Indigo

[indigo]

 I'm Indigo. Have a history of struggling with depression since childhhood. Mostly I managed to keep this hidden from my family and have managed by swimming as hard as I can upstream, managed to hold it together most of the the time except for a few dramatic down spirals. Through the eighties I self medicated with marijuana which kept me afloat pretty well.

 

In the nineties I started taking 20mg of Prozac after a heartbreak  that I could not get over.  (five years later I was still waking every morning drowning in grief). Kept taking same dose of prozac until a couple of years ago. Every year I'd try to get off it by taking  a capsule every other day (doctor's advice) but withdrawal would knock me into total despair. Finally learned about tapering slowly on line.

 

In two years I have gradually dropped from 20 mg of Prozac to 4mg by squeezing little  powder out of the capsules and weighing them with gram scale. At first I was more cavalier about the size of the drops. Took me awhile to learn how much I could drop without total darkness sweeping over me. I know Prozac is supposed to be easy to get off compared to other drugs, but it has not been easy for me. This was especially  true when I got down to a very low dose. Then I suddenly began to get severe withdrawal with each drop. 

 

Appreciated finding the  information and graph on this forum about this phenomenum about severity of withdrawal symptoms closer you get to the end or I might have given up. I began to micro taper and changed to liquid prozac which is way easier for tiny percentige drops.  I use a I ml syringe and because I hate the taste, I drop it into a 000 capsule and swallow. I am now dropping .5 of 1 ml at a time. When I'm get steady after  all up and downs of withdrawal, then give myself a week or so rest before I drop again. 

Edited January 26, 2015 by cymbaltawithdrawal5600
added line breaks for readability

[Brandy]

I'm very glad you found better ways to taper! Doctors are so uninformed about this, and give out very unfortunate taper plans like the every other day dosing which causes nothing but problems.

 

I'm glad you started your own "Intro" thread here. I think you might need to do proportionately smaller drops, and even more likely, longer holds between drops in dose, now that you're getting so low in dose. I'll leave it to others who have more knowledge about that to advise you.

 

Congratulations on getting so low in dose! What symptoms are you experiencing now?

[Addax]

Hi indigo. Welcome to SA. I was so happy to read your story and am thrilled you've managed your withdrawal wisely and safely. Dont be afraid to hold longer between drops. I know you must be so eager to be off Prozac and being so close to the end would make me want to rush off too.

 

A moderator will come a long shortly to welcome you and provide assistance, but in the meantime could you create a signature for yourself? It's a good source of reference for people who come to your thread. Here's how you do it: http://survivingantidepressants.org/index.php?/topic/893-please-put-your-withdrawal-history-in-your-signature/

 

Glad your found this site :-)

[mammaP]

Hi Indigo, welcome to SA. You have done well to taper prozac and get to the low dose that you are at now.

I think that a longer hold might be beneficial for you at this stage, to give your brain a chance to catch up. 

It is more difficult at the lower doses and if we told our doctors that we had withdrawal by cutting 0.25

they would laugh and tell us it is psychological!  

 

We recommend tapering no more than 10% of the current dose with 4 weeks between cuts. At the end of

a taper lots of people tend to speed up but it is actually better to slow down and be gentle, it is a shame 

to end up in withdrawal after being so careful.

 

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

 

And here http://survivingantidepressants.org/index.php?/topic/2878-micro-taper-instead-of-10-or-5-decreases/

 

It will help if you can fill out your signature as Addax suggested, it will appear at the bottom of your posts. 

[indigo]

Thanks for your responses. This website is a life saver.

[cymbaltawithdrawal5600]

You also might want to hold longer now while you have first made the transition to liquid. Some have found that , because the liquid tends to be absorbed faster, that their symptoms ramp up temporarily. Keeping notes on paper of how you feel every day will allow you to see this and make longer hold times.

[indigo]

Thanks for this advice cymbaltawithdrawal5600. I've been having a severe WD symptoms  beginning a few days after switching to liquid.

