cmusic: A long history and finally saying enough

[cmusic]

Hello everyone

 

I wanted to share my journey through hell that has been going on for several years. I have been on AD's since 03, but in 2010 when I crashed and have not been the same since. I have great life, a wonderful wife and 2 great boys, a good job, and supportive family and friends. But I can’t enjoy any of it – my life at the moment is simply a struggle to get through each day.

 

In 2002, my doc gave me Zoloft for what was a persistent but manageable level of anxiety. Supposed to take the edge off and is safe and can be used indefinitely. Between 2003 and 2010 I was on Zoloft, Lexapro, and Prozac (with Xanax as needed). I went through those years ok, except for increasing GI issues.

 

I crashed in 2010 after trying to switch from Prozac to a tricyclic (because of GI issues). I was on the couch in acute panic, crying hysterically, couldn't stomach food, with insane levels of anguish and fear and depression. I thought my life was ending. My psychiatrist told me to triple my benzos, and as a result I didn't go off them for over a year.

 

Currently every day is a significant struggle.. Anxiety and depression are magnified to levels that basically incapacitate me in the mornings. I cry every morning with an overwhelming sense of doom, a dread for living the day, can barely stomach the smallest amount of food from nausea, GI distress, etc. I return to somewhat normal at night, only to become Mr. Hyde again the following day.

 

It's pretty clear to me that SSRI's no longer work for me. Every time I increase the dose or change meds to try and help, I seem to get a month of releief then the intense anxiety and depression begins again. It's almost like I'm adapting to the meds.

 

I wasn't sure it's appropriate to reach out to you directly, but I wanted to try. I can certainly offer my history on the forums as well, was going to post this on the tapering page if appropritate. I'm just looking for some level of confidence that the issues I'm going through could be attributable to the drugs, and getting off is something that in the long term could make me well again.

 

• In everyone's experience, is it possible for a person to experience the equivalent of withdrawal while still on meds (as they cease to be effective)? Are acute depression, anxiety, maginified emotionality, loss of interest, no appetite and nausea all considered withdrawal symptoms? (even if you had these while still on)?

• My PDoc said I could just get right off the 30mg Prozac because of the long half life and built-in taper. Byt I read here that a slow taper is the only way to go. I've been off for a week and I don't feel good, but I also don't see how adding back a small bit would help (when I felt almost the same while I was still on the drug). Honestly I'm at a loss... and thinking I'm goign to try to just power through this as best I can.

My hope is that I can get off and get through whatever bad period there is and get better to a sustainable point where I can live my life. My fear is that I'm somehow damaged beyond repair and that getting off the meds will leave me in this state indefinitely.

 

I have been to holistic clinics where they measure your neurotransmitter levels through your urine (surprise my serotonin was low). I'm taking a very expensive regimen of supplements. I've managed to keep my job but it's been smoke and mirrors and is getting harder. I have lost the ability to feel joy, have barely any motivation to pursue interests or live the day, and feel like I'm losing my family and my life. I'm literally terrified.

 

Any thoughts or ideas anyone might have on my questions above would be appreciated. Or even just validation that I'm making the right decision.

 

Thanks and good luck to you all.

[tezza]

Hi and welcome. I'm sorry you're going through this. You say you felt almost the same when you were on the medicine, I take that to mean you actually feel a little worse now. Is that correct?

 

If you do feel worse then you may not want to try to power through it, as you say. You could have 'protracted withdrawal' that can last months or even years.

 

I'm sure one of the staff or the admin will have good advice for you. What happened when you took Lamictal?

 

If you did cold turkey switches, it could have caused withdrawals even though you began a new medication. Doctors are not usually very knowledgeable about stopping or switching meds.

 

It's also possible that you may be having benzo withdrawals since you took them for a year.

 

Wish the best for you and someone will come by to advise you soon.

 

Tezza

[Michael]

Hi Cmusic. Welcome to the forum. It sounds like your in pretty rough shape, sorry to hear that.

