LauraC: Zoloft / sertraline withdrawal symptoms

[LauraC]

Hi everyone,

I’ve just come across this website and sounds like there is some great forums and support. So hoping for some guidance and assurance! So I’ve taken 100mg of Sertraline for approximately 10yrs. Initially prescribed for post natal depression and anxiety. While on medication I experienced a traumatic incident, therefore medication was increased to support with the depression and PTSD. I’ve attempted to taper off Sertraline before, without success. I had recently forgot to collect my prescription and after around 3 days of no medication. I thought it could be an opportunity to cold turkey from the medication. I am now on day 7 and having the worst withdrawal symptoms ever! Feeling tired, headaches, brain zaps, feeling so irritable! I’m awful to be around! And so emotional, just breaking down and sobbing. I feel helpless and and so low. I’m being irrational and not being thinking straight at all. Now I suppose my query is, has anyone else experienced this, how long for, is it worth trying to hang in there? How long does this awful feeling last? I’m a senior manager at work and need to be focused, I can’t take time out either, it’s a new promotion. Any support or advice you can give would be greatly appreciated! Thank you everyone 😊

[ChessieCat]

Hi Laura and welcome to SA,

 

It's really good that you have found SA so soon after stopping your sertraline.  What you are experiencing are common withdrawal symptoms.  Dr Joseph Glenmullen's WD Symptoms Checklist

 

The only known way to reduce withdrawal symptoms is to take some of the drug which your brain has adapted to.  The sooner this is done the better chance there is of reinstatement being successful.

 

Please do not take the last dose your were taking because it might be too much and could make things worse.  It is better to start with a lower dose and increase by a small amount if necessary.  Please see Post #1 of this topic:  About reinstating and stabilizing to reduce withdrawal symptoms

 

If you stopped taking 100mg 1 week ago, then you could try taking 50mg.  It takes about 4 days for a dose to get to full level / steady state in the blood and a bit longer for it to register in the brain.  You will need to be patient during this time.  Stabilising takes time and it can happen in a windows and waves pattern.  We recommend that you keep daily notes of your symptoms so that you can be more objective about how reinstatement is affecting you.

 

Tips for tapering off Zoloft (sertraline)

 

This is what happened to me.  I was taking 100mg Pristiq and because it is only available in 50mg and 100mg doses I started taking 50mg.  Over a 2 week period my brain fog got worse and worse and even walking took my full concentration.  It was at this time that I researched and found SA.  They suggested that I increase my dose but I wanted to find out more about what they were suggesting and of course the brain fog made it difficult to take in the information I was reading.  However, a couple of days after joining SA I was unable to type.  I have been a professional typist for 40+ years so I knew something was wrong.  I decided to take extra Pristiq and after only about 4 hours I was able to type again and the brain fog was lifting.  I had a benchmark so I had proof that it was the lack of drug that caused the brain fog and inability to type.  The difference was like night and day.  I also knew that there was no way that this was wishful thinking etc.

 

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

[Dejavu]

Hi, Laura, and welcome from me as well. You will find a wealth of support and guidance here. Chessie Cat has already given you the best advice, and I would like to add that, if you do not reinstate a small amount of sertraline, your symptoms will likely worsen before they improve. And we are talking months or even longer to see improvement. To avoid that, the best course of action is to reinstate, wait to stabilize, and then begin a slow gradual taper.

 

We have a much-beloved member who goes by Rosetta. She cold-turkeyed, and unfortunately by the time she found this forum, it was too late for her to reinstate. She has been battling withdrawal symptoms for about 2.5 years now. Here is her advice: 

 

"However, I would like to add my voice here and say two things that I feel are important:

1. You will in all likelihood get better - much better, and

2. If a moderator suggests that you reinstate, please read thehorror stories of those of us who did not have that chancebefore you decide that you "do not want to go "backwards."

 

I made the same mistake you did. I fast-tapered 50mgs of sertraline over 3-4 weeks. Bottom line: I was literally bedbound for 4 months, with about two dozen symptoms. After reinstatement, I am slowly beginning to stabilize, and will begin my taper soon. 

