SuzieQ's first (and hopefully last) attempt at coming off fluoxetine (prozac) and quetiapine (seroquel)

[suzieQ]

Hi! New here. 21 years old, male, from Sweden. Backstory:

 

Sought help almost a year ago for depression and obsessive/ruminative behaviour. Became worse during the summer and by august I was borderline suicidal because of how bad I felt about myself.

Was put on fluoxetine (prozac) 20mg. Hours after my first dose I experienced alleviated obsessisions/ruminations and felt better about myself, and by the end of the third week, I was almost restored. I told my psychiatrist that I had mild obsessisions and ruminations, and he suggested that we increased the dosage to 30mg in an attempt to free me completely from it.

 

It worked. For almost six months, I felt normal again. Never over the top by any means; just happy, and stable. By january this year, I had a small 'prozac poop-out' - slightly melancholic, with a small increase in obsessive and compulsive behaviour. My doc turned up my medication to 40mg, and once again, I felt normal, if not a bit restless. Some days I had trouble sleeping. Friends and family still considered me to be stable, and that's how I felt too. Just a bit overstimulated from the medication. My therapist and psychiatrist disagreed, and this is when the idea of me being bipolar was born.

 

Concerned with my sudden insomnia and restlessness, my psychiatrist put me back to 30mg. Soon thereafter it 'pooped out' on me again; apparantly this strengthened their case, and along with the fact that I told them that my grandmother is medicated for bipolar disorder (if she is or not might not be as clear cut of a case as I earlier thought), I was now introduced to my new med - Seroquel. I was upped to 40mg once again, with the addition of 25mg Seroquel to be taken nightly.

 

Back to the present. I've been on this combination for a month. Being frustrated of the sedative effects of seroquel, I started researching and quickly realized that at the dosage I'm on, it only acts like an antihistamine, and not 'mood-stabilizing' in any way what so ever. This means that I have been on 40mg of fluoxetine, fully stable, for a month now, with no problems with insomnia or restlessness. On top of that, I was on 30mg fluoxetine for 6 months, while, like my father put it, being "more stable than you've been in many years". I have no history of either hypo- or manic episodes.To me, this suggests that a bipolar diagnosis is unlikely.

 

From what I can understand, my psychiatrist hasn't diagnosed me yet, but has on multiple occassions said that I gave him bipolar 'vibes'. This, along with my grandmothers supposed bipolarity (my dad is not in any way bipolar btw), and the fact that the fluoxetine worked 'instantly' for me and then pooped out, apparantly suggests that I'm bipolar.

 

Looking at the side-effects of Seroquel, I realize that this is not something I'm okay with taking without being very, very convinced of my 'bipolarity'. The side-effects look absolutely terrifiying, and honestly, I don't think my psychiatrist has nearly enough evidence for this diagnosis. My parents agrees.

 

So I have an appointment soon where I will bring all of this up with my psychiatrist, but I have a feeling that he's going to be reluctant. Lastly we spoke he told me that he wanted to try and up the seroquel dosage further.

 

I'm not on seroquel at the moment, and so far, I haven't noticed any problems. I still sleep well, I don't experience any restlessness. In fact, I feel quite happy and hopeful about everything. The idea of increasing the dosage of seroquel to therapuetic doses of 2-300mg is unappealing.

 

Input would be greatly appreciated, whatever it might be.

 

Thanks in advance,

suzieQ

[Jemima]

Hello, susieQ-

 

Antidepressants are quite stimulating and this effect can be mistaken for mania, especially at higher doses. Cutting your dosage by 10 mg. so abruptly likely brought on some withdrawal symptoms too, which can include hyperactivity.  It isn't unusual for someone who is having side effects from antidepressants to be misdiagnosed as bipolar, as you'll see if you care to browse our Intro section.

