Terry: withdrawing from Xanax and Zoloft

[Terry]

40 minutes ago, Shep said:

 

This is such great news, Terry! I'm so glad to read about your 4-day window. 

 

Please hold. That is the best advice I can give. You are right to say that it's not a good idea to taper the benzo alongside the AD. 

 

How many hours a night are you sleeping now? 

I generally get between 5 and 6 hours a night, sometimes a little more, but not all in one piece (at least 2  bathroom trips/night).

[Shep]

2 minutes ago, Terry said:

I generally get between 5 and 6 hours a night, sometimes a little more, but not all in one piece (at least 2  bathroom trips/night).

 

This sounds good, Terry. It shows you can go back to sleep after waking up. You're actually doing better than I am in that respect. I hope your sleep is restorative. 

 

Please keep holding and let us know how you're doing over the next few days. A 4 day window is very good and shows a lot of nervous system resiliency. 

[Terry]

I've had 8 pretty good days in a row with only minor WD symptoms.  I'm wondering if it's OK to lower my AD dose at this point.  I don't quite know when to make that move.

[Terry]

On 9/30/2017 at 11:24 AM, Shep said:

 

This sounds good, Terry. It shows you can go back to sleep after waking up. You're actually doing better than I am in that respect. I hope your sleep is restorative. 

 

Please keep holding and let us know how you're doing over the next few days. A 4 day window is very good and shows a lot of nervous system resiliency. 

I've had 8 pretty good days in a row with only minor WD symptoms.  I'm wondering if it's OK to lower my AD dose at this point.  I don't quite know when to make that move.

 

Quote

[baroquep]

Hi Terry, normally people wait a couple of weeks once they start feeling well before making another change.  And because you were pretty rough for a while there, I'd probably hold another month just to be on the safe side.  After I destabilized back in March, I waited two months to start tapering again.  From my perspective, it's always best to be safe rather than sorry.  

Keep it Simple, Slow and Stable

Start Small Listen to Your Body

[Terry]

12 minutes ago, baroquep said:

Hi Terry, normally people wait a couple of weeks once they start feeling well before making another change.  And because you were pretty rough for a while there, I'd probably hold another month just to be on the safe side.  After I destabilized back in March, I waited two months to start tapering again.  From my perspective, it's always best to be safe rather than sorry.  
 

Keep it Simple, Slow and Stable

Start Small Listen to Your Body

I guess I'm so anxious to get to the Xanax taper because I've been reading such horror stories about benzo withdrawal.  It almost makes me want to just hold on the sertrilene and work on reducing the Xanax instead.  I'm really afraid of another terrible withdrawal.

[Shep]

Just now, Terry said:

I guess I'm so anxious to get to the Xanax taper because I've been reading such horror stories about benzo withdrawal.  It almost makes me want to just hold on the sertrilene and work on reducing the Xanax instead.  I'm really afraid of another terrible withdrawal.

 

I'm going to add to what Baroquep said and also advise holding at least a month.

 

Your best bet not to be one of those benzo horror stories is to let your nervous system stabilize as much as possible so you start your taper out with a strong nervous system. The fact that you were able to stabilize so quickly by spreading your Xanax doses out says your nervous system still has some resiliency. It's not broken. But you do need to nurture it. 

 

From what I'm reading, you're doing really well. Please hold and I bet you feel even better. 

 

 

[baroquep]

not sure why this link didn't post ... here is another one on stabilizing.  I'll get back to you regarding your other question about tapering sertrilene vs Xanax.

After Reinstating or UpDosing - How Long to Stabilize?

[baroquep]

Hi again, regarding which to taper first ... I'll attach the link with the information and draw your attention to this:

 

When you are taking an antidepressant and a benzo, if you are not having significant adverse effects from the benzo, consider tapering the antidepressant first for these reasons:

• Antidepressants are activating while benzos are sedating. The action of the benzo can soften the suffering from antidepressant withdrawal symptoms.
• Conversely, a concurrent antidepressant will not reduce withdrawal symptoms during a benzo taper. With all due respect, Prof. Heather Ashton's suggestion antidepressants might help is misguided, see http://survivingantidepressants.org/index.php?/topic/1510-ashton-manual-recommendation-of-antidepressants/page__view__findpost__p__14205
  
