stopping fluvoxamine

[watercolors]

I had a very difficult summer with my OCD, anxiety and depression. I went off fluoxetine ( I know, bad decision) and my ocd, anxiety and depression came back full force. I went to therapy, and met with a psychiatrist. She put me back on fluoxetine. I developed a rash and blood spots. She took me off of fluoxetine and put me on fluvoxamine. This medicine worked so well. I have felt like my self again for the past 3 months. Unfortunately, a week ago I had post menopausal spotting for about 3 days and a few days ago blood spots appeared on my arm again. I called the on call psychiatrist , who said to stop taking meds , no weaning. I have an appointment with my psychiatrist tomorrow morning. I am very worried about my anxiety, ocd, and depression returning. I am worried that there isn't a medicine I can tolerate. And I am terrified of the post meno bleeding that I had.

[panic_down_under]

Unfortunately, a week ago I had post menopausal spotting for about 3 days and a few days ago blood spots appeared on my arm again. I called the on call psychiatrist , who said to stop taking meds , no weaning.

All SSRIs are mild anticoagulants so the spotting may have been caused by fluvoxamine, but it equally may not be. Either way, unless you also need to take other anticoagulants, including NSAID painkillers such as aspirin, you probably won't need to discontinue the AD.


I have an appointment with my psychiatrist tomorrow morning.

I wouldn't discontinue the med until you've talked with your psychiatrist. Quitting any AD 'cold-turkey' is very unwise. If you do need to discontinue fluvoxamine then the better option is to switch to another med overnight. With the exception of switching to/from MAOI class ADs there is no need to wean off one AD to switch to another.

[watercolors]

Thank you for responding. I have not taken my fluvoxamine in 2 days. Tonight will be the third missed dose. I am seeing my psychiatrist early and am hoping if she wants me to stop taking it that I can be weaned off of it. I stopped an AD once "cold turkey'. It was awful. I have a lot of blood spots. I will just have to wait and see what she says.

[watercolors]

I saw my psychiatrist. She is not going to wean me off of fluvoxamine, Just stopping "cold turkey". I have not taken it in over a week and My OCD is already coming back. As soon as my spots are 60% gone she will start me on Zoloft. Fortunately, the spots are almost completely gone. I am so scared I will have the same issue on Zoloft. My anxiety is coming back full force. I'm crying a lot again. She doesn't think the post meno bleeding is connected to the fluvoxamine, so I have to get that checked out. SO , of course, my health anxiety is increasing.

[panic_down_under]

I saw my psychiatrist. She is not going to wean me off of fluvoxamine, Just stopping "cold turkey".

Sigh. :emot-fail: The one saving grace in this is that if you have to cold-turkey a SSRI then fluvoxamine is probably the one to do it from as while it has a relatively short elimination half-life in plasma of 15-22 hours, it seems to be metabolised more slowly in the brain with a half-life there of around 58-80 hours which usually moderates the crash into severe anxiety though it may not ease any physical withdrawal symptoms elsewhere.


I have not taken it in over a week and My OCD is already coming back.

That fits with the brain half-life timing.


As soon as my spots are 60% gone she will start me on Zoloft. Fortunately, the spots are almost completely gone. I am so scared I will have the same issue on Zoloft.

Unfortunately, there is no way of knowing whether sertraline (Zoloft) will also cause the blood spots, though if two SSRIs have apparently triggered the same symptom the risk is likely greater than 50:50. The problem is doctors these days often have little experience with older ADs so tend to stick with what they know, SSRIs and SNRIs plus a few 'orphan' ones like mirtazapine.

[watercolors]

Yikes! These withdrawl symptoms are awful. I am dizzy with brains zaps and headaches. Will the zoloft help ease these symptoms once I begin taking it? I agree with you that I will probably have the same reaction with the zoloft. This is tough. It isn't easy starting and stopping these meds, as so many on this forum know. Thank you for responding. Next psychiatrist appt on friday.

[panic_down_under]

Yikes! These withdrawl symptoms are awful. I am dizzy with brains zaps and headaches.

Any of the usual otc painkillers should ease the headache, but paracetamol/acetaminophen is preferred when taking sertonergic ADs as they are moderate anticoagulants as are the NSAIDs such as aspirin and ibuprofen, etc. Unfortunately, I don't know of any way of stopping the zaps.


Will the zoloft help ease these symptoms once I begin taking it?

It should do.


I agree with you that I will probably have the same reaction with the zoloft...It isn't easy starting and stopping these meds

The only predictable thing about ADs is their unpredictability so we could both be pleasantly surprised. Hope so. :emot-nod: 🤞

[watercolors]

Thank you for your reply. Today my symptoms are easing. Dizziness and headaches went away. Brain zaps have lessened.

[panic_down_under]

That's great! :yesyes:

[watercolors]

Had a good day yesterday. Not so good today. I don't know if it is part of the withdrawl or because my anxiety is increasing. Having a lot of the brain zaps today and sweating. It's been a very very stressful week. I want to feel better. Psychiatrist tomorrow.

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I am breaking out already. I am stopping zoloft. My son and I both have covid. 😒

[panic_down_under]

Seems like all the SSRIs and SNRIs are going to cause blood spots. The older TCA ADs are likely to be a better bet. Either amitriptyline, or nortriptyline. Amitriptyline still has a significant effect on serotonin, but less so than SSRIs/SNRIs, with nortriptyline being mostly a noradrenaline, aka norepinephrine, reuptake inhibitor with only a weak impact on serotonin.