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Kingo: Hello. Seeking help on the journey.


Kingo

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Hello everyone. I stumbled across this site and am hoping to find help. 

 

I was diagnosed with OCD in 2008, while in college, (after a few months of a counselor telling me I only had symptoms). I was also told I had depression, but this was likely caused by my OCD/anxiety and was secondary. I was prescribed Zoloft/sertraline. It was great. I had been so scared of taking meds and they helped me out immensely. That was late 2008. Looking back I feel I was not informed about many things. For example, I was not told that it was possible to stop in a few months, if your anxiety was more under control. I was not told how difficult it would be to get off the medication. I saw a new counselor and he also helped. I actually only met with him 2-3 times, since I felt my anxiety was under control. 

 

The following summer (2009), I felt like the anxiety was gone, and stopped taking sertraline cold turkey. Again, nobody told me this was a bad idea. It did turn out ok though, I had no withdrawal symptoms and I was not anxious at all. I don't remember exactly when I started taking it again, I think fall of 2009. I've taken it ever since, except for earlier this year. I tried tapering. Went to 125 for a couple weeks, then 100 for probably close to a month. I really didn't feel that different. My anxiety was about the same as when I was taking 150. When I reduced to 75 I think I may have felt a little more anxiety, but not significant, and I'm not really sure. I wish I would have kept a record. I went down to 50mg, was there for a couple weeks I think, and then one day I forgot to take my medication and decided that was it. I did take 25 a couple days, when I started feeling a little off. 

 

Then it hit me. I had a panic attack while working. This had never happened to me before. I would get irritated a lot easier, my mood was all over the place. I cried, had a very foggy brain and was very depressed. I didn't want to do anything. This went on for about a week. I didn't know if I was experiencing withdrawal or if this was an indication I should get back on the medication. Because my anxiety wasn't really that different than it had been when I was taking 100 mg or 150mg. Maybe a little worse, but the main issue was the depression, mood swings, and lightheadedness. I asked a doctor and she said to go back on the medication. So I did. It didn't seem to help much so the doctor bumped it to 200mg. I was now more anxious than ever. I had trouble leaving the house (which was never an issue before) and some similar OCD stuff that had bothered me over a decade previous (making sure my shirt was tucked in, hand washing). She referred me to a psychiatrist. I told the psychiatrist that the 200 seemed to be working, but there were still some anxiety symptoms after a couple weeks. She asked if I wanted to go to 250 to see if that knocked out the symptoms. The difference was negligible, but I was on the 250 for about a month. That's when I started reading about withdrawal symptoms and saying "hey, it seems like I was having those." 

 

I did more reading and research and saw that most folks asking about sertraline on message boards were on 25-100 mg. Very rarely did I see 150 and hardly ever 200. This was a little alarming to me because have always considered myself somewhat lucky in that my OCD was not what I saw as extreme. It didn't seem to take much to knock me out of that way of thinking (for example, one time my friend saw me struggling with laundry. I explained I was handling it a certain way because of germs. He said "germs don't work that way." I stopped, thought about it and thought "hmmm, he's right" and proceeded with normal laundry, without extra handwashing. 

 

So I said to myself "Self, I don't really see that much difference between 200 and 250. I'm just gonna drop down to 225 and see what happens." I did that earlier this week and I've been feeling better than usual. Is that the medication helping me be able to get my anxiety in check? Sure, definitely possible. I also think I'm getting more mentally balanced out after a difficult few months where both my grandma and a beloved family dog passed away. I also don't sleep the best and am signed up for a sleep study. 

 

But what REAAAAALLY got me frustrated was when I spoke with my psychiatrist this week. She said something about "new research" and, since there were still anxiety symptoms, she wanted me to try 300mg. She was very much in disagreement that I wanted to stick at 225, but went along with it. I have felt no withdrawal symptoms since reducing to 225, but do not plan on making any other changes until really formulating a plan. At the very least, I'd like to see if I can get back to the "normal" 150.

 

I guess this all comes down to this. Is sertraline really something I need? It certainly may be. But its not like I've been anxiety free while taking it. I also have had no side effects.  I don't know if I should try tapering off again, or not. I've heard success stories and not success stories. Also, is a lifestyle change like working out more, losing 20-30 lbs, sleeping better, working through treatment with a counselor, will that be enough to allow me to not need it? 

 

I'm just looking for suggestions and input from folks who have been there before. Any help is welcome and appreciated. 

 

December 2008 - Started Zoloft - 100mg
January 2009 - Started Zoloft - 150mg
June 2009 - Quit cold turkey. No withdrawal symptoms
November 2009 - Started Zoloft again, 150 mg
March 2023 - tapered to 125mg Zoloft
Late March 2023 - tapered to 100mg
April 2023 - Tapered to 75mg
May 2023 - tapered to 50mg
Late May 2023 - off meds. Withdrawal symptoms included one panic attack, depression, mood swings, brain fog, tingling in fingers. Was off for a week or so, doctors advised I go back on.
June 2023 - 150mg, Two Weeks Later - 200mg
July 2023 - 250mg
August 2023 - 225 mg

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  • Administrator

Hi there @Kingo

Welcome to S.A. You've had a bit of a rough ride, by the sound of it. Thanks for completing your drug signature.

