused by a lack of sufficient Serotonin in the brain. This theory was first developed in the 1950′s when it was noticed that patients’ mood improved when their levels of Serotonin was increased. It is currently impossible to measure the levels of Serotonin in a living brain. 90% of the body’s Serotonin exists in the gut, so researchers measure that amount, and extrapolate a concurrent increase in levels in the brain. Ironically, studies have also proven that reducing Serotonin in the brain can lead to improved mood. These results have brought the chemical imbalance theory under question in recent years. It is beginning to appear that artificially adjusting Serotonin levels in the brain does not have the intended effect, and may be the cause of some of the symptoms that SSRI were originally developed to treat.

 

The method that SSRI use to increase Serotonin levels in the brain is at the heart of the withdrawal problem. By blocking Serotonin receptors on neurons, the brain becomes dependent on the drug to maintain consistent levels of Serotonin. As the brain becomes accustomed to the drug, it no longer has to produce or regulate Serotonin as it did before. When the drug is removed, the receptors that stimulate Serotonin production are still blocked, and levels of this neurotransmitter begin to fluctuate. Since Serotonin is closely involved in mood and the ability to cope with emotions, this fluctuation causes wide mood swings and uncontrollable emotions. It seems that the level of Serotonin in the brain is not as important as consistent levels. As the brain adjusts to the need to self regulate levels of Serotonin, many patients experience a cascade of extreme emotional and physical symptoms. Analogous to the stages of grief or joy, these symptoms don’t always come all at once. In most cases, withdrawal symptoms come and go as the user lowers their dose of the drug. Some common emotion symptoms include depression, anxiety, anger, confusion, insomnia, and memory loss. For most people, these are symptoms that they experience in every day life. Usually, they are manageable and temporary. The difference for the withdrawal sufferer is that these emotions become unmanageable and intense. The regular mechanism that we use to control our emotions no longer works during withdrawal. It’s hard to imagine the loss of control that accompanies withdrawal symptoms. When a normal person succumbs to anger, it is still a conscious decision. In withdrawal, there is no spiral that precipitates the uncontrollable rage, it springs fully formed in the mind and propels itself without any input from the person experiencing it. The other emotional symptoms of withdrawal act in a similar way. Even when the patient exercises mindfulness and self awareness, anxiety, depression, and the other symptoms come on with little warning. They have a realness and power that most people are not used to. Since the brain’s balance has been disrupted, reality itself has been changed for the patient. Instead of an emotional wave that must be conquered or endured, these emotions become reality, with no alternative.

 

As time goes by, the patient will eventually be able to self regulate each emotion at a level similar to before they began taking an SSRI. One of the frustrating things about weaning off an SSRI is that the patient is only aware of progress after a phase has passed. They may feel extreme anxiety, but realize that the rage they experienced a few months before no longer bothers them. While they are experiencing a phase, there is no context to compare their emotions to. Since the emotions are so powerful and uncontrollable, emotional self awareness is short circuited, leading to mental relativism. The patient doesn’t realize the whole range of emotions, just the small extreme range that they are experiencing at the moment. The alternative to blind rage isn’t calmness, as it would be in a normal person. Instead, irrational anger is the lower end of the emotional range.

During withdrawal, these realities change and evolve as some emotions become dominant. Patients may experience uncontrollable rage for a few weeks, then enter a stage where depression dominates. These emotional tides are outward signs of the brain readjusting to the need to self regulate neurotransmitter levels. It is almost as if the mind is going through the entire inventory of emotion trying to catalog what’s necessary to regulate each one. Some people will experience several uncontrollable emotions at the same time, but the uncontrollable aspect of them will fade away one at a time. The variety and severity of symptoms often lead doctors to prescribe other drugs to mitigate the effects. This strategy compounds the problems of withdrawal by adding a second effect to an existing condition. The patient now has to deal with withdrawal as well as the effects of a new drug and perhaps a new set of withdrawal symptoms. The best strategy for dealing with SSRI withdrawal symptoms is time and slow weaning. A prolonged weaning schedule will reduce the severity and number of withdrawal symptoms. The brain requires a certain amount of time to adjust back to a natural balance of neurotransmitters which can’t be rushed. By slowly weaning off an SSRI, the brain does not have to deal with a sudden change to Serotonin levels, and can adjust at a natural rate. It takes a great deal of time for receptors in the brain to regenerate. A schedule that reduces the drug by 10% each month is usually sufficient. Schedules can vary depending on the patient. Some will be able to reduce their dose more quickly, others may have to go more slowly.

 

2005-2008: Effexor; 1/2008 Tapered 3 months, then quit. 7/2008-2009 Reinstated Effexor (crying spells at start of new job.)
2009-3/2013: Switched to Pristiq 50 mg then 100 mg
3/2013: Switched to Lexapro 10mg. Cut down to 5 mg. CT for 2 weeks then reinstated for 6 weeks
8/2013-8/2014: Tapering Lexapro (Lots of withdrawal symptoms)
11/2014 -8/2015: Developed severe insomnia and uncontrollable daily crying spells
12/2014-6/2015: Tried Ambien, Klonopin,Ativan, Lunesta, Sonata, Trazadone, Seroquel, Rameron, Gabapentin - Developed Anxiety disorder, PTSD, and Psychogenic Myoclonus
7/2015-1/2016: Reinstated Lexapro 2 mg (mild improvement, but crying spells still present)

1/2016-5/2017: Lexapro 5 mg ( helped a lot, but poor stress tolerance & depressive episodes)

5/20/2017 - Raised dose to Lexapro 10 mg due to lingering depression(Total of 2 failed tapers & severe PAWS)

9/11/2018 - Present: Still on 10 mg Lexapro and mostly recovered.(Extremely sensitive to stress which triggers Myoclonus.)

Intro page: http://survivingantidepressants.org/index.php?/topic/4149-lilu-depression-worsened-by-meds/

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This is actually very good, except that for many people (especially people with multidrug histories, long histories on the med, previous attempts to CT or rapid taper, and/or started as teenagers before the brain was mature) 10% a month may be too fast.

 

Still, this is a very good piece. And I appreciate the discussion of the uncontrollable mood/emotion swings and the way, when in them, we can't "see outside" of them.

Started on Prozac and Xanax in 1992 for PTSD after an assault. One drug led to more, the usual story. Got sicker and sicker, but believed I needed the drugs for my "underlying disease". Long story...lost everything. Life savings, home, physical and mental health, relationships, friendships, ability to work, everything. Amitryptiline, Prozac, bupropion, buspirone, flurazepam, diazepam, alprazolam, Paxil, citalopram, lamotrigine, gabapentin...probably more I've forgotten. 

Started multidrug taper in Feb 2010.  Doing a very slow microtaper, down to low doses now and feeling SO much better, getting my old personality and my brain back! Able to work full time, have a full social life, and cope with stress better than ever. Not perfect, but much better. After 23 lost years. Big Pharma has a lot to answer for. And "medicine for profit" is just not a great idea.

 

Feb 15 2010:  300 mg Neurontin  200 Lamictal   10 Celexa      0.65 Xanax   and 5 mg Ambien 

Feb 10 2014:   62 Lamictal    1.1 Celexa         0.135 Xanax    1.8 Valium

Feb 10 2015:   50 Lamictal      0.875 Celexa    0.11 Xanax      1.5 Valium

Feb 15 2016:   47.5 Lamictal   0.75 Celexa      0.0875 Xanax    1.42 Valium    

2/12/20             12                       0.045               0.007                   1 

 

I'm not a doctor. Any advice I give is just my civilian opinion.

