Cruizer: sertraline / Zoloft nightmare

[Cruizer]

3 hours ago, Altostrata said:

If switching to liquid has caused an increase in your symptoms, I would go back to the tablet dosage you were taking before. My guess is further tapering of sertraline will not help.

 

Some people have a very difficult time going off sertraline, particularly when they get to very low doses. Your history of withdrawal syndrome is obscured by the probable adverse effects from your drinking, but you may be one of those people who need a bridge to get off sertaline.

 

Usually, doctors would use fluoxetine (Prozac) as that bridge. Citalopram may also work. See The Prozac switch or "bridging" with fluoxetine

 

A gradual crossover is best. You might start by adding 0.5mg liquid citalopram or fluoxetine to your sertraline dose and see what that does. Then, over 2 weeks, gradually increase citalopram or fluoxetine while gradually decreasing sertraline until you are taking  4.5mg citalopram or fluoxetine and zero sertraline.

 

You'd stabilize on that for some months and then gradually taper off.

 

If liquid fluoxetine or citalopram are not available in Australia, you may need to make your own liquid.

 

Are you near Melbourne, by any chance?

Hi @Altostrata, thanks for the advice. 

I live in Adelaide, South Australia. What does Melbourne have? 

I slept better last night but still had a cortisol spike at around 430am. Like I said it's hard to tell whether this is directly linked to the switch to liquid as I was getting these in waves before. I will persist with the liquid for a few more days and see if it settles. If it does not than I will switch back to tablet in which I have still not been stable on. 

With regards to Bridging to Prozac, if you look at the dose equivalents to each drug, Prozac 40mg is equivalent to Sertraline 98.5mg. Therefore 4.5mg of Sertraline is equivalent to 1.83mg of Prozac.? 

If you could clarify that please?

I would have to get Sertraline tablets compounded into smaller to do the bridge which I can do. Could you give me a bridging schedule please? I.e. 25% every 2 weeks for example? 

I agree the alcohol may have obscured my symptoms early, but again I have not drunken alcohol for 14 months now. In the last 14 months symptoms got better and then worse over the period. I have not stabilized at 4.5mg in 18 months. I had couple of 2 week windows in there, but last one of them was in June and since then the symptoms have been the worst. I have not attempted to drop dose since January this year and been getting worse. That was why I thought it may be tolerence or adverse reactions. 

Bridging may be the best course of action but does scare me as I am not in a stable spot now. I have put up with a lot in the last 18 months. I don't care if it takes me another 5 years to taper, I just want to feel stable. 

 

One more question. If my symptoms ease in the next few days from changing to liquid Sertraline, should I wait a couple of weeks and then try a small reduction? 

 

Thanks again for your help

 

 

[Altostrata]

55 minutes ago, Cruizer said:

If my symptoms ease in the next few days from changing to liquid Sertraline, should I wait a couple of weeks and then try a small reduction?

 

Yes, let's see how this goes.

 

To bridge, you'd add a little Prozac and see how it goes. Don't worry about equivalencies.

[Cruizer]

Just wanted to make a note on a pattern that has been happening for the last 14 months. 

I have 4mg. capsules made up from a compounding pharmacist. I get them to make 60 tablets at a time for me. 

The last 7 batch changes I have noted significant head symptoms like brain fog, head pressure, fuzzy head, scrunchy face and squinting a lot within 2 days of the batch change. It is pretty clear that there is some variable happening when I change batches. 

[Cruizer]

I changed my 0.5mg compounded capsule to liquid 24 days ago. So now I am taking 4mg compounded tablet + 0.5mg of home made liquid. 

Day 1-4 saw significant nausea/insomnia and cortisol spikes. By day 5 these symptoms stopped and I began sleeping and eating normally again. Day 6 and 7 were mainly head symptoms like head pressure, tight band around head etc. 

By day 8 all the severe symptoms were gone and I felt better. 

From Day 8 to about day 22 I had periods of better motivation and enthusiasm, was getting tasks around the house that I had put off for months done, felt more connected with my kids, and had significantly clearer thinking. Mornings were the majority of symptoms specifically 30-45mins after taking medication during this 14 day period.

