Kiki mom introduction

January 7

My son is 16 y/o. I will summerize as best as possible. Obviously, we now want off this drug somehow. Just not sure how to proceed

Fall 2023, son was feeling depressed. He went to his doctor, recieved a adhd dx about the same time and was offered medication. Started Concerta end of Nov 23. Started getting jittery/stimulated and nauseous. Was switched to Vyvanse middle of March d/t this and not feeling it helped with focus/brain fog. Still the same. Went in crisis to emerg first week in April due to depression. Prescribed 20mg Prozac. Felt it helped with mood but other symptoms remained. I was unaware but his nausea advanced to vomiting on occassion sometime in summer. Still felt over stimulated and nauseated and brain fog. We were very unaware of all the information regarding antidepressants at that time, or the tapering but because my son has always been "sensitive", we started visually decreasing the med from the capsule before going to the pediatrician for his November appointment. Probably went to approx 10 mg. He is unaware how much thos might have added to any symptoms. At this appointment, pediatrician precribed 75mg zoloft due to mood not lifting enough. She said to decrease 20mg dose by half for 5 days then switch (we had decreased to 10 mg approximately by then however) and switch immediately to zoloft 25mg, increasing every 7 days till he achieved 75mg. We decreased his prozac from 10 to 5mg (approx) for a little over 1 week starting approx Nov 18th before starting zoloft at 25mg on approximately Nov 27th or 28th. By the end of the week before the switch, his symptoms increased significantly to almost total insomnia, shaking, littering, unable to eat and increase in his nausea/vomiting, ++ agitation, anxiety, confusion, mood swings, flu symptoms, burning sensation etc. On starting the zoloft, it took some edge off the symptoms slowly over the first week. Because of this horrendous experience, however, we did not increase dose from the 25mg. We were not sure if increasing for more of zoloft was wise given the symptoms when switching from prozac to zoloft We are now scared of these drugs. He continues with lingering symptoms. We are so unsure what to do now

January 7

Welcome @kikimom

A lot of changes have been made in a relatively short period of time. Those changes would leave anyone feeling dreadful.

There is no quick fix. Much patience and stability are likely to be the solution.

Those that taper too quickly often develop very unpleasant withdrawal symptoms. This Daily checklist of antidepressant withdrawal symptoms is a helpful summary of what many experience. Can your son relate to this list?

Has he stopped Prozac? Is it just Sertraline he is on now? Sorry, I'm just a little confused by the signature. We need dates/drugs/doses in the signature.

Once you clarify, we can chat again.

Emonda

January 7

Emonda,

Thank you do much for your reply

Yes, DC prozac 6 weeks ago when starting the sertraline at 25mg. Has not increased past the 25mg as suggested by pediatrician.

He can relate to very many of these symptoms. The first little bit at end of prozac decrease before sertraline started (as described above) was very acute with almost 24hour/day insomnia and very jittery/constant movement and agitation extreme nausea vomiting etc. He has checked off a number of the withdrawal symptoms. Many remain though sertraline start decreased the extreme acuity.

January 7

28 minutes ago, kikimom said:

Yes, DC prozac 6 weeks ago when starting the sertraline at 25mg. Has not increased past the 25mg as suggested by pediatrician.

Ok, so just Sertraline at this time. Nothing else?

28 minutes ago, kikimom said:

He can relate to very many of these symptoms.

I'd take this as a positive = WD symptoms.

29 minutes ago, kikimom said:

The first little bit at end of prozac decrease before sertraline started (as described above) was very acute with almost 24hour/day insomnia and very jittery/constant movement and agitation extreme nausea vomiting etc

Changing from one AD to another is brutal (speaking from experience x 3)!

The drugs likely work on different receptors, so you have WD from one as your body tries to adjust to another.

30 minutes ago, kikimom said:

decreased the extreme acuity.

So, a slight, gradual improvement? If so, I'd be sitting tight. Think weeks and months, not days.

If the doctor adds more drugs or changes the dose, you're just adding fuel to the fire.

