anna7887: starting Zoloft taper soon

[anna7887]

@Altostratathe feeling faint is entirely random , It is definitely triggered by public places, it rarely happens at home. 
 

Prior to the procedure, my only withdrawal symptoms were digestive issues and maybe dizziness spells here and there. I did not have any depression or anxiety spells like this. 

[Altostrata]

16 hours ago, anna7887 said:

I can’t recognize any pattern of increased symptoms following the dose. Sometimes I feel like my muscle aches/ twitches are slightly worse but they always seem to be bad at night. My anxiety and depression seems to be worse in the morning.

 

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. This can show if your symptoms are adverse effects from one of your drugs.

 

It appears you may have some degree of POTS (Postural orthostatic tachycardia). Did you have this before you took any psychiatric drugs? Is it an outcome of having Lyme disease?

 

If so, it's possible that withdrawal is exacerbating this. Please research ways to manage POTS.

[anna7887]

Thank you @Altostrata I will work on the diary. I never had POTs like symptoms prior to zoloft. They seemed to first occur in 2015 about 5 years on zoloft, when I first experienced Lyme like symptoms (I’ve never fully embraced my diagnosis as I’ve never had a definitively positive Lyme test, although a few Lyme literate docs have diagnosed me based on clinical symptoms).
 

The pots like/ neurocardiogenic near syncope first started when I started treating the Lyme. I think my body reacts extremely strongly to all medicine, and it goes into fight, flight, freeze and the near fainting occurs. It started up again after the propofol in July, improved, and now it’s back. I try all the pots protocols (salt, compression socks, etc) nothing helps… it seems like it’s triggered by stress and anxiety so I’m trying to focus on mindfulness, yoga, meditation. Thanks again for getting back to me. I’ll work on the diary. 

[anna7887]

I made the decision to start Prozac. I can’t risk losing another job and I’m non functional. My doctor wants me stop the 6mg zoloft and replace with 6mg of Prozac and work up to 10mg, I know this isn’t advised. Can someone help me with a cross taper schedule?

[ChessieCat]

Please read Post #1 of this topic:

 

the-prozac-switch-or-bridging-with-fluoxetine

 

From this post:

 

dose-equivalents-equivalency-comparison-for-antidepressants-and-second-generation-antipsychotics

 

fluoxetine 40mg/day was equivalent to

sertraline 98.5mg/day

 

Using the above data 1mg Zoloft / sertraline = approximately 0.4mg Prozac / fluoxetine

 

Post #1 of this topic explains how to get non standard doses:

 

tips-for-tapering-off-prozac-fluoxetine

 

(Divided both sides by 98.5)

 

Please note that Prozac / fluoxetine has a very long half life.  This means that if you take too much and you have a bad effect from it, and then you reduce the dose, it can take a week or longer for the lower dose to come into effect, and during that time you would have to cope any bad effects from the too high a dose.

 

On 7/3/2011 at 4:11 AM, Altostrata said:

 

Prozac has the longest half-life of any SSRI. After you take it for a few days, half-life is about 16 days. Fluoxetine itself has a half-life of 2-4 days, but as it is processed, your body creates an active antidepressant metabolite, norfluoxetine, which has a half-life of 7-15 days. So Prozac keeps on extending its half-life as it is metabolized.

According to http://en.wikipedia.org/wiki/Fluoxetine , fluoxetine and norfluoxetine inhibit each other's metabolism, extending the half-life of the drug. Because the half-lives are so long, the full effect of Prozac on the brain may not be felt for several weeks.

 

 

 

[anna7887]

Thank you @ChessieCat, I took 5mg of Prozac last night, and within an hour started experiencing extreme restlessness, agitation, etc.. felt like I had a few cups of coffee. Couldn’t sleep. Also think my usually muscle aches are much worse. Would this be considered an adverse reaction? Or do I need to try a lower dose?

[ChessieCat]

Q:  Did you take Zoloft and Prozac?

 

If yes, what doses?

 

When doing a cross taper you take less of the first drug and add a tiny bit of the second drug for a short time and then reduce the first drug a bit more and add a bit more of the second drug.

