Leprechaun38: afraid of not being able to taper off sertraline / Zoloft

[Leprechaun38]

Leprechaun38: Starting tapering off Sertraline

 

Hi everyone! First of all, sorry about my English.

 

I'm a Brazilian woman - 38 years old and here is my history.

The first time I was taken to a psychiatrist I was 17 years old. At that time, because of a love disappointment, I ended up taking cocaine for a while to escape the sadness of a broken heart. I was really very depressed and the first doctor diagnosed me with bipolar disorder. He prescribed venlafaxine and lithium and said that because of family history, I might probably have to take this medication forever. I started with high doses of venlafaxine - 150mg, and after getting better the doctors started prescribing me "maintenance doses",  from 50mg to 75mg. When I had relapses on depression, they increased the dose again.

Here is a summary of my use of psychoactive drugs:
1998-2001: venlafaxine and lithium
2001-2008: venlafaxine only
2008-2011: I stopped taking it on my own, gradually, and got very well without any medication.

In 2011, I was married and started suffering domestic violence. So, I started having panic attacks for the first time in life. After much resistance, I returned to a psychiatrist who prescribed me Paroxetine 20mg and sublingual clonazepam (this one only if necessary).

In 2014, I got pregnant. So I tried to stop the medications for the health of my baby. I went through a nightmare and my psychiatrist switched from paroxetine to sertraline. Then, taking psychotherapy sessions, I was finally able to get divorced from my violent husband and decided to try tappering off the medication once again and gradually. Always the same nightmare, and while psychiatrists claimed it was a relapse, and that I had to get back to higher doses,  I was sure I was only having withdrawal symptoms. 

This year, 2019, I decided once again to try withdrawing the medication as I do not see any reason to keep taking it. I've been taken antidepressants since I'm 17. I do not want it anymore.

 

Well, I went from 100mg (regular doses since 2014) to 75mg, and after 3 months I tried to reduce it to 50mg. Unfortunatelly I started having panic attacks immediately. I cannot have panic atacks alone with my kid. He is only 4 years old. What would I say to him? I do not want to cause him any trauma. 

 

What was I supposed to do? I went then back to my 75mg.

I'm lost, hopeless, because I want to stop the medication but the withdrawal symptoms are too heavy for me to deal with. I get completely lost of myself, get confused, emotional trap. 

 

There are no doctors in Brazil who could help me in the process and also, could not find brazilian forums like this one. 

 

I started reading Dr. Joanna Moncrief e Peter Breggin and their theses make all sense to me.

Please I need help!

 

I appreciate any response!

 

Edited March 9, 2022 by ChessieCat
added old Intro topic title before merging with 2nd Intro and added spacing.

[Gridley]

Welcome to SA, Leprechaun38.  When did you go back up to 75mg?  How are you feeling now?  

 

The vast majority of doctors, not only in Brazil but everywhere, know nothing about safe tapering or about withdrawal.  They will invariably say, as yours did, that withdrawal is relapse and put you on more drugs.

 

We recommend tapering by no more than 10% of your current dose every four weeks. Going from 100mg to 75mg to 50mg was too fast, causing you to experience intolerable withdrawal symptoms.

Why taper by 10% of my dosage?

 

You need to be stable before you start to taper.  That's why I asked you how you're feeling.  "Stable" doesn't mean you have no withdrawal symptoms but rather that your symptoms are more or less the same every day without big swings in mood.

 

Using a 10% taper, you would go in your first month down from 75mg to 67.5.  A month later your dose would be 60.8mg.  You just multiply your current dose by .9 to get your next dose.  

 

The following link is specifically about tapering sertraline and contains information on how to take the smaller doses you'll need to do the 10% taper.  There are several methods.  One is to cut tablets and weigh them on a scale.   Do you have Amazon.com in Brazil?  If so, you can order the AWS Gemini 20 scale and use that.  Or,  if liquid sertraline is available in Brazil, that would be a good method.  If not, you can make your own liquid from tablets.  This is all explained in the following link:

 

Tips for tapering off Zoloft (sertraline)

 

How to make a liquid from tablets or capsules

 

The symptoms you experienced when you tapered too fast were withdrawal symptoms.  Avoiding or minimizing them is the purpose of the 10% taper.