I recently watched a YouTube video of Dr Horowitz. He commented that it is often best to hold for stability, even if that takes months. Sure you can increase/decrease, but you need to understand it can make things worse.

If the young fella has seen a slight improvement, that sounds like he is heading in the right direction.

Some general info:

Recovery from ADs and tapering is not linear. There are good days and not-so-good days/weeks/months. This is referred to as the Windows and waves pattern of stabilization.

The following general links are worth reading:

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 - Hopefully a 16 year old doesn't do this...but I didn't want to assume!

Don't change the manufacturer of your AD.

Once again, welcome to S.A.

Emonda

January 8

Emonda,

I see this site is volunteer run so thank you so much for your time you are dedicating to us. And thank you do much for all that information!!

Yes, only sertraline

I'm reading correctly that you meant it was therefore wd symptoms, not that it was a good (positive thing?)

He had an improvement the first week, definately, but not sure about the past 5? He is missing school and activities dt how "flared" he is.

Might be tricky getting his pediatrician to be OK with him not increasing from the 25mg to the 75mg she wanted him to take! Trying to figure out how to present that as, I'm pretty sure from her standpoint, he is not doing well so we should be increasing it!

I'm assuming any substance - weed, vaping nicotine and alcohol all must fit into that category?

Do I just keep replying to this thread and that automatically "tags" you?

January 8

2 hours ago, kikimom said:

Do I just keep replying to this thread and that automatically "tags" you?

Yes

2 hours ago, kikimom said:

assuming any substance - weed, vaping nicotine and alcohol all must fit into that category?

Definitely avoid as well as caffeine

2 hours ago, kikimom said:

tricky getting his pediatrician to be OK with him not increasing from the 25mg to the 75mg she wanted him to take!

Your son is dealing with withdrawal probably from Prozac and concerta, adding/increasing drugs is only going to cover the symptoms and cause complications such as more side effects.

Some of us have had to let the doctor think we are following their instructions to get the prescription. That does not mean you have to take the dose. The pharmacy could fill the dose using 25mg pills.

I am disgusted at a pediatrician pushing these pills. Did they warn you that these drugs have a black box warning? I am sure they didn’t. They play god with people’s lives.

Please keep communicating with your son as to his feelings. This is a very difficult journey. It is hard to be functional but keep reassuring him that it will get better.

Mark Horowitz has numerous YouTube videos out there and has written a book called The Maudsley Deprescribing Guide. It is a great resource to have. It is now being used in the UK and Australia as a guide to getting off these drugs though doctors are slow in responding.

Glad you found this site. We are here for you and your son. ❤️🙏

January 8

Thank you Emonda

So WD is still occurring for prozac (and maybe concerta/vyvanse) underneath his sertraline prescription even though it seemed to dampen symptoms somewhat?

And of course they did not warn us - it is thrown around like candy. I'm so regretful he was ever put on any of it but especially this last change - seems like we are just trying to make it continually worse! Looks like a lot of people have more trouble with sertraline than the prozac!

I will definately be trying to keep open and honest communication as best I can.

I will be replying to this thread for my questions - thank you so much!

January 8

5 minutes ago, kikimom said:

So WD is still occurring for prozac (and maybe concerta/vyvanse) underneath his sertraline prescription even though it seemed to dampen symptoms somewhat?

Yes. These drugs have some similarity in the way they affect the body but they cannot identically replace one another. It will be impossible for one to completely eliminate the withdrawal from another drug. Fortunately it has helped a little. Since your son has been on sertraline for 6 weeks his body will also be adapting and becoming dependent on it as well.

I am so sorry he is having to deal with this.
I am in Victoria BC and as my doctor here says ‘psychiatry is a sh*t show in Canada’. Unfortunately it is worldwide. They have been trained by Big Pharma to believe this junk works. All big pharma cares about is profit and the doctors get kick backs so they keep writing the prescriptions.
What are his daily symptoms? Did Emonda suggest that he keep a daily journal rating them 1-10? It is a good way to monitor progress. Does he seem like he is reaching any kind of stability in regard to symptoms?

