housemouse: Zoloft and Abilify problems

[housemouse]

My doctor said I was Bi-polar and started me on different drugs. Began Abilify, 10 mg in 2004  after the traumatic brain injury. I reduced approx. three mths ago from 5mg to 2.5 mg for 10 days then half again for 21 days then stopped.

 

For the last few months I have had headaches. I have been told I was more fun to be around while on Abilify.

Now my doctor wants me to cut the 50 mg of  Zoloft to 25 mg. to give me some anxiety relief.  She said that she wants me to start Abilify (generic) if reducing the Zoloft does not help.  I'm afraid to do this because of possible sensitivity from already tapering Abilify (brand) too rapidly.

 

I suffered from depression from approx 1984- 2006.  PTSD sexual incident in 2001.  I attempted suicide.  I was in shock.

 

I had an auto accident in April of 2004, as a pedestrian, and have a traumatic brain injury.  Dr. diagnosed me with bi-polar after this incident.

 

My symptoms are headaches, irritibility, anxiety, difficulty with concentration, poor memory.

 

Should I begin taking 25 mg of Zoloft and possibly Abilify (generic)?  I do not want to be on medication.   I appreciate any help that you can give me so very much.

 

Here is my history:

Generic Zoloft tab 25 mg approx 8-15-15, began Zoloft brand, 50 mg on 7-22-16.  My symptoms have worsened since increasing the dosage.

Synthroid tablet100mcg,began 1-2010.

L-Theanine double strength200mg veg Capsules by Now, Magnesium high potency 400 mg softgel by Nature Made,

D3 maximum strength2000 IU by Kirkland Signature, Ultimate Thermofit by It Works(thermogenic weight loss), Biotin fast dissolve 5000mcg extra strength tablets by Natrol, Fish oil 1400mg vegetarian softgel 900mg Omega-3 enteric triple strength, and AbsorbMax by BioTrust veggie caps advanced digestive enzyme complex.

 

Edited August 18, 2016 by scallywag
tags added

[scallywag]

Hi housemouse -- Welcome to Surviving Antidepressants (SA)
 
I hope you'll find the information in the SA forums helpful for your situation.  I'm sorry that you are in the position that you're looking for this information, but am glad that you found us.

A request: Would you summarize your medication 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

• It's more helpful if you use approximate dates (month and year is fine if you can't remember the day) than a relative time frame:
  mid-February 2016 vs. 6 months ago
• Supplement information is helpful in your sig; brands and doses aren't necessary. We'll ask if we have questions.
• Leave out diagnoses and symptoms. Symptoms change and diagnoses aren't especially relevant to tapering.

 

Your symptoms are common for people in withdrawal from neuroactive/psychiatric drugs.  For more detail, please read

What is withdrawal syndrome
 

You asked about your doctor's recommendations. Let's look at those now:

• June 2016 - last dose of abilify after fast taper
• July 2016 - 2 changes: increase Zoloft dose from 25 mg to 50, and switch from generic to brand-name
• August 2016 - proposing
  • 50% decrease in Zoloft from 50 mg to 25 mg;
  • if Zoloft decrease isn't effective, reinstate abilify.

Our experience with people who experience withdrawal symptoms after having discontinued a psych drug is that reinstatement a tiny dose of the discontinued drug is the safest bet to alleviate the withdrawal symptoms. In your case that would be Abilify. Adjusting your Zoloft dose is unlikely to address the source of your symptoms -- withdrawal.
 
Reinstating is a gamble: it might work; it might not.  Please read this thread and come back here to your introduction to ask questions about your situation:

About reinstating and stabilizing to reduce withdrawal symptoms
 
 
Should you reinstate the Abilify, you will eventually taper off the reinstated dose. Remember that it will be a small dose, probably 1 mg or less. Tips for tapering off Abilify (aripiprazole)
 
Also, for future reference:
Tips for tapering off Zoloft (sertraline)


This topic provides a description of what is going on in your CNS (central nervous system) when you reduce dosage or after discontinuing a neuroactive drug:
Brain "remodeling"

 

You can get notifications when someone posts in your thread if you follow the topic. How to follow a topic: 

1. Click the gray "Follow this topic" button near the top of the page, on the right side.
   A dialog box appears with notification options.
2. Select one of the notify options, then
3. Click follow this topic in the dialog box.

 

I've given you a lot of "homework."  Have a look at the links and come back here with your questions and any updates.

[housemouse]

Okay, thank you!  I've got one more thread to read.  So much great info!

 

So, you recommend that I should reinstate generic abilify at 1 mg and take 25 mg of Zoloft at night?

 

I want to make sure that I understand correctly.  My brain is so foggy and it's hard to concentrate. 

 

Again, thank you so much for your help!

[scallywag]

Just a clarification question: You're taking 50 mg Zoloft but split to two doses of 25 mg, one in the morning one in the evening?

