Cruizer: sertraline / Zoloft nightmare

[brassmonkey]

Hi Cruizer--  the big question is "how long has this been going on"?  Three to four months after a crash is a reasonable amount of time to restabilize.  It's the length of time at WDnormal that indicates the stability.  If it's only been a couple of weeks, then it would be a good idea to wait a bit longer.  Six weeks to two months of stability is a good idea before starting to taper again.

 

I was looking through your signature and it appears that you were going quite fast with your taper at 5% every two to three weeks.  This is probably what caused the crash you mentioned.  For your new taper, when you start up again, it would be a good idea to take it a lot slower.  I would suggest doing a 5% Brassmonkey Slide.  This would be tapering 1.25% a week for four weeks and then holding an additional two weeks.  This would give a taper of 5% every six weeks, which would be a lot easier on your system and greatly reduce the amount of symptoms you would be feeling.  Doing a taper this way will take a long time, any proper taper will, but it usually ends up being faster because a person doesn't have to take time to recover from crashes along the way. Also with the lower symptom load quality of life can improve much more quickly.

 

I glad you're feeling better and are looking to start moving forward again.

 

Brassmonkey

[Cruizer]

Hi All, 

I am feeling really lost at the moment. I thought things were turning a corner as I had some good patches but all of a sudden I have been smashed again and it is lasting a lot longer than normal waves I have. It has been nearly 3 weeks now since this wave started and it seems to be getting worse. The symptoms are not the acute anxiety and cortisol spikes in the morning when i first crashed, but rather that real anhedonia feeling. I am flat and everything seems like a task to do. I am starting to have crying spells in the past week also. I have not been tapering for 6 months now!!! Surely i should have stabilized by now? But when i look at my monthly avg. It has been going up not down! I am really lost as to what i am supposed to do. Its not like i had cold turkey or anything before my crash, i was going at 5% every 2 weeks. Ok that may have been a little quick for me but i have been holding for 6 bloody months. I am trying to do the right thing here but i am starting to wonder whether these reactions are actually the drug and not the withdrawal! A similar thing happened at the start of my taper. I went a little quick and crashed (back in july 2016) and i then held until January. However like now the longer i was holding the worse i was feeling... then i started to taper again and immediately felt better (not great but better). I really dont know what is going on and i would appreciate any feedback please.?? 

[RusTW]

Hi Cruizer I was put on 125 mg zoloft was on it less than a year.did a fast taper down to 50 mg in j the last 2 1/2months.I also CT seroquel 2-300 mg.reinstated 100 mg have also tapered that down to 50 mg also in the last 2 1/2 months.I'm having the same ? Is the zoloft making it worse.I get amped up and OCD thinking more now after  taking it.but I know my ct messed me up too.I'm holding now but wondering.2yrs good job tapering.how can u tell if its w/d or taper causing symptoms.

[RusTW]

I hope your wave passes soon

[brassmonkey]

Could you give us a daily record of your symptom patterns?  That would be very helpful in figuring out what is going on.

[Cruizer]

5 hours ago, brassmonkey said:

Could you give us a daily record of your symptom patterns?  That would be very helpful in figuring out what is going on.

I keep a spreadsheet and record my daily avg level and also some brief comments of the days events. I have always done this. 

Looking back on the last 3 weeks and also the past few months i would say most of my days go like this:

I am generally up once or twice s night with my 2 year old but still get a solid 6-7hours or more most nights. I generally wake when my son wakes me at around 7am. Normally seem reasonable in the first hour or so. I take my 19mg compounded zoloft tablet at around 8:30am every morning with a fish oil tablet also. I leave for work shortly after. I would say within about 45 minutes to an hour after i take the tablet is when i start to notice a real flat feeling come over me. Sometimes i feel depressed but most of the time it is just a real "can't be stuffed" doing anything and everything seems to irritate me. I generally have a coffee in the morning and this can "pick me up" for a while (sometimes not) and i just push through the morning/early arvo as best i can. I normally see this lift a bit mid afternoon and most of the time i have my 2nd coffee and this perks me up for the rest of the day and i can feel relatively mild symptoms. Late aftwrnoon and night times are generally the best time for me when symptoms are more mild. I would say this best describes my average days. 

