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Lakelander82: Sertraline general query and tapering info


Lakelander82

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I'm new to this site so please bear with me. Basically I want some advice and info regarding the tapering of Sertraline. I have taken Sertraline 50 mg for about two years now and feel "normal" on this dosage. I've tried to taper unsuccessfully before usually by halfing my dosage. Since last Saturday I've been taking 25mg but I feel like a different person on this dosage. I feel fragile, irritable, I'm hyper stimulated by small sounds and I just don't feel "with it" so to speak. On the lower dosage I feel less confident in public and more easily overwhelmed/upset and I also cry quite a bit. I also don't feel like leaving the house on the lower dose (I force myself most times) but on the 50 mg I leave the house freely. Socialising is a major problem for me.

Mornings are a really bad time for me - I can wake up with varying degrees of anxiety mostly mild to moderate but sometimes severe. My only problem is that an hour or two upon rising my mind/brain simply goes DEAD. This is the only word I would use to describe it. I will simultaneously become fatigued/weak/Tearful/, my memory/concentration will plummet and all I will feel like doing is going to bed. I won't have the energy to deal with or be around people or solve any problems. Once the tablet kicks in a few hours later I will generally be ok. I sometimes get this horrible feeling in the evening time about 9- 10 PM but generally the MORNINGS are far more common. These effects are far more pronounced at 25mg than 50mg.

Is this horrible feeling down to the withdrawal effects of the dosage reduction or is it down to my depression still being unresolved? Would the effects at 25mg be any different even if I tapered down by 10% from 50mg? I sometimes feel that it doesn't matter what way I taper the dose, I will still return to being depressed once I'm on a lower dose or zero dosage. Is my brain totally dependent on these things to function???

If you function ok with the meds is it worth the hassle/ side effects trying to function without them?
I would be really, really grateful for your thoughts and opinions guys.

May 2007 - October 2007 Citalopram 20 mg od. 1st Antidepressant ever taken. No problem with fast taper and no withdrawal effects. No antidepressants for over 5 years.

 

January 2013 started Citalopram 20mg.

March 2014 Switched to Sertraline 50 mg od.

23rd June 2016 started taper 45mg

23.07.16 40.5mg 23.08.16 36.45mg 27.09.16 34.65mg 24.10.16 32.90mg 28.11.16 31.26mg 04.01.17 32mg 25.02.17 31mg 22.03.17 30mg 14.04.17 29mg 09.05.17 28mg 07.06.17 27mg 08.06.17 26mg 13.07.17 25mg 07.08.17 24mg 24.08.17 23mg 13.09.17 22mg 12.10.17 21mg 10.11.17 20mg 04.12.17 19mg 01.01.18 17mg 25.01.18 15mg 22.02.18 13.5mg 25.03.18 12.15mg 

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  • Moderator Emeritus

Hi Lakelander and welcome!

 

You're asking great questions and found a good place to get some suggestions!  It looks as if you've read some threads on the forums-- you know about the conservative 10%/month approach recommended here.

 

It is very likely that what you describe are withdrawal (or the preferred manufacturers' euphemism "discontinuation") symptoms.

 

Many, many people have safely discontinued psych drugs. Several of the moderators and members here have taken multiple drugs and are now either completely off them, or are taking themselves slowly off and doing well.

 

I'll leave your questions about dosage for one of the moderators, who share knowledge and will discuss best ideas for you.

 

Have you had a look at the: Tips on tapering off Zoloft (sertraline) aka Lustral?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results

Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to  0.0 mg  Aug. 12; details here


scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet

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  • Moderator Emeritus

Hello Lakelander82 - welcome to SA!

 

I have moved your post to create an Intro topic for you, since this is about your situation and you are new here.  Your intro is where you can ask questions about your situation, give updates, express concerns, and generally document your journey.  By clicking "Follow" above, you will be notified when someone responds on your thread.  Bookmark your Intro so you can find it more easily.

 

Please fill in your signature block with your drug information, including dates and dosages to the best of your knowledge, and any other drugs that you take.  This appears at the bottom of all your posts so that people can see your history at a glance.

 

Please put your Withdrawal History in Signature

 

Your 50% cut from 50 to 25 mg sertraline is causing you withdrawal symptoms.

 

Introduction to AD Withdrawal Syndrome

 

It sounds as though you are going through daily Windows and Waves Pattern of Stabilization due to tapering too quickly.  This causes Neuro Emotions which feel like we are relapsing from our original condition.  People commonly feel worse for the first part of the day and rally in the late afternoon/evening.

 

We recommend a much gentler taper schedule.  Why taper by 10% of my dosage?

 

It helps to understand a bit more about what happens to our brain while on these drugs:  Brain Remodelling (Rhi's Description of Brain Healing)

 

Once you have read these links, you'll be better prepared to come off sertraline successfully.  Right now, it may be best for you to reinstate to 50 mg, since you'd only been down to 25 mg a week, and then do a properly slow taper from there.  We recommend reinstatement when a big drop or cold turkey is recent, as it is the best way to avoid extreme withdrawal symptoms.  

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

Once you have been stable for a few weeks on the reinstatement, you can then resume tapering.  Of course, reinstatement is entirely your decision.  You will need to give your nervous system time to settle down before trying again.  Here is information about tapering sertraline:

 

Tips for tapering off Zoloft (sertraline)

 

Please come back with questions.  You will find SA a very supportive place!

 

SG

Started ADs back around 1995 after bad break-up, starting with Prozac.  Switched to Wellbutrin, and then to Effexor in 2002
Effexor XR 2002-2014 up to 225 mg at one point, down to 37.5 mg towards end but back up to 75 mg in 2014; now realize I had W/D as I dropped down, memory very poor about history.  Extreme emotions, poor concentration as I stepped back down, didn't connect the dots!
Summer 2014 reduced to 0 very quickly, was sick of anhedonia/sexual dysfunction due to meds, depression never controlled if not worse. Didn't recognize WD since symptoms built slowly (thought I had ADD! and menopausal on top of it), starting with severe sweats, very bad cog-fog and memory issues, culminating in weight loss, severe anxiety and depression, panic, severe apathy and insomnia by eight months off.  Saw p-doc who put me on Remeron, increased from 7.5 mg/day to 37.5 mg by May 22, 2015; still doing very badly though able to sleep.

June 1. 2015 Reinstated Effexor XR 37.5 mg, Remeron dropped to 30 mg PM. Immediate relief of symptoms, like nothing had ever happened!  Joined SA and began on advice of friend who recognized it was WD all along! Began tapering in July 2015.

Been tapering both meds ever since, focusing on one more than the other or doing no more than 5% of each per month.

12 mg Effexor and 5.8 mg Remeron (mirtazapine SolTabs to make a solution with OraPlus) as of 5/4/2017 

Update 3/14/18: 2.9 mg Remeron and 6 mg Effexor; 6/10/18:  2.6 mg Remeron and 4.9 mg Effexor

 

My intro: http://survivingantidepressants.org/index.php?/topic/9313-squirrellygirl-effexor-withdrawal-etc/page-2#entry196679

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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Thanks for the replies guys. Last night went to bed in great spirits only to wake up this morning feeling like a bag of shi*e for want of a better description. My thoughts haven't changed from last night to this morning so the explanation has to be physiological rather than psychological. This morning's feeling resembles being very hungover, tired and groggy - I was hardly able to waken up from my deep slumber which isn't an uncommon feeling for me in the morning. Sometimes feels as if I've been hit by a train. By evening time I'll most likely be grand! I still think there's ambiguity regarding whether this is actually my depression returning or it's the withdrawal of the drug. I mean if I slowly taper down to 25mg from 50mg via 10% decreases, is there not a chance I'll feel exactly the same at 25mg?

 

I welcome your erudite views on these matters guys- it's ironic that I'm a Pharmacist by Profession and I'm asking opinions on these matters, but your first hand experience triumphs what the textbooks say any day of the week!

 

I've briefly skimmed through tapering methods - Sertraline liquid isn't available in the UK (I prefer to call my part of the world Ireland, but we'll not go there!), so that means either shaving off a tenth of the tablet via a tablet cutter which seems fiddly to mean or crushing the entire tablet and making a liquid/suspension with water and drawing up a known quantity of the drug. Which seems easier? Is it possible to shave a tenth of a tablet off via a tablet cutter??

May 2007 - October 2007 Citalopram 20 mg od. 1st Antidepressant ever taken. No problem with fast taper and no withdrawal effects. No antidepressants for over 5 years.

 

January 2013 started Citalopram 20mg.

March 2014 Switched to Sertraline 50 mg od.

