xlmplmplmp: PSSD and Derealization

[xlmplmplmp]

Hey everyone! I've had PSSD for 3 months after discontinuing from 60mg Prozac. I am back on a low dose (10mg) and am planning to increase until the withdrawal symptoms subside and then go on a slow taper from there. Having strange sensations like I'm swimming through life. Plan to call my doctor tomorrow to let him know my plan to increase Prozac.

[Altostrata]

Welcome, xlmplmplmp.

 

Quite often, withdrawal symptoms will subside with a low dose. If I were you, I'd give 10mg a couple of weeks, at least, to see if that does the trick.

 

Has the reinstatement decreased your withdrawal symptoms at all?

[xlmplmplmp]

Not much, unfortunately. I've been somewhat manic, running around and having difficulty making decisions. Looking back, there was a three week period before I discontinued Prozac when I didn't have access to a script. I wonder if that shock to my system resulted in this current dilemna. I feel really guilty about this - I didn't know just how disabling antidepressant withdrawal could be or even how to recognize when someone is going through it. I see my doctor in two weeks to discuss options moving forward. We had talked previously but it wasn't until I did research that I came to believe I am going through withdrawal symptoms. Is there hope this will subside in a reasonable time frame? I called up Dr. Shipko but his message was filled with doom and gloom. I just don't know how long I can handle this!

[xlmplmplmp]

Is a few years a reasonable timeframe for PSSD resolution? I'm trying to make healthier life choices - exercising and eating better as well as avoiding alcohol. I have a hard time doing these things because I am so upset over the PSSD symptoms. Are there are reliable methods for even short term relief?

[tgirl]

X,

There are a few members on here that also have pssd.

Please do a search for them. They will be a wonderful source of support.

 

 

You can do this by going under the search option and entering in pssd. Under the word search.

 

What was dr. Shipko's message?

hoping you are well,

Tgirl

[xlmplmplmp]

Thanks Tgirl. Dr. Shipko audibly groaned when I told him I was on 60mg of Prozac for ten or so years. I've tried to quit before but always ended up in a psych ward. He said that the withdrawal reactions from that will be long lasting and my ability to function will be greater impaired. As if. I had a window a few days ago of intense positive emotion I haven't felt in years. I'm going to stay on the awful Prozac until I see my psych and we gradually taper down.

[tgirl]

X,

Is the pssd the main reason your wanting to get off it?

I don't know much about Prozac, but isn't that a high dose?

Hope you are well!

Tgirl

[xlmplmplmp]

Yeah, it was a high dose over a long period of time. I used it for OCD which typically calls for higher doses of SSRI medication. I went up on the medicine over the years as my own decision. Looking back now I deeply regret doing so. Oh well. I want to be free of medicine. I am hopefull I can be successful.

[mammaP]

Hi X, I'm sorry that you are having such a hard time with prozac, and sorry that Dr Shipko wasn't

able to help. I agree with Alto that holding at 10mg may be enough to help you stabilise. Once you

are stable you can then start a slow taper from the 10mg. Prozac is available in a liquid which makes 

it easier to taper at low doses. I'm sorry but I don't know very much about the PSSD problem, so can't 

offer any thoughts on that subject but I really hope it gets better for you. 

 

It would help us if you can put your drug and tapering history in your signature, you can find how to do

that here http://survivingantidepressants.org/index.php?/topic/893-please-put-your-withdrawal-history-in-your-signature/

 

We have a topic on PSSD if you would like to look at it, you may find some info there. http://survivingantidepressants.org/index.php?/topic/52-post-ssri-sexual-dysfunction-pssd

[Altostrata]

xlmp, you are doing the right thing by changing to a healthy lifestyle. Take care of your body and it will heal your nervous system.

 

If I were you, I would stay at 10mg for quite a while, perhaps some months, before deciding what to do next. It sounds like your system is getting used to it and may be stabilizing.

 

It may take some time for recovery from the effects of the drug. Could be some number of months, could be a year, could be 3 years.

