GoodSarah: 26 weeks pregnant and tapering off zoloft- life is rough

[Altostrata]

Very good to hear!

[GoodSarah]

HI all- another check in- I'm down to 5mg!! yay!!! Overall things are going well- no tummy issues in forever now. I had a cold/flu virus for over 2 weeks that I'm still at the tail end of so my energy has been down and I had a few days of serious depression during the illness. But it didn't feel like WD-more like being emotionally and physically exhausted from being sick for 2 weeks and pregnant plus dealing with the taper. Sleep continues to improve- it's still quite broken and sometimes I have bad nights but Im feeling like it's better quality sleep most of the time. I'm on day 4 of 5mgs- and on the second night I had a moment of panicky feeling in the middle of the night- which hasn't happened in awhile. But since I've been using mindfulness meditation and reading up on a mindset of acceptance I was able to let it pass and I did get back to sleep that night. So that might have been a bit of WD. If all goes well I'm going down to 2.5 then jumping off-can't wait!!!! Baby will be here in less than a month!

[GoodSarah]

HI all- here's an update-

 

I had the baby 6/16 (<3 her!!!) I was still on 4mg sertraline. I had post-partum euphoria for a few weeks and just went completely off. I'm not sure if that was too dramatic of a drop off, or if Post Partum stuff kicked in , but right after I quit I crashed super hard. As you may remember, insomnia has been my biggest issue (the reason I was put on meds to begin with) And it came on with a vengeance. I even experienced suicidal ideation, which was new and really scary.

 

Desperate I went to a new psych doc and agreed to try Lexapro. Tried it for almost 2 weeks and started experiencing side effects like upset stomach and hot flashes. Went off it over a period of 5 days, Slowly things have started to improve for me. I feel so much more like myself. I don't have much panic or anxiety anymore and I'm not depressed  much. I'm even considering starting back at a part time job (baby is almost 4 months old)

 

Currently I have been AD free for almost 2 months. The insomnia has gotten better. I use Remeron 7mg very occasionally to sleep. After my insomnia hell I'm grateful there is a med that does help me ( i know it doesn't help everyone and believe me I've taken many sleeping meds that didn't work)  I take i about 1-2 X week. But my goal is to be completely med free in the near future. I'm still on the path to recovery but really glad to be off the SSRIs- they are so NOT helpful in any way. Thankfully I found a Nurse Practitioner who understands that they don't work for me and is working with me to become med free. I feel some guilt when I need the remeron. I wish I could just sleep like a normal person. But I keep telling myself I'm still inrecpvery (from the birth and from the meds and from mental health isssues) and I shouldn't beat myself up for needing the med every now and then.  Any thoughts on this? I know this board doesn't support psych meds in general-I'm just really hoping the remeron is a temporary solution and my sleep will continue to even out. Like I said I use it 1-2 X week 1/2 a pill.

 

Hang in there everyone!!!!!

[tgirl]

Hello Sarah,

Congrats on the new baby! I bet she is beautiful.

 

Just wanted to add that remeron is also a psych drug, and a very powerful one at that. It was also need tapering.

 

Just wanted to say congrats!

Tgirl

[Purplestars22]

Hey Goodsarah, congratulations on your bundle of joy. Have you tried melatonin to sleep? This thread might be helpful: http://survivingantidepressants.org/index.php?/topic/53-sleep-problems/

[GoodSarah]

HI guys- My insomnia has been such a beast. I could write a book on proper sleep hygiene since I've been to so many doctors and a therapist. Luckily things have turned around a bit for me. I was sleeping 2-4 hours a night for months straight during and after my pregnancy no matter what I tried including a lot of supplements, OTC meds, and some perscriptions.  I totally get that Remeron is a psych med. My goal is to be completely med free. But it works for me when I need to sleep and can't. For me, to have 1 or 2 bad nights a week is a huge improvement and I'm hoping the upward trend continues. As far as tapering remeron-I'm not sure how that would work since my use is only occasional. But yeah I know it's a short term crutch. I'm still on the road to recovery...

[mammaP]

Hi Sarah, thanks for the update and congratulations on your new baby daughter.   I'm glad that things are improving for you and sleep is getting better. That withdrawal insomnia is terrible!  

