[Rebel Maven]

I suffered from severe Serotonin Discontinuation Syndrome (SDS) for seven months until I reinstated Prozac 40mg in July 2013 and began marginally improving.

In November 2013 I drank a large dose of caffeine for the first time in over a year that lead to sudden Serotonin Syndrome (SS).

On December 12, 2012 I began cutting Prozac by a 10% reduction (from 40mg to 36mg). That is 20 days ago from today, January 8, 2014. I had planned on a one month hold and to cut until I reach Prozac 30mg and then hold for two months.

Since then the symptoms of Serotonin Syndrome (SS) have increased exponentially.

I am now exhibiting signs of mild to moderate Serotonin Syndrome (SS) and Metabolic Alkalosis.

My uninformed doctor advised me to discontinue the Prozac 40mg immediately.

I am not going to do this as I will just end up back in Serotonin Withdrawal Syndrome (SDS).

I am trying to decide which has the bigger risk:

Cutting more rapidly

-or-

Holding for a shorter length of time.

Please help me.

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Primary Diagnosis:

SSRI induced Bipolar 1, Anxiety and Panic Disorder, Agoraphobia, PTSD, GERD

Medication history:

07/2000: Put on fluoxetine 40mg, nortriptalyne 10mg, orphenadrine PRN, Ambien, and massive doses of triptans (sumatriptan Imitrex injections and tablets) for migraine headaches I was having 3-4 days out of the week that could last up to six weeks at a time. Was already on Vicodin PRN and Xanax PRN for these headaches and sleep.
07/2009: LAVH, migraines stopped completely. Discontinued all meds except Xanax. I was fine – no withdrawals.
04/2010: Started massive doses of serotonin the enhancing supplements 5HTP and chromium to loose weight and help with mild depression. Went hypomanic within months.
12/2010: CT off massive doses of serotonin the enhancing supplements 5HTP and chromium due to oral surgery and the bleeding risk from the chromium.
01/2011: Severe Serotonin Discontinuation Syndrome. Extreme withdrawals.
01/2011: Inpatient. Put on fluoxetine 40mg, gabapentin 1,200mg, trazodone 100mg. Still on alprazolam 4mg SID and omeprazole 20mg SID.
11/12/2012: Rapid taper off gabapentin 300mg q8h (1,200mg per day), fluoxetine 40mg SID, trazodone 100mg SID at bedtime. On alprazolam 1mg SID at bedtime.
01/07/2013: Crashed and came down off extreme mania that I had for several months prior to crashing and ended up in major depression due to the rapid multiple drug taper. Horrendous withdrawals worse than last time. (HUGE mistake - do not do this please!)
07/1012013: Reinstated fluoxetine 40mg SID.
07/13/2013: Reinstated trazodone 150mg SID at bedtime.
07/13/2013: alprazolam 2.5mg SID for sleep.
11/20/13: Drank large amount of caffeine and went from Serotonin Withdrawal Syndrome to mild symptoms of Serotonin Syndrome and Metabolic Alkalosis.
12/11/2013: fluoxetine cut 10% from 40mg to 36mg.
12/11/2013: alprazolam 0.5-1mg but not over 2.5mg daily PRN for Symptoms of mild Serotonin Syndrome.
01/03/2014: Symptoms of mild to moderate Serotonin Syndrome and Metabolic Alkalosis increasing exponentially. (13 days post cut).
01/08/2014: Symptoms of moderate Serotonin Syndrome and Metabolic Alkalosis still increasing exponentially. (20 days post cut).