 

Believe me, I understand the 'insane levels of anguish and fear and depression'. I've been going through that with increasing intensity since last September. I hope that it's due to an anti-psychotic that I started in August.

 

I don't have the experience to comment on whether the symptoms you're having are actually from withdrawl due to decreasing effectiveness. I'm in a situation where I can't distingush the side effects of taking a drug from the withdrawl effects of getting off of it gradually or the withdrawl effects from a step reduction in another drug. That confusion makes it very difficult to understand what to do.

 

What I can tell you is that I have experienced some benefits from reducing the anti-psychotic but the benefits come and go. Some days I'm better; some days I'm back in the soup. Others here report similar experiences, and it's taken me quite a few days after reducing my dosage before I see any benefit. I also have had some very bad days right after a dosage decrease.

 

The received wisdom here is that, if you decrease your dosage of an anti-depressant and your symptoms get worse, then you decreased it too much and you're experiencing withdrawl symptoms. The general recommendation is for a proportionate taper using reductions of 10% of current dose. It sounds like you have stopped the Prozac cold-turkey. I did that once with Citalopram and went through several weeks of hell. In the end, only you can decide whether to stay the course or do something different, e.g. go back on to a small dose of the Prozac.

 

Whichever you decide, I hope that you will consider the idea that your brain has shown that it changes in response to changes in dosage of a drug. As you pointed out, 'Every time I increase the dose or change meds to try and help, I seem to get a month of releief then the intense anxiety and depression begins again.' If your brain takes a month to change after an increase in dosage, it will likely take at least that amount of time to adjust after a decrease in dosage, but it will change. The hell you're going through right now will change. Your brain has to get use to the idea of operating without the inhibition to seratonin reuptake. It will do that.

 

Exactly how you will be remains unknown. We're all in that boat here. In general though, people seem to feel better after getting off of the drugs than they did on them. I find that reading some of the success storys helps me to have some hope.

 

I wish the best for you.

[Altostrata]

Welcome, cmusic.

 

You write:

I crashed in 2010 after trying to switch from Prozac to a tricyclic (because of GI issues). I was on the couch in acute panic, crying hysterically, couldn't stomach food, with insane levels of anguish and fear and depression. I thought my life was ending. My psychiatrist told me to triple my benzos, and as a result I didn't go off them for over a year.

Did you go back on 30mg Prozac at that point? How did you go off the benzos?

 

It sounds to me like you got severe withdrawal symptoms when you went off Prozac to switch to a tricyclic. Did reinstating the Prozac help then? Did the benzos help?

[lindamorellato]

I am on a similar journey. I am off lexapro and not doing the best. I am working on getting off a mood stabilizer and an antipsychotic. I wish you all the best. I want to hear us all getting better and off these drugs if at all possible. I feel like crap during the day. Every little thing at work sets me off. I want to find the old me. I have confidence that this website and the helpful and caring people here will get us through.

 

What I am learning is slow and steady wins the race.

 

Linda

[cmusic]

Hi everyone,

 

Thanks for the replies and well wishes.

 

To Altostrata's question - when I realized after the crash it could be SSRI withdrawal, my PDoc at the time said 'pick one that worked before'. So I actually went back Lexapro. But it didn't have a real chance of helping because at that point I was well dependent on Benzos.

 

In two months we decided I needed something stronger, so we tried Effexor. I was on that for the next two years. With the Effexor, I increased the dose no less than five times - each resulted in about a month of being a little better, then another cliff.

 

So around November I wanted off Effexor and cross tapered back to Prozac because that's the recommended approach. Now trying to get off the Prozac itself, as I only felt ok for about a month.

 

I know - complicated story. Feels like a complete mess.

 

With the benzos, I ended up going fr the xanax to lorazapam to a steady dose of Valium over about nine months. It worked for a while them stopped and I had rebound. I tapered them down and eventually got off, had a month of really bad rebound, then seemed to be over it. I still use a Klonopin once every few weeks, but have been off daily use for over a year.

