LydiaCS: Tapering Zoloft

[LydiaCS]

Hello all, 

 

I've been on 50 mg of Zoloft since 2016 for a period of depression that, in retrospect, was largely situational.

 

In 2016, I was living in a new city and very isolated. I was 20 at the time, and had struggled with sustained depressive episodes since high school. Eventually, I sought help. Medication seemed more affordable than therapy. After a 10 min consultation and a short questionnaire, I was prescribed Zoloft on the spot. 

 

When I started taking Zoloft, I remember experiencing some side effects. My libido was completely shot, for example. I didn't notice much improvement in my mood for many years. My mood began to improve as my life (and interpersonal choices) improved, but my family and I attributed these improvements to the drug. That was the unspoken assumption. I was "cured!" 

 

I am 25 now, and I live my life very differently than I did at 20. When I was younger, I romanticized depression and felt my experience of it was meaningful on some level. I believed that my suffering meant I was closer to some elusive existential truth. I now understand how destructive this thinking is.

 

I should also mention that I lived very passively in my younger years. I had extremely poor boundaries, and a very poor sense of self. I did not advocate for myself in interpersonal relationships. I found myself in many relationships in which I played a supporting role to stronger personalities. I felt my "low-maintenance" approach to relationships was honorable, but it was really just self-denial. Naturally, years of denying my needs and boundaries led to increasing feelings of resentment, bitterness, and distrust. As soon as I consciously embraced a victim mentality, I guaranteed my victimhood again and again, playing out the same toxic dynamics. 

 

In 2019, after an epic rock bottom, I realized I had to start living my life differently. The first step I made towards change was *finally* acknowledging and accepting that I was responsible for my own life. This fundamental mindset shift has infinitely improved my life. 

 

In January, 2022, I decided I would start tapering off of Zoloft in the new year. I had been talking about doing it for years, but I only recently felt stable enough in my life and my self to give it a shot. I'm currently on week 3 of my taper, but I'm worried I may be moving too quickly.

 

I've been cutting my pills, so I took 75% of my dose for one week, then moved down to 50% for the last two weeks. I'm still on 50% now, and as I'm reading the entries here, I realize I need to take this much slower. I experienced withdrawals during week one - Headaches, brain zaps, anxiety, brain freeze. They stabilized after about a week, so I transitioned to 50%. I haven't experienced brain zaps or headaches since the second reduction, but I feel I have less control over my emotions. I'm more prone to nice feelings like tearful awe, but also anxiety and distress. 

 

I've been making many lifestyle changes to ease the transition. I've stopped drinking alcohol, and I've reduced my caffeine intake. I'm pretty sensitive to caffeine and I've been drinking coffee religiously for nearly a decade, so I'm also experiencing caffeine withdrawals, which can be pretty debilitating. I've been trying to incorporate exercise, meditation, and more sleep in my weekly routine. I'm also reading Kelly Brogan's "A Mind of Your Own," which has inspired me to cut out dairy, gluten, and desserts. 

 

I live alone, I moved to a new city during the pandemic, and I've had to distance myself from a lot of my old friends, so I feel pretty isolated in this process. I'm very, very grateful to have found this resource. I will continue to check in as things shift, but I'm worried about the fact that I can't objectively assess myself if things go awry. Thankfully, I have a good relationship with my parents, but I don't seem them very often. 

 

Anyone else tapering and living alone? 

 

[Kiasofia]

Welcome @LydiaCS
I'm glad you found us at this stage in your taper.  Do I understand correctly that you were on 50mg three weeks ago and are now at 25mg? If so I would consider increasing the dose back to 37,5 or at the very least not reducing further for many months.

 

To help us better advise you, can you please create a signature with all of the drugs that you are taking and have been taking in the last couple of years following these instructions:

How to List Drug History in Signature

 

About tapering Zoloft:
Tips for tapering off sertraline (Zoloft)

NEVER SKIP DOSES TO TAPER

 

It is often easier to taper at the higher doses than the lower ones. This explains why:

Why taper? SERT transporter occupancy studies show importance of gradual change in plasma concentration

 

As there are common misconceptions about how these drugs work I found this post helpful to understand what is going on:

How Psychiatric Drugs Remodel Your Brain 

 

Coming off these drugs can cause many different withdrawal symptoms, often leading to doctors thinking the original condition is returning or that another mental illness has emerged.

What is withdrawal syndrome?

Dr. Joseph Glenmullen's withdrawal symptom checklist

 

When we recover, there are times of feeling OK mixed in with times of feeling bad.  This is called windows and waves.

The Windows and Waves Pattern of Stabilization  

 

Aside from a high quality fish oil and magnesium, be careful with supplements. Your central nervous system (CNS) has become sensitized from psychiatric drug use and can react unpredictably. Alcohol, caffeine, nicotine and other mind altering substances can make the condition worse.