It is not always like this but a good majority is. 

Most of my daily symptoms that are up and down during the days are: feeling flat and disinterested in doing much at all, can get quite bad brain fog and sometimes find it hard to put clear sentences together and fumble over words. Short term memory is horrible. 

Most of the time i am quite irritable also. Anxiety comes and goes but is definitely not my main symptom anymore. Appetite fluctuates but i generally eat every meal, and tend to be more hungry at night. Please if you need anymore info from me let me know @brassmonkey

[Altostrata]

23 hours ago, Cruizer said:

I take my 19mg compounded zoloft tablet at around 8:30am every morning with a fish oil tablet also. I leave for work shortly after. I would say within about 45 minutes to an hour after i take the tablet is when i start to notice a real flat feeling come over me.

 

Do you feel better or worse before you take 19mg Zoloft?

[Cruizer]

Hi Alto, on avg. I feel better before i take the zoloft in the morning. I went through 6 years on this medication and was up and down the whole time even though i was on a steady dose. I then realised through research that the medication was most likely the reason i was feeling so badly. That is when i found this website and started to taper. The only difference between symptoms then and now during tapering is the symptom of anhedonia seem to be more constant. During my 2.5 years of tapering i have held twice for a period of 5 months. Both times the longer i held the worse i felt.  

[Altostrata]

My guess is your body is telling you it wants less Zoloft. How about decreasing 1mg, to 18mg? Please let us know how you're doing.

[littleball]

Hi Cruizer, I see your problem, I too have always felt horrible while taking drugs, but they made me think it was depression. Now in WD I still feel bad but in a different way. Your energy will return. There will be up and downs, of course.

We will get through this. Listen to Alto in the meanwhile

[Cruizer]

Thanks for the suggestion Alto and to all that offered comments of support. 

I have been really looking through my daily history that i record to see if i could pick up patterns. This is why it is extremely important to keep a journal. 

The first time i held for 5 months back in 2016 i seemed to get gradually worse symptoms each month until i started to taper again in January 2017 at a rate of 10% every 30 days. I went from 60mg down to 19mg in 13 months. This is a tad under 10% a month. Each month that i dropped the first 2 weeks my symotom avg. would improve followed by a slight increase over the following 2 weeks until i dropped again which would see symotoms lift again slightly. I could feel an immediate change on the first day or 2 of the drop which would mainly be head symptoms and what i have heard people call "scrunchy face". This would then subside and i would feel better. In February this year when i crashed it came about 2 weeks after surgery on my collarbone and knee. I was very groggy for about 24hrs after the surgery which the nurses were a little confused on. I am thinking this may have had a big influence on why i had a spike in symptoms. However i decided to hold from feb as my 2nd child was due in April. My main symptom is anhedonia or emotinal anaesthesia. i know this because i have written it constantly in my daily journal. "I just feel disinterested and irritated". This has become more regular the longer i have held. I thought that i should continue to hold until my symptoms went away but after going back through my history i am starting to think that the majority of my symptoms (mainly emotional anesthesia) is actually a side effect of the drug and not so much the withdrawal. I think in the next week i will drop down a mg. to see if anything changes for the better. Cheers

[Cruizer]

Hi folks, 

Wanted to give an update after i droped from 19mg - 18mg 2 weeks ago. 

Without doubt i felt better as an average in terms of my mood and motivation. The first 6 days after drop i felt immediate head symptoms. A little giddy, head pressure in temple area and behind eyes etc. I had a bad day of anxiety on 3rd day but this passed after that day. After day 5 i had a really good patch of about 7 days where i was feeling clear mentally, was in good spirits at work and at home. Starting looking forward to doing things and could feel my enthusiasm coming back. 

Day 13 and 14 i then started to feel the old symptoms start to creep back in and normally about half hour to an hour after tablet in the morning. A little nausea despite still eating normally, irritation, flatness, and some disinterest in doing things. Certainly no worse than when i was on 19mg.

This seems to have been almost a mirror image of what has happened to me in the past when dropping. 

