Hi all, this is my introduction post. I'm a 36 year old female who is restarting a fluoxetine taper in the past 10 days, but as you can see by my signature I have been basically tapering (or reinstating) various psych meds for about the last 10 years. By far my most bothersome/persistent symptom is night time anxiety and panic/awakening upon sleep onset. I will jerk awake, twitch, or temporarily stop breathing, usually at sleep onset and sometimes at other times during the night. These are all symptoms that emerged during my withdrawal crisis (no previous history) and now come/go in a wave/window pattern. I am confused as to whether this is sleep conditioned anxiety from the crisis (I developed somniphobia very badly during akathisia) or if something's gone awry neurologically due to the withdrawal. Has anyone else experienced anything like this?

[Admin note] - Text from signature

Age 21 ~2010 — first prescribed psych drugs. Lexapro and Xanax. Told by psychiatrist that I can “take them like skittles” because he could “get anyone off of benzos.” 

Age ~22 ~2012— Trazodone prescribed soon after for sleep disturbance. Around this time also prescribed Celexa to replace Lexapro. 

Age ~22— attempted discontinuation of Celexa, tapering over 20-30 days after psychiatrist announced he would be leaving the state. Symptoms of de-realization/de-personalization, continuous crying, depression, suicidal thoughts, severe OCD rumination/intrusion and intrusive thoughts, unable to get out of bed. Went to urgent care and SSRI medications were reinstated. Diagnosed as relapse of mh symptoms and established with another psychiatrist.

Age ~23-27— continued to take SSRI and benzodiazepine medications, attempting adjunctive medications such as Wellbutrin to manage sexual side effects, prazosin for nightmares. Attempted various SSRIs including trintellix, eventually landing on Prozac medication. Alprazolam Xanax use continued to escalate during this time, eventually becoming scheduled dose 1-3 times per day with additional dosing for breakthrough anxiety. 

Age ~28— Diagnosed with ADHD and began Ritalin medication in addition to SSRIs, benzodiazepines, and trazodone. Attempted various stimulant medications and adjunctive such as Tenex off label for ADHD and to manage stimulant induced anxiety and brain fog/fatigue. 

Age ~30— Went to ER due to hypertensive episode ascribed to ADHD medications. Discontinued Ritalin. 

Age ~30 Self-initiated Xanax taper via pill-cutting. I don’t remember duration. Experienced anxiety, panic, derealization/depersonalization. 

Age ~31 Began self-initiated Prozac taper. Decreased prozac dose from 40 mg to 30 mg (3 10 mg pills). Began to decrease prozac by 10 mg at a time, holding about 6 months between each titration. When I hit 10 mg, I began cutting tablets which enabled me to decrease 10 mg--> 7.5 mg—>5 mg. I also cross-tapered trazodone during a hold on the fluoxetine taper. Discontinuation symptoms were persistent but overall manageable up to that point. I experienced brain zaps, derealization/depersonalization, strange neurological sensations, visual disturbances, dizziness and vertigo episodes. At around 7.5 or 5 mg (summer of 2024) I began having suicidal thoughts and intense dysphoria. Held for a few months and implemented metabolic interventions such as fasting, ketogenic and meat-based diet, cold exposure therapy, stabilized somewhat, then pushed through with the taper. Decreased from 2.5 to approximately 1 mg or under in the autumn/winter of 2024. Began to experience increased overwhelm, stress sensitivity, and restlessness which I did not immediately attribute to withdrawal. The nightmare began soon after. I believe I experienced compounding withdrawal due to the long half life of fluoxetine, resulting in delayed but nevertheless severe withdrawal. Severe withdrawal showed up in late January 2025 which involved extreme insomnia and somniphobia, sleep-onset panic/jolting, akathisia, dysautonomia, cognitive and perceptual disturbances, suicidality, neurological and physical symptoms, and profound psychological suffering. Reinstated 5 mg of prozac. In mid February I was taken to the ER to rule out a heart problems due to persistent sweating, heart palpitations, every symptom of heart attack. 

Age ~34 In February met with DNP who diagnosed relapse of symptoms. Tried several different medications to manage the crisis state including Ativan, gabapentin. Experienced kindling and paradoxical reactions to medications, supplements, etc. Reinstated to 10 mg of prozac. I was profoundly disabled. Eventually psych prescribed Xanax for sleep as my primary sxs were sleep disturbance/somniphobia, akathisia, and terror especially at night. Began to stabilize a bit but still unable to work. DNP recommended increasing prozac to 20 mg and trazodone was prescribed to augment sleep. Desperately, I increased the fluoxetine dose, and experienced restlessness, increased anxiety, followed by narcoleptic tiredness and brain fog that lasted for months. Around this time I established with a functional medicine provider. Labs from around that time showed elevated quinolinic acid, neuroinflammation, gut dysbiosis, cortisol/adrenaline surges, and post-menopausal-range estrogen levels. 

Several months in I was able to sleep somewhat normally, work part time, and most of my original SSRI withdrawal symptoms slowly abated over the course of about 1+ yr. During that time, I slowly tapered off of Xanax, and trazodone soon after. Waves and windows pattern persisted, as did jolting/sleep disturbance which continues to this day. After about a year and a half, I have been able to read books again, and work normally for the most part. I continue to have waves/windows pattern, stress sensitivity, and strange neurological symptoms that appear to be adjacent to sleep disordered breathing patterns which I never experienced prior to this. I also experience adrenaline surges at night, brain zaps, cognitive slowing, etc. 

