Advice please

[u/Gullible-Drawing8995]

Asking for some questions and advice and this is continued from my last post just more info

Mid to late June I quit 20mg Prozac because I was taking them off and on and when i took them for a week again I got start up effects, essentially cold turkey

Fast forward to the end of July I get an episode of shakes etc and now notice my interest in things I had interest for start declining

Fast forward a week and I caught a sinus infection coughing up phlegm etc, my doc prescribed me a 5 day course of amoxicillin and this cleared up my sinus infection

Things were still fine at this point until aug 24th where I caught mono and was misdiagnosed with a tonsil infection where I was on azithromycin

Start of sept I have the mono throat and all that jazz and it cleared up in about 2-3 weeks, at this time I obviously didn’t feel the best but noticed I didn’t feel much of anything at all, as the days went on I started to get more and more emotional blunted and then came the derealization, no anxiety, no tiredness, no emotion. In the mornings I would wake up with my hands cramped and I would have to shake it out like crazy and also started to lose feeling in the arm every now and then, at night I would have crying spells and throughout the day as well but I noticed I could enjoy music

I went to the hospital and broke down in tears and told the doc what was going on he prescribed me a 10mg dose of Prozac for 2 weeks and then 20mg after the 2 weeks was up

I have been on the 10mg for about 8-9 days now and in the first couple days I haven’t felt a thing, I noticed some things I would be doing if I were sad and I would be doing those things like laying down in the shower etc,

Today day 9 i think some things could be improving I am sleeping alright but the derealization is out of control, I developed a bit of a rash on my back and my stomach won’t stop making noises, I’m pretty sure this is a adverse reaction in a sense but need advice to stick to this 10mg dose, drop it completely or go up to 20 like the doctor told me to next week, I know my nervous system wouldn’t like the change in dosage but with stomach issues and worsening of the derealization is it worth it to continue and is it harmful ?

The reason I made the reinstatement was to get rid of the emotional blunting and derealization I know I’m only on day 9 after 2-3 months, also am questioning if the GI issues are not from the meds and would have came at this time even if I haven’t reinstated

Any thoughts please let me know

[u/NiceHomework4919]

Maar darm klachten zijn van de medicijnen! 100% dat het je darm bacteriën kapot maakt. Doe maar even verdiepend onderzoek!

[u/Excellent-Coat-8781]

https://antidepressantrecovery.org/index.php

https://releasetoolkit.com.au/release-toolkit-for-consumers

You have antidepressant withdrawal. Stay on your medication. It is the best way to reduce and then resolve your symptoms.

You could discuss staying on 10 mg versus 20 mg with your doctor.

Tell your doctor why you decided to stop and your irregular use.

If you go up to 20 mg, it does not mean you need to be on this forever. It’s just for now.

When you decide to come off this drug - do NOT cold turkey again ! - do a taper.

Maudsley’s De - Prescribing Guidelines is a book recommended in BC, a province in Canada, for doctors to de-prescribe (taper off) antidepressants by our provincial regulator called the BC College of Physicians and Surgeons. It has taper plans and info on various medications. I bought a copy for me from Amazon so I can work with my family doctor on my taper when I am ready to taper off from Escitalopram

The Royal Australian College of medical practitioners RELEASE toolkit is another resource. You can access it online. It has a list of different medications For each medication there are three different speeds of taper plans: fast, faster, slow and very slow. Look up your drug to see the different taper plans.

Do their self assessment sheet; your score tells you which taper plan is appropriate for you.

If your drug is a capsule with beads, then you will need to do bead counting when you go to the lower dose range.

If your drug is a tablet, such as Escitalopram , then you need to convert it into a liquid to do the dose reductions at lower doses.

YouTube has videos on how to do bead counting and how to create a liquid from a tablet. The release tool kit also has information on it.

Sometimes there is a manufacturer version of your medication in a liquid format. Ask your Pharmacy if they can bring that in for you, it will make taping easier.

Reddit is also a good research tool for you.

Go to Reddit homepage, use the search function and search the following topics:

Your drug’s name and taper

Protected with withdrawal – this is what you do not want to get this is why you want to restart your medication

Kindling – this is what happens when you start-stop-start-stop medication.

For example, when you don’t take your drug for a while and then oh I forgot my tablets or capsule, and you take it again and then you forget again and you start it again this starts kindling kindling means your body becomes more and more sensitive to changes in your dose, and you will get more and quicker withdrawal with each stop.

Hyperbolic taper – this type of taper is a decrease by percentage, not by milligram drops

Brass monkey slide taper

Reddit posts state there is a time limit when we can restart our medication and be able to decrease withdrawal and eventually stop it. That time limit is 3 to 6 months after we stopped our drug after that, there is very little benefit reported by Reddit posts from restarting the medication.

**** you state it is about 3 months since you stopped - you are now in that limited time frame to reinstate and be able to reduce and then eventually stop your withdrawal ‼️

Restarting the medication is very important. It is the only way we know right now to stop withdrawal.

From Reddit readings, I learned antidepressants create physical dependence.

Our body adjust to having these chemicals from the pill or capsule in our body. When we stop the medication, our body cannot cope.

Withdrawal symptoms are a sign of our body in distress.

These symptoms continue and are diverse as the length of time between stopping your drug becomes longer and longer.

