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Road2drugfree: Should I reinstate?

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Road2drugfree   
Road2drugfree

I was on Prozac for around 6 and a half years, 50 percent of the time i was on two 20mg tablets and the other 50 percent i was on one 20mg tablet. I self tapered for around a month and a half by taking one every other day, then every 2nd day, then every 3rd day...etc and eventually i was off them. I took my last pill nearly a month ago. I am feeling withdrawals. Bloating, bad skin, rosacea-like symptoms, irritable, anger, aches and pains, negative thoughts. Its very uncomfortable and debilitating BUT i would be able to stick it through if i knew i was on the right path. I'm just worried that i messed up because of how fast i tapered. I don't know wether to keep going or if i should start taking prozac again and taper more slowly? 

Edited by baroquep

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baroquep   
baroquep

Hi Road2drugfree, 

 

Welcome to Surviving Antidepressants (SA).  Am glad that you found the site before going any further in your journey.

 

SA recommends tapering by no more than 10% of your current dose followed by a hold of at least 4 weeks between decreases to allow the brain to adapt to the changes in the central nervous system (CNS).  When changes are made too quickly or doses are alternated/skipped or the drug is discontinued abruptly, the brain is unable to adapt to the sudden change and this results in uncomfortable withdrawal symptoms.  What you are experiencing it completely normal under the circumstances.  I am attaching a few links so that you can familiarize yourself with the recommendations made by Surviving Antidepressants.  

 

Before you begin tapering what you need to know

What is Withdrawal Syndrome?

Why taper by 10% of my dosage?

Recommendations for Tapering off Prozac/Fluoxetine

 

What symptoms are your currently experiencing?  When did you first start to notice withdrawal symptoms?  Please provide as many details of what you are currently dealing with so that we have an idea of what is happening.

 

The only known solution to decrease or eliminate withdrawal symptoms is to reinstate a very small amount of the drug into your system and then to hold until you stabilize.  I will attach the link on reinstatement to give you an idea of the process involved and something I think you may want to consider.

 

About reinstating and stabilizing to reduce withdrawal symptoms

What to Expect in Reinstatement (James Heaney article)

 

Before we are able to provide you with any specific information with respect to your situation, we would ask that you summarize your withdrawal/drug history in a signature - ALL drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months in particular?  

 

We ask all members to provide their drug history as a signature.  This will be a permanent part of your introduction and it helps moderators to be able to see all of your details at a glance.  You can find the information on how to complete your signature at the link below:

 

Account Settings – Create or Edit a signature.

 

    •    Please leave out symptoms and diagnoses.

    •    A list is easier to understand than one or multiple paragraphs. 

    •    Any drugs prior to 24 months ago can just be listed with start and stop years.

    •    Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago)

    •    Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016.

   

Please feel free to ask any questions, need clarification on a topic or would like to reach out to other members of the community.  Surviving Antidepressants is a supportive community, the members are here to help and know what you are dealing with.    

 

Best,

BaroqueP

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Road2drugfree   
Road2drugfree

Thanks for the reply so soon. I actually decided to come off Prozac as it was already causing poor metabolism and sometimes bloating.

 

I drank while on prozac regularly enough which i know is very bad now. I regret that alot. I was already feeling pretty crappy before i started tapering off prozac because i was on holidays with my family and drank quite a bit. HUGE MISTAKE on my behalf to do that.

 

Anyways i felt my first withdrawals about 2 weeks after i took my last pill. I felt aches and pains in my joints, bad brain fog, irritability, anger, slight depression, i felt some emotions coming back more though. I was able to cry, which i hadn't really done in a long time prior. My stomach got more bloated than before, had lots of gas too, sinus issues, oily skin, rosacea-like symptoms, loss of tightness of the skin on my face.  That's all i can remember for now. I think thats them all.

 

I have pretty bad brain fog at the moment so im sorry if i cant get everything across. I had them symptoms for like a week and a half, maybe two weeks. Then i felt like i was improving quite a bit for a few days and then it went all back downhill again and here i am after a few days of improvement, back to square one on the withdrawals.

 

Prozac is the only drug i have taken also. 

Edited by ChessieCat
removed unnecessary huge quote

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ChessieCat   
ChessieCat

Unfortunately the withdrawal symptoms may get much worse and could last longer than you expect.  The drug changes our brain and the only known way to reduce the withdrawal symptoms is to reinstate a very small dose of the drug which the brain wants.  There is more chance of reinstatement working the earlier it is done.