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Sweetcreature

I agree. I like it also. It explains a lot of what I went through and confirms that neuro emotions come and go we need more people who are patient and understand this instead of running back to the doctors ( when at our most vulnerable)

 

SC

May 2001 - age 24 given 20 mg seroxat. Tried to reduce myself after a year. Told by GP to take on alternate days and I would be fine. FAIL. Assumed 'wrong time' due to university stress and that my 'depression' must be worse than I thought.

Increased dose to 30 mg December 2002. Tried the same technique as before to reduce- made it down to a quarter tablet but couldn't stand symptoms, had a sneaking suspicion that it was due to tablets but never considered dependency - 'depression is a diseased brain after all' (is what I was told)

 

Continued until October 2010 - tried to CT and managed to last five months - assumed the depression was really bad but had no understanding of the reason for awful anxiety. Ran back to GP started Prozac- went crazy thought I was going to die. Stopped Prozac after two weeks.

April 2010 Started sertraline. Stablished but felt numbed.

September 2010 Asked for seroxat again. Upped my dose to 30 after three weeks. Felt hyper, caffeinated, but functional. Glad to be over what I thought was 'depression'..

Realised it is the meds, want to be free at last - July 2012 started 10% taper from original dose and took supplements. Took suppliments sporadically and despite the temptation the taper, wanted it 'over with'. Taper took exactly six months and 10 days.

Reductions were as follows:
First 2 weeks- 27 mg
Next 2- 24mg
Next 2- 21 mg
Next 2- 18mg
Next 2 15 mg
Next 2 12 mg (held for four weeks due to house move from London back to Ireland)
Next 2 weeks- 9 mg
Next 2 weeks- 6 mg
Next 2- weeks 3 mg
Next 2 weeks 1.5 mg (held for 5 weeks as scared)
10th February 2013 Jumped to zero

Within 3 weeks sadness, led to anxiety.  Restarted suppliments - helped a bit.  Stressful move to London. A lot of fatigue and DEEP emotions. Crying LOTS. Took suppliments on and off, moved back to Ireland after being back in London for only eight weeks as felt too sad and unsettled. 

 

No suppliments when moved back.  Unhappy at being back, scared I wouldn't ever find happiness - deep deep sadness, anger, STUPIDLY went back to doctor and decided I must just be a 'depressive'.  Given Citalopram/Celexa 20mg.

 

Took it for seven days, changed my mind, decided to be 'strong' and put it behind me. (No particularly adverse effects that I recall, save for day 5 having inner vibrations in arms and legs) Still had pack of tablets however and every time emotions got hard felt I had to 'go back onto tablets'.  I did this from July until November. (On them off them on them off them) ........

 

Started to get body vibrations and told myself it was 'anxiety' and I was 'giving myself panic attacks.  I continued to cry as I 'started' the tablets again and again - not wanting to go back there but not sure what else to do. 

 

More vibrations - but didn't make the connection that I had a compromised CNS -  thought it was anxiety....chest started to pound in Sept, vibrations continued...lost weight, became anxious, sleep was awful and I tried a variety of remedies to replace the tablets and calm my anxiety and lift my mood.  I think they made things worse.

 

(These included, St.Johns Wort, Rescue Remedy, Homeopathic treatments, Chinese herbs, Passiflora, and suppliments from the online company who state they are experts in assisting people get off meds)

 

Also did the following:

 

Talking therapy

Human Givens Therapy

Homeopathy

Narcotics Anonymous

 

October 23rd took Citalopram (20mg) for 12 days - no relief

 

November 6th Started Seroxat 10 mg (to be safe) stupidly upped to 20 the next day.

 

Stayed on 20 for 18 days, no relief, stopped for two days suddenly, relief came - short lived, vibrations and torture came after 72 hours.  Suicidal for days.  Upped to 30 thinking it would improved.  Even more suicidal.  Dropped to 20 again (December 9th) not suicidal, but not better. Started liquid 28th December reduced to 18 mg in effort to reduce and stabilise.  Don't know where to go from here.  Living with parents who are supportive beyond words.

Sweetcreature

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  • Moderator Emeritus

Thanks for sharing this. It is good information. RU

Fall 1995 xanax, zoloft. switched to Serzone

1996- spring 2003serzone/ xanax/ lightbox.

b]Fall 2003- Fall 2004? Lexapro 10 mg. Light box /4 mg. xanax.[/b]

2004 - Fall of 2009 10 mg Lex, 150 mg Wellbutrin XL % 4 mg xanax

November 2009- Sept. 2011 10 mg lex., 300 Well. XL, 4 mg Xanax [/b

Sept.2012- July 2012 20 mg Lex 300 Well. XL, 4 mg Xanax

My mantra " go slow & with the flow "

3/2/13.. Began equal dosing 5 Xs /day xanax, while simultaneously incorporating a 2.5 % drop ( from 3.5 mg/day to 3.4 mg/day)

4/6/13 dropped from 300 mg. Wellbutrin XL to 150 mg. Difficult but DONE! Down to 3.3 mg xanax/ day / 6/10/13 3 mg xanax/day; 7/15/2013 2.88mg xanax/day.

10/ 1/2013...... 2.5 mg xanax… ( switched to tablets again) WOO HOO!!!!!! Holding here… cont. with Lexapro.

1/ 2/2014.. tapered to 18mg ( by weight) of a 26 mg ( by weight) pill of 20 mg tab. lexapro. goal is 13mg (by weight OR 10 mg by ingredient content) and STOPPED. Feeling very down with unbalanced, unpredictable WD symptoms.

1/2/2014- ??? Taking a brain-healing break from tapering anything after actively tapering something for 1.5 years. So… daily doses as of 2/2/2014: 18 mg by weight Lex, 150 mg Well. XL, 2.5 mg xanax, down from 26 mg by weight Lex., 300 mg well. XL, 4 mg xanax in August, 2012. I'll take it. :) 5/8/14 started equivalent dose liquid./ tabs. 5/13/14 1.5 % cut.

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  • Moderator Emeritus

Excellent article! Thanks Lilu for sharing it. 

**I am not a medical professional, if in doubt please consult a doctor with withdrawal knowledge.

 

 

Different drugs occasionally (mostly benzos) 1976 - 1981 (no problem)

1993 - 2002 in and out of hospital. every type of drug + ECT. Staring with seroxat

2002  effexor. 

Tapered  March 2012 to March 2013, ending with 5 beads.

Withdrawal April 2013 . Reinstated 5 beads reduced to 4 beads May 2013

Restarted taper  Nov 2013  

OFF EFFEXOR Feb 2015    :D 

Tapered atenolol and omeprazole Dec 2013 - May 2014

 

Tapering tramadol, Feb 2015 100mg , March 2015 50mg  

 July 2017 30mg.  May 15 2018 25mg

Taking fish oil, magnesium, B12, folic acid, bilberry eyebright for eye pressure. 

 

My story http://survivingantidepressants.org/index.php?/topic/4199-hello-mammap-checking-in/page-33

 

Lesson learned, slow down taper at lower doses. Taper no more than 10% of CURRENT dose if possible

 

 

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npanth's blog is very good. We have other posts by him here as well.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • 4 months later...
  • Administrator
Altostrata

Our esteemed member and moderator Rhi's description of the neurobiology of withdrawal syndrome:


 

A lot of people, including healthcare practitioners; in fact, I guess, most people-- are operating from entirely the wrong paradigm, or way of thinking, about these meds. They're thinking of them like aspirin--as something that has an effect when it's in your system, and then when it gets out of your system the effect goes away.

 

That's not what happens with medications that alter neurotransmitter function, we are learning.

What happens when you change the chemistry of the brain is, the brain adjusts its chemistry and structure to try to return to homeostasis, or biochemical and functional balance. It tries to restabilize the chemistry. 

