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2 Year long Zoloft taper, At 1mg now, when to jump off?


Zolozombie

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Hey all, 

 

First time posting here...after a whole two years tapering. Never realized how active the site was and have been relying on Reddit for communicating w/ other people struggling with the same thing.

 

2015 thrown on Zoloft (increasing dose over time) and klonopin (.5mg as needed)-> 2016 thrown on stimulant (vyvanse at first but transitioned to dexedrine)->combo worked well for a couple years, tolerance & dependence grew w/ the stim and benzo, doc recommended every day w/ benzo.... 2018 bunch of side effects kicking in, doc decides to leave the state and I have to find a new one. I get a new one who rips me off the stimulant and the benzo in the same few weeks. Ugly rapid taper klonopin withdrawal in 2018 led to destroyed trust in psychiatry...docs denying I was having withdrawal even though it was so clear I was, then they increased the zoloft dose to max dose. 2019 realized zoloft wasn't doing anything for me any longer, started that taper SLOWLY. Basically cut ties with that psych and was tapering on my own w/ GP supervision. Went back on stimulant too.

 

First part was easy, 200->175->150->125->100mg (April 2019-September 2019)

Below 100mg in the fall of 2019 had a lot of instability brewing and mood swings, general acute withdrawal effects on a cyclical basis as I reduced the dose 25mg at a time, then cut that in half (in hindsight was going too fast). 

 

Covid broke out in 2020, made my way to 25mg (minimum dose of zoloft) and held there as I was still dealing with withdrawal. Waited till the end of the year to start it up again. 

 

Dec 2020 started taper again, but made the mistake of doubling down on my stimulant dose and using every day without skipping days (another sh*tty move in hindsight). Using both IR and ER dexedrine (10mg at the time, now down to 5mg)

 

At first went half (25mg->12.5 back and forth, then down over the span of a month)...did half again 12.5->6.5mg ->3ish ->1ish over the span of about 3 months. (Probably too fast again in hindsight) Tried to make my way off in April 2021 by skipping days and was in a world of hurt to put it lightly. Recruited a new psych who told me to get back on 1mg every day. Also using compounding pharmacy now, where before I was nearly eyeballing 1/25th of a tablet cut. Stabilized over the last few months pretty well. Making my way off stimulant slowly as psych thinks that may have made things worse (at least the IR probably was, the ER not so much).

 

Anyway my question to any veterans reading this how do I deal with this last 1mg. Do I take another 6 months of 10% reduction? When do I make the jump? Trying to do this successfully, it's been too long of a road to give up. I'm not sure if I want to give up the ADHD med entirely just yet, but I'm getting off the IR imminently for good as I think the spikes and crashes of the amphetamine only made things harder to deal with when it comes to the SSRI. 

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  • Moderator

Hi Zolozombie,

 

Welcome to this support site. 

 

Can you please give us specific information about your drug history for all drugs you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise list (no symptoms), only drug names, specific dates (as best you can say for example early March if you don't recall the day) and dosages of each medication decrease or increase.  Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

https://www.survivingantidepressants.org/topic/18343-please-summarize-your-withdrawal-history-in-your-signature/

 

You did a great job tapering sertraline from 100 to 1mg. I guess you are right that you went quite fast. Tapering more then 10% of the last taken dose is not recommended and could result in (heavy) withdrawal symptoms. As you also found out is that skipping doses is not a good way either to taper. Also this can disturb the nervous system. We nearly all have made these mistakes, just because we did not knew. And doctors don't know either, or don't tell us how to taper properly.

 

You are very right to be so careful with the last milligram. This is where many of us go wrong and jump too soon. These drugs are so extremely strong at low dosages, so go slow! The best compass at these low dosages are your body and your mind. Notice carefully the signals of those. You will notice when you would go to fast, by increasing WD symptoms. Be careful because symptoms sometimes start 3-4 months after a taper in the endgame....

 

To give an idea what 1mg of Zoloft does: This 1 mg stil blocks around 15% of the serotonine receptors. Whereas 50mg Zoloft blocks around 80% of these receptors. A safe dosage to jump would be 0,03 mg.