[xlmplmplmp]

Thanks for the advice, Alto. As for mamma P, I will add my signature was I have access to my medical records. I have quite the history, haha! I like the hopeful message of this site as oppossed to some of the others. In my hopelessness I was making rash decisions. Believing that I can recover given time may indeed even hasten the recovery. I hope to slowly taper from Prozac over a period of months and be patient, making healthy changes to my body before attempting other

remedies for PSSD.

[xlmplmplmp]

I'm at the most calm I've felt in months. I'm actually on 20mg of Prozac now. This has stemmed the derealization and cognition issues significantly. The PSSD, though terribly present, no longer gnaws at me with every step. Unfortunately my writing is stilted and my ability to express my emotions, while occurring in a more logical pattern, lacks the same frantic energy as when I was off Prozac weeks ago. I'm hollowed out but no longer suffering so much shame and pain. I have to force myself to react to other situations and other people instead of simply reacting naturally. I'm confident I can get off this stuff and get back to being my old self, if only a faint shadow of who I used to be.

[Rhiannon]

xImp, hang in there. This is a tough road but you can do it.

 

We find that changing doses around actually can make things worse. 20 mg is probably fine, but please don't change again. It's going to take quite a while to stabilize after your CT from such a high dose with such long use plus a history of going on and off various meds at various doses. That's a high risk history and there is just no simple easy way to get out of that trap.

 

(Shipko is right that your situation is extremely challenging; where we disagree is that it's hopeless. He hasn't seen what we have seen when people go very very slowly and really take their time. It really works, but it requires immense patience and commitment.)

 

What you're facing now is, first, the need to give your brain time to stabilize and heal. It has remodeled itself around the drugs, so it's going to need to remodel itself to function at the dose you're on now, and that's just going to take time, there's no way around it. Growing a new brain is not a fast process, and your brain doesn't really know how to do it (evolution has not prepared us for what these drugs do to us since we've never encountered them in previous generations). 

 

Once your brain has stabilized and healed from the trauma of the CT (which will take many months, maybe a year or more) your next project will be a gradual, safe taper, going slow enough that your brain can adjust and remodel itself and heal itself as you taper. That will probably take a couple of years, but it's going to be easier than what you're going through now, because you'll be stable and in control of your taper and you'll be feeling much better.

 

If you do take the time and go through this process slowly, over the next few years, you will actually end up much better than "a shadow of who you used to be" I think.  If you really take it slow and give your nervous system the time and support it needs to heal and regrow itself, you will get yourself back in ways you can't even imagine right now. I won't go into it, but for me it's been amazing, and I've seen other people do it too, get themselves and their lives back. It is SO worth it.

 

The biggest challenge is patience and self control. This is a huge undertaking. Take it seriously, approach it as a major life project. The outcome will be worth it.

 

Right now, and the next year or two, is the roughest part, but hang in there and don't do anything drastic and you'll get through it.

[xlmplmplmp]

Thanks Rhi. Yeah, I guess I can be panicky and impatient. I'm a young guy and hate the PSSD with a passion. If haste isn't going to improve it then I'll have to wait. A few months on 20mg and then taper slowly. I hope it works!

[xlmplmplmp]

Hey everyone! I've decided to try the slow taper the next time I see my psych. The more distressing symptoms - derealization, cognition and memory lapses have subsided somewhat. My understanding is that over time these conditions will improve as long as I don't do anything hasty or unwise. My original plan was to try a 20-week taper off of 20mg Prozac, but I think a more conservative (and safer) approach would be a 40-week taper (10% each month for 10 months.) I've been in contact over the phone with someone else with PSSD. He has reported that exercise seems to help alleviate the symptoms somewhat.

[xlmplmplmp]

Another update! Life has been pretty okay recently. The worst of the symptoms have all subsided and I am more or less back to normal (for me normal is my brain on Prozac.)

 

Having had the most wonderful window where all agoraphobia was gone has given me the hope and motivation to dedicate myself to a slow taper. I can beat this beast. I plan to take a year to taper but will go at my body's schedule and take it as easy as I can.

 

I'm preparing myself to deal with the more troubling symptoms as they arise. I believe I can be successful.

