Hi everyone. I am a 23 year old student getting my Master's in Social work. I’m currently holding nortriptyline 125 mg since Aug 5, 2026 (about 65 days). No other meds. Not tapering. I’m trying to stabilize after a long, messy history and I’m looking for peer experiences and advice. I do think at some point if I ever recovery that I would begin a very slow taper over a period of like 10 years. I dont know if I can ever get off these drugs, since im so sensitive now, and worry if I will ever stablize and feel normal agian. Despite that, getting to lower dose is a goal I have like 10-50mg before I get old would be my goal. If I ever fully could get off I would. Just looking for guidance, support, reassurence from anyone while I hold and hopefully stablize one day.

Background (brief):

I was on nortriptyline 125 mg for about a year (2023–2024). A rapid taper (125→0 over 2 months) caused severe withdrawal. I reinstated 50 mg, then tried to drop to 40 mg and had a severe destabilization (including a steroid in Jan 2025 that I believe kindled me and caused EXTREME PANIC AND OCD). I was hospitalized in April 2025 after trying to commit suicide due to severe mental and physical symptoms. Nortriptyline was stopped abruptly, and I was put on Zoloft, Abilify, Klonopin, and mirtazapine for "OCD". I had severe symptoms once taken off nortriptyline. This included leg tremors, nonstop moving of my hands and rubbing myself to keep myself moving, taking thousands of steps per day, not being able to sleep at night, or waking up one hour after I fell asleep, PSSD. I stopped all except Zoloft and things did improve slightly, then went to Rodgers OCD clinic in July 2025 and restarted nortriptyline and stopped the 50mg of Zoloft, titrating back to 125 mg over 5 weeks. All these things were labeled as OCD at the time. I also tried Buspar for 40 days and cold turkeyed off which caused a lot of OCD symptoms again but that was the only real symptom, no classic withdrawal like I had with nortriptyline. I was stable withdrawal wise on 125 mg for about 6 months. In Dec 2025 I tried a clomipramine cross-taper since my mental symptoms never had improved since the first kindling on the steroid + going off Buspar, which failed and caused more destabilization since it wasn't a med issue but withdrawal/destabilization one. Then I tapered down to 50 mg by March 2026, briefly stopped for 3 days after thinking the meds were the problem, reinstated 50 mg, and got worse for 63 days until this May. Since then I’ve been updosing.

Updosing since May 2026:

• May 19: 50→75 mg. Felt a little better, more tired, less akathisia (came and went).

• Jun 19: 75→100 mg. First 2–3 days felt ~90% better (low OCD, no akathisia), then crashed into severe panic/anxiety. Held ~6 weeks “in the middle, where I would feel 90% better no akathisia and felt sick or tired, to bad anxiety and akathisia sensations.

• Aug 4: couldn’t sleep, extreme impulsivity, diarrhea. Started to feel bad crash again so went up to my original dose that I got better at Rodgers on the 125mg, and my long term dose I was healthy on before I tried tapering ever.

• Since Aug 5: holding at 125 mg. Akathisia generally less than on 50/75/100. OCD improved slightly compared to before. Sexual function returned (strong erections, morning wood when in a good wave). Heartburn generally less.

Current status (windows and waves) since on the 125mg:

• Improvements:

  • Less akathisia overall (when the waves come now while still horrible, I don't physically have to pace like I was in May more just internal terror feeling but that comes and goes now).

  • OCD better but still extremely bad during bad waves, during good waves it's manageable.

  • Strong erections and morning wood (which I never had before I went to 125mg on the 50mg).

  • Normal stools at times but still mostly sliding back between constipation and diarrhea.

  • Heartburn generally less than 50mg but still have bad waves of it like a few days ago.

  • Had best day in months on Sep 28 after having really bad two nights before that, felt normal happiness and joy, calm. First few days this week were okay; but wave has come back the last 3 days with bad akathisia again which has demotivated and scared me.

  • I have a lot of OCD fears around this lasting forever and ruining my life every time the bad waves happen.

  • I also struggled with chronic pain before this, which is why I was put on it originally. I had realized the chronic pain was caused by neuroplastic aka called TMS/Mind body syndrome. I have thankfully gotten a lot better from them before I went through this, but some have came back due to the nervous system issues, but am better at coping with them now. So I have at times have tried to convince myself these experiences could be similar due to neuroplastic changes that I can influence just by not being afraid of it like my other symptoms, but currently doubtful and think it's more like an injury that is healing, and come to accept that.

• Waves: early waking, constipation, dry skin/itchy skin and eyes, heartburn, dry hair/dandruff, vivid dreams/nightmares, OCD spikes and extreme instrusive thoughts or random fears that make no sense, akathisia mixed with extreme fear, urinary hesitancy/frequency, sore calves.

• The cholinergic/autonomic symptoms became much more prominent after the drop to 50 mg and the 3-day stop. They seem to come in waves, alternating with anticholinergic symptoms (dryness, constipation, nightmares) which is what in nortriptyline causes the dryness. In one direction of the wave it shows as dryness and other times it may show as bad anxiety and going to the bathroom often. This comes hand in hand with my waves.

• My provider doesn’t believe in withdrawal; my therapist says it’s anxiety. I’m using TMS/neuroplastic strategies for the fear layer, but I know there’s a real pharmacological withdrawal piece too.

