NickinAus Advice on reinstating then tapering Zoloft after severe withdrawals, breakdown and hospitalization?

[NickinAus]

Hi everyone,

 

I'd like to start by saying I'm very grateful to have found this community. I'm a 34 year old male in Melbourne, Australia... Zoloft has pretty much destroyed my relationship, and ruined my life.

 

BACKGROUND

 

I was a pretty normal guy in a steady relationship, and (in my opinion) was un-neccessarily prescribed Zoloft 50mg after experiencing mild/situational anxiety. In my ignorance of the subject (and poor advice from GP), I stayed on Zoloft for around 1 year 8 months, during which time my relationship fell apart, and soon after stopped taking it very abruptly, almost cold turkey (I know now this was a bad idea).

 

WITHDRAWAL/BREAKDOWN

 

At first after discontinuing, I experienced dizziness, headaches etc. for probably around 2 months, but my mood was pretty well fine. Depression & anxiety gradually got really bad over the following 3-5 months, at which point, in conjunction with some stressful life events, I tried reinstating at 25mgs several times and experienced kindling. I then crashed and experienced a prolonged nervous breakdown, couldn't function, had to quit my job, lost 10% of my bodyweight, and couldn't handle living on my own anymore. I'd wake up at night shaking, and could feel cortisol/adrenaline pulsing through my body and my heart pounding constantly through the days... I was able to admit myself to a private psychiatric hospital around 1.5 months later... As I predicted though, the psychiatrist there insisted I'd experienced a 'relapse' of my 'condition' (a condition I arguably never really even had), and just wanted to put me back on an ever higher dose of antidepressants. For this reason I discharged myself after 4 days of resisting his advice.

 

REINSTATEMENT

 

In conjunction with taking more time off work, I've reinstated Zoloft for the past 3 weeks at 8mgs (with the intention of restabilizing, then slowly tapering off), having upped it to 10mg 3 days ago. I'm feeling better than I was, and feel semi-functional again. Maybe 50% back to my 'old self'. Still experiencing some milder depression, some lighter internal & external shaking, and the need to sleep long hours at this time... I'm wondering if I'm on the right track, and if it's likely I'll experience much more improvement at 10mg? If so, how long it might take for me to feel more normal again, or to consider starting to tapering off..?

 

I'd appreciate any other advice you can give me as well, thank you so much!

[Altostrata]

Welcome @NickinAus

 

Thanks for the information in your excellent signature.

 

It appears that after you cold-turkey 50mg sertraline in August 2022, you developed severe withdrawal syndrome that go worse, with a hypersensitivity to drugs, which we see quite often here. This resulted in a "nervous breakdown" with unprecedented symptoms and hospitalization.

 

On 2/6/2023 at 1:13 AM, NickinAus said:

I've reinstated Zoloft for the past 3 weeks at 8mgs (with the intention of restabilizing, then slowly tapering off), having upped it to 10mg 3 days ago. I'm feeling better than I was, and feel semi-functional again.

 

This probably was the right call for you. How did it occur to you?

 

Since you saw benefit so quickly from 10mg, that might be enough for you to stabilize. This can take time, maybe weeks, but you may be able to return to work and usual activities as long as you treat your nervous system gently.

 

Your nervous system is vulnerable now and it's important that you do not rock the boat by drinking alcohol or adding other drugs -- this can cause a resurgence of bad symptoms.

 

Many people find fish oil and magnesium supplements helpful, see

 

https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

 

https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

You might try a little bit of one at a time to see how it affects you. Please let us know how you’re doing.

[NickinAus]

Hi Altostrata,

 

Thanks so much for your response. I reinstated using Zoloft liquid after reading advice from this site.

 

I've started taking fish oil, a B vitamin complex, and a multivitamin containing magnesium so far.

 

Thanks for the advice about alcohol etc. I started having a drink or 2 recently and noticed I did feel a bit worse after doing that.

 

I've upped my dosage to 12mg over the last week as well and feeling a little better still... I'm really hoping this internal & external shaking I've been experiencing will eventually subside though... I never had it before taking the Zoloft unfortunately. It's better than it was though...

 

I'm not sure whether to stick at my current dosage a bit longer and see what happens, or to try increasing the dosage a bit more until I start feeling better... I'm very wary of increasing the dosage too high however after what happened to me last year when I went off it...

[NickinAus]

I also have some sexual side effects from Zoloft, and am wondering if it's generally better to reinstate using the same SSRI which caused your withdrawals, rather than switching to a different one with less side effects?

[getofflex]

On 2/16/2023 at 8:26 PM, NickinAus said:

I'm not sure whether to stick at my current dosage a bit longer and see what happens, or to try increasing the dosage a bit more until I start feeling better... I'm very wary of increasing the dosage too high however after what happened to me last year when I went off it...

If I were you, I would not increase the dose again.  Remember, you had a bad reaction to reinstating to 25 mg in the past, so increasing the dose will put you at risk of kindling again.  It can take several weeks to a couple of months for a reinstatment to become fully effective, so please give it time.  The best way to help your nervous system heal, is to stay on this current dose of 12 mg for a long time, as in several months. I personally would give it 3-6 months, maybe even longer, and really allow your system to adjust.  These links explains why making frequent dose changes is hard on your system: 

 

How Psychiatric Drugs Remodel Your Brain

 

Keep It Simple, Slow, and Stable

 

Here are some other helpful links. 