[Petunia]

Thanks for the update xlm, I'm glad to hear that you are feeling better and have almost stabilized back on 20mg Prozac.  I have no doubt that you will be able to taper off, if you go slow enough.  If symptoms start to arise, you could make smaller cuts.

 

Are you still having some waves of increased symptoms, or would you say that you have stabilized now? When you are ready, perhaps you could start with a 5% cut to see how you react to that.

[Rhiannon]

Another update! Life has been pretty okay recently. The worst of the symptoms have all subsided and I am more or less back to normal (for me normal is my brain on Prozac.)

 

Having had the most wonderful window where all agoraphobia was gone has given me the hope and motivation to dedicate myself to a slow taper. I can beat this beast. I plan to take a year to taper but will go at my body's schedule and take it as easy as I can.

 

I'm preparing myself to deal with the more troubling symptoms as they arise. I believe I can be successful.

 

I'm not trying to rain on your parade or anything, it's just that I've been doing this for a long time now, have seen hundreds of people go through it (failing and succeeding both) and the one thing that leads to failure most reliably is trying to go too fast.

 

You will find that at lower doses (like below 8 or so) the drug effects will lessen, but the taper will become more tricky and need to be slowed down. Under 5 mg is the danger zone where people are most likely to crash and end up back on their original dose or more.

 

You can probably safely go a bit faster at first, but be extremely diligent about listening to your body, and please please please try to overcome your impatience. It is absolutely not worth it. Everyone thinks they can just use their will power or whatever and bite the bullet and get through the withdrawal symptoms, but everyone who does that, finds out that it's not a matter of strength, or guts, or willpower. Believe me if it was I would have been done a long time ago.

 

It's like saying willpower will make it possible to overcome gravity and fly. Like with enough willpower and strength you can walk on a broken bone whether or not it has had enough time to heal.

 

The processes that cause withdrawal symptoms are complex and real and can't be avoided or beaten. The only thing that works is to take it as slow as your body needs, so your nervous system can heal, and that's just not a fast thing. 

 

There is a reason Shipko is so pessimistic. I can be pessimistic too, actually, not because it can't be done (because I know it can) but because so few people will actually listen when I tell them what actually works, and so many people think they can just do it as fast as they want and will just keep pushing in spite of their symptoms. 

 

Seriously, if you want to do this and really make it work, take it slow.

 

Also, read Anatomy of an Epidemic, if you haven't yet.

[nz11]

 My original plan was to try a 20-week taper off of 20mg Prozac, but I think a more conservative (and safer) approach would be a 40-week taper (10% each month for 10 months.)

xlmp,

Greetings from the bottom of the world...im trying my hardest to go a day without posting but its not easy.

 

Couple of things,

 

..this so called conservative taper you are planning does not appear to be a conservative taper, from what i can see. If you read the tapering at 10% thread you will see that  the next months dose is 0.9 times the previous months dose. This taper will take 30 months from a 20mg start. This taper gives the greatest chance for success.

 

What i believe you are planning to attempt is a constant drop of 2mg per month (being 10% of the original dose of 20 mg)...sorry that is too fast...and not the type of taper recommended here. This taper takes as you say 10 months but you may not reach the end of it without being sent back to start again.

 

I have seen many get down to 20 from higher doses in an ok state that is the easy part getting off the last 20 is not so easy in fact it can be very difficult and this is where i perhaps see things a little different from Rhi for I believe its critical to start slowly from 20 mg, especailly also in light of the way you got to 20. 

eg 5% per 1-2 month to start with esp if one has been on for some time or exposed to a revolving smorgasboard of these chemicals. Both of which you have been. The wdl symptoms are delayed so you may get to 12mg and think all is fine then bam ...you are hit from a previous dose drop but from which dose drop? from 'who knows what stage' and its 'back to jail do not pass go do not collect $200 -start all over again'

 

Re : Shipko ..i agree with Rhi.

You know what i reckon these wonderful people world experts may well not be doing/seeing  a 5% per month or per several months or 10 % taper with people so they perhaps imo may not even conceive of such slowness in tapering that is why they are not positive about people getting off they are not doing the taper time with people. Remember these people are not seeing people every day unlike these forums so they may not be following patients progress or reminding people of the need to stick to the game plan as such some may think 'oh 10% taper is nice but thats for everyone else except me, cos i can tough this out ' ...I am sure it would not be cheap to see these people every other day either.