A period of a few days of head symptoms followed by a week or so of feeling better, more motivated, feeling like im interested in life. Then after about 2 weeks from the drop its like the drug starts to build up again and i start getting the usual symptoms of irritation, disinterest and slight nausea. 

So far the theory of the drug zoloft is my issue and not so much withdrawal as such seems to be proving true. 

Would love some opinions @Altostrata

@brassmonkey

[Altostrata]

9 minutes ago, Cruizer said:

Day 13 and 14 i then started to feel the old symptoms start to creep back in and normally about half hour to an hour after tablet in the morning. A little nausea despite still eating normally, irritation, flatness, and some disinterest in doing things. Certainly no worse than when i was on 19mg.

 

Yes, these could be side effects of Zoloft. You will still want to taper gradually. They should diminish as the dosage decreases.

 

Emotional anesthesia is a very common side effect of antidepressants, that's how they "work."

[Cruizer]

Just a bit of an update from me. Some positive results from dropping to 18mg from 19. Only had one severe day of anxiety on day 3 and then for the remaining 4 weeks was mild to moderate. Avg. for the 4 weeks was 1.32 per day which was the lowest avg for symptoms for 8 months. Overall i could see my mood was better and i was much more productive at work and home. Dropped to 17mg yesterday and have been feeling the normal head symptoms of a drop almost immediately. Tightness at front of head and behind eyes, slight swishy feeling and some major brain fog. Stumbling over sentences a bit. This normally lasts 3-5 days and then it passes. At this stage the plan is to continue slowly by decreasing 1 mg every 4 weeks until im down to 10mg and then reassess from there. Best wishes to all! 

[RachelSusan]

Hi Cruizer,

I just wanted to stop by and offer my support. It sounds like you have things under control.  Tapering is not pleasant but you do have a great plan in place and it seems to be working. Good for you.

Warm wishes,

RS

[WackoSirJacko]

On 9/10/2018 at 6:41 AM, Cruizer said:

Just a bit of an update from me. Some positive results from dropping to 18mg from 19. Only had one severe day of anxiety on day 3 and then for the remaining 4 weeks was mild to moderate. Avg. for the 4 weeks was 1.32 per day which was the lowest avg for symptoms for 8 months. Overall i could see my mood was better and i was much more productive at work and home. Dropped to 17mg yesterday and have been feeling the normal head symptoms of a drop almost immediately. Tightness at front of head and behind eyes, slight swishy feeling and some major brain fog. Stumbling over sentences a bit. This normally lasts 3-5 days and then it passes. At this stage the plan is to continue slowly by decreasing 1 mg every 4 weeks until im down to 10mg and then reassess from there. Best wishes to all! 

 

This is totally my theory too! I've gone from 45 to 25 over 9 months and my drop to 25 was in July. That felt like a big drop and then in a few weeks I crashed. That crash was 3 weeks ago and since then I've been up and down, I feel like holding but I think when you start the journey, you can't really stop. I too feel like the drug is taking hold and causing a malaise. I may drop 1mg to see if it brings me out of this funk I'm feeling.

[Cruizer]

Hi All, an update from me and unfortunately it is not a good one. My symptoms have increased and changed since my 2nd drop.

So I spent 4 weeks on 18mg after dropping from 19mg. Best 4 weeks I have had for the last 8 months. Then I dropped from 18mg to 17mg and had another great 1st week.

I then went on a holiday with my wife and 2 kids under 2. Bit stressful but was really looking forward to it. On day 2 of the holiday I started to find anxiety was lifting.

A few days later I was waking at 4:30am with racing pulse and started to vomit in the mornings. I realised I might be having some issues with the light coming in at 5am and creating some cortisol spikes. After returning home from the holiday my symptoms dropped about 3 days later and I had another good week of only mild symptoms. Then I had a couple of drinks on Saturday night after my Footy team won the GF (only about 4or 5 drinks) and the next day I was smashed with another big wave.

What I am confused and worried about is that the symptoms I have now since I started dropping again are different to what I was experiencing during the 6 month hold.