23rd June 2016 started taper 45mg

23.07.16 40.5mg 23.08.16 36.45mg 27.09.16 34.65mg 24.10.16 32.90mg 28.11.16 31.26mg 04.01.17 32mg 25.02.17 31mg 22.03.17 30mg 14.04.17 29mg 09.05.17 28mg 07.06.17 27mg 08.06.17 26mg 13.07.17 25mg 07.08.17 24mg 24.08.17 23mg 13.09.17 22mg 12.10.17 21mg 10.11.17 20mg 04.12.17 19mg 01.01.18 17mg 25.01.18 15mg 22.02.18 13.5mg 25.03.18 12.15mg 

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  • Moderator Emeritus

Hello Lake,

 

There are no guarantees but it is very likely you will not experience withdrawal symptoms when you taper slowly. If you read that thread on brain remodelling that Squirely posted for you it will explain why.

 

Lots of people, myself included, taper using a self-made liquid. The link to how to taper zoloft explains how to do it.

 

It's very simple: I use 1:1 ratio of whater vs mgs of the drug. All you need is a syringe and a smallish jar with a lid. You can put 50 mg pill in 50 ml of water and then take out any anount you need. Shaving isn't that precise and taking the right dose is extremely important for stabilising.

 

Ask any questions you might have to get it right. After a while it gets so easy and natural.

Current: 9/2022 Xanax 0.08, Lexapro 2

2020 Xanax 0.26 (down from 2 mg in 2013), Lexapro 2.85 mg (down from 5 mg 2013)

Amitriptyline (tricyclic AD) and clonazepam for 3 months to treat headache in 1996 
1999. - present Xanax prn up to 3 mg.
2000-2005 Prozac CT twice, 2005-2010 Zoloft CT 3 times, 2010-2013 Escitalopram 10 mg
went from 2.5 to zero on 7 Aug 2013, bad crash 40 days after
reinstated to 5 mg Escitalopram 4Oct 2013 and holding liquid Xanax every 5 hours
28 Jan 2014 Xanax 1.9, 18 Apr  2015 1 mg,  25 June 2015 Lex 4.8, 6 Aug Lexapro 4.6, 1 Jan 2016 0.64  Xanax     9 month hold

24 Sept 2016 4.5 Lex, 17 Oct 4.4 Lex (Nov 0.63 Xanax, Dec 0.625 Xanax), 1 Jan 2017 4.3 Lex, 24 Jan 4.2, 5 Feb 4.1, 24 Mar 4 mg, 10 Apr 3.9 mg, May 3.85, June 3.8, July 3.75, 22 July 3.7, 15 Aug 3.65, 17 Sept 3.6, 1 Jan 2018 3.55, 19 Jan 3.5, 16 Mar 3.4, 14 Apr 3.3, 23 May 3.2, 16 June 3.15, 15 Jul 3.1, 31 Jul 3, 21 Aug 2.9 26 Sept 2.85, 14 Nov Xan 0.61, 1 Dec 0.59, 19 Dec 0.58, 4 Jan 0.565, 6 Feb 0.55, 20 Feb 0.535, 1 Mar 0.505, 10 Mar 0.475, 14 Mar 0.45, 4 Apr 0.415, 13 Apr 0.37, 21 Apr 0.33, 29 Apr 0.29, 10 May 0.27, 17 May 0.25, 28 May 0.22, 19 June 0.22, 21 Jun updose to 0.24, 24 Jun updose to 0.26

Supplements: Omega 3 + Vit E, Vit C, D, magnesium, Taurine, probiotic 

I'm not a medical professional. Any advice I give is based on my own experience and reading. 

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Hello Lake,

There are no guarantees but it is very likely you will not experience withdrawal symptoms when you taper slowly. If you read that thread on brain remodelling that Squirely posted for you it will explain why.

Lots of people, myself included, taper using a self-made liquid. The link to how to taper zoloft explains how to do it.

It's very simple: I use 1:1 ratio of whater vs mgs of the drug. All you need is a syringe and a smallish jar with a lid. You can put 50 mg pill in 50 ml of water and then take out any anount you need. Shaving isn't that precise and taking the right dose is extremely important for stabilising.

Ask any questions you might have to get it right. After a while it gets so easy and natural.

 

Thanks. I think I'll dissolve 50mg in 10mls of water and and take 9mls, 8mls, 7mls etc at each of the dosage decreases. I don't think there's any real disadvantage to using a smaller quantity of water.

May 2007 - October 2007 Citalopram 20 mg od. 1st Antidepressant ever taken. No problem with fast taper and no withdrawal effects. No antidepressants for over 5 years.

 

January 2013 started Citalopram 20mg.

March 2014 Switched to Sertraline 50 mg od.

23rd June 2016 started taper 45mg

23.07.16 40.5mg 23.08.16 36.45mg 27.09.16 34.65mg 24.10.16 32.90mg 28.11.16 31.26mg 04.01.17 32mg 25.02.17 31mg 22.03.17 30mg 14.04.17 29mg 09.05.17 28mg 07.06.17 27mg 08.06.17 26mg 13.07.17 25mg 07.08.17 24mg 24.08.17 23mg 13.09.17 22mg 12.10.17 21mg 10.11.17 20mg 04.12.17 19mg 01.01.18 17mg 25.01.18 15mg 22.02.18 13.5mg 25.03.18 12.15mg 

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Hello Lake,

There are no guarantees but it is very likely you will not experience withdrawal symptoms when you taper slowly. If you read that thread on brain remodelling that Squirely posted for you it will explain why.

Lots of people, myself included, taper using a self-made liquid. The link to how to taper zoloft explains how to do it.

It's very simple: I use 1:1 ratio of whater vs mgs of the drug. All you need is a syringe and a smallish jar with a lid. You can put 50 mg pill in 50 ml of water and then take out any anount you need. Shaving isn't that precise and taking the right dose is extremely important for stabilising.

Ask any questions you might have to get it right. After a while it gets so easy and natural.

Thanks. I think I'll dissolve 50mg in 10mls of water and and take 9mls, 8mls, 7mls etc at each of the dosage decreases. I don't think there's any real disadvantage to using a smaller quantity of water.
Oops I made the schoolboy error of 10% reduction from the original dose of 50mg each time so the 8mls, 7mls etc would be incorrect!

May 2007 - October 2007 Citalopram 20 mg od. 1st Antidepressant ever taken. No problem with fast taper and no withdrawal effects. No antidepressants for over 5 years.

 

January 2013 started Citalopram 20mg.

March 2014 Switched to Sertraline 50 mg od.

23rd June 2016 started taper 45mg

23.07.16 40.5mg 23.08.16 36.45mg 27.09.16 34.65mg 24.10.16 32.90mg 28.11.16 31.26mg 04.01.17 32mg 25.02.17 31mg 22.03.17 30mg 14.04.17 29mg 09.05.17 28mg 07.06.17 27mg 08.06.17 26mg 13.07.17 25mg 07.08.17 24mg 24.08.17 23mg 13.09.17 22mg 12.10.17 21mg 10.11.17 20mg 04.12.17 19mg 01.01.18 17mg 25.01.18 15mg 22.02.18 13.5mg 25.03.18 12.15mg 

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  • Moderator Emeritus

That's because I'm mathematically challanged :) but more liquid ensures greater precision. You can make a ratio that suits you best. Just be careful not to decrease by more than 10 % of your previous dose every 30 days or even longer. The key is listening to your body. Better start small until you see how you react.

 

Decrasing from 9 ml to 8 and 7 will soon get you into trouble because you will start decreasing more than 10 % of your current dose.

 

Now is however time for a long hold and possibly even an updose if that 50 % cut is making things too hard for you.

 

Hope this makes sense.

