Bewildered73: Distinguishing withdrawal from relapse is essential

[Bewildered73]

Last summer, after I quit the last antidepressant (after 7 years of antidepressants and anxiolytics) under the guidance of my former psychiatrist, I started rapidly to develop old and new symptoms. I tried to resist but in two months time I fell into the abyss of withdrawal, without knowing what was happening to me. I went back to my psychiatrist who not only did not recognize or mention the withdrawal status, but prescribed new drugs that didn't help and made things worse, like paroxetine. I was lost and fearfully sick, I lost 3 kilos in one week, then I contacted another psychiatrist who still didn't say a word about withrdrawal but prescribed benzodiazepines that immediately reduced the symptoms. Then he added two antidepressants and diagnosed "major depression, relapse". I was in shock. I tried to explain that my initial and main problem were anxiety and panic but he said thet it was all part of the depressive state. As soon as we tried to reduce anxiolytics the symptoms burst out again. That's when something clicked in my head. I searched the Internet for weeks to find someone who could help me out of the maze, and fortunately I did. Now I'm following a program to eliminate antidepressants under strict medical a psychological control, and I feel confident. Psychiatrists in Italy never talk about the risk of withdrawal symptoms, turning people into lifetime patients. I was lucky enough, being a psychologist and speaking English to be able to find the help I needed, but most people go on taking more and more drugs that work less and less. 

The site people can refer to in Italy is: https://www.smettereglipsicofarmaci.unifi.it/index.php (University of Florence).

[Gridley]

Hello, Bewildered73 and welcome to SA.  I'm sorry about your terrible experiences but am happy you have found a program that works for you.

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.

• 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 leave out symptoms and diagnoses. 
• A list is easier to understand than one or multiple paragraphs. 
• Link to Account Settings – Create or Edit a signature.

I'm sending some links that explain some of the protocol of SA.  Some of them you may be familiar with and some may differ from the program you are on.

 

At Surviving Antidepressants, it is recommended that a person taper by no more than 10% of their current dose with at least a four week hold in-between decreases.  The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.  Some people may have to taper at a more conservative rate as they are sensitive to even the smallest drops.

 

Why taper by 10% of my dosage?

 

Brain Remodelling

  

What is Withdrawal Syndrome?

 

Glenmullen’s withdrawal symptom list.

 

About reinstating and stabilizing to reduce withdrawal symptoms.

 

These links should be of particular interest to you:

This post and Is it withdrawal or relapse?

 

The Dr. Claire Weekes Method of Recovering from a Sensitized Nervous System

 

Non-drug techniques to cope with emotional symptoms.

 

Taking multiple psych drugs? Which drug to taper first?

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

I hope you find these links helpful.

 

Best,

Gridley

 

 

 

[Bewildered73]

Dear Gridley, thanks for the information. I'm not sure I understood what I have to do exactly, but I will take a look at the links and keep browsing the site.

 

It seems like the withdrawal issue is quite known by people on the site, wish I had found it sooner...

 

Bests,

Paola

 

 

[ChessieCat]

Hi bewildered and welcome from me too.

 

I have visited the website you mentioned and was able to use google translate to view it.  Would you be able to tell about how they plan to help you get off your drug?  Even though they are aware of withdrawal they might want you to get off too quickly or change drugs or add drugs.

 

You might be interested in what happened to me:

 

 

October 2015 I reduced my dose from 100mg to 50mg Pristiq.  I experienced extreme cog/brain fog for 3 weeks and everything I did required my undivided attention, even walking.  I began researching antidepressant withdrawal.  That was when I discovered the website survivingantidepressants.org.  Several days later  I was unable to type.  Being a professional typist since the age of 16 I knew that something wasn’t right.  It had been suggested by the website moderators that I increase my dose of Pristiq.  When I couldn’t type I took extra Pristiq and after about 4 hours I was able to type again.  Because I had a benchmark I knew that it was because I had reduced my Pristiq too quickly.

 

I have been tapering using SA's protocol and I am now down to 12mg and have only suffered minimal withdrawal symptoms.

[Gridley]

There's nothing to do, really, except please create your drug signature.   Account Settings – Create or Edit a signature.

[Bewildered73]

51 minutes ago, ChessieCat said:

Hi bewildered and welcome from me too.

