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Artistic1: Zoloft taper - looking for advice and support

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Artistic1

I was on Celexa 20 mg. for 10 months in 2015 for generalized anxiety disorder and mild/moderate depression, which hit me suddenly at age 65. Felt good enough to taper off over 32 weeks with no withdrawal problems, but 6 months after last dose, symptoms of anxiety and depression were back with a vengeance. Started Zoloft 25 mg in 2017 (probably should have gone back to Celexa). Increased dose to 50 mg within 4 months. Didn't like the way it was/wasn't working and didn't want to increase the dose. I'm really fearful of what these drugs can do. Tapered down to 12.5 mg over 19 months by 3.125 mg increments. Felt good until I hit 12.5 mg, then felt terrible and had to go back to 25 mg in August, 2019. Admittedly, I wasn't consistent in the tapering intervals. Some were 4 weeks, 12 weeks, 6 weeks, etc. depending on how I felt at each dose. 

 

I have been with a CBT therapist since 2017 which has really helped. Anxiety practically gone, depression is mild, but not like before. I really want to be off the Zoloft. Haven't slept well in 4 years and worry about what it's doing to my sleep patterns and who knows what else. I take supplements to help - phosphatidylserine, magnesium, omega fish oil.

 

So.....I am now tapering again. Went from 25 mg to 21.875 over 10 weeks (decrease of 3.125 mg because that's the easiest way to cut my pills into quarters and eighths.) Just reduced again to 18.75 on April 14 and plan to stay there for 10 weeks. (My theory is it can take 4-12 weeks for an INCREASE in the dose to start working, so the reverse could also be true.) I think I'm sensitive to small changes in the doses.

 

My question is  -  is 3.125 mg too large of a taper?  I can slice my pills smaller with a scalpel if need be. Looking for advice about how to make this taper work so I can be successful this time. Any recommendations for doses and time line would be helpful. I don't care how long it takes, although at age 71, I don't want to take forever!

Thanks so much!

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Gridley

Welcome to SA, Artistic1.  I'm glad you're having success with CBT.  We're happy to help you with your Zoloft taper.

 

Our general recommendation is to taper no more than 10% of current dose every four weeks.

 

Why taper by 10% of my dosage?

 

At this stage of your taper,  the taper of 3.125mg over ten weeks is well within those guidelines.  However, as your dose gets smaller at some point you'll be going too fast if you stay with a straight 3.125mg cut each time.  Another problem with decreasing by a straight cut accelerates the percentage of your dose that you would be decreasing each time, making it rougher and rougher with each drop.  By contrast, decreasing by a percentage decelerates the amount of each drop and makes things gentler on your system.

 

As you said, you could slice you pills smaller, but as you get lower it's going to be more difficult to do this and get consistent and accurate doses using pill cutting as your method.  This will become especially important when you get to the low doses.  Something like 85% of the drug's effectiveness happens in the first 10mg, so making even a small change can have a big effect symptom-wise.

 

Alternatives to pill cutting are using a digital scale (which is what I've been doing) to decease by 10%, using liquid Zoloft or making your own liquid.  Please read through the following link on tapering Zoloft, which includes how to use these tapering methods.  

 

Tips for tapering off Zoloft (sertraline)

 

Please let me know any questions you have.

 

You're already taking magnesium and omegas, which are the only supplements we recommend, since our systems are sensitized during withdrawal.  Regarding the phosphatidylserine, you might want to research a bit.  I was on it for a while for cortisol surges, then read that you're not supposed to be on it longer than a certain number of months.  Information is sketchy on the Internet about this limit (and I couldn't rewind the source when I looked again).  In any case, I stopped taking it just out of caution.

 

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

 

 

 

 

 

 

 

 

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Artistic1

Thank you for your reply, Gridley. I read through many of your posts and am awed by all that you've accomplished. 

 

I looked at the links you provided - those were helpful. I will see about getting the liquid form of Zoloft from my doctor. That sounds like the easiest way to get an accurate 10%. However, if I use a digital scale, do you discard the part of the pill that you don't use? I think I read that cutting the pills can reduce the effectiveness of the parts not used.

 

I also read about not taking phosphatidylserine for more than a few months. I've been on it for about 1 1/2 years. Should probably taper off that, although it REALLY helped with the cortisol surges, and I don't have them at all like I used to. (Nice to know that someone else knows what those are!) Did you try anything else for the surges?

 

Best wishes!

