Frost ; 5 months on 25mg sertraline/day

[Frost]

Hi.

So I have no real idea on how to really start this topic, especially since my time on the drugs and dosage seem very low compared to most - I also just started discussing the idea of stopping my medication with family/SO last week, and I just found this forum by googling the process of coming off it.

 

I was prescribed 25mg/day of zoloft(sertraline) at the beginning of February of this year, after about a year or so of depression (which I attributed then and now to being in the process of finishing college and just general worry about life & the future, along with the suicide of a good friend that hit me pretty hard).

 

It was prescribed after I had gone through a month of therapy, which I continued during my first 3 months on the drugs, and I found it to be immensely helpful even before I assumed the drugs to be working (though I suppose the two work together).

I felt an improvement in my mental state very early in the course of the medication, but started feeling somewhat impaired by it after about 2 months - I started feeling very nervous, and anxious more than I had been before, even though I was no longer depressed as I had been before, I started having severe sleep issues (3-4 day episodes of insomnia happened more often that I liked), and overall just felt odd.

 

I was initially told that it would take a few months for the medication to really take effect, and that I would likely need to increase the dosage after about half a year, but since I started feeling significantly better as far as my depression was concerned by the beginning of April already, I definitely do not wish to do that - whether or not that improvement was more of a placebo effect from starting the medication, or had to do with my general life situation bettering itself (finding a job, being able to do better in college), I do not know.

 

What I do know, and what made me initially hesitant to start these drugs in the first place is that they without a doubt have significant impacts, regarding brain chemistry, and lifestyle and I am now at a point in my life where I am more concerned about the impact of staying on the drugs rather than off them, especially since I have noticed side effects so early and on such a low dosage.

 

Since I was already on the lowest dose, I started the process of quitting today by taking a half pill (so 12.5mg) and was going to continue to do so until the end of this week, at which point I was hoping to stop the medication entirely.

 

From everything I have read on here however, tapering tends to be a much longer process than that, but it also seems like most of those experiences came from those who were on higher doses and/or for longer amounts of time.

 

I was hoping to hear from those who have had experiences (personally or through others) of quitting the medication early or on low doses, because I have read anything from no side effects to the worst side effects, but I found this forum to seem like a very good place for accurate and genuine information (which is hard to find on the internet), and any sort of information or help would be greatly appreciated.

 

I'm sorry if this post isn't well organized, I was really just trying to fit in all the information I could think of.

 

Thanks in advance for any helpful insights/comments

[scallywag]

Frost, welcome to SA!  I'm glad you've found us and hope that you find the knowledge and experience shared here useful.

 

Thanks for creating an introduction for yourself.  The next step is to create your signature.  This shows up below every post you make and below every message you send in the private message system.  Here's how to create yours: Please put your withdrawal history in signature

 

Some topics you may find helpful:

Tips for tapering off Zoloft (sertraline)

3KIS: Keep it slow. Keep it simple. Keep it stable.

Why taper by 10% of my dosage?

 

What you describe about increased anxiety while on the antidepressant is not uncommon, regrettably. Although Zoloft is prescribed for anxiety, a known side-effect of it is, you guessed it -- anxiety! If you're up for more reading as you finish college (Congratulations, btw!) you may find Robert Whitaker's Anatomy of an Epidemic educational, enlightening, and infuriating. He documents many studies about the ineffectiveness of psych drugs for many. I was taken aback to read that most depressions and anxious periods resolve on their own, WITHOUT medication. Your obvious inherent good sense is clearly something you can trust.

 

This topic/thread is for you -- post updates, track your symptoms, ask questions, communicate with other members, etc. I hope you'll be back soon to let us know how you're doing.

[Frost]

Thank you for the warm welcome. I added my history to my signature, and will continue updating it as I go along through the next weeks(months).

 

Thanks for the reading recommendation too! I added it to my list (which I work through one book a month or so, though it's been slower recently).

 

I was indeed very surprised at how easily/quickly I was just prescribed a drug that is definitely not to be taken lightly regarding its side effects and long term impact on people (if this forum is any indication of that). While I had been pretty comfortable with my therapist, the drug was prescribed by a general practitioner at my college health center, after about a 15 minute interview about my depression, which I felt was entirely insufficient to diagnose anything, much less something as complex as depression.

 

The anxiety being a Catch-22 is very annoying indeed, but hopefully it will improve quickly as I get off the medication.

[scallywag]

Thanks for adding your signature.  A GP who didn't know you should have taken much more time with you before prescribing an SSRI than a 15 minute appointment. Walk-in type health centres are a crap shoot.  I commented earlier on your good sense; our 2^nd post makes me say, "Ditto."

 

Some people find 2 supplements helpful with anxiety, depression and withdrawal symptoms of the same: magnesium and omega-3 fatty acids (fish oil).

