West: dealing with effects of coming off Prozac, having to start Zoloft

[ChessieCat]

Sounds like you need to learn to deal with that and it is something that you could start learning now so that when you get to that stage you will not have any issues.

 

It is part and parcel of getting off the drug with minimal discomfort.  None of us like doing it.  But we do what we have to do.  What other option/s do we have?  And you have it easier than members who have to meticulously weigh crushed tablets on a jeweller's scale or count really tiny beads from inside a capsule because they cannot make a liquid from their drug.

 

The alternative is jumping off too soon and possibly experiencing withdrawal symptoms.

 

I didn't change to liquid until right near the end of my taper so it was something that I needed to learn to do.  Up until then I had been taking capsules made by the compounder.  It is not difficult.  I made sure to write things down and always do things the same way.

 

There were some reductions where I was using 1 litre of water, made it up and got rid of most of it and only kept a bit more than what I knew I would need.

 

I worked out a few different dilutions and had those written down so I didn't have to calculate it each time.  I would calculate my new dose and then work out which dilution would best work.  If I couldn't easily get the dose I would round up (not down) and for the next reduction calculate on the rounded up amount.  I only ever used the one dilution for a dose, not a combination.

 

And you can practice without using your tablets.  And if you need help you can always ask here:

 

how-to-make-a-liquid-from-tablets-or-capsules

 

Here's the link to a copy of my spreadsheet.  It might give you an idea of how I worked things out.  If it confuses you, forget it.  There aren't any calculations available but note the headings.  The top part of the spreadsheet is fairly consistent, the bottom part is after I started getting used to what I was doing.  The headings with 10mL, 5mL, 3mL, 1mL are the syringe sizes.

 

Here are most of the dilutions that I was using.  Note that these were using 2mg capsules (the spreadsheet shows more using smaller doses):

 

2mg / 200mL =  0.01mg : 1mL

2mg / 400mL =  0.005mg : 1mL

2mg / 800mL =  0.0025mg:1mL

2mg / 1000mL = 0.002mg : 1mL

 

 

 

 

[West]

@ChessieCat This is all very true, and I appreciate the reality check. I guess I'm just still adjusting to the way my life changed forever in October due to all this—"years of issues with antidepressants" wasn't ever something I saw in my future, although now of course I have to work with it as best I can.

 

My overall plan is to focus on living as normally as I can on Zoloft for a long while. If nothing huge changes or goes wrong, next November, I will start preparing for my taper. In the mean time, I've gained an interest in the science behind all this, so I'm occasionally doing some reading, starting with Dr. Glenmullen's The Antidepressant Solution because it seems just right for my layman's level of knowledge.

[West]

I'm physically still doing quite well, which is a huge blessing! However, I've been having some experiences this past week that have sent me back here with more questions.

 

My original symptoms, which I attributed to withdrawal, were uncharacteristic anger, random crying, frequent urination, and tingling feet. All but the last have recently returned at a lower level of severity, even though I seemed to have fixed everything by reinstating a low dosage of Zoloft. (I suppose not technically "reinstating," since my original drug was Prozac, but I explicitly started taking Zoloft to manage withdrawal symptoms.)

 

Would this then mean that these resurgent symptoms aren't connected to withdrawal, but are purely mental health–related? This question is important to me because in the case of withdrawal, I would treat the symptoms by doing nothing and waiting to get out of this wave, but in the case of mental health, I would make exploring them a goal in therapy and work on shifting my life circumstances to figure out a way of living that makes me less distressed.

 

I guess the core of the question is: Is it common for those who have successfully reinstated to fight withdrawal to later on continue experiencing "echoes" of that same withdrawal?

[ChessieCat]

Please edit your drug signature to show dates, not seasons; I am in Australia, so seasons don't make any sense to the Southern Hemisphere folk.

 

Please state your drugs separately like this:

 

Drug name:  date, dose; date, dose; date, dose; date, last dose xxmg

 

And state the last dose you took for the drugs you are no longer taking.

 

Also add the date you started Zoloft, not just the month.  Thank you.

 

 

Q:  Have you discussed this with your medical professional?

 

 

This has me confused:

 

(Prozac)

20mg fall 2019–July 2021

20mg 2 weeks in October 2021

 

Q:  Am I correct in thinking that you did NOT take Prozac in August and September 2021?

 

Q:  When you stopped Prozac did you jump off at 20mg?

 

You could possibly be experiencing withdrawal symptoms from Prozac that the Zoloft is not covering.  There is also a possibility that what you are experiencing are side effects of the Zoloft.  I do not think that it is

 

Because of there being multiple changes in a short period of time it is difficult to tell what is causing your current issues.

 

If you keep daily symptoms notes, one of the staff may be able to assess them to try and work out what is happening:

 

Keep Notes on Paper

 

Please also see:

 

Is it withdrawal or relapse?  Or something else?

How do I know it's withdrawal and not relapse?

[West]

Thank you for your help, @ChessieCat. Especially for pointing out the seasons thing—I used that formatting because I can’t recall exactly when those events happened, but of course it would only be helpful if you’re in my hemisphere! How silly of me. Hopefully my signature is formatted properly now.

 

Q: Have you discussed this with your medical professional?

 

No. My psychiatrist does not believe me about anything related to withdrawal. She would almost certainly consider this a reason to up my Zoloft dosage, which I do not want to do unless absolutely necessary. When I had these same symptoms before (October 2021, before I briefly reinstated Prozac) I consulted with my primary care doctor, who found nothing physically wrong with me.

