Missourimama: Cold Turkey 1.5 weeks off Zoloft because of pregnancy and scared I'm experiencing WD

[Missourimama]

Hello all,

 

I'm sorry, I know I need to add a drug history to my signature and will do so but right now I need urgent help. 

 

I started taking clonazepam PRN in July of 2019 after an adverse reaction to a prednisone for poison ivy. I have struggled with episodic panic disorder on and off since childhood, often with years-long periods of stability, and prior to 2019 had gone on and off benzos perhaps 4 times over the course of 15 years with no withdrawal at all, but never ADs. 

 

Eventually, the panic disorder escalated to hospitalization in February of 2020. I have always been wary of ADs but finally conceded to trying one for the sake of my family. After a couple months of Prozac (which I asked for specifically because I had read it was the easiest to come off of), I tried Zoloft because Prozac made the anxiety worse. 

 

Zoloft seemed to stabilize me a bit. Therapy helped immensely. Anyway, long story short, I didn't think it was possible for me to get pregnant again (my husband and I have 2 awesome kids). But... here I am, now six weeks pregnant. I cold turkey'd a week and a half ago as soon as I got a positive test. I know this is not recommended and I seem to be suffering the consequences. 

 

I am scared I'm going "back to how I was" before I landed in a psychiatric hospital. Panic attacks, catastrophic thinking, suicidal ideation... it's really scary. It's not constant - I seem to have a good day followed by a bad day - but it's very concerning. 

 

What should I do? I do NOT want to ruin the rest of my baby's life by neonatal exposure to SSRIs because I can't handle withdrawal.

 

I should note that I *sort of* tried reinstating with 12.5 mg a week ago and that made me feel AWFUL. So I'm actually afraid to try that again. 

 

I have been forced to take a small dose of clonazepam here and there which I know is pregnancy category C and therefore also not advised. There were just a few times I absolutely could not take the waves of panic attacks after several hours. 

 

Please help! I'm teary and scared. 

[Onmyway]

Hi @Missourimama,

I'm so sorry that you are in a bind. I have asked more experienced moderators to jump in and help you. 

 

From my understanding, Zoloft does not cross the placenta very well, so it's one of the better ones to be on if you happen to be pregnant. Usually we do reinstatement of a very small dose - something of 1mg or so, the minimal that helps you get the WD symptoms under control. The 12.5 may have been too high and caused an adverse reaction. It is also possible that you have kindled and a reintroduction may not be possible. Or you may choose to not reinstate. We'll do our best to get you the best advice we can. 

 

it's a difficult situation you're in. I know panic attacks are hard. Are you using any non drug techniques to cope? Can you do Epsom salt baths? Does magnesium help lower anxiety levels even a bit?

 

Hope things settle a bit soon 

OMW

 

 

[Missourimama]

@OnmywayThank you so much for the response! I do have magnesium, unfortunately it doesn't touch the intense anxiety but I'll keep trying it, perhaps it can have a cumulative effect.

 

Today has been a better day than yesterday, and making me hopeful that perhaps I'll be one of the luckier ones. Reading the section about what our brain does once we get off ADs was really helpful - it's always been helpful for me to have those physical details, same with understanding what a panic attack is.

 

I've noticed that keeping busy and socializing (despite the nausea from pregnancy, which makes it challenging) does really help, maybe just a distraction but still! 

 

I really appreciate this site. Thank you again. I think I will see how things go for a few more days before considering reinstating, but I will definitely keep that in the back of my mind as a potential safety net. It's comforting to know too that Zoloft doesn't cross the placenta well just in case I would need to reinstate!

[Onmyway]

Hi @Missourimama, 

 

I misspoke earlier. Or rather I relied on doctors' statements that sertraline (zoloft) does not pass into the placenta very well. They often prescribe it to pregnant women with the statement that it is safer. I looked it up in the literature and found a study that shows that there is a wide variation in how much of it is in the plasma of pregnant women and how much passes into the placenta. I hate to make this a bigger dilemma for you but I also know that you should be fully informed. It is best to read this paper yourself and if you need help understanding things I can help with that. I am so sorry you have to make such difficult decision when your brain is being pounded with withdrawal symptoms. May this all be resolved quickly. 