 

I know of a person in my town he went on paxil in 95 started doing a taper in 2005 and in 2015 after 10 years of doing very long holds and very tiny drops using a razor blade to cut shavings off is now on 5mg  and had very little wdl symptoms. We have been open in our talking but not too open yet i have inferred from things said that he has severe pssd and like so many have silently accepted this 'obscenely wrong new normal'  . I am in my 5yr of pssd and i see no sign of an improvement at this stage in fact i feel as if i have been rendered an asexual being. I am only speaking for myself you may well have recovery. 

 

Here is a quote from Whitakers book,

When it comes to dead bodies in current psychotropic trials there are a greater number of them in the active treatment group than in the placebo groups. This is quite different from what happens in penicillin trials or trials of drugs that really work.

David Healy 2008

I like Healy ..he calls a spade a spade!

 

So thats my 2 cents worth and my one post for the day....i'm on rations!

[xlmplmplmp]

Thanks for the replies, everyone! I will respond to each in turn.

 

Petu - I still have small windows and waves. During windows I tend to be more optimistic and energetic and able to interact with the world. The waves aren't too bad; I mainly experience increased anxiety or lethargy. I sleep a lot more than I did during acute withdrawal where I would reliably wake up at 4:00am and 8:00am in utter panic, which is unfortunately an experience many on this board would recognize.

 

Rhi - I will not chain myself to a schedule. It will take as long as it takes and I will try my best to be patient and listen to my brain and body as I decrease my dose. I won't try to reduce in order to meet any deadline but let my experiences be my guide. I have read and enjoyed Anatomy of an Epidemic and follow Whitaker and Healy's activities and advice with interest.

 

nz11 - I will go at my body's pace and not attempt to rush what can't be rushed. Thanks for the advice.

[selena]

Thanks for the replies, everyone! I will respond to each in turn.

 

Petu - I still have small windows and waves. During windows I tend to be more optimistic and energetic and able to interact with the world. The waves aren't too bad; I mainly experience increased anxiety or lethargy. I sleep a lot more than I did during acute withdrawal where I would reliably wake up at 4:00am and 8:00am in utter panic, which is unfortunately an experience many on this board would recognize.

 

Rhi - I will not chain myself to a schedule. It will take as long as it takes and I will try my best to be patient and listen to my brain and body as I decrease my dose. I won't try to reduce in order to meet any deadline but let my experiences be my guide. I have read and enjoyed Anatomy of an Epidemic and follow Whitaker and Healy's activities and advice with interest.

 

nz11 - I will go at my body's pace and not attempt to rush what can't be rushed. Thanks for the advice.

 

 

Hey there! Just to say that I also have PSSD and was on 50mg citalopram for three years. if you need someone to chat to I am here as I am going through the same

 

All the best

 

Selena

[xlmplmplmp]

Hoh boy, I had quite the wave today! I'll keep this experience in mind as a reminder when I taper the dosage of Prozac not to go too fast!

[xlmplmplmp]

Ugh, another wave. I'm going to meetings to avoid drinking, which is a pernicious habit of mine. I'm working on CBT methods to deal with OCD. I use the Four Steps advocated in "Brain Lock."

 

It's strange, as hopeful as I am that I will heal and as glad I am that I am no longer in the throes of utter terror, I deeply regret doing this damage to my brain over the years. It wasn't something I intended nor something I realized was possible, but I still long for days that could have been. Oh well. My cognitiion is intact and my memory is returning piece by piece. PSSD remains but I have hope I will see improvements. I caved in and took a prescribed stimulant which seems to have alleviate some of the dysfunction. It isn't a good long-term strategy but the relief is welcome might even be worth the risk.

