An Uncensored Account of My Experience with SSRI Withdrawal

I've been oddly silent for over a week recently, and I know a lot of people are wondering what happened to me. Clients even told me they were worried about me, because I never cancel appointments, but I canceled just about all of them last week.

Well, the truth is that I spent the last week withdrawing from drugs. The legal kind.

A few years ago (and I honestly can't remember how many - 4, 5, 6?) I began taking a small dose of Lexapro to help with severe PMS. I took just 5 mg, half a pill, 10 days before my period. The first month, I didn't notice a difference. Erin did, however. She sat me down and told me "Honey, I want you to take this pill every day."

In just a few months, I was taking it every day. It helped tremendously with the feeling of underlying anxiety that I had dealt with for as long as I could remember and didn't realize was a problem for most of my life. For the first time I was realizing that this low-level anxiety was doing a lot of damage. It was hard to be happy when I was always nervously anticipating what would go wrong next.

All these decisions were made, of course, under the guidance of a psychiatrist, and I've talked a little about this experience in my book. And over the years I've noticed that most of my clients are on both an SSRI (such as Lexapro, Paxil, Prozac, Zoloft) and a psychostimulant (such as Concerta, Ritalin, Adderall), just like me. Depression and anxiety are the two most common coexisting conditions for people with AD/HD, and many of us find ourselves needing a little quality of life boost.

So fast forward to 2008. I've made a lot of changes in my life. I've made physical changes that help keep my brain balanced, like eating more nutritiously and getting better sleep. And I exercise moderately, although I probably got more exercise when I lived in the city. I've also made practical changes in my life by learning and applying the skills I need to manage anxiety.

I saw my psychiatrist a few weeks ago and told her that I thought it was time to go off the Lexapro. "I can't explain it," I told her. "But I just have this weird, intuition-like feeling that it's time to go off the Lexapro." She had a wise response, I thought, which was to go off the medication and then, if I felt anxious again and I needed to go back on it, at least I'd know why. I wouldn't feel like I was popping pills for no reason.

So we set up a schedule for me to begin weening off the Lexapro. Seven and a half mgs for 2 weeks, then 5 mgs for two weeks, then 2.5 mgs for 2 weeks, then done. It would take a while, but it would hopefully be easier than going "cold turkey." And my doctor warned me that the withdrawal would be bad. "So bad," she said, "that you'll feel way worse than you did before you went on the medication. Don't confuse the withdrawal with anxiety or depression symptoms."

I had no idea just how bad the withdrawal would be.

I had some mood swings and fatigue each time I went down a notch on the meds. Going down from 7.5 mgs to 5 mgs was a little harder, and I decided that I wanted this process to be done already, and that I would go from 5mg to 0. (And, please be sure to note, this is something I discussed with my doctor.)

I planned it perfectly, or so I thought. I stopped taking the meds on a Wednesday night, with no appointments that Thursday or Friday, and I figured that I would pretty much experience most of the withdrawal symptoms over the weekend. I might need to sleep a little late on Monday and Tuesday, which would be no problem because my client appointments started later in the day. I thought it would be fine. I was wrong.

For a few days after dropping the Lexapro completely, I just had mood swings. I oscillated between being giddy, weepy, and angry. I was tired. But it wasn't that bad. On Sunday, we took our usual hike in the mountains, and I felt like walking in the sunshine and brisk air for a couple of hours was exactly what I needed. By Monday, I was in a completely different place.

For four days, Monday through Thursday, I was in the throws of SSRI withdrawal. It was awful. Here are just a few of the symptoms I experienced:

• Extreme mood swings, which included raging anger. I looked for things to throw on more than one occasion. And I'd be lying if I said that I didn't actually throw them.
• Awful sadness. I cried at everything. I cried when I saw 10 seconds of upcoming scenes for the Chef Jeff Project. A troubled kid was hugging Chef Jeff, and I lost it.
• Extreme fatigue, and extreme insomnia. I was so tired, and often couldn't sleep.
• I felt flu-y. Stuffy head, sore throat, headaches, muscle pain. I would start off strong, and go downhill quickly in the day. You wouldn't think that withdrawal from a psychiatric medication would cause flu-like symptoms, but it's actually really common.
• General fogginess. I was on slow speed. It took me a lot longer to process what I was hearing, and to put my own thoughts into words. On one or two occasions, I told Erin the same thing twice, as in repeated the sentence right away without even realizing it.
• Really intense, anxiety-filled dreams. Tons of them, including the one about some guy trying to have sex with my mother at a county fair. (Yes, you read that right.) When I told my mom about it, she quickly responded, "That's not a dream, it's a nightmare!"
• Cravings. I mostly wanted salty meat and a lot of Asian food. I had a craving for a dish that I used to get at a Vietnamese restaurant in the city...that I haven't had in over 3 years! Also, orange juice. I don't really drink juice, so that was a bit weird, too.
• Skin sensitivity. One night the sheets would feel super comfy, and the next night those same sheets made me itch beyond belief.