Current: 9/2022 Xanax 0.08, Lexapro 2

2020 Xanax 0.26 (down from 2 mg in 2013), Lexapro 2.85 mg (down from 5 mg 2013)

Amitriptyline (tricyclic AD) and clonazepam for 3 months to treat headache in 1996 
1999. - present Xanax prn up to 3 mg.
2000-2005 Prozac CT twice, 2005-2010 Zoloft CT 3 times, 2010-2013 Escitalopram 10 mg
went from 2.5 to zero on 7 Aug 2013, bad crash 40 days after
reinstated to 5 mg Escitalopram 4Oct 2013 and holding liquid Xanax every 5 hours
28 Jan 2014 Xanax 1.9, 18 Apr  2015 1 mg,  25 June 2015 Lex 4.8, 6 Aug Lexapro 4.6, 1 Jan 2016 0.64  Xanax     9 month hold

24 Sept 2016 4.5 Lex, 17 Oct 4.4 Lex (Nov 0.63 Xanax, Dec 0.625 Xanax), 1 Jan 2017 4.3 Lex, 24 Jan 4.2, 5 Feb 4.1, 24 Mar 4 mg, 10 Apr 3.9 mg, May 3.85, June 3.8, July 3.75, 22 July 3.7, 15 Aug 3.65, 17 Sept 3.6, 1 Jan 2018 3.55, 19 Jan 3.5, 16 Mar 3.4, 14 Apr 3.3, 23 May 3.2, 16 June 3.15, 15 Jul 3.1, 31 Jul 3, 21 Aug 2.9 26 Sept 2.85, 14 Nov Xan 0.61, 1 Dec 0.59, 19 Dec 0.58, 4 Jan 0.565, 6 Feb 0.55, 20 Feb 0.535, 1 Mar 0.505, 10 Mar 0.475, 14 Mar 0.45, 4 Apr 0.415, 13 Apr 0.37, 21 Apr 0.33, 29 Apr 0.29, 10 May 0.27, 17 May 0.25, 28 May 0.22, 19 June 0.22, 21 Jun updose to 0.24, 24 Jun updose to 0.26

Supplements: Omega 3 + Vit E, Vit C, D, magnesium, Taurine, probiotic 

I'm not a medical professional. Any advice I give is based on my own experience and reading. 

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  • Moderator Emeritus

I only saw your second post after I posted... You are a pharmacist :) you'll get a hang of this quickly :)

Current: 9/2022 Xanax 0.08, Lexapro 2

2020 Xanax 0.26 (down from 2 mg in 2013), Lexapro 2.85 mg (down from 5 mg 2013)

Amitriptyline (tricyclic AD) and clonazepam for 3 months to treat headache in 1996 
1999. - present Xanax prn up to 3 mg.
2000-2005 Prozac CT twice, 2005-2010 Zoloft CT 3 times, 2010-2013 Escitalopram 10 mg
went from 2.5 to zero on 7 Aug 2013, bad crash 40 days after
reinstated to 5 mg Escitalopram 4Oct 2013 and holding liquid Xanax every 5 hours
28 Jan 2014 Xanax 1.9, 18 Apr  2015 1 mg,  25 June 2015 Lex 4.8, 6 Aug Lexapro 4.6, 1 Jan 2016 0.64  Xanax     9 month hold

24 Sept 2016 4.5 Lex, 17 Oct 4.4 Lex (Nov 0.63 Xanax, Dec 0.625 Xanax), 1 Jan 2017 4.3 Lex, 24 Jan 4.2, 5 Feb 4.1, 24 Mar 4 mg, 10 Apr 3.9 mg, May 3.85, June 3.8, July 3.75, 22 July 3.7, 15 Aug 3.65, 17 Sept 3.6, 1 Jan 2018 3.55, 19 Jan 3.5, 16 Mar 3.4, 14 Apr 3.3, 23 May 3.2, 16 June 3.15, 15 Jul 3.1, 31 Jul 3, 21 Aug 2.9 26 Sept 2.85, 14 Nov Xan 0.61, 1 Dec 0.59, 19 Dec 0.58, 4 Jan 0.565, 6 Feb 0.55, 20 Feb 0.535, 1 Mar 0.505, 10 Mar 0.475, 14 Mar 0.45, 4 Apr 0.415, 13 Apr 0.37, 21 Apr 0.33, 29 Apr 0.29, 10 May 0.27, 17 May 0.25, 28 May 0.22, 19 June 0.22, 21 Jun updose to 0.24, 24 Jun updose to 0.26

Supplements: Omega 3 + Vit E, Vit C, D, magnesium, Taurine, probiotic 

I'm not a medical professional. Any advice I give is based on my own experience and reading. 

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Was doing my sums there and it would take me 15months to get down to a dosage of just over 10 mgs - quite demoralising to say the least but it's definitely possible.

May 2007 - October 2007 Citalopram 20 mg od. 1st Antidepressant ever taken. No problem with fast taper and no withdrawal effects. No antidepressants for over 5 years.

 

January 2013 started Citalopram 20mg.

March 2014 Switched to Sertraline 50 mg od.

23rd June 2016 started taper 45mg

23.07.16 40.5mg 23.08.16 36.45mg 27.09.16 34.65mg 24.10.16 32.90mg 28.11.16 31.26mg 04.01.17 32mg 25.02.17 31mg 22.03.17 30mg 14.04.17 29mg 09.05.17 28mg 07.06.17 27mg 08.06.17 26mg 13.07.17 25mg 07.08.17 24mg 24.08.17 23mg 13.09.17 22mg 12.10.17 21mg 10.11.17 20mg 04.12.17 19mg 01.01.18 17mg 25.01.18 15mg 22.02.18 13.5mg 25.03.18 12.15mg 

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Lakelander.  I can understand how this must seem to be an inordinate amount of time. However, in the grand scheme of things it is not only going to give you a better quality of life as you taper , but less symptoms overall and if you can stay even and stable as you go it will hardly impact on your life. That is the goal here. If you can carry on living without missing a beat , that is a successful taper. 

 

If you wouldn't mind adding your drug history , it will help to understand your context. It will appear below each of your posts. 

Please put your withdrawal history in your signature

 

Ali

Many SSRI's and SSNRI's over 20 years. Zoloft for 7 years followed by Effexor, Lexapro, Prozac, Cymbalta, Celexa, Pristiq, Valdoxan, Mianserin and more - on and off. No tapering. Cold turkey off Valdoxan - end of May 2014

 

                                                  Psych Drug - free since May 2014
.
         

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Lakelander, I've been tapering sertraline for ages now. I use a compounding pharmacy to make up capsules in the right dose - it's made it really easy. No liquid here either, and smallest pills 50mg. I could break easily along the score to make halves, less easily into quarters and less easily again smaller. It was really inaccurate though, the smaller the bits, so heaven knows how the dose changes really played out. When they got too crumbly I discarded.

 

Personally, I like the compounding pharmacy and hopefully I'm educating them about it at the same time.

2005 St John's Wort / 2006-2012 Lexapro 20mg, 2 failed attempts to stop, tapered over 4.5 months in early 2012

January 2013 started Sertraline, over time worked up to 100mg

July 2014 Sertraline dropped from 100mg to 75mg, held for six months, slower tapering until 2019 22 Dec 3.2mg

2020 Sertraline 19 Jan 3.1mg, 26 Jan 3.0mg; 1 Mar 2.9, 7 Mar 2.8, May (some drops here) 24 May 2.5, May 29 2.4, June 21 2.3, June 28 2.2mg,  July 4 2.1mg, July 24 (or maybe a bit before) 2mg, early Nov switched to home made suspension; 29 Nov 1.8mg; approx 25 Dec 1.6mg)

2021 Some time in about Jan/Feb realised probably on more like 1.8mg and poss mixing error in making suspension; doses after 10 Feb accurate; 10 Feb 1.6mg; 7 Mar 1.4, continued monthly

10% drops until 1mg, then dropped 0.1mg monthly.

May 2022,0.1mg, now dropping 0.01mg per week

My thread here at SA: https://www.survivingantidepressants.org/topic/1775-bubbles/page/18/

CurrentSertraline: 0.08mg / Armour Thyroid

 

 

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Do any of you give credence to the term Tardive Dysphoria, whereby long term Antidepressant use produces Treatment resistant Depression? This Is something that worried me most about SSRI use.

 

I'm really struggling as to the rationale for the use of SSRIs in the first place - if they are used to ameliorate Depression but make things worse in the long run, why use them in the first place? What other strategies have we to combat Depression apart from Meds? I know mindfulness is the whole buzz at the min but it won't work for everybody. I know aerobic exercise is of great benefit and by cutting my dose in half my logic was that my running, swimming etc would fill in the gap by producing the extra serotonin my brain needed. Unfortunately, it didn't work out this way. This site had shown me that there's no way of circumventing the slow taper.

May 2007 - October 2007 Citalopram 20 mg od. 1st Antidepressant ever taken. No problem with fast taper and no withdrawal effects. No antidepressants for over 5 years.

 

January 2013 started Citalopram 20mg.

March 2014 Switched to Sertraline 50 mg od.