 

I am pretty worried about what my experience tapering will be. During my waves I experience extreme suicidal ideation of the sort that seems alien yet at the same time utterly compelling. It's like some sort of primal fear that rips through me. The feelings of "this is forever unless you end it now" seem to be a common withdrawal symptom. These drugs do terrible things to the mind, and though our brains will recover given time and care, we must not forget the wounds we've sufferred or those who have inflicted them upon us. When I have saved up more money and if I am able to maintain my employment during my taper I hope to pursue a career in either public health or clinical psychology. I will use the rage I have resulting from what I've lost combined with the brain and willpower I am building now to help ensure a better world so that others aren't as likely to suffer the way I have. That sounds a bit vainglorious but I need to be dramatic in order to motivate myself and match the intensity of the trials I am enduring.

[xlmplmplmp]

I talked to my psychiatrist about my plan to taper and he seems supportive. I will pick up liquid Prozac tomorrow and start with a 2mg reduction for the first month. I'm looking forward to being free of this awful chemical. I'm more or less back to where I was before which is being depressed 24/7 but stable and able to make decisions. In a year or so I may feel much more alive. Though the PSSD may remain for years on out I will be able to smile with there actually being genuine feeling behind it.

[xlmplmplmp]

On 18mg of Prozac! My first reduction is going okay so far. I have to wait it out this month and then reduce another 2mg the next. I hope I can get through this okay, I loathe being on this stuff.

[xlmplmplmp]

I wish everyone the best in luck in their healing! I am at 16mg of Prozac now and doing fine. I know the 10% taper should be at your current dose, but it is so much easier for me to measure out 2mg or 1mg amounts. I am still figuring out how fast my brain is healing - seemingly so far it heals pretty quickly. I won't push it or go faster than I need to and won't be afraid to have long holds if I need to but unless I really start suffering I will stick to 2mg or 1mg reductions.

[LoveandLight]

Great your doing well!

[Songbird]

You might do okay with 2mg drops for a while, but I think under 10mg you'll want to make smaller drops (e.g. 10, 9, 8, 7.5, 7, 6.5) and then smaller again below 5mg.  It's okay to do a not exact percentage taper, but keep the 10% in mind as a guideline for the maximum drop amount.

[xlmplmplmp]

Sure thing. I am having a hard time avoiding alcohol but am doing better now. I don't seem to be suffering too terribly from withdrawal but the SSRI numbness really gets to me still. I take fish oil and I haven't noticed any drastic improvements but will continue trying it out.

[xlmplmplmp]

Hey everyone! Just wanted to give a bit of an update. I'm at 13mg of Prozac now and doing pretty well. I cut by 1mg every two weeks or so. I'm not the most diligent or dedicated of people so I tend to change my plans as I go along but I seem to be doing okay! I still drink and smoke too much but I'm able to hold down a job and talk to people and live in my own head without wanting to blow my brains out, so those are all pluses, right? I wish everyone the best of luck in their healing and will provide further updates down the line.

[xlmplmplmp]

Hey everyone! I hope all is well. I'm down to 8mg now. I have found this taper so far to not be too terrible. I am going a bit faster than the recommended rate but I find being able to go at my own pace to be psychologically important for me to such an extent it outways the risk, in my opinion. I reduce every two weeks by 1mg. I'll see how this goes. I aim to be off the drug by my birthday in Novemember. We'll see how well that works out.

[Altostrata]

Good to hear, xlmp. A decrease of 1mg from 8mg is 12.5%, the proportion of your decreases is getting bigger.

 

You may wish to play it safe and reduce by .5mg every 2 weeks from this point.

[xlmplmplmp]

Sure thing.

[xlmplmplmp]

Well, one of the bits of wisdom I've gathered on this site is to avoid excessive stimulation while in withdrawal. This morning one my roommates (a middle-aged woman) assaulted me for "making too much noise" while snacking in the kitchen at night and waking up her kids. She pushed me and screamed in my face. When the landlord was called over she yelled "I am going to kill him" in reference to me with multiple witnesses in the house. I gathered up my stuff and packed it into my car and drove to a local coffee shop and when I parked I realized she had slashed one of my tires. I called the police and am now looking for another place to stay. Yay life experience! I'm glad I held my own though, withdrawal or not.

[Altostrata]

That sounds terrible. You definitely need a more peaceful place to live.

[xlmplmplmp]

Haha, yeah, that's for sure.