AdyA: 2nd time weaning off Zoloft - insomnia

[AdyA]

Hi,

Thank you for this forum. I started taking Zoloft 2 years ago when my baby was 6 months old. With no previous history of mental health issues, they said I had post-partuum depression. It's hard to know what caused the spiral, but I am definitely sensitive to sleep. I think being disrupted every night from my natural sleep wore me down over the months and I became mentally vulnerable. I went on 100 mg Zoloft for 9 months and once I felt myself in April 2019, I weaned off. However, the symptoms slowly crept back up on me and by December 2019 I hit rock bottom again. I tried my best not to get there again... So I went back on them at 100mg. Since then I have been doing a lot of mental strengthening work, practicing mind stillness and meditation which has helped. Feeling in a mentally stronger place, I am trying to wean again. It has been okay except now I am having sleeping problems. Even if I don't currently have the feelings of depression and anxiety, if I'm not sleeping my state degrades. It's like I'm caught in a spiral.

Does anyone have insight? See below for my withdrawal schedule in my signature...

Thank you so much.

 

[Gridley]

Welcome to SA, AdyA.  Thank you for doing your drug signature; it's very helpful.

 

You are tapering faster than what we recommend, which is no more than 10% of your current dose every four weeks.

 

Why taper by 10% of my dosage?

 

Tapering faster puts you at risk of withdrawal symptoms, one of the most common of which is insomnia.

 

What is withdrawal syndrome.

 

Glenmullen’s withdrawal symptom list.

 

When we take psychiatric 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.  

 

I  suggest you hold at 75mg for at least three months to allow your system to stabilize.  If after 3 months you're feeling stable, you can begin a 10% taper off the Zoloft.  The following link is specifically about tapering Zoloft, including how to get the nonstandard doses you'll need for your 10% taper.

 

Tips for tapering off Zoloft (sertraline)

 

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.

 

The following links are about improving your sleep.

 

Tips to help sleep - so many of us have that awful withdrawal insomnia

 

Relaxation exercises, guided meditations, calming videos, sleep hypnosi

 

Tricks and tips to fall asleep faster

http://articles.mercola.com/sites/articles/archive/2017/02/16/tips-tricks-fall-asleep-faster.aspx?utm_source=dnl&utm_medium=email&utm_content=art1&utm_campaign=20170216Z1&et_cid=DM133787&et_rid=1889748952

 

This link contains helpful information, including insomnia and also non-drug coping skills.  

 

Important topics about symptoms, including sleep problems

 

Some members have found Melatonin helpful with insomnia.  

 

See Melatonin for sleep   It's best to start at a very low dosage, such as .25mg, and gradually increase if needed to the lowest effective dose.  

 

The following post was written by one of our moderators, Apace, and contains much wisdom about dealing with insomnia.

 

 

There is, unfortunately, no "silver bullet" to withdrawal or any of its symptoms, including insomnia.  If there were, SA would be a much smaller site than it is at this point.  Sadly, it continues to grow as more and more people get caught in the psychiatric medication "web."

 

Insomnia and disordered sleeping is a hallmark of psychiatric medication withdrawal.  It starts earlier than that with many studies making it clear that SSRIs (and other psych meds) frequently suppress REM sleep for those who take the meds.  https://www.sleepio.com/articles/sleep-aids/antidepressants-and-sleep/  Given this as a backdrop, it should be no surprise that coming off the meds can wreak havoc on sleep.  The good news, however, is that the brain works hard to achieve homeostasis and, all other things being equal, the brain will return to a place where sleep becomes, as it should be, a matter of routine.  How long that takes for any one person is impossible to predict.  Having "only" been on an SSRI for 2 years is a positive fact in your recovery, as there are plenty who were on 5-10x longer than that who have healed their lives and their sleep successfully.  But there is no easy formula to apply.  If I could tell you that being on the meds 2 years meant X months of recovery I'd gladly tell you that.  It just doesn't work like that.  It should be a positive and mean a shorter recovery, but there is no certainty.

 

So, what do you do?  In no particular order, some of the things to try:

 

• Don't place too much significance on sleep.  Rest should be the key and when your body absolutely needs to sleep it will.  The anxiety that comes with lying awake and saying "I must sleep" is far worse than the not sleeping.  It's hard but it can be done.
• Try a journaling practice before bed -- get out the things that are on your mind and add 3 things you are grateful for from the day
• Get a sleep ritual in place so that you do the same thing day after day and start to repair your circadian rhythms
• Take a warm bath with epsom salts few hours before bedtime and add in a cup of chamomile tea
• Use lavender essential oils in a diffuser at bedtime
• Exercise early in the day so that you aren't activated near bedtime
• Get outside and get some sunlight early in the day so that your rhythms are reestablished
• Make sure you have a consistent bedtime 
• Try not to be too activated in the couple of hours before bed and, of course, no caffeine
• Add a meditation practice
• Try yoga
• Go for walks in nature

Most insomnia is the result of the body being "hyperstimulated."  It is very hard to calm down an overstimulated body, especially when it is the result of chemical cascades that come as a result of medication use and withdrawal.  But, it can be done to a certain degree and the skills learned will provide valuable as your body improves over time.  