23rd June 2016 started taper 45mg

23.07.16 40.5mg 23.08.16 36.45mg 27.09.16 34.65mg 24.10.16 32.90mg 28.11.16 31.26mg 04.01.17 32mg 25.02.17 31mg 22.03.17 30mg 14.04.17 29mg 09.05.17 28mg 07.06.17 27mg 08.06.17 26mg 13.07.17 25mg 07.08.17 24mg 24.08.17 23mg 13.09.17 22mg 12.10.17 21mg 10.11.17 20mg 04.12.17 19mg 01.01.18 17mg 25.01.18 15mg 22.02.18 13.5mg 25.03.18 12.15mg 

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Yes. we know that term . TD.  We didn't know when we started that they( SSRI'S )  could make it worse. We all went on them with faith . Strategies  - diet,  exercise, sun , meditation, deep breathing, certain supplements and a little bit of positivity !  We don't necessarily need more serotonin . That is a myth. The brain is and was fine to begin with. It never needed tampering with. 

Many SSRI's and SSNRI's over 20 years. Zoloft for 7 years followed by Effexor, Lexapro, Prozac, Cymbalta, Celexa, Pristiq, Valdoxan, Mianserin and more - on and off. No tapering. Cold turkey off Valdoxan - end of May 2014

 

                                                  Psych Drug - free since May 2014
.
         

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Should I reinstate my 50mg dose until two weeks from today and then start the taper or should I just wait to I'm fully stabilised again be that in a week and half and then start the taper?

May 2007 - October 2007 Citalopram 20 mg od. 1st Antidepressant ever taken. No problem with fast taper and no withdrawal effects. No antidepressants for over 5 years.

 

January 2013 started Citalopram 20mg.

March 2014 Switched to Sertraline 50 mg od.

23rd June 2016 started taper 45mg

23.07.16 40.5mg 23.08.16 36.45mg 27.09.16 34.65mg 24.10.16 32.90mg 28.11.16 31.26mg 04.01.17 32mg 25.02.17 31mg 22.03.17 30mg 14.04.17 29mg 09.05.17 28mg 07.06.17 27mg 08.06.17 26mg 13.07.17 25mg 07.08.17 24mg 24.08.17 23mg 13.09.17 22mg 12.10.17 21mg 10.11.17 20mg 04.12.17 19mg 01.01.18 17mg 25.01.18 15mg 22.02.18 13.5mg 25.03.18 12.15mg 

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  • Moderator Emeritus

Hi Lake

We've been pouring information at you like water coming out of a fire hose. You may have missed what SquirrellyGirl posted above in post #3

Right now, it may be best for you to reinstate to 50 mg, since you'd only been down to 25 mg a week, and then do a properly slow taper from there.

It can be very helpful to keep track of your symptoms on paper.  Pay attention to your physical, emotional, and mental symptoms; record the symptoms and the time they occurred.  You may see patterns related to the timing of your sertraline dose or related to when you reduce a dose. The data you collect can help guide you later in your taper.

 

I like seeing the improvement in my symptoms, though I've been fortunate that my most disruptive ones have resolved within a few weeks.  and when a symptom occurs I see that it's related to dose change and how long it lasted previously. 

 

I use a spreadsheet from Tapering forum  - Dr. Joseph Glenmullens withdrawal symptom checklist.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results

Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to  0.0 mg  Aug. 12; details here


scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet

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  • Moderator Emeritus

Do any of you give credence to the term Tardive Dysphoria, whereby long term Antidepressant use produces Treatment resistant Depression? This Is something that worried me most about SSRI use.

 

I'm really struggling as to the rationale for the use of SSRIs in the first place - if they are used to ameliorate Depression but make things worse in the long run, why use them in the first place? What other strategies have we to combat Depression apart from Meds? I know mindfulness is the whole buzz at the min but it won't work for everybody. I know aerobic exercise is of great benefit and by cutting my dose in half my logic was that my running, swimming etc would fill in the gap by producing the extra serotonin my brain needed. Unfortunately, it didn't work out this way. This site had shown me that there's no way of circumventing the slow taper.

 

That's a hot topic!  And as a pharmacist, it must give you pause.  If you spend any time with Anatomy of an Epidemic and the like (youtube videos by Robert Whitaker and Joanna Moncreiff etc) you will see over and over that ADs should be reserved for severe depression if at all, and used very short term.  It's amazing what I've seen people be described ADs for,  "Life," such as upset due to a break-up, job loss, normal mourning of a loved one etc.  Same with the anxiolytics.  

 

Many of us are long-term users and found that we were symptomatic practically the whole time.  I would say that my reactivity and degree of distress in response to stress got worse and worse over time, and meanwhile I was numb to the joys of life, couldn't feel deep connection, excitement, enthusiasm, etc.  Peter Breggin calls it "spellbinding," when we just don't make the connection between the drug and it's negative affects.

 

I worked in a research lab and am a bit of a stickler, so I will add that when doing dilutions, it would be best to add the tablet to a subset of your liquid, and then bring the level up to the final volume, to allow for displacement. This would be most important if you were changing concentrations, going from a 2:1 to a 1:1 etc.  For those who don't understand what I mean, if you put your 50 mg tablet in 50 ml of water, the tablet will displace a little bit of water relative to the volume so you have slightly more than 50 ml, but if I took that same tablet and added it to 5 ml of water, it would displace a relatively larger amount.  I'm probably thoroughly confusing everyone now!

 

Ok, back to lurking.

 

SG

Started ADs back around 1995 after bad break-up, starting with Prozac.  Switched to Wellbutrin, and then to Effexor in 2002
Effexor XR 2002-2014 up to 225 mg at one point, down to 37.5 mg towards end but back up to 75 mg in 2014; now realize I had W/D as I dropped down, memory very poor about history.  Extreme emotions, poor concentration as I stepped back down, didn't connect the dots!
Summer 2014 reduced to 0 very quickly, was sick of anhedonia/sexual dysfunction due to meds, depression never controlled if not worse. Didn't recognize WD since symptoms built slowly (thought I had ADD! and menopausal on top of it), starting with severe sweats, very bad cog-fog and memory issues, culminating in weight loss, severe anxiety and depression, panic, severe apathy and insomnia by eight months off.  Saw p-doc who put me on Remeron, increased from 7.5 mg/day to 37.5 mg by May 22, 2015; still doing very badly though able to sleep.

June 1. 2015 Reinstated Effexor XR 37.5 mg, Remeron dropped to 30 mg PM. Immediate relief of symptoms, like nothing had ever happened!  Joined SA and began on advice of friend who recognized it was WD all along! Began tapering in July 2015.

Been tapering both meds ever since, focusing on one more than the other or doing no more than 5% of each per month.

12 mg Effexor and 5.8 mg Remeron (mirtazapine SolTabs to make a solution with OraPlus) as of 5/4/2017 

Update 3/14/18: 2.9 mg Remeron and 6 mg Effexor; 6/10/18:  2.6 mg Remeron and 4.9 mg Effexor

 

My intro: http://survivingantidepressants.org/index.php?/topic/9313-squirrellygirl-effexor-withdrawal-etc/page-2#entry196679

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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I take all your points on board however I still take issue with everything being down to "withdrawal effects". There was a time in 2012 when I was so depressed/ anxious and I hadn't been on an SSRI since my first in 2007, and that was only for about 5 months. I tapered fine and functioned fine in the intervening 5 years until my depressive episode.

May 2007 - October 2007 Citalopram 20 mg od. 1st Antidepressant ever taken. No problem with fast taper and no withdrawal effects. No antidepressants for over 5 years.

 

January 2013 started Citalopram 20mg.

March 2014 Switched to Sertraline 50 mg od.

23rd June 2016 started taper 45mg

23.07.16 40.5mg 23.08.16 36.45mg 27.09.16 34.65mg 24.10.16 32.90mg 28.11.16 31.26mg 04.01.17 32mg 25.02.17 31mg 22.03.17 30mg 14.04.17 29mg 09.05.17 28mg 07.06.17 27mg 08.06.17 26mg 13.07.17 25mg 07.08.17 24mg 24.08.17 23mg 13.09.17 22mg 12.10.17 21mg 10.11.17 20mg 04.12.17 19mg 01.01.18 17mg 25.01.18 15mg 22.02.18 13.5mg 25.03.18 12.15mg 

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  • Moderator Emeritus

Of course there is depression and anxiety and other experiences of a brain that struggles that are not related to drugs simply because they occured before a person started taking drugs in the first place.

 

However, there seems to be more and more evidence that use of psychotropic medication worsened the long-term outcome of such states and made them a long-term condition with often debilitating consequences (Check Anatomy of an Epidemic by Robert Whitaker). Psychotropics have become a first (and very often only) line of treatment before any other treatment is even tried and doctors are in denial to withdrawal symptoms which occur even after a very short use. That's the real problem...

