fightback72: Tolerance withdrawal, need to start taper

[fightback72]

I have been reading the great information on this site for some time now and seeing all the many people that are suffering on here, unfortunately with getting off of these medications. Almost 3 months ago I began getting withdrawal type symptoms without even changing my dose of zoloft. I didn't know what was wrong with me at first but before I figured it out I went to my GP and got a physical and everything checked out fine. Then the pieces of the puzzle started to slowly come together on my own. I had been through withdrawal before when I cut down my zoloft from 50mg to 25mg and then onto 25mg every 4 days. I've been taking my zoloft just like this for about 5 years or so wanting to get off it completely but knew I had to pick a good time to do it so there wouldn't be any extra stress on me. Now it's reached the point where I must get off of it. I never knew that I could grow tolerant to this medication at all. Only knew about needing to taper slowly in order to quit it. This came as a shock to me. Of course no doctor ever told me this. I had done a lot of research on withdrawal over the years. I was glad to find this site as there is so much support and info on how to taper correctly, especially how to turn your tablets into a liquid suspension to taper. 

I began the Point of Return program and so far have found it to be a big help with my symptoms. I was suffering before with flu-like symptoms, intolerance to heat or sun, agitation, anxiety, crying spells, dizzyness, lightheadedness, warm sensations in the head (not nice), headaches that weren't quite like a headache and fatigue real bad at times. I also have IBS and fibromyalgia by the way. I have not begun the taper yet. Just bought the syringe and I have one of those clear urine collection bottles that I'm wondering if I can use that as my container to dissolve the tablets? Also since I have been taking my Zoloft every 4 days, not sure if I should continue with every 4 days as I transition from tablet to liquid form and continue like that? Any help would be greatly appreciated. 

[mammaP]

Hi Fightback, welcome to SA. 

First, well done for doing some research before starting to tapoer, I am glad that you found us because so many of us ( myself included) ended up here after tapering far too fast or from cold turkey. 

Taking zoloft every 4 days means you are going into withdrawal every few days and is not recommended. I have personally known several people who have done this, even tried it myself years ago but it always catches up and causes interdose withdrawal eventually. It is important to get the doses steady and consistent every day before you start to taper. You could try doing 12.5 every day and see how it goes. It will take 4 days to get a steady concentration in the blood so it will teke a week or so before you notice a difference with every day dosing. If you take 25mg every day that will be a considerable updose that you could react to after 5 years of every 4 days. In my tapering experience and from what we see here I would recommend holding that dose when you have stabilised for 2 or 3 months. This will really give your braion time to adjust to the new dosing and then you can start a slow and safe taper. Our way of tapering takes time but gets you off the drug safely and by listening to your body and holding off a taper if there are any withdrawal symptoms you can be free of the drug FOREVER. 

 

I use a urine sample bottle and syringe for my taper and they work perfectly! 

 

Here is our topic for tapering zoloft. 

 

http://survivingantidepressants.org/index.php?/topic/1441-tips-for-tapering-off-zoloft-sertraline/

 

3 KIS

http://survivingantidepressants.org/index.php?/topic/6632-the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable/

 

Tapering 10% 

http://survivingantidepressants.org/index.php?/topic/1024-why-taper-by-10-of-my-dosage/

 

We ask all members to fill in their signature with drugs and tapering history. You can find instructions here

http://survivingantidepressants.org/index.php?/topic/12364-please-put-your-withdrawal-history-in-your-signature/

 

Edited August 2, 2017 by mammaP
added link

[fightback72]

Hi mammap,

Thank you so much for that information. I had really thought I was just getting intolerant to the drug but maybe I'm not after all and the every 4 days just caught up with me. I didn't know that could happen either. Thought I was out of the woods. Every day I would feel bad, even after taking my zoloft. I would like to start the liquid tapering tomorrow so I will attempt 12.5mg every day like you said and hold that for 2-3 months. I'm so glad that I got the right container. I couldn't find the proper glass jar anywhere. I was reading that it's best to start a liquid taper doing part of your dose as a tablet and the other half as liquid? Is it really a problem for me to just do 12.5mg from liquid only at the beginning? Not sure if I would be getting that precise 6.25mg by cutting the tablet with a pill cutter.

