Locuststar: tapering sertraline / Zoloft after 10+ years

[Locuststar]

Anyone successfully coming off this medication after 10 years or more? I am planning a slow taper process.

[Altostrata]

Welcome, Locuststar.

 

I moved your post here to start your Introductions topic, where you can ask questions about your particular situation and track your progress.

 

Please use search in the Introductions forum for "Zoloft" and "sertraline" to see how other people are doing tapering this drug. See the Succes Stories forum for success stories.

 

Have you read Tips for tapering off Zoloft (sertraline)?

 

To help us out, see these instructions Please put your drug and withdrawal history in your signature

[bubbles]

Hello Locuststar

 

I've been on SSRIs (with a brief gap) for over a decade, though only on sertraline for five and half years. I restabilized on sertraline after a bad time having come off Lexapro, and started a very slow taper off sertraline after about 18 months on it in 2014. I'm at 9mg now and plan to take about 20 months to finish.

 

I'm considering this process to be tapering off SSRIs, rather than just the sertraline, so I consider it 12 years of SSRIs. I've mostly crawled down and have had a few wobbles, but nothing major and nothing that lasted longer than a week or two.

 

I started out by breaking tablets but I've mostly used a compounding pharmacy to create intermediate doses. I believe that a liquid sertraline is available in some countries which would be simpler.

 

Best wishes

Bubbles

[Locuststar]

Thanks for accepting me to this forum.

 

Thanks for sharing Bubbles, it made me hopeful. I’ve been on ssri for 18 years (sertraline 10 years, before that citalopram), so 18 months or 2 years seems to be the timespan... I’m also on Mirtazapine since december last year, but I heard the sertraline is harder to come off. I dropped from 50mg to 25mg (stupid idea) last summer only to up again in a few months due to intolerable symtoms. I went up to 75 mg and then the doctors raised it to 100, at that time my problems with this med really became terrible. I am since october last year on 75 mg.

 

Are you tapering by yourself or do you have support from a doctor? 

[bubbles]

I have support from doctor and pharmacist and they're really helpful. I have been tapering for almost four years and expect to be finished in another 1-3/4 years. I have prioritized feeling well and am not prepared to make the sort of drops that give me more than mild symptoms and only for up to a week or so. It will be a 5.5 year taper, all going well. I'm trying to go so slowly that my brain can rewire itself along the way. It's a slow process, but I'm confident that I'll get there.

 

I think that there is a sertraline liquid, in some countries (not mine). Does that exist where you are? That would simplify tapering.

[Locuststar]

Sounds wise to take your time. I think there is liquid Zoloft in my country (Sweden) so that maybe will simplify things. I am now in pre-pre taper i guess. Trying to contact my recent prescriber and hear his view on slow tapering. He will probably have me to stay on the drug but I have options with a private doctor. I am also trying to collect all my medical files for the past 18 years. Do you have a therapist also?

[bubbles]

I did have, but I haven't seen him for some time now. Liquid would certainly help as you could taper at whatever increment you needed. I've had great help with a compounding pharmacy, so that's another option.

[Locuststar]

Need help. Tapered 75mg of sertraline to 50mg on February 10 this year, but had to reinstate at 75mg on march 8 because of panic/anxiety. I am also on 30mg Mirtazapine since december. Two weeks after my last increase of sertraline I had terrible panic/anxiety but have not changed my dosage except I skipped (only once) or decreased dosage to 50 mg (twice) for a couple of times two-three weeks ago. Right now I have a hard time to stabilize. Having waves of anxiety but also this crippling feeling of emotional numbness. Is it the skipping or short decrease (drug holiday) a few weeks ago that still destabilizes me? I have also been taking Promethazine daily the last week (25 mg) but that seems to make things worse. Advice needed.

[Locuststar]

Also wondering how I can edit my title for my topic since I spelled incorrect..."after" not "arter"...

[brassmonkey]

Monkey Magic strikes again. 