For example: SSRI antidepressants work as "serotonin reuptake inhibitors." That is, they cause serotonin to remain in the space between neurons, rather than being taken back up into the cells to be re-used, like it would be in a normal healthy nondrugged brain.

So the brain, which wants to re-establish normal signaling and function, adapts to the higher level of serotonin between neurons (in the "synapse", the space between neurons where signals get passed along). It does this by removing serotonin receptors, so that the signal is reduced and changed to something closer to normal. It also decreases the amount of serotonin it produces overall. 

To do that, genes have to be turned on and off; new proteins have to be made; whole cascades of chemical reactions have to be changed, which means turning on and off OTHER genes; cells are destroyed, new cells are made; in other words, a complex physiologic remodeling takes place. This takes place over time. The brain does not grow and change rapidly. 

This is a vast oversimplification of the amount of adaptation that takes place in the brain when we change its normal chemistry, but that's the principle.

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay.

When the drug is removed, the remodeling process has to take place in reverse.

SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. 

It's a matter of, as I describe it, having to grow a new brain. 

I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long. 

With multiple drugs and a history of drug changes and cold turkeys, all of this becomes even more complicated. And if a person is started on these kinds of drugs at an early age before the brain has ever completely established normal mature functioning--well, it can't be good. (All of which is why I recommend an extremely slow taper particularly to anyone with a multiple drug history, a history of many years on meds, a history of past cold turkeys or frequent med changes, and a history of being put on drugs at a young age.)

This isn't intended to scare people, but hopefully to give you some idea of what's happening, and to help you respect and understand the process so you can work with it; ALSO, because you are likely to encounter many, many people who still believe these drugs work kind of like aspirin, or a glass of wine, and all you need to do is stop and get it out of your system. 

Now you can explain to them that no, getting it out of your system is not the issue; the issue is, you need to regrow or at least remodel your brain. This is a long, slow, very poorly understood process, and it needs to be respected.

 

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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  • 5 months later...

This is my first post so I do not know if I am entering this in the correct section. I began tapering from Lexapro last fall and my last dose was in April of this year. I actually felt good for four months. I was sleeping well and had energy. Then I noticed I began to experience fatigue and began to wake up in the middle of the night and could not go back to sleep. I began experiencing constant adrenalin rushes. After going four nights without any sleep, I had to go to the ER to get some relief. Now I am taking herbs, amino acids, and sometimes Klonopin (which I hadn't taken in years). I am seriously thinking of calling the doctor to get back on Lexapro, but am so disappointed I made it this far only to have to get back on. Not sure what to do, but I can't take this much longer. I knew to taper slowly but I did not know about protracted withdrawal. Any suggestions or advice? I can't hang on much longer.

Hi bgail, you first post should be in the Introductions page. One of the mods can move it for you later.  But I can definitely relate to what you're going through. Although I didn't have four good months after finishing my taper of Lexapro, which I did over a year and finished in August. Insomnia has been a huge problem. I'm also using Klonopin and Ambien to help me sleep, but then I feel like a total zombie and have crying spells afterwards.

What did they do for you at the ER?

What do the adrenaline rushes feel like?

What amino acids are you taking? L-Tyrosine and SAMe can be powerful norepinephrine activators, if that's what you're taking. 

I'm finding that I've become, like many people on this site, hyper-senstive to all neuro-active substances.

2005-2008: Effexor; 1/2008 Tapered 3 months, then quit. 7/2008-2009 Reinstated Effexor (crying spells at start of new job.)
2009-3/2013: Switched to Pristiq 50 mg then 100 mg
3/2013: Switched to Lexapro 10mg. Cut down to 5 mg. CT for 2 weeks then reinstated for 6 weeks
8/2013-8/2014: Tapering Lexapro (Lots of withdrawal symptoms)
11/2014 -8/2015: Developed severe insomnia and uncontrollable daily crying spells
12/2014-6/2015: Tried Ambien, Klonopin,Ativan, Lunesta, Sonata, Trazadone, Seroquel, Rameron, Gabapentin - Developed Anxiety disorder, PTSD, and Psychogenic Myoclonus
7/2015-1/2016: Reinstated Lexapro 2 mg (mild improvement, but crying spells still present)

1/2016-5/2017: Lexapro 5 mg ( helped a lot, but poor stress tolerance & depressive episodes)

5/20/2017 - Raised dose to Lexapro 10 mg due to lingering depression(Total of 2 failed tapers & severe PAWS)

9/11/2018 - Present: Still on 10 mg Lexapro and mostly recovered.(Extremely sensitive to stress which triggers Myoclonus.)

Intro page: http://survivingantidepressants.org/index.php?/topic/4149-lilu-depression-worsened-by-meds/

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  • 3 months later...

withdrawal symptoms go away but side effects persist 

please people there is a big difference between both and we should learn to distinguish the two problems to be more efficient in finding solutions.

 

''I''took paxil for 30 days (did`nt felt  a lot of side effects when ''I'' stopped it)

after two weeks I developed the worst headache I ever felt (some sort of permanent migraine, tinnitus..).

after a month of headaches a decided to take another pill to see.I took a pill because i was thinking that it  was may be withdrawal and it caused me a what my doctor called `some thing like serotonin syndrome`` which never improved and caused me severe muscle problems...

in retrospect I know that it was not a serotonin syndrome , my receptor were very stimulated and reacted in weird ways

 

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  • Administrator

One huge difference is

  • Side effects occur when you are on the drug, they are a result of the drug's presence in your body.
  • Withdrawal symptoms occur when you reduce the drug, they are a result of physiological dependence and the drug's absence at the accustomed level in your body.

Mild side effects, such as nausea, might go away over time. In fact, doctors assume that ALL side effects will go away over time. However, this is not true, and continuing side effects indicate the drug and your body will never get along at that dosage.

 

Continuing side effects or severe side effects, often called adverse effects, will continue as long as you are on the drug. I

 

Adverse effects are dosage-related; it's possible that a lower dose will not cause side effects. Unfortunately, misinformation about psychiatric drugs is so pervasive that many doctors will increase the dosage rather than decrease it when side effects persist, in the mistaken belief that more is always better. Excessive dosage can bring on additional problems.

 

Severe side effects are often called adverse effects. Confusingly, withdrawal syndrome is also sometimes called an adverse effect of drugs, but it cannot be called a side effect because side effects arise from the presence rather than the absence of the drug.

 

Withdrawal syndrome arises from inconsistent dosing or dosage reduction and tends to resolve over time.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • Moderator Emeritus

Great explanation, Alto, thanks!

**I'm not a doctor and don't give medical advice, merely personal experience
***Off all meds since Nov. 2014. Mentally & emotionally recovered; physically not
-Dual cold turkeys off TCA & Ativan in Oct 2014. Prescribed from 2011-2014

-All meds were Rxed off-label for an autoimmune illness.  It was a MISDIAGNOSIS, but I did not find out until AFTER meds caused damage.  All med tapers/cold turkeys directed by doctors 

-Nortriptyline May 2012 - Dec 2013. Cold turkey off nortrip & cold switched to desipramine

-Desipramine Jan 2014 - Oct. 29, 2014 (rapid taper/cold turkey)

-Lorazepam 1 mg per night during 2011
-Lorazepam 1 mg per month in 2012 (or less)

-Lorazepam on & off, Dec 2013 through Aug 2014. Didn't exceed 3x a week

-Lorazepam again in Oct. 2014 to help get off of desipramine. Last dose lzpam was 1 mg, Nov. 2, 2014. Immediate paradoxical reactions to benzos after stopping TCAs 

-First muscle/dystonia side effects started on nortriptyline, but docs too stupid to figure it out. On desipramine, muscle tremors & rigidity worsened

-Two weeks after I got off all meds, I developed full-blown TD.  Tardive dystonia, dyskinesia, myoclonic jerks ALL over body, ribcage wiggles, facial tics, twitching tongue & fingers, tremors/twitches of arms, legs, cognitive impairment, throat muscles semi-paralyzed & unable to swallow solid food, brain zaps, ears ring, dizzy, everything looks too far away, insomnia, numbness & electric shocks everywhere when I try to fall asleep, jerk awake from sleep with big, gasping breaths, wake with terrors & tremors, severely depressed.  NO HISTORY OF DEPRESSION, EVER. Meds CREATED it.