[GoodSarah]

Hi all- just checking in. Baby is now 6.5 months old. I've been off the zoloft since the end of June. Sleep is a big issue still. It's so off and on. For a couple weeks I was sleeping great, 8-9 hours solid. Then I went through a phase where I would get crappy sleep 1 night and good sleep the next. Then a few good days then a few bad. Well right now I guess I'm in a bit of an insomnia wave again. It's so incredibly frustrating. Everything is so unpredictable and I have a baby to take care of all day. I was really proud of myself, I didn't use any mirtazapine for sleep for almost a whole month. But now that the insomnia is back I've been relying on it more than I care to admit. I know it's better to deal with this issue without drugs. But when I'm laying in bed for hours ad I know baby i going to wake up at 7am whether I sleep or not, well I just can't take it then and I cave in. If I didn't have the baby I might be better at toughing it out. I'm hoping this is just part of the healing process. I was only on the zoloft for about 4 months. My sleep issues started in my second trimester of pregnancy. Maybe it's hormones. Who knows. Anyone else out there carrying on with life despite the insomnia? I find it's better to stay busy. If I stay home and don't do anything I get really anxious and feel more exhausted.

[bubble]

Hello Good Sarah and thank you so much for coming to update us. Congratulations on your little one

 

I'm so glad that despite everything on balance things worked out well for you.

My concern is now your Remeron use. Remeron is an antidepressant, it's not a sleeping pill. Using antidepressants on the as needed basis is very destabilising for the brain.

 

Here is our information on Remeron: http://survivingantidepressants.org/index.php?/topic/5301-tips-for-tapering-off-remeron-mirtazapine/

 

If you decide that you can't manage your inosmnia with non drug methods it would be less harmful to take it regularly as it is supposed to be taken, maybe at a very low dose, lower than what they call 'therapeutic'.

 

Wishing you a continued improvement.

 

[GoodSarah]

Hi Bubble, im feeling very trapped and upset. I really don't want to start a daily regimen of any psych meds. It sounds like mirtazapone is a real tough taper and that's scary. But it makes sense that intermittent use could be destabilizing. I just don't know what to do. When I was improving I felt so good like I was getting back to the real me. I went a long time without using the mirtazapine. All of

October and November I only used it on the first night of my period ( I'm extremely sensitive to hormones) or when I was sick and couldn't sleep due to discomfort. Now all that progress has been erased and I feel like I'm faced with selling my soul to the devil in exchange for drug induced sleep. Insomnia was the original issue that got me on the psych-train in the first place. Most people sleep well after a night or two of insomnia. During and right after mympregnancy I went weeks upon weeks with 2-3 hours of sleep to the point of feeling hopeless. I considered impatient hospitalization. Thankfully I'm lasses that point partially because the mirtazapine has "saved me" a few times. I just don't know what to do. I wish my brain was a normal brain. I'm about to start my cycle and I'm praying that ends this recent insomnia wave. If it doesn't then I feel like i will have to make a very

Hard decision about where to go from here. If there's anyone else fighting extreme insomnia

I would love to hear your thoughts

[Meimeiquest]

Kelly Brogan is a pdoc (very expensive, I think) who works a lot with peripartum issues. This won't help right now, but she has a book coming out in March entitled something like "A Mind of Her (or Your?) Own" about depression in women. Maybe that will have some ideas. Until then, she blogs at kellybroganmd.com.

 

Whether correct or not, Mensah Medical believes copper elevation is involved in a lot of peripartum psychiatric stuff, when the copper that rises in pregnancy doesn't come down correctly. Foods rich in zinc and vitamin B6 might help if that is the case.

 

We have some threads on sleep problems that you can search out. If you Google (not a search inside this site) survivingantidepressants fatigue insomnia you should be able to find them. Inositol is my personal favorite, but everyone seems to be individual.

 

Good luck to you and your family! Please don't let angst over this overshadow these special days...I know easier said than done!

[Altostrata]

Sarah, insomnia is very common in new parents.

 

There are many supplements and maybe herbs that might help you lower your nervous system reactivity -- they tend to be subtle, but they are fairly safe. Here are our suggestions Important topics about symptoms, including sleep problems

 

Meditation is a very, very handy skill for many purposes, including settling down to sleep. Some people like yoga, too.