 

I have visited the website you mentioned and was able to use google translate to view it.  Would you be able to tell about how they plan to help you get off your drug?  Even though they are aware of withdrawal they might want you to get off too quickly or change drugs or add drugs.

 

You might be interested in what happened to me:

 

 

October 2015 I reduced my dose from 100mg to 50mg Pristiq.  I experienced extreme cog/brain fog for 3 weeks and everything I did required my undivided attention, even walking.  I began researching antidepressant withdrawal.  That was when I discovered the website survivingantidepressants.org.  Several days later  I was unable to type.  Being a professional typist since the age of 16 I knew that something wasn’t right.  It had been suggested by the website moderators that I increase my dose of Pristiq.  When I couldn’t type I took extra Pristiq and after about 4 hours I was able to type again.  Because I had a benchmark I knew that it was because I had reduced my Pristiq too quickly.

 

I have been tapering using SA's protocol and I am now down to 12mg and have only suffered minimal withdrawal symptoms.

Dear ChessieCat, thanks for your feedback.

The program I am following does not follow the 10% rule. The team analyzes each case and decides together with the patient how and when to begin. During tapering, doses can be changhed if withdrawal symptoms are too harsh or not easy to deal with. They change the program during tapering, distinguishing between withdrawal symptoms (in this case they evaluate tapering speed) and underlying pathology (in this case adapting appropriate drugs in small doses). In my case, the major problem is that I have been treated for an anxiety disorder with antidepressants for seven years. Once established that my problem is anxiety and panic, we decided to taper all antidepressants, at the moment paroxetine and venaflaxine, taking all the time necessary to avoid disabling withdrawal symptoms. I also have a specialized cognitive psychotherapist who folows me, and this helps a lot too. In my experience, knowing that the symptoms are due to withdrawal and not to new and frightening unknown psychopathology has been life changing in the way I deal with them. But I am only at the beginning. I have been told that the process usually lasts from 6 to 8 months, but can take even longer. 

[Bewildered73]

1 hour ago, Gridley said:

There's nothing to do, really, except please create your drug signature.   Account Settings – Create or Edit a signature.

Ok, will do.

Thanks

1 hour ago, ChessieCat said:

Hi bewildered and welcome from me too.

 

I have visited the website you mentioned and was able to use google translate to view it.  Would you be able to tell about how they plan to help you get off your drug?  Even though they are aware of withdrawal they might want you to get off too quickly or change drugs or add drugs.

 

You might be interested in what happened to me:

 

 

October 2015 I reduced my dose from 100mg to 50mg Pristiq.  I experienced extreme cog/brain fog for 3 weeks and everything I did required my undivided attention, even walking.  I began researching antidepressant withdrawal.  That was when I discovered the website survivingantidepressants.org.  Several days later  I was unable to type.  Being a professional typist since the age of 16 I knew that something wasn’t right.  It had been suggested by the website moderators that I increase my dose of Pristiq.  When I couldn’t type I took extra Pristiq and after about 4 hours I was able to type again.  Because I had a benchmark I knew that it was because I had reduced my Pristiq too quickly.

 

I have been tapering using SA's protocol and I am now down to 12mg and have only suffered minimal withdrawal symptoms.

Dear ChessieCat, thanks for your feedback.

The program I am following does not follow the 10% rule. The team analyzes each case and decides together with the patient how and when to begin. During tapering, doses can be changhed if withdrawal symptoms are too harsh or not easy to deal with. They change the program during tapering, distinguishing between withdrawal symptoms (in this case they evaluate tapering speed) and underlying pathology (in this case adapting appropriate drugs in small doses). In my case, the major problem is that I have been treated for an anxiety disorder with antidepressants for seven years. Once established that my problem is anxiety and panic, we decided to taper all antidepressants, at the moment paroxetine and venaflaxine, taking all the time necessary to avoid disabling withdrawal symptoms. I also have a specialized cognitive psychotherapist who folows me, and this helps a lot too. In my experience, knowing that the symptoms are due to withdrawal and not to new and frightening unknown psychopathology has been life changing in the way I deal with them. But I am only at the beginning. I have been told that the process usually lasts from 6 to 8 months, but can take even longer. 

[AliG]

Hey Bewildered. Welcome.

