20 years with Zoloft/Sertraline. Unfortunately ongoing.

[itchyfeet]

Hi,

 

First of all, thank you for this amazing place. I've only been lurking, but it has given me a lot of both comfort and hope for the past 3 years.

 

The past is a bit hazy, but my first symptoms of depression and anxiety began when I was around 21-22. I'd been in uni studying computer engineering for a few years, when i was hit by a an overwhelming combination of anxiety, panic and depression. Depression runs in my family, and at the time, i attributed it to genetics and a "chemical imbalance". Looking back, a combination of stress, bad "life skills" and economic worries seems at least as important.

After a 3 years of isolating my self, falling (way) behind in my courses and loosing most of my social life, i finally spoke with my GP. Given my family history, he quickly diagnosed with depression and put me on Zoloft/Sertraline 50mg (a dosage that worked for my dad). Within a month i started feeling better, and after three months I was feeling (*almost*) like myself again. It wasn't easy, but I slowly got my life back together, met a girl and finished my MSc in engineering. Things were looking OK.

 

The drugs definitely worked but i couldn't shake this feeling that somethings wasn't quite right. Like a hint of underlying depression, slightly numbed feelings and a sense of detachment from the world around me. Not perfect but bearable.

Fast forward almost 20 years(!).

3 years ago i was 40, married (no kids by choice), in good health and with a good, secure and stressless job. Still on 50mg of Zoloft and feeling almost good, but still with that sense of numbness and detachment! I decided it was time to live without the medication.

 

I did a lot of research and finally decided i was ready to start tapering. Compared to some of you guys, i was probably a bit too sloppy. The pattern went something like this: Shave off a bit (approx 1/8) of each pill. Wait for symptoms or changes in mood. Wait for symptoms to go away and mood to stabilize. Repeat.

I did this for 2 years. When i hit 25mg (or half a pill) the symptoms started getting pretty bad. Each time i reduced the dosage, a few weeks would go by, and i would start to get dizzy spells and feel very irritable and very depressed. And each time things got better within a month or so. When i was feeling good i was feeling better than i ever have on Zoloft.

 

About a year ago the pill was so small i couldn't shave off anymore. I went from approx. 8mg to 0mg. Like the other times i reduced the dose, i expected a period of symptoms followed by stability. This also happened at the last taper, but after a few weeks of feeling good, the symptoms came back worse than ever.

This (waves and windows) pattern has now repeated for about a year. Problem is that the windows are getting shorter and fewer and the waves seem almost permanent.

 

I'm now permanently depressed, irritable, angry, can't sleep at night and everything just seems hopeless. It feels like my marriage is falling apart, and I'm afraid I'll lose the few good friends i have left. I started seeing a therapist a few months ago, but haven't really felt any improvement.

 

I'm considering reinstating Zoloft at 25mg to see if this helps. If not, i may have to up the dose to the full 50mg again. Hopefully I'll get better and be able to give this another shot in a few years (perhaps with a more stable taper and maybe a therapist or psychiatrist by my side).

 

I'm not sure why I'm writing this. Maybe i need to hear that it's OK to reinstate at this point. Or at least i hope to get some ideas to do better the next time i try this.

 

Thank you for reading

itchy

[Onmyway]

4 hours ago, itchyfeet said:

Hi,

 

First of all, thank you for this amazing place. I've only been lurking, but it has given me a lot of both comfort and hope for the past 3 years.

 

The past is a bit hazy, but my first symptoms of depression and anxiety began when I was around 21-22. I'd been in uni studying computer engineering for a few years, when i was hit by a an overwhelming combination of anxiety, panic and depression. Depression runs in my family, and at the time, i attributed it to genetics and a "chemical imbalance". Looking back, a combination of stress, bad "life skills" and economic worries seems at least as important.

After a 3 years of isolating my self, falling (way) behind in my courses and loosing most of my social life, i finally spoke with my GP. Given my family history, he quickly diagnosed with depression and put me on Zoloft/Sertraline 50mg (a dosage that worked for my dad). Within a month i started feeling better, and after three months I was feeling (*almost*) like myself again. It wasn't easy, but I slowly got my life back together, met a girl and finished my MSc in engineering. Things were looking OK.

 

The drugs definitely worked but i couldn't shake this feeling that somethings wasn't quite right. Like a hint of underlying depression, slightly numbed feelings and a sense of detachment from the world around me. Not perfect but bearable.

Fast forward almost 20 years(!).

