Struggling: Reinstatement

[Struggling]

Hello, I have been reading this site for months and months, and just decided to join, sadly too late.  I wish I had found this info sooner, as I would not be dealing with what I am dealing with now.  I have some very specific questions, as my history is a bit complex, and cant find any topics to relate to.  

 

I am almost 8 weeks into my 25mg reinstatement of Zoloft, after a too fast taper from 100mg which I took for a year, tapered to zero last december.  Back then I went through the classic acute symptoms, severe fatique, brain zaps, brain fog, tinnitus, eye pressure, weight loss.etc.  

 

Then I was taking prozac 20mg on an as needed basis. Which helped at times, I was able to work and get through the day, but then things went bad this past May.  I was debilitated (anxiety like I have never in a million years knew existed, insomnia, night sweats, intrusive thoughts) and out of work for 2 weeks.  

 

Thats when I realized I should go back on the Zoloft, which is what originally sent me into w/d syndrome (I thiink). Slowly began to stabalize mentaly, but been having bizarre symptoms like near hypo glycemic events, but my sugar isnt low (i check it) and constant empty feeling in my stomach, like hunger, but I dont want to eat.  

 

I have had several awesome days (besides the empty/hungry/anxious/ gut feeling), sharp as a tack days and overall my mood has been good and not too much anxiety.  Today was my worst day yet.  I had a muffin, which I had cut out sugary carbs, and things went bad.  Burning in my face and scalp and super anxious feeling.  Had 2 bad shaky events (low sugar feeling) in one day, which hasnt happened yet. 

 

My question is, has anyone had this (low blood sugar feeling) how long does it last, and could I have reinstated too much zoloft as I have never had this before. Sugar def is a huge trigger for me I have noticed.  Am I still having w/d sydrome even tho I reinstated? Should I go up in dose, ride it out, or go down? Are windows and waves normal after reinstatement? 

Edited July 23, 2016 by scallywag
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[downtongirl]

Welcome struggling...sorry you have been through this ordeal.  A moderator will most likely be by shortly.  I am glad your reinstatement is working...I am trying to reinstate/switch to prozac myself.  May I ask how long after reinstatement before you started feeling back to normal?

[Struggling]

Thanks for the reply:) I was out of immediate jeopardy after maybe a week or two, however it seems as though I am going through massive windows and waves since i began reinstatement.  I am not stabilized yet.  

[downtongirl]

what have been your worse symptoms....I am struggling with waves of anxiety that jolts through my body, terrible insomnia most nights I can not sleep a wink with out a sleep aid, and some days very bad anhedonia.

[Struggling]

My worst symptoms are this feeling of low blood sugar.  This has happened about 5 times since i reinstated.  It is scary because whatever Im doing, I need to have access to the right food to stop it.  i get shaky and confused.  Today is one of my worst days yet.  I started out with a good day, virtually no anxiety, been sleeping great, but then the brain fog came and I had a cup of coffee to try to wake up, knowing that would make things worse.  Right now I pretty restless, and my vision is so blurred, I have to do this on the computer because I cant see the small print on my phone! overall, my symptoms have been present, but manageable.  I work full time, am a single mother of 3, and am trying to hold it all together.  I have read that reinstatement can take months.  I keep praying for the switch to happen!

[downtongirl]

Hmmm....I don't think I have had the symptom of feeling like you have low blood sugar...doesn't sound like fun.  When you quit was anxiety a big symptom for you and did you struggle with sleep?

 

Is your restlessness an inability to sit still?

 

I know I am hoping and praying it does not take months to stabilize.

[Struggling]

Yes inability to sit still.  I have never felt so many forms of anxiety that I have in this last year.  It has ranged form sever heart palpitations, heart rate of 130, muscle tightness, burning sensations, tingling, and restless feeling.  I often get the restless feeling in the morning, but resolves.  Overall my sleep has been pretty good.  I cut out sleep aids cold turkey and have been using sleepy time tea. I have had maybe 3 nights of terrible insomnia, 2 being near the full moon.  I have a feeling tonight might be one too.  I think Im in a bad wave.  How long have you been off meds that you are trying to switch to prozac?