I think this is where I am somewhere in between bad drug reactions and WD. During the long hold my main symptoms after the initial crash were mainly emotional numbness and just disinterested in doing much (Common drug side effect); now my symptoms are acute anxiety upon waking and severe nausea! Also my sleep is fluctuating. I am waking early in the mornings and having what I describe as "micro dreams" until I get up. This is where I am having really weird dreams for say 5 minute periods and then wake startled.

I am so confused on what to do! The longer I hold doses the worse the anhedonia gets, but then when I do drop the early waking and severe anxiety returns. It seems I am very sensitive to any fluctuation in dosage whether that be up or down. My thinking is that if I am going to go through this anyway when dropping dose, I may as well keep going at a steady pace so that I actually eventually get of this poison.

So just to summarise: Since beginning to taper again 7 weeks ago, the anhedonia that I felt for the past 4-6 months of holding has lifted significantly but after 5 weeks the anxiety and nausea has increased tenfold! I am having real windows and waves and I don't know what I should do! Help please

[ChessieCat]

59 minutes ago, Cruizer said:

After returning home from the holiday my symptoms dropped about 3 days later and I had another good week of only mild symptoms.

 

Things were improving until

 

1 hour ago, Cruizer said:

Then I had a couple of drinks on Saturday night after my Footy team won the GF (only about 4or 5 drinks) and the next day I was smashed with another big wave.

 

I think that says it all ...

 

[WackoSirJacko]

2 hours ago, Cruizer said:

Hi All, an update from me and unfortunately it is not a good one. My symptoms have increased and changed since my 2nd drop.

So I spent 4 weeks on 18mg after dropping from 19mg. Best 4 weeks I have had for the last 8 months. Then I dropped from 18mg to 17mg and had another great 1st week.

I then went on a holiday with my wife and 2 kids under 2. Bit stressful but was really looking forward to it. On day 2 of the holiday I started to find anxiety was lifting.

A few days later I was waking at 4:30am with racing pulse and started to vomit in the mornings. I realised I might be having some issues with the light coming in at 5am and creating some cortisol spikes. After returning home from the holiday my symptoms dropped about 3 days later and I had another good week of only mild symptoms. Then I had a couple of drinks on Saturday night after my Footy team won the GF (only about 4or 5 drinks) and the next day I was smashed with another big wave.

What I am confused and worried about is that the symptoms I have now since I started dropping again are different to what I was experiencing during the 6 month hold.

I think this is where I am somewhere in between bad drug reactions and WD. During the long hold my main symptoms after the initial crash were mainly emotional numbness and just disinterested in doing much (Common drug side effect); now my symptoms are acute anxiety upon waking and severe nausea! Also my sleep is fluctuating. I am waking early in the mornings and having what I describe as "micro dreams" until I get up. This is where I am having really weird dreams for say 5 minute periods and then wake startled.

I am so confused on what to do! The longer I hold doses the worse the anhedonia gets, but then when I do drop the early waking and severe anxiety returns. It seems I am very sensitive to any fluctuation in dosage whether that be up or down. My thinking is that if I am going to go through this anyway when dropping dose, I may as well keep going at a steady pace so that I actually eventually get of this poison.

So just to summarise: Since beginning to taper again 7 weeks ago, the anhedonia that I felt for the past 4-6 months of holding has lifted significantly but after 5 weeks the anxiety and nausea has increased tenfold! I am having real windows and waves and I don't know what I should do! Help please

 

It's a funny old game, I too have a drink now and again, sometimes a good session. It does knock you right off and make you crash sometimes and people on here tend to avoid all alcohol. Personally, I think the social benefits and having a few hours of forgetting and living a normal life now and again outway the crash effect it can have sometimes. I'll get lynched for saying this but it's important to me and everyone is different. However, managing and learning when you can and shouldn't have a drink is important. 

 

What you are experiencing are cortisol spikes in the morning as you know. I've had them, had the micro-dreams, had some this morning. I think you are doing just fine, you can't do this thing without symptoms, you just got to accept them and let them pass. My theory on the feeling good after tapering is that it loosens the reuptake inhibition a bit, letting the brain absorb neurotransmitters a bit more. That makes us feel good. But this then means we have disrupted the balance and we are absorbing slightly more serotonin etc than we are currently producing. Eventually this means we run out. But then when we run out our brain gets the signal to create more cells that produce the serotonin etc. We level out after a period and we go through it all again with another taper. The anhedonia I feel comes for 2 reasons. The drug gains control again, plus our brain shuts down emotions to try and repair and cope with the changes.