Then batch of 4mg. Changed and head symptoms started again. 

Looking to make a small reduction of 0.1mg in the next week or so to test the waters. That would be a 2.2% drop. I have a feeling the first 5 or so days may give me grief whilst adjusting but hopefully after that I might see something similar to what happened above. 

 

[ChessieCat]

48 minutes ago, Cruizer said:

It is pretty clear that there is some variable happening when I change batches. 

 

The following is just a suggestion.

 

Instead of doing a direct swap you could buy your new batch prior to you finishing the current batch.  You could then alternate the current and new capsules for a week or more.

[Cruizer]

10 minutes ago, ChessieCat said:

 

The following is just a suggestion.

 

Instead of doing a direct swap you could buy your new batch prior to you finishing the current batch.  You could then alternate the current and new capsules for a week or more.

Thanks for the suggestion Chessie. Yes I might try that next time. 

I had planned on changing all to liquid and tapering from there which would obviously avoid the batch issues, however the severity of symptoms even though it was only 5 days when changing the 0.5mg to liquid could see me unstable for a longer period which I would prefer to avoid. 

My thoughts on tapering were to taper the liquid part down to 0 putting me on a straight 4mg. Then from there getting a compounded 3mg. tablet and changing 1mg to liquid. Then once again tapering the liquid down to zero and repeating the process. 

What's your thoughts on that?

[ChessieCat]

On 9/26/2021 at 9:25 AM, Altostrata said:

To bridge, you'd add a little Prozac and see how it goes.

 

Are you bridging to Prozac?  Or are you staying on sertraline?

[Cruizer]

Just now, ChessieCat said:

 

Are you bridging to Prozac?  Or are you staying on sertraline?

Staying on Sertraline at this stage. With not really knowing whether what I am experiencing is withdrawal, side effects or poopout, I feel I need to try tapering before changing meds. 

Like I've mentioned in previous posts, holding now for 19 months and getting worse not better. Leads me to think perhaps could be side effects from meds or poopout. Or I could just be one of those who finds it hard at the lower doses. 

[ChessieCat]

Has poop out been discussed here before?

 

I posted to another member about this earlier today.

 

You, like the other member, have been on your drug for a long time.

 

First question is has anything happened during this time; eg alcohol, antibiotics, sickness, operation, major life stressors (financial, relationship, moving, job, travel).

 

If not, then:

 

Q: Has the worsening of your symptoms come on gradually over a long period of time?

 

You have been on the same drug for a long time.  There is a possibility that the drug may have reached tolerance, also known as poop-out and technical name tachyphylaxis.

 

Tachyphylaxis, Reaching Tolerance or as It's Lovingly Known “Poop-Out”

 

tolerance-or-poop-out-or-tachyphylaxis

 

 

Generally:

 

"Regular/normal" withdrawal symptoms happen after making a reduction and then improve fairly quickly.

 

Poop out also produces withdrawal symptoms (and the normal "solution" is to take more of the drug, which after reaching poop out again needs to be increased) but they happen gradually and do not improve with a long hold.

[Altostrata]

2 hours ago, Cruizer said:

The last 7 batch changes I have noted significant head symptoms like brain fog, head pressure, fuzzy head, scrunchy face and squinting a lot within 2 days of the batch change.

 

Ask the pharmacy if they changed suppliers. Or, they may have gotten a new lot of sertraline that is fresher and stronger than the old lot.

[ChessieCat]

Brassmonkey had to taper out of poop out from Paxil. 

 

I've just done a search and found a couple of good posts by him about this issue:

 

☼-brassmonkey-talking-about-myself

 

☼-brassmonkey-talking-about-myself

 

[Cruizer]

2 minutes ago, ChessieCat said:

Has poop out been discussed here before?

 

I posted to another member about this earlier today.

 

You, like the other member, have been on your drug for a long time.

 

First question is has anything happened during this time; eg alcohol, antibiotics, sickness, operation, major life stressors (financial, relationship, moving, job, travel).