• I think I have seen some improvement definitely since May when I began increasing again. Especially when I went onto the 100mg and had some great days again for a few days, and some recent days on the 125mg even though the days can still be really bad. It seems like stabilizing is taking a lot longer than it did last summer in 2025 where within 3 months back on the dose, most my physical symptoms were gone. I guess I have been sensitized more since then from all the changes and things.

• Does anyone have any advice or timeline expectations? I know no one knows but idk who else to talk to about this. My parents think it is a mind body thing, and something that is not structural in nature which is sad. I was thinking about seeing a withdrawal coach to help me support my stabilization (I hope that's what the good signs have shown).

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 withdrawal 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.

The value of this forum is in the community it fosters. We hope that all of our members will be able to learn from each others' experiences, both the good and the bad. To this end, we strongly encourage members to not only document their personal journey on their own thread, but to read and post on other members' threads and otherwise make full use of the resources available throughout the forum.

 

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

 

Thank you for updating your signature.

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

 

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!

4 hours ago, thejoker3131 said:

• My provider doesn’t believe in withdrawal; my therapist says it’s anxiety. I’m using TMS/neuroplastic strategies for the fear layer, but I know there’s a real pharmacological withdrawal piece too.

You know yourself and your body and can sense that what is happening to you is not normal nor natural, and this has led you to look for other information and presumably landed you on this site. You'll find that many can relate to this being dismissed by clinicians who simply refuse to countenance that the drugs could cause harm. It's a very common theme among people's stories here and previously on the SA forum.

4 hours ago, thejoker3131 said:

• I think I have seen some improvement definitely since May when I began increasing again. Especially when I went onto the 100mg and had some great days again for a few days, and some recent days on the 125mg even though the days can still be really bad. It seems like stabilizing is taking a lot longer than it did last summer in 2025 where within 3 months back on the dose, most my physical symptoms were gone. I guess I have been sensitized more since then from all the changes and things.

It is likely that you have been sensitised by that, yes. This is something that we have observed happening to a lot of others. The more sensitised people get, the less predictably they react to further changes, additional drugs etc. and what this usually looks like is more destabilisation.

Some improvement is good.

4 hours ago, thejoker3131 said:

• Does anyone have any advice or timeline expectations? I know no one knows but idk who else to talk to about this. My parents think it is a mind body thing, and something that is not structural in nature which is sad. I was thinking about seeing a withdrawal coach to help me support my stabilization (I hope that's what the good signs have shown).

Improving is a positive sign.

If there's one thing we've learned supporting people with the harms that these drugs can do, it's that making concrete statements is not possible. Everyone is different, reacts differently, and then as we've touched upon has different drug histories in the mix. Even staying on a drug and tolerating it for ever if it has been tolerated previously is not a given for everyone.

I think really you do need to try to hold on your current dose, as you tolerated it previously, and as you seem to have a sense of- accept that this is more difficult for you than it previously has been due to everything that has happened.

 

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

Hi @thejoker3131 welcome to the forum. Just wanted to let you know that I am a psychiatrist and I too have been immensely harmed by psychiatric medication. I have been in protracted withdrawal for a year now. I like to let people know this, because many find it validating that a psychiatrist acknowledges the harm these drugs can do.

Nortriptylline is a very powerful drug, as you know. I am sorry you were put on it for pain, rather than being taught psychological coping skills. I am glad you managed to learn these on your own. I think your mindset overall is good. Stabilising on Nortriptylline if you are able to, and then considering a very long slow taper. Just be aware that stabilisation can take a long time. Some people never get 100% well again, after being injured, whilst staying on the drugs. Keep us updated. This forum can help understanding symptoms and decision making with regard to how long to keep holding and when (or if) to taper.

Edited October 11Oct 11 by Chippy
Moved to correct thread, edited the correct users name in the body of the text

Hi @thejoker3131 and welcome to the forum. You seem to have a good sense of what has been going on despite skepticism from your provider and the other people around you. As you've suggested, and as Luke advises as well, I think the best path forward for you is to hold your dose here until you feel a lot more stable. It's a good sign that you've noticed some improvements in your symptoms at this dose. It can take a long time to stabilize though, so I would be prepared for a long hold.

I had a similar journey to you with a bunch of drug changes in the span of a year, ending up reinstated on my long-term drug, and I've now been holding for over 6 months. I'm much, much better than I was at the start of my hold but still not stable. That's not to discourage you, but rather to say that this can be a long journey and you're doing the right thing by holding. The nervous system needs patience and consistency.

I see you mention potentially talking to a withdrawal coach. There are a bunch of good ones out there, and I've met with a couple myself. I'm happy to provide a couple recommendations if you're interested.

Glad you found us.

Welcome to the forum @thejoker3131 I am glad you found us. Your experience is not unique, for some they end up on a journey of being offered new drugs and multiple dose shifts until they realise this is only adding to the harm these drugs have caused. Holding seems like a smart move to me right. The body is smart, it is constantly trying to heal and adjust to find some balance. Holding stops us from getting in its way of doing this important task. We are all here for you. Time is our friend and on your side. You've got many years ahead of you and I know they can be amazing drug free ones (if that is what you choose). Recover is not linear but it is possible and is already happening. Chippy.