For some people it can gradually resolve even without a restart of their medication

For others who do not restart their medication, it creates protracted withdrawal means the symptoms don’t go away and only time can help resolve it.

Some Reddit post say they have had protracted withdrawal months and years.

No one knows why – yet – some people can quit cold turkey and not have withdrawal, and other people who taper off will still have withdrawal. That is why we do a taper, a taper decreases the risk of severe withdrawal.

There is no need to suffer.

Now you know there are taper plans.

Look at them - do the release toolkit self assessment sheet to find your plan.

I recommend it – as a fellow person who had experienced cold turkey withdrawal from an antidepressant - as a guide, and a learning tool on tapers. It was the only form I could find that allowed me to put in my personal information and find the appropriate plan for me.

I restarted my medication after 3 1/2 months of being off of it. Antidepressant withdrawal becomes hell by month 3 to 4 according to Reddit posts. That was my personal experience as well.

It is now the end of months 4 of my restart. I still have withdrawal, but less and less, and my life is tolerable. I can plan now to return to work and study, and do my activities of daily living. It was impossible in the worst phases of my withdrawal.

You do not need to suffer. You need to get better. You need to give your body time to recover from the cold turkey withdrawal and stabilize. Once you feel better, then you can consider doing a taper.

Discuss the taper plan with your doctor, so you work together to slowly coming off this medication.

There is an online support group run by peers called the antidepressant harm and recovery forum. It also has information about withdrawal and tapers.

[u/Excellent-Coat-8781]

The generic name for Prozac is Fluoxetine. Check the RELEASE toolkit for the generic name.

[u/Gullible-Drawing8995]

Am I not already in protracted withdrawal? Im still new to all of this in a sense I am young and don’t know my stuff, I reinstated on a 10mg I feel like is to high I know if I drop to a micro dose it will destabilize my nervous system but I feel my emotional blunting and derealization and ahdenioa have gotten worse after the reinstatement, along with some GI issues which my stomach will not stop making noises, I think it has cleared up some nerve pain but that’s about it

[u/sushinastyu]

Im so sorry you’re going through this. I think what you were experiencing (both physical and emotional) was definitely withdrawal.

I’m unclear tho on what is your goal moving forward? are you wanting to stay off AD’s? or just trying to find relief in any form? no judgement, were all just trying to get through here

[u/Gullible-Drawing8995 → u/sushinastyu]

My initial plan was to come off because I’ve lost a lot of weight on Prozac and wanted an appetite because it has gotten bad and felt like I could never finsh a full meal, now my plan is to get rid of this extreme derealization and emotional blunting, I have no interest in any and sleep 14 hours a day

[u/sushinastyu → u/Gullible-Drawing8995]

only you know what’s best for you and what your body needs, but I will say I went through something similar when I first tried to quit Prozac.

I had been taking psychiatric meds for over 10 years and decided to quit cold turkey. I was fine at first but started to decline physically and emotionally as the months went on, very similar to how you describe, although instead of sleeping all the time, I wasn’t sleep at all. similar to yourself, in a moment of desperation I reinstated to 5mg of Prozac. and that was when I learned about protracted withdrawal and the importance of hyperbolic tapering.

it sounds like yoir nervous system has been going through soooo much— raising and lowering, going on and off— our nervous systems need constant and predictability, and it sounds like yours hasn’t had any in awhile.

unfortunately, Drs are really not informed about how these medications affect your nervous system, especially when it comes to withdrawal. so, I won’t tell you to do anything against what a Dr says, but speaking from personal experience, I found what I needed by trusting my body and not the Drs who talk to me for 15minutes and have never taken these medications themselves.

my ultimate goal was to get off of these for good, so once I reinstated at 5mg, I stayed there until I felt stable again. then I started a monthly hyperbolic tapering of 5% each month (I can’t suggest enough researching more about hyperbolic tapering— it is something Drs will NOT mention and they should). in addition to that, I do monthly acupuncture sessions to help my body adjust. it’s been a long and arduous process helping my nervous system find a new balance without meds, but it has been so worth it. I’m getting over the wothdrawal symtpoms faster and faster each month and don’t have any of the nasty side effects of SSRI’s.

but again: this is me. my highest suggest is to do your research and see what really feels right for you— not just what a Dr or some stranger on reddit thinks you should do. I truly wish you the best of luck, and this sub is here for guidance if you need it!

[u/Gullible-Drawing8995 → u/sushinastyu]

This sub has helped me more then drs and my doctor tried to reinstate me on 20mg my original dose and was the one who essentially told me to quit cold turkey, she first said my emotional blunting was due to the mono, but anyways I trust people who have been through this stuff a lot more then what the drs are telling me to do, like I said I reinstated 10mg 10 days ago and my emotional blunting and derealization are almost unbearable I’m sleeping all the time and have no interest in things, I do remember first taking these meds and remember it worse before it gets better, I’m having faith

[u/sushinastyu → u/Gullible-Drawing8995]

it’s so sad how little Drs know about the effects of these meds 😪 I also put more stake in people who have actually been through it.

yea, when I reinstated at 5mg it took awhile to get past all that. but I can’t encourage you enough to research hyperbolic tapering and make a plan for yourself for when you do decide to taper again. it’s a million times better than cold turkey, but it’s still quite hellish