 I'd decided to hold the same dose as dry prozac when changing to liquid, in case there were any repercussions. I thought these might be mild since I was not dropping.

I was totally taken by surprise by severity of the impact. Went from feeling fine (I was at the end of my last hold when I switched to liquid)  to a heart aching, weepy, fearful person as if I'd done a big drop. Still going through it. Makes sense that the liquid would be absorbed faster though not sure why that should make such a huge difference.

[cymbaltawithdrawal5600]

That's why a lot of people don't do a drop at the same time as they do the switch to a liquid. All is not lost, however. If you hold long enough the symptoms usually resolve. It just makes it temporarily yukky until your body adjusts. You just don't want to rudsh the last partss of a tap[er is all. Some even switch to a micro taper and much longer holds to kind of 'slide' their body off the med, especially way at the end.

 

Have you read Hudgen's topic? He really did a micro and had bearable symptoms to the end.

[Rhiannon]

Thanks for this advice cymbaltawithdrawal5600. I've been having a severe WD symptoms  beginning a few days after switching to liquid.

 I'd decided to hold the same dose as dry prozac when changing to liquid, in case there were any repercussions. I thought these might be mild since I was not dropping.

I was totally taken by surprise by severity of the impact. Went from feeling fine (I was at the end of my last hold when I switched to liquid)  to a heart aching, weepy, fearful person as if I'd done a big drop. Still going through it. Makes sense that the liquid would be absorbed faster though not sure why that should make such a huge difference.

 

Are you certain that you're getting the same amount of the drug? If you were taking 145 mg of powder, and 263 mg of powder contained 20 mg of Prozac, then you were taking 11.something mg of Prozac in the powder form. I have no idea how much Prozac is contained in 0.92 mL of the liquid you're using, but if you can tell me what the conversion factor is (how much mg of Prozac per mL of liquid) I can check it. Or maybe you're on top of this, I'm not saying you aren't, just that the information you have posted doesn't make it possible to double check the math.

[indigo]

 I didn't drop when I switched to liquid, but mty math might not have right.

This is my math.

1mL liquid = 150 mg of dry prozac powder from capsule which is 4.00 mg actual prozac

0.98 ……=  148.4                                                                              3.92

0.96…….=  146.8………………………………………………………..3.84

0.94…….=   145.2 ……………………………………………………….3.76 

0.92……=  143.2…………………………………………………………3.68

[indigo]

Hmm.  This is embarrassing : In changing over to prozac liquid using 1 mL syringe, I think I may have made a miscalculation in thinking each little line on the syringe was one decimal point rather than two. Then when strong withdrawal hit me I was too anxious, upset and confused to think clearly. I have to admit it really scares me that these miniscule adjustments to the dose have such a strong effect when a tiny error can be so easy to make. One of my obsessive fears when I'm in withdrawal is that I won't be able to keep my head clear enough to manage this, will make a slight error, or forget I've taken my dose for that day and repeat it, or think I've taken it when I haven't. Anyone else have this "paranoia"? Feeling a bit steadier today. Will stick with exactly same notch on the syringe until I'm feeling totally fine, then give myself the rest of a longer hold, before I drop again. So strange to have this whole secret struggle going on.

[Rhiannon]

Ok, I'm still confused, if 263 mg of powder is the full capsule (which it says in your sig) and that's 20 mg, then how is 150 mg of powder only 4 mg? I'm sure I'm misunderstanding something.

 

And it sounds like you're making your own liquid, correct?

[indigo]

After going over everything, I realized why the numbers don't make sense. I forgot to mention

 when writing my drug history signature, that after cutting powder out of 20 mg capsules of prozac long enough to have halved the original dose 20 mg, 

 I switched over 10 mg capsules and began cutting from them.This of course affected the calibration.

Sorry to have left this out. No wonder you were confused. Thanks for noticing. I will change this in my Signature right away.

