John

After reinstating or updosing, how long to stabilize?

93 posts in this topic

That's definitely my hope.

-Tim

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What if a person reinstates and is having bad side effects? In my case I reinstated Prozac at 5mg and have been in it for a month and a half. I am getting severe burning and sensitivity in the palms of my hands, feet, forearms, neck, and face. I can't be completely sure it's the Prozac since I was on a low dose of Remeron with it. But if I need to get off again am I now stuck with enduring this hell through a slow taper?

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If you've been off months, it might take months before you stabilize. 

I think I'm learning this the hard way - and with only a small dosage of Prozac too. After reinstatement it's been a relatively comfortable number of weeks - thinking I've completely stabilized. Then, WHAMMO! a miserable week. So dizzy right now, it's hard to type. . . 

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Hang in there Salted. Many of us have taken months as opposed to weeks to stabilize.

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Thank-you basildev.

After feeling 'normal' for awhile, it's just hard to go backwards a bit.

Of course, I'll do my best to hang in there. Besides, what are our options? = to keep on!!

-Salted

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Salted: I am new here and just read your full story. Omigosh!! While I am not glad that anyone else has suffered from w/d, I am relieved to be in good company. Sounds like our histories are similar in some respects, having been prescribed Prozac and a benzo; learning what these drugs actually were; and then trying to get off. I am your age and also have an incredible spouse and, like your wife, am wrestling with menopause and unwanted side effects from long-term Prozac use (which I chalked up to aging and family-of-origin issues). Am also very interested, when I return to work after a hiatus, in using my writing/editing skills for Type II diabetes info/education!

 

I am on way to beach tomorrow for a family vacation where there will be huge amounts of junk food and alcohol among our beloved twenty-somethings. Am resolving to walk every morning and look up some good mocktail recipes for evening treats. It's not easy with all these temptations, is it? :P

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It's been forever since I've checked in. Have been strongly considering beginning my taper now. I've honestly been scared to try as I don't want to go through the HELL I went through before.  Hopefully, with the help from my holistic doctor, I can finally rid myself of this nightmare . . .

 

-Tim 

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Hi Tim, welcome back.  You were one of the first people to welcome me when I joined here, and then you disappeared, I'm happy to hear that you are ready to begin your taper.  Try not to worry, by tapering slowly this time, and with the help and support here, I'm sure it will be much easier this time.

 

Here are our Prozac tapering tips:

http://survivinganti...zac-fluoxetine/

 

And here is the link to your original introduction/update thread:

 

http://survivingantidepressants.org/index.php?/topic/4226-saltedginkgonuts-benzo-and-ssri-withdrawal/

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Hello Friend:

I finally feel ready. Thanks for your support!

Blessings, -Tim

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Hi Tim, so you have been on 20 mg Prozac since April 2013? How have you been and any other changes?

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I've actually been on 10 mg for many months now. I toughed it out to get there and I'd like to taper to zero. I might do 7.5 for a month or two, then titrate down 2.5 more for a couple of months, etc. until I can reach zero. My holistic doctor is guiding me.

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SGN, please consider the taper we recommend, 10% of your current dose at a time.

 

It can actually be relatively painless. It doesn't have to be hell.

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I've actually been on 10 mg for many months now. I toughed it out to get there and I'd like to taper to zero. I might do 7.5 for a month or two, then titrate down 2.5 more for a couple of months, etc. until I can reach zero. My holistic doctor is guiding me.

 

Agree with Rhi.. The '10% rule' worked for me, and as long as I keep to... 'reduce by 10% of the previous dose, hold for a month'.. my quality of life is not negatively impacted.  I don't think holistic docs understand tapering any more than regular MDs. I just went to a seminar given by a naturopath.. she thinks a healthy life style is key to being able to reduce rapidly, or even CT.. I'd hate to see how many unfortunate souls she has left in her wake. The 10% route has been a life saver for me.  Mercifully, I came to a site similar to SurvivingADs before I'd sensitized my CNS, so in that regard I'm fortunate. Every day now I'm thankful to have learned about the slow but sure route..

 

Although it may seem counter intuitive, we need to take even more care reducing from lower doses.  It's

is usually easier to taper from higher doses and often folks can move along a little faster, but the lower you go, the more the need for caution.

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Hi,

 

I posted here back in August when I was in the middle of a horrible withdrawal from CT of Prozac. Due to the advice of those on here I decided to reinstate despite being so adamant I would never again when i at first was taken off.

