RecentlyDisillusioned: Sertraline - time to reinstate and start gradual taper?

[RecentlyDisillusioned]

Hi,

 

I have suffered from mild to moderate depression for most of my life but had always refused to take medication as thankfully it was never too extreme and I felt uneasy at the thought of messing with my brain chemistry. 

 

I developed "postnatal depression" after having my second child.  I always felt that my depression at that time was really just a natural reaction to dealing with very little sleep and bringing up 2 small people with no extended family support.  But I was worried my mood swings were no longer just my problem and they could potentially be harming my children so I agreed to start taking 50mg of sertraline towards the end of 2014, and then soon after increased the dose to 100mg which seemed to help (but who knows??)

 

My GP has been encouraging me to stop the meds for a while so we agreed on what I guess is a fairly typical schedule, and I made it a bit more gradual as I had noticed pretty bad withdrawal symptoms when I had previously run out of tablets for just a couple of days.  I started reducing in April this year.  My GP suggested to immediately drop down to 50mg/day but I alternated 100 and 50 for a couple of weeks first, then 50/day for a few weeks, then alternated 50 on and 50 off for a couple of weeks and stopped completely a few days ago. Since then, I've started to feel awful brain fog/dizziness most of the time, I've had a couple of brain zaps, insomnia, tiredness, rage and today I've started getting a bit weepy.  I thought I was doing fine with the dose reduction before this week, but looking back I think I have probably had more anger than normal for a few weeks now.  It is quite confusing because I've always suffered from rage during certain times of the month and I am still breastfeeding my toddler which seems to make the rage worse as it messes with my hormones, so its quite hard to gauge whether it has actually been worse than "normal"

 

I went into a bit of a panic today about the whole thing and dear old google led me to this site and opened my eyes to all the people going through hell trying to come off these drugs.  From what I've read on here so far, it sounds like my best bet would be to reinstate the sertraline and then do a proper gradual taper.  I didn't read enough before deciding to just pop a 50mg tablet this evening as I was so desperate to feel better.  Then I read more and wondered if I could've started back at a lower dose and perhaps its not too late to try that?  Where would you recommend I go from here?  Sorry I have been quite vague with dates, I've already forgotten which day I last took a tablet before today.  

 

I'm in the UK so from what I've read on here so far, it sounds like I probably won't be able to find sertraline in liquid form so I will probably make my own solution - does that sound like the best option?  Do I need to make a fresh solution each day?

 

I'm already feeling so glad to have found this wonderful site and hope it may have saved me from a hellish withdrawal experience! Many thanks

 

 

 

[Shep]

Hi, RecentlyDisillusioned.

 

Welcome to the forum. It sounds like you've been bouncing around the sertraline doses for quite awhile now, so no wonder you're not feeling so well.

 

Once you stabilize and get started on a slow and careful taper, hopefully a lot of those symptoms will quiet down. 
 

My GP suggested to immediately drop down to 50mg/day but I alternated 100 and 50 for a couple of weeks first, then 50/day for a few weeks, then alternated 50 on and 50 off for a couple of weeks and stopped completely a few days ago. 

 

 

And then you mentioned taking 50 mg today. It takes at least 4 days for your mind and body to register a reinstatement. During this time, it's important to write down the time of day you take the sertraline, the dose, and your symptoms.  This is a great resource to help with that: 

 

Dr. Joseph Glenmullen's withdrawal symptom checklist

 

You may be hyper-sensitive already to this medication, so please take notes, as it will help determine your next step in the reinstatement. Please do not skip doses  - alternating doses will further destabilize your already fragile CNS. 

 

I don't have tapering experience off of sertraline, so I'm going to ask the other mods to check in with you when they're online. In the meantime, here are some links to read over that will explain reinstating and tapering: 

 

About reinstating and stabilizing to reduce withdrawal symptoms 

 

Why taper by 10% of my dosage?

 

Tips for tapering off Zoloft (sertraline)

 

These links explain the symptom pattern of withdrawal and recovery;

 

What is withdrawal syndrome? 

 
The Windows and Waves Pattern of Stabilization

 

Some people find fish oil and magnesium to calming to the CNS. Some people are still too sensitive for supplements, so please research carefully: 

 

King of supplements: Omega-3 fatty acids (fish oil)

 

Magnesium, nature's calcium channel blocker

 

This is your thread to keep up with your symptoms and ask plenty of questions. I'm glad you're here for support. Other mods will check in with you when they're online. Wishing you much luck on your taper. 

