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Eunoia: Went cold turkey with Sertraline (Zoloft) and suffering the consequences


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Hi everyone

 

First of all, I'm really glad I found this forum since there aren't many other places where I can go with these kinds of questions and get thoughtful and concrete support. So thank you in advance :)

 

Due to a combination of childhood trauma and (I guess) being gifted (which results in experiencing certain aspects of life more intensely), I developed a general anxiety disorder from an early age. When I started working this anxiety also mainfested itself in the form of panic attacks. These only happened at night and usually resulted in me lying awake for the whole night. After a while, I got panic attacks because I was afraid I was not gonna get any sleep, which resulted in a perfect little vicious circle.

 

About nine years ago I went into therapy, which helped me a great deal. I also got a prescription for Sertraline at that time that helped me eliminate the panic attacks I had. During those 9 years everything went reasonably well. There were ups and downs, some better times and some worse. There was some anxiety but never to the extent I couldn't manage it anymore.

 

I did try to keep working on myself which led me to a new form of therapy I discovered last summer. It was called IFS (Internal Family Systems). The therapist at the time was quick to point out that, since the goal of the therapy was to get in touch with your inner/bodily sensations, my process was probably being hampered by my use of Sertraline. Since I was feeling good at the time and I hadn't had any panic attacks for close to a decade I decided to try and stop. I formed my own month-long taper plan and then quit entirely.

 

It went alright the first couple of weeks but then after a month or two I had small disagreement with a friend just before I went to bed. This triggered my first panic attack in 9 years. It was such an enormous slap in the face, such defeat, that it felt like the ground collapsed under my feet. And then the days after were marked with a strong increase in anxiety as well. This led me to very quickly resort back to medication and start up my Sertraline again. This then led to a week of insomnia as my body had to get used to the medication all over again. It took another couple of weeks before I felt like my old self again.

 

Fast forward to a month ago. I was doing really well. I had been doing Qi Gong practice daily since January which had already resulted in some increased confidence and well-being. I had been running, been eating healthy and not drinking too much alcohol. So all in all, things were going really well. I was really happy. I was also planning a long trip (multiple months) in Asia which I was looking forward to very much.

 

Knowing Japan has a limit of how much medication you bring into the country and worrying that they might find it suspicious that I have a multiple-month reserve of Sertraline with me, I decided that the easiest thing to do was perhaps to just quit again. After all, I was in a great spot and surely, I could now cope with the withdrawal symptoms (if any). I consulted my doctor and he said that since I was "only" taking 25mg I could just stop cold turkey and he didn't expect any issues.

 

So a month ago, I pulled the trigger and quit my 25mg of Sertraline again, cold turkey.

 

The first few weeks were fine. I barely noticed any difference which felt very encouraging. But then last Thursday, I had another panic attack when I was trying to fall asleep. I woke up with a jolt and my heart went racing while my chest felt I had been hit with a sledgehammer. What was interesting, though, is that there was no strong mental aspect to the whole ordeal. I was able to keep the despair and fear at bay and patiently observe the physical manifestation. After a bit, I turned on my night lamp and read a bit, which calmed me down somewhat. I went back to sleep and after a bit of tossing and turning I did manage to fall asleep.

 

The next morning I was very, very tired and also had some mixed feelings. On one hand, I was happy I did not lay awake the whole night and I was able manage the attack (to a certain degree). On the other hand I felt defeated for suffering another attack in the first place. But since I didn't experience too much anxiety I decided to not resort to medication immediately again and just see what the next days would bring. There was, of course, some trepidation when I went to sleep Friday night but I did not suffer another attack. And neither did I the nights after.

 

Which brings us to this week.  Up until the today I did not have any new panic attacks, which is a relief but does not entirely remove the trepidation I still feel every night when I go to sleep. However, the anxiety I did not feel the last couple of weeks has come back in full force during the day. I feel an inordinate amount of worry and doubt and at times just sheer despair and hopelessness like I almost never felt before.

 

I am not sure if this is due to withdrawal, relapse or anything in between. Whatever is the case, I am not sure if I can endure these feelings for an extended amount of time. They cast such a dark shadow on every aspect of my life that it is difficult to keep perspective and hope.

 

So I'm at a loss at the moment. Tomorrow I am going to the doctor, for something unrelated, and I am going to ask him to maybe start up my Sertraline. And if that means I have to stay on it for quite a while longer and then taper very, very slowly, that is fine by me. At least I'll have this site to guide me next time.

 

If you read my whole essay, thank you for your time and energy! I would love to know what your thoughts and experiences are.

All the best,
Eunoia

 

 

 

 

Edited by Emonda
Name to title

2015 – 2023: 50mg Sertraline

Aug 2023: Fast taper down off Sertraline

2023-2024: 25mg Sertraline

May 2024: No taper off Sertraline

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  • Emonda changed the title to Eunoia: Went cold turkey with Sertraline (Zoloft) and suffering the consequences
  • Administrator

Welcome @Eunoia,

Sorry to hear of your story, although it is very common.