 

Video on Recovery from Psych Drugs

 

Windows and Waves Pattern of Stabilization

 

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

 

 

 

[Kelsears]

@NickinAus

hello I hope you’re feeling even better today. Your story caught my eye because we have very similar stories. I was placed on Zoloft for what they thought was post pardon anxiety. I just reinstated Zoloft a week ago at 1.5mg I haven’t seen any improvement yet. I definitely feel like I’m in the stage of where you were with your mental breakdown. They hospital cut me cold Turkey really messing me up. Your reinstatement is giving me hope. I’m so desperate and hopeless. 
 

Kelly 

[NickinAus]

@Kelsears

 

Hi Kelly,

 

I'm glad you got in touch. Going through the withdrawals / discontinuation syndrome was an absolute nightmare... I know just how hard it is. Getting through hour to hour, day to day was so incredibly hard. I want you to know that your brain is probably playing all sorts of tricks on you right now, but that there is hope and a way out. I had nobody to help me, and my mind was constantly convincing me that there was no way out, that my life was over, that I'd never get better, and ending it all was my only way out.

 

But, I'm doing so much better now, and none of this turned out to be true... But it took a bit of time, will power, and just hanging in there.

 

I reinstated about 3.5 months ago, around the same time I admitted myself to a private psych facility for about 5 days... The psychiatrists kept telling me it wasn't discontinuation problems, it was just my 'depression and anxiety symptoms' re-emerging, and wanted to put me straight on to 100mg of zoloft. I knew from the horrible 'kindling' I experienced after trying to restart at 25mg or even 12.5mg, that this was a bad idea, and refused to take their advice.

 

I personally restarted at 4mg zoloft liquid for about a week and started to feel some sort of noticeable effect between around 4-8mg. I got the liquid made up using a standard prescription for tablets, but made up as a liquid a compounding pharmacy (starting at 10mg per 1ml liquid, then later going up to 20mg per 1ml liquid). I slowly tapered up to 20mg over about 3 months, not going up by more than 2mg at a time... Whether I needed to do it quite this slow I'm not sure, but it worked for me... This is a bit higher dosage than what alot of people take/recommend during reinstatement, but again it worked for me... Although I haven't started my taper down quite yet, and am a bit nervous about it... I plan to start tapering soon though.

 

I did alot of this by feel, and how I reacted to different dosages and timeframes. What worked for my body, may work differently for you.

 

If you have any questions, please ask. And please do keep me posted on how you're going. You got this!

 

 

 

 

[Altostrata]

Good to hear you're doing better, @NickinAus

 

You did it the right way (except for the inpatient stint, that sounds like the usual awfulness).

 

We advise to initiate reinstatement at a very low dose; we also advise carefully monitoring the result and adjusting the dose accordingly. Sometimes it takes a higher dose to address withdrawal symptoms, but going up in dose gradually reduces the risk of kindling.

[Kelsears]

@NickinAus

hello thank you for replying back. Your story gives me hope. I was kindled and cut cold turkey from Zoloft. Im 7 day into reinstating Zoloft in liquid form. The depression just got to much for me to handle. I knew I needed to try something or end up back at the hospital that originally  did this too me. 
 How are you feeling now?  Im still on such a low dose I’m not sure it’s doing much yet. But trying to keep it slow and steady to not cause anymore havoc in my nervous system. 
I like you never had these symptoms before the medication. And now I have them all and they’re out of control. I just want sone relief so I can just relax for just a few hours. Im soooo mentally and physically exhausted all the time. 

 

[Altostrata]

What withdrawal symptoms have diminished? What symptoms remain?

[NickinAus]

Hi Alto,

 

Thanks for your help and advice so far. I'd say almost all of my withdrawal symptoms have stopped, with the exception of very mild morning shakes/internal vibration from time to time. And perhaps my memory and attention span isn't quite what it was before. But I pretty much feel like a normal person again, which is amazing considering how horrible I was doing just a few months ago...

 

@Kelsears

There is indeed hope, but it will probably take some time. It was absolute hell for me, but I'm so glad I found this forum, it's been a literal lifesaver. As I said above, I pretty much feel like a normal person again. It might take a couple months until you start to function again at an acceptable level. Hang in there, and in the meantime I'd suggest trying your best to find some supports, be it family, friends, a counsellor or otherwise.

[Altostrata]

Good to hear. Please let us know when you are ready to taper.

[NickinAus]

Thanks Alto, I'm after some feedback about whether the below is a wise/reasonable thing to do right now, or not? Thank you!

 

I'm deciding whether I should start tapering now, or hold off... As I think I previously mentioned, I started my Zoloft reinstatement on Jan 16 this year, and slowly increased my dosage to 20mg over about 2.5-3 months. I've been holding at 20mg for the last 1-1.5 months and have been feeling fairly well back to normal & symptom free the last 2-4 weeks...

 

I'm quite keen to taper down/off the medication, but am also wary about doing it too quickly, considering how very bad I was not all that long ago... I'm also worried about my body/brain becoming more dependent on the medication, the longer I stay on it...

 

I figure though that if I taper down 10% every 4 weeks to 1 month, that's still another 9-10 months that I'll be on the medication... I'm also thinking perhaps I could taper down to 10mg (still at 10% reductions per month), and then sit there for a while before tapering off completely... I would also take note of how I'm feeling and stop tapering if I notice a return in symptoms etc...

[Altostrata]

On 5/6/2023 at 8:32 AM, NickinAus said:

I'd say almost all of my withdrawal symptoms have stopped, with the exception of very mild morning shakes/internal vibration from time to time.

 

What is the status of this vibration?

 

How has your sleep pattern changed in the last month?