Itee84 - Prozac withdrawal

[ltee84]

Hi there,

 

I have been doing tons of reading on this topic in the hopes I can find some clarity or answers. Unfortunately it had become clear so little is known with regards to getting off SSRIs. (Seems little is even known about exactly how they even WORK!)

 

I was put on 40 mg Prozac at age eleven ( depression/anxiety diagnoses...despite severe family issues being at the core I was simply diagnosed and medicated) I am now 29 and for years have been frustrated by a system that cares it seems only to medicate.

I attempted to "wean" ( I put in quotations as I did it without any supervision) myself off four years ago with horrible results. Even worse were the effects of reinstating the med. It was a hell like no other I have experienced.

 

Fast forward 4 years: I have seen a psychiatrist for close to a year now who agreed I shouldn't have been medicated for such a long period of time. I explained that being medicated life long is NOT something I want. As of mid may he decided i should try coming off but I was shocked when he suggested just "going off"..no weaning. He stated due to long half life it should be fine as it will gradually decrease on its own. Looking back I regret listening to him on that as nowhere can I find that that is ever suggested.

 

For about a month I was fine...didn't notice a difference. Then little things popped up. Severe dizziness... Then body tingling and body pain (mainly legs) which has lead me to MRIs and a neurologist. I have the worst morning anxiety that essentially cripples me. Days where I cry non stop.. Intermittant suicidal thoughts and then some days where I see light at the end of the tunnel. I feel like I'm on a rollercoaster from hell and despite having been in a similar situation I am pretty adamant about not going back on.

 

I apologize for the long introduction but I know of nobody that can relate to this experience and that is in itself an isolating experience.

[Addax]

Itee84-

 

I'm just a member here but wanted to welcome you. You have come to the right place for help. An admin and/or moderator will be by shortly to offer you some direction and suggestions. I just happen to have gotten here first .

I'm sorry you have to experience this, but now that you're here you'll find a lot of support.

 

I'm withdrawing from Prozac after being on it for 25 years. I made a number of cold turkey attempts and felt much like you and proceeded to reinstate. Prozac's longer half-life does not buffer withdrawal. It may seem that way in relation to some of the other SSRIs with shorter half-lives though, and it can be less drastic I guess in some instances, but it's not self tapering. The other thing with Prozac is that withdrawal symptoms can sneak up on you. Last time I attempted, before stumbling upon this site, I was hit with horrible withdrawal symptoms 4 months after my last Prozac capsule. I tapered too quickly. This go round with the guidance and support from the people here at SA has been completely different... COMPLETELY.

 

Follow the staffs recommendations here and I think you'll find yourself feeling better soon.

 

Welcome!

[Rhiannon]

ltee, welcome to the forum.

 

Please clarify for us what's going on right now. Did you quit 40 mg of Prozac cold turkey one month ago? That's what it sounds like from your description but I'm not sure I'm interpreting correctly.

 

You started this drug early and took it during about half of the years that your immature brain was growing and developing, so it affected the way your brain grew. Now you will need to taper it slowly enough to allow your brain to regrow itself, to change and shape itself back to how it was supposed to be. This is not a process that can be rushed. Clearly your psychiatrist is ignorant of neuroscience and physiology. 

 

The first thing you'll need to do is reinstate on a lower dose of Prozac, probably something like 10-20 mg (that's what I would try to start with). Can you get those tablets? If you tell your doctor about the withdrawal symptoms you're experiencing you may be able to get a prescription for 10 mg tablets. Since you had a bad reaction to reinstatement in the past you may want to start with 10 mg and then go up only if you need to.

 

Once your symptoms settle and stabilize, you can begin a very slow taper. Fortunately Prozac comes in a liquid formulation, which will be good for starting with, and you'll have time to explore other options as you go.

 

I have to go to work now but hopefully another moderator will be along soon to give you the links to our topics on reinstatement and tapering.  Or you can go explore our Tapering section yourself, reading the topics pinned at the top there and following the links provided.

[Rhiannon]

Bubble, do you have one of my "trellis" pieces in your stash? I think it would help ltee to understand that her brain has grown around the artificial chemistry induced by Prozac the same as a plant growing around a trellis. You can't just yank out the trellis. You need to give the plant the support it needs, that it is shaped around, that it has grown around, and then just remove the trellis bit by bit as the plant re-finds its own healthy natural shape and support.