 

It's horrendous but you just got to think that every time these symptoms come it's our brain working on finding a balance again. It's actually good to be unstable, it means the brain gets signals to instigate change. Just make sure you CBT the hell out of the symptoms and send the message back to the brain that you aren't scared of them and that they are not needed, or else the brain thinks they are justified and continues to release more stress hormones.

 

I've also got a sneaking suspicion that putting our brain into a hangover where we've used up vital neurotransmitters on a night out triggers the brain to make more to replenish them. If we are stable at all times, no stress, no beers, trying to keep as level as possible then our brain isn't being trained to develop the coping mechanics be they biological or psychological. This is just my opinion and I could change these thoughts as I learn.

[Cruizer]

Thanks for the replies guys. 

Wacko i tend to agree with you on the occasional drink. I always tend to regret it after but sometimes having a drink in a social scene is a nice way to feel normal. I am in sales with my job and building relationships is very important. Every now and then sharing a beer or two with an important customer is required. I do admit though that i tend to avoid these sitiations so that i dont have to drink. I could count on one hand the amount of days i have had a drink this year. It is now very rare due to feeling so ordinary following it. 

I am not totally convinced this wave was just caused by having a few drinks but it probably didnt help. I am still going to drop on Sunday by another mg and most likely again in 4 weeks after that. I need track how i am reacting and whether it is getting worse, better or the same as i continue to wean. All the best

 

[Cruizer]

Hi all, I apologise in advance as this is going to be a long post. But it is important as I am in a world of trouble right now and need help.

I have felt this before and alarm bells are starting to ring again that I am having significant issues with Akathisia. When I go back to when I first started taking Zoloft around 9 years ago now, the agitation and internal restlessness started about 5-7 days after taking my first dose. As you would see by my first post, this was then treated by the doctor by increasing my dose which made things worse. Now I am not in anyway as bad as some of the videos I have watched but the symptoms are similar. I have always thought that this medication was causing my issues as I had nothing like this before I started all those years ago. When looking back on before I started to taper, akathisia symptoms were my main symptoms for all those years granted they came and went at different intensities. Once I started to taper I felt better until I went a little fast one time and crashed. However looking back on the time that I crashed, I did an updose because of swishy head symptoms which I knew were common withdrawal. The updose really hurt at the time in terms of symptoms. It seemed to make it worse. Then in February this year when I "crashed again" it was after a surgery in which I would have had loads of Benzo's etc. to put me under. The crash came about 2 weeks later. Then after this crash a few weeks ago it seemed to follow a weeks course of antibiotics for a sinus infection. (I have read that antibiotics can increase symptoms of Akathisea). This is where I am stuck! Most of the places I look on the internet describe akathisea as a side effect of drugs and they estimate as high as 20% of people taking SSRI's will have problems with Akathisea. Most places say by stopping the medication, the akathesia goes away. So my question is that by me tapering at such a slow rate and I prolonging my suffering of Akathisea??? Akathisea is by far the worst symptom I have! The symptoms of Akathisea I have right now are the same as they were when I was on a full dose of Zoloft i.e. before I started tapering. So in my eyes this can't be withdrawal can it?

The severity of these symptoms change but below is a summary of what I go through:

At its worst: I will thrash around in bed like I am on some kind of illegal drug, I will vomit, I need to constantly keep moving and find walking the streets for hours is one of the only things that helps. These very bad periods normally only last between 5-15 days and never more.

What I experience constantly from when I started taking Zoloft 9 years ago until today: I am never fully relaxed; I move my feet and curl my toes up in my shoes; I am constantly tapping or playing with things in my hands; I chew my nails and skin on my fingers and crack my knuckles constantly; I need to keep busy and occupied, otherwise I start to feel worse; exercise almost always makes me feel better for a while; I am worse in the morning than at night; I am almost always irritated to some extent and very impatient.