 

From my own perspective, my sleep is still not great, but it it better than it was.  I went through many stretches of 2 or 3 days with zero or an hour or two a night of sleep.  At this point, I have the occasional sleepless night, but most nights I'm good for at least 5 and usually closer to 6 hours.  By "normal" people standards that's not great, but it feels pretty good when compared to 0 or 2-3 hours a night.  As the saying goes, "in the land of the blind the one-eyed man is king!"

 

Try not to let it become the dominant factor in your life.  Over time, it will get better and you will heal.  Just do your best to continue to live your life what your brain is repairing itself.

 

----

 

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

 

l

 

 

 

 

 

 

[AdyA]

Hi Gridley,

 

Wow, thank you so much for all this information. It makes me hopeful. It is surprising that doctors do not know the scientific information behind withdrawal - didn't they study this? I guess this is what happens with a broken drug company-government regulator-doctor system, that really doesn't treat patients as people, but just defective.

 

I especially appreciated the article regarding brain versus mind. Learning about the physiological impacts these meds have on our brains and what happens to the different parts of the brain as you try to wean. How chaotic it is for the system, and how it compares to brain damage. We have to be  patient by realizing that our system is actually working FOR us and not against us. It is an important distinction to realize there is a difference between withdrawal symptoms and relapse even if that's not what everyone is telling us ("oh if you feel that way, it must mean the meds we're working so why get off?"). It has been tremendously helpful to tell myself that even though symptoms may be similar to depression and anxiety, it is actually something very different at work. Especially when I know I've done so much hard work over the past 2 years with therapy, spirituality, meditation to de-construct all those difficult emotions and programming that I accumulated and led my system to a breaking point, which happens to be called "depression" and "anxiety" in this world. When you don't have this as a tool, you think you are relapsing because your system has that memory from before of those symptoms so it does make that association.

 

Anyway that's how I'm feeling right now - we shall see how this goes. I do feel mentally stronger and like my thoughts are in the right place for this. I thank my brain and my body every day for the amazing healing they are doing. 

 

With regards to my situation, I agree I need to taper much more slowly. I went back to 75mg and already my sleep was better last night (able to fall asleep, woke up in the middle of the night, awake for 2-3 hours, then fell back asleep) compared to the night before when I only slept for 1-2 hours. So I will take your suggestion and go with 75mg for the next three months, obviously taking it day by day and listening to my body.

 

Thanks again and I'll be in touch

AdyA

 

 

[AdyA]

@Gridley Hi Gridley,

 

Last time I weaned off, I had symptoms creep up on me about 2 months after I finished. I thought it was the depression and anxiety creeping back up on me. Is it possible that it was withdrawal syndrome instead? If yes, what explains the lag between stopping and it creeping back up on me, since they say Zoloft is 99% out of your system in 5 days. Also what explains that the symptoms progressively got worse not better with time? For the second question maybe my mind got involved and the worry of getting depression and anxiety again actually brought me down that very same spiral. Can you please explain though if there may be a physiological reason (brain, CNS) rather than a psychological one?

 

Thank you kindly.

AdyA

[Erell]

Hello Adya, 

 

3 hours ago, AdyA said:

Last time I weaned off, I had symptoms creep up on me about 2 months after I finished. I thought it was the depression and anxiety creeping back up on me. Is it possible that it was withdrawal syndrome instead?

 

It was likely WD symptoms (you made very fast tapers).

 

 

3 hours ago, AdyA said:

If yes, what explains the lag between stopping and it creeping back up on me, since they say Zoloft is 99% out of your system in 5 days.

 

Unfortunately, we don't have studies to try to explain this phenomenon. But if take a look to all the testimonies gathered on SA, you'll see that this is a very common process. 

 

3 hours ago, AdyA said:

Also what explains that the symptoms progressively got worse not better with time?

 

In general, symptoms get better. But they get better very slowly and gradually : we are talking here about months, years.

Meanwhile, healing process goes through a Windows and waves pattern : symptoms get worse during waves.

 

Take care ❤️

 

[Gridley]

2 hours ago, AdyA said:

I had symptoms creep up on me about 2 months after I finished. I thought it was the depression and anxiety creeping back up on me. Is it possible that it was withdrawal syndrome instead?