 

Q: Am I correct in thinking you did NOT take Prozac in August and September 2021?

 

Yes, that’s correct. That was the period between when I decided to get off Prozac and when I briefly reinstated it to try to deal with the issues I’m currently experiencing now.
 

Q: When you stopped Prozac did you jump off at 20mg?

 

Yes.
 

I will try to keep notes of my symptoms.

[ChessieCat]

2 hours ago, West said:

Hopefully my signature is formatted properly now.

 

Thank you that is much better.

 

October 2019–July 2021, 20mg (last dose, went off by skipping doses)

 

It would be good if you could give some extra detail here about how you skipped doses and for how long.  If you skipped doses, the last dose could not have been 20mg.

 

Thank you for adding the dates for October 2021 onwards.  That is very helpful.

[West]

I don’t remember the process of skipping doses very well, unfortunately. I started around the end of June by taking my 20mg pill every other day, and then every 3 days, and then stopping entirely by the end of July. During this time I was dizzy and had diarrhea, but it cleared up by August. The long-term withdrawal symptoms began in September/October.

[ChessieCat]

On 2/9/2022 at 1:27 AM, West said:

I started around the end of June by taking my 20mg pill every other day, and then every 3 days, and then stopping entirely by the end of July.

 

Please add this information to your drug signature.

[ChessieCat]

Have you managed to do any daily symptom notes?

[West]

Yes, here's what I have for the past few days:

 

2/8

5am: Wake up early and can't fall back asleep

8am: Normal bowel movement

830am: Took Zoloft

11am: Diarrhea

12am: Anxiety and "burning nerves" feeling in shoulders

2pm: Back pain

Frequent urination throughout the day

 

2/9

5am: Wake up early and can't fall back asleep

830am: Normal bowel movement

9am: Took Zoloft

1030am: Normal bowel movement

1130am: Anxiety and hot flashes

12pm: Took propranolol for anxiety

1230pm: Whole-body shivering

2pm: Diarrhea

3pm: Metallic taste in mouth

6pm: Mild fever

Difficulty falling asleep at night

 

2/10

6am: Woke up at proper time

630am: Took Zoloft

7am: Normal bowel movement

8am: Significant tingling feeling in feet

1130am: Normal bowel movement

Feeling calm for the rest of the day

 

Most of my symptoms occur in the morning/afternoon and then I feel better by night, which you can see as I don't have much to record in the evening hours. This is consistent with how I felt after my disastrous reinstatement of Prozac in October 2021.

[West]

I'm sorry to do this while you're trying to help, @ChessieCat, but I think I am actually going to try to step back from using this forum. It feels like it's contributing to my anxiety issues, not because anyone here is causing me anxiety, but because it's another avenue through which I personally obsess over my issues. I am going to plan to stop coming here for a while and focus on healthy eating, exercise, calming activities, and working with my therapist. I hope that I will be able to come back one day and share my successes with the folks here. Thank you so much to @ChessieCat and everyone else who has helped and encouraged me so far—you're doing amazing work.

[ChessieCat]

Thank you for letting us know.

[West]

Just popping in for a brief positive update.

For the past few months, I’ve essentially been living a normal life! All my symptoms are gone except the flashes of anger (which I am working on learning how to live with and avoid taking out on other people) and some minor remnants of back pain. I am staying on 12.5mg of Zoloft for now and plan to reevaluate in a few months and potentially start a taper.

 

Overall, I feel extremely lucky that my psychiatrist suggested the Zoloft, since starting it was when my situation really began to turn around. It’s a little frustrating that I will eventually have a long taper process to safely discontinue, but I think this is the best case scenario for me.

 

There have certainly been losses that I’ve had to deal with—I moved out of NYC to be closer to family because of the higher level of support I needed during this ordeal, and because withdrawal seems to have “turned up” my preexisting sensory issues so that the sounds of a busy city are too much for me day to day. I think I will have to be very careful with myself going forward so that I don’t overtax my still-healing nervous system. All this is tough to accept given I am just starting to build a life for myself at age 24, but I’m just so grateful to have my health back and no longer spend every day nauseous in bed. Basic things like the ability to eat or go for a nice walk are so much more beautiful to me now!

[ChessieCat]

Thank you.  That is really good news.

 

When you do start to taper you might consider this method.  You would have more control over your taper and can hold at any time during a taper cycle.

 

Brass Monkey Slide

 

Remember that the aim of tapering is keep withdrawal symptoms to a minimum so that you can live as normal a life as possible.  It is not about getting off as quickly as possible.

 

And remember to take your dose at about the same time every day.

 

Please return to let us know how you are.

 

For future reference:

 

Important topics in the Tapering forum and FAQ

 

Tips for tapering off sertraline (Zoloft)

[West]

Thank you for the links, ChessieCat! I hope you’re doing well, too. I’ll certainly be back here to work on my plan for tapering, probably in 2023.

[West]

I hope the end of the year has been going OK for everyone.

 

I don’t have anything new to report, but since it’s now been a year since I first posted, I wanted to update to say I’m doing fine, with no changes since I last posted. Seeing people who were able to get stable was a big inspiration for me when I was first in crisis, so I’m making a point of being another one of those examples.

[angela9985]

Thank you so much for your update! I am so glad that you are doing well.