[brassmonkey]

Hi Frost-- welcome to the group. I'm so glad you found us before things got too far. You're in an excellent position to taper off of the zoloft, but is needs to be done correctly. Unfortunatly these are extremely powerful drugs, a point most doctors don't seem to understand, and if a peson has been on them, even at a low dose, for over a month they are at risk of developing Withdrawal Syndrome if the drug is removed too fast. Because of that we recommend the 10% method that SW directed you to with the links above.

 

You mentioned having cut you dose in half yesterday. This is not a good thing. Large or rapid changes in dosage have a bad habit of oversensitizing the body to the drug and can make it so any dose change causes an extreme response. It would be a very good idea to reinstate the full dose and allow things to stabilize for a couple of weeks before starting a planned 10% taper. Any dose change, either up or down, takes a minimum of four days to become steady state in the blood. Once the drug is steady state the body can start adjusting to it. The one or two days of a 50% cut may trip off some symptoms even with a quick reinstatement. That's why I said to wait a couple of weeks before starting any taper, to give yourself time for things to sort themselves out.

 

Each individuals experience with WD is different so it's not accurate to compare your situation with others. Most of the other members here have been on high doses for a long time, been poly drugged, fast tapered or CTed. These are entirely different situations from the one you're in. Done correctly there is a good chance that you will hardly notice the taper as it proceeds.

[Frost]

Thanks for the words of advice! I do like the 10% process being mentioned & the science I've read behind it seems solid. My two concerns are A. that I will be going to Japan in August, at which point I would like to be off the drug entirely, due to the difficulty of availability/import there, and B. my general dislike for being on it for any longer than I already have been.

 

I was first thinking that if I did follow a tapering process I could cut back 10% each week (given the 4-5 day adjustment period you mentioned). 

 

But I was also thinking, and I fully understand that this is a rather radical process, but again due to the pretty short time and low dose I was on the drug for compared to most, that I might be able to handle any withdrawal symptoms fairly well in just quitting my medication entirely - I did my research on withdrawal symptoms, and they do not sound impossible to manage given a good support system of friends, family, loved ones, exercise, diet, sleep, supplements, etc. 

I have dealt with withdrawals from recreational drugs before in my life (1.5 years of opiate addiction which I voluntarily ended within a month - withdrawals sucked so bad, but I got through them).

 

If this isn't an appropriate thread for this forum I apologize sincerely, I do not mean to discredit all the great advice and work given here - but as you and SW have said, my scenario is quite different from those who have been on the drug for years.

 

What also made me further consider this method of quitting further is how you mentioned that large or rapid changes in dose oversensitize the body to the drug - wouldn't quitting it entirely be (while possibly miserable for the withdrawal period) be doable since in that case the body wouldn't further be exposed to the drug at all, and as such oversensitization wouldn't be an issue beyond initial withdrawal? (Maybe i'm understanding that wrong, in that case do correct me!)

 

Ultimately I am trying to figure out, would I only be dealing with withdrawal for a week/month long period at most or could it still be longer lasting?

(And I guess this is more me asking myself since this is a very underdocumented case from everything I've read here and elsewhere on the internet).

 

*Edit: After doing some more research, anecdotal evidence (to be taken as that, of course) I've found for other cases in which people quit after less than half a year, their withdrawal symptoms seem to be significantly less pronounced/long lasting than those on it for longer than 1 year. Symptoms for "short" term use seem to be mostly limited to the "brain zaps" (which I am incredibly interested to experience because descriptions sound like they can't do it justice) for anywhere from 1-3 weeks. Other common symptoms are overwhelming emotional availability (Crying spells, irritability).

 

I also get that ultimately this isn't the safest/most pleasant way to do this, and I wouldn't go so far as to say that anyone should decide this based on my choice, but I feel like it is worth a try for me personally.

 

Again, I apologize if I seem naively eager to get off this, or sound like I don't value all the advice given, but I really dislike the way in which it has affected me during the last 2 months or so, and maybe my confidence in being able to handle getting off it is misguided. But I feel like it is worth trying to handle these symptoms, and if anything document my experiences for others who are looking to get off the drug after a short time (<half a year) /low dose (lowest prescribable dose of sertraline), if only to say - hey, its not worth just quitting, taper, even if you've only been on it for a short time/low dose.

But the possibility of quitting with withdrawal of a week-month versus quitting over the course of almost 3 months and then still having possible withdrawal symptoms seems like something worth trying to me. 

Edited June 14, 2016 by Frost

[scallywag]

Frost, our advice is almost always to take it slow, 10%.  What you actually do is up to you.  You're currently at 12.5, having made that change yesterday.  Hold there and keep track of your symptoms, if any, and when they occur.  That will give you data and a view, admittedly only a partial one, of w/d for you.