Thank you for your help. This site is an invaluable resource.

[mammaP]

Liquid will be fine, you will be using the same tablets so theer shouldn't be a problem. It will take some time to stabilise but try not to worry. 

I haven't heard of that programme, how did it help you? 

Edited August 2, 2017 by mammaP

[fightback72]

Well I have been cutting my 50mg tablets in half to make 25mg, so should I use the whole 50mg tablet in the liquid and draw 25mg from that into the syringe?

 

Point Of Return.org offers an in-home withdrawal program using nutritional supplements and they give you advice on any interactions that could occur with your current medicines or food. They also have their own support forum online when you join. This is my 11th day taking their supplements and I have to say it has given me back almost all my energy and my appetite. I started going outside again. I'm not feeling any head pain, just still a bit sensitive to the sun. Still watching my energy expenditure but almost feel like myself again. The anxiety has calmed down along with the crying spells. I would recommend this program for anyone to feel comfortable again and get much relief from the withdrawal symptoms. It's a bit on the pricey side but it is worth it to me.

[fightback72]

I meant that I'll be taking 12.5mg from the liquid so I can use a 50mg tablet to do it? I'll be using water. 

[mammaP]

Yes that will be great 

[mammaP]

You could screw the lid on and keep it in the fridge so that one tablet will do 4 days.

[fightback72]

Thank you so much. You've been a big help. It's a scary process having to go through this withdrawal but this site has really helped calm me down about tapering and doing it with confidence. 

[fightback72]

I have some 25mg tablets. I could cut those in half and make 12.5mg. Would it be better to take tablets first for a week or more and then switch to liquid using the 50mg tablets to get 12.5mg dosages? Would this help or hurt? Using different size tablets makes a difference?

[fightback72]

Hello, I really need some advice on what to do about my Zoloft. I was taking Zoloft 25mg every 4 days for about five years and developed withdrawal symptoms within the past 3 months due to interdose withdrawal. I reinstated 5 days ago at 12.5mg daily so that I could properly taper. I need to know if it's normal to be experiencing nausea, loss of appetite, and stomach discomfort at this point. I was starting to feel somewhat better than this before I began the Zoloft again. I know these can be side effects of the medication but it feels worse than when I first started Zoloft over 19 years ago. Nothing is really helping me with the nausea. I tried ginger tea, sprite, toast and I take probiotics. I need to know if this is normal. What should I do? Do I continue? 

[ChessieCat]

6 hours ago, fightback72 said:

I was taking Zoloft 25mg every 4 days for about five years and developed withdrawal symptoms within the past 3 months due to interdose withdrawal. I reinstated 5 days ago at 12.5mg daily

 

Am I right interpreting this that you were taking 25mg 1 day and then not taking another dose until 4 days later, and doing that for 5 years?  So basically only taking it twice a week?

 

If this is correct, and you have started taking 12.5mg daily, and you are getting bad symptoms, then it would appear that you have reinstated too high.

 

Please read Post #1 carefully:  About reinstating and stabilizing to reduce withdrawal symptoms

 

If my interpretion is correct, then you might find that as low a dose as 1mg or 2mg may be enough to reduce your withdrawal symptoms.  If it were me, and this is my personal opinion, then I would be reducing my dose to 1mg or 2mg immediately.

[fightback72]

ChessieCat, Yes you got it right. I know one of the side effects of Zoloft that is very common is that it can hurt the stomach. I have IBS so it might make me more vulnerable. This pill always bothered my stomach but when I took it at 25mg every 4 days, it bothered it much less and it was more tolerable. So you're saying you would jump all the way from 12.5mg down to 1mg or 2mg just like that? If I did that then I would have to start a liquid taper. I've been cutting a 25mg pill in half for 6 days now. If I go lower, does it matter if I use 50mg tablets or 25mg tablets in liquid to draw up 1mg or 2mg? Just took a Zoloft and am feeling bad right now. I want to do the right thing. 