 

I will tell you my own experience.  I am a professional typist of 40+ years, with high speed and accuracy.  Just before finding SA I decided to reduce my Pristiq from 100mg to 50mg.  Over the next 3 weeks I was suffering very bad brain fog.  At the end of the 3 weeks I could not type.  Thanks to the information I received here I updosed after about 4 hours the brain fog was clearing and I was able to type again.  There was no way that this could have been placebo.  I have since been tapering successfully and am currently taking 20mg.

 

Here's a symptom list.  You may be experiencing symptoms which you aren't connecting to AD WD.  Dr Joseph Glenmullen's WD Symptoms Checklist

 

The dependence is a physiological dependence, not a physical dependence like nicotine or caffeine.  These might help you to understand:

 

Brain Remodelling


Video:  Healing From Antidepressants - Patterns of Recovery

 

 

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Road2drugfree   
Road2drugfree

So is reinstating the best option for me? Should I start taking 5mg of Prozac daily as soon as possible? 

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baroquep   
baroquep

Before we are able to provide you with any specific information with respect to your situation, we would ask that you summarize your withdrawal/drug history in a signature - ALL drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months in particular?  

 

We ask all members to provide their drug history as a signature.  This will be a permanent part of your introduction and it helps moderators to be able to see all of your details at a glance.  You can find the information on how to complete your signature at the link below:

 

Account Settings – Create or Edit a signature.

 

    •    Please leave out symptoms and diagnoses.

    •    A list is easier to understand than one or multiple paragraphs. 

    •    Any drugs prior to 24 months ago can just be listed with start and stop years.

    •    Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago)

    •    Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016.

   

 

 

Edited by baroquep

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Road2drugfree   
Road2drugfree

Okay i have done that. If there is anything i need to add or change please let me know. Thanks.

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baroquep   
baroquep

Hi Road2drugfree,

 

Thank you for making those changes, it is a lot easier to understand your signature now.  

 

As you have only been off of Prozac for about a month, I would try a small reinstatement of 5mg Prozac and see how you do.  Please discontinue immediately if you have an adverse reaction.  Please be aware that it is never recommended to skip or double up on doses as this will only make your symptoms worse.  You need to be taking 5mg everyday and please try and take it at the same time each day so that you can get a steady stream into your system.  It takes approximately four days to get a steady dose in your system, so don't panic if you don't feel better immediately, it takes a bit of time.

 

How are you going to prepare your 5mg dose? Will you be measuring with a scale? Or using a compounding pharmacy?  It is important to be as accurate as possible as these drugs are very potent.  

 

I'm going to re-attach the links on rinstatement below for you to read so that you can familiarize yourself with the process.  It is very important for you to know what to expect.  

 

About reinstating and stabilizing to reduce withdrawal symptoms

What to Expect in Reinstatement (James Heaney article)

Recommendations for Tapering off Prozac/Fluoxetine

 

Please let us know how you are feeling over the next few days and we can answer any of your questions and help guide you through the process.  Feel free to connect with other members of the Surviving Antidepressants community, they are very supportive group and know what you are going through.  

 

As well, please keep track of your symptoms so that we can measure your progress or be able to determine if you are running into trouble.  You can use your intro thread as a diary to see if reinstatement has been successful or whether or not you may need to increase your dose slightly to reduce or eliminate your withdrawal symptoms.  

 

Dr Joseph Glenmullen's Withdrawal Symptoms

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Road2drugfree   
Road2drugfree

Okay thank you so much for this help. I really appreciate it as i'm in a very dark place at the moment but i see the light for sure. I'm going to go to the pharmacy and see what they can do in regards to liquid prozac and the scales.

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baroquep   
baroquep

Please be aware that you may have issues with liquid prozac as it gets into the system a lot faster than pills and it will likely be pretty potent.  If you are able to find a compounding pharmacy in your area, that would be your best bet.  If not, I am attaching a few links regarding preparing doses and introducing liquids that you should have a look at to help you decide how you are going to prepare the 5mg dose.  Getting an accurate measurement for reinstatement and to taper off down the road is extremely important.  

 

Tablets or Liquid

Compounding pharmacies 

Using an oral syringe and other tapering techniques
Using a digital scale to measure doses

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Road2drugfree   
Road2drugfree

This is all very confusing to me to be honest... I have pretty bad brain fog which isn't helping. Would i be able to just get liquid prozac and a little measuring cup and measure out the 5mg dosage like that?

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baroquep   
baroquep

Hi again, I have asked one of the more experienced moderators to post on your thread regarding liquid prozac and how to prepare your doses.  One of them will get back to you shortly.