-Month 7: hair falling out; no vision improvement; still tardive dystonia; facial & tongue tics returned
-Month 8: back to acute, incl. Grand Mal seizure-like episodes. New mental torment, PGAD, worse insomnia
-Month 9: tardive dystonia worse, dyskinesia returned. Unable to breathe well due to dystonia in stomach, chest, throat
-Month 13: Back to acute, brain zaps back, developed eczema & stomach problems. Left leg no longer works right due to dystonia, meaning both legs now damaged
-4 years off: Huge improvements, incl. improved dystonia

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@Altostrata

you actually  misunderstood me

 

antidepressants have side effects that are permanent like arrhythmia,changes in blood pressure ,diabetes ,fibrosis, sexual dysfunction....

 

in this forum they are never discussed.Some side effects appear later after you have stopped the medication(the antidepressant ``lowers the threshold ``for them to happen and you can`t do anything about that )and that is why we talk of  increased stroke risk ,cardiovascular diseases ,osteoporosis .They are not due to withdrawal but they will appear later 

 

withdrawal effect can persist in rare case if the body is unable to adjust again.I think of it like a wound ,the less wounded you are the faster  you heal but some don`t regain full strength .Some don`t heal very much also.

 

I wish there is more awareness of those tardive side effects too because they exist .

Edited by scallywag
lines added at paragraph breaks

''I''took paxil for 30 days (did`nt felt  a lot of side effects when ''I'' stopped it)

after two weeks I developed the worst headache I ever felt (some sort of permanent migraine, tinnitus..).

after a month of headaches a decided to take another pill to see.I took a pill because i was thinking that it  was may be withdrawal and it caused me a what my doctor called `some thing like serotonin syndrome`` which never improved and caused me severe muscle problems...

in retrospect I know that it was not a serotonin syndrome , my receptor were very stimulated and reacted in weird ways

 

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  • Administrator

Those side effects are not necessarily permanent. We have many, many people who have recovered from them.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • 1 month later...

Personal thinking after 6 years off any psychotropic

 

withdrawal syndrome is many disorders, some acute, some less acute...made by a substance we can call poison, toxic...each med is a toxic(even insuline gives gangrene after years...)

 

nobody has the same disorders, therefore for example, we speak from pseudo parkinson, pseudo high blood pressure etc - not the real parkinson from natural disease -

 

before pills, the body was in order, sick for example in a local place, the rest is in order...

the pill makes disorders everywhere, not in one place, in random ...

 

can we cure disorder with a pill, no , a pill cannot replace in order, only the brain can replace , he is the boss, not the pill, the pill can only make a new disorder...

 

can the brain order all in same place as original?

impossible or we had testimonies of people 15 years on a drug and cured 100%, this do not exist,

he creates a new order, sometime not good for us and after years often...

 

what about people who where 2 years on drug and say they are 100%? less you are on drug, less are disorders, if you have 5% wrong in your liver, kidneys, heart valve, you will have no visible or feeling problem, but the disorder exist and will maybe reorder with months or years...

for anxiety 

12 years paxil - cold turkey 1,5 month - switch celexa 1 year taper; total 13 years on brain meds 

67 years old - 9 years  med free

 

in protracted withdrawal

rigidity standing and walking, dryness gougerot-szoegren, sleep deteriorate,

function as have a lack of nerves, improving have been very little 

 

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impossible or we had testimonies of people 15 years on a drug and cured 100%, this do not exist,

 

 

WRONG!!

I have seen people who were on the drug 15+yrs, and they are doing ok now....

Attitude Stan...your thoughts will create your inmediate future...if you think it's not going to happen, it wont.

4 years aprox. on 150mgs.Effexor for situational major depression.No AD before.
Tapered 150-0mgs in 3 months.

Tapered Quetiapine,Xanax in the last 18 months.NO med of any kind anymore.
First 3 months off acute w/d
Protracted w/d ever since.
Symptoms:Anxiety,anhedonia,insomnia,tinnitus,PSSD

04/13/2014 Awful Relapse.Recovered fairly fast.

3 years and 4 months off.

waves and windows.Very much recovered.

November 2015,health issue.Setback.
 

 

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  • 4 weeks later...

English is Stan's second language.  I don't see a lot of people doing great who were drugged for 15 or more years 100% recovery is less likely in my opinion possibly because many have tolerance before this time and are on more than one drug by the time 15 years comes around. I was drugged for 18 years so I keep an extra keen eye open for anyone in my time frame.  Some did not reach tolerance but some did I don't have specific numbers but it is a mixed bag.  Improper tapering and drugs switches are also more likely in this group of people as less was known about these drugs 15 20 25 years ago compared to today proper taper and withdrawal was unheard of then. I have been reading sites like this for 8 years now this is my opinion after watching these years.  

As for my thoughts creating the future... kind of a mean thing to say to a person who is in protracted withdrawal in my humble opinion. A bit of kindness and understanding goes a long way on sites like this again in my humble opinion. 

It feels bit to me like blaming the victim... if you can think happy thoughts you will heal if you can't you won't heal and it will be your own fault... like that... it just doesn't seem right to me.  I also think there is a stage of recovery people reach where negativity is the theme for a certain time and not much shifted me when I was in it so I try to be careful about predicting other peoples healing journey. I think the worst thing one could say would be they are creating their own misery when it is the brain/body recovery that is actually at work. This is how I see it. 

I wish you healing and peace.

WARNING THIS WILL BE LONG
Had a car accident in 85
Codeine was the pain med when I was release from hosp continuous use till 89
Given PROZAC by a specialist to help with nerve pain in my leg 89-90 not sure which year
Was not told a thing about it being a psych med thought it was a pain killer no info about psych side effects I went nuts had hallucinations. As I had a head injury and was diagnosed with a concussion in 85 I was sent to a head injury clinic in 1990 five years after the accident. I don't think they knew I had been on prozac I did not think it a big deal and never did finish the bottle of pills. I had tests of course lots of them. Was put into a pain clinic and given amitriptyline which stopped the withdrawal but had many side effects. But I could sleep something I had not done in a very long time the pain lessened. My mother got cancer in 94 they switched my meds to Zoloft to help deal with this pressure as I was her main care giver she died in 96. I stopped zoloft in 96 had withdrawal was put on paxil went nutty quit it ct put on resperidol quit it ct had withdrawal was put on Effexor... 2years later celexa was added 20mg then increased to 40mg huge personality change went wild. Did too fast taper off Celexa 05 as I felt unwell for a long time prior... quit Effexor 150mg ct 07 found ****** 8 months into withdrawal learned some things was banned from there in 08 have kept learning since. there is really not enough room here to put my history but I have a lot of opinions about a lot of things especially any of the drugs mentioned above.
One thing I would like to add here is this tidbit ALL OPIATES INCREASE SEROTONIN it is not a huge jump to being in chronic pain to being put on an ssri/snri and opiates will affect your antidepressants and your thinking.

