Merry: tapering for years and now stuck

[merry]

Hi all,

I have been tapering zoloft for nearly 4 years now and it has been somewhat straightforward up until now, thanks to the excellent advice here and other on-line sites.  My  tapering schedule has been the smallest amount I can easily measure (so now I do 0.2 g or 0.01 ml) and wait until I'm stable, then wait a bit more.  I've still had nearly every WD symptom but they have generally mild enough so I can mostly function and generally go away after a week or so.  Until....

 

Last summer I reached 9 mg and the WD symptoms (gut/sleep) were so bad and hung on for a month.  Then I found an "alternative psychiatrist" who gave some supplements that relieved some symptoms but kept pushing things that I kept reacting badly to.  So I stopped taking all supplements but continued to slowly taper after I felt better.

 

On January 1, I hit 7 mg and haven't been stable since.  I tried to take the previous supplements, but I think they made things worse.  I seem to react badly to everything--keep getting stomach pains from all sorts of foods; I am afraid to eat sometimes.  I've been getting only a few hours of sleep a night and it has been miserable.

 

Sorry for the pity party--I really don't know what to do.  Right now I'm holding at 7 mg and slowly trying one supplement at a time to see what works.  But ultimately, even if I do get through this horrific time, I'm not sure it's worth tapering again.  On the other hand...ugh!  I just want to be free of this drug!  I also worry if there would come a time when I would have to CT for some reason; being at a lower dose would reduce the risks in that case.

 

I am very upset with psychiatry and worried for my future.

[ChessieCat]

Hi Merry,

 

Is this the first time you have created in Introduction topic since you joined?  You've been a member since 2014!  Welcome ... finally!

 

Many members here find that the lower their dose gets the slower they need to go.  This can be done by reducing by less than 10% and/or holding for longer.

 

Here are some topics which you might find interesting and helpful:

 

Why taper paper: dose-occupancy curves

 

Windows and Waves Pattern of Stabilization

 

Stabilising After a Reduction - What Does That Mean?

Withdrawal Normal Description

 

Brain Remodelling

Video:  Healing From Antidepressants - Patterns of Recovery

 

And from What is Happening in Your Brain:

 

"Basically- you have a building where the MAJOR steel structures are [...] to be rebuilt at different times - ALL while people are coming and going in the building and attempting to work.

It would be like if the World Trade Center Towers hadn't completely fallen - but had crumbled inside in different places.. Imagine if you were [...] to rebuild the tower - WHILE people were coming and going and [...] to work in the building!  You'd have to set up a temporary elevator - but when you needed to fix part of that area, you'd have to tear down that elevator and set up a temporary elevator somewhere else. And so on. You'd have to build, work around, then tear down, then build again, then work around, then build... ALL while people are coming and going, ALL while the furniture is being replaced, ALL while the walls are getting repainted... ALL while [...] is going on INSIDE the building. No doubt it would be chaotic. That is EXACTLY what is happening with windows and waves.  The windows are where the body has "got it right" for a day or so - but then the building shifts and the brain works on something else - and it's chaos again while another temporary pathway is set up to reroute function until repairs are made. 

And just like the Twin Towers- it's possible - but the building is a major effort -and it takes a good year or more sometimes."

[JamesF]

On 24/02/2018 at 8:12 PM, merry said:

Hi all,

I have been tapering zoloft for nearly 4 years now and it has been somewhat straightforward up until now, thanks to the excellent advice here and other on-line sites.  My  tapering schedule has been the smallest amount I can easily measure (so now I do 0.2 g or 0.01 ml) and wait until I'm stable, then wait a bit more.  I've still had nearly every WD symptom but they have generally mild enough so I can mostly function and generally go away after a week or so.  Until....

 

Last summer I reached 9 mg and the WD symptoms (gut/sleep) were so bad and hung on for a month.  Then I found an "alternative psychiatrist" who gave some supplements that relieved some symptoms but kept pushing things that I kept reacting badly to.  So I stopped taking all supplements but continued to slowly taper after I felt better.

 

On January 1, I hit 7 mg and haven't been stable since.  I tried to take the previous supplements, but I think they made things worse.  I seem to react badly to everything--keep getting stomach pains from all sorts of foods; I am afraid to eat sometimes.  I've been getting only a few hours of sleep a night and it has been miserable.

