SSRI Discontinuation Syndrome from Cipralex
November 28, 2010 9:09 PM   Subscribe

Due to stupid administrative reasons outside of my control, I had to abruptly quit taking Cipralex for a few days. Now, I am having an extremely nasty case of SSRI discontinuation syndrome. What can I do to help alleviate the symptoms?

Apparently, filling out insurance forms correctly and on time does not prevent the university from still somehow screwing it all up. As a result, I've run out of my Cipralex prescription, and will not be able to refill it until Wednesday. I am having very bad zaps that seem to be increasing in both frequency and amplitude; this is the worst case of SSRI discontinuation syndrome that I have ever experienced.

I would like nothing more than to stay at home and do nothing until I can refill my prescription. Unfortunately, simply taking it easy for the next few days is not an option, due to a major conference deadline on Wednesday. What, if anything, can I do to alleviate the symptoms meanwhile?

Please note: I am not looking for medical advice; for this, I will contact my doctor (who will most likely just tell me to tough it out). I am looking for home remedy-esque suggestions that will be both comforting and distracting (e.g., hot soup).

Thanks in advance!
posted by tickingclock to Science & Nature (23 answers total) 3 users marked this as a favorite
 
When I get brain spins from missing Effexor, I am a big fan of caffeine and carbohydrates. Like bad carbs -- mashed potatoes and white bread. I find the slight carb high counteracts the spins, and shuts them down for a few hours. May work on the zaps, may not.
posted by freshwater at 9:14 PM on November 28, 2010


Samples from your psychiatrist to tide you over? Contact a prescription assistance program? Pay out of pocket and file for reimbursement?

Whatever you do, please involve your psychiatrist. Home remedies are NOT the answer to mental health problems.
posted by lovelylucy at 9:21 PM on November 28, 2010 [6 favorites]


Canada might be different, but here you can talk to the pharmacist who normally fills your prescriptions, and they can give you a few pills as an "emergency refill."
posted by Houstonian at 9:28 PM on November 28, 2010 [1 favorite]


Is the problem that you can only get your insurance to pay for Cipralex starting on Wednesday? Can you fill a prescription for only a few tablets elsewhere in the meantime and pay for it out of pocket? That should be less than $10.

If that is not an option for some reason, perhaps you could ask your physician of getting a prescription for a similar and much cheaper drug such as citalopram and paying for it yourself.
posted by grouse at 9:29 PM on November 28, 2010


I've gotten emergency refills, too. They give you one or two pills to tide you over.
posted by Cool Papa Bell at 9:30 PM on November 28, 2010


Go to your pharmacy as soon as possible. This isn't a controlled substance and they shouldn't have a problem giving you a couple of pills. If they balk, offer to pay cash for a couple tablets, which shouldn't cost very much at all. If they are giving you trouble, ask to speak to the pharmacist, instead of the clerk or technician who might be at the cash register.

Failing that, you say it's your University that's involved here. Their health service should have a "patient advocate" or ombudsman or similar person who's job is to unstick nonsense like this. There's no reason for you to suffer needlessly because of a bureaucratic screw-up.
posted by zachlipton at 9:48 PM on November 28, 2010 [1 favorite]


As others have suggested, go to your pharmacist and ask for an emergency supply. If you've an empty bottle lying around, bring that with you.

I've had to deal with the zaps more than once - I've yet to come across anything that can mitigate the symptoms. Trying to "tough it out" can be debilitating. Find a way to get a few doses.

On another note: If you (or other readers) want to try to get off an SSRI, make sure you work with your doctor to taper off the dose. You can split pills, or even switch to a liquid version of the medication to ease off gradually.
posted by aladfar at 10:01 PM on November 28, 2010 [1 favorite]


Have you tried asking your prescribing doctor if they have samples of Cipralex available? It (along with some of the other popular patent-protected SSRIs) is not an uncommon drug for doctors to have a supply of.
posted by thisjax at 10:28 PM on November 28, 2010


You can try switching to St. John's Wort, 300 mg daily, until your Cipralex/Lexapro is refilled. SJW is over-the-counter in Canada but is contraindicated if you are taking other meds; see here for more details.

As far as home remedies go, zaps are a great excuse to eat the cheesiest, greasiest, least healthy stuff you can find. You can eat healthy when you're back on your meds.
posted by infinitewindow at 10:32 PM on November 28, 2010


who will most likely just tell me to tough it out

I don't understand why you'd assume this, unless you have the world's worst pdoc. Doctors typically take SSRI compliance very seriously and do not want their patients to accidentally withdraw cold-turkey. If your pharmacist can't help you (in a way you can afford), then typically your doctor's office can.
posted by thisjax at 10:33 PM on November 28, 2010 [1 favorite]


St. John's Wort, 300 mg daily.

