Oliver1974: sertraline / Zoloft tapering

[Oliver1974]

Shep

 

Thank you for the advice. I’ve actually been on the same 2mg dose of Diazepam for 53 days, and on the same dose of Trazadone for 42 days. This is why I’m so suprized that I’m feeling something like withdrawals?!

 

 

[Oliver1974]

This is a rather personal topic but such is life.

 

I’ve had loose stool for a couple weeks now. I haven’t changed my diet or my meds for 54 days.

 

I have been more anxious though. I seem to be getting enough sleep but I’m yawning and my back feels tight and sore. My pulse has also been racing a bit.

 

- Should I take something to harden my stool? 

 

- Could my body be getting used to the diazepam and it’s no longer having the same affect?

 

- Could my body be getting used to the Zoloft,  and it’s no longer having the same affect. 

 

I really do do not want to start chasing  symptoms by increasing medications. 

That seems like a very dangerous game to play with any drug especially benzodiazepines. 

 

Stefan

[Shep]

16 hours ago, Oliver1974 said:

 I’ve actually been on the same 2mg dose of Diazepam for 53 days, and on the same dose of Trazadone for 42 days. This is why I’m so suprized that I’m feeling something like withdrawals?!

 

 

Psychiatric drugs come with a delayed withdrawal symptom pattern. This is why so many people are told that their symptoms are not withdrawal but are the "original condition" coming back. Doctors don't understand this and believe once a drug is out of your system, you are no longer suffering from withdrawal. It's also very non-linear with lots of windows and waves and symptoms morphing and waning. 

 

You had some drastic reductions in the past few months. Those reductions are now catching up to you. 

 

Please see:

 

One theory of antidepressant withdrawal syndrome

 

How psychiatric drugs remodel your brain

 

What is happening in your brain?

 

Also, please re-read what ChessieCat posts on the first page of your thread. She left you excellent information about this. 

 

2 hours ago, Oliver1974 said:

I’ve had loose stool for a couple weeks now. I haven’t changed my diet or my meds for 54 days.

 

Please see:

 

Digestive problems: nausea, diarrhoea, bloating, GERD

 

You are too far out from the last benzo reduction to updose safely, as that's best done within 2 - 4 weeks after coming off. However, you may benefit from a very small reinstatement of the Trazadone. Antidepressant reinstatements can be effective even several months after coming off. However, the farther out you are, the lower the dose you'll want to reinstate, as your nervous system is destabilized and may hyper-react to it. But a very small dose can aid with the withdrawal symptoms. 

 

Please see:

 

About reinstating and stabilizing to reduce withdrawal symptoms 

 

In your notes on the first page of your thread, you have 0.1ml listed as your last Trazadone dose. How much was that in milligrams? 

 

Please start a drug and symptoms journal. Manymoretodays gave instructions in her post here. We really need to see your symptoms within the context of when you take your drugs. 

[Shep]

Oliver, one other thought - are you taking any supplements? Certain supplements like magnesium can cause loose stools, so if you're taking any supplements, please list them. 

[Oliver1974]

Hello Shep,

 

Trazadone 0.1 ml = 1 mg 

 

I was taking  magnesium citrate for a long time but I stopped on the 22 of March.  I tried my friends apnea breathing machine and it turns out that it showed I had sleep  Apnea. Then another friend  told me that magnesium makes hypoapnea’s worse, so I stopped taking that supplement.  however from what I can remember I was feeling a little anxious before then and my stool was not great.  I’ve also been taking one omega three fish oil capsule every morning for many months  so I don’t think it’s that either.

 

regards

Stefan

[Oliver1974]

Shep,

 

My symptoms are noticeable today but not severe.

 

7:00am: Woke up and took 75 mg Zoloft, 0.5 ml of Diazepam and 1 omega 3. Worried about feeling anxiety.

 

7:00-9:00: Did not want to get up. Felt a bit down.

