HopeNeeded Debilitating Withdrawals (Vision, Disequilibrium, Confusion, etc...)

[HopeNeeded]

Okay, question - the psychiatrist has recommended trying to reinstate 12.5mg Zoloft INSTEAD of the Prozac. He cited the potency and long half-life of Prozac as a drug, along with the fact that last year - trying to wean off Zoloft - was the first time I had a bad reaction to withdrawals. 

 

I would really appreciate some advice on this. Thanks so much.

[Altostrata]

Yes, your withdrawal syndrome started with going off Zoloft.

 

However, more recently, a little Prozac seemed to help. This is a more reliable indicator than your having been on Zoloft 6 months ago.

 

Switching drugs, going on and off drugs, changing dosage are all wearing on your nervous system. This experimentation, which your doctor seems to like, is adding to your distressing symptoms.

 

Your doctor's reasoning about Prozac's long half-life makes no sense at all. It is an advantage when tapering, not a disadvantage.

[westcoast]

Hi Jaclyn, How are you doing? I just found your thread and wanted to say hello. I was a lot like you when I finally got off all the drugs, and I have gotten much better. I couldn't handle reading or answering questions.

 

Did you get talk to your doctor about cyproheptadine? I

 

This is from wikipedia:

• According to a small study, cyproheptadine hydrochloride has been found to improve sleep, calmness, as well as mood and energy levels, and to improve both negative and (sometimes even) positive psychotic symptoms in a subgroup of chronic schizophrenics who do not respond (either completely or sufficiently) to other therapies.^[21]
• Cyproheptadine may improve akathisia in patients on antipsychotic medications.^[22]
• In clinical trials in which cyproheptadine was used as an adjunct to antipsychotic treatment for patients with schizophrenia, an improvement in negative symptoms was seen.^[23]

 

and here is medline

Here's medline http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682541.html

[clearday]

Also from wikipedia, adverse affects of Cyproheptadine include:

 

Adverse effects include:

• Sedation and sleepiness (often transient)
  
• Dizziness
  
• Disturbed coordination
  
• Confusion
  
• Restlessness
  
• Excitation
  
• Nervousness
  
• Tremor
  
• Irritability
  
• Insomnia
  
• Paresthesias
  
• Neuritis
  
• Convulsions
  
• Euphoria
  
• Hallucinations
  
• Hysteria
  
• Faintness
  
• Allergic manifestation of rash and edema
  
• Diphoresis
  
• Urticaria
  
• Photosensitivity
  
• Acute labyrinthitis
  
• Diplopia (seeing double)
  
• Vertigo
  
• Tinnitus
  
• Hypotension (low blood pressure)
  
• Palpitation
  
• Extrasystoles
  
• Anaphylactic shock
  
• Hemolytic anemia
  
• Blood dyscrasias such as leukopenia, agranulocytosis andthrombocytopenia
  
• Cholestasis
  
• Hepatic (liver) side effects such as:
  

- Hepatitis - Jaundice - Hepatic failure - Hepatic function abnormality

• Epigastric distress
  
• Anorexia
  
• Nausea
  
• Vomiting
  
• Diarrhea
  
• Anticholinergic side effects such as:
  

- Blurred vision - Constipation - Xerostomia (dry mouth) - Tachycardia (high heart rate) - Urinary retention - Difficulty passing urine - Nasal congestion - Nasal or throat dryness

• Urinary frequency
  
• Early menses
  
• Thickening of bronchial secretions
  
• Tightness of chest and wheezing
  
• Fatigue
  
• Chills
  
• Headache
  
• Increased appetite
  
• Weight gain
  

[HopeNeeded]

Westcoast - thanks for saying hi (and the helpful info) - it means a lot to me. I'm so glad to hear you're doing better! If you don't mind my asking, what were your worst symptoms and how long did they/have they lasted? I will go check out your thread to get more info, as well.

 

Clearday - thanks so much for the info. I have stopped taking the cyproheptadine (only took it for two days to see if I had serotonin syndrome from the reinstatement). Either way, your support is very much appreciated. How are you feeling?