[Altostrata]

But it seems you're completely off Prozac now?

 

It is possible to continue to have withdrawal symptoms even though you've reinstated the original drug, or substituted any number of drugs.

 

Going on and off all those antidepressants, plus the benzo withdrawal, may have maintained your nervous system in the destabilized state.

 

Quite often severe withdrawal symptoms cause a hypersensitivity to other neuroactive drugs, supplements, and even foods. It is possible every time you switched an antidepressant, your nervous system was relieved, then reacted negatively to the new drug.

 

I believe you've proved that antidepressants are not going to help you in your situation. Your nervous system will calm down, you'll have to avoid upsetting it and support the healing as much as you can.

 

Things that can help are slow, meditative breathing; gentle, regular exercise like walking; eating fresh foods and minimizing sugar, caffeine, and artificial flavorings.

 

I'm sorry there's no instant answer, it will take time for your nervous system to heal and you will need to be patient.

[Altostrata]

Fish oil and magnesium can help healing and reduce symptoms, see http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/ and http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/

[cmusic]

Thanks again. I know it's going to take time and I think you're right about having proven that Antidepressants are no longer the right path for me. As long as I have hope that I will heal naturally. Doctors don't provide any comfort in this regard. It's huge to have real people on forums like this that will tell you the truth.

[Altostrata]

Do you like to swim? You might find it calming and it will help your body work better to heal.

[cmusic]

Hi everyone,

 

Wanted to post an update about my daily pattern about a month off Prozac. Due to the long half life, I believe I'm now starting to enter the period where my system is without the drug in it. About two weeks out, I started getting brain zaps so I figured the real withdrawal was beginning.

 

The biggest issues for me are

 

1. Neuro-anxiety

2. Intense depression (this comes after intense periods of panic)

3. Nausea and GI distress

 

The typical pattern is as follows:

 

I wake in the morning and within 15 minutes I'm starting to get panic. I (try to) choose at that point to label the panic as bad, or just be with it and accept it. I begin to move but as I do I think about things and worry. I try to label in my head - this is a thought, this is worry, this is an intense feeling (panic), etc. I make attempt after attempt to re-focus on breathing and being in the current moment.

 

However, once the GI symptoms start it becomes incredibly difficult. The fight-or-flight causes my stomach to ball up and any smell or thought of food becomes intensely nauseating. I know the nausea is a byproduct of the panic because benzos immediately illeviate it. However I refuse to take a benzo so I force down yogurt or a banana or something and get out the door. By this point I'm getting close to tears.

 

I usually feel somewhat better after crying, but it's short lived. The drive to work is difficult and I find myself fighting to stay awake. I get severe anxiety before entering the office and find it very difficult to concentrate when sitting at my desk. Sometimes I shut the door for 15 minutes or so and try to meditate.

 

I usually force some soup down for lunch. Going for walks around the office help me snap out for a bit and put the game face on. Meetings do that too, although I've sensed my reactions to other people as more tense and abrupt than they should be. I also have physical nervousness and shakes.

 

Things usually start to get better around 3-4 pm. Why this happens is not clear. I can't fully relax, but I can concentrate so I spend the later part of the day catching up on everything I didn't do in the morning. This usually results in staying late. 2-3 times a week I go to the gym after work. I see my kids at night and try to get some joy from that. Then I lie in bed relieved that the day is over.

 

But then, Groundhog Day.

[Altostrata]

You're only off Prozac for a month??? Have your symptoms gotten worse?

 

If so, you might get liquid Prozac and reinstate a very small amount, 2mg for example. This may help take the edge off the Prozac withdrawal symptoms. You might take that for a while, then very, very gradually taper off it.

[cmusic]

Hi Alto,

 

Yeah a month. But here's the issue with me - most of this stuff was happening while I was still on it. It's more intense now but it wasn't like I was comfortable when taking the drug. I actually think I was somehow withdrawing while still on it, or building tolerance or whatever.