27 minutes ago, Bewildered73 said:

In my experience, knowing that the symptoms are due to withdrawal and not to new and frightening unknown psychopathology has been life changing in the way I deal with them. But I am only at the beginning. I have been told that the process usually lasts from 6 to 8 months, but can take even longer. 

 

I'm sorry if I have missed it , but I'm unsure as to what you mean.  Please explain ~ it can take a lot longer than that ~ 

 

What program are you on, exactly?

 

I'm happy for you if you have found something that works for you  ~ How can we help you ?

[Bewildered73]

52 minutes ago, Bewildered73 said:

The program I am following does not follow the 10% rule. The team analyzes each case and decides together with the patient how and when to begin. During tapering, doses can be changhed if withdrawal symptoms are too harsh or not easy to deal with. They change the program during tapering, distinguishing between withdrawal symptoms (in this case they evaluate tapering speed) and underlying pathology (in this case adapting appropriate drugs in small doses). In my case, the major problem is that I have been treated for an anxiety disorder with antidepressants for seven years. Once established that my problem is anxiety and panic, we decided to taper all antidepressants, at the moment paroxetine and venaflaxine, taking all the time necessary to avoid disabling withdrawal symptoms. I also have a specialized cognitive psychotherapist who folows me, and this helps a lot too.

Yes, I have been told that it can take a lot longer, also in my case. The fact that I am responding well to the initial tapering doesn't mean that things won't get worse as we go on. The program I am following is quoted on top. I can give more details if needed.

I'm not looking for specific help, for now, I just wanted to share my experience in case someone - especially here in Italy - could benefit from it, and compare it with other people's experience.

[AliG]

Hey B. That's great ! Thank you ~ I'm sure that we can all benefit from your experience and knowledge. Please keep us up to date on your progress. I wish you well.

 

Ali

[Madeleine]

Keep in mind that symptoms are cumulative and you could feel reductions quite a while later..  So, for example, while tapering you could feel okay, and make cuts based on your symptoms.  But then, all of a sudden, you could start feeling the effects from dose reduction 1 and 2, when you are making your 5th cut, and you won't know which particular dose reduction caused your symptoms.  That is why it's recommended that you cut 10 per cent per month or less. This rate has been established through trial and error through many peoples' collective experience as the rate that lets your brain recuperate, stabilize between cuts and therefore manage your taper and minimize or even prevent withdrawal symptoms the best. 
 

[ChessieCat]

Please create your drug signature and update as you make changes.  Thank you.

 

We ask all members to create a drug signature.  This appears below every post you make.  Please update it whenever you make a change.  This is the preferred format which makes it easier for us to see your drug history at a glance:

 

A request: Would you summarize your history in a signature - ALL drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly?

• 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.
• Link to Account Settings – Create or Edit a signature.

[Altostrata]

On 3/1/2018 at 3:33 AM, Bewildered73 said:

Ok, will do.

Thanks

Dear ChessieCat, thanks for your feedback.

The program I am following does not follow the 10% rule. The team analyzes each case and decides together with the patient how and when to begin. During tapering, doses can be changhed if withdrawal symptoms are too harsh or not easy to deal with. They change the program during tapering, distinguishing between withdrawal symptoms (in this case they evaluate tapering speed) and underlying pathology (in this case adapting appropriate drugs in small doses). In my case, the major problem is that I have been treated for an anxiety disorder with antidepressants for seven years. Once established that my problem is anxiety and panic, we decided to taper all antidepressants, at the moment paroxetine and venaflaxine, taking all the time necessary to avoid disabling withdrawal symptoms. I also have a specialized cognitive psychotherapist who folows me, and this helps a lot too. In my experience, knowing that the symptoms are due to withdrawal and not to new and frightening unknown psychopathology has been life changing in the way I deal with them. But I am only at the beginning. I have been told that the process usually lasts from 6 to 8 months, but can take even longer. 

 

This is very important -- the physicians need to closely monitor symptoms and immediately adjust the taper if symptoms appear.

 

This is where almost all doctors go wrong. They do not recognize withdrawal symptoms, or dismiss them as minor and transitory.

 

Madeleine is absolutely correct, the effect of dosage reductions can be cumulative -- you will need to watch out for this, too.

 

Very good to hear you've found medical professionals concerned about tapering and withdrawal syndrome.