 

When tapering, slow is the way to go. To gain a better understanding of what we mean by the word slow, the following link will help you:

Why taper by 10% of my dosage? The reductions should get smaller and smaller each month, for example: 10mg, 9mg, 8.1mg, 7.3mg etc. Importantly, if you develop unpleasant side effects from tapering, halt the taper, give yourself time to settle, and once stable, taper more slowly and by smaller amounts moving forward.

 

You've tapered way faster than this, and horrible WD symptoms are the outcome: Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

10 hours ago, Eunoia said:

Tomorrow I am going to the doctor, for something unrelated, and I am going to ask him to maybe start up my Sertraline.

 

I read in your post you stopped one month ago. So, you should read these two links: About Reinstating and Stabilizing to Reduce Withdrawal Symptoms and Kindling

 

At less than a month CT from an AD, I've seen people reinstate 50% of what they stopped. At just over a month, I've seen people reinstate 25%, and beyond 3-months, it's very unpredictable (proceed with extreme caution)....but we all respond differently.

 

Given you've gone on and off twice lately, I'd be more cautions than above. I've read that when people go on and off they become more prone to kindling. What is the right amount? I can't say...but less is best. Start low and see how you go. Monitor your symptoms.

 

I've read so many accounts on this site of people who have reinstated too high and are now in a world of pain. You don't want to be in that position.

 

A few helpful links:

Windows and waves pattern of stabilization

Emotional Spirals

Non-drug coping strategies

Melatonin for sleep

We don't suggest many supplements, but two that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. Add one at a time and start with a low dose to see how it affects you. 


Magnesium

Omega-3 fatty acids (fish oil)

 

Avoid alcohol.

 

Don't change the manufacturer of your AD.

 

This is your own Introduction topic.  Each member has only ONE Introduction topic.  Your own Introduction topic is the best place to ask questions and the place to journal your progress.  This keeps your history in one place and means you do not have to repeat your story. 

Once again, welcome to S.A.

Emonda

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: 19 Jan 2.33mg, 26 Jan 2.28mg, 2 Feb 2.24mg, 8 Feb 2.19mg, 29 Feb 2.15mg, 7 Mar 2.10mg, 14 Mar 2.06mg, 21 Mar 1.99mg, 10 Apr 1.95mg, 17 Apr 1.91mg, 24 Apr 1.87mg, 1 May 1.83mg, 23 May 1.80mg, 30 May 1.76mg, 8 Jun 1.72mg, 13 Jun 1.66mg, 3 Jul 1.62mg, 10 Jul 1.58mg, 17 Jul 1.54mg

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Thank you very, very much for the elaborate and thoughtful response.

 

Regarding the reinstating, I read both of those links but it's difficult to gauge how it would effect me since it seems to be different for everyone.

 

It does make me a bit scared to think I can't go back to my medication and having to undergo these feelings for an extended period of time.

 

Do you suppose what I feel now will subside by itself? Would those supplements help in a meaningful way?

 

On the one hand it would be great if I could see this through, on the other I don't think I have the strength to endure these feelings of anxiety and dread and doubt for a long amount of time.

2015 – 2023: 50mg Sertraline

Aug 2023: Fast taper down off Sertraline

2023-2024: 25mg Sertraline

May 2024: No taper off Sertraline

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  • Administrator
31 minutes ago, Eunoia said:

It does make me a bit scared to think I can't go back to my medication and having to undergo these feelings for an extended period of time.

 

I certainly didn't want to scare you; rather, make sure you proceed cautiously with a potential reinstatement. Start low and see how you go.

 

I read in The Maudsley Deprescribing Guide last night that a cautious way of starting could be by testing your response with 5% of the amount you CT from. That certainly is a low place to start from.

 

32 minutes ago, Eunoia said:

Do you suppose what I feel now will subside by itself?

 

It takes time and much patience. To be frank, it can get worse before it gets better. Dr Horowitz refers to this as white-knuckling it. I never managed to succeed with that.

 

35 minutes ago, Eunoia said:

Would those supplements help in a meaningful way?

 

For me, the magnesium seems to help. It takes the edge off slightly and helps with sleep.

 

36 minutes ago, Eunoia said:

I don't think I have the strength to endure these feelings of anxiety and dread and doubt for a long amount of time.

 

I wish I could tell you exactly what to do, but I can't. Reinstating certainly is a worthy consideration given you're only one month off.

 

Starting low and testing how you respond is prudent. You can reassess a week or two after that.

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: 19 Jan 2.33mg, 26 Jan 2.28mg, 2 Feb 2.24mg, 8 Feb 2.19mg, 29 Feb 2.15mg, 7 Mar 2.10mg, 14 Mar 2.06mg, 21 Mar 1.99mg, 10 Apr 1.95mg, 17 Apr 1.91mg, 24 Apr 1.87mg, 1 May 1.83mg, 23 May 1.80mg, 30 May 1.76mg, 8 Jun 1.72mg, 13 Jun 1.66mg, 3 Jul 1.62mg, 10 Jul 1.58mg, 17 Jul 1.54mg

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14 minutes ago, Emonda said:

I certainly didn't want to scare you; rather, make sure you proceed cautiously with a potential reinstatement. Start low and see how you go.