[clearday]

I'm in a bad wave. Thanks for asking -

 

Looking forward to my next window, it's not coming fast enough.

[HopeNeeded]

So sorry to hear that, clearday... I'm waiting to find out what a window feels like. Fingers crossed yours comes soon. xo

[Iamfine]

Jaclyn- you mentioned in an earlier post that your symptoms were worse later in the day instead of morning like most people report.mi am the same. I can just plan on feeling bad starting at around 2:30 pm to about 6:00 pm. They blame morning problems on cortisol or some such thing (it's all a guess psychiatry in general is just a guess). My solution has been to plan on being busy during those hours. I run every other day and I do my runs during those hours. On my off days I plan simple, enjoyable tasks during that time period. Works for me. Good luck to you.

[HopeNeeded]

Iamfine- thanks so much for the advice. I used to be super active, spinning 5-6x/week, running on the weekends. Now I'm so dizzy and unbalanced/confused that it's all I can do to take a walk around the block. If/when I get a window, I will try your method of getting through the rougher times. Thanks again!

[Iamfine]

You will get relief. I've been on most of the meds and I've fast tapered and if I can get better anyone can.

[HopeNeeded]

Iamfine - were you able to exercise even when you were in the throws of withdrawal? 

[JanCarol]

Hey Jaclyn

 

How is your reinstatement going?  It has been at least 10 days, so you should know whether or not it is working.  I hope it is gentle and effective.

 

When I look at your drug history, here is what I see -

 

Your psychiatrist has told you, each time you weaned off of a drug, that you have "relapsed" that your "depression has returned" - but each time you have weaned off, your symptoms got really bad between 3-6 months out.  These "depressions" are more likely to have been withdrawals.

 

I know you call it "situational" which means there were other stressors involved.  Certainly, there are traumas and difficulties that stress us, but when those traumas and difficulties hit when we are in the deep throes of withdrawal from these brain-altering drugs - well, you don't really stand a chance against that kind of a wave, do you?

 

So reconsider your drug journey, and see if what I say is true. 

 

You wrote:

 

 I used to be super active, spinning 5-6x/week, running on the weekends. Now I'm so dizzy and unbalanced/confused that it's all I can do to take a walk around the block. 

 

You may find that during withdrawal, besides the dizziness, it is counterproductive to do hard exercise.  We recommend gentle exercise - walking is excellent, as it is good at balancing the brain.  Light weight lifting is good.  Light cardio - being able to speak while you do it is a clue.  In my understanding, the reason behind this is that healing the brain takes a LOT of energy, and if you overdo (this includes work, errands, exercise, chores, or even social engagements which can be stressful), that it wears you down and slows your recovery.  Don't worry about intense activity, or exercise just now.

 

We recommend yoga, tai chi, walking, light dancing.  And have you been introduced to Mindfulness and Acceptance yet?  Also, have you tried Magnesium

 

and

 

Omega-3 fish oil ?

 

I think you could find them helpful.  

 

Slow and steady, gentle and kind.  Imagine your brain is a baby kitten - reactive, frightened.   Be kind to your brain and yourself.  In our current culture, it is considered "selfish" to take care of ourselves.  But it is vital to take care of yourself first, then, when you get better, you will more be able to take on new tasks, exercise more vigorously, and be of greater help to others.

 

You seem to be doing much better since your reinstatement.  Listen to Alto when she says NO MORE CHANGES for awhile.  The more you change drugs, it's like bouncing a rubber ball again and it takes awhile for it to settle down after each change.

[Iamfine]

Iamfine - were you able to exercise even when you were in the throws of withdrawal?

 

No, in fact for several months there it was a major accomplishment if I walked down to the mailbox to get the mail. Exercise was impossible. I can remember trying to walk just a short distance down the road and I would make it about 100 yards before turning around almost in tears and lay on the couch in misery the rest of the day.

