apace41: tapering Zoloft / sertraline

[apace41]

Hi Andy. Just wanted to see how you were feeling. Has the dizziness gotten better?

 

Thanks so much for checking in, Bromor!  Very sweet of you.

 

It's been a very hit or miss thing which is kind of confusing to me.  I had a pretty good afternoon yesterday, exercised (30 minutes spinning) and felt pretty decent in the evening.  Created some level of optimism.  Woke up with the same dizziness.

 

When I say confusing I mean that I've had opinions from people I respect (which mirror my own thoughts) suggesting:

 

• Dizziness is all withdrawal
• Dizziness is anxiety-driven which is exacerbated by withdrawal
• Dizziness has nothing to do with either withdrawal or anxiety but is driven by an underlying condition in the vestibular function (you'd need to read the whole thread to understand this started in 1986 prior to meds)
• Dizziness is vestibular but is exacerbated by withdrawal

It's so confusing your head could spin.  Oh, wait, that's the PROBLEM!  LOL. 

 

Anyway, I've decided to make the assumption that it is all intertwined so I will (hopefully) be able to continue my taper in the near future which will address that piece.  At the same time I'm going to work on quelling any anxiety that is not "neuro" based through some meditation practices and other cognitive behavioral approaches as well as trying some vestibular rehab stuff online.  I'm also going to start a homeopathic aid for dizziness that contains known herbs that calm dizziness including ginger and lemongrass.  Finally, on Saturday, I will begin a Yoga class (I used to do Yoga regularly but I've been off it due to hip pain -- this is a gentle class [i'd never make it in Australia apparently!]).

 

Thanks again for your interest, Bromor.

 

Best,

 

Andy

[AliG]

Andy,   You wouldn't stand a chance over here !  LOL.     You would have to get " Yoga  Fit " and every other kind of " fit".  It's " sink or swim " . It's  brutal !  

Ali

[apace41]

Andy,   You wouldn't stand a chance over here !  LOL.     You would have to get " Yoga  Fit " and every other kind of " fit".  It's " sink or swim " . It's  brutal !  

Ali

 

Boy, Ali, after hearing from JC and you if I didn't know any better I'd think you Aussies have some kind of inferiority complex and need to prove to the rest of us how "tough" you are.

 

But since I know better I won't say that.

 

 

Andy

[bromor]

It's so confusing your head could spin. Oh, wait, that's the PROBLEM! LOL.

 

???????? ok ~ so I'm confessing this totally made me laugh!

 

I'm sure it's no surprise that I like the idea of using homeopathic meds to help with the dizziness. If you have access to essential oils, peppermint, ocotea, tangerine & frankincense are recommended to help dizziness.

 

I'll admit ~ I'm impressed with your spin class. I barely made it through working, cooking, laundry & 15 min on my treadmill. And yoga ~ well ~ *someday*.

[AliG]

 LOL .    I dare you to come over and find out for yourself  !   J.C. will back me up. It's " survival of the fittest", in " OZ" !!  We are indeed, a " tough breed" !!

[apace41]

I'm sure it's no surprise that I like the idea of using homeopathic meds to help with the dizziness. If you have access to essential oils, peppermint, ocotea, tangerine & frankincense are recommended to help dizziness.

 

I'll admit ~ I'm impressed with your spin class. I barely made it through working, cooking, laundry & 15 min on my treadmill. And yoga ~ well ~ *someday*.

 

I use frankincense, Bromor, but I will look into the others!  Thanks.  The only good thing about a CPAP machine is you can breathe essential oils through the machine all night long. 

 

It's not a "spin class" -- I'm far too antisocial for that.   It's a spinning bike that has a great program and pushes you along with it.  "In 30 seconds begin standing climb in hand position 3..."  "You're doing great! Keep hydrated."  Great way not to deal with overly enthusiastic and sadistic spinning class instructors.

 

LOL. 

 

Andy

[bromor]

Hi Andy. Thanks for stopping my my thread. Hope you are feeling less dizzy these days. I hear ya on an actual class ~ while I love being around people ~ I would just rather NOT be social while being yelled at and sweating ha! Have a great weekend.

