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GreenIvy: Tapering while raising a family


GreenIvy

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Hello, I have been on 25mg of zoloft Sertraline for 10 years for depression. I would like to taper and hopefully be off this drug in the future because I want to have more children. I am still young and do not want to be on this drug for the rest of my life.   I have 2 small children and was on this medication for both pregnancies. I worry about the effects the medication may have had on my children being exposed during pregnancy.  I feel frustrated for the fact that when I was first prescribed this drug in my early 20's the doctor neglected to tell me how difficult it would be to get off this drug and that I could put my future children at risk.  If I successfully taper slowly over 3 years, I  feel afraid of the withdraw symptoms. Mainly I feel afraid because I know the withdraw symptoms can be debilitating and I have a job, husband, and 2 small children.  

 

Do people taper when they have all these family responsibilities? I worry it would be too much of a risk to go all the way down to 0mg.  I am thinking I should just try to make it to a lower dose.

2012: citalopram eventually switched 50 zoloft

2012: 50 mg sertraline decreased to 25 mg sertraline

2021: 1 month taper from 25mg to 0mg sertraline in January.   Experienced withdraw symptoms 

2021: Feb  doctor reinstated 50mg sertraline,  decreased to 25mg April 2021

2021: October birth of baby doctor increased to 50 mg sertraline after panic attack.   

2021: November 25 mg sertraline 

Currently: on 25 mg sertraline and Prenatal vitamin 

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Posted (edited)

Introduction

 

Hi, I have been on 25 mg sertraline for 10 years and would like to begin tapering because I don't want to be on this medication for the rest of my life since.  

 

 

Edited by ChessieCat
added Intro topic title before merging with intro topic

2012: citalopram eventually switched 50 zoloft

2012: 50 mg sertraline decreased to 25 mg sertraline

2021: 1 month taper from 25mg to 0mg sertraline in January.   Experienced withdraw symptoms 

2021: Feb  doctor reinstated 50mg sertraline,  decreased to 25mg April 2021

2021: October birth of baby doctor increased to 50 mg sertraline after panic attack.   

2021: November 25 mg sertraline 

Currently: on 25 mg sertraline and Prenatal vitamin 

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  • Moderator

Hi @GreenIvy

welcome to SA. Sorry you have been put on these drugs so young (me too) without being told of the reproductive consequences.

However, fear not, you can come off of them. If you taper your drugs properly from the start you should feel little if any withdrawal symptoms and should be able to be present for your family during the process and enjoy seeing your little ones grow. Most of us, suffering here, did not do it the right way. In very rare circumstances even slow tapers can be difficult but there is no reason to think that you are one of those cases. 

 

Here is most of what you need to know about tapering. Read it carefully and ask questions if something is unclear or you need advice. 

Important topics in the Tapering forum and FAQ - Tapering - Surviving Antidepressants

 

The key is to taper very slowly and stop and hold if symptoms appear. 

Why taper by 10% of my dosage? - Tapering - Surviving Antidepressants

Why taper? SERT transporter occupancy studies show importance of gradual change in plasma concentration - Tapering - Surviving Antidepressants

 

To begin, can you please create a drug signature? It will help us advise you better. 

How to List Drug History in Signature - Introductions and updates - Surviving Antidepressants

 

Please read the above links and let's get you ready to start :)
OMW

 

 

I am not a doctor and this should not be considered medical advice. You can use the information provided in whatever way you want and all decisions on your treatment are yours. 

 

If you would like to get a response from me directly please type @Onmyway some place in your message so I get notified of your post. I am not able to follow all of the threads all the time.

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week, 

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785

 

Supplements: magnesium citrate and bi-glycinate

 

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  • ChessieCat changed the title to GreenIvy: Tapering while raising a family

Thank you @Onmyway. I updated my signature.   I did an excel sheet of a 10% taper schedule from 25mg to 0.5mg. It looks like it will take a little over 3 years to taper. Does that sound right? It is a very long process. 

2012: citalopram eventually switched 50 zoloft

2012: 50 mg sertraline decreased to 25 mg sertraline

2021: 1 month taper from 25mg to 0mg sertraline in January.   Experienced withdraw symptoms 

2021: Feb  doctor reinstated 50mg sertraline,  decreased to 25mg April 2021

2021: October birth of baby doctor increased to 50 mg sertraline after panic attack.   

2021: November 25 mg sertraline 

Currently: on 25 mg sertraline and Prenatal vitamin 

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  • Moderator Emeritus

Yes, that sounds about right, but it may take longer because SA suggests holding for longer if you are going through additional stress or are sick.  Also the suggested jump off dose is about 0.025mg.  It took me 6 years to get off 100mg Pristiq.

 

Even though it seems ridiculously long, it is a safer way of getting off your drug with minimal withdrawal symptoms and being able to live your life as normally as possible whilst doing it.

 

And every reduction you make means less drug you are taking.  There came a time whilst I was tapering that it felt silly taking such a low dose, but because of what I have learned here at SA and what I have seen other members go through, it made sense to keep tapering carefully.  And I kept reminding myself that it wasn't me that needed the drug, it was my brain that needed it.

