Rubied: getting off Abilify and Zoloft for good

[Rubied]

Hi everyone!

 

My name is Rubied and I live in the Netherlands. This is my, hopefully summarized enough, story. I would be immensely grateful to get any response on this thread and to hopefully be able to continue posting so I can get some relief out of the situation I'm currently in.

 

I'm 29 years old, suffered a major trauma/abduction at age 17 which changed my entire life. Barely lived, but survived, for years, without any medication.

Moved to the Netherlands end of 2018 to start my career, and started really suffering psychologically with the compounded effects of trauma, moving countries, starting a job etc: depression, starting hearing/seeing things, severe untreated PTSD and anxiety.

For the first time in my life I got psychological help, at the end of 2019.

In 2020 I was started on 25 mg of Sertraline to help with the depression, which got increased to 50mg in 2021.

In 2022, Sertraline got increased to 75mg as my depression wasn't improving much. Due to a psychotic episode I had in 2022, I got put on 5mg Abilify.

Then, February of this year, my father died, I got promoted, my job offices changed, and my manager changed, all in the same week. It sparked another psychotic episode and I was put in psych ward for 1 week and increased to 10mg Abilify.

 

Meanwhile, important to mention: I come from a family who never really believed in 'mental illness' or mental health drugs, they believe in 'natural healing' with sunlight and being around animals and so on. I spent some weeks with them and they influenced me to quit my psychiatric drugs as they believe it does more harm than good in the long run. In my latest episode I had a 'vision', where we are living in a type of 'Matrix' controlled by superior beings who are experimenting on us with medications and other random life events. So all of this has influenced me.

However, I like to think I am of sane mind currently, and I would much rather pursue a 'natural way of living and healing' and come off this scary medication I've been put on.

 

I have tapered from 75mg to 50mg sertraline for 4 weeks now, so currently I take:

- 10mg Abilify

- 50mg Sertraline

 

I would like to safely, taper off all my medication, and I know this is the internet, but if you have any good advice for me, I would be deeply grateful. I am currently typing this, very emotional, having spent Easter alone in my room with stomach cramps from nausea of the increased Abilify, and sick of this medication nightmare.

I just feel in my gut, no pun intended, that medication is not the right approach with me and it doesn't feel right, those are my main motivators if I have to be honest, besides the side effects which I haven't delved into much.

 

Thanks if you have read this thus far,

-Rubied

Edited April 11, 2023 by Gridley

[Gridley]

Welcome to SA, Rubied.  We're a site for tapering off psychiatric drugs and for dealing with withdrawal.  Thanks for completing your drug signature..

 

We recommend tapering no faster than 10% of your current (not original) dose every 4 weeks.  The following link explains the reasoning behind the 10% taper.

 

Why taper by 10% of my dosage?

 

You reduction of Sertraline last month from 75mg to 50mg was faster than we recommend.  Have you experienced any withdrawal symptoms?  

 

What is withdrawal syndrome.

 

Brain Remodelling 

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

We recommend tapering only one drug at a time.  Otherwise, if there are problems, you won't know the cause.  We recommend tapering activating/stimulating drugs, known as accelerators, first, leaving sedating drugs, known as brakes, in place to aid sleep to be tapered later.  SSRI's such as Sertraline are accelerators, and antipsychotics such as Abilify are brakes.  So your decision to taper the Sertraline first would be in line with our usual advice.  The only reasons to taper an antipsychotic first would be the relative harmfulness of this class of drugs or if you're having a bad reaction  to the Abilify.

 

The following link is specifically about tapering Sertraline, including how to get the nonstandard doses needed for a 10% taper.  Three methods require a doctor's cooperation in the form of a prescription: prescription liquid, a compounding pharmacy and tapering strips.  Two methods you can do on your own: making your own liquid and weighing with a digital scale such as the Smart Weigh Gem20. 

 

Tips for tapering off sertraline (Zoloft)

 

There is considerable support for the view that, for all classes of psychiatric drugs people, people do better in the long run off these drugs rather than on them.  I recommend the following book:

 

Anatomy of an Epidemic

 

Here's a video book trailer by the author, Robert Whitaker:

 

Robert Whitaker, author Anatomy of an Epidemic video (11 minutes)

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium (glycinate is a good form) and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Add in one at a time and at a low dose in case you do experience problems.

 

This is your introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community.  I hope you’ll find the information in the SA forums helpful for your situation.  I'm sorry that you are in the position that you need the information, but I am glad that you found us.

 

 

[Rubied]

Thanks for your reply Gridley.

 

I did indeed experience withdrawal symptoms from Sertraline.

A few days after reducing 75 to 50mg I experienced an intense need to move and I found myself literally dancing for hours in my bedroom listening to music. I also experienced some random brain zaps, increased anxiety and being jittery in general. It's like something was 'ramping up' internally in my body way too fast.

However I must add a disclaimer: my doctors increased my Abilify dose just 2 weeks ago and I currently don't know what is withdrawal and what is increased med side effects.

I've also experienced, since 5 days ago, terrible intestinal issues, nausea to the point of vomiting and I've lost weight too. This, I blame the increased dose of Abilify on, but it could be from Sertraline (?).