 

If you are feeling worse then you either need to stop it or reduce the dose.

 

It is better to start with a small dose and increase by small increments than to risk taking too much.

 

Please be sure to let your doctor know that it made you worse.  He needs to take responsibility for this drug switch.

[anna7887]

@ChessieCat I took 5mg of Prozac and 6mg of zoloft. I realize this was way too much. Still experiencing akathisia 22 hours later , I may have to take a benzo now to sleep. Now what do I do? I feel like if I take my zoloft tonight the akathisia will get worse..can I give my body a break from Prozac and maybe restart at a much lower dose once my akathisia settles? I did feel a lot less depressed/ anxious today oddly enough, just wired. 

 

I told my doc and she told me to stop both drugs immediately. All my docs are clueless.

[Altostrata]

23 hours ago, anna7887 said:

All my docs are clueless.

 

We're well aware of this, @anna7887 That's why this site exists and we give the advice we do.

 

If I were you, I'd stop just the Prozac, for now, let the adverse reaction settle down. It would be very helpful if you kept those daily notes throughout this process.

[ChessieCat]

On 12/4/2021 at 5:41 AM, Altostrata said:

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. This can show if your symptoms are adverse effects from one of your drugs.

 

The instruction for the daily notes.

[anna7887]

12/17

7:30am: wake up feel anxious 

8:00am- a little bit of low strength coffee. Anxiety much worst stopped drinking. 

8:00am-9 feel good eat breakfast 

9:00am- anxiety starts. Chest feels tight/ heart funny. Palms sweaty. Feel weak. Bone pain. Anxious about work calls. 

9:15am- alkaseltzer gold 

9:40am- extreme weakness, palor, shakiness, inability to comprehend info. Had to jump off work call. 

10am- exhaustion , crying, feel so scared for job stability. Laying in bed.

10:30am took blackstrap molasses (for my low ferritin) and 2,000iu of D3

11am-12pm- still very anxious but not as weak . Slight vertigo. 

12:30-took lavender oil for anxiety and upcoming work calls 

1-2pm anxiety resolved just exhausted. Green tea to get through rest of day. 

4-5pm- depression sets in/ intrusive thoughts  

6pm- dinner feel better 

7pm- anxiety, racing heart at 80bpm, usually in 50s has been this way since taking Prozac 

8:30pm-6mg of zoloft heart rate increases / anxiety within 10 min of taking it 

10pm- magnesium/ homeopathy sleep aid 

Sleep 8 hours fairly well

 

Edited December 21, 2021 by ChessieCat
Resized font

[Altostrata]

On 12/18/2021 at 4:53 AM, anna7887 said:

8:30pm-6mg of zoloft heart rate increases / anxiety within 10 min of taking it 

 

Hello, @anna7887 Has this continued to happen?

 

How has your symptom pattern changed in the last few days?

[anna7887]

@Altostratanot in a meaningful way. By Saturday my heart rate seemed to calm down quite a bit. Took my zoloft tonight and hasn’t really increased. I do feel like my Lyme/ dystaunomia symptoms have been much worse as of late, heart rate increases a lot after eating, near fainting etc so hard to pinpoint if it has to do with the zoloft. I am sure though the one dose of Prozac increased my muscle pain pretty significantly, although I found it odd my depression/ anxiety improved for 1-2 days. Not sure if I should still consider a cross taper. Thanks for checking in. 

[anna7887]

The depression and weakness I am feeling is unimaginable. I cannot believe I followed the 5% taper rule over 3.5 years and feel the way I do. Is this even heard of from one procedure / propofol? I am 5 months out from the procedure and the depression, anxiety, weakness, is just horrendous. I never had depression like this pre zoloft or during my taper up until the procedure, I just can’t make sense of it. I am hardly able to function. I am close to losing another job. Should I try updosing again? Bridge to Prozac at a much slower pace? I need help, please. I am losing hope. 

[Altostrata]

Please explain more about how you feel "depression".

 

Unfortunately, fatigue is common in withdrawal.

 

Yes, you might consider bridging to Prozac. If you add 0.5mg to the Zoloft you're taking, you might get a sense if that's the right direction. Or, you might use citalopram instead of Prozac -- the half-life is shorter and adverse effects, if any, would not last as long.