January 8

Thank you for jumping in LostinCanada - I always appreciate you 😊

3 hours ago, kikimom said:

I see this site is volunteer run so thank you so much for your time you are dedicating to us. And thank you do much for all that information!!

The team is very small, but we do what we can to assist.

3 hours ago, kikimom said:

you meant it was therefore wd symptoms

Yes, I'd expect WD symptoms from the original drugs.

As LIC (LostinCanada) and I both commented, they work of different receptors, so one is not a straight swap for the other. Definitely WD symptoms from stopping original drugs. It normally takes 3-4 weeks to notice WD with Prozac.

3 hours ago, kikimom said:

Might be tricky getting his pediatrician to be OK with him not increasing from the 25mg to the 75mg she wanted him to take! Trying to figure out how to present that as, I'm pretty sure from her standpoint, he is not doing well so we should be increasing it!

I support LICs comments on this.

3 hours ago, kikimom said:

I'm assuming any substance - weed, vaping nicotine and alcohol all must fit into that category?

Absolutely - he doesn't want to touch any of that stuff.

33 minutes ago, kikimom said:

nd of course they did not warn us - it is thrown around like candy. I'm so regretful he was ever put on any of it but especially this last change - seems like we are just trying to make it continually worse!

All too common, sadly

16 minutes ago, LostInCanada said:

Did Emonda suggest that he keep a daily journal rating them 1-10? It is a good way to monitor progress.

Use the WD checklist I gave you to track progress. I find it helpful to reflect back.

We don't have all the answers, but we have learnt from our own experiences and those of others here.

Keep us posted.

January 8

Can you please clarify the reason for the change from Prozac to Sertraline?

10 hours ago, kikimom said:

Felt it helped with mood but other symptoms remained.

What symptoms?

10 hours ago, kikimom said:

I was unaware but his nausea advanced to vomiting on occassion sometime in summer. Still felt over stimulated and nauseated and brain fog.

Was this while on Prozac? Your summer and my summer are different I think...so just trying to make sure I understand. You're saying this was a side effect of Prozac?

January 8

Thank you so much to both of you! Lost in Canada, I didn't notice it was your response previously! We are in Northern Ontario - it will be tricky navigating this here!

Tricky with pediatrician and doctor to convince to keep going with this without switching (she prescribed 75 but he is only taking 25mg)- he has lost about 40lbs in a short period of time and you can physically see he isn't doing well. I'm trying to work a strategy in my head when we have our appointment

I'm not positive if it was a side effect of the prozac but it very well could have been/strong likelihood.

His mood had the edge taken off but I guess not high enough, lost interest in things, still feeling the overstimulating etc that started with Concerta med. That is why the change

He felt the wd from 10mg prozac to 5mg within 5 days before the switch. It very much concerns me that, at 6 weeks, it could be just truly starting now. I don't think we have reached a stability yet. Working hard to try to get a sense of this. Hard to know what is doing what right now.

I am getting him to review the symptoms and, he has many, but maybe rate the top ones every few days?

January 8

Hi @kikimom, and welcome to SA! We're so glad you found our wonderful community, and you're in very good hands here. By following the guidance here, your son has the best chances of making a full recovery from the mess that his own doctor has put him in.

If you have a chance, your family might want to watch the documentary film Medicating Normal, which highlights the dangers of these drugs. It's very eye-opening.

https://www.youtube.com/watch?v=BJ4F_ZF3u9M

January 8

4 hours ago, kikimom said:

We are in Northern Ontario - it will be tricky navigating this here!

We used to live in Pembroke... that's as far north as I got. Definitely limited resources.

Maybe something in here will help.

January 8

How much Vyvanse is he on daily? Please add dates with dosage to your signature thank you. ♥️

You will need to be firm that you will not increase his dose of sertraline 3 fold....that isn't even reasonable on any level. There is a real danger of serotonin syndrome...he is way too young and he went to the doctor a healthy young male and these drugs/doctors have resulted in him losing weight, etc. and being in this position.