Current: 9/2022 Xanax 0.08, Lexapro 2

2020 Xanax 0.26 (down from 2 mg in 2013), Lexapro 2.85 mg (down from 5 mg 2013)

Amitriptyline (tricyclic AD) and clonazepam for 3 months to treat headache in 1996 
1999. - present Xanax prn up to 3 mg.
2000-2005 Prozac CT twice, 2005-2010 Zoloft CT 3 times, 2010-2013 Escitalopram 10 mg
went from 2.5 to zero on 7 Aug 2013, bad crash 40 days after
reinstated to 5 mg Escitalopram 4Oct 2013 and holding liquid Xanax every 5 hours
28 Jan 2014 Xanax 1.9, 18 Apr  2015 1 mg,  25 June 2015 Lex 4.8, 6 Aug Lexapro 4.6, 1 Jan 2016 0.64  Xanax     9 month hold

24 Sept 2016 4.5 Lex, 17 Oct 4.4 Lex (Nov 0.63 Xanax, Dec 0.625 Xanax), 1 Jan 2017 4.3 Lex, 24 Jan 4.2, 5 Feb 4.1, 24 Mar 4 mg, 10 Apr 3.9 mg, May 3.85, June 3.8, July 3.75, 22 July 3.7, 15 Aug 3.65, 17 Sept 3.6, 1 Jan 2018 3.55, 19 Jan 3.5, 16 Mar 3.4, 14 Apr 3.3, 23 May 3.2, 16 June 3.15, 15 Jul 3.1, 31 Jul 3, 21 Aug 2.9 26 Sept 2.85, 14 Nov Xan 0.61, 1 Dec 0.59, 19 Dec 0.58, 4 Jan 0.565, 6 Feb 0.55, 20 Feb 0.535, 1 Mar 0.505, 10 Mar 0.475, 14 Mar 0.45, 4 Apr 0.415, 13 Apr 0.37, 21 Apr 0.33, 29 Apr 0.29, 10 May 0.27, 17 May 0.25, 28 May 0.22, 19 June 0.22, 21 Jun updose to 0.24, 24 Jun updose to 0.26

Supplements: Omega 3 + Vit E, Vit C, D, magnesium, Taurine, probiotic 

I'm not a medical professional. Any advice I give is based on my own experience and reading. 

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The older I get the more I realise that Medicine is a best guess based on symptoms, then throwing a drug at it the in hope it cures it. Sometimes there's little to no science involved in it. There's a controversial Scientist and ex Doctor whom I can't remember the name of, who states that the remedies used to cure illnesses often produce worse effects than the original condition. Homeopathy often gets slated in the press for having no empirical evidence to back it up, yet what evidence for efficacy do SSRIs have? At worst Homeopathic remedies are harmless duds than produce no harm, but the same can't be said of SSRIs. Surely this flies in the face of a Doctor's Hippocratic oath of "do no harm". It seems to me doctors can prescribe these things willy nilly, with near total impunity!!

May 2007 - October 2007 Citalopram 20 mg od. 1st Antidepressant ever taken. No problem with fast taper and no withdrawal effects. No antidepressants for over 5 years.

 

January 2013 started Citalopram 20mg.

March 2014 Switched to Sertraline 50 mg od.

23rd June 2016 started taper 45mg

23.07.16 40.5mg 23.08.16 36.45mg 27.09.16 34.65mg 24.10.16 32.90mg 28.11.16 31.26mg 04.01.17 32mg 25.02.17 31mg 22.03.17 30mg 14.04.17 29mg 09.05.17 28mg 07.06.17 27mg 08.06.17 26mg 13.07.17 25mg 07.08.17 24mg 24.08.17 23mg 13.09.17 22mg 12.10.17 21mg 10.11.17 20mg 04.12.17 19mg 01.01.18 17mg 25.01.18 15mg 22.02.18 13.5mg 25.03.18 12.15mg 

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  • Moderator Emeritus

I have spent tons of time over on patient.info, where droves of people post about going on psych drug A, B, or C, and suffering such horrid start up side effects (including anxiety, depression, SI) and when will it stop?  Other people chime in saying "hang in there, it will get better - it just takes time for these meds to work!"  By the time their nervous system does the push-back remodeling in response to the drug-induced imbalances, the person starts to feel better, and I speculate that they perceive this as "the drug" working and are so happy to no longer feel horrid, hello placebo affect!

 

It's frightening to me that doctors still seem to have no understanding of the remodeling occurring in the nervous system in response to the drug-induced neurotransmitter imbalances that necessitates slow tapering.  Someone recently said that at the minimum effective dose their doctor said it was so little as to not be doing anything so the patient could just stop taking it!  Well, if you look at the occupancy rates of these drugs, there's still a whole lot of influence that "minimum effective dose" is having, blocking 80% of serotonin receptors!!!!  With the remodeling, how can it NOT cause withdrawal going to zero!  They don't seem to know about this!!!

 

http://ils.unc.edu/bmh/neoref/this.dir.unneeded/schizophrenia/review/tmp/352.pdf

 

SG

Started ADs back around 1995 after bad break-up, starting with Prozac.  Switched to Wellbutrin, and then to Effexor in 2002
Effexor XR 2002-2014 up to 225 mg at one point, down to 37.5 mg towards end but back up to 75 mg in 2014; now realize I had W/D as I dropped down, memory very poor about history.  Extreme emotions, poor concentration as I stepped back down, didn't connect the dots!
Summer 2014 reduced to 0 very quickly, was sick of anhedonia/sexual dysfunction due to meds, depression never controlled if not worse. Didn't recognize WD since symptoms built slowly (thought I had ADD! and menopausal on top of it), starting with severe sweats, very bad cog-fog and memory issues, culminating in weight loss, severe anxiety and depression, panic, severe apathy and insomnia by eight months off.  Saw p-doc who put me on Remeron, increased from 7.5 mg/day to 37.5 mg by May 22, 2015; still doing very badly though able to sleep.

June 1. 2015 Reinstated Effexor XR 37.5 mg, Remeron dropped to 30 mg PM. Immediate relief of symptoms, like nothing had ever happened!  Joined SA and began on advice of friend who recognized it was WD all along! Began tapering in July 2015.

Been tapering both meds ever since, focusing on one more than the other or doing no more than 5% of each per month.

12 mg Effexor and 5.8 mg Remeron (mirtazapine SolTabs to make a solution with OraPlus) as of 5/4/2017 

Update 3/14/18: 2.9 mg Remeron and 6 mg Effexor; 6/10/18:  2.6 mg Remeron and 4.9 mg Effexor

 

My intro: http://survivingantidepressants.org/index.php?/topic/9313-squirrellygirl-effexor-withdrawal-etc/page-2#entry196679

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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I'm sure many of you, like myself have visited several Psychologists through the years and the consistent message seems to be that you can always choose your thoughts and it's not life events that determine how you feel it's how you react to those events. This is a great life Philosophy to take on board but Psychologists dont appreciate how hard this is to implement when coming off Antidepressants. Choosing your thoughts is next to impossible when the "hardware" isn't functioning right in the first place.

If I'm suffering from dead head (I think I might patent the term :-D), there's no amount of will power, positive thinking, cognitive restructuring/reframing etc that will help my brain to function any better. My brain is simply not operating the way it should do, and until the hardware is working correctly, it's pointless trying to learn CBT methods etc.

May 2007 - October 2007 Citalopram 20 mg od. 1st Antidepressant ever taken. No problem with fast taper and no withdrawal effects. No antidepressants for over 5 years.

 

January 2013 started Citalopram 20mg.

March 2014 Switched to Sertraline 50 mg od.

23rd June 2016 started taper 45mg

23.07.16 40.5mg 23.08.16 36.45mg 27.09.16 34.65mg 24.10.16 32.90mg 28.11.16 31.26mg 04.01.17 32mg 25.02.17 31mg 22.03.17 30mg 14.04.17 29mg 09.05.17 28mg 07.06.17 27mg 08.06.17 26mg 13.07.17 25mg 07.08.17 24mg 24.08.17 23mg 13.09.17 22mg 12.10.17 21mg 10.11.17 20mg 04.12.17 19mg 01.01.18 17mg 25.01.18 15mg 22.02.18 13.5mg 25.03.18 12.15mg 

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If you don't mind, I'll use this thread to discuss a myriad of things instead of starting a new thread each time.