As I do not update much I will put my quit date Nov. 17 2007 I quit Effexor cold turkey. 

http://survivingantidepressants.org/index.php?/topic/1096-introducing-myself-btdt/

There is a crack in everything ..That's how the light gets in :)

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this makes me think of a post in PP where Buxy2222 who is here also, after several years(maybe 6?)and  bad , the Scottys telling her : "if you think you will not heal, you will never heal" and she answer them that if thoughts could heal withdrawal, it would be known and it gave a classic little fight...

the antidepressants are poison, against toxics,  thoughts cannot fight, or so little; what you can do is delude yourself you heal, but it is only a dream...

if you took cocaine and have problems, nice thinking will do nada...

nice thinking help a healthy body, not a drugged brain with mood chemical altered...

the effects of good thoughts are very tiny if they are...

i speak friendly, 

for anxiety 

12 years paxil - cold turkey 1,5 month - switch celexa 1 year taper; total 13 years on brain meds 

67 years old - 9 years  med free

 

in protracted withdrawal

rigidity standing and walking, dryness gougerot-szoegren, sleep deteriorate,

function as have a lack of nerves, improving have been very little 

 

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 I truly believe there are things that we can do to help ourselves be more at ease when we are in some stages of withdrawal.  I am a firm believer in meditation and/or deep relaxation as I have found it to be helpful in almost all stages of withdrawal and it  was indeed the first thing I ever noticed to make an almost unnoticeable change in my suffering.  The more I did it the more noticeable the change was it was in no way a miracle but small moves towards healing need to be honored and sought if  we are going to survive this wd syndrome and get to a more stable place.  Yes it can be that bad and I do not want to harp on that.... but we need things to see us through this.  Deep relaxation was one of those things for me... the book " The Power of Now"  helped me greatly with my perspective at one point so much so you will see my recommending it all over the internet to help people survive withdrawal. How much we heal is an unanswered question how much we suffer can be helped by some things we choose sometimes...not always.  An important   fact as surviving this is the most important thing at the end of the day.sadly not everybody makes it out.. if we are going to survive we need to have tools to help us.  

Understanding what is going on is part of the tool box in my opinion this area is still lacking but some head way has been made.  

 

I want any new person who comes to this thread to be hopeful but not foolish... it will be challenging to get through this.  Some things that will help are understanding and some tools to try.  Please heed the warning of those who came before you... we/they learned by doing and have no reason to tell you any lies if we say to start supplement low it is because we suffered from not doing so... if we say taper has to be better than cold turkey it is because we have done cold turkey... let our mistakes help you to not make the same ones.. to lessen your suffering and increase your odds of a more complete recovery.  The only motive we have to be here is to help other people not have to go through the pain we have lived... well that is my reason... I think it is the same for others and support.  

 

We are all learning from each other lets try to be as kind as we call everybody hurts. 

 

Tools to help you:

http://survivingantidepressants.org/index.php?/forum/8-symptoms-and-self-care/

 

Journals to learn from:

http://survivingantidepressants.org/index.php?/forum/16-from-journals-and-scientific-sources/

peace

WARNING THIS WILL BE LONG
Had a car accident in 85
Codeine was the pain med when I was release from hosp continuous use till 89
Given PROZAC by a specialist to help with nerve pain in my leg 89-90 not sure which year
Was not told a thing about it being a psych med thought it was a pain killer no info about psych side effects I went nuts had hallucinations. As I had a head injury and was diagnosed with a concussion in 85 I was sent to a head injury clinic in 1990 five years after the accident. I don't think they knew I had been on prozac I did not think it a big deal and never did finish the bottle of pills. I had tests of course lots of them. Was put into a pain clinic and given amitriptyline which stopped the withdrawal but had many side effects. But I could sleep something I had not done in a very long time the pain lessened. My mother got cancer in 94 they switched my meds to Zoloft to help deal with this pressure as I was her main care giver she died in 96. I stopped zoloft in 96 had withdrawal was put on paxil went nutty quit it ct put on resperidol quit it ct had withdrawal was put on Effexor... 2years later celexa was added 20mg then increased to 40mg huge personality change went wild. Did too fast taper off Celexa 05 as I felt unwell for a long time prior... quit Effexor 150mg ct 07 found ****** 8 months into withdrawal learned some things was banned from there in 08 have kept learning since. there is really not enough room here to put my history but I have a lot of opinions about a lot of things especially any of the drugs mentioned above.
One thing I would like to add here is this tidbit ALL OPIATES INCREASE SEROTONIN it is not a huge jump to being in chronic pain to being put on an ssri/snri and opiates will affect your antidepressants and your thinking.

As I do not update much I will put my quit date Nov. 17 2007 I quit Effexor cold turkey. 

http://survivingantidepressants.org/index.php?/topic/1096-introducing-myself-btdt/

There is a crack in everything ..That's how the light gets in :)

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  • 2 weeks later...

I have a question to people who have been tapering ADs for years and have reached about the last 30-10% of the initial dose.

 

Are the symptoms you get in withdrawal always the same and very specific to you or do they change over time?

 

  • After tapering over 2 years off Cymbalta I started thinking/noticing whether at first my symptoms of WD brought on such things as severe depressive episodes, extensive crying, sensory overload and also very physical notions as brain fog, brain zaps and extreme sleepiness.
  • Now I suspect that the tables are turned and instead the prevalent WD symptom is intense panic and anxiety together with fear and all physical sensations that can happen during a panic attack (only they are constant).

Is such a turn possible? Has anyone experienced anything like this? How have you managed?

  • 2,5 years of slowly tapering down Cymbalta from 60 mg. Then tried going from 8,44 mg to 1 mg in 8 days. (April 1st 2015). That's when the real hell started. Reinstated. Didn't help. I was added Ativan (2 mg 2 times a day for relentless akathisia that started with jumping Cymbalta). For years had been taking Zopitin 7,5 mg and Stilnox 10 mg for I had not been able to sleep naturally since the 1st day I started Cymbalta). Used to take Xanax occasionally.
  • All of the above were stopped cold turkey when I was hospitalized in the beginning of May 2015.
  • Prior to that I have been on and off the whole spectrum of different AD-s for 15 years (since I was 17).

My introduction.

 

Tapering:

  • Olanzapine (starting point 2,1 mg): Jan 2016  /---/ April 2018 0 mg. (From 2,1 mg to 0 mg in 1y 3mo).
  • Diazepam (starting at 5 mg) : switching to liquid May 2018;  4,6 mg (June 2018) /---/ 0 mg (Feb 2020) (From 10 to 5 - nobody knows, from 5 to 0 in 1 y 10 mo)
  • Valdoxan (starting at 25 mg): switching to liquid (Feb 2019) /---/ 0 mg (July 2020)

 

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Hi

 

It took me about 6mths to taper trazodone.

I got lazy in the end, as you have to eat before trazodone and the taper went a bit off, and I just came off them.

I was failing to take them.

I do get more depression even though the traz didnt help my depression, but anytime I get a negative thought, i know it's only the traz.

Im getting better though, as I am on a higher dose menopause HRT and waiting fot that to kick in.

I did three tapers valium, seroquel and traz and the menopause complicated them.

Some people can get off ad's and psych meds quicker but you never know how you will react.

I dont advise people tapering my way, as I was lazy and couldnt be bothered with the hassle after the milk valium taper.

pregan taper 600mg down to 240mg, daily cuts since xmas

valium, just over 75mg, tapering 0.1 a day, will keep this more udated, cos amounts going down

i have borderline personality, chronic ptsd, and suspected adhd and substance misuse as a symptom, which i am addressing with help of medical staff, drugs agencies & mh sta

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I would like to know more specifically if anyone has experienced that for example starting to taper they had one set of withdrawal symptoms and perhaps after a while the symptoms they get when they reduce the medicine are totally or partially different.