[Altostrata]

51 minutes ago, Locuststar said:

Need help. Tapered 75mg of sertraline to 50mg on February 10 this year, but had to reinstate at 75mg on march 8 because of panic/anxiety. I am also on 30mg Mirtazapine since december. Two weeks after my last increase of sertraline I had terrible panic/anxiety but have not changed my dosage except I skipped (only once) or decreased dosage to 50 mg (twice) for a couple of times two-three weeks ago. Right now I have a hard time to stabilize. Having waves of anxiety but also this crippling feeling of emotional numbness. Is it the skipping or short decrease (drug holiday) a few weeks ago that still destabilizes me? I have also been taking Promethazine daily the last week (25 mg) but that seems to make things worse. Advice needed.

 

Skipping and changing dosage can cause problems. What times of day do you take your drugs, and at what dosages? Please be very careful to hold steady while we figure this out.

 

What is the promethazine supposed to do for you?

 

Please put ALL your drugs in the Drug Interactions Checker https://www.drugs.com/drug_interactions.php
and copy and paste the results in this topic.

[Locuststar]

I take 75mg sertraline at 9 am and 30mg Mirtazapine at 10 pm. The Promethazine is for anxiety.

 

Interactions between your drugs

Major

sertraline  mirtazapine

Applies to: sertraline, mirtazapine

Using sertraline together with mirtazapine can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate

promethazine  sertraline

Applies to: promethazine, sertraline

Using promethazine together with sertraline can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate

promethazine  mirtazapine

Applies to: promethazine, mirtazapine

Using promethazine together with mirtazapine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

[Locuststar]

Feeling more stable today and haven´t touched the promethazine since tuesday because it messes with my CNS, hopefully I will never touch it again after reading about drug interactions. I´m very careful taking my meds on the same times every day. I am seeing a doctor next friday discussing a  slow taper process (10% per month or less). 

[SkyBlue]

6 hours ago, Locuststar said:

Feeling more stable today and haven´t touched the promethazine since tuesday because it messes with my CNS, hopefully I will never touch it again after reading about drug interactions. I´m very careful taking my meds on the same times every day. I am seeing a doctor next friday discussing a  slow taper process (10% per month or less). 

 

Hi Locuststar,

I'm glad you're feeling more stable today. 

Also glad that you're taking the meds at the same time every day. Consistency is so important.

 

Hopefully your doctor will be supportive of the 10% (or less) taper method. There may be some raised eyebrows and suggestions that you "could go much faster," but it sounds like you know better. 

 

Let us know how everything goes.

 

Had you only been taking Promethazine for one week, prior to stopping on Tuesday?

 

[Locuststar]

Thank you SkyBlue for support! I feel grateful for finding this forum.

 

I´m actually switching to a new doctor who is all about slow tapering so I trust he will know what´s right for me. And I have informed my current doctor about this and he was actually very supportive. Too bad he already put me on another drug! (Mirtazapine). 

 

I had only been takning promethazine for a week, I was suppose to use it when I needed it bu I hope I will never use it again since it messes me up!

 

All in all I had a stable day, a bit depressed but rather feeling low than being a total nervous wreck.

 

Take care and best wishes to you!

[Locuststar]

Struck by terrible anxiety today out of the blue. Had one cup of coffee this morning which seems to be a bad idea. I´m taking my meds on exact times and dosages. Can it be withdrawal from promethazine I´m experiencing along with intolerance from caffeine? I haven´t used promethazine since tuesday and yesterday I seemed to be ok, I even exercised without trouble. Feeling nervous and strange. Really frustrated by all this.

[Locuststar]

Hi again, I need some advice. I have a new doctor who is all about tapering sertraline at 10 % per month. However he thought I could drop Mirtazapine much faster because he said that drug is easier to come off and I have only been on it for approximately 6 months. Because I have severe emotional numbness he suggested that I dropped Mirtazapine from 30 mg to 15 mg (to see if my motivation comes back) which I did on friday. I haven´t had any severe reactions but I do have had some increased anxiety. My sleeping have been fine though. Anyway I don´t feel secure dropping 50 % så we decided that I reinstated to 22,5 mg which I did yesterday. My primary focus is now instead to taper sertraline as soon as possible by 10 % but I don´t feel safe to taper anything before I feel more stable. How long do you think I should hold before anymore tapering? 