This is a bad idea. You don't know how much Cipralex is still in your system. St John's Wort itself has a half-life of up to a week. The interaction between them is unpleasant and potentially life-threatening. Don't do this unless you've discussed it with your doctor.
posted by embrangled at 11:20 PM on November 28, 2010 [8 favorites]


Speaking from experience, Benadryl (or its generic form) really helps the zaps. Omega 3 fish oil can help too.
posted by mirepoix at 2:10 AM on November 29, 2010


I would add that abrupt SSRI withdrawal is arguably a medical emergency; while the physical symptoms might not kill you, the mental health ones might. You're in Canada; healthcare is cheap or free, right? If your doctor or pharmacist can't help you, go to a 24 hour clinic or the emergency department of your local hospital. They will take your situation seriously, and you will get the medication you need.
posted by embrangled at 4:12 AM on November 29, 2010


As others have said, and I say again for emphasis - go to the pharmacy and get an emergency refill. They will give you enough to tide you over for a couple of days - if not a week. Messing around with your meds is NOT A GOOD IDEA.

Go to the crazymeds forum and they will tell you - at length - why. They might also be able to help you with your withdrawal symptoms until you get your emergency refill.
posted by patheral at 7:00 AM on November 29, 2010


In my experience, the only thing that helps with zaps is Benadryl.
posted by emilyd22222 at 8:05 AM on November 29, 2010


Nthing call the pharmacy. They will often do whatever they can think of to get you a couple pills -- even if it means fronting you 3 from a future (supplied to them, but not yet purchased/billed) prescription.

Some days, I really love pharmacists.
posted by MeiraV at 8:08 AM on November 29, 2010


Yes, call the pharmacy!

When I had the brain zaps from Cymbalta withdrawal, Benadryl was seriously the only thing that helped.

I'm also a fan of chocolate as a general, all-purpose soothing substance.
posted by misha at 8:39 AM on November 29, 2010


Response by poster: Thanks for the answers, everyone. I will try calling the pharmacy; I didn't realize there were such things as emergency refills. I should try to see the doctor, too, although I am a little hesitant as I am afraid of the potentially long wait at the waiting room. Once, I had to wait for two hours for a five-minute appointment at the university clinic, and ever since, I've been avoiding making unnecessary trips to the doctor. (I'm getting increasingly disillusioned with the administration at the university clinic and pharmacy, in case it's not quite obvious.)

This is a complete side note, but I wish that somewhere earlier in my education -- say, in high school -- somebody had told me that mental health issues are real physical problems and that missing a dose can be a serious thing. I see that now, but my parents have always taken the position that such things can be toughed out, and it is now taking me years of active effort to undo their damaging views. Sigh.
posted by tickingclock at 8:53 AM on November 29, 2010


I should try to see the doctor, too

Call the doctor. You are unlikely to need to see them for this. It will probably be easier to take care of this over the phone.

Once, I had to wait for two hours for a five-minute appointment at the university clinic, and ever since, I've been avoiding making unnecessary trips to the doctor.

I never go to a doctor's appointment without something to read or write. Surely you have some papers you could catch up on while you are waiting. Doctor's offices running behind schedule is not something limited to your university clinic.
posted by grouse at 9:00 AM on November 29, 2010


Response by poster: Call the doctor. You are unlikely to need to see them for this. It will probably be easier to take care of this over the phone.

The clinic does not let me talk to the doctor over the phone due to clinic policy; I have to go in person.

Well, I got my emergency refills in the end. When I called, I was pleasantly surprised to find out that apparently my prescription was ready, so I went to pick it up right away. When I got there, I was told that the insurance stuff still has not been resolved and that nobody had called the pharmacy (?!). Frustrated and angry, I ended up crying and making a big scene, which seemed to convince pharmacist that emergency refills were needed.

My head hurts a lot and I feel frustrated. I constantly feel belittled and ignored by the doctors, counsellors, and pharmacists on campus. I feel like I'm not being my usual rational and professional self. I wish I had people to talk to or rely on, but most of my friends and support network is back home.
posted by tickingclock at 9:37 AM on November 29, 2010


Can you call a friend back home? Tell them it is really important that you need someone to talk to today.
posted by grouse at 9:44 AM on November 29, 2010


You just did the right thing even though it was difficult and nerve-wrecking. You did great. Every little hurdle is just so much harder to navigate when you are sick, and I bet that intense feeling of being ignored is one of the symptoms.

I wonder if you're preparing an APA proposal, because I'm ready to tear my hair out even without prescription mix-ups.
posted by Shusha at 10:24 AM on November 29, 2010


Yes definately go the free sample route or call the pharmaceutical company. They have patient assistant programs or possibly can get a rep in touch with your doc to give you teh samples.
posted by stormpooper at 1:29 PM on November 29, 2010


« Older brick + TV   |   Snood is a dumb word and hard to google Newer »
This thread is closed to new comments.