 

I hope that you'll keep in mind that you don't want to be going through extended post-fast-taper withdrawal symptoms when you're in Japan. How long will you be there? Have you confirmed availability problems of Zoloft (sertraline) in Japan?

[Frost]

I understand that this is highly unorthodox in terms of your recommended methods, and that's why I really am thinking about this immensely today and for the next few days, trying to make an educated decision for my own situation. I will definitely continue my lowered dose for the week, and keep track of any symptoms that I notice.

 

Sertraline in japan is a highly controlled substance (and many other anti-depressants are not available at all), as such I would have to have it prescribed by a psychiatrist there, or a psychiatrist here - which would require a visit to a psychiatrist which I have never done or felt necessary before - and which I do not find appropriate considering I haven't actually been depressed in 2 months.

I wouldn't really know what to say, besides "i need more of my medication so I can stop my medication."

 

Perhaps I should have never been on the medication in the first place, but that is an irrelevant point for me to consider now, as the past is obviously unchangeable.

 

But you also addressed my main thought behind speeding up my process of getting off the drugs now, regarding the possible withdrawal symptoms later - I am thinking that I would rather deal with symptoms (whether they last a week, or 2, or the next 2 months) now, where I am at home, with family, and without much stress before my time abroad.

This way, should I notice a significant relapse, or absolutely unbearable symptoms of withdrawal, I would be able to restart the medication (possibly at a lower dose) in time before Japan, until I am ready to taper off it completely after that time (I will be in Japan for 8 months).

 

But the other alternative, in which I do not try this at all, to me seems to be staying on my current dose until after Japan to avoid any symptoms there, from tapering throughout the summer, which would be effectively tripling the time I have been on the medication already - which makes me concerned that the process of quitting it AFTER that would be much more difficult, even with tapering.

 

Like I said, my main reason for considering this is that here and now I can focus 100% on getting over this medication and really not much else, without any acute causes/factors of anxiety/depression.

This is how I would ultimately like to see as well whether my depression is/was acute or recurring, or in a way rational or irrational - I still think that my depression was to the greater extent mediated through therapy (in which I was always only diagnosed with "mild" depression symptoms, and only once I started the medication did the concern of anxiety become apparent to my therapist).

 

I really hope that this will be a relatively easy process, and that is all I can hope for at this point - ultimately only time will tell.

Thank you again for your very immediate and thoughtful responses! The support you are offering even when I'm really being somewhat stubborn is heartwarming

[brassmonkey]

Ultimatly the decission is up to you, we can only make suggestions based on what we have seen and experienced. It is good that you're researching the move fully before your make it.

 

I have known several street drug addicts you have gone on to WD fro ADs also and to a person they agree that ADs are many times harder than herion to get off of. The mechanism that ADs work be is totally different than street drugs and their Addiction and WD are not the same. ADs make physical changes to the brain and nervous system. These changes are well established by the end of the first month of use. They also require the presence of the drug to be maintained and function. If the drug is removed the brain litterly can't function properly and causes all the symptoms we all know and loth. By withdrawing the drug slowly the brain can systamitacly undo the changes and return to normal with only minor disruptions. We all want the drug out of our bodies as soon as possible, but because to the physical changes it's just not practical.

 

Your situation is different in that you only have one drug to fight off, not several with compex interactions. But none the less it can be a difficult process. There are not accurate numbers but we have found that only 20% of people trying to get off these drugs have no difficulty quitting quickly. The rest of us have problems ranging from mild to the cases you see here and worse.

 

WD is frequently complicated by the fact that there is a honeymoon period after a quick reduction/taper or CT during which the person feels great for several weeks. Then one morning they wake up with the worst symptoms they have ever experienced. Once this has happened their system has become sensitized and it is very difficult and takes months to get things back on track, if stability can be acheived at all. Many people think that "oh, if it gets bad, I'll just go back on the drug and everything will be Okay". There is a very short window during which reinstatement is fairly assured to work, but the longer one waits the less likely it is to happen, and the more likely an adverse reaction is to occure. An adverse reaction makes normal WD look like a picnic.

 

Either way you look at it, you're going to have some symptoms while on your trip. You're experiencing some side effects already so if you stay on, then you'll have those to contend with. If you fast taper the symptoms won't be cleared up by August and you stand a good chance of the honeymoon period ending while you're there. I would suggest staying on until you get back and then doing a nice controlled taper. We can't say how long WD can take because each case is different. Simple math will tell how long a basic 10% taper will last, but that's only part of it. Anicdotal evidence shows that it will take a long time.

 

Again though, do your research and the decission is up to you, and I really hope you have an easy time of it.

 

BTW I really miss my spell checker.

