Ozanna: withdrawal from Zoloft and Abilify

[Ozanna]

2013 - 50mg Zoloft
2016 - increase to 150mg Zoloft
2016 - Lamictal in addition to Zoloft
2018 - Serequel in addition to Zoloft
2019 - 5mg Abilify in addition to Zoloft
2022 - tapered off Zoloft decrease of 25mg per week over 6 weeks and then tapered off Abilify 5mg over 2 weeks.

It has been 4 weeks since my last dose of Zoloft and 2 weeks since last dose of Abilify.  

I had no withdrawal symptoms until 4 days ago.  For the last 4 days, I have had severe anxiety that is constant and will not go away.  The anxiety has contributed to difficulty sleeping as well.  

 

I tapered under the supervision and guidance of my doctor.  Is this anxiety a withdrawal symptom?  Is this a relapse?  Should I reinstate?  Reinstate at a low dose?  25mg or 50mg reinstate?  Is there any hope for not reinstating?  I don't know what to do...I'm so scared...I had no idea coming off the meds was going to be this hard.  Please help!

 

Edited July 17, 2022 by ChessieCat
added spacing

[Ozanna]

Update:  the anxiety got so bad I didn't know what to do other than reinstate.  So I have taken a 50mg tablet of Zoloft for the past 3 days.  

My psych doctor is not available this week to talk to. She's out of the office.  I trust this community more than I trust her anyway.  Since reinstating, my anxiety has decreased partially but not completely.  It's still interfering with sleep too.  

Did I reinstate too much?  How long until this anxiety goes away?  Will I have to titrate up even more to get rid of this anxiety?  

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  I'm sorry to hear that you are dealing with this psychiatric drug withdrawal situation.  You are having these symptoms because you tapered off of your drugs too quickly, and your nervous system did not have time to adjust to being off of the drugs.  We suggest a very gradual 10% per month taper of the current dose on this site, tapering one drug at a time.  

 

How do you feel since you reinstated the 50 mg of Zoloft? The difficult thing here is, you stopped 2 drugs almost at once, and so we don't know what is causing what. We don't know for sure if the insomnia and anxiety is from the Zoloft withdrawal, or the Abilify withdrawal.  

 

In your drug sig, can you please supply actual dates, instead of "4 weeks ago" and "2 weeks ago".  When staff read your signature in the future, this will be much clearer to them, so they don't have to go back to your first post, trying to figure out 2 weeks from when?  Also, can you please list the dates your started your tapers in 2022?  Are you still on the Lamictal and the Seroquel? 

 

How to List Drug History in Signature

 

Here is some important information about how these drugs actually work.  This explains why we get symptoms from going off of these medications:

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

Video on Recovery from Psych Drugs

 

Windows and Waves Pattern of Stabilization

 

 

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

 

Stability is really important when we are tapering off psych meds.  Please read the link about stability:

 

Keep It Simple, Slow, and Stable

 

 

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

 

You may have reinstated at too high a dose, going back to 50 mg of Zoloft.  We suggest a very low reinstatement dose to start off with.  

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

I've given you quite a bit of information here.  I will confer with the other staff, and we will come up with some suggestions for you.  Hang in there, you can get through this, although I know it's tough.  

[Ozanna]

Update:

The 50mg Zoloft reinstatement has removed the anxiety partially but not completely.

I look forward to hearing your suggestions for how I should proceed with next steps.  Right now, I just want to stabilize.  

How long do you think stabilizing will take?  What if I have to titrate up even more on the Zoloft to get stable?  That's my fear.  

[getofflex]

The staff and I are currently discussing your situation, and one of us will get back to you soon.  

 

I seriously doubt that we will have you increase your dose of Zoloft.  If anything, we may ask you to cut it back, but please don't change your drugs until advised.  

 

Please answer these questions, because we can't advise you properly unless we have complete and detailed information.  

 

Are you currently having any other symptoms besides anxiety?  

 

How is your sleep?  

 

How is your eating?

 

How is your day to day functioning?  

 

Also, can you please list the dates your started your tapers in 2022?  

 

Are you still on the Lamictal and the Seroquel? 

 

 

[Ozanna]

Are you currently having any other symptoms besides anxiety?  

 

Anxiety is only symptom but it is severe.  Taking 50mg has decreased anxiety partially but not completely. 

 

How is your sleep?  

 

Anxiety is interfering with my ability to sleep.

 

How is your eating?

 

Eating is no change.

 

How is your day to day functioning?  

 

I'm able to go to work.  Before reinstating the anxiety got so bad I was debilitated so that's why I reinstated I didn't know what else to do.