 

The Prozac switch or "bridging" with fluoxetine
 

[anna7887]

@Altostratathe depression is this deep sadness that I feel in my chest. All these memories from my childhood and adulthood are surfacing in negative ways, I have these crying spells multiple times a day. I feel just so unwell. I may try a bridge, I just don’t know what to do. I feel like I’m dying. My other health issues complicate this. I feel like I’ll never heal.

[Altostrata]

Your "depression" sounds like a withdrawal symptom. This is likely to gradually go away. Do what you can to cope with these symptoms. See 

 

The Windows and Waves Pattern of Stabilization

 

Neuro-emotions

 

Non-drug techniques to cope with emotional symptoms

 

Easing your way into meditation for a stressed-out nervous system

 

Music for self-care: calms hyperalertness, anxiety, aids relaxation and sleep

 

Dealing With Emotional Spirals 

 

Shame, guilt, regret, and self-criticism

 

Deep emotional pain and crying spells, spontaneous weeping

 

Since you've been holding at 6mg, has your pattern of physical symptoms changed?

[anna7887]

@Altostratathank you. In reading the guidelines I’ve noted that one shouldn’t take both Prozac and zoloft for longer than 2 weeks. Since I’m on such a low dose, is it possible to bridge slower? I started the .5mg 2 days ago. I feel agitated, caffeinated almost, but trying to stick it out. 
 

As far as holding at the 6mg of zoloft and my symptom pattern. I felt like I was having some windows in October/ November, but once I got the Covid vaccine it seems all my Lyme symptoms/ depression flared pretty dramatically. I know things can take time to settle down but my intuition is telling me that because of my other health issues I’m an extreme case, and may need the cross taper to finally become free of these meds. I’m going to give Prozac a little longer before deciding if it’s making things worse or better. Is that reasonable? 

[anna7887]

The agitation / restlessness was so bad last night I had to take a klonopin to sleep. Does this mean the Prozac isn’t for me? Or do I try to tough it out in hopes it will settle down as my body adjusts? Still confused if I should just stick with .5mg , for how long, and at what point do I start decreasing the zoloft? Thank you! 

[Altostrata]

Did you add Prozac? When and how much?

[anna7887]

@Altostrata I added .5mg of Prozac beginning Monday. The restlessness was really bad the first night but then seemed to lift slightly. I took it again Tuesday and Wednesday and in some ways felt good, but hard to tell I also got acupuncture started juicing more etc. so I dunno. On the fence if I should continue. I don’t believe I’ll be able to cross taper in 2 weeks knowing my body, I would prob have to do it in 3 months or longer and may just prolong everything, so confused. 

[Altostrata]

What time o'clock do you take Prozac? How do you feel before and after you take it?

[anna7887]

@Altostratatook it out about 8am, within an hour or two I feel very caffeinated/ adrenaline surges. 

[Altostrata]

Are the caffeinated/ adrenaline surges new? When did they start? Do you also drink caffeine at about that time?

[anna7887]

@Altostrataits been a few weeks since I took the Prozac for about three days, I’ve since stopped. I am still taking 6mg of zoloft. My depression actually feels better, but my anxiety is awful. I am barely hanging onto my job. I was thinking of trying the celexa bridge next since I had a bad reaction to Prozac. Would I start by taking only 1mg of celexa with my usual zoloft? 

[Altostrata]

Why do you think you had a bad reaction to Prozac?

 

Are you still drinking coffee?

[anna7887]

@Altostratait was giving me restlessness/ anxiety within an hour of taking it, wasn’t sleeping well, even at 1mg, granted I only took it for 3 days. Yes, have 1 cup of very low strength coffee in AM. I have severe chronic fatigue so it’s very difficult to stop entirely. 

[Altostrata]

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. This can show if your symptoms are adverse effects from one of your drugs.

[anna7887]

@Altostratasince I am only taking Zoloft currently, am I keeping a symptom journal still? Or only after starting celexa?

[Altostrata]

If you're determined to start Celexa, you don't need to post daily notes of anything. Please confer with your prescriber regarding your drug switch.