Thank you for your help. Much appreciated. 

[ChessieCat]

You could make a liquid using 1/2 pill (12.5mg) in water and take 1/4 of the solution.  If you measure 100ml of water you would take 25ml as a dose.  That would give you 4 doses of 3.125mg.

 

From Post #1 how-to-make-a-liquid-from-tablets-or-capsules

 

"Refrigerate homemade liquids
Most homemade solutions may keep for at least a few days, refrigerated. Drugs tend to be degraded by heat and light, which is why pharmacy containers are tinted.
 
Refrigeration delays the growth of bacteria and mold in your homemade liquid, which was not made under sterile conditions."

 

Make batch on Day 1 and take on Days 1, 2, 3 and 4 then make a new batch on Day 5.  This would use the solution in 3 days.

 

You could use this method for the time being.  However accuracy is very important especially at low doses.  You will need to investigate ways of how to get accurate small doses for tapering.  You might want to consider getting a scale so you can weight smaller amounts, or check out the suggestions in Post #1 of Tips for tapering off Zoloft (sertraline)

 

[ChessieCat]

With regards to the dose jump, when taking it every 4 days you were "averaging" 3.125mg per day.

[ChessieCat]

If you are concerned about such a big jump, then you could always go to 6.25mg daily.

[fightback72]

Thank you for your swift response, ChessieCat. I read about reinstatement and see that maybe this dose of 12.5 every day will not work for me. As a matter of fact, I just took a dose tonight and experienced shaking all over after an hour and a half of having taken it. So the question is do I begin with 1mg instead of 3.125? I know the post about reinstatement says to start small and go up if you need to. I did go three months experiencing withdrawal without ever stopping my dose every 4 days. It looks like my CNS is sensitized to the drug which I am really suspicious of now since I noticed before on the 4th day when I took the zoloft I felt worse for the next two or three days. I only have a 10mL syringe so if I wanted to measure out 1mg then I would have to get a smaller syringe that I see others use for smaller doses or get a scale? I was wondering about the scale. I like that I could still swallow part of a tablet but cutting it and checking it and cutting it and checking it again on the scale sounds frustrating. I guess I would have to look into that further. 

I have a urine sample bottle to use as my container and only goes up to 90mL. So can I use 70 mL instead (just so I'm sure there's no leakage when I mix it up) of 100mL of water and then take 17.5mL for each dose? Is that right?

Thanks so much in this urgent matter. Just trying to understand liquid tapering fully so I don't make a mistake with dosages. I'll need to start the new dose tomorrow. Can't stand another day of 12.5mg.

 

[ChessieCat]

I'm a bit foggy headed at the moment because I haven't been sleeping well and I think I'm also suffering from hayfever so I'm not able to read through your topic.  Sorry.

 

If you've gone directly from 12.5mg every 4 days and then to 12.5mg every day, then going to 3.125mg would possibly be okay, basing the dose on the average.  If you went off your drug completely (eg for 2-3 months) and reinstated at 12.5mg daily, then you could try a lower dose.

 

If you are planning on using 12.5mg into 70ml and taking 1/4 which is 17.5ml, that is okay.  It's a good idea to keep a record of your dose formulae so that you know what you are doing and don't make a mistake.

 

Good luck.  I hope you feel some relief soon.  Once you get your dose sorted, it would be a good idea to hold for a few months before even considering tapering.  Keep notes on paper daily so that you can notice any change in symptoms.

[ChessieCat]

BTW I hope your urine container is unused

[fightback72]

Oh yes my urine container has never been used 

I was doing 25mg every 4 days and for the past 6 days just started 12.5mg every day. I never stopped the drug completely so when I read about reinstatement I thought maybe it didn't apply to me. Now I see that it does because of how I'm feeling with these side effects. 

I read that the water should be room temperature when making the liquid but it's okay that the water's cold for the next 3 days after taking it out of the refrigerator?

Yes I have been taking notes of my symptoms lately and I will note my formula too for the liquid.

