Restoration123: when should I start my Zoloft / sertraline taper?

[Restoration123]

Hi there! I took a low dose of Ativan for 8 weeks and quickly developed physical dependence. It's been about 4 months since I cold turkeyed off Ativan. I've been taking Sertaline for 6 months and now I'm ready to think about tapering. I'm still not completely recovered from the benzo withdrawal -- I'd say that I'm drastically improved (the withdrawal was awful!) and I'm fully functional now. However, I still have mild Ativan withdrawal symptoms.

 

A couple of months ago, I started to notice that the Sertraline is making me very drowsy. Also, I've gained a lot of weight and feel emotionally numb. For these reasons, I'd like to taper off the Zoloft and get back to my medication-free, natural baseline. Do you think I should wait longer to taper? Should I wait until I'm completely healed from benzo withdrawal?  Would appreciate your thoughts!

[Shep]

Hi, Restoration.

 

Welcome to Surviving Antidepressants. 

 

On 5/19/2019 at 2:51 AM, Restoration123 said:

Do you think I should wait longer to taper? Should I wait until I'm completely healed from benzo withdrawal?  Would appreciate your thoughts!

 

We recommend waiting to taper until you are at Withdrawal Normal. From what you've posted so far, it sounds like you may be there already.

 

Withdrawal Normal

 

What benzo withdrawal symptoms do you continue to have? 

 

In your signature, you state you are on 87 mg. Since Zoloft comes in increments of 25 mg, it looks like you've already started tapering. What dose were you initially prescribed and what rate have you reduced? 

 

Here is some information about tapering and withdrawal:

 

Why taper by 10% of my dosage?

 

Tips for tapering off Zoloft (sertraline)

 

What is withdrawal syndrome? 
 
The Windows and Waves Pattern of Stabilization

 

Please continue to use this thread to document your taper and to ask questions. As you let us know more about your taper, we can give you more targeted advice and information. 

Edited May 21, 2019 by Shep
fixed typo

[Restoration123]

Hi! A few days ago I attempted to start tapering Zoloft .... I cut about 12.5 mg off my 100 mg dose. I noticed some increased anxiety and insomnia ... I took this to mean that I'm not ready for this cut, so I reinstated back to 100 mg.

 

I'm still pretty fresh off benzos and recently started work again after 3 months of disability leave. I don't want to further tax my already sensitive system, but I do want to get off Zoloft! I'm thinking I'll try my taper again, but this time using a VERY gradual liquid microtaper. Has anyone done this? Do you have any advice for a daily reduction liquid taper?

 

As for my current benzo WD symptoms, I have skin sensitivity, crackling in my ear when I yawn, slight dizziness and slight anxiety. Not fully recovered, but drastically improved from acute withdrawal, which basically left me a dysfunctional basketcase!

 

Thank you in advance!

[Songbird]

On 5/22/2019 at 8:13 AM, Restoration123 said:

I'm thinking I'll try my taper again, but this time using a VERY gradual liquid microtaper. Has anyone done this? Do you have any advice for a daily reduction liquid taper?

 

Yes, plenty of members are doing very gradual liquid tapers, although not daily reductions, that would likely be too fast.

For more information, see these topics:  

Micro-taper instead of 10% or 5% reductions

The Brassmonkey Slide method of micro-tapering

 

Are you able to get a commercially-made liquid, or will you be making your own?

[Restoration123]

Is Sertraline soluable in water? Here's what I'm thinking .... I'll dissolve a 100mg tablet in 100ml of water, remove a teeny tiny amount  with a syringe (according to the taper schedule somewhere around 0.33ml), and then drink the rest. Does that sound like a good plan?

 

My concern is that it looks like it will take YEARS for me to taper off at this rate, and I've only been taking Sertraline for 6-7 months. I'll start off with 10% but I really do hope that I can go faster! 

 

Has anyone else here experienced bad side effects from Sertraline or Zoloft?  

Any tips or advice for me?

 

(Btw Songbird, I think there's a person who uses your name on Benzo Buddies. Is that you?  )

 

Medication sucks! Blah! 

[Restoration123]

I've heard some people dissolve their pills in milk or vodka. Is it okay to dissolve Sertraline in water??