[clearday]

Indigo wrote on Addax thread, "Then read an article by a psychiatrist saying SSR's cause permanent  brain damage and people who've been on them a long time never recover. 

 How true is this? Thank you for your story Addax and the support of this thread."

 

Hi,

 

Years ago, I went through brutal long term withdrawal from six years of Prozac. I am completely recovered from Prozac WD. It took a loooong time for me, over three years. Don't despair, and don't give much weight to articles about "permanent brain damage". Yes, these drugs may cause long term changes that may take years to clear up. Yes maybe they do cause some "permanent" damage in rare cases. But the overall majority of patients who have been on Prozac for years come off the drugs in a few months with minimum side effects. And we are in the minority who just take a lot longer to recover. The main thing is that you have identified the cause of your symptoms,  it is protracted SSRI withdrawal - and have the information you need to properly handle your recovery.

 

Have you read this, from one of us who has recovered? Took him four and half years, but - he recovered:

 

http://survivingantidepressants.org/index.php?/topic/3523-success-recovery-from-protracted-zoloft-withdrawal-and-pssd/

 

“The recovery was slow and painful, but I became conscious of every little improvement as it happened. I got used to the pattern: something would get better for a while, then suddenly everything would swing right back and all that recovery would vanish. But I learnt the trick - once something had recovered temporarily, it was only a matter of time before it recovered permanently. It made no difference if it came back for a while... it had already revealed its weakness, and sooner or later it was going to be gone for good. That was true in every single case.”

[indigo]

Thanks so much for your your steadying words and the link clearday. Means a lot.

[cymbaltawithdrawal5600]

Couple of months ago  I thought I was in my final stretch of getting off prozac (from 20 mg to 3.75 mg in two years or so), then hit a wall and decided to micro-taper to avoid severe withdrawal.

But three days ago, after a one month hold,  I micro dropped liquid prozac 0.1 ml and 

yesterday it hit me hard. This WD hit much faster than any before and much more suddenly.

Woke up feeling fine , then two hours later sobbing  with no apparent trigger.

This toppled me into despair that going at this micro slow rate I'll  never get off prozac.

Then read an article by a psychiatrist saying SSR's cause permanent  brain damage and people who've been on them a long time never recover. 

 How true is this?

 

Hi Indigo,

 

I copied this from Addax's thread to answer you in your own thread.

 

You know what I think? Those docs who say that are forgetting their 'scientific' training and ought to be spanked (really!) What an ill-considered thing to say, that damage is 'permanent'. They are basing their 'opinion' on insufficient evidence which probably includes a lot of anecdotal 'evidence' such as that found on a forum such as this.

 

Can I prove what I think? No I can't. But I am not going to let that stop me from voicing the opinion that I think it is not true what they are saying.

 

The first thing I would do if I were you is to double check all of your measurements that you used in making your drop. It may be no accident that you posted in Addax's thread. Did you note what she did with her measuring?

 

By the way, what kind of 'permanent damage' was the article talking about? Sitting in the corner drooling on yourself in a residential home or something? Even 'depression' is a cyclical affair and has its ups and downs.

[indigo]

Thanks for your reply.f I wasn't tipped into WD I'd probably have dimissed the article r researched it.

But you know how it is when it's all you can do to get through the day. I'll check out what Addax did with

her measuring. It does seem that my WD reactions have been much more difficult since I switched to liquid prozac.

 (pharmacy kind.) The last drop of 0.1mL is half way between two of the small lines on a 1mL syringe so there is a tiny bit of guess work.

I bought some magnifying eye glasses so I could be more accurate and that helps. 

[cymbaltawithdrawal5600]

Indigo,

 

You say you have switched to the 'pharmacy kind' of liquid, would you put that into your sig and remove the stuff about the powder? What I meant for you to check is that the solution you are using and the amount of it is giving you an (even approximate) reduction of of the drug that one tenth of a ml equates to. What dose are you taking every day, in milligrams? You'll have to humor me here, I seem to be a little dense if I don't have milligram doses in front of me to calculate things.