 

That's why we are saying you need to reinstate. Staying off Prozac right now is like yanking a trellis out from a plant. The plant might survive, but it's not going to be in very good shape and it's going to take it a long time to recover.  I have never seen someone who was started as young as you, recover from a CT without ending up back on drugs, usually more of them. So please carefully consider what we are suggesting as far as reinstating a smaller dose.

[Addax]

Rhi has a gift in being able to explain what has gone on while taking SSRIs and what goes on when you're tapering. I hope Rhi doesn't mind, but here's a link to a thread that includes a number of great quotes from Rhi (and a few others):

 

http://survivingantidepressants.org/index.php?/topic/6447-best-of-sa/

[dalsaan]

Hi itee

 

Welcome to SA. You will find a warm and welcoming community.

 

Here is a link that discusses reinstatement http://survivingantidepressants.org/index.php?/topic/3079-about-reinstating-and-stabilizing-to-stop-withdrawal-symptoms/

 

And here is another on tapering after you have stabilised http://survivingantidepressants.org/index.php?/topic/759-tips-for-tapering-off-prozac-fluoxetine/

 

Dalsaan

[Karma]

Hi Itee,

 

Welcome to our community.  When you get a chance please add your recent drug withdrawal history in your signature.  It will show up with each of your posts to moderators and members can quickly familiarize themselves with your situation before offering advise.

 

Here is the link that explains the signature: http://survivingantidepressants.org/index.php?/topic/893-please-put-your-withdrawal-history-in-your-signature/

 

I suggest that you read through the links Dalsaan provided.  I also agree with considering a reinstatement of a much lower dose.  Your system will be sensitized after being on these drugs and much less medication will have a powerful impact.

 

Karma

[mammaP]

Hi Itee, I agree with the others that reinstating a small dose may make you

much more comfortable. None of us want to reinstate, but it really can make a difference. It isn't failure

or weakness, it is doing the best thing for your brain and nervous system. Many people here are in

protracted withdrawal from stopping anti depressants cold turkey, or a taper that has been too fast.

I tapered too fast and very reluctantly reinstated as Alto advised, I felt better within hours! It has still been

a roller coaster ride with good days and bad but better than all days being bad ones. 

 

If you still don't want to reinstate you will find lots of suggestions for ways of coping in our symptoms and self care topics

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

[mammaP]

Here is Rhi's take on growing a new brain, an excellent illustration.  

 

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. 

[ltee84]

Sorry for the delay in reply. I completely forgot to even check if anyone replied and then strangely enough when googling "morning anxiety" I found my post as a result.

 

Thank you for all those that have replied. To answer Rhi's question: I went off the Prozac 40 mg in May and symptoms started appearing I'd say end of June beginning of July. First it was physical symptoms and I didn't relate it to coming off the Prozac at all..went to many Dr. Appts. MRI.. neurologist..until I realized it was related.

I reinstated 10 mg of Prozac a week ago..despite the psychiatrist trying to convince me to try Zoloft or Cipralex.

He also has tried to prescribe seroquel for my interrupted sleep but I didn't take it.

 

Currently my anxiety is awful...the morning is the worst but almost anything will spike a huge immediate increase in my anxiety. I fainted twice last week. I was given Ativan and Klonopin but am trying to resist taking everyday or more than once a day as I don't want to add another problem down the line.

This process is beyond agonizing. My body is exhausted..I have no appetite..have lost Ten pounds in a month and my business is suffering. not to mention the toll it is taking on my mom.

There isn't a feeling that I have felt that is worse than this.

[Petunia]

Hi Itee,

I don't think you realize the seriousness of the situation you are in.  I don't want to scare you, but this could get much worse if you don't start educating yourself about these drugs, withdrawal and how to protect your brain and nervous system.  People lose their careers, homes, relationships and even their lives as a result of improperly coming off these drugs.

 

This happened to me, I'm in protracted withdrawal for over 3 years.  I hardly ever leave my house.  If I manage to get up, shower, empty the dishwasher and take out the garbage, that's a good day.

 

I wish you had come back earlier and read the responses on your thread.  Please read them again now, along with the links provided.

 

I'm happy to read that you have reinstated 10mg.  According to medical knowledge, reinstatement is the only way to alleviate withdrawal symptoms.  Reinstatement is best done immediately upon appearance of withdrawal symptoms. The more time that passes, the less likely it is to work.  Please read through this information about reinstatement so you will know what to expect.

 

http://survivinganti...rawal-symptoms/

 

I'd highly recommend reading Anatomy of an Epidemic by Robert Whitaker  and checking out some of the videos at  Council for Evidence Based Psychiatry

 

 

I was given Ativan and Klonopin but am trying to resist taking everyday or more than once a day as I don't want to add another problem down the line.
 

