dreamstate: 6 weeks cold turkey - reinstating

[dreamstate]

Topic title:  5 weeks later...BAM. Suddenly super depressed

 

Summary of history with ssris

--------------------------------------------------

-was on multiple SSRIs for 5 years(celex,welbutrin,effexor).

- stopped everything cold turkey and stayed off everything for 7 years.

-started again in Feb 2018 on sertraline and got up to 200mg over the course of 18 months.

-gradually stopped taking it over 3 months span (dosing once every 2 days, eventually once every 3 days, then cold turkey )

 

Current situation and my 2 options:

------------------------------------------------------

I'm on week 5. I relatively fine and hopeful...

Then all of a sudden BAM......I went from mildly depressed to suddenly feeling heavily depressed and lethargic.

 

OPTION A)   Wait until Appointment october 3rd(cannot get sooner) ask doctor to go back on smaller dosage 50mg.

 

OPTION I still have script of 200mg at pharmacy for 5-6 months.  Should I just hop on this big dosage?

 

 

I just am curious about your personal opinions. Dislaimers aside. What would you do if you were me?

Edited September 4, 2019 by ChessieCat
added topic title

[dreamstate]

Summary of history with ssris

--------------------------------------------------

-was on multiple SSRIs for 5 years(celex,welbutrin,effexor).

- stopped everything cold turkey and stayed off everything for 7 years.

-started again in Feb 2018 on sertraline and got up to 200mg over the course of 18 months.

-gradually stopped taking it over 3 months span (dosing once every 2 days, eventually once every 3 days, then cold turkey )

-I felt great until exactly at the 5th week mark and everything suddenly became hundred times worse.

 

My symptoms

----------------------------

I feel I'm in a bad dream, feels like i'm not in my body, i have a constant headache and pressure behind my eyes,

I feel like I have a heavy burden on my shoulders, the world feels darker, afraid of going outside, EXTREMELY impaired mentally,

very lethargic. I can't do anything.

 

Plan

-------

Went to pharmacy and got my 200mg sertraline capsules(powder inside, not beads).

Gonna try to aim and aproximate 12-20dmg dose.

 

 

I just am curious about your personal opinions. Dislaimers aside. What would you do if you were me? It's been 6 weeks since day I went cold Turkey.  

[Gridley]

Welcome to SA, dreamstate.  

 

The symptoms you describe are typical withdrawal symptoms.

 

What is withdrawal syndrome.

 

Glenmullen’s withdrawal symptom list.

 

What you're talking about is reinstatement.  The only known way to reduce withdrawal symptoms is to take a small amount of the drug which the brain has adapted to, in your case Sertraline.  At six weeks out, you are within the 3-month window during which reinstatement predictably works.

 

SA recommends a small dose.  It is better to start with a small amount and increase if needed than to risk taking too much.  The 12-20mg range you mentioned sounds about right.  You need to take the same dose every day.

 

Please carefully read Post #1 of this topic:  About reinstating and stabilizing to reduce withdrawal symptoms

 

This link is specifically about tapering Sertraline, including how to measure your doses-- basically either making a liquid from your powder or weighing the powder.  Many members use the AWS Gemini-20 scale, available on Amazon.  These more precise measuring methods are more consistent  than "eyeballing" it.  

 

Tips for tapering off Zoloft (sertraline)

 

It takes about 4 days for a dose to get to full level in the blood and a bit longer for it to register in the brain.  You may feel some improvement after a couple of days, but it can take weeks or longer to stabilize.  It's a good idea to take daily notes on paper of your symptoms to monitor how reinstatement is working for you.

 

The idea of reinstating isn't to get rid of withdrawal symptoms completely but to bring them to a bearable level.

 

After you have stabilized, you can begin a safe 10% of current dose taper down to zero.

 

 http://survivingantidepressants.org/index.php?/topic/1024-why-taper-by-10-of-my-dosage/

 

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

 

 

 

 

 

[dreamstate]

Gridley , you have NO IDEA how much I appreciate your thoughtful response!! It gives me Hope.. I'm gonna devour the information you've included. THANK YOU SO MUCH!!!

 

Same goes to anyone else who has anything to share, I would greatly welcome your inputs.

[dreamstate]

I took  12-20mg (eyeballing) about 2 hours ago. I am perplexed because I feel ALOT better right now.  It went from totally unbearable to feeling very bearable.

 

Is this even possible?

[ChessieCat]

This is what happened to me.  I was taking 100mg Pristiq and 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.  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.

 

 

 

Please create your drug signature using the following format.   Keep it simple.  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

 

 

[Gridley]

29 minutes ago, dreamstate said:

It went from totally unbearable to feeling very bearable.

 

dreamstate, that is fantastic that you're feeling better!

 

[dreamstate]

1 minute ago, Gridley said:

 

dreamstate, that is fantastic that you're feeling better!

 

Thank you so much Gridley!  I will report tomorow. If I retain even 25% of the improvement, I will be super happy!

[dreamstate]

12 minutes ago, ChessieCat said:

This is what happened to me.  I was taking 100mg Pristiq and 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.  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.