[scallywag]

Seconding brassmonkey's well wishes for you.  I hope you're one of the unicorns - people told of in urban legends who go off ADs with little to no withdrawal!

[Frost]

So it's been a while, but since I am now on my 7th day of 0mg, and overall I'm doing great - I wanted to share my progress (which I wrote down in a journal day to day):

 

June 13, 2016

Took 12.5mg first time.

 

Felt pretty good overall, no noticeable difference, slightly less tired (placebo?)

 

June 14, 2016

continued 12.5mg dosage

 

no noticeable symptoms from previous day, probably expected in the next 2-3 days?

 

Headache in the evening, not bad enough to lose sleep

 

June 15, 2016

First day of 0mg

 

Woke up with mild headache/upset stomach (possibly due to rapid dose change? Also drinking the night before), got better as I got up & ate some food

 

mild headache in the evening, no other symptoms so far

 

June 16, 2016

second day of 0mg

 

woke up feeling kind of weird, anxious, headache, tingling extremities

 

felt better within the hour, mild headache remained, but barely noticeable once fully awake

 

mood still the same, no noticeable changes as far as mental status is concerned after that morning

 

June 17, 2016

day 3 of 0mg

 

no mental symptoms, physical limited to some mild headaches in the mornings. usually goes away within an hour or two

 

June 18, 2016

day 4 of 0mg

 

still nothing beyond some minor headaches that last maybe 1-2 hours, never more than 3 hours after waking up

 

June 19, 2016

day 5 of 0mg

 

some nausea and continued headaches in the morning

 

June 20, 2016

day 6 of 0mg

 

mild irritability/overly emotional (crying during movies) but in a good way - feels nice to be able to cry without being really depressed, having emotions again versus feeling kind of emotionally numb, headaches are getting better over all

 

June 21, 2016

day 7 of 0mg

 

headaches,the most persistent symptom so far. Also didn't sleep well (due to being up til like 4am for other reasons), some nausea (which might have been due to eating mcdonalds at 4am, which I don't usually do and hangover) – still no real mood changes/mental symptoms of concern beyond that anxiety one morning

had what I *think* was my first brain zap? Not sure. Thought they'd be more noticeable. Maybe just stretching a muscle in my neck.

 

-------------------------------------------

 

so in summary i'm doing pretty well. while the headaches are annoying, they've been getting better, and I haven't really noticed any significant changes in my mental status - the closest to it would be something that I'm having a hard time describing, in which I feel more... able to react? Feel? I don't know, everything just seems more interesting & I don't have the general zombie-like emotional apathy i started to notice in the last month or so on the drugs.

 

I will update this further, at least for the next 2 weeks I still plan on doing journal entries day by day, after that (assuming I am still doing fine) I would do them week by week until the end of the summer.

[scallywag]

Frost, I hope you're one of the lucky ones who can make the jump from 25 mg to 0 mg sertraline within a week with only mild symptoms that don't last long.

 

June 12 looks to be your last day at 25 mg sertraline, which you have taken since Feb.

June 13 you dropped to 12.5 mg

June 15 you stopped

 

That's a BIG change for your brain and the rest of your central nervous system (CNS). Even though you were on a low dose for only 4 months , your symptoms are informing you that your CNS has made modifications in response to sertraline's presence and effects.

 

If you get new or worsening symptoms, please post.

[wareagle82]

Good luck Frost.  I know you'll be fine.  The advice here is good and well researched.  But you also have to know that each person is different.  I plan on a slow taper as recommended, BUT the truth is that no doctor or anyone here can predict what will happen with a faster taper, or even Cold Turkey.  There are people who can do that and sail through.  Do what you think is right and keep your eyes wide open as to the possible consequences.  If you need help you've found a good source.

 

Steve

[Frost]

So I'm getting along very well! Thanks wareagle for the words of encouragement

 

Here's my "journal" entries for the time since my last (I started condensing it into weekly posts, as day by day I wasn't really noticing much):

 

June 22-29, 2016

days 8-15 of 0mg

 

Headaches disappeared completely over the first couple days, otherwise no further symptoms that I've been able to identify

 

June 29-July 4, 2016

days 16-21 of 0mg

 

physical symptoms entirely absent (no headaches, never experienced any brain zaps except for the possible one on June 21). Some mild worrying about small things, but it feels good – in the way that before everything seemed dampened, unless it was extreme, so that unless I was massively freaking out, I was just kind of passive to everything. I don't know how much I was aware of this while on the medication, but being able to actually feel some worry, nervousness, etc, without it being extreme is nice. I wonder if these were moreso from the anxiety side effect of the medication?

 

Overall I'm hoping no effects will still present itself this far after, but I'm still being careful, and will continue to monitor my condition (as well as having friends and family and my SO keep an eye on it).