Do any of you suffer from severe muscle tension? I get bad muscle tension in my neck, shoulders and back (especially upper back). The only way I have of relieving this is by either getting a massage or swimming front crawl. They only treat the problem though they don't prevent it from reoccurring. Once I stressed or rushed, it sets the wheels in motion for the muscle tension to occur, in which case I have to go for a swim or get a massage to remove the tension from my body. It's a never ending self perpetuating cycle. Magnesium supplements does nothing for it. I know the only sure method is to prevent the stress from happening in the first place, but this is easier said than done. I'm on 50mg of Sertraline at the minute, and am worried this muscle tension will just be intensified when I reach lower doses and dare I said it, zero dose. In which case I ask myself, what's the benefits to coming off the drug if it just makes my stress threshold very low.

 

The other thing that bothers me is the weird dreams and nightmares at night. Very often they are dreams about being overwhelmed/stressed (basically losing the plot) in Public and altercations/arguments/physical fights with other people. Quite often I wake up from these dreams drenched in sweat. Sometimes I dream incessantly, for instance this morning I woke three separate times after having bad dreams each of those times. I'm often exhausted and lethargic the same morning. Again with these dreams, I'm worried the effects will be much more pronounced when off the drug.

May 2007 - October 2007 Citalopram 20 mg od. 1st Antidepressant ever taken. No problem with fast taper and no withdrawal effects. No antidepressants for over 5 years.

 

January 2013 started Citalopram 20mg.

March 2014 Switched to Sertraline 50 mg od.

23rd June 2016 started taper 45mg

23.07.16 40.5mg 23.08.16 36.45mg 27.09.16 34.65mg 24.10.16 32.90mg 28.11.16 31.26mg 04.01.17 32mg 25.02.17 31mg 22.03.17 30mg 14.04.17 29mg 09.05.17 28mg 07.06.17 27mg 08.06.17 26mg 13.07.17 25mg 07.08.17 24mg 24.08.17 23mg 13.09.17 22mg 12.10.17 21mg 10.11.17 20mg 04.12.17 19mg 01.01.18 17mg 25.01.18 15mg 22.02.18 13.5mg 25.03.18 12.15mg 

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  • Moderator Emeritus

Hi Lakelander, 

 

If you could fill out your signature block it would really help us out:  Please put your Withdrawal History in Signature. This allows us to see your history at a glance under each post so that we don't have to read through your whole thread to get a sense of what's going on.  Thank you.

 

All of this is a sign that your nervous system is still currently destabilized.  Pain is a very common wd effect.  Nightmares and strange dreams as well.  I get the weird dreams on the morning, too, but I think this is a feature of mirtazapine.  Yes, it could get worse as you taper IF you continue to taper while having wd symptoms, adding more instability on top of instability.  Nerves are being affected throughout your body, not just your brain.  This all is a sign to hold.

 

Here's a thread on muscle pain etc.:  http://survivingantidepressants.org/index.php?/topic/6504-tension-pain-twitches-spasms-in-muscles-and-joints/

 

See the comments after the initial post.

 

Along the lines of self-care, here's an interesting post about at-home myofacial release:  http://survivingantidepressants.org/index.php?/topic/2833-self-help-for-muscle-tightness-pain/

 

Where are you at with your dosage?  Did you reinstate?  Have you done any tapering?  What is your symptom pattern?  What time do you take your meds?

 

True, it can be very difficult for CBT to take effect when in the midst of neuro emotions, but one must still try to find what might help in the way of self-care, along the lines of self-soothing.  I think this is one obvious way to tell the difference between emotional issues due to withdrawal vs the original version.  Someone I was responding to yesterday (I think it was Help777) was saying that her brain couldn't handle guided meditations, not able to listen to a voice, but the sounds of the ocean were soothing.  There's a website called Calm.com that allows you to select the time you want to "meditate," guided or unguided, with your choice of scenery and background sounds, such as waves, running water of a river, rainfall, etc.  I have found those kinds of sounds to be calming as well.  The sound of water moving such as with waves is something to focus on, meditate on.  

 

You just have to keep trying to see what can help distract from the ruminating.  And it's hard in the beginning to catch yourself engaging in ruminating, but it gets easier the  more you try.  I have found it helpful to say to myself "there goes withdrawal playing tricks again, but I'm not gonna play!"

 

SG

Started ADs back around 1995 after bad break-up, starting with Prozac.  Switched to Wellbutrin, and then to Effexor in 2002
Effexor XR 2002-2014 up to 225 mg at one point, down to 37.5 mg towards end but back up to 75 mg in 2014; now realize I had W/D as I dropped down, memory very poor about history.  Extreme emotions, poor concentration as I stepped back down, didn't connect the dots!
Summer 2014 reduced to 0 very quickly, was sick of anhedonia/sexual dysfunction due to meds, depression never controlled if not worse. Didn't recognize WD since symptoms built slowly (thought I had ADD! and menopausal on top of it), starting with severe sweats, very bad cog-fog and memory issues, culminating in weight loss, severe anxiety and depression, panic, severe apathy and insomnia by eight months off.  Saw p-doc who put me on Remeron, increased from 7.5 mg/day to 37.5 mg by May 22, 2015; still doing very badly though able to sleep.

June 1. 2015 Reinstated Effexor XR 37.5 mg, Remeron dropped to 30 mg PM. Immediate relief of symptoms, like nothing had ever happened!  Joined SA and began on advice of friend who recognized it was WD all along! Began tapering in July 2015.

Been tapering both meds ever since, focusing on one more than the other or doing no more than 5% of each per month.

12 mg Effexor and 5.8 mg Remeron (mirtazapine SolTabs to make a solution with OraPlus) as of 5/4/2017 

Update 3/14/18: 2.9 mg Remeron and 6 mg Effexor; 6/10/18:  2.6 mg Remeron and 4.9 mg Effexor

 

My intro: http://survivingantidepressants.org/index.php?/topic/9313-squirrellygirl-effexor-withdrawal-etc/page-2#entry196679

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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I will fill in the signature soon...but imo it's kind of irrelevant because my problem is very much in the here and now and my memory of time periods on medications is very sketchy. I've been on citalopram twice before and sertraline since 2014. That's the long and short of it, no Benzos, no Opoids, no Antipsyhotics.

 

Today I felt like sh*te for the most of the day and it's only now at a quarter to 5 in the evening I'm starting to come round. Was irritable, lethargic, jumpy, tearful, on tender hooks, and cognitively not "with it" at all. Also had bad muscle tension in neck and shoulders. I Forgot what day it was at times. This is me on 50 mg of Sertraline....now imagine me on 25 mg or 10 mg, regardless of how slow my taper is. I partially function on the meds but even with a slow taper I'll go back to being non functional on the lower doses.

May 2007 - October 2007 Citalopram 20 mg od. 1st Antidepressant ever taken. No problem with fast taper and no withdrawal effects. No antidepressants for over 5 years.

 

January 2013 started Citalopram 20mg.

March 2014 Switched to Sertraline 50 mg od.

23rd June 2016 started taper 45mg

23.07.16 40.5mg 23.08.16 36.45mg 27.09.16 34.65mg 24.10.16 32.90mg 28.11.16 31.26mg 04.01.17 32mg 25.02.17 31mg 22.03.17 30mg 14.04.17 29mg 09.05.17 28mg 07.06.17 27mg 08.06.17 26mg 13.07.17 25mg 07.08.17 24mg 24.08.17 23mg 13.09.17 22mg 12.10.17 21mg 10.11.17 20mg 04.12.17 19mg 01.01.18 17mg 25.01.18 15mg 22.02.18 13.5mg 25.03.18 12.15mg 

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  • Moderator Emeritus

Hi Lakelander82, 

 

The reason we want you to fill in your signature block is so that when you post, we can see your history at a glance without having to read through your whole thread to get context for your current post.  We mods are spread very thin, are volunteers, and only have so much time; reading through someone's thread as it gets longer and longer is just not efficient use of our time.  If you could just fill it in with details of this current drug, dosage changes and times for those, that would help.

 

So, you DID reinstate 50?  How long ago was that? I can't tell from skimming your thread.  You were destabilized from dropping to 25, and it takes four days for the reinstatement to come to a steady level and then days more for the nervous system to respond to that.  Your system has been sensitized to changes, and it could take more time to settle out and feel better from the reinstatement.  If you could give us those details maybe we can figure out what's what. 

 

When we feel like *$%@ we want to DO something to make it stop, but right now what you need is to hold tight and allow your system to find stability again.  Dropping by 50% is going to cause a lot of reverberations of all the interdependent moving parts, so to speak.  Add back that back while things are still catywampus and it's still going to take time for it all to settle out.