  • 2,5 years of slowly tapering down Cymbalta from 60 mg. Then tried going from 8,44 mg to 1 mg in 8 days. (April 1st 2015). That's when the real hell started. Reinstated. Didn't help. I was added Ativan (2 mg 2 times a day for relentless akathisia that started with jumping Cymbalta). For years had been taking Zopitin 7,5 mg and Stilnox 10 mg for I had not been able to sleep naturally since the 1st day I started Cymbalta). Used to take Xanax occasionally.
  • All of the above were stopped cold turkey when I was hospitalized in the beginning of May 2015.
  • Prior to that I have been on and off the whole spectrum of different AD-s for 15 years (since I was 17).

My introduction.

 

Tapering:

  • Olanzapine (starting point 2,1 mg): Jan 2016  /---/ April 2018 0 mg. (From 2,1 mg to 0 mg in 1y 3mo).
  • Diazepam (starting at 5 mg) : switching to liquid May 2018;  4,6 mg (June 2018) /---/ 0 mg (Feb 2020) (From 10 to 5 - nobody knows, from 5 to 0 in 1 y 10 mo)
  • Valdoxan (starting at 25 mg): switching to liquid (Feb 2019) /---/ 0 mg (July 2020)

 

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Anyone?

  • 2,5 years of slowly tapering down Cymbalta from 60 mg. Then tried going from 8,44 mg to 1 mg in 8 days. (April 1st 2015). That's when the real hell started. Reinstated. Didn't help. I was added Ativan (2 mg 2 times a day for relentless akathisia that started with jumping Cymbalta). For years had been taking Zopitin 7,5 mg and Stilnox 10 mg for I had not been able to sleep naturally since the 1st day I started Cymbalta). Used to take Xanax occasionally.
  • All of the above were stopped cold turkey when I was hospitalized in the beginning of May 2015.
  • Prior to that I have been on and off the whole spectrum of different AD-s for 15 years (since I was 17).

My introduction.

 

Tapering:

  • Olanzapine (starting point 2,1 mg): Jan 2016  /---/ April 2018 0 mg. (From 2,1 mg to 0 mg in 1y 3mo).
  • Diazepam (starting at 5 mg) : switching to liquid May 2018;  4,6 mg (June 2018) /---/ 0 mg (Feb 2020) (From 10 to 5 - nobody knows, from 5 to 0 in 1 y 10 mo)
  • Valdoxan (starting at 25 mg): switching to liquid (Feb 2019) /---/ 0 mg (July 2020)

 

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Yes, the symptoms that I attribute to withdrawal change quite regularly, usually after I stabilize.  It's always a bit terrifying to wait and see what the new WD will bring, but good to know they will slowly dissipate as well.

January 2014 Zoloft 150 mg

May 2014 Started tapering

January 2015  Zoloft 54 mg

January 2016 18 mg

January 2017 12 mg

January 2018 7 mg CRASH! 

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I have definitely noticed this to be the case throughout my years of tapering. For instance, when I first began tapering body whooshes/zaps were my biggest symptom whereas now they are very rare. Also, in the beginning of my taper the duration of my symptoms held a definite pattern. Symptoms would show up around day 3 and start resolving by day 10. Now, it is much more unpredictable as to when they will arrive and when I will stabilize.

 

I have also noticed that new symptoms can arrive suddenly, stick around for anywhere from a few weeks to a year or so, and then disappear as quickly as they arrived.

 

I seem to remember others talking about how on higher doses their symptoms were more physical, and when they reach lower doses their symptoms were more mental. I'm not sure if anyone here can attest to that being the case in their situation. I can't say that has been the case in mine.

 

So to answer your question, yes I think think it is quite normal for symptoms to change over time and as your dose gets lower.

a.k.a JMarie

Paxil since Mar.1998

2006-2007:40-20mg
2009: 20mg to 14mg 2010: 14mg to 10.5mg 2011: 10.5 to 7.6mg  2012: 7.5 to 6.8mg

2013: 6.7-6.3mg 2014: 6.2mg-5.8mg 2015: 5.7 to 5.15mg 2016: 5.1-4.6mg

1/19/17: 4.5mg 3/17/17: 4.4mg

6/15/17: 4.35mg 8/10/17: 4.3mg

1/29/18: 4.1mg 5/07/18: 4.0mg

7/31/18: 3.9mg

 

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quite hard to answer that question but it seems that symptoms are changing. but they are even changing during shorter time and not following any clear pattern (such as, towards the end, clearly different direction). 

 

I would say the same thing as ladybug, that previously my withdrawal had more clear pattern. lately it has been less predictible. but I'm not sure if it's withdrawal that is changing or the fact that so much things have changed in my life and maybe also in my body due to some things (acupuncture, etc). 

 

I used to have very clear physical symptoms such as tiredness and oversleeping, but during the last drop it was less clear, but the mental symptoms were maybe more than previously and they didn't appear as clear pattern, they came and went. 

 

I'm just about to make the next drop and I have no idea what is waiting for me now. 

 

sorry, tried to answer the question, but this issue is unclear for me, and it's very hard to answer. I'm very interested in more answers from others. 

in 2002- 0,5 tablet cipramil for half a year, ended it uneventfully. in 2006 - citalopram for half a year, ended in horrific state, ditched the drugs CT. 2007-2008 not feeling well but drug free. in 2008 prozac 20mg + quetiapine 25mg. 2009 tried to stop, ended up in hole after couple of months, started zoloft. 2009-2011 zoloft 50mg. went to 25mg in 2011 summer, it resulted in half a year horrible suffering. reinstated, changed drugs, nothing happened. by 2012 beginning suddenly felt great and CT meds. after 4 months came suddenly most horrible human suffering that's possible. was started on prozac and questiapine. started tapering slowly, GFCF diet and Hardy Nutritionals vitamins in 2013 summer. 

current medications: 1) fluoxetine and quetiapine since Aug 2012; 2) Daily Essential Nutrients by Hardy Nutritionals 7 capsules / since May 2013 + omega3; 3) Gluten-free-casein-free diet since june 2013

 

Started withdrawing slowly since april 2013. Mostly around 10% cuts. 

April'13 - March'14: fluoxetine 40mg -> 19,5mg; quetiapine 50mg -> 40mg
April'14-March'15: fluoxetine 19,5mg -> 14,4mg; quetiapine 40mg -> 22mg

April'15-March'16: fluoxetine 14,4mg -> 7,4mg; quetiapine 22mg -> 15mg

April'16-March'17: fluoxetine 7,4mg -> 5,0mg; quetiapine 15mg -> 7,25mg

April'17-March'18: fluoxetine 5,0mg -> 4,0mg; quetiapine 7,25mg -> 0 (as of 1st Feb 2018)!!!!

April´18-March´19: fluoxetine 4,0mg - > 2,3mg. Jumped off fluoxetine 1,4mg due to pregnancy in July 2019. Oct 2019 severe withdrawal syndrome started.

Took mistakenly a complex for hormonal support that included pregnenolone dec2019-april2020. Stopped it april 2020 and immediately severe akathisia started. Have had life threatening akathisia since, 100% disabled, suicidal, very hard to hold on. 

 

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I seem to remember others talking about how on higher doses their symptoms were more physical, and when they reach lower doses their symptoms were more mental. I'm not sure if anyone here can attest to that being the case in their situation. I can't say that has been the case in mine.

Thank you for your answer. This is also I tendency I have been noticing. I just wanted to ask what sort of mental symptoms are they that these people report to be having at the lowed doses? For me it has been extreme panic.

