Managing SSRI Withdrawal: Another Way

Print Friendly, PDF & Email
November 4, 2020 | 42 Comments

Comments

  1. This is a great post in so many ways.

    This is such an exciting development, getting in to the nitty-gritty as to hows and whys of antidepressant actions and the potential of plant derived TRP agonists for severe withdrawal and possible Akathisia

    David finding an Engineer –

    I can attest to stopping an SSRI and the ‘crippling’ withdrawal taking a few weeks to manifest –

    I have always wanted to know why all this happened: medically, scientifically, pharmacologically.

    J taking us through his withdrawal experiences and him looking at it realistically is a real boost and has enormous research possibilities for those of us who were blindly taken up alleys.

    I think J is really on to something and if I describe briefly, it might help J with his research and J has really thought this through – bear with me in trying to piece together the puzzles

    In 2002 it took 6/7 weeks off Seroxat for the withdrawal to become completely unmanageable –

    A few days after dropping from 20mg the brain zaps started, then my brain feeling like it was floating around and lurching from side to side in my head, then the continued breaking down in a torrent of tears and distress, then the nightmares, and so many other symptoms that I couldn’t function at all and made the worst mistake possible, I restarted it.

    Then I was consumed with a physical energy that was horrific.
    I too was given Diazepam, in a mental hospital which seemed to settle me somewhat.
    However, with no Diazepam in my system when I drove home, vivid thoughts of extinguishing myself became very real and within three days I found myself acting out on hallucinations.

    Given Diazepam in another hospital and gasping for Seroxat, my system settled down very quickly.

    In 2003, I now had to reduce from 40mg.
    The plan from a hospital pharmacist was year-long with Paroxetine liquid.

    I am describing this as you are about to use liquid Sertraline and I wouldn’t want you to go through what happened next.

    I was back in the world of 2002, with the last remaining mls.
    The doctor refused me Diazepam and I was a complete mess of physical and mental collapse.
    I had to force him to give me Diazepam and he wrote out a disclaimer in my notes for me to sign.

    Month after month, I was bed-bound slowly becoming a vegetable. Anorexia, spasms and jerks, a dissociated state. If my mother had not been staying with us, I would gradually have declined to such an extent that my then five stone self would have succumbed to bodily failure.

    There were no additional pills in 2003 as in 2002, the Diazepam, Lorazepam, Librium and Propanolol.
    I was abandoned and neglected medically despite constant calls to the doctors.
    The surgery was a mere one and a half miles from my home down a country road.

    But it happened. Slowly, slowly, slowly I began to recover due to the loving care of my mother.
    Not one drug had passed my way since the liquid, thankfully.
    If they had thrown all the drugs at me and I had gone down that route again, I could have been locked in for years –

    As you sound totally tuned in to yourself, please watch yourself as you administer the last of the liquid.

    All the supplements you suggest sound well-rounded and natural and I am quite persuaded that these could have helped me during months of severe decline when my body was getting no nutrients and nothing to feed on.

    Instead a slow poisoning was taking place with absolutely nothing to stop it –

    We haven’t delved too much in to Ion Channels and the effects from antidepressants but it is clearly something we should know about. After all, the manufacturers must have done some work in this area and I have always wanted to know why they work in the way they do and it is great that you as an engineer with great thinking skills are well-placed to take us along.

    Just been reading up a bit for some background ‘ion channels as targets of psychopharmacological drug action’

    https://www.chegg.com/flashcards/chapter-3-ion-channels-as-targets-of-psychopharmacological-drug-action-1a8bdc1f-c885-4833-9375-e8486537be4e/deck

    Thank you J for further steps forward in our understandings of the mechanisms of antidepressants and how they affect so many of us.

      • I have been on 100mg of Setraline a day for 12 years. I decided for many reasons that I have had enough. I did a little research and read about gaba and it’s effects on the brain. I purchased some gummies which took the edge off but what I found to be really useful was valarium. A 300mg dose was enough too really lesson the symptoms of discontinuation. I take a 400mg at night. The brain zaps are quieter and less frequent and I feel able to concentrate. I am only on day nine of discontinuation and I know I have a way to go but now I believe I can make it through.

