Jump to content
NoMeaning25

Which is the worst antidepressant for withdrawal?

Recommended Posts

NoMeaning25

This has probably been asked, but i have just wondered. Most people who are still bad at 10 years out was on paxil (Buxy, Paul, Squirrel) Is it true that paxil is the worst in regards to withdrawal severity and length of withdrawal? Any studies on this? 

 

Sorry, im 22 months off with no improvements and really feeling sorry for myself :'( Maybe its because i was on paxil, although my time exposure on paxil was only 2 years... before that i was on celexa for 2 years.

 

Im just looking for answers really. I just dont understand, how is it possible that i am so severe at 22 months off? The indescribable fear that i am stuck like this forever is unrelenting and i need relief 

Share this post


Link to post
Share on other sites
Claudius

I only used Paxil so cannot compare them, but I think is is the worst indeed. I cannot imagine how something could be worst than Paxil WD. Also for me it took almost 2 years to experience a first window. And many many years afterwards to feel close to recovery. 

Did you stop cold turkey or taper off?

Share this post


Link to post
Share on other sites
NoMeaning25

I tapered off during a 6 week period by skipping dosages... I dont know whats worse, skipping or cold turkey!!!

Share this post


Link to post
Share on other sites
Addax

Your question caught my eye and I did a quick search and came upon this article: "SSRIs and SNRIs: A review of the Discontinuation Syndrome in Children and Adolescents" by Sheik Hosenbocus, MD,and Raj Chahal, MSW2 (J Can Acad Child Adolesc Psychiatry. Feb 2011; 20(1): 60–67.)

 

Although the article is discussing children and adolescents the literature cited is from adult populations. There is almost no data on kids regarding discontinuation.

 

The article doesn't talk about longterm or protracted withdrawal but it does suggest that Paxil withdrawal, at least in the short term, is "the worst." This doesn't mean that Paxil is necessarily associated more with protracted withdrawal than other SSRIs, but if it's the worst in terms of early withdrawal it suggests to me there may be more going on than with other SSRIs and that being the "worst" MAY apply to the longterm as well.

 

I'm including some quotes from the literature review portion of article, but I want to include a caveat. This is just one article on the topic. If you read the entire article keep in mind that some of the information on the length of withdrawal and tapering is scantly informed and the literature review is not exhaustive' AND it doesn't take into account the multitude of anecdotal evidence supplied by the hundreds and even thousands of cases of people like the ones on this site. So please, if you read the full article, do so critically! The last quote I included is just a general statement, but I liked what it said..

 

The quotes from the article:

 

"All SSRIs have been implicated including fluoxetine, sertraline, paroxetine, fluvoxamine, citalopram and lately escitalopram, although the respective reactions may not be of equal severity."

 

"The severity of the discontinuation syndrome is not the same for each SSRI. It seems to be related to the drug’s half- life. The shorter the half-life the quicker the drug will be eliminated and the more common is the discontinuation reaction (Coupland et al., 1996, Judge, Quail & Jacobson, 2002)."

 

"many reports indicate that the most common or severe reactions occur with paroxetine, intermediate ones with fluvoxamine and sertraline and the least common or severe ones with fluoxetine. "

 

"Paroxetine was associated with 13 symptoms out of a 17 item scale, 3 out of 17 for sertraline and up to the fifth day no symptoms for fluoxetine (Haddad, 2001). "

 

"Paroxetine has been associated with more frequent discontinuation symptoms than the other SSRIs. The rate of discontinuation with paroxetine has been reported at 34.5% compared to placebo at 13.5% in a 12 week double-blind placebo-controlled study (Haddad, 2001). An analysis of the rate of discontinuation syndrome in the United Kingdom, expressed per 1000 prescriptions written, revealed that the rate for paroxetine was over 100 times higher than fluoxetine and 10 times higher than sertraline or fluvoxamine (Haddad, 2001). Symptoms even occur during tapering of paroxetine (Black et al., 2000)."

