Solang: New hope

[Solang]

I may try the small bottle and syringe, especially since the MD got my Rx wrong and gave me 50 mg tabs instead of 25 mg.  But I'm not going to say anything about the error because that way I get double the amount of meds for the same price, which is a big deal seeing as my insurance is ending in 5 weeks.  (Which probably also makes the compounding pharmacy option way too expensive.)

[Altostrata]

Have you tried getting the Zoloft liquid version?

[Solang]

I did another sertraline redux to 37.5 mg about a week ago simultaneously with quitting the FW and starting to hike the the John Muir Trail. So far I feel great, as predicted since I am hiking about 10 miles per day through beautiful scenery. My only symptom thus far is nightmares every night, except last night thank goodness I got a break from that! I will probably reinstate the FW when I get off the trail in a week. I didn't want to carry the dang thing through the mountains. Today I am at a hiker stop with WiFi but won't have internet again for about a week.

 

Are there any threads specifically about nightmares? I have been unable to find one.

 

Just found out I also have sleep apnea so I will be getting an oral appliance for that.

[Solang]

I got off the trail on july second and am still feeling good holding at 37.5 milligrams zoloft, 300 wellbutrin, and not using the fisher wallace. Yesterday I looked at a self help workbook I was doing called the mind body work book for ptsd. I saw some things I had written about my work situation, and I realize that it was an incredibly toxic place that was definitely preventing me from feeling better. Well, I actually already knew that but it was quite a jolt to be suddenly brought back into that situation in my mind. It also gave me hope that I will be successful with my medication reduction because it became glaringly clear how stressful being in that work place was for me, and now that stress is gone. Fortunately I have the savings that enabled me to get out of that place. I know there are many others who do not have that luxury. The nightmares have subsided a great deal also.

[Petunia]

Thanks for the update Solang, I'm glad you are doing well.  Good to hear about your insight which confirmed the work decision, its funny how sometimes we need to get some distance from things before we can see them clearly.

[Solang]

Thanks Petu. Yes, when I saw that little bit in the workbook my whole body cringed, almost violently. Some people had encouraged me to leave, others said I should be grateful for the job, and others thought I should treat it as a sort of meditative practice of holding my center in the midst of negativity and drama. Now my body screams "don't ever take me back to a place like that!"

[Solang]

Wow, life has been throwing me some major curve balls, and as a result I've found it necessary to go back up slightly on my Zoloft, by adding back 1/16th of a dose.  Hopefully this will stave off the sense of overwhelm (I like the term "dystalgia" from the neuro-emotions thread, which seems to describe the feeling pretty well) that turns into uncontrollable crying spells at very inopportune times (i.e., in public).  And, the waking up at 3am and tossing and turning the rest of the night.  

 

Of course, the stuff I've been going through might cause anyone to have such symptoms, let alone someone doing med w/d!  Specifically, I went traveling with a friend - which I knew was a bad idea, but did it anyway, because I didn't want to be alone.  Then she started treating my like my narcissistic mother and ex, and I realized she really isn't a friend.  Soon after that, the person I considered my best friend flew into a rage at me over a relatively minor confrontation, and I realized she isn't really a friend either (at least, not one that I can risk being very close to - her hostile episodes completely throw my nervous system out of whack).  A couple of weeks later, my boyfriend told me he had slept with someone else.  And then just the other day, my boyfriend told me that a person I thought was our mutual friend doesn't want me around at all because I am "too negative" and "can't let go of the past" and she doesn't like that I quit my job.  Jeeze, I feel like my life is falling apart!!!!  This sucks!!!

[Solang]

I cannot believe what a dingbat I am.  I guess I could say this happened because of withdrawal, but it's not the first time I've done something like this.  Here's what happened:  I use "pill reminders" that I put together every two weeks so I don't have to measure anything out for the following two weeks.  Two weeks ago, instead of putting TWO 150mg Wellbutrins in per day, I only put in ONE!!!  I know part of the reason is that for 90 days at one point I was using 300mg pills.  Nonetheless, I was not PRESENT to what I was doing when I put those pill reminders together two weeks ago!  And I was so focused on carefully cutting the dang Zoloft that I wasn't thinking enough about the Wellbutrin.  

