Brain: my brain on drugs

[simon]

Just read through your thread and found it very interesting; also the thoughts it provoked from the others who have been following it!.

That's what I like about this forum; everyone seems to have something of relevance to chip in with. Its given me food for thought.

I'm glad they have all stayed with you and really wish you well with the new tapering.

Simon

[Rhiannon]

Good to hear from you, and it sounds like you're doing great!

 

My only comment about your tapering schedule is: be prepared to adjust and adapt if your body's actual real life responses don't happen to fit into the schedule you have planned in advance. Schedules are good for approximations, but the real expert on withdrawal is your body.

[Brain]

Good to hear from you, and it sounds like you're doing great!

 

My only comment about your tapering schedule is: be prepared to adjust and adapt if your body's actual real life responses don't happen to fit into the schedule you have planned in advance. Schedules are good for approximations, but the real expert on withdrawal is your body.

I definitely agree. Thanks, Rhi

[Brain]

Some further observations regarding changes experienced since decreasing my Wellbutrin dose in April:

 

Previously I've connected lower energy with the drop from 300mg to 150mg I did in April. My feeling was that the Wellbutrin was having a stimulating effect on me, and with that effect withdrawn somewhat I thus felt less energy. That still seems to be true, but I also think there's a bigger picture here.

 

Here's the theory: Sertraline, which I've been on for 16 years, has long since lost any effectiveness it may once have had, and is instead causing numerous long-term side-effects. In fact, those side-effects (mainly in the form of increased depression---I was in pretty bad shape) were profound enough that 10 years ago I started on Wellbutrin to counteract them. Earlier this year when I lowered my Wellbutrin dose it partly unmasked sertraline's side-effects: fatigue, weight gain, restless legs, and cognitive problems, esp. while writing---maybe a form of dysgraphia.

 

To dig a little deeper, I went over to the side-effects list for Zoloft at drugs.com and picked out the ones I feel I've experienced newly since the dose change:

• confusion [doing dumb things like yesterday beginning to open a package that wasn't addressed to me, until someone else pointed out my error]
• drowsiness [trouble staying awake in the afternoon at work---more than usual, anyway]
• loss of bladder control [sometimes after I pee and think I'm done and zip my pants back up, a moment later I feel something dribbling. This is a recent thing.]
• racing heartbeat [i've noticed on two or three occasions that my heart seems to race for a few seconds before going back to normal]
• restlessness [restless legs]
• bloody, black, or tarry stools [about a month ago I saw what seemed to be blood in my stool]
• decreased vision [sometimes it feels like I just don't see as well---like things are dimmer somehow]
• high or low blood pressure [low blood pressure]
• lightheadedness [i feel like I'm more susceptible to "head rushes" than usual]
• weight gain [i've put on a few pounds, as well as more fat]
• frequent urge to urinate [i have to pee more often than I used to]

Of course this might not prove anything since the list of side-effects is super long. But these do all seem to be recent changes in my body, and so happen to be on the side-effects list. I don't know if this really makes sense---the theory that Wellbutrin can substantially "mask" the side-effects of Zoloft---but seeing this pattern of weird things going on in my body since lowering the dose of Wellbutrin makes me think there really could be something else going on.

[Petunia]

Thanks for the update Brain,

 

I think it would be difficult to know the difference between unmasked side effects of Zoloft, due to lowering the dose of Wellbutrin, and withdrawal symptoms from lowering the Wellbutrin.  The effects these drugs have in our bodies is unpredictable and any change can cause any number of symptoms.  As the nervous system changes, often, symptoms completely different from those experienced previously arise from the same dose which may have been taken previously.  It can drive you crazy trying to figure it out.  Eventually people seem to give up trying to understand and predict and just go with what seems to work best....slow tapering, guided by the body's responses and symptoms, based on the 10% method.

 

I hope the new tapering plan goes well.  Please would you add the date you cut from 100mg to 90mg to your signature, that way we don't have to scroll back through your thread to find out.  Have you noticed any of the increased symptoms that you predicted?

[Brain]

Please would you add the date you cut from 100mg to 90mg to your signature, that way we don't have to scroll back through your thread to find out.