Probably the most notable symptom, especially to those around me, was the anger I felt. It was so bad. Everything pissed me off...and I mean pissed me off. I knew the anger was coming when my poor little babies (my dogs) would start shaking. It was like they felt it coming on before I did. And just to be clear, I did not hit or abuse them at all. If you have dogs, then you know that they are very sensitive to the moods of the people around them.

I used to watch Celebrity Rehab and think the people on there who got pissed off so often were just fucked up. Now I understand that the drug withdrawal makes them fucked up. So fucked up that minor trespasses become major, anger-filled events. I can now relate, because even though I didn't withdraw from heavy drugs, I was that fucked up.

It strikes me as I write this post that I can't quite put into words just how badly those 4 days were last week. It was more than not just feeling like myself. It was painful, both physically and emotionally. And even though I knew that the feelings would pass, I couldn't help wondering if it was worth it. The Lexapro really helped me for years, and I'm thankful for that. But I might have thought twice if I knew that this withdrawal period would be a part of the process.

I've been feeling better for a few days now, and I actually feel pretty good today. Well, that might be an overstatement. I feel good compared to how I had been feeling. But I'm confident that I won't have to cancel any coaching appointments this week. Catching up on email is another story...

I wrote this post for a few reasons:

1. I wanted to explain to everyone why I "flaked" for over a week. I especially wanted to explain to my clients who aren't used to this kind of behavior from me.
2. I wanted to document my experience, and process it for myself.
3. I wanted to offer an open account of my experience to those who might benefit from it. Even though I knew that I would experience a withdrawal period, I wasn't quite prepared for the severity. I spent a good deal of time online this week trying to make sure I wasn't crazy.

I'm leaving the comments open on this post (for now, anyway) but my assistant and I are going to be really diligent about deleting inappropriate comments. If you want to tell me that drugs are evil, don't bother. If you want me to look into Scientology or you represent an "alternative" product, don't bother. In fact, if you want to tell me what I should or shouldn't do, don't bother. Even if you're trying to be helpful. Fortunately, I have a good doctor, a supportive partner, and two loving dogs who haven't had the shakes for 5 days. I have everything I need.

If, on the other hand, you want to offer a kind word or share your own experience, then please do.

And if you've stumbled upon this post and are looking for more information on the subject, then here are a few resources that might be helpful:

• SSRI Discontinuation Syndrome (Wikipedia)
• SSRI/SNRI Withdrawl Syndrome (Depression Central)
• The best resource = your doctor.

Thanks to everyone who patiently awaited my arrival back to society. I'll be reporting more on this subject and my experience in the coming weeks.

Comments

[Paul Copcutt]

Jen - Wow what an amazing, mind opening and authentic post - sent shivers down my spine. I know you have already come out of this and will continue to feel better and better - know that there are many more of us there with you (even when you are throwing something ! :)) that care for you. - Do take care and shout if you need anything.

[Terry Matlen]

Jen,
You constantly amaze me with your bravery, your willingness to open up- even to complete strangers on the internet- and your profound wisdom.

I feel badly that you went through such an awful time but applaud you for looking at this square in the face and sharing the horrific details with us.

By doing that, you've not only shown us that it's ok to be honest and open, but you also are telling people what they might expect under the same circumstances.

I'm glad you're getting back to your old self. You are one tough cookie!

Hugs,
Terry

[Doug E]

I echo what Terry and Paul have said. I find sometimes I can forget that real people with real lives are on the other side of blogs and counters and phones. Your situation reminds me to think about the fact that sometimes, it's all one can do just to face the day.

As you start writing about this, I would be interested in reading about how you think ADD factored into your rehabbing.

Keep your eyes on the prize...

Doug E

[Jennifer Koretsky]

Thanks so much to Paul, Terry, and Doug E for your kinds words and support. I appreciate that very much!