 

I tried for a long time to get to a steady state so I could feel ok and then taper off gradually. But I could never achieve that steady state and finally said enough is enough. Prior to Prozac, I had done a long cross taper from Effexor. But whatever help the Prozac offered went away quickly. My doctor wanted me on Lamictal, Seroquel, or any other dart we could throw at the board. I said I thanks but no thanks.

 

I have thought about adding back a small amount of Prozac, but unfortunately I don't think it would help. The full dose didn't even help!

 

The harsh reality for me is I've gotten through a month and will get through more months and hope it will get better. Other than benzos I haven't found anything that makes me feel at all better. And we know where that road goes.

[peggy]

that's quite a complicated story cmusic - i guess you are between a rock and a hard place and the only way out is through. I would really encourage you to keep a log. It's great that you start to feel better in the afternoon - that does show that your system is trying for normality. It sounds like you may have entered withdrawal back in 2010 when you withdrew from prozac - perhaps too quickly, going to other medications don't always help when you are in withdrawal from a different one.

 

i didn't notice if you said you were taking fish oil? That is probably the most effective and safest supplement. i would probably be wary of all the supplements you are taking - measuring serotonin in your urine does nothing to demonstrate what it is in your brain and serotonin is only part of the story anyway.

[areyouthere]

I would really encourage you to keep a log.

I second this cmusic. I didn't see the need to do this until I started a daily log of my moods and then I started to see some patterns that really helped see the signs, for example, of a crappy mood coming on and I could do something proactive like go take a walk to ward it off.

 

It's great that you start to feel better in the afternoon - that does show that your system is trying for normality.

What Peggy says here is true. And documenting such things will help you see how far you have come when things aren't going so great. Ups and downs seem to be a common theme around here. We kind of like to celebrate each other's "ups" and support one another during the "downs"... it helps.

 

Welcome music!

 

RU

[cmusic]

that's quite a complicated story cmusic - i guess you are between a rock and a hard place and the only way out is through. I would really encourage you to keep a log. It's great that you start to feel better in the afternoon - that does show that your system is trying for normality. It sounds like you may have entered withdrawal back in 2010 when you withdrew from prozac - perhaps too quickly, going to other medications don't always help when you are in withdrawal from a different one.

 

i didn't notice if you said you were taking fish oil? That is probably the most effective and safest supplement. i would probably be wary of all the supplements you are taking - measuring serotonin in your urine does nothing to demonstrate what it is in your brain and serotonin is only part of the story anyway.

 

Thanks. Yeah complicated is an understatement. It's been a complete mess for the last several years trying to find a combination of drugs that would keep me steady. It's frustrating when you see the doctors guessing because they try to lead you to believe there's some method to the madness when there isn't. And you keep trying to analyze and fix the problem, manage the drugs, which leads to obsessive worry and continues the death spiral.

 

I do take fish oil - a pretty high dose every day - and I do think it helps. I've also been seeing a real cognitive behavioral specialist for the last six months and one of the tasks is to keep a pretty detailed journal. I've got a good iPhone app that I write in 2-3 times a day.

 

Thanks for all the kind words. It's tough to stay hopeful when you're in a down period but if communities like these do nothing more than give people hope than it's hugely valuable. The only way out is through - seems like that's the truth.

[dunerbug]

So sorry you are struggling.

 

I relate to the agony you describe.

 

I will say though to taper slow. I know some will say prozac has a built in taper.... but let me tell you, I've experienced something totally different.

[Altostrata]

If your symptoms have gotten worse, that's a sign the Prozac was doing something. A higher dose might have made you worse, but a very low dose might help the withdrawal symptoms.

[peggy]

music - what is the iphone ap? do you mind sharing?