[Songbird]

I don't think all your progress has been erased, it could just be a temporary wave.  I know how it feels to need a med for sleep - there have been times when I've used zopiclone for a while when nothing else worked (usually when in severe withdrawal from a crash).  Here's my thread about it: http://survivingantidepressants.org/index.php?/topic/7862-reasonable-use-of-z-drugs-for-sleep/. The main points are to use the minimum effective dose, and then gradually reduce it.

 

In Wikipedia it says: "Mirtazapine is a very strong H₁ receptor inverse agonist and, as a result, it can cause powerful sedative and hypnotic effects.^[5] After a short period of chronic treatment, however, the H₁ receptor tends to desensitize and the antihistamine effects become more tolerable."  I know Wikipedia isn't the last word on anything, but it does suggest that if you're taking mirtazapine for sleep you're probably better off with just occasional use, as it might become ineffective if you took it every day. 

 

The main problem I see with it potentially being destabilising is that it affects many receptors, especially serotonin receptors.  It seems to be one of a number of psych drugs that are sometimes used for their sedative/hypnotic side effect, because they act as anti-histamines, but this seems to ignore all the other receptors they also affect.  For example, I was prescribed Seroquel (an anti-psychotic) for sleep by one psychiatrist, who believed it was safer and less addictive than zopiclone, however the Seroquel didn't work well for me for sleep and did other weird things.

 

I am also sensitive to hormones and got on the "psych train" with PPD anxiety and insomnia.  These days I often experience insomnia as part of PMS, although not with anxiety and not nearly as severe.  I find melatonin and valerian helpful, and there are other herbs and supplements that can help, such as passionflower, chamomile, lemon balm and hops.  Relaxation exercises and sleep CDs can also be helpful.  At my lowest point, when I was in extremely bad w/d and couldn't sleep at all, a sleep CD saved me.  Also doing relaxation exercises regularly.  So there are lots of non-med things you can try.  Individual responses to herbs and supplements vary a lot, so there may need to experiment to find what works for you.  Start with small doses in case you are sensitive, and introduce only one at a time so you can see what effect it has.

 

You could consider "crossing over" from a med to a supplement - for example, introduce melatonin, and take a slightly reduced dose of your sleep med, and then taper the med down while staying on the melatonin (or whatever it is).  This is how I've managed to get off zopiclone in the past - I used it with melatonin and valerian, and reduced the zopiclone dose down gradually until I was sleeping with just the melatonin and valerian (which I later also tapered).   You do have to be careful about combining things - technically you shouldn't combine zopiclone with valerian as they both affect the GABA system, however I was taking relatively low doses (unlike the Seroquel, which I needed a big dose of to actually work). 

 

Another thing that helped me a lot was positive self-talk to reduce my bedtime anxiety (I don't have it now, but did for a long time).  For example, telling myself over and over that whatever happened, I would handle it.  Also, tricking my brain by telling it I was just going to lie down and rest, thereby reducing the mental pressure to "fall asleep".  I would just lie down and rest, and rest is a good thing (and if I happened to fall asleep, that would be a bonus) .

 

Sorry if I'm rambling on a bit.  Just would like to assure you that people here have faced similar issues, so we understand, and you don't have to sell your soul to the devil just yet, as there are other options to try. 

[GoodSarah]

I'm done with mirtazapine. When I first took it it knocked me out and I was groggy the next day. I took it 1-2 x week for about 3 month, sometimes

Much less frequently if I was In a sleep window. But now it has basically no effect. I suppose it's for the best since I don't want to become dependent or have to taper it. I'm trying a valerian supplement at night - it helps a bit but it's not a knockout. For some reason my brain is super resistant to sedatives and sleep meds. Over the years I've stayed up through Klonipin Xanax ambien hydoxyzine trazodone lunesta and now mirtazapine. I had a bout of sleep problems about 8 years ago (I'm 29) which is when I tried most of these drugs. I wish I could just take an OTC pill or

Melatonin but I guess I'm wired to be resistant. For the past few nights I've been sleeping but very fitfully. I dream a lot but I wake up a lot it's not very restful. I really hope our baby never has to experience insomnia like this. I'm still glad not to be on Zoloft though.

