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SeptGirl: Zoloft taper

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SeptGirl
Posted (edited)

Moderator note: link to benzo forum thread - SeptGirl: Weaning Off Alprazolam And Stopped Zoloft

 

I’ve been on Zoloft (Sertaline) 50mg since the first week of June.  It’s now mid August.  I’ve never felt well on this drug and the doc has finally approved a weaning schedule.  He said alternate 50mg one day, 25mg the next.  That’s where he left it for now.  Does this seem reasonable?  I’m thinking this will be for two weeks then go to 25mg daily for two weeks.  Would it be likely to stop after that or continue on with 12.5mg dosing for two weeks.  I’m sure my doc will let me know what the continuing process will be but just trying to get thoughts on this.  I want OFF this drug

Edited by Shep
added link to benzo forum thread and tags

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Altostrata

Welcome, SeptGirl.

 

Please do not alternate dosing to taper!!! Some people get terrible withdrawal symptoms from this.

 

Please read this before tapering: Tips for tapering off Zoloft (sertraline) Zoloft comes in a prescription liquid. Highly recommend you get that if you can, to help you taper more gradually.

 

Unfortunately, while you've been on Zoloft only a short time, you might find it difficult to go off. Have you ever accidentally skipped a pill? What happened then?

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SeptGirl

I’ve never skipped a dose.  I’ve been researching and feel the best alternative for me is to go from 50mg a day to 25mg a day for two to three weeks.  Then I’ll dose at 12.5mg for another two to three weeks and then 6.25mg for two weeks.  I base this on the fact I haven’t been on Sertaline that long and the taper seems more reasonable that going higher to lower doses.  I’m hoping I make the right decision.  The side effects of being in this drug are life altering. Thanks for your response. 

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Altostrata

We would not advise a decrease from 50mg to 25mg a day -- that's a 50% decrease.

 

Our protocol calls for 10% reductions per month, based on the last dosage. In your case, since you have been having adverse reactions, you might be able to manage 10% reductions more often.

 

Smaller reductions are better tolerated. This can best be accomplished by combining a 25mg tablet daily with the rest in liquid form.

 

What are your adverse reactions?

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SeptGirl

Nausea, stomach pain, burning skin/tingling and restlessness.  I could go to 37.7mg cutting 25mg in half plus taking a 25mg tab.

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SeptGirl

Sorry...37.5mg!

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SeptGirl

Blood pressure and heart rate spikes too.

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Altostrata

Given those reaction, you might try a 25% decrease to start, to 37.5mg as you said. It's unfortunate your doctor kept you on the drug for so long.

 

If I were you, I'd request a prescription for 25mg tablets plus the liquid form, for further tapering.

 

Please let us know how you're doing.

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SeptGirl

Happy to report I am Zoloft FREE!!  Today is my 6th day without the poison. My blood pressure is back to normal.  Nausea is subsiding too.  So far the only side effect I have is intense itching! I’ll take it!   I’m also slowing weaning off Xanax.  It’s long overdue for me to see the world and address my issues drug free.  It’s going to be a long road getting off the Xanax, but I’ll get there!  I’ve NEVER taken more than prescribed but my dose is way too high at this point.  My Mom died in mid May.  Since then, my doc has increased my Xanax dose from 0.5mg 3x/day to 1mg 3x/day to 1mg 4x/day.  I was on the highest dose for just about three weeks but am at the end of my second week of tapering that dose.  Next taper begins on Wednesday.  I’m now seeing a psychiatrist and he’s very positive and on the same page with my health goals.  I can’t wait to be healthy again and non drug dependent!! 😊

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marconyc

Good for you. Do everything you can—therapy, yoga, running, etc—to avoid these drugs. Process your grief and don’t let psychiatrists try to medicate normal human reactions to loss.