[housemouse]

Yes, that's correct. I did take only one 25 mg at bedtime last night and tonight, though.

[Altostrata]

Welcome, housemouse.

 

I agree with scallywag that you might reduce to 25mg Zoloft and reinstate generic Abilify at 1mg BUT I would try the Zoloft reduction first. Give it a week or so. It could be that you don't need to experiment with Abilify reinstatement.

 

We don't advise making more than one drug change at a time, you have to see what it does first.

 

Does Zoloft make you anxious or does it make you groggy? If it makes you anxious, probably taking the 25mg in the morning would be better than taking it in the evening, when it might disturb your sleep.

[housemouse]

Alto; That sounds like good advice! I will begin taking 25mg of Zoloft in the mornings and see if it helps the headaches and anxiety.

Thank you so much for your help!

[housemouse]

I took 25mg Zoloft this am. Was sleepy all day. Not a lot, but enough that I needed a nap. 1 hour. Will call Dr. Monday morning to get lowest dose of generic Abilify which is 2mg for children. WAs a little irritable, impatient and heart was racing today, August 21,2016.Thanks.

[housemouse]

Sorry I am not thinking. You said try Zoloft 25mg for a week or so. At that time I will see if you think I should start generic Abilify. Their smallest dose is 2mg for children. I will cut in half to make it 1 mg. Thank you!

[scallywag]

Sure ask for the scrip for 2 mg Abilify; you don't have to fill it if the Zoloft reduction works.

 

If the 25 mg Zoloft is making you groggy, it might make sense to take advantage of that. Does it work for you to take it in the evening?

[housemouse]

This is the 3rd time today I have tried to send this. My heart has been racing. I have to take deep breaths, can't think, racing thoughts and irritable! Took 25mg Zoloft this am. No headache. Interrupting while someone talking to me. Dr said she will order generic Abilify 2mg since I can't afford brandAbilify. At 2mg the kids dose. Thanks.

[housemouse]

This is the 3 Rd time this am to try to get this texted to you. Today is 8/24/16. 3 days since I checked in last. 3 days now since I misplaced my scheduling book! At times I can't think good, and confused, Every day anxious, heart races, I have to take deep breaths, and I get upset and irratable easy. I was anxious already and changed feeding routine of her 9 dogs! She said that was not exceptable. She was angry with me and then late to work. This am.

Dr ordered generic Abilify 2 mg. it is being processed. Thanks.

[housemouse]

Left out it was my roommate that was upset with me this morning. Feeling better now a little.

[JanCarol]

Hey Housemouse -

 

I'm glad you are feeling calmer now.

 

A 50% reduction can have withdrawal effects, even if you were on that high dose for a short time.

 

Be patient with yourself.

 

Your brain is a reactive wild baby animal:

 

It's changing, and scared, and inclined to panic and bite.  

 

Be gentle to your brain during this time.  Some people avoid bright lights, loud noises, crowded places - stay in a nice, quiet house and choose calming activities.  Distraction is a good way to get through these side effects, as sometimes we need to try different things.  Some people dance, some lie in a dark room with an eye pillow, some take warm epsom salts baths or walks through parklands.  Some like to play silly video games - other people find them disturbing, but can watch old episodes of Lassie or Happy Days.  Find things to do which distract you from your symptoms - because the best way through them is to wait, and not do anything.

 

Of course, there are things you can do.  I am a firm believer in a toolkit, a practice - something which grounds and centers you through the difficult times.  I love my yoga, and am thrilled to finally be able to go back to karate class. (I had to take 20 months off due to injury that wouldn't heal due to endocrine problems!)  But when I couldn't go to karate, I kept trying things, trying to find a practice which would soothe me.

 

One practice which I thoroughly enjoyed was Chi Gung and Tai Chi.  Here, you can try 7 minutes of it (no excuses!  It's just 7 minutes!)

 

We have a whole section of the website devoted to Non Drug Techniques for Coping with Emotional Symptoms (and they help with physical symptoms, too)

 

I also recommend Dr. Claire Weekes - Recovering from a Sensitized Nervous System to help you learn to accept and survive your symptoms.

 

Also - it may be important for you to hear about Neuro-emotion - this is the way withdrawal amplifies a normal, natural emotion into something that feels huge and overwhelming.  It has a seed of truth in it - the hurt, the anger - but because of the withdrawal chemicals and sensitivity, it's like looking at the emotion under an electron microscope - it becomes so large and sticky that it almost bears no resemblance to the actual emotion.  Or to you.  It's chemical emotion.

 

If your symptoms escalate, you may need to consider a small updose - but you've had a window, a moment of relief - which is an awesome positive sign.  Let's see if you can go another week without updosing, and without adding the Abilify.

