Zwerger Posted November 13, 2020 Share Posted November 13, 2020 (edited) I have a 23 year old non-vocal child (autism, self-injury, mood disorder and agitated catatonia.) Since they cannot tell me about the withdrawal effects they are experiencing I'm reaching out for some help. They have been on 175mg of Zoloft for 3+ years, they have also been experiencing severe periodic limb movements of sleep which I've read can be a side effect of Zoloft. The doc recommended reducing Zoloft by 25mg every two weeks. Within 3 days of reducing the Zoloft my adult child starting have problems with falling asleep and staying asleep as well having short periods of unusual agitation during the day. The doc doesn't think the insomnia is related to the taper but it is clear to me that there is a direct correlation. My thoughts are reducing the daily zoloft in increments of 11.5mg per month (cutting a 25mg pill in half,) This taper would take us through mid-October of next year before we could discontinue. Does this sound reasonable? Are there any other possible/likely discontinuation symptoms I should be on the watch for? Regards' Zwerger Parent of Adult non-vocal child with various mental health conditions Zoloft 175 Taper Recommendations Needed Venlafaxine 150MG Trazodone 250MG Depakote ER 500mg tabs, takes two pills each in AM and PM for a total of 2000mg Edited November 13, 2020 by Gridley Link to comment
Moderator Emeritus Gridley Posted November 13, 2020 Moderator Emeritus Share Posted November 13, 2020 (edited) Welcome to SA, Zwerger. To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly. You can just copy the information in your post using the following link. Account Settings – Create or Edit a signature. Insomnia and agitation are common withdrawal symptoms. Here are two links, the first to give you a background on withdrawal, the second listing typical withdrawal symptoms. What is withdrawal syndrome. Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) We recommend tapering by 10% of current dose every four weeks. Why taper by 10% of my dosage? There are a couple of problems with the tapering method you suggest. Pill cutting can work but often the doses are inconsistent and inexact with this method. The second problem is that as long as you're at a high enough dose, a straight drop of 12.5mg a month is fine. But as you get lower in dose 12.5mg a month is going to be more than the recommended 10% per month. Decreasing by a straight unvarying milligram drop also accelerates the amount that you would be decreasing each time making it rougher and rougher with each drop. Decreasing by a percentage however decelerates the amount of each drop and makes things gentler on your system. This link is specifically about tapering Zoloft. Zoloft comes in a prescription liquid in the U.S., and we recommend this method as being easy and accurate. If you decide to switch from tablet to liquid, you should do a gradual crossover from tablet to liquid before continuing your taper. This link is specifically about tapering Zoloft and includes information about the liquid as well as other tapering methods. Tips for tapering off sertraline (Zoloft) You're wise to wan to get your son off the Zoloft. I've run your son's drugs trough a drug interaction site, and there are major interactions among Zoloft, Venlafaxine and Trazodone, as follows: Interactions between your drugs Major traZODone sertraline Applies to: trazodone, Zoloft (sertraline) Using traZODone together with sertraline can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor. Major traZODone venlafaxine Applies to: trazodone, venlafaxine Using traZODone together with venlafaxine can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor. Major sertraline venlafaxine Applies to: Zoloft (sertraline), venlafaxine Using sertraline together with venlafaxine can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor. ------ 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 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. Get supplements that are single ingredient (not mixed with other types of supplements). This is your Introduction topic, where you can complete your son's drug signature, ask questions and connect with other members. We're glad you found your way here. Edited November 13, 2020 by Gridley Gridley Introduction Lexapro 20 mg since 2004. Begin Brassmonkey Slide Taper Jan. 2017. End 2017 year 1 of taper at 9.25mg End 2018 year 2 of taper at 4.1mg End 2019 year 3 of taper at 1.0mg Oct. 30, 2020 Jump to zero from 0.025mg. Current dose: 0.000mg 3 year, 10 month taper is 100% complete. Ativan 1 mg to 1.875mg 1986-2020, two CT's and reinstatements Nov. 2020, 7-week Ativan-Valium crossover to 18.75mg Valium Feb. 2021, begin 10%/4 week taper of 18.75mg Valium End 2021 year 1 of Valium taper at 6mg End 2022 year 2 of Valium taper at 2.75mg End 2023 year 3 of Valium taper at 1mg Jan. 24, 2024: Hold at 1mg and shift to Imipramine taper. Taper is 95% complete. Imipramine 75 mg daily since 1986. Jan.-Sept. 2016 tapered to 14.4mg March 22, 2022: Begin 10%/4 week taper Aug. 5, 2022: hold at 9.5mg and shift to Valium taper Jan. 24, 2024: Resume Imipramine taper. Current dose as of Aug 26: 4.0mg Taper is 95% complete. Supplements: multiple, quercetin, omega-3, vitamins C, E and D3, magnesium glycinate, probiotic, zinc, melatonin .3mg, iron, serrapeptase, nattokinase, L-Glutamine, milk thistle, choline I am not a medical professional and this is not medical advice. It is information based on my own experience as well as that of other members who have survived these drugs. Link to comment
Moderator Emeritus ChessieCat Posted November 14, 2020 Moderator Emeritus Share Posted November 14, 2020 Hi and welcome to SA from me too. Please post what specific times the drugs are taken. 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 Link to comment
Administrator Altostrata Posted November 14, 2020 Administrator Share Posted November 14, 2020 Welcome, @Zwerger Sleeplessness is indeed a very common symptom of too-fast tapering of antidepressants. You might split the difference, go back to 162.5mg Zoloft, and see if that helps. The increase should take effect in about 4 days. The easiest way to do this is to take the majority of the daily dose in tablet form and the rest in liquid for easy dosage adjustment. Zoloft comes in a liquid form for this purpose; see the link Gridley gave you. As you can see from the drug interaction report, there are problems with your child's polypharmacy. Prescribing 3 antidepressants together -- Zoloft, venlafaxine, trazodone -- is not good medical practice. Adding Depakote to this is also questionable. If I were you, I would not take further advice about psychiatric drugs from this prescriber. Please let us know how your child is doing. This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted. Link to comment
Zwerger Posted October 8, 2021 Author Share Posted October 8, 2021 Dear SA - As a follow-up to this post I'm wondering if what we're seeing with our child could be a side effect of the zoloft taper. Our child, as we've continued the taper, is having symptoms of depression/fatigue. It's difficult to know since she is non-verbal. The symptom we're seeing is her wanting to be in bed all day. This is quite abnormal for her and doesn't necessarily appear to be fatigue. Any thoughts? Thank you! Link to comment
Administrator Altostrata Posted October 9, 2021 Administrator Share Posted October 9, 2021 Yes, depression and fatigue can be withdrawal symptoms. One of our Moderators Emeritus, @Glosmom, was in a similar situation. Perhaps she will return to talk with you. Her daughter is now doing much better, see This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted. Link to comment
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