 

Sad to say, but many doctors get their "knowledge" of psychiatric drugs from Big Pharma, which can and does lie about their effectiveness, side effects, and difficulties of withdrawal.  It's quite common for pharmaceutical companies to bury the bad research and present only the positive stuff to the FDA. Your psychiatrist doesn't seem to be at all aware of the downside of these drugs, and if I were you, I'd look for someone more knowledgeable in addition to a psychotherapist who could help you overcome depression and obsessive-compulsive behavior.

 

Aside from that, I'm not sure we can help you very much.  It sounds to me as if you're more or less content with being on an antidepressant.  The purpose of this forum is to help people who want to get off of antidepressants and other psychiatric drugs to do so as safely and comfortably as possible. None of us staff are qualified to give advice about what psychiatric drugs to take, how much, et cetera.

[suzieQ]

Thank you for your reply Jemima.

 

I guess I wanted to see if anyone on here could relate to my story in any way.

 

I'll definitely browse around the intro section to learn more about this.

 

All the best

SQ

[Skyler]

Suzie.. search for bipolar, go to the search box in the upper right hand corner of this page. You will find out how often (HUGE) people on ADs are given a bipolar diagnosis. Search the forum as opposed to just this topic.

 

All the best.. Skyler

[Altostrata]

Welcome, susieQ.

 

If 30mg is too little and 40mg too much, 35mg might be just right.

 

Your psychiatrist lacks imagination in that he cannot imagine a dosage that isn't supplied by a drug company. On the other hand, "vibes" is no way to diagnose anyone.

 

As others have said, this is a forum for going off psychiatric drugs, so we can't help you with figuring out a new cocktail, we don't do that.

[suzieQ]

Suzie.. search for bipolar, go to the search box in the upper right hand corner of this page. You will find out how often (HUGE) people on ADs are given a bipolar diagnosis. Search the forum as opposed to just this topic.

 

All the best.. Skyler

 

Thank you for your reply! I have been browsing for a bit already, and have been redirected to other sites as well. I'm very surprised of what I'm reading, to say the least. I will keep researching, but I'm very grateful for having found this site.

All the best!

 

 

 

Welcome, susieQ.

 

If 30mg is too little and 40mg too much, 35mg might be just right.

 

Your psychiatrist lacks imagination in that he cannot imagine a dosage that isn't supplied by a drug company. On the other hand, "vibes" is no way to diagnose anyone.

 

As others have said, this is a forum for going off psychiatric drugs, so we can't help you with figuring out a new cocktail, we don't do that.

 

Hi, thank you for your reply!

 

I wasn't actually looking for a new cocktail, probably could've worded my threadstart better. I was already set on quitting the seroquel, but this forum has so far been a real eye-opener. I'm going to seriously consider getting off fluoxetine as well, and this looks like a great place for support in doing so.

 

Thank you for creating a forum like this. I can't believe it's taken me this long to find it.

 

All the best

SQ

[Jemima]

I'm sorry, I misunderstood.  I didn't get it that you wanted to get off the seroquel. Here's our topic on tapering off of that:  Tips for Tapering Off Seroquel  As you probably know, this is an atypical antipsychotic.  In my opinion, they are very dangerous drugs with lots of scary health side effects, so you are wise to taper off of this first.

 

We'll be happy to help.  You might also browse the Tapering section where there are explanations of how to taper and why to go slowly at 10% of the current dose or less.

 

Welcome to the forum.

[Altostrata]

If Seroquel isn't doing any good -- some people take it for sleep -- it's far to risky to keep taking just because.

[suzieQ]

Thank you both for your replies.

 

I just got off the phone with my psychiatrist and he approved of my plans to try and taper off fluoxetine.

 

I would like to keep a 'journal' on here, but I can't edit my OP. Can I start a new thread? (in that case you can of course delete this one)

 

all the best

[suzieQ]

Hi!

 

I'm a 21y/o male living in sweden.
 