 

We are a volunteer-run community of people who have been or are in the process of getting off of psychiatric drugs. If you would like to taper off ADs, then you will find some helpful information on this site. 

 

Looking at your tapering since March 2023, it looks like you have gone way too quickly, and that would likely lead to WD symptoms. The recommendation is to reduce by 10% per month of the most recent dose. The amount of the reduction gets smaller and smaller every month. I'd suggest you start by reading Why taper by 10% of my dosage?  Also, be sure to take your AD every day at the same time of day. It’s so essential during the tapering process.

 

If you read this WD symptom checklist, you will see that the symptoms you have described are probably WD symptoms.

 

2 hours ago, Kingo said:

But what REAAAAALLY got me frustrated was when I spoke with my psychiatrist this week. She said something about "new research" and, since there were still anxiety symptoms, she wanted me to try 300mg.

 

It's your body and your choice. Don't be pressured by the doctor if you are not comfortable with their advice. You can always seek a second opinion. I'm not a doctor, but 300mg is twice what I took ~20 years ago. Just to confirm, are you still on 225mg as per your signature, or did you increase to 300mg?

 

What is not helpful is chopping and changing the dose. You need stability. Have a read of the information here: Keep it simple, keep it slow, and keep it stable.

 

Another moderator may chime in with their thoughts, but if it were me, I'd let the dust settle at 225mg for a few months until you feel stable, and only then, consider adopting the maximum 10% monthly taper.

 

I hope this is sufficient information to get you started. Sing out with any questions.

 

Emonda

 

 

Edited by Emonda
typo

Please don't send me PMs. I am not a doctor. My comments are based on my personal experience with ADs and tapering. Consult your doctor about your own medical decisions.

Start of taper: Jan ’22 Vortioxetine 15mg, 

End year 1: 4.5mg, 

End year 2: 2.38mg, 

Year 3: 8 Feb 2.19mg, 21 Mar 1.99mg, 2 May 1.83mg, 13 Jun 1.69mg, 25 Jul 1.50mg, 14 Aug 1.46mg, 3 Sep 1.43mg, 10 Sep 1.40mg, 17 Sep 1.37mg, 16 Oct 1.34mg, 23 Oct 1.32mg, 30 Oct 1.29mg

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Thank you so much @Emonda

 

To answer your question, yes, I'm at 225. I did not want to increase to 300. 

 

I will read up on the resources. Thank you.

December 2008 - Started Zoloft - 100mg
January 2009 - Started Zoloft - 150mg
June 2009 - Quit cold turkey. No withdrawal symptoms
November 2009 - Started Zoloft again, 150 mg
March 2023 - tapered to 125mg Zoloft
Late March 2023 - tapered to 100mg
April 2023 - Tapered to 75mg
May 2023 - tapered to 50mg
Late May 2023 - off meds. Withdrawal symptoms included one panic attack, depression, mood swings, brain fog, tingling in fingers. Was off for a week or so, doctors advised I go back on.
June 2023 - 150mg, Two Weeks Later - 200mg
July 2023 - 250mg
August 2023 - 225 mg

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  • Moderator Emeritus

Hi @Kingo

 

I agree with Emonda's advice. Do take a few months to stabilize and then you can taper by no more than 10% every 4 weeks. I would also avoid alcohol and other psychotropic medicines or even supplements while tapering - they tend to set people off. 

 

Regarding your Q about OCD. I like the way Martin Seif and Sally Winston understand OCD - I like their book - Needing To Know For Sure  . Our brains seem to be working differently but there is no evidence that this difference is related in any way to serotonin and that these drugs work any better than placebo. In fact the idea of a chemical imbalance causing MH issues is without any evidence. Have a look at this scientific article that shows that ADs are no better than placebo for depression. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/

 

In OCD treatments you need to break the distress-behavior-relief-more distress-more intense behavior etc. cycle. It is a loop that gets created in your brain (neurons that fire together, wire together) and if you can repeatedly break that loop you can conquer OCD. The key is distress tolerance - ability to not do the behavior when the urge occurs, resisting reassurance seeking (asking others to confirm that things are OK). OCD is challenging but it is treatable and manageable quite well with the relevant treatment. ERP (exposure response therapy) is based on CBT and is as good as drugs (without any side or withdrawal effects) but is challenging to apply and requires a lot of work. The good thing is that relief is long lasting. Check out Claire Weekes' work on distress tolerance. 

 

Hope you find some respite soon, 

OMW

Edited by Onmyway

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

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  • getofflex changed the title to Kingo: Hello. Seeking help on the journey.

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