 

10:00am: Had Breakfast of 2 toasts with avocado, olive oil, turkey and a capsule of chai latte.  The chai latte has 34 g of caffeine.  I have not had any of them for about a week because I was thinking that it might be causing some of the anxiety. Today I decided to have one to see if it might lift my mood a bit,  and I think it did .

 

3:00pm: Late lunch. Soup, rice, chicken. I feel my body is buzzing a bit. It feels like withdrawals but not strong. Still worried about anxiety. After my interdose Xanax withdrawals 7 months ago and my two failed Zoloft tapers, I fear the onset of anxiety probably every day. It really messed with me. Zoloft withdrawal was so mentally and physically excruciating,  I really wondered if I was ever going to be OK or if I was going to die.

 

5:00pm: Had a piece of cake. Feeling OK.

 

9:30pm: Ate a dinner of vegetable cream soup with some stake. Feeling fine. Evenings are always much better for me than mornings.

 

10:15: Dose of 0.5 ml of Diazepam with water. Reading a book and feeling fine.

 

10:33: Putting  on the apnea machine and going to bed.

 

 

I’m extremely reluctant to start taking any amount of Trazodone or other drugs.  Honestly Id rather suffer a bit.  Ever since I felt the effect of these toxins in my body I’ve wanted to get off all this junk! 

 

 

 

regards

Stefan

[Shep]

14 hours ago, Oliver1974 said:

The chai latte has 34 g of caffeine.  I have not had any of them for about a week because I was thinking that it might be causing some of the anxiety. Today I decided to have one to see if it might lift my mood a bit,  and I think it did .

 

Caffeine has a 6 hour half-life, so if you do drink coffee, please keep that in mind. Since you had that at 10 am, by 4 pm you would still have 50% of the caffeine in your system. By 10 pm, 25%. 

 

Many of us find that we do better without caffeine. I switched over to peppermint tea. Peppermint can enhance cognitive ability, so it's a great way to wake up without the caffeine. You may find other alternatives you like better if the caffeine does become a problem. 

 

14 hours ago, Oliver1974 said:

My symptoms are noticeable today but not severe.

 

 

I'm glad to read this. Sounds like you are stabilizing. 

[Oliver1974]

Shep,

 

Gosh how silly of me.  I didn’t realize that half life actually means half the life of the drug!  I thought it was just a medical term to describe how long the drug stays in your system.  In other words I thought that because the half-life of caffeine was six hours, then it only stays in your system for six hours.  I assumed that my 4 o’clock I would be caffeine free. That changes things.  I wonder if that’s why I had such a restless night, and a lot of sleep apnea’s? 

 

 Thank you for clearing this up.  I was just looking for a little bit more pep in my step. I think this Zoloft  extinguishes any zest, spark,  call it what you will.  The pharmacy mentioned that Bea royal jelly might be a good way to get a little bit more energy in the morning rather than caffeine.  Have you ever tried that? I will switch to peppermint tea today. I must tell you I’m so sick of feeling like I’m not firing on all cylinders.  I really dislike the feeling of my brain being subdued chemically.

 

Regards

Stefan

[Oliver1974]

 

Just in case there’s anybody out there that did not understand the drug half life calculations  properly like me. Here it is.

 

https://www.google.com/amp/s/www.news-medical.net/amp/health/What-is-the-Half-Life-of-a-Drug.aspx

[Shep]

43 minutes ago, Oliver1974 said:

The pharmacy mentioned that Bea royal jelly might be a good way to get a little bit more energy in the morning rather than caffeine.  Have you ever tried that? 

 

I've never tried it, but I did find a thread about it here:

 

Bee Pollen, Royal Jelly and other Bee Products

 

19 minutes ago, Oliver1974 said:

 

Just in case there’s anybody out there that did not understand the drug half life calculations  properly like me. Here it is.

 

https://www.google.com/amp/s/www.news-medical.net/amp/health/What-is-the-Half-Life-of-a-Drug.aspx

 

And here's an online calculator to make it easier to calculate:

 

Drug Half-Life Calculator

 

This is a learning process. We all walk away from this experience with a lot of knowledge that we wouldn't have otherwise.