 

 

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Gridley
18 minutes ago, Artistic1 said:

However, if I use a digital scale, do you discard the part of the pill that you don't use? I think I read that cutting the pills can reduce the effectiveness of the parts not used.

 

No, you keep it for later use.  Cutting the pills doesn't reduce the effectiveness, at least with Zoloft.   What I do with my Lexapro is grind the tablet into a powder between two spoons and weigh my dose with the powder.  

 

If you switch to a liquid, we recommend a gradual crossover during which you don't taper (you only want to make one change at a time)

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

1/2 dose tablet, 1/2 dose liquid for 3 to 7 days

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

all liquid thereafter

 

I didn't try anything else for the surges.  As I got lower on my Lexapro dose, the surges gradually went away.  I don't have them at all now.

 

 

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Artistic1

Thank you so much! This is so helpful!

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IanM
On 4/27/2020 at 11:13 AM, Artistic1 said:

...

 

I also read about not taking phosphatidylserine for more than a few months. I've been on it for about 1 1/2 years. Should probably taper off that, although it REALLY helped with the cortisol surges, and I don't have them at all like I used to. (Nice to know that someone else knows what those are!) Did you try anything else for the surges?

 

 

 

Hi Artistic1. Any chance you could link to the brand of PS you use? I read somewhere, maybe here on SA, that PS is no longer effective for much of anything since it is not made from animal sources anymore (a change driven by fear of mad cow disease, etc).

 

Thanks!

 

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Artistic1

I take the Pure Encapsulations Phosphatidylserine 100 mg. I buy it on Amazon, but this brand is not cheap. There are cheaper ones out there from reputable manufacturers, so you can look around. A naturopath started me on this brand, and since it worked so well in reducing my cortisol surges, I bite the bullet and pay the asking price. I take two a day - one with breakfast and one with dinner. The recommended dose is 300 mg per day, but 200 works for me. I recommend starting with 100 mg per day, then go up. I've been taking it for almost 2 years. The studies on it have only researched a length of 6 months, but I haven't found anything to say you can't take it longer. Once I get my Zoloft down to a lower level, I plan to try to wean off the PS 100, too, and see how that goes.

 

PS 100 is made either from soy lecithin or sunflower lecithin. Pure Encapsulations is the soy version. Since I started on the soy type and it worked, I didn't want to switch to the sunflower type since the soy was working. But if you are sensitive to soy, the other type may be better. 

 

Good luck!

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brassmonkey

IanM-- I would strongly suggest that you do not get mixed up with Pure Encapsulations Phosphatidylserine. It works directly on the systems that we are trying to heal. For some people it may help with cortisol spikes, but it is adding another drug to the mix that has to be carefully tapered and will inhibit healing from ADs in general.

 

Artistic1-- yes you should do a slow careful taper off of this drug, as you mentioned above.  Also please do not recommend medications to other members, it is against site rules. You can say "this helped me" but don't actually recommend it.

 

Pure Encapsulations Phosphatidylserine is in a group of nootropics that includes 5htp and phenibut which are known to cause problems for people in ADWD.  Both of which, especially phenibut are very hard to taper. We highly recommend staying away from them.

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Artistic1

Can anyone recommend a reliable digital scale for measuring the doses, and also where to buy it? I've looked on Amazon, but there are so many, and I have no idea which would be best. Price is not a big factor for me....I want accuracy.

Thanks!

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Artistic1

Sorry about putting information in there that is not allowed. I'm fairly new here and was answering a question that IanM had asked. I will be more careful with my posts about supplements etc. Thanks.

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ChessieCat
On 5/4/2020 at 11:36 AM, Artistic1 said:

Can anyone recommend a reliable digital scale for measuring the doses, and also where to buy it? I've looked on Amazon, but there are so many, and I have no idea which would be best. Price is not a big factor for me....I want accuracy.

Thanks!

 

using-a-digital-scale-to-measure-doses

Many SA members use the Gemini 20 scale.  Moderator BrassMonkey used one of these all through his successful taper.

 

Search results for Gemini in the linked topic:  https://www.survivingantidepressants.org/search/?q=gemini&quick=1&type=forums_topic&item=1596

 

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Artistic1

An update on my condition....I'm doing pretty well, all things considered. In fact, after reading so many stories from others on this group, I think I'm in a really good place. My dose right now is 18.75 mg Zoloft, down from 25 mg at the beginning of the year (and that is down from 50 mg in 2017). My taper is on a 10-week cycle right now. I'm not taking any chances with the first drops in medication. Going to give my system a nice long time to adjust. As the doses get smaller, I might be able to reduce the cycle to 8 or 6 weeks between tapers.