 

I recommend not to taper more then 10% per month. If WD effects increase, take a hold until WD symptoms are mostly gone again. This process may take time, but all time you invest, you will get back (and much more). Because if you would go too fast it might increase WD and then you may need much more time to get to zero!

 

Underneath I put a table showing the serotonine receptor blockage vs several dosages of Zoloft. This may help you to understand why slowly tapering during the endgame is so extremely important.

 

When you need assistance in how to make extreme low dosages, let me know. We can advise you there how too.

 

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

 

https://www.survivingantidepressants.org/topic/22958-never-skip-doses-to-taper/

 

https://www.survivingantidepressants.org/topic/1441-tips-for-tapering-zoloft-sertraline/

 

 

% of 1 pill(20 mg)

Dosage in mg

Zoloft/sertraline

% blockage serotonin receptor

(SERT)

100

50

78

50

25

72

25

12,5

62

12,5

6,3

48

10

5

44

7,5

3,75

37

5

2,5

29

4

2

25

3

1,5

20

2

1

14,5

1,5

0,75

11

1

0,5

8

0,5

0,25

4

0,25

0,12

2

0,1

0,05

0,9

0,05

0,03

0,5

 

 

Edited by Go2zero

1993    Anafranil (Clomipramine) for a few months. Later in 1993 Paxil for a few months 1993- 2006      No medication

2006   Effexor, Cymbalta, some Benzo’s. All for short periods. Later in 2006 Lexapro (escitalopram) 10 mg and shortly after Wellbutrin XR 150mg, against side effects Lexapro 

Since 2006 until end of 2015: Several times on and off Lexapro and Wellbutrin and several slight dosage changes. Mostly taken dosages: 5mg Lexapro and 150mg Wellbutrin

2016  Dosage change Lexapro from 5mg to 2,5 mg. Wellbutrin stayed om 150mg

November 2016 – April 2017 Down from 2,5mg to 0,6mg Lexapro (in steps) without much problems. Wellbutrin down from 150mg to 66mg. Also without much problems.

April 2017 – March 2019       Lexapro 0,6 mg        April 2017 - August 2018       Wellbutrin in small steps down from 66mg in to 37,5 mg . Quite heavy WD after each step.

March 2019 – May 2019 Lexapro down from 0,6 to 0,3mg then Prozac to 0,6 mg switch because severe discontinuation effects (may also have been from Wellbutrin..)    

Wellbutrin down from 37,5mg to 35,3mg 

October 2019        Seroquel 12,5 mg for 4 weeks because of extreme sleeping problems, then weaning off in 2 weeks       Prozac up dosage to 1,2 mg

March 2020     Wellbutrin in 2 steps down from 35,3mg to 33,3mg   Extreme withdrawal affects during 8 months. Stopped tapering Wellbutrin  until total off Prozac. February 2020 – November 2020   Prozac down in steps from 1,2mg to 0,57mg. 

Jan 2021 Prozac down to:  0,55> 0,53>0,51mg,   Feb 0,47mg ,  Mar 0,42mg,   Apr 0,37, longer hold because of WD symptoms July 0,36 and hold again, Sept 19 0,35, Sept 26 0,34mg, Oct 3 0,33mg  

 

Supplements: Fish Oil (3000mg), Magnesium 100 mg, 2 drops of Lavender Oil when feeling anxiety. 50mg of L-Theanine when severe discontinuation effects caused by Wellbutrin

 

Please note this is NOT a medical advice. Discuss all your medical issues with a doctor who understands psychical drugs and really knows how to withdraw from them. I wish that you will find one.

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Just the trifecta, Dexedrine, Zoloft and Klonopin. Klonopin I kicked nearly cold turkey (rapid taper) in 2018 but led to a rough time I'm wishing to avoid going through again.

Zoloft 200mg->175->150->125->100 Summer 2019-Fall ->75mg->62ish->50->36ish->25mg Fall through winter 2019, Held there through most of 2020,

Dec 2020--Present 25mg->12.5 (alternating days for 2 weeks, then steady at 12.5 for two weeks)->6.25ish (alternating then steady again) -> 3ish (alternating then steady again) -> 1ish (alternating then steady), failed attempt to jump after taking one day on one day off for April-May. Reinstated 1mg June1st and have been there since.  