  • 2,5 years of slowly tapering down Cymbalta from 60 mg. Then tried going from 8,44 mg to 1 mg in 8 days. (April 1st 2015). That's when the real hell started. Reinstated. Didn't help. I was added Ativan (2 mg 2 times a day for relentless akathisia that started with jumping Cymbalta). For years had been taking Zopitin 7,5 mg and Stilnox 10 mg for I had not been able to sleep naturally since the 1st day I started Cymbalta). Used to take Xanax occasionally.
  • All of the above were stopped cold turkey when I was hospitalized in the beginning of May 2015.
  • Prior to that I have been on and off the whole spectrum of different AD-s for 15 years (since I was 17).

My introduction.

 

Tapering:

  • Olanzapine (starting point 2,1 mg): Jan 2016  /---/ April 2018 0 mg. (From 2,1 mg to 0 mg in 1y 3mo).
  • Diazepam (starting at 5 mg) : switching to liquid May 2018;  4,6 mg (June 2018) /---/ 0 mg (Feb 2020) (From 10 to 5 - nobody knows, from 5 to 0 in 1 y 10 mo)
  • Valdoxan (starting at 25 mg): switching to liquid (Feb 2019) /---/ 0 mg (July 2020)

 

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I seem to remember others talking about how on higher doses their symptoms were more physical, and when they reach lower doses their symptoms were more mental. I'm not sure if anyone here can attest to that being the case in their situation. I can't say that has been the case in mine.

Thank you for your answer. This is also I tendency I have been noticing. I just wanted to ask what sort of mental symptoms are they that these people report to be having at the lowed doses? For me it has been extreme panic.

 

 

I believe they were referring mostly to anxiety and depression type symptoms.

a.k.a JMarie

Paxil since Mar.1998

2006-2007:40-20mg
2009: 20mg to 14mg 2010: 14mg to 10.5mg 2011: 10.5 to 7.6mg  2012: 7.5 to 6.8mg

2013: 6.7-6.3mg 2014: 6.2mg-5.8mg 2015: 5.7 to 5.15mg 2016: 5.1-4.6mg

1/19/17: 4.5mg 3/17/17: 4.4mg

6/15/17: 4.35mg 8/10/17: 4.3mg

1/29/18: 4.1mg 5/07/18: 4.0mg

7/31/18: 3.9mg

 

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My symptoms did not fit any kind of pattern while tapering. Sometimes, they were more emotional and others, more physical. I didn't have much depression, and in fact, stopped having most of it as soon as I started reducing. I had some waves of anxiety, but they'd be short periods. The most difficult emotional aspects were irritability and anger, which I had plenty of...as well as repetitive thoughts.

Remeron for depression. Started at 7.5 mg. in 2005. Gradual increases over 8 years, up to 45 mg. in 2012.Began tapering in June 2013. Went from 45 to 30 mg in the first 3-4 months. Held for a couple of months.Started tapering by 3.75 mg every month or 2, with some longer holding periods. Eventually went down to 3.75 mg. about April 2014. Stopped taking Remeron August 2014. Developed issues with histamine a week after stopping--symptoms reduced through diet and a few supplements. Currently having issues with a few foods. Most of the histamine intolerance has resolved or is at least, in remission.

Current Medications:

Current Supplements: Cannabis (CBD and THC), Vitamin C, D, Quercetin, CoQ10, Tart Cherry, Probiotic, Phytoplankton oil, magnesium. What has helped me most: qi gong, exercise, healthy diet, meditation, IV vitamins, homeopathy, massage, acupuncture, chiropractic, music, and cuddling my cats..

My introduction: http://survivingantidepressants.org/index.php?/topic/8459-mirtazapine-withdrawal-freespirit/#entry144282

Please note: I am not a therapist or medical practitioner. Any suggestions offered come solely from my personal experience in recovering from childhood trauma, therapy, and AD use. Please seek appropriate care for yourself.

 

“After a cruel childhood, one must reinvent oneself. Then re-imagine the world.”
Mary Oliver
 

 

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For me at first the symptoms included a lot of brain zaps and neurological difficulties, I had a lot of neural pains and extreme sleepiness plus heavy  brain fog and dizziness. But I also experienced huge mood swings, lots of crying and very-very depressed moods. 

Now with my last faux pas when I tried rapid reduction (and with one WD before that) symptoms changed a lot. Now I am paralysed by panic, I cannot get to crying for all the fear, I get a lot of the cortisol flushes both morning and day and many other physical symptoms that can be associated to anxiety and panic on some level. I feel intense fear and I have trembling in my hands and legs. I also got a really bad case of akathisia for whic I quickly started taking medication for so hopefully this will not last (currently on the med and doing better). I also get a lot of derealisation feelings this time (to me they have always been connected to severe anxiety).

  • 2,5 years of slowly tapering down Cymbalta from 60 mg. Then tried going from 8,44 mg to 1 mg in 8 days. (April 1st 2015). That's when the real hell started. Reinstated. Didn't help. I was added Ativan (2 mg 2 times a day for relentless akathisia that started with jumping Cymbalta). For years had been taking Zopitin 7,5 mg and Stilnox 10 mg for I had not been able to sleep naturally since the 1st day I started Cymbalta). Used to take Xanax occasionally.
  • All of the above were stopped cold turkey when I was hospitalized in the beginning of May 2015.
  • Prior to that I have been on and off the whole spectrum of different AD-s for 15 years (since I was 17).

My introduction.

 

Tapering:

  • Olanzapine (starting point 2,1 mg): Jan 2016  /---/ April 2018 0 mg. (From 2,1 mg to 0 mg in 1y 3mo).
  • Diazepam (starting at 5 mg) : switching to liquid May 2018;  4,6 mg (June 2018) /---/ 0 mg (Feb 2020) (From 10 to 5 - nobody knows, from 5 to 0 in 1 y 10 mo)
  • Valdoxan (starting at 25 mg): switching to liquid (Feb 2019) /---/ 0 mg (July 2020)

 

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in my worst withdrawal episode I had at first neurological symptoms like dizziness, vertigo, vision problems, etc. they were minor and didn't bother me that much. after about 3-4 months I started to have mood swings, that increased in time and got really wild. until at some point my mood just crashed. in a matter of week I became from sane, functioning human being to utterly broken and crazy, nonfunctioning painful mess. I even don't remember exact symptoms very clearly, but it was extreme emotional pain, suicidal thoughts, extreme fear and sense of not feeling secure at all, all feeling of security was gone and I was left in a terrifying world.I remember that every second was pain, and that went on for two months. when i think back to it, I don't remember much physical symptoms, it was mainly emotional.

 

I'm thinking right now that your change of symptoms may have been from reaching the end.. and the crash you had may have been from jumping the last bit. but it's also an option of late-onset withdrawal syndrome - that you moved to fast with all the cuts and didn't leave enough time inbetween to correctly stabilize, so you run ahead of your nervous systems ability to heal. just a thing to consider...

in 2002- 0,5 tablet cipramil for half a year, ended it uneventfully. in 2006 - citalopram for half a year, ended in horrific state, ditched the drugs CT. 2007-2008 not feeling well but drug free. in 2008 prozac 20mg + quetiapine 25mg. 2009 tried to stop, ended up in hole after couple of months, started zoloft. 2009-2011 zoloft 50mg. went to 25mg in 2011 summer, it resulted in half a year horrible suffering. reinstated, changed drugs, nothing happened. by 2012 beginning suddenly felt great and CT meds. after 4 months came suddenly most horrible human suffering that's possible. was started on prozac and questiapine. started tapering slowly, GFCF diet and Hardy Nutritionals vitamins in 2013 summer. 

current medications: 1) fluoxetine and quetiapine since Aug 2012; 2) Daily Essential Nutrients by Hardy Nutritionals 7 capsules / since May 2013 + omega3; 3) Gluten-free-casein-free diet since june 2013

 

Started withdrawing slowly since april 2013. Mostly around 10% cuts. 