 

Gives a bit of purpose to the journey. We do learn from it. 

[Oliver1974]

Shep,

 

I’ve never read so many books in my life! Who knew it would take utter terror to make me literate. 

 

Sadly the majority of the books out there on Antidepressants tend to leave the reader on a clif peering down into the unknown titration/symptom/time abyss!

 

Stefan

[Oliver1974]

7.30am:

 

Woke up and got out of bed. Took 75 mg of Zoloft and 0.5 ml of Diazepam. Not a very restful sleep. Was awake multiple times looking at my whatch. Feel a bit anxious. Back is tight. Day is gray and rainy. Apnea machine said I had 22 hypoapneas.

 

8:00am:

 

Eating breakfast. One chai latte, toast, avocado, olive oil, turkey. Lower back is still tight and I still feel trepidation/anxiety. Or could it be nervousness? 

 

9:05:

 

Feeling a bit less anxious. Wondering what could be causing it. Thinking it must be my past. I think coffee is affecting my mood positively. Zoloft leaves me les excited and kinda down. I would limit myself to one chai latte in the morning and see how that goes. From what I’ve read, it seems like caffeine stays in your system for six hours, so that will not interfere with my sleep I’m hoping. It also has a mood boosting dopamine connection.

 

9:41

 

I’d say caffeine is having a positive affect on my mood. God I hope it doesn’t turn around and bite me!

 

11:25

 

Feeling more alert but slightly jittery, tired and yawning a lot. I’ll try half a cup tomorrow. Let’s see how I feel after lunch. 

 

1:10

 

Head feels stuffy. I’m also a bit hungry.

Had a savory pastry. Felt OK

 

2:30

 

Had lunch of fried chicken and rice. Then chocolate. Felt OK

 

9:00

 

Dinner of vegetable soup and pasta pesto. Feeling calm.

 

10:00

 

Reading a book

 

10:30

 

Took 0.5 ml diazepam, apnea machine, lights out and to bed.

 

 

 

 

[Oliver1974]

Today’s story

 

 

4:00am

 

Took the apnea mask off. Was uncomfortable.

 

5:00am

 

Awake looking at my watch.

 

6:00

 

Awake looking at my watch.

7:30

 

Wake up feeling shaky. Took 75 mg Zoloft and 0.5 ml diazepam. I hate taking this junk, it makes me feel trapped. Going to have my usual breakfast but only had half the chai latte and one sample of royal bee jelly.

 

8:34

 

Feeling lonely though I have my family around. Looking back on my life it seems utter caos. I’m worried about feeling anxiety.

 

8:48

 

Feeling a bit tense. Just want to be rid of all these chemicals. I just want to feel like I’m at the wheel and not at the mercy of drugs.

 

9:59

 

Feel something in my stomach back and arms. Is it anxiety? Hunger? The drugs? My eye twitches. It’s my lazy eye and I’ve been reading a lot. Could it be that or another reason for twitching? I’m really scared of coming off of Zoloft, the last experience I had was horrific. But, I’m not going to live on this garbage for the rest of my life. I absolutely hate being on medication.

 

10:09

 

Yawning. Feeling a bit tired. Could it be a coffee crash? I was doing the same thing yesterday. Or do I need more breakfast? My sleep app says I slept 7:46 min? It’s like the im having mini waves of anxiety. Back is tight and then it isn’t then it is then it isn’t.

 

10:51

 

Don’t think I can have caffeine in the morning. I’m still feeling anxious. Dam it!

 

 

11:30

 

Had some ham, bread and orange juice.

 

1:12

 

Anxiety has gone........I think

 

2:00

 

Feeling a bit shaky. Like my nervous system has been under a lot of stress. Yawning. Tapping my feat.

 

3:00

 

At lunch. Anxiety has diminished considerably.

 

4:00

 

Tired so I decided to take an hour nap. Woke up feeling OK

 

9:30

 

Had dinner after a therapy session and feel much more relaxed. Therapy is helping a lot. I’m obviously terrified of having another bad Zoloft titration experience. I think that the therapist I’m working with will help me get past this fear.

