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lfran: withdrawal from Zoloft, continuing to fight


lfran

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Hi all, I'm new and needing assistance. I was on antidepressants/stimulants for years and have managed to quit the stimulants, but am living through the hell of withdrawal from my SSRI, Zoloft after tapering too fast as you'll see below. This nightmare started in late May of 2020. I have some physical symptoms besides extreme fatigue, and the withdrawal itself is extreme anxiety, panic, depression, brain fog, confusion, poor memory... most of what is on the list of typical symptoms, and what I have come to understand is OCD. The crushing, breathless feeling of just having to get by minute to minute is like nothing I have ever experienced before. After reinstating Zoloft 12.5 mg in July, I seemed to stabilize a little bit after a few months, and withdrawal symptoms are just slightly better although the OCD is not budging. 

I need help/advice with moving forward with a taper. Right now I am not sure if I should wait a while and stabilize further since I just tried to stop the 12.5mg cold turkey less than two weeks ago and realized after 3 days it was a bad idea (although it did lead me to this site). I have been back on the 12.5mg Zoloft for a week. I was able to get liquid sertraline (Zoloft) from my doctor but I am unsure how to do the dosing. What I mean is, I recognize that I should reduce by 10% every 4 weeks, but I am unsure of how to dose this out from the liquid.

I would really appreciate some help with this and advice on how long I should wait until trying to reduce.

  • Started Zoloft in 2004 (unsure of dosage. Started Adderall in 2007 (10mg). From 2008 to 2012, tried a variety of stimulants (dosage unknown): Adderall XR, Ritalin XR, Concerta. From 2008 to 2011, tried a variety of antidepressants (dosage unknown): Prozac, Lexapro, Effexor. In 2011, after a suicidal episode, was put on 100mg Zoloft and 150mg Trazodone. Continued to take and abuse Adderall. In November 2012, quit Adderall cold turkey. In November 2013, went on Vyvanse 30mg. Somewhere between 2017 and 2019 reduced Trazodone down to 100mg. In 2019, reduced Zoloft from 100mg to 50mg and Trazodone to 50 mg.
  • In March of 2020, tapered off Zoloft by taking 50 mg every other day (approved by doctor), then every 2nd day, then every 3rd day. Quit Vyvanse cold turkey in April 2020
  • Stopped Zoloft completely by May of 2020
  • In March of 2020, tapered Trazodone from 50mg to 25mg by May 2020
  • May 22, 2020 withdrawal nightmare set in; OCD symptoms take hold
  • Mid July 2020, broke down and reinstated 12.5mg Zoloft
  • August 2020 began TMS treatments and reinstated Trazodone 100mg
  • September 2020 reduced Trazodone down to 50-75mg 
  • Between September- November 2020 tried twice unsuccessfully to quit Zoloft cold turkey
  • 11/12/20- 12.5mg Zoloft, 75mg Trazodone
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  • Moderator
manymoretodays

Hi Ifran and welcome aboard,

 

Thank you for getting your signature done.

 

Sometimes slightly better is good. 

 

So you did a Vyvanse CT in April.  Did every other day dosing with Zoloft and then off of Zoloft in May.  Went down and up with Trazodone since March.

Added in some TMS treatments.

Tried 3 days off Zoloft recently.

 

And now are on 12.5 mg Zoloft and 75 mg Trazodone.

 

That's a lot of changes. 

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.  The CNS likes stability. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur. And sleep is really important during withdrawal. 

 

The rule of 3KIS:Keep it simple, slow, and stable

and extracted from ^:

Do not suddenly quit taking your drugs. Do not skip doses to taper. These big, fast changes are the opposite of providing stability for your nervous system. Skipping doses causes the amount of the drug in your bloodstream to go up and down. Do not do this for any psychiatric drug.  See this graph which compares skipping days vs daily dosing.

 

On 11/12/2020 at 1:17 PM, lfran said:

I need help/advice with moving forward with a taper. Right now I am not sure if I should wait a while and stabilize further since I just tried to stop the 12.5mg cold turkey less than two weeks ago and realized after 3 days it was a bad idea (although it did lead me to this site). I have been back on the 12.5mg Zoloft for a week. I was able to get liquid sertraline (Zoloft) from my doctor but I am unsure how to do the dosing. What I mean is, I recognize that I should reduce by 10% every 4 weeks, but I am unsure of how to dose this out from the liquid.

I would really appreciate some help with this and advice on how long I should wait until trying to reduce.

 

Yes, it may be best to stabilize now, before attempting to taper again.  Give your nervous system a chance for some recovery and consistency.   6 months might be a good time frame, before tapering again.

 

Tips for tapering off Zoloft(sertraline)

you'll see about 1/2 down in ^ link, that once you measure your dose of Zoloft, then it has to be further diluted.  I'll extract that section:

Use Zoloft liquid concentrate to taper
http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=52077:

Quote

Zoloft oral concentrate is available in a multidose 60 mL bottle. Each mL of solution contains sertraline hydrochloride equivalent to 20 mg of sertraline. The solution contains the following inactive ingredients: glycerin, alcohol (12%), menthol, butylated hydroxytoluene (BHT).

