Jump to content
John

After reinstating or updosing, how long to stabilize?

Recommended Posts

John   
John

Now that its been 19 months since my cold turkey from Effexor, Im about 85% recovered. As you know im now tapering slowly off of Effexor from when I reinstated in my 3rd month of the cold turkey. How is it that im recovering from the first withdrawal while im still on the medication the second time and tapering?

Share this post


Link to post
Share on other sites
Altostrata   
Altostrata

The autonomic dysregulation caused by the first withdrawal was only partly corrected by medication. Going back on medication does not guarantee that withdrawal damage will be "fixed."

Share this post


Link to post
Share on other sites
Barbarannamated   
Barbarannamated

John,

I read your post several times and it's not computing (I'm not fully awake yet). If I'm reading correctly, you CT'd Effexor, then reinstated and are tapering now. How have you determined that you are 85% recovered from CT ? Excuse me if you've discussed this already.

Share this post


Link to post
Share on other sites
John   
John

Well, of course the 85 percent isn't exact. I'm just estimating it on how I feel. Compared to 19 months ago, I feel much much better. There are days and weeks that go by without the horrifying anxiety that I had constantly when this all began, and even when it does flare up, its not nearly as severe as it was.

Share this post


Link to post
Share on other sites
Barbarannamated   
Barbarannamated

Sorry, John. I think I understand. I had not heard of anyone differentiating stages of w/d from same drug as you did. Interesting.

Share this post


Link to post
Share on other sites
John   
John

Have you heard of people going through this with a different drug?

Share this post


Link to post
Share on other sites
Barbarannamated   
Barbarannamated

I haven't been on other boards, but have read of a few here who are tapering an SS/NRI and benzo or anticonvulsant, for example, and can differentiate the w/d symptoms and patterns.

Share this post


Link to post
Share on other sites
Altostrata   
Altostrata

I believe your nervous system has been going through a gradual healing process, John, perhaps helped a bit by the reinstatement of Effexor.

Share this post


Link to post
Share on other sites
basildev   
basildev

Hi Everybody,

 

I'm interested in hearing your experiences with this topic.

 

Has anybody noticed their symptoms getting worse BEFORE they improve after an updose? Mine seem to have progressively worsened over a 2 week period.

 

What is the average time it takes for you to feel better after you updose?

 

At what point do you say 'the (highest) updose hasn't worked, where do I go from here'?

 

Any insight and your experience is greatly appreciated

 

thanks

Share this post


Link to post
Share on other sites
Rhiannon   
Rhiannon

Basil, this isn't something that's happened to me personally, because I haven't had to do a large updose on my taper (only small corrections so far, fortunately). But I have seen it happen to other people. It's especially common with benzos. The problem seems to be that once your CNS is screwed up and destabilized by the drugs and the withdrawal attempt/s, it doesn't necessarily react predictably and smoothly to a reinstatement or updose. Updosing and reinstatement can be a bit of a crapshoot in that way.

 

By far the best thing to do, if you can, especially if you've already had a "crash and burn" in your history somewhere, is to taper so slowly and incrementally that you don't have to do a large updose.

 

Someone with more experience with ADs will be along here to advise you what to do now. I just wanted to let you know that your experience is not uncommon.

Share this post


Link to post
Share on other sites
strawberry17   
strawberry17

I think Rhi's answer pretty much nailed it. I've been at this game for years now, and had a range of experiences reinstating/updosing, in the past I've been able to reinstate to full dose after months out from a cold turkey withdrawal and recover fairly quickly, but I understand that's pretty unusual.

In the past 5 years I've been tapering excrutiatingly slowly, the drops have been so tiny and such a long time between that I've been tricking my nervous system. However I fell foul before Christmas, too big a drop near the end, and had to updose a bit, and if I'm honest I'm still not entirely right. As Rhi said everything is a crap shoot really when it comes to reinstating or updosing, you just never know how long it's going to take. I'm sorry if that isn't what you want to hear. Really the best thing you can do is an excrutiatingly slow taper when you do feel better. I've been 5 years tapering, but I personally know someone else in their 7th year.