 

I have windows and waves, like everyone, but the waves are less intense than they were last year, and the windows are better and more often. My waves include dizziness/light-headedness, fatigue, poor sleep, mild depression, pressure in my head, muscle tension in my back. Things that don't feel good, but are not debilitating. Believe me, I've had symptoms in the past where I didn't think I could do one more day, but I always did. 

 

I'm so glad to have found this forum. There is plenty of support here. One of the best posts I read was about WD Normal. That just made so much sense to me, and makes it easier to accept the symptoms each day. In fact, I now look at my WD normal as healing!

 

Best to everyone!

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Gridley
Posted (edited)
46 minutes ago, Artistic1 said:

As the doses get smaller, I might be able to reduce the cycle to 8 or 6 weeks between tapers.

 

As the doses get smaller, they get more potent, especially the last 10mg.  This is a time for slowing, not speeding up a taper.

 

I'm glad you're doing well, Artistic.

Edited by Gridley

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Artistic1

Thanks for the reply. So do you think that 10 weeks between tapers is too long and not really needed at this point? I can do 6 or 8 weeks now instead, until I get to about 10 mg, and then hold for longer?  I know everyone is going to respond differently, but just looking for advice. I'm 71, and while I realize the process can't be rushed, I don't want to be into my 80s getting off the Zoloft!

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Altostrata
23 hours ago, Artistic1 said:

My waves include dizziness/light-headedness, fatigue, poor sleep, mild depression, pressure in my head, muscle tension in my back.

 

Hello -- do these symptoms occur after you make a reduction? Do they get better as you hold for 10 weeks?

 

How are you measuring your doses? Were you unable to get Zoloft liquid?

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Artistic1

Thank you for helping me. The symptoms occur the worst about 12 days after a reduction. I've only done one 10 week hold (from 21.875 down to 18.75). I am now at week 5 at 18.75, and the symptoms are very mild. The symptoms are more prevalent and stronger when I don't sleep well, so I know that has a definite effect. (When I tapered last year, I never had a consistent schedule and was dropping by 3.125 mg each time. Because the tapers were too large and done at different intervals, I got really bad at 12. 5 mg and went back up to 25 mg and started over. Just started my 10% taper this February after I found this site.)

 

I am measuring my doses by cutting a 25 mg pill with a pill cutter.  I take 1/2 pill (12.5 mg) + 1/4 pill (6.25 mg) = 18.75 mg.

 

I didn't inquire about getting the Zoloft liquid. Wasn't sure I wanted to switch from pill to liquid. I bought a digital scale so I can be more accurate with the pill doses as I taper down. I also have a mL flask with pipette if I want to make my own liquid. But I would appreciate your advice.

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Artistic1

Thank you so much.

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Artistic1
Posted (edited)

Zoloft Taper - looking for advice and support

 

Looking for advice on next dose reduction......I reduced my Zoloft from 21.875 mg to 18.75 mg on April 14. Coming up on 8 weeks at this dose on Tuesday, June 9. I was planning on doing a 10% taper every 8 weeks, which would be on June 9, but now I'd appreciate some advice.

Through the middle of May, I felt quite good. I even had about 14 days of normal sleep, which hasn't happened in 3 years. Felt REALLY good the last week of May - like normal. What a great window. Then, a wave rolled in starting June 1. My waves are fairly mild. Symptoms are some depression, mild anxiety hovering in the background, lightheadedness/waterlogged feeling in my head, poor sleep has returned (darn!) I don't have any really debilitating symptoms that prevent me from functioning. Just down. My waves are like what is described on this group as my "WD Normal."

So....even though my plan was to do a taper every 8 weeks, should I wait for a good window before doing the next reduction?

Thanks for any advice.

 

Edited by ChessieCat
added topic title

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Gridley
1 hour ago, Artistic1 said:

o....even though my plan was to do a taper every 8 weeks, should I wait for a good window before doing the next reduction?

We always say, listen to your body, not to a schedule.  I don't know that you have to wait for a window but you might want to hold for a couple more weeks and see if you're feeling better.

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Artistic1

Thanks. That's good advice.

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Artistic1

An update to my taper, which is going pretty well so far. I'm encouraged!

