Carn1523: Zoloft/prozac from age 17 to now (age 34)

[Carn1523]

Greetings,

 

I've been on Zoloft|Prozac for about 17 years now.

 

First, a little bit about my pre-SSRI history. When I was in middle/high school I struggled to pay attention in class and complete homework assignments, and when I was ~13 I was diagnosed with moderate ADD and mild OCD (though I cannot recall exactly what led to the OCD diagnosis). I was prescribed Ritalin for a year or two, but wasn't comfortable with how it made me feel and eventually ceased use. During high school I experimented heavily with illicit drugs and it as during this time period that anxiety manifested itself in my life. I was ~15 when I was diagnosed with generalized anxiety disorder as well as social anxiety disorder. After taking ecstasy at age ~16 I began to regularly experience a feeling of impending doom, an awful anxiety-like sensation that I now believe is a panic attack or something similar. At 16 or 17 I became addicted to Oxycontin. Near my 18th birthday, I was lucky enough to receive help for my substance abuse issues, and have been clean and sober from Oxycontin and heavy drugs ever since. I did struggle with alcoholism in my early twenties but ended up quitting alcohol altogether and haven't had a drink in ~8 years.

 

As part of substance rehabilitation at ~17, my doctor put me on Zoloft. This helped immensely with my social anxiety for long periods of time, but eventually the effects would always become muted. When this muting occurred, my doctor would often switch me to Prozac (or, if I was on Prozac, back to Zoloft), or increase my dosage, in an attempt to recapture the effect. This treatment was effective for a few months at a time, but never effective long-term. It's difficult for me to recall my medication history in that 17-year timeline, but I do know that I've been on Zoloft or Prozac for the majority of that timeline, and that my Zoloft dosage has ranged from 25mg to 200mg. My average Zoloft dosage in that time period was probably 100-150mg, and my current Zoloft dosage is 150mg. During that time period I have quit SSRIs altogether at least 4-5 times, generally with "fast taper" of 1-4 weeks, but I've always ended up back on medication. Social anxiety is what generally drives me back to the medication.

 

I've been taking 150mg for around 4 months, and the benefits of 100mg->150mg have dwindled considerably. Like many times before, I'm wondering whether I really want to be on SSRIs for the rest of my life.

 

The potential negative SSRI side effects I experience are as follows.

1. The majority of my emotions are dull. I rarely feel happiness, excitement, sadness, affection, etc. When I do feel these emotions, they feel muted and distant, as if I am observing the experience of someone else. On the other hand, some negative emotions are still quite sharp, such as anxiety and fear.
2. Brain fog. I often have difficulty finding the right words when speaking. My mind feels significantly less "awake" than it did when I was younger.
3. Twitches/tremors.
4. Stomach issues. I was diagnosed with IBS around 8 years ago.
5. Muscle/nerve pain. I've been diagnosed with several Repetitive Stress Injuries, such as cubital tunnel syndrome.
6. In some ways over the years my social anxiety has gotten worse, rather than better. I feel "out of step" with others in conversations. I have trouble finding the cadence of a conversation and knowing when to interject. I often find myself bored or distracted during conversations, and jump from topic to topic quickly.
7. Trouble sleeping. I wake up a lot, have lots of intense dreams, and typically do not feel fully rested when I wake up in the morning.

 

I recognize that these may or may not be related to my SSRI usage, as I've listed all symptoms that spring to mind which may possibly be related. In fact it is probably impossible to establish causation for many of these.

 

So that's me. I haven't yet made the decision of whether to go off SSRIs. If I do decide to quit, then I will slow taper as recommended on the site, as I am susceptible to the withdrawal symptoms we all know and hate. I also understand that I will need to address the root causes of my anxiety, and to that end I am seeing a therapist and practicing meditation. Having said that, I'm still scared that I won't be able to identify/address the underlying issues.

 

I appreciate you reading, and am grateful for any thoughts which may spring to mind.

 

- Carn1523

[Gridley]

Welcome to SA, Carn1523.  Congratulations on being Oxycontin and alcohol free.

 

As you make your decision as to whether or not you want to stay on SSRI's, there are a few things you might want to consider.  First, these drugs were originally not meant to be taken for life (or for long periods).  Their effects long-term were never tested during the approval process and the long-term effects on general health have not been studied.  Also, at some point these drugs are going to "poop out" (the scientific term is tachyphylaxis), which means they're going to stop working; you mentioned that the 150mg Zoloft is less effective than before.  The only thing to do at that point is increase the dosage (which will give you a little more time until the next poop-out but there will come a time when the drug just stops working).  The alternative is to switch to another drug, which may or may not work, which may cause you an adverse (allergic) reaction or intolerable side effects and which puts you on a potentially endless drug merry-go-round.  Finally, you mentioned that you've fast tapered several times and always ended back on the drug.  Every time you fast taper your central nervous system becomes more and more sensitive, so this is not a process you want to continue indefinitely.  

 

The dulling of the emotions is the process by which these drugs work.  Many of the other negatives you list are side effects.  Others, like increased social anxiety and insomnia are very likely withdrawal symptoms from your fast tapers.  

 

Our general recommendation is to taper no more than 10% of your current dose every four weeks.  Doctors will almost invariably want to taper you faster.

 

Why taper by 10% of my dosage?

 

Here are two slower tapers we also recommend.

 

A micro-taper is the gentlest way to come off these drugs. 

 

Micro-taper instead of 10% or 5% decreases

 

The Brassmonkey Slide is a way of making micro-taper reductions weekly, as opposed to a larger reduction once a month. 

 

The Brassmonkey Slide Method of Micro-tapering

 

This link is specifically about tapering Zoloft, including how to get the smaller non-standard doses you'll need for your taper.

 

Tips for tapering off Zoloft (sertraline)

 

This is your Introduction topic, where you can ask questions and connect with other members.  We're glad you found your way here.

 

 

 

 

 

 

[Carn1523]

Thanks @Gridley! I began using the 10% method on January 13th by reducing from 150mg to 135mg. Next planned reduction is February 13th from 135mg to 121.5mg.

 

So far I feel fine. I started running 1-2 times a week and I believe that has helped me feel better than I did at 150mg without running.

[Gridley]

On 1/26/2020 at 12:13 PM, Carn1523 said:

I began using the 10% method on January 13th by reducing from 150mg to 135mg. Next planned reduction is February 13th from 135mg to 121.5mg.

 

That sounds very good, Carn.  Please keep us updated.