 

If you take a benzo more than once or twice a week, you risk dependance and then that will need to be tapered.  We recommend NOT using any other drugs to manage anxiety while in withdrawal because they can cause even more problems in a destabilized nervous system.  We find that with short acting benzos people can then get withdrawal symptoms as blood levels fall (anxiety, tremulousness, panic). This is called "interdose withdrawal", or rebound anxiety.

 

Here is the link to our symptoms and self care section, you may find some useful non-drug ideas to help manage symptoms as you recover.  Especially read the topics pinned at the top.

 

If you stay in touch and keep us updated, we can help, this is one of the best resources in the world for safely coming off psychiatric medications.

 

Petu.

[Addax]

Hi itee.

 

Glad you popped back in. I'm sorry things got so bad. Withdrawal is a horrible experience. I was where you are just over a year ago and like I wrote above, I reinstated. If it's anything like my reinstatement right at the second week you'll notice significant relief. Of course everyone is different, but in general a week is a short time so don't fret if you're not feeling better yet. I think you made a good call with refusing the change in meds.

 

Seriously consider what Petu wrote about the benzos and rebound anxiety. Ativan helped me sleep while I was experiencing bad withdrawal symptoms but my anxiety was much worse the mornings after I took it.

 

You're going to feel better, just give it some time.

[Ruthjess]

Hi there.

I have also been off prozac for three months now. Just though it might help to compare symptoms. Things dont seem to be getting better. Bad anxiety and at night i have realy bad tingles in my body and legs and when i drift off to sleep i get jolted awake! Its is aweful! I also get the tingles as soon as i wake up in the mornings too and always wake up at first light. Are you also getting those shocks at night?

[ltee84]

Is anyone familiar with symptoms that persist after reinstatement? Upon CT w/d i began to get pins and needles (first in my legs) which then progressed to random parasthesis throughout the body (i can go days without it)..after stabilization post reinstatement I still have intermittent pins and needles. Could this be related??

 

Also..i'm not sure if this question is ok to ask ir whether it needs to be in the tapering forum but does anyone know whether a taper of 4 mg every 4-6 weeks would be too fast ?

 

Thanks!!

[Frustrated]

I have had pins and needles throughout the last seven months, pre and post reinstatement.  I think it is still just WDs but I  only reinstated a tiny amount.  I think it is possible to still have symptoms after reinstatement  because the brain was still affected.

[Ruthjess]

I hope you dont mind me asking but i realy need to talk to someone about this...  Did you also get realy bad shocks and tingles at night?

[Ruthjess]

Were you on Prozac or Paxil? My questions are related to prozac, as im three months down the line and still getting these tingles and shocks badly, its scaring me.

[Frustrated]

I get tingles on and off all the time.  Right now they are in my left leg, foot and in  my back and left hand.  I had shocks in the beginning, but now it is mostly tingles and burning and pain, and my muscles pop.  It would seem my muscles are over active despite taking magnesium.  The reinstatement has offered me a couple of windows from this but it is still present.  I am pretty sure it is med related.

[Frustrated]

I was on paxil but I think all ADs affect the brain so it is probably similar.

[ltee84]

I hope you dont mind me asking but i realy need to talk to someone about this...  Did you also get realy bad shocks and tingles

 

I have tried to see if there is a pattern between when i get the tingles (not as much shocks) but I haven't really been able to track any sort of pattern. They seem to be in my legs more often than not..but will sometimes radiate into my hands..stomach etc.

Back in the midst of w/d i had awful cramping and joint pain as well as muscle spasms. The pins and needles is what seems to have stayed since stabilizing...so it makes me wonder if it is related as all medical tests I have done have come back normal.

[mammaP]

Hi Itee, glad that you are feeling more stable now. When did you go to 30mg from 10?  It may be side effects of the prozac and if so they will

lessen as the dose gets lower. We recommend tapering 10% of the current dose with at least 4 weeks between cuts. This is very important

especially with your history. Going faster is not worth the risk! 

 

Here is the topic for tapering prozac http://survivingantidepressants.org/index.php?/topic/759-tips-for-tapering-off-prozac-fluoxetine/

 

It is important to read and understand the 3 KIS http://survivingantidepressants.org/index.php?/topic/6632-the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable/

[ltee84]

Hi Itee, glad that you are feeling more stable now. When did you go to 30mg from 10?  It may be side effects of the prozac and if so they will

lessen as the dose gets lower. We recommend tapering 10% of the current dose with at least 4 weeks between cuts. This is very important

especially with your history. Going faster is not worth the risk! 