 

What is withdrawal syndrome.

 

Glenmullen’s withdrawal symptom list.

 

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.  

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

This is your Introduction topic, where you can ask questions, post updates, and interact with other members.  We're glad you found your way here.  And your English is fine.

 

 

[Leprechaun38]

Thank you so much Gridley for your help!

 

As I said, about two months ago I was feeling really well, self-confident, life stable, and decided to reduce the sertraline dose from 75mg to 50mg focusing on tapering off. Right afterwards, I felt dizzy, sick with nausea, had headaches, brain zaps, but those symtoms were already expecteded and so, I could manage that.... until started having panic attacks two weeks after reducing the dose. I cannot manage this. It makes me feel so miserable, feels like dying. I stayed on 50mg for a month, that is, two weeks holding out this situation of panic sindrome. Then decided to increase the dose back to 75mg. That was a really hard decision to take.

Honestly, I don't feel recovered yet from these two panicking weeks. I do not know if it is chemical or emotional, maybe both, but it seems my self-estime got lot lower because I was very confident that I would be able this time to definetely wean from antidepressants and I finally could not. 

 

Actually, after this episode, I'm very afraid of trying to taper off again because I have so many professional challenges ahead this year. 

I cannot pause my life to do this. And reading the reports in this forum, it seems to me that some people, even doing it as recommended - that 10% dicrease at a time - get severe wave symtoms. Is it better for me to wait a bit until my life is stabler, without all these chalenges? I can foresee that on March 2020 things will be a litle smoother for me.

 

I'm very grateful for you spending your time helping people like me. Antidepressants did help me once, but the price now seems too high!

There must be other alternatives to get healed from panic disorder without getting stuck on a drug. Even though Sertraline helped me with this, I prefer going back to myself. I want to be able to cry again. Plenty of emotions are locked somewhere inside me asking urgently to get out! I want my life back, sexually and emotionally talking.

[Gridley]

51 minutes ago, Leprechaun38 said:

 Is it better for me to wait a bit until my life is stabler, without all these chalenges? I can foresee that on March 2020 things will be a litle smoother for me.

 

 

Yes, it would be much better to wait until there is less stress and fewer challenges in your life.  Also, waiting will give you time to get stable on your increase back to 75mg.

 

There will be some withdrawal symptoms from a taper.  The idea is to keep them to a tolerable level so you can continue to function.  Some people can't tolerate a 10% taper and have to go more slowly.  We can talk more about this whenever you're ready to taper.

[Leprechaun38]

I finally found a doctor in my country who agrees I have to tapper off sertraline. I told him I had many problems tapering off it before because of the withdrawal symptoms, then he wants to put me into aripiprazole in order to help with that symptoms. Does that make any sense, or I will get addicted to another drug? 

[ChessieCat]

Here is your Introduction topic.  Each member has 1 Introduction topic which keeps their history in one place.  It is the best place to ask questions about your own situation and journal your progress.  This topic will be merged with your original topic here:

 

leprechaun38-afraid-of-not-being-able-to-taper-off-sertralineoloft

 

So that we can see your drug history at a glance please follow these instructions and create your drug signature:

 

Instructions:  Withdrawal History Signature

 

The last time you posted was July 2019.  Please post telling us about all drug and supplements changes and you have made during that time.  Please also describe what happened when you made those changes.  Please also tell us about your current symptoms, the severity and how long you have had them.  Basically we need you to fill us in with the information about what has happened during the time since you last posted.