[GoodSarah]

Today is rough. Two days ago I decided to stop using the mirtazapine. Night before last night was fine- got plenty of decent sleep. But last night was the worst night I've had in forever. Not only did I not sleep at all( this is very rare for me I usually at least sleep a few hours even on a bad night). But I threw up and had tummy problems. And I also had brain zaps! I haven't had brain zaps since I was in the Zoloft. I will admit I'm scared and pretty anxious now. Ive taken long breaks from the mitt before with no issues so I'm surprised that I'm doing so poorly now. I guess my fear is that some tipping point has been reached and now my

CNS is destabilized again?

I'm in therapy and am just starting to re-enter the workforce and doing some volunteer work with post party's women. Sorry if I sound whiny or depressing. As Alto said I know that insomnia happens to a lot of new parents. It's just really hard. I really hope I stabilize soon and can recover from taking the mirtazapine willy-nilly. I should have known better. But it was working really well for awhile and I foolishly thought that using it sparingly would be ok. Who was I kidding I feel so weak and dumb now.

[Ouarezki]

Hi sarah: first of all CONGRATS on the baby you're a brave woman!

 

I used t have TERRIBLE insomnia, with tremors the LOT. I would dread night time so much...but remeron cured that for me, i got good night sleep after soo long and evenually it took the fear of night time away: so i beleive it cured me from that.

 

Afte a while i discontinued myself and I've never had insomnia for more than a day!!

 

Trust me you can do this, don't worry too much about tapering, just get some sleep thats what matters and soon you'll ween off confidantly.

 

 

Unfortunalt I'm pregnant now and I had to cold turkey, i'm having a terrible time with it all, would love some advice, I keep thinking i won't feel joy for the child, i don't now, and will not eveer

[GoodSarah]

Hi there oaurezki congrats to YOU too ???? every woman's post partum experience is different. It's really common to worry about bonding with the baby and sometimes it takes a few months to get that " in love " feeling. Amazingly, I have tremendous love for my little baby girl.

It's so funny because her existence ( from conception) was and has been to cause of much suffering for me- it's what prompted my psych med journey. Somehow my love for her doesn't seem to be diminished even though I continue to suffer. Keep me posted on your pregnancy I'd love to stay in touch. I think nature has a way of binding mom and baby despite the hardship

[Sarabera]

HI Sarah,

Thanks for stopping by, it really helped me get through the day to know that others in my situation can function somewhat on 2-3 hours sleep. I actually started feeling better as the day went on. Sorry you had such a rough night, I'm sure things will look better soon. I can't give you any advice on the mirtazapine as I am in a very similar situation with flurazepam--debating whether to use it to try and taper down to better sleep after 3 horrid nights. Don't blame yourself for what you did--we do what we do to function, trying to get the best info we can at any time. Have you had any of your hormones tested?

Sarah (bera)

[Songbird]

But it was working really well for awhile and I foolishly thought that using it sparingly would be ok. Who was I kidding I feel so weak and dumb now.

 

Don't beat yourself up, using things sparingly can work for some people.  Also, you have other stresses going on, like re-entering the workforce.  You could be worried about this, even at a subconscious level, which could be impacting your ability to relax and sleep.  The combination of withdrawal and stress can really exacerbate things.  Have you tried relaxation exercises?

[GoodSarah]

Hi Sarah- I had my hormones tested and my progesterone was slightly below range. We're rechecking next month to see if it's still low. The problem with being post partum is that hormones are all over the place right now so it's hard to say if/how imbalanced I am. It would be nice if there was something tangible like that to point to though.

 

Songbird- thank you for being so kind. I really need support right now. I've experimented with mindfulness and breathing exercises. I do like the work of John Kabat-Zinn. But after almost a year of this insomnia I have a hard time putting faith in their effectiveness  for me. Almost like it hurts too much to hope it will help.  Do you have a favorite? I'm open to suggestions

[Songbird]

Talking about post-partum hormones reminds me of when I originally crashed about four days after the birth of my first child.  Not long after going home I kind of readmitted myself to hospital as I wasn't coping.  A kindly midwife who I used to talk to in the middle of the night told me about some doctor she'd heard of who treated people with natural progesterone, but I didn't get his name.  Later I ended up going the psychiatrist and meds route.  I have often wondered what would have happened if I'd been able to have natural hormone treatment instead.
 
