ReclaimingAmyo: wanting to stop Sertraline and Lamotrigine

[ReclaimAmyo]

Hi everyone. I'm here to see if I can stop the antidepressant (Sertraline) and anticonvulsant (Lamotrigine) I'm using and find out who I am, if I'm no longer dependent on them. Also I want to see if discontinuation will bring down elevated liver enzymes. I've been on Sertriline (100mg) for at least 5 years and I started Lamotrigine (250 mg Extended Release) 2-3 years ago. After I started Lamotrigine, I tried to discontinue Zoloft. I think I went down to by 25 mg every two weeks and then off completely. I felt too sad, I guess, so I went back to 100mg as a maintenance. I've been on Prozac and Lexapro off and on for depression. I probably had Lexapro replaced with Zoloft and I don't remember how I did during the switch. It seems like I just quit taking Prozac after about a year. That was in '92 I'm guessing.

Edited September 6, 2021 by arbor

[arbor]

Hello @ReclaimAmyo,

Welcome to SA.

 

To get you started and to give you pertinent information, could you summarize your medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements in a list format.  This link should help you with that:

 

Account Settings – Create or Edit a signature.

 

I support you in your journey to find out who you are without the drugs.  Withdrawal can make you feel as if you are dependent on them.  However, by going slowly and letting your system stabilize as you go, slowly your system can recover from the drugs.

 

We usually recommend tapering one drug at a time, starting with sertraline in your case, and when you're done and stable, moving to lamotrigine.  Also, you may have noticed that we recommend a slow approach to tapering, reducing by no more than 10% of the current dose every 4 weeks to lessen the risk of withdrawal symptoms arising.  These links explain why:

  

Why taper by 10% of my dosage?  (The general philosophy of gradual tapering)

 

Taking multiple psych drugs? Which drug to taper first?

 

Here are some links that address your drugs in particular:

 

Tips for tapering Zoloft (sertraline) 

 

Tips for tapering off Lamictal (lamotrigine)

 

Please ask questions as they come up.  Many people benefit from keeping track of their progress.  Here are a links to help you:

Rate symptoms daily to track patterns and progress

 

Keep notes on paper

 

Dr. Joseph Glenmullen's withdrawal symptom checklist

 

This is a good site to have supporting you as you begin.  I'll start you with these links and add others later so as not to overwhelm you with the wealth of information and experience here.  I encourage you to browse the site and learn what you can.

 

 

This is your Introduction site where you can ask questions and connect with other members.

I'm glad you've found us. 

Arbor

 

 

 

 

[ReclaimAmyo]

XR Lamotrigine vs. immediate release when tapering

 

Anyone know if it's advisable to switch from Extended Release Lamotrigine to immediate release before starting taper? I'm getting off 100mg Zoloft first but I'm planning ahead. Since cutting an ER tablet in half undoes the ER bit (don't really understand this), it seems it would be easier to use another form of Lamotrigine. Any suggestions?

 

Edited September 11, 2021 by ChessieCat
added topic title before merging 2 Intro topics

[ChessieCat]

When changing forms of a drug it is suggested that you do a cross over.  At that time you do not make a reduction or make any other changes at the some time.  The suggested cross over method is to do 3/4 + 1/4, 1/2 + 1/2, 1/4 + 3/4 for 3 to 7 days for each combination or longer if needed.  This is a gentler was to do it.

 

Please see Post #1 of this topic for information on how to get the dose you need:

 

tips-for-tapering-off-lamictal-lamotrigine

 

[ChessieCat]

17 hours ago, ReclaimAmyo said:

Anyone know if it's advisable to switch from Extended Release Lamotrigine to immediate release before starting taper?

 

It would probably be easier to stay with the extended release lamotrigine until you are ready to taper it.

 

Something that you might also consider is tapering Zoloft to a certain dose and then tapering lamotrigine for a while because you are taking a very high dose of the lamotrigine.  This is something that I suggest you ask about here in your Introduction topic when you get a bit lower on your Zoloft.

 

There are interactions between your 2 drugs.