[ChessieCat]

From Post #1 of Tips for tapering off Zoloft (sertraline)

 

Quote

Make your own liquid
Many people make their own Zoloft liquid out of tablets and water. See How to make a liquid from tablets or capsules

 

[Restoration123]

Hi Chessie. Thanks for your reply. Yes I read the thread about making liquid out of tablets ... but I also heard that Zoloft has a low solubility in water? If the medication is not properly dissolved in the appropriate liquid, it can mess up your taper. That's why people use vodka, milk, etc. instead of water. 

 

Does anyone know anything about this? Is alcohol preferred over water for dissolving Sertraline?  I cannot find this information on the web nor in this forum. The tablet deconstructs in water quickly, but I also noticed that there is sentiment that settles to the bottom. I'm wondering if I should be dissolving the tablet in 1 mg of vodka and then adding water? Or using milk (bc some medications are fat soluable and bind to the fat in mlik)? 

[Songbird]

On 5/25/2019 at 7:43 AM, Restoration123 said:

My concern is that it looks like it will take YEARS for me to taper off at this rate, and I've only been taking Sertraline for 6-7 months. I'll start off with 10% but I really do hope that I can go faster! 

 

(Btw Songbird, I think there's a person who uses your name on Benzo Buddies. Is that you?  )

 

It's possible you may be able to go faster, but best to start out cautiously and only speed up gradually, so you can observe how your body responds to the dose reductions.  (No, it's not me on Benzo Buddies).

[Songbird]

1 hour ago, Restoration123 said:

If the medication is not properly dissolved in the appropriate liquid, it can mess up your taper. That's why people use vodka, milk, etc. instead of water. 

 

If you can crush your pills into fine powder, you could use a suspending fluid such as Oraplus to create a suspension instead of a solution.

See:  Pharmaceutical liquids to make suspensions

[brassmonkey]

I'm reposting my answer to your PM here so you will have a better record of it.

 

Learning which liquid to dissolve a drug in is very important for a successful taper. For Sertraline there are a good number of liquids that will dissolve it.  Many of which are only suitable for industrial processing and not for human consumption.  There are three solvents that will work: DMSO, Ethanol and water ( in declining order).  DMSO is hard to get, so that's out. Leaving Ethanol and water.

 

Ethanol is the most effective because it will dissolve 15.7mg of Sertraline per ml of liquid.  This is working with full strength ethanol  (about 190 proof)  Vodka is typically 80-90 proof so would dissolve half that much or 7.85 mg/ml.

 

Water dissolves at a rate of 3.8mg/ml  or roughly half the amount of vodka.

 

So either liquid can be used.

 

Sertraline dose not dissolve in milk, but it does pass into mothers milk and can be passed on to a child in that manner.

 

I would dissolve it in vodka and then mix the measured dose with something to make it more drinkable. This gives a new meaning to the term "drug cocktail" (sorry for the bad pun, but it's too early in the morning).

[Restoration123]

I'm currently taking Sertraline (Zoloft) and have been on it for a few months. I've heard that Prozac is easier to taper bc of its long half-life. Has anyone successfully crossed over? Any insights or advice?  Are there potential complications with switching medications? 

 

I'm 4.5 months off a benzo (Ativan), so I'm trying to figure out when to start my taper and how to best approach it ...

[Restoration123]

I'm thinking about a cross-over from Sertraline (Zoloft) to Prozac. I heard it's easier to withdraw from Prozac bc of its long half life. Any thoughts?

[ChessieCat]

 

the-prozac-switch-or-bridging-with-prozac

[Restoration123]

Thanks for the link! Sounds like I should try to taper from Sertraline first before going the Prozac route .... Eager to get off the Sertraline bc it's making me FAT.  Lol. But I'm still going through benzo withdrawal so it may not be the right time ....  I'm recently back to work now so I have to stay functional and let my nervous system heal and recover .... Ahhh medication sucks! 

[Shep]

5 hours ago, Restoration123 said:

I'm currently taking Sertraline (Zoloft) and have been on it for a few months. I've heard that Prozac is easier to taper bc of its long half-life. Has anyone successfully crossed over? Any insights or advice?  Are there potential complications with switching medications? 

 

I'm 4.5 months off a benzo (Ativan), so I'm trying to figure out when to start my taper and how to best approach it ...