  In Dr. Stuart Shipko's e-book Xanax Withdrawal (2012), he addresses the Ashton Manual's apparent recommendation of antidepressants to counter benzo-withdrawal depression, see http://survivingantidepressants.org/index.php?/topic/1510-ashton-manual-recommendation-of-antidepressants/page__view__findpost__p__28759
• Often, benzos are prescribed to cover up adverse effects, such as anxiety, insomnia, and akathisia, from an antidepressant. When you remove the benzo, the antidepressant's adverse effects come to the forefront. You then may be in such distress, it is difficult to taper the antidepressant slowly enough to forestall severe withdrawal symptoms.
• Benzo withdrawal before antidepressant withdrawal increases the risk of a difficult antidepressant withdrawal.

Here is the link to the complete topic:

 

Taking Multiple Psych Drugs - Which Drug to Taper First

Edited October 5, 2017 by baroquep

[Madeleine]

So glad to hear you are feeling better and sleeping better!!!!   Don't rush and it should be fine. 

[Terry]

34 minutes ago, Shep said:

 

I'm going to add to what Baroquep said and also advise holding at least a month.

 

Your best bet not to be one of those benzo horror stories is to let your nervous system stabilize as much as possible so you start your taper out with a strong nervous system. The fact that you were able to stabilize so quickly by spreading your Xanax doses out says your nervous system still has some resiliency. It's not broken. But you do need to nurture it. 

 

From what I'm reading, you're doing really well. Please hold and I bet you feel even better. 

 

 

Thanks, Shep.  I guess I really need patience in this process.  I've tapered before, quite slowly, and was successful, but I only had an AD to get rid of.

[Terry]

31 minutes ago, baroquep said:

Hi again, regarding which to taper first ... I'll attach the link with the information and draw your attention to this:

 

When you are taking an antidepressant and a benzo, if you are not having significant adverse effects from the benzo, consider tapering the antidepressant first for these reasons:

• Antidepressants are activating while benzos are sedating. The action of the benzo can soften the suffering from antidepressant withdrawal symptoms.
• Conversely, a concurrent antidepressant will not reduce withdrawal symptoms during a benzo taper. With all due respect, Prof. Heather Ashton's suggestion antidepressants might help is misguided, see http://survivingantidepressants.org/index.php?/topic/1510-ashton-manual-recommendation-of-antidepressants/page__view__findpost__p__14205
  
  In Dr. Stuart Shipko's e-book Xanax Withdrawal (2012), he addresses the Ashton Manual's apparent recommendation of antidepressants to counter benzo-withdrawal depression, see http://survivingantidepressants.org/index.php?/topic/1510-ashton-manual-recommendation-of-antidepressants/page__view__findpost__p__28759
• Often, benzos are prescribed to cover up adverse effects, such as anxiety, insomnia, and akathisia, from an antidepressant. When you remove the benzo, the antidepressant's adverse effects come to the forefront. You then may be in such distress, it is difficult to taper the antidepressant slowly enough to forestall severe withdrawal symptoms.
• Benzo withdrawal before antidepressant withdrawal increases the risk of a difficult antidepressant withdrawal.

Here is the link to the complete topic:

 

Taking Multiple Psych Drugs - Which Drug to Taper First

Thanks, Baroquep.  I'll have to check this out.

[Terry]

18 hours ago, Madeleine said:

So glad to hear you are feeling better and sleeping better!!!!   Don't rush and it should be fine. 

Thanks, Madeleine.  So far today hasn't been as good as the previous week.  I'm hoping it will be better soon.  I'm afraid if I go very slowly on tapering the AD I won't be able to get rid of the benzo for several years down the road.

[baroquep]

Hi Terry, how are things?  thought that this link might help to explain how the central nervous system stabilizes and the reason we recommend holding for so long after a change.  CNS healing tends to follow a windows and waves pattern of stabilization and you'll want to make sure that when you start tapering again, as Shep also pointed out, from a position of strength rather than when still on shaky ground.  If I were you, I'd hold where you are for at least a couple of months which will allow you enough time to track your patterns to ensure that you are on an upward trend over a long period of time.     