Share this post


Link to post
Share on other sites
basildev   
basildev

Hey thanks Rhi and Strawb.

 

Actually it's exactly what I wanted the hear Strawberry. Just like you in the past I've been able to reinstate the full dose from zero and recovered within a matter of days.

 

This time it's far more challenging and I was worried that if I wasn't right in a few weeks I'd never be right. Became paranoid that even though in the past reinstatement has worked fine, this time my luck's run out and I'm doomed to feel this way forever.

 

Also I think lack of sleep is giving me symptoms that otherwise would have fallen by the wayside.

 

Thank you both for sharing your knowledge and experience.

Share this post


Link to post
Share on other sites
tezza   
tezza

Basil,

 

I CTd Risperdal from .5 to zero for two weeks in September '11. I reinstated .5 October 1, '11. By the end of October, I slept for two nights and thought it was ok to taper some off the tablet at that time. I know now that I should have waited longer before tapering. I have no clue how much I was trimming off the tablet.

 

In December I trimmed some more off, again I was guessing the amount. I found this site and ordered a scale, I was taking approximately .375 mg. Alto told me to insist on the liquid from my doctor, I finally got it in Jan. '12 and was able to accurately measure out my .375 dose. I stayed on that dose until March 22, at which time I reduced to .35. I was in real bad shape from the time I CTd until a few days after I made that reduction to .35. Then, I started getting better, FINALLY!

 

I was one sick puppy for all those months but when I started getting better it gradually got progressively better from then on. I still feel some fleeting moments, almost like flashbacks, of mild depression. The anxiety has improved tremendously. Sleep isn't perfect but usually tolerable. Muscle twitches are only occasional now. Tinnitus is 90% better.

 

I have micro-tapered at a slow rate. Usually, when someone micro-tapers, they cut every few days. I hold two or three weeks between tapers but I'm multi-tapering.

 

I want to add that my original dose of Risperdal was 1mg, so .5 was only half the original dose. Risperdal is a VERY POWERFUL drug!

 

My point is: I was very sick for a LONG time and, thank God, I'm so much better now. I hope this gives you hope and encouragement. You will stabilize, I'm sure of it. It will take longer than you'd hope for, I'm sure, but you must believe that it WILL happen. Just try to be as patient as you can and try really hard not to stress over 'not getting better immediately'. Sometimes it just takes longer, especially when a lot of changes have been made.

 

Note that I held for three months at .375mg. That was to allow my nervous system time to adjust to all the previous changes I'd made too close together. I'm now down to .19mg which may not seem like much but it's actually almost 1/5 of the original dose. I'm looking to be tapering off that for at least another year, maybe longer.

 

Don't give up hope....you will get better, just give yourself some time to stabilize.

 

Hugs and love,

 

Tezza

Share this post


Link to post
Share on other sites
basildev   
basildev

Wow!

 

So it took you 6 months to stabilize! That must have been tough Tezza.

 

I feel so much better after hearing these stories because I thought if I didn't get better within 4 weeks (which seemed to be the average expected time for reinatatement/updosing to kick in) it was all over for me. Now I see that it's different for everyone and I can relax a bit. I don't mind waiting, as long as it's worth it in the end - and let's face it, what other choice do I have??? I sure aint goin for a different med. This one's bad enough.

 

It does pose another question in my mind, though; I have often read and re-read the statement 'sometimes reinstatement/updosing doesn't work'. (while panicking that of course, I am one of the unlucky for for which updosing won't work)

 

Maybe some of these people didn't give it enough time to work? Maybe if they, like you, stuck it out for as long as 6 months it would have eventually allowed them to stabilize? Just a thought.

 

Hugs and love right back atcha:)

Share this post


Link to post
Share on other sites
strawberry17   
strawberry17

I'm glad you're ok with what we've posted Basildev, because I was having a bad yesterday and I worried that what I had written might not make you feel better about your situation.

Share this post


Link to post
Share on other sites
tezza   
tezza

Basil,

 

I truly believe that you will get better, too! After 6 months, I still had some bad waves for a while but there were more (and longer) windows than waves. It happened so gradually that I can't pinpoint exactly when the greatest difference took place.

