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Dejavu: can anyone tell me what's going on?


Dejavu

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  • Moderator Emeritus
Posted (edited)

I hope this post is not too long, but I have been through the pharmaceutical wringer and I'm not being heard, believed or helped by my doctors:

 

2 years ago around May 2016, I had my first panic attack. ER doc rx'd Ativan .5mg 3x a day. Never said a word about dependence.  After 3 weeks the script ran out and so I just stopped, and of course, all hell broke loose.

 

Went to my PCP who dx'd me with anxiety and rx'd xanax and Effexor. After 1 night of throwing up, I stopped the Effexor. What I didn't know at the time was that the dose of xanax he prescribed was HALF the equivalent of the ativan I had been taking. He obviously knew nothing about dosage equivalencies. I could not understand why I was so very sick.

 

I found a Pdoc who I thought was very understanding and said she could help me. She switched me to Klonopin and rx'd 25mg Zoloft, and upped the dosage to 50 mg after two weeks. After stabilizing on a whopping 3mg Klonopin, I started to cut, taking 50 mg Zoloft all the while. All during this time I was very weak and shaky, which I attributed to the benzo, but now I'm not so sure. 

 

I finished my benzo taper in Nov of last year, and really suffered very little, if any, acute, but still felt a little shaky.

 

I then decided to come off the zoloft, as the Pdoc stated it was "very gentle" and I could just quit. Being gun shy after the benzo fiasco, I did do a short taper and came off with no issues in January of this year. Shortly after that, my leg shakiness and hand tremor went away, but I still did not connect them to Zoloft, because all the emphasis was on benzo withdrawal and how "gentle" zoloft was. 

 

In May of this year, it was clear that my mother, who had been very, very sick for very, very long, was dying. By this time, I had a new PCP and no Pdoc. Since I was extremely stressed and grieving, my PCP suggested I go back on zoloft, and I didn't see why not, so I restarted 50 mg. Immediately, I had weakness and tremor again. In August 2018, two months after my Mom died, I decided to come off the Zoloft. Still believing it was a benign drug, I once again did a fast taper of about 3 weeks. I felt fantastic off of it - no more weakness or tremor, TONS more energy - until 31 days later when it all came back full force. The trembling, weakness, and anxiety just all of a sudden came back.

 

Finally, the penny dropped for me, and I found this site and realized it was withdrawal. I went back to my old Pdoc who laughed in my face and said withdrawal is impossible after 1 month. She told me to face the fact that I needed to be medicated and gave me the smallest dose of Lexapro. I took it for a week, but was feeling progressively worse, and I knew I didn't want her to treat me anymore. I went to my PCP and told her the whole story. She does believe me and is trying to help, but I think she's out of ideas.

 

She did give me a DNA test for drug sensitivities, which shows me to be a slow metabolizer of most SSRIs and SNRIs, and an "intermediate" metabolizer of one SSRI, Prozac. For lack of a better answer, she put me back on 25 mg of Zoloft to attempt stabilization, but its been 3 weeks and I just keep getting worse. I now have insomnia, very high chemical anxiety, muscle twitches, no appetite, cold feet, temp changes, diarrhea and morning cortisol spikes along with the weakness and tremor. I am effectively bedridden.

 

As of today, I have upped my dose to 37.5, but knowing that I retain high concentrations of zoloft for longer than normal, I worry about serotonin syndrome.

 

My PCP wants to switch me to Buspirone, since my DNA test indicates I would tolerate that well, but she wants me to find a Pdoc to help with the switch, so here we go again!! I just want to stablize on something so that I can function, and then down the road a couple or few months, start the long taper that should be done. Does anyone have any suggestions for me? I'm really struggling. Thanks for reading this long post.

 

Edited by ChessieCat
spacing

2016 - Zoloft 50 mg for klonopin w/d

Approx. Nov 2017 - successful taper of klonopin; Approx. Jan. 2018 - rapid taper Zoloft over 2 wks - no w/d symptoms; May 2018 - Reinstate 50 mg Zoloft per doctor; Aug 2018 - Rapid taper Zoloft over 3-4 weeks - no w/d symptoms for 1 mo.; Late Oct 2018 - pdoc rx'd 5mg lexapro -took for 1 wk; Early Nov 2018 - Reinstate 25 mg Zoloft; updose to 37.5 on Nov 28, 2018; Nov 30 2018 - returned to 25mg Zoloft upon mod. advice; Dec 9 - Dec10 2018 - 12.5mg zoloft liquid+12.5mg zoloft pill; Dec 11 2018 - 25mg zoloft all liquid; Feb 14 2019 - updosed to 26.25 mg liquid; Mar 6 2019 - updosed to 26.88 mg liquid - new symptoms; Mar 13 2019 - back down to 26.25 mg per mod suggestion

Dose Changes: Dec 2 2019 - 5% to 25mg; Jan 14 2020 - 10% to 22.5 (increase in sxs all month); Mar 10-15? 2020,  accidental updose to 25mg; Mar 22 2020 - back down to 22.5mg; Apr 12 2020 - 2.5% to 21.94mg; Apr 19 2020 - 2.5% to 21.375mg (symptom increase); May 17 2020 - 2.5% to 20.625mg; May 24 2020 - 2.5% to 20.1mg - Jun 14 2020 - noticed uptick in symptoms settled 2 days later - July 10 2020 - onset of wave

  • ChessieCat changed the title to Dejavu: Can anyone tell me what's going on?
  • Moderator Emeritus
Posted

Hello Dejavu, welcome to SA.  It does sound like you were hit with Zoloft withdrawal.  As for the doctor who claimed Zoloft is "gentle", I'm afraid that's the stupidest thing I've heard in a long time.

 

It would be helpful if you could create a signature containing a summary of your med history, including all drugs, doses and dates (starting and stopping).  Your signature appears below every post you make, and helps us see your situation easily without having to read from the top every time.   You could look at my signature for an example.  Instructions for creating your signature are here: Please put your withdrawal history in your signature.  You can edit your signature here: edit your signature in Account Settings.

 

Regarding a switch to buspirone - doctors often want people in withdrawal to switch meds, and usually we see that it does not help and often makes things worse.  The various different meds often do not cover for each other very well at all.  We often see people being switched from one drug to another repeatedly, trying to find the magic pill that fixes everything, and instead causing complete chaos in their nervous systems.

 

I think reinstating the Zoloft was probably a good idea, but it can be tricky to choose a good reinstatement dose, as people can become very sensitive after some time off a drug, and a much lower than normal dose may be better, to prevent adverse reactions.  See this topic for more information:  about reinstating and stabilizing to reduce withdrawal symptoms.  How have your symptoms changed since reinstating Zoloft?  Do you feel that the reinstatement has helped at all, or made things worse?   

 

Please post all your updates and questions about your situation here in your introduction topic, and we will try to help you as best we can.

2001–2002 paroxetine

2003  citalopram

2004-2008  paroxetine (various failed tapers) 
2008  paroxetine slow taper down to

2016  Aug off paroxetine
2016-2017  citalopram May 20mg  Oct 15mg … slow taper down to 4.8mg
2018-2023 Feb 4.6mg slow taper down to 1.0mg

2024  Jan 0.9mg  Mar 0.8mg May 0.7mg Aug 0.6mg Oct 0.5mg

  • Moderator Emeritus
Posted

Thanks for responding. I don't tolerate Zoloft too well. It makes me weak and shaky and it takes quite a while for that particular side effect to settle down (it never goes completely away as long as I'm taking it). Right now, since I've just updosed, it's pretty debilitating. I know from my DNA test that I'm a very slow metabolizer of SSRIs, but the test also indicated that either Buspirone or Trazodone would work better for me and not likely to cause side effects. That's the only reason I am tempted to switch. I suspect that a long slow taper from a med that gives me fewer side effects might be an easier ride down, long term. I intend to go as slow as I need to in order to stay functional. But with the Zoloft, I feel like I'm stuck - side effects on the front end and withdrawal symptoms on the back.  But if switching most likely won't work, it doesn't seem like I have a choice but to sit still on 37.5 until I stabilize. I hope it happens fairly soon - I'm off work until Jan, but after that I have to get back to work or I will lose clients. My job involves going to the courthouse several times a week, a great deal of walking, and dealing with lawyers, judges and defendants, none of which I feel I can handle at present - physically OR emotionally. Trying not to worry too much about that right now, but its hard when the chemical anxiety is ramped up so much at the moment. Should I just wait to stabilize? I feel like I should be doing something more proactive than just waiting, but patience has never been one of my virtues. Guess I'm just scared...