Windows and Waves Pattern of Stabilization

Rate Symptoms Daily to Check Patterns and Progress

 

[Terry]

1 hour ago, baroquep said:

Hi Terry, how are things?  thought that this link might help to explain how the central nervous system stabilizes and the reason we recommend holding for so long after a change.  CNS healing tends to follow a windows and waves pattern of stabilization and you'll want to make sure that when you start tapering again, as Shep also pointed out, from a position of strength rather than when still on shaky ground.  If I were you, I'd hold where you are for at least a couple of months which will allow you enough time to track your patterns to ensure that you are on an upward trend over a long period of time.     

Windows and Waves Pattern of Stabilization

Rate Symptoms Daily to Check Patterns and Progress

 

Things seem to be going quite well.  The last two weeks have been mostly good, with very  minor symptoms.  Do I need to be totally symptom free before tapering again?

[baroquep]

Glad to hear that things are going relatively well, that is very good news.   I just wanted to point out that you might want to do a good long hold before you start tapering.  Some people do taper while experiencing minor withdrawal, but for me personally, the goal is a symptom free taper.  I won't do another decrease until I am pretty much symptom free both emotionally and physically.  At the beginning of my taper, I was feeling really good, amazing actually, and thought I could go start tapering at a good pace right away despite the warnings of one of the moderators here to do a nice long hold and, surprise, surprise, I ended up crashing pretty badly and had to do a three month hold.  When I see what to me, appears that a member is getting an itch to get started before a person is really ready, it's a red flag to me and just trying to ensure that the next step that you take is going to be a smooth one  

[Terry]

I have a tapering question.  I have been diluting my sertraline with water to get the right dosage and am noticing that there are fine particles in the solution.  I have to swirl the solution and then immediately draw it into a syringe.  I can always see some of these particles sticking to the bottom of the glass.  It seems to be working OK for me now, but when it gets down to the low doses I'm wondering how accurate this method will be.  

[ChessieCat]

The tablets contain fillers which don't dissolve.

 

On 27/07/2012 at 11:44 AM, Altostrata said:

You will be able to see particles swirling around in the water (some of the filler used in tablets and capsules is insoluble).

 

[Terry]

49 minutes ago, ChessieCat said:

The tablets contain fillers which don't dissolve.

Thanks ChessieCat.  I was concerned that I might have to go to a compounding pharmacy for this prescription, and I don't know if, or how well my insurance might cover that.  Now that I know, I'll just continue making my own dilutions.  So far, so good!

[Terry]

I have been feeling really good the last 3 weeks, so I guess I'm tapering OK.  Tomorrow I plan to make the next cut.  Wish I could taper the alprazolam at the same time.

[Terry]

Maybe I've heard this before, but I'm wondering why it's inadvisable to taper both a benzo and an AD at the same time.  It could certainly shorten the time to be med-free.

 

[Madeleine]

It's inadvisable as you can't manage symptoms, as you won't know which decrease is causing what symptoms. If you get withdrawal symptoms, you won't know if it's the cut to the AD, to the benzo or a combination.  If you do one at a time, then you know, and you can slow down that one, and hold if need be, then start cutting again when you stabilize. 

 What benzo(s) are you on? And how much? I don't see it in your signature.  

 

[ChessieCat]

2 hours ago, Madeleine said:

If you do one at a time, then you know, and you can slow down that one, and hold if need be, then start cutting again when you stabilize. 

 

I agree with Madeleine.

 

2 hours ago, Terry said:

It could certainly shorten the time to be med-free.

 

If you do two at the same time you will not know what is causing any issues which arise.  This could result in you updosing one or both drugs which in the long run will end up taking longer to get off.

[Terry]

3 hours ago, Madeleine said:

It's inadvisable as you can't manage symptoms, as you won't know which decrease is causing what symptoms. If you get withdrawal symptoms, you won't know if it's the cut to the AD, to the benzo or a combination.  If you do one at a time, then you know, and you can slow down that one, and hold if need be, then start cutting again when you stabilize. 

 What benzo(s) are you on? And how much? I don't see it in your signature.  

 

I'm on alprazolam, 0.25 mg.  I can't remember how to get to my signature to change it.

[Terry]

1 hour ago, ChessieCat said:

 

I agree with Madeleine.

 

 

If you do two at the same time you will not know what is causing any issues which arise.  This could result in you updosing one or both drugs which in the long run will end up taking longer to get off.

It's just very hard to think it'll take me 5 years or so to get off drugs I started in July.