I hope you're able to read this and I hope you are able to get better sleep soon.

Thank you for helping me. 

[ChessieCat]

9 hours ago, fightback72 said:

Oh yes my urine container has never been used

 

I'm very pleased to hear that!

 

From your last post it seems like you are understanding the cause and effect and the rationale.  This is helpful:  Skipping Days vs Every Day Dosing Graph

 

9 hours ago, fightback72 said:

I read that the water should be room temperature when making the liquid but it's okay that the water's cold for the next 3 days after taking it out of the refrigerator?

 

I haven't heard of any issues of taking the dose directly out of the fridge.  Just make sure that you give it a good shake and extract your dose ASAP after shaking, but not so quickly and panicky that you knock the container over!

 

Yes, I hope I can start sleeping more again very soon.  I'm thankful that I am still sleeping, but the reduction in the amount of sleep is starting to accumulate and I'm noticing the effect it is having on me.  I'm trying not to stress about it because that only makes things worse.  See the link in my signature for an excellent diagram about how stress affects us.  You can hover over the labels for more information.

 

9 hours ago, fightback72 said:

Thank you for helping me. 

 

You are very welcome.  I'm glad I've been able to help.

 

Withdrawal Normal Description

 

Windows and Waves Pattern of Stabilization

Stabilising After a Reduction - What Does That Mean?

[fightback72]

Thank you for the very helpful links  I'll be reading those.  I'll be trying 3.125mg tonight and staying positive. Is it any better to shoot the dose into a separate glass and drink it that way or just shoot it into the mouth? I'm not expecting it to taste good. Oh I will definitely be shaking the container very good. I don't want to mess up my dosage. I will stay calm when I do it too so I don't knock anything over  

Yes, losing sleep can cause you undue anxiety. It always helps knowing that any anxiety you get is most likely from losing sleep before and/or withdrawal. 

Crossing my fingers 

Thank you again

 

[ChessieCat]

The main thing is to make sure you get all of the dose and do the same thing each time.  I think getting the dose directly from the syringe and then filling the syringe with water and drinking that as well would be the easiest instead of messing around with an additional container.

[fightback72]

 So I ended up squirting the syringe into my mouth but I did not add more water to the syringe after taking the dose. I will do that tonight and from now on. I think I may have messed up because I tried stirring the solution again with the lid off and that ended in some water splashing out. Do I need to redo my solution before taking another dose? I'm not sure. I want to do it right. Plus I'm trying to see correctly to get the end of the plunger between the tick marks to get to 5 because I do 10mg and then I have to refill and do 7.5mg since I'm using a 10mL syringe.

Today I have a headache and some of those warm head sensations as I call it and a little shakiness. I guess it's from doing 6 days of 12.5mg to doing 3.125mg. 

Thank you Chessiecat so much for your help. I can't thank you enough. This is so new to me and starting out I feel unsure that I'm doing this right.

[fightback72]

My head has been really hurting me all day long along with some nausea and not wanting to eat much. Ugh. Not sure about staying at this dose. This is not tolerable. That last night I did 12.5mg I got scared because I was shaking all over for a while and thinking it was too much. Maybe I have serotonin syndrome? Then woke up in the morning all sweaty. That 7th day was better though before I took that jump that night to 3.125mg liquid only.  Just afraid to take another 12.5mg tablet but this is bad. I don't know what to do. Please help!

[fightback72]

I took my second dose tonight and while I don't feel head pain now, I have that inner nervousness going on for hours now. Do I stick with this dose or does this mean that my CNS is just too sensitive to handle this drug anymore and I should just stop it. OMG. I can only hope this ends soon. This is horrible. 