I went into psychiatric treatment almost a year ago for depression with obsessive/compulsive symptoms. After feeling good for months, I recently decided to research the possibility of coming of the medications entirely, and decided to do so shortly after. I wanted to do it with the help of my psychiatrist's, given that he'd be okay with it.

 

August 2013:
Was prescribed 20mg fluoxetine/day

 

September 2013:

Fluoxetine dosage upped to 30mg/day

 

January 2014:

Fluoxetine dosage upped to 40mg/day

 

February 2014:

Fluoxetine dosage reduced to 30mg/day

 

March 2014:
Fluoxetine dosage upped to 40mg/day

25mg quetiapine introduced for sleep

 

2014-05-07
Discussed tapering off the medications with my psychiatrist for the first time; he was very supportive, and suggested a six week taper for the fluoxetine. Admittedly a bit faster than recommended on here; but my goal is to be free from all medication come september when I begin my studies to become an engineer. Keeping the relatively short time I've been on fluoxetine and my access to quetiapine in mind we agreed that this was a reasonable arrangement, and if any complications should arise, I am to consult him how to progress.

 

This is my first day on 30mg, and will continue on this dosage for two weeks. If no complications, keep tapering to 20mg for two weeks, then again, down to 10mg.

Week 5, 18th of june, I have an appointment scheduled with my psychiatrist, where I will discuss getting off fluoxetine entirely if everything has gone according to the plan, and draw up a schedule for getting off quetiapine as well (if not cold turkey, since 25mg quetiapine acts as an antihistamine and shouldn't need tapering).

 

I will keep this thread updated during the following two months.

 

All the best,

SuzieQ

[Skyler]

You might be interested... http://pro.psychcentral.com/2014/is-bipolar-disorder-over-diagnosed/005909.html

 

You have been thru the mill with meds! WOW

[suzieQ]

You might be interested... http://pro.psychcentral.com/2014/is-bipolar-disorder-over-diagnosed/005909.html

 

You have been thru the mill with meds! WOW

 

Thank you for the link, this is exactly what I believe to be the case here. More specifically this:

 

"When faced with limited time for diagnostic interviews and the pressure to prescribe by patients and their families, well-meaning clinicians may give the diagnosis after a single brief interview. Not uncommonly, we find that it was diagnosed on the basis of mood fluctuation over minutes, temper tantrums, and fleeting insomnia. The rapidly expanding repertoire of medications approved for bipolar disorder, and their relative ease of use, may also contribute to over-diagnosis. Unfortunately, in some cases the treatment may be worse than the symptoms themselves"

 

All the best

SQ

[Rhiannon]

Six weeks? Off 40 mg? umm...good luck.

 

Recommend you take a look at this:

http://survivingantidepressants.org/index.php?/topic/6036-why-taper-paper-demonstrates-importance-of-gradual-change-in-plasma-concentration/

 

and especially the charts beginning on page 4. There's one for fluoxetine. You'll see why we recommend an exponential-decay type rate of taper (10% of current dose is what we recommend).

 

You may find at lower doses the side effects are reduced sufficiently that you can function in your life the way you want to (school, etc.) and still taper at a more reasonable pace.

 

Also, it's not uncommon for someone in your situation (fairly short time on the meds and not a lot of attempts to quit in the past) to be able to come off and ride out the acute symptoms, only to be hit with another wave of symptoms after some months down the road.

 

When this happens they're usually diagnosed with "relapse" and put back on the meds, or new ones. Often at that point they begin to believe they have an "underlying condition" and need to be on meds for life. If this happens to you, be aware that it's a common pattern in withdrawal and is a reaction to the drug, and it will pass if you don't re-medicate it, although it may be unpleasant for a while.

 

Also, highly recommend you take a look at Anatomy of an Epidemic by Robert Whitaker.

 

And, seriously, not just snarkily--good luck. May you be one of the lucky ones!

[suzieQ]

Six weeks? Off 40 mg? umm...good luck.