 

It's a little complicated but I think that's an accurate judgement of what's happening. I only say this because my pharmacy messed up my prescription 2 days ago and I had to scrounge up some leftover Sertraline, so I ended up taking 25mg Sertraline for 2 days and got the same 'dancing mania' back again.

 

I do have a question in all this, can I safely just cut back on Abilify to my original dose of 5mg, seeing as I was just only increased to 10mg 2 weeks ago? At least, I understood from this website so far that anything over 1 month is at risk of withdrawal symptoms, so I should be alright, correct....?

 

Summarizing, I just took my 'usual' dose of Sertraline (50mg) and my 'original' dose of Abilify (5mg) and I hope to be more stable the coming days.

 

I know what to expect from Sertraline withdrawal now, and it's terrible. I now know I need to do it slower.

However, I do not know what to expect from Abilify, which is why I am inclined to taper off this one first, as it seems 'more dangerous' to me. But I do not know if my approach is correct, after reading your reply.

 

I am not a doctor, but I am surprised my doctors are 'playing' with my brain like this, having me go down from Sertraline whilst simultaneously upping my Abilify, isn't that playing russian roullette with my brain...? I won't make more comments on that but I am quite angry that I am in this situation, terrified of lowering dosages due to previous experiences.

 

As a last note: I do consider myself a very sensitive person in general, be that with medications, with people, with life, so that's another reason I ended up on this forum.

[Gridley]

@Rubied

 

13 minutes ago, Rubied said:

A few days after reducing 75 to 50mg I experienced an intense need to move and I found myself literally dancing for hours in my bedroom listening to music. I also experienced some random brain zaps, increased anxiety and being jittery in general. It's like something was 'ramping up' internally in my body way too fast.

However I must add a disclaimer: my doctors increased my Abilify dose just 2 weeks ago and I currently don't know what is withdrawal and what is increased med side effects.

I've also experienced, since 5 days ago, terrible intestinal issues, nausea to the point of vomiting and I've lost weight too. This, I blame the increased dose of Abilify on, but it could be from Sertraline (?).

 

 

It's very hard to determine which of the two changes (increased Abilify, decreased Sertraline) caused the intense need to move.  As the link about akathisia explains, it could be either or both.

 

Akathisia vs restlessness, anxiety, agitation - Symptoms …

 

16 minutes ago, Rubied said:

At least, I understood from this website so far that anything over 1 month is at risk of withdrawal symptoms, so I should be alright, correct....?

The one-month withdrawal time frame applies only to taking the drug for the first time and doesn't apply here.  We can't say that reducing from 10mg to 5mg is safe.  At this point your system is destabilized.  You will have to use your own judgment as to whether to stay at 5mg Abilify.  I'm going to bring your situation to the attention of the other staff.

 

If you want to taper the Abilify first, there are good reasons for that.  However, I wouldn't taper anything for at least three months, maybe longer, until your system has stabilized.  
 

[Rubied]

I'm updating this thread to document my struggles with my psychiatrist:

Firstly, it's insanely difficult to get an appointment with this guy. All is fine and easy to get me ON drugs, but to get off? It's like scheduling an appointment with the pope - near impossible.

I had a difficult conversation with my psych nurse who, in other words said, we don't recommend you going off drugs, but if you want to, it's your life. Basically left me out in the ocean alone.

I had asked, ok if I'm recommended to be on these drugs, how much longer? A year, was what she said. I answered, I've been on it for over a year. Oh, was the answer. So now what....? No answer, and then, lets try to get you an appointment with the psychiatrist.

 

I feel duped and tricked by the medical system, it seems like perhaps their intentions were good, but now they've left me alone and afraid with no support to get off these medications. I only rely on this as I'd rather have them on my side and on standby in case something happens, then muscle it out on my own (with this forum).

I'm left in tears at the prospect of being alone in all of this, not really knowing what is best for me at this moment, with the underlying messages from my therapy team being "do this our way, or else do whatever you want and we don't know the rest".

 

Last night I took my original dose of 5mg Abilify, and the 'usual' 50mg Sertraline. I want out of both of these eventually, as my life is dull, lifeless and all my pleasure for it has vanished. I don't enjoy things any longer, and I can only pin it on medication effects. Anxiety, brain zaps, dull life, all remain. Perhaps a lot is to do with my past unresolved trauma, but thats something I can work on without drugs, in my opinion.

 

I also have a very important course, one I've been planning for years, my dream job related, happening in June, and I don't want to be an emotional rollercoaster and ruin it by messing with too many variables until then. So I am quite lost and worried, as worst case I have to continue this dose for some more months which just feels like continuing to poison my poor brain purposefully.

 

Worst of all..... I do not longer know, what is a delusion, what is a conspiracy theory, what is gut feeling, and what is logical reasoning in all of this. I am absolutely lost, not knowing if my psychosis is drug induced or from myself, not knowing who to trust, not fully trusting my own judgement either.... help!