 

Sertraline concentrations in pregnant women are steady and the drug transfer to their infants is low | SpringerLink

 

OMW

Edited February 28, 2022 by Onmyway

[Missourimama]

Dear @Onmyway,

 

Thank you so much, I really appreciate it! I definitely want to be fully informed. Yesterday was mostly a good day and I feel okay this morning which is making me a bit more hopeful. I'm going to start going to therapy every week again which helped me immensely in the past and I'm hopeful it can do the same while I'm riding out withdrawal. I feel grateful that at least I have never experienced the physical symptoms many suffer from such as brain zaps, flu-like symptoms, etc. It grieves me to read through this site and see how many are suffering.

[Shep]

On 2/27/2022 at 1:26 PM, Missourimama said:

I started taking clonazepam PRN in July of 2019 after an adverse reaction to a prednisone for poison ivy. I have struggled with episodic panic disorder on and off since childhood, often with years-long periods of stability, and prior to 2019 had gone on and off benzos perhaps 4 times over the course of 15 years with no withdrawal at all, but never ADs. 

 

On 2/27/2022 at 1:26 PM, Missourimama said:

I have been forced to take a small dose of clonazepam here and there which I know is pregnancy category C and therefore also not advised.

 

Hi, Missourimama.

 

Please tell us more about your drug history. The reason I ask is benzo dependency can sneak up on you. People can become dependent even with periodic use and they also are notorious for causing rebound and paradoxical reactions. It's possible some of the intense anxiety is from going into withdrawal in between the periodic benzo doses. 

 

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[getofflex]

Hello, and I'm very sorry you are having to deal with this.  There are many non drug ways to help with anxiety.  I will post some of them here:  

 

Audio:  First Aid for Panic (4 minutes)

 

CBT Course:  An Introductory Self-Help Course in Cognitive Behaviour Therapy

 

Audio:  How to Recover from Anxiety - Dr Claire Weekes

 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help ...

 

Emotional Spirals

 

Acknowledge Accept Float

 

Music to Calm Anxiety

 

Breathing Technique for Anxiety

 

Meditation

[Altostrata]

Hello, @Missourimama

 

I agree with Shep.

 

On 2/27/2022 at 10:26 AM, Missourimama said:

Eventually, the panic disorder escalated to hospitalization in February of 2020.

 

Moreover, if you've been using benzos for periods here and there, it's possible these panic attacks are actually benzo withdrawal symptoms. A very mild withdrawal condition can be exacerbated by occasional alcohol or even antibiotic treatment, and produce symptoms of severe withdrawal, such as panic attacks, which are also characteristic of antidepressant withdrawal.

 

What we see here is that a history of going on and off psychiatric drugs, including benzos, increases vulnerability to psychiatric drug adverse reactions (such as you experienced with Prozac) and withdrawal symptoms.

 

You might have felt better on Zoloft because the benzo withdrawal symptoms faded over time, as withdrawal symptoms will do, though sometimes it takes a very long time.

 

On 2/27/2022 at 10:26 AM, Missourimama said:

I should note that I *sort of* tried reinstating with 12.5 mg a week ago and that made me feel AWFUL. So I'm actually afraid to try that again. 

 

I have been forced to take a small dose of clonazepam here and there which I know is pregnancy category C and therefore also not advised. There were just a few times I absolutely could not take the waves of panic attacks after several hours. 

.

In my amateur opinion, all antidepressants have the same risk in pregnancy, but paroxetine is highest and fluoxetine is lowest for postnatal withdrawal symptoms. 

 

For what reasons have you been taking clonazepam lately?

 

You might do better with a smaller reinstatement, even 1mg, of sertraline. Lower dosage would me lower exposure for your baby. It comes in a prescription liquid so you can take small dosages. We have seen even 1mg-5mg can relieve withdrawal, you'd taper off by minute amounts later.

[Missourimama]

@altostrata Hey, thank you so much for this! I do have a history of going on and off psych drugs, but the overall time on psych drugs is far less than time not on psych drugs - in the past, I have several times had scripts for benzos for months at a time and when the scripts ran out I just kind of went on with life and didn't take anything for years at a time. I have a history of panic attacks dating back to childhood, obviously before I ever took benzos so I'm hoping withdrawal is not the case there. I'm a nervous person 😔 

 

I think I'm going to try and stay the course with cold turkey on both. No clonazepam for 4 days now. I was always careful never to escalate dosage or usage - only ever took .25 mg or RARELY .5 mg if I was really freaking out. Tried not to ever take it subsequent days. I know that's not absolutely protective against withdrawal but hoping that makes things less severe. I know it is probably not a popular opinion here but I truly feel benzos have saved my life more than once but obviously I do not want to poison my child, and I was starting to lean on them too much anyway. Felt quite anxious today but it typically gets better in the evening. I have therapy on Thursday which always helps. 