  2. What an excellent post. My word, J, you certainly have been busy and have managed to present your work in such an easy-to-read manner. I won’t pretend that I know exactly what you’re talking about – ‘ion channels’ etc. are double Dutch to me! However, by the time I’d finished reading I did feel that everything you’d said did make sense. I haven’t ever taken these kinds of drugs but I have watched my son go through severe problems on, and in withdrawing from, prescribed psychiatric drugs over the past good few years. Many of your comments would also apply to his problems.
    It is wonderful to have this piece, written from different perspectives, all happening in the one person. You have suffered on the drugs that you were prescribed, you have researched into the possible causes of your suffering and then found ways of, possibly, supporting yourself and making withdrawal easier. You have bravely personally tested your findings and found some relief from their use – and now you are sharing all of this with as many sufferers as may read it here.
    All of that plus using your engineering background to support the search for a better understanding of PSSD etc. What a fantastic stride forward this could turn out to be. I sincerely hope that being involved in all that you have been doing has, in its own way, helped you with your own struggle too. Thank you for sharing your story so far.

  3. Think that this is a very promising way to approach your next withdrawal.
    I can certainly appreciate the concern of taking too many at once. When I was experimenting with supplements for my ME/CFS, much time was spent balancing my desire to keep adding something new vis my gut feeling to err on the side of caution. Still, it is worth remembering to try everything in turn (even writing out a protocol, as I found my memory became over loaded with things to remember), (I borrowed ideas to, of how to keep track of my progress, from looking at my Linux Error Log files, etc). My rational for trying everything eventually, was firmed up by experience and the disappointment, that what works for some people doesn’t work for all – and some of my first choices were not efficacious as claimed by others. So I will add to you list another TRPM8 Antagonist Rhodiola rosea, which has been recommended by many for aiding withdrawals. The Journal of the American Botanical Council reported on 180 studies done on Rhodiola Rosea and lists more indications than under the European ‘Tradition Herbal Registration’. [1] Of course there are many more which I expect you will mention in due time.

    Now that gut microbiota is being more widely accepted for its ability to affect the mind, I noticed a paper published this year where children in standard urban and nature-oriented daycare centres were analysed for comparison. Obviously, the later developed a more divers biome and better immunity. [2] Whilst Mikhaila Peterson has posted a video demonstrating exactly how she did her own fecal microbiome transplants. Many people with mental health issues find gardening beneficial, I wonder if this is an overlooked part of the reason?

    In western medicine the paradigm is ‘one drug one disease’ and the more conditions one has the more drugs one gets put on. The Traditional Chines approach appears to focus on aiding the return of good haemostasis by prescribing a combination of herbs, so allowing the body to get on with the job of healing itself, which seems to me, similar to what is being proposed here. Good luck.

    [1] Rhodiola Rosea article with references to studies. https://nootropicsexpert.com/rhodiola-rosea/#_edn1

    [2] Biodiversity intervention enhances immune regulation and health-associated commensal microbiota among daycare children https://advances.sciencemag.org/content/6/42/eaba2578?elqTrackId=a9f74176dd194ccc80e22d48d567cc9b

  4. Be very careful when adding in supplements, I read a paper which demonstrated that Ginko Biloba, Rhodesa Root, Milk Thistle, Ginseng showed a statistically significant increase of inducing serotonin syndrome when combined with an ssri. L-Tyrosine can appear to improve things to begin with but further downstream this can induce hyperthyroidism which nobody wants on top of protracted withdrawal. Being a bit paranoid and asking a few questions is a good thing sometimes.

  5. J I think the way you have tackled the research is awesome. I simply don’t have the ability to follow the science but have read other suggestions about use of supplements which don’t give the reasons as you have explained If your findings can be ‘condensed’ into s what individuals could take according to their own situation that would be great even if it doesn’t lead to a total cure for everyone (We have learned to be cautious as you’ll know too well).. Looking forward to your next post.
    A thanks for your link to the cards – they are really useful for me

  6. Below is a large industrial tape winding machine, it is not unreasonable to imagine that a water soluable ssri infused 1mg/cm tapering tape might be produced.  A day vs length App could tell someone who wants to taper how much tape to dissolve in water each morning.  The App just follows the hyperbolic dose reduction curve and displays a daily length in mm to cut from the roll.

    https://youtu.be/iaa7-uKcUWg

    Here a fella builds a simple Arduino driven bobbin winding machine, a similar device could produce rolls of ssri tapering tape.