 

So, three days later, not realizing what I had done, I assumed that my increased symptoms were due to the Zoloft reduction I had done 5 weeks prior, and increased the Zoloft from 31.25 mg to 34 mg.  Needless to say, this did not significantly help my symptoms.  After a week of this, I was having serious suicidal ideations and massive crying spells.  I had a wonderful spiritual healing the day after my worst crying spell/ideations and felt much better.  But I've noticed a steady increase in my skin-picking behavior, to where it's become almost constant, and very very challenging to just keep my hands away from my skin!  Then a couple of nights ago I had akasthisia and couldn't get to sleep, couldn't stop moving around.  I finally took a benadryl that night to get to sleep.  Last night I slept well, but this morning when I had run out of the reminders and had to take the Wellbutrin straight from the bottle, I realized what I had done!  

 

I am still not 100% sure that I really didn't have two pills in each of the days, because the pill cases are empty now, but I'm about 90% sure, especially since reading that akathisia can be caused by dopamine antagonists, and since Wellbutrin is a dopamine agonist, obviously such a quick reduction in it will have the same effect as a dopamine antagonist.  

 

So I think what I'm going to to now is go halfway back up on the Wellbutrin today, by taking 225 mg/day (150mg extended release plus 75mg immediate release in the morning).  I wasn't planning on reducing the Wellbutrin until I was down to 25mg Zoloft, but now that I've accidentally started the reduction I don't want to make another wild dosage swing back up to the full amount.  Plus I can say that it seems Wellbutrin is not as difficult for me to reduce as Zoloft, because if I had suddenly gone down 50% on the Zoloft - which I did at one point on recommendation of a MD - my symptoms would have been much more debilitating.  But, I'm looking for ADVICE about this, if anyone has any.  Or at least some reassurance that I'm not a total MORON for doing this.  And, to remind everyone to TRIPLE CHECK your dosages when you put your pills together!!!

[mammaP]

Hi Solang, I moved your new post to your intro thread, it is one thread per person here in the intro

forum, it keeps everything in one place and is easier to keep track of things. 

 

You have taken half your dose of wellbutrin for 2 weeks, how long ago did you increase the zoloft?

 

I think it is a good idea to increase by half for now, that will then be a 25% reduction instead of the 50%,

then maybe up another 15% in a few days time . It will probably take a while to settle down again because

of the increase in zoloft too.  Your nervous system will stabilise so try not to worry too much. The good thing

is that now you know what is happening to your body and can wait it out. Knowing makes a huge difference,

it is hellish when you don't know what is causing the symptoms, especially when you have been so careful.

 

Don't beat yourself up about it, I've made mistakes with mine at times and suffered the consequences! 

[Solang]

Thanks Mamma P, I hadn't thought about tapering back up on the Wellbutrin.  The Zoloft increase was on Sept. 27th.  

 

And thanks for the reminder not to be too hard on myself.  Also I need to not to be so concerned that I'm not getting anything done.  That is another withdrawal symptom - having lots of nervous energy yet being too scattered to actually accomplish anything!

[simon]

Hi Solang

Ive been reading through your posts and found them all very interesting (although at times way beyond my understanding!)

The very first post of jan 28th you mentioned the prospect of a technique that would require you to devote 2 hours a day to meditation; and that being beyond your capacity to engage in cos of work commitments etc.

My situation is that im quite new to this forum and quite shell-shocked by the prospect of slow withdrawal etc. but im going to do it when I stabilize.

Over the last 18 months ive fallen into depressive episodes' on 2 occasions and latterly over the last couple of months attempted to get off an AD too fast and after 6 weeks being free of the drug, crashed pretty badly. (similar to your experience of SSRIs)

About a year ago I did a course in MBCT, which is the Jon Kabat-Zinn inspired form of mindfulness meditation. I went for it full on and it has become an integral part or my life for many reasons.

On those 2 occasions when I had depression ( Ithink caused by combination of these drugs 'pooping out' and the  onset of a medical condition which was a great shock), I had lots of time to meditate and learn the practise of mindfulness.

What worked for me then was the sitting practice (or lying) whereby you attend to your breathing, and as thoughts come into your mind you acknowledge them but don't follow them, as you return to the sensation of the breath in the body. The important thing is not to try to blot out thoughts (as they always return if you do that) but accept them before bringing the mind back to the breath. Or it can be any other sense (like sounds,or even sights but I find the breath easiest as its always there!)

The thing is what I learnt is that in depression, rumination is the killer. It gets you into this downward spiral. Constantly dwelling on the same old negative thoughts.

For me, the meditation became a sort of training of the mind; you begin to recognise what the mind is up to and that you have some control over how far you go with a particular thought.

Often, if you are highly anxious, you end up miles down the road, as one thought leads to another, to another. But each time you come back to the breath, you've regained control and some confidence that you can steer the mind from inappropriate pathways.