 

Restoration, I moved this post off the benzo forum and here to your main intro thread, since you're off your benzo and the question is really about an antidepressant crossover. 

 

Regarding when to start a taper after coming off a benzo, you may find this post helpful, as it describes the concept of being at Withdrawal Normal before making any more changes.

 

Withdrawal Normal

[Restoration123]

Topic title:  Tapering an AD after benzo withdrawal

 

Hi there! I'm wondering if there's anyone here who has tapered an AD after benzo withdrawal ... if so, can you share your experiences? Did you wait until you were completely healed from the benzo withdrawal before tapering the AD?

 

I'm just over 6 months off a benzo -- fully functional but I still have some symptoms.  I recently made a small reduction in my AD (about 3%) and I'm noticing some increased symptoms .... so I'm wondering if I should reinstate to my full dose, hold where I am or continue to taper (but very slowly). 

 

Edited July 25, 2019 by ChessieCat
added topic title

[ChessieCat]

Merged 2 topics - this keeps history in one place.

 

Please update your drug signature using this format.  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

 

We are better able to offer suggestions when we have this information.

 

1 hour ago, Restoration123 said:

I'm just over 6 months off a benzo -- fully functional but I still have some symptoms.  I recently made a small reduction in my AD (about 3%) and I'm noticing some increased symptoms .... so I'm wondering if I should reinstate to my full dose, hold where I am or continue to taper (but very slowly). 

 

If you have only made a small reduction and your symptoms are bearable it is probably better to hold on this dose until you reach WDnormal (withdrawal normal)

 

If your symptoms are unbearable it will depend on how long ago you made the 3% reduction what amount of updose you might do.  Generally you only make a small updose, not go back to the last dose.

[Restoration123]

25 minutes ago, ChessieCat said:

 

If your symptoms are unbearable it will depend on how long ago you made the 3% reduction what amount of updose you might do.  Generally you only make a small updose, not go back to the last dose.

 

I've been holding (at 3% reduction) for 1 week. I do think I'm feeling a bit better ... I just want to make sure that I'm not going to get slammed with more symptoms a month from now??  I made such a small cut and I felt it -- it makes me wonder if it's too early for me to taper (given that I'm not completely healed from benzo withdrawal). 

[ChessieCat]

3 hours ago, Restoration123 said:

Has anyone else here tried keto for SSRI-induced weight gain?

 

 

I've moved you post to this topic:  diets-that-may-cause-problems-restriction-ketosis-raw-low-carb

 

[Restoration123]

Hi there. It's been 6 weeks since I started my Sertraline taper. I started off with a daily microtaper aiming at 12% reduction over a month, but it was too fast for me.  I started to get symptoms, so I've been cutting and holding. I've decreased my dosage by a total of 4.3mg (I started at 100mg so a small reduction).  I've been holding at the 4.3mg reduction for about two weeks.

 

I thought I was feeling okay and stabilizing. Just yesterday and today I'm starting to notice new symptoms ... some weird numbness and tingling in my legs and uncomfortable sinus pressure.   Sertraline (generic Zoloft) has a short half-life .... so shouldn't the symptoms show 3-4 days after a cut? Is it possible that I'm experiencing more severe withdrawal now (even though I've been holding at the same dose for a couple of weeks)?

 

I'm considering updosing and increasing by 2mg.  Since it's a such a small amount, maybe I should go back to the full 100mg? (crushing and dissolving the pill, the syringe ... it's work!).  I don't think I'm fully recovered from benzo withdrawal yet, so it may not be the right time for me to taper off Sertraline .... Thoughts??

[ChessieCat]

If you symptoms are bearable it would be best if you hold for a while until you reach WDnormal (withdrawal normal)

 

If your symptoms are unbearable you might try increasing by a tiny amount.  Eg 0.25mg or 0.5mg

 

It's not unusual to feel discomfort when tapering.  It's important to learn and use non drug coping techniques to get through the discomfort and not automatically turn to a drug as a quick fix.

 

Here's some additional information which might help you to understand what is happening:

 

Recovery isn't linear it happens in a Windows and Waves Pattern

 

Withdrawal Normal Description

When we take a psychiatric drug, we are adding chemical/s to the brain.  The brain then has to change to adapt to getting the chemical/s.  It might have to change something to do with A and then once that change has been made it affects B so another change has to be made and so on down the line.  It is a chain reaction, a domino effect.

