Coming off SSRIs

Cold turkey or gradual?

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06/02/2011 at 07:14

Fluoxetine (prozac) specifically.

I've been taking it since late October, and it may or may not have helped with the depression, but I haven't had more than 2 decent nights' sleep since I started taking it.   Okay, my sleep pattern was pretty crap to start with, but this has completely destroyed it.  I'm up at 2 or 3am every night, sometimes get back off for an hour about 5ish, but it's gone on so long I'm no longer functioning, so the pills have got to go.

There were mixed views on the depression thread a couple of months back.  Some said gradual withdrawal, some said cold turkey had been fine. The GP says cold turkey "shouldn't" present any problems, but.....

Anyone done it and if so how did you find it?

kittenkat    pirate
06/02/2011 at 07:28
Cold turkey was ok for me, but then I hated Fluoxetine anyway. Are you getting any other help except medication for the depression Hash?
06/02/2011 at 08:28
We always recommend weaning off, Hash, rather than going cold turkey.
06/02/2011 at 08:36

Cheers Slugsta

Red wine and beer kk.

Seriously though, enough of the pills. Option 2 is the sort that dope you down, which I really don't fancy and I think I'll do better with running and just trying to think more positively.  Also I thought I might give meditation a bash.

06/02/2011 at 10:25
When i came off them i had the shakes and headaches, i was slowly reducing the amount i took. I have'nt taken them for a few years now. Have you tried the natural alternatives? My mum used St johns wort for some time and found it helped and i have been taking something called 5HTP for a while now, no side effects and for mild to moderate depression it might be worth a try. Hope you feel better and keep smiling even if you feel like crying!!  x
06/02/2011 at 10:47
Slugsta wrote (see)
We always recommend weaning off, Hash, rather than going cold turkey.

i second this Hash, any SSRI,s or MAOI,s are better with titration down over a period of time. neednt be a long time.. just better this way than a total halt.
06/02/2011 at 10:53

Hash - is the beer and wine comment a complete joke? Only if you are drinking, even in moderation, and are having trouble sleeping then I'd suggest that you give up ALL alcohol before anything else. A glass of wine may make you sleepy at the time you are drinking it, but alcohol is renowned for messing up sleep patterns.

I think your doc is the best judge of how you come off the a/d's as he/she knows more about you and the dosage you have been using.
I had more trouble swapping between different drugs in the search for the appropriate one than I did in coming off them completely when I felt the time was right.

I don't think 6  months is a fair trial of a/d's if your depression is still an issue. Maybe you should try a different drug?

Good luck. Sleep deprivation is the pits.

06/02/2011 at 11:11
I don't think there's a simple answer to your question, I think the effects of coming off SSRIs varies between people, much as whether they work or not varies between people.  I have had treatment with fluoxetine a few times and citalopram once.  I have come straight off fluoxetine every time, and had no problems at all, but I found that citalopram made me really agitated and I had to taper the dose over a couple of weeks.
ejc
06/02/2011 at 12:12
Vicky Pea wrote (see)
I don't think there's a simple answer to your question, I think the effects of coming off SSRIs varies between people, much as whether they work or not varies between people. 


+1

Speak with whoever gave you the prescription (your GP?). They might want to monitor you as you taper down. 

06/02/2011 at 16:28

Thanks for the replies, all.  I really don't know what to do - the way I felt when I walked into the surgery in October was waaaay better than how I feel now after three months of almost total sleep deprivation, at least I could function in my job with depression.

I just remember the hideous, chemical induced anxiety from fluoxetine in the first couple of weeks of taking it.  Part of me thinks tapering is the way forward, part of me wishes I'd never taken one in the first place so don't touch them any more.

Shoplady I can't take St John's Wort as I'm on the pill for oestrogen in place of HRT, but otherwise I definitely would do, it used to work a treat with no side effects.

06/02/2011 at 17:25
I'm sure your GP wouldn't advise that you stay on fluoxetine if it's making you feel worse instead of better.  They may suggest stopping and seeing how you feel without any tablets, or changing to a different one.  If they suggest tapering off it'll only be a matter of a couple of weeks of taking a tablet every other day or something.
Good luck
06/02/2011 at 17:40

Thanks Vicky.  It's amazing how many runners are in the same boat, considering exercise is supposely a cure-all for depression!