 

Take this time of waiting to learn new things about how to be patient and gentle with yourself.  Treat that baby animal (yourself!) with love and respect and give it time to grow up and learn its way in the world again without the chemical support that it had.

[housemouse]

I watched and did exercises of 7 minutes of magic. The little baby...( what is it?) it is so cute! Feeling better today. Thank you.

[ChessieCat]

It's a baby ring tail possum

[housemouse]

Thank you for telling me what kind of baby animal it is!

[housemouse]

Felt good yesterday Great this am 7-9 am ! Took Zoloft 25 mg. 40 minutes later I was getting anxious and , heart racing a little. Roommate says I forget little things that I have done for 2 -3 years. Had problems that brought on stress then upset Patrice roommate therefore I became upset! We were on our way to eat lunch but I was not hungry by then. Wanted to cry.

[housemouse]

Today is Friday September 2,2016. It has been 15 days since I cut Zoloft to 25 mg. I am still having anxiety and a lot of irritable behavior with thoughts. May I start generic Abilify at 1 mg? Thanks.

[housemouse]

Also rapid heartbeat with faster breathing. Still forgetting things. Even by time one answers my call, I don't remember why I called them! Thanks.

[scallywag]

Have your symptoms changed in the last 2 weeks? If so which are new, which have improved, which have worsened?

[housemouse]

My new symptom is that I'm thinking irrational thoughts before verbalizing them. I'm extremely impatient with others and situations.

 

Improvements are rapid heartbeat is not as fast or as often as it was. I'm not needing to take as many deep breaths as before because the short rapid breathing has also improved.

 

Worsening symptoms: memory, decision making, loss of appetite have all has worsened.

 

Thank you for all of your help!

[scallywag]

housemouse, you've given the Zoloft reduction (50 mg to 25 mg) 2+ weeks and have seen some symptoms improve, some worsen and new ones arise. If you decide to try a reinstatement of Abilify at 1 mg, please take it at the same time every day and take notes of the time you take it and your symptoms. The most informative way to take notes is as follows:

• Morning:
  • time of medications: drugs and doses
  • symptoms and the time they arise
• Afternoon:
  • time of medications: drugs and doses
  • symptoms and the time they arise
• Evening:
  • time of medications: drugs and doses
  • symptoms and the time they arise
• Bedtime:
  • time of medications: drugs and doses
  • symptoms throughout the night, including waking, and the time they arise

It takes several days for a medication to reach a steady state in your body. Abilify has a median half-life of 75 hours, longer than SSRIs like Zoloft. Steady state is reached at about 6 days. From there you should give your CNS (central nervous system) another week to respond to the reintroduction of Abilify.

[housemouse]

Thank you so much. I will start the 1mg of generic Abilify as soon as I reread what you said. I already forgot if you said I should take at night or am. I am taking Zoloft in am. Does it matter if I take both at same time?in the morning?

I think I will be able to donate next week! I appreciate all y'all are doing!!! God(YHWH) bless you all!!!

[scallywag]

At what time of day did you take the Abilify when you were taking the full dose?

[housemouse]

Early in the morning, before light when I took the synthroid . But I found out I was not supposed to take any thing else when I took Synthroid. So I wait at least 2 hours before taking Zoloft and will take generic Abilify with it. Ok? About 9 or 10 am? Ok? Thank you.

[housemouse]

I was taking the full dose of Abilify early in the morning when I took the synthroid. Then I took it with Zoloft about 8am for the last year. I hope that answered your question better.

[scallywag]

Respect the synthroid requirements; take the abilify 2 hours or more after.

[housemouse]

I definitely intended to take the 1mg with 25mg Zoloft more than 4 hours after Synthroid which I take about 3:30am every morning when I wake up. Thank you.

[housemouse]

Today is Wednesday 9/28/16 and I am having paranoia thoughts! ! Breathing and racing heart has slowed, but anxiety and irritability is still with me! Dr. said today he will lower Synthroid for my thyroid. It is more hyper. HE SAID THAT 4 months ago, but did not do it! I have lost from 141 to 128 since Thursday, May19,2016 without really trying! I still need to lose more since I am only 4'9. I am taking 1pill- 100mcg(0.1mg).Dr. Told me to take 3/4 of the pill daily.

[scallywag]

Remember that as your weight drops the synthroid should be adjusted downward. 

[housemouse]

Today is 10/03/16. I ask Dr. To change my Synthroid which is synthetic to Natural-Throid. It would be 75mcg instead of 100mcg. Changing to mg. at 48.75mg. Ok with You? Thanks!

 

I feel great today and yesterday! I ran out of L-Theanine and started back on a better one 09/30/16. It and maybe generic Abilify combined has helped me get to this happy! state of mind. I wonder how long it will last??? Bless you all for taking the time to help me! Later on I will send another donation. Thanks again!