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SeptGirl

The psychiatrist is getting me OFF the drugs!  My primary got me on them. 😖 I hope you do well with your journey! 💜

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Altostrata
1 hour ago, SeptGirl said:

Happy to report I am Zoloft FREE!!  Today is my 6th day without the poison. My blood pressure is back to normal.  Nausea is subsiding too.  So far the only side effect I have is intense itching! I’ll take it!   I’m also slowing weaning off Xanax.  It’s long overdue for me to see the world and address my issues drug free.  It’s going to be a long road getting off the Xanax, but I’ll get there!  I’ve NEVER taken more than prescribed but my dose is way too high at this point.  My Mom died in mid May.  Since then, my doc has increased my Xanax dose from 0.5mg 3x/day to 1mg 3x/day to 1mg 4x/day.  I was on the highest dose for just about three weeks but am at the end of my second week of tapering that dose.  Next taper begins on Wednesday.  I’m now seeing a psychiatrist and he’s very positive and on the same page with my health goals.  I can’t wait to be healthy again and non drug dependent!! 😊

 

SeptGirl, please do NOT change your Xanax dosing at this time. Keep everything very steady. Your nervous system has had a shock from your going off Zoloft -- that's what the itching means -- more drug changes will make it more confused. Please give it a chance to settle down.

 

It seems you went off Zoloft very quickly. If I were you, I'd wait at least a month and let symptoms go away completely before reducing the Xanax. If your withdrawal symptoms get worse over that month, reinstating a tiny bit of Zoloft, such as 1mg, may help. Keeping daily notes on paper about your symptoms, when you take your drugs, and their dosages would be a good idea. Your psychiatrist will appreciate this, too.

 

I am glad you have found a psychiatrist to help you go off drugs altogether. Are you taking others? To help us out, follow these instructions Please put your drug and withdrawal history in your signature

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SeptGirl

I wasn’t on the Zoloft for long...6/8/18 so less than three months.  I started at 25/mg week for a week,  50mg  for a week, 75mg for just a few days - too many side effects, back to 50mg for a week (still too many side effects) back to 25mg for the better portion of the duration then off.  This contradicts my first post but my brain was scrambled!! 🤪  I see the psychiatrist again in two weeks.  I may hold at my current Xanax taper until then...I don’t want to backtrack.  There is NO way I’m ever going back on Zoloft...not even a crumb!!!   I will  bring up your suggestion regarding the Xanax to the doc. I appreciate your input! 😊. As much as I want to be OFF the drugs, I want to make it the easiest transition possible.

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Shep
On 8/17/2018 at 3:59 PM, SeptGirl said:

I’ve never skipped a dose.  I’ve been researching and feel the best alternative for me is to go from 50mg a day to 25mg a day for two to three weeks.  Then I’ll dose at 12.5mg for another two to three weeks and then 6.25mg for two weeks.  I base this on the fact I haven’t been on Sertaline that long and the taper seems more reasonable that going higher to lower doses.  I’m hoping I make the right decision.  The side effects of being in this drug are life altering. Thanks for your response. 

 

Please note that you were on antidepressants for 10 years. That factor weighs in, too - it's not just about the Sertaline. 

 

Side effects are dose-related, so I wouldn't discount a reinstatement. It might be helpful.

 

Please do not make any more drug changes. 

 

Moderators, please note that SeptGirl now has a benzo thread here:

 

SeptGirl: Weaning Off Alprazolam And Stopped Zoloft

 

But it's possible that some of your symptoms are connected to the rapid taper off Zoloft after 10 years of being on Celexa. 

 

It's possible a reinstatement may help, but at a much lower dose than what you were taking. Please see:

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

I've asked the other moderators more familiar with Zoloft and Celexa to respond. In the meantime, please do not make any more reductions in the Xanax. 

 

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Shep

In order for us to better help you determine if you are dealing with antidepressant withdrawal or issues related to the Xanax (i.e. inter-dose withdrawal, paradoxical effects, and / or rebound anxiety), please post a drug and symptoms journal. This is the best format to use. 

 

Drug and Symptoms Journal Format

 

Also, please include:

 

  • any supplements you are taking
  • when you are eating
  • the number of hours you are sleeping each night

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SeptGirl

I sleep at least 6 hours a night.  I take no supplements due to continuing nausea.  I’m afraid to add anything different because of the nausea.  I eat at 7 a.m....yogurt and a banana.  Lunch is a sandwich.  4 p.m. snack of saltine crackers to help settle stomach.  Dinner is usually chicken and a veggie.  I drink a lot of water.  

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SeptGirl

I do take ginger caps occasionally for nausea.  That’s the only “supplement” I take.  I take acetaminophen or ibuprofen if needed.

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SeptGirl

I’d like to add that I went to the ER on 8/7/18 after the doc on call told me to updose to 75mg of Zoloft.  On the third day, my BP went to 175/143, HR 120. ER doc said drop back to 50mg and continue wean.  I did.  

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Altostrata

We need to know the times of day you take your drugs and whatever symptoms you have before and after that. A daily drug and symptom journal helps us figure out which effects are drug-related and which are withdrawal.

