Auxesia: starting a slow sertraline taper, happy to have found this site

[Auxesia]

Hello

 

I have been taking sertraline 100mg for 2.5 years and am starting a 10% of previous dose cut and hold style taper from 75mg. I cut to 75mg in October 2018 on advice from my therapist to alternate 100/75 for a month and then hold at 75, but I started experiencing WD symptoms in waves and have held at 75mg since that time while I have researched tapering. 

 

When I started having these WD symptoms I finally feel as though I had confirmation that my original symptoms for which I was prescribed sertraline were actually WD symptoms for a drug domperidone (see bottom of post for details) which I was prescribed off label as a lactation aide. These more recent WD symptoms I have experienced are a mild version of what I experienced initially. My initial thoughts at the time were that domperidone was the culprit, but after raising this with several doctors I was told that I was experiencing anxiety/PND/panic disorder which I eventually accepted. This led to spending two months in a psychiatric ward and being prescribed sertraline.

 

I have seen that a few users here had the same reaction to weaning off domperidone as I did. So my theory is that going on and off a high dose (120mg) of this drug twice in a month was the start of this. I hope that because I am 2.5 years on from this experience it won't be factoring in to what's happening now, but I'm putting it here so you all know about it.

 

So, my plan is to do a 10% taper from 75mg and just hold until stable each time.

 

My main symptom is I think a kind of kindling thing? My nerves just feel like they are all switched on and overreacting to everything. The post about PGAD resonates with me, but I think I feel it because all my nerves are sensitised. And the other one is GI related. My theory is my vagus nerve gets irritated and I get pain, heartburn and diarrhoea but no nausea. I get some dizziness, and feel a bit disconnected to reality in the worst bits.

 

My strategies for coping are tapering slowly, mindfulness and meditation, a small daily dose of magnesium, I've just started some yoga. 

 

Anyway, I'm going to hang around here while I taper and hopefully contribute some useful information and support! Nice to meet you all and thank you for existing! 

 

Quote

Domperidone, sold under the brand name Motilium among others, is a peripherally selective dopamine D₂ receptor antagonist that was developed by Janssen Pharmaceutica and is used as an antiemetic, gastroprokinetic agent, and galactagogue. Wikipedia

 

Edited March 5, 2019 by ChessieCat
added drug details

[Auxesia]

So my first update is that eight days ago I switched 25mg off my dose to liquid (home made water suspension) and I stupidly thought that would be easy - four days in I got a pretty strong wave of WD symptoms which seemed to come and go every few hours over the last 4 days getting less intense each time. The initial wave was the first time I have had 'panic' in 2.5 years, thankfully I have learnt how to cope with that pretty well, but my confidence in tapering has taken a knock! 

 

Is there anyone else who has had a crappy reaction to the switch to liquid who could share their experience? I've had a search around and have only found brief mentions of it happening. 

 

Also, I'm not planning on changing anything for a few weeks at least, but would it be better to proceed in changing the whole dose (25mg at a time) to liquid, or taper down the liquid but until I get to 50mg?

[Auxesia]

I know no one has responded yet, but I'm going to add things as I figure them out anyway for my own benefit! 

 

I had thought this previously, but now I've noticed alot of people here have the same experience - I think the nervy feelings I get are centred around the vagus nerve. When I am hungry it is a hundred times worse. So I am going to concentrate on eating properly and also add in some breathing exercises to help my vagus nerve. 

 

WD symptoms are much less now so I'm feeling a bit more confident about the next change! 

[Carmie]

Hi Auxesia, 

 

I’m sorry no one has responded to you as yet. I just saw your post. I’ll get back to you when I’m able to. Maybe someone else will in the meantime. I’ve had real bad brain fog. I’ve been spending some time on SA this morning but my brain fog is just starting to ramp up really badly again and I can’t read all your posts. 

 

Take care💚

 

 

[intothewoods]

Hi Auxesia, 

On 3/5/2019 at 4:15 AM, Auxesia said:

Is there anyone else who has had a crappy reaction to the switch to liquid who could share their experience? I've had a search around and have only found brief mentions of it happening. 

I converted two of my longtime meds, Elavil and Provigil, to water solutions within two weeks in December. It was definitely rough the first month, increased akathisia, shivers, increased appetite now that you mention it (am a green smoothie, super-food freak but they don't fill me up quite the same since shifting). It's getting so much better now and truthfully, I rolled with it better than many other symptoms because for so long I wanted to convert to liquids to gain control. It's liberating💪. 