What I found in the past and now that makes this worse is: Alcohol always hurts me a day or so later; any type of medicine like cough medicine, cold and flu tablets and any ibuprofen always floors me within a day or so of taking it. Any positive things that happen to me that excite me tends to flare up symptoms a day or so later.

Looking at past history from my daily journals, 95% of the time I drop a dose, I tend to feel better for a period of 1-4 weeks. Then it is like my body adjusts and the Zoloft becomes a problem again. I really feel like I need to get off Zoloft. I am not saying I am going to quit from 17mg to nothing, but I feel I need to speed up a little and say be done in the next 6 months. I know this is probably against normal protocol but I feel I am prolonging my issues by staying on this. Please @Altostrata @brassmonkey @LexAnger can you give me some advice here. I am a little scared at what I read Dr Shipko say about withdrawing causing akathisea but his theory doesn't seem to match up with what I am reading elsewhere including here. 17mg which is my current dose is only about 12% of my original dose of 150mg. so I have come along way. I have been tapering for 32 months now with a couple of holds in there. Please guys, advice is needed and appreciated.

[Altostrata]

It may be that Zoloft was always too activating for you.

 

Do your symptoms follow any daily pattern?  Please keep daily notes on paper about your symptoms, when you take your drugs, and their dosages. Use a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right.

 

You're now at a fraction of your original dosage. Has the intensity of the symptoms decreased since this time last year?

 

[Cruizer]

Thanks for replying @Altostrata

I dropped yesterday expecting a decrease in symptoms and it has had the opposite effect. In terms of symptom intensity it is very much worse than this time last year. I was trying to convince myself that this was a medication side effect but the way i feel now is exactly how i have felt the last two crashes. I am in a really bad place at the moment and am considering an updose. I was only at 16mg for a day and took 17mg this morning. I am thinking maybe 18 or 19mg might help this pass a little quicker. What do you think? I then plan on holding until i am a lot better and then tapering slower and by using the brass monkey slide. 

[ChessieCat]

7 minutes ago, Cruizer said:

I dropped yesterday

 

It takes about 4 days for a dose change to get to full level in the blood and a bit longer for it to register in the brain.  It is possible that because of your previous experience you were anxious about the dose reduction and this caused the increase in symptoms.  During this time you need to stay as calm and patient as possible and not panic.  At times like this we feel that we need to do something, but that is not always helpful.  It is not helpful responding to any panic by changing your dose.  There is no magic bullet.  Keep it Simple, Slow and Stable

 

The brain likes consistency.  Jumping around it doses is only going to confuse your brain.  You need to choose a dose and stick to it.  Unfortunately during this process there are going to be times of discomfort.  It is important to learn and to use Non-drug techniques to cope to get through the tough times.  It also a good idea to Keep Notes on Paper and to Rate Symptoms Daily to Check Patterns and Progress.

[Cruizer]

1 minute ago, ChessieCat said:

 

It takes about 4 days for a dose change to get to full level in the blood and a bit longer for it to register in the brain.  It is possible that because of your previous experience you were anxious about the dose reduction and this caused the increase in symptoms.  During this time you need to stay as calm and patient as possible and not panic.  At times like this we feel that we need to do something, but that is not always helpful.  It is not helpful responding to any panic by changing your dose.  There is no magic bullet.  Keep it Simple, Slow and Stable

 

The brain likes consistency.  Jumping around it doses is only going to confuse your brain.  You need to choose a dose and stick to it.  Unfortunately during this process there are going to be times of discomfort.  It is important to learn and to use Non-drug techniques to cope to get through the tough times.  It also a good idea to Keep Notes on Paper and to Rate Symptoms Daily to Check Patterns and Progress.

Thanks for the prompt reply. You are probably right about feeling anxious about the whole thing. I have been flat out researching stuff for the past week so i have scared myself a little which has added to my woes. 

I do keep a daily journal and rank my symptoms between 0-4. It certainly does help track patterns. I am going to stay on 17mg and ride this out and hold for another while. I did have some dental work done about 4 weeks ago as well as a round of antibiotics and my first flare up happened about 3 days later. 

 

[Altostrata]

When did you take Zoloft and when did these increased symptoms start? What were the symptoms?