[Struggling]

Since I reinstated, I have had a pretty clear mind and no heart anxiety.  A lot of reactions to food, which is extremely difficult to manage.  

[downtongirl]

Well I am a taper/ct failure story for sure....I have been trying to become med free since 2008....followed dr.'s advice in spring of 2008 and in three months quit effexor xr, zoloft, and klonopin after 13 years...after a month I crashed and successfully reinstated.  In 2010 I started a year long taper to get off of trazadone and effexor xr....had to bridge to prozac and buspar to do so....then I did a ct with prozac and buspar because my dr. said I was on such low dosages that I could just stop them...yea not so much a bout a month later crashed and ended up on cymbalta and klonopin....then in 2012/2013 I began tapering off of klonopin and it was hell.  Then tried some other ad's with not much success...I have had withdrawal so bad that I have ended going to the hospital and admitted as an inpatient 6 times in the past 5 years.  Last summer I bridged once again effexor to prozac and it worked stayed on just prozac for a month and stopped....survived three months until January this year and crashed big time!  Tried to reinstate didn't work...ended up on lamictal and gabapentin and effexor.....this time effexor did not work like it had done before so in June I started the transition to prozac and it is not working as well as it did last summer.  So to answer your question the longest I have been psych drug free in the past 21 years is 3 months.

[Struggling]

Wow it sounds like you have been struggling for a long time and I'm afraid that's what I am up again since I have been on these drugs a very long time myself. Have you found any help here on this site?

[downtongirl]

Yes I have...there is a wealth of knowledge here and a lot of valuable information.  I would highly suggest reading the symptoms and self care forums there is also a link for reinstatement.

 

Don't compare yourself to me I have no patience never have always been a down fall of mine.  You are holding steady with a dosage which I have not been doing over the past month but am going to!  I have read it can unfortunately take a couple of months.

 

Has the reinstatement helped the restlessness, agitation, anxiety or did the reinstatement cause that?

[Struggling]

I thought thd reinstatement was helping, however I have been in a bad wave since last Friday. Thars why I posted here, was hoping to find out if my dose is way too much or not enough. It hasn't been a regular pattern, which I read is prob wd symptoms. But it's so frustrating to feel so great one day then horrific the next.

[downtongirl]

Hmmm....you might need to go up a bit but I would wait for a moderator to reply.

[Struggling]

This is my first post lol did I post in the right place? How long does it take to get a response? It's seems alto will know what I should do

[nz11]

Hi Struggling.

Yep you posted in the right place. Sometimes you can get a response real fast. SA operates 24/7.

It can take months to stabilize esp when you have shaken a 15 yr apple cart.

nz11

[scallywag]

... I am almost 8 weeks into my 25mg reinstatement of Zoloft, after a too fast taper from 100mg which I took for a year, tapered to zero last december.  Back then I went through the classic acute symptoms, severe fatique, brain zaps, brain fog, tinnitus, eye pressure, weight loss.etc.  

 

Then I was taking prozac 20mg on an as needed basis. Which helped at times, I was able to work and get through the day, but then things went bad this past May.  I was debilitated (anxiety like I have never in a million years knew existed, insomnia, night sweats, intrusive thoughts) and out of work for 2 weeks.  

 

Thats when I realized I should go back on the Zoloft, which is what originally sent me into w/d syndrome (I thiink). Slowly began to stabalize mentaly, but been having bizarre symptoms like near hypo glycemic events, but my sugar isnt low (i check it) and constant empty feeling in my stomach, like hunger, but I dont want to eat.  

 

I have had several awesome days (besides the empty/hungry/anxious/ gut feeling), sharp as a tack days and overall my mood has been good and not too much anxiety.  Today was my worst day yet.  I had a muffin, which I had cut out sugary carbs, and things went bad.  Burning in my face and scalp and super anxious feeling.  Had 2 bad shaky events (low sugar feeling) in one day, which hasnt happened yet. 

 

My question is, has anyone had this (low blood sugar feeling) how long does it last, and could I have reinstated too much zoloft as I have never had this before. Sugar def is a huge trigger for me I have noticed.  Am I still having w/d sydrome even tho I reinstated? Should I go up in dose, ride it out, or go down? Are windows and waves normal after reinstatement?