[Rubied]

I regret not putting this in my original post (don't know if it can be edited) but I do have other experiences that I should report here:

 

2020: before Zoloft and Abilify, I have tried in total:

- Olanzapine (2 days, starting vomiting, quit CT)

- 3 weeks of Haldol together with Fluanxol (cant remember dose but when I was increased to the 'therapeutic dose' of each I had convulsions and such severe akathisia my fiancé sent me to the ER and I quit it CT, then spent weeks not knowing who I was in this world and everything being unfamiliar, absolutely horrifying)

- a few weeks of quetiapine (dont remember the dose)

- sporadic use of temazepam, lorazepam, oxazepam and diazepam never for more than 3 weeks in a row - since 2020, last used 3 weeks ago, quit CT as I suspect it makes me 'go crazy'

- 1 week of mirtazapine (dose unknown)

[Rubied]

Updated my signature to better reflect the full picture of drugs I've taken.

 

It's now 4 days since I jumped back down from 10 to 5mg of Abilify after being on 10mg for aprox. 2 weeks. So far, nothing new is happening.

I'm still suffering from gastrointestinal issues, severe nausea and anxiety from having been put on 10mg Abilify not long ago. I've lost 3 kgs just the last 2-3 weeks. This was my major reason to go back down to 5mg, as I'm also in anorexia recovery.

I half expect some kind of withdrawal symptoms to happen from going back to 5mg Abilify, but I am trying to maintain a positive attitude that it will be ok.

I am taking Gridley's advice and letting my system stabilize for some weeks/months until I decide to taper off from both drugs, after June.

 

I must say that the weightloss has sparked an internal struggle within me between my healthy side fighting the eating disorder and unhealthy side. I am striving to find the healthy side to help myself advocate for myself and allow time to recover before tapering off. I am struggling big time with my own mind.

The unhealthy side wants me to taper immediately both drugs - sertraline withdrawal makes me 'dance around like crazy' burning calories and I suspect altering dosages of abilify makes me nauseous, thus leading to weightloss. I must stop this before it escalates, it is obviously not healthy, nobody healthy wants to make themselves ill on purpose just to lose weight.

 

Perhaps I am not yet of healthy mind to begin a taper process and I am fighting my hardest to see the logical side of things and healthy side of things. I know I am digressing a bit with this new information but I feel I have to be honest if anyone is to drop any advice here. I feel quite vulnerable in general, emotional and lost. I can not discern if its from any diagnosed disorder, or due to drug imbalance effects.

I still go to intense emotional therapy sessions currently for PTSD. Maybe another reason to wait until I taper (?).

 

I don't mean to turn this into some emotional cathartic dump - my true and initial intention remains: I really do want to come off these meds with a slow taper. But if its the right time, I don't know.

[FireflyFyte]

32 minutes ago, Rubied said:

I really do want to come off these meds with a slow taper. But if its the right time, I don't know.

 

I think your idea to stabilize for awhile before tapering is the right one. You have been through a lot of drug changes lately and it sounds like you are knowingly in a vulnerable state so adding more variables could further disrupt your life. 

[Rubied]

Feeling miserable today.

I have no pleasure for life, everything is grey and uninteresting, I am hating that birds are singing outside whilst I sit uselessly at my laptop and do nothing more than scroll on it, or my phone, all day. It's gotten to the stage now that I'm on my couch on my phone until evening, when darkness comes, I don't even bother to get up to switch the lights on. I simply can't be bothered and don't feel like it. I'm miserable.

I am tempted to already start my tapering process to get off this hellish drug combo but according to this site, my system is still very unstable, and I should wait. I still am suffering from the increase and then decrease of abilify by being extremely nauseous, diarrea from hell, anxiety, jittery and depressed mood in general.

 

I want to cry from desperation. I don't remember feeling this emotionally blunted and apathetic to life before taking these drugs. Life is simply not worth it at the moment.

 

I feel cheated by the medical system, my appointments keep getting postponed or cancelled, and my psychiatrist is "so busy" he can only see me in 3-4 weeks if I'm lucky. To get me on these drugs was just a click on his computer to prescribe me stuff at the pharmacy... to get off suddenly he's too busy. I'm so angry at all of this.

 

Would it be so bad to start the 10% each month on last dose tapering process....? I'm impatient by nature but I also want to LIVE for once.

[Gridley]

3 hours ago, Rubied said:

 

Would it be so bad to start the 10% each month on last dose tapering process....?

I would wait at least 3 months.  You need to stabilize from the two big changes to Abilify and Sertraline.    

[FarmGirlWorks]

3 hours ago, Rubied said:

feel cheated by the medical system, my appointments keep getting postponed or cancelled, and my psychiatrist is "so busy" he can only see me in 3-4 weeks if I'm lucky. To get me on these drugs was just a click on his computer to prescribe me stuff at the pharmacy... to get off suddenly he's too busy. I'm so angry at all of this.

True, true, true: it’s all too easy to get “diagnosed”/prescribed and sent to a pharmacy than when you want help getting off. I went thru a similar situation recently. Despite saying that SSRIs do not work for me and could we look at non-drug options, he prescribed an SSRI which I promptly threw out. It hurts to feel alone in the med system but you are not alone here ☺️SA is a life-saver. 

[Rubied]

Trying to remain calm and patient. Key word: trying.

I have to listen to Gridley and others and WAIT some months before tapering, but after spending maybe 2 hours now reading success stories and other horror stories here on SA, I'm more and more tempted, paradoxically, to start getting off these nightmarish drugs asap.