 

Getting off a psychiatric drug has nothing to do with how strong and determined we are as a person.  The brain has adapted to getting the drug and it needs to be taken away gradually to allow the brain to get used to not getting as much of the drug.  If it is taken away quickly, that is what can result in withdrawal symptoms because the brain is busy trying to regain homeostasis.

 * * * * * *   PLEASE WATCH THIS VIDEO   * * * * * *

Antidepressant Withdrawal Syndrome and its Management

 

MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

Woohoo!!!  Finally off Pristiq    Post 0 updates start here

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

My full tapering program     My Intro (goes to my tapering graph)    My website

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

Please DO NOT TAG me - thank you.

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Thank you Chessie cat and Onmyway!  I updated my excel sheet to make my jump off dose 0.025mg.

2012: citalopram eventually switched 50 zoloft

2012: 50 mg sertraline decreased to 25 mg sertraline

2021: 1 month taper from 25mg to 0mg sertraline in January.   Experienced withdraw symptoms 

2021: Feb  doctor reinstated 50mg sertraline,  decreased to 25mg April 2021

2021: October birth of baby doctor increased to 50 mg sertraline after panic attack.   

2021: November 25 mg sertraline 

Currently: on 25 mg sertraline and Prenatal vitamin 

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  • Moderator
On 4/20/2022 at 6:49 AM, GreenIvy said:

Thank you @Onmyway. I updated my signature.   I did an excel sheet of a 10% taper schedule from 25mg to 0.5mg. It looks like it will take a little over 3 years to taper. Does that sound right? It is a very long process. 

@GreenIvy

if you find yourself not having any WD symptoms on this 10% a month decrease for a few months, you can trial a 10% every 3 weeks decrease. There is some risk with that as some symptoms may be delayed but may be worth a try at the higher doses. It becomes harder to do it at the lower ones as they tend to be more difficult to wean off of. 

 

I am glad you are doing a proper taper plan. We are here to support you throughout. 

OMW

I am not a doctor and this should not be considered medical advice. You can use the information provided in whatever way you want and all decisions on your treatment are yours. 

 

If you would like to get a response from me directly please type @Onmyway some place in your message so I get notified of your post. I am not able to follow all of the threads all the time.

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week, 

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785

 

Supplements: magnesium citrate and bi-glycinate

 

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I have 2 questions about tapering. 

 

1. When an individual follows the correct slow taper guidelines, has there been people who were able to continue working and maintain daily responsibilities throughout the entire process? I know that withdraw symptoms can be debilitating. But if tapering is done properly and one listens to their body, have there been people who carried on with daily life.  All of the horrible stories  I read make me cautious. (Please provide examples of people who followed the recommended tapering guidelines)

 

I am asking because I have a family to raise  2 kids and am taking classes to advance my career. 

 

2. Regarding withdraw symptom:  since sertraline zoloft is the only drug I am on, does this drug have withdraw symptoms more commonly associated with it that I should be on the lookout for?

2012: citalopram eventually switched 50 zoloft

2012: 50 mg sertraline decreased to 25 mg sertraline

2021: 1 month taper from 25mg to 0mg sertraline in January.   Experienced withdraw symptoms 

2021: Feb  doctor reinstated 50mg sertraline,  decreased to 25mg April 2021

2021: October birth of baby doctor increased to 50 mg sertraline after panic attack.   

2021: November 25 mg sertraline 

Currently: on 25 mg sertraline and Prenatal vitamin 

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  • Moderator
Posted (edited)

Hi @GreenIvy

yes, if you follow the proper tapering guidelines things are manageable. I quit from 5 to 0mg after a 5 month taper from 40 citalopram and the first five months were absolutely awful even though I reinstated within a month - the day the Horowitz article came out. Things slowly stabilized and I have been able to hold a relatively demanding professional job while tapering from reinstatement. My nervous system is sensitized (I had been on these drugs for almost 20 years when I tried to stop) so I drop by less than 10% a month and if I feel withdrawal symptoms I hold for a few extra days or a week or a month. But I am at the low end - 0.7mg so the low end is harder and smaller drops might need to be considered. I am having windows and waves - some days are much worse than others but they are all manageable. Have in mind that during this I also underwent 3 IVF cycles. It was tough but also manageable. I am not saying IVF is anything like raising children but that you can manage even physically and emotionally taxing things if your taper is slow enough and you are able to stop tapering and hold when needed. You have to be flexible with things during the process. 

 

Symptoms that have improved were: 

sleep - the first 5 months I got about 2-4 hrs a night, I would be constantly jerked awake in terror multiple times. Sometimes slept even less, now I can get 6 regularly, sometimes more. The terror awakenings are still here in waves but much better also. And I have learned to manage them better. Get out of bed and do stuff, which with two kids you probably have to do anyway. 

 

paresthesias - at some point I had half of my body (left side head to tow) tingling. It was very disconcerting, completely gone. 