 

Thank you again for your generosity of wisdom and advice!!!

[Missourimama]

@getofflexThank you! I love Claire Weekes. I am struggling again today, my anxiety is just through the roof, I'm starting to wonder whether I will have to get back on Zoloft and taper. I just don't want to expose my baby to it especially during this first trimester when organs are forming! I am really freaking out. Not a good day today at all. 

[Missourimama]

22 hours ago, Altostrata said:

Hello, @Missourimama

 

I agree with Shep.

 

 

Moreover, if you've been using benzos for periods here and there, it's possible these panic attacks are actually benzo withdrawal symptoms. A very mild withdrawal condition can be exacerbated by occasional alcohol or even antibiotic treatment, and produce symptoms of severe withdrawal, such as panic attacks, which are also characteristic of antidepressant withdrawal.

 

What we see here is that a history of going on and off psychiatric drugs, including benzos, increases vulnerability to psychiatric drug adverse reactions (such as you experienced with Prozac) and withdrawal symptoms.

 

You might have felt better on Zoloft because the benzo withdrawal symptoms faded over time, as withdrawal symptoms will do, though sometimes it takes a very long time.

 

.

In my amateur opinion, all antidepressants have the same risk in pregnancy, but paroxetine is highest and fluoxetine is lowest for postnatal withdrawal symptoms. 

 

For what reasons have you been taking clonazepam lately?

 

You might do better with a smaller reinstatement, even 1mg, of sertraline. Lower dosage would me lower exposure for your baby. It comes in a prescription liquid so you can take small dosages. We have seen even 1mg-5mg can relieve withdrawal, you'd taper off by minute amounts later.

@Altostrata Well, I am really struggling again today. PGAD, which I had occasionally before I ever took SSRIs, is flaring up again and freaking me out. I'm guessing it's just the anxiety but it's really troubling me deeply. I may have to reinstate 1 mg Zoloft. I don't know what else to do, I can't take more clonazepam. I am scared.  

[Missourimama]

I'm just really struggling. Feeling like a failure. I thought I could be one of the "lucky" ones who came off cold turkey with minimal problems. I intentionally stayed on a very low dose despite pressure from my meds provider to go up, and sometimes I would "forget" to take the Zoloft for days at a time. I thought maybe that was some small insurance against future withdrawal. 

 

I hate this. I don't want to permanently brain-damage my baby because I can't cut it with withdrawals! It's just so hard not knowing when it will end or get better. Right now I feel barely functional and I have two wonderful older children whom I homeschool and I need to be okay for them!

[Missourimama]

@OnmywayCould you please explain to me what "kindling" is? I searched and see lots of discussion about it but can't find a quick definition. Thank you! 

[getofflex]

I'm sorry to hear that you are having a lot of anxiety today.  I understand how unpleasant this is.  Please remember, anxiety will not kill you, no matter how bad it is.  Today is a bad day, but perhaps tomorrow will be a better day.  Is there a way you can get someone to help you with homeschooling the kids?  Try not to freak out about PGAD, that won't kill you either.  I know it really uncomfortable, but it's not going to last forever.  Withdrawal can really suck, but it is not forever.  

 

The main thing that helps me with panic and anxiety is a strong spiritual life.  

 

Acceptance and Hope

 

Finding Meaning

 

When I'm dealing with something very bad, I try to take it just one day at a time, one hour at a time, or even one moment at a time.  Tell yourself, I can deal with this, just for this one hour.  Try to stay in the moment as much as you can.  Radical acceptance can really help. Here are some links about these things.  

 

Acknowledge Accept Float

 

https://www.verywellmind.com/what-is-radical-acceptance-5120614

 

You asked about kindling.  That means that the nervous system becomes sensitized from going on and off psychoactive drugs repeatedly, and each subsequent withdrawal becomes more difficult and painful.  Here is a link on that:  

 

Nervous System Hypersensitivity and Kindling

 

I hope and pray you feel better soon!  