It is fairly common for there to be a "honeymoon period" 2 to 3 months after stopping the drug, then to be hit with withdrawal symptoms.  The fact that the Zoloft is "out of your system" in 5 days is not the controlling factor.  During the time you were on the drug, a large percentage of your brain's neurotransmitters were put out of commission by the drug (which is what SSRI's do to perform their nasty magic).   As healing begins and your neurotransmitters start functioning again, symptoms occurs as your brain tries mightily to make sense of the new situation.  There are other aspects of the brain and CNS that also come into play, but that is the physiological explanation of why symptoms (depression is a common withdrawal symptom) occur.

 

Symptoms are going to come and go in a waves and windows pattern.  At first, the waves (bad symptoms) are going to be longer and stronger, with windows (feeling better) very short, even almost nonexistent.  As time passes, frustratingly slowly, there are more window.  

 

The Windows and Waves Pattern of Stabilization - Symptoms ...

And yes, the worry about return of the depression can put a lot of strains on your CNS and that can cause symptoms to worsen.

 

These explain withdrawal and the healing process really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

   On 8/30/2011 at 2:28 PM,  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 12/3/2015 at 10:41 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.  

 

 

 

[AdyA]

Alright, thank you very much for your responses. It makes me sad for my body & I am praying that it can heal itself ❤️Are there any long term damages to the brain or CNS from this?

 

Yes I will need to practice patience - I was hoping to have another baby soon, but I will need to let go of that for now... The mind strengthening work has been crucial to even get to a point where I feel strong enough to tackle withdrawal and also for not getting caught up in all the symptoms, nuances, or the what ifs of the past or the future.

 

I would highly recommend the below guided visualization for calming the nervous system. Our thoughts have a direct material impact.

 

 

 

[Gridley]

18 minutes ago, AdyA said:

Are there any long term damages to the brain or CNS from this?

From what we have seen here, the damage is not permanent and you will heal.  If you will read some of the posts in the "Success Stories" forum of SA you will find examples of this.

 

Success stories: Recovery from withdrawal

[AdyA]

Hi,

I'm wondering if there are any connections between the following, according to what you've observed with peers on SA:

- duration of exposure to SSRIs and withdrawal syndrome

- dosage and withdrawal syndrome

- age and withdrawal syndrome

Thank you

 

 

[AdyA]

Good morning

 

@Gridley @Erell

It's been a week since I went back to 75mg and sleep is better. Some nights I sleep through (ahhh!) and for others I'm waking up for a few hours. I suppose this is the window and waves pattern. I will stay here for 3 months to see if any other withdrawal symptoms appear from the 100mg-75mg taper, before I resume tapering. 

 

If I do well in these three months and feel ready to reduce afterwards, I was thinking of doing the following: trying to go to 50mg for another 3-4 months and if I can't handle that, come back to 75mg and then starting the 10% taper. In your experience, can you please explain any risks associated with this approach?

 

Thank you!

AdyA

[Gridley]

1 hour ago, AdyA said:

In your experience, can you please explain any risks associated with this approach?

That is a 25% drop, more than twice what we recommend, and there is a considerable risk that you will suffer some very unpleasant and long-lasting withdrawal symptoms.  It didn't work last time, and there's even less chance that it will work this time since your system is sensitized.  Once you become destabilized, which a 25% drop has every promise of making happen, it can be very hard to regain homeostasis.

 

For that reason I strongly urge you not to drop to 50mg but rather to taper by our recommenced 10% of current dose every four weeks.  This is not something to experiment around with.  

[Erell]

Can only ditto what Gridley said !

 

[AdyA]

There are some differences between the approach I mentioned above and what happened to me last time. Last time I came off in 6 weeks which was slower than what my doctor had prescribed. This time I am just wondering whether I can do those 25% drops - the minimum dosages the pills come in, but do each drop very slowly over many months which allows me to catch myself before I'm at 0mg. Anyway I respect SA's recommendation, because ultimately if you fall it can be excruciating to get yourself back to a stable place and it is a nightmare, I've been there. And since there is no research on this whole withdrawal thing there's really no way to know which people can handle those bigger tapers and which people can't so that's why you guys recommend the 10% taper across the board - it makes total sense. To be fair, my doctor said she has had patients who get off the drugs ok and don't get back on, and she's had others who have requested the 10% taper. She said it's personal and she agrees there is not enough research on this, and she's willing to support me if I go with the 10% taper. It's just hard because I did the calculation and from 75mg of 10% taper a month, it'll take me 6 years to get off Zoloft. I've only been on it for 9 months + 5 months. It seems crazy for a small slip up in my life when I never had any "mental health" issues in my life prior to this. And I have a young toddler and want to continue building a family. To wait 7 years before having another kid seems hard and I'll be old. 