 

Dexedrine on the other hand, Mid 2019, went back on 5mg ER twice a day for a while with weekends off. Then in early 2020 went back to IR only, 2-3 times a day 5mg with some days off during the week. Kept that up through the end of the year but when I started the zoloft taper again I went back to taking ER as well as IR (10mg ER + 5mg IR once or twice in the afternoon). I made the mistake of opening these ER capsules thinking I was lessening the amount but I think I was actually messing up the proportions, leading to ugly side effects. About June 1st to now I've been working my way off the dexedrine and it's been somewhat successful (as last time I came off in 2018 II crashed hard when I dropped it too quick, in combination with dropping klonopin...all at the orders of a sh*tty psychiatrist). I'm down from 10mg ER + 10mg IR June 1 to 5mg ER, and 2.5mg IR (soon to be no IR) now Aug 1. I may hang out on the 5mg ER and continue the zoloft taper because I really want to get that one finished already after now 2 years of taking this too cautiously.

 

Is there a source for that SERT blocking at different levels? Why do literally no MD's ever bring this up. I fear I'm making this worse for myself by reading into it (As has been the case the last 2 years). Surely if I cold turkey'd at .5mg all my tapering would have been worth something right?? I just can't do another year of tapering, I can't. I need this behind me.

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  • Moderator

Hi Zolozombie,

 

Thanks for your info. Could you please put this in your signature? So that it shows up under every post you make. See for example my signature under my posts. The reason we ask this is that the moderators/mentors and other members can see fast and easily what you have been using and tapering over time. This site is run by volunteers and we do not have the time (and energy) to read all posts over again and again. 

 

Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

https://www.survivingantidepressants.org/topic/18343-please-summarize-your-withdrawal-history-in-your-signature/

 

11 minutes ago, Zolozombie said:

Is there a source for that SERT blocking at different levels? Why do literally no MD's ever bring this up. I fear I'm making this worse for myself by reading into it (As has been the case the last 2 years). 

There are many sources on this. Doctors should know, but most don't.... 

 

Here is one source:   https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.161.5.826

Look also carefully at the graphs where you can see how suddenly SERT starts dropping at the lower dosages.

 

16 minutes ago, Zolozombie said:

Surely if I cold turkey'd at .5mg all my tapering would have been worth something right?? I just can't do another year of tapering, I can't. I need this behind me.

I understand your frustration. But try to look at it from the positive way. You did do a TREMENDOUS JOB by tapering down from 200 to 1 mg! You have come so far. Do not give up. The finish really is in sight!

 

This process is not easy. We all know that here. I have been tapering many years already and I have come very far also, like you. But there are moments that our body needs rest from all this WD stress. My tapering may take several years more than I initially expected. But going CT on these low levels can ruin everything you did up to now.

 

And what will bring that to you? On this site you can find support to do the last part of your tapering. You are not alone!

 

1993    Anafranil (Clomipramine) for a few months. Later in 1993 Paxil for a few months 1993- 2006      No medication

2006   Effexor, Cymbalta, some Benzo’s. All for short periods. Later in 2006 Lexapro (escitalopram) 10 mg and shortly after Wellbutrin XR 150mg, against side effects Lexapro 

Since 2006 until end of 2015: Several times on and off Lexapro and Wellbutrin and several slight dosage changes. Mostly taken dosages: 5mg Lexapro and 150mg Wellbutrin

2016  Dosage change Lexapro from 5mg to 2,5 mg. Wellbutrin stayed om 150mg

November 2016 – April 2017 Down from 2,5mg to 0,6mg Lexapro (in steps) without much problems. Wellbutrin down from 150mg to 66mg. Also without much problems.

April 2017 – March 2019       Lexapro 0,6 mg        April 2017 - August 2018       Wellbutrin in small steps down from 66mg in to 37,5 mg . Quite heavy WD after each step.