 

"The rates also seem to differ in different studies. A comparison study reported the incidence of the discontinuation syndrome as 20% for paroxetine, 14% for fluvoxamine, 2.4% for sertraline and 0% for fluoxetine (Coupland et al., 1996). Yet another study reported a frequency of 42% in the paroxetine group and 9% in the fluoxetine group (Bogetto, Bellino, Revello & Patria, 2002). A randomized controlled trial comparing 3 SSRIs found the highest incidence with paroxetine (66%) followed by sertraline (60%) and the lowest incidence (14%) was with fluoxetine (Warner et al, 2006)."

 

"There is still a need to identify this condition early as failure to recognize discontinuation symptoms may lead the physician to think that a relapse of the treated condition is occurring and he/she may re-start treatment with the same medication instead of dealing with the discontinuation symptoms. The patient feels better once back on the SSRI. A vicious cycle thus develops as each time the physician tries to discontinue the medication the same complaints occur and medication is continued longer than necessary. The consequences of stopping the medication and fear of experiencing strong withdrawal effects can lead some patients to continue these medications longer than necessary even when they are ready to stop (Verbeek-Heida & Mathot, 2006). Most of the discontinuation symptoms are physical and misdiagnosis can also lead to unnecessary investigations to clarify the physical complaints or to inappropriate treatment (Haddad, 2001) including use of other medications. "

Share this post


Link to post
Share on other sites
Claudius

I tapered off during a 6 week period by skipping dosages... I dont know whats worse, skipping or cold turkey!!!

 

I am no expert in this, but my guess is that alternating/skipping dosages is even worse than cold turkey, if possible.

 

While cold turkey van make you sick as hell, recovery starts technically on the first day you don't swallow the drug anymore. The point is that during recovery you can be very very sick and due to the neuropathic destabilisation, recovery takes much more time than when tapering slowly.

But when alternating or skipping doses, you get sick either but I believe that no recovery takes place when alternating, so the period of alternating does not make any sense: it only makes you sick but does not contribute to the healing.

Share this post


Link to post
Share on other sites
Rhiannon

I've seen a lot of people in protracted withdrawal from various drugs and I can't say that Paxil has any special corner on the market of drugs from hell, although it does have the reputation for being harder to get off than some of its contemporaries (Prozac anyway, maybe Celexa). Some of the newer ADs like Pristiq and Cymbalta have pretty bad reputations too. And I've seen a lot of people sick for many years after coming off benzos.

 

So I guess what I'm saying is that Paxil does seem to be pretty rough but I don't think we have enough evidence to say it's the worst. Not that it really matters anyway, I suppose. I think there's more variation from person to person than from drug to drug. In other words it seems to be more the person's individual genetics plus their individual history plus the way they came off, plus which particular AD it was--so many factors that which AD it was is only a small part of the story.

 

And so many people have been on multiple meds. So many factors. As far as I know there's no good research of any kind that teases out these differences. 

Share this post


Link to post
Share on other sites
Jemima

Olivia, I moved your topic here because it's a debatable subject rather than information on non-drug ways to relieve withdrawal symptoms, which is what the 'Symptoms and self-care' discussion is about.

 

I've observed on this forum that folks who are trying to get off Paxil and Effexor seem to have the hardest time, although for the most part I agree with everything Rhi said. There are people who are able to go cold turkey with no problems and people who are so sensitive to the SSRI and SNRI antidepressants that they get sick almost immediately.  I suspect, if there's ever any valid research on the subject, we'll find that people with a longer history of drug use, especially drug cocktails, or a history of being switched from one drug to another are those who will prove to have the hardest time. I was only on antidepressants for fifteen months and it's taken me over two and a half years to get close to normal again.  I had been prescribed Remeron and Pristiq at the same time, got off the Remeron, and switched to Lexapro, from which I did a too-fast taper. I was also advised to do the every-other-day routine at the end, fortunately only for a week if I remember right.

