I know this post is from 9 years ago but I just read it today and it was very helpful to me!
I hope that you are doing well in your life and are happy.
I have weaned myself off of Celexa, after SSRI's for 18 years. The side effects of Celexa - interuption of sleep - got to be too much to bear. Fatigue is my main problem now. I sleep way better off of SSRI's. Next is to wean down the coffee. I'm 55 years old and starting to have some health problems and want to get a baseline to figure out what the cause of the fatigue is. (I also did shift work for decades, so that burned me out too.) I am having some recurrence of the depression, but there are many losses for me to deal with in my life and I'm in counseling and doing meditation to cope.
Specifically, your suggestion of the spreadsheet seems brilliant! There are so many things related to mood, that I know it will help me to separate out the fatigue and mood stuff. I have a new psychiatrist, so this might help communicate things to him.
Hi all :)
I am new to the forum but old to SSRI use I guess. I have been on 3 different SSRIs. Started with Prozac, the second I can't remember just now, the third and current is Celexa which I have found the best. All in all, about 10 years on the SSRI drugs. Just now I am about 6 weeks into reducing my current dose of 40mg down to zero, if it is feasible. The originating causes of the depression are no longer there so I figure I will see if it is possible to get off the meds. I have a medical and auditing background so have found what I can on SSRI discontinuation syndrome. Information is only part of what I need to make this possible, the other part is real life experience, as I see here on these forums. I hope, with your help, I can do this thing.
Research seems to show the discontinuation symptoms kick in about 2-3 days after dropping the dosage, and last (if you are lucky) for a week or so. Depression symptoms, if they recur are likely 3 weeks after the dosage drop. Having been around depression for so long I feel like I know the symptoms, both of overdose and underdose of meds and depression symptoms. Can be tricky to work out whether waking up in the middle of the night is due to which of these 3, but I figure I am good with it now. I know how sneaky the depression can be in infiltrating your thinking - to that end I have made myself up an Xcel spreadsheet with 10 things that affect my mood - family, money, sleep, social life etc. as well as a general mood indictior. That way, if my mood is out of the ordinary down I can check if there is any logical reason for it or just depression coming in.
Additionally I have listed all the usual symptoms of SSRI withdrawal and log them as they occur. Helps know that I am not actually unwell. Today's ones are chills, sleepiness, mild headache, slurred speech and shoulder stiffness and aching.
I decided on an 8 month program to reduce my dose. 10 years is a long time on the drugs and 40mg a decent dose. First month 1.5 tablets was a big drop at 25% reduction (30mg) and the side-effects were okay but I would not want to have them worse. I am going down 1/4 tablet a month from here on down to wherever I can get to. So I have had 4 weeks at 30mg, currently just 1 week into the 25mg dose and getting moderate side-effects. No signs of depression coming back. Yay. Also very into Eckhart Tolle's books The New Earth and Power of Now. Best I have found for getting my thinking into shape.
There ya go. That is me. Thank you for being here. I appreciate you. Cheers!
Hi again Rahul
Thank you for the best wishes. I did talk with Mum the other day and let her know she was mentioned on a blog on a depression forum. She said the whole process of withdrawal sounds very daunting and that she wouldn't even try if she hadn't a good reason. In her case, the reason being the higher dosages linked to heart arrhythmia. She had moved back to 1 7/8 tablets (37.5mg) daily after she recognized increasing anxiety and agitation with no outside cause. I did think that getting to mood stability on 25% reduction of dosage (1 3/4 tablets) after 4 weeks was surprising so wasn't surprised that there were recognizable withdrawal symptoms. She is happy to leave it at that for a bit until the lower dose feels comfortable.
Rahul's path, which he shared with me in private message, was thought provoking and may have some similarities to others on the forum. With his permission partially reproduced here:
i've had no history of any mental disorder till age 35 (i'm 46 now). when i was 35, i started using xanax (0.5 mg) recreationally and developed an addiction but never increased my dose. 6 years later my doctor made me quit it cold turkey. i was not aware of benzodiazepine withdrawals (have become aware only in the last 2 weeks!!) and went into severe suicidal depression. after 2 weeks of suffering, the doctor diagnosed that i had a psychiatric illness and started an ssri (lexapro) and reinstated my xanax. i got OK. this year i started getting mild depression (tolerable) but revisited my doc and he increased my ssri dose (10 mg to 20 mg lex) and cut out xanax. again i went into severe withdrawals from xanax (benzodiazepine) exacerbated by the AD start up. meanwhile i searched the net and read about benzodiazepine withdrawals. then i had my doc reinstate my xanax. he made me cross over to chlordiazepoxide (another benzo with a longer half life) and i instantly became OK!
now my point is this. with the knowledge i have gathered in the last two weeks, i am now able to look back on my history and see how i have been misdiagnosed. the path ahead is to gradually taper from the benzo and then quit ssri. being on a benzo long term causes mild depression too (tolerance develops and you start suffering from mild withdrawal symptoms like depression) which explains why i felt depressed while still on the benzo and ssri.