Deb

[pocketnurse]

Hi Andy

 

In answer to your question re body pain, the only thing that ever helps is a warm bath and being asleep (not at the same time lol)! I have no pain whilst asleep but within minutes of waking I get random pains however I am aware that I hold my body in very rigid positions so my muscles are constantly tense (I should probably have a six pack). I haven't found anything else that helps. Like you I do have some health anxiety and as a nurse I can come up with many other very unpleasant possibilities for my symptoms!

Time is most likely the only "cure".

 

Sending hugs.

 

PN xx

[apace41]

Thanks for your reply, PN.

 

I edited the post to make the fix you subsequently posted and deleted the subsequent post.

 

Just keeping my thread clean!  LOL. 

 

I know the feeling about pain.  I try to fall asleep before the pain in my hips makes it hard to do so.   Frustrating!

 

Andy

[apace41]

So, I've been in an extended hold at 25mg of sertraline for the past 4 months.  The idea was that I would be going away at the end of the year and it would be convenient to be at a single 25mg pill rather than tapering while away, and, at the same time, I would get to a point where I was feeling really good and stable so I could go after that last 25mg from a position of strength.

 

To quote Steinbeck, "the best laid plans of mice and men oft go astray."  The past 4 months have seen what I would call a slow decline in my overall "wellness".  While I have done some things that would constitute stress to my CNS (such as the 16 hour drive to and from Florida) and the recent snow shoveling, I'm still not sure why "on the whole" I feel less well than I did in October when I stopped the taper.  My primary symptoms are:

 

• dizziness that is pretty much 24/7 -- to be clear, it is not for the most part room spinning vertigo-like dizziness, rather it is the kind of "floor feels unsteady" up and down kind of discomfort.  Much of it is very subjective as I can do things from a balance perspective that other people can't do who have no sense of dizziness or unsteadiness. By way of example, sometimes when my eyes are closed, so there is no external input that would cause dizziness, I have a sense of my vision (almost behind my eyes) doing a somersault (if that makes any sense whatsoever)

• depersonalization/derealization much of the time.  It is not acute in the sense of making me have a lot of secondary anxiety and panic attacks but it is there at a low level behind the scenes on a fairly constant basis.  I think I am sort of "getting used to it" and learning to manage it so it doesn't freak me out, but there are times I find it rather uncomfortable

• palpitations from time to time, but I've had those for so long that I pretty much ignore them

• anxiety that comes and goes in waves, although I am not highly anxious most of the time -- much of the anxiety is health-related anxiety where I get pains and catastrophize that it is a heart attack, stroke, fill in the blank.  I've always had some tendencies in this regard but it is much worse in the recent past

• hip and joint paint that could be from osteoarthritis per my orthopedist, but I think may well be resulting from or exacerbated by the withdrawal process

• depression which I honestly believe (aside from an occasional wave of hopeless feeling) is because of the rest of this crap.

It is important from my perspective to note that much of the symptoms that I am having can frequently be tied to or solely result from extreme anxiety (true for dizziness, dp/dr, palpitations) and my working assumption is that I had an anxiety condition 25 years ago that was essentially "put on hold" by the meds and when they became less effective in 2012 and the symptoms started breaking through leading to me deciding to get off, I exacerbated the symptoms through the withdrawal process.  In other words, I am in that conundrum of "is it withdrawal" or "is it the underlying condition" or "is it a combination of both?"  Of course, that thought process of doubting whether withdrawal is at the core is, in and of itself often a withdrawal symptom.

 

 

So, as we come up to the beginning of February, I am thinking it might just be time to start tapering again because the hold is not really helping me.  Of course, I have fear that tapering could make things worse, but I don't know that I can see any good reason to extend this already lengthy hold if I'm not feeling better.

 

I'd appreciate thoughts from people on what they think makes the most sense here.

 

Best,

 

Andy

[Altostrata]

Hi, Andy. It sounds like you're snowed in?

 

Were you ever sensitive to light? It sounds like your nervous system is getting overstimulated by something.

[apace41]

Hi, Andy. It sounds like you're snowed in?

 

Not any more, Alto.  Got out last Monday and was back at work all week.  Lots of snow but it's all just sitting around getting dirty now.  Amazing how quickly it goes from pretty to gross..

