blackcat : introduction, tapering off sertraline after an awful paroxetine WD

[blackcat]

Hi, after lurking for a bit and doing a bit of reading on antidepressant WD, I've finally decided to create an account here to plan & document my tapering. Apologies, this will be a long introduction.

 

I'm a 23 yo woman who has been on antidepressants for 4 years, after being diagnosed with depression and anxiety (although I suspect I've suffered from both since my early teens).

 

I was in uni when it happened, and was having a bit of a breakdown. I was very suicidal, isolated myself from most people I knew, walked out of exams, spent days crying on the floor lol the whole nine yards. I was blessed with a super understanding GP who advised me to take a year off and seek therapy. He also asked whether I wanted to try medication. I was desperate to stop feeling that way, so I started taking 50mg Sertraline / Zoloft (which I still think was the right thing for me to do at that point). I got a therapist and worked through some stuff. No unmanageable side effects from the meds, and they kept me from thinking about wanting to commit suicide all the time so I could focus on therapy. Unfortunately I also started to abuse weed around this time, it was an easy way to feel instantly less miserable and to get to sleep, and I was drinking a lot too, although depending on your uni experience you might say I was drinking the standard amount for a student. But I was 'functioning'. I was hanging out with friends, going out, and just enjoying having time off my studies while being in a uni town.

 

Honestly a lot of that time is a complete blur for me from the depression/weed/alcohol, so I'm not too sure about the exact timeline. But I didn't stay on sertraline for long because at some point I got some weird blistery skin rashes on my legs and a (different) doctor told me it might be from the sertraline, so I got switched to paroxetine instead. I don't really remember the withdrawals from switching, because around the same time my grandma passed away and I got dumped, so I was an emotional trainwreck and didn't really attribute any part of my mental state to WD. I don't think I tapered at all when switching, though.

 

All was mostly fine for a while after that. I managed to finish my studies, moved in with my partner, and things were looking up. My GP would ask every now and then if I wanted to keep taking the paroxetine as he could see I was much better, but I kept putting it off, scared of my depression coming back. I knew I couldn't stay on it forever and that the longer I was on it, the more difficult it would be to stop. Plus I noticed my libido decreasing more and more. So in April 2021 I asked my GP if I could switch back to sertraline, since I couldn't remember having any problems with libido on it, and I knew the withdrawals weren't meant to be as bad. (Most of the GPs I had after the skin rash thing happened didn't seem to think it was due to the sertraline, but just kept me on paroxetine since I had already been switched).

 

I told my GP I was concerned about withdrawals, having read a few anecdotes on reddit, and the general consensus there seemed to be that paroxetine was one of the worst SSRIs for withdrawals. He reassured me that only happened if you quit cold turkey, and told me to space out my dose to every 2 days, then every 3 days, and then start taking sertraline (!!!!). That went about as well as you can imagine. I felt miserable all the time, had really vivid nightmares, woke up soaked in sweat almost every morning, got brain zaps, dizzy spells, etc. I was really lucky that those WD effects lasted only a few weeks. After a little while of being on sertraline, I felt a lot less horrific (although the bar was low at that point), but one thing that remained was intense intrusive thoughts about self harm and suicide. I told this to my GP and he upped my dose to 100mg. After a few weeks, I started feeling a lot better. My libido was still really low though, and I started to wonder whether the antidepressants I had been taking had also contributed to other things, like my weight gain, increasing digestive issues.

 

Then, after having a blood test done for a completely unrelated reason, while visiting my parents (in another country), I found out that I had high cholesterol levels (LDL/'bad' cholesterol), which is almost impossible to attribute to my diet and lifestyle alone. The doctors there said that genetics were definitely at play, but that it was very likely that the antidepressants had something to do with it as well.