 

Sorry for the pity party--I really don't know what to do.  Right now I'm holding at 7 mg and slowly trying one supplement at a time to see what works.  But ultimately, even if I do get through this horrific time, I'm not sure it's worth tapering again.  On the other hand...ugh!  I just want to be free of this drug!  I also worry if there would come a time when I would have to CT for some reason; being at a lower dose would reduce the risks in that case.

 

I am very upset with psychiatry and worried for my future.

 

Hi Merry, 

ChessieCat has posted useful info.

Just a few points I noticed from what you wrote and from my own experience of going through severe withdrawal a few times.

 

• "My  tapering schedule has been the smallest amount I can easily measure (so now I do 0.2 g or 0.01 ml) and wait until I'm stable, then wait a bit more" super glad to hear this and it's definitely the right approach. My last taper was 18 months, and way too fast still, so I will never have a timeline in future. The approach of being sensitive to your own rate of healing and waiting however long it takes to stabilise is 100% the right one.

 

• "Last summer I reached 9 mg and the WD symptoms (gut/sleep) were so bad and hung on for a month"  this is common because the lowest doses have the highest % effect.  I also had big problems at the lowest doses.
  
  Here's some info I recently posted in another thread: http://survivingantidepressants.org/topic/16600-starquake-how-long-will-prozac-withdrawal-last/?tab=comments#comment-332146 
  
  And here's the graph I put together that indicates likely effect vs dose for zoloft: 
  
  

As you can see, even small dose drops produce a very large % drop in the effect on 5-HTT (Serotonin receptor) Occupancy.  

So, with equal reductions in doses, the smaller doses get, the longer it might theoretically take to stabilise.

 

 

• "On January 1, I hit 7 mg and haven't been stable since"  Another phenomena I noticed during low doses of zoloft (the 2mg - 15mg range) and that are widely reported here, are delayed onset symptoms after a dose reduction.
  
  From a biological perspective, this is likely related to a reversal of the time taken for SSRIs to have an effect. During onset, SSRIs reach blood concentration after a week or so, the effect on serotonin receptors then produces a whole host of down stream changes that take somewhere around 4 - 8 weeks. This is the reason they're often cited to work after a few months. Likewise, the antidepressant effect of SSRIs is no longer theorised to be directly related to serotonin, but instead is likely related to these other changes that happen some time after this.
  
  It seems that it's common to get hit pretty hard 2-6 months after reductions at the lower doses, possibly for the above reason. 
  
  Either way, I think a sensible approach would be simply to hold a lot longer than might seem necessary at these low doses (e.g. 2 months after apparent stability). 
  
  For you, it could also be possible that you got a delayed onset withdrawal from one of your prior dose reductions, so your brain is essentially still play "catch up".

 

• "Then I found an "alternative psychiatrist" who gave some supplements that relieved some symptoms but kept pushing things that I kept reacting badly to.  So I stopped taking all supplements but continued to slowly taper after I felt better."   This could also be a reason for recent lack of stability. 
  
  Overall, supplements intended to treat or alleviate withdrawal don't seem to work. I must have tried 100 things. I was also prescribed benzos for my symptoms. Many here were prescribed drugs like Lamictal, SNRIs, and so on. I haven't seen a single instance yet of them working well. Usually, they seem to create new dependency and withdrawal of themselves, while not reducing suffering of the original symptoms. 
  
  It seems that the only way to relieve withdrawal symptoms is to either reinstate and stabilize, or wait and stabilize. These drugs have unique psychopharmaceutical effects on the brain, so they aren't good substitutes for each other, nor will they relieve symptoms caused by each other.
  
  I'm not sure exactly what he gave you, but it seems likely that it might have caused a few "impacts" in an already quite hypersensitive and destabilised nervous system, which might take a bit of time to recover from. In future, it might be wise to treat symptoms by reinstating or waiting, rather than adding anything new that could produce destabilisation. And of course, all the great alternative methods/therapies posted here like meditation, tapping, hypnosis, good diet, etc. 
  
   
• "Sorry for the pity party--I really don't know what to do.  Right now I'm holding at 7 mg and slowly trying one supplement at a time to see what works."
  
  MOD NOTE:  Please see this post regarding updose suggestion.  Have you tried a small updose to the dosage in mg you were previously stable at - 9 mg? This sounds very sensible.
  
  I wouldn't worry about going up a bit, minimising suffering and withdrawal symptoms, and being functional/happy is far more important than the precise dosage you're at. Supplements may have a small effect on healing, but ultimately the symptoms are caused by effects of the original drug not yet healed or stabilised, so resolution is likely through reinstatement or waiting. 
  