[WinningThrough]

Hi Jaclyn. Thanks for visiting my thread. I'm sorry you're having such a rough time. I do hope you stabilise and things improve for you soon.

[HopeNeeded]

JanCarol - Thank you SO much for responding to my thread. I don't know if my reinstatement is working... It seems to be very up and down. I have not tried Fish Oil and Magnesium but will order them online as soon as I'm finished writing this. Should I stop the reinstatement if I don't feel much better, at this point? I will definitely take Alto and your advice re stabilizing and being consistent and gentle. Do you mind elaborating what I should feel if the reinstatement is working? 

 

Iamfine - While I am so sorry you ever felt the way I do now, it is so inspiring to hear that you were once like me (as far as debilitation and severity of symptoms) and are now able to workout regularly. How long did it take for you to get to such a place?
 

WinningThrough - I appreciate your kind words. I hope the same for you. 

[Altostrata]

If it doesn't seem to be hurting, I would stick with reinstatement. It can take a while to help.

[Iamfine]

I started coming off drugs about two years ago but only decided to get off everything about 4 or 5 months ago. That was before I found this site and have since slowed the taper of my remaining meds much more slowly. Probably faster than 10% per month but not a lot faster. I still feel like crap sometimes but much better than even 4 months ago.

[westcoast]

Hi Jaclyn, sorry for the late return. My memory is bad.

 

My worst symptoms were in 2013. (The adventure is outlined in my sig file. It all started with Effexor in 09, when I was a a few years shy of 50.)

 

I'd was almost, or sometimes, psychotic on ADHD drugs by Nov 2012, living in a converted attic alone, and crashed. I'd quit the ADHD drugs, been prescribed Effexor, gone mad again, quit that, and then the dread, and inability to read, or  tolerate phone calls set in. (I couldn't organize my thoughts to pay a bill, couldn't deal with computer forms.)

 

I was having mild seizures, but that period is a blur. I was diagnosed with intractable epilepsy by a specialist. Something spiked in my brain during the eeg, and things I did when he had had me stand on one foot and so on were the only abnormalities. Intractable means no pills help, so it would have been a high fat ketogenic diet. I think I was just jacked on drug withdrawal. I still to deranged to follow up. That was March '13. Early morning dread and 1:15 am awakenings with a pounding heart set in. That went on for months and it was very difficult to survive. I'd lost most everything by then--friends, permanent boyfriend, money, and career. My head always hurt in the morning, but not like a headache. It felt like hell was visited on my skull or maybe my brain. It was icy and hot, and felt like an emotion not of this earth.

 

It was better by Dec 2014. I credit trying a semi-ketogenic therapy I got off the internet with the turnaround. (Coconut oil and grass fed butter, a tablespoon each, in my coffee.) The dread just went away within 2 weeks. I'm not my old self, but I am not subjectively horrified 24/7.

 

How are you doing now? (it's about to be the 26th.)

W

[HopeNeeded]

REINSTATEMENT UPDATE: Just increased the Sertraline to 25mg/day... Clear periods had completely stopped. Do you guys think it is too fast to increase?
 

WestCoast - I so appreciate you taking the time to post on my thread. I relate to SO MUCH of what you went through... Specifically "then the dread, and inability to read, or  tolerate phone calls set in. (I couldn't organize my thoughts to pay a bill, couldn't deal with computer forms.)". It is hard for me to even read/post on here... But I must to stay semi-hopeful. 

 

I'm really scared that I'm never going to be able to get a job again. None of my friends or family understand what's going on - I mean, neither do I... But I just feel like I'm permanently and forever impaired - which I can't live with. Really appreciate your support and encouragement. 

 

Jaclyn

[Altostrata]

Jaclyn, when you say clear periods have completely stopped -- what were your symptoms and how many days did this last?

 

How are you feeling now?

[HopeNeeded]

Alto - I'm not sure I fully understand your question. My symptoms have been the same as prior to reinstating - constant - without the occasional periods of lesser symptoms that I experienced when I began reinstatement. Right now I'm feeling awful. Woke up with the usual horrible headache, dizziness, confusion, dizziness...