    https://youtu.be/kGyuscK9GaA

    • I thought I might try this supplement which has alot of component herbs I have not looked into. It has produced splitting headaches and even my teeth began to sting. There are many composite powder supplements like this one, I would be inclined to avoid them. It is wise to add single component supplements to a regime one at a time and give it a few weeks to see if it has been helpful. I would avoid this one now. I’m not going to make a Cup-a-soup with this one again, I’ll add it to groundbait when I go out fishing it won’t go to waste.

      https://www.amazon.co.uk/Wisdom-Supplements-Hemp-More-Supplement/dp/B087YN52GW

    • Certainly plenty of food for thought here. Next requirement could be a prototype of something that could measure the individual’s absorption of the drug so that it could indicate at what rate it was safe to reduce ( as in dose strength or time needed before further reduction). The “hyperbolic dose reduction curve” would not necessarily show an individual’s safe rate of reduction surely?

      • I think a try it and see curve is the only reasonable idea, if the dose reductionnis too steep you can back up and adjust curve parameters to make it shallower. It is impossible to know parameters for a perfect tapering curve for every individual before they taper.

        This paper is super interesting it suggests it is possible to objectively measure what is going on in ion channels using non invasive methods.  It might be useful to do something like this to see if ion channel agonist compounds have improved things.  The easy way to assess improvement in say ssri protracted withdrawals is just to ask patients about there subjective experiences though this non invasive profiling idea seems very science fiction.  I think having something like this for every person who tapers is a little bit unrealistic.

        https://www.sciencedirect.com/science/article/pii/S1053811915007788

        • I totally agree that withdrawal should be at the person’s speed and their word should be accepted – they each know their own body better than anyone else. Many doctors have difficulty in accepting this and tend to impose their idea of ‘slow withdrawal’ – if they can get away with it! It takes a very strong ‘withdrawer’ to disagree with the very person responsible for prescribing the medication in the first place. Even amongst people who reduce, speed of withdrawal can vary a vast amount. In my opinion, this fact, be it through liquid form or tapering strips of the medication, HAS to be widely accepted. The “Try my way and if you fail we can increase the dose again” can lead to a very slippery slope.

          • My feeling is a water soluable pva ssri infused tape would provide anyone who wants to taper from any ssri with enormous safe tapering flexibility which is just what you want I think. Having to fiddle around with syringes and liquids every morning isn’t the best tapering tool for a patient.

  7. Im afraid i do not follow, how are you or we going to use plant compound supplements, you want us to self experiment? Surely all of these supplements have been tried before.

    • Daniel

      No one has an answer to this. The post is one person’s effort to find what helps him and let others know rather than trying to set himself up as a guru or biohacker offering to cure you or others. We need to know what bits of this combination work for people other than J and what bits don’t or whether there are other things that help. J’s research looked at TRP receptors and herbs or other things that act on them and you and others need to do some research on these and see if anything jumps out at you.

      The acid test for J will be whether some combination enables him to get fully off the SSRI he is currently on

      David

  8. Later I’m going to try and regenerate my entire physiology like Dr. WHO or a Planarian Flatworm. If I think hard enough I’m sure that will definitely happen. Following my successful regeneration I am sure I will feel alot better.

  9. I love that you mention Sulforaphane. It seems to have so many benefits. Joe Rogan interviewed Dr. Ronda Patrick where she goes into detail about a lot of the benefits and research behind sulforaphane. Sprouting your own broccoli seeds is not difficult.
    https://youtu.be/2Yh4fjOFfDo

  10. I found I was unable to deal with all the nonsense that goes down driving on the roads so I decided it was wise for me to stop driving.  You get told not to drive after a general anesthetic but no such advice is given to those with ssri protracted withdrawals.  I think the dissemination of such advice might be wise.

