Cachemu: Zoloft Failed Tapering Attempts, Need Guidance

[Cachemu]

¡Hello! I'm a 23F diagnosed with Generalized Anxiety and Panic Disorder. Since childhood I developed GI problems in response to anxious situations and tended to stress more than my peers when faced with challenges. 

 

In July 2019, a neighbor broke in violently into our house which forced us to move, all while I was presenting exams to get into university. This triggered a cascade of panic attacks I interpreted as cardiac failure. After several health tests, we discarded cardiac issues and I found my way to a public psychiatry institution. 

 

In October 2019 I was formally diagnosed with Panic Disorder and Generalized Anxiety, and in November I initiated 25mg of Zoloft for 2 weeks and then settled at 50mg. Ever since I started Zoloft the panic attacks stopped entirely and even my regular anxiety got better (no more GI issues, felt more outgoing, faced challenges with less stress).

 

I was supposed to continue the 50mg for 6 months, but because of covid I was not able to get appointments or even communicate with a psychiatrist until August 2021. I was asigned a new psychiatrist who told me that since I had been feeling better for more than 6 months, I could get off the medication by tapering to 25mg for 2 weeks and then quitting entirely. The tapering proved to be to quick since I developed brain zaps, increased irritability, insomnia and passively suicidal thoughts. I got scared and went back to the psychiatrist in September 2021 who reinstated 25mg again for 2 weeks and settle at 50mg. This stopped the negative symptoms and returned me to the state I was in before (no anxiety).

 

The following appointments were few and far apart, until in March 2023 I expressed I wanted to try and quit again. This time, I tapered to 25mg for 4 weeks, then 12.5mg for another 4 weeks and then nothing. I once again experienced brain zaps and irritability, just not as bad as the first tapering attempt.

 

Things went sort-of-smoothly and in June 2023 I went on a month long trip abroad. During this trip I developed a serious infection which forced me to go back home. I believe the stress from this event was too much and ever since I got back the anxiety, GI problems, insomnia and negative thoughts have creeped back like they did on my first attempt. 

 

I am once again scared, and my impulse is to go back to the medication and try to taper off again at a later time. However, I feel that every time I'll try to taper off I'll come back to the same result. I have not yet contacted a psychiatrist, and I'm in need of guidance. 

 

Thank you for reading this far.

[Onmyway]

Hi @Cachemu

it is not uncommon to have a 'honeymoon period' once you stop the drugs and the withdrawal symptoms to manifest a bit later - sometimes up to 3 months. You may want to reinstate a tiny amount to see how you feel - I would recommend maybe 1mg for a few weeks and then if that does help a bit but not enough and does not cause side effects you can updose a bit more. 

 

Here is more about reinstatement: 

 

This will help you figure out how to get small doses. 

 

[Cachemu]

Hello Onmyway, thank you for the reply. 

Unfortunately, during the following days of my post my panic attacks came back full force and my parents rushed me to a new psychiatrist. This psychiatrist reinstated me on 25mg on July 15th, and upped me to 50mg 6 days later. When I refused I was threatened to be put on antipsychotics or hospitalized, so... I'm back on square one. 

 

The panic attacks diminished a little, the nausea and insomnia went away, but the high anxiety in the mornings remain. 

 

I feel defeated and broken. 

 

I'm looking for another psychiatrist at the moment. However, between the lack of liquid sertraline and compound pharmacies in my country, as well as the unwillingness of doctors to try different taper methods I'm afraid I'll have to taper following the 10% method on my own. 

 

I've also started looking for psychotherapy. 

 

How long should I wait before attempting to taper again? I'm feeling pretty unstable for now. 

Thanks

[Altostrata]

@Cachemu If you are feeling an increase in anxiety after taking 50mg Zoloft in morning, you might decrease to 25mg. You can cut the tablet in half.