 

Let us know what you decide to do, and we will help you along the way. If you do decide to reinstate - and I hope you do - please do not jump around on the dosage. This will cause even more dysfunction, as the brain craves stability. If your dosage needs to be adjusted, we will help you do that safely. Please do your best to respond fully to any requests for information we make. There is a reason we are asking.

 

Again, welcome. We are glad you're here and will help you any way we can. 

 

 

 

Edited August 18, 2019 by Dejavu

[LauraC]

Hi, thank you for your advice. I feel a bit silly doing this to myself! I should have known to do it on a gradual basis. I just hate being in them so much! I can’t manage these symptoms so will need to reinstate it. So I have access to 100mg, could I simply cut the tablet in half to make it 50mg. And then are you saying to remain at 50mg or build back up to 100mg? In your experience how long do you remain at that dose to stabilise before tapering off again? I previous tapered with drs guidance and I remember feeling terrible so ended up with the same dose! I really want to succeed at this so if it’s a real gradual taper then that’s what I will do. I certainly know I can’t do cold turkey and I feel so sorry for my family, I have been awful these past few days. My poor 10yr old, thinks he has done something wrong, I can’t have that so need to find a way of making it work. Thanks for you advice and support

[Dejavu]

Most, if not all of us, are here because we followed medical advice. Unfortunately, doctors know almost nothing about withdrawal and in fact, many do not acknowledge that it exists beyond a few weeks after stopping. So you are in good company here.

 

I am sending several links below that will help explain exactly what is happening, and the safest way to move forward. But in a nutshell, we recommend you reinstate at 50mg and hold steady at that dose until you achieve stability. After you've reinstated, we may ask you to post your daily symptoms so that we can help you determine whether the 50mg is working, or whether you need to increase. But any increase would be a very tiny amount (think single milligrams or less). These drugs are powerful, and a little goes a very long way, especially in a body that has already been destabilized by withdrawal. Reinstating too high a dose can often make matters worse. We are all about a harm reduction approach to getting off these meds, and slow, steady and stable has been shown to yield the best results. 

 

To begin your reinstatement, you can indeed halve your 100mg tablets, but I would highly recommend using a pill cutter to achieve the best accuracy. If you can obtain 50mg tablets, all the better. After you've stabilized and are ready to begin your taper, you have three options: (1) purchase a scale to cut and weigh your pills; (2) ask your doctor to prescribe liquid zoloft; or (3) make your own liquid by dissolving the tablets in water. Because my doctor does not recognize the need to taper slowly, I have chosen not to disclose that I am tapering. I therefore make my own liquid because my insurance does not cover liquid sertraline. It's actually quite simple to do. Whichever method you choose, we can help with math and tapering schedules. But that's a bit down the road at the moment. Right now your priority is reinstatement and stabilization. 

 

Please read these links and let us know if you have any questions.

 

https://www.survivingantidepressants.org/topic/7562-about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms/

 

https://www.survivingantidepressants.org/topic/82-the-windows-and-waves-pattern-of-stabilization/

 

https://www.survivingantidepressants.org/topic/1024-why-taper-by-10-of-my-dosage/

 

[Sassenach]

Hi Laura

 

Welcome and from an expat yorkshireman.

 

Dejavu has given you great advice.

I waited three months to reinstate and really wished that I had done it sooner.

I am now slowly stabilsing thanks to the advice on this site.

 

Sassenach

[LauraC]

Hi everyone, thank you. If I had not come across this site, I most likely would have continued to go cold turkey. So following advice from the forum, I thought it was best to reinstate. The withdrawal symptoms were too much! I spoke with my Dr and pharmacist this morning about the medication and asked if I could get 50mg tablets. However they both recommended that I reinstate the full 100mg, which I have done. I still feel quite unwell and my anxiety appears to have increased, which wasn’t a withdrawal symptom. However I do feel slightly better already! I will hopefully stabilise on this for a good few mth before I begin to taper. I read the guidance links and they were really useful about tapering and much slower than my dr previously advised. Hopefully I will be successful in the future 

[Sassenach]

Hello Laura

Full dose reinstatement is the only answer the medical profession knows.