[cmusic]

Sure - there are two I have used - one is called 'Day One' and the other Momento. If you search the App Store for journal or diary you'll find these and others. Day one backs up to cloud and syncs to multiple devices but doesn't export or print well (yet). So I switched to Momento - which doesn't save to a server (so you need to do backups manually) but does allow for exporting and printing - which I need to bring my notes to my CBT appointments. They are both nice apps - both allow you to tag entries.

[peggy]

thanks music!

[cmusic]

About six weeks ago I went off Prozac cold turkey. My doctor assured me that this particular drug has a long half life and a natural taper. I had my concerns but decided to do it. One of the major decision criteria was that I was pretty much in a perpetual hell while on this and other meds - it's not like I was stable and could slowly chip away at it.

 

But now I am of course regretting that decision and the wisdom on this site has been proven right again. Panic and fear so intense I can barely move - stomach in a knot - GI issues, and hysterical crying, over emotionality, and depression. But these things were there when I was still on the drug (albeit a little less intense and more 'cycling').

 

My question is, after six weeks, could a reinstatement of a small dose still be beneficial? If one was on 30 mg, what would be the ballpark for getting back on - 5, 10?

 

I have a wonderful cognitive behavioral therapist who is also an MD - she's helped me immensely on the behavioral side but this is clearly a drug induced issue as a result of a decade of SSRI's.

 

Any thoughts from anyone who might have gone cold turkey for a bit then reinstated? Just wondering if I'm doing the right thing.

[cmusic]

Shoot just saw another thread about this...

[cmusic]

About six weeks ago I went off Prozac cold turkey. My doctor assured me that this particular drug has a long half life and a natural taper. I had my concerns but decided to do it. One of the major decision criteria was that I was pretty much in a perpetual hell while on the meds - it's not like I was stable and could slowly chip away at it.

 

But now I am of course regretting that decision and the wisdom on this site has been proven right again. Panic and fear so intense I can barely move - stomach in a knot - GI issues, and hysterical crying, over emotionality, and depression. But what trips me up is that these things were there when I was still on the drug (albeit a little less intense and more 'cycling').

 

So after six weeks I'm considering a reinstatement. I am hoping a small dose could still be beneficial? I'm trying to figure out if I was on 30 mg, what would be the ballpark for getting back on - 5, 10?

 

Having gone cold turkey and now looking to reinstate, any advice would be helpful around dose and longevity (realizing it's not formal medical advice). Just wondering if I'm doing the right thing. Happy (well not really) to be a test subject here.

Edited January 16, 2014 by Petu
fixed text

[Jemima]

I'm bumping this topic because I just merged two posts regarding reinstatement with cmusic's Intro, to which I'm sure he would like a response. Unfortunately, merging sometimes shoves posts to the bottom of the heap and this is my way of bringing it back to the top.

[Altostrata]

cmusic, if I were you, I'd give 5mg a try.

[cmusic]

Funny that's what I was thinking too. Ok I guess I'll try 5 and commit to it until I get a good sense of whether its going to help me level out. Thinking a few months.

 

Thanks again

[cmusic]

Well it's been about a week and a half back on 5mg and I can not say it has helped in any way. In fact I may have gotten worse. My stomach is in agony, I have severe unrelenting panic, depression, crying, and getting through the day in this state is not easy. There are more external stressors than I would like right now - moving into a new house, work, and family - all adding to the overwhelming panic. I don't eat more than a yogurt and a piece of fruit until 5PM when my stomach lets up a little. The weekend was horrific.

 

Back to the issue at hand, I'm off Prozac again - for the last time. This appears to be my endgame for better or worse. I don't think I really ever had the opportunity for a slow, controlled taper because I went into withdrawal back in 2010 after stopping prozac (a mistake) and since then nothing has worked for me. In fact, I wonder if AD's can go 'paradoxical' in the same fashion as benzos, trying to stay on them just kept me in perpetual withdrawal or some kind of sensitized state...?

 

PDoc again brought up Lamictal. Primary care brought up TMS. It seems like when you have a hammer everything looks like a nail. If this is in-fact withdrawal, there is no tool for that - only time.