[fightback72]

 I need some good advice on what to do. I was someone that skipped doses for 5 years doing 25mg of Zoloft every 4 days. I started experiencing withdrawal symptoms out of the blue since May, maybe even earlier but didn't recognize the little signs? I started to notice that I felt worse at this point after taking a Zoloft. So for at least 3 months I had been suffering and then I reinstated the Zoloft at 12.5mg daily for 6 days. I didn't like the way I was feeling and it seemed too strong like it was hurting rather than helping to relieve my withdrawal symptoms. That dose gave me stomach pain, nausea, and loss of appetite. On the 6th night after about an hour and a half after taking it I experienced trembling all over. I began to think that maybe I have serotonin syndrome or that this was too much drug for me at this point. However, that next day I didn't have any more stomach pain and maybe it was turning a corner but I was afraid to continue.

I read about reinstatement and saw that it said if you had been skipping doses that it's best to start up again at a very low dose, between 1-5mg. I switched over to liquid the last two nights (tonight being the second night) doing 3.125mg instead. Today I had head pain all day with some nausea on and off and loss of appetite. I felt some inner nervousness by day for a little while but it didn't stick around. Then later on in the night way before I took my second dose, the inner nervousness really began as my head pain was slowly leaving. I couldn't seem to calm down no matter what I tried. It was awful. Very very tense. I don't know if this is akathisia or not. Just a very extreme unsettled feeling with my heart racing. What do I do? Do I stick this out since it's only been now my second night at this dosage or do I go back to 12.5mg (tablet or liquid?) or do I need to go even lower or just stop this drug completely. Am I totally desensitized to Zoloft now that I've had withdrawal for at least 3 months? 

This experience just reminds me just how evil these drugs really are to us.

Thank you to all and any that can help me in what to do. 

[nz11]

I couldn't seem to calm down no matter what I tried. It was awful. Very very tense. I don't know if this is akathisia or not. Just a very extreme unsettled feeling with my heart racing. What do I do? Do I stick this out since it's only been now my second night at this dosage or do I go back to 12.5mg (tablet or liquid?) or do I need to go even lower or just stop this drug completely.

 ....What do I do? Do I stick this out since it's only been now my second night at this dosage or do I go back to 12.5mg (tablet or liquid?) or do I need to go even lower or just stop this drug completely

 

How are you feeling today fightback? I am very concerned for you. Love the site name you have chosen by the way.

Do you have family around to support you at this time?

After 21 yrs drug use your cns and brain will be very sensitive to dose changes. Its amazing that you went for 5 years and no serious wdls when you were in a constant state of flux regarding the levels of drug in the body caused by a half life of about 25 hours and dosages every 4 days.

CC is spot on in saying that 25 mg every four days is 6.25 daily. That to me sounds like the logical dosage to go for and attempt to 'hold' on. It may take many months for this to stabilize. It will take 7 days to reach steady state in the body.

No disrespect to the wonderful MammaP but I'm not sure what her reasoning was for 12.5 mg per day she may have uncharacteristically misread your info and thought you were taking 25 mg every alternative day. 

[Lets not forget there are only 3 perfect people in this world ...my wifes ex husband, the Pope (according to my neighbor) and the Alto. ]. I know I myself  have misread thread info at times.

You have effectively doubled the dose then one day prior to steady state being reached you dropped it (to 3.125) by approx. 75 %, these are large changes and may have the ability to set off and trigger serious withdrawal symptoms. Full blown ssri wdl is very difficult to reign in and is a struggle to endure.

 My feeling is that 3.125 mg may be too low. You may struggle to hold it here. But its your call. imo the best thing at this stage is not to make any more changes. 'Pick a dose and stick to it'.  

You have also raised an unusual issue in regards to the situation where a drug has been taken for years at a dosage of once every 4 days, perhaps the  'gap' in dosing  needs to be tapered to daily? Idk As the sudden jump to going  daily may also perhaps cause surprise for the cns. 

Please do not stop this drug completely.

Finally there is one more thing I would like to tell you and if things get real rough and you go to a doctor for an opinion then before you swallow anything extra please get a second opinion from the good folk here at sa. For no one knows a drug like the ones who have swallowed it. 

 

Akathisia has a three pronged defn being, experiencing an uncontrollable restlessness an uncontrollable psychological distress and an overwhelming push to commit suicide.