 

If not, then:

 

Q: Has the worsening of your symptoms come on gradually over a long period of time?

 

You have been on the same drug for a long time.  There is a possibility that the drug may have reached tolerance, also known as poop-out and technical name tachyphylaxis.

 

Tachyphylaxis, Reaching Tolerance or as It's Lovingly Known “Poop-Out”

 

tolerance-or-poop-out-or-tachyphylaxis

 

 

Generally:

 

"Regular/normal" withdrawal symptoms happen after making a reduction and then improve fairly quickly.

 

Poop out also produces withdrawal symptoms (and the normal "solution" is to take more of the drug, which after reaching poop out again needs to be increased) but they happen gradually and do not improve with a long hold.

Thanks for your reply. Yes I have discussed this here before and was in fact in poopout which Brass identified in 2018. However I tapered a little too quick from 17mg down to 4.5mg in about 10 months so not hugely fast but faster than 10%. I crashed after a heavy alcohol session and have held for 19 months since. I have held 4 times now during my taper which started in 2016. Each time I held I felt progressively worse until I finally started to taper again where I then felt better. 

Brass has already mentioned my long hold this time may be poopout again.

The reason I haven't tried tapering again for about 10 months is I felt sharp increases in symptoms when I did try. However I only tried for 3 days which is likely not enough of a test period. Like changing to liquid, the first 4 days sucked but then I was ok. 

All this said and done, if I start to taper and begin feeling better, I will kick myself for holding for so long again. But I will be happy to be moving in the right direction. 

In answer to any alcohol / antibiotics and life stressors etc. I have not had an alcoholic drink for 15 months now. And no to all the others. I can also safely say (as I keep a daily journal) that my "windows" of feeling good are far shorter than what they were 12 months ago and the waves of more consistent symptoms are far longer. 

[Cruizer]

11 minutes ago, ChessieCat said:

Brassmonkey had to taper out of poop out from Paxil. 

 

I've just done a search and found a couple of good posts by him about this issue:

 

☼-brassmonkey-talking-about-myself

 

☼-brassmonkey-talking-about-myself

 

Thanks for these links. I have extensively read about poopout but not these two links. Very helpful thank you. 

Who is the other member you were talking with? 

[Cruizer]

13 minutes ago, Altostrata said:

 

Ask the pharmacy if they changed suppliers. Or, they may have gotten a new lot of sertraline that is fresher and stronger than the old lot.

Hi Alto, I have before and they seem to think they are using the same brand, or they called it last time I checked their proffered brand. I can say that I am pretty confident they did change at some stage. 

But I am confirming each time now as I have a packet of the 50mg that I make my liquid from so I take that with me and make sure they make the compounded tablets from that same brand. 

I changed batches 5 days ago and again a significant increase in head symptoms within 2 days. 

[Altostrata]

Do you feel now that your customary dosage is too strong?

 

Unfortunately, there are a lot of factors we can't control in the process. The manufacturer might have changed something in the tablets. You might never figure out what the difference is.

 

Or, your system may be telling you to make a tiny decrease, it's ready.

[ChessieCat]

  

11 hours ago, LeoD said:

Hi All, 

Have not been here over a year, slowly have been tapering from 7.5 mg to 5 mg during that time. Currently sitting on 5 mg for ~ 3 weeks. I am not decreasing, but my symptoms are getting worse, especially in the last month. Depression like never before, always on the brink of crying, complete brain fog, no motivation, no memory, loss of sleep at night, rumination and thoughts about being better off dead .

The eternal question: to wait, to updose or to keep tapering. If I wait and keep feeling worse, will I miss the window to updose? Updose how? Should I hope that the symptoms will subside or is this unrealistic at this point?

Do we know of cases when depression and cognition improve during a long hold? I do not think I can just wait for it to stop getting worse - where I am now is not consistent with functioning at all. Need an improvement.

Advice please?

leo 

 

[Cruizer]

2 minutes ago, Altostrata said:

Do you feel now that your customary dosage is too strong?