The relaxation exercise that saved me during my big crash was a yoga DVD called "Just Relax" by David Swenson.  The reason it worked so well for me was because I had severe akathisia, making lying still almost impossible.  The DVD starts with gentle yoga movements, so I was able to calm down my nervous system first while moving, and by then was able to lie still for the progressive muscle relaxation and visualisation parts.  I've also created my own relaxation exercise recordings here: http://survivingantidepressants.org/index.php?/topic/10981-relaxation-exercises/ however they were created quite recently so I haven't use them a lot.  Maybe some SA members can test them out and see if they are helpful to anyone, lol.

 

I understand not wanting to get your hopes up and having them dashed.  I think part of the work we have to do is accepting whatever happens.  I mean, not putting pressure on ourselves to fall asleep, and telling ourselves that whatever happens, we will handle it.  Some self-help people would call it not being too attached to a particular outcome.  Not easy when we want that outcome desperately, I know.

[Sarabera]

Hi Sarah,

Checking in to see how it is going....hope you've had some respite from insomnia!

Sarabera

[GoodSarah]

Thanks for checking in Sarabera- as usual sleep is a fickle mistress. Last night I only slept 1-3 hrs ( not sure since i don't look at the clock anymore) but the night before I got 8 or9 hours without any meds. My stupid psychiatric NP wants me to try trazodone again even though it hasn't worked in the past. Right now I'm just trying to ride this wave- kind of white-knuckling it. I do have hope because I've had significant sleep windows before. And my situation is pretty complicated. I did come off Zoloft right when I had the baby in June but I'm also PP and my husband is unemployed and we have a new baby so I've got a lot of factors. At least I get to see my therapist today

[Sarabera]

That's great that you have nights of good (non-drugged) sleep, very good sign. Hope you can tough it out and get to a better spot. Trazadone is very similar to the drug that I am on (amitryptiline). Trazadone never worked much for me for whatever reason--just made me feel like a zombie. You've got a lot on your plate, so take good care of yourself in every way possible. My husband says I could have never survived having a baby--he's probably right!

Sarah

[Songbird]

My stupid psychiatric NP wants me to try trazodone again even though it hasn't worked in the past.

 

That does sound stupid.  Why does he/she think it will work now when it never did before?

[GoodSarah]

Hi everyone I'm really reluctant to post now because I've pretty much had to rely on Xanax for sleep for most nights. I feel so guilty and horrible about this. I've tried so many things for sleep. I've had a few good sleep Windows and I'm still hopeful that they will come back. But unfortunately Xanax is the only thing that gives me sleep. I've tried touching it out and just dealing with the insomnia. But mine is so persistent. I never crash. When I'm in a sleep wave I go

For nights in end with 1-3 hours. I have an infant at home and I work part time. I hate saying it but the Xanax is saving me. I know it's dangerous and it could turn on me. Maybe I'll have to join the benzo forum. Right now I'm just trying to be honest about what's going on. I don't think the insomnia is withdrawal related as this was the original issue that brought me to psychiatry in the first place.

[Meimeiquest]

My doc just suggested lemon balm for me. He says the usual dose is 1000mg twice daily, 400 mg twice daily seems best for me. Not that my sleep is perfect with it, either. And you've probably already tried it,

 

Thanks for keeping in touch. I was prescribed a benzo for sleep too...and life goes on. It sounds l like you are doing okay otherwise?

[GoodSarah]

I'm doing ok. I'm learning to live a life again and sometimes I'm happy. I love baby and she's healthy and happy. My hubby is unemployed and that's stressful . But yeah when I use the Xanax and get sleep I'm much happier and feel almost normal. Thank you for saying hello Meime!

[Flowers]

I wouldn't be too hard on yourself - you know the risks of benzos and maybe you will find something else more natural that helps just as well. But you have to think of your life with a little one which would be almost impossible with only a couple of hours sleep. Maybe your sleep will get back to a normal pattern soon without the Xanax.

 

Best Wishes xxx

[Sarabera]

I'm having a benzo issue too....Must be the time of year?! I used up all my Ambien, now into the flurazepam. It's all kind of a mess right now so I won't go into it so much, just want you to know you are not alone. I've got an appt. with a psych nurse on Friday, and a couple of names to go to, so really hoping something works out and I can get some help with this. All I can say is try and keep your dose as low as possible and steady. This really sucks, and I hope with the turning of the season things get a bit easier. Have you ever tapered a benzo?