Edited March 3, 2022 by getofflex

[Missourimama]

@getofflexThank you so so much for all this. It helps immensely just to hear these simple truths from someone else... somehow they can sound more powerful and concrete coming from someone else rather than when I am just trying to reassure myself.

 

I am reading more information on this site and feel now I made a mistake in trying to quit abruptly. I just desperately wanted to protect this baby, but I'm hoping I can try a minimal reinstatement and slowly taper off of that thus exposing the baby minimally at least. I still hate to idea of exposing him / her to this drug while the brain, organs and major body systems are developing 😔 It breaks my heart. I just keep praying for his / her protection during this process, that somehow it won't have an effect.

 

I wish I hasn't completely surrendered to the psych drugs as I did. My breakdown in early 2020 was very, very hard on my family and obviously very hard on me. I felt I needed to submit to stabilization through meds for the sake of those who love me. I didn't think it was possible for us to conceive again (long story) so I just didn't really consider that, but here we are! It is truly a gift and I hate that my joy in it has been obscured by this withdrawal issue.

 

My faith is very central to my life too but the severe anxiety makes it so difficult to feel that peace! I hate that. Going to my therapist tomorrow, thank God! She has truly been instrumental in saving my life. I had gone down to seeing her once a month but when this all began I asked if I could come back once a week and she made space for me!

 

Again, thank you for the response, encouragement and information. It means more than I can express!

[Altostrata]

16 minutes ago, Missourimama said:

My breakdown in early 2020 was very, very hard on my family and obviously very hard on me.

 

As noted before, this may have been an adverse effect of inconsistent dosing or benzo use, not a breakdown. We see this all the time.

 

On 3/1/2022 at 5:39 PM, Altostrata said:

You might do better with a smaller reinstatement, even 1mg, of sertraline. Lower dosage would me lower exposure for your baby. It comes in a prescription liquid so you can take small dosages. We have seen even 1mg-5mg can relieve withdrawal, you'd taper off by minute amounts later.

 

If you have withdrawal syndrome, you'll probably feel better even with this very small reinstatement. We  assume your system is  sensitized; a very low dose minimizes risk of kindling.

 

I am sorry women who become pregnant are put in this position.

[Missourimama]

@OnmywayI know you said you were actually mistaken on Zoloft not crossing the placenta well... but I'm wondering because i have now reinstated such a low dose that theoretically this would be minimal exposure for the baby? I don't want to hurt my child and am alarmed over reading how SSRIS effect brain development (larger amygdala etc). 

[Altostrata]

This very small reinstatement would have minimal effect on the baby. Taking a benzo would have much more of an effect.

 

I see you have also started trazodone? We will be unable to tell the effects of the drugs apart. You may be taking one or the other unnecessarily. We advise making only one drug change at a time, to better observe the effect.

[Missourimama]

Hi all,

 

I have decided to continue without reinstating and my husband and I have agreed it will be better for my mental health to get off this site and stop looking up information about AD withdrawal in general because I think it is exacerbating my anxiety. I am certain this site has helped many, many people but it's not the best choice for me right now. All the people I know IRL who have gotten off ADs have either gone cold turkey or done a fast doctor-recommended taper and all said they only had withdrawal symptoms for 2-3 weeks. I know many are not so fortunate as demonstrated by this site but at this point with the pregnancy I just have to hope and pray that I will be a short-term withdrawal case. I am blessed to have not had any physical symptoms at all aside from nausea which has now faded (though pregnancy nausea is now kicking in but is not as severe), just the anxiety and panic which can feel very severe and debilitating at times. I also discovered I have a UTI yesterday which I think was making me fear I had PGAD. I have had some very difficult "waves" the past few days, but I have also had some wonderful windows that lasted for hours or even the whole evening (I tend to feel better at night). Professional therapy as well as talking to my husband (who himself withdrew from numerous psych drugs in his early 20s) is helping immensely. 

 

Thank you again for all the wisdom and help. I truly appreciate what you do, it is just not the best spot for me at this time. Just wanted to update you instead of simply disappearing. Perhaps here in a few months I will return to update. Thank you from the bottom of my heart. God bless you. 

[getofflex]

3 hours ago, Missourimama said:

I have decided to continue without reinstating and my husband and I have agreed it will be better for my mental health to get off this site and stop looking up information about AD withdrawal in general because I think it is exacerbating my anxiety.