 

 

The latest dose change is included in my signature already, though I admit it may be hard to spot: "Dropped to 90mg 5 Dec 2014."

 

 Have you noticed any of the increased symptoms that you predicted? 

If you are referring to the sertraline side-effects I listed, yes, I have already experienced those since changing the Wellbutrin dose last year. If you are referring to withdrawal effects from reducing sertraline then no, I don't think I've observed anything in particular since reducing the sertraline dose early this month.

 

Eventually people seem to give up trying to understand and predict and just go with what seems to work best

 

And I expect I likely will, too, yet I believe that by logging observations such as these they may prove useful to others in elucidating patterns in their own experiences.

 

The ability to predict primary effects / side-effects / withdrawal effects given somebody's medication history (such as contained in many people's signatures) would be a valuable planning tool. Lack of data seems to be the main impediment.

[Altostrata]

 

The ability to predict primary effects / side-effects / withdrawal effects given somebody's medication history (such as contained in many people's signatures) would be a valuable planning tool. Lack of data seems to be the main impediment.

 

 

If you can figure out how to do this, you could publish. I know David Healy's Rxisk.org is trying to devise algorithms related to drug use.

[Brain]

Quick update:

I'm down to 60mg/day on sertraline and doing well. I've been taking it down 10mg/month. My plan is to cut the rate by half to 5mg/month once I get down to 50mg/day. Then, when I've halved the dose again to 25mg/day, I'll cut the rate by half again to 2.5mg/month.

 

Another way to state this strategy is "half your dose once every half a year, doing so in 5 steps of 10% of the original, one step per month, with a sixth month staying in place; repeat until the dose is small enough that the medication can be dropped completely." So from 100 the monthly doses would be [90, 80, 70, 60, 50, 50] [45, 40, 35, 30, 25, 25] [22.5, 20, 17.5, 15, 12.5, 12.5] etc.

 

For me this is simpler, but it maintains the basic property of exponential decrease in taper rate as the absolute dose gets smaller.

 

With these 1/10th increments I'm able to easily cut the pills to proper dose with a knife. Note that for people who are highly sensitive to the dosage this may not be precise enough and liquid formulation would be better, but for me this is sufficient as I never really notice even missed doses and am not very dose sensitive in the short term.

 

The last time I was at doses this low was 5 years ago, and I was an emotional wreck with intense OCD and depression as withdrawal effects. This time, taking things much more slowly, I am doing well and feel that the course I'm on is sustainable.

[Brain]

Since my last report, I have tapered Zoloft to 50mg and held there for five months, during which time I've been quite stable. On 7 Sep 2015 I resumed the Zoloft taper, this time at the 5mg/month rate of reduction previously discussed, dropping from 50mg to 45mg. So far I don't notice any effect of this reduction.

 

My previous plan included tapering for five months and holding one month. However, I felt that one month was not long enough, and preferred to wait a few more months to consolidate my gains.

 

The 5mg/month reductions are being carried out simply by cutting 1/10th off of 50mg pills. For me this seems to be sufficiently precise.

 

I'm now taking less than 20% of my original 250mg dose of Zoloft. I feel that I now have greater access to my own feelings than I've had since I was a teenager. This makes certain types of growth possible that simply were not accessible to me during the long Sertraline night, the fifteen years in which I was a slave to its numbing effects.

 

Regarding the symptoms I reported after the Wellbutrin taper, I find I still do dumb things, still get tired in the afternoon, still leak urine, still have occasional racing heartbeat, still sometimes have fuzzy vision, and still have low blood pressure. But since last report my legs are less often restless, I've seen no blood in my stool, I don't get particularly lightheaded, my weight has stabilized, and I don't need to pee unusually often. On the whole none of this feels very significant, most of the symptoms being also correlated with growing older ;-)

 

Reading through my topic again has been interesting. There have been moments of tension between me and this community. I appreciate your thoughts and even pushback through the years, all of which has helped me carry out a wiser taper.

 

I will keep my eyes open for withdrawal symptoms as I attempt the taper from 50mg to 25mg in the coming months. This is a critical juncture for me as it is where I ran into trouble during my previous taper attempt five years ago. But I'm going much slower this time, having been stable at 50mg for almost half a year---a dose I had arrived at by gradual monthly reductions as well. So I'm optimistic that things will proceed smoothly.