 

I'm glad you can relax and rest easier now. It just takes time but your brain is trying to repair itself even now. It will happen, maybe it won't take as long as it did for me.

 

My mother went cold-turkey off so many medicines over several years and although it took months after reinstating, she always eventually stabilized.

 

I wish so badly that I knew what all she left off and was started back on. I do know she had at least two FULL shoe boxes of partially filled bottles that she had left off. She was usually on only one or two medicines at the time.

Share this post


Link to post
Share on other sites
Altostrata   
Altostrata

If you've been tapering, then updose too much, the increased antidepressant may be activating.

 

Overstimulation is a common side effect of antidepressants. One of the symptoms is sleeplessness.

 

As you taper, your nervous system may adjust to the lower level of the drug. Then, if you jump up in dose, it reacts as though you're taking a higher dose than you've ever tolerated before.

Share this post


Link to post
Share on other sites
basildev   
basildev

Okay

 

so I've dropped down to 19mg, on day 3 of the new dose. Got about half an hour extra sleep and no hot flushes yesterday, one small hot just at 3AM this morning - so a slight improvement).

 

How long do you think I should hold on that dose before dropping again, Alto?

 

(PS: This thread probably should be merged into my intro topic - not sure)

Share this post


Link to post
Share on other sites
basildev   
basildev

Strawb,

 

sorry you're struggling too. Last night before I went to sleep I said to myself 'may I sleep well tonight, and may Strawberry sleep well tonight too':)

 

At the end of the day I need to hear the truth from people so I can make an informed decision.

 

You spoke the truth and I'm grateful for that

 

xx

Share this post


Link to post
Share on other sites
basildev   
basildev

Thanks Tezza.

 

It's just hard to know what dose to finally settle on.

Share this post


Link to post
Share on other sites
strawberry17   
strawberry17

Thanks Basildev that's lovley :)

Sadly I didn't and feel pretty rubbish again.

Share this post


Link to post
Share on other sites
Altostrata   
Altostrata

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.

Share this post


Link to post
Share on other sites
basildev   
basildev

Yes I agree Alto,

 

I searched high and low for a thread like this until I started it myself.

 

Today is day 4 of drop to 19 mg and sleep is no better. But hot flushes have gone away.

 

I really don't have any other withdrawal symptoms except poor sleep. I think I'll wait maybe a few more days.

Share this post


Link to post
Share on other sites
Hope1   
Hope1

i am concerned about my local mental health group want now to "help" with my withdrawl. i feel the "standard" withdrawl amounts & timescales are too high & too fast for me.

 

how do you guys manage this situation & health workers who won't listen?

Share this post


Link to post
Share on other sites
strawberry17   
strawberry17

Hope1 I would make sure you have someone with you, like your husband or a close friend to help fight your corner, write down your thoughts and feelings in bullet points as it's so easy to forget things and get bamboozled by "professionals", maybe print some information out from here to back up your arguments. Remember it's your body and your mind and you want to be in control of what happens to you, you know yourself better than anyone.

Share this post


Link to post
Share on other sites
Altostrata   
Altostrata

You can listen to what they have to say and calmly tell them you'll take it into consideration and make your own decisions given what you know about withdrawal. You do not have to let them bully you into whatever.

 

Open the dialog, you may need them at some time.

Share this post


Link to post
Share on other sites
SaltedGingkoNuts   
SaltedGingkoNuts

After 4 years of Prozac, I quit Cold Turkey. I didn't know about withdrawals at all. After three months off, after enduring major withdrawal symptoms, I reinstated. As I level off on Prozac again, I am wondering how long should I let my body adjust before I can begin a proper TAPER schedule?

 

Any advice would be appreciated.

 

-Tim

Share this post


Link to post
Share on other sites
basildev   
basildev

Hi Tim,

 

Are you having any symptoms at the moment?

 

It doesn't seem to be that long since you have reinstated.

 

If I were you I would wait until all of the current symptoms have subsided before even beginning to think about tapering.