 

Take care.

  

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Road2drugfree   
Road2drugfree

Okay thank you.

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ChessieCat   
ChessieCat

It is better to make one change at a time.  The reason for this is that if you have issues, you won't know what is causing it.

 

My suggestion is to stay on tablet form until things stabilise.  This may take a month or two.  Once you are stable on that dose, then you could do a cross over to prescribed liquid but do not change the dose.  Some members find that they are not able to tolerate prescribed liquid.  However it is possible to make your own see Recommendations for Tapering off Prozac/Fluoxetine).

 

To cross over you would take eg 3/4 tablet dose + 1/4 liquid dose for a few days, then 1/2 + 1/2 for a few more then 1/4 + 3/4 for a few more.  Once you have made the switch to all liquid it would be best to stay on that form of the drug for a least 2 to 3 weeks before making a reduction.

 

Keep it Simple, Slow and Stable

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Road2drugfree   
Road2drugfree

so i should reinstate with 5mg Prozac pills? Do i get the 10mg pills and cut them in half?

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baroquep   
baroquep

HI R2D,

 

I've taken the information below from the Tips for Tapering Off Prozac found here Tips for Tapering off Prozac/Fluoxetine


Divide up capsule contents with an electronic scale (you'll want to split the 10mg pill in two)
If you want to be even more precise, weigh the powder in a capsule with an electronic scale, divide it up, and put it into empty gelatin capsules. The powder is very fluffy, though -- make sure it doesn't blow off the scale.

 

See Using a digital scale to measure doses

 

Have a compounding pharmacy make up capsules of smaller dosages
A compounding pharmacy will accurately weigh the doses and put them into capsules for you. See http://survivingantidepressants.org/index.php?/topic/235-tapering-techniques/page__p__3001#entry3001

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Road2drugfree   
Road2drugfree

Would it be okay if i just cut the pill in half each time without weighing? 

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ChessieCat   
ChessieCat

You can make your own Prozac liquid.  The links we had in the tips for tapering prozac no longer provide the information and I am researching at the moment so will let you know if/when I find something.

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ChessieCat   
ChessieCat
39 minutes ago, ChessieCat said:

You can make your own Prozac liquid.  The links we had in the tips for tapering prozac no longer provide the information and I am researching at the moment so will let you know if/when I find something.

 

Just want to remind you to only make one change at a time as per my post here:  http://survivingantidepressants.org/topic/15727-road2drugfree-should-i-reinstate/?do=findComment&comment=303323

 

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Road2drugfree   
Road2drugfree

I'm not looking to make any other changes apart from reinstating at a 5mg does of prozac. I'm going to get the 10mg prozac prescription and cut them in half.

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ChessieCat   
ChessieCat
54 minutes ago, ChessieCat said:

The links we had in the tips for tapering prozac no longer provide the information

 

We still need to try and get the information about DIY prozac liquid to put in the Tips for Tapering topic, even if not for you at a later time, then for other members.  So the research continues ...

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Road2drugfree   
Road2drugfree

Yeah that makes sense. Is it safe for me to cut 10mg tablets in half and take my 5mg dosage that way?

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baroquep   
baroquep

Hi there, Yes, it is safe.  I am attaching a link regarding pill splitting.  If you are able, you might want to try cutting into halves and then quarters and take a quarter of the pill the first day, that way it won't be too much of a shock to your system and you'll be able to see if there are any adverse effects.  Wait at least four days, keep track of your symptoms and see how you are feeling and then post back here and we'll go from there.  It's best to take it slow.  Because you were alternating doses before tapering, I am a little concerned that you might have a reaction, so best to introduce it slowly and work up to 5mg only if necessary.

 

 

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Road2drugfree   
Road2drugfree

Okay thanks. Would it be okay for me to cut the 20mg prozac pills i have left into halves, then quarters? I say this because i don't know if i'll be able to get 10mg yet.

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AliG   
AliG

R2DF . That will be fine: Consistency is the main thing and please just stick with that. 

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Road2drugfree   
Road2drugfree

So if i split my 20mg pills into 5 mg do i have to keep using 20mg pills or can i switch to splitting the 10mg pills once i get them?

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Road2drugfree   
Road2drugfree

I'm so confused. I've been researching and people are saying it's dangerous to swallow and open or split capsule. Also i tried to split my 20mg capsule down to 5mg but it seems nearly impossible to do without losing some of the powder stuff inside it.

