# My Head Hurts #4: The Side Effects *12 October 2025*  > [!info] Important! > It's important to say, I'm not a Doctor. The following is my personal experience. Please talk to your Doctor before you change your medication. This is the fourth post in a series detailing my experience of antidepressant withdrawal syndrome. Starting in November 2024, I tapered down my use of Amitriptyline over eight months. At the same time, starting to take Fluoxetine (Prozac), originally 40 mg/day, I now take 30 mg. I finally stopped taking the Amitriptyline three months ago, with my final dose of 2 mg. My symptoms haven't changed significantly since [[My Head Hurts 3]] last month; except for the bouts of pain/ache/restlessness (see below), which are far worse. In each post, I've referred to the side effects, but I haven't really gone into any detail about how they affect me or how they've changed over time. Everything I've read indicates that we all experience side effects in different ways and to varying degrees. > *"My head hurt so profoundly that it made me incapable of doing anything other than sitting still, in a quiet room with my eyes closed".* The severity also seems very dependent on several factors, including: - **How long you'd been taking the medication before you started tapering.** I took Amitriptyline for 25 years. The dose varied; at one point, it was 50 mg/day. - **The dose when you started tapering.** I started tapering from a dose of 25 mg/day. - **How quickly you tapered.** Both the size of the reduction and the time between steps. What is known as hyperbolic tapering (very slowly) seems to be the current accepted best practice. I might post about that in the future. This [guide from the Royal College of Psychiatrists](https://www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/stopping-antidepressants) is helpful. The time you're taking the medication seems less significant the longer you're on it. In other words, stopping after four months should be easier than after twelve months. The difference between, say, ten years and twenty years may not be so great. > [!info] Important! >Please remember, this is my layperson's understanding of complicated medical data. Always discuss your medication with your Doctor. ## How withdrawal affects me The UK mental health charity, Mind, produces a [list of common withdrawal side effects](https://www.mind.org.uk/information-support/drugs-and-treatments/antidepressants/withdrawal-effects-of-antidepressants) which correlate closely with my personal experience. Headaches, for example, were very significant in the early stages but have become far less pronounced over time. - **Joint pain, aches, numbness and restless legs**: I've always struggled to describe this feeling. It's very similar to the drained ache you get with flu, at times it feels as like an electric shock (update: since posting, I discovered this condition is known as [akathisia](https://en.wikipedia.org/wiki/Akathisia)). My lower legs and forearms are most affected, but recently it's more of a whole body thing. For me, it's by far the worst side effect. - **Insomnia**: Some of my inability to sleep is a result of the aches and pains, most noticeably in my legs. But there also seems to be an element of standard insomnia thrown in for good measure. - **Tiredness**: This is obvious, I suppose. But the overwhelming fatigue has the largest impact on my day-to-day activity levels. - **Cold/flu symptoms**: Cough, sore throat, and a blocked nose. - **Itchy skin**: I seem to have developed a more pronounced histamine response. I normally suffer from mild hay fever, but that was far worse this year. I get very itchy skin, although a daily antihistamine tablet mainly keeps it at bay. - **Dizziness**: Thankfully, this has largely disappeared in the last couple of months. - **Nausea**: Not too bad. It comes in waves, but subsides very quickly. - **Headaches**: Withdrawal was heralded by the most overwhelming headaches, hence the name of this series. My head hurt so profoundly that it made me incapable of doing anything other than sitting still, in a quiet room with my eyes closed. Thankfully, they're far less frequent and much less severe. - **Sensitivity to certain noises**: This is a weird one. I've become very sensitive to certain noises. Imagine clanging a saucepan lid on something hard, that's the one! In writing this list and trying to describe each of the symptoms, I realise that in the main they're all connected to the nervous system, but I guess that makes perfect sense. Antidepressants change brain chemistry; my brain is now trying to readjust, after 25 years, to the absence of Amitriptyline. As I've mentioned before, my nagging concern is that maybe the side effects of withdrawal stopped some time ago, and what I'm experiencing is a reaction to the Fluoxetine. I don't think that's the case, but it would be good to know for sure. Unfortunately, I started taking Fluoxetine at the same time I cut down the Amitriptyline. Changing two independent variables concurrently is never a good idea. Then I'm not a psychological experiment, or am I? Dr Mark Horowitz's [website](https://markhorowitz.org/) offers the most practical, professional advice I've found online. The academic papers are impenetrable to the non-professional, but he has useful [links to newspaper articles](https://markhorowitz.org/media-articles/) which explain things in layman's terms. The UK mental health charity, [Mind](https://www.mind.org.uk/information-support/drugs-and-treatments/antidepressants/withdrawal-effects-of-antidepressants/), is also a good resource. Take care out there. Previous post: [[My Head Hurts 3]] #Amitriptyline #Fluoxetine #MHH #mental-health #lester-beall > [!Comments] > As yet, I don't have any way to accept comments directly on the blog. > Feel free to [email](mailto:[email protected]).