 

Were you ever sensitive to light? It sounds like your nervous system is getting overstimulated by something.

 

Never had any kind of light sensitivity of which I'm aware.  The things potentially affecting my nervous system in the recent past are work, shoveling all of the white stuff last weekend and the usual, like coffee and a glass of wine or beer at night (which I'm giving up for the foreseeable future).  Nothing out of the ordinary I can think of.

 

Any other thoughts welcome. 

 

Andy

[Altostrata]

Do you wear sunglasses when you're outside and there's snow on the ground?

 

When I lived in a snowy area (upstate NY), the glare almost gave me headaches, and that was decades before antidepressants.

[apace41]

No, I don't.  Never really thought of that.

[Flowers]

Hi Andy - It was very interesting to read your post although I am sorry you are not feeling so good lately. Like you I was given AD's for anxiety and have been on them a long time. I now think the drug was starting to lose it's effectiveness after keeping anxiety at bay for many years.

 

 

I am certainly not an expert so will leave any advice to them. Just a thought though do you think it could be the drug itself doing this to you?

 

You have done a wonderful taper so far but of course are still taking the drug. I say this because I have been trying to stabilise for a long time, more or less a year after a too quick taper. I have had all your symptoms and have come to the conclusion that although WD symptoms can persist it could be the drug doing this to me. Of course it is impossible to know until drug free which is a long way off in my case.

I have started my taper at last and am waiting patiently to see if there is any improvement.

 

Maybe if you were to do another cut it might just help.

 

Best

 

Flowers

[apace41]

Thanks, Flowers.  I appreciate the input.  That's kind of where I'm leaning.

 

Best,

 

Andy

[brassmonkey]

When I was living in the snow country in Montana we would have people contract "snow blindness" while indoors because of the glare coming through the windows.  Eye protection, even on overcast days, is very important.

 

As far as your taper goes, I think it's time to move on.  Long holds can be advantageous for a while, but for some people there's a limit to their effectiveness. A decline in well being is a sure sign that the time has come.  Don't underestimate the effects of the work stress on your WD symptoms.  My job is not in the least stressful but just the routine of getting up and out  then facing the deadlines and meetings will kick start my symptoms every time.  I'll be feeling great Sunday night, but by Wednesday afternoon everything is starting to kick up, and I'm talking the symptoms you just mentioned.  I've had those symptoms the entire way down, so I'm quite certain they're WD related. 

 

Hope you don't get buried with this latest storm.

[Altostrata]

Before making any change in your dosage, Andy, I would cut down on the visual stimulation. You may wish to wear the amber glasses while working on the computer also, particularly at night.

[apace41]

When I was living in the snow country in Montana we would have people contract "snow blindness" while indoors because of the glare coming through the windows.  Eye protection, even on overcast days, is very important.

 

Thanks, Tom.  Good reminder.  I should know that but I need to be more cognizant.

 

As far as your taper goes, I think it's time to move on.  Long holds can be advantageous for a while, but for some people there's a limit to their effectiveness. A decline in well being is a sure sign that the time has come.  Don't underestimate the effects of the work stress on your WD symptoms.  My job is not in the least stressful but just the routine of getting up and out  then facing the deadlines and meetings will kick start my symptoms every time.  I'll be feeling great Sunday night, but by Wednesday afternoon everything is starting to kick up, and I'm talking the symptoms you just mentioned.  I've had those symptoms the entire way down, so I'm quite certain they're WD related. 

 

I appreciate your thoughts, Tom.  I agree that work stress is a big aspect of this.  I'm usually pretty good by Sunday night and feel it by the end of the day Monday or Tuesday.  I agree with you regarding the need to get the taper going.  I'm going to follow Alto's advice regarding the amber glasses, and see what impact if any they have, but I intend to restart the taper sooner rather than later.  I'm not getting any younger here!

 

Hope you don't get buried with this latest storm.

 

Lots of snow.  Lots of shoveling, but able to get out and not be trapped after the weekend.

[apace41]

Before making any change in your dosage, Andy, I would cut down on the visual stimulation. You may wish to wear the amber glasses while working on the computer also, particularly at night.