[Cruizer]

I take zoloft at 830am. I have been in a bad wave for the past 8 days. I was on 17mg for the past 4 weeks aside from yesterday when i took a compounded 16mg tablet. I have had insomnia for the past 4 days. Last night i only slept an hour. I drifted off for about 20 minutes and when i woke i was in a panic. I vomitted and then cried uncontrollably. I am getting a burning feeling like a hot flush in my face and also down my back. These symptoms have only come in the past week. Thank you

[Cruizer]

Also i am having depersonalization in the past 5 days off and on. I am so naucious and have a cracking headache. I am having waves during the day that i could almost say is a panic attack. I cant sit still and just want to escape this hell. It can last about half hour or so and then passes to a certain degree. This is the worst day i can remember. I love my wife and 2 boys so much and it is breaking me. I am trying to do the right thing here.... i had been holding for 6 months and was feeling a lot of emotinal anesthisia during the last 2 months of the hold. Since i have started tapering again 8 weeks ago, i had a good lift for 5 weeks and then bam i am what i just explained above which is 10 times worse. I just ate some food and my wife gave me a couple of lollies which helped a little. My symptoms tend to lift late afternoon and at night i can feel somewhat normal. I really dont get how dropping 2mg which was about 6% after a 6 month hold could do this? Especially after a better initial 5 weeks. I have had some stress lately with going on a holiday and also my football team in grand final play off but surely that cant be it?! @Altostrata

[ChessieCat]

On 10/3/2018 at 4:42 PM, Cruizer said:

Then I had a couple of drinks on Saturday night after my Footy team won the GF (only about 4or 5 drinks) and the next day I was smashed with another big wave.

 

[Cruizer]

11 minutes ago, ChessieCat said:

 

This was 8 days ago and today has been my worst day so far. It was only about 3-4 standard drinks. I had a red wine the week before and didnt get any reaction.

I also have drank alcohol once or twice during that 6 month hold and although i had a lift in symptoms that following week it was nothing like this. 

So @ChessieCat what would your suggestion be of my next point of action. Hold for another long period or just until this wave subsides etc. Appreciate you helping here.  

[Cruizer]

I also wanted to make a point that i had been looking into the CYP450 liver enzyme that metabolizes most ssri medications including zoloft. 

As you can see i have had genetic testing done a couple of years ago and they way i interpreted my results that i have attached is that I have a polymorphism on a couple of the main pathways that metabolize zoloft. To me this would make me a poor metabolizer of zoloft meaning levels can build up to a toxic state? Is that what anyone else gets from this?

 

[Cruizer]

Here is an interesting one, and I am really keen to hear what other peoples experience have been with compounded tablets and whether I could be onto something here.

Ever since I went too fast about 24 months ago, I have been getting my Zoloft compounded at a local pharmacy. What I have noticed even when holding a dose is when I get another batch of 30 tablets, I seem to always have a spike in symptoms for a few days etc. I also have been up and down like a yo yo for the past 24 months even when holding a dose.

I have asked before, but today I felt like I really needed to find out how they compound it as I was aware they were using fillers.

The lady said they calculate how much medication I need (in my case 17mg) and times it by 30 days (17x30 = 510mg). Then they have it crushed up with their machine.

Then what they do is work out how much the minimum weight is required for each capsule and add filler to reach this figure. So for example each capsule might need to weigh 3mg and the medication weight might only be 1mg so they add 2mg of filler etc. They use the same method to work out how much filler they need for 30 tablets and then they add this in with the medication. So they effectively have a "container' of some kind that is filled with the medication and filler and then they mix it all up to make one powder. That mix is then evenly distributed (weight) to each of the 30 capsules.

My question to the pharmacist was "how do you know there is an even amount of filler and medication in each capsule?" i.e. how do you know you are putting in 17mg of medication if it is mixed in with filler. Does this sound right? Could I be getting a different dose every tablet (i.e. 50/50 filler to medication one tablet and 60/40 filler to med the next?) 

The pharmacist said without individually testing each tablet it is impossible to tell, but she was saying that it would be within like .1% but I just can't see how it could be if the tablet and filler are both white powder mixed together. I understand that over the 30 tablets it would end up being even but this has me very concerned.