Important topics about tests, supplements, treatments, diet

 

Here is our symptoms and self care section, you may find some useful ideas to help manage symptoms as you recover. 

Symptoms and self care topics 

 

This is your Introductory topic, where you can ask questions and connect with other members.  We're glad you found your way here. Please stay in touch and let us know how you are doing.

 

 

Edited February 1, 2022 by Kiasofia

[LydiaCS]

Yes, I was at 50 mg 3 weeks ago and am currently on 25 mg. I'm not experiencing any debilitating symptoms, but I do feel emotionally fragile and very susceptible to stimulants, even processed sugars. I'll hold off for a few months before I taper any further. 

 

Thank you for these resources! I've added my signature.

[ChessieCat]

Hello LydiaCS and welcome from me too,

 

Thank you for creating your drug signature.

 

It would be very helpful if you would add the dates for the Zoloft for 2022.  So we need to see the date when you reduced to 37.5mg and also the date when you reduced to 25mg.

 

Like this:

 

2022 - Zoloft:  date, 37.5mg; date, 25mg;

 

Please remember to update it whenever you make a change.

 

Thank you.

 

5 hours ago, LydiaCS said:

but I do feel emotionally fragile and very susceptible to stimulants, even processed sugars

 

These are withdrawal symptoms and might worsen over the next few weeks.

 

From the information you have provided you are tapering too quickly.  If you wee taking 50mg in December 2021 and then reduced to 37.5mg then to 25mg both in January, 2022, you have made a 50% reduction in a 1 month period.  SA's recommended taper rate is not more than 10% of the current dose with a hold of at least 4 weeks to allow the brain to adapt to not getting as much of the drug.

 

I agree with Kiasofia that it would be a good idea to return to 37.5mg.

 

Please note that the suggested updose is if you do this IMMEDIATELY.  If you leave if for longer you might need to increase by a smaller amount.

[LydiaCS]

Thank you, ChessieCat. I really appreciate the advice. 

 

I'll go back up to 37.5mg tomorrow.

 

When should I plan my next reduction? Should I plan to implement a 10% reduction using the liquid method? 

[ChessieCat]

You are welcome.  I arrived at SA 2 weeks after reducing my Pristiq by 50%.  After updosing and stabilising I have successfully tapered of it completely.

 

Please read the following topics linked below.

 

It is important to listen to your body/symptoms and not make another reduction if you are still experiencing withdrawal symptoms.  It is better to hold for longer than to reduce too soon.

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

Stability

 

WDnormal

 

And Brassmonkey talks more about it here:

 

tao-of-the-brassmonkey

 

SA strongly encourages members to learn and use non drug coping skills:

 

Non-drug techniques to cope

 

When you do make your next reduction I suggest you make a small reduction to test to see if you are stable enough to recommence tapering.  When I tried to make a 10% reduction about 3 months after I updosed (after my bad withdrawal symptoms) I had bad ear pain and updosed by a small amount and it cleared after several hours.  However it is better to not have to updose.  The effect of yoyoing doses has a cumulative effect; you might be able to do it for a while but there might come a time when it doesn't work and it sometimes can be difficult to stabiise once this happens.  You could try doing a 2.5% reduction as a test to see if you are ready.  This way you will be less likely to need to updose.

 

Getting off a psychiatric drug is not a race.  And it has nothing to do with how strong or determined we are as a person.  The brain has adapted to getting the drug and we need to "sneak it away" and allow the brain to make small adaptations as we taper, instead of trying to make a lot of changes like it has to when the drug is removed too quickly.

 

The idea of tapering get off the drug and be able to live your life as normally as possible.

[Kiasofia]

I'm glad to see you decided to updose and all the good advice from ChessieCat😊

[Blossom71]

Hi @LydiaCS

 

just wanted to drop by and say hello!

I hope the updose helps x

[ChessieCat]

Please let us know how you are going. 

 

Q:  Have you noticed the withdrawal symptoms improving.

 

Thanks.

[LydiaCS]

Hi ChessieCat, 

 

I'm on day 2 of updosing and I'm feeling pretty weird. I'm experiencing dizziness, confusion, and some disordered thinking. I just canceled a social plan because I just feel too strange to be socially present and engaged right now. 

 

Is this a normal shift after a dose change? Will it stabilize within the next few days?

[ChessieCat]

It takes about 4 days for a dose to get to full level in the blood and a bit longer for it to register in the brain.

 

Q:  Did you feel/are you feeling anxious about the updose?