2016 - Zoloft 50 mg for klonopin w/d

Approx. Nov 2017 - successful taper of klonopin; Approx. Jan. 2018 - rapid taper Zoloft over 2 wks - no w/d symptoms; May 2018 - Reinstate 50 mg Zoloft per doctor; Aug 2018 - Rapid taper Zoloft over 3-4 weeks - no w/d symptoms for 1 mo.; Late Oct 2018 - pdoc rx'd 5mg lexapro -took for 1 wk; Early Nov 2018 - Reinstate 25 mg Zoloft; updose to 37.5 on Nov 28, 2018; Nov 30 2018 - returned to 25mg Zoloft upon mod. advice; Dec 9 - Dec10 2018 - 12.5mg zoloft liquid+12.5mg zoloft pill; Dec 11 2018 - 25mg zoloft all liquid; Feb 14 2019 - updosed to 26.25 mg liquid; Mar 6 2019 - updosed to 26.88 mg liquid - new symptoms; Mar 13 2019 - back down to 26.25 mg per mod suggestion

Dose Changes: Dec 2 2019 - 5% to 25mg; Jan 14 2020 - 10% to 22.5 (increase in sxs all month); Mar 10-15? 2020,  accidental updose to 25mg; Mar 22 2020 - back down to 22.5mg; Apr 12 2020 - 2.5% to 21.94mg; Apr 19 2020 - 2.5% to 21.375mg (symptom increase); May 17 2020 - 2.5% to 20.625mg; May 24 2020 - 2.5% to 20.1mg - Jun 14 2020 - noticed uptick in symptoms settled 2 days later - July 10 2020 - onset of wave

  • Moderator Emeritus
Posted
6 minutes ago, Dejavu said:

Thanks for responding. I don't tolerate Zoloft too well. It makes me weak and shaky and it takes quite a while for that particular side effect to settle down (it never goes completely away as long as I'm taking it). Right now, since I've just updosed, it's pretty debilitating. I know from my DNA test that I'm a very slow metabolizer of SSRIs, but the test also indicated that either Buspirone or Trazodone would work better for me and not likely to cause side effects. That's the only reason I am tempted to switch. I suspect that a long slow taper from a med that gives me fewer side effects might be an easier ride down, long term. I intend to go as slow as I need to in order to stay functional. But with the Zoloft, I feel like I'm stuck - side effects on the front side and withdrawal symptoms on the back.  But if switching most likely won't work, it doesn't seem like I have a choice but to sit still on 37.5 until I stabilize. 

 

It's hard to say whether a switch will work, it's very unpredictable, but it's definitely a high-risk gamble.  As far as the compromise of side effects versus withdrawal effects - this is why it's tricky choosing a reinstatement dose.  The 37.5mg dose might be too much.  We need to know your symptom pattern after each change in dose.  Please can you answer my questions from above:

 

1 hour ago, Songbird said:

 How have your symptoms changed since reinstating Zoloft?  Do you feel that the reinstatement has helped at all, or made things worse?   

 

What happened after you reinstated at 25mg Zoloft?  Did anything improve?  Why did you decide to increase dose to 37.5mg?  Have you felt any difference since the increase?  We need as much information as possible in order to be able to give helpful replies.

2001–2002 paroxetine

2003  citalopram

2004-2008  paroxetine (various failed tapers) 
2008  paroxetine slow taper down to

2016  Aug off paroxetine
2016-2017  citalopram May 20mg  Oct 15mg … slow taper down to 4.8mg
2018-2023 Feb 4.6mg slow taper down to 1.0mg

2024  Jan 0.9mg  Mar 0.8mg May 0.7mg Aug 0.6mg Oct 0.5mg

  • Moderator Emeritus
Posted

Sorry to have left that out...brain fog, you know.

 

When I first reinstated, I felt a great deal better for about ten days. But I had a ridiculous amount of external stress going on - one of my brothers had a heart valve replacement, and while he was hospitalized, my other brother collapsed, and then he too needed quadruple bypass surgery. Having just lost my mom and my sister a year before, and realizing how close I came to losing my only two remaining siblings at the same time, worked my already delicate nervous system into a meltdown. Anxiety and insomnia have been ever present. So, because of that and also because I realized that my reinstatement dose of 25mg represented a 50% cut, I made the decision to go up to 37.5. That was only 2 days ago, so I'm still not sure if it was the right thing to do. The weakness and tremor is intensified, but it always is after an updose. Do you think it would be better to go back down to 25 mg since its only been 2 days, or would that be likely to make things worse?

2016 - Zoloft 50 mg for klonopin w/d

Approx. Nov 2017 - successful taper of klonopin; Approx. Jan. 2018 - rapid taper Zoloft over 2 wks - no w/d symptoms; May 2018 - Reinstate 50 mg Zoloft per doctor; Aug 2018 - Rapid taper Zoloft over 3-4 weeks - no w/d symptoms for 1 mo.; Late Oct 2018 - pdoc rx'd 5mg lexapro -took for 1 wk; Early Nov 2018 - Reinstate 25 mg Zoloft; updose to 37.5 on Nov 28, 2018; Nov 30 2018 - returned to 25mg Zoloft upon mod. advice; Dec 9 - Dec10 2018 - 12.5mg zoloft liquid+12.5mg zoloft pill; Dec 11 2018 - 25mg zoloft all liquid; Feb 14 2019 - updosed to 26.25 mg liquid; Mar 6 2019 - updosed to 26.88 mg liquid - new symptoms; Mar 13 2019 - back down to 26.25 mg per mod suggestion

Dose Changes: Dec 2 2019 - 5% to 25mg; Jan 14 2020 - 10% to 22.5 (increase in sxs all month); Mar 10-15? 2020,  accidental updose to 25mg; Mar 22 2020 - back down to 22.5mg; Apr 12 2020 - 2.5% to 21.94mg; Apr 19 2020 - 2.5% to 21.375mg (symptom increase); May 17 2020 - 2.5% to 20.625mg; May 24 2020 - 2.5% to 20.1mg - Jun 14 2020 - noticed uptick in symptoms settled 2 days later - July 10 2020 - onset of wave

  • Moderator Emeritus
Posted

Hi Dejavu, just popping into let you know that you've found the right place and the mods on here will be with you to help you figure out the proper dose. I am also trying to stabilize on a reinstated dose and it hasn't been easy.

 

Some quick words of encouragement: Stay strong. Listen to your body. Lean on trusted friends and family who can walk through this with you. Take notes on paper about your symptoms, daily activities, and meds/supplements so you can tell when things are improving. You WILL get through this. 

Apr 2018: Began 10 mg Amitriptyline (for headaches & insomnia from concussion).

Jul - Aug 2018: Fast taper to 5 mg and then 2.5 mg (too fast, hellish withdrawal at 2.5 mg). Sept 2018: Reinstated 10 mg (many symptoms improved). Oct 2018 - Apr 2019: Updosed & stabilized on 11 mg (2 waves at 3 and 5 months post-withdrawal). Apr 2019 - Apr 2020: Tapered 0.5-0.25 mg per month using compounded pills: 11 mg —> 6 mg. (2 waves at 12 and 16 months post-withdrawal.) Apr 2020 - present: Switched to a liquid taper at rate of 0.1 mg per month. Currently: 1.1 mg. No more waves. 

 

Supplements: Omega-3 fish oil, Vit B12, coenzyme Q10, Hawthorn extract (for tachycardia) Tools for insomnia/waves (as needed): Epsom salt foot soaks, 0.5 mg Melatonin, quality time, waves WILL PASS. Lifestyle: Eat real foods, mostly plants; sunlight, walking, yoga; symptom tracking on adapted Glenmullen chart.

  • Moderator Emeritus
Posted

Thank you Composter, for the kind words of encouragement. I need it right now. Very symptomatic today and don't know whether to take the 37.5 or go back down to 25. Hard to write anything down right now with tremor and muscle twitches, but I'll do my best. If anyone has dosing advice I would love to hear it. I don't want to start reducing before I'm stable in the reinstatement, but what if I don't stabilize? How long should I wait before deciding reinstatement did not work? 