Hopefully printing off info from the link or getting a copy of the Maudsley Deprescribing Guide could help in talking to them.

https://www.amazon.ca/Maudsley-Guidelines-prescribing-David-Taylor/dp/111982298X/ref=mp_s_a_1_1?crid=3LS6MROWN8VTO&dib=eyJ2IjoiMSJ9.JHRtfLNPzDT1EMU78Y52NZg61RGit7iolxAM-zOjD_VDQ6mARHxEl8C92aQKJlX5hp4GQAC4Zt2P4_XTwaMYma3Pew1T4laTHxuvQskEqvk.AdPkEsJUOMDI9L5GPqTI3MAbBGzdPDuVXxMhpLZS-PQ&dib_tag=se&keywords=the+maudsley+deprescribing+guidelines&qid=1736352973&sprefix=the+mau%2Caps%2C183&sr=8-1

January 8

Thank you! When you say info from the link, you are referring to the discussion you linked to me, correct?

No Vyvanse currently. Stopped stimulants before SSRIs started

I ordered the guidelines!

Don't know what to do about the 25mg sertraline caps (lowest) once we actually get there....

Can rescue doses in withdrawal be helpful at all? I'm getting the sense the answer is no

January 8

44 minutes ago, kikimom said:

When you say info from the link, you are referring to the discussion you linked to me, correct

Yes. There many links to papers, studies, etc you can copy off to show the doctors. If your doctor has any humility they would have to admit limited experience compared to the studies.

46 minutes ago, kikimom said:

No Vyvanse currently

47 minutes ago, kikimom said:

Don't know what to do about the 25mg sertraline caps (lowest) once we actually get there....

Good.

Are they capsules or pills. I will send links about, cutting, weighing, making a liquid from pills/capsules,etc. Good you are thinking ahead and prepared. He has not been on the Zoloft long and a quicker than usual taper may work. It talks about this in the Maudsley Guide but symptoms need to be monitored closely.

Also usually reinstatement of a small amount of prozac, 1 mg would be usual but because of the addition of Zoloft it complicates things.

Please read the links that I send separately.

January 8

January 8

January 8

January 8

23 hours ago, kikimom said:

Fall 2023, son was feeling depressed.

I just need to say this is so normal for a teenager. With hormones and trying to adjust to growing up. My heart just breaks. Just some reassurance and a bit of counseling/therapy would have helped. The teenage years are tough and the world is getting tougher. Please give him a big hug from me and let him know we are here to help. We are all living this nightmare but we are winning. He will too and come out on the other end better for it. ♥️🙏

January 8

31 minutes ago, LostInCanada said:

Fall 2023, son was feeling depressed.

I'm sorry he was feeling depressed. It's a shame the doctor did not first look at his diet and lifestyle to see what the root causes could be. @LostInCanada is right - some counseling might have proved beneficial first. It's a shame we can't tell our doctor we're "depressed" anymore for fear we'll be encouraged to take drugs. It seems like every normal human emotion is pathologized and medicalized into a brain "disease" that needs a pill to "fix" it. The harm that is being done is beyond criminal, especially to all the children that are being drugged. Sorry for my rant, but it just boils my blood as to what is taking place.

So glad you're being helped by all the great and knowledgable people here! 💝

Edited January 8 by Catina7

January 8

Lost in Canada and Catina, you are both very kind

Yes, I imagine it does complicate it. Not only that, I can't see a doctor quickly agreeing (can't even get into one) to prescribe me the prozac while on sertraline in any quick order. Ugh! He gas been dc prozac and on sertraline x 25mg for 6 weeks now.

Our sertraline is 25mg caps - very little powder in them. Don't know that Canada has another form! Doesn't seem to dissolve overly well in water....

January 8

19 minutes ago, kikimom said:

Doesn't seem to dissolve overly well in water....

Read the links. It doesn't have to dissolve, just needs to be suspended while you extract the dose with a syringe. (no needle)

Some use maple syrup in water to do that or juice. It will look cloudy in water. Always stir before extracting.

22 minutes ago, kikimom said:

can't see a doctor quickly agreeing (can't even get into one) to prescribe me the prozac while on sertraline in any quick order.

Do you have walk in clinics? Also the pharmacy may do an emergency refill based on previous history if you say you are waiting on an appointment. These are just things to think about.