 

And remember that feeling like you'll never get better is a withdrawal symptom.  It helps to keep a journal or at least keep up your Intro here.  Reading back through mine and seeing that I'd made progress helped me to believe that eventually I'd be okay.

Share this post


Link to post
Share on other sites
Barbarannamated

I've been on and off approximately 25-30 psychoactive drugs used to treat chronic pain and depression since 1993. I'm still on a few and at 3 years off of the SNRI, Pristiq, I have to agree with all that Rhi said. I am still struggling tremendously.

 

I don't mean to frighten anyone. I did a very quick taper off of Pristiq and CT'd Vyvanse.

Share this post


Link to post
Share on other sites
a99

prozac was the only AD I took .

Despite the claims of being easy to get off  ( which was never the case with me ) it has a very bad reputation among many people who stopped it and stayed very sick for many many years and some never got better .I found many horror stories with prozac specifically

.

I'm scared to death , not only i was cursed with prozac instead of another drug , I- as well - quit it cold turkey preceded by several fast tapers and reinstatements which means I messed a lot with my system and caused it immense chock , not to metion that I was drugged at a really young age (14) when my bain wasn't even fully developped which certainly increases the risks .

Is there hope that I'm not permanently damaged ? any possibility for me to make a full recovery ? I'm I doomed for 7 years or more like may other people who took the same drug ?

I'm 15.5 off , the first 12 months were horrible , I had many inhumanly difficult symptoms that come and go , and some that never seem to fade like impaired memory , flat feeligns ,DR/DP and a hellish anxiety but In the past month I started to have some decent times where I feel some happy emotions and clarity of mind , it only lasts minutes though .

 does that mean that there's hope for me ?

I'm really scared !

 

Share this post


Link to post
Share on other sites
Iamfine

You've been off Prozac since March 2014 and are still seeing symptoms? You will be fine, I went off Prozac twice, one time with a two week taper (from 80 mg to zero in two weeks) and another time a few months ago I came off 20 mg cold turkey but onto another seretogenic drug. Prozac is one of the easier of the ssri's to come off of because of it's crazy long half life. You will be fine, just hang in there. What are your symptoms like now?

Share this post


Link to post
Share on other sites
a99

my main symptoms :

 

head pressure

muscle twitiching/ spasms

impaired short and long term memory

impaired cognition

severe anxiety +horrible feeling of terror

disturbed sleep / insomnia

headaches

DR/DP

weight gain

general fatigue

frequent mood swings

neuro emotions : anger , depression , nostalgia , regret , guilt , self consciousness ,

nervousness 

restlessness

akathisia

anhedonia

Share this post


Link to post
Share on other sites
Theon

Hello a99:

 

I thik I share your opinion of prozac being evil. I have read a lot of success stories in this forum, but very very few are prozac success stories...

 

I think prozac withdrawal comes sooooo much later than the other withdrawals, making it more tricky to deal with, and I have read of a lot of people permanently damaged by prozac....

 

I just hope that you and me can recover from this.

Share this post


Link to post
Share on other sites
Aliwill

God I hope not. I'm on Procac. Also no other drugs. I've been slowly tapering for 2 years and down to 2mg. I'm currently holding in preparation of my last micro taper to zero. Expecting this to take me about 6 months to get to 0. I have to say that I've had very few symptoms until now. (Which were set off by a couple of doses of Tramadol after an op 4 months ago) this has been so different to any CT's that I'd did. Hopefully I'll be able to give you a bit of a success story in a year or so. I'm keeping positive that I will beat this drug. Wish me luck. Luck and love to you Theon and A99. Hope you are feeling better soon.

Share this post


Link to post
Share on other sites
Theon

God I hope not. I'm on Procac. Also no other drugs. I've been slowly tapering for 2 years and down to 2mg. I'm currently holding in preparation of my last micro taper to zero. Expecting this to take me about 6 months to get to 0. I have to say that I've had very few symptoms until now. (Which were set off by a couple of doses of Tramadol after an op 4 months ago) this has been so different to any CT's that I'd did. Hopefully I'll be able to give you a bit of a success story in a year or so. I'm keeping positive that I will beat this drug. Wish me luck. Luck and love to you Theon and A99. Hope you are feeling better soon.