 

Thanks, Alto.  Just ordered a pair of the glasses.  We'll see whether that helps.

 

Once I stabilize from this wave, I think I will restart the taper since I wasn't seeing any improvement prior to this snow event.

 

I appreciate all your input.

 

Best,

 

Andy

[Petunia]

I'm glad you were able to get some help here on your thread Andy. The way you describe your dizziness sounds like the 'boaty' feeling talked about on benzo boards. I've had that a few times since being in withdrawal, but never lasting longer than a few seconds. Before drugs I used to get it whenever I had jet-lag.

 

In other words, I am in that conundrum of "is it withdrawal" or "is it the underlying condition" or "is it a combination of both?" 

 

 

If you had a tendency for anxiety previously and haven't done anything to address that, which you may have, then my guess is its likely to be a combination of breakthrough of previous 'condition', withdrawal exacerbating previous condition, which it tends to do and pure withdrawal stuff.

 

My prediction   is that once you're safely tapered and recovered, most of it will resolve itself and you will be left with your original anxiety which will be more manageable now you have some tools and skills.

 

I hope the glasses help.   

[apace41]

Thanks, Petu.  I appreciate your thoughts.

 

That is the right description -- the "boaty" feeling.  Like you can't get your "sealegs." Sometime worse than others but after a while it starts to wear on you and it also causes a stiff neck because you aren't moving freely.

 

I think I am learning more coping tools now than I ever had to before.  Once this is behind me (please God), I think I will be better able to deal with some of life's stuff than I was when I was 24 and put on the meds.

 

Best,

 

Andy

[bromor]

Andy ~ you will have awesome coping skills when you get through this!!! For what it's worth ~ I think the Zoloft was a bandaid applied to your (& mine....I was put on Zoloft for anxiety) symptom. The real reason whether it be physical or mental wasn't dealt with. This is just my own opinion but I think that my personal anxiety had physical, emotional & mental roots ~ it's been like putting a very complex puzzle together for me to figure out how to fix the imbalance not just alleviate my symptoms. (Although, my word!! I do want those GONE!) keep us updated on how you're feeling. Oh & mag taurate really helped my heart palps.

 

Have a great day! ☀️

[apace41]

I agree with your assessment, Bromor.

 

Now the question is whether the dizziness was a symptom of the underlying condition or the underlying condition itself, i.e., was it anxiety-induced dizziness?  Never felt that anxious but perhaps it was long-term low level fight or flight?  Hard to say.

 

I appreciate your kind words and I'm continuing to fight the good fight.  As with all, some days are better and worse than others.

 

Best,

 

Andy

[Altostrata]

Andy, has reducing light stimulation helped at all?

[apace41]

Andy, has reducing light stimulation helped at all?

 

Thanks for checking in, Alto.  It's only been two days since I got the glasses so it's a little hard to say.  Maybe a touch, but it seems to vary a fair amount with my stress level.  I'm reading "when panic attacks" which is a CBT book to try to get some ideas to cover that angle as well.

 

I must say, however, I look pretty cool in my new amber shades.

 

LOL.

 

 

Andy

[brassmonkey]

"I must say, however, I look pretty cool in my new amber shades."

 

Image is 90% of the battle. LOL

[bromor]

Read an article about the MTHFR mutation causing dizziness ~ I know you said you had gotten testing done before.... Anyway, if I can remember where I read it, I'll post the link. It was very interesting.

[apace41]

Thanks, Bromor!
 

I really appreciate your thinking of me.

 

I'd love to see that if you can find it.  Hope you are feeling well.

 

Best,

 

Andy

 

[bromor]

Of course I can't find it now!! Anyway, if you search for info on MTHFR & symptoms ~ there is a ton of info out there. Very interesting. Next time though I read something like that, I'll at least put a note in my phone because gone are the days when I had a good "rememberer"

[Serenity23]

Of course I can't find it now!! Anyway, if you search for info on MTHFR & symptoms ~ there is a ton of info out there. Very interesting. Next time though I read something like that, I'll at least put a note in my phone because gone are the days when I had a good "rememberer"

 

Just wanted to chime in that last January when I had that stroke-like event happen, I had been following a plant based diet for a few years.I was taking a multivitamin that had some B12 in it, but I wasn't taking a separate B12 supplement. I was convinced at the time, that the neurological issues were from lack of B12. I asked my doctor for a shot of B12, and I took some sublingual at home. I almost "broke his machine" because my B12 was so high when it was tested.