[Reta Russell Hougton]

Thank you for sharing your experience with this drug. I think we often place too much trust in our doctors and do not get the full story about long term use of meds. I hope you are feeling better. I know it was a very dark week for you.

[Liz Field]

Thank you for sharing your experiences with us - that takes a lot of courage. I especially want to thank you for mentioning about the anger you were feeling, because I have been going through that myself, and for whatever reason, never connected it to ADHD. I mean, everything was making me angry, and I'd react with just an over the top outburst or long simmer of silence and disgust. Something just kind of snapped one day, and I decided I wasn't going to live my life in a constant state of anger. I have long owned the book Being Peace, which I think you have mentioned before. So I dusted it off and read it, and also bought a couple of other books by Thich Nhat Hanh about mindfulness. These have been a big help. I have also just started taking SAMe, or S-Adenodyl Methionine. This is an amino acid supplement that can't be found in foods. It is enjoying much success in both humans and animals as an antidepressant that also helps with cognative function. Just started taking it so it's too new to rate right now, but I'll see how it goes. Best of luck to you.

[Eric]

Ick. Hang in there, I know it isn't easy.

I find that humor always helps, and this comic seems to capture the essence of ADHD:

http://buttersafe.com/2007/08/23/watermelon/

I laugh every time. peace!

[david kassir]

WOW!!! very intense....I read about these withdrawls & thought it was relative to only sensitive people but then again I imagine this must be common given that your body has been digesting these meds all these years. Would love to hear how its going in the future.....

[CT]

Jen,

I know I've been quiet for a while, but have been reading the blog. All I can say is... Thank God you and those around you came through it unharmed. (I mean, I hope Punky isn't still hiding from you or something...)

My stints on SSRI's were only short term. But talk about bad getting off. Don't feel the least bit apologetic or weak or stupid or anything. You really took on one hell of a challenge and saw it through. You (and Erin) Rock!

CT

p.s. it ain't actually totally over yet, but you probably know that. The brain rebels and rages and then calms down first. The rest of your body will have its own say, less loudly and less quickly and in less straightforward ways. But it too will come to heel (or is that heal?)Keep on Keepin' on. No Regrets!

[Karen]

I don't know much about BLOGS- but I received your e-mail and clicked on the link to the blog. Guess it's time for me to learn more about blogs. I am very interested in hearing the reasons behind your decision to "get off of" Lexapro.

THANKS AGAIN for sharing.

[Ariane Benefit, Organizing Coach]

Jen, what an ordeal! I so admire and respect you for sharing your experience so openly. I've been taking Wellbutrin for many years to help with PMS and last year I tried to go off...it was like a living hell. I went back on it...I just couldn't deal with the withdrawal and my doctor did NOT tell me that it would end. Didn't even metion it. I'm going through menopause right now which was why I thought maybe it was time to stop feeling like I was "dependent" on meds. I guess I just wanted to know, like you, if all my efforts to manage my stress etc. had paid off. My doctor insists that meds are the best way to hand bio-chemical issues. Now I wonder if I should get another doctor.

You are such a generous and giving human being. Thanks so much for being you!

[Lynn]

Thanks for sharing. I have been on anti-depressant meds for ... a long long time and I too am interested in hearing why you wanted to get off of them. I am also interested in getting off of them - but after reading your blog - i am extremely hesistant now.

[Eric Dickhaus]

Jen, I just finished your book, which arrived pretty quickly to me here in Italy, and I think it was terrific! You post about the SSRI withdrawl was both courageous and necessary, because as you mentioned many people with AD/HD are taking similar medications. I am curious to follow you in the next few months and see how things progress for you and what decisions you make about how to handle your anxiety. Many people are skittish about taking antidepressants, and hope one day to quit, even if they do a great deal of good. I think this is because we grew up thinking that our minds were seperate from our bodies, and shouldn't need chemical help. But on the other hand, once drugs have had their effect, they may no longer be required, and it is difficult to know when or if this is the case. Sharing your decision, and the results you observed, will help many people understand their own similar decisions better. People like you make a difference every day, I just hope this works out as you hoped!

[Amy]

Jennifer,

Thanks so much for sharing your experience! I really admire you for persisting through such an awful experience. It pisses me off that drug companies try to say this isn't withdrawal or drug dependency.