 

Hi Struggling -- Welcome to Surviving Antidepressants (SA)

 

I hope you'll find the information in the SA forums enlightening and helpful for your taper.  I'm sorry that you are in the position that you need the information, but am glad that you found us.

 

To answer your questions:

 

Waves of symptoms can continue after reinstatement.  It's difficult to predict how long they'll last or which ones will occur for any individual.

 

Shaky, low-blood sugar events are generally prevented by having sufficient protein at meals and snacks and minimizing refined carbohydrates or high glycemic carbohydrates (there are different carb strategies). Finding a way of eating that keeps your blood sugar levels steady.

 

As for what you should do, that depends on your symptoms. Would you keep track of your symptoms on paper and then post them here? 

A request: Would you summarize your history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-18 months particularly? Any drugs prior to that can just be listed with start and stop years. Please put your withdrawal history in signature

[Shep]

Hi, Struggling.

 

Here is some information on tapering Zoloft, as well as the link to the thread on reinstating:

 

Tips for tapering off Zoloft (sertraline)

 

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

 

Please see these links for more information about what to expect during withdrawal and recovery:

 

 

What is withdrawal syndrome?
 

 
The Windows and Waves Pattern of Stabilization

 

 

Welcome to the forum. I'm glad you're here for information and support. Please use this thread to keep up with your symptoms and to ask plenty of questions.

 

 

[Struggling]

Scalllywag is the low blood sugar problem common in wd? I have checked my sugars w a glucometer and have been normal. And the severe events like yesterday have only happened a few times since 2 months of reinstatement.

I will try to keep better track of my daily symptoms as I have not been doing that this whole time. I have def noticed that sugary carbs, (which I used to live off of) are a trigger for flushing/burning sensation and what I believe is carb intolerance. I stopped eating sugar completely a few months ago which put my nervous system in more shock since I was a heavy sugar user. Seems that when I consume it, my system is just so confused. Unfortanetly I am a smoker and haven't had the strength to quit through this but the smoking and caffeine doesn't have an impact like sugar, weird.

[Struggling]

And what is meant by an immediate bad reaction to the drug? All my symptoms are consistent with wd syndrome, so I wonder if I should go up some on the Zoloft. I have read that some have RI tiny doses and after reading that, 25mg seems like a really large dose.

[Shep]

You wrote, "All my symptoms are consistent with wd syndrome". When you reinstated 8 weeks ago, did any of your withdrawal symptoms resolve? Do you feel you are functional now in comparison?

 

You mentioned blood sugar issues. These are VERY common during withdrawal, as antidepressants can affect insulin and cause metabolic issues (weight gain or loss).

 

Here's a thread with more information:

 

Sugar: Its effect on mental health and withdrawal

 

There are a number of other threads you can find by using the Search feature.

 

A great website for information on diet and withdrawal is Beyond Meds:

 

Beyond Meds - Gut Health

 

 

Many people find that following a basic low-blood sugar diet can help, which involves plenty of protein and decreased carbs, especially refined carbs and sugar. Eating several small meals throughout the day may help. Many of us simply can't tolerate sugar or caffeine during withdrawal and well into recovery. And some of us have to follow elimination diets due to GI problems. Antidepressants are notorious for causing all sorts of GI problems, as 90% (or more) of your serotonin is located in the gut.

 

Do you feel that if your low blood sugar symptoms were resolved, this would help enough and you could continue on at your current amount of reinstatement?

 

[Struggling]

After reinstatement I got my brain sharpness back, lethargy was gone, I felt motivated, my psych is pretty intact. But then the bad days hit, then I forget the good ones.

Food in general is a huge problem for me since the original reason for going on these drugs around 1999, was for bulimia. I feel I'm metabolically impaired to begin with. I have had a constant empty feeling in my stomach after reinstatement, like I never really feel full. That comes and goes and so does the feeling of low blood sugar. The brain confusion gets bad during a bad event, like yesterday. My sleep has been good which makes me very lucky.

Overall, I have been fully functional, I am a nurse and work full time and am surrounded by stimulation (lights, noise, etc).