In my mind, the longer I am on them right now, the harder it is to get off them. I have like this innate itching need to get off them but I am indeed petrified of WD. I keep reading about WD happening many months after the last pill, and it being unpredictable.

 

I'd like to tell SA that I have a different approach to this, which i will start documenting. I may not know much about tapering, but I have done my fair bit of research on nutrition and effects on the mind.

There are some protocols I will already start doing, in order to make the tapering process easier. Since these are all natural remedies, there is no harm that can come from it, and I can start now, even if it's just to get in the habit of it, and perhaps it will 'train' my system a bit to handle things better when or if WD hits once I start tapering. So the below is my 'pre-work' during stabilisation and before tapering.

 

It will be very important to take care of my gut health. The following is called the gut health starter pack:

- Wake up sun

- 2 tablets of charcoal

- 75cl of sparkling water

- 30 min later breakfast

 

I plan to start the gut health starter pack, all but the charcoal for now, as it will be wasted, seeing as I am still taking these drugs for this period of stabilisation. However, it might aid someone else so I am dropping it here. If anyone wants references to what I'm posting, I'm happy to share. It doesn't come from myself, these are taken from articles, and books, on healing your body and mind.

 

Anything to do with the brain and feeding the brains helps detox that which was in the brain. For this I will focus on bio products (food expenses will go up, alas), mainly the following products: fish, natural cream, smoothies with raspberries, raw milk.

 

Detox from drugs is characterized by coating on the tongue, sour taste in the mouth, chemical smelling urine, skin eruptions, nausea and/or headache, return of initial symptoms pre-drug usage.

Some recipes for detoxification of drugs that I found which I will already start using:

- 2 tbsp of unheated honey per 1 cup of raw fresh orange juice to help the body neutralize drugs.

- Smoothies made with raspberries. Here, smoothie is meant by a drink made with raw eggs blended with a raw fresh fruit or raw fresh fruit puree and unheated honey (aids digestion).

 

As is mentioned hundreds of time on this site: time and patience!!

I must trust my CNS to stabilize itself first before I put it through the tapering process. I can, for myself, begin the above dietary protocols. I can only try, right? Worst case scenario, I will have some interesting smoothies to drink, makes a change to my usual breakfast...

[Rubied]

I feel completely apathetic to life.

I can't feel anything. Everything is one big giant 'meh'. I simply do not care about anything. I have no interest in anything I do, past hobbies are no longer interesting, I have no passion. This is unbearable. I spend my whole day on my phone or laptop, scrolling the internet, and when night comes, I can't even be bothered to get up to switch the lights on. How is this a way of living?

Before I was prescribed anything, I was indeed living in high anxiety, depression and a serious case of insomnia. The only thing that's improved is the insomnia, as the combination of Abilify and Zoloft makes me so sleepy, I sleep 10h a day (and also the reason I take my meds in the evening). The rest has remained the same, or worse. This is absolutely maddening.

I don't think I can wait another 3 months in this state, I am literally wasting my life away.

 

I used to be so active. I used to be physically active, I loved running, playing soccer, going out with people. Now I sit at home doing nothing at all, can't be bothered to contact friends, and on weekends I'm in the same clothes for days and can't be bothered to shower. I wish the time away, and I'm 29, I should be living LIFE not wishing to waste time so I can go back to sleep. My life is in order: I have a career, even got promoted, financially stable, bought a house 1 year ago, take all my allocated holidays, have an amazing fiancé who I will marry next year.... everything is great, so why don't I feel great?

Is this all from taking antidepressants and antipsychotics...?

 

Getting desperate to feel something worth living for.

 

[Embi]

Hi Rubied, it sounds like you are dealing with a LOT of different mental and physical situations right now. It’s no wonder that you are feeling apathetic with the combination of it all. 
 

I understand that time feels like an age and you want to do something, anything to try and break out of what is happening. I have to keep reminding myself that it has only been 6 weeks since I crashed - it feels like months and months. It makes it so hard to hold on and wait until things stabilise, but I know from my previous experiences that stabilisation is possible. I agree with the other advice that you got here that you should wait at least 3 months until you are stable. When I reduced from 75mg to 50mg of sertraline it destabilised me badly. I ended up waiting 6 months before tapering, but those 6 months weren’t wasted. I felt so much better as time went on and I’m now very glad that I waited. 

 

Have you felt this apathy for the whole time that you have been on sertraline and abilify?

[Rubied]

@Embi Thanks for replying.

 

Have I felt this apathy the whole time on meds? As far as I can remember, yes. Because that's another issue I've had, memory lapses/loss in general. I can barely remember anything. Time passes and I have little recollection of it.

I was going through a lot in life when I started medication, most memorably high anxiety, feeling a LOT of feelings, and trying to process very old intense trauma that I survived. So my therapy team decided to 'numb me' by putting me on these meds, and it worked, for a while. The numbness and general apathy was briefly welcomed as it gave me a break from all the intense feelings and emotions. But now, I would have rather muscled it out and dealt with it with natural coping mechanisms than with medication. Now I'm stuck in this cat and mouse game of taking meds not to be in withdrawal and not wanting to take them because they make me numb and dead to life.

