Freeburrd: intro - tapering off Zoloft after many years

[Freeburrd]

Hi All - Glad to have found this group. I have been taking anti-depressants now for almost 20 years. I am a 45 year old female from Washington state, USA. I'm gainfully employed, in a stable marriage, have a smart, funny kid, have a good social circle with supportive friends - and you would never know by looking at me (or my fakebook profile) the struggles I've had with anti-depressant medications. It is a subject I do not talk about, except with my doctor and therapist. I am at a point in my life now where I am seriously considering tapering off - but I am scared.  Here's my history (note that this entire 20 year span I have been in counseling. Sometimes once a week, sometimes once a month.  I have switched counselors a few times but for the most part going to therapy has been pretty consistent - and has been a big help).  

 

Age 19 (1994) - diagnosed with generalized anxiety disorder while in college. Suffered very scary panic attacks. Given xanax - 0.5mg - I never took it. I was afraid of it. I tried to calm my nerves through exercise, prayer, meditation, chamomile tea, nutritional supplements and talk therapy.  It worked on and off - but about every six months I would have an episode of panic attacks that would last for a few weeks, then would subside. Depression / mental illness does run in my family - and I made note of that. 

 

Age 26 (2000) - Got married to husband #1. After wedding started having really bad panic attacks - debilitating. I was ready for an SSRI - desperate to feel better. Primary doc put me on Zoloft 50mg. It helped. I was panic free for about 2-3 years, but was gaining weight and did not have a libido. Weaned off the zoloft rather quickly in an every other day format (dr recommended) - and within a few weeks - my panic attacks were back. Went back on Zoloft - now up to 100mg.  

 

Age 31 (2005) - Got divorced. Still on Zoloft 100mg daily. Experiencing significant weight gain. A friend told me about "zoloft gut" which freaked me out and I decided I wanted to try something different. Doc put me on Wellbutrin. Tapered off the zoloft quickly, and onto the wellbutrin (don't remember dose, sorry) - the wellbutrin was horrible for me. My emotions were all over the place. Erratic behavior, mood swings, crying spells, very irritable, heightened sensitivity.  Called doc and she took me off the wellbutrin - and put me back on the zoloft - now 150mg.  

 

Age 35 (2010) - Got married to husband #2. Got pregnant. Reduced zoloft to 25mg during pregnancy. No symptoms - felt good during pregnancy 

 

Age 36 (2011) - Post pardum depression hit. Upped zoloft back to 100mg. 

 

Age 38 (2013) - Very deep depressions, cyclical - PMDD - about a week prior to menstruation would drop to suicidal ideation, lethargy - coud barely get out of bed. Very scary. Found a new doc, a Psychiatric ARNP - she suggested I switch to Lexapro - so I weaned off the zoloft and onto the lexapro. It didn't really help - still having deep dips of depression (but no mania - not bipolar).  She augmented the lexapro with lamictal - that helped in the beginning. It pulled me out of the deep dips of depression. However, the side effects were brutal.

 

Age 40 (2015) - Still on lexapro and lamictal - Cognitive issues abound - my once quick as a whip, smart, high functioning brain - was forgetting the word for simple everyday things - I'd go to open a folder on my computer, and could not remember why - I'd look at a stapler on my desk and it would take me a few seconds to think of the word "stapler". It freaked me out. I went to a new psychiatrist (as I just didn't have a good feeling about the psych ARNP) - and she said "why did you go off the zoloft in the first place". She took me off the lexapro, and put me back on zoloft 100mg.  She reduced my lamictal but didn't take me off - just to see if maybe a lower dose would help with side effects.  

 

Age 41 (2016) - Cognitive issues still there, but maybe a bit less due to lesser dose of Lamictal. Decided I wanted off lamictal. Dr. weaned me off slowly - and I didn't really have withdrawals. My cognitive function improved, but it is still not back to where it was prior to taking Lamictal in the first place. Went back to taking just 100mg zoloft. 