 

 

 

[gn11]

Hi RecentlyDisillusioned,

 

I just found this site a few days as well. I have found it to be very helpful so far. I've learned a lot from reading and I've had some helpful responses. I hope you find what you are looking for, My situation is very different as I was in a 5mg dose of Celexa for over a year. I wasn't able to drop below that because the doctor put me in a taper that was too fast  according to  I've learned here. After eye surgery and a  longer course of cortisone drops (longer than I should have by medical mistake). I started getting very sick...just recently I realized that I was having withdrawal symptoms. Anyhow, I increased my dose and will go to a slower taper starting in a couple of months.

 

My experience is that I had to figure out all this things on my own as  doctors don't seem to be educated on withdrawal issues.

 

Good luck with your recovery and best wishes!  

[RecentlyDisillusioned]

Thanks so much for the replies. My main question now is whether 50mg sounds like a sensible level to try and stabilise at and to start the tapering process from?

[Shep]

Yes, the 50 mg is a good starting point. Taking it at the same time of the day will help with consistency. Also, please read over this link on reinstating:

 

About reinstating and stabilizing to reduce withdrawal symptoms 

 

It takes at least 4 days for your system to register a reinstatement. During this time, it's really important that you keep track of your symptoms. This will help you decide how you proceed with your reinstatement and taper.  

 

Please let us know how you're doing over the next few days. 

[JanCarol]

Hey RD, I wish I could put my fingers on the quote.  It was from David Healy, a respected psychiatrist in the UK who is raising awareness about these drugs - and while - it is not the best to be pregnant or breastfeeding on them, you also need to function.

 

To rip you off the drug now, would be more traumatic, too difficult.  

 

Slow and steady, take care of yourself and baby.  It's the best you can do at this point.

 

Once you've stabilized we can talk about tapers.  Here's something to think about in the meantime - a post about why we don't "alternate" doses:

Every-other day dosing

 

Welcome to SA!

[RecentlyDisillusioned]

Thanks Shep and Jan. I already feel much better today, although I think I might have some mild side-effects from going back on. Nothing as bad as how I was feeling from the withdrawal. It's the first day in ages that I've not shouted at my poor babies, all thanks to this site! I've started keeping lots of notes on symptoms so I hope I'll manage to keep that up.

 

I actually started to wonder if my breastfed son could possibly be suffering withdrawal too. I think studies have found only trace amounts of sertraline get passed through breastmilk but he is 2 years old and still feeds a lot so I very much doubt whether there's any data relevant to our situation. The last few days he has been very difficult but of course that is totally confounded by my state of mind so I guess there's no way of knowing.

[Shep]

How are you feeling now RD? I think it's been about a week since your reinstatement. Do you feel that it's working?

 

Hope all is going well with you and your babies. 

[RecentlyDisillusioned]

Hi Shep. Thanks for checking in with me. Yes, I am feeling so much better now. It didn't take long at all after reinstating to feel "normal" again.

 

So I think I may start to taper off in a couple of weeks.

[JanCarol]

That's good, it means that your symptoms were withdrawal.

 

Take your time to taper.  Please let us know in your signature, your current dose, and date of discontinuation and reinstatement.

 

Maybe wait a month.  A gentle taper is the best way, to keep you healthy for bub - and - to keep from giving him withdrawal symptoms, too.

 

Please review the links that Shep provided, to see if you have any questions before starting your taper.  This is a thing better prepared for, making sure you have food in freezer, and someone to call if you get upset.  Preparing to Taper

 

and Psych Central 6 Ways to Prepare for Antidepressant Withdrawal

 

I'm so glad you are feeling better!

[RecentlyDisillusioned]

I've finally decided to start my taper process.  I've been feeling pretty stable since the reinstatement.  My GP is not being very supportive of the gradual taper approach and feels I will be fine if I just halve my current dose (so go from 25 to 50mg/day sertraline) for a few weeks and then stop and she thinks I just need to ride it out.  I'm convinced she is wrong but she isn't willing to prescribe liquid sertraline so I have just ordered a digital scale and my maths is good so I'm planning to do some pill cutting at least initially.

 

Has anyone used a device like this - https://www.amazon.co.uk/Capsule-Connection-Machine-00-Kit/dp/B006OQ4316/ref=cm_cr_arp_d_product_top?ie=UTF8?  I will post in the taper forum too.  Thought it might be ok at least in the early stages before I need to get more accurate.

 

Wish me luck!

[scallywag]

Here's a topic about Using a digital scale to measure doses.

 

I've seen the device you posted. I'm not sure that it would be useful for tapering. I will look at it again when my taper is complete for making custom supplements.