2016 - Zoloft 50 mg for klonopin w/d

Approx. Nov 2017 - successful taper of klonopin; Approx. Jan. 2018 - rapid taper Zoloft over 2 wks - no w/d symptoms; May 2018 - Reinstate 50 mg Zoloft per doctor; Aug 2018 - Rapid taper Zoloft over 3-4 weeks - no w/d symptoms for 1 mo.; Late Oct 2018 - pdoc rx'd 5mg lexapro -took for 1 wk; Early Nov 2018 - Reinstate 25 mg Zoloft; updose to 37.5 on Nov 28, 2018; Nov 30 2018 - returned to 25mg Zoloft upon mod. advice; Dec 9 - Dec10 2018 - 12.5mg zoloft liquid+12.5mg zoloft pill; Dec 11 2018 - 25mg zoloft all liquid; Feb 14 2019 - updosed to 26.25 mg liquid; Mar 6 2019 - updosed to 26.88 mg liquid - new symptoms; Mar 13 2019 - back down to 26.25 mg per mod suggestion

Dose Changes: Dec 2 2019 - 5% to 25mg; Jan 14 2020 - 10% to 22.5 (increase in sxs all month); Mar 10-15? 2020,  accidental updose to 25mg; Mar 22 2020 - back down to 22.5mg; Apr 12 2020 - 2.5% to 21.94mg; Apr 19 2020 - 2.5% to 21.375mg (symptom increase); May 17 2020 - 2.5% to 20.625mg; May 24 2020 - 2.5% to 20.1mg - Jun 14 2020 - noticed uptick in symptoms settled 2 days later - July 10 2020 - onset of wave

  • Moderator Emeritus
Posted
6 hours ago, Dejavu said:

Very symptomatic today and don't know whether to take the 37.5 or go back down to 25. Hard to write anything down right now with tremor and muscle twitches, but I'll do my best. If anyone has dosing advice I would love to hear it. I don't want to start reducing before I'm stable in the reinstatement, but what if I don't stabilize? How long should I wait before deciding reinstatement did not work? 

 

I'm so sorry about your family's health problems - as you say, all that stress will have played a big role in this along with the withdrawal.  What symptoms are you having currently?  I think the reinstatement was the right idea, but choosing the dose is the tricky part.  After being off for a while, the nervous system will have made some changes, and reinstating the original dose can have a high risk of not working or causing adverse reactions.  It is possible that the 37.5mg dose may be too high.   I've asked other mods for their opinions on the dose, and we will get back to you soon. 

2001–2002 paroxetine

2003  citalopram

2004-2008  paroxetine (various failed tapers) 
2008  paroxetine slow taper down to

2016  Aug off paroxetine
2016-2017  citalopram May 20mg  Oct 15mg … slow taper down to 4.8mg
2018-2023 Feb 4.6mg slow taper down to 1.0mg

2024  Jan 0.9mg  Mar 0.8mg May 0.7mg Aug 0.6mg Oct 0.5mg

  • Moderator Emeritus
Posted

Thank you Songbird. I welcome any suggestions. I'm at a loss. The major problem is the weakness and tremors. When they are severe as they currently are, I can do almost nothing but lie down. Sometimes even sitting up is difficult. They happen any time I'm taking zoloft, but go down with dose reductions and stop completely when I'm off. That's why trying a med switch is so tempting right now. If I could only taper from something that doesn't cause the tremor I know I would have a much easier time of it. I know its a huge risk, but with my DNA test suggesting I would tolerate Buspar or Trazodone easier...well, I just don't know what to do. I did go ahead and abandon the 37.5 dose in favor of the 25 tonight. It just seems counterintuitive to updose that high when I'm suffering these intense SE's, but I will await more suggestions before I do anything else. I am grateful for your help.

2016 - Zoloft 50 mg for klonopin w/d

Approx. Nov 2017 - successful taper of klonopin; Approx. Jan. 2018 - rapid taper Zoloft over 2 wks - no w/d symptoms; May 2018 - Reinstate 50 mg Zoloft per doctor; Aug 2018 - Rapid taper Zoloft over 3-4 weeks - no w/d symptoms for 1 mo.; Late Oct 2018 - pdoc rx'd 5mg lexapro -took for 1 wk; Early Nov 2018 - Reinstate 25 mg Zoloft; updose to 37.5 on Nov 28, 2018; Nov 30 2018 - returned to 25mg Zoloft upon mod. advice; Dec 9 - Dec10 2018 - 12.5mg zoloft liquid+12.5mg zoloft pill; Dec 11 2018 - 25mg zoloft all liquid; Feb 14 2019 - updosed to 26.25 mg liquid; Mar 6 2019 - updosed to 26.88 mg liquid - new symptoms; Mar 13 2019 - back down to 26.25 mg per mod suggestion

Dose Changes: Dec 2 2019 - 5% to 25mg; Jan 14 2020 - 10% to 22.5 (increase in sxs all month); Mar 10-15? 2020,  accidental updose to 25mg; Mar 22 2020 - back down to 22.5mg; Apr 12 2020 - 2.5% to 21.94mg; Apr 19 2020 - 2.5% to 21.375mg (symptom increase); May 17 2020 - 2.5% to 20.625mg; May 24 2020 - 2.5% to 20.1mg - Jun 14 2020 - noticed uptick in symptoms settled 2 days later - July 10 2020 - onset of wave

  • Moderator Emeritus
Posted
19 hours ago, Dejavu said:

I did go ahead and abandon the 37.5 dose in favor of the 25 tonight. It just seems counterintuitive to updose that high when I'm suffering these intense SE's, but I will await more suggestions before I do anything else. I am grateful for your help.

 

Holding at 25mg sounds like a reasonable plan.  It would be helpful to keep daily symptom notes (you could write them on paper or in a notebook).  This will be useful to look for patterns over time, such as what symptoms improve, worsen, or stay the same.  Mods may ask you to post them here to assist us in understanding your situation.  Here's an example (note this is a made up example):

 

23 June

7 a.m. woke up, anxiety 3/10

8 a.m. ate breakfast, took 20mg Prozac tablet

10 a.m. anxiety 7/10, nausea 3/10

12 p.m. ate lunch, anxiety 5/10, nausea 1/10

2 p.m. anxiety 4/10, nausea 2/10

6 p.m. ate dinner, took magnesium tablet 200mg, anxiety 2/10, no nausea

8 p.m. anxiety 1/10

11 p.m. went to bed, anxiety 2/10, difficulty falling asleep for 2 hours

4 a.m. woke up, no anxiety, went back to sleep for 3 hours

2001–2002 paroxetine

2003  citalopram

2004-2008  paroxetine (various failed tapers) 
2008  paroxetine slow taper down to

2016  Aug off paroxetine
2016-2017  citalopram May 20mg  Oct 15mg … slow taper down to 4.8mg
2018-2023 Feb 4.6mg slow taper down to 1.0mg

2024  Jan 0.9mg  Mar 0.8mg May 0.7mg Aug 0.6mg Oct 0.5mg

  • Moderator Emeritus
Posted

Okay, thanks. I know this is a loaded question, but any general idea how long before I stabilize?

I'm starting to feel kinda hopeless; like I'm stuck.

 

2016 - Zoloft 50 mg for klonopin w/d

Approx. Nov 2017 - successful taper of klonopin; Approx. Jan. 2018 - rapid taper Zoloft over 2 wks - no w/d symptoms; May 2018 - Reinstate 50 mg Zoloft per doctor; Aug 2018 - Rapid taper Zoloft over 3-4 weeks - no w/d symptoms for 1 mo.; Late Oct 2018 - pdoc rx'd 5mg lexapro -took for 1 wk; Early Nov 2018 - Reinstate 25 mg Zoloft; updose to 37.5 on Nov 28, 2018; Nov 30 2018 - returned to 25mg Zoloft upon mod. advice; Dec 9 - Dec10 2018 - 12.5mg zoloft liquid+12.5mg zoloft pill; Dec 11 2018 - 25mg zoloft all liquid; Feb 14 2019 - updosed to 26.25 mg liquid; Mar 6 2019 - updosed to 26.88 mg liquid - new symptoms; Mar 13 2019 - back down to 26.25 mg per mod suggestion

Dose Changes: Dec 2 2019 - 5% to 25mg; Jan 14 2020 - 10% to 22.5 (increase in sxs all month); Mar 10-15? 2020,  accidental updose to 25mg; Mar 22 2020 - back down to 22.5mg; Apr 12 2020 - 2.5% to 21.94mg; Apr 19 2020 - 2.5% to 21.375mg (symptom increase); May 17 2020 - 2.5% to 20.625mg; May 24 2020 - 2.5% to 20.1mg - Jun 14 2020 - noticed uptick in symptoms settled 2 days later - July 10 2020 - onset of wave

  • Moderator Emeritus
Posted

It's hard to say how long it will take to stabilise.  It would be helpful if you can continue to post daily symptom notes.  Please include the time you take any meds and supplements and the dose taken, and the time and severity of symptoms throughout the day.  It would be good to see notes for the next few days to look for patterns and get a good idea what's going on.  It's possible that even the 25mg dose might be too much for your nervous system in its current sensitive state, in which case you might be better to reduce to a lower dose, e.g. 12.5mg.  The easiest way to get smaller doses is by using a liquid form of the drug.  Would you be able to get a prescription for liquid Zoloft?

2001–2002 paroxetine

2003  citalopram

2004-2008  paroxetine (various failed tapers) 
2008  paroxetine slow taper down to

2016  Aug off paroxetine
2016-2017  citalopram May 20mg  Oct 15mg … slow taper down to 4.8mg
2018-2023 Feb 4.6mg slow taper down to 1.0mg

2024  Jan 0.9mg  Mar 0.8mg May 0.7mg Aug 0.6mg Oct 0.5mg

  • Moderator Emeritus
Posted

I'm sure I can get my doc to rx a liquid. My plan has been to do a liquid taper as soon as I'm stable. Here are my notes from yesterday and so far today.