 

On April 14, I had already tapered to 18.75 mg of Zoloft on my own, when I started with this group and doing a slow taper. I held at that dose for 8 weeks, and had a few mild waves, but by the end of week 8, (June 9) I was feeling quite stable - even had some really great days! On June 9, I started to taper again. 18.75 mg of Zoloft has a pill weight of .058 mg on my digital scale. I went down approximately 4.3% to .056 mg on the scale. That's approximately 17.95 mg of the Zoloft. After 5 days, I went down to .055 mg pill weight, held at that for 5 days, and yesterday, I went down to .054 mg pill weight. I will hold at that dose until June 24, when I will taper to my target of 16.875 mg (.053 mg pill weight), which is a 10% reduction from the 18.75. 

 

So it's a 10 week cycle: 8 weeks at the same dose, then small incremental reductions over 2 weeks to the new target dose, then hold that for 8 weeks etc.

 

Right now, this seems to keep me really stable with minimal WD symptoms.

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Altostrata

Sounds like a modified @brassmonkey taper. Good to hear it's working for you.

 

It's logical that smaller reductions at a time are more tolerable than larger reductions!

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Artistic1

Thank you for responding. I can use all the support I can get, and this group is the best place for that!

 

I did my taper to 16.875 mg on June 24, and now at a week later, my symptoms are mild. Hope they stay that way. Sleep is fractured and not really restful, but I'm dealing with it. If I could repair my sleep, I'd be so much better!

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Gridley
1 hour ago, Artistic1 said:

If I could repair my sleep, I'd be so much better!

I don't know if you've already tried it, but some people have found that Melatonin helps.  Start with a low dose like 0.25mg and gradually work up to the lowest effective dose -- but not too much because too much can go paradoxical (keep you awake).

 

Melatonin for sleep

 

I use NootropicsDepot (available on Amazon).  It's exactly 0.3 mg. 

 

.

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Artistic1

Thanks, Gridley. I know that with melatonin, a low dose is better than taking more. The .3 mg. is just right. Will check it out.

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Artistic1

Could use some encouragement today. It's been two weeks since I tapered my dose of Zoloft to 16.875 mg. Symptoms were mild at first, but I've been in a wave of mild depression, mild anxiety, dizziness, groggy head for the last 5 days. Now on day 6. I realize that's not a very long wave, but in the past, I would usually pull out of these after about 3 days. I also realize that as the taper gets lower, the symptoms can get worse. I just want to hang in there, but the last time I tapered last year, (where I now know I went too fast) it did me in at 12.5 mg, and I don't want that to happen again. I am 71 and looking at about 4 years to get off this med at my current rate. I just need a mental boost to keep my confidence up and keep me going. Any encouragement is appreciated!

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Gridley
17 minutes ago, Artistic1 said:

I just need a mental boost to keep me going. Any encouragement is appreciated!

Symptoms are going to vary at different points in the taper.  You are doing an excellent, slow taper with nice, long holds, and your attitude is very good.  What happened previously at 12.5 is no indicator that it will happen again (as you said, that happened when you went too fast).  There is often no rhyme or reason about symptoms and waves and how fast you pull out of them.  Be gentle with yourself and try not to worry.  You are doing very well.

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Artistic1

Thank you so much, Gridley! I have some support here at home, but no one understands the process like the people on this group. Have a great day!

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Hanna72

Sending  strength and good vibes your way. This time will be different for you. You are doing the taper nice and smoothly. You will come out of this journey strong and proud of yourself.


“Believe you can

and you are halfway there”

     
My best wishes to you🙏

 

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RachelSusan

@Artistic1

 

Hello Artistic1,

 

Let me introduce myself. I am Rachel, and like you a Zoloft traveler.  Starting in 2016 I had a lot of problems with this horrendous medication. After finding this site and trying once again to get off the Zoloft I am slowly doing it. Currently down to 1.12 mg from a big 150 mg.  I've been at it since 2016 and while it seems like a long time it's really not. If we do the taper right it sort of works in the background.   Just remember you can never go too slow with your tapering, but  you can go too fast. If you are getting symptoms that are too severe for you perhaps wait more time between a taper, or taper a smaller amount next time. Let your body tell you how to proceed. But you are doing it and you are doing it the correct way, slowly and with help. You are doing amazing well.

 

Warm wishes,

RS

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Artistic1

Hi, RachelSusan - thank you for your message! I am learning to be more patient with this taper. Getting the support on this group really helps. It means so much when people here take the time to write a helpful message.

 

Congratulations on reaching your low, low dose - looking forward to achieving that goal myself. 

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