 

Unfortunately, there are a lot of factors we can't control in the process. The manufacturer might have changed something in the tablets. You might never figure out what the difference is.

 

Or, your system may be telling you to make a tiny decrease, it's ready.

I can definitely tell you that I feel a change for the worse around 45 minutes after I take the med each morning. It's like a fog / fuzziness

[Altostrata]

How about a decrease to 4.4mg?

[Cruizer]

34 minutes ago, Altostrata said:

How about a decrease to 4.4mg?

Hi Alto, yes that's the plan and resaon for me changing the 0.5mg portion of my dose to liquid to allow me to do that. I have a couple of work commitments in the next week so I am going to reduce next week. Will keep you posted on what happens. Thanks for your input. 

[Cruizer]

On 10/16/2021 at 6:43 AM, Cruizer said:

Hi Alto, yes that's the plan and resaon for me changing the 0.5mg portion of my dose to liquid to allow me to do that. I have a couple of work commitments in the next week so I am going to reduce next week. Will keep you posted on what happens. Thanks for your input. 

I'm feeling completely fed up and pretty hard done by if I'm honest. I know we all are but I'm so lost as to what to do. 

After holding for 18 months and not feeling any better (actually getting worse) I changed 0.5mg to liquid and kept taking the 4mg tablet compounded of Sertraline. Rough first 6 or so days but then the next 3 -4 weeks were pretty decent. Still had symptoms but felt clearer for longer and  ore motivated for longer periods. 14 days ago I made a tiny reduction of the liquid from 0.5 to 0.4mg giving me a daily dose of 4.4mg. First 5 days were pretty reasonable which is better than the last 3 tries. However on day 6 it hit quick. I felt good in the morning and then whack! Anxiety lifted and I just felt off. Since then the apathy and anhedonia has been intense as have the head symptoms (headaches/tight band around head). Then Friday night had really high pulse through the night, could not sleep and when I did drop off would wake startled. I feel so fuzzy and I just don't want to do anything. This has been now going for 9 days. 

 

I'm completely lost on a strategy here. I started tapering in Feb 2016 so 5 and a half years ago. I'm down from 150mg to 4.4mg now but the last 20 months has been nothing but cruel and horrible. Yes I am having what you could call windows, but they are shorter than 12 months ago and the the waves are more intense sometimes and last longer. It just doesn't seem right to me. 

My thoughts were that I should just keep going with my taper at 0.1mg every 4 weeks and see what happens. @brassmonkey you said poopout can be all over the place until your body recognises its winning the battle. I also read however that you once said from a crash you stabilize, then go through a better period which then gradually gets worse which is you slipping back into poopout. This has happened to me before but since my crash in March 2020 I would say this has not happened. I have had maybe 3 windows of around 3 weeks where symptoms were far milder but then back into acute symptoms from there. 

 

I also look at it and think, maybe I just have to keep tapering and due to the low dose and sharp decline in receptor occupancy from here down I will get spikes anyway. I just want to stabilize and feel somewhat normal. If I was off of the med and feeling this way I feel like I could be patient and wait, but I am not off of the med and have around 3 years of slow tapering to go. Something just doesn't add up to me. 

 

Or @Altostrata do you think a bridge to prozac is my next step? I'm so frustrated. I have a young family (2 boys 5 and 3.) I work fulltime in a job I like so I would not say I'm stressed at all. I just want to live my life and I'm starting to feel disconnected from my kids which is so upsetting. 

Is there others that have taken this long to stabilize after a crash? 

 

So quick summary

- Switched 0.5mg to liquid felt better after initial 7 or 8 days.

- been holding dose of 4.5mg sertraline until 14 days ago for 20 months. 

- waves of symptoms were getting worse and longer prior to changing to liquid

- Everytime I get a new batch of compounded tablets I feel different and fuzzy. Noticed this every batch for last 12 months. 

- been in poopout before. Total time on Sertraline is now 12 years. No other drugs been taken. 

-gave up alcohol July 2020

-gave up weight training Feb 2021.

 

Alto and Brass, please help. I'm so stuck as to what to do. Do I:

- ride the waves out and keep tapering in case this is poopout or side effects still? 