 

Dec 2 2018

Couldn't sleep last night until 4am

12:30 pm woke up - anxiety 9/10, weakness and tremor 10/10 - cant stand up or sit for long

 

1:30 - sat outside in sun and meditated 20 mins - anxiety 6/10

 

3pm - took 225mg magnesium - crying spell - appetite zero - ate fruit

 

5pm - lying down all day - anx. 8/10 - weakness 10/10

 

7pm - Ate small bowl of soup - took 2600 mg Fish Oil - crying spell - anx. 8/10 - depression 6/10 - weakness 8/10 - dizziness 2/10

 

9pm - Took shower - could barely stand long enough - weakness and tremor 9/10 - anxiety 9/10 - depression 9/10

 

10pm - took 25mg Zoloft - crying spell - everything else same

 

Dec 3

Midnight - Insomnia 10/10 - muscle twitches 3/10

 

2:30 am - Took 25 mg hydroxyzine and 6mg melatonin - fell asleep around 4am

 

12:30 pm - woke up with NO cortisol spike!! Anxiety 4/10 - depression 1/10 - weakness/tremor 7/10 - appetite 1/10 - diarrhea 2/10 - muscle twitches 1/10

 

3:30 pm - meditation/fell asleep - woke up w/anxiety 8/10 - depression 8/10 - appetite 3/10 - crying spell

 

4:30 pm - walked 1/4 mile on treadmill and got dressed - depression 9/10 - anxiety 9/10 - took 225mg magnesium and felt slight decrease in anxiety and depression 30 mins later - weakness/tremor 8/10 - dizziness 4/10

 

6pm - crying spell

 

7pm - weakness/tremor 6/10 - anxiety 6/10 - dizziness 4/10 - twitches 4/10 - appetite 4/10 - ate dinner - took 2600mg fish oil - diarrhea 6/10 - headache 2/10

 

 

 

 

2016 - Zoloft 50 mg for klonopin w/d

Approx. Nov 2017 - successful taper of klonopin; Approx. Jan. 2018 - rapid taper Zoloft over 2 wks - no w/d symptoms; May 2018 - Reinstate 50 mg Zoloft per doctor; Aug 2018 - Rapid taper Zoloft over 3-4 weeks - no w/d symptoms for 1 mo.; Late Oct 2018 - pdoc rx'd 5mg lexapro -took for 1 wk; Early Nov 2018 - Reinstate 25 mg Zoloft; updose to 37.5 on Nov 28, 2018; Nov 30 2018 - returned to 25mg Zoloft upon mod. advice; Dec 9 - Dec10 2018 - 12.5mg zoloft liquid+12.5mg zoloft pill; Dec 11 2018 - 25mg zoloft all liquid; Feb 14 2019 - updosed to 26.25 mg liquid; Mar 6 2019 - updosed to 26.88 mg liquid - new symptoms; Mar 13 2019 - back down to 26.25 mg per mod suggestion

Dose Changes: Dec 2 2019 - 5% to 25mg; Jan 14 2020 - 10% to 22.5 (increase in sxs all month); Mar 10-15? 2020,  accidental updose to 25mg; Mar 22 2020 - back down to 22.5mg; Apr 12 2020 - 2.5% to 21.94mg; Apr 19 2020 - 2.5% to 21.375mg (symptom increase); May 17 2020 - 2.5% to 20.625mg; May 24 2020 - 2.5% to 20.1mg - Jun 14 2020 - noticed uptick in symptoms settled 2 days later - July 10 2020 - onset of wave

  • Moderator Emeritus
Posted

Hang in there. I went through a very rough wave last week with the same sort of insomnia and crying spells you are writing about. Keep breathing, it WILL pass and your brain WILL stabilize.

 

Some non-drug tools for insomnia that have helped are 0.5 to 1 mg melatonin, Epsom salt foot soaks, and calming tea for sleep (you can find at CVS, Whole Foods, or TJ's). Sitting out in the sun is also very helpful; I'm glad you are doing that.

 

For the crying, anguish and despair, there is nothing that can replace the care from another human. I hope you have loved ones (family or friends) whom you can call. There are also helplines available where you can just call up and talk. 

 

If you have the resources to do so, see if you can connect w a psychiatrist or therapist near you who is familiar with AD withdrawal. Search this directory with your location: https://www.madinamerica.com/provider-directory/

 

As for how long it will take to stabilize, everyone is different, but it takes time. The worst of your symptoms should improve in 2-6 weeks. Beyond that, it may take months to feel fully stable, emotionally and physically. But rest assured you will feel much better than now. Remind yourself that this is temporary; it will pass.

Apr 2018: Began 10 mg Amitriptyline (for headaches & insomnia from concussion).

Jul - Aug 2018: Fast taper to 5 mg and then 2.5 mg (too fast, hellish withdrawal at 2.5 mg). Sept 2018: Reinstated 10 mg (many symptoms improved). Oct 2018 - Apr 2019: Updosed & stabilized on 11 mg (2 waves at 3 and 5 months post-withdrawal). Apr 2019 - Apr 2020: Tapered 0.5-0.25 mg per month using compounded pills: 11 mg —> 6 mg. (2 waves at 12 and 16 months post-withdrawal.) Apr 2020 - present: Switched to a liquid taper at rate of 0.1 mg per month. Currently: 1.1 mg. No more waves. 

 

Supplements: Omega-3 fish oil, Vit B12, coenzyme Q10, Hawthorn extract (for tachycardia) Tools for insomnia/waves (as needed): Epsom salt foot soaks, 0.5 mg Melatonin, quality time, waves WILL PASS. Lifestyle: Eat real foods, mostly plants; sunlight, walking, yoga; symptom tracking on adapted Glenmullen chart.

  • Moderator Emeritus
Posted

This is text from one of Brassmonkey's posts regarding stabilizing. I can't find where the direct link is (perhaps a mod can help with this) but this section was very insightful so I saved it to my phone when I read it last month.

Screenshot_2018-10-18-18-19-25.png

Apr 2018: Began 10 mg Amitriptyline (for headaches & insomnia from concussion).

Jul - Aug 2018: Fast taper to 5 mg and then 2.5 mg (too fast, hellish withdrawal at 2.5 mg). Sept 2018: Reinstated 10 mg (many symptoms improved). Oct 2018 - Apr 2019: Updosed & stabilized on 11 mg (2 waves at 3 and 5 months post-withdrawal). Apr 2019 - Apr 2020: Tapered 0.5-0.25 mg per month using compounded pills: 11 mg —> 6 mg. (2 waves at 12 and 16 months post-withdrawal.) Apr 2020 - present: Switched to a liquid taper at rate of 0.1 mg per month. Currently: 1.1 mg. No more waves. 

 

Supplements: Omega-3 fish oil, Vit B12, coenzyme Q10, Hawthorn extract (for tachycardia) Tools for insomnia/waves (as needed): Epsom salt foot soaks, 0.5 mg Melatonin, quality time, waves WILL PASS. Lifestyle: Eat real foods, mostly plants; sunlight, walking, yoga; symptom tracking on adapted Glenmullen chart.

  • Moderator Emeritus
Posted

I cannot tell you how much I appreciate your and Songbird's help. I just cried when I read your message because I cannot believe total strangers would be so kind to me. My husband is a rock - he's going to help me with a liquid taper when the time comes because my math skills are not so sharp right now. But I worry that he is growing tired of all this - a benzo taper just finished last year, non-stop sickness and death in my family for 4 years now - I don't know why he's still here. He says that's just the depression and anxiety talking and he loves me and isn't going anywhere. My heart is breaking because I'm going to have to tell my 3 daughters and 8 grandkids that I cannot do a Christmas for them this year - not only am I going through withdrawal but this will be the first Christmas without my beloved Mom. I can't even watch a Christmas commercial on TV without breaking down.

 

I'm headed to a naturopthic doctor tomorrow for advice. I will be researching every suggestion he makes before I do any of it, though. My DNA test shows that I am a slow metabolizer of SSRIs. I know from painful past experience that it takes about a month for zoloft withdrawal to show up for me. The test also indicates that the gene that controls gaba/glutimate is not functioning properly. This makes sense, since I've been anxious ever since childhood with no external cause. So it would seem that gabaergic supplements would help me, but many are serotonergic as well, and since I'm still on 25mgs of Zoloft and a known slow metabolizer, I need to be very careful about serotonin syndrome. We'll see how savvy he is about all that.