 

10:27

 

Reading a book for 20 minutes, taking 0.5 ml liquid diazepam, turning out the lights, putting on the apnea machine and  going to bed.

 

 

 

 

 

 

 

[Shep]

15 hours ago, Oliver1974 said:

Don’t think I can have caffeine in the morning. I’m still feeling anxious. Dam it!

 

 

You may want to cut caffeine out completely and see how you do for a couple of weeks. 

[Oliver1974]

I have totally taken caffeine off the menu. 

[Carmie]

9 hours ago, Oliver1974 said:

I have totally taken caffeine off the menu. 

 

Good for you Oliver!👍

 

Sending hugs🤗

[Oliver1974]

So how do I wake up nice and peaceful without taking crazy inventory of my life and impending future?

 

All it does is rev me up and make me anxious. Why can’t I just let the day unfold?

[Shep]

3 hours ago, Oliver1974 said:

So how do I wake up nice and peaceful without taking crazy inventory of my life and impending future?

 

No one is forcing you to take "crazy inventory" of your life. That's a choice. 

 

Make another choice. Here's how: 

 

"Change the channel" -- dealing with cognitive symptoms

 

Dealing With Emotional Spirals

 

Acceptance

 

More ideas to help cope:

 

Non-drug techniques to cope with emotional symptoms

 

Unfortunately, you aren't likely to "wake up nice and peaceful" for awhile due to the chemical assault you are going through, but do try to use some of these techniques and non-drug coping skills to make your journey more comfortable.

 

if you view your symptoms as teachers, they will guide you through the right non-drug coping techniques that are right for you. View the symptoms as opportunities to practice things like mindfulness and acceptance and you'll walk away from this experience with all of the tools you need to handle whatever stress comes your way without drugs. 

 

As my favorite mindfulness guru Mooji says, "Your thoughts are like visitors and you are NOT a hotel. Don't let them in!"

[Oliver1974]

Shep,

 

Thank you for all this good advice.

 

Stefan

[Shep]

You're welcome, Stefan.

 

The more you practice these techniques, the more they become automatic. 

 

[Oliver1974]

Shep

 

Can I actually look forward to coming off Zoloft? Surly I shouldn’t be SO caught up in doom and gloom. It can’t be ALL bad, right?

[Oliver1974]

 I highly recommend the following book :

 

 Complex PTSD from surviving to thriving by Pete Walker. Trust me, it’s very relevant.

[herod]

Oliver, you should absolutely look forward to coming off Zoloft! You will come to appreciate feeling normal and functional.

[Shep]

3 hours ago, Oliver1974 said:

 I highly recommend the following book :

 

 Complex PTSD from surviving to thriving by Pete Walker. Trust me, it’s very relevant.

 

Please feel free to post it in the recommended book section. 

 

Recommended books

[Oliver1974]

Topic title:  Any advice when switching to Liquid Setraline?

 

I’ve been on 75 mg of Setraline (Zoloft) for 9 months. I’m getting ready to start tapering and I’m wondering which of the two forms is better, using a compound pharmacy to prepare me pills or switching  to liquid.

 

What freaks me out about the liquid sertraline, is the amount I would have to take to make up the 75 mg.  Unlike the pill form where the active ingredient is suspended in some inert product, liquid sertraline is suspended in a more powerful chemical I think . 

 

Edited April 11, 2019 by ChessieCat
added topic title

[Oliver1974]

Taking the following into consideration, do you think I would have any unpleasant reactions if I switched from Setraline pills to liquid? I’m a little worried about the metabolization speeds. It would be really horrible should that change. Trial and error with this stuff is like juggling plutonium!

 

“Sertraline hydrochloride is a white crystalline powder that is slightly soluble in water and isopropyl alcohol, and sparingly soluble in ethanol. 