 

Please post your daily notes as soon as possible so we can answer your questions.

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SeptGirl

Where do I post daily notes?  

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ChessieCat

here in your intro topic, just a regular post

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Altostrata

SeptGirl, how did you feel after you switched from Celexa to Zoloft? Is that when you started feeling unwell? What were your symptoms on Zoloft?

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SeptGirl

I’ve been seeing a psychiatrist for two months now.  Yesterday we discussed the SSRI drugs I was on and how I tapered.  I was  on Celexa for ten years (doses were 20mg, to 40mg, then to 30mg for at least a year or so).  I felt unwell on Celexa but not disfunctional like I am now.  My primary doc switched me from Celexa 30mg directly to Zoloft 25mg/week, 50mg/month, 75mg for a couple of weeks, back to 50mg a month or so, 75mg for three days, 50mg for a couple of weeks then 25mg for a week then off). I felt absolutely terrible while on Zoloft that’s why the dosing kept being changed.  I was very nauseated but didn’t have all the symptoms I have now.  Psychiatrist thinks I may have suffered serotonin discontinuation syndrome because the Zoloft dose was not an appropriate dose to compensate for the Celexa 30mg dose.  He thinks the Zoloft dose should have been at least 100mg to start.  This was in the beginning of June, 2018.  I took the final Zoloft 25mg dose on 8/29/18.  He doesn’t think that low of a dose would contribute to serotonin discontinuation syndrome either as it’s not even a therapeutic dose.  As of today, I am still suffering from anxiety, nausea, stomach pain, paresthesia, dizziness, no appetite, anxiety and weight loss.  He feels any withdrawal symptoms should have long ago stopped.  I’m also weaning off Alprazolam.  I was on 4mg/day in August and am now down to 2.50mg/day...reducing .25mg every two weeks.  He’s adamant I’m not going through withdrawal from the Alprazolam as the weaning schedule is slow.  I told him I don’t want to be on antidepressants because I felt terrible on them. He isn’t pushing an antidepressant either.  He did bring up trying buspirone but I’m on the fence with that and neither is he.  My question is, IF I went back on one to try to stabilize, would I go back to Celexa?  At this point, I’m willing to try a very SMALL dose if I would get relief from my current symptoms.  At the same time, I don’t want to damage my brain further.  I would definitely ask him before doing anything.   I’m desperate for relief.  Thanks. 

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Shep

SeptGirl, I received your PM but am responding in your topic, as moderators don't give taper advice via the PM system. 

 

On 11/1/2018 at 10:20 AM, SeptGirl said:

 I was on 4mg/day in August and am now down to 2.50mg/day...reducing .25mg every two weeks.

 

As I posted in your benzo forum thread at the beginning of October: 

 

On 10/2/2018 at 8:09 AM, Shep said:

Please STOP tapering. You are setting yourself up for a severe withdrawal, SeptGirl.

 

 

You are tapering the benzo far too fast, especially for someone who's been on a benzo for 10 years and came off an AD with a rapid taper after 10 years. 

 

 

On 11/1/2018 at 10:20 AM, SeptGirl said:

My question is, IF I went back on one to try to stabilize, would I go back to Celexa?  At this point, I’m willing to try a very SMALL dose if I would get relief from my current symptoms.  

 

It's possible that a small amount of Celexa may help, but we need a drug and symptoms journal: 

 

On 10/2/2018 at 7:21 AM, Shep said:

In order for us to better help you determine if you are dealing with antidepressant withdrawal or issues related to the Xanax (i.e. inter-dose withdrawal, paradoxical effects, and / or rebound anxiety), please post a drug and symptoms journal. This is the best format to use. 

 

Drug and Symptoms Journal Format

 

Also, please include:

 

  • any supplements you are taking
  • when you are eating
  • the number of hours you are sleeping each night

 

We still need this drug and symptoms journal. 

 

It's possible that a small amount of the Celexa may help, but you need to stop taping the benzo. And we need a drug and symptoms journal. 

 

I'll ask the other moderators what dose you should try to reinstate at this point. 

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SeptGirl

Every day I suffer from nausea, paresthesia (tingling and burning skin feeling), no appetite, dizzy, stomach pain, weight loss and stomach pain.

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Shep

Thank you for the additional information, however, we need to know what time of day you suffer from these symptoms and when you take your drugs. Without this information, we cannot help you.