[AdyA]

One more thing about last time I weaned off. As previously mentioned, my symptoms progressively got worse, not better. You responded that normally the symptoms get better not worse (albeit very gradually). This makes me question whether it wasn't my underlying mental health issue coming back, rather than withdrawal, and I know you guys responded you think it's the withdrawal, but really there's no way to know. In addition, there was so much personal growth I hadn't done at that point. When the symptoms started reappearing I went to places I have never gone before within myself, in terms of spirituality, getting to know myself, pushing myself to get to the bottom of the why I have having these feelings, which even therapy didn't bring me there. For me, my mental health was actually such a positive thing in the grand scheme of life because it was speaking to me, telling me to get closer to my true essence. I just had to listen properly, with the right filter.

 

Anyway I digress.

[Gridley]

24 minutes ago, AdyA said:

I did the calculation and from 75mg of 10% taper a month, it'll take me 6 years to get off Zoloft. I've only been on it for 9 months + 5 months. It seems crazy for a small slip up in my life when I never had any "mental health" issues in my life prior to this. And I have a young toddler and want to continue building a family. To wait 7 years before having another kid seems hard and I'll be old. 

That is one of the tragedies of these horrible drugs.  Many members are in a similar situation, having to taper for years after having been on the drug for a relatively short time.  

 

29 minutes ago, AdyA said:

This time I am just wondering whether I can do those 25% drops - the minimum dosages the pills come in, but do each drop very slowly over many months which allows me to catch myself before I'm a

 

Regarding the minimum dosages, this link explains how to get the nonstandard doses for the 10% taper.

 

Tips for tapering off Zoloft (sertraline)

 

Regarding doing 25% drops slowly so you can catch yourself, the problem with that approach is that symptoms are often delayed and by the time you notice and try to catch yourself, it could be too late and the damage is done.  Once that happens, you'll be looking at an even longer tapering period due to the time needed for updosing and stabilizing before beginning to taper again. 

 

 

[AdyA]

Okay thank you Gridley for sharing this insight. I appreciate it and I appreciate this forum   

[AdyA]

Hi,

 

I just wanted to provide an update, for the purpose of your organization's data collection. Kindly note that I am not looking for any advice at this time.

 

- I reduced to 75mg for 4-5 months and experienced no side effects (except for going to 50mg too quickly and going back up to 75mg)

- On July 21, I reduced to 50mg. For 3 weeks I had no side effects, but then in the pre-menstrual phase of my menstrual cycle, I experienced 3 nights of insomnia. Afterwards, it was back to normal for 4 weeks.

- The following month, again in the pre-menstrual phase of my menstrual cycle, I experienced depressive symptoms. They lasted about 3-4 days then they went away.

- My plan is to stay on 50mg for a total of 4 months and see if the symptoms creep up again at my pre-menstrual phase. If so, I will stay at this dose until they are no longer, before I make my next taper to 25mg.

 

*Side note* I remember from last time I tapered, symptoms also crept up in the pre-menstrual phase of my menstrual cycle. I started thinking I had some kind of menstrual disorder. But upon further research, I discovered that when we experience problems in the pre-menstrual phase of our cycle, it's actually not a problem with our cycle, but rather our body is talking to us, through our menstrual cycle and trying to bring our attention to the problems that exists within us whether physical, emotional, etc. 

 

[AdyA]

Hi there :)

 

I just wanted to provide an update so that SA can have a complete picture of my story, as I know it adds to your knowledge base for stats etc.

 

Last time I wrote, I had made it to 50mg - I was there from July 21 to November 18 (122 days). 

 

On November 19, I decreased to 25mg, for 80 days. I was very fortunate and did not experience any withdrawal symptoms this time around.

 

On February 6, I stopped the 25mg and went off the meds. I had physical symptoms for 3-4 days :  dizziness, light headedness, nausea, diarrhea, extreme fatigue, brain fog, lack of focus. I took care of myself and it went away. 

 

Now I feel good and stable. I chose not to go with SA's recommendation of the 10% taper, because I was on 100mg and a 10% taper meant I would be on them for like another 8-10 years. I just didn't find that reasonable for my personal situation since I would like to start trying for a second child. That said, I really did agree with the harm reduction approach, and I appreciate all the education and support that SA offers. In my case, taking 3-4 months for each dose decrease seemed to have worked well for my body. I understand that every single person and body is different so what may work well for one person, may not for another.

 

I wish you all the best on your journey, and remember, you are the only one who knows yourself best, and that knowing comes from the inside not the outside.

 

With Love,

Adrienne