Setraline (ZOLOFT) tablets for oral administration contain 28.0 mg, 56.0 mg and 111.9 mg sertraline hydrochloride equivalent to 25, 50 and 100 mg of sertraline and the following inactive ingredients: dibasic calcium phosphate dihydrate, D & C Yellow #10 aluminum lake (in 25 mg tablet), FD & C Blue #1 aluminum lake (in 25 mg tablet), FD & C Red #40 aluminum lake (in 25 mg tablet), FD & C Blue #2 aluminum lake (in 50 mg tablet), hydroxypropyl cellulose, hypromellose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, polysorbate 80, sodium starch glycolate, synthetic yellow iron oxide (in 100 mg tablet), and titanium dioxide.

 

Setraline (ZOLOFT) oral solution are available in a multidose 60 mL bottle. Each mL of solution contains 22.4 mg sertraline hydrochloride equivalent to 20 mg of sertraline. The solution contains the following inactive ingredients: glycerin, alcohol (12%), menthol, butylated hydroxytoluene (BHT). The oral solution must be diluted prior to administration.”

 

Edited April 11, 2019 by ChessieCat
reduced font

[ChessieCat]

Instead of taking the whole dose in liquid form the easier way would be to take the larger portion in tablet form and the balance in liquid.

 

combining-tablets-or-capsules-with-liquid-to-taper

 

So 50mg tablet + liquid to make up your dose.  Once you get lower you can use 25mg tablets.

 

If you are concerned about the chemicals in the prescription liquid of Zoloft you can make your own liquid by dissolving a tablet in water, which can be kept for about 3 days (4 doses - original dose day 0, dose 2 counted as day 1).  Putting a tablet in the same amount of liquid as the mg dose (ie 25mg tablet in 25mL water, 50mg tablet in 50mL water) gives a 1:1 ratio, so 1mL liquid = 1mg dose.  When you get to lower doses you can make a 1:10 ratio by increasing the water 10x the tablet dose.

 

There may be some sediment which sticks to the bottom but this is fillers.  If this concerns you, you can add a tiny amount of vodka to solution.

 

how-to-make-a-liquid-from-tablets-or-capsules

 

tips-for-tapering-off-zoloft-sertraline

 

When doing a full change from tablet to liquid (or brand to generic tablet, ie changing form of the drug) we suggest doing a cross over by taking 3/4 + 1/4, 1/2 + 1/2, 1/4 + 3/4 combinations of old and new for 3 to 7 days.  Or 2/3 + 1/3, 1/2 + 1/2, 1/3 + 2/3 combinations if it is difficult to get 1/4 doses and 1/3 doses are easier.

[Oliver1974]

Hello friends,

 

After serious consideration, I decided to go back to the compounding pharmacy and have them completely redo my titration capitals.

 

The first ones they did had me titrating add a quarter mg a day. This time I’ve had them make up new batches that accurately have me decreasing by the 10% a month rule.  I’ve also had them make me month long hold periods at weekly intervals.

 

It’s an insane amount of work and many hundreds if not thousands of pills, but after the HORROR I went through with my first two failed Setraline tapers, I want to  minimize as much risk as possible. 

 

Stefan 

[Oliver1974]

Cont.............

 

I shall always be reducing my monthly dose by 10%. So if the first month I start off with 75 mg, I will reduce it by 7.5 mg in that month, leaving me with 67.5mg. The following month I will reduce the 67.6mg by 10% etc.

 

Gradually reducing my doses this way is meant  to keep my blood setraline levels decreasing on a constant smooth curve, and thus minimizing shock to my nervous system or what they lovingly call discontinuation syndrome.

 

I currently take 75mg of Zoloft first thing in the morning with 1 mg of diazepam. And another 1 mg of diazepam at night.

 

- I’m taking top quality omega 3 fish oil in the morning.

 

- I stopped using tobacco, alcohol, caffeine and cannabis 9 months ago. I’m 100% clean. 

 

- My sleep hygiene is good, though my sleep is interrupted. I get about 7.5 hours.

 

- My diet is OK and hardly any junk food.

 

- I have two therapists I work with.

 

- My wife and friends are supportive.

