SSRI withdrawal - Acetylcholine

[Jwicks1995]

I need further resources to aid in me reducing my SSRI doseage. I've been plagued with them for about 2 years now and only got on them because of misdiagnosis and other health issues i.e SLEEP APNEA. My cognition and libido are destroyed and i find myself having to use a milligram scale in order to not get symptoms of acetylcholine excess and an influx of depressive negative thoughts if i reduce too quickly. The annoying thing is that i feel notieably better any time i take something with anti-serotonin properties such as Gingko or Vitex. Although too much of either can leave me feeling the depressive symptoms. My life is basically determined by these stupid drugs by the milligram..

Is anyone able to explain the mechanism behind SSRI withdrawal? If anti serotonin drugs make me feel better - I'd assume that reducing dose would help, yet every time I try I feel worse. I just want my cognition back but not at the cost of inescapable stress symptoms ....

 

[LucH]

Hi
You’re not really withdrawing serotonin with SSRI.
There are a lot of misunderstanding with SSRI’s drugs. Serotonin, like histamine, has its own physiological functions, but it’s a stress mediator that must be systematically balanced. See Ray PEAT’s article to understand the functions in details. This article too:

By increasing extracellular serotonin, SSRIs disrupt energy homeostasis and often worsen symptoms during acute treatment

Excerpt (from Ray PEAT's article):
Progesterone, thyroid, and niacinamide (not nicotinic acid or inositol hexanicotinate) are other safe substances that help reduce the formation of serotonin and / or speed up its elimination. (Niacinamide appears to increase the absorption of serotonin.) (…)

According to RP bamboo shoots or raw carrots helps reduce endotoxin and serotonin. Activated charcoal can absorb many toxins, including bacterial endotoxin; it is therefore likely to reduce the absorption of serotonin from the intestine. Since it can also bind or destroy vitamins, it should only be used intermittently. (…)

Hypothyroidism is a very common cause of increased serotonin (see for example, Henley, et al., 1998), and if one takes thyroid hormone supplementation until symptoms are resolved, it is likely that serotonin will be normalized.

I recently wrote an article (in French but with English links):
La sérotonine comme booster ou downer?
(Serotonin as booster or downer?) (With links in English)
Note: SSRI worsen the problem and do not help much, except among certain patients.

I would try to eat a collation with a banana or a mango or some pineapple, rich in tryptophan (at 4 or 5 o’clock PM) (the precursor of serotonin), without intake of other amino acids from meat (competition).
A piece of chocolate or a few pieces of shredded coconut, at the 4-5 p.m. snack would be good too.

Mind liver function (protection) and get informed on CO2 (carbon dioxide).

Poor digestion disrupts the microbiome and ultimately induces dysbiosis. This will disrupt and increase intestinal indoleamine 2,3-dioxygenase activity, which shifts tryptophan metabolism from modulating some useful enzymatic cascade.

“Indoleamine 2,3-dioxygenase deletion or inhibition improves insulin sensitivity, preserves the gut mucosal barrier, decreases endotoxemia and chronic inflammation, and regulates lipid metabolism in liver and adipose tissues.” Indoleamine 2,3-dioxygenase as a potential therapeutic target.
Genetic deficiency of indoleamine 2,3-dioxygenase promotes gut microbiota-mediated metabolic health

PS: I do not really understand all the process but keep in mind that homeostasis is the good path to search for. Less, not add. Try to capture excess hormones in order to balance (homeostasis).

Hope it will help.
LucH

 

[Frankdee20]

It’s going to take time

 

[dukesbobby777]

SSRI drugs are extremely powerful. If reduction in its intake makes you feel bad, then you need to taper off extremely slowly and/or carefully. Preferably under a medical professional’s supervision. If taking a anti-serotonin drug alongside the SSRI makes you feel better (whilst on the SSRI), you could carry on using it to mitigate the miserable side effects that occur from the SSRI. But you should find that apathetic, emotionless and zombie state should subside the more you lower the dosage. Good luck with it. I’ve been through SSRI withdrawal myself after taking low dose escitalopram for about a year.

The long term plan should be to try and increase thyroid function. If we consider that the stress hormones are excitatory, dulling, apathetic, neurotoxic (in many instances), etc (and many more words can describe them), then getting the body to run on thyroid is the only true other alternative. And many things can help with that. Hence some people who join this forum don’t even know to start. I only mention this because it’s important to move somewhere more productive (and to a place that is an improvement) from the grip of state dominated by heavy serotonin reuptake.