 

Which finally brings me to today. Looking back, I now think that the intrusive thoughts I had earlier this year were leftover WD effects from paroxetine, and not a result of being on too low a dose of sertraline. I don't know how much of the cholesterol, weight gain and digestive problems can be attributed to long-term antidepressant use, but I won't find out unless I try to come off SSRIs. I just got back to the UK and told my GP I wanted to start lowering my dose very gradually, citing my previous WD experience as a reason for precaution, and all I managed to do was to get a recommendation of 75mg to start instead of the 50mg she initially recommended. She also wants me to wait until the new year to start tapering and said I should stay on a consistent dose of sertraline for at least 6 months before reducing the dose, and told me that liquid sertraline was reserved for those who couldn't swallow pills.

 

Needless to say I'm not going straight down to 75mg, and I'm not going to wait to start the taper. I'm waiting for my pill grinder and capsules to arrive, and I'm focusing on having a really good diet and sleeping pattern in the meantime. Wish me luck...

 

 

 

[blackcat]

I know my first post hasn't been approved yet, but I wanted to add updates as they happened:

 

- I ordered a pill crusher, empty capsules, precision scales (gemini 20) and a tiny funnel, which should be coming later today, except for the scales which will arrive later in the week. I'm feeling really anxious/excited to get everything started so I'm trying to calm myself down and not try to do too much at once.

 

- Supplements: I recently started taking vitamin D3 (after a blood test revealed a deficiency), as well as probiotics (for GI issues), and have not experienced any problems with those. I also ordered two additional supplements: B12 (being on a plant-based diet, I should be taking this anyway) and omega-3. I want to start taking these one at a time as I saw recommended in several topics here, and want to do so before starting my taper, so I'm not switching up too many things at once. My question for this is, are there any guidelines as to how long I should wait to ensure I'm not having any adverse reactions to a supplement? How long should I wait between starting a new supplement, and starting my taper?

 

- Some basic health habits I'm also trying to get into before I start the taper: gentle cardio exercise (unfortunately I can't walk/jog because of a foot injury, and I don't want to go to the gym due to covid at the moment, so I might get an exercise bike), waking up & going to sleep at the same time every day, eating healthy (with a focus on losing weight and reducing my LDL levels).

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs. It certainly sounds like you have been through the wringer.  I'm sorry these things have happened to you.  You are in the right place.  You are right, that was bad tapering advice when they told you to skip doses to taper.  And, I'm glad you are not having the skin rashes since you went back to the Zoloft.  

 

Thank you for providing a concise drug signature.  This helps us a lot.  

 

Here is some information about how these drugs actually work.   This explains why we get symptoms from going off of these medications, and why it's so important to taper so slowly and carefully, and be very cautious about changing our doses: 

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

Video on Recovery from Psych Drugs

 

What is Happening in Your Brain

 

Windows and Waves Pattern of Stabilization

 

 

Tapering is best done extremely slowly, and we generally taper by 10% of the current dose no more than once every 4 weeks, so that the taper becomes exponentially smaller.

 

 Why Taper by 10% of my Dosage  

 

Tips for Tapering Zoloft

 

 

How are you feeling now?  Have you pretty much recovered from the withdrawal symptoms from your prior drug changes?  If so, then you could cautiously start tapering.  If not, then I would suggest waiting until you feel stable to start your taper.  

 

 

Also, as we are tapering, we suggest keeping things slow, simple, and stable. 

 

Keep it Simple, Slow, and Stable

 

 

Here is a link with checklists of common WD symptoms: 

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

 

Omega 3 Fish Oil

 

I've given you quite a bit of information here.  It sounds like you have already done some good research into how to safely taper, and are in a good position to do so.  Just bear in mind that the most important thing is to go very slowly and carefully.  Sometimes withdrawal symptoms can take a week, two, or even 3 weeks to show up, which is why we suggest waiting at least 4 weeks between reductions.  Please let us know how it goes!  

[getofflex]

On 11/30/2021 at 8:30 AM, blackcat said:

'm feeling really anxious/excited to get everything started so I'm trying to calm myself down and not try to do too much at once

Sounds good!  It sounds like you are well prepared for this.  