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Road2drugfree   
Road2drugfree

Should i open my 20mg prozac capsule and split the powder into 4 quarters and pour one quarter of that into an empty gelatin capsule. I'm getting stressed out over this because i feel each day that i haven't reinstated is closer to not being able to reinstate at all..

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baroquep   
baroquep

Hi there, yes, in a pinch you could split the powder from the capsule into four even piles and put each pile into an empty gelatin capsule.  

 

I found these instructions in Tips for Tapering Prozac

 

Using gelatin capsules to divide doses

 

Some people report success with dividing contents of capsules into smaller amounts. This is easier when the contents are granules or pellets rather than powder.

 

The technique, which requires a steady hand, is:

 

1) Purchase empty gelatin (or vegetarian equivalent) capsules at a health food store, herbal medicine store, or online (Puritan's Pride carries empty capsules with free shipping). Get the largest size you can find: 000 or 00 are best; they will be easiest for you to manipulate. (For capsule sizes, see http://www.torpac.com/Reference/unlinked_size_chart.htm)

 

2) Open as many empty capsules as you intend to use.

 

3) Open a medication capsule by grasping it at both ends and gently twisting it. It should come apart in the middle.

 

4) Carefully pour the contents of the medication capsule onto a creased piece of clean black or dark paper. The fold will help keep beads from rolling around. The dark color makes them easier to see and count.

 

5) Using a knife or other straight edge, divide the pellets evenly into two, three, or four groups by eye. You may wish to count pellets. (Note: If you are especially sensitive to variations in dosage, use a digital electronic scale to measure the doses more precisely.)

 

6) With an empty gelatin capsule, carefully scoop up one pile. Put the cap on the capsule. Repeat with other piles.

 

7) Put the divided doses into a clean medicine bottle marked with the dosage.

 

Edited by baroquep

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Road2drugfree   
Road2drugfree

Okay thanks, i should be starting it tomorrow. I've talked to a few family members about it and they are a bit concerned that i'm going to be "messing" around with the powder inside of an antidepressant. I get where the concern comes from though. I am a bit apprehensive myself tbh. 

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baroquep   
baroquep

Hi Road2drugfree, I certainly don't want to add to your stress and indecision, but the sooner you reinstate, the better.  The longer the drug has been out of your system, the harder it will be for your central nervous system to accommodate.  

As long as you measure the doses as evenly as you can before putting into an empty gelatin capsule, you shouldn't have a problem.  Many people here have used the techniques outlined in the link I provided above/below and have been able to manage.  If I were you, I'd reread the link and maybe do a few test capsules so that you can feel comfortable and confident with the procedure.  I have my prescription prepared by a compounding pharmacy so have not had to deal with splitting pills, but am sure that you can find a lot of other threads on this site where people are splitting and measuring their doses on an ongoing basis and you can get more information there.

Once you stabilize on the 5mg, you can think about switching to liquid Prozac which will certainly make things a lot easier to deal with on a daily basis.  But for now, if you do not have any other alternative but to split the 20mg pill yourself, your options are limited to the techniques that other members have used.

Let us know if you have any other questions or need clarification on anything.  

 

Tablets that may be split or crushed

Using a digital scale to measure doses

 

 

 

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Road2drugfree   
Road2drugfree

I'm finding it very hard to get geleatin capsules where im from too. What if i go on the liquid prozac and see how i react to that?

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baroquep   
baroquep

If you try the liquid Prozac, you will have to start at an extremely small dose and then titrate up only if necessary.  I would start with 0.5mg - 1mg and see how you respond.  I am concerned that it may be such a shock to your system, so it is best to introduce it at a snail's pace.  Sometimes even as little as 0.25 mg will be enough to settle your withdrawal symptoms and if you don't have to go all the way up to 5mg, all the better.  

 

Are you comfortable enough to prepare a liquid from your capsules?  Do you have a syringe small enough that it can measure the minute doses?

 

I'm attaching the link on how to turn capsules into liquid, please have a look and let me know if you have any questions.

 

 

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Road2drugfree   
Road2drugfree

I found the gelatin capsules online though it will take a few days. I'm worried to wait that long for them to arrive.

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baroquep   
baroquep

are you able to get to a pharmacy ?  you could purchase a small syringe at a pharmacy.  

 

you need to make a decision about how you are going to prepare your doses so that you are comfortable with what you will need to do on an ongoing basis.  

 

reinstatement is best done as soon as withdrawal symptoms appear but imagine that a couple more days isn't going to make a major difference.  

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