Anyway I did lots of this, also bodyscans and walking meditations and each of the 2 occasions mentioned above I came out of the depression in about 6 weeks. For me that is a very short timescale. But the other thing is that I also experienced far fewer symptom of depression . I could eat, sleep concentrate, which again , for me, was very unusual compared to previous times.

All these techniques are on utube of course and I also belong to a forum here in the uk called 'Everyday mindfulness.org'

To be honest, my present predicament is different and in the depths of it I couldn't really connect' with the meditation. But I still went through the motions and that alone I believe is worthwhile. Things are going on below inspite of any 'feelings' to the contrary.

As far as length of time is concerned , I recommend it as a good investment of time in the long run. ~Also, the idea of mindfulness is to incorporate it into your whole day,its about living in the present and not on auto-pilot all the time. The reason ive spoken about the formal meditation side of it is that, really that's all I could do in those dark days. And it was enough.

 

I wish you all good things

 

Simon

[Altostrata]

So I think what I'm going to to now is go halfway back up on the Wellbutrin today, by taking 225 mg/day (150mg extended release plus 75mg immediate release in the morning).

 

This makes sense to me. Let us know how you're doing.

[Solang]

Alto, thanks for your response.  I'm actually hoping I can get away with staying at 225mg and not got up anymore, but we'll see.  I feel ok right now (2nd day on 225mg), but it may be awhile before I can get much accomplished.  

 

Mamma P, thanks for combining my threads.  Next time if I'm seeking urgent advice I will just change the title of my topic...?

 

Simon,  I appreciate your recommendation of meditation.  I wonder if you know Salma Darling?  She teaches the Kabat-Zin course and seems to split her time between California and the UK.  I've actually taken Vipassana/Insight meditation classes a couple of times.  These were six week classes that met once per week, and I was able to discipline myself into meditating for 20 mins per day for those six weeks, and I did notice some positive effects.  Unfortunately self-discipline is not one of my strong points, though I'm trying to change that!  In fact, I will be doing a month-long residential yoga teacher training course at a spiritual community (Ananda) from October 26 to November 23rd.  In addition to hatha yoga it will involve a fair amount of daily sitting meditation as well as chanting.  I expect this will have a very calming effect on my nervous system, and perhaps (please please!) I will develop the discipline to stick with it after the course is over.  

 

Aside from lack of discipline, I sometimes have challenges with physical pain while sitting still - in my neck and back.  This pain even sometimes is pretty bad even if I'm lying on the floor.  But I'm doing near-daily physical therapy exercises on my own, which seem to be helping.  I've been doing sitting meditation 15 mins per day for the past week or so, but my thoughts were flying around wildly.  Well, now I know why (the accidental Wellbutrin underdose!).  I expect that my ability to "concentrate" will improve as my nervous system adjusts to the dose change.  I really applaud you "going through the motions" even when you couldn't connect with the meditation.  That inspires me to keep at it even if it seems like all I can do is notice once every minute or two that my thoughts have been flying around wildly.  

 

You are totally right about the negative rumination - that's a huge problem for me.  I've been doing a little work from a book on "Acceptance and Commitment Therapy,"  which involves a lot of mindfulness.  The idea is to accept whatever thoughts or feelings you're having in the moment (which of course first requires that you be aware of them), then maintain the observer role (realize that the thoughts and feelings are NOT you and they don't have to influence your behavior if you don't want them to), and commit to a course of action that aligns with your values regardless of whatever unpleasant thoughts and feelings may come up.  In other words, you accept your thoughts and feelings rather than thinking something's wrong if they are negative and that therefore you must figure out what is wrong and make them stop.  Of course, in my view, I must be careful not to take this TOO far, because SOMETIMES our thoughts and feelings ARE telling us that something needs to change (for example, that we need to taper our meds much more slowly).  I'd say the vast majority of the time though that the ruminations are not helpful and the best thing I can do is just let them float on by.

 

Thanks again for the renewed inspiration!

[simon]

Yes, well one of the things about these forums is that you don't know exactly what the person youre writing to has tried already! And I see you are well aware of some of these therapies.
I think though that as other people read the conversations, they too might well be picking up bits that are useful to them.

I really think that for many people its got to be so useful to have things like meditation in place as its a safeguard against falling again into negative thinking once the drug withdrawal is over and during it as well.

Over here, mindfulness is now classed as an 'evidence based' therapy by the national health service and so gets plenty of credence. And of course yoga and tai-chi compliment it too.