 

The same thing happens when we take the drug away.  That's why it's possible to experience such a vast array of withdrawal symptoms, and they can change, and be of different intensity.

 

are-we-there-yet-how-long-is-withdrawal-going-to-take

 

These explain it really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

On 8/31/2011 at 5:28 AM, Rhiannon said:

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.

 

AND

 

On 12/4/2015 at 2:41 AM, apace41 said:

Basically- you have a building where the MAJOR steel structures are trying to be rebuilt at different times - ALL while people are coming and going in the building and attempting to work.

It would be like if the World Trade Center Towers hadn't completely fallen - but had crumbled inside in different places.. Imagine if you were trying to rebuild the tower - WHILE people were coming and going and trying to work in the building!  You'd have to set up a temporary elevator - but when you needed to fix part of that area, you'd have to tear down that elevator and set up a temporary elevator somewhere else. And so on. You'd have to build, work around, then tear down, then build again, then work around, then build... ALL while people are coming and going, ALL while the furniture is being replaced, ALL while the walls are getting repainted... ALL while life is going on INSIDE the building. No doubt it would be chaotic. That is EXACTLY what is happening with windows and waves.  The windows are where the body has "got it right" for a day or so - but then the building shifts and the brain works on something else - and it's chaos again while another temporary pathway is set up to reroute function until repairs are made.  

 

[Restoration123]

Thanks Chessie. I actually edited the post while you replied. I've been holding at the same dose for 2 weeks, and Sertraline has a short half life. Is it possible that the withdrawal is just hitting me now? Or maybe this is a temporary wave that I should power through? I felt pretty good a couple of days ago, but suddenly feel a lot worse.

[ChessieCat]

During any taper, there will be times of discomfort.  We strongly encourage members to learn and use non drug coping techniques to help get through tough times.

 

Understanding what is happening helps us to not get caught up with the second fear, or fear of the fear.  This happens when we experience sensations in our body and because we don't understand them we are scared of them and then start to panic.

 

This document has a diagram of the body explaining what happens in the body when we become anxious:

 

https://www.getselfhelp.co.uk/docs/AnxietySelfHelp.pdf

 

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

 

Audio FEMALE VOICE:  First Aid for Panic (4 minutes)

 

Audio MALE VOICE:  First Aid for Panic (4 minutes)

 

Non-drug techniques to cope

 

dealing-with-emotional-spirals

 

Dr Claire Weekes suffered from anxiety and learned and taught ways of coping.  There are videos available on YouTube.

 

Claire Weekes' Method of Recovering from a Sensitized Nervous System

 

Audio:  How to Recover from Anxiety - Dr Claire Weekes

 

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

 

Resources:  Centre for Clinical Interventions (PDF modules that you can work through, eg:  Depression, Distress Intolerance, Health Anxiety, Low Self-Esteem, Panic Attacks, Perfectionism, Procrastination, Social Anxiety, Worrying)

 

On 4/28/2017 at 4:03 AM, brassmonkey said:

 

AAF: Acknowledge, Accept, Float.  It's what you have to do when nothing else works, and can be a very powerful tool in coping with anxiety.  The neuroemotional anxiety many of us feel during WD is directly caused by the drugs and their chemical reactions in the brain.  Making it so there is nothing we can do about them.  They won't respond to other drugs, relaxation techniques and the like.  They do, however, react very well to being ignored.  That's the concept behind AAF.  Acknowledge, get to know the feeling involved, explore them.  Accept, These feelings are a part of you and they aren't going anywhere fast. Float, let the feeling float off as you get on with your life as best as you can.  It's a well documented fact that the more you feed in to anxiety the worse it gets.  What starts as generalized neuroemotinal anxiety can be easily blown into a full fledged panic attack just by thinking about it.

 

I often liken it to an unwanted house guest.  At first you talk to them, have conversations, communicate with them.  After a while you figure out that they aren't leaving and there is nothing you can do to get rid of them.  So you go on about your day, working around them until they get bored and leave.

 

It can take some practice, but AAF really does work.  I hope you give it a try.