I am not sure if reinstating prozac is the way to go... waiting on a senior moderator to weigh in.

January 8

This letter may also be helpful:

https://docs.google.com/document/d/1Tlw-xEpRWk_K6177V_A_xnfbUUHq2n_ktdeFr3Un4-s/edit?tab=t.0

January 8

LostinCanada

Thank you for all the time you are taking to support us!

That is an amazing letter. I think his Primary Care doctor might be the most likely to be open to this. However, they are so overworked at our clinic and short, not sure if that would be a barrier to her looking at it. And she is not the original prescriber so that can sometimes be a barrier too - might insist we work with pediatrician. Not so sure about his pediatrician being open to it though. Too bad we have to navigate medical politics in addition to everything else like incompetence, lack of knowledge and obvious health crisis!

January 8

Well, a bit has been posted here while I was asleep.

A question from one of the others behind the scene: if he stopped Vyvanse, when did he stop taking it?

If I understand your signature:

start date was March 2024
end date was April 2024

Is this right?

2 hours ago, LostInCanada said:

I am not sure if reinstating prozac is the way to go... waiting on a senior moderator to weigh in.

I'm not sure, either. A discussion is taking place behind the scenes.

A few Mods are reading this and will share their thoughts either here, to LIC or myself.

January 8

10 minutes ago, kikimom said:

I think his Primary Care doctor might be the most likely to be open to this.

Hopefully you can express your lack of confidence with the pediatrician. It was what I had to do with my GP regarding the psychiatrist I was stuck going to. My GP responded positively to the proof.

January 8

On 1/9/2025 at 7:52 AM, Emonda said:

Well, a bit has been posted here while I was asleep.

A question from one of the others behind the scene: if he stopped Vyvanse, when did he stop taking it?

If I understand your signature:

start date was March 2024

end date was April 2024

Is this right?

I'm not sure, either. A discussion is taking place behind the scenes.

A few Mods are reading this and will share their thoughts either here, to LIC or myself.

Emonda,

Yes, Vyvanse was short.

I'm not sure about reinstatement - I would love the weigh in on it.

January 10

@kikimom we are still consulting…should have an answer soon. How was your son today?

January 10

Hi LostinCanada,

He was about the same I think. Trying to communicate effectively with a 16yo teenage boy for the amount of details I want can be a little harder than you may think!

I'm almost a little nervous of the answer! Maybe because my brain is calculating risks in different directions!

January 10

14 minutes ago, kikimom said:

Trying to communicate effectively with a 16yo teenage boy for the amount of details I want can be a little harder than you may think!

I can imagine. We have 2 girls and during those teen years they weren’t always as talkative as I would have liked. Boys are even more reserved when it comes to talking about feelings, etc.

15 minutes ago, kikimom said:

my brain is calculating risks in different directions!

I don’t think this is a bad thing. Good to research lots on here to make an informed decision. The section on reinstatement might be helpful. I just didn’t want you to think we forgot about you. ❤️

Saturday at 08:15 PM

Dear @kikimom

I am just listing some information for you to consider so you have some facts to weigh into your decision.

The decision in the end is yours and your son’s. We try to give advice based on collective knowledge as well as what we believe with lessen the suffering and cause minimal harm. These drugs are powerful and there is no perfect solution. Risks come with each decision. Risks also come with doing nothing.

Reinstatement is the only way that we have seen withdrawal symptoms lessen and even go away quicker than just waiting it out from an abrupt stop of medication. Either way it takes time to get back to normal. Reinstatement usually eases that journey. (Sometimes an abrupt stop is necessary with severe adverse and life threatening reactions.)

As mentioned before no drug can completely fill in and stop the withdrawals from another drug.

Prozac is a tricky one.... because of norfluoxetine which is the metabolized part of the drug (it doesn't fully leaves the body for a solid 3 months), the worst of WD from prozac can take 9 months to show by others ' experiences on here. This is why we feel a very small reinstatement of Prozac is necessary to address the dependency that your son’s body has in regard to this drug. Because your son’s body has already adapted to less Prozac, the amount of Prozac needed is much less.