Another thing I find too ,is that doing something like a' bodyscan' where you normally lie down, it helps to have a guide. So I put on a utube of a woman called Florence Meyer and that allows you to go at the right pace (and she does have a very soothing voice!) If you ever do this though, don't beat yourself up about the fact that you cant necessarily 'feel' each part of the body. With me at the moment drugs tend to dull sensations at times and it helps to be aware of that.

Simon

[Altostrata]

Everyone here is seeking urgent advice. No need to change your title. We always look in the Introductions forum first.

[Solang]

Hi Simon I will check out that Florence Meyer video :-)

 

Right now I am dealing with a lot of stress.  I've been trying to sublet my apartment for my upcoming yoga teacher training (starting on Oct. 26th) and three month trip to Ecuador (4 months total), but I haven't found anyone yet.  So, I'm having to decide whether to give up my place and put my stuff in storage, or spend the money to keep the place.  I also have discovered that the two people who I had lined up to look after my cat while I'm away aren't going to work out!!!  So, there's a lot of stuff I need to be doing to deal with these issues, but the withdrawal from the Wellbutrin accidental underdose has completely sapped my energy, focus and motivation.  OK, I'm determined to take action now!!!

[Solang]

Yet another reminder to be more present. I woke up much earlier than usual this morning, thinking maybe it was because of the sweets I ate last night. I went to take my morning meds and realized I had taken the morning meds last night! Sheesh!!

 

The good news is I've got subletters to pay almost 2/3 of my rent while I'm away. They signed the sublease yesterday and I was instantly relieved. Still gotta deal with the cat. My motivation is getting better due partly to adjusting to the lower Wellbutrin dose and partly to running out of time to procrastinate. Plus, I feel much more able to focus when I don't have some issues like finding a sublettor hanging over my head. I will consider myself well recovered when I can focus and act constructively regardless of any such"issues" remaining unresolved.

[Solang]

Just checking in since I've made two cuts since the last time I checked in. I've decided to cut the wellbutrin and leave the zoloft alone for a while. The Wellbutrin is definitely the more activating one. Once I get down to 150 milligrams of Wellbutrin I will go back to cutting the Zoloft until I am down to 25 milligrams and then I may take a break from reducing for a while. At that point I will be taking one pill of each instead of one pill plus a fraction. I am going through a lot of changes in my life I just finished a one month residential yoga teacher training which was wonderful. And in a few days I am going to go to Ecuador for 3 months to study Spanish and just travel around. I must admit I am feeling that I need a break from the reductions because although it is going well it is definitely an adjustment for my body and psyche each time I reduce. I do feel that I've made a lot of progress and I'm really happy at how things are going so far.

[mammaP]

It's great to see that you are doing so well Solang, and you are right to have a good long hold

while you do something fun. I hope your trip goes well and you have an amazing time. Let us know how 

it went when you get back wont you we love to hear all the good stuff too 

[Solang]

Thanks so much mama P. This forum has been a true God send to me. I would not have been able to make this progress if I hadn't found it. I am very appreciative of your encouragement and I will keep posting.

[Brain]

Hi Solang,

I see you're a fellow Zoloft+Wellbutrin taperer and wanted to say hi.

 

You said:

I've been on some form of antidepressants for over 20 years. Mostly it's been a combination of Zoloft, plus Wellbutrin to counteract the effects of the Zoloft. I've attempted to get off at least 4 times due to side effects (e.g., sleepiness, fatigue, low libido) and each time have encountered terrible protracted withdrawal. Of course, I was told that this was a return of the underlying depression, and that I needed to stay on the meds for the rest of my life "just like a diabetic needs to stay on insulin."

I also saw @Mjau mention using Wellbutrin to counteract a Zoloft sideeffect (restless legs in particular), so now I'm seeing a pattern. I had never thought I was using Wellbutrin to counteract Zoloft's sideeffects, but perhaps that was what happened? After some 6 years on the "antidepressant" Zoloft I found myself at a point of incredible depression and crisis, which led me to get on Wellbutrin. Perhaps the crisis was actually side effects of the Zoloft?

 

Each time I have reduced my Wellbutrin dose I have noticed a great deal of sleepiness and fatigue. Maybe that's really side effects of Zoloft reappearing since Wellbutrin is no longer sufficiently counteracting them?

 

I hope you are doing well and that you have wonderful adventures traveling the world!

[Altostrata]

Brain, there may be a drug-drug interaction involved, see the Drug Interactions Checker http://www.drugs.com/drug_interactions.html

 

I would never take Wellbutrin for restless legs. You might end up with restless everything else.