 

I'm sorry you are still feeling so bad :-(

 

SG

Started ADs back around 1995 after bad break-up, starting with Prozac.  Switched to Wellbutrin, and then to Effexor in 2002
Effexor XR 2002-2014 up to 225 mg at one point, down to 37.5 mg towards end but back up to 75 mg in 2014; now realize I had W/D as I dropped down, memory very poor about history.  Extreme emotions, poor concentration as I stepped back down, didn't connect the dots!
Summer 2014 reduced to 0 very quickly, was sick of anhedonia/sexual dysfunction due to meds, depression never controlled if not worse. Didn't recognize WD since symptoms built slowly (thought I had ADD! and menopausal on top of it), starting with severe sweats, very bad cog-fog and memory issues, culminating in weight loss, severe anxiety and depression, panic, severe apathy and insomnia by eight months off.  Saw p-doc who put me on Remeron, increased from 7.5 mg/day to 37.5 mg by May 22, 2015; still doing very badly though able to sleep.

June 1. 2015 Reinstated Effexor XR 37.5 mg, Remeron dropped to 30 mg PM. Immediate relief of symptoms, like nothing had ever happened!  Joined SA and began on advice of friend who recognized it was WD all along! Began tapering in July 2015.

Been tapering both meds ever since, focusing on one more than the other or doing no more than 5% of each per month.

12 mg Effexor and 5.8 mg Remeron (mirtazapine SolTabs to make a solution with OraPlus) as of 5/4/2017 

Update 3/14/18: 2.9 mg Remeron and 6 mg Effexor; 6/10/18:  2.6 mg Remeron and 4.9 mg Effexor

 

My intro: http://survivingantidepressants.org/index.php?/topic/9313-squirrellygirl-effexor-withdrawal-etc/page-2#entry196679

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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I've been on 50 mg now since Sunday of last week- so ten days including today. Not sure how long to keep at this dose. Being "stabilised"

is very much a relative term.

 

I just keep going back to the fact that there have been periods in my life when I've been on no medication and I was literally crippled with Anxiety. I couldn't leave the front door. There was literally no alternative to starting medication.

We're only hypothesising that everything is down to the withdrawal effects of the drug - if your Depression was never treated in the first place with these Drugs, is it all Withdrawal effects we're experiencing?

May 2007 - October 2007 Citalopram 20 mg od. 1st Antidepressant ever taken. No problem with fast taper and no withdrawal effects. No antidepressants for over 5 years.

 

January 2013 started Citalopram 20mg.

March 2014 Switched to Sertraline 50 mg od.

23rd June 2016 started taper 45mg

23.07.16 40.5mg 23.08.16 36.45mg 27.09.16 34.65mg 24.10.16 32.90mg 28.11.16 31.26mg 04.01.17 32mg 25.02.17 31mg 22.03.17 30mg 14.04.17 29mg 09.05.17 28mg 07.06.17 27mg 08.06.17 26mg 13.07.17 25mg 07.08.17 24mg 24.08.17 23mg 13.09.17 22mg 12.10.17 21mg 10.11.17 20mg 04.12.17 19mg 01.01.18 17mg 25.01.18 15mg 22.02.18 13.5mg 25.03.18 12.15mg 

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It's not irrelevant to fill in your Signature. It just  helps us to see what is happening  . We believe that the drugs cripple and destroy , but if you have a different perspective then by all means , please explain. 

No one is saying that anxiety doesn't exist, just that we don't need to be medicated for it !  And/ or depression  ! 

We are trying to help people who want to come off these drugs and at the end of the day it is a waste of time to carry on with this hypothesis . Yes , it is withdrawal .

Ali

Many SSRI's and SSNRI's over 20 years. Zoloft for 7 years followed by Effexor, Lexapro, Prozac, Cymbalta, Celexa, Pristiq, Valdoxan, Mianserin and more - on and off. No tapering. Cold turkey off Valdoxan - end of May 2014

 

                                                  Psych Drug - free since May 2014
.
         

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It's not irrelevant to fill in your Signature. It just helps us to see what is happening . We believe that the drugs cripple and destroy , but if you have a different perspective then by all means , please explain.

No one is saying that anxiety doesn't exist, just that we don't need to be medicated for it ! And/ or depression !

We are trying to help people who want to come off these drugs and at the end of the day it is a waste of time to carry on with this hypothesis . Yes , it is withdrawal .

Ali

Calm down dear, I'm merely trying to stimulate debate. I'm not convinced myself of the effectiveness of these meds either, but at the same time I want to be won over so to speak by the withdrawal proponents. Where for example is the empirical evidence that the brain undergoes "remodelling" upon gradual reduction of the drug?

May 2007 - October 2007 Citalopram 20 mg od. 1st Antidepressant ever taken. No problem with fast taper and no withdrawal effects. No antidepressants for over 5 years.

 

January 2013 started Citalopram 20mg.

March 2014 Switched to Sertraline 50 mg od.

23rd June 2016 started taper 45mg

23.07.16 40.5mg 23.08.16 36.45mg 27.09.16 34.65mg 24.10.16 32.90mg 28.11.16 31.26mg 04.01.17 32mg 25.02.17 31mg 22.03.17 30mg 14.04.17 29mg 09.05.17 28mg 07.06.17 27mg 08.06.17 26mg 13.07.17 25mg 07.08.17 24mg 24.08.17 23mg 13.09.17 22mg 12.10.17 21mg 10.11.17 20mg 04.12.17 19mg 01.01.18 17mg 25.01.18 15mg 22.02.18 13.5mg 25.03.18 12.15mg 

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.    :)    Thank you for filling in your drug history signature.

Many SSRI's and SSNRI's over 20 years. Zoloft for 7 years followed by Effexor, Lexapro, Prozac, Cymbalta, Celexa, Pristiq, Valdoxan, Mianserin and more - on and off. No tapering. Cold turkey off Valdoxan - end of May 2014

 

                                                  Psych Drug - free since May 2014
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  • Moderator Emeritus
On 6/9/2016 at 1:46 AM, Lakelander82 said:

.. I want to be won over so to speak by the withdrawal proponents. Where for example is the empirical evidence that the brain undergoes "remodelling" upon gradual reduction of the drug?

All of us posting in these forums are conducting are n=1 experiments and determining for ourselves whether the withdrawal hypothesis is consistent with what we're experiencing, then making decisions about how to work with our medications. You may be in the wrong place if you're looking either to be won over or to have a debate about evidence, scientific or empirical.

 

As for the remodelling hypothesis/theory: The idea that the brain responds to the addition of psychoactives by upregulating or downregulating receptors explains a number of phenomena: tachyphylaxis (drug "poop-out"), drug tolerance, symptoms experienced upon immediate cessation of SSRI/SNRI, and symptoms experienced during tapers.

 

None of us have the technology or methodology to determine whether it's true or not. Quite frankly, I'll let someone get up close and personal with my brain tissue if and only if I need neurosurgery or when I'm dead.

 

If it doesn't make sense to you or is inconsistent with what you experience while on psych drugs or tapering off them, that's cool.  At any rate what matters more to you: why symptoms occur or how to minimize them?

Edited by AliG

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results

Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to  0.0 mg  Aug. 12; details here


scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet

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I take your point Scally, there will be a large degree of subjectivity to these discussions.

 

I would add though if someone prior to taking an antidepressant a person was depressed because they had low confidence/ low self esteem and generally didn't "love themselves" - doing a slow taper isn't going to change those innate personality traits and the Depression/ Anxiety will most likely return.

May 2007 - October 2007 Citalopram 20 mg od. 1st Antidepressant ever taken. No problem with fast taper and no withdrawal effects. No antidepressants for over 5 years.

 

January 2013 started Citalopram 20mg.

March 2014 Switched to Sertraline 50 mg od.

23rd June 2016 started taper 45mg

23.07.16 40.5mg 23.08.16 36.45mg 27.09.16 34.65mg 24.10.16 32.90mg 28.11.16 31.26mg 04.01.17 32mg 25.02.17 31mg 22.03.17 30mg 14.04.17 29mg 09.05.17 28mg 07.06.17 27mg 08.06.17 26mg 13.07.17 25mg 07.08.17 24mg 24.08.17 23mg 13.09.17 22mg 12.10.17 21mg 10.11.17 20mg 04.12.17 19mg 01.01.18 17mg 25.01.18 15mg 22.02.18 13.5mg 25.03.18 12.15mg 

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I agree with you about addressing other issues that contribute to depression or anxiety, from both the psychological and physiological perspectives. That's why there's a forum here about symptoms and self-care, in particular the topic about non-drug techniques.