    The sooner everyone has self driving vehicles the better I think.

    https://youtu.be/v8q0Z_veRg0

  11. We want to get some control over our symptoms so look for data that tells you what supplements will do that.  Homeostasis is alot like Biological Control Theory.

    https://www.spiraxsarco.com/learn-about-steam/basic-control-theory/basic-control-theory

    This is a good example of applied control theory, these rocket things use inertial navigation to sense changes which allows actuators to be adjusted to make trajectory alterations.

    https://youtu.be/WR7B3re23og

    Homeostasis is the Biological equivalent.

    https://en.m.wikipedia.org/wiki/Homeostasis

  12. Is reinstatement advised for someone who has been off an SSRI for 9 weeks and has experienced withdrawals for 7, mainly insomnia, headache and waves of depression/anxiety? The full term of SSRI usage was just under 6 months

    • I personally wouldn’t reinstate but no-one knows what underpins SSRI withdrawal so no-one can tell you for sure

      D

  13. Is there typically a correlation between duration on the medication and recovery term? Symptoms during waves are debilitating and interfere with all daily activities. Only mild side effects were noticed on lexapro when dosage was raised from 10mg to 20mg due to miscommunication with the prescribing doctor. A stabilized continuous usage at a lower dose would be preferred over another tapering attempt as well.

    • You can have problems for the rest of your life from a few weeks of pills. That said its the close to physical work you put in to as it were reconnect the bits of your body that are more likely to help make life comfortable than returning to another SSRI – but its your call

      D

  14. I discovered valerian’s counteracting of SSRI cessation by accident. I usually make a valerian chamomile tea with one teaspoon of ground dried valerian root from a health food store per pot for insomnia. I had this before bedtime because I was having SSRI withdrawal after quitting citalopram 20mg/d… ie flu-like symptoms, strong electric-like twinges, poor coordination and of course the insomnia. It took all of those symptoms away and the effect lasts through the day. Valerian is fantastic stuff.

    I found this via Google as I was curious if anyone else had noticed this and/or research the biochemical pathways responsible. Thank you!

  15. Every time I go out to pick up groceries this sort of thing happens to me and I nearly fall over just like R2D2 the celebrity robot.  Plus I have the palinopsia now so the last time someone asked how long have you been seeing your new doctor I said about 30 minutes after I stopped looking at her.  The hyperhidrosis is going to get embarrassing soon as we transition into Summer although I take Sage and other things which had evidence to diminish that, I’m like a walking lawn sprinkler which is a rubbish super power. There is unlikely to be a popular film franchise about Lawn Spinkler Man but I might find utility in a garden center or plant nursery.   I found a forum with people discussing visual snow and palinopsia to diminish these visual disturbances it was suggested that Vitamin D3 8000 iu, Magnesium Glycinate, 20mg Boron and Vitamin K2 MK4 worked.  I have not yet tried adding Boron and Vitamin K2 MK4 but I might do that to see if it ameliorate the palinopsia. Sometimes withdrawal symptoms make you feel like you are being mugged by an invisible assailant every day which nobody wants in their life.

    https://youtu.be/geD8HxtQ_lY

    I’m thinking if I could replace my brain with something more reliable like a cpu laid out on breadboards.  This is a fun educational exercise but as you can get a micro like this on a 2mm square surface mount device these days it isn’t practical for embedded systems development.  There are probably small micros in your toaster, microwave oven and washing machine these days they get almost everywhere as they are very useful devices. I think this breadboarding of cpus is very cool even if it has no real utility.

    https://youtu.be/DLajNGYMC2o

  16. It became clear to me that those who are suffering from ssri protracted withdrawal symptoms would be likely to return to their GP for further guidance. I decided this isn’t always wise and can lead someone onto a dangerous path of further medications that will make matters worse. Managing withdrawals symptoms using herbal anxiolytics works well enough for me. I would suggest it would be quite foolish to accept a prescription for an antipsychotic to ameliorate withdrawals symptoms. My feeling is it is very likely that in many peoples withdrawal symtoms could be interpreted as a bipolar type illness which would lead one down a dangerous path. My suggestion to use herbal anxiolytics such as Valerin Root should keep people on a safer path during tapering from an ssri. Withdrawals symptoms should never be managed by feeding a patient antipsychotic drugs, I have seen that happening and the results for such further prescriptions are not good. Hopefully information like this will catch people with ssri withdrawals and make them reconsider returning to their trusted doctors/psychiatrist for withdrawals management advice. I had a worrying vision of many people in withdrawals states being fed dangerous antipsychotics.