 

Also, can you please list the dates your started your tapers in 2022?  

 

Zoloft taper began May 13th and ended June 17th.  Abilify taper began June 17th and ended June 24th.  I didn't find this website until I experience withdrawal symptoms.  I thought I was following my doctor's orders and everything would be fine.  I had no idea this would happen to me.

 

Are you still on the Lamictal and the Seroquel? 

 

Not on either.

[Ozanna]

Update:

Anxiety is improved with reinstating 50mg Zoloft 7/17/22

 

Insomnia is not improved

[getofflex]

We at SA usually suggest a low reinstatement amount.  You have reinstated at a much higher dose than what we suggest.  It may be that a lower dose will still help with your anxiety, and also help you sleep better.  Since you just did this reinstatement 4 days ago, you could reduce the dose of your Zoloft reinstatement, and see if that helps with your sleep.  SSRI drugs tend to be activating, and cause insomnia in many people.    Another reason it's good to reduce the dose, is often going off a drug, then reinstating at a high dose can lead to kindling.  Please read the link above about reinstating, if you haven't already.  

 

Here is a link about kindling: 

 

Post Withdrawal Nervous System Hypersensitivity and Kindling

 

How many hours of sleep do you get at night on average?  If insomnia is severe, you could consider dropping the dose down to 12.5 mg of Zoloft.  If you decide to do this, stick with this precise dose, take it at the same time each and every day.  I assume the 50 mg Zoloft was one tablet?  You could split the tablet in fourths.  If you do reduce the dose, do so right away, rather than waiting.  This link will help you with various methods of dosing. 

 

Dosing and Tapering Zoloft

 

Then again, if you can tolerate the insomnia, and still work, you may want to keep things as they are.  It is entirely up to you. 

Edited July 21, 2022 by getofflex

[Ozanna]

Ok I will reduce to 12.5 and let you know how it goes.  

[getofflex]

OK, please realize that there are no guarantees with a reinstatement, and there is always a certain element of risk.  Please update you drug signature to show your Zoloft reinstatement(s).  Thank you.  

[Ozanna]

@Getofflex, I have been on the 12.5mg Zoloft reinstatement 5 days.  I'm not getting relief for my anxiety nor my insomnia.  Last night, I woke up every hour on the hour (11, 12, 1, 2, 3, 4, 5, 6). 

I've been dealing with these severe withdrawal symptoms for two weeks now.  I'm drowning.  I can't function.  I feel hopeless.  I don't know what to do.  I just want to feel ok again.  What is it going to take to fix me?  

I'm scared I need to go back on the full dose of both meds.  Is that the only thing that will put an end to this nightmare?  

What does SA suggest for me?  

[getofflex]

5 hours ago, Ozanna said:

@Getofflex, I have been on the 12.5mg Zoloft reinstatement 5 days.  I'm not getting relief for my anxiety nor my insomnia

It takes a week for a reinstatement to become steady state in your system, and register with your brain.  I would give it 2 more days, and see what happens.  I will also confer with the other staff, to see what else can be done.  Hang in there.  

[Ozanna]

Ok thank you

[Altostrata]

Hello, @Ozanna Do you feel better or worse now than when you were taking 50mg Zoloft?

 

What does the anxiety feel like? Is it better or worse at any particular times of day? How do you feel before taking Zoloft and after taking Zoloft each day?

[Ozanna]

@Altostrata

 

Hello, @Ozanna Do you feel better or worse now than when you were taking 50mg Zoloft?

 

It's about the same.  The anxiety is gone partially but not completely.  And I sleep about every other night.  

 

What does the anxiety feel like? 

 

It feels like a sense of panic in my body that will not go away.  And sometimes it feels like my chest is tightening.

 

Is it better or worse at any particular times of day?

 

I seem to feel better starting in the afternoon and then into the evening.

 

How do you feel before taking Zoloft and after taking Zoloft each day?

 

I have been taking the Zoloft right before bed each day.  So I feel good before taking it and then struggle to sleep after taking it.

 

[Altostrata]

Excellent job answering my questions.

 

It looks like your sleep pattern is improving, but Zoloft may be interfering with your sleep. Suggest you move the Zoloft earlier in the day, to take it at noon. Be sure to note how you feel before and after taking it and let us know how you're doing.

 

The anxiety feeling should gradually settle down over some weeks.

[Ozanna]

@Altostrata

Ok, thank you, I will take it earlier and let you know how it goes.

 

How do people survive "weeks" of this anxiety?