 

 

[ChessieCat]

2 minutes ago, Restoration123 said:

Sertraline has a short half life.

 

Sertraline has a half life of about 26 hours.

 

Two weeks on 96mg from 100mg and getting withdrawal symptoms is not unusual.  That's why the recommended 10% taper is to hold for 4 weeks.

[bubbles]

2 hours ago, ChessieCat said:

 

Sertraline has a half life of about 26 hours.

 

Two weeks on 96mg from 100mg and getting withdrawal symptoms is not unusual.  That's why the recommended 10% taper is to hold for 4 weeks. 

 

Sertraline also has an active metabolite with a longer half life, about 66 hours. In my working out (working on five half life cycles), it takes about 5 or 6 days to get to the new baseline for sertraline but 2 weeks to get to the new baseline of the active metabolite. I'm not a pharmacist, so willing to be better informed by an expert!, but that's my personal figuring. For me, I work on the later figure.

 

[Restoration123]

On 8/21/2019 at 5:50 PM, bubbles said:

 

Sertraline also has an active metabolite with a longer half life, about 66 hours. In my working out (working on five half life cycles), it takes about 5 or 6 days to get to the new baseline for sertraline but 2 weeks to get to the new baseline of the active metabolite. I'm not a pharmacist, so willing to be better informed by an expert!, but that's my personal figuring. For me, I work on the later figure.

 

 

Thanks Bubbles! So are you cutting every 2 weeks?  How has your Sertraline taper been? I'm just starting so I'd be interested in hearing about your experience

[bubbles]

5 hours ago, Restoration123 said:

 

Thanks Bubbles! So are you cutting every 2 weeks?  How has your Sertraline taper been? I'm just starting so I'd be interested in hearing about your experience

 

No, absolutely not every two weeks, more like four.

 

I think the brain needs time to adapt to the new dose and that can't start until that two week point. So two weeks to get to new low (allowing five half lives) then 2? weeks to adapt?

 

I tend to do a drop of up to 10% (but most much smaller and a couple bigger, one because of a calculation error). I usually find I can do three or four before I need a longer hold. That suggests that four weeks is too short, probably.

 

To put it in perspective, my highest point was 100mg and I'm now at 4mg. It has taken five years so far. I'm in a hold now but will probably starting a small drop in a couple of weeks. I have prioritised feeling well, have worked and studied and generally led a normal life. I've had some glitches, of course, though they haven't been all withdrawal. 

[bubbles]

I should clarify - when I say I have prioritised feeling well... I don't do suffering.  I don't drop again until I feel really normal.

[Restoration123]

Is tinnitus a symptom of SSRI withdrawal? I am SLOWLY tapering Sertraline and tonight I'm noticing that my ears are ringing! Should I updose??

[Shep]

Yes, tinnitus is a symptoms of SSRI withdrawal. 

 

Tinnitus, another ear problem. What does all that noise mean?

 

2 hours ago, Restoration123 said:

Should I updose??

 

How severe is this symptom? What is your monthly taper rate? 

 

Please post the doses you've been taking over the past few months so we can better offer you advice. You may want to keep track of your monthly dose in your signature. A direct link to your signature is here:

 

Account - Settings - Create or Edit Your Signature

 

[Restoration123]

I think I've had slight tinnitus for a while, but last night it was noticeably louder and it actually disrupted my sleep   I've updated my signature. I don't yet have a set taper rate ... I'm just going by my symptoms. I'm still not fully recovered from Ativan withdrawal, which is why I'm going ULTRA slow. I went from 100mg to 92mg over 3.5 months.  Just recently I significantly sped up my taper -- I wonder if I"m going too fast and that's why my ears are ringing. Today I updosed by 0.5mg hoping it will help alleviate the tinnitus.

 

Does the tinnitus go away as we recover from SSRI withdrawal?

[Restoration123]

Is it important to take your dose at the same exact time every day?  Can it cause withdrawal if the timing of your dose is slightly erratic -- say a 3-hour variable window? 

[Shep]

Yes, it's very important to take your dose at the same time every day. When you alter your dosing patterns, it destabilizes your nervous system. Your nervous system needs as much consistency as you can give it. 

[Altostrata]

Hello, @Restoration123, how are you doing?