  In my case for instance, withdrawing too fast also meant that I eventually had to go back to square one ... so I didn't even save time or suffering by going off fast, I just caused more of it. This was hard for me to handle, because I'd invested a lot of time and suffering trying to get to a low dose. But if I could go back, I would 100% have updosed a tiny bit and just held there for a long while to recover my life and health.
  
   
• "But ultimately, even if I do get through this horrific time, I'm not sure it's worth tapering again.  On the other hand...ugh!  I just want to be free of this drug!  I also worry if there would come a time when I would have to CT for some reason; being at a lower dose would reduce the risks in that case."
  
  I fully understand the need to be free of the drug - but I must tell you, even if nothing else I wrote is helpful, this one sentiment is what caused me a lot of suffering. 
  
  It's far better to be stable, functional, and free of withdrawal (MOD NOTE:  only have minimal withdrawal symptoms) while on a tiny dose than it is to be suffering and "free" of the drug. Because you're not really free even if you're off it, the effects of a CT may linger far longer than they might have done with a slow and stable reduction. 
  
  This sentiment also means we can ignore our own sensitivity or pace when it comes to withdrawal speed or choosing when to jump off. I figured I was so close to the end when I got to <10mg, that I didn't wait to fully stabilize, I just kept reducing and reducing on a fixed timetable, then jumped, ... and got hit mega hard. I had to go back on after months and months of extreme suffering. So a report from the trenches... it's not worth it! Stabilize... hold as long as it takes to stabilize and retain a functional life.... you'll heal, but only at the speed your body can 

 

 

Anyway... hope that was helpful ? 

Objectively you're at a very tiny dose, very close to healing and being off it. So be kind to yourself and don't rush to the finish line, it's never worth it. Take time, stabilise, increase a tiny amount if you need to ... put your own health and functionality before any need to be free of the meds by a certain date. 

Take care and hope things settle down for you soon. 

Edited February 25, 2018 by ChessieCat
added mod notes

[merry]

Thank you, Chessie, for your welcome and everything that the moderators do!  I haven't felt the need to post an intro until now, as the last few years have been slow and painful but manageable.  Now they have reached unmanageable.

 

Thank you, James, for your kind and thoughtful post.  I appreciate hearing your hard-earned advice and sharing your experiences with these horrible things.  What really resonated: your idea that my current lack of stability could be just a delayed WD response, especially after my crash last summer.  Both the pdocs I was seeing were really pushing me to make fast reductions and were annoyed that I wanted to go slower, and so perhaps I pushed the tapering too fast over the last few months.

 

I do like the idea of supplementation, whether through careful diet modification or supplement pills: that there is something out there that can help stabilize our biochemistry and we just have to find it.  But my list of sensitivities to food and vitamins (already a very long list has developed over the last few years) has rapidly grown these last few months.  Unfortunately, my insomnia gives me plenty of time to google what-the-heck-is-wrong-with-me (parasite?  other infection?)  and the list of things to try is quite long.  But perhaps the potential pain caused by supplementation is not worth the potential benefits.  I'll try to up my meditation/tapping/relaxation and hope my body and brain can stabilize on their own.

 

The main option I'm currently considering is just to stop the taper.  Multiple months of WD agony for 0.2 mg reduction is too much, and if I have to CT sometime in the future I'll deal with it then.  But maybe after a nice long hold--like a year--I could try for 6.8.

I'm not really interested in updosing to 7.2, my last decent dose--still holding out hope that I'll stabilize at 7.0.  But may need to consider it after a few more weeks; thanks for the reminder of that possibility.

 

It sounds like you have had quite a journey, James!  I hope that you, too, are able to finally rid yourself of medication and in any case find happiness and functionality wherever you are.

[ChessieCat]

On 24/02/2018 at 10:09 PM, JamesF said:

Have you tried a small updose to the dosage in mg you were previously stable at - 9 mg? This sounds very sensible.

I wouldn't worry about going up a bit, minimising suffering and withdrawal symptoms, and being functional/happy is far more important than the precise dosage you're at.

 

It is better to updose by a very small amount than to increase too much.  It may be better to try 0.5mg or 1mg (7.5mg or 8mg) more because your brain will already have made some adaptations whilst being on the lower dose.  If you then find that you are experiencing unbearable symptoms then you would updose again by a very small amount.

Edited February 25, 2018 by ChessieCat