Dahz: Withdrawal from 100mg Sertraline (Zoloft)

[Dahz]

Started withdrawal on 29/10/2018 from 100mg to 50 on doctors request, first major mistake..

Taper way too fast, if only hindsight could be acted upon!

I'm now 1 month in and won't reinstate as I've persevered for this long however symptoms are very troubling to me. These symptoms mimic the symptons that caused me to turn to AD's in the first place, headaches, low mood and the such.

Looking for any guidance and advice through this tough time?

[Gridley]

 

Welcome to SA, DAHZ,

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.

 

Account Settings – Create or Edit a signature.

 

We recommend tapering by no more than 10% of current dose every four weeks.  Some members have to go slower.

 

Why taper by 10% of my dosage?

 

Brain Remodelling 

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

This link explains how to make or obtain nonstandard doses that you'll need for your taper.

 

Tips for tapering off Zoloft (sertraline

 

To help you understand the symptoms you are experiencing, here is some information on withdrawal.  The withdrawal time doesn't necessarily correlate with the time you were on the drug.  These drugs alter the architecture of the brain, and the time necessary to heal the brain and return to homeostasis is, unfortunately, impossible to predict.  

 

What is withdrawal syndrome.

 

Glenmullen’s withdrawal symptom list.

 

 The Windows and Waves Pattern of Stabilization

 

When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

 

Youtube video, 4 minutes: Healing from antidepressants

 

You wrote that you don't want to reinstate, and that of course is your decision.  Reinstatement isn’t a guarantee of diminished symptoms for everyone, but it’s the best tactic available.   

Reinstatement of a very small dose of the original drug, while not a guarantee of diminished withdrawal symptoms for everyone,  is the only known way to help alleviate withdrawal syndrome.  The only other alternative is to try and wait out the symptoms and manage as best you can until your central nervous system returns to homeostasis.  Unfortunately no one can give you an exact timeline as to when you will start feeling better and while some do recover relatively easily, for others it can take many months or longer.  

 

We usually suggest a much smaller reinstatement dose than your last dose--certainly not back up to 100mg.  What I would suggest is an updose of 5mg (a total of 55mg) to see if that helps with your withdrawal symptoms.  In any case, for your information, here's a link that is informative:

 

About reinstating and stabilizing to reduce withdrawal symptoms. -- at least the first page of the topic

 

It's important to try and remain as calm as possible and not to panic.  It's important to learn and use Non-drug techniques to cope

 

You might find these helpful:

 

Audio:  First Aid for Panic (4 minutes)
 

CBT Course:  An Introductory Self-Help Course in Cognitive Behaviour Therapy
 

Audio:  How to Recover from Anxiety - Dr Claire Weekes
 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help ...

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Please research all supplements first and only add in one at a time and at a low dose in case you do experience problems.

This is your introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community.  I hope you’ll find the information in the SA forums helpful for your situation.  I'm sorry that you are in the position that you need the information, but I am glad that you found us.

 

 

 

 

[ChessieCat]

Hi Dahz and welcome to SA,

 

Gridley has responded whilst I have been typing my response so some of the information may be repeated.

 

SA recommends tapering by no more than 10% of the current dose with a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.  Why taper by 10% of my dosage?

 

When we reduce too quickly we experience withdrawal symptoms.  Dr Joseph Glenmullen's WD Symptoms Checklist

 

I understand that you don't want to updose, however the only know way to reduce withdrawal symptoms is to give the brain the drug that it has adapted to.  About reinstating and stabilizing to reduce withdrawal symptoms  So that you better understand how these drug affect us I will tell you of my own experience.

 

I reduced my Pristiq from 100mg to 50mg.  I experienced extreme cog fog where even walking took my full concentration.  At the end of 3 weeks I was unable to type.  Being a professional typist for 40+ years I had a benchmark and knew that something was wrong.  Thankfully I had joined SA a few days before this happened and they had suggested taking extra Pristiq.  When I couldn't type I took extra Pristiq and about 4 hours later I was able to type again and the brain fog was clearing.  After stabilising for a few months I have been successfully tapering following SA's protocol and I am now down to 5.5mg.

