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nutritional support

Anxiety case study: a very very slow SSRI taper with tryptophan and other nutritional support

August 28, 2020 By Trudy Scott 6 Comments

anxiety case study

Today I’m sharing an update from someone in my community who is tapering from an SSRI (Cipralex/lexapro) in the best way possible – very methodically and doing a very very slow taper, using compounded medication and nutritional support. It is a team approach with a supportive doctor monitoring for serotonin syndrome, her pharmacist compounding her medication and input from me.

She has an excellent diet that contains enough healthy protein and fats, plenty of vegetables, and no sugar or caffeine. She has the basic nutrients covered and is on the pyroluria protocol (these nutrients help make serotonin). She is using the amino acid tryptophan for serotonin support as she tapers. And she is out walking in nature and practicing mindfulness.

All of this sets her up for success and being able to avoid antidepressant discontinuation syndrome.

Here is her story:

I began tapering off 10 mg of Cipralex in November 2017. I have my little “Support Team” that includes a compounding pharmacist and my GP. Feeling very fortunate that I have these people as my taper has not exactly gone as planned (although far better than my last two attempts)

Originally, the plan was to go down by 10% of the dose and stay at that dose for 4 weeks. That didn’t work for me. I was fine when I dropped from 10mg to 9, but after my next 10% drop I experienced that familiar withdrawal hell. I got a little scared, but stuck with it, and decided to stay at that dose for a bit longer. While I leveled out, I did a lot of reading about how SSRIs work. I learned about the 1/2 life of Cipralex (all SSRIs have a different 1/2 life) and what was actually happening physiologically as my body adjusts to the lower dose. It’s a recovery process.

With that new knowledge, I decided to try another approach. I knew I couldn’t handle a drop of 10%. So, I started to taper at a rate of 0.1mg once a week (far less than 10%!). By day three at the new dose, I could feel the withdrawal, but it was far less severe. Small drops=small “withdrawal wave”. I discovered that I am able to manage a 2% drop of the current dose and I have been able to drop that % each week. So, I’m still reducing by 8% a month, which means I am close to the original plan of dropping by 10% a month. At this time I am at 6.24mg.

Yes, it is a very slow process and I have a long way to go, but it’s working. I have read that some people have to reduce by 1% of their current dose and remain at that dose for 4 weeks to allow their body the time to heal and adjust to life on the lower dose. Having the liquid compound has made such a difference! You sure would have difficulty accurately shaving off a pill by 2%!! If anyone is trying to come off of this drug, do your best to find a compounding pharmacist!

I find that I must stick to a very healthy diet. I eat a lot of fresh, raw and cooked vegetables. I mean a LOT of vegetables. I eat good sources of protein and walk for at least 45 min almost every day. I steer clear of sugar and caffeine. Both make my withdrawal much worse.

Every day I take omega 3, vitamin C, vitamin D, vitamin B complex. I take the supplements for pyroluria, vitamin B6, evening primrose oil and zinc. I take magnesium at night. I took Trudy’s amino acids course online and did all of the amino acid trials. I discovered all I really need is tryptophan. It has made a huge difference for me. Yes, I take Lidke tryptophan. For us Canadians, it can be ordered online.

I practice mindfulness. I’ve read a lot about the anxious brain (the reason I took Cipralex in the first place) so I understand what is happening now, what is real and what is just noise in my head.

Antidepressant discontinuation syndrome

This is the best way to taper SSRI medications in order to avoid withdrawal effects, also known as discontinuation syndrome which can be very severe for some folks.

Accordingly to this paper, Antidepressant discontinuation syndrome occurs in about 20% of patients who reduce the dose or abruptly stop an antidepressant that they have been taking for one month. This paper states that “symptoms are usually mild….occur within two to four days after drug cessation and usually last one to two weeks.”

It also states that occasionally symptoms “may persist up to one year…and if the same or a similar drug is started, the symptoms will resolve within one to three days.”

I typically hear from individuals who fall into the category of severe symptoms that are persisting past 2 weeks. It’s not uncommon to see symptoms continue for a year and often longer in some cases.

Also from the above paper, is the mnemonic FINISH which summarizes these symptoms:

  • Flu-like symptoms (lethargy, fatigue, headache, achiness, sweating)
  • Insomnia (with vivid dreams or nightmares)
  • Nausea (sometimes vomiting)
  • Imbalance (dizziness, vertigo, light-headedness)
  • Sensory disturbances (“burning,” “tingling,” “electric-like” or “shock-like” sensations) and
  • Hyperarousal (anxiety, irritability, agitation, aggression, mania, jerkiness).”

How you will feel if your serotonin is low and how to learn more

With low serotonin you will have the worry-in-your-head and ruminating type of anxiety, panic attacks and phobias, lack of confidence, depression, negativity, imposter syndrome, PMS, irritability, anger issues, insomnia and afternoon/evening cravings.

If you suspect low serotonin symptoms and are new to using the amino acids and do not have my book I highly recommend getting it and reading it before jumping in to taking supplements and navigating this with your prescribing physician: The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings. You may need to lend him/her a copy of my book too.