 

No, it's really good of you to make me aware of all these factors. It's something the doctors where I go don't do in the slightest. Probably because they don't know any better.

 

13 minutes ago, Emonda said:

It takes time and much patience. To be frank, it can get worse before it gets better. Dr Horowitz refers to this as white-knuckling it. I never managed to succeed with that.

 

The alternative to this white-knuckling would be a much more prolonged taper program? As in, this is something that happens when you quit too soon and it becomes a coin-flip on how well you'll fare in the next months?

 

16 minutes ago, Emonda said:

I wish I could tell you exactly what to do, but I can't. Reinstating certainly is a worthy consideration given you're only one month off.


I feel a bit better today but also just sort of numb and fragile, like there is a bit more balance but it wouldn't take much to upset that balance. And there is very little energy for anything else than preserving that balance.

I think in general, all things considered, reinstating seems to be the best option for now. If I wait longer, my withdrawal might become even worse and then the reinstating will go even more difficult as well.

 

One more question about reinstating, if I would start with something like 12.5mg or less, does that then mean I can never go higher than that again? Is it the intention to taper off again as soon as possible (when having reached a strong, grounded baseline again). Or can it also be a stepping stone to just go back to 25mg and continue for some more time before considering tapering again?

Thanks again for your kind and patient replies. If I had a doctor that showed this much patience and involvement I probably wouldn't be in this mess in the first place.

 

 

2015 – 2023: 50mg Sertraline

Aug 2023: Fast taper down off Sertraline

2023-2024: 25mg Sertraline

May 2024: No taper off Sertraline

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  • Administrator
44 minutes ago, Eunoia said:

The alternative to this white-knuckling would be a much more prolonged taper program?

 

The alternative is reinstatement at a low dose.

 

45 minutes ago, Eunoia said:

I feel a bit better today but also just sort of numb and fragile, like there is a bit more balance but it wouldn't take much to upset that balance. And there is very little energy for anything else than preserving that balance.

 

Yeah, I know that feeling!

 

45 minutes ago, Eunoia said:

reinstating seems to be the best option for now. If I wait longer, my withdrawal might become even worse and then the reinstating will go even more difficult as well.

 

That's what I'd be doing, at a low dose.

 

47 minutes ago, Eunoia said:

does that then mean I can never go higher than that again?

 

Not at all. It's just cautiously testing the waters with a low-dose reinstatement.

 

If you respond well (no kindling) but still have horrible WD symptoms after 2 or 3 weeks, people increase the dose by no more than 10% and repeat the process again. That is, they sit back and observe how they respond for 2-3 weeks. I think this is what you mean by "stepping stones".

 

Once you feel stability return, you hold for an extended period (months), then slowly taper as per the 10% link I gave you in the initial post.

 

51 minutes ago, Eunoia said:

Thanks again for your kind and patient replies. If I had a doctor that showed this much patience and involvement I probably wouldn't be in this mess in the first place.

 

My pleasure. To this day, I am grateful to the Moderator who first responded to me...I valued his kind, and patient replies 🙂

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: 19 Jan 2.33mg, 26 Jan 2.28mg, 2 Feb 2.24mg, 8 Feb 2.19mg, 29 Feb 2.15mg, 7 Mar 2.10mg, 14 Mar 2.06mg, 21 Mar 1.99mg, 10 Apr 1.95mg, 17 Apr 1.91mg, 24 Apr 1.87mg, 1 May 1.83mg, 23 May 1.80mg, 30 May 1.76mg, 8 Jun 1.72mg, 13 Jun 1.66mg, 3 Jul 1.62mg, 10 Jul 1.58mg, 17 Jul 1.54mg

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  • 2 weeks later...

@Eunoia Hi, I don't give any advice bit it sounds wise to try reinstatement if you have the opportunity. I did not reinstate, 8 months off after too fast taper Zoloft and it's worse than ever. I don't miss the substance but the WD is worse than I thought possible.

Everyone is different and it's individual how it works though.

 

Hope it goes well for you. 🌿

 

 

2008 Zoloft 50mg 

2022 May - 62,5mg (doctor wanted to increase). Felt sick, went back to 50mg efter 2 weeks

2022 Oct - Reducing dose to 37,5mg (from 50mg). WD in few days, advised to go back to 50 - I then got adverse worse paradoxical effect

2022 Oct - Zoloft 50mg adverse reaction

2023 May 5th - Reducing dose to 25mg (directly from 50mg by Dr, WD).

2023 Aug 1st - Reducing dose to 12,5mg 

2023 Oct 10th - Removed dose from 12mg to zero by Dr. Reinstated 2,5mg citalopram after 3 months, bad reaction. Reinstated 0,5mg zoloft for 6 days after 7 months, didn’t work. In terrible WD.

 

 

 


 

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