 

Reinstating/updosing has nothing to do with how strong we are as a person.  When we take the drug our brain changes and when we take the drug away then the brain tries to regain homeostasis, or factory settings, or level itself back out.  This is what causes the withdrawal symptoms.

 

Gridley has suggested taking 55mg.  When I updosed I took 75mg.  Your brain will already have made some adaptation during the 4 weeks you have been on 50mg so you don't need to take 100mg.  You could increase by 5mg and see if that relieves the withdrawal symptoms.  The idea of reinstating isn't to get rid of withdrawal symptoms completely, but to bring them to a bearable level.  It is better to start with a small amount and increase gradually instead of taking too much.  It takes about 4 days for a dose change to get to full level in the blood and a bit longer for it to register in the brain.  You might feel some improvement a bit earlier, like I did.  Please keep daily notes of paper of your symptoms.  This way you can view them objectively and see how updosing is working.

 

This is your own Introductions topic where you can ask questions and journal your progress.

[ChessieCat]

Please create a drug signature using the following format:

 

Please make it nice simple by following these instructions (NO diagnoses or symptoms please - thank you):

• details for last 2 years - dates, ALL drugs, doses
• summary for older than 2 years - just years and drug/s

Account Settings – Create or Edit a signature

[Dahz]

Thankyou very much Gridley and ChessieCat for your help, it is very much appreciated and very comforting!

Two further questions:

My medication comes in 50mg tablets, which is the smallest dose available. How would I manage to updose by the 5mg that you have suggested? 

Secondly during your slow tapers have you incurred any uncomfortable withdrawal symptoms?

 

 

[ChessieCat]

Tips for tapering off Zoloft (sertraline)

 

You can easily make a liquid from your tablets.  The above topic explains how to do this.

 

Do everything the same way with the same equipment and use the same place to measure the liquid.  To get the extra 5mg:

 

Dissolve 50mg tablet in 50mL of water.

 

Each 1mL of liquid will equal 1mg of dose.

 

Therefore you would extract and take 5mL of liquid to get 5mg dose.

 

OR

 

Dissolve 50mg tablet in 100mL of water.

 

Each 1mL of liquid will equal 0.5mg of dose.  Or 2mL of liquid will equal 1mg of dose.

 

Therefore you would extract and take 10mL of liquid to get 5mg dose.

 

You should be able to keep the remaining liquid for about 4 doses.  Keep it in a dark, sealed container in the refrigerator.  So take the first dose on day 1 and then take 3 more doses and discard the remainder.  Don't be concerned if the remainder doesn't appear to measure the same amount as you have been taking.  The doses you have been extracting have all been the same.

[Gridley]

8 hours ago, Dahz said:

 

Secondly during your slow tapers have you incurred any uncomfortable withdrawal symptoms?

 

 

 

Generally there is going to be some degree of discomfort during even a slow taper.  The intent of the slow taper is make this discomfort tolerable and as minimal as possible.  During the two years I've been tapering Lexapro (in a slow Brassmonkey slide taper), I've experienced mainly insomnia and anxiety but the discomfort has been tolerable. I also have anhedonia and apathy and just have to live with it until it passes.   I rate my symptoms daily on a zero to 5 basis, and the majority of days have been rated zero (no symptoms or minimal symptoms).  Some days are 1 or 2, but these in the minority.  A few 3's and 4's during high-stress times, never a 5.

[Dahz]

Hi again, 

 

Tomorrow I start my updose and will use the 10% taper method from then on. However I'm going travelling in 2 months for 6 months, here it will be very difficult to keep measuring out doses, and I'm very worried as to how I'm going to manage any symptoms. Thus, if I updose to 55mg, how long should I hold at this before going down to 50 mg which I can take easily where-ever I am? Furthermore, even a month after the original reduction, is it likely that updosing by 5mg can relieve me of my symptoms?

 

Thanks in advance

[ChessieCat]

You will probably need to take 55mg for about 3 months before even considering reducing again.  The easiest was to take the additional amount when travelling would be to have compounded capsules.  You will need to find out whether you can take them where your are travelling to and if you can what you might need to get through customs.

 

If you are planning on staying at 55mg you will only need 5mg capsules.  If it was me, I wouldn't be making any reductions during the time I was away.  My priority would be enjoying my trip without having to worry about tapering and withdrawal symptoms.