You should start at 50 mg at least for the first few days.

Your body will know within 4 to 7 days whether this dose is enough.

If it is not enough you can always updose you will have lost nothing.

It is not worth the risk of kindling.

Keep in touch.

Sassenach

[ChessieCat]

I agree with what Sass has suggested.

[Dejavu]

Personally, I feel you're making a mistake reinstating the full amount. I hate to see you go down the path I did, because it cannot be undone. Ten months after reinstatement, I'm still not completely stable. I hope it turns out differently for you than it did for me. But it does not bode well that you're now experiencing an uptick in anxiety. 

 

23 hours ago, Dejavu said:

Most, if not all of us, are here because we followed medical advice. Unfortunately, doctors know almost nothing about withdrawal and in fact, many do not acknowledge that it exists beyond a few weeks after stopping. 

 

The mods on this site have guided many, many, many people successfully through this process, and while we are not doctors, the advice we give is based on what we have seen firsthand over and over again. The decision is yours, of course. But given my experience, I would feel personally remiss if I did not try to warn you that things could get much worse on such a high dose. There is no way to know, which is why it's best to start low and increase if necessary.   It is not too late to go back to 50mg at this point if you change your mind. 

 

Whatever you decide, please keep us posted.

[ChessieCat]

From Post #1 of the reinstatement topic:

 

On 10/9/2012 at 10:17 AM, Altostrata said:

 

These drugs are vastly more powerful than they need to be; often reinstatement at half dosage AT MOST is sufficient and many people do well with a lot less. You want to be taking only the lowest dose EFFECTIVE to reduce withdrawal symptoms.

 

 

 

On 10/9/2012 at 10:17 AM, Altostrata said:

 

Often a partial dose will relieve withdrawal symptoms. If, for example, you were taking 20mg Paxil and quit rapidly or cold-turkeyed only a few days ago, 5mg may be enough. After trying the lower dose for a week, you can always increase if you feel you need more.

 

 

 

On 10/9/2012 at 10:17 AM, Altostrata said:

 

Experiencing withdrawal may have sensitized you to drugs and a larger dose may cause an outsized adverse reaction.

 

 

 

[Sassenach]

Hi Laura

 

I suspect you are falling into the trap og believing the NHS is always right. Mostly it is.

It has however admitted that its information on these drugs is " incorrect ", see "in the news forum".

If you experience a further increase in anxiety and wish to lower the dose, get in touch and I will explain your rights under the NHS and the ongoing care requirement.

 

Sassenach

 

 

[LauraC]

Thank you, I will go back to 50mg today, why would they only advise this option, if it’s not good? Obviously they need to be more aware of withdrawal from anti depressant. What is kindling? 

[ChessieCat]

Please read Post #1 of the reinstatement topic.  It contains a lot of information and may answer your question/s.

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

Not many medical professionals understand and/or know about tapering, withdrawal and adverse reactions to psychiatric drugs, which is why this site exists.

 

Gwen Olsen was a pharmaceutical representative for 15 years.

 

Video:  Ex-Big Pharma Rep:  We’re Trained To Misinform -The Drugs ARE Dangerous (6 minute video)
 

Video:  Ex-Big Pharma Rep:  Manipulating Doctors to Sell More Drugs (10 minute video)

 

Interview:  Confessions of an Rx Drug Pusher (51 minutes Gwen Olsen - ex pharmaceutical representative)

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.  

 

Edited August 21, 2019 by ChessieCat

[ChessieCat]

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.

 

 

[Sassenach]

Hi Laura.

 

Kindling happens when your CNS ( central nervous system ) is in disarray, usually because of too fast a taper or cold turkey.

Doctors are taught to immediately reinstate the original at full dose.

The CNS takes time to adjust so there is a delayed effect as it starts to climb down after the cessation, the reinstatement begins by trying to lift the drug level.

Your CNS is basically on a rollercoaster it cannot cope with.