Since your son has been on sertraline for 6 weeks, there may be some dependency on it as well.

These are the possible choices:

1-Have your son stay on sertraline and try to stabilize on it. This is not a quick solution and can take a very long time. The body will still need to heal from the withdrawals caused by Prozac. Once more stable, your son can start to taper from Sertraline. Tapering is a long process no matter what drug is involved.

2-Reinstate a small amount of Prozac and do a 2 week crossover from Sertraline to Prozac. This too may have some bumps involved and any symptoms need to be monitored closely and recorded daily on here so we can adjust as needed. Once the Prozac is reinstated and your son is stable, tapering can begin. Again it is a long process.

The next message will outline how choice 2 can be accomplished and at what specific doses would be needed to do this as safely as possible.

Saturday at 08:28 PM

@kikimom

This is what myself and @Go2zero are recommending. Both drugs will need to be made into liquid. Prozac is easily dissolved and good in the fridge for 14 days. A 20 mg pill can be mixed with 40ml of water to give a 1:2 ratio of drug to liquid- 1mg of drug = 2 ml of liquid

Sertraline should be used immediately with any extra discarded. Sertraline has limited solubility so the solution must be stirred vigorously before drawing up the dosage. The same ratio can be used here. Water or juice can be used for sertraline.

Accuracy is important and using the same standard for measurements throughout the process is important. Syringes without needles can be ordered on Amazon.ca. Usually they are one time usage so many use clear tape or clear nail polish to protect the measurement lines. This allows multiple uses for the syringe.

Prozac in mg Sertraline in mg

Day 1 1 10

Day 2 1 8

Day 3 2 7

Day 4 2 6

Day 5 3 5

Day 6 3 4

Day 7 4 3

Day 8 4 2

Day 9 5 1

Day 10 5 0

Day 11 6 0

Day 12 6 0

Day 13 7

Saturday at 08:35 PM

We are here to answer any questions and help. Please read the first post in each of the following links to learn more about tapering both these drugs:

Sunday at 12:44 AM

Thank you both so much for your consideration and time!

You mentioned the risk either way - and I do see that. This is why the decision is a hard one. So I think the risk with cross tapering is not tolerating the reinstatement of the prozac very well, the stress on the body of another change from one to the other and the quick withdrawal from sertraline which , after almost 7 weeks, I'm assuming his body has adapted quite a bit to? Which means he might also get hit with sertraline withdrawals for a while too, correct? Oh my, no wonder it's a hard call

Sunday at 01:03 AM

1 minute ago, kikimom said:

the risk with cross tapering is not tolerating the reinstatement of the prozac very well,

This is a risk but because it is less than 3 months it is usually well tolerated. Generally with reinstatement it is quickly accepted back into the body. For myself, after 3 months of not having my drug, the worst of my withdrawal symptoms were quickly reversed. That is why the drug would be slowly reintroduced at a low dose and monitored closely. If there was any adverse reactions (kindling) we would adjust the doses quickly.

6 minutes ago, kikimom said:

stress on the body of another change from one to the other

There is some stress but the body is dependent on prozac and not having it is causing stress as well. Because of the long half life, the withdrawal can still become worse.

9 minutes ago, kikimom said:

quick withdrawal from sertraline which , after almost 7 weeks, I'm assuming his body has adapted quite a bit to?

Yes he has but is still in an acceptable range to do a quick taper off. Again monitoring closely and adjusting if need be.

10 minutes ago, kikimom said:

might also get hit with sertraline withdrawals for a while too, correct?

He might. We would address that if needed. Usually it is the original drug that carries the weight of the withdrawal issues.

I know this is overwhelming and difficult. It isn't fair to either of you.

I also know accessibility to meds might be an issue. Many have had to let doctors believe one thing while doing what they need to do they can get off the drugs.

It may mean getting a prozac prescription in your name. I am not encouraging lying but sometimes we need to withhold information for the sake of getting off these drugs when doctors are not cooperative despite evidence.

♥️🙏

Kiki mom introduction

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