[SkyBlue]

17 hours ago, Locuststar said:

Hi again, I need some advice. I have a new doctor who is all about tapering sertraline at 10 % per month. However he thought I could drop Mirtazapine much faster because he said that drug is easier to come off and I have only been on it for approximately 6 months. Because I have severe emotional numbness he suggested that I dropped Mirtazapine from 30 mg to 15 mg (to see if my motivation comes back) which I did on friday. I haven´t had any severe reactions but I do have had some increased anxiety. My sleeping have been fine though. Anyway I don´t feel secure dropping 50 % så we decided that I reinstated to 22,5 mg which I did yesterday. My primary focus is now instead to taper sertraline as soon as possible by 10 % but I don´t feel safe to taper anything before I feel more stable. How long do you think I should hold before anymore tapering? 

 

Six months is, unfortunately, long enough for a psych drug to "get its hooks into you" and cause enough changes that it will be need to be tapered slowly. 

A 50% cut is a drastic change for the nervous system. 

 

You've had quite a lot of changes in the Sertraline, going up and down; then adding Mirt to it and increasing that, then the 50% decrease, then an updose. This is way too many changes for the nervous system.

 

We can't just try large decreases and hope that a reinstatement will be the safety net. 

The best thing to do is to please pick a dose and stick with it.

 

Allow yourself to get stable. I know you want to taper the sertraline as soon as possible, but sometimes slower is actually the fastest way. Then you're not going faster, having to slow down, hold, suffer symptoms, etc. If it was safe and reliable to decrease by larger amounts, we would recommend that. But it just isn't. 

[Locuststar]

Thank you for your reply SkyeBlue. I will give myself time to stabilize on this dosage before I taper Sertraline. 

[Locuststar]

Also, how can I tag Mirtazapine in My topic? I would also like to add Zoloft.

[TrustInLife]

Hi, I have some things in common with you. On Sertraline 25 mg in the morning at the moment, and have 5 days ago tapered from 30 mg Mirtazapine to 15 mg Mirtazapine. I’m also in Sweden. I am curious how you are doing since last you wrote? I truly hope you are good and stable. I’m struggling a bit with different withdrawal symptoms and I truly truly hope they will pass soon. Considering to taper Sertraline as well soon. As I am wondering if the Sertraline makes my ears make a whoosing /and ringing sound. 

[Locuststar]

22 hours ago, TrustInLife said:

Hi, I have some things in common with you. On Sertraline 25 mg in the morning at the moment, and have 5 days ago tapered from 30 mg Mirtazapine to 15 mg Mirtazapine. I’m also in Sweden. I am curious how you are doing since last you wrote? I truly hope you are good and stable. I’m struggling a bit with different withdrawal symptoms and I truly truly hope they will pass soon. Considering to taper Sertraline as well soon. As I am wondering if the Sertraline makes my ears make a whoosing /and ringing sound. 

Hi TrustInLife! Thanks for reaching out. I am doing okey at the moment, some anxiety but manageable. Did you go directly from 30 mg to 15 mg? How long have you been on sertraline and mirtazapine respectively? Is ringing ears your main symptom?

[Locuststar]

I really need advice on what to do because I am in a terrible situation and can´t really function right now. I realize I tapered Mirtazapine down to 7,5 mg too fast, I was convinced by my doctor that I could go faster because I hadn´t been on the drug that long and that this drug was easier to come off. 

 

In february I was hit with terrible anxiety and updosed Zoloft back to 55 mg. That seemed to work for a while but three weeks later I started having bad insomnia and got prescriptions for sleeping pills. I feel really destabilized right now and my doctor advised me to go back up in dose on the Mirtazapine to 11 mg, and I did that two days ago but only to 9 mg. Should I continue with 9 mg or stay on 7,5 mg and wait it out.

 

Feel really hopeless and desperate.

[Carmie]

Hi Locustar, 

 

How are you doing now? Did you end up updosing to 11mg of mirtazapine?

 

Yes, tapering down the 30mg of mirtazapine to 7.5mg in around 7 months was too quick. You’ve been on 7.5mg since November though, so your brain would have gotten used to that dose. Going up to 11mg may be too high. If you’re still at 9mg please stay there for now. 

 

Making too many changes so close together, which included updosing your Sertraline in February too can destabilise the brain as well.

 

What sleeping pills are you on? When did you start them, and what dose are you taking?

 

Please let us know how you’re doing, and how many mgs of mirtazapine you are on now. Thank you. 

 

Sending hugs🤗