 

BTW, I really recommend that everyone get a DNA test done for drug sensitivity. Even if your insurance doesn't cover (mine did), its not astronomically expensive (around $300). It tests for all major drugs, not just ADs. Had I done it before, it would have saved me much grief. However, had I never gotten it done, my doctor even admits she would have taken me down the rabbit hole of trying one SSRI after another, and none of them would have worked (except possibly Prozac) and God only knows what kind of dosage increases/polydrugging/misdiagnoses would have resulted. Kudos to her for suggesting the test. 

 

Anyway, thanks Composter. I take great comfort in your assurances. It is exactly what I need. I appreciate you reaching out to me in the middle of your own struggle. I hope you continue to improve each and every day.

2016 - Zoloft 50 mg for klonopin w/d

Approx. Nov 2017 - successful taper of klonopin; Approx. Jan. 2018 - rapid taper Zoloft over 2 wks - no w/d symptoms; May 2018 - Reinstate 50 mg Zoloft per doctor; Aug 2018 - Rapid taper Zoloft over 3-4 weeks - no w/d symptoms for 1 mo.; Late Oct 2018 - pdoc rx'd 5mg lexapro -took for 1 wk; Early Nov 2018 - Reinstate 25 mg Zoloft; updose to 37.5 on Nov 28, 2018; Nov 30 2018 - returned to 25mg Zoloft upon mod. advice; Dec 9 - Dec10 2018 - 12.5mg zoloft liquid+12.5mg zoloft pill; Dec 11 2018 - 25mg zoloft all liquid; Feb 14 2019 - updosed to 26.25 mg liquid; Mar 6 2019 - updosed to 26.88 mg liquid - new symptoms; Mar 13 2019 - back down to 26.25 mg per mod suggestion

Dose Changes: Dec 2 2019 - 5% to 25mg; Jan 14 2020 - 10% to 22.5 (increase in sxs all month); Mar 10-15? 2020,  accidental updose to 25mg; Mar 22 2020 - back down to 22.5mg; Apr 12 2020 - 2.5% to 21.94mg; Apr 19 2020 - 2.5% to 21.375mg (symptom increase); May 17 2020 - 2.5% to 20.625mg; May 24 2020 - 2.5% to 20.1mg - Jun 14 2020 - noticed uptick in symptoms settled 2 days later - July 10 2020 - onset of wave

  • Moderator Emeritus
Posted

Those notes look good, please keep posting them each day, it will really help us to understand what's going on.  Let's get a few more days of notes and then reevaluate.  If you can get hold of the liquid soon that will be good - you'll have flexibility with your dose going forward. 

 

Questions: Are you taking hydroxyzine every night, or only occasionally?  What about melatonin?  6mg is a hefty dose of melatonin, have you tried a small dose, e.g. 0.5mg?  With melatonin, small doses usually work better.

 

Please let us know what your naturopath recommends before starting any new supplements.  I'm a huge believer in natural forms of medicine, but just like doctors, most natural health practitioners don't understand AD withdrawal and will treat it as for depression and/or anxiety.  A nervous system that is in confusion from AD withdrawal can react in unexpected ways to many supplements.  Any supplement that affects neurotransmitters can be especially risky. 

 

Brassmonkey's post about how long things take is here:  Are we there yet? How long is withdrawal going to take?

 

 

2001–2002 paroxetine

2003  citalopram

2004-2008  paroxetine (various failed tapers) 
2008  paroxetine slow taper down to

2016  Aug off paroxetine
2016-2017  citalopram May 20mg  Oct 15mg … slow taper down to 4.8mg
2018-2023 Feb 4.6mg slow taper down to 1.0mg

2024  Jan 0.9mg  Mar 0.8mg May 0.7mg Aug 0.6mg Oct 0.5mg

  • Moderator Emeritus
Posted

Thanks so very much for taking me under your wing (pun intended!). You are the best! I will definitely check in here with the ND's recommendations before going forward. I have an appointment Friday with my PCP and I will ask for liquid then.

 

I read the thread above. It is full of helpful info but triggers my anxiety greatly. I am so tired of withdrawal - more months or possibly years (!!!) of putting my life on hold. I did not ask for this - all I did was follow doctors' orders - the punishment certainly doesn't fit the crime. It was a horrible surprise to realize this "gentle" drug has hurt me so much. I guess everyone here has felt the same. I'm just not sure I have the strength to go through this again. I have a hard time remembering that life does go on during withdrawal; that it is not constant suffering and that things will be getting better once I've stabilized. I'm white-knuckling 24/7 right now, and I just can't see any blue sky from here. I know I sound ridiculously needy and pathetic right now. Please don't give up on me. 

 

I have taken the hydroxyzine about 3x for sleep. I switch between hydroxyzine, ibuprofen (which has an anxiolytic effect on me), and benadryl so none of them poop out on me. I pretty much dose melatonin every night. I have a fear of not being able to sleep. I don't have insomnia under ordinary circumstances so it is frightening to me when it happens. When I am awake in the deep night while everyone else is asleep I get anxiety bordering on panic. My melatonin tabs are 3mg each. I will try a quarter of a pill with ibuprofen tonight.

 

I have also looked at the list of withdrawal-savvy therapists that Composter provided me. There are none in my city, but one about 200 miles away who does video sessions. I'm going to contact him tomorrow.

 

Thank you again. So much.

2016 - Zoloft 50 mg for klonopin w/d

Approx. Nov 2017 - successful taper of klonopin; Approx. Jan. 2018 - rapid taper Zoloft over 2 wks - no w/d symptoms; May 2018 - Reinstate 50 mg Zoloft per doctor; Aug 2018 - Rapid taper Zoloft over 3-4 weeks - no w/d symptoms for 1 mo.; Late Oct 2018 - pdoc rx'd 5mg lexapro -took for 1 wk; Early Nov 2018 - Reinstate 25 mg Zoloft; updose to 37.5 on Nov 28, 2018; Nov 30 2018 - returned to 25mg Zoloft upon mod. advice; Dec 9 - Dec10 2018 - 12.5mg zoloft liquid+12.5mg zoloft pill; Dec 11 2018 - 25mg zoloft all liquid; Feb 14 2019 - updosed to 26.25 mg liquid; Mar 6 2019 - updosed to 26.88 mg liquid - new symptoms; Mar 13 2019 - back down to 26.25 mg per mod suggestion

Dose Changes: Dec 2 2019 - 5% to 25mg; Jan 14 2020 - 10% to 22.5 (increase in sxs all month); Mar 10-15? 2020,  accidental updose to 25mg; Mar 22 2020 - back down to 22.5mg; Apr 12 2020 - 2.5% to 21.94mg; Apr 19 2020 - 2.5% to 21.375mg (symptom increase); May 17 2020 - 2.5% to 20.625mg; May 24 2020 - 2.5% to 20.1mg - Jun 14 2020 - noticed uptick in symptoms settled 2 days later - July 10 2020 - onset of wave

  • Moderator Emeritus
Posted
34 minutes ago, Dejavu said:

I have also looked at the list of withdrawal-savvy therapists that Composter provided me. There are none in my city, but one about 200 miles away who does video sessions. I'm going to contact him tomorrow.

 

If you think this person is good, could you please let gardenlady know.  It may worth her checking them out as she is having difficulty finding someone locally.  Thank you.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

  • Moderator Emeritus
Posted

Absolutely! 

2016 - Zoloft 50 mg for klonopin w/d

Approx. Nov 2017 - successful taper of klonopin; Approx. Jan. 2018 - rapid taper Zoloft over 2 wks - no w/d symptoms; May 2018 - Reinstate 50 mg Zoloft per doctor; Aug 2018 - Rapid taper Zoloft over 3-4 weeks - no w/d symptoms for 1 mo.; Late Oct 2018 - pdoc rx'd 5mg lexapro -took for 1 wk; Early Nov 2018 - Reinstate 25 mg Zoloft; updose to 37.5 on Nov 28, 2018; Nov 30 2018 - returned to 25mg Zoloft upon mod. advice; Dec 9 - Dec10 2018 - 12.5mg zoloft liquid+12.5mg zoloft pill; Dec 11 2018 - 25mg zoloft all liquid; Feb 14 2019 - updosed to 26.25 mg liquid; Mar 6 2019 - updosed to 26.88 mg liquid - new symptoms; Mar 13 2019 - back down to 26.25 mg per mod suggestion

Dose Changes: Dec 2 2019 - 5% to 25mg; Jan 14 2020 - 10% to 22.5 (increase in sxs all month); Mar 10-15? 2020,  accidental updose to 25mg; Mar 22 2020 - back down to 22.5mg; Apr 12 2020 - 2.5% to 21.94mg; Apr 19 2020 - 2.5% to 21.375mg (symptom increase); May 17 2020 - 2.5% to 20.625mg; May 24 2020 - 2.5% to 20.1mg - Jun 14 2020 - noticed uptick in symptoms settled 2 days later - July 10 2020 - onset of wave