- updose to 4.5mg and keep holding?

- updose past 4.5mg to say 4.6 or even 5 and see if that helps?

- do I switch to Prozac a longer half life. 

 

😭

 

 

[Cruizer]

@brassmonkey just wanted to add that since the drop the major symptom is severe anhedonia and apathy. Everything feels so hard. I read that you said this is a very common wd effect but also an effect of the drug. Looks like you said this was severe for you all the way through your taper until you were off. 

I'm about to turn 37 and I've been on this crap for 12 years. 20 month hold has to be long enough to stabilize from a crash and continue tapering right? Perhaps this is the way it will be until I get off and then sometime after? I would hate to hold for longer or switch drugs and just prolong what is going to happen anyway if you get what I mean? I think the fact that I feel the sinking feeling and haze hit me almost exactly 45 minutes after I take meds in the morning probably shows the med is having a role to play in this apathy and anhedonia. 

[Altostrata]

Sorry to hear this tiny change was so difficult. Are you making your own liquid? What is your method?

[Cruizer]

4 minutes ago, Altostrata said:

Sorry to hear this tiny change was so difficult. Are you making your own liquid? What is your method?

@Altostrata Yes I am. I am measuring 50ml of water by using a 5ml syringe I.e. drawing out 5mls 10 times. This goes into a measuring tube with a lid. I then drop the tablet in there and it dissolves mainly in around 2 minutes. I then keep in refrigerator and change every 3 to 4 days. 

I then have a 1ml syringe that I use to measure the .4ml and place directly in my mouth. Also draw a bit of normal water out to flush syringe into my mouth again. I need to swirl the tube in the morning or give a shake as it looks like it is all on the bottom. Solution is cloudy with some small visible fragments but seemed to be ok before the drop. 

[Altostrata]

5 hours ago, Cruizer said:

- Switched 0.5mg to liquid felt better after initial 7 or 8 days.

 

Why do you think you felt better after substituting that 0.5mg in liquid form?

[Cruizer]

Just now, Altostrata said:

 

Why do you think you felt better after substituting that 0.5mg in liquid form?

@AltostrataI keep a daily journal as well as rank my days from 0-4 zero being no symptoms and 4 being very severe. 

There were periods of 3 to 4 days where I had only mild symptoms and felt more motivated to do things around the house, busier and more focussed on work, playing with my kids etc. My month avg was 1.6 whereas the previous 3 months were all above 2.2 so it was a considerable drop. 

Not symptom free but better. 

It may have just been a window coming anyway. I didn't notice any change until about day 6 of drop. 

[Altostrata]

How about substituting another 0.5mg of tablet with 0.5mg of liquid? You'd be taking 1.0mg liquid.

[Cruizer]

1 minute ago, Altostrata said:

How about substituting another 0.5mg of tablet with 0.5mg of liquid? You'd be taking 1.0mg liquid.

@Altostrata this had crossed my mind. The plan originally was to switch the whole amount over to liquid but when I had such a bad initial week I thought I might do it in stages. I would have to get some 3mg compounded so it would be going from 0.4mg of liquid plus 4mg tablet to 1.4mg liquid plus 3mg compounded tablet. 

I've always been suspicious about the compounded tablets. Eveytime I changed batches my head symptoms ramp right up within a day. This could be what has been keeping me sensitive for the past 20 months? 

Do you think I should updose back to 4.5mg and do the switch to liquid? Or should I wait and see?

I'm at the stage where whatever I'm doing isn't working so I need to trial a few things. 

 

Is it at all possible that I will just have to put up with debilitating symptoms for periods of every drop? Or should this not be the case? 

 

[Cruizer]

@Altostrata it got me thinking about the uptick I tend to get with new batches. I normally get 60 tablets made at a time to cover 2 months. 

Remembering I score my days 0-4 based on how severe symptoms were; I went back and avg. the 1st 30 days vs the 2nd 30 days to get a picture of the batch. 

Out of 6 x 60 day cycles, there was a significant difference with the first 30 days of a change being more severe than the 2nd 30 days aside from once. 