 

From http://www.nlm.nih.gov/medlineplus/druginfo/meds/a697048.html
 

 

Quote

Sertraline concentrate must be diluted before use. Immediately before taking it, use the provided dropper to remove the amount of concentrate your doctor has told you to take. Mix the concentrate with 4 ounces (1/2 cup [120 milliliters]) of water, ginger ale, lemon or lime soda, lemonade, or orange juice. Do not mix the concentrate with any liquids other than the ones listed. Drink immediately.

 
US order code for Zoloft 20mg/ml Concentrate Solution NDC 000494940

 

Unlike other oral liquid antidepressant preparations, Zoloft liquid should be mixed with water because if it is taken directly from the bottle, it is likely to cause a burning sensation in the mouth.

As it is in a 20mg per mL concentration, this means using an oral syringe to measure out the proper amount. If you wish to take 50mg, you would take 2.5mL from the bottle, drop it in a small glass of water, etc., and drink it all.
 
If you are taking 50mg and wish to reduce by 10% (5mg), you would take 2.25mL (45mg) from the bottle, drop it in a small glass of water, etc., and drink it all.

Personally, I would use water rather than fruit juice or soda so I can see what's left in the glass. I might even drink the mixture, fill the glass again, swirl it a bit, and drink that to make sure to get all the Zoloft out of the glass.

 

If you are using the 20 mg/ml concentrate, then 12.5 mg would be 0.625 mL(millileter).  You'll do best, using a 1 mL oral syringe to measure your dose prior to any further dilution. 

Using an oral syringe and other tapering topics

you'll see an image of a 1 mL syringe, in the 2nd or 3rd post ^

 

 

When do you take your Zoloft each day?

When do you take your Trazodone?

  

On 11/12/2020 at 1:17 PM, lfran said:

The crushing, breathless feeling of just having to get by minute to minute is like nothing I have ever experienced before. After reinstating Zoloft 12.5 mg in July, I seemed to stabilize a little bit after a few months, and withdrawal symptoms are just slightly better although the OCD is not budging. 

 

And oh my, yes, I'm glad WD(withdrawal) symptoms have abated a bit, even if just a little.

Dr. Glenmullen's withdrawal symptom checklist

What is withdrawal syndrome?

 

And I'm going to add one more link, I think you will like, and it may help you with ideas for non-drug coping too:

 

Obsessive compulsive disorder or OCD: Repetitive intrusive thoughts, compulsive behaviors

 

Welcome aboard again Ifran.  I hope I covered most of your questions. 

This is your introduction/journal page where you have now introduced yourself to the community, you can ask questions here regarding your tapering, give updates, and just keep a record of your journey.

 

Best, L, P, H, and G,

moderator manymoretodays(mmt)

 

 

 

 

Edited by manymoretodays
links, and added a bit more

Started with psycho meds/psychiatric care circa 1988.  In retrospect, and on contemplation, situational overwhelm.

Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time).

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!  Tapered @ 10% every 4 weeks, sometimes 2 weeks to

2016 Dec 16 medication free!!

Longer signature post here, with current supplements.

Herb and alcohol free since 5/15/2016. 

None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider. manymoretodays

 

Link to post

I take the sertraline in the morning and the trazodone at night. I am so appreciative of all your help. Thank you. 

  • Started Zoloft in 2004 (unsure of dosage. Started Adderall in 2007 (10mg). From 2008 to 2012, tried a variety of stimulants (dosage unknown): Adderall XR, Ritalin XR, Concerta. From 2008 to 2011, tried a variety of antidepressants (dosage unknown): Prozac, Lexapro, Effexor. In 2011, after a suicidal episode, was put on 100mg Zoloft and 150mg Trazodone. Continued to take and abuse Adderall. In November 2012, quit Adderall cold turkey. In November 2013, went on Vyvanse 30mg. Somewhere between 2017 and 2019 reduced Trazodone down to 100mg. In 2019, reduced Zoloft from 100mg to 50mg and Trazodone to 50 mg.
  • In March of 2020, tapered off Zoloft by taking 50 mg every other day (approved by doctor), then every 2nd day, then every 3rd day. Quit Vyvanse cold turkey in April 2020
  • Stopped Zoloft completely by May of 2020
  • In March of 2020, tapered Trazodone from 50mg to 25mg by May 2020
  • May 22, 2020 withdrawal nightmare set in; OCD symptoms take hold
  • Mid July 2020, broke down and reinstated 12.5mg Zoloft
  • August 2020 began TMS treatments and reinstated Trazodone 100mg
  • September 2020 reduced Trazodone down to 50-75mg 
  • Between September- November 2020 tried twice unsuccessfully to quit Zoloft cold turkey
  • 11/12/20- 12.5mg Zoloft, 75mg Trazodone
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