reluctantpharmagirl: From Zoloft to Wellbutrin

March 3, 2014

Alto recommends a total of 2,000-3,000 mg (combined) EPA + DHA. As with any supplement, it's best to try just a little at first and see how you react. You might try a quarter to half a teaspoon for a few days and then gradually work your way up to two teaspoons a day if you don't have a bad reaction. A very few people find that they're sensitive and can't take fish oil, so it's best to be cautious.

I'm gratified to read that I helped you stay focused. It's difficult, I know. When I was in withdrawal (from Lexapro, by the way) I didn't turn to psychiatric meds to "fix" things, but I did spend a small fortune trying every supplement that held out any hope. Aside from fish oil and magnesium, it was a waste of money and most of them made me feel worse.

Following Alto's advice is a very good idea. She's one of a handful of experts in antidepressant withdrawal.

March 3, 2014

Also, I never seem to be able to connect going off the drug with what's going on, either. It's as if I've got amnesia. And similarly, when I go back on the drug, it's hard to remember the distress I was in while off. My brain can no longer access that level of despair. Very weird. This makes it difficult to explain the withdrawal to doctors and therapists.

It's great that you've had that insight.

I see the same thing happen during withdrawal, with windows and waves. That's why I always tell people to keep a daily journal ranking their withdrawal symptoms on a scale of 1 to 5, along with a record of their dosage changes, cuts, etc. plus any big stressors. We always think "Oh no problem I will remember how I did after that cut, oh no problem I will remember how well I was feeling after that hold" and then Nope. I don't really see it when -I- do it, so much, because that's the nature of it, our self-insight is messed up somehow, but it's obvious when reading other peoples' threads, and when I read back over my own journal.

There's something about the process, the fluctuating chemistry, that makes it hard for us to remember accurately, to assess accurately how we are in relation to how we've been in the past, something like that.

There's actually a medical word for this phenomenon, more or less: "anosognosia." Peter Breggin has written about it quite a bit. He uses the term "spellbinding" in his popular writing, but when he's talking medicalese he refers to "intoxication anosognosia" resulting from psych drug use. I believe it also happens with psych drug withdrawal, probably for similar neurochemical reasons.

March 5, 2014

Thanks, Rhi. I looked up anosognosia. Fascinating.

Today is a day I want to remember. I want to shout from the rooftops that I finally hit a WINDOW!!! I don't know if I'm stabilizing at 25 mg, or if it's the BEAUTY OF FISH OIL, but several times during the day today, I took note of how good I was feeling. No anxiety, not hiding under the covers, no physical symptoms -- just went about my day. Even made it to yoga tonight. And cooked a meal, which I haven't done in months. Yay!

What changed? Who knows. I did a couple things in the past two days ...

(1) Bought magnesium-glycinate and took 1 pill yesterday (200 mg), which really knocked me out for 3 hours, but also moved some things through my system that I had thought were weight gain, so now I feel renewed hope that I am not going to be as big as a barn while reinstating and tapering. Yes, I need to cut those in half or 1/4 going forward, but it was much needed and appreciated.

(2) picked up Nordic Naturals liquid fish oil and have been taking it religiously. I SWEAR BY THIS STUFF!! I know you all already knew that, but wow -- it really works. I've been vegan the past 2.5 years, so my body probably needed it even more.

(3) returned to morning, consistent, steady-state 25 mg doses of Zoloft.

So, that's where I am. I went from spending the entire weekend in bed and thinking I needed to be hospitalized (or go live with my mother) to actually having hope today that I would find happiness again, and it might even be without a drug.

I also cancelled some upcoming commitments that were stressing me out. I tend to overcommit, and I want to