The GP said cold turkey should be fine Vicky.  But then that's the same GP who said he doesn't like HRT on principle.

06/02/2011 at 17:42
id echo liasie wit the gp. maybe they may want to keep you on some form of meds but change them? a friend had massive probs with fluxotine and when he changed to citilopram all was rosey. different types suit different people.
06/02/2011 at 17:45
Hash. wrote (see)

Thanks Vicky.  It's amazing how many runners are in the same boat, considering exercise is supposely a cure-all for depression!

It is isn't it?  For me, running helps me keep my head above water. I'm sure I would get more severely depressed, and more often, without exercise.
06/02/2011 at 22:24
I too did'nt do the St johns wort due to the side effects that it can have with the pill, but the 5HTP does'nt interfere with the pill and so that is what i use, it might be worth giving it a try. I order it online as its much cheaper and i take 100mg each day as i found 50mg did not do much. I found exercising made no difference in my moods but did help me to sleep better. x
06/02/2011 at 22:35

I think running does help with mild depression but it also gives one a big stick to beat themselves with (when the running goes wrong / is missed etc).

This probably flies in the face of good advice Hash, but I dropped straight off a long term, high dose of a/d's. I didn't have any side effects that I was aware of, but my family may tell a different story!

You sound as though you don't have a totally perfect relationship with your GP?
Maybe a new GP and a new look at your depression / sleep problems is this week's priority?

Meanwhile sleep when you can if you can't do it when you 'should'.

xxxx

07/02/2011 at 02:36

If its any help, I used to be on Seroxat which is an SSRI. Seroxat (or otherwise known as Paroxtine) has a bit of a history- google it. you'll see what I mean! It wasn't something I wanted to be on because it wasn't working that much and I don't like taking pills for no reason, then I saw the headlines and the idea that this drug had not been properly researched, that at 18 I had been prescribed it yet the new findings had banned it for people under 18 years freaked me out. So I decided to drop it probably for the wrong reasons, eg fear rather then if it had been doing anything at all.

 I knew there were side effects so I cut back from 40mls to zero over 9 months. After this, 2 months later I landed myself a stay in a psychiatric hospital. I wanted to kill myself, the depression and anxiety had been creaping up over the past few months and some news knocked me off my balance, I was unable to cope. I went back on to the pills soon after my stay.

I had another hack at trying to come off the pills again over 18 months- managed this time but it was a 20mg drop to zero over this time period so much much slower and it seems to have been do-able. I am by no means cured, I still battle with my moods, depression/anxiety and etc but I still see a psychotherpist (had seen one throughout) and really rate this for helping with things, pills just were not doing it for me and if anything left me feeling disorientated as I would feel out of sorts, or hyper or randomly fine when things that normally would have bothered me didn't. People had killed themselves on this drug, killed others in random bouts of rage when they had been previously described as pacafists, I don't trust myself not to flip out, jump out a window or take an OD, this drug did not leave me feeling safe, I had no reason to believe it would affect me in the way it affected others but I'd bet they felt the same way originally too.

07/02/2011 at 06:55

Jennn that sounds absolutely hellish, what a horrible thing to go through. A friend of mine was also on seroxat a few years ago and said the same about coming off it - it completely messed him up.  He knew what he was feeling was chemically induced, but it didn't make it any less real when he was experiencing it. Glad you managed to get away from it, but sorry to hear you're still battling with the depression.  

I noticed the time you posted that.....   Hope you managed to get back to sleep again.

limper wrote (see)

Meanwhile sleep when you can if you can't do it when you 'should'.


Hear hear Limper
Edited: 07/02/2011 at 07:03
07/02/2011 at 13:27
Ive been trying and failing for years to get off seroxat.In my humble opinion they should never have been licensed.They helped with the anxiety,but given the choice again i would refuse them.
07/02/2011 at 17:35
I was prescribed Seroxat for post-natal depression about 14 years ago and as it had zero positive effect on me after 4 weeks, I was switched to fluoxetine.  I'm relieved that I stopped Seroxat, given the bad experiences so many people have had on it. I'm surprised it hasn't been withdrawn.
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