 

It would say something like '2 ml of liquid contains 20 mg prozac'. What does your bottle say?

[indigo]

O.K. Edited my signature to just say I changed to liquid prozac.

On the bottle it says:  Fluoxetine 20mg/5mL SOL SIL

I'm taking 0.92 ML a day.

[indigo]

I've been reading several papers that talk about possible withdrawal symptoms when switching from capsules to liquid prozac.(one by David Healy. Thanks Alto).

 Feeling somewhat heartened by this, because WD was so severe when I switched, and so unpredictable because I had not dropped the dose. A month after switching to liquid I micro-dropped 0.01mL.

WD symptoms arrived faster, quite intense then eased up fairly soon. A new cyclic pattern seems to be emerging: I'll feel fine, then suddenly swamped by dark thoughts and deep sadness, 

then a few hours later feel fine again all in the same 24 hours. Wonder if this has to do with liquid drug being absorbed faster.

[Altostrata]

Hello, Indigo. Yes, it could be because of the way the Prozac is absorbed.

[Rhiannon]

O.K. Edited my signature to just say I changed to liquid prozac.

On the bottle it says:  Fluoxetine 20mg/5mL SOL SIL

I'm taking 0.92 ML a day.

 

Okay, that's what I needed to see too, so 4 mg per 1 mL, and you're taking 0.92 mL, so that's 3.68 mg of Prozac total.

 

My guess is that in addition to the liquid being absorbed differently (I have found that too with the liquid Valium I'm using), the liquid formulation you are using is too concentrated for you to get the small drops you need accurately. Can you ask the pharmacy if it would be okay to dilute your liquid with distilled water to make it less concentrated? That would make it a LOT easier to cut by small amounts and make sure you're taking the same amount every day.

 

Is this making sense? What I am saying is, your liquid is pretty concentrated, so it's going to be tricky to make small cuts and have them be exactly the same dose every day. I don't know what kind of syringe you are using but it seems like the difference between 0.92 mL and 0.93 mL would be pretty hard to see, yet it means the difference between 3.68 and 3.72 mg of Prozac. So you may be bouncing around on dose more than you realize. That can make it hard to stabilize.

 

Or if I'm inventing a problem where you don't actually feel like you have one, please ignore me. :-)

[indigo]

Yes it is hard to see, especially as with this dose I have to guess half way between two lines.

However, just bought some very strong reading glasses that magnify the lines on the syringe

so can see much more clearly.Diluting sounds like a good plan. However I'm afraid to change

anything  at all right now as I'm still stabalizing after the switch to liquid.

[Addax]

How are you feeling? What are your symptoms right now?

[indigo]

Thanks for asking Addax. No symptoms right now.

It's the kind of day when I think I've totally recovered from the last drop.

However, I've learned there will probably more dark dips before I fully stabilize.

 Taking advantage of this window to refinish my bathroom floor, and  

had the farrier here to trim my horse's hooves. Beautiful spring day here.

How are you doing today?

[dalsaan]

what a lovely post.  You might want to hold for a little while to 1) enjoy it and 2) make sure you are as stable as possible before the next drop

 

Enjoy the day

 

D

[indigo]

Thanks Dalsaan. Yes, on days like this I tend to get enthusiastic about my next drop, but I'm learning to cool my jets.

Humbling how slow this is going, but I imagine my brain as a tree sprouting new buds along the twigs of it's branches in it's own time.

No hurrying it.

[Addax]

I'm well, Indigo. And done ranting :-)

 

I'm glad you're doing well and have been symptom free. It is hard to fight that urge to drop when you're feeling good. I hear ha, I know I'm going to have to remind myself to hold during those times.