 

If yes, then that can confuse things because anxiety can create its own symptoms which you might think are being caused by the increase in the drug:

 

From  https://www.getselfhelp.co.uk/anxiety-self-help/

 

 

 

Edited February 3, 2022 by ChessieCat

[LydiaCS]

Hi everyone, 

 

I've been on 50 mg Zoloft since 2016, and decided I was ready to get off of it this year. In January, I reduced my dose to 37.5 mg and experienced brain zaps, crying spells, and low energy. Eventually, I stabilized and felt it best to wait before I continue my reduction. That said, I haven't been the same since I started my taper. I've been much more emotionally fragile and prone to dark, cyclical thoughts. Hangovers are especially depressing (I work at a bar and drink 1-2 nights/week) in a way that they haven't been in the past. I'm just functional enough to get my work done, take care of myself, my place, etc., but I'm 25 and at a pivotal point my career when I need as much motivation and energy as I can possibly get. The timing of this taper is starting to feel like a form of self-sabotage as I feel my hope for my work, relationships, etc start to wane. 

 

I'm unhappy with the city I currently live in, and I told my parents I'd like to start planning a move. They've noted my behavioral changes, and have been critical of my taper. They've made it clear that they don't think I'm stable enough to pull off a major move right now. At this point, I think I just need to return to my original dose and plan to return to this taper once I've reached a more stable, settled point in my life.. whenever that happens. 

 

I've been cutting my pills, so I'm likely taking a slightly different dose every day. My original dose seems like a decent option at this point b/c at least it's a stable dose. 

 

Thoughts? Any early stage Zoloft tapers? Anything I should anticipate when I return to my original 50 mg dose?

[getofflex]

Previous post moved to your intro topic to keep your history all in one place.  Please post questions and discussion about your situation in this one thread, to avoid confusion and duplication of efforts.  Thank you.  

[getofflex]

3 hours ago, LydiaCS said:

I've been on 50 mg Zoloft since 2016, and decided I was ready to get off of it this year. In January, I reduced my dose to 37.5 mg and experienced brain zaps, crying spells, and low energy. Eventually, I stabilized and felt it best to wait before I continue my reduction. That said, I haven't been the same since I started my taper. I've been much more emotionally fragile and prone to dark, cyclical thoughts.

We at SA have a conservative approach to tapering - no more than 10% reduction. when you dropped from 50 to 37.5, that was a 25% drop.  It's a good thing that you updosed to 37.5 mg in February, and have been holding ever since. 

 

 Why Taper by 10% of my Dosage  

 

3 hours ago, LydiaCS said:

Hangovers are especially depressing (I work at a bar and drink 1-2 nights/week) in a way that they haven't been in the past.

We strongly suggest you completely avoid alcohol during a taper, and while your nervous system is sensitized from psychiatric drug changes.  Alcohol tends to significantly worsen WD for many people, and I've seen cases where just 1 drink put people in a wave that lasted for several weeks.  This is a thread where members discuss how alcohol has affected them:  

 

Alcohol and Beer

 

3 hours ago, LydiaCS said:

At this point, I think I just need to return to my original dose and plan to return to this taper once I've reached a more stable, settled point in my life.. whenever that happens. 

I would not suggest you return to your original dose of Zoloft.  After being on this dose for 6 months, your brain has made lots of adjustments, and jumping back up to that higher dose puts you at significant risk of kindling.  This means your nervous system would become even more destabilized and sensitized, your symptoms would worsen, and future tapering would be even more difficult.  I would suggest that you hold on this current dose of Zoloft, avoid alcohol and other mind altering substances, and take care of yourself using healthy, non drug means.  Please be sure you are precise in your dosing.  Don't skip or miss any doses.  Instead of cutting the tablet, try crushing the tablet and weighing it, or switching to liquid.  This link explains how to do these things.

 

Tapering and Dosing Zoloft

 

If it were me, I would hold on this dose of 37.5 mg for a while, and not move until I felt stabilized.  

 

 

Edited July 8, 2022 by getofflex

[LydiaCS]

Thanks for your response. I took 50 mg this morning for the first time since my taper, and now I'm worried. Would you suggest I return to 37.5 mg tomorrow?

[getofflex]

Yes,  I would suggest you return to 37.5 mg tomorrow.  Please read this link about stability - it is very important, and in time, will really help you if you do what it suggests:

 

Keep It Simple, Slow, and Stable

 

 

[Blossom71]

Hi @LydiaCS

I'm currently tapering Sertraline.  My original dose was 150mg and I'm down to 34mg.

I did larger jumps from 150mg down to 50mg without too many problems, but I'm having it take it much slower since I got under 50mg.

 

Stability is absolutely the key for me. I was making changes quicker than was right for my body, and it caught up with me. Not immediately, but the changes were cumulative.

Take time to listen to your body. Its hard not to be impatient but patience will pay off.   

 

I hope you're doing ok.