[baroquep]

Hi Terry, so glad to hear that you are doing a lot better now, know that it was a little rough there for a while and it's good to see that people can and do get better with a little patience and perseverance.  Will have to echo what both Madeleine and ChessieCat have said, it is much better to taper one drug at a time and to take as much time as you need to get off of these drugs safely.  I tried speeding up my taper at the beginning of the year and it set me back a few months.  Wishing you continued healing and that your taper is uneventful on your journey off these drugs, no matter how long it takes   

Keep it Simple, Slow and Stable

[Terry]

On 10/24/2017 at 3:47 PM, ChessieCat said:

The tablets contain fillers which don't dissolve.

 

 

I talked to my pharmacist today and she told me that sertraline should not be diluted with water.  Maybe that's why I always have particles in my dilutions.  I'm not sure why that is, but she just told me to talk to my doctor.  Her method of tapering was to go to a daily half tablet, then every other day, etc., etc., which I think we all know doesn't work.  I'm not going to talk to my doctor, first because he will discourage me from tapering and second because I'm sure his tapering plan would be similar to the pharmacist's.

[ChessieCat]

From Page 1 of tips-for-tapering-off-seroquel-quetiapine

 

On 09/08/2014 at 5:55 AM, mammaP said:

You could ask your doctor to switch you over to immediate release tablets and make a liquid from them as above.  Many members make their own liquid from their tablets and get on fine with it. 

[Terry]

Has anyone else used just water to dilute sertraline for tapering?  My pharmacist says I can't do it, tho she didn't explain why.  I can see that there are particles which don't dissolve, but was told by one of the moderators that those could be just fillers.  I'm wondering if anyone has experienced doing a full taper with this method.

[Terry]

On 11/11/2017 at 6:02 PM, ChessieCat said:

From Page 1 of tips-for-tapering-off-seroquel-quetiapine

 

This link is for seroquel, not sertraline.

[Terry]

I had been feeling so good and now nearly 2 weeks after making a cut of 10% I only slept until 3 AM, am having anxiety, chills, and was crying this morning.  We are hosting our children and grandchildren on Thanksgiving and I'm wondering if I'll be tough enough to do everything.  I'm thinking that trying to make dilutions of sertraline with water may be my problem, as it doesn't dissolve well.  Advice, anyone?

 

[ChessieCat]

Sorry about the wrong link.  Here is the correct one:

 

Tips for tapering off Zoloft (sertraline)

 

"Make your own liquid
Many people make their own Zoloft liquid out of tablets and water. See How to make a liquid from tablets or capsules"

[Terry]

I had been feeling quite good on 15.5 mg sertraline so decided to taper 10% to 14.0 mg.  I held there for 12 days but began having WD symptoms.  I then decided to go back up to 15.5 mg, but on day 7 I'm still not feeling as good as I had before tapering.  Should I have toughed out the WD at 14.0 mg?  Any advice would be appreciated.

[ChessieCat]

I've been doing a cautious taper and sometimes experience withdrawal symptoms.  When this happens I ask myself am I able to live with them if they continue.  Several times the answer was no, and I updosed by a small amount, not gone back to the previous dose.

 

After 12 days your brain would have made some adaptation to being on a lower dose so it would not have needed the previous dose.  Increasing by 0.5mg may have been enough.

 

However we do need to accept that there will be times of discomfort.  We need to learn to sit with the discomfort, provided that the discomfort is not unbearable, if our goal is to get off the drug.  It is important to learn non drug techniques to get us through the uncomfortable times and not rely on a drug.

 

You may want to consider reducing by 5% next time you taper.  Or use a different taper method:

 

Brass Monkey Slide

 

Rhi's "Start Small, Listen to Your Body" Taper Plan

 

Micro-taper instead of 10% or 5% decreases

[Terry]

Thanks so much Chessie, for the advice and the links.  Sometimes I feel like I don't have the strength to endure much anymore.  

[Terry]

On 11/27/2017 at 3:13 PM, ChessieCat said:

However we do need to accept that there will be times of discomfort.  We need to learn to sit with the discomfort, provided that the discomfort is not unbearable, if our goal is to get off the drug. 

Correct me if I have the wrong Idea.  I thought it was necessary to be stabilized, without any WD symptoms, before starting another taper.  So if I understand your statement, you can have discomfort and still proceed with the next taper?  And what exactly does it mean to be stabilized?