 

Age 43 (2018) - Have experienced significant weight gain. Made the decision to have weight loss surgery.  Had gastric bypass and talked to psych about the malabsorbtion issues now that my stomach has been re-routed. She suggested I go up to 200mg zoloft. I was against it - I wanted to take it down... but I trusted her, so went up to 200 mg. 

 

Age 44 (2019) - My mother passed away - we were very close. I started having troubles with alcohol (a nasty risk of gastric bypass patients you don't hear enough about). So - in 2019 I made the decision to quit drinking. Sober now for 9 months and working the AA program successfully with a sponsor. Still on 200 mg zoloft. 

 

Age 45 (current) -  For about six weeks I have been feeling depressed and physically lethargic (could it beeeeeee QUARANTINE!?). My counselor screened me for depression and I scored "moderate to severe". She suggested I go see my psychiatrist in case my medication needs tweaking.  So - I saw the psychiatrist (virtually). She suggested two options - I augment the 200mg zoloft with 2mg Abilify or I go on Effexor.  I am VERY apprehensive to do either. I don't want to be on either - especially Abilify. Deep down I feel like I should reduce the zoloft and very slowly work towards being off anti-depressants completely - but psych tells me no.  My therapist tells me to trust my gut. I am telling me to trust my gut. GOD is telling me to trust my gut. But - psychiatrist tells me no.  My gut tells me I can handle it and what once worked for me is not working for me anymore.  I have grown up a lot over the last 20 years.  SO - I am confused. How much of this is just grief from my mother being gone and the fact we are in a quarantine?  Should I trust my gut here and reduce the zoloft?  feel very trapped in this viscious cycle. I am in a much more stable place today - especially with my anxiety.  I have not suffered a panic attack in well over a decade. I have done extensive therapy, EMDR for some childhood trauma, my weight is stable, I am sober, and I have confidence I can handle the hard things. I feel like I just have been listening to what doctors and psychiatrists tell me to do for years out of fear and out of mistrust of myself and the "what if I'm wrong" question that's constantly in my head...   I just want some honest feed back from people who have been there done that. I know the decision is ultimately in my hands but if you relate, have experiences or thoughts on this please share. I would love to hear what you have to say.  Thanks for reading!!  

 

-Freeburrd 

 

[Gridley]

Welcome to SA, Freeburrd.

 

It seems like you've answered your own question, Freeburrd.  You've done a lot of good therapy, you feel confident, and you've got a pretty strong lineup of advocates for trusting your gut and on the other side just the psychiatrist who sees his/her job as putting you on more or different drugs.  It's really drug Russian roulette adding Abilify or switching to Effexor.  Abilify, a powerful antipsychotic, would be another drug you'd have to taper off, Effexor can be very difficult to taper and, if you switch,  you run the risk of withdrawal from Zoloft.  We're a site for going off psychiatric drugs, so if you choose to go with your gut, we'd be happy to help you taper the Zoloft.

 

We recommend tapering by no more than 10% of your current dose every four weeks.

 

Why taper by 10% of my dosage?

 

The Brassmonkey Slide, which we also recommend,  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 nonstandard doses you'll need for your taper.

 

Tips for tapering off Zoloft (sertraline)

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium (glycinate is a good form) and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Add in one at a time and at a low dose in case you do experience problems.

 

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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

[Freeburrd]

On 5/30/2020 at 8:00 AM, Gridley said:

Gridley, thank you so much for your response. I have done more research and a lot of introspection and I have made the decision to slowly taper off the Zoloft, 10% at a time. I have support from my therapist and husband. Today I took my first dose at 10% reduction (200mg down to 180mg for 4 weeks). I’ll keep you all posted on how it goes. 

 

 

[Gridley]

12 hours ago, Freeburrd said:

slowly taper off the Zoloft,

That's great, Freeburrd.  Remember, it's a 10% reduction off current dose, so your next reduction in four weeks would be 10% of 180 (18mg), 180 - 18 = 162mg.