  17. It appears quite evident to me that the symptoms that crop up in ssri withdrawals will significantly lower the threshold for burnout in those working in a demanding capacity such as doctors and nurses in Hospitals. I don’t think supplements will make any difference to this however they do make life alot more comfortable. In my experience I have no problem with thinking other than sometimes I appear to have racing thoughts, but physical activity is significantly curtailed due to fatigue and hyperhidrosis. For me life becomes alot more uncomfortable if I have to move around alot in a withdrawals condition. If we get a heatwave this summer I will want to stay indoors even more, I really couldn’t deal with the heat and it’s effects on me last summer. It is a good bet I will start to obsess about air conditioning later this year as I find the heat very oppressive. I have a Sage supplement already which should help reduce excessive sweating. I had a bit of a scout around for others which I don’t currently take I found reports that Schisandra Berry, Red Clover and Black Cohosh might help reduce the hyperhidrosis symptoms. I have not tried adding these supplements into my current regime. I might add in extra ones slowly to see if they improves matters. I have a worry that adding in too many things increases the odds of experiencing unintended side effects sometimes that could make things worse. Sometimes it is better to leave things as they are but you won’t know if you never try. I feel safer taking a bit of a risk adding in the occasional new supplement than I would approaching a doctor/psychiatrist for a synthetic drug solution.

  18. I have an unfortunate tendency to experience visions of bad things happening that might have ssri prescription as a cause. I probably have an overactive imagination already but the visions feel like real events and produce uncomfortable emotions in me. I have had a strong aversion to drinking alcohol for some time now only having the occasional beer. However because of the unnerving catatrophic visions I was having yesterday I bought 4 cans of brewdog beer in my local grocery store and drank it all, I had it in mind I would just have two and then stop but I drank them all. Later in my infinite wisdom I went back and bought 4 further cans thinking I would just have one more and keep the rest for another day which was wishful thinking as I drank all of those cans. Being drunk diminished the uncomfortable emotions. However I now take my daily supplement regime and it helps alot, adding in quite a bit of alcohol was not the best idea. As I sobered up later I felt nauseous but I wasn’t physically sick, I just felt bloody dreadful. Given my experience I would be strongly inclined to avoid drinking too much alcohol (over 2 pints of beer) if you are already taking quite a few supplements. At the time of consumption it feels great however the sobering up period was very unpleasant. My aversion to alcohol has been reinforced by yesterdays experince I won’t do it again. Brewdog beers are very nice but they don’t go well with supplements. So endeth todays lesson.

  19. I was curious to record ecg and sleep data so I could objectively observe if my use of various supplements had improved things. I have so far been able to see that my ecg data is much smoother with less rapid changes in heart rate than occurred previously and also my sleeping has obviously improved due to.taking a few herbal anxiolytics an hour or so before bedtime.

    I was curious to see what was going on with my ecg the morning after my ill advised drinking session when I felt really quite awful spending most of the morning in bed in a fetal position. The ecg data showed quite obvious anomalies cf data captured for previous days. There were two large ecg hills where my heart rate rose rapidly and stayed high for quite a some time, I had never observed this in my ecg data before. I decided these two ecg humps correlated with my subjective experience of feeling dreadful. I hadn’t felt like drinking beer for ages but my theory is as I slept very badly on Friday night which is evident from the data I felt extra grumpy and thought beer might diminish that. Beer does diminish a bad mood for a time which is great but I decided that on balance the distressing after effects that followed my drinking significantly outweighed the good that was produced during drinking. I’ve decided drinking whilst on supplements is not very wise. I think having one or two cans now and then might be ok but probably don’t drink 8 even if it is a very nice beer.

    I found quite a few papers which explained to me how the ethanol in my Beer occupies the pores in a variety of ion channels for a few hours. Ethanol does not bind strongly to the pores and is pushed out quite quickly which is just as well if you think about it. I do not understand why ethanol binds weakly to an ion channel pore whereas other chemicals seem to bind very strongly and are thus not easily displaced. I want to understand the physical mechanism which leads certain chemicals to remain strongly bound to a pore permanently altering it’s operation.

  20. I can report that I have got my sleep sorted out so there isn’t a problem there. It is just the times when I am awake that still appear to be a bit of an endurance test currently. I find mornings to be the worst times I take supplements in the morning and with lunch which appear to make afternoons much more comfortable for me. I’m not a morning person I tend to be a bit moody and irritable still. I take some sleeping anxiolytic herbs with my dinner and those work very well. I will just wait a bit before I taper off further probably at a reduced rate each week as from what I understand I can expect things to get more difficult approaching 0mg. I still don’t feel ready to go back to work really as I would get myself in trouble.

Leave a Reply to annie