If this is what you are suffering try not to let it and the uncharacteristic thoughts that flood the mind frighten you although it is frightening. It will pass.

 

nz11

[fightback72]

Thank you so much for your concern. I haven't found anyone else that's been taking an AD every 4 days for 5 years like me and could not decide how to proceed. Yes I guess I have been lucky that I was able to go this long without any withdrawal. I mistakenly believed it would get me closer to stopping when I finally chose to taper this drug to get off of it completely. 

I have been feeling that inner nervousness and some agitation today along with some head pain today.

I'm about to take my dose for the night. Now I'm thinking I made a mistake and should have gone to 6.25mg. Do you think I should stick with 3.125mg or go to 6.25mg tonight? Maybe you can get back to me tonight? I don't want to be wrong and suffer needlessly. I have been going through withdrawal since at least May that I'm sure of. There were signs looking back now that I may have been having some of it before that time but it wasn't quite as obvious.

Thank you so much. I feel so alone having taken my doses the way I have for 5 years. I didn't know what I was doing to myself.

[fightback72]

Yes I have family support from my mom, sister and my boyfriend. I live with my mom which does help.

 

[ChessieCat]

You may still be experiencing start up side effects from having been on 12.5mg for 6 days.  It takes about 4 days for the drug to get to steady state in the blood and a bit longer for it to register in the brain.

 

My opinion is that it would be better to stay at the dose you are on 3.125mg.  You might find that you will be feeling some improvement within the next couple of days.

 

Obviously the lower dose you can stabilise on the less you will have to taper.

 

Non-drug techniques

[fightback72]

Thank you ChessieCat. I took 3.125mg again tonight and was just reading again under the topic of "About Reinstating and Stabilizing to Reduce Withdrawal Symptoms" and was paying attention to the part that says, "If you've had withdrawal symptoms for a month or more, it's likely your system is somewhat sensitized to drugs. You might wish to try reinstating at a lower dosage, such as 2mg-5mg." Even though I never fully stopped the drug, I have had withdrawal for more than a month so like you say I think you're right about staying at 3.125mg. That part does apply to me. Should I still assess how I feel after 7 days and if better or the same just stay at this dose? If not do I just hang on in there and let myself stabilize on this dose? My instinct is to stay at this dose.

Thank you so much again. It's been a tough few months and hard to decide which way to go in my case since I don't see any examples of others that have taken it as I did for the past 5 years.

 

[fightback72]

Okay, not sure how I did this but I made a mistake somewhere with my liquid. Thought I checked all my measurements carefully. Sunday night I made my batch of 70mL of water with 12,5mg pill, taking out 17.5mg for each dose to get 3.125mg. Tonight was my last dose from this batch. I somehow ended up not having enough?  I'm kind of worried about how I'll feel tomorrow. Yikes! First I got my 10mg and then it just went past like 5mg. What do you do when this happens? I wasn't sure. I just took it like that. I know I didn't spill any liquid before tonight.

I think tomorrow I'll change it up to doing 80mL liquid to 20mg each dose to get 3.125mg from now on. Would that be okay?

I appreciate the help.

 

[Madeleine]

I'm not a moderator but I've read in other cases that if you make dosing mistake to just go back to regular dose the next day. 

[fightback72]

Thank you. 

[fightback72]

So I am on Day 16 of 3.125mg of Zoloft. I'm wondering about others experiences with anxiety and panic attacks during withdrawal. For the last 9 years I have been recovered from panic episodes and high anxiety. As the withdrawal began (which when it started I did not know it was withdrawal yet since I never stopped the drug, just was taking it every 4 days for about 5 years) I started to get a few at certain times but now I feel the anxiety getting worse. I'm not handling stressful situations the same way that I was and feel like this experience may be reinforcing a bad habit. It's making me scared to continue with my taper when the time comes. I keep up with my CBT program that I used to heal myself. Has anyone been recovered from their panic and anxiety atacks and then it tried to start back up during withdrawal? Did you recover when withdrawal was over? Did it continue on throughout the entire withdrawal? I am so frustrated with this and in despair over it.