I have tried a couple of times to get off effexor because of the side effects, but stopped each time after becoming really irritable. My family was already arguing a lot then and irritability just made things worse. It helps to know that I could perhaps get off it if I dedicated the time, prepped myself with meditation, and isolated myself. Maybe in a cabin in Wisconsin? However, I've read in forums how some people continue to feel bad even after months off the SSRI. Did that possibility concern you, too?

[caryn]

I went from 20 -> 10 mg. slowly. The worst part was feeling as though there were electricity surges in my brain; I have since gone back to 20 mg. w/ an additional 5 mg. for "pms" week that has turned into "perimenopause pms" 12 day carnival ride.

[Stefan]

Hi Jen
After 13 years on Dex, I just gave them up. Ok I was kinda helped - I had lost the prescription for the repeats and it was such a palaba getting an appointment every six months or so with the psychiatrist on the other side of Sydney. Unable to get the time for another appointment (and a bit embarrassed at losing the script) I just thought, hey I managed without these before 1995, there must be a way to do it again. It wasn't an easy ride, but I am glad I took the step. My son had been on Ritalin and in recent years Concerta since he was diagnosed with ADHD at 5 years old (he is now 18), he had decided to do without them about a year ago once he left high school and he hasnt looked back. It would be good to find a forum where those concerned about their long term use of SSRIs or those who have weaned themselves off them can share their experiences. Thanks for sharing your story Jen, I really enjoyed your book.

[LEANNE]

Jen;
Thanks for your true feelings. I have add and have been on paxil for 11 years. I am scared to come off of it and it is like metors like you that help us all even think of one day being drug free....
Thank you for your great help and suggestions with the emails you send me...it is these that have helped me not only admit I have add, but know that I can perhaps manage, and live a semi norma life now with great tools and moral support from people like you and your great followers.

[Michael Hadley]

Jennifer,

It sounds like your withdrawal from Lexapro sucked big time.

I was on Lexapro about a year then switched over to Paxil. Lexapro seems to prevent me from feeling anything - no highs, no lows, no libido. Paxil had worked for me before except for another sexual side effect. Sometimes you just put up with the side effects.

It's hard to find the right combination of drugs. Best wishes going forward.

Michael

[drew]

Some people really have a sucky time weaning SSRIs; others just stop with no problems. I had the electrical-zoomie thing every time I moved my head for weeks coming "off of" Effexor (the most common SSRI/SNRI to have the side effects you described with Lexapro).

Just a thought: Bipolar Spectrum Disorder often looks an awful lot like ADD+anxiety+depression+weird uncontrollable mood changes (all of which are often WORSENED by starting or stopping SSRIs in people with Bipolar Stuff). The co-morbidity of ADD with BPSD is at least as high as ADD and anxiety, which is near-universal. I actually think ADD/anxiety/bipolar spectrum/depression/fibromyalgia/sleep weirdness are all manifestations of a common syndrome as of yet named. Limbic system ("primative" drives/emotions) not playing nice with the frontal lobes (our "editor"), and other chemical traffic cops along the way busy eating donuts?

Enough, but with such a severe and significant reaction to stopping an SSRI, might be a good "shrink" topic...

[Tom Romano]

My experience with Lexapro was the same as yours, except my withdrawal symptoms lasted much longer. They were severe for 3 weeks, and slowly went away over 6 more weeks. It has only been within the past 3 weeks that I'm feeling normal again. I was on Lexapro since it first came out until the end of November, 2008, which is about 5 or more years. I have done much in the past to work with the effects that ADD has on me. Lexapro withdrawal took over my life, and now I feel as if I'm back at square 1 dealing with ADD. I realize that this does not happen to everyone, but everyone needs to be warned about the possibility of this horrible nightmare occurring.

[AG]

Jen,

Thanks for your wonderful post.I understand more than you will ever know exactly what you went through because I am going through it myself right now!! To say that it is horrible does not even begin to describe the experience, and I don't know if there are words to even do so. I will say though, consider yourself lucky. I was put on 40mg of Lexapro my freshman year of college and had know idea the shear terror that it would cause in my life 5 years later. I have been tapering for more than 1 year and still suffer from debilitating withdrawals. The worst part is that although you said in your post, doctors=the best resource, I find that this has not been the case. The best answer they can give me is presciption pad and a bottle full of pillls. I have spent countless hours online reading stories of people just like you and I that have had their lives literally stolen from them as a result of prescription drug addiction. I am not anti-drug, but I am anti-deception!!