 

I'm literally contemplating cutting my dose already tonight. I have to feel something. Life right now is nothing to me. I could easily walk off a bridge and I doubt I would even feel anything. I have to feel life.

I might get slapped for this, but I sometimes wonder wouldn't it be better to be 'destabilised' than not feeling life at all...?

Am I just being impatient and immature? Or is desperation going to get the better of me?

 

There is one variable in this whole game of life: in June for the whole month I will follow my dream course, one that was denied to me when I was a student (majored in the STEM field instead of the creative field I really wanted). That means two things: I have to be stable for June, BUT, I also have to be able to be creative then!!! The meds took it all from me, I am incapable of being creative for a year at least.

 

I am faced with the decision of a lifetime right now:

1. Taper to 25mg Sertraline, keep 5mg Abilify, in order to FEEL SOMETHING and get some creativity back, so I can enjoy my course, which was very expensive and one that I am (or should be! Can't feel it!) looking forward to my whole adult life

2. Be stable, but not feel anything and risk wasting the course because I can't feel or be creative enough for it, but, I would be stable.

 

I don't know what to do...!

[Embi]

This is only a decision you can make. I can only tell you that my personal experience with destabilisation has been pretty debilitating and has made it hard to work at all. 
 

If you can’t take three months then you could try one month to start and rethink it then? You might even experience some relief from the numbness at 50mg once you have stabilised a bit. 

[Rubied]

I will think about this carefully. I was already on sick leave for 2 weeks when I had my 'psychotic break' just a few weeks ago.... I keep swearing that it's induced by the med change, but my team keeps telling me its from the stress in my life and my father passing away in February. No idea what to believe anymore. My family tells me drugs are poison and to quit them NOW, and my team tells me it helps me and to KEEP taking them, and I'm stuck in the middle.

 

I also will ask again for the psychiatry appointment to be earlier, as it's only 3 weeks from now. I have little support in life and would like my psychiatrist to help me with this, even if he doesn't want to, he can at least adjust my doses to what I'm taking currently, as now I'm taking 5mg Abilify and 50mg Sertraline but my pills are 10mg Abilify, and 50mg Sertraline, so I have to keep splitting the 10mg pill, which makes no sense seeing as they have 5mg pills readily available.

 

I went to my diary to see exactly when I changed doses of everything, udpated for future reference:

7th March: 75 to 50mg Sertraline, 5mg Abilify

20th March: 50mg Sertraline, 5 to 10mg Abilify

10th April: 50mg Sertraline, 10 to 5mg Abilify

 

As of today it's 6 weeks since the Sertraline change (and I feel 'fine' on this front), and nearly 1 week from the abrupt Abilify change (still suffering from GI issues since end of March, but its disappearing lately, other than that I also feel 'fine').

 

I am battling my own mind, wondering which part really wants to change the meds dosage now.

[Rubied]

I can no longer live emotionless. I can't feel anything.

I might regret this but I'm lowering my Sertraline dose today with the advice of my psychiatrist and nurse. I told them I feel apathy, anhedonia, emotional numbness, even the death of my father barely made a dent in my life, and I've stopped caring for things and for people around me. This is not normal. I don't feel suicidal, but this isn't living either. It's maddening, I cannot express myself, even though I type like it, I'm sitting here stone-faced and just typing my fingers away, with an internal agitation that doesn't express itself, it's like absolutely everything is suppressed inside me. A nice metaphor is a dwindling fire inside me, it's just embers right now, not full flame, but not dead either, just almost.

[Rubied]

After 1 week of going down to 25mg Sertraline and 2 weeks down to 5mg Abilify, so far I've noticed:

- Getting very quickly dizzy and faint when I get up too quickly or just walking up the stairs

- Incredible fatigue, everything makes me so tired, today I went on a 15min walk and it completely floored me and I had to take a nap

- Flu-like symptoms, headache, aches in my body

- Increased irritability that sits in the body, cannot be expressed, it's stuck and eats me from inside out

- Feeling of apathy and lack of motivation remains the same, feel like I don't care about anybody or anything around me

 

I'll be holding these doses until end of June. Hoping that it doesn't get worse than this, quite worried when my doses become increasingly smaller, from what I've read on this site.

[Rubied]

Quick update

Started experiencing tremors since 2 days ago. I've been very stressed about work so maybe that's the cause, but I never used to shake like this. I lift my hand up and its shaking.

Still feeling very dizzy getting up and walking up stairs, which is unusual. My gastrointestinal issues have now resolved thankfully, so I guess I can attribute that to the changes in Abilify 1 month ago.

I'm a bit suspicious that no other symptoms are plaguing me, I am counting my lucky stars right now. But maybe it's a matter of time, I keep reading how some people are hit with wicked bad withdrawal a few months after lowering doses or going off meds, so maybe I shouldn't be so relaxed about it yet.

 

So far, summary of symptoms since my change of doses are: dizzy, fatigue, headaches, aches in body, irritability, apathetic for the rest, lack of motivation, tremors in the hands.

[Andra]

Dear Rubied,

• The tremors are a result of the massive dose changes - Abilify mostly, and possibly combined with the sertraline tapering. You were also on a carousel of benzodiazepines, that only made you more fragile.