 

So I already knew I felt different very soon after a new batch (within a day or 2). 

But this shows that the first 30 days I'm worse than the 2nd 30 days of a batch change. It could be that each batch change is stronger or different in some way and that may be why I have not been stabilising. Thoughts Alto?

Also might explain why after the initial 8 days of changing just 0.5mg to liquid, I felt the best I have in 12 months for the next 30 days prior to dropping. 

I may never know either why this is happening but felt I should mention it. 

[Cruizer]

Sorry for the large amounts of questions Alto. But I just discovered something useful. I was browsing another members page and was reading how they were a fast metabolizer of Zoloft. Now I had genetic testing done years ago and I just revisited it. And there it was in black and white that I am a Ultra Rapid metabolizer of drugs that use the CYP2C19 gene. It lists the drugs on my report and one of them is of course Zoloft. 

Perhaps there maybe some merit in changing to Prozac and having a longer half life. 

Have you discussed this at all with any other members that are rapid metabolizers?

[JesusSavemefromWD]

1 hour ago, Cruizer said:

Sorry for the large amounts of questions Alto. But I just discovered something useful. I was browsing another members page and was reading how they were a fast metabolizer of Zoloft. Now I had genetic testing done years ago and I just revisited it. And there it was in black and white that I am a Ultra Rapid metabolizer of drugs that use the CYP2C19 gene. It lists the drugs on my report and one of them is of course Zoloft. 

Perhaps there maybe some merit in changing to Prozac and having a longer half life. 

Have you discussed this at all with any other members that are rapid metabolizers?

Hi,

I am a rapid metabolizer of Zoloft and I think that’s at least one of the reasons I was hit so hard by a low dose of Zoloft just for 3.5 weeks. During the 4.5 weeks of tapering that it followed the 3.5 weeks at 25mg, as I kept lowering the dose I was going from ok into complete hell within the same day. I am pretty sure I was experiencing interdose withdrawls. Zoloft has a half life of approximately 26 hrs, but for rapid metabolizers and at low doses it is probably less than 24 hrs , so every day about 20 hrs after my previous dose BAM hell for a few hours till the next dose would kick in and I d go automatically from hell to ok , it felt like a click in my brain and all was ok. So basically it was like I was going on and off Zoloft every day, no stability at all, and I believe that’s why I am still so sick a year after. Doctors think that if ur a rapid metabolizer a low dose will not reach ur brain at all , so u shouldn’t get any side effects or benefits of the drug , but it’s wrong, they are clueless regarding these drugs, trust me 25mg did reach my brain!!!

[Cruizer]

12 hours ago, JesusSavemefromWD said:

Hi,

I am a rapid metabolizer of Zoloft and I think that’s at least one of the reasons I was hit so hard by a low dose of Zoloft just for 3.5 weeks. During the 4.5 weeks of tapering that it followed the 3.5 weeks at 25mg, as I kept lowering the dose I was going from ok into complete hell within the same day. I am pretty sure I was experiencing interdose withdrawls. Zoloft has a half life of approximately 26 hrs, but for rapid metabolizers and at low doses it is probably less than 24 hrs , so every day about 20 hrs after my previous dose BAM hell for a few hours till the next dose would kick in and I d go automatically from hell to ok , it felt like a click in my brain and all was ok. So basically it was like I was going on and off Zoloft every day, no stability at all, and I believe that’s why I am still so sick a year after. Doctors think that if ur a rapid metabolizer a low dose will not reach ur brain at all , so u shouldn’t get any side effects or benefits of the drug , but it’s wrong, they are clueless regarding these drugs, trust me 25mg did reach my brain!!!

Yes you were the member I was talking about in this post. 

It is probably the main evidence that I can gather that makes the most sense to me. I did taper a little to fast to where I am now but it was not massive. (17mg. - 4.5mg in 10 months). I was hit after a session of alcohol kicked off a wave but progressively got worse and worse the longer I held which I couldn't work out why. I mean I was having longer and more intense waves 15 months after my initial crash which made no sense to me. The head symptoms are the main thing that is getting worse too and I noticed that I was almost permanently getting the feeling I used to when I would first drop a dose and my body was adjusting. I called it "scrunchy face" and eyebrow lifts. It just feels like something weird is going on. I get it every morning about 45 minutes after I take the med. 