 

Long story short, I will be enduring this as best I can, with the occasional Klonopin and hopefully some working out. It's not ideal but it's the hand I have been dealt. I just hope I don't lose everything in the process. Pretty scared.

[Altostrata]

A very small amount of Lamictal may reduce the symptoms, see http://survivingantidepressants.org/index.php?/topic/3898-feelingalone-serotonin-syndrome-and-withdrawels/

[cmusic]

I'm struggling pretty bad. The worst part is the vicious panic that results in not being able to eat. The level of panic is so high from the second I open my eyes, my stomach immediately churns and the thought of food becomes hideous. I usually force down a banana, a yogurt, or something in the morning, soup for lunch, and until recently something solid for dinner. But even dinner now is becoming a challenge.

 

The only thing that seems to take the edge off enough to give me an appetite back is a benzo. Even knowing the dangers I feel like if I don't do something I'm going to end up in the hospital. Since the end of January I've lost 15 pounds. My stomach is constantly a fireball of acid and churning. I don't know what to do because people need to eat.

 

Has anyone faced this?

[Altostrata]

I had similar symptoms. A very small amount, up to 5mg, of Lamictal helped. See http://survivingantidepressants.org/index.php?/topic/392-one-theory-of-antidepressant-withdrawal-syndrome/

[cmusic]

Thanks Alto - I can't say I'm sure I know why such a small dose of Lamictal would help, but I'm willing to give it a try. The other thing that has seemed to help just a little is Benadryl. Again not sure why but read that it has similarities to SSRI's.

[Altostrata]

Please read the topics for which you have links above.

[cmusic]

Apologies - somehow missed the link to the other post with the info on Lamictal. Attention to detail has been a bit of a challenge lately.. Thanks again for all the information.

[areyouthere]

cmusic.... just an observation... I hope that you continue to see the CBT who is also an MD. Your posts seemed to calm down quite a bit after seeing him/ her until this last bit with stomach issues. You mentioned that only a benzo helped with that. Where are you with deciding whether to use one or not?

 

RU

[cmusic]

Hi RU,

 

Yes I'm still seeing her every two weeks. She's quite expensive (medical head of a university CBT / anxiety center) but it's probably worth it to continue given where I am with this. The ironic thing is that I think I've learned some pretty strong coping skills and mindfulness behaviors in all of this. But when it's acute physical withdrawal at this level of intensity, things are so magnified that you can only hang on so long before you become overwhelmed by sheer exhaustion and emotional pain.

 

The situation has gotten worse recently because of the eating thing. The intense depression and fear are bad enough - but when the panic drives my stomach to sickness as soon as I wake and I get no relief until the evening it compounds everything. I can't eat so that makes the stomach wretched with acid, my brain gets no fuel, and the body goes into starvation mode. I try like heck to get food down during the day but it is pretty darn impossible. Maybe an apple, a yogurt, and a half a cup of soup or something by 5pm.

 

Benzos help in low amounts because the take the edge off the anxiety just enough to relax the vice on my stomach. But I am very wary of taking them in high doses or continuously because I spent 9 months on daily use and by the end of it I was in rebound crisis and the withdrawal was torture. I've not been dependent on them for over a year now, just use a klonopin or ativan very infrequently in the most intense situations. However, the thought has crossed my mind many times to just get back on the daily benzo to help with this withdrawal and then worry about that later. SSRI withdrawal after close to a decade of use is far worse.

 

I've started the very low dose lamictal that Alto suggested, and also got a beta blocker I'm going to try taking every night. It doesn't work great but may help to take a little of the adrenaline out of the picture.

 

I just have to hope that this is the most difficult stage (2 months off SSRI's) and that it will get easier soon. I'm not looking for perfect, just a litle bit less severe. I can handle a lot but at a 10/10 it's brutal and I'm barely hanging on. My 4 year old looked me in the eye today and said he misses me and that we don't spend enough time together. I miss him too.