March 2019 – May 2019 Lexapro down from 0,6 to 0,3mg then Prozac to 0,6 mg switch because severe discontinuation effects (may also have been from Wellbutrin..)    

Wellbutrin down from 37,5mg to 35,3mg 

October 2019        Seroquel 12,5 mg for 4 weeks because of extreme sleeping problems, then weaning off in 2 weeks       Prozac up dosage to 1,2 mg

March 2020     Wellbutrin in 2 steps down from 35,3mg to 33,3mg   Extreme withdrawal affects during 8 months. Stopped tapering Wellbutrin  until total off Prozac. February 2020 – November 2020   Prozac down in steps from 1,2mg to 0,57mg. 

Jan 2021 Prozac down to:  0,55> 0,53>0,51mg,   Feb 0,47mg ,  Mar 0,42mg,   Apr 0,37, longer hold because of WD symptoms July 0,36 and hold again, Sept 19 0,35, Sept 26 0,34mg, Oct 3 0,33mg  

 

Supplements: Fish Oil (3000mg), Magnesium 100 mg, 2 drops of Lavender Oil when feeling anxiety. 50mg of L-Theanine when severe discontinuation effects caused by Wellbutrin

 

Please note this is NOT a medical advice. Discuss all your medical issues with a doctor who understands psychical drugs and really knows how to withdraw from them. I wish that you will find one.

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I would see if a mod can get you a response. If it were my own taper I would hold at 1 mg for a while to make sure you feel okay, you did a very quick taper previously, once you feel like there isnt any residual withdrawal from that then taper from 1 mg to 0 over a period of time your body feels comfortable with, the 10% guideline is a good place to start.

 

It seems tedious but will be worth it.

40 yo Male. Started Paxil about 15 years ago. 10 mg (pill weight .125 - .129 g). 5 yrs wanted less side effects, doctor took me off Paxil over couple week period and put me on Wellbutrin. Not good. Went back on Paxil. Relieved my symptoms, but didn't work as well and more side effects. Severe reaction between Paxil and Zomig Summer of 2012. Head was affected during warmer days (cloudiness, confusion, pressure). Began 10% withdrawal 10/24/12.

Withdrawel helped many symptoms, but also added side effects: nausea, dizziness, tiredness. Hyper-anxiety started January 2014.

Went through a 2 year period of de-realization (2016-2018).  Rarely any windows.  
Current dose: 0.00 as of 4/10/21.  Made a lot of progress in my withdrawal symptoms the last 2 years of my taper.  I think doing a liquid taper helped stabilize things on the lower doses.  A lot of my symptoms have reduced significantly.  Hoping for even more improvement now that I am off.
My thread: http://survivingantidepressants.org/index.php?/topic/8909-rusty1-paxil-withdrawal-help-and-advice-welcome/#entry150222

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@Rusty1 I really think calling a 2 year long taper quick is a stretch lol. Some of my changes could've been a little more drawn out, especially holding basically all of 2020 at 25mg. I essentially got to 1mg in March/April, then destabilized myself a bit by trying one day on one day off...went back on 1mg every day w/ compounding pharmacy liquid zoloft and have been more and more stable ever since actually. 

 

Tedious is an understatement haha. But thanks I tend to agree with the 'what your body/mind are telling you' approach. I'll probably give a 15% reduction a shot, but at this point I'm reading too much and I'll end up with psychosomatic symptoms just because I've now read 10% so much...

 

@Go2zero thank you both so much already for your input, genuinely. I really hate how varied these perspectives are across all information domains...I go to my doctor, he says one thing, go to one psychiatrist, he says another, go to another psychiatrist she says another...look on reddit, people are cold turkeying and fine after a month. Come here....and I still have a whole year of tapering ahead of me. 

 

I'm legitimately at the point where I don't know who to believe. I'm going to spend more time here for sure though as you guys seem to really understand the struggle. I also just can't help but feel like there's a point where I'm being absolutely too cautious....