 

How are you?

[Altostrata]

I'm okay, thanks.

 

Was there any change when you increased Zoloft?

[HopeNeeded]

I just increased a few days ago... No change. What to do?

[HopeNeeded]

Doc is saying to stop Zoloft completely because it isn't working... Advice?

[Altostrata]

It takes at least 4 days for a dosage change to fully register in your body.

 

Is it making your symptoms worse?

 

It will not immediately fix your withdrawal symptoms. The signs will be subtle at first. If it's not making you worse, I would give it some more time.

[HopeNeeded]

Alto - Thanks for responding. I think it may be making them slightly worse - definitely no better. Would you still recommend continuing? If not, do I ween off or just stop? I'm in a living hell, as you know

Thanks so much 

[Altostrata]

Jaclyn, I had to re-read your entire topic to get an idea of what's going on.

 

It seems to me that you might have Pristiq withdrawal syndrome OR Prozac withdrawal syndrome.

 

The question is whether Prozac reduced your withdrawal symptoms when you started taking it again.

 

Here, I'm trying to find out whether the initial substitution of Prozac for Pristiq compensated for Pristiq withdrawal symptoms:

Welcome, Jaclyn.

 

How long did you take the Prozac after you were off Pristiq? Did you have any of these symptoms while you were taking Prozac alone?

 

But it's not clear that the switch from Pristiq to Prozac worked as your doctor expected:

Apologies for the questions I missed... Brain function isn't my strong suit, at the moment. Answers to unanswered questions below. Please help :-/

*I was on Prozac for about 2-3 weeks after stopping the Pristiq (1 week on both Pristiq and Prozac - which I guess is what is referred to as a "cross taper")
*Symptoms on Pristiq were mostly vision related. I noticed my vision was blurry - not as bad as now - but definitely off, which I had experienced with Sertraline in the past. Additionally, I felt a little numbness and haziness - nothing at all like now, but those were the reasons I wanted to stop Pristiq. The Prozac was added simply as a means to bring me off of the Pristiq.
*Symptoms during my short time on Prozac? Hard to say bc I was coming off of Pristiq... I would just say increased anxiety and muscle weakness on top of the Pristiq side effects (outlined above).
*Doctor switched from Zoloft to Pristiq because he didn't feel the Zoloft was helping my depression. ('Funny' bc it is now clear that all ssris were not helping the depression, but exacerbating it.)

Were these answers helpful?

 

We kept on telling you that 2.5mg Prozac might help. Then you reinstated Prozac and, at the direction of your doctor, who does not appear to know what he's doing, you took too much:

Struggling to think/type - but will try to give some more info, in hopes that someone will care/respond if I do...

 

May 27th - reinstated 5mg Prozac (felt like I was slowly making progress until I hit a wall and symptoms seemed to be worse). 

June 7th - increased to 10mg Prozac (no relief)

June 11th (today) - Symptoms have been the worst they've ever been, with addition of constant nausea and increased body temp/sweating. These additions have caused my psychiatrist to believe that the Prozac has given me Serotonin Syndrome and instructed me to completely stop it. 

 

ADVICE, please please please!?!?

 

You did not have serotonin syndrome, you were taking too much Prozac:

Jaclyn, if I were you, I'd go back down to 5mg. It sounds like 10mg is too strong for you.

 

The subtle progress you were experiencing upon the initial 5mg reinstatement of Prozac indicates that, if you gave it time, Prozac might work:

Alto - Yes, my doc originally reinstated me on 5mg (5/27/15)... I think I was making some progress. Hard to explain what that progress was - but I could just feel the slightest bit of progress (if symptoms are usually at a 9-10 in severity, they were moving toward the 7.5-8 range). The progress was slow and seemed to stop, so my psychiatrist increased the dosage to 10mg on 6/7/15. Within 3 days my symptoms were at their worst, with the addition of severe nausea and increased body temp/sweating. On 6/11/15, my psychiatrist said it seemed I had serotonin syndrome from the 10mg reinstatement, and instructed me to cease taking the Prozac for a few days... I took nothing from 6/11-6/13. On 6/14/15, my psychiatrist advised trying the 2.5mg. That is where I am... So far no relief. Is that helpful? What should I put in my signature?