 

Good luck Aliwill :D. I am sure you will do it! Looking forward to hear your success story!

Share this post


Link to post
Share on other sites
Petunia

Prozac is no more evil than any other antidepressant. You can find horror stories and success stories with every drug you search for. This is one person's opinion. Most people going CT off any psychiatric drug after long term use are going to have some problems, occasionally for quite a long time, this is why we recommend careful tapering.

 

I think prozac withdrawal comes sooooo much later than the other withdrawals, making it more tricky to deal with, and I have read of a lot of people permanently damaged by prozac....

 

Please would you provide links to the evidence of permanent damage because I've never seen any.

Share this post


Link to post
Share on other sites
Iamfine

Prozac is no more evil than any other antidepressant. You can find horror stories and success stories with every drug you search for. This is one person's opinion. Most people going CT off any psychiatric drug after long term use are going to have some problems, occasionally for quite a long time, this is why we recommend careful tapering.

 

Please would you provide links to the evidence of permanent damage because I've never seen any.

I agree with Petu, I have been on almost all of them at one point or another and they are mostly evil, no need to be scared by one post. They actually use Prozac as a bridge drug to get people off other ad's because of its long half life. I'm not quite in the camp that says all these drugs are evil but many of them are, everyone is different. I can just tell you that, in my experience, Prozac was one of the easier drugs to come off of, even at a high dose.

 

And Petu, I don't think "most" people have trouble after a ct, maybe a better word would be "many".

Share this post


Link to post
Share on other sites
Aliwill

Iamfine, great to hear a positive story re prozac. I also had a great post to my page today from Petu, thanks again.

 

Interested Iamfine, as I am unaware of the class of many drugs, (I do know that seroquel is an AS) is the Luvox or Geodon an SSRI?

 

When you tapered from Prozac, did you have any other SSRI's in your system or was your taper from Prozac a full taper from SSRI's?

 

I'm really interested to gain information on all things Prozac tapering. As I am at the pointy end of my Prozac taper, 2mgs, am starting to think about when I come off totally.

I'm not going CT from 2mg's as Ive had too bad a reaction to cold turkeys, so am planning to micro taper the last bit by 0.1mg per week down to 0.1mg before I finish. I know this seems very conservative but better that than the alternative. Hopefully this will put me in a good place for stopping this drug once and for all.

Share this post


Link to post
Share on other sites
Iamfine

Yes, Luvox is a ssri, Geodon is an AS like Seroquel. Both times I went off Prozac was to go to another seretogenic drug. Both times I went to Lexapro, which was my go to drug for years but it finally pooped out on me. The ssri's haven't been good to me as a class for the most part. Prozac worked for awhile the first time, and Paxil worked for a short time. Lex worked the longest. I'm finishing tapering off Luvox now and will not go back to that class again. I have not ruled out keeping Geodon onboard since it has worked for me better than anything else. My doctors have always had me do a two week cross taper and I've done it many times without trouble. If I do decide to dump Geodon I will do it at a 10% rate.

Share this post


Link to post
Share on other sites
Aliwill

Thanks Iamfine. I am sending you good vibes for your taper with Luvox. I will keep an eye out and check on your progress. Best of luck.

Share this post


Link to post
Share on other sites
Theon

Prozac is no more evil than any other antidepressant. You can find horror stories and success stories with every drug you search for. This is one person's opinion. Most people going CT off any psychiatric drug after long term use are going to have some problems, occasionally for quite a long time, this is why we recommend careful tapering.

 

yeah you are right, Petu.

 

I am sorry, I think I tend to see my problems worse than those of the rest of the people (when actually mine are better than most of the people here), and I wrote that comment without thinking too much.