You sound seriously on top of things, very proactive, and have good energy flowing from your posts. Keep researching SA and little by little, you'll see a big picture start to fill in as well as a pile of smaller ones. SA reminds me of one of those inexhaustible boutiques where fun and fascinating things await in every corner high and low.  I'm charting my course this way and loving every second. The experiences, the talent, the collective wisdom of everyone is truly priceless. 

 

[intothewoods]

Auxesia, 

 

I should have added that I would never convert two meds to liquid so close together like that unless it was an emergency (it was with the Provigil). 

SA also recommends crosstaper when switching med formulations (in this case you might have dosed  part tablet and part liquid) to give the body time to acclimate. Or if you do convert straight to liquid, hold at least a week at the same dose. 

 

Switching too much up too fast kicks up the waves and can destabilize us but sounds like you're getting things ironed out. My body actually seems to like the water formulas better now. 

 

Hope today is smoother for you. Sydney's a lovely city. 🏙️

 

~ C 

 

[intothewoods]

 

 

On 3/5/2019 at 4:15 AM, Auxesia said:

Also, I'm not planning on changing anything for a few weeks at least, but would it be better to proceed in changing the whole dose (25mg at a time) to liquid, or taper down the liquid but until I get to 50mg?

 

Ok, I"m on my tablet finally, not my phone, so my apologies for not being thorough in seeing your signature and that you have only switched 25 mg of your 75 mg dose of Sertaline to water solution. That's actually pretty smart (Alto or one of the mods will be along soon to tell you for sure;  I'm not a mod but learning like you  ) and it sounds like your waves are beginning to resolve from that change. Any change, no matter how tiny, can bring the "nervy" symptoms you describe and, as well, all the changes we've made in previous months and years have a cumulative effect. I made way too many changes before coming to SA in December 2018 and no matter what I do, feel like a walking earthquake. LOL.

 

You'll be waking up soon so wanted to clarify. Your brain sounds like mine, analyzing and really seeking the best for your body. Keep going. We're all going to get there, especially helping each other the best we can. 

 

Catherine 

 

 

[Carmie]

Hi Auxesia, 

 

How are you doing? So you changed 25mg of your meds to liquid? Are you now on 50mg tablets and 25mg liquid? Please wait until you stabilise before you make anymore changes. 

 

The usual crossover formula is : 

 

3/4 of the old formula.                       1/4 liquid.

 

1/2 of the old formula.                        1/2 liquid. 

 

1/4 of the old formula.                        3/4 liquid. 

 

Then all liquid. 

 

You do each step for three to seven days, or longer, depending on how you’re feeling. 

 

Please let us know how you’re doing. I’m so glad to hear that you’re eventually going to do a slow taper. I’ve been in psych wards too for severe akathisia, I thought something was terribly wrong with me, but it was the meds and withdrawals all along. It was such a relief when I finally figured out what was wrong with me. 

 

We can get off these meds, we just have to go really slowly. 

 

Sending hugs🤗

[Auxesia]

Thanks so much Carmie!

 

I see you are a fellow Aussie

Yes I'm thinking I probably switched over too much dose to liquid for my body. I've gem feeling quite good the last few days, but I think I'll wait a little bit longer and switch a smaller amount (maybe 12.5mg for ease of splitting the tablet) and see how that goes. 

 

I'm sorry to hear that you have had the same experience thinking there is something horribly wrong and ending up in the psych ward Really the most terrifying thing that has happened to me in my life! But yes, although I was a bit angry initially, what a relief to realise what was actually going on. 

 

Big hugs to you, and hope you are having a good day!

[Carmie]

Hi Auxesia, 

 

Hope you’re doing okay. We can’t change the past, so no need to worry about having changed a bit too much of the tablet to liquid. You still did much better than going to all liquid straight away, many people have done this before knowing you have to do it slowly. 

 

I did a silly thing last year too before I knew about crossovers and I changed from water titrating my tablet to water titrating a compounded capsule without a crossover. I went through three months of waves because of that. After all that I learnt that compounding formulas aren’t always that accurate so I went back to my tablet. This time though I did a crossover and I had no problems at all. Just goes to show a little knowledge goes a long way. 

 

Apparently we are going to be getting rain up here in Queensland. It’s been so warm. I hear it’s been quite warm in Sydney too. ChessieCat, one of the other moderators, is from Sydney, and she’s been mentioning the hot summer you’ve had down there too. 

 

Yes, it’s best to always have a good long hold when we have made big changes, we need to stabilise before we taper. Once we taper, we do it by no more than 10% and always hold for at least a month. We need to listen to our bodies, if we haven’t stabilised within a month we need to hold until we do.

 

Take care💚

 

Edited March 14, 2019 by Carmie
Addition