 

 

So awesome Chessie. I love it !! Thank you for sharing with me. *crossing fingers* that I wake up with this improvement tomorow

[dreamstate]

I don't have a scale yet but I'm tempted to stay on 20-25mg for a very long time.

Can I just take 1 capsule 100mg and dilute it in 1L of water then drink 1/4 of the bottle everyday(after shaking well)  ?

The reason I'm asking is I'm in financial trouble atm.

[Gridley]

13 minutes ago, dreamstate said:

Can I just take 1 capsule 100mg and dilute it in 1L of water then drink 1/4 of the bottle everyday(after shaking well)  ?

 

I've never done liquid so I'm not the best person to answer.  There are certain protocols you need to follow about the ratio of powder to liquid and how to use a syringe to get a precise measurement and how long you can keep the homemade liquid in the refrigerator.  Some people don't do well on liquids.  

 

I'm going to bring this to the attention of the other mods so someone more expert in this area can answer you.

[dreamstate]

3 minutes ago, Gridley said:

 

I've never done liquid so I'm not the best person to answer.  There are certain protocols you need to follow about the ratio of powder to liquid and how to use a syringe to get a precise measurement and how long you can keep the homemade liquid in the refrigerator.  Some people don't do well on liquids.  

 

I'm going to bring this to the attention of the other mods so someone more expert in this area can answer you.

 

Truly grateful to you gridley!   At most I expect to keep the solution 4 days( drinking 1/4 of bottle per day)

[brassmonkey]

Hi Dreamstate-- It's a good plan, but with one drawback, Sertraline doesn't dissolve well in water.  You could do a suspension of the powder in water, but you would have to mix it very well each time you use it to make sure nothing has settled out.  It is an accepted method and plenty of people use it.  I would use a smaller amount of water to assure a more even distribution of the powder.

 

There is an alternative, Sertraline dissolves at a rate of 5mg/mL of ethanol. So if you can get some grain alcohol or "Everclear" you could dissolve one capsule of powder in 4 teaspoons of liquid (20mL).  If you can only get regular vodka you would have to use 8 teaspoons per capsule.  Let it stand overnight to fully dissolve, and don't worry about the stuff that settles to the bottom, it's just fillers.  Doing this 1tsp (5mL) would give a dose of 20mgai for the grain alcohol, and 2tsp (10mL) would give a dose of 20mgai for the vodka. This would be using a proper kitchen measuring spoon filled to the rim, not the most accurate but should work in this case.

 

Hope that helps.

[dreamstate]

23 minutes ago, brassmonkey said:

Hi Dreamstate-- It's a good plan, but with one drawback, Sertraline doesn't dissolve well in water.  You could do a suspension of the powder in water, but you would have to mix it very well each time you use it to make sure nothing has settled out.  It is an accepted method and plenty of people use it.  I would use a smaller amount of water to assure a more even distribution of the powder.

 

There is an alternative, Sertraline dissolves at a rate of 5mg/mL of ethanol. So if you can get some grain alcohol or "Everclear" you could dissolve one capsule of powder in 4 teaspoons of liquid (20mL).  If you can only get regular vodka you would have to use 8 teaspoons per capsule.  Let it stand overnight to fully dissolve, and don't worry about the stuff that settles to the bottom, it's just fillers.  Doing this 1tsp (5mL) would give a dose of 20mgai for the grain alcohol, and 2tsp (10mL) would give a dose of 20mgai for the vodka. This would be using a proper kitchen measuring spoon filled to the rim, not the most accurate but should work in this case.

 

Hope that helps.

 

Thank you for taking the time to explain this to me. I really appreciate it.  It looks like I will have to mix it with ALOT less water. Maybe 200ml and drink 40ml at a time(after shaking it violently for a good 30 seconds). I would use alcohol but I my stomach cannot tolerate it and I used to be an alcoholic(I fear the taste would be a trigger I can't risk it).

 

If anyone has any objections to me mixing 100mg pill of sertraline in a 200ml of water and shugging 40ml at a time, let me know.

Not to say I won't get the scale, I have no choice to buy it when the time comes to increase/decrease dosage. I'm just hoping I can get by on 25mg/day of sertraline atm.

[brassmonkey]

I had a feeling about the alcohol, but wanted to throw it in for general reference. Mixing alcohol and ADs isn't a good idea anyway, but for some of them it's the only chemical that does the trick. There is a product available on line and through some drug stores called "Oraplus".  It is a thick liquid designed for making suspensions.  Mix it really well and the powder doesn't settle out.  You mentioned financial concerns so that might exclude it, but it's out there.

 

Your plan for using 200mL of water sound fine, but I think you would have to drink 50mL to get a 25mgai dose, not the 40mL that you mentioned in your last post.

[dreamstate]

5 hours ago, brassmonkey said:

I had a feeling about the alcohol, but wanted to throw it in for general reference. Mixing alcohol and ADs isn't a good idea anyway, but for some of them it's the only chemical that does the trick. There is a product available on line and through some drug stores called "Oraplus".  It is a thick liquid designed for making suspensions.  Mix it really well and the powder doesn't settle out.  You mentioned financial concerns so that might exclude it, but it's out there.