In regards to tapering Abilify. 10 mgs have a 90 per cent dopamine receptor occupancy. 5 mgs around 70 per cent dopamine receptor occupancy. This was a massive jump. In terms of your medication schedule  the general approach is to take the AD in the morning and the AP in the evening. Maybe someone more experienced might provide more insight in regards to getting the AP and the AD at the same time, in the evening.

 

• In regards to the AP taper, we followed  a 5% D2 receptor release every two weeks, no more than 10% monthly and holding more towards the end.  We extended the last tapers to minimize any possible lagging symptoms. Each person is different, so pace your tapering according to your body response. The benchmark symptom is your sleep. You do not want to spiral into insomnia.  Below is an article where at the end,  you will find a table with the correspondence between the dose and the dopamine receptor occupancy.

https://www.nature.com/articles/npp200833. 

Maybe do more internet research or get in touch with a specialist in psychopharmacology to get the equivalencies between receptor occupancy and Abilify dose. Keep in mind that there are slight variations  from person to person, based on metabolism, medication history, etc. 

 

• . Do not expect to find validation from the psychiatrist medical team. They will ignore or try to minimize the withdrawal or the side effects of the medication, and they will try to introduce other drugs or keep you indefinitely on the ones you are taking now. 

It is not a big conspiration or anything - most of them lack critical thinking and they are not trained in school in respect to withdrawal effects .Also , they do not have skin in the game. It is not their life that it is at stake. 

We kept in touch with the psychiatrist only to get the prescriptions that allowed a safe taper. The strategy was to show up,  smile, and get the prescription. No mention about tapering or asking for advice. I  refused any suggestions of medication change. The strategy was to get enough meds to ensure a safe taper, and end the visits asap. Some people are lucky enough to find support from their psychiatrist. It was not my daughter's case. However we relied on "virtual" psychiatrists and other professionals in the field -   Joanna Moncrieff, David Horowitz, Peter Breggin, David Healey, David Cohen. Basically I read their articles  and listened to most of their  interviews.

 

• You already have your family support which is pure gold. Trauma informed therapy might be helpful if you look for validation and support in your recovery. I had no idea how to find a psychologist, so I wrote to several big names,  in my country, briefly exposing the situation. and asking for recommendations. To my amazement some of them  responded. On a Sunday, no more no less. From there, following their list of recommended colleagues psychologists we were able to find a very good  therapist. What I mean is that like in every other profession there are people dedicated to their work and others who are there only for paying the bills. 
• Other strategies - Acupuncture, Pilates, swimming, massage, therapeutic waters, no alcohol, lately no coffee, good diet and the pet .  In other words, well being and self care. 
• If necessary take a break or get a less stressful job. You will have all the time to get back to your profession in a much better shape.

 

All the best in your journey. 

[Rubied]

Update

It's been 1 month now that I am free from all medications, off Abilify since May, off Sertraline since about 1 month ( I think, maybe longer).

I wish I had written it down, but I did a fast taper off the sertraline, going from 25 - 12.5 - 6 - 3mg, the last doses I stayed at for about 3-4 weeks before cutting off. I'm not really sure.

 

I've been crying every day for almost 3 months now. I've been incredibly depressed and it's gotten to the point I feel so desperate I almost considered going back to antidepressants. I don't know what to do.

I don't have any other symptoms, I did have 'vibrating head' feeling for a few weeks when I stopped the antidepressants, it's gone now, but the depression is back and stronger than ever.

I feel incredibly lonely, I don't have much support from family as I thought. I miss my father, dead now for 6 months. I am failing at my job, have called in sick countless times, and been practically non-productive for 3 months. I've gone to interviews for new jobs, but I can't land anything, and every disappointment cuts into me even deeper. I know my job greatly affects me too currently. It's extremely idle and boring and it's been like that for almost 4 years now.

I am only alive right now because I love my fiancé so much. I don't want to ever hurt him by ending my life. I am not living though and I don't know how to fix it. I do everything my therapy team tells me to: exercise, eat healthy, sleep enough, engage socially, try to do hobbies even if I don't like them. They don't know how to help me further. I do talk therapy with 2 therapists but it doesn't help too much. I feel so useless and hopeless.

 

I don't know why I am so deeply depressed. I would just expect to be discontent with life a bit, but not to this massive extent.

 

I really don't know what to do, so I'm writing here in hopes someone has some insight or advice, because I really dont want to get back on antidepressants again.

 

 

[FireflyFyte]

3 hours ago, Rubied said:

I don't know why I am so deeply depressed. I would just expect to be discontent with life a bit, but not to this massive extent.

 

Hi Rubied,

 

You tapered quickly off of two drugs which could cause withdrawal and depression can be one of the ways that it surfaces.

 

I understand that you don't want to go back on the medications but you may want to consider reinstatement at a low dose to see if it eases your current symptoms. You can read more about this at About reinstating and stabilizing to reduce withdrawal symptoms. Please let us know if this is an avenue you are interested in pursuing and will confer with other moderators to determine an amount to reinstate.