 

Recommend you take a look at this:

http://survivingantidepressants.org/index.php?/topic/6036-why-taper-paper-demonstrates-importance-of-gradual-change-in-plasma-concentration/

 

and especially the charts beginning on page 4. There's one for fluoxetine. You'll see why we recommend an exponential-decay type rate of taper (10% of current dose is what we recommend).

 

You may find at lower doses the side effects are reduced sufficiently that you can function in your life the way you want to (school, etc.) and still taper at a more reasonable pace.

 

Seriously, good luck, though. 

 

Eight weeks, sorry, typo in my OP. 10mg every two weeks.

I realize it may be too fast but my psychiatrist ensured me that under his supervision and with the help of seroquel the W/D should be manageable. Thank you for the link though, looks interesting. I will read it and rethink my strategy if needed. I was under the impression that fluoxetine is a fairly easy med to taper when I discussed it with my psychiatrist earlier today.

 

All the best and thank you for the encouragement,

SQ

[Rhiannon]

Sorry, I edited my post while you were posting. (Just in case anybody sees that and wonders if they're losing what's left of their mind...)

 

:-)

[suzieQ]

Sorry, I edited my post while you were posting. (Just in case anybody sees that and wonders if they're losing what's left of their mind...)

 

:-)

Haha, thank you for elaborating. Might have to rethink this. I feel like I've found the right place to do this though.

 

I'm actually some 50 pages into Anatomy of an Epidemic right now, fascinating stuff indeed.

 

EDIT:

Often at that point they begin to believe they have an "underlying condition" and need to be on meds for life. If this happens to you, be aware that it's a common pattern in withdrawal and is a reaction to the drug, and it will pass if you don't re-medicate it, although it may be unpleasant for a while.

 

This was of particular interest to me, I will try to keep that in mind if I decide to go down that path.

[Skyler]

Hi again Suzie.. you seem like a quick study! Soooo, when you get thru with my reading link, and Rhi's reading link, and Robert Whitaker... you might be interested in http://survivingantidepressants.org/index.php?/topic/4463-how-do-you-introduce-your-doctor-to-the-concept-of-withdrawal-syndrome/?hl=doctors#entry54708

 

"How do I educate my psychiatrist without her being offended or dismissing this information. What would be the most helpful studies, write ups from this site or elsewhere to print out and give to her?"

[Altostrata]

You can use this Intro topic as your journal.

[Skyler]

Suzie... you have two intro threads?

[Altostrata]

I merged the two threads.

 

SuzieQ, even psychiatrists don't know much about tapering and withdrawal symptoms. Your doctor might learn a great deal from your situation.

[Addax]

Just came upon your thread, SuzieQ.

 

I'm glad you found SA, and I understand your feeling of urgency. I really, really do.

 

I tapered from 60mg Prozac in 2012(maybe started late 2011). I thought it was a slow and careful taper. Not sure exactly how long I took... Maybe 4-5 months. I was lucky enough to be working from home for part of that, because I was experiencing withdrawal symptoms. Except for the weird shifting feeling in my head when I would move, I didn't recognize what was going on as withdrawal. It was very uncomfortable. Anxiety went from "attacks" to lasting all day. Akathasia was initially manageable... Or more accurately, I could hide my discomfort. There was other stuff too... It sort of leveled out for awhile, but then 4 months after my last 20mg tablet it got very bad. It's all in my own thread if you want to read it.

 

Granted, I took Prozac for more years than you've been alive. However, even with that, my withdrawal from Prozac has been relatively mild compared to some who have taken it much more short term.

 

I'm not telling you this to scare you. And if you do the short taper, I hope it's uneventful and successful in time for your classes to start. I just think it's so important that you hear what Alto, Rhi, and the others are saying and consider their advice seriously.

 

My tapering experience has been an entirely different animal this time around. It's slow, and not entirely free of withdrawal symptoms, but they've been tolerable and the experience has been SOOO much better than the last time.