I guess I'm being impatient, since yesterday was a very bad day, and I'm just so mad that I have to have to be so cautious w food. I miss carbs

[Shep]

I hear you, Struggling. I also miss carbs. I actually was a long time vegetarian before withdrawal, but I became so weak and was unable to handle supplements (they caused severe GI problems), so I slowly added in fish and chicken. It really helped. I eliminated processed food and refined carbs. My diet is really clean - no caffeine and almost no sugar.  And it's made a huge difference.

 

It really sounds like you hit a kind of "sweet spot" with your reinstatement and are dealing with the usual windows and waves, but are for the most part functional. This is good. There will be good and bad days, but with a slow and careful taper, I hope you're able to stay just as functional.

 

There is a non-drug coping skills section you may wish to check out that may help as you have to deal with work stress and stimulation:

 

Non-drug techniques to cope with emotional symptoms

 

Perhaps incorporating mindfulness and other stress and anxiety reducing techniques will help if any residual bullimia symptoms should arise.

 

Use as much self care as you can, and you'll do just fine.

[Struggling]

Thank you for the support, so glad I came here. I have a lot of reading to do! I've been doing acupuncture and chiropractic often, and the chamomile tea really had helped my sleep considering I was dependent on sleep aids forever.

It's a lot of change all at once, which can be overwhelming in itself. I cut out Diet Coke and the carbs.. And drink tons of water. I have lost 25lbs since May, but that seems to be common.

I think I will stick with my dose for a while longer then decide which way to go.

I did read a post that someone reinstated a double dose and at 3 months the switch happened. So I'm praying it will be that way for me.

????

[Shep]

Struggling, please give us more information on the "sleep aids" you were using. The names, doses, and the date you came off may help give an overall picture.

 

Some sleep aids carry a difficult discontinuation syndrome, so it's important to know what symptoms are coming from prior meds and what is happening due to your current reinstatement.

[Struggling]

I always used a PM something with doxylamine succinate or diphenhydramine. I only took 12.5 never used a whole tab d\t the groggy next day. I can't really remember dates but it seems Benadryl was the one I was using most recently and it was a children's tablet which I cut in half which would make it 6.25 mg . At the end of May I stopped the Benadryl cold turkey because I learned about their serotoninergic effects snd got scared of serotonin Toxicity. So I started the tea. How long could sleep aid discontinuation last for? I also used 0.5 mg of Ativan for about a year many many years ago I never had a problem getting off of that drug. for some strange reason.

[Shep]

I am so glad you are off Ativan. I was afraid you were also dealing with benzodiazepine withdrawal, but if it was many years ago, you should be okay. However, please be very careful of benzos in the future. Some people are able to come off a benzo once, but the next time it's much more difficult. The same with other psych drugs. This is a thread that explains how this happens:

 

Limbic Kindling -- Hardwiring the brain for hypersensitivity

 

You are right about the serotoninergic effects of drugs like Benadryl - it's best to avoid, especially during withdrawal when your system is fragile. How long "sleep aid discontinuation" lasts for really depends on the individual.

 

How are you sleeping now? If sleep is still an issue, please check out the information here:

 

 

Melatonin for Sleep

 

 

Sleep problems - That Awful Withdrawal Insomnia

 

 

[RachelSusan]

Welcome struggling...I wanted to introduce myself because I too and struggling.  I reinstated my zoloft some 17 days ago and I am just now starting to feel a little better after a great deal of physical symptoms. I hope you feel better soon.

RS

[AliG]

Struggling. Welcome. I'm so glad that you found us. If you follow the protocol outlined here you should be fine. How are your symptoms now ? Do you feel the reinstatement is helping at this dose?

 

Please take notes during this time so that you have a point of reference for the future.The more detailed they are, the better. 

 

Have a read of Symptoms & Self Care as well. It is a mine of information that will help to get you through this. There are many non- drug ways of coping with withdrawal that will ultimately serve you well in the future. Once you have the coping tools/skills , there is really no reason to resort back to the drugs.

I was on and off the drugs for close to 20 years and I'm healing. You can do it , too.