Some people also get some relief from the following supplements while tapering - 

• King of supplements: Omega-3 fatty acids (fish oil)
• Magnesium, nature's calcium channel blocker

You might also see some benefits from light exercise such as walks in nature or gentle yoga.

 

Are you currently drinking alcohol?

 

Thanks,

 

Firefly

[Rubied]

Hi FireflyFyte, thanks for responding

 

No I don't drink, I only drank last week at my cousin's wedding, but it was one night, other than that, just water and occasionally juice for me.

 

I am not going to lie, I am terrified of reinstating any drug right now. It was so hard to come off. I also don't know if this depression is just something I need to ride out, and if it's also mostly caused by my current life right now (very unhappy in my job, my father died some months ago, very lonely I live thousands of km away from family, a small physical injury preventing me from doing sports so I am very sedentary currently). Part of me thinks that once I find a better suited job for me, things might be manageable and I could ride out whats happening currently. I don't know, is that a stupid idea?

I feel I can't rationally think either.

 

Walks in nature is something I should do though. I try sometimes, but some days it's already a miracle to just get out of bed.

 

I guess I'm just trying to figure out if this depression is from the drugs or all the recent events in my life. But I honestly don't know anymore. I'm exhausted, grieving, depressed and my life is starting to fall apart, maybe reinstatement is my only choice now....? If so, what dose and how long? I did manage to acquire the liquid form of Zoloft when I was going down to 3mg.

[FireflyFyte]

1 hour ago, Rubied said:

Part of me thinks that once I find a better suited job for me, things might be manageable and I could ride out whats happening currently. I don't know, is that a stupid idea?

 

I don't think it's a stupid idea. An ill suited job can cause a lot of distress so it could certainly be a factor in what you are currently experiencing.

 

1 hour ago, Rubied said:

I guess I'm just trying to figure out if this depression is from the drugs or all the recent events in my life. But I honestly don't know anymore. I'm exhausted, grieving, depressed and my life is starting to fall apart, maybe reinstatement is my only choice now....? If so, what dose and how long? I did manage to acquire the liquid form of Zoloft when I was going down to 3mg.

 

I have pinged the other moderators to get their feedback about reinstatement. Please hold tight until they can comment.

 

Are you currently in therapy? Given all of your life stressors, especially the loss of your father, it might be helpful to talk to a professional. 

[Rubied]

Hi, again appreciate your response

 

This morning I woke up with the goal of getting to the office, and broke down wailing as soon as I got in the car. I decided yet again to call in sick, this time 'partially sick' so I have less pressure to perform, but also enough time to arrange interviews and go to them when necessary (it would be at the same company but within another department), and I felt immediately a little bit better. I'm rambling. But yes I'm trying to hold on right now.

 

I am currently in talk therapy, CBT. It's barely helping. But I keep trying anyway. My therapist keeps saying I am making progress but it'll take time.

[Altostrata]

Hello, @Rubied If you find withdrawal syndrome unbearable, you may wish to consider low-dose reinstatement, stabilize, and taper properly by tiny amounts later. But since you went off 2 drugs at once, we cannot tell what drug might be best to reinstate.

 

Coming off an antipsychotic such as Abilify too fast may cause very serious symptoms. How did you feel after you came Abilify in May, while you were still taking Zoloft?

 

What new symptoms appeared after you came off Zoloft? 

 

How have your symptoms changed in the last month? What is your current symptom pattern? 

 

On 8/29/2023 at 8:55 AM, Rubied said:

I only drank last week at my cousin's wedding, but it was one night

 

Even an only occasional drink may set your recovery back many months.

[Rubied]

Hi @Altostrata, thanks for your response

 

After coming off Abilify, to be honest I didn't feel any different at all. I could even say I don't think I had any effects coming down from Abilify whatsoever.

Zoloft on the other hand, has been terrible. The lower the dosage, the more depressed I have been, occasional brain zaps, very dizzy randomly, 'vibrating head feeling' that lasted a few weeks. The vibrating head has disappeared the last 2 weeks, and so have the brain zaps. So I now currently experience very deep depression (I'm crying within 10 min of waking up, lasting all morning, daily), anhedonia, random body pains mostly in my neck and shoulders, and I have developed a fear of being alone which makes me cry if I think about it. The worst symptom (which I still don't know if its from withdrawal or not) is the severe depression and weepiness. I feel I might lose my job if this continues.

 

About the occasional drinking, I will stop completely. I want to fix myself, I am so desperate! I'm crying as I type, I don't want to live like this

[Rubied]

I have to write today, as I am completely alone. My partner is on a business trip, and I live thousands of km's away from my family.

I am completely alone in my house that we bought together last year, which feels big and empty and full of past-hope that's turned into painful happy-to-be memories that have dissipated.

 

I wake up and within minutes struggle to not cry. Maybe I should just let it out? I feel incredibly lonely. I am very depressed. I force myself to go for a walk in nature lately, which helps maybe 1%, for a short time.

I don't know what's wrong with me. I am losing hope.  My wonderful partner is only back in 10 more excruciating days, he makes my life better, but I know I am hurting him with my suffering. I want to be ok.

How on earth do I get out of this depression WITHOUT ADs? It was the reason I started them in the first place, around 3 years ago. Instead they just suppressed everything and made it all worse.