 

Otherwise, I would like to see what's going on with your symptom pattern.

[anna7887]

@Altostratasorry for all the questions, but my prescriber wants me to start 10mg of celexa and stop the zoloft, I know this is not smart in withdrawal. So I’m looking on guidance on how best to bridge. Do I start with 1mg of celexa and 5mg of zoloft for a few days then titrate celexa up and zoloft down all within 2 weeks? I cannot find a doc that will help me with the bridge method. 

[Altostrata]

5 minutes ago, anna7887 said:

but my prescriber wants me to start 10mg of celexa and stop the zoloft

 

Does your prescriber not know how to accomplish this switch?

 

I'm sorry, it's a fine line but we do not provide free auxiliary assistance to doctors. If you want to follow your doctor's instructions, please have your doctor resolve these questions. If your doctor is clueless, perhaps you shouldn't do what your doctor says?

[anna7887]

@AltostrataAs you are very aware, Most doctors don’t know how to advise tapers or cross tapers, isn’t that why this page exists? I need to provide suggestions to my prescriber on the cross taper because according to her, she’s never dealt with someone so sensitive. I am looking for guidance on this.  
 

You had suggested a few weeks ago I try celexa vs Prozac as the half life is shorter, I am trying to follow your advice and give it a shot. Sensing I am not wanted on this site anymore. 

[FinleyDog]

@anna7887 hi Anna I’ve been reading through your posts after I was searching to see if others had issues with gastric emptying due to withdrawal. Anyway, my heart is breaking for you but I wanted to let you know that a lot of your symptoms sound like what I was going through years ago before I was properly diagnosed with Adrenal Insufficiency. ( not the adrenal fatigue others speak of but the actual disease state). I wondered if you have seen an endocrinologist? The stress of your procedure may have pushed you into this state if you were having issues leading up to it. I am of course not a doctor but I recognize that weak awful feeling of feeling faint and it happens from the slightest stress, along with other symptoms you spoke about. 
Have you tried taking something called “cortef” ? It may help. But I really suggest seeing an Endo asap. 
 

I do hope you find someone that can help you. This seems to me to be more than withdrawal. I could be wrong. I actually found the small decreases were hurting me more than the bigger ones so I dropped my Prozac finally after weaning for a long time and I feel way better. 
 

good luck and I’ll be praying for you to feel better. 

[Altostrata]

On 1/11/2022 at 6:01 PM, anna7887 said:

@AltostrataAs you are very aware, Most doctors don’t know how to advise tapers or cross tapers, isn’t that why this page exists? I need to provide suggestions to my prescriber on the cross taper because according to her, she’s never dealt with someone so sensitive. I am looking for guidance on this.  
 

You had suggested a few weeks ago I try celexa vs Prozac as the half life is shorter, I am trying to follow your advice and give it a shot. Sensing I am not wanted on this site anymore. 

 

If your intention is to do this switch in order to go off the drug altogether, we can support that.

 

However, I requested this (more than once)

On 1/11/2022 at 5:11 PM, Altostrata said:

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. This can show if your symptoms are adverse effects from one of your drugs.

 

to verify that you are having adverse effects from Zoloft. With your sensitivities and health issues, I would not want to put your body through the stress of a drug switch unless you really needed to.

[anna7887]

I’m in bad shape. My doc rx’ed liquid zoloft and I didn’t realize I was doing the math wrong, and was accidentally ingesting closer to 10mg vs the usual 6mg about two weeks ago. I took this dose for 4-5 days when I realized what was going on. I developed akathisia, insomnia, near fainting spells, extreme nausea. I immediately threw out the liquid and started making my own again, but can’t tolerate my usual 6mg. I started taking about 4mg seven days ago, and I’m still getting the sense I may be suddenly unable to tolerate any of it. Within an hour of taking it I get cortisol surges, anxiety, feel toxic, nausea, unable to sleep much. I’m having a salt like metal taste in my mouth which worsens during panic. Near constant palpitations. I am so close to going to the ER, but keep reminding myself this has to be zoloft. Not sure what to do from here. I’m almost wondering If I should try an even lower dose? I’m so ready to off all the poison.