Share this post


Link to post
Share on other sites
Jemima   
Jemima

There is no set time for adjusting after reinstatement. Everything about antidepressant withdrawal is unique to the individual, their physiology, their history of drug use, and numerous other factors. Once withdrawal symptoms have been mostly relieved by reinstatement, I would guess that at least a month should pass before considering tapering, but the most important thing is to listen to one's body and act accordingly. If bothersome withdrawal symptoms remain after a month of stabilization it may be necessary to updose a bit and try again rather than start tapering down.

 

I wish that there were easy answers that fit everybody, but the whole field of antidepressant "discontinuation" syndrome (a term preferred by the medical establishment which claims that antidepressants are not addictive) is in its infancy and much is still to be learned.

Share this post


Link to post
Share on other sites
SaltedGingkoNuts   
SaltedGingkoNuts

Actually I'm only on my eighth day of Prozac reinstatement, so it hasn't been that long. Felt like *#!@ until today, and even then only about a 7 out of 10. The thing that has me bummed is that this "reinstatement" is actaully a higher dose (doctor recommended) than I took for years (was on 10mg daily, now at 20mg daily). So, I know I'm getting my body 'used' to 20mg now. So it'll take LONGER to taper, but right now, I don't care HOW LONG IT TAKES!!!!

Thanks for the replies, my new friends.

-Tim

Share this post


Link to post
Share on other sites
basildev   
basildev

Tim,

 

the higher dose of Prozac might indeed take your body longer to get used to.

 

Don't be in a hurry to taper just yet.

 

Listen to your body and take it slowly.

Share this post


Link to post
Share on other sites
Rhiannon   
Rhiannon

I'm confused, did you also stop the lorazepam cold turkey recently? If so I highly recommend reinstating and once you're stable doing a reasonable taper on that. Benzo withdrawal is NOT a good thing.

Share this post


Link to post
Share on other sites
SaltedGingkoNuts   
SaltedGingkoNuts

I'm confused, did you also stop the lorazepam cold turkey recently? If so I highly recommend reinstating and once you're stable doing a reasonable taper on that. Benzo withdrawal is NOT a good thing.

 

Actually I did also quit the benzos Cold Turkey. (I didn't know I wasn't supposed to either)! I think I'm actally ok regarding those though because I only took them for about 21 days. Today is Day 19 off of them. Let me attach the whole story.

 

I'm so grateful for this forum!

 

-Tim

AntiDepressant Nightmare Complete Edited.pdf

Share this post


Link to post
Share on other sites
Altostrata   
Altostrata

You need to let your nervous system stabilize after reinstating. How long this might take depends on how long you've been off the drug and other factors.

 

If you were off only a couple of days, you might stabilize for a month before trying to taper. If you've been off longer, to be safe, you should give your nervous system longer to stabilize, even if symptoms go away right away.

 

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

 

Do not attempt to taper again until you feel symptom-free.

 

(Cold turkey off another psych drug simultaneously compounds the situation.)

Share this post


Link to post
Share on other sites
SaltedGingkoNuts   
SaltedGingkoNuts

You need to let your nervous system stabilize after reinstating. How long this might take depends on how long you've been off the drug and other factors.

 

If you were off only a couple of days, you might stabilize for a month before trying to taper. If you've been off longer, to be safe, you should give your nervous system longer to stabilize, even if symptoms go away right away.

 

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

 

Do not attempt to taper again until you feel symptom-free.

 

(Cold turkey off another psych drug simultaneously compounds the situation.)

 

 

Yes, that's what I hope to do. I'm in no hurry and will take how ever long is best. Thanks for the advisement. Grateful!

 

-Tim

Share this post


Link to post
Share on other sites
Rhiannon   
Rhiannon

 

I'm confused, did you also stop the lorazepam cold turkey recently? If so I highly recommend reinstating and once you're stable doing a reasonable taper on that. Benzo withdrawal is NOT a good thing.

 

Actually I did also quit the benzos Cold Turkey. (I didn't know I wasn't supposed to either)! I think I'm actally ok regarding those though because I only took them for about 21 days. Today is Day 19 off of them. Let me attach the whole story.

 

I'm so grateful for this forum!

 

-Tim

 

21 days only? good. It's probably contributing to your symptoms now but hopefully will balance out quickly.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

×

Important Information

By using this site, you agree to our Terms of Use.