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This page is so under construction. Consider it a placeholder. Here’s the best article I’ve seen on SSRI/SNRI discontinuation. I’ll be
stealing as much as I dare from it using that article as a key resource when I get off my lazy ass to finish this. Any doctor who suggests a discontinuation schedule as conservative, if not more so, than mine is really on to something as far as I’m concerned.
There’s a term, “brain shivers.” You’ll know it if you ever experience it. Other symptoms include dizziness, nausea, headache, painful tingling / pins & needles feelings (paresthesia) - especially in your hands and feet, fatigue, vomiting, irritability, insomnia, diarrhea, anxiety, and excessive sweating (hyperhidrosis).
To suddenly stop taking them is to feel so very much worse than you were feeling before you ever considered taking meds.
Not everyone experiences SSRI discontinuation syndrome, and for those who do the effects range from mild to extreme. Not all doctors recognize this as an issue, so that sucks even more.
If you’re taking, or an immediate-release form of the med is available like Effexor has, invest in a pill splitter.
Be sure to read the section about how long it takes for a med to clear out of your system and wait that long to taper down to the next stage in your dosage.
Another option is to switch to the liquid form that many of the meds have available, that way you can reduce your dosage by as much as you damn well please and take as long as you can afford to discontinue to med. If it’s really bad you may want to switch to liquid Prozac (fluoxetine) for the final discontinuation. That can take a very long time, but because of Prozac’s 9.3 day half-life it usually has the mildest discontinuation syndrome effects of all the SSRIs. The long half-life is a double-edged sword. If you’re on a high dosage and especially sensitive to the discontinuation syndrome, it will take forever to get off of Prozac, but at least it won’t be as bad as the other meds. If you’re not as sensitive to the discontinuation syndrome, Prozac’s long half-life makes it easier to discontinue than any of the other SSRIs.
Some atypical antipsychotics like Seroquel and Geodon offer enough serotonergic action (Geodon does both serotonin and norepinephtrine reuptake inhibition) to make the discontinuation nowhere near as bad, if it happens at all. So if you have some Seroquel (quetiapine) on hand for insomnia, you’ll want to take some for your SSRI discontinuation. Be careful though, as both Seroquel and Geodon have discontinuation syndromes themselves!
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What causes SSRI Discontinuation syndrome? Good question. According to the somewhat controversial neurotransmitter depletion hypothesis, discontinuation syndrome happens because:
- You were depressed because you didn’t have enough brain juice to start with.
- The drug would poop-out if you kept taking it, but you stop taking it before that happens, because the side effects suck too much, you ran out, etc.
- That starts a cascade of events in your brain that results in no serotonin (or whatever) at the receptors involved and your brain developing a tolerance to it in any event.
As for the mechanism behind the symptoms, that’s an even better question. I.e. they know even less. I’ve found one paper so far: A possible explanation for dizziness following SSRI discontinuation. According to the authors the vestibular nucleus complex (VNC) has “an abundance of serotonin receptors,” so an “abrupt withdrawal from an SSRI is likely to have a substantial impact on the electrophysiological activity of neurons within it.” That will make you dizzy.
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SSRI/SNRI Discontinuation Syndrome by Jerod Poore is copyright © 2011 Jerod Poore
Date created: 1 July 2011 Last edited by: JerodPoore on: 2014–05–31
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Almost all of the material on this site is by Jerod Poore and is copyright © 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, and 2016 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and something along the lines of following disclaimer, I’m usually cool with it.
All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else. Plus we are big pottymouths and talk about S-E-X a lot.
Know your sources!
Nobody on this site is a doctor, a therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. While it’s not as bad as it used to be, some doctors still get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication1. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
All information on this site has been obtained from the medications’ product information / summary of product characteristic (PI/SPC) sheets and/or medication guides - which is all you get from sites like WebMD, RxList,
NAMBLA NAMI, etc., the sources that are referenced throughout the site, our personal experience and the experiences family, friends, and what people have reported on various reputable sites all over teh intergoogles. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or medication guide/patient information leaflet (PIL) that comes with your medications and never ever throw them away. OK, you can throw away duplicate copies, but keep at least one, as that’s your proof of purchase of having taken a med in case a doctor doubts your medical history. Plus they take up less space than a bottle, although keeping one inside of a pill bottle is even better.
Crazymeds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
Crazymeds is optimized for ridiculously large screens and browsers that don’t block ads. I use Firefox and Chrome, running under Windows 72. On a computer that sits on top of my desk. With a 23 inch monitor. Hey, at least you can make the text larger or smaller by clicking on the + or - buttons in the upper right hand corner. If you have Java enabled. Like 99% of the websites on the planet, Crazymeds is hosted on domain running an open source operating system with a variety of open source applications, including the software used to display what you’ve been reading. As such Crazymeds is not responsible for whatever weird shit your browser does or does not do when you read this site3.
Crazymeds now uses a secure server, but it is not so secure that you can discuss anything having to do with nuclear power facilities, air traffic control systems, aircraft navigation systems, weapons control systems, or any other system requiring failsafe operation whose failure could lead to injury, death or environmental damage. Just so you know. So if you’re mentally interesting and have a job that deals with that sort of thing, talk about said job elsewhere. Otherwise feel free to discuss your meds and brain cooties.
No neurologists, psychiatrists, therapists or pharmacists were harmed in the production of this website. Use only as directed. Void where prohibited. Contains nuts. Certain restrictions may apply. All data are subject to availability. Not available on all mobile devices, in the 12 Galaxies Guiltied to a Zegnatronic Rocket Society, or in all dimensions of reality. Hail Xenu!
‘Everything is true, nothing is permitted.’ - Jerod Poore
1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.
2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.
3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?* I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion as anonymity on teh Intergoogles. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.
* Yes, I know I’m using open source browsers. I also test the site using the now-defunct IE and Safari browsers. Their popularity - and superiority - killed IE and Safari, so that’s why I rely on the open source browsers. It’s like brand vs. generic meds. Sometimes the generic is better than the brand.