[NJJ]

Hi Brain

 

I was just reading some of your thread. It is good to read that another person who has been on zoloft for the same amount of time is able to withdrawal without to much drama. I've never been on a dose higher than 75mg so you've done really well getting it down from 100/200mg to 50mg. Best of luck with the rest of your taper. Keep us updated!

[Brain]

When I last posted I was just beginning the 50mg -> 25mg phase of my Zoloft taper, which I've now basically completed, going to 45mg September, 40mg October, 35mg November, 30mg December, and 25mg January (more or less).

 

This has been as smooth a taper as could have been hoped. I haven't noticed any particular withdrawal effects. My ability to feel my own emotions has continued to be enhanced as the dose has dropped, which is challenging but essential to growth. It's easier for me to realize that I'm upset about this or that because I feel it much more clearly. But I feel like that's what this taper is all about---facing life without the numbing effects of the drugs, the inability to feel what you feel being one of the most dehumanizing things about them.

 

The success of this recent taper phase has me feeling very optimistic about being able to eventually get off the Zoloft completely because it has shown me that I can be at this low dose without the terrible OCD and anxiety problems I experienced when I tapered rapidly down to 25mg in 2010. This time feels completely different. My life feels better, not worse.

 

I'm a little bit uncertain what to do next. I'm currently at 150mg Wellbutrin, 25mg Zoloft. I'm inclined to hold there in February and then resume the Zoloft taper in March at the reduced taper rate of 2.5mg/month. That would get me through the next phase down to 12.5mg by July. But since these low doses gave me so much trouble six years ago, I'm curious whether any other Zoloft taperers out there could share their experiences working around 25mg. I'm wondering:

• Should I hold here longer?
• Did you have any particular trouble in the under-25mg dose range?
• When did you finally call small enough small enough and drop to zero?

Overall, I'm feeling proud about what I've achieved now that I'm operating normally with only 10% of my original 250mg Zoloft dose, and I'm looking forward to building on these gains to kick this drug out of my life completely. It feels within reach!

[Brain]

I'm also thinking about the next steps for the Wellbutrin taper. I've been at 150mg Wellbutrin XL for almost two years. Here's the strategy I'm considering:

 

Switch from 150mg Wellbutrin XL daily to 75mg Wellbutrin SR twice daily. After a month on the SR tablets, begin to taper. Following Altostrata's recommendation in the Wellbutrin tapering topic, I would cut the 75mg SR tabs into quarters and taper by those 18.75mg increments. I'm thinking I'll use a monthly taper interval because it's conservative (compared to Altostrata's recommendation of 2 week intervals) and because it keeps aligned with my Zoloft schedule.

 

It would look like this:

Month 1: full tablet in the morning and 3/4 tablet at night

Month 2: 3/4 tablet in the morning and 3/4 tablet at night

Month 3: 3/4 tablet in the morning and 1/2 tablet at night

Month 4: 1/2 tablet in the morning and 1/2 tablet at night

Month 5: 1/2 tablet in the morning and 1/4 tablet at night

Month 6: 1/4 tablet in the morning and 1/4 tablet at night

Month 7: 1/4 tablet in the morning and no tablet at night

Month 8: discontinue completely

 

If I have trouble with any of the taper steps I'll hold and then increase the interval to 6 weeks or two months.

 

Perhaps I'll wait on the Zoloft taper until this Wellbutrin taper has been successfully under way for two or three months. 2016 would look like this:

Jan: Wellbutrin XL 150mg ; Zoloft 25mg

Feb: Wellbutrin SR 150mg ; Zoloft 25mg

Mar: Wellbutrin SR 7/8 * 150mg ; Zoloft 25mg

Apr: Wellbutrin SR 6/8 * 150mg ; Zoloft 25mg

May: Wellbutrin SR 5/8 * 150mg ; Zoloft 25mg

Jun: Wellbutrin SR 4/8 * 150mg ; Zoloft 22.5mg

Jul: Wellbutrin SR 3/8 * 150mg ; Zoloft 20mg

Aug: Wellbutrin SR 2/8 * 150mg ; Zoloft 17.5mg

Sep: Wellbutrin SR 1/8 * 150mg ; Zoloft 15mg

Oct: discontinue Wellbutrin ; Zoloft 15mg

Nov: Zoloft 15mg

Dec: Zoloft 12.5mg

 

I threw in a hold at 15mg Zoloft for three months while I completely drop the Wellbutrin, just to minimize any Wellbutrin discontinuation turbulence.