I will wait to hear back from Alto and any other Mod but it may well be I am not stabilising due to this which makes sense. 

[Altostrata]

@Cruizer, there are too many factors for anyone to determine what's going on with your 4.5mg dose.

 

But if you felt better substituting 0.5mg liquid for 0.5mg tablet, perhaps somehow the liquid better agrees with you.

 

I cannot see how your metabolization rate would be a factor in this.

 

I cannot follow what you're doing with your compounded doses but I'm sure you can figure out the logistics.

[Cruizer]

1 minute ago, Altostrata said:

@Cruizer, there are too many factors for anyone to determine what's going on with your 4.5mg dose.

 

But if you felt better substituting 0.5mg liquid for 0.5mg tablet, perhaps somehow the liquid better agrees with you.

 

I cannot see how your metabolization rate would be a factor in this.

 

I cannot follow what you're doing with your compounded doses but I'm sure you can figure out the logistics.

 

@Altostrata when you say you cannot see how my metabolization rate would be a factor, do you mean in the liquid change or in general? 

You suggested around a month ago I may need to bridge to Prozac to get off of meds due to longer half life making it somewhat easier and more gentle. 

If I am a rapid metabolizer of Sertraline which my health/genetic report says I am, do you think that it could make sense that I am having interdose withdrawal due to half life of Zoloft only being 26 hours? I mean if 26 hours is for regular metabolizers I could be a lot shorter than this and that is why I haven't been able to stabilize at 4.5mg?

 

So what should I try from here? Should I updose back to 4.5mg from 4.4mg for the time being and then look to bridge to Prozac or should I begin swapping to all liquid in stages? 

 

I know you must get a lot of messages Alto, I appreciate your insight. I am at a bit of a crossroad now as a long hold has done nothing to stabilize me.

[JesusSavemefromWD]

24 minutes ago, Cruizer said:

Yes you were the member I was talking about in this post. 

It is probably the main evidence that I can gather that makes the most sense to me. I did taper a little to fast to where I am now but it was not massive. (17mg. - 4.5mg in 10 months). I was hit after a session of alcohol kicked off a wave but progressively got worse and worse the longer I held which I couldn't work out why. I mean I was having longer and more intense waves 15 months after my initial crash which made no sense to me. The head symptoms are the main thing that is getting worse too and I noticed that I was almost permanently getting the feeling I used to when I would first drop a dose and my body was adjusting. I called it "scrunchy face" and eyebrow lifts. It just feels like something weird is going on. I get it every morning about 45 minutes after I take the med. 

I will wait to hear back from Alto and any other Mod but it may well be I am not stabilising due to this which makes sense. 

I didn’t realize u were referring to my thread . There are also other SA members who are rapid metabolizers and mention difficulties withdrawing. I have also heard a talk from a foreign psychiatrist (can’t remember unfortunately her name) claiming that rapid metabolizers are prone to severe side effects as much as are slow metabolizers. Good luck to your next steps. 

[Altostrata]

I don't know if you have interdose withdrawal. To ascertain  that, please keep daily notes of times o’clock you take your drugs, their dosages, and your symptoms throughout the day.

 

We need to know how you feel before and after taking each drug, and your symptoms in between. Post 24 hours of notes at a time in this topic, in a simple list format with time o’clock on the left and notation (symptom or drug and dosage) on the right.

[Cruizer]

6 minutes ago, Altostrata said:

I don't know if you have interdose withdrawal. To ascertain  that, please keep daily notes of times o’clock you take your drugs, their dosages, and your symptoms throughout the day.

 

We need to know how you feel before and after taking each drug, and your symptoms in between. Post 24 hours of notes at a time in this topic, in a simple list format with time o’clock on the left and notation (symptom or drug and dosage) on the right.

Ok thanks Alto. Will do.