 

In answer to your question.  No, it does not make any sense to add aripiprazole.  If you do a drug interaction check for Zoloft and and aripiprazole there is a moderate interaction:

 

From:  https://www.drugs.com/interactions-check.php?drug_list=233-0,2057-1348

Interactions between your drugs

Moderate

sertraline

ARIPiprazole

Applies to: Zoloft (sertraline), aripiprazole

Sertraline may increase the blood levels of ARIPiprazole. This can increase the risk and/or severity of side effects such as drowsiness, seizure, Parkinson-like symptoms, abnormal muscle movements, and low blood pressure. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if you experience agitation, aggression, confusion, convulsions, muscle spasm, or movements that you can't stop or control such as lip smacking, chewing, puckering, frowning or scowling, tongue thrusting, teeth clenching, jaw twitching, blinking, eye rolling, shaking or jerking of arms and legs, tremor, jitteriness, restlessness, pacing, and foot tapping. Also be alert to symptoms of low blood pressure such as dizziness, lightheadedness, fainting, and/or increased pulse or heart rate.

[Altostrata]

Hello, @Leprechaun38

 

To go off sertaline, the best way is to use a liquid, see Tips for tapering off Zoloft (sertraline)

 

No, it doesn't make any sense to add apriprazole, it may not aid tapering and it's likely you will have to eventually taper off that, too.

[Leprechaun38]

@AltostrataHello! Once again trying to tapper from sertraline, but a bit slower. There’s no liquid form here in Brazil. Very Long time with 1 and a half pill (75mg), more than 5 years. Now I reduced to 1 and a quarter (62, 5mg). It’s been five days, having no withdrawal symptoms so far🙌🏻

[Altostrata]

That's good to hear. Strongly recommend you read Tips for tapering off Zoloft (sertraline) It tells you how to make a liquid.

 

To help us out, follow these instructions Please put your drug and withdrawal history in your signature You may need to use a computer to do this.

[Leprechaun38]

Leprechaun38: Starting tapering off Sertraline

 

Hi everyone! 

Trying once more tapering off from Sertraline. Now slower.. 

From 75mg to 62,5mg. Hope I can manage this time. It’s been 15 days already, was feeling nothing until now. Feeling a bit more tired, sometimes too reactive emotionally. But much more tolerable than when I reduced from 75 to 50. 🙏 

For the next reductions I intend to try making liquid from pills, as suggested.

 

How long does it take for me to try another step?

 

 

Edited March 9, 2022 by ChessieCat
added Intro topic title before merging with intro topic

[Gridley]

Welcome to SA, Leprechaun38.

 

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.

 

Your drop from 75mg to 62.5 was over a 16% reduction.  We recommend tapering by no more than 10% of current dose every four weeks.

 

Why taper by 10% of my dosage?

 

This link is specifically about tapering Sertraline.

 

Tips for tapering off sertraline (Zoloft)

 

When switching from one form of a drug to another (in your case from tablet to liquid) we recommend a gradual crossover to reduce the chance of disturbing your system due to the change.  Do not taper further until this crossover is complete.  Here's the crossover:

 

3/4 dose tablet, 1/4 dose liquid for 3 to 7 days

1/2, 1/2 for 3 to 7 days

1/4 dose tablet, 3/4 dose liquid for 3 to 7 days

all liquid thereafter

 

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) 

 

Add in one at a time and at a low dose in case you do experience problems. Get supplements that are single ingredient (not mixed with other types of supplements).

 

This is your Introduction topic, where you can complete your drug signature, ask questions and connect with other members.  We're glad you found your way here.

 

 

 

 

 

 

[Altostrata]

Hello, how are you doing?

 

Brazil members, please post here 

 

 

[Leprechaun38]

Hi, I’m fine thanks 🙏 

Keeping my withdrawal plan!

Each month I’ve cut my Sertraline doses around 10%, as suggested. Now on 56mg. Planning next step within next 2 weeks when I go for 50mg.

It seems to be working. I feel less withdrawal symptoms this way. 

I keep in touch! Thanks for being here ❤️

[Leprechaun38]

The worst withdrawal symptoms’ wave

 

Hi guys, need some help, please! 