 

Your plan for using 200mL of water sound fine, but I think you would have to drink 50mL to get a 25mgai dose, not the 40mL that you mentioned in your last post.

 

oh thanks brass.  Haha such as an easy calculation but seems like I'm unable to overcome the brain fog lol

 

 

[dreamstate]

update:

 

I definitely feel as good as yesterday since reinstating sertraline. Mainly the depression lifted by 80%.

Remaining current symptoms are: insomnia at night, no motivation to work or concentrate, lethargy/brainfog especially after eating.

 

Interestingly, the tiredness almost vanishes after 6pm. It's been like this for as long as I can remember.

I did eyeball 1/4 of the 100mg capsule as best as I could. I'm hoping that by ingesting 1 x 100mg pill within a

span of 4 days that my dosage averages out(probably deviation +- 5-10mg/day since I can't be exact). One thing for certain is I will not consume the 100mg any sooner or later than within 4 days.

[Gridley]

12 hours ago, dreamstate said:

I definitely feel as good as yesterday since reinstating sertraline. Mainly the depression lifted by 80%.

Remaining current symptoms are: insomnia at night, no motivation to work or concentrate, lethargy/brainfog especially after eating.

 

That is great news, dreamstate.  The reinstatement is working.

 

 

 

 

[dreamstate]

updated signature. Forgot that I took Citalopram 20mg for 3 months back in 2017.

 

For the future(when I reach 7 days at 25mg by next wednesday), I'm considering upping the dosage to 33mg to see if it can help abit with the remaining symptoms and SAD. An added bonus would be that is is easier to split 1 capsule in 3 parts than it is into four parts(when you don't have a scale). These past 6 weeks made me realize that I don't want to go to zero either if that means that my original depression/anxiety returns but I also never want to go back to 100mg+ dosages as I did not feel any better then I do right now.  I just want to be at the lowest dose possible while retaining the most benefits possible against my GAD,SAD and depression.

 

I realize this is a forum for those people wanting to quit SSRIs for good; however, I also feel like I got better results/advice then I would have had from my doctors/pharmacists who live in denial about the situation.  In fact, the pharmacist told me to reinstate immediately at 100mg for one week and then jump back to 200mg. If it weren't for this website, I would probably be feeling SEVERELY impaired,confused and dealing with a plethora of side effects from such a sudden massive dosage. The maximum I would ever consider again is maybe 50mg depending on how I feel.

 

Please do not hesitate to leave any comments/advice. Thank you all in advance.

[Gridley]

37 minutes ago, dreamstate said:

'm considering upping the dosage to 33mg

 

I'd recommend you stay with the current 25mg.  Going to 33mg is a 30% increase and could overwhelm your system.  It is tempting to tinker with your dose but also quite risky.  Your system is very sensitized and if you take too much, you can destabilize it.  It can be difficult to restabilize if this happens.   Remember, the goal of reinstatement is not to eliminate withdrawal symptoms but to bring them down to a tolerable level.  To put it colloquially, I wouldn't rock the boat.  If at some point in the future you want to updose a small amount (not 30%) that option will remain open to you.  But give 25mg a chance to do its job.

 

It still may take some weeks or months for your nervous system to settle down. You probably will continue to have waves and windows, but symptoms won't be as intense. That is to say, your remaining symptoms could fade as time passes.

 

Regarding not going to zero, you are free to taper down as far as you are comfortable with.  Already your drug burden is much less than when you were on 100mg.

[dreamstate]

20 minutes ago, Gridley said:

 

I'd recommend you stay with the current 25mg.  Going to 33mg is a 30% increase and could overwhelm your system.  It is tempting to tinker with your dose but also quite risky.  Your system is very sensitized and if you take too much, you can destabilize it.  It can be difficult to restabilize if this happens.   Remember, the goal of reinstatement is not to eliminate withdrawal symptoms but to bring them down to a tolerable level.  To put it colloquially, I wouldn't rock the boat.  If at some point in the future you want to updose a small amount (not 30%) that option will remain open to you.  But give 25mg a chance to do its job.

 

It still may take some weeks or months for your nervous system to settle down. You probably will continue to have waves and windows, but symptoms won't be as intense. That is to say, your remaining symptoms could fade as time passes.

 

Regarding not going to zero, you are free to taper down as far as you are comfortable with.  Already your drug burden is much less than when you were on 100mg.

 

Thank you for this.  How long should I hold at a particular dosage before considering a small increase and how much should an increase look like?

[Gridley]

8 minutes ago, dreamstate said:

How long should I hold at a particular dosage before considering a small increase and how much should an increase look like?

I would give it three months at the current dose.  If you decide to increase, I wouldn't go any higher than 27 or 28mg.

[dreamstate]

6 minutes ago, Gridley said:

I would give it three months at the current dose.  If you decide to increase, I wouldn't go any higher than 27 or 28mg.

Thank you very much. I will heed your advice 100%.