I think you have made a brave decision, to continue without reinstating.  I can fully understand that you need to step back from our site, since it is increasing your anxiety.  I assume you CT'ed the Zoloft and the trazodone both?  

 

I see you posted a quote from the Bible.  Reading the Bible slowly and prayerfully always calms my anxiety.  I'll be praying for you and your baby.  

[Missourimama]

@getofflex Thank you so very much - your comment made me cry! I am so touched and encouraged that you are praying for me and the baby. Yes, I CT'd both the trazodone and zoloft. When I tried reinstating a few days ago it made me feel very strange and unpleasant. I am hoping and praying for the best. Sometimes when I am very overwhelmed I love to just lay down and listen to an audio version of Scripture, or have my 10-year-old daughter read it to me, which is very sweet. Thank you again for the prayers, that is deeply meaningful for me and I am so grateful. 

[ChessieCat]

Hi,

 

It looks like there is an error in your drug signature.  Please also check that the earlier years are correct.

 

February 2021: Became pregnant. Cold turkey'd everything. WD started a few days later, all psych symptoms- severe anxiety, panic, dread, fear. 

 

This link goes straight to your drug signature.  Remember to Save.

 

Account Settings – Create or Edit a signature

[Onmyway]

On 3/5/2022 at 3:46 PM, Missourimama said:

Hi all,

 

I have decided to continue without reinstating and my husband and I have agreed it will be better for my mental health to get off this site and stop looking up information about AD withdrawal in general because I think it is exacerbating my anxiety. I am certain this site has helped many, many people but it's not the best choice for me right now. God bless you. 

Hi @Missourimama

hope you have an easy time and pls do what is best for you and your health. We are here if you ever need us again but hopefully you won't. May you have a healthy and easy pregnancy and a healthy and happy baby! 

 

We are thinking of you, 
OMW 

[Altostrata]

Please let us know how you're doing.

[Missourimama]

Hello all! I've been thinking lately that I needed to come and give and update. I'm currently almost 15 weeks pregnant, about 8 weeks off all my medications and doing very well! 

 

The first 3-4 weeks of withdrawal were truly hellish. The intense feeling of hyperarousal was the worst - it honestly reminded me a bit of the "initiation syndrome" which I experienced when I first went on ADs, but it was significantly worse. The best I can describe it is that it felt as though there was no rest or refuge anywhere in the universe - not for my body, not for my mind, not for my soul. As I type that out now it sounds awfully hyperbolic but that's truly how it felt! My digestive system was also way out of whack for a couple of weeks. The suicidal ideation was also very scary - even though I kept reminding myself it was a symptom of withdrawal, it felt very real, and that was terrifying. I returned to therapy once a week and that helped immensely - I would tell myself "I only need to make it to the next therapy appointment". My husband was aware of what was going on but was very concerned. My faith was very, very important to me during this time and I found it crucial to "fix my eyes on things unseen" because I could not *feel* hope.

 

There were a handful of times in those early weeks that I took a quarter of a .5 mg clonazepam. I'm not proud of that, but there were times the feelings were so intense I didn't know what else to do. I did that for the last time maybe around 5-6 weeks ago. I'm hoping the dosage was so small that it did not affect the baby.  

 

I appreciate your concern and your showing me grace when I needed to take a break from this site. I deeply appreciate all you do here but reading the stories of those who suffered for many months or even years was adding to my distress because I became so fearful that I might be one of those whose suffering was greatly protracted (and you all are truly heroic for enduring that!). 

 

Thankfully, I seem to have emerged from acute withdrawal around 3.5 weeks. It was such a profound relief. As for protracted withdrawal, I seem to have been lucky, or else pregnancy is masking some of those symptoms because I generally feel quite well. I have struggled with frequent headaches but I struggled with that prior to pregnancy due to TMD. But psychologically I have felt quite well. 

 

While I am glad I made it through and have the comfort of knowing my baby will not be exposed to psychiatric drugs in utero, I absolutely understand now why cold turkey is so strongly cautioned against, and I will never go on ADs again in my life. It's not worth experiencing that again, and honestly I never really felt like they helped me much anyway - I just finally submitted to them because I felt like I needed to.  

 

Thank you again for your support and all you do here. You all are truly a lifeline for many - you were for me. Although I did need to take a break, having read the stories and knowing that withdrawal is real was immensely helpful in enduring it. God bless you.