It will become Kindled and it is a very long process to try and resolve.

Doctors then make the matter worse by giving more drugs, often benzos to try and alleviate the symptoms.

This is why so many of us were urging you not to fully reinstate, we have seen it so many times before.

Chessie has given you a lot of links above which will help you to understand what is happening to you, they are important reading as knowledge is definitely important on this subject.

I will get back to you later today with requests that will help us to see you through this.

 

Sassenach

 

[LauraC]

Hi everyone,

 

thank you for the advice, it’s a shame that drs are not issuing this advice rather than just going back to the full dose. I have returned to 50mg after day 2. I am still feeling quite anxious and restless but my withdrawal symptoms have gone. I am also struggling to sleep, and feel generally tired and lethargic. I am confident I will feel better in time though. The dr is still eager for me to go on 100mg. I am really annoyed at myself for thinking I could have done a cold turkey. I have caused all this for nothing really, I feel worse than I did before but it’s a lesson learnt! Thank you so much and I will give the advice a read 

[ChessieCat]

If you hadn't gone cold turkey you wouldn't have found this site.

 

What might have happened:  You might have told you doctor that you wanted to get off your drug and they may well have advised a taper which is much faster than SA's recommended harm reduction approach.  If you got withdrawal symptoms you/doctor may not have realised that it was withdrawal.  From other members' experiences when this happens there are several different things which may happen.  The person is told that it is their original condition returning, told that they need the drug for life like a diabetic needs insulin (that's what I was told by a psychologist), it is in their mind so they need psychiatric treatment, they are put back on too high a dose of the same drug, they are changed to a different drug (which may or may not cover the withdrawal of the original drug), they may be put back on the original drug with additional drug/s added.

 

So even though it was not good that you cold turkeyed, the other possibilities are much worse.  At least now you are on a much lower dose than you were and you have the knowledge to do a careful taper once you stabilise.

 

Unfortunately stabilising may take several months during which time you will most probably have ups and downs with your symptoms, but remember that it is better to start from good stable foundation before you taper.

 

It is a good idea to keep a record of your symptoms, rating them, so that if you start doubting the process you can look back and see the difference and be objective about it. 

 

There are some different options (print and computer) for recording your symptoms here:  Dr Joseph Glenmullen's Withdrawal Symptoms

 

When we are feeling bad (eg like when we have the flu) we can't always notice that we are feeling a bit better than we were are the beginning.  I've also found it helpful to compare how I am feeling now with how I was feeling at my worse, instead of comparing it with how I was feeling at my best.

 

We also strongly recommend learning and using non drug techniques.  These are no only helpful now but can be helpful for life in general when you are off your drug.

[Sassenach]

Hi Laura

 

How are you feeling?

 

Sassenach

[Giulietta]

Hello Laura.

 

Welcome to SA from just over the pond.

 

When I stopped cymbalta/duloxetine CT last year (bad advice from the MD before I learned of SA) - I made the mistake of reinstating the full dosage (more bad advice from the MD before I learned of SA). I wish I had not gone back to the full dose. I didn't know that these drugs are so potent - and that only a portion of the full dose would have alleviated my withdrawal symptoms. When I started a taper 3 months after full reinstatement - my taper journey did not start auspiciously. After a few months - it started to stabilize.  😉

 

 

 

 

[LauraC]

Hi,

thank you, I am feeling much better. Still quite tired but generally feeling good. I will see how I go with the 50mg and speak with the Dr about increasing if needed as I still feel anxious. But for now I’m sticking it out at 50mg. Thanks 

[ChessieCat]

5 minutes ago, LauraC said:

I will see how I go with the 50mg and speak with the Dr about increasing if needed as I still feel anxious.

 

It can take time for things to settle down after cold turkeying a drug and reinstating.  If you mention to the doctor about increasing your dose they will probably tell you to take 75mg or 100mg.  They tend to think in terms of tablet amounts and therapeutic doses.  SA prefers "lowest effective dose".

 

If you do decide that you want to increase please let use know.  We will suggest a very small increase.