 

- I have  The surviving antidepressant community.

 

Can you see any holes in my plan? Is there anything else I should consider?

 

Needless to say I’m quite frightened about this process. I wish I wasn’t but I am. Your support is truly invaluable.

 

Warmest regards

Stefan 

 

[Shep]

Keeping to a 10% schedule is good, but remember, if you need to, you can always hold longer and  / or reduce by less than 10%. Let your symptoms be your guide.

 

 

[Oliver1974]

Shep,

 

I suppose I could as the farmacy to make me smaller reductions if needed, but I seriously hope I won’t need them.

 

I just want this torture to be over and to be fully awake again 😞

 

[Oliver1974]

What are the positive effects of tapering off Zoloft?  I know we talk a lot about the doom and gloom, but surely there must be some positive feelings! 

 

I know we are all individual, but has anybody done a continuation study rather than a discontinuation study? 

 

Can I expect to feel more spice for life?  More energetic? More sex drive?

 

Regards

Stefan

 

[Shep]

7 hours ago, Oliver1974 said:

I know we are all individual, but has anybody done a continuation study rather than a discontinuation study? 

 

 

Yes, this is the result of continuation studies:

 

Now Antidepressant-Induced Chronic Depression Has a Name: Tardive Dysphoria

 

7 hours ago, Oliver1974 said:

Can I expect to feel more spice for life?  More energetic? More sex drive?

 

 

Please see:

 

Success Stories

[Oliver1974]

Good morning,

 

I wake up in the morning worried about how my body is going to feel. I went through so much anxiety and muscle tension last year that I think it’s given me PTSD.  This is the first time my body has ever failed me so to speak. I used to trust it’s workings implicitly but now...........?

 

Things like the onset of hunger freak me out because it feels like anxiety in the abdomen area. Working out and feeling my muscles ache also freaks me out.  I’ve put on 30 pounds, so I need to work out.

 

My first two attempts at Zoloft titration where total ignorant nightmares. Though I’m much more informed today, It’s still my primary fear when I think about titrating this coming September.

 

 Does anybody else know what I’m talking about?

 

Regards

Stefan

 

 

[Shep]

Sounds a bit like health anxiety. This thread may help:

 

Health anxiety, hypochondria, and obsession with symptoms

 

The withdrawal experience can trigger this even in people who never experienced these kinds of worries before.

 

From what you wrote, you were in good health before all of this and had no reason to expect your body to fail. Try not to let your thoughts spiral. These symptoms can be severe but there's no reason to think you won't heal and go onto do all of the exercise and activities you were able to do prior to withdrawal. 

 

 

[Oliver1974]

Shep,

 

What got me into this mess to begin with was worrying about poor digestion. I was caught in a vicious circle. My stress was causing my poor digestion and then worrying about my digestion was causing me more stress.

 

I wasn’t aware of this at the time, so I did every test imaginable to try and find out what the hell was wrong with my body, but everything came back normal!

 

The doctors thought I was crazy and that it was all in my head.  I kept on trying to explain to them that it was not all in my head and that I was not digesting my food properly and that my stool was totally different than what it used to be like. 

 

In the end I was prescribed Xanax, and the next day my digestive system completely changed back to normal.  Sadly though, what had cured my digestion would later turn out to be an even more painful double edged sword.

 

Until a year ago when all of this craziness started and I was prescribed this cocktail of toxic crap,  my body had never felt antidepressants, benzos, failed  titrations,  intermittent withdrawals,  any of that s..t.

 

Even though I’m not currently titrating  ( I will be in September) every time my back hurts a bit, my head feels cloudy, my stomach feels different or I’m a bit tired, alarm bells go off telling me to brace for impact.  It could be something as routine as feeling hungry. I’m like, oh my God here comes the anxiety in my abdomen again, and then my stomach rumbles and I’m like frewwwwew thank God it’s just hunger. 

 

Honestly I cannot believe I’m going through any of this. A year ago if you had told me that I would be feeling any of this I would’ve said you’re totally out of your mind. 

 

Stef