Rubygirl: Zoloft/sertraline withdrawal

[Rubygirl]

Hi all, 

Need some advice about whether or not to reinstate a low dose to cut WD symptoms. My history is as follows:

 

2003- 2010 Effexor 150 mg
switched to 150 mg of Zoloft 2010 - 2021
2021 Slowly went down to 100 mg of Zoloft
February 2022 Began too fast taper. Down to 50 mg
March 28, 2022 - dropped to 25 mg

May 15 W/D symptoms began with a vengeance

 

This was done under the advice of a psychiatric NP. Now I know it was wayyyy too fast. 

 

My last taper of sertraline was from 50mg to 25 mg on March 28. Didn't feel any symptoms until May 15th. 

The last 2 day have been hell- racing thoughts, shivers, brain zaps, nausea, diarrhea, feelings of doom/dread, mental fog, insomnia, restlessness in limbs. I am miserable and contemplating how I can even go to work. 

 

I know from reading the files not to reinstate at 50 mg but am confused what level I might return to have some relief from these WD symptoms. My plan would be to hold for a longggggg while (seriously thinking a year) before trying any future taper. 

 

Once I figure out the best dose to reinstate at, do I ask for liquid sertraline?

 

Any help would be so appreciated!

 

[Frogie]

@Rubygirl

 

Welcome to SA. We are a volunteer ran site helping members such as yourself taper off psychotic medications, or have tapered off and are now healing.

 

This is your introduction page where you will receive information, ask questions and meet other members. We ask that you only have one introduction page so we can keep all your information in one place.

 

Unfortunately, most dr's don't know how to taper you off these medications, and it causes all the withdrawal symptoms you are speaking of. We never suggest more than 10% a month, and some go even slower.

 

Why taper by 10% of my dosage?

The slowness of slow tapers

About reinstating and stabilizing to reduce withdrawal symptoms

 

What is withdrawal syndrome?

Dr. Joseph Glenmullen's withdrawal symptom checklist

 

Digestive problems:  Nausea, Diarrhoea, Bloating, GERD

 

If you don't think you can hold at 25 mg for a while and see of these symptoms lessen, you could try to updose to 37.5 mg. It will take 7-10 days for this to reach fully in your system. Then you would hold, like you suggested for a long time before trying to taper again.

 

If you want to try to switch over to liquid, after you stabilize, it is much easier to use. You would take 3/4 tablet and 1/4 liquid for a week, 1/2 tablet and 1/2 liquid for a week, 1/4 tablet and 3/4 liquid for a week, then all liquid. But don't do this until you are stable as I stated.

 

Tips for tapering off sertraline (Zoloft)

 

 

The Brassmonkey Slide Method of Micro-tapering

 

We don't suggest supplements as they can be too stimulating to the nervous system except 2 that seem to be calming to some. If you want to try one, try it in a small amount and wait a few days before introducing the other.

 

Magnesium

Omega-3 Fish Oil

 

After reading the links provided, please reach out to us with any questions you may have.

[Rubygirl]

Thank you so much @Frogie ! 

I have an appointment with my psychiatric NP tomorrow and am going to request to reinstate to 37.5 mg. 

Based on your opinion, should some of the WD symptoms abate?

 

[Frogie]

@Rubygirl

 

I think with a good long hold, you should feel better. But everyone is different.

 

Keep me posted.

[Rubygirl]

Thank you Frogie!

I had my appointment with my psychiatrist yesterday and she agreed to updose to 37.5 mg and see how I feel in 2-3 weeks.

I took my first higher dose yesterday. I did sleep better last night (with melatonin). Today my restlessness was still there and mood was very low. I called in sick to work as i felt unable to concentrate and even drive. My brain feels sluggish. I feel like my mood changes minute by minute! Trying to keep positive. Sat outside a lot today, made sure I was eating and drinking lots of water. My hopes are high that this low updose will help but i am still scared it won’t.
Now we wait and see…

[Rubygirl]

@Frogie Just curious, if I were to need to updose further, would it be to 50 mgs? Would that be done in 2 weeks? That is not my plan, but curious about what my possibilities are. Thank you!

[Frogie]

@Rubygirl

 

Not necessarily back up to 50 mg. We would gradually increase you by maybe 0.50 mg and see how you do. It takes 7-10 days for it to reach full stability in your system.

[Rubygirl]

@Frogie I am currently splitting the 25mg pills with a pill cutter and taking one and a half each day to equal 37.5mg.

is that ok?

what would I do should I need to updose by .5mg?

[Frogie]

@Rubygirl

 

That will work for now, but it's not very accurate.

 

The best thing to do is get a scale, weigh and crush your tablets to get the most accuracy.

 

You can read this link and it will give you some information on how to do this.

 

Using a scale to weigh and measure doses

[Rubygirl]

Hi @Frogie,

Wanted to update you on the past week. It's been exactly a week since I updosed to 37.5. My physical symptoms have lessened greatly (restless leg has greatly improved). My morning anxiety however, has been terrible. I basically cannot function until about 10 am. I know the morning cortisol anxiety is very common for those in withdrawal. I take my sertraline everyday at 7 am. I'm wondering if the morning anxiety is worsened by the fact that I am almost 24 hours from my dose at that point? I do remember that when I started sertraline 12 years ago, the morning anxiety was the worst symptom. 