Quite a few interesting things here. I was reminded of the story/song "there was an old woman who swallowed a fly, I don't know why she swallowed a fly" The song goes on to say she then swallowed a spider to catch the fly, bird, cat, dog, goat, cow and a horse all to try and catch what went down previously. With medications of any sort there is a danger that the medicines themselves, as Rahul says in his case, can cause a further issue which further medications are then prescribed to fix. So we have a benzodiazapine to fix the original problem (the fly) with a side effect profile which may have caused depression. In comes the SSRI (the spider).
Sequential use of medications can be an important treatment and diagnostic strategy (Dr Gregory House is a fairly extreme example of its use) and can also be very important when the initial drug is an essential treatment and the following drugs help with unavoidable side-effects. When it is not warranted it is called polypharmacy and is a big problem in the treatment of the elderly.
Which is not to say that it wasn't warranted in the clinical situation for Rahul. Just saying.
What it does mean is that it is sometimes much easier to just add a drug to the mix rather than fix the initiating cause. In the old woman's case I am amused to see that part of the song is "I don't know why she swallowed the fly". Perhaps if they had found out why she swallowed the fly the whole course of the song would have been changed.
The danger with adding drugs to fix other drugs is self evident. The next step might be more drugs to counteract any side-effects of the SSRIs. And the more drugs you add the more confusing logical treatment gets.
The other way it relates to Rahul's post he says he started the benzodiazapines recreationally. It somewhat implies we don't know why he swallowed the fly. The really fascinating thing about the human body is that as an organism it is very canny at finding ways to find nutrients it needs. Take the example below of the guy adrift in a boat for weeks (haven't been able to prove a hoax or real but a great example regardless)
"Not knowingly, but I watched something on TV about a man who was cast adrift in a life-boat for months, short of food he was forced to eat the Eyes of the Fish he managed to catch and ate these the last because they were so unpalatable. But after a while he began to like the taste so-much-so that he then ate these last because they were to him at the time a treat.
It turns out, after he was rescued that these Fish Eyes contain some nutrients or vitamins that his body (I think it was his Brain) needed to survive and were not available in any other part of the Fish he caught. In essence his Brain played a trick on him it forced him by means of a craving to eat these Fish Eyes in order to survive.
We like to think that we are in total control of our bodies but in a sense we only reside in these bodies ie the Brain, and to survive our bodies including our Brain can play all kinds of tricks on us to get what they want to survive even if it means eating what we would consider disgusting food.
The man by the way who is now well fed and fit again, now considers those Fish Eyes that he once craved for while adrift disgusting."
Pregnancy cravings and other strange eating behaviors are well documents. In my case, when I was a child I used to eat the leaves of one particular type of tree. Don't know why and I tried the leaves a few years ago and they are yuk.
So, for Rahul, its conceivable his body found the equivalent of fish eyes for him (The benzodiazapines work on the GABA neurotransmitters with a different action to the SSRIs). This is supported in that the benzodiazapines also seem to work effectively as Rahul says to "instantly become ok".
Here's one of the things about treatment of mood disorders. We are used to using drugs that fix the problem and then allow us to move on. For example, we get a bacterial infection, take antibiotics, most usually the bugs are killed, we stop antibiotics and move on without them. On occasion we might need to take them for an extended periods (few months) but the expectation is they will fix the bugs. If they don't the diagnosis goes deeper. Is there an immunity problem? Is there a hidden node of infection? Find the initiating cause and fix it is the essential goal. With the mood drugs I think we would all prefer we could do the same thing. Take them for a few months and fix the bugs, leave the drugs and get on with life. Unfortunately the drugs don't fix the initiating cause and stopping the drugs means whatever caused the mood disorder is then given free rein again. If whatever the initiating cause was is not removed and/or the damage to the factories (in my example) cannot be reversed then the mood disorder almost certainly will return.
So, swallowing spiders will not fix the swallowing flies disorder. The guy in the lifeboat fixed his initiating cause in that he got other foods which satisfied his nutritional needs and now he won't eat fish eyes. After the baby is born the cravings generally don't recur. I don't eat leaves off plants any more probably for the same reason as the lifeboat guy.
My question to Rahul then (and to all of us) is, before you come off the drugs, have you fixed the initiating cause? Perhaps supplementing with something with a lesser side-effect profile (other nutrients/supplements/foods) or compensating sufficiently (removing stress, exercise). If not, then reducing the dosage will probably get you back to square one and needing the drug again for the same reasons as before.
Hard to argue that if nothing changes, nothing changes.
Maths equation: Situation + 0 = Situation
All has a purpose I guess. I have always found it hard to see when you are in the middle of it.
Consider that perhaps your detox is progressing too rapidly, a common problem in the medical field as they themselves have not experienced it. And no, this is not an easy process, too many variables. We can only be true to ourselves and our symptoms. If I can give you any advise, stick with the Med profession for your answers in these matters and if you pDr. doesn't address your needs, find another...