 

Your psychiatrist doesn't have a clue what's going on.

 

It takes at least 4 days for the drug to reach steady-state in your bloodstream.

 

It sounds like 5mg might have worked for you, but now you may be sensitized because of the jump to 10mg and bad reaction to that.

 

You'll have to give the 2.5mg time to see if it can reduce the intensity of symptoms. If it helps only a little, that's a good sign.

 

I would monitor for a week at least before making any decisions. Be sure to take at the same time each day.

 

Then despite all the time and effort I've put into spelling out a plan and for a reason I cannot fathom, your psychiatrist has you taking Zoloft.

 

Do you have any Prozac left? If I were you, I'd take 2.5mg Prozac, initially cross-taper with Zoloft for 4 days, then decrease the Zoloft by 5mg every 4 days until you're off it.

 

Alternatively, on the theory that at the bottom, you're suffering from Pristiq withdrawal, I'd try a very low dose of Effexor XR (cross-taper with Zoloft as above). Effexor XR is a reasonable substitute for Pristiq.

 

Whatever you do, expect a rocky ride. There is no easy fix for these drug adverse effects. You've been on and off and up and down on drugs and it will take some time for your nervous system to settle down.

 

You might as well take that psychiatrist off your payroll and work with your GP instead. Any doctor can write a prescription for these drugs.

[HopeNeeded]

Thanks, Alto, for taking the time. I'm not ignoring or discounting any advice - I am just trying to do what is best and not make anything worse. I will take your advice and try the 2.5mg Prozac again (cross tapering with Zoloft, as your recommended). 

 

Again, really appreciate it. I need some relief. I don't know how much left I have in me...

[Altostrata]

Many of the people here are in a similar situation, Jaclyn. This site exists because doctors don't know how to taper.

[HopeNeeded]

4th in bed, phone turned off to avoid the "where are you" and "how are you feeling" questions. I don't know how much more I can take. Really need some type of support or encouragement right now.

[Altostrata]

Visiting others' topics and offering them support is a good way to build online relationships.

[HopeNeeded]

Alto - Have definitely tried that to no avail. Not sure what I'm doing wrong but will try again...

[LoveandLight]

Sorry Jaclyn if you feel deserted here..I hope things improve soon x

[HopeNeeded]

Thanks so much, loveandlight. I wish you the same. It's a terrible feeling to know that I can relate to so many on this site, but don't know how.

[Flowers]

Hi Jaclyn

 

So sorry you are still  going through a tough time.  Alto will help you get your meds sorted out to give you the best chance of recovery. It may take some time though so be prepared to be patient!

 

I think when I first joined this site I was slow to get responses too. Keep posting on other's threads if you can so your name keeps coming up  on the list. I think this generates interest and then  maybe you will come across someone you hit it off with. I know this is hard when we don't feel like writing or doing anything at all!

 

There are lots on here who have taken or are taking the same drugs as you - maybe they have had similar experiences  as you have?

 

I hope you get your drugs and dosage sorted out soon and that you go on to stabilise.

 

Best Wishes

 

Flowers xxx

[bluebalu86]

Hi honey, I'm sorry things aren't good at the moment, it's the same for me. Let's try and hang on together. When you feel better you should try and talk to people, post on their threads etc., that way you will make some friends here and receive more support. Everyone here wishes you only the best, but maybe people don't know who you are if you don't post on their threads, so try to do that when you're better and feel more able. Also, it might help if you put a picture on your profile - any picture that you like - that way people will be able to connect your nickname with a visual and you will be more easily recognized.  I wish you peace and healing my dear, and Alto will give you good advice how to manage your meds situation. Many hugs and kisses for you