[Altostrata]

If you look around the Introductions topics, you will see people coping with many terrible symptoms. If they have gone off a drug, sometime we suggest reinstatement. Still, you need to be patient while your system settles down.

[getofflex]

@Ozannahow are you doing today? 

[Ozanna]

@getofflex@AltostrataThanks for checking in on me.  The anxiety was unbearable and 12.5mg wasn't giving me any relief, so I reinstated at 50mg.  I was desperate.  The 50mg has, luckily, relieved the anxiety symptom.

 

The insomnia, on the other hand, is still bad.  At this point, I have become convinced that both the anxiety and the insomnia are withdrawal symptoms from coming off the Abilify, not the Zoloft.

 

I REFUSE to reinstate any Abilify.  I will suffer with this insomnia before I will go back on that drug!

 

What do you think?

[getofflex]

Ok, but please don't keep changing the dose of your drug.  

 

Please stick with the 50 mg of Zoloft for a while.  It takes a week for the drug to fully register with your system, and even longer for a reinstatement to reach it's full effect - sometimes 2-3 months.  Frequently changing the dose, and jumping on and off, puts you at high risk of making your symptoms worse, due to kindling.  A reinstatement is not a cure for withdrawal, it just makes it less severe and easier to bear.  You're going to have to learn to cope with some anxiety and discomfort.  Here are some links that might help: 

 

Acknowledge Accept Float

 

Music to Calm Anxiety

 

Breathing Technique for Anxiety

 

 

Audio:  How to Recover from Anxiety - Dr Claire Weekes

 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help ...

 

15 hours ago, ChessieCat said:

Audio:  First Aid for Panic (4 minutes) Female voice - getselfhelp.co.uk

 

Audio:  First Aid for Panic (4 minutes) Male voice - getselfhelp.co.uk

 

 

Meditation

 

 

I agree, I would not jump back on Abilify now, especially with the frequent dose changes you have done with the Zoloft.  

 

Please read this quote below:

 

On 5/12/2021 at 11:15 AM, Yesyes123 said:

"My withdrawal symptoms are so bad, I tried X and it didn't work, so I changed it to Y and it made me even worse, so I am now doing Z hoping to get better by the end of the week!"

 

Every time I see someone say things along these lines, I truly feel bad for them.

 

This type of behavior is like playing ping-pong with your brain and Central Nervous System, as people sometimes say around here.

And I don't mean only with psychiatric drugs - that goes for supplements, sleep patterns, food, etc.

 

"Stability" - this post by the amazing @brassmonkeyis spot on, as everything else he puts out.

 

"For some people who are very sensitive to changes in dosage, it may take two or three months for people to stabilize after such an adjustment.  Some people will take even longer."

In this quote he's referring to stabilizing after dose changes in psychiatric drugs - but similar patterns can be seen in many other things, such as supplements.

I often see people taking fish oil or other supplement for 3 days and complaining that it "didn't work" or made them more anxious...

In such short period, there is really no way to see the effect of the substance on you (unless you have a clear, strong and definite adverse reaction immediately).

 

Your body likes stability.

That's the main idea here. If you keep jumping around with supplements, doses, diets, excercise routines, etc, you will very hardly find stability.

 

You need to find something that seems to work for you and stick with it for a while in order to truly benefit from it.

You will definitely have to do some experimenting in order to find what works for you - but that does not mean you are allowed to try every single thing in 1 week hoping to get better sooner. It will take some time... for some, shorter. For others, longer. But we all get there eventually.

 

I have personally only started to see benefits in fish oil after nearly 2 months of taking the same dose daily.

 

Something to think about!

 

 

Edited July 30, 2022 by getofflex

[Ozanna]

Since my withdrawal symptoms started two weeks ago, I "catch" myself throughout the day grinding my teeth and repetitively running my tongue over my teeth.  Is this dyskinesia?  Or a weird withdrawal symptom?  Maybe it's just caused by the anxiety?

[getofflex]

You can do a site search to find out about this.  This link explains how: 

 

How to do a Site Search on SA

[mstimc]

6 hours ago, Ozanna said:

Since my withdrawal symptoms started two weeks ago, I "catch" myself throughout the day grinding my teeth and repetitively running my tongue over my teeth.  Is this dyskinesia?  Or a weird withdrawal symptom?  Maybe it's just caused by the anxiety?

Hi Ozanna

 

I'd chalk this up to anxiety.  I do the same thing when I'm feeling anxious.  My wife notices and usually brings it to my attention.  I think when your body is experiencing anxiety, some part of it wants to be moving all the time, even if its just your tongue.  I do wear a night guard for the bruxism. 