 

On 11/30/2021 at 8:30 AM, blackcat said:

Supplements: I recently started taking vitamin D3 (after a blood test revealed a deficiency), as well as probiotics (for GI issues), and have not experienced any problems with those. I also ordered two additional supplements: B12 (being on a plant-based diet, I should be taking this anyway) and omega-3

I don't know if insomnia is part of your withdrawal symptom list.  If it is, vitamin D3 and B vitamins can be activating, and worsen insomnia.  These links provide more information about supplements with respect to how they affect our withdrawal.  

 

Supplements, Herbs, Vitamins, etc.

 

Vitamin D3

 

Vitamin B12

 

On 11/30/2021 at 8:30 AM, blackcat said:

I want to start taking these one at a time as I saw recommended in several topics here, and want to do so before starting my taper, so I'm not switching up too many things at once. My question for this is, are there any guidelines as to how long I should wait to ensure I'm not having any adverse reactions to a supplement? How long should I wait between starting a new supplement, and starting my taper?

It's great idea to start them one by one, and start at a small dose to see how it affects you.  I'm not sure how long to wait to see if it causes an adverse effect.  I would give it at least a week.  Once you have your supplement program in place, if it were me, I would wait about 2-3 weeks to start the taper.  

 

On 11/30/2021 at 8:30 AM, blackcat said:

Some basic health habits I'm also trying to get into before I start the taper: gentle cardio exercise (unfortunately I can't walk/jog because of a foot injury, and I don't want to go to the gym due to covid at the moment, so I might get an exercise bike), waking up & going to sleep at the same time every day, eating healthy (with a focus on losing weight and reducing my LDL levels).

Just note of warning:  I would suggest going pretty easy on the exercise bike.  Doing intense exercise tends to get the adrenaline going.  When we are tapering and/or in withdrawal, our nervous systems tend to be activated, and adrenaline will increase this activation, which could result in uncomfortable symptoms such as anxiety, agitation, sleeplessness, racing thoughts, restlessness, etc.

 

You may want to wait until you are done with your taper to do a weight loss program.  That is a lot of changes for your system to handle all at once.  You may find that you lose weight naturally as you taper, since antidepressants tend to cause weight gain.   

[blackcat]

Thank you so much for all the resources getofflex.

 

I've been feeling pretty stable mentally for a while now, but the physical health concerns are what make me want to start tapering now. I haven't had any withdrawal symptoms for a couple months now thankfully. I'm just grateful to have found this community before starting to come off the antidepressants, so I don't blindly follow advice from my GP like last time... I really wish they were better informed on these matters.

 

Thanks for the advice on the supplements as well. 1-2 weeks sounds like a reasonable amount of time to wait between each supplement. Thankfully, I don't have any issues with insomnia – if anything I tend to suffer from really bad energy levels, and sleep a lot. I haven't had any issues with the D3, also it's a pretty low dose as far as supplements go, but I'll keep that in mind for the B12!

 

I'll make sure to keep the exercise gentle as well. I'm not really counting calories or anything for the weight loss at this stage, just staying away from junk food & unhealthy snacks, so I'm taking things fairly slow! I'm really hoping the taper will help with the weight though. I've never had 'weight issues' until going on antidepressants.

 

[getofflex]

On 12/1/2021 at 12:17 PM, blackcat said:

I've been feeling pretty stable mentally for a while now, but the physical health concerns are what make me want to start tapering now. I haven't had any withdrawal symptoms for a couple months now thankfully.

I'm glad to hear this. 

 

On 12/1/2021 at 12:17 PM, blackcat said:

I'll make sure to keep the exercise gentle as well. I'm not really counting calories or anything for the weight loss at this stage, just staying away from junk food & unhealthy snacks, so I'm taking things fairly slow!

This sounds very sensible, and good!  It's the best way to go.  Keeping your diet clean and healthy should help your nervous system during the tapering, as well.