[Brain]

@Altostrata, agreed, I certainly don't think using Wellbutrin to treat restless legs is wise---I'm just saying that there's a potential pattern of people adding Wellbutrin to counteract sideeffects of sertraline. They think they're using it to treat "treatment-resistent depression", but in reality they're just using it to try to fix what sertraline broke. It's a theory. Looking at my own history that could very well be the case.

 

Here's a link to the analysis you suggested. The main thing that shows up seems to be seizure risk, along with increasing plasma concentrations of other drugs.

[Altostrata]

That major interaction indicates the Wellbutin-sertraline combo is activating, and not in a good way. Wellbutrin along can cause seizures.

 

Wellbutrin is usually added to SSRIs to counter the sexual side effects.

 

Let's now return this thread to Solang....

[Solang]

hi brain and alto.I am having an interesting time in ecuador.in my experience, the wellbutrin counteracted the following side effects of Zoloft: sleepiness, sexual problems, lack of focus and motivation.at this point I am basically leap frogging in my taper. 1 month I will reduce the Zoloft and the next month I will reduce the wellbutrin.I once tried to take wellbutrin on its own and felt like I was going to jump out of my skin.

 

someone just told me you're supposed to take half as long to get off antidepressants as you have been on them. That would mean it would take me 10 years! I hope that's not the case. I do expect however that it will take 3 years or so.

[Altostrata]

Please let us know how you're doing, Solang.

 

Since you have such a dramatic reaction to Wellbutrin, you may want to keep ahead with tapering that. It's better to be able to sleep than not.

[Solang]

Is it common to have immune system weakness as a result of withdrawal? I seem to get every dang thing that I even HEAR somebody has. AND, I'm having auto-immune reactions (e.g., my eyes and mouth swell and itch like crazy with seemingly no provocation).

[Altostrata]

That may be a hypersensitivity reaction. Please look in the Symptoms and Self-Care forum.

[Solang]

I'm very pleased to be down to half my original dose of Zoloft. Though I know it's possible that it will get harder now due to the dose/response curves posted somewhere on here. I'm doing OK emotionally (keeping stressor way down) other than frequent anxious dreams. But my body continues to give me trouble with fatigue, frequent illness (weak immune system), and auto-immune reactions. My acne has gotten horrendous to the point that I don't want to leave my a

artment. My motivation is also crap. The only things I'M motivated to do are surf the web and have sex, but maybe thats totally normal.

 

I just returned from Ecuador and am going to get serious about my health. No dairy, very little sugar, low carb , and I just ordered the Gupta Amygdala Retraining Program.

[chicken]

Good job! Solang with getting down to half your dose. I'm happy for you!

[Solang]

Thanks Chicken, I appreciate the support :-)

[Brain]

Looks like your Wellbutrin is also nearly halved relative to a year ago. Sounds like you're having a bit of a rough time at this level.

[Solang]

Hi Brain, yes Wellbutrin is almost down to half also. I have to remind myself that problems in my mind and body are the result of med withdrawal. Yesterday I was having suicidal thoughts and then I remembered that this is a temporary state of drug withdrawal, so not pay too much attention to it. There's a lot of "riding it out" in this process and it gets frustrating because I just want to be free and know what the real me is like without side effects and withdrawal symptoms.

[Solang]

So I'm now officially at the halfway point on both my medications. I'm feeling okay except that I have not slept well for the last week. I know I have resources that I am not utilizing to help with this such as meditations before bed. Every night I go to bed thinking this night will be a good night. But if it keeps up I will try the meditations. I received the amygdala retraining program and am about to watch the session with the actual techniques.

 

I am going to have to start using a different method to reduce the Zoloft next month. I am concerned that putting it in water will somehow change its effectiveness, so I will be searching the threads about this issue. So far I have gotten away with cutting the pills.

[Altostrata]

Hi, Solang. Zoloft comes in a liquid, see Tips for tapering off Zoloft (sertraline)

[Solang]

So the insomnia continued (started on March 21st), and I began using the Fisher Wallace again before sleep three nights ago to combat it, which seems to be helping.  I'm also having some anxiety symptoms, but those could be situational (thinking about how I'm going to support myself when my savings runs out!).  I'm a bit scared because I've just recently gone below the dose threshold on the Zoloft where the graphs show the bio-activity of the drug having a very steep dose-response curve.  And, in the past, it took about two months after "jumping off" completely to get the really bad symptoms.  I will keep an eye on myself!