Share this post


Link to post
Share on other sites
Altostrata

Prozac is not particularly evil, we see prolonged post-acute withdrawal syndrome from ALL the psychiatric drugs.

Share this post


Link to post
Share on other sites
a99

thank you everyone for your positive replies .

Theon : wishing you recovery and success

Aiwil : you've come a long way , best of luck to you , looking to hear a success story from you soon .

I do have a question : my symptoms used to be persistent 24 h for over a year  , lately I'm noticing improvements that last a few hours everyday  , does that make me far away  from being permanently damaged ? do permanently damaged people have windows too ? 

I'm sorry if I sounded pessimistic , I just never was this scared :(

Share this post


Link to post
Share on other sites
Aliwill

All windows are good signs. Unfortunately you just have to hang on, then hang on some more when you have waves. Now that you have started having windows, no matter how small, hopefully they just keep increasing for you. Pessimism can definately be a side effect of the withdrawal, I know that when I've been CT in the past I became extremly pessimistic. No-one else can understand the pain you are experiencing unless they have been through it. Even in my recent destablization (Has lasted about 1 month but definately improving) I started to wonder whether 2mg was the lowest I will ever get. Now that the symptoms have started to subside, I am back to positive again that I will be dropping again soon enough.

 

Please try to see these windows as a breakthrough in your recovery. You are getting better.

 

Sending love your way

Share this post


Link to post
Share on other sites
Addax

I am a Prozac veteran. I started in 1988/89. It was only after a horrific withdrawal experience in 2012 that I realized I'd become physically dependent on the drug. I had been on 60 mg until 2012, then after the withdrawal experience reinstated to 40mg and added Welbutrin, which essentially meant I was probably taking the equivalent of 60-80mg of Prozac. Anyway, you can read my journey in my thread, but right now I'm at 20mg and have held here for just over 4 months now to ensure I can get through that lag of 4months before the delayed onset of symptoms. This hold has been great. No symptoms in nearly two months and I'm past the 4 months and still nothing. I'm so thankful. This is not to say I'm not nervous for my next drop. But I'm confident that my conservative taper plan and self care will get me through the next steps.

 

Aliwill - Stay conservative! I think that's great. I'm being incredibly conservative and with long holds from this point on.

 

a99 - I understand your fears (dread?). I've been there and was convinced I was forever brain damaged and would never be off... I was 18 when I started, so my brain wasn't fully developed, but our brains are so much more plastic and adaptable then you'd expect. Here I am at nearly middle age and I can say that from experience my brain seems to be firing on all cylinders despite the drug and two horrific withdrawal experiences.

 

Also, beware of the hopelessness and belief that you will never heal! Those thoughts, in and of themselves, are w/d symptoms. I'm serious on that. Our brains can become incredibly cruel to us when withdrawing and the thoughts are incredibly convincing. I promise you, they are just thoughts and the "evidence" you find to support them are, for lack of a better word, delusions. It sounds crazy, but it's so true. These delusions that we are permanently damaged and will never heal Is one of the cruelest symptoms of withdrawal. And despite me telling you this you will probably believe your brain over me even though I've lived it :-). And that's okay, because when you come through this I'll simply go to your thread and write, "I told a so!" :-P

Share this post


Link to post
Share on other sites
a99

thank you for the replies and the positivity !

I can't wait for the day when all of this is behind me !

Share this post


Link to post
Share on other sites
a99

anyone else with an experience with prozac ?

Share this post


Link to post
Share on other sites
indigo

So glad to find this thread. Good to hear from somone else who was only on Prozac and is down to very low dose.

I have only taken Prozac. Was on it for more than ten years, and been tapering for two years,

coming down from 20mg to about 3.50 mg. It seems to be getting harder as I get lower, but that might

be a WD delusion. Six months ago I switched to liquid prozac so that I could do minute drops with a

1 mL syringe. Even after these tiny drops I get severe anxiety, repetiive negative thoughts and sadness.