April'13 - March'14: fluoxetine 40mg -> 19,5mg; quetiapine 50mg -> 40mg
April'14-March'15: fluoxetine 19,5mg -> 14,4mg; quetiapine 40mg -> 22mg

April'15-March'16: fluoxetine 14,4mg -> 7,4mg; quetiapine 22mg -> 15mg

April'16-March'17: fluoxetine 7,4mg -> 5,0mg; quetiapine 15mg -> 7,25mg

April'17-March'18: fluoxetine 5,0mg -> 4,0mg; quetiapine 7,25mg -> 0 (as of 1st Feb 2018)!!!!

April´18-March´19: fluoxetine 4,0mg - > 2,3mg. Jumped off fluoxetine 1,4mg due to pregnancy in July 2019. Oct 2019 severe withdrawal syndrome started.

Took mistakenly a complex for hormonal support that included pregnenolone dec2019-april2020. Stopped it april 2020 and immediately severe akathisia started. Have had life threatening akathisia since, 100% disabled, suicidal, very hard to hold on. 

 

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I would like to know more specifically if anyone has experienced that for example starting to taper they had one set of withdrawal symptoms and perhaps after a while the symptoms they get when they reduce the medicine are totally or partially different.

Thinking about it, I think i got psychiatric symptoms coming off the last of my tapers, seroquel and trazodone.

I think I got a psychotic delusional state, as mentioned in another post. I think I am going through one now, about some practical issues.

I am aware it is delusional though and that helps massively.

pregan taper 600mg down to 240mg, daily cuts since xmas

valium, just over 75mg, tapering 0.1 a day, will keep this more udated, cos amounts going down

i have borderline personality, chronic ptsd, and suspected adhd and substance misuse as a symptom, which i am addressing with help of medical staff, drugs agencies & mh sta

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  • 2 weeks later...

i would say my symptoms early on were more physical too...swooshy head and more of a physical anxiety (stomach upset, diarrhea, shakes, vertigo, breathless feeling), there were also mental symptoms too, like depression and DR and a nervous unsettled anxiety in the mind, fearful of every bad thing possible. Towards the middle of my taper it was mostly just DR and anxiety (always worse upon waking) and now i find some drops i have no symptoms at all, and some bring on some anxiety/DR. However, i began my taper in an unstable state because i had practically CT'd a high Effexor dose some months prior and was already in rough shape. That has been a background hum for the duration of my taper...and i would get waves and windows throughout that seemed to have more to do with that, than my paxil taper (make sense,lol?). Its a mixed bag...and from what Ive read symptoms can vary and change throughout. But for me I have definately noticed the impact of my drops is no longer as predictable...and appears to take longer to register (almost two weeks post drop now as opposed to a matter of days).

2 Timothy 1-7 For God hath not given us the spirit of fear; but of power, and of love, and of a sound mind.

Effexor 75mg to 262.5mg 2005-2010 for post partum depression

Started having poop out mid 2010, also switched generic brands, then crashed in Dec 2010 (anxiety/ "terror", intense DR, anhedonia, suicidal ideation, chills, insomnia, horrible intrusive thoughts, disorientation, ect)
Rapid "tapered" from 262.5mg Effexor in 3 months

Tried Celexa,Cipralex, then Paxil to deal with wd(this switching made things worse and added akathesia)

Found online support and started tapering Paxil 7 months after quitting Effexor (at this point was having small windows).

Paxil taper: dropped 10% every 4-8 weeks

Year 1 October 2011 to Nov 2012 20mg to 10mg

Year 2 March 2013 to Feb 2014 10mg to 4mg

Year 3 April 2014 to May 2015 4mg to 1.1mg

Year 4 June 2015 1.1mg , dropping by 10% until .5mg, after then dropped by 0.1mg every 5 weeks until 0.1mg.

Finished! Official last dose of 0.1mg on June 15/16

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clarabella79

Hi!

 

This is my 2nd gradual taper and my symptoms are the same this time as last time (fortunately, they're pretty mild), but they have changed as time's gone on. I've noticed more in the way of muscular aches/pains/twinges, tiredness, increased sensitivity to loud noises as I've decreased my dose further. During the early stages (between, say, 18mg and 13mg), I noticed I felt more calm and on an even keel emotionally than I had when I was taking the so-called "therapeutic" 20mg dose (anxiety, mood swings and derealisation were side effects for me at the therapeutic dose - not exactly ideal!). I was also experiencing night sweats during the early stages (bearing in mind it was during an English autumn and winter, so not exactly the warmest place on the planet!).

 

Last time around, I remember the emotional instability starting to kick in at around the 6mg mark and for me it was very much as others (particularly ladybug, rapunzel2 and freespirit) have described. Lesson learned: taper more slowly this time!

 

Hope that helps!

1st Sep '14 - reduced to 18mg from 20mg; 15th Sep - 17mg; 29th Sep -16mg; 21st Oct - 15mg; 10th Nov - 13.5mg; 1st Dec - 13mg;

11th Dec - 12.5mg; 5th Jan '15 - 12mg; 20th Jan - 11.5mg; 11th Feb  - 11mg; 26th Feb - 10.5mg; 5th Mar - 10mg; 1st Apr - 9mg; 29th Apr - 8.5mg; 29th May - 8mg; 18th Jun - 7.7mg; 9th July - 7.4mg; 11th Aug - 6.8mg; 2nd Sep - 6.5mg; 12th Sep - 6.3mg; 26th Sep - 6mg; 10th Oct - 5.7mg; 30th Oct - 5.3mg; 28th Nov - 4.8mg; 20th Dec - 4.4mg. 

Medication History:

January 1997: 20mg Paroxetine (Seroxat) daily for depression with anxiety. CT withdrawal attempted 1997 and 1999. Dividing pills withdrawal attempted 2002. Liquid/pill 13 month tapered withdrawal 2007/8. Started to become very ill days after CTing at 2mg. Prescribed other antidepressants (CitalopramMirtazipine) but neither were as effective and had more side effects, so Paroxetine 20mg reinstated June 2008.

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Over the past year my WD effects were not always the same. I experienced headaches, vertigo, a feeling of a tight band wrapped around my head, nausea, panic attacks (especially at night in bed). Could never got my finger on it, mostly they came as a surprise. As in: what's next?

However, I found that during stressful times (for example during the time I had problems at work) the anxiety at night were dominant.

The nausea would come and go during the day. But only for a period of about a week after tapering. But also not after every tapering.

So for me it was a wait and see every time.

The starting period of tapering (coming from 100 mg to 75 mg and then 50 mg) gave me the least problems. The futher and the smaller the tapering, towards the end, were prone to show the most problems.

I suppose it's different for everybody how it goes. And maybe it has also to do with the kind of AD you're using.

Try to figure out if there's a pattern, in how your life goes at those moments. Just my 2 cents.

Diagnosis: GAD (2008), clinical depression (2012), again clinical depression (2016) and ptsd (2016)

History of: paroxetine, lexapro, sertraline, bupropion, zyprexa, seroquel, nortrilen, oxazepam, lorazepam, diazepam, nortriptyline.

 

Successfully came off nortriptyline after a full year of tapering from 100 mg. Quit in May 2015.

February 2016 started mirtazapine, followed by levothyroxine in April 2016 (diagnosis hypothyroidism)

 

Current meds/supplements: mirtazapine 15 mg, levothyroxine 50 µg, diazepam 1mg (tapering off) and melatonin 5 mg.

 

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