I decided it made sense to go back on and then attempt a proper withdrawal. I reinstated in August and around October I was more or less stabilizing with some lingering anxiety and lack of appetite sticking around til about November. I still get pins and needles which is weird but perhaps common? I decided to see a Naturopath who seems to have some experience with helping people taper and made a plan for me to taper...however my pdoc refused to give me the prescription for the liquid as he felt it was far too soon to even consider it. (This is the doctor who thought cold turkey would be no problem) His basis for refusal is that when someone experiences a depression (him calling it that still irks me) their likelihood of experiencing once in the year after is exponentially high and so that me not waiting a year would be foolish. Now I am beyond frightened to mess with anything that could lead me to where I was and part of me thinks maybe my body does more time after going through some an upheaval not even 6 months ago...but at the same time I am eager to start the process of TRYING to rid my body of this poison.

I guess I am just asking for the opinion of the people who HAVE dealt with this...because as we all know...the medical community seems to know very little!!

 

Thanks!!

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Hey, Itee.  Tapering's been on my mind too lately.  The question of when to begin a taper is personal and difficult, especially after having had a frightening withdrawal experience.  I've waited two years since withdrawal started, and I have yet to begin or plan my taper.  Like you, I worry about ending up back in the hell that was earlier withdrawal.  And I worry also about the effects of continuing to stay on the drug.  It's a tough situation we find ourselves in.  

 

Can I ask what your Naturopath's tapering plan is?  I would consider changing your pdoc if I were you, they sound dismissive and unhelpful.  

 

I'm sure someone who's taken the taper plunge will come around and share their experiences, just thought I'd try to commiserate a little.  

 

P.S. Here is another thread on the same topic:

http://survivingantidepressants.org/index.php?/topic/4244-after-reinstating-how-long-before-beginning-taper/
 

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I think going back on and tapering slowly was a good idea. My experience with doctors is that they are woefully uninformed and probably what they profess to know

about prozac (and other drugs) comes largely from the pharma companies. The big drug companies and doctors are the people that got us into this bad situation. I agree with you: it's crucialto get your information from people who have personal experience of getting off these drugs. The administrators are especially knowledgeable and helpful. We are all in this together. It's hard but we can do it.

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Thanks for your responses!

 

Narcissus: It is SUCH  a frustrating situation..and to be honest its on my mind every single day now. Not only was the experience of w/d so unbelievably hellish (as everyone here knows) but now I feel trapped. :(

The naturopath has suggested a bunch of supplements which I started taking anways..magnesium/taurine, vitamin c, b complex and omega 3's. His tapering schedule I think (once i decide to be brave and try it) is a bit fast for my liking now...he suggests a 4 mg dose decrease (about every 5-6 weeks) in the span of 29 weeks. 

When my pdoc saw that he dismissed it and said he would do it much longer...(i think i would too but i find it a bit comical that after cold turkey taking me off he now thinks i should go SUPER slow..hindsight sure is 20/20!!

I haven't seen him in 2 months as to be honest I A) Don't trust him anymore and B) I associate him now with the hell I was in.

To be honest, I am a bit sick of pdocs in general...I am in the situation I am in because of lazy pdocs who saw a kid dealing with sh*tty life circumstances and instead of talking gave her a pill. Since then every pdoc I have seen tries to put me on different meds..."try this one! its great!"....makes me sick.

 

 

Indigo: You're spot on that Dr's are incredibly uniformed. I am pretty sure my general physician thinks the theory of a serotonin imbalance causing depression/anxiety is still valid. I am almost positive when i ask her for a prescription for liquid prozac she is going to try and tell me why I should stay on it for life and why its OK. Its almost like most doctors assume patients will just listen to anything they are told and not research things on their own. I don't know about you but I find the fact that after reinstatement/stabilization people usually assume "see, you needed the pill..u feel better now don't u?" That pisses me off so much and I always want to say to those people "So would the heroin addict need the heroin too if they felt "better" when they were given it again?"  But..ofcourse nobody sees it that way. :angry:

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Itee, I too reinstated last fall and am now stable at 30mg of prozac. Unfortunately I'm beginning to encounter some of the side effects that had been alleviated at lower doses. For that reason the idea of beginning to taper has been dancing in my head as well. Theres a part of me that's pretty scared to start, but another part that's angry and wants to show I can do it and live without it! Granted, it'll be a few years before I'm free of it since I'm planing an ultra-slow taper this go round.