(Also that tricky WD symptom where you think you'll never get off the drug, that you're permanently damaged)

One WD symptom I have not heard talked about much is having an extremely low stress threshold. I'll feel O.K., think I've

recovered from last drop, then some big stressor will happen (like my house got burgarized) and I'm back into  full WD anxiety mode.

Share this post


Link to post
Share on other sites
bluebalu86

We have talked about this symptoms indigo - decreased ability to handle stress. It is very common.

Share this post


Link to post
Share on other sites
Aliwill

So good to find other Prozacers here.  I'm currently in a holding pattern after a recent destalilization. At 2mg.  I believe it to be from Tramodol that I took for pain a few months ago, you can read about it on my thread. I'm feeling better, withdrawal symptoms definately getting better, but intending on holding another couple of months before I swap to a micro taper to 0.

 

I'd love you all to come over to my thread too and wish me luck, chat, and keep me positive. I'll also start following all the Prozac peoples threads here, and will check in regularly to offer encoragement.

 

We can do this guys, I believe the most important thing is patience, and the holds. Although, I too want this drug out of my system ASAP. The holds are definately what has allowed me to get this far.

 

A99 sorry for hijacking your thread. I know you can do this, but with this drug please do long holds. I cant wait to follow your story, which I believe will be a success. Keep positive, and if you can't then check in and we will become your cheer squad.

 

Sending love.

Share this post


Link to post
Share on other sites
a99

Indigo - you have come a long way , congratulations ! good luck with the rest !

Aliwill - you're doing a great job , best of luck with your micro taper !

thank you for your encouragement . I agree on the importance of holds but i'm not concerned with them as I went cold turkey  but  patience and time are definitely the answer ! 

Share this post


Link to post
Share on other sites
Aliwill

Sorry a99,

 

I have read your thread and did know that you had gone cold turkey, but my concentration is a bit off at the moment. (Insert sad face) Sorry if I upset you.

 

Yes holding on is the key for tapers, but cold turkey, thats painful. Just remember each day is a new day and hopefully the one where your symptoms start to get less and less.

 

Each day is a day closer to freedom for you.

 

Sending Love

Share this post


Link to post
Share on other sites
Theon

Hello prozac fellows.

 

My experience with prozac 20 mg so far has been of two periods of 3 and 4 months with a period of 5 months drug free in between.

Now I am in my third month of tappering and holding on 5 mg.

I really want to finish the tapper before the end of july, and unless I get very sick this month, I think I will do it .

 

I am  quite sure that next winter I will get bad anxiety again (my anxiety always gets worse in winter), but this time I am determined to hold on without prozac.

 

I have read the threads of all of you guys, and wish you all the best.

Share this post


Link to post
Share on other sites
Aliwill

Theon,

 

Please understand that to go from 5mg to 0 in 3-4 weeks is far to fast. I.m seriously considering a small up dose (from 2 back to 2.5ml) , after being detabilized from an Operation and Tramadol 3 months ago. (Well not considering, I'm going to do it tonight) You have also dropped the Prozac from 20mg so quickly. It has taken me 2.5 years to get this far and I'm still having hiccups. You need to hold and see how you go for atleast another few months.

 

Huge alarm bells ringing for me, I just want you to be OK.

 

A long slow taper at the end is the only way to ward off withdrawal and I'm really concerned that you are putting yourself in harms way. Please take it slow.

 

(Sorry again A99 for hijacking your post but felt I really needed to say something).

 

Let us know your decision on your thread Theon, I'm following you so will get updates.

Share this post


Link to post
Share on other sites
Tweet

Hello all, I am 14 months out after a ct off 20 mg prozac. Thank you all for your input and please stay in touch. 

I sure would like to hear some updates🙂

 

Share this post


Link to post
Share on other sites

Please sign in to comment

You will be able to leave a comment after signing in



Sign In Now

×
×
  • Create New...

Important Information

Terms of Use Privacy Policy