 

This isn't set in stone and I'd appreciate feedback. I've never actually simultaneously tapered two drugs. Is it a good idea with this combination? If it got me off of Wellbutrin and down to 12.5mg Zoloft by the end of the year that would be incredible, but I'm a little afraid of being too aggressive. I guess I'll just have to see how I respond to things.

[AliG]

Hi Brain. Congratulations , on getting to this point.  As far as your Zoloft schedule goes :  I would say alternating dosages , is not a good idea as it can be very destabilizing to your C.N.S.  As you probably know, we don't recommend tapering two drugs at once, however, some have done it /doing it  successfully. The difference is the degree and severity of the taper. Your schedule does seem aggressive, but as you already know you are " out on a limb " doing it your way . Is it a good idea ?  Probably,not . As you get lower in dosage , it  becomes even  more important to take it slower with your drops and to hold longer.   I would be extremely careful , from this point on. I hope you can continue to taper with no severe ramifications. . Please let us know how it works out for you. You might want to read this. :

http://Why taper? Paper demonstrates importance of gradual change in plasma concentration

Best wishes,

Ali

[bubble]

Hello Brain

I must say I'm very impressed with your journey. I've read through your thread and it was very interesting to see how your attitude has been changing and I'm really glad you have stuck with us for over 3 years now. Really impressive and great results.

 

By now you know very well what we think (and you know it yourself, you are an old hand

 

So you know that regardless what anyone says, even the biggest authority it is ultimately your brain that you have to negotiate with. You know about tapering at low doses, you know about neuroplasticity, lag time, listening to your body, using the calendar only for approximation purposes...

 

If you haven't seen it so far I would recommend this thread: http://survivingantidepressants.org/index.php?/topic/4954-rhis-start-small-listen-to-your-body-taper-plan/

 

In any case, start small, listen to your body (and act accordingly). 

 

About your questions to other Zoloft users here and in the tapering section I would say that each brain is different. Nobody has had even a similar history like you. While drugs have some things in common our own individual histories introduces too many variables which annul those commonalities.  That's why it's so difficult if not impossible to come up with models which you mentioned in your previous posts.

 

It seems that you have read through your thread recently. If you haven't it's I think the best source of information for you at the moment. You will see that what Rhi and Alto wrote 3 years ago speaks to you now, maybe even with more clarity. It sure speaks to me

 

Once again congratulations on the great progress so far and I look forward to future updates.

[bubble]

There is something else I remembered... Have you read the Wellbutrin thread carefully and noticed Adax's experience while tapering it quickly alongside the other antidepressant:

 

I jumped off Wellbutrine quickly after reading that it was a weaker antidepressant and that people have been able to tolerate larger cuts.  The first few cuts I made went well and there were improvements in the form of relief from some minor side effects, so I kept going with the larger cuts.  I thought the short half-life meant that if there were going to be bad w/d symptoms associated with the steep decrease that I would feel them pretty quickly... apparently not.  It took a few weeks to catch up with me. Rhi even warned me, but  I attributed some evolving side effects to an error I'd made making my prozac solution.  

 

 

 

After a very bad withdrawal experience I have done a great amount of reflection on my taper as well as reading and asking questions about Wellbutrin when combined with prozac. I wanted to add a note of caution here if tapering Wellbutrin while taking an SSRI.

Here is my understanding of what occurs:
It appears that when used in conjunction with an SSRI Wellbutrin will cause an increase in the plasma level of the SSRI. The basic story is Wellbutrin competes with the SSRI to be metabolized. This causes the SSRI to be metabolized more slowly, essentially causing a "back-up" and increasing the amount of SSRI in your system. It's like increasing the amount of prozac you are taking without actually taking a higher dose. This competition to be metabolized also keeps the SSRI in your system longer, or in other words, extends the half-life.