  • Moderator Emeritus
Posted

Okay, Songbird: so I just got back from the ND. He seems to be pretty savvy about AD withdrawal. He found my cortisol level really high (no surprise there), but he also found my Vitamin D deficiency (which I did not tell him about, sort of as a "test" - I just don't trust anyone with a white coat these days!). I know about it and have been taking 50000IUs per my PCP for a few months. It was VERY low and probably still is. Anyway, the ND wants to start very slow because my system is so sensitized, so he gets that. He recomnended a blend from Integrative Therapeutics called Cortisol Manager. It contains Suntheanine, Ashwagandha and Magnolia Bark. I've researched all 3 of these and found that there are no interractions with Sertraline reported. I am petrified of Serotonin Syndrome since I'm a known slow metabolizer, but at 25 mgs I am also on less than a therapeutic dose. I've got to try something; the nonstop anxiety and cortisol spikes in the morning are off the charts. I'm also having a few more physical symptoms - I will post those separately. I'm supposed to take one of these tabs tonight. This guy spent well over an hour with me and asked every question in the book. He seemed very open and allowed both my husband and brother come into the exam room with me  He seems knowledgeable and compassionate, and said he would not hurt my condition any further. I made an appointment with him next week for accupuncture and CBT. He doesnt want to do any more supplements until we see how I do with the Cortisol Manager. Does all this sound reasonable to you?

2016 - Zoloft 50 mg for klonopin w/d

Approx. Nov 2017 - successful taper of klonopin; Approx. Jan. 2018 - rapid taper Zoloft over 2 wks - no w/d symptoms; May 2018 - Reinstate 50 mg Zoloft per doctor; Aug 2018 - Rapid taper Zoloft over 3-4 weeks - no w/d symptoms for 1 mo.; Late Oct 2018 - pdoc rx'd 5mg lexapro -took for 1 wk; Early Nov 2018 - Reinstate 25 mg Zoloft; updose to 37.5 on Nov 28, 2018; Nov 30 2018 - returned to 25mg Zoloft upon mod. advice; Dec 9 - Dec10 2018 - 12.5mg zoloft liquid+12.5mg zoloft pill; Dec 11 2018 - 25mg zoloft all liquid; Feb 14 2019 - updosed to 26.25 mg liquid; Mar 6 2019 - updosed to 26.88 mg liquid - new symptoms; Mar 13 2019 - back down to 26.25 mg per mod suggestion

Dose Changes: Dec 2 2019 - 5% to 25mg; Jan 14 2020 - 10% to 22.5 (increase in sxs all month); Mar 10-15? 2020,  accidental updose to 25mg; Mar 22 2020 - back down to 22.5mg; Apr 12 2020 - 2.5% to 21.94mg; Apr 19 2020 - 2.5% to 21.375mg (symptom increase); May 17 2020 - 2.5% to 20.625mg; May 24 2020 - 2.5% to 20.1mg - Jun 14 2020 - noticed uptick in symptoms settled 2 days later - July 10 2020 - onset of wave

  • Moderator Emeritus
Posted
53 minutes ago, Dejavu said:

therapeutic dose

 

Therapeutic dose is an arbitrary (based on random choice or personal whim, rather than any reason or system) amount which the pharmaceutical companies use. 

 

The better term to use is lowest effective dose.

 

56 minutes ago, Dejavu said:

I made an appointment with him next week for accupuncture

 

Acupuncture - Please see Posts #6 & #8 (not detox or stimulation)

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

  • Moderator Emeritus
Posted

The trouble with taking anything that is a mix of ingredients is that if you have a reaction you will now know what is causing the problem.  Keep it Simple, Slow and Stable

 

It's also a good idea to research how things affect members who are going through withdrawal.

 

57 minutes ago, Dejavu said:

Ashwagandha

 

This post is from SA's topic on ashwagandha:

 

 

59 minutes ago, Dejavu said:

Suntheanine

 

l-theanine-for-anxiety-insomnia

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

  • Moderator Emeritus
Posted

Thank you for the info Chessie Cat. I will make sure he understands what I'm looking for in accupuncture treatment. I think he realizes that stimulation would be a big fat no-no right now. And yes, I was leery of a multi-ingredient product as well, but I've taken theanine before and other than sedation (which would be welcome at this point) I had no other effect, so at least if I have a bad reaction to this product I'll know it's either from ashwagandha or magnolia bark (well, I guess there's a risk of synergystic adverse effects as well). I've researched the brand and it is reputable. I'm going to have to cross my fingers and give it a go, I guess. I am starting with half of his recommended starting dose.

2016 - Zoloft 50 mg for klonopin w/d

Approx. Nov 2017 - successful taper of klonopin; Approx. Jan. 2018 - rapid taper Zoloft over 2 wks - no w/d symptoms; May 2018 - Reinstate 50 mg Zoloft per doctor; Aug 2018 - Rapid taper Zoloft over 3-4 weeks - no w/d symptoms for 1 mo.; Late Oct 2018 - pdoc rx'd 5mg lexapro -took for 1 wk; Early Nov 2018 - Reinstate 25 mg Zoloft; updose to 37.5 on Nov 28, 2018; Nov 30 2018 - returned to 25mg Zoloft upon mod. advice; Dec 9 - Dec10 2018 - 12.5mg zoloft liquid+12.5mg zoloft pill; Dec 11 2018 - 25mg zoloft all liquid; Feb 14 2019 - updosed to 26.25 mg liquid; Mar 6 2019 - updosed to 26.88 mg liquid - new symptoms; Mar 13 2019 - back down to 26.25 mg per mod suggestion

Dose Changes: Dec 2 2019 - 5% to 25mg; Jan 14 2020 - 10% to 22.5 (increase in sxs all month); Mar 10-15? 2020,  accidental updose to 25mg; Mar 22 2020 - back down to 22.5mg; Apr 12 2020 - 2.5% to 21.94mg; Apr 19 2020 - 2.5% to 21.375mg (symptom increase); May 17 2020 - 2.5% to 20.625mg; May 24 2020 - 2.5% to 20.1mg - Jun 14 2020 - noticed uptick in symptoms settled 2 days later - July 10 2020 - onset of wave

  • Moderator Emeritus
Posted

I suggest you start with a small amount and increase it gradually if there is no bad reaction to it.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

  • Moderator Emeritus
Posted

Okay, that sounds like a better plan. 1/4 pill?

2016 - Zoloft 50 mg for klonopin w/d

Approx. Nov 2017 - successful taper of klonopin; Approx. Jan. 2018 - rapid taper Zoloft over 2 wks - no w/d symptoms; May 2018 - Reinstate 50 mg Zoloft per doctor; Aug 2018 - Rapid taper Zoloft over 3-4 weeks - no w/d symptoms for 1 mo.; Late Oct 2018 - pdoc rx'd 5mg lexapro -took for 1 wk; Early Nov 2018 - Reinstate 25 mg Zoloft; updose to 37.5 on Nov 28, 2018; Nov 30 2018 - returned to 25mg Zoloft upon mod. advice; Dec 9 - Dec10 2018 - 12.5mg zoloft liquid+12.5mg zoloft pill; Dec 11 2018 - 25mg zoloft all liquid; Feb 14 2019 - updosed to 26.25 mg liquid; Mar 6 2019 - updosed to 26.88 mg liquid - new symptoms; Mar 13 2019 - back down to 26.25 mg per mod suggestion

Dose Changes: Dec 2 2019 - 5% to 25mg; Jan 14 2020 - 10% to 22.5 (increase in sxs all month); Mar 10-15? 2020,  accidental updose to 25mg; Mar 22 2020 - back down to 22.5mg; Apr 12 2020 - 2.5% to 21.94mg; Apr 19 2020 - 2.5% to 21.375mg (symptom increase); May 17 2020 - 2.5% to 20.625mg; May 24 2020 - 2.5% to 20.1mg - Jun 14 2020 - noticed uptick in symptoms settled 2 days later - July 10 2020 - onset of wave

  • Moderator Emeritus
Posted

Yes 1/4 pill sounds reasonable.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

  • Moderator Emeritus
Posted

Dec 3 - continued

9pm - anxiety 5/10 - depression 4/10 - weakness/tremors 6/10

 

10pm - took 25mg Zoloft - anxiety 6/10 - depression 5/10 - diarrhea episode - dizziness 3/10 - palps 2/10 - appetite 6/10

 

December 4

2:30am - Took 1 mg melatonin and 2 ibuprofen - woke up approx 15x during night

 

12 noon - woke up/showered -dizziness 6/10 - anxiety 6/10 - depression 6/10 - nausea 6/10 - weakness/tremor 7/10 - muscle twitches 5/10 - diarrhea episode

 

2pm - appt w/ND. Anxiety 8/10 - depression 8/10 - dizziness 7/10 - weakness/tremor 6/10 - crying spell