 

[Frankdee20]

SSRI drugs are extremely powerful. If reduction in its intake makes you feel bad, then you need to taper off extremely slowly and/or carefully. Preferably under a medical professional’s supervision. If taking a anti-serotonin drug alongside the SSRI makes you feel better (whilst on the SSRI), you could carry on using it to mitigate the miserable side effects that occur from the SSRI. But you should find that apathetic, emotionless and zombie state should subside the more you lower the dosage. Good luck with it. I’ve been through SSRI withdrawal myself after taking low dose escitalopram for about a year.

The long term plan should be to try and increase thyroid function. If we consider that the stress hormones are excitatory, dulling, apathetic, neurotoxic (in many instances), etc (and many more words can describe them), then getting the body to run on thyroid is the only true other alternative. And many things can help with that. Hence some people who join this forum don’t even know to start. I only mention this because it’s important to move somewhere more productive (and to a place that is an improvement) from the grip of state dominated by heavy serotonin reuptake.

He can expect adrenaline storms and all sorts of dysregulation in his physiology though, when I had this issue, every supplement gave me flashbacks

 

[dukesbobby777]

He can expect adrenaline storms and all sorts of dysregulation in his physiology though, when I had this issue, every supplement gave me flashbacks

Did you get the brain zaps? Yeah I agree. I’m glad I was only on a low dose of escitalopram. And even that was difficult to come off. I think a long taper off should be the best approach to try and minimize the withdrawal.

 

[Jwicks1995]

SSRI drugs are extremely powerful. If reduction in its intake makes you feel bad, then you need to taper off extremely slowly and/or carefully. Preferably under a medical professional’s supervision. If taking a anti-serotonin drug alongside the SSRI makes you feel better (whilst on the SSRI), you could carry on using it to mitigate the miserable side effects that occur from the SSRI. But you should find that apathetic, emotionless and zombie state should subside the more you lower the dosage. Good luck with it. I’ve been through SSRI withdrawal myself after taking low dose escitalopram for about a year.

The long term plan should be to try and increase thyroid function. If we consider that the stress hormones are excitatory, dulling, apathetic, neurotoxic (in many instances), etc (and many more words can describe them), then getting the body to run on thyroid is the only true other alternative. And many things can help with that. Hence some people who join this forum don’t even know to start. I only mention this because it’s important to move somewhere more productive (and to a place that is an improvement) from the grip of state dominated by heavy serotonin reuptake.

How would I approach increasing thyroid function? This area is something I lack knowledge in. I'm versed in pharmacology other neighbouring aspects but I've never delved much on thyroid health etc. I know my TSH a few years back was quite good - 0.6 I believe. Would something on idea labs store assist my thyroid?

 

[dukesbobby777]

How would I approach increasing thyroid function? This area is something I lack knowledge in. I'm versed in pharmacology other neighbouring aspects but I've never delved much on thyroid health etc. I know my TSH a few years back was quite good - 0.6 I believe. Would something on idea labs store assist my thyroid?

It’s just the most common things that you hear Ray Peat recommending. Getting enough protein. Getting enough carbs and being restrictive with PUFA intake. But remind yourself that it’s a long ball game. PUFA accumulated in the tissues can take up to four years to expel. So you can do everything right and still struggle with temps, pulse, mood, etc. Also the gut can be a huge thing to master, and just finding things that you can successfully eat without getting endotoxin reactions.

If I were in your situation, I’d focus on slowly tapering from the SSRI, but I’d immediately get enough protein each meal (per day) and always eaten with enough carbs. The ample amounts of protein per meal will help a lot with brain function and stress. Restrict the PUFAs to the maximum. Don’t be afraid of the saturated fats. Always make sure you eat enough calories each day, and try to eat the most nutritious food you can. Get the Cronometer app on your phone and track your diet.

Everything on IdeaLabs will assist the thyroid (either directly or indirectly). They have so many supplements working in differing mechanisms it’s hard to recommend anything in particular. Just read as much as you can about the products beforehand if you decide to purchase any, as they are all strong metabolic boosters in their own ways. And if you end up taking a few at once, it can be easy to overdo it.