There is a complete chapter on the amino acids and one for pyroluria, plus information on real whole food, sugar and blood sugar, gluten, digestion and much more.  If you’re not a reader there is now also an audible version.

Here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution and additional information on Anxiety and targeted individual amino acid supplements: a summary

Please also read and follow these Amino Acid Precautions.

This lists The Antianxiety Food Solution Amino Acid and Pyroluria Supplements that I use with my individual clients and those in my group programs – you will find the Lidtke Tryptophan here. You can also read more about why I prefer the Lidtke tryptophan on this blog.

I would like to end off by saying how much I appreciate this woman and others sharing their stories like this so we can all learn!

Please also share your taper story and what you did to make it easier.  If you had challenges share those too. Let us know if you can relate to any of the above FINISH symptoms and how long they lasted.

Feel free to post your questions here too.

Filed Under: Anxiety, Tryptophan Tagged With: achiness, aggression, agitation, antidepressant, anxiety, B6, burning, cravings, diet, Dizziness, fatigue, flu-like symptoms, headache, insomnia, irritability, jerkiness, lethargy, light-headedness, mania, nausea, Nightmares, nutritional support, panic, serotonin, shock-like sensations, SSRI, SSRI taper, sweating, tingling, tryptophan, vertigo, vivid dreams, vomiting, worry, zinc

Nutritional and lifestyle support for mercury toxicity and detoxification in general

February 4, 2018 By Trudy Scott 7 Comments

 

I’ve poured through most of the transcripts of the Heavy Metals Summit and there is so much information on nutritional and lifestyle support for mercury toxicity and the detoxification process in general:

  • sweating and using a sauna in order to detox through the skin
  • broccoli sprouts (due to a glutathione boost from sulforaphane, an organosulfur compound – in Julie Matthews’s interview)
  • reducing EMF/ELF and microwave exposure – in Dr. Mercola’s talk! He shares how all this can make matters worse and has some simple approaches like turning off power in the bedroom at night! This was new to me and a brilliant approach!
  • eating organic (to minimize GMO/glyphosate effects on a leaky gut and a leaky blood brain barrier) and never using Roundup
  • addressing low zinc and low selenium
  • supporting methylation so the body can detox on it’s own
  • supporting the liver and increasing bile production which is needed for detoxification
  • addressing low stomach acid which is needed for bile production and absorption of minerals like zinc (which is depleted by heavy metals)
  • avoiding meds like PPIs (which reduce stomach acid) and NSAIDs (which contribute to leaky gut)
  • thyroid support/iodine (as needed)
  • getting the brain’s glymphatic system working with sufficient sleep, melatonin (liposomal) and even liposomal GABA (in Dr. Christine Schaffer’s interview)
  • supporting the vagus nerve in order to improve digestion and detoxification
  • using an air filter and water filters
  • using foods/products like curcumin, ginger, probiotics, apple pectin
  • adding DPP-4 enzyme for gluten issues (mercury depletes this)
  • avoid energy-efficient bulbs (they are high mercury)
  • having Epsom salts baths
  • improving elimination from the bowels and much more

This is the support I offer as a nutritionist and it’s wonderful to hear all these doctors/practitioners discuss about all this with a tie back to mercury, lead and other metals.

Whey is not mentioned on the summit but since someone shared how it’s benefiting her (in the comments of the Boyd Haley blog) I’m sharing here too since it helps with glutathione production. In this paper “a case is made for the use of hydrolyzed whey protein to support metal detoxification and neurological function.” I recommend whey to clients if tolerated.

Many years ago I heard a presentation by a biological dentist who then became a nutritionist – he shared that he used whey with mercury toxic patients (together with other nutrients) and saw metals go up in hair analysis and then come down as their symptoms improved.

As I’ve mentioned in the past, mercury chelation is a controversial topic and you’ll see comments very divided on what the safest approach is. This is not my area of expertise and I’m very cautious with recommendations in this area as I’ve had reports of harm from individuals using all the approaches you’ll hear about on the summit (and even the Andy Cutler protocol which is not covered). My best advice is to follow all the nutritional/lifestyle recommendations and if you do decide to go the chelation root, do your homework, find a practitioner to work with and listen to your gut. If what you’re doing doesn’t feel right then stop doing it.

As with any chronic health condition, mercury detox is a comprehensive approach and very individualized.

There is also a discussion about safe removal of amalgams/mercury fillings. They do need to be done safely so as not to cause further issues. The IOMT also offers excellent guidelines.

The summit also covers other metals like copper (Ann Louise Gittleman covers this and I blog about it here), arsenic (Dr. Joseph Pizzorno covers this – reducing consumption is a big factor; and non-organic chicken is a source) and aluminum.

You can still register here to hear day 7 interviews and the encores: The Heavy Metals Summit.

Have you seen benefits with a nutritional approach?

Filed Under: Events Tagged With: anxiety, broccoli, detox, detoxification, heavy metals summit, liver support, magnesium, mercury, mercury toxicity, minerals, nutritional, nutritional support, sauna, sleep, zinc

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