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 the fact that after reinstatement/stabilization people usually assume "see, you needed the pill..u feel better now don't u?" That pisses me off so much and I always want to say to those people "So would the heroin addict need the heroin too if they felt "better" when they were given it again?"  But..ofcourse nobody sees it that way. :angry:

 

So true. I tried to get off prozac repeatedly by following my doctors advice to take one every other day, then every three days etc. Of course  wheniver I tried that, it played havoc with my brain, and I had to go back to original dose. Eventually went to see a psychiatrist for help getting off prozac. He saw no reason to quit if it was working for me.Why not stay on it. It was only after I found this forum and the Icarus Project online that I found any real information and support.

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Itee, I too reinstated last fall and am now stable at 30mg of prozac. Unfortunately I'm beginning to encounter some of the side effects that had been alleviated at lower doses. For that reason the idea of beginning to taper has been dancing in my head as well. Theres a part of me that's pretty scared to start, but another part that's angry and wants to show I can do it and live without it! Granted, it'll be a few years before I'm free of it since I'm planing an ultra-slow taper this go round.

 Yep same boat... the fear but yet the anger and wanting to do it is a pull i feel daily. What side effects have you gotten since reinstating?

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 the fact that after reinstatement/stabilization people usually assume "see, you needed the pill..u feel better now don't u?" That pisses me off so much and I always want to say to those people "So would the heroin addict need the heroin too if they felt "better" when they were given it again?"  But..ofcourse nobody sees it that way. :angry:

 

So true. I tried to get off prozac repeatedly by following my doctors advice to take one every other day, then every three days etc. Of course  wheniver I tried that, it played havoc with my brain, and I had to go back to original dose. Eventually went to see a psychiatrist for help getting off prozac. He saw no reason to quit if it was working for me.Why not stay on it. It was only after I found this forum and the Icarus Project online that I found any real information and support.

 

Yes...i love that skewed logic most people seem to have...with that logic I have NO idea why narcotics like cocaine and heroin are looked down upon.

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I'm going to update my thread this weekend. It will include my description of the side effects emerging. Thankfully the are relatively mild and tolerable as compared to how they were on higher doses.

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hello! I just thought I might be able to offer some insight. I had a terrible poop out while on Effexor, I didnt realize thats what it was 9and of course my Dr said I needed more effexor and kept doping me up). Updosing made things better for a few weeks and then I crashed harder, still being ignorant and trusting my Dr, i updosed once more and within a week was having suicidal thoughts and racing terrifying unreality and anxiety. From there I did a 3 month taper off nearly 300mg Effexor, and started 20mg of Cipralex, suffered immensely for 2 months then tried Celexa, suffered for 2 months then tried Paxil...still hanging by a thread I managed to find some online support and learned what was happening. So at that point I waited. After about 3-4 months in this waiting game, i noticed I was starting to feel better. Not 100%, but much better. I then began my taper. I tapered by 10% of my dose every 4-8 weeks. I dont think I was fully stable when I started my taper, because over the last 3 years of this taper, i have experienced typical windows and waves, as anyone else who had cold turleyed or rapidly tapered and remained off. i was of the mindset that i may never "fully stabilize" as clearly my CNS had been shaken by the previous years experience, and until I was off comepletely I would continue to have at least *some* symptoms. So here i am....now at 1.5 mg of Paxil, from 20mg and it has taken 3 years. My waves are very mild and short now. In fact my biggest complaint is anhedonia, and terrible PMS. Not bad considering where I came from (deaths door) 3-4 years ago. Unless you feel horrid, I think at some point its best to just get on with your taper, and move forward with it by listening to your body. Its totally do-able! Good luck.

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I had a lot of things that were physical, chills, shaking hands and knees, dizzy swooshy feelings, akathesia, diarhea, and it resolved. What happened was, it took 4 months for that to resolve while i waited on the 20mg Paxil...and when it resolved i began my taper...but a few months later it came back again, but milder. It would continue to do this for the next 18 months, milder each time until it never came back at all. Then i settled into more of an anhedonic/irritated stage that was steady. I still get waves...but they are very slight, and mainly include a bit of elevated anxiety/depression (mild) and some DR...but its usually after I taper, and only lasts a few days. But that physical stuff never came back, its been gone for at least 2 years now!

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I posted this question in my intro blog, but I've been considering up dosing back to my original dose of 20 mg (currently taking 15, felt fine for 2 months, now experiencing withdraw. I know now from reading on here that I tapered too much, too fast. That's why i'm considering the up dose, so I can start to taper 10 % after well stabilized). Is 2 1\2 months too long a time for me to up dose to 20mg?