 

For example, I have a strong suspicion that my depression is a symptom of thyroid issues. Long after I took my first anti-depressant, I discovered that I have at least 5 relatives with hypothyroidism on both sides of the family (mother, aunt, grandmother, uncle, grandfather) and it's possible that my dad is too.  Despite having normal TSH levels, I have many symptoms consistent with hypothyroidism or iodine+selenium deficiency.

 

At times I want to scream at having suffered for years and had a lower quality of life by all measures possibly because this has gone undiagnosed and untreated. I may have brought it on myself with what I now call "diethead" -- thinking during my teens and 20s that I was grossly overweight (I wasn't, only 15 lbs/1 stone or so) and taking on one unhealthy faddy eating style after another perturbing a central nervous system already predisposed to issues and endocrine hormones adjusting post-puberty. Absent that foolishness, who knows.  Looking forward, all I can do is address it and the habitual negative thought patterns and behaviours that have developed.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results

Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to  0.0 mg  Aug. 12; details here


scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet

Link to comment

I generally take care of myself. Today for instance I ran 4 miles. I've never been overweight in my life but there was a time when I did next to no exercise and yet I wasn't depressed or anxious in this period. So the exercise as a great panacea for Depression theory goes out the window.

 

I eat well, and have tried meditation but I've found it does literally nothing for me. I have no problem clearing my mind of thoughts for the time period Im engaging in it, but it doesn't change a system on hyper alert or reduce my stress response to situations.

I take a multivitamin, omega 3 fish oil as supplements. Magnesium does nothing for me except give me the runs, and I've tried various formulations, and taken them at different times of the day without food.

 

If all these self help techniques fail, what else is there? I've discussed and analysed things with Psychologists to the death - all I end up with is more questions than answers and it makes me feel worse if anything. Paralysis by analysis seems apt.

May 2007 - October 2007 Citalopram 20 mg od. 1st Antidepressant ever taken. No problem with fast taper and no withdrawal effects. No antidepressants for over 5 years.

 

January 2013 started Citalopram 20mg.

March 2014 Switched to Sertraline 50 mg od.

23rd June 2016 started taper 45mg

23.07.16 40.5mg 23.08.16 36.45mg 27.09.16 34.65mg 24.10.16 32.90mg 28.11.16 31.26mg 04.01.17 32mg 25.02.17 31mg 22.03.17 30mg 14.04.17 29mg 09.05.17 28mg 07.06.17 27mg 08.06.17 26mg 13.07.17 25mg 07.08.17 24mg 24.08.17 23mg 13.09.17 22mg 12.10.17 21mg 10.11.17 20mg 04.12.17 19mg 01.01.18 17mg 25.01.18 15mg 22.02.18 13.5mg 25.03.18 12.15mg 

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I take your point Scally, there will be a large degree of subjectivity to these discussions.

 

I would add though if someone prior to taking an antidepressant a person was depressed because they had low confidence/ low self esteem and generally didn't "love themselves" - doing a slow taper isn't going to change those innate personality traits and the Depression/ Anxiety will most likely return.

 

I agree with scallywag, there are many causes for emotional problems that go undiagnosed, and if you present with an emotional problem, you are more likely to be given psych meds than to be worked up and have other causes ruled out.  I suspect that when a person presents with depression that seems to have no "cause" such as low self-esteem, feeling worthless, etc, then perhaps it truly is from a physiological source such as hypothyroidism or yeast overgrowth or something along those lines.

 

Yes, if there were psychological reasons for anxiety and depression before drugs, and those thinking processes were not dealt with, then they'll likely be there when the drugs are gone.  Drugs just put off doing the work that should have been done to begin with.

 

Anxiety and panic take on a life of their own because of secondary fear/anxiety/panic - worrying about having another panic attack, worrying about not being able to go to sleep or stay asleep, worry about worry.  Even people with panic attacks that weren't put on drugs have some seed back somewhere that got the ball rolling, even if the person is no longer aware of what it was.  The trick is getting the right therapist to get at it.  Peter Breggin writes of such things, being able to help schizophrenics identify why the voices started, some trauma in the past that went into hiding and the voices are trying to communicate about it - and the voices go away.  That's a condition I thought HAD to be medicated, but Robert Whitaker's work brings to light that people do WORSE in the long run on antipsychotic meds!  

 

I was just reading an article about the MTHFR gene mutations and methylation, and how that mutation can lead to anxiety, depression and other afflictions.  This article was interesting:  https://www.youtube.com/watch?v=ljyvgWYmmvQ

 

I sent it to my sister, because she is one heck of a worry-wart, always has been!  Anxiety is big in my family tree, as is depression. 

 

So, this is all very thought provoking.  I think depression and anxiety can be strategies of sorts for coping (or not coping) with stress, becoming wired in as default responses, and what is wired can be unwired via neuroplasticity.  But we are also learning that there's so many other causes.  Where do psych drugs fit in?  A band aid for the worst case scenarios to get a handle, and then do the work and get off of them!  Unsustainable as a long term solution.  Problem is, the meds often make people apathetic about doing the work, as they don't seem to care as much (my case), and I also feel they make it harder for the work to stick.

 

When one is reducing their meds and have depression and anxiety, I think WD first, because obviously you are monkeying with neurotransmitter levels.  Down the road, once off the meds, if depression and anxiety come back but there's clear triggers like pre-med days, then sure, a recurrence of your wired behavior/responses that were never unwired.  If no obvious triggers or you've done the work and rewired yourself, but now have inexplicable cortisol surges and anxiety, depression, then probably a wave.

 

Just my 2 cents!

SG

Started ADs back around 1995 after bad break-up, starting with Prozac.  Switched to Wellbutrin, and then to Effexor in 2002
Effexor XR 2002-2014 up to 225 mg at one point, down to 37.5 mg towards end but back up to 75 mg in 2014; now realize I had W/D as I dropped down, memory very poor about history.  Extreme emotions, poor concentration as I stepped back down, didn't connect the dots!
Summer 2014 reduced to 0 very quickly, was sick of anhedonia/sexual dysfunction due to meds, depression never controlled if not worse. Didn't recognize WD since symptoms built slowly (thought I had ADD! and menopausal on top of it), starting with severe sweats, very bad cog-fog and memory issues, culminating in weight loss, severe anxiety and depression, panic, severe apathy and insomnia by eight months off.  Saw p-doc who put me on Remeron, increased from 7.5 mg/day to 37.5 mg by May 22, 2015; still doing very badly though able to sleep.

June 1. 2015 Reinstated Effexor XR 37.5 mg, Remeron dropped to 30 mg PM. Immediate relief of symptoms, like nothing had ever happened!  Joined SA and began on advice of friend who recognized it was WD all along! Began tapering in July 2015.

Been tapering both meds ever since, focusing on one more than the other or doing no more than 5% of each per month.

12 mg Effexor and 5.8 mg Remeron (mirtazapine SolTabs to make a solution with OraPlus) as of 5/4/2017 

Update 3/14/18: 2.9 mg Remeron and 6 mg Effexor; 6/10/18:  2.6 mg Remeron and 4.9 mg Effexor

 

My intro: http://survivingantidepressants.org/index.php?/topic/9313-squirrellygirl-effexor-withdrawal-etc/page-2#entry196679

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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Quick question everyone. I've reinstated my dosage of 50 mg now for nearly three weeks. I feel okish, tired quite a bit and tearful at times though. On a scale of 1 -10 with ten being absolutely stupendous and zero being at Rock bottom, I feel about a 5. Is this stabilisation in your opinion and should I proceed with the taper? I'm eager to kick on with this taper as I feel the Sertraline has or is beginning to poop out and I won't feel any better no matter how long I wait before beginning to taper. I'm between a rock and hard place at the minute deciding what to do.

May 2007 - October 2007 Citalopram 20 mg od. 1st Antidepressant ever taken. No problem with fast taper and no withdrawal effects. No antidepressants for over 5 years.

 

January 2013 started Citalopram 20mg.

March 2014 Switched to Sertraline 50 mg od.

23rd June 2016 started taper 45mg

23.07.16 40.5mg 23.08.16 36.45mg 27.09.16 34.65mg 24.10.16 32.90mg 28.11.16 31.26mg 04.01.17 32mg 25.02.17 31mg 22.03.17 30mg 14.04.17 29mg 09.05.17 28mg 07.06.17 27mg 08.06.17 26mg 13.07.17 25mg 07.08.17 24mg 24.08.17 23mg 13.09.17 22mg 12.10.17 21mg 10.11.17 20mg 04.12.17 19mg 01.01.18 17mg 25.01.18 15mg 22.02.18 13.5mg 25.03.18 12.15mg 

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  • ChessieCat changed the title to Lakelander82: Sertraline general query and tapering info

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