 

Throughout the day I am still experiencing shakiness, mood swings, some DR, weepiness, memory fog.  But I have windows of clarity and "normalcy." I use the afternoons and evenings, when I feel my best, to make sure I am showering and spending time with my kids. 

 

This WD has sped up some life decisions that were already going to happen. I was supposed to be exiting my full-time job on June 3rd to transition to being home more with my kids and to focus on my graduate degree and internship. I decided yesterday to resign effective immediately as I feel I am in an acute phase and need to be caring for myself. 

 

I am planning on holding here at 37.5 mg to see if I can stabilize and if the morning anxiety improves. Thanks for your support!

[Frogie]

@Rubygirl

 

I don't have my computer with me to add some links. But I will answer you this evening.

 

Glad you are doing better though!

[Frogie]

@Rubygirl

 

It sounds like the updose is working. I'm so glad.

 

The restless legs is normal even for "normal" people. Have you tried a weighted blanket? I have one and a small lap size I got on Amazon I can put on my knees and calves and it really helps. Epson salt baths help a lot with that too.

 

The anxiety you are experiencing in the morning is very normal. That is cortisol spikes and happens to everyone. But the people like us, feel it 100 times worse than one's that have never taken anything. Just do lots of self care. Take a nice hot shower (or cold if you can stand it, I can't) and listen to soothing music, things like that.

 

I'm so happy for you to be able to go back to school. That is a huge achievement! Be very proud of yourself. I'm very proud of you.

 

Please keep me up to date and don't hesitate to ask any other questions you may have.😊

 

 

[Pandora]

Rubygirl,

Did you do a direct switch to Zoloft? I'm on 150mg Effexor as well and looking to minimize symptoms.  

[Rubygirl]

Hi @Pandora

Honestly, I don’t remember. I think I did a cross taper. I remember starting Zoloft at 50 mgs and tapering up to 150mg. Sorry I can’t be of more help!

[Kaervin]

Hi Ruby,

 

You are in a similar situation as me. I managed to get down to 25mgs from a max of 100 mgs no problem. Then in March I cut my dose in half down to 12.5 mg. I did ok until the end of May, so there was almost a 2 month delay in the horrible withdrawal. RLS at night is bad, but have read others suggest weighted blankets and magnesium. The overwhelming dread, malaise, and heat intolerance is rough though.

 

During the worst of our withdrawals we are prone to making hasty decisions. Listen to those who have traveled this path already and keep their suggestions in mind when you decide any further plan of action with your doctor. 

 

If my own symptoms continue to get worse to the point of not being able to go to work or function, then I will probably updose as well, albeit by a small amount. Here's hoping I can muster the fortitude to get through this bad spell.

 

I wish you the best of luck. We will see normalcy once again. Hang tough.

[RachelSusan]

@Rubygirl

 

Hi Rubygirl,

 

I have been following your posts. I wanted to say how sorry I am that you are going through this.  Back in 2016 I stopped Zoloft suddenly and went through a terrible withdrawal.  I had to reinstate and while the ordeal was terrible with time it did slowly improve. The problem is the time it takes to recover is far to long, at least in my opinion. I wanted to send my best wishes to you and to tell you I hope you improve quickly.  I did make it through reinstatement and a long taper off. I do still check in here though because I think it is a great site and if I can offer someone a little bit of hope I like to do so.

 

Rachel

[Rubygirl]

Thank you so much @RachelSusan! I actually ended up updosing to 50 mg on May 31st. While I think it was the right decision in the long run, now I don't know if the symptoms I'm experiencing are withdrawal or are start-up effects. My anxiety is still very high in the morning and then improves in the afternoon/night. Besides anxiety, low mood, and interrupted sleep, I don't have any other symptoms. I guess I should consider myself lucky, but I'm struggling. 

 

How long did it take you to feel stable once you updosed? 

 

Thanks for your encouragement?

[RachelSusan]

Hi Ruby,

 

I see you have Frogie as a moderator. Lucky you. Frogie is so far beyond excellent I don't have a word good enough. Frogie will be a great source of information regarding dosages and many other things.

 

As for my experience, it took me many months before I felt stable because I kept changing my dosage around. I didn't get results fast enough after the reinstatement so I didn't trust it. Looking back at it now I wish I had just waited once I up-dosed. I think once I did finally stop changing things it took me two or three months, but like I said it is because I think I did the wrong thing, at least for me. I know everyone is different.

 

Hang in there, I know it is hard but you will improve.

[Rubygirl]

I made the very difficult decision to reinstate 100 mg. I need to find stability before I try to taper in the future. I might take a break from the forum for now, but will definitely return when I’m ready to start a much slower (years long) taper. 
 

Thanks for your help and support @Frogie 
@rachelsusan

[Believer]

@Rubygirl

You need to do what’s right for you. I hope you are finding relief from your symptoms and that reinstatement works for you, I truly do. This is a hard journey.

 

We’ll be here for you when you’re ready to try again.

 

Take care of you.

 

Believer

 

[Frogie]

@Rubygirl

 

Sorry I was out with covid and some other health conditions so I wasn't able to answer you.

 

100 mg is a really high dosage to reinstate. I suggested maybe .05-1.0 mg and you could go up from there if needed.

 

How are you feeling?

[RachelSusan]

@Rubygirl I know you needed to take a break from this forum, so I don't even know if you will see my post. If you do see it please know that I am thinking about you and wishing the very best for you. I hope you are feeling a bit better.

Warm wishes,

Rachel