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Obviously there is a difference between the two - But how different really are they?  I have read on here that re-instating a drug from "0" is best done as soon as symptoms appear.  Does the same apply for up dosing? It is also commonly said that re-instating from "0" sometimes does not relieve symptoms. Does the same apply for up dosing , or are symptoms more commonly relieved when up dosing? And have you found relief of symptoms quite some time after up dosing? or is up dosing symptom relief fairly instant?

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Hi Nick--  easy questions with not so easy answers.  Have you read the thread on reinstatement?  About reinstating and stabilizing to reduce withdrawal symptom

 

Reinstatement and updosing serve the same purpose, that is to try and reduce symptoms that are unbearable.  Reinstatement is to start taking the drug again after a person has stopped taking it all together, where as updosing is to increase the dose a small amount while still in the process of tapering off of a drug.

 

Doing a reinstatement is time sensitive and like you stated, the sooner the better after symptoms appear.  However, reinstatement is a rather drastic move and not to be done lightly.  These drugs are very powerful and if they are not tapered properly they can leave the brain in a very sensitized state.  Many people who are suffering intense symptoms after reaching "0" are in this sensitized state and the reintroduction of the drug can make it worse.  Also the sever symptoms frequently don't show up for several months after the drug has been stopped.  Which adds in even more risk factors.  Reinstating a very small amount, say 2mg for example, often will help take the edge off of the symptoms, but a higher dose could just throw the brain into more chaos.  We don't often recommend a reinstatement, but when we do it is always at a very low dose with the proviso of "and see what happens".

 

Updosing is never advised when symptoms just show up.  Because that's what symptoms do.  With every change in dosage the brain has to readjust and rebuild and that will cause symptoms, which can take several weeks to stabilize.  Which is why we recommend such small decreases, to minimize them.  Updosing is considered when the symptoms from a decrease have reached the unbearable level, which is an indication that the drop was too large or too soon.

 

There is no guarantee that either a reinstatement or an updose will elevate symptoms and the bad part is that it can take several weeks before you know.

 

That's the nutshell version.  

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Brassmonkey- thank you for that detailed response . One lingering question - if there is no improvement of symptoms from updose/ reinstatement after a few weeks, would it be safe to assume that withdrawal symptoms will improve/ diminish over time ?

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I have yet to see someones symptoms NOT improve over time.  Even the worst cases eventually sort themselves out.  Everything else is just trying to keep ourselves functional/comfortable while we let the time pass.

 

Give your updose another month or so and you should be stabilizing by them.  Give the stability a month or so to really take affect then you can start your 5% taper.  You're on the right track.

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Hi Nick,

I have had to updose several times in my taper - i get massive anxiety too if my cut is either too much or not enough time between cuts and i have a catch up going on.  For me, the anxiety does not go completely until about 4 weeks.  Looking back there is usually a gradual reduction but it doesn't really feel like that at the time.  One day i will wake up and it will be gone, and i know it's gone - I just FEEL different, difficult to explain.

 

Hang on, it will get better!

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It takes 3-4 days for a dosage change to reach steady-state in your bloodstream. You may not feel the entire effect until then. This is a good topic for others to see, too, basildev. Your experience could be a good example (I hope) of fine-tuning dosage when updosing.

 

Are sx's such as, anhedonia and loss of appetite some of the sx's which generally take 3-4 four days to feel a positive effect from when updosing?

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I have yet to see someones symptoms NOT improve over time.  Even the worst cases eventually sort themselves out.  Everything else is just trying to keep ourselves functional/comfortable while we let the time pass.

 

Give your updose another month or so and you should be stabilizing by them.  Give the stability a month or so to really take affect then you can start your 5% taper.  You're on the right track.

 

Hi Brass,

Is anxiety generally the symptom which takes at least 3-4 weeks to get relief from when udosing?

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I have yet to see someones symptoms NOT improve over time.  Even the worst cases eventually sort themselves out.  Everything else is just trying to keep ourselves functional/comfortable while we let the time pass.

 

Give your updose another month or so and you should be stabilizing by them.  Give the stability a month or so to really take affect then you can start your 5% taper.  You're on the right track.

 

Hi Brass,

Is anxiety generally the symptom which takes at least 3-4 weeks to get relief from when udosing?

 

 

This really depends on the person and on how unstable you were. In my experience, it can take several weeks for an updose to alleviate symptoms, but I feel some improvement within days.

 

On the other hand, people who were very unstable for longer periods of time may take months to stabilize completely.

 

So it doesn't depend so much on the type of symptom. It depends more on the person and on how long you had been unstable...

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