 

Here is the topic for tapering prozac http://survivingantidepressants.org/index.php?/topic/759-tips-for-tapering-off-prozac-fluoxetine/

 

It is important to read and understand the 3 KIS http://survivingantidepressants.org/index.php?/topic/6632-the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable/

 

 

The increase to 30 from 10 happened within a month or so. I wish in hindsight i waited longer to stabilize at the lower dose but the pdoc kept making me paranoid that if i waited it may not work. He tried to get me up to 40 at one point but i decided to wait and see if 30 would be sufficient...it was. 

 

The thing with the pins and needles being from the Prozac confuses me because I have been on it for so long and never had that as a side effect. Is it possible for new side effects so many years later??

 

Okay..so the naturopath I have seen created a program of 10% taper every 4-6 weeks...I am thinking lower may be safer...

[mammaP]

Your naturopath created a taper of 10% every 4-6 weeks? I am impressed!  Prozac is available in a liquid which is easier to taper at the low doses, which is important when tapering 10% of the current dose. I'm going to find a link for you that shows receptor occupancy and it is surprising how much is there at low doses which emphasises the need to go slow. Maybe you could print it off for your naturopath? I think he/she may be interested in seeing it and you will find it fascinating. http://www.mediafire.com/view/f3h1ao5ijfj93/papers#0yp2c8pbjrziaab

 

When you have been in withdrawal everything changes and we find that people are often not able to tolerate the same doses they had before.  Some have real bad reactions and some minor symptoms and others are just fine. Or do you feel that is a residue of the withdrawal? You know your own body and if you do feel that it is still slight withdrawal it would be better to wait longer before tapering, until a few weeks after all the symptoms have gone. Tapering while still in withdrawal is not a good idea because you will never be stable between cuts. You've been through a lot and deserve to be free of symptoms, which can be the case when tapering carefully. 

[ltee84]

Yeah he does a lot of reading on the topic and seems pretty well informed (as far as any medical professional goes) ..his taper program consists of 4 mg decreases every 4 weeks. To be honest that scares me a bit eventhough it would be the first time I have ever properly tapered..but after severe withdrawal I am contemplating doing it even slower than that...especially due to the amount of time I have been on it.

 

I honestly have no idea in regards to the pins and needles. I can go days with them fairly present..then days of not feeling them. The only reason i have begun thinking maybe it is related to the withdrawal is because that was when I first felt the sensation..so part of me thinks maybe its just residual..however..everything else feels fairly stable. I have gone to my gp many times regarding it with no help...thats why i have started thinking maybe its related.

[Altostrata]

Are you taking fish oil and magnesium? see

http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/
http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/

 

To what extent have the pins and needles declined since you reinstated?
 

[ltee84]

Are you taking fish oil and magnesium? see

http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/

 

To what extent have the pins and needles declined since you reinstated?

 

 

I started taking Magnesium and fish oil a couple months ago as part of the regimen suggested by the naturopath I went to who has some experience with tapering. 

There is really no pattern and the pins and needles can be constant for days and then gone for days. I only relate them to withdrawal because i first felt them in July one month into the CT . They actually lessened a bit while I was still off the Prozac but became intermittent throughout WD and since.

I guess maybe its just one of those weird things. I have also had random vibrating sensations on and off in one leg...I guess there is no real way to know if it is related..

[Altostrata]

Do you do a lot of sitting? Are the pins and needles related to the positions of your arms or legs?

[ltee84]

Hi..

 

No I don't do a significant amount of sitting..no more than the usual person (which I guess doesn't say much) I work in a pretty active job. I don't seem to find a relation between any position I am in. Its very bizarre. I also get random buzzing sensations...it just doesn't make sense and because it began when i went off CT i can only assume maybe its related...despite stabilizing since. Have you heard of any lasting effects after???

[Altostrata]

Strange symptoms can come and go for quite a while after cold turkey.

[Ruthjess]

Itee84, it is definately related to withdrawal. I am experiencing the same thing. Its always worse at night though, or if im stressed. Its also worse after excercise so ive stopped all cardio vascular exercise. Saw a GP today and he just looked at me as though i was bonkers. Not impressed, i know the difference between anxiety and bizarre shock sensations and jolts at night that stop you from being able to sleep. He just said i must go back on medications cause its the disorder relapsing, What a waiste of money, but its even worse to feel alone and misunderstood/helpless.