 

I’ve been through the worst wave of withdrawal symptoms since started tapering off Sertraline. I’m reducing 10% of dose every 1 or 2 months, depending on how I’m feeling. Now on 31mg.

 

But I’ve not been able to sleep which makes myself cannot bear the day after full of work and responsabilities, including a son of 6 years old who recently watched me having the worst crisis with the return of panic attacks. I have bited and cut my left arm several times, which I had never did in my lifetime.. feeling so ashamed of him and my partner. I Had already stopped taking clonazepam, and was using 0.21 melatonin pills instead. But, it’s  not working anymore. So got back to 0.75 clonazepam at night. Felling so depressed and desperate. I didn’t want to start taking benzos again, had already overcome it,  but I need to sleep. 

 

Thanks in advance for any suggestions 

 

Edited March 9, 2022 by ChessieCat
added topic title before merging with intro topic

[ChessieCat]

Two Introductions and a new topic (different forum) have been merged into member's second Introduction topic.

[ChessieCat]

10 hours ago, Leprechaun38 said:

I’m reducing 10% of dose every 1 or 2 months, depending on how I’m feeling. Now on 31mg.

 

Q:  How are you calculating your reductions?

 

2022, January - new cut from 37,5mg to 31mg

 

Your last reduction shown above was a 17.3333% decrease.

 

Why taper by 10% of my dosage?

Dr Joseph Glenmullen's WD Symptoms Checklist

 

SA's recommended taper rate is no more than 10% of the CURRENT dose (not the original/starting dose) followed by a hold of at least 4 weeks to allow the brain to adapt to not getting as much of the drug.

 

See:

 

Stability

 

WDnormal

 

And Brassmonkey talks more about it here:

 

tao-of-the-brassmonkey

 

10 hours ago, Leprechaun38 said:

So got back to 0.75 clonazepam at night.

 

Q:  How long have you been taking the clonazepam?  Do you take it every night?  Please list the dates that you have taken the benzo in the last 2 weeks.

 

It does not take very long to become dependent on a benzo.  Hi @Frogie can you follow up on this one please once member has advised their benzo usage?  Thanks.

 

[Leprechaun38]

Hi @ChessieCat

thanks for your return!

first of all, decided today going back to the dose 37.5 for not being able to manage this last cut

 

A1- for being easier for me cutting pills. Here in Brazil, we have 25mg the minimum dose. So I could cut 1 pill into 4 pieces. I went from 1 pill and a half to 1 pill and a quarter, which results in 31,25 mg, right?

 I was trying to avoid making liquid form myself. Didn’t think could make this difference to my brain adaption.

 

A2 - Taking clonazepam again since 2 or 3 weeks but not everyday. It’s been 4 days now taking everyday since my insomnia got worst.

 

Thanks

[Frogie]

@Leprechaun38

 

If you do not want to become dependent on the clonazepam, you need to stop taking it. If you take it everyday your body can become dependent on it in as little as 7 days.

 

[Leprechaun38]

Hi @ChessieCat

thanks for your return!

first of all, decided today going back to the dose 37.5 for not being able to manage this last drop

 

A1- for being easier for me cutting pills. Here in Brazil, we have 25mg the minimum dose. So I could cut 1 pill into 4 pieces. I went from 1 pill and a half to 1 pill and a quarter, which results in 31,25 mg, right?

 I was trying to avoid making liquid form myself. Didn’t think could make this difference to my brain adaption.

 

A2 - Taking clonazepam again since 2 or 3 weeks but not everyday. It’s been 4 days now taking everyday since my insomnia got worst.

 

Thanks

[Leprechaun38]

@Frogie

Hello! Thanks so much for your help. Last night I did not take benzos. Instead, I took some supplements to help me sleeping. I could sleep the whole night with 0.21 melatonin plus a mixture of passiflora, valeriana and avena dativa D1, that is, anthroposophical medicine. Do you think that is ok?