What does this mean? As I understand it it means that when you taper Wellbutrin you are inadvertently tapering your SSRI, even if you haven't decreased the actual amount of the SSRI you are taking. This means the unintentional taper of your SSRI is probably much steeper than what would be a 10% decrease. In some cases Wellbutrin appears to cause large increases in the SSRI level.

I and my new pdoc believe this is what happened to me. My large and quick drops in my Wellbutrin dose effected major drops in my blood plasma level of prozac even though I wasn't actively tapering my prozac dose at the time. This is likely to be why my withdrawal symptoms were so delayed, sudden, and extreme.

Because the relationship between the drop in Wellbutrin dose and drop in the plasma level of the SSRI can be significant but does not appear to be linear I suggest you proceed with your Wellbutrin taper with extreme caution. Be very conservative even if you feel fine while decreasing your Wellbutrin.

 

[Brain]

AliG: what do you mean by alternating dosages?

 

Perhaps it would be best for me to hold the Zoloft at 25mg for now and just work on the Wellbutrin. That's what I did during my last Wellbutrin decrease, which seems to have worked fine and given me a good foothold for the last 75mg of Zoloft decreases.

 

 

The Hybrid Approach

 

I feel I could do a better job explaining my current tapering approach.

 

In general there seem to be two approaches to systematic tapering: absolute and relative. Under absolute tapering, the dose is reduced by a certain percentage in absolute terms at each interval. 100, 90, 80, 70, 60, 50, 40, 30, 20, 10, 0

 

Under relative tapering, the dose is reduced by a certain percentage in relative terms at each interval. 100, 90, 81, 73, 66, 59, ...

 

Absolute tapering is really simple, but it causes withdrawal issues because the neurological systems involved seem to be somehow exponential rather than linear. Relative tapering is complicated---how exactly do you go about getting 66% of a pill? This leads to the complexities of liquid preparations or crushing and weighing, all of which I would rather do without.

 

My approach is a hybrid of absolute and relative tapering. It rests on the observation that the difference between absolute and relative decreases starts out small and only builds up gradually. So for a while absolute decreases can be applied without causing significant differences from the relative approach. 

 

absolute vs relative

90 vs 90    dif. 0%

80 vs 81    dif. 1%

70 vs 73    dif. 3%

60 vs 66    dif. 6%

50 vs 59    dif. 9%

 

The relative size of the absolute decreases increases the longer you go:

10 / 100 = 10%

10 / 90 = 11%

10 / 80 = 13%

10 / 70 = 14%

10 / 60 = 17%

 

My approach is to use absolute dose reductions of 10% for five months, followed by one rest month where no reduction is made. These six months are called a tapering phase, and they yield an overall absolute reduction of 50%, compared to the 47% reduction that six months of relative 10% reductions achieves. After each phase, the rate of reduction is halved, thus keeping the broader exponential property that's vital to success.

 

To me this is the best of both worlds. The short-term 10% absolute reductions are easy to think about and easy to carry out. But the fact that the rate of reduction gets cut in half after each phase means that things don't get out of hand---the basic principle that the rate of reduction should decrease as the dose gets lower is respected.

 

10mg/month phase:  90    80 70    60 50    50

5mg/month phase:    45    40 35    30 25    25

2.5mg/month phase: 22.5 20 17.5 15 12.5 12.5

...

 

The absolute decreases within a phase are definitely more aggressive than relative decreases, especially toward the end of the phase where the relative size of the decrease gets up to 17% in the fifth month. But I believe that the longer-term trajectory is more important than these short-term deviations, and in this regard the hybrid approach is only slightly more aggressive than the traditional relative approach.

 

I've done two such tapering phases already with no apparent problems. Of course, I did hold for more than one month after the first one.

 

 

Wellbutrin Exception?

You'll observe that I'm intending to use only absolute dose reductions for my Wellbutrin taper. This is because I already know that I can survive a 50% precipitous drop in Wellbutrin dose without major problems. (My 300mg->150mg decrease in 2014.) I won't even get up to that rate of decrease until the second to last month. At that point if things are shaky then obviously I can slow it down,  but for now I think it's a reasonable plan.