 

akathisia - the first month I had akathisia, some physical, some mental and that was absolute hell but haven't had it since

 

neuro-emotions - my fuse is still short - I get angry easily which is so unlike me and have to remove myself from situations but overall I am doing much better in this department; I can still go into rumination cycles after a drop - they can be anything from the past to some present situation but it is not to the level it was in the very beginning (proper awful withdrawal). I had sheer terror from random things - like buses! - after the fast taper. First few months I felt absolute disgust at everything, had derealization, the world was bleak and at times as scary as hell. Now, that's gone though some emotional distress in waves is not unheard of. 

 

dizziness and nausea - I could only eat ginger cookies the first 4-5 months -  totally gone, very healthy appetite;

 

anxiety was non-stop in the beginning - has largely improved

 

fatigue - I have occasional fatigue usually after a cold or some other viral illness and it can linger for weeks but I think that is probably more viral than WD. I don't think i have any physical symptoms left now when I think about it.  Emotional are manageable. 

 

On occasion I have had symptoms like hyperacusis - sounds feeling much louder but it is much rarer now. 

 

The reason why I am listing the first 4-5 months and now is to demonstrate the difference between serious withdrawal from rapid taper (I tapered 40mg to 0 in 5 months by going 40-30-20-10-5-0 until all hell broke loose)  and the withdrawal symptoms of a slow taper after reinstatement and stabilization (now). I reinstated at 2.5mg - would have tried less but didn't have SA at the time. I still have bad days and anxiety and rumination and irritability can be annoying. But it is nothing to the level it was in the beginning with a fast taper. 

 

Tbh, I don't see another way to get off of these drugs than to go very slowly. That is why I do what I do here so people don't have to go through the hell that I went through.

 

You can also do this with our support. You just have to listen to your body. This is absolutely doable. Even with a job and kids and other demands. It is not an easy process by any means. But it is doable. YOU can do it. 

 

OMW

 

 

Edited by Onmyway

I am not a doctor and this should not be considered medical advice. You can use the information provided in whatever way you want and all decisions on your treatment are yours. 

 

If you would like to get a response from me directly please type @Onmyway some place in your message so I get notified of your post. I am not able to follow all of the threads all the time.

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week, 

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785

 

Supplements: magnesium citrate and bi-glycinate

 

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Thank you for your response!!

2012: citalopram eventually switched 50 zoloft

2012: 50 mg sertraline decreased to 25 mg sertraline

2021: 1 month taper from 25mg to 0mg sertraline in January.   Experienced withdraw symptoms 

2021: Feb  doctor reinstated 50mg sertraline,  decreased to 25mg April 2021

2021: October birth of baby doctor increased to 50 mg sertraline after panic attack.   

2021: November 25 mg sertraline 

Currently: on 25 mg sertraline and Prenatal vitamin 

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  • 2 weeks later...

For anyone who took sertraline zoloft during pregnancy: Did your children NOT have developmental delays and NO behavioral issues?

 

I have a toddler and baby and want to be hopeful that they will not have issues down the road even though they were exposed to ssri during pregnancy (started with 25mg zoloft decreased to 12.5mg in the first pregnancy and started at 50 mg zoloft decreased to 25mg during the second pregnancy). 

 

I feel upset that my obgyn and psychiatrist told me it was completely safe. 

2012: citalopram eventually switched 50 zoloft

2012: 50 mg sertraline decreased to 25 mg sertraline

2021: 1 month taper from 25mg to 0mg sertraline in January.   Experienced withdraw symptoms 

2021: Feb  doctor reinstated 50mg sertraline,  decreased to 25mg April 2021

2021: October birth of baby doctor increased to 50 mg sertraline after panic attack.   

2021: November 25 mg sertraline 

Currently: on 25 mg sertraline and Prenatal vitamin 

Link to comment
  • Moderator

Hi @GreenIvy

the studies that I have seen look at the rate of ASD in people exposed to SSRIs in the womb. The best ones are population level observations from the Nordic countries. They show that the rate of ASD is increased but not by that much. When not adjusted for maternal depression or anxiety (whatever they mean for the child) the risk ratios were around 2 (so double the incidence) but after adjusting the differences were smaller and not statistically significant - i.e. could be due to chance. Even if the rate was increased, it was still small - less than 2-3% of exposed babies. What you can do is keep an eye on the children and if they do exhibit signs of delays get them early intervention.

 

I don't think anyone should take these drugs in pregnancy (or at all) but often women are misinformed. However what's been done has been done. You can't change the past. Good news is you were on quite low doses. Take good care of yourself and your babies and we will all hope for the best.

 

Sending you hugs, 

OMW

 

PS. Articles that report on SSRI use and ASD

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3832387/

https://pubmed.ncbi.nlm.nih.gov/28528584/

 

I am not a doctor and this should not be considered medical advice. You can use the information provided in whatever way you want and all decisions on your treatment are yours. 

 

If you would like to get a response from me directly please type @Onmyway some place in your message so I get notified of your post. I am not able to follow all of the threads all the time.

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week, 

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785

 

Supplements: magnesium citrate and bi-glycinate

 

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