 

You asked about the HPA axis I mentioned in my rant. Here's a link to Wikipedia's description: http://en.m.wikipedia.org/wiki/Hypothalamic–pituitary–adrenal_axis

 

I said it seemed obvious but that's really because I've grown familiar with literature around the stress response and related things. I think Wikipedia does a good job in explaining it.

 

Enjoy this time! I hope you find the next drop to be a smooth transition.

[Songbird]

I imagine my brain as a tree sprouting new buds along the twigs of it's branches in it's own time.

No hurrying it.

I love this mental image!

[direstraits]

hi,Indigo-just wanted to thank you for your supporton my thread-it means alot

 

hope you're doing OK

[indigo]

 Thanks for asking direstraits. Had a few dark clouds pass over today. I guess it's progress that

I'm able to recognize they have no basis, that nothing has changed since yesterday when I felt fine,

 that  it's just my neurons trying to make new connections or whatever the brain does to recover.

Driving along with my heart aching I crooned to myself " Everything is O.K. This will pass", over and over.

In the rear view mirror I see my dog in the back seat watching me alert.

She pays close attention to my changing moods.

 I posted a photo of her on the pets forum if anyone is interested.

[direstraits]

she's adorable! so nice to have pets to comfort us during this misery

 

I have 2 kitties

[indigo]

I almost always wake up around 4 a.m. feeling anxiety and dread. 

Just realized this is actually a withdrawal symptom.

I've read that this is a cortisol imbalance. The flight or flight hormone

kicking in wakes you telling you to be alert for possible threat.

 I try to lie quietly telling myself it's just bio-chemical but 

getting up and making a cup of tea and 

stroking my dog distracts me from deadly thinking. 

 Still unclear how or why this happens.

Would apreciate any link would explain.

[Rhiannon]

Yes it is hard to see, especially as with this dose I have to guess half way between two lines.

However, just bought some very strong reading glasses that magnify the lines on the syringe

so can see much more clearly.Diluting sounds like a good plan. However I'm afraid to change

anything  at all right now as I'm still stabalizing after the switch to liquid.

 

I don't think you should change anything yet, but as you proceed with your taper, you'll probably need to dilute your liquid so you can get small enough drops. For example, if you put 1 mL of your liquid in with 9 mL of water you'll have 4 mg per 10 mL or 1 mg per 2.5 mL, which should make it possible to cut down by smaller increments. Or you could use some other proportion. I'd recommend no more than 1 mg per 1 mL though and at the really small doses even more dilute than that.

 

Do you think you could mention in your sig line that your dilution is 4 mg per mL? When you say "Current dose is 0.92 mL" that's meaningless to people who are reading it, we don't know how much actual drug you're getting, unless we know how many milligrams of drug in each mL.

 

(for example if your dilution was 5 mg per mL you'd be taking 4.6 mg of Prozac, or if it was 1 mg per mL you'd be taking 0.92 mg of Prozac, we can't tell.)

[indigo]

Hi Rhi. Thanks for checking in. I changed my Signature to state fluoextine solution concentration as you suggested.

I'm getting used to this concentration of solution with the 1 ML oral syringe. The magnifying reading glasses helped.

Also fine tuning as I get used to doing this. For instance I noticed that I have to make sure the air in the syringe is released 

under the surface of the solution so that there are no bubbles in the syringe when I draw up the dose.

Takes vigilance because the solution is clear, the bubble is clear, and the syringe is clear.So before I got magnifying reading glasses bubbles were invisible.

An almost invisible bubble displacing a tiny amount of solution can cause unexplained  WD symptoms. 

I will dilute in the prozac solution eventually but  this concentration seems to be working fine the way it is now.

Waves of anxiety and dread  come and go but not overwhelming. 

[Addax]

Aside from the abrupt cortisol induced awakenings how are you doing, indigo?

 

It's horible how our system becomes so discombobulated and causes these cortisol spikes. Look up "HPA-axis." You should find some good explanations. Maybe even google "HPA-Axis dis regulation."