 

When I was in the hospital, I assertively asked for the MTHRF test. The doctor did it, and it came back that I didn't have the gene. Another doctor told me that the MTHFR test is a complete waste of money. I am convinced now that my neurological issues had nothing to do with a lack of B12, and all to do with my tapering too fast off of zoloft as well as whatever underlying anxiety still was present.

 

I stopped eating plant based from the time I was in the hospital, to the present day, to try and eat more balanced and to show them that I wanted to do everything in my power to improve my health. My B12 labs were still normal in the hospital.

 

B12 deficiency is rare unless you're on a 100% whole foods plant based diet without some sort of B12 supplementation.

[apace41]

Of course I can't find it now!! Anyway, if you search for info on MTHFR & symptoms ~ there is a ton of info out there. Very interesting. Next time though I read something like that, I'll at least put a note in my phone because gone are the days when I had a good "rememberer"

 

Thanks, Bromor!  I appreciate your looking.  I have read several other pieces on MTHFR and understand how some people think it could be a factor. 

 

 

When I was in the hospital, I assertively asked for the MTHRF test. The doctor did it, and it came back that I didn't have the gene. Another doctor told me that the MTHFR test is a complete waste of money. I am convinced now that my neurological issues had nothing to do with a lack of B12, and all to do with my tapering too fast off of zoloft as well as whatever underlying anxiety still was present.

 

Thanks for your note, Serenity.  I think the notion that MTHFR is "worthless" is an overstatement by that doctor.  I think a better way of saying it is that "it proves too much in some people".  In other words, just because you have the gene (especially if you are heterozygous), it is hard to know how much (if any) effect that has in any one person.  For some people, the MTHFR can significantly impact things like homocysteine levels and related heart disease, but for others there is no such correlation.  I think it can simply serve as a marker for things you might want to keep an eye on.  In addition, because the fix of adding methyl folate is so simple and inexpensive, it's probably worth a try for most people (of course, MOST people are not in SSRI w/d where adding a B complex vitamin can be too activating  ).

 

Best,

 

Andy

[bromor]

Hi Andy. How is the dizziness? Hope it's abated some. Are you currently tapering again? Just wanted to check in with you.

[apace41]

Hi Andy. How is the dizziness? Hope it's abated some. Are you currently tapering again? Just wanted to check in with you.

 

Thanks, Bromor!  I have to make a true confession that might get my "moderator license" revoked!

 

I started what I THOUGHT was my reduction last Monday.  I took a combo of pill and liquid for 5 days.  In the middle of the night Friday I had some unease when I realized something was wrong.  It struck me that I had been making a liquid using a 1:1 ratio of liquid ml to mg when the ratio is really 1:2, i.e., I was using 32.5mg instead of 22.5mg for 5 days.  I decided to the next (Saturday) to drop back down to 25mg for as long as it takes to stabilize and then start my PROPER reduction. 

 

Since I passed the 4 days it takes for the meds to take hold in the body, I am definitely feeling the drop from 32.5 to 25.  I figure it will be a struggle for a couple more days but I'm hoping that's all it will be.  I was NOT going to taper from 32.5 for this small mistake.  I really don't believe this will be a longer term problem. At least I hope not.

 

So, long story short, it's probably not the best time to be asking about my symptoms!

 

Hope you are doing well.

 

Best,

 

Andy

[brassmonkey]

Hi Andy-- sorry to hear about the mishap with the dosing.  Luckily you caught it pretty quickly.  It shouldn't cause trouble for too long, so there is no need to taper from the 32.5.  Taking it in a couple of steps like you're doing should work fine.

 

Don't  worry you won't loose your license, but we will be giggling behind your back. LOL  Hey guys, did you hear what Andy did? 

[apace41]

Hey guys, did you hear what Andy did? 

 

You are merciless, Tom!

 

I knew it. 

 

LOL,

 

Andy