[Frogie]

@Leprechaun38

 

Just be careful with the Passionflower and Valeriana, they may have to be tapered also. But you could take it for a short time and see if that helps. I wouldn't take it for more than a week though.

 

Have you tried melatonin?

 

 

It seems to help a lot of members on here.

 

I'm glad to hear you are not taking the benzo anymore.

[Altostrata]

22 hours ago, Leprechaun38 said:

I was trying to avoid making liquid form myself. Didn’t think could make this difference to my brain adaption.

 

Please be prepared to taper more gradually. Usually, it's easiest with a liquid.

[Blossom71]

Hi @Leprechaun38

I was scared of making my own liquid too until I tried it.  It is really easy.

 

I am currently on 38.5mg sertraline so I put 50mg sertraline (crushed tablets)  in 50ml water and dissolve. Then i give it a good stir, take out 11.5ml using a syringe, then I drink what’s left. It’s much easier than trying to cut your tablets to the correct size.

[Leprechaun38]

@Altostrata

Yes, I will. Thanks! I couldn’t bear last drop by cutting pills. 

Yesterday, I finally found a critical psychiatrist in Brazil who recognizes antidepressants dependence and said he can also help me with that. We set a meeting for next Tuesday. I’ve been tapering for more than year. How long it may last until I get free from it? Hope long enough to be smoother.. Sorry, you don’t need to answer that. ❤️

 

I’ve heard about your story... Proud of you! If I survive from this hell, I want to help creating a peer support group in my country, just as you did, helping so many people 🍀

 

 

 

[Leprechaun38]

@Blossom71

Thanks for encouraging me! I will definitely do it ❤️

[Faure]

Hi @Leprechaun38, sorry to hear you have had nasty withdrawal symptoms. It does seem like a lot of hassle getting a 10% reduction, but it is easy to get used to once you start. I do my drops by grinding pills then weighing and putting capsules.  The first day I did this I thought I couldn’t possibly do this for 4-5 years! Very quickly it became easy and I can make up my week’s pills in 15 minutes now.
 

I’m doing the BrassMonkey slide which is 2.5% drops for 4 weeks then a 2 week hold (so still 10% reductions but over 6 weeks instead of 4).  I experienced short lived and mild WD symptoms for the first few months, now I’m 9 months in and barely get any. I have functioned well throughout and increased my workload very gradually. The meds made me so tired I couldn’t do even part time hours. The medication makes me very tired, but less so as it reduces. It is frustratingly slow and will take years, but better that than get ill from WD and have life come to a complete halt. I am encouraged by improvements in my energy levels and mood almost all the time. My mood is more stable on a lower dose than it ever was in the higher one! 
 

Let us know how you get on with your liquid taper ☺️

[Leprechaun38]

Hi @Faure

Thanks for your help! I’m very much convinced by now that in anyway, I shouldn’t drop more than 10% every 6 weeks. I will let you all know, guys, my next steps! 

 

Feeling better today 🌻

 

[ChessieCat]

the-brassmonkey-slide

 

This taper method is done over a 6 week period.  You can choose the rate (eg instead of 2.5% weekly for 4 weeks you could do 1% weekly for 4 weeks - see quote below).  The reductions are made weekly which allows you more control over your taper.  As with any taper it is best to hold on a dose for longer when needed.

  

On 4/23/2018 at 5:07 AM, brassmonkey said:

            Week 1 reduce 2.5%

            Week 2 reduce an additional 2.5% (for a total of 5%)

            Week 3 reduce an additional 2.5% (for a total of 7.5%)

            Week 4 reduce an additional 2.5% (for a total of 10%)

            Weeks 5,6 Hold at the last reduction level

 

[Leprechaun38]

@ChessieCat

Hi, good morning! If I use the @brassmonkey slide, I will finish tapering in 6 years time. Is that correct? 😳

 

As in my signature, I got back to my last dose after crashing in which I was holding for more than 2 months. 37,5mg

[ChessieCat]

10 hours ago, Leprechaun38 said:

I will finish tapering in 6 years time. Is that correct?