 

I mean to apply my hybrid approach only to the Zoloft taper.

[Brain]

bubble: yes I did read through that thread recently. That's part of my current thinking that I'll just focus on the Wellbutrin for now and hold the Zoloft where it's at in the meantime. Thanks for pointing it out.

[Brain]

It's time for an update!

 

I've been hanging out at 150mg Wellbutrin XL and 25mg Zoloft for a while now. And... it's been tough. But in a good way.

 

I think what's happening is I've regained access to emotions that I haven't felt in a long, long time. Some mornings I'll wake up feeling really depressed. Feeling isolated, like I have to face the world alone. It's the same feeling I had in high school at age 14 when I first became depressed. It's hard, but I think this is good. It's like these feelings have been frozen in time during all these many years on the drugs, and now that I'm taking little enough of them the feelings are thawing. It's put me in a crisis---struggling to feel loved, struggling with doubts about whether God is there, wondering who I am and what I even believe and where I belong. Some days the feelings are so strong that I'll leave my office at work, go up to the hill above my building, and just cry.

 

Some would say the depression has returned and that I need the drugs. But this is what I need. This is how I can heal. I've been numbed to my feelings for over half my life. The time has come to feel!

 

I've been meeting with a therapist and in spite of the pain am hopeful of making some real progress now that I can feel my own feelings.

[ChessieCat]

Hi Brain,

 

Thanks for stopping in and updating.

 

Something I read in a book which I try and remember if I am having unwanted feelings:  It's just a feeling and feelings change.

[Brain]

Hi everybody,

It's been a few years, and I wanted to check in and give an update. There's been quite a bit going on.

 

In April 2014 I dropped Wellbutrin from 300mg to 150mg, and by December 2015 I had brought my Zoloft dose down from 200 to 25 after a three year taper.

 

When I dropped the Wellbutrin, I noticed a drastic drop in my energy level. Ever since then I've felt more fatigued, had a harder time getting up in the morning, etc.

 

I've also experienced first drastic weight loss (from 190 to 170 in 8 months)  followed by drastic weight gain (from 170 to 210 in 2.5 years). I've written in detail about that on the weight gain/weight loss thread here.

 

The truth is in this time I've become more depressed than I have been for quite a while. I had been on that Wellbutrin dose for something like 10 years before dropping it. And I had been at at least 200mg of Zoloft for over 15 years. These are pretty drastic changes to things my body had become very accustomed to.

 

I'm pretty sure there's also something else going on with me medically: the fatigue, fuzzy thinking, tingling hands and feet, balance issues, memory problems, etc. all tell me that. I'm working hard to figure out the cause, considering all possibilities, including (but certainly not limited to):

• Lyme disease
• MS
• B12 deficiency
• Other metabolic disorders like MTHFR deficiency
• Etc.

I wonder if perhaps there has been some other explanation for the depression ever since I was a teenager. It may be that the antidepressants were masking a depression that has some physiological cause, but which I neglected to investigate because the drugs were numbing the depression so it felt less urgent.

 

I'd love to hear anybody's stories about finding physiological underlying causes of their depression.

 

I'm also looking into really seriously working with cognitive behavioral therapy, mindfulness meditation, EMDR, journaling, much more regular exercise (trying to fight that weight gain!), etc. as alternative ways of tackling the depression. This has been a very satisfying path to explore, and I only wish I had taken things like that more seriously as a teenager instead of getting on the drugs. Live and learn.

 

For the past three years my antidepressant taper has been on hiatus as I have been working through the fallout of the taper I've already accomplished. Part of me still wants so much to be done for good with these drugs, but I feel emotionally unstable enough at the current doses that I don't think it's advisable to resume tapering any time soon.

 

I hope everybody is making good progress in their lives and finding ways to live well without the burden of the drugs. Wishing you the best.

[ChessieCat]

It might be a good idea to get full blood work done to test to check for deficiencies.  For example, Vitamin D.

[Brain]

@ChessieCat Yes, I have had a number done but there's more to check. I was low on D but started supplementing, and now it's at a good level. My B12 is low but the followup test (methylmalonic acid) was normal, so I don't think it's that, but who knows? Folate has been normal, thyroid normal, etc.