She is looking into whether she can make up a liquid for me in the future which should be more accurate.

 

Is what I am saying above make sense to everyone? Or is this pretty standard how people have compounding meds done?

 

[ChessieCat]

Tablets that we buy "ready made" also contain fillers and I imagine that they are made the same way except in a larger (giant probably) batch.

[Cruizer]

Yes I understand the ready made tablets are made with fillers also, but on a giant scale and in larger mg with industrial equipment not doubt making less room for error.

To make 30 tablets and manually mix the powders together (med and filler) and then pour them into individual capsules, how could they possibly know this is a 1:1 ratio or 2:1 ratio of meds to filler? Does this make sense @ChessieCat? Could this not be a very accurate way?

Would that not be like mixing 100gm of almonds and then 100gm of cashews together and then pouring them into 10 x 20gm bags hoping this gives you an even spread of almonds and cashews in each bag? (only thing I could come up with

 

[ChessieCat]

I can understand your concern but for me it's not worth worrying about.  And in fact I have no other choice but to get my Pristiq compounded.

 

I get my doses compounded using 100mg tablets and get lots of 0.5mg, 1mg, 2mg, 5mg (my next batch will include 0.25mg) and in the past 10mg, 20mg, 30mg and 40mg.  I have to get 100 of each dose made and in the past I have had 500, 600 and 700 capsules made up at a time.  My current dose is 6.5mg.

 

And there is probably a similar error between weighing doses yourself and having them made up by a compounding pharmacist.

 

However, if you are able to get a liquid made up then you may be able to be more accurate with doses, but even with liquid you could end up with a minor difference.

[WackoSirJacko]

3 hours ago, Cruizer said:

Yes I understand the ready made tablets are made with fillers also, but on a giant scale and in larger mg with industrial equipment not doubt making less room for error.

To make 30 tablets and manually mix the powders together (med and filler) and then pour them into individual capsules, how could they possibly know this is a 1:1 ratio or 2:1 ratio of meds to filler? Does this make sense @ChessieCat? Could this not be a very accurate way?

Would that not be like mixing 100gm of almonds and then 100gm of cashews together and then pouring them into 10 x 20gm bags hoping this gives you an even spread of almonds and cashews in each bag? (only thing I could come up with

 

Dude,

 

From reading your last few posts it seems that you have just lost control a bit. You're panicking and reading too much and spiralling into mania. Your mind is desperately trying to find a solution to everything all at once and it's driving you crazy. You need to hold your hand up to your brain and shout STOP! Stop thinking of compound tablets, stop trying to understand it, stop trying to work it out. I've totally been there. Try to slowly gain back control. Firstly, accept you are where you are. Accept you are in a bad wave and that you don't entirely know why. Then realise in yourself that it's ok not to entirely know why. Slowly reduce the panic you have. The stress hormones are flooding into your bloodstream, that's all it is. Making absolutely everything 20 times worse than it is. Don't expect it to stabilise immediately. Just try to stem the flow at first by accepting you feel horrendous.

 

Next you need to start introducing the idea to your mind that it will get better. Because it will. And that you don't need to do anything to let that happen. You don't need to change dose, you don't need to research, you just need to accept the horrible feeling and know that it will pass. Because it will pass. You don't need to understand compound pharma stuff, you just need to do the same that hundreds of successful taperers have done. Read some success stories and reinforce the FACT in your mind that there is an end to this hell. 

 

Sleep - accept what you get. Accept that you are tossing and turning. Accept that you are awake and tell your brain you don't care. YOU ARE NOT SCARED. Eventually you will just drift off and sleep WILL come back slowly. Be happy to just lie there with your eyes closed, not caring whether you sleep or not.

 

DRIVE THESE POSITIVE THOUGHTS into your mind religiously, DISMISS the negative and harmful thoughts as untruths. Your brain is scanning for a reason why you feel so bad, scanning to justify the stress hormones. If all it finds is positive thoughts and the negative is dismissed, the message will get back to your hypocampus to turn off the stress hormones.

 

All that's happened is youve got yourself into a thought spiral of fear making you worse and worse. That's all. You've just got to reverse the process.