3 years ago i was 40, married (no kids by choice), in good health and with a good, secure and stressless job. Still on 50mg of Zoloft and feeling almost good, but still with that sense of numbness and detachment! I decided it was time to live without the medication.

 

I did a lot of research and finally decided i was ready to start tapering. Compared to some of you guys, i was probably a bit too sloppy. The pattern went something like this: Shave off a bit (approx 1/8) of each pill. Wait for symptoms or changes in mood. Wait for symptoms to go away and mood to stabilize. Repeat.

I did this for 2 years. When i hit 25mg (or half a pill) the symptoms started getting pretty bad. Each time i reduced the dosage, a few weeks would go by, and i would start to get dizzy spells and feel very irritable and very depressed. And each time things got better within a month or so. When i was feeling good i was feeling better than i ever have on Zoloft.

 

About a year ago the pill was so small i couldn't shave off anymore. I went from approx. 8mg to 0mg. Like the other times i reduced the dose, i expected a period of symptoms followed by stability. This also happened at the last taper, but after a few weeks of feeling good, the symptoms came back worse than ever.

This (waves and windows) pattern has now repeated for about a year. Problem is that the windows are getting shorter and fewer and the waves seem almost permanent.

 

I'm now permanently depressed, irritable, angry, can't sleep at night and everything just seems hopeless. It feels like my marriage is falling apart, and I'm afraid I'll lose the few good friends i have left. I started seeing a therapist a few months ago, but haven't really felt any improvement.

 

I'm considering reinstating Zoloft at 25mg to see if this helps. If not, i may have to up the dose to the full 50mg again. Hopefully I'll get better and be able to give this another shot in a few years (perhaps with a more stable taper and maybe a therapist or psychiatrist by my side).

 

I'm not sure why I'm writing this. Maybe i need to hear that it's OK to reinstate at this point. Or at least i hope to get some ideas to do better the next time i try this.

 

Thank you for reading

itchy

 

Welcome to SA @itchyfeet, 

 

I am so sorry your withdrawal symptoms have been getting difficult recently. Let's try to help you out get through this difficult time. 

Since you have been lurking around, as you say, you probably have read a lot of the threads here but I would like to still draw your attention to this one - Why taper? SERT transporter occupancy studies show importance of gradual change in plasma concentration - Tapering - Surviving Antidepressants. In that you will find scientific papers that show that the impact of these drugs is really high at low doses. In fact the majority of the effect of the drugs is at the lower doses - for citalopram for example - a 20mg dose gives around 80% SERT occupancy (similar to how many of the specific receptors are blocked, 10 mg is about 75% occupancy, 5mg is about 60% occupancy and 1 mg is about 25% occupancy. I don't know the specific formulas for sertraline but the idea is that a lot of the effect is at the lowest doses so when you came off of it at 8mg you were slightly better off than cold turkey-ing. (I came off at 5mg thinking I had tapered properly since I hadn't felt much from 40mg to 5mg). On SA people who come off drugs cold turkey usually have a recovery period of about 2-3 yrs (variations exists of course - from over a decade to less than a year). There is also a talk of a long/difficult wave at 10-12 months off and you are right in that period right now from what I can see from your signature. So it might be worth trying to grin and bear for a couple of months and see if things will get much better then as they seem to get after the 10-12 month wave. 

 

You can certainly reinstate. It seems to work best when done within a few weeks and at a low dosage - around 0.5-1mg which is often enough to get rid of the worst symptoms. The worry with reinstatement is that it can sometimes make things much worse. The longer you have been without the medicine, the lower the chance that it will help. But again, everyone is different so we don't know how you, in particular, will react. The advice, however, remains to try cautiously at a low dose. You might want to be precise this time and go for 0.5mg and see how you react, then if no bad symptoms and no improvement can try to increase in a week. Hopefully, however, you will get some improvement quickly and that will be enough to stabilize you. 

How to make a liquid from tablets or capsules - Tapering - Surviving Antidepressants

Recording drug schedule and symptoms to track patterns and progress - Tapering - Surviving Antidepressants

Tips for tapering Zoloft (sertraline) - Tapering - Surviving Antidepressants

 

Also, have you seen this topic? There are lots of things that you can try to feel better in the meantime, 

Non-drug techniques to cope with emotional symptoms - Symptoms and self-care - Surviving Antidepressants

 

You can also try to take some magnesium and Omega 3. There are good threads on that. 

 

Hope things get better soon, 

OMW