Age 36— I have begun to taper Prozac again, this time using a hyperbolic taper method. Currently at 17 mg. Recently re-prescribed Ritalin to address ongoing ADHD/executive functioning issues. I took it for about 5 days and was fine, but soon after experienced increased sleep disturbance and depression/persistent crying, so I stopped taking it. 

I’m sure I’ve tried other medications including various antidepressants but can’t remember details or timelines beyond what is outlined above. At different times attempted to decrease or discontinue medications but these are the most significant taper attempts w/ the most severe withdrawal states.

Hi @OpNoZac

Welcome to the forum!

 

This is a volunteer-run, community forum aimed at helping those who are tapering and/or experiencing difficulties with psychiatric medications and withdrawl syndrome. We are not medical professionals and cannot offer medical advice. We simply offer support and opinions which you could use as talking points with a medical provider knowledgeable in withdrawing off psychiatric medications.

 

Please familiarise yourself with the forum rules and the disclaimer located here: Guidelines

 

Please make sure your signature is kept up to date with your drug history. This will allow members to see some basic information about your drug history and situation so that they may help you best. Information on how to do this is located in the FAQs section above, but here is a direct link: Update Signature

Once this is done, future posts made by you will have this signature turned on by default. For this reason please keep it clear but condensed as possible.

Please use the format outline here Preferred signature/drug history format

I'm so sorry to read about the tough time you've had recently you will find plenty of support here for sure.

8 hours ago, OpNoZac said:

I'm a 36 year old female who is restarting a fluoxetine taper in the past 10 days,

Can you confirm what you are taking now, and the reductions and dates of your current taper?

How are you feeling at the moment? Can you rate your symptoms out of 10? 10 being the worse?

8 hours ago, OpNoZac said:

but as you can see by my signature I have been basically tapering (or reinstating) various psych meds for about the last 10 years.

I have moved your old signature into the intro post for safe keeping.

It is too long for a signature. I pasted a condensed version of it into your signature for the minute.

Can I ask you redo your signature in the format requested? Link below.

Update Signature

Preferred signature/drug history format

Im sorry, I can you have been through a lot over the years. Your CNS is going to be very sensitive now.

8 hours ago, OpNoZac said:

By far my most bothersome/persistent symptom is night time anxiety and panic/awakening upon sleep onset. I will jerk awake, twitch, or temporarily stop breathing, usually at sleep onset and sometimes at other times during the night. These are all symptoms that emerged during my withdrawal crisis (no previous history) and now come/go in a wave/window pattern. I am confused as to whether this is sleep conditioned anxiety from the crisis (I developed somniphobia very badly during akathisia) or if something's gone awry neurologically due to the withdrawal. Has anyone else experienced anything like this?

These symptoms are extremely common of a dysregulated nervous system. I would like to see a updated signature as requested, particuarly from the last year, but I think you may be better of holding at this point and letting things settle down. Your history is a little fragmented and hard to follow, but I can see there has been many changes. I also suspect you have been tapering too quickly recently too. Reductions should be no more than 10% of your last dose in a 30 day period. This is often too fast for people though. Tapering Information

I look forward to hearing from you.

In the mean time this is what I would do if I were you:

 

-Stay Hydrated 

 

-Eat a good clean whole food diet, avoiding processed foods and sugars.

 

-Stay away from caffeine, alcohol and antihistamines and any other psychoactive substances.

 

Supplements are to be avoided initially, as they often irritate our nervous systems. Try to get your nutrition through food.

 

Down the line, you may wish to introduce Fish Oil and Magnesium. Those who can tolerate them have found them calming to the nervous system. Be careful try one at a time and start low and see how you get on should you choose to try them.

 

A daily walk is very important as much as you can manage, if you can manage it. Gets you your fresh air and Vitamin D does wonders for your mind!

 

You are very welcome here and I hope you find the site supportive.

Chippy

Hi Chippy, thank you for your reply. I am having a hard day today but will return to make the updates you requested when I am able. In the meantime it is incredibly reassuring to know that I am not alone in my sleep/neurological symptoms. I have not heard anyone else describe the sleep disordered breathing/jolting/waking continually at sleep onset with anxiety (not saying that others haven't experienced this, just that I haven't encountered any stories about it). It is making me lose my mind and I am sometimes very desperate.

12 hours ago, OpNoZac said:

Hi Chippy, thank you for your reply. I am having a hard day today but will return to make the updates you requested when I am able. In the meantime it is incredibly reassuring to know that I am not alone in my sleep/neurological symptoms. I have not heard anyone else describe the sleep disordered breathing/jolting/waking continually at sleep onset with anxiety (not saying that others haven't experienced this, just that I haven't encountered any stories about it). It is making me lose my mind and I am sometimes very desperate.

My pleasure.

No hurry at all. We are here when you need.

I think that it is always difficult to find other who are exactly the same as us, but your symptoms are all very common, often each person is unique but similar at the same time.

Welcome to the forum.

As @Chippy said, those symptoms are very common withdrawal symptoms. I'd even go as far as to say that most here will have experienced them to a degree.

I'd be very cautious about introducing new drugs during your taper, as you've found, they can cause further issues.