[Ozanna]

@mstimcThanks for the reassurance!  I've been reading about other people's experiences and symptoms trying to educate myself on withdrawal now that I'm in the middle of it.  And I found myself suddenly starting to worry maybe what I was doing with my mouth was actually dyskinesia.  

[mstimc]

8 minutes ago, Ozanna said:

@mstimcThanks for the reassurance!  I've been reading about other people's experiences and symptoms trying to educate myself on withdrawal now that I'm in the middle of it.  And I found myself suddenly starting to worry maybe what I was doing with my mouth was actually dyskinesia.  

 

 

One of the nastiest tricks anxiety plays on us is turning normal things into catastrophes  (hence the term "catastrophizing"). It'll take any habit, whether its teeth clenching or nail biting, and turn it into another uncontrollable manifestation of something worse.  These thoughts are fears will come, but remember they are just that--thoughts and fears, and have only the power we give them.  Next time you find yourself clenching or running your tongue over your teeth, just be mindful and try to stop.  Treat it like slouching: "Oops, I'm hunching over the computer again.  Gotta straighten up." Tell yourself "I'm clenching, time to be mindful of the tension in my body and work on relaxing a little."  No judgement, no far, just recognition and a reasonable response.  You'll do great!

[Ozanna]

@mstimcThanks so much for the encouragement!  It really means a lot to me.

[Altostrata]

Bruxism is a common complement to withdrawal symptoms. A night guard will be helpful.

[Ozanna]

Update:The anxiety is better overall than it was before reinstating.  I've been taking the Zoloft in the mornings.  I'm noticing the anxiety is the worst in the morning and then seems to wear off by the afternoon and evening.   

 

The insomnia is still a problem.  I wake up several times during the night each night, but I am able to get back to sleep so I'm getting some sleep.  

 

I'm having a lot of difficult thoughts about what I'm going through.  Part of me wants to believe that my symptoms are withdrawal and that they will pass with time if I am patient.  Another part of me wonders if maybe I really do suffer from anxiety this bad because there's something wrong with me and it will never go away and I was stupid for thinking I could survive without the meds.  

 

Anyone else have these thoughts?

[getofflex]

7 minutes ago, Ozanna said:

I'm having a lot of difficult thoughts about what I'm going through.  Part of me wants to believe that my symptoms are withdrawal and that they will pass with time if I am patient.  Another part of me wonders if maybe I really do suffer from anxiety this bad because there's something wrong with me and it will never go away and I was stupid for thinking I could survive without the meds.  

 

Anyone else have these thoughts?

Yes, these are extremely common in withdrawal.  Please don't believe these thoughts!  This is our withdrawal monkey brain talking.  Our withdrawal monkey brain is the part of our brain that is producing distorted, negative thoughts.   This is also knows as catastrophizing, meaning, imagining the worse case scenario.  Please read the success stories to counter these fatalistic thoughts.  Also, read this link as well, it really sums it up quite well: 

 

Steps for Managing WD Symptoms

[Ozanna]

Thank you.

[Altostrata]

It appears reinstatement is working. You should see gradual improvement. Please give it time and let us know how you're doing.

[Ozanna]

@AltostrataI reinstated the Zoloft but I didn't reinstate the Abilify.  I now believe my symptoms are actually a result of coming off the Abilify (though it's hard to say for sure because I tapered them back to back) because the anxiety and insomnia are classic, textbook symptoms of Abilify withdrawal and because reinstating the Zoloft hasn't completely relieved the symptoms.  Do you think I'm going to have to reinstate the Abilify as well, in order to completely relieve the anxiety and insomnia?  I'm on the fence about reinstating Abilify.  On one hand, it really damaged my body physically (gained 100lbs).  But on the other hand, I really want to be able to sleep through the night again and to feel like myself again.  I'm leaning towards not reinstating Abilify and just giving my brain/body time to heal from the withdrawal of Abilify on it's own.  

[Altostrata]

We expect gradual improvement after reinstating. You are seeing gradual improvement. I would not bring in the complication of reinstating a second drug at this time.

[Ozanna]

Ok thank you.

[Ozanna]

In beginning, I thought the insomnia was a result of the anxiety. But now I see that they are two separate symptoms.  I don't feel any anxiety during the night anymore, yet I still have trouble sleeping.  I fall asleep easily, but the problem is I wake up every couple of hours throughout the night.  The only explanation I can come up with for what wakes me up each time is this theory: during the sleep cycle, when I transition from one level of sleep to another, I think the transition is causing me to wake up.  

What do you think?