I feel so desperate, I am very much alone. I try to make some social outings once in a while, but it's incredibly tiring and I feel like I'm just suppressing my emotions until I get back home. Maybe I am the problem all along? Maybe it wasn't even all these drugs? I don't know anymore what is WD, what is a me problem, or anything.

 

My family is falling apart, it's just myself, my siblings and my mother. We are all deeply grieving. My job is falling apart. I've missed so much work, my manager is obliged to get HR involved and I don't know what to expect. I don't want to fail any longer. I feel so behind in life, I see people around me happy, just living, and I am suffering suffering suffering

 

I've gone through all the threads about emotions, emotional spirals etc. Some give me a tiny bit of hope, but not really. I keep second guessing if I am suffering because I have no good coping mechanisms from what life gave me, or if it's from the drugs these past 3 years. I really don't know and I feel so invalid for posting here because maybe I don't 'belong' here.

[FireflyFyte]

6 hours ago, Rubied said:

I've gone through all the threads about emotions, emotional spirals etc. Some give me a tiny bit of hope, but not really. I keep second guessing if I am suffering because I have no good coping mechanisms from what life gave me, or if it's from the drugs these past 3 years. I really don't know and I feel so invalid for posting here because maybe I don't 'belong' here.

 

There is a solid possibility that some of what you are currently experiencing is directly related to withdrawals.

 

As Alto mentioned, you may want to consider reinstating one of your medications at a low dose. You can read more about reinstatement at About reinstating and stabilizing to reduce withdrawal symptoms. Since you think that you didn't suffer an ill effects from dropping the Abilify, you may want to think about reinstating the Sertraline at a very low dose. I will default to @Altostrata as far as dosage.

[Altostrata]

@Rubied your symptoms sound more like sertraline withdrawal, you may wish to reinstate 1mg sertraline to start, see what it does. You may be able to get the prescription liquid to take this small amount with an oral syringe.

 

Try to relax and not worry -- we have hundreds of people who have gotten through withdrawal syndrome and gotten on with their lives.

[Rubied]

Yesterday I typed up a reply only to delete it. I've been thinking about what to do, a lot.

I am afraid of reinstating, after reading the long thread about reinstatements that did not help people but made them worse (in many cases). I know I have a sensitive body and mind, and I want to be free from meds, I really fear that reinstating could set me back further. Yes, it could help, but then I would have to spend many months stabilizing, and many more months slowly tapering off. It could also make things worse.

 

I jumped off sertraline at 3mg, almost exactly 5 weeks ago, on 28th July. I went to my diary to re-check and wanted to note it here. I want to wait 1 more week. If things don't improve or if they degrade further, I think I will try reinstating, even though 1mg feels like too much.

 

I know both Altostrata and FireflyFyte say there is a big chance this is sertraline withdrawal, but I can't help to wonder if a big chunk is situational depression.

 

Today I woke up, within minutes found myself fighting back tears and crying. Loneliness, despair, hopelessness, all themes in my head. The thought that I have to go back to work tomorrow looming over me.

I went downstairs, made some coffee, journalled a bit, checked my phone for messages. Started crying again. Decided to go for a long walk in nature seeing as its sunny today. It helped marginally. Keep fighting back tears. I feel exhausted too. I have lots of housework to do to keep me busy, but I am so idle. I feel like a big failure. Logically I know I'm not, I've done much in my life even with all the adversity. But now? I feel like a shell of my former self, with brain capacity maybe of a 5 year old.

Yesterday in a moment of desperation I contacted a spiritual healer. Asked if they can help me. Waiting on a reply. I don't even 'believe' in this stuff, but who knows...?

I think social media is also ruining my mind a bit. I am on my phone a lot, when I feel tired I lay on the couch and just scroll (reddit, instagram, whatever). Maybe I need to take a long break.

 

I think I have lost weight, unintentionally. Too scared to check on the scales.

 

Despair and suffering.

[Altostrata]

10 hours ago, Rubied said:

I am afraid of reinstating, after reading the long thread about reinstatements that did not help people but made them worse (in many cases).

 

If you mean this topic, it doesn't say that at all.

 

If you prefer to cope with your post-drug symptoms until they go away, that's a valid choice.

[Rubied]

At breaking point today.

Ears are ringing suddenly, experiencing rapid waves of crying, resolution, crying, resolution, non-stop. Trying not to panic currently. Yesterday I had rapid waves of crying, then not being able to cry at all, on and off. This is insanity.

Went to the supermarket yesterday, bought some grapes, went to self checkout to avoid talking to people but couldnt find the grape code, started to panic and some lady came to help me and said "well of course, you have to WEIGH the grapes first!" I felt so stupid and I broke down there and then, left in a hurry.

My partner is back on Sunday, but I can't be alone right now. I think I will fly home to my family for the rest of the week.

[FireflyFyte]

6 hours ago, Rubied said:

My partner is back on Sunday, but I can't be alone right now. I think I will fly home to my family for the rest of the week.

 

I am glad that you are reaching out to your family for support. Take care of yourself.

[FireflyFyte]

Hi Rubied,

 

Checking in to see how you are doing. Are you with family?

 

Best,

 

Firefly