Sarah

[GoodSarah]

Thank you Meime, Flowers, and Sarabera for your kindness. I was really feeling bad about my situation but now I feel glad I can be honest. I'm still hopeful. I've had windows at times when I thought all hope was lost so that knowledge keeps me going.

I've used Xanax very sparingly since baby was born ( like 3-5 pills a month) but now it's most nights. I've never tapered because it's never been my go-to so this is kind of new. Sara let me know how your appointment goes- right now I'm just going with it with the Xanax and trying not to freak out about it

[Ssriwarrior]

GoodSarah, 

 

I work with postpartum women for a living and wanted to share my 2 cents: 

 

-if I had to choose a psych drug to rely on in the postpartum period it would always be a benzo over an SSRI.  Yes, I understand the guilt, and dependency fears, but I think SSRIs tend to be worse overall.  

 

-have you had your thyroid checked?  A full thyroid panel?  Insomnia is very common with hyper thyroid, and thyroid dysfunction is super common postpartum. 

 

-do you supplement with Omega 3s?  Magnesium (chelated or glycinate) 

 

-Vitamin D is often low in postpartum women and related to sleep 

 

-Ashwaghanda is good for hormone balance, sleep, and thyroid balance if you are no longer nursing.  I recommend it before Melatonin bc Melatonin is a hormone and your hormones don't need any more hormones.  

[GoodSarah]

Hi all- it's now been one year since I took my first pill of Zoloft. I'm glad to have ditched it. My update is: about two weeks ago I injured my neck/back fairly badly. I don't even know what exactly I did as the pain came on over a few days. My suspicion is that j must have wrenched it while handling baby. She is almost 8 months and definitely over 20lbs. I've never had any injuries so it's been hard and it's slowing me down. I have to take 5 mg of flexeril every 6 hours until I can get into PT which hopefully will be soon ( just got a referral today) I have mixed feelings about this new med. I am now so wary of any pharmaceuticals. But it has helped the pain ( pain is a level 7) and I can move again . I have to be able to function because I work part time and care for an infant all day.

The weird thing is - I've been sleeping great!!! I haven't taken a Xanax or mirtazapine in over two weeks. I know the flexeril is belong with that but I actually started sleeping before I injured myself. I'm so grateful but it's ironic that I'm enjoying a sleep window but am also dealing with this injury. Life is just relentless sometimes. I know my sleep window might close but glad it's here now. Windows make waves so much more bearable. Also I'm glad to have a break from the Xanax because I do not want to develop a dependence. Best case scenario this window is a nice long one

[Sarabera]

Fantastic to hear that you are sleeping again! Flexiril is a muscle relaxant? don't know a whole lot about those. I have found that I usually injure myself from having a combination of stress plus heavy/unusual lifting. I do a lot heavy lifting with my job, and it is rarely a problem for me. Pain meds (almost all) actually slow healing, so take the minimum you have to, to get by. Having a break from the Xanax is really good. Could be that your hormones are adjusting back and helping you sleep better, hopefully it is permanent!

 

Meeting with the psych nurse was a disaster! She told me to "just quit" both drugs, wouldn't give me a small prescription to help taper the benzo (but was willing to offer all kinds of other drugs, including Seroquel), and didn't believe in withdrawal symptoms. So I did a fast taper (forced) off of flurazepam that is going okay. I was actually sleeping great for the most part with the benzo and while tapering, but now my usual crappy but livable sleep is back (sleep in 2 to 4 hour chunks). Hope to be in a position to tackle amitryptiline soon.

Sarah

[Sarabera]

Hi GoodSarah,

Thanks for stopping by, my situation is kind of a mess right now. Hopefully I can figure a way out of this soon. Glad to hear you've had a break from the psych drugs, every day off is a blessing!

Sarah

[GoodSarah]

Sarabera- all I can say is I've been in the "mess" a bunch of times. I've learned to try to accept those times. It's ok to be in survival mode. You've had periods where you were sleeping better, it's likely that will happen again even if only for a short period of time. For me just the knowledge that I've had sleep Windows helps me get through a sleep wave. It's gotten better when I felt like any relief was beyond hope of hope. I haven't yet had any sustained Windows(like months at a time) but knowing there out there keeps me going. Keep me posted

Sarah