 

5pm - ate for first time today - appetite 3/10 - anxiety 6/10 - depression 6/10 - muscle twitches 2/10 - dizziness 4/10 - no nausea - took 350mg magnesium

 

7pm - crying spell - anxiety 8/10 - depression 8/10 - weakness/tremor 6/10 - diarrhea episode

 

8:30 - ate dinner - had brief visual disturbance (thought refrigerator was leaning to one side) - took 2600mg fish oil - crying spell - anxiety 6/10 - depression 8/10 - weakness/tremor 5/10 - dizziness 2/10 - no nausea

 

10pm - took 25mg Zoloft - anxiety 6/10 - depression 7/10 - weakness/tremor 5/10 - dizziness 2/10 - no nausea

2016 - Zoloft 50 mg for klonopin w/d

Approx. Nov 2017 - successful taper of klonopin; Approx. Jan. 2018 - rapid taper Zoloft over 2 wks - no w/d symptoms; May 2018 - Reinstate 50 mg Zoloft per doctor; Aug 2018 - Rapid taper Zoloft over 3-4 weeks - no w/d symptoms for 1 mo.; Late Oct 2018 - pdoc rx'd 5mg lexapro -took for 1 wk; Early Nov 2018 - Reinstate 25 mg Zoloft; updose to 37.5 on Nov 28, 2018; Nov 30 2018 - returned to 25mg Zoloft upon mod. advice; Dec 9 - Dec10 2018 - 12.5mg zoloft liquid+12.5mg zoloft pill; Dec 11 2018 - 25mg zoloft all liquid; Feb 14 2019 - updosed to 26.25 mg liquid; Mar 6 2019 - updosed to 26.88 mg liquid - new symptoms; Mar 13 2019 - back down to 26.25 mg per mod suggestion

Dose Changes: Dec 2 2019 - 5% to 25mg; Jan 14 2020 - 10% to 22.5 (increase in sxs all month); Mar 10-15? 2020,  accidental updose to 25mg; Mar 22 2020 - back down to 22.5mg; Apr 12 2020 - 2.5% to 21.94mg; Apr 19 2020 - 2.5% to 21.375mg (symptom increase); May 17 2020 - 2.5% to 20.625mg; May 24 2020 - 2.5% to 20.1mg - Jun 14 2020 - noticed uptick in symptoms settled 2 days later - July 10 2020 - onset of wave

  • Moderator Emeritus
Posted

Dec 5

12midnight - Took 1/4 Cortisol Manager recommended by ND plus 3 mgs melatonin (lower doses do nothing for me) - fell asleep around 2am

 

8am - woke up w/o cortisol spike - went back to sleep

 

Noon - woke to phone call from my aunt saying my uncle (who has been like a father to me) has end stage pancreatic cancer. I've been crying all day. Anxiety 9/10 - depression 10/10. Weakness/tremor of hands 4/10 - of legs 8/10 - dizziness 3/10 - appetite 0 - nausea 3/10

 

3pm - walked 1/2 mile on treadmill (hanging on for dear life) - ate hard boiled egg - no nausea

 

6pm - Took 350 mg magnesium

 

I am feeling desperate and hopeless. I've been holding at reinstated 25mg for almost a month and I'm worse than when I first reinstated. Its all I can do to take a 15 minute shower. The idea of having yet another funeral to go through soon absolutely panics me. I won't be able to do it in my present condition. Should I just say to hell with it and start my taper? Am I stuck this way for life? Please someone pop in with a little reassurance. Please. 

2016 - Zoloft 50 mg for klonopin w/d

Approx. Nov 2017 - successful taper of klonopin; Approx. Jan. 2018 - rapid taper Zoloft over 2 wks - no w/d symptoms; May 2018 - Reinstate 50 mg Zoloft per doctor; Aug 2018 - Rapid taper Zoloft over 3-4 weeks - no w/d symptoms for 1 mo.; Late Oct 2018 - pdoc rx'd 5mg lexapro -took for 1 wk; Early Nov 2018 - Reinstate 25 mg Zoloft; updose to 37.5 on Nov 28, 2018; Nov 30 2018 - returned to 25mg Zoloft upon mod. advice; Dec 9 - Dec10 2018 - 12.5mg zoloft liquid+12.5mg zoloft pill; Dec 11 2018 - 25mg zoloft all liquid; Feb 14 2019 - updosed to 26.25 mg liquid; Mar 6 2019 - updosed to 26.88 mg liquid - new symptoms; Mar 13 2019 - back down to 26.25 mg per mod suggestion

Dose Changes: Dec 2 2019 - 5% to 25mg; Jan 14 2020 - 10% to 22.5 (increase in sxs all month); Mar 10-15? 2020,  accidental updose to 25mg; Mar 22 2020 - back down to 22.5mg; Apr 12 2020 - 2.5% to 21.94mg; Apr 19 2020 - 2.5% to 21.375mg (symptom increase); May 17 2020 - 2.5% to 20.625mg; May 24 2020 - 2.5% to 20.1mg - Jun 14 2020 - noticed uptick in symptoms settled 2 days later - July 10 2020 - onset of wave

  • Moderator Emeritus
Posted

@Dejavu this will definitely not be forever. You are in the acute phase of trying to stabilize. It feels like hell right now but it WILL pass. When I went through the acute phase of my withdrawal there was nothing much I could do except sit and breathe through the pain. Don't think about anything: the future, your current state, your family's health. These are not for you to worry about right now in your state. Your brain is going through all sorts of fear, helplessness, despair, and doom. Do NOT hold onto those thoughts and let the fear grip you. I am praying for you now, my friend.

 

Play some soft music, breathe, and hold onto mantras or prayers that can provide peace to you: "Let healing come." "This is just temporary." "This is not my brain; this is just the result of the medication." "God/a higher power is in control." "My support system is with me." Right now what's important is for your brain and nervous system to calm down and heal. My mother was my rock just like your husband is for you. Accept that love, find gratitude during this process, know that you are loved and you WILL get through this.

 

It sounds like the Cortisol Manager is helping. You are doing such a great job reaching out to find local resources and specialists. Keep breathing, and keep moving forward. One step at a time.

 

@Songbird any recommendations on a dosage change from the mods? Perhaps 25 mg is too high a dose for Dejavu's reinstatement.

Apr 2018: Began 10 mg Amitriptyline (for headaches & insomnia from concussion).

Jul - Aug 2018: Fast taper to 5 mg and then 2.5 mg (too fast, hellish withdrawal at 2.5 mg). Sept 2018: Reinstated 10 mg (many symptoms improved). Oct 2018 - Apr 2019: Updosed & stabilized on 11 mg (2 waves at 3 and 5 months post-withdrawal). Apr 2019 - Apr 2020: Tapered 0.5-0.25 mg per month using compounded pills: 11 mg —> 6 mg. (2 waves at 12 and 16 months post-withdrawal.) Apr 2020 - present: Switched to a liquid taper at rate of 0.1 mg per month. Currently: 1.1 mg. No more waves. 

 

Supplements: Omega-3 fish oil, Vit B12, coenzyme Q10, Hawthorn extract (for tachycardia) Tools for insomnia/waves (as needed): Epsom salt foot soaks, 0.5 mg Melatonin, quality time, waves WILL PASS. Lifestyle: Eat real foods, mostly plants; sunlight, walking, yoga; symptom tracking on adapted Glenmullen chart.

  • Moderator Emeritus
Posted
7 minutes ago, composter said:

 

9 minutes ago, composter said:

@Dejavu 

 

@Songbird any recommendations on a dosage change from the mods? Perhaps 25 mg is too high a dose for Dejavu's reinstatement.

But if I lower my reinstatement dose, isn't that the same as a taper? Won't I go into worse w/d than I am now? 

2016 - Zoloft 50 mg for klonopin w/d

Approx. Nov 2017 - successful taper of klonopin; Approx. Jan. 2018 - rapid taper Zoloft over 2 wks - no w/d symptoms; May 2018 - Reinstate 50 mg Zoloft per doctor; Aug 2018 - Rapid taper Zoloft over 3-4 weeks - no w/d symptoms for 1 mo.; Late Oct 2018 - pdoc rx'd 5mg lexapro -took for 1 wk; Early Nov 2018 - Reinstate 25 mg Zoloft; updose to 37.5 on Nov 28, 2018; Nov 30 2018 - returned to 25mg Zoloft upon mod. advice; Dec 9 - Dec10 2018 - 12.5mg zoloft liquid+12.5mg zoloft pill; Dec 11 2018 - 25mg zoloft all liquid; Feb 14 2019 - updosed to 26.25 mg liquid; Mar 6 2019 - updosed to 26.88 mg liquid - new symptoms; Mar 13 2019 - back down to 26.25 mg per mod suggestion

Dose Changes: Dec 2 2019 - 5% to 25mg; Jan 14 2020 - 10% to 22.5 (increase in sxs all month); Mar 10-15? 2020,  accidental updose to 25mg; Mar 22 2020 - back down to 22.5mg; Apr 12 2020 - 2.5% to 21.94mg; Apr 19 2020 - 2.5% to 21.375mg (symptom increase); May 17 2020 - 2.5% to 20.625mg; May 24 2020 - 2.5% to 20.1mg - Jun 14 2020 - noticed uptick in symptoms settled 2 days later - July 10 2020 - onset of wave

  • Moderator Emeritus
Posted
1 hour ago, Dejavu said:

I've been holding at reinstated 25mg for almost a month and I'm worse than when I first reinstated. 