 

This is the drug and symptoms journal format we need:

 

On 9/27/2016 at 2:49 PM, Altostrata said:

A symptom pattern that occurs regularly over several days could mean the symptoms are from withdrawal, other adverse effects of drugs, or something else you do on a daily schedule.

 

In the course of discussion in your Introductions forum topic, you may be asked to keep notes on paper of your daily symptom pattern, including when you take your drugs, their dosages, and any symptoms.

 

What we need to see for every individual day over several days is:

- Time and dosage for drugs taken in morning
- Time and description of any symptoms in the morning
 
- Time and dosage for drugs taken in afternoon
- Time and description of any symptoms in the afternoon
 
- Time and dosage for drugs taken in evening
- Time and description of any symptoms in the evening
 
- Time and dosage for drugs taken in middle of the night
- Time and description of any symptoms in the middle of the night (such as waking)
 
And so forth. A diary, in chronological order, such as:
 
6 a.m. Woke and vomited
8 a.m. Took 2.5mg Lexapro
10 a.m. Had diarrhea
10:30 a.m. Ate breakfast
11:35 a.m. Got a headache, lasted one hour
12:35 p.m. Ate lunch
4 p.m. Stomachache
5 p.m. Took 2.5mg Lexapro
6 p.m. Ate dinner
9:20 p.m. Headache
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Headache got worse
10:30 p.m. Fell asleep
2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")
2:45 a.m. Fell asleep
4:30 a.m. Woke with headache

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SeptGirl

 5:00 a.m.   Wake up anxious, sweating, nauseated, stomach pain, dizzy and paresthesia.

                     Symptoms do not improve during the day.

 7:00  a.m.  Eat yogurt and banana 

 8:00  a.m.  Take .75mg Alprazolam 

11:30 a.m.  Take levothyroxine.05mcg

12:30 p.m.  Eat lunch

 2:00 p.m.   Take .75mg Alprazolam 

 3:30 p.m.   Snack... crackers, ginger ale

 6:30 p.m.   Dinner

 8:00 p.m.   Take .50mg Alprazolam 

12:00 a.m.   Bed

  1:30 a.m.   Take .50 Alprazolam 

 

Schedule is the same every day.  Symptoms remain all day every day.  I force myself to eat and drink water.

 

 

 

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Altostrata

Hi, SeptGirl. Do you feel any effect of alprazolam? What happens after you take an alprazolam dose?

 

How did you feel unwell when you were taking Celexa?

 

Very few physicians understand anything about tapering or withdrawal syndrome. You can get withdrawal syndrome from the first drug even if you've substituted another.

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SeptGirl

I feel the Alprazolam Is helping the anxiety but am not ruling out it’s also partially responsible for my nausea. My current dose is 2.50/mg day spread over four doses/day.  I do feel less anxious but still not totally calm.  I just can’t stop taking it as I would be risking seizures. I’m on a slow taper...less than 10% every two weeks. I mentioned Ashton to the psychiatrist and he was disinterested.  I felt some nausea at times on Celexa.  Honestly, I don’t remember WHY my doc switched me to Zoloft. My Mom died on May 15th or it may have been because I repeatedly complained of nausea?  He also doubled the Alprazolam dose from 1.5mg/day to 3mg/day in early June and then increased it again to 4mg/day in early July.  I specifically remember asking him if going from 30mg/day of Celexa to 25mg/50mg of Zoloft/day was a comparable dose exchange.  He said yes. When he switched the AD, is when the nausea was relentless.  By the first week of August I was deathly ill after a three day increase to 75mg of Zoloft.  That’s about the time the paresthesia, stomach pain, dizziness and increased anxiety started....enough that I went to the ER with high blood pressure and heart rate and uncontrollable shaking.  The psychiatrist doesn’t seem to think I’m currently suffering from discontinuation syndrome.  He wasn’t my doc until late August. He believes I may have had discontinuation syndrome but am now suffering from anxiety because the AD  was stopped.  He isn’t ruling out AD therapy in the future though I don’t want to be on them again.  I would ONLY consider a brief/low dose reinstatement if it could potentially reverse the symptoms I have now. I can’t risk getting worse than I already am. Thanks for your reply. 

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Altostrata
21 minutes ago, SeptGirl said:

I just can’t stop taking it as I would be risking seizures.

 

Did you have seizures prior to taking any psychiatric drugs?