 

The following is from https://www.drugs.com/drug_interactions.html

 

 

Quote

 

Interactions between your drugs

Moderate

sertraline

lamoTRIgine

Applies to: Zoloft (sertraline), Lamictal (lamotrigine)

Treatment with sertraline may occasionally cause blood sodium levels to get too low, a condition known as hyponatremia, and using it with lamoTRIgine can increase that risk. In addition, sertraline can cause seizures in susceptible patients, which may reduce the effectiveness of medications that are used to control seizures such as lamoTRIgine. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. You should seek medical attention if you experience nausea, vomiting, headache, lethargy, irritability, difficulty concentrating, memory impairment, confusion, muscle spasm, weakness or unsteadiness, as these may be symptoms of hyponatremia. More severe cases may lead to hallucination, fainting, seizure, coma, and even death. Also let your doctor know if you develop seizures or experience an increase in seizures during treatment with sertraline. Additionally, because these medications may cause dizziness, drowsiness, and impairment in judgment, reaction speed and motor coordination, you should avoid driving or operating hazardous machinery until you know how they affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

 

 

The following is from https://reference.medscape.com/drug-interactionchecker

 

 

Quote

 

1 Interaction Found

Patient Regimen

•   sertraline
  • Zoloft
•   lamotrigine
  • Lamictal

Monitor Closely

• lamotrigine + sertraline

  lamotrigine increases toxicity of sertraline by unspecified interaction mechanism. Modify Therapy/Monitor Closely. CNS depressants may increase the toxic effects of selective serotonin reuptake inhibitors; psychomotor impairment may be enhanced.

 

 

[ReclaimAmyo]

I won't be tapering Lamotrigine for several years (after Zoloft). However, I've read that cutting an ER tablet in half renders it no longer an ER 24hr. Should I switch to the regular tabs so I can taper more easily? Are the drugs interchangeable? Will that cause withdrawal symptoms?

[ReclaimAmyo]

Thank you, Chessie Cat. I have been having psychomotor trouble in a couple of areas. From a safety standpoint, the worst is driving. While I've been extremely lucky so far, I'm no longer going to tempt fate. I was chalking up my driving discomfort to being old (61 years). There are too many things on the road to look for: pedestrians, cars, traffic lights. Thank you for cluing me in to this side-effect with the current drugs I'm on. You may have saved my or other people's lives.

[Altostrata]

Hello, @ReclaimAmyo I would not worry about changing your lamotrigine until you are ready to taper it.

 

However, do you have any adverse effects from it? What effect does it have on you? What times o'clock do your take your drugs, with their dosages?

[ReclaimAmyo]

I'm not having any adverse effects with the 250mg ER Lamictal. I've been taking it for 4.7 years so if I noticed any changes when I started, I didn't write them, so I can't answer that. I take all my meds before bed. My first taper is 90mg from 100mg of Sertraline. I'm 3 days in. So far no side effects except for one body zap per day (I don't get brain zaps). I will probably finish Sertraline taper first before starting Lamictal taper, since Lamictal makes Sertraline a neuro-toxin.

[ReclaimAmyo]

Zoloft taper & not calling things by correct name

 

I'm on my third taper from 100mg Zoloft. I'm 2 weeks into 72.9mg. I will say things that are related to what I say but it's not quite right. For example: I'll say "look at the nice Christmas tree" but I'm talking about a string of outdoor lights on a house.

 

Would this be considered brain fog? Anybody else had similar symptom with Zoloft that passed? I also take 250mg Lamotagine.

 

Edited November 23, 2021 by ChessieCat
added topic title before merging with intro topic

[ChessieCat]

Yes, I've had that happen to me.  And I can remember another member saying that they couldn't remember the word "broom" and ended up saying "the thing you sweep the floor with".  It was so funny that I have remembered that from about 4 or 5 years ago!

 

And other members have had similar symptoms during their taper.  I've had brain fog and it is different.  Brain fog is when it feels like your head is full of cotton wool.  When I had it badly when I reduced my dose from 100mg Pristiq to 50mg (walking took my full concentration), I said it was like trying to think through mud.

 

There are many existing topics on SA.  You can use the site search function or an internet search engine and add site:survivingantidepressants.org to the search term.

 

Here is SA's topic:

 

language-problems-trouble-finding-words-forgetting-words

 

[ChessieCat]

This is what happened to me.  I didn't mess my words up at this time, I couldn't type:

 

I was taking 100mg Pristiq and reduced my dose to 50mg.  During the 2 weeks I was on the lower dose I suffered extreme cog fog where even walking took my full concentration.  It was like my head was full of mud.  At the end of the 2 weeks I couldn't type.  Being a professional typist I immediately realised that something was terribly wrong.  I had joined SA a few days before I couldn't type and they had suggested taking more of my drug but I didn't straight away because I was doing a lot of reading trying to understand what was happening.

 

When I couldn't type I decided to take extra Pristiq and after only about 4 HOURS (not days) I was able to type again and the brain fog was lifting.  Because I had a benchmark I knew that it was the drug which had caused it.