 

That sounds about right to me.  I used the microdose spread sheet (you will need to change the input when you click on the link) to calculate it using the following: 

 

37.5 is the starting dose, 42 is the number of days in the cycle (= 6 weeks) and 10 is the % reduction for the cycle:

 

14-Mar-2022

37.50

42

10

 

Last dose / date

 

0.0054

10-Nov-2031

 

However, it is better not to stick to a calendar to get off your drug but to listen to your symptoms/body and hold when needed, eg if you are sick or there is additional stress.  The idea is to get off with minimal discomfort so that you can live your life as normally as possible.

 

If we have it in our mind that we will be off by a particular date, it can be very disheartening and cause impatience if that date needs to be changed.

 

It is better to think of it as an approximate date but remind yourself that it might not be the definitive date.  We have members of SA who have tried to go too fast and it has ended up taking longer than if they had just done a steady taper.  Some have ended up on an additional drug which they then have to taper.

 

Patience is very much needed but it can be very hard.  I found it helpful to post about my frustrations and indecision.  Writing it down helped to get it out of my head and other members would post and provide encouragement.

 

 

Edited March 13, 2022 by ChessieCat

[Leprechaun38]

Hi guys, showing up to say I am better, got back to my Withdrawal normal symptoms,  that I could stop taking benzos, it’s been around 2 weeks, and started taking melatonin pills 0.21mg. But once again having sleeping problems. Isn’t a too low dose?

 

what are your experiences with it?

thanks again 

[Altostrata]

2 hours ago, Leprechaun38 said:

that I could stop taking benzos

 

@Leprechaun38 when were you taking benzos? What benzos, what dosage, how often? Did you just stop taking them?

[Leprechaun38]

Hi @Altostratathanks for getting back to me. I started having really bad insomnia about four months ago, then I decided taking clonazepam every other day when I couldn’t sleep. Began with 0,25mg, then when it stopped working, increased to 0,5mg and finally 0,75mg last month. That was a huge mistake! Some days it helped, but to be honest, it messed up my sleep and my days after. 

 

I don’t want to take benzos anymore! But the worst withdrawal symptom while tapering  from sertraline is definitely not being able to sleep the whole night. I feel miserable weak, it’s kind of unbearable because I work and have a son to take care of.. 

 

About three weeks ago, I had a severe crisis and stopped taking benzos. I knew it was being harmful. And decided taking melatonin instead. It did help me. I began sleeping better, but it’s been two days now with insomnia again. 

That’s why I ask about melatonin dosage. 

 

 

[Leprechaun38]

Hi guys! Passing by to say that I found out I got dependent on clonazepam too, unfortunately, as I was taking it not every day but 3 or 4 times a week since the end of last year because of the sleeps problems I had with sertraline’s withdrawal. I wanted to solve a problem creating a new one.

 

About 1 month ago I stopped taking benzos at once believing I wasn’t dependent. However, as I told you in the messages above, even taking melatonin and valeriana for 2 weeks, I kept having hard sleep problems. Then, talking to my doctor he said I had to reinstate clonazepam and tapper it gradually. So, besides reinstating sertraline up to 50mg, I did it for clonazepam, and I’m now taking 0.5mg before sleeping. He said I should taper first clonazepam, cutting 0,1mg every two weeks. 

But, I’m now very afraid of taking this step since my nervous system is too sensitized for any change and I started feeling somewhat stable again. I held, then, 0,5mg for 3 weeks.

 

Should I start tapering clonazepam even so, or hold a while?

 

The thing is that I hadn’t read about reinstatement before, and after doing and reading about it here, it seems to me that I have a bit of akathisia, too many thoughts and need for movement all the time, and it’s probably due to reinstating sertraline above the dosage recommended, from 31mg to 50mg. Probably too much. 

 

Thanks for for any suggestions. I have an appointment today with my prescriber. I’ve also read here in other section about changing clonazepam for diazepam. Why is that?

 

Best wishes for all