 

Under any circumstances, do not suddenly stop taking any psychiatric drug! Withdrawal syndrome can be much worse than what you're already feeling.

 

Please stop tapering alprazolam, we need to capture your baseline symptom pattern in those daily notes @Shep  described. When you change dosage, this affects your symptom pattern.

 

So when you were taking Celexa, you were also nauseous? Do you have any Celexa left?

 

What happens between 12 a.m. and 1:30 a.m., when you take a dose of alprazolam? What is your sleep pattern?

 

When did you start thyroid hormone? What effect did it have? When was the last time you had your dosage adjusted?

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SeptGirl

No seizure history.  I didn’t “suddenly” stop taking the psychiatric drug.  It wasn’t a slow taper by any means but I did what the doctor said.  At the end, I took  Zoloft 50mg for three weeks, 25mg for about five days then off.  Psychiatrist says 25mg isn’t even an adult “therapeutic dose” and stopping at 25mg was okay.  I was on Zoloft less than three months with the mean dose of 50mg.  I set my alarm to take the Alprazolam at 1:30 a.m. to keep the six hour dosing schedule but the majority of the nights I’m still awake in bed. If I happen to doze off, I take it and go back to sleep.  I did have some nausea while on Celexa but not all of the time. I didn’t have paresthesia, dizziness or stomach pain.  I have plenty of a Celexa left. The irony of all this?  I’m a Certified Pharmacy Technician (CPhT) and should have known better.  I’m so pissed at myself for getting where I am!!  Doctor do no harm...what a joke!!!   When I taper the Alprazolam dose, I have slightly more anxiety for a couple of days but level out.  As far as the Alprazolam taper, my next taper isn’t due for two more weeks.  Psychiatrist said I have to get to 2.00/mg to continue treatment.

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Altostrata

I was referring to your passing reference to quitting alprazolam, not the way you went off Zoloft.

 

46 minutes ago, SeptGirl said:

Psychiatrist said I have to get to 2.00/mg to continue treatment.

 

What is this psychiatrist's reasoning for this?

 

26 minutes ago, SeptGirl said:

The nausea has not decreased since I’ve begun tapering the Alprazolam dose.  The paresthesia, dizziness and stomach pain are pretty much the same before the taper began.  

 

12 minutes ago, Altostrata said:

My guess is those symptoms are SSRI withdrawal, not side effects of the benzo.

 

Please consider stopping the benzo taper, getting liquid Celexa, and reinstating 0.5mg to reduce the withdrawal symptoms. You'd taper off by miniscule amounts later. Let's talk about this in your Introductions topic.

 

Please let us know how you're doing.

 

5 minutes ago, SeptGirl said:

That’s what I’ve been telling the psychiatrist!!!  A 1/2mg could reduce withdrawal symptoms...or you mean 5mg?  I’m guessing 1/2mg since you mentioned liquid. You’ve been very patient and helpful.  Thank you.

 

Yes, believe it or not, even 0.5mg Celexa could reduce withdrawal symptoms. It's a starting dose, to see how you do with it. It's possible 0.5mg is enough, or your sweet spot might be a little more. How to make a liquid with your Celexa tablets:

 

Tips for tapering off Celexa (citalopram)

 

Making a citalopram solution yourself

 

Very few psychiatrists have the least little clue about withdrawal symptoms. Yours is likely to scoff at this plan, but we have many people who have been successful with it.

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SeptGirl

So not having taken ANY Celexa since early June (five months ago) doesn’t present any reinstatement issues since it’s such a low dose?   And I’m not sure what the psychiatrist’s reasoning is for the 2mg/day dose.  I’ll ask at my next appointment.  I’m assuming it’s to make sure I’m following the taper schedule? 

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Altostrata

Reinstating low-dose Celexa is worth a shot.

 

You'll have to inform your psychiatrist that you will taper off Xanax once you get stable on Celexa, if you continue to see this doctor. Any doctor can prescribe these drugs, it doesn't have to be a psychiatrist. (Although, at least this one is aware of withdrawal syndrome, although he doesn't know much about it.)

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SeptGirl

I’ll inform him.  Do you really think I can stabilize on such a low dose?  If so, what would be a reasonable time frame for relief if it helps?  It would be a miracle.  

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Altostrata

0.5mg Celexa is a starting dose. You'd know if it is helping within a few days. If you don't feel anything, might need a bit more.

 

We see many people here benefit from a very low dose, and then taper off.

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