 

It pisses me off beyond ANYTHING, that I go to MDs and nurse practitioners and they're all like, yeah just get off already you're on such a low dose. I PAY to see these shmucks. And yet, what I've experienced has mostly been in line with what I've read online for free from random strangers. I want to be done with this so much, it's taking a toll on my psyche as I'm ruminating on the meds all the damn time since I have to be my own psychiatrist. I really don't even want to believe that 10% is necessary at this low of a dose... just the idea of having to taper for another year is practically giving me an acute anxiety attack at the moment. On that note I'm gonna take a breath lol.

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  • Moderator
3 hours ago, Zolozombie said:

I really hate how varied these perspectives are across all information domains...I go to my doctor, he says one thing, go to one psychiatrist, he says another, go to another psychiatrist she says another...look on reddit, people are cold turkeying and fine after a month. Come here....and I still have a whole year of tapering ahead of me. 

Unfortunately this is how it works....  It is a well known story. We taper too fast, since doctors tell us that slow tapering is not necessary. We get WD symptoms and doctors tell us, it is relapse. We start or update meds again because we believe it is relapse. By doing this we sensitize and upset our nervous system. WD symptoms are getting worse every time we do this. 

 

Doctors learn that these SSRI's are NOT addictive. WD is most often seen by them as relapse! They just don't know! And most doctors do not spend enough time on their patients. Prescribing pills is so much easier then really getting into the situation of a patient.

 

I cannot convince you to go slow on the last mg. You will have to believe it yourself. I hope this will not go the hard way. I can just advise you to go slow and listen very carefully to your body. Do some extra research on this site. There is so much proof that going slow and carefully is the best  (and often the only) way to go.

 

When WD symptoms get too extreme do not updose to levels over 1mg. Be careful! You have come so far. Setting goals with tapering has brought many people in trouble...

1993    Anafranil (Clomipramine) for a few months. Later in 1993 Paxil for a few months 1993- 2006      No medication

2006   Effexor, Cymbalta, some Benzo’s. All for short periods. Later in 2006 Lexapro (escitalopram) 10 mg and shortly after Wellbutrin XR 150mg, against side effects Lexapro 

Since 2006 until end of 2015: Several times on and off Lexapro and Wellbutrin and several slight dosage changes. Mostly taken dosages: 5mg Lexapro and 150mg Wellbutrin

2016  Dosage change Lexapro from 5mg to 2,5 mg. Wellbutrin stayed om 150mg

November 2016 – April 2017 Down from 2,5mg to 0,6mg Lexapro (in steps) without much problems. Wellbutrin down from 150mg to 66mg. Also without much problems.

April 2017 – March 2019       Lexapro 0,6 mg        April 2017 - August 2018       Wellbutrin in small steps down from 66mg in to 37,5 mg . Quite heavy WD after each step.

March 2019 – May 2019 Lexapro down from 0,6 to 0,3mg then Prozac to 0,6 mg switch because severe discontinuation effects (may also have been from Wellbutrin..)    

Wellbutrin down from 37,5mg to 35,3mg 

October 2019        Seroquel 12,5 mg for 4 weeks because of extreme sleeping problems, then weaning off in 2 weeks       Prozac up dosage to 1,2 mg

March 2020     Wellbutrin in 2 steps down from 35,3mg to 33,3mg   Extreme withdrawal affects during 8 months. Stopped tapering Wellbutrin  until total off Prozac. February 2020 – November 2020   Prozac down in steps from 1,2mg to 0,57mg. 

Jan 2021 Prozac down to:  0,55> 0,53>0,51mg,   Feb 0,47mg ,  Mar 0,42mg,   Apr 0,37, longer hold because of WD symptoms July 0,36 and hold again, Sept 19 0,35, Sept 26 0,34mg, Oct 3 0,33mg  

 

Supplements: Fish Oil (3000mg), Magnesium 100 mg, 2 drops of Lavender Oil when feeling anxiety. 50mg of L-Theanine when severe discontinuation effects caused by Wellbutrin

 

Please note this is NOT a medical advice. Discuss all your medical issues with a doctor who understands psychical drugs and really knows how to withdraw from them. I wish that you will find one.

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