Ali

[Struggling]

Hello all ty. I'm wondering if anyone has noticed that there is a difference between symptoms during acute withdrawal versus symptoms in withdrawal syndrome. All the symptoms I had in the acute withdrawal when I first went off the Zoloft have subsided but now I have a whole new set of symptoms. I've been in a bad wave for about two weeks now since reinstatement . I'm not sure if I should wait longer or try to go up on the Zoloft it's hard to figure out if the Zoloft is giving me these reactions however they are not consistent on a daily basis. The symptoms I'm having now are heaviness in my chest which is anxiety I think and serious blood sugar problems which I never had during the acute withdrawal phase back in December . The symptoms I had during the acute withdrawal phase were severe fatigue heaviness in the eyes brain fog those have all subsided, what's happening now is completely different and I'm confused! Thanks

[Struggling]

My symptoms aren't consistent with the time I take the Zoloft each day so I don't see it being a reaction to the drug. what I mean to say is could the reinstatement caused intensified new symptoms? Or is this typical after such a period (5 months) after I tapered too fast.

[Swede]

Hello Struggling! I'm sorry for your suffering!

 

Been having low blood sugar problems since 2009. Back then I had no idea what withdrawal was but had tapered anafranil/klomipramin for about 9 months. It took me 6 years to realize that it was probably those antidepressants causing all of my strange symptoms. Tapered cipralex from november 2014-march 2015(too fast).

 

This low blood sugar gives me hell every day, I'm in a scary wave(tsunami) right now and for the last week it's been very very tough.

 

I'm constantly thinking about this and must plan around this all the time, extreamly frustrating.

 

I've done some tests and they looked fine. My endochronologist gave me an glucometer but the readings show perfect values every time.

 

I'm not a diabetic and this is so very strange... It must be a withdrawal symptom.

 

It feels like I have to eat all the time and that takes away the pleasure of eating. I'm also having a stomach giving me even more hell so what I can eat is very limiting.

 

I'm sorry I don't have any good things to share from this.

[Struggling]

That's a long time to be suffering, I'm sorry swede. All we can do is get through each day. Thanks for the response, even tho it's bad news:(

[KarenB]

Withdrawal symptoms can change quite randomly.  Some will ease, some intensify, old ones disappear, new ones appear.  This can keep happening throughout your tapering journey. 

 

It does sound like a wave, since your symptoms had improved when you first reinstated.  It's all a part of the settling process, horrible as it is.  The thing is, each little change you made since December has had an effect on your Central Nervous System, and now it's working hard to settle everything down again.  It will take time. 

 

I think for now holding is a good idea.  I wouldn't suggest increasing your dose, as 25mg should have been more than enough to provide stabilisation. 

 

Are you taking Fish oil and Magnesium - and have you worked them up to the recommended doses? 

[Struggling]

Hi Karen thanks for the response. I tried fish oil since last week. I bought a bottle from my acupuncturist which has a high dose of epa//dha (750mg) per 2 caps. I started with one cap, can't tell how it affected me, as some days my symptoms change by the hour. I did notice I had a lot of heatburn, which I think is probably common for fish oil. I may try a less potent brand, or open the cap and take half. I find Epsom salt soothing but one time I took a mag oxide, and it seemed to give me a reaction. It's so hard to tell what causes a reaction and what doesn't. Yesterday I was able to tolerate sugar, and some days I just can't tolerate anything. This is quite the ride!

[KarenB]

I'd suggest keeping daily notes about symptoms - it really can help to pin down some causes and effects.  Try the lower dose of fish-oil and see if the heart burn improves.  Or, stop it completely for a week or so then re-start at a low level.  Can you regularly use the epsom salts?  If your body doesn't like sugar some days, it's probably a good idea to stop having it altogether.  When things are hard it's worth getting as much going in your favour as you can. 

[Struggling]

Karen, regarding triggers, do people notice certain triggers cause an instant reaction, or does it tend to make the next day turn bad? I'm sure it's all individual, but it's hard to pinpoint triggers. I notice if drink coffee, my chest gets tight, which happens instantly. Other times I'm just not sure if it's something that I did the day before. I'm so scared to eat anything! And I'm hungry a lot! I feel my whole metabolic system is in chaos. And the smoking sure isn't helping, but I don't know how I could handle that w/d right now. I've given up so much. But I know we all have.