[Freeburrd]

Hi All - Just an update. It's been 16 days since I started tapering with the 10% method. Went from 200mg zoloft down to 180mg. It has been manageable. I have felt side effects - some anxiety (shortness of breath, chest pain, feeling detached from reality) - I've noticed that I really have to watch the caffeine intake and drink more water - that makes a huge difference on my anxiety. Other side effects have been headaches, mild brain zaps, slow cognitive function (not being able to think of a word, pointing to a stapler and not being able to say the word stapler, or it taking me 10 seconds to find the word - I HATE it), mild insomnia (sleeping less than I usually do).  All these symptoms have been intermittent. I started lightly exercising in the morning a week ago and have been doing so for about 15-20 minute every morning.today I am feeling pretty stable. I am not regretting this - and even though the eager beaver in me wants to drop another 10% now, I will wait until day 30 before I drop the next 10% to 162mg.  Anyways, I guess all this is to say - for me, it hasn't been total torture (yet) - and even though it's a very long tunnel - I can see the light at the end. 

[Gridley]

28 minutes ago, Freeburrd said:

I will wait until day 30

Good idea, Freeburrd.  Taking is slowly will pay off.  It's normal to have withdrawal symptoms when you reduce.  The ones you describe are typical. They should fade as your system acclimates to the lower dose. If the symptoms become intolerable, it means you are tapering too fast.  If this happened please let us know and we can come up with a different tapering plan.  As you approach day 30 please let us know how you're doing.

[Freeburrd]

12 minutes ago, Gridley said:

As you approach day 30 please let us know how you're doing.

 

Will do, thank you Gridley!! 

[Freeburrd]

Hi All - just an update that I am doing well. I increased my taper speed a bit - going down 20% a month. I just got down to 100mg Zoloft, and I have had minimal side effects.I have noticed a few brain zaps, usually within 2-3 days after taking dose down, but they dissipate as my body acclimates to the lower dose.  I've experienced no panic attacks or deep depressions - and feel pretty normal. Normal emotions, normal mood swings (for me, I struggle most with mood during PMS). So far I am happy with this process. I know I am tapering down a bit faster than advised, at my own risk, but for me personally it is working. I am making sure to follow my gut on this and be super honest about everything. I am thinking I may slow down the taper now that I am at 100 mg... and go back to only 10% per month. We shall see how 100mgs is going come October.  I'll keep you posted.  Hope you are all faring well.  Thanks.    

[ChessieCat]

5 hours ago, Freeburrd said:

I know I am tapering down a bit faster than advised, at my own risk, but for me personally it is working. I am making sure to follow my gut on this and be super honest about everything. I am thinking I may slow down the taper now that I am at 100 mg... and go back to only 10% per month.

 

Just in case you don't know, the 10% taper is calculated on the current dose, not the starting dose.  There are comparison graphs of the hyperbolic and linear tapers in Post #1 of the topic linked below.

 

The reason you have probably been okay tapering at a greater percentage is that you were taking a very high dose of Zoloft.  As the dose gets lower the dose occupancy changes.  And at the very low doses many members find that they have to go slower, reducing by less and/or holding for longer.  This topic explains it:  Why taper paper: dose-occupancy curves

 

I think that reducing by no more than 10% from now on is a good idea.  Especially since you experienced brain zaps when you last reduced.  That is a definite sign that you tapered by too much.    This is not a race.  It is better not to taper by too much and cause more than minimal withdrawal symptoms.  The idea of tapering is to reduce the drug at a rate where we only experience minimal withdrawal symptoms.  Brain zaps are a major withdrawal symptom.  It is a sign that the brain is unhappy with not getting enough drug.  We have members here who have tried tapering too quickly and in the end it has taken them longer to get off the drug.

 

What is good though, is that you have lowered your drug burden.  To help keep you patient it is better to look at how much you've reduced than to look had how much you still have to go.