I just discovered that I can order tests directly rather than going through my doctor e.g. healthlabs.com, so I'm planning to check a million things at once coming up soon.

[Brain]

An update on my journey since 2019.

 

I still have those neurological / nervous problems here and there, but they are intermittent and I can't figure out their cause, so I don't think much about it.

 

Even before the pandemic, I wasn't doing very well. I was in a new city with few friends, having lost my faith, and job, and relationship, oh and my dad died back in 2014, can't remember if I mentioned that. I had become a bit of a hypochondriac---the old OCD madness had crept back into my life at the low 25mg  dose of Zoloft.

 

So, at a doctor's suggestion, in late 2019 I increased my Zoloft from 25mg back to 50mg. I didn't want to erase all of my tapering progress, so I didn't go back up to 200 (let alone 250), but it was a bit of a setback.

 

In April 2020 I attempted to increase Wellbutrin XL back to 300, but I felt it affected my memory negatively, which prompted me to drop that drug completely, cold-turkey. Which went off without a hitch, apparently, though I did notice another wave of weight gain, as with the 300->150 drop.

 

I had been on the Wellbutrin from a young enough age (21) and for long enough, that I didn't realize how much it had become "baked in" to my personality. In particular, the stimulant effect of the Wellbutrin functioned much like an ADD drug for me, and getting off of it made it feel like I had ADD. I had a bit of a crisis about it, where I wondered if I had even chosen the wrong profession (a bit of worst-case scenario thinking) because my ability to focus had been artificially elevated.

 

But now I drink more coffee than I used to, which has the advantage of being a variable dosage that I can skip with no problem.

 

I still wasn't doing well at those doses, but rather than think maybe other factors in my life were involved (social isolation? unemployment? physical fitness at an alltime low? lack of community? etc) I was back on the antidepressant treadmill. At a doctor's suggestion, I switched from Zoloft to Prozac, a new drug for me, ramping up to 40mg.

 

At this relatively higher dose I have been doing pretty well. But also, I got a job. And started branching out more socially. (Still not that much.) Joined a 12-step recovery program (ACA) to deal with after-effects of my crappy childhood. And started getting in better shape. ("getting in better shape" has been a whole process of its own; I've had to change my philosophy about the meaning of pain in exercise, and come to a belief that given enough time my body will adapt to the demands placed upon it.)

 

Even doing pretty well, I still have really dark times. It's like I'm two people - one quite functional and happy, and one depressed.

 

I have also done a good amount of cannabis, though I'm abstaining these days because it makes me anxious. And I've done mushrooms twice---would like to do those more.

 

 

I finally got a word for what we experienced growing up, the thing I think made me depressed in the first place: neglect.

 

My main task as I see it at this juncture in life is to learn to take better care of myself. The opposite of neglect. It's a daunting but also enjoyable project.

 

 

I was reading "The Tao of Fully Feeling" by Pete Walker the other day, and he references a PBS Frontline episode from 1995 titled "Welcome to Happy Valley", dealing with an overzealous SSRI-prescribing psychologist in Wenatchee, Washington, who is disciplined by his profession:

• https://www.youtube.com/watch?v=vM3k-ghKerI
• https://www.youtube.com/watch?v=H8VxZtX4hdM
• https://www.youtube.com/watch?v=oCDrOQZCJjg
• https://www.youtube.com/watch?v=xIHu-pjwHFE

I grew up in the same region, and was first prescribed antidepressants at age 14 within just a few years of the air date of that video.

 

The second link is particularly troubling: wherein a former patient of the doctor describes his cult-leader-like attempts to get her to take Prozac.

 

It was just a reminder of the water I swam in when I was first put on these drugs. And I, like the patients in that video, would have said that they saved my life.

 

 

I've done some EMDR. I've not gotten that much out of it. I've done some mindfulness meditation, which at first was frightening (because of the dark things that would come to mind) but now I find very powerful as a tool. It feels like the opposite of the antidepressant ethos of don't feel that.

 

I've been working hard to hide less of myself from people. I've been writing a lot of poetry, trying to resolve the deep sadness and pain I carry with me still.

 

 

I face a dilemma, as I definitely find life easier when I'm taking more of the SSRIs, but I don't want to be on them all the rest of my life.

 

I am thinking about attempting another taper, this time of Prozac. Not sure, but I'm thinking about it. I have a few more tools in my toolbelt, so to speak, than last time.

 

I had concluded that I was one of the few people with severe depression that the antidepressants actually work for.

 

Even if that is the case, I still feel like the depression is actually there for a reason, and I'd rather face it that suppress it.

 

 

I hope everyone is doing well 🙂

[ChessieCat]

Thank you for coming back to update your topic.

 

Important topics in the Tapering forum and FAQ

 

Post #1 explains how to get non standard doses:

 

Tips for tapering off fluoxetine (Prozac)

[Brain]

Titled:  Even Slower Taper

 

Hi,

I've tried on-and-off since about 2010 to get off the antidepressants, which I've been on in one form or another since age 15. (I'm now 39.) What I've succeded at is getting from 200mg Zoloft + 300mg Wellbutrin XL down to 40mg Prozac and 0mg Wellbutrin. I had been down to 25mg Zoloft when things started to come apart for me emotionally, which is part of why I switched over to Prozac and moved up to a relatively higher dose.

 

Since I've been on these drugs from such an early age, much of my personality and personal habits are formed around the assumption of their presence. My strategies for dealing with emotional upsets and psychological stress may never have developed properly to begin with because I was relying on antidepressants instead.

 

I wonder if I might need to take a far slower approach to tapering than I once thought. Because changes to thought patterns and personality structure don't happen overnight. That sort of stuff takes years, if it ever happens at all.

 

I do feel I'm coming to a better relationship with myself and my thoughts than I once had. I used to be so punitive toward myself---really brutal. I've also been a very judgmental person towards others. The two things are really the same thing. As I change as a person, I wonder if some of my original need for the antidepressants might not be reduced. But it's impossible to say without attempting a taper.

 

I have other reasons for wanting to try another taper. Just today the dentist told me that SSRIs are known to cause/exacerbate nighttime teeth grinding and jaw clenching, something that's been a problem for me for a long time. I also recently learned of SSRIs' connection to reduced bone density and propensity for fractures with age.

 

I'd really rather minimize my use of these drugs. It's just that they're so "baked in" to who I am at this point, it's hard to see in practice how I can do that. I wish so much I'd never been put on them, and faced my emotional issues and their causes directly instead. But as I learn more and change as a person, I'm hopeful my need for them can be lessened.

Edited December 18, 2022 by manymoretodays
merged to Introduction, title added

[manymoretodays]

Hi Brain,

Can you get your signature updated with some of this information above.

I'll just give you this topic to help you do that:

How to Summarize Your Drug History in your Signature

the first post there will link you to your signature too, so you can make it clearer.

 

It sounds like you are just on Prozac only now?

Did you do fast tapers with Zoloft and Wellbutrin?

Are you hoping to go drug free one day?

 

I did see that you are possibly trying lot's of things now.

Are you giving due credit to symptoms arising simply from your drugs or medications, and then also from WD(withdrawal)?

 

And oh wow, you've been a member here since 2012.  Can you see the beauty of when you return, to post right here in your Introduction topic.  You can then look back and see what has been offered prior.

 

Yes, you can do slower tapers.  I'm referring to the title of the post I merged above to your main topic here, your Introduction and topic.

I'm wondering what you've been up to, with any recent tapers.

And am also a bit confused about what you are on right now.

 

There are microtapers, for those who wish to go more slowly.

Micro-tapers instead of 10% or 5% decreases

 

Go easy with what used to be "recreational" substances now being used by psychiatry too.  I thought I saw some mention of that in one of your more recent posts.  The reason being that most of us are more sensitive to things if in WD(withdrawal), and I don't know that any of the latest usage in psychiatry of psychedelics has any long reaching curative power, or that there has been time to see that yet.  So just be careful, cautious what you put into your body now.

Important topics about tests, supplements, treatments, diet

look at the first post ^, and you'll see a bunch of other topics indexed there too

 

Well, and hey.......I'm not real clear on what your asking in your last post, or maybe you are just making a statement......so clarify please and thanks.

 

Best, L, P, H, and G,

mmt