 

According to your signature you reinstated 18 November, that makes it only two and a half weeks.  It's possible that 25mg dose is too high.  Are you able to create a dose of 12.5mg by taking half a 25mg tablet?

2001–2002 paroxetine

2003  citalopram

2004-2008  paroxetine (various failed tapers) 
2008  paroxetine slow taper down to

2016  Aug off paroxetine
2016-2017  citalopram May 20mg  Oct 15mg … slow taper down to 4.8mg
2018-2023 Feb 4.6mg slow taper down to 1.0mg

2024  Jan 0.9mg  Mar 0.8mg May 0.7mg Aug 0.6mg Oct 0.5mg

  • Moderator Emeritus
Posted

Yes 18 Nov. I guess I'm counting the week before that when the pdoc put me on 5mg of Lexapro, which he said is the equivalent of 25 mg Zoloft. I felt hideous that week and needed to be at hospital with my brothers, so my PCP direct switched me back to 25 mg Zoloft.

 

Yes, I have 25 mg tablets and can split them well. But is that too much of a taper? Please bear with me; I did read the reinstatement thread, but I guess I just don't understand. I know I can't start to taper until I'm stable, but wouldn't this be tantamount to a 50% taper? I'm sorry if I sound dense...

2016 - Zoloft 50 mg for klonopin w/d

Approx. Nov 2017 - successful taper of klonopin; Approx. Jan. 2018 - rapid taper Zoloft over 2 wks - no w/d symptoms; May 2018 - Reinstate 50 mg Zoloft per doctor; Aug 2018 - Rapid taper Zoloft over 3-4 weeks - no w/d symptoms for 1 mo.; Late Oct 2018 - pdoc rx'd 5mg lexapro -took for 1 wk; Early Nov 2018 - Reinstate 25 mg Zoloft; updose to 37.5 on Nov 28, 2018; Nov 30 2018 - returned to 25mg Zoloft upon mod. advice; Dec 9 - Dec10 2018 - 12.5mg zoloft liquid+12.5mg zoloft pill; Dec 11 2018 - 25mg zoloft all liquid; Feb 14 2019 - updosed to 26.25 mg liquid; Mar 6 2019 - updosed to 26.88 mg liquid - new symptoms; Mar 13 2019 - back down to 26.25 mg per mod suggestion

Dose Changes: Dec 2 2019 - 5% to 25mg; Jan 14 2020 - 10% to 22.5 (increase in sxs all month); Mar 10-15? 2020,  accidental updose to 25mg; Mar 22 2020 - back down to 22.5mg; Apr 12 2020 - 2.5% to 21.94mg; Apr 19 2020 - 2.5% to 21.375mg (symptom increase); May 17 2020 - 2.5% to 20.625mg; May 24 2020 - 2.5% to 20.1mg - Jun 14 2020 - noticed uptick in symptoms settled 2 days later - July 10 2020 - onset of wave

  • Moderator Emeritus
Posted

Not dense, those are good questions.  Trying to find a good reinstatement dose is tricky.  You are correct that we usually don't advise a 50% dose cut during a taper.  In your case, since you've been off Zoloft for many months, your system may now be sensitive to Zoloft and the 25mg dose could be too high.  You haven't been back on the Zoloft for very long, and bear in mind that it takes four or five days for the plasma concentration to increase up to the new dose, so it's really only been a couple of weeks at 25mg.  It's probably better to drop the dose down now rather than stay on the higher dose for longer.  Keep in mind that with reinstatement there may not be a perfect dose that alleviates all symptoms - the aim is more to find a dose where symptoms are bearable.

2001–2002 paroxetine

2003  citalopram

2004-2008  paroxetine (various failed tapers) 
2008  paroxetine slow taper down to

2016  Aug off paroxetine
2016-2017  citalopram May 20mg  Oct 15mg … slow taper down to 4.8mg
2018-2023 Feb 4.6mg slow taper down to 1.0mg

2024  Jan 0.9mg  Mar 0.8mg May 0.7mg Aug 0.6mg Oct 0.5mg

  • Moderator Emeritus
Posted

I was only completely off Zoloft for 5 weeks, one of which was the Lexapro fiasco. I don't know if that matters much or not. I will try the 12.5 for a bit and see what happens. Thank you again!

2016 - Zoloft 50 mg for klonopin w/d

Approx. Nov 2017 - successful taper of klonopin; Approx. Jan. 2018 - rapid taper Zoloft over 2 wks - no w/d symptoms; May 2018 - Reinstate 50 mg Zoloft per doctor; Aug 2018 - Rapid taper Zoloft over 3-4 weeks - no w/d symptoms for 1 mo.; Late Oct 2018 - pdoc rx'd 5mg lexapro -took for 1 wk; Early Nov 2018 - Reinstate 25 mg Zoloft; updose to 37.5 on Nov 28, 2018; Nov 30 2018 - returned to 25mg Zoloft upon mod. advice; Dec 9 - Dec10 2018 - 12.5mg zoloft liquid+12.5mg zoloft pill; Dec 11 2018 - 25mg zoloft all liquid; Feb 14 2019 - updosed to 26.25 mg liquid; Mar 6 2019 - updosed to 26.88 mg liquid - new symptoms; Mar 13 2019 - back down to 26.25 mg per mod suggestion

Dose Changes: Dec 2 2019 - 5% to 25mg; Jan 14 2020 - 10% to 22.5 (increase in sxs all month); Mar 10-15? 2020,  accidental updose to 25mg; Mar 22 2020 - back down to 22.5mg; Apr 12 2020 - 2.5% to 21.94mg; Apr 19 2020 - 2.5% to 21.375mg (symptom increase); May 17 2020 - 2.5% to 20.625mg; May 24 2020 - 2.5% to 20.1mg - Jun 14 2020 - noticed uptick in symptoms settled 2 days later - July 10 2020 - onset of wave

  • Moderator Emeritus
Posted

@composter - once again, you pull my morale out of the depths. It's so hard for me to believe/remember that this is temporary. I'm in a tough spot because I feel lousy on Zoloft. The muscle weakness and shakes I feel are side effects of Zoloft, not withdrawal. They go away when I go off completely. Since I was only rx'd Zoloft to "help" me taper Klonopin (thanks a lot, doc!), I always thought it was the benzo w/d, when all along it was the AD. It is the most disabling symptom I have. So I'm hoping that the lower I go, the less I'll feel that. Thank you for the moral support and the prayers. I don't even feel human right now.

2016 - Zoloft 50 mg for klonopin w/d

Approx. Nov 2017 - successful taper of klonopin; Approx. Jan. 2018 - rapid taper Zoloft over 2 wks - no w/d symptoms; May 2018 - Reinstate 50 mg Zoloft per doctor; Aug 2018 - Rapid taper Zoloft over 3-4 weeks - no w/d symptoms for 1 mo.; Late Oct 2018 - pdoc rx'd 5mg lexapro -took for 1 wk; Early Nov 2018 - Reinstate 25 mg Zoloft; updose to 37.5 on Nov 28, 2018; Nov 30 2018 - returned to 25mg Zoloft upon mod. advice; Dec 9 - Dec10 2018 - 12.5mg zoloft liquid+12.5mg zoloft pill; Dec 11 2018 - 25mg zoloft all liquid; Feb 14 2019 - updosed to 26.25 mg liquid; Mar 6 2019 - updosed to 26.88 mg liquid - new symptoms; Mar 13 2019 - back down to 26.25 mg per mod suggestion

Dose Changes: Dec 2 2019 - 5% to 25mg; Jan 14 2020 - 10% to 22.5 (increase in sxs all month); Mar 10-15? 2020,  accidental updose to 25mg; Mar 22 2020 - back down to 22.5mg; Apr 12 2020 - 2.5% to 21.94mg; Apr 19 2020 - 2.5% to 21.375mg (symptom increase); May 17 2020 - 2.5% to 20.625mg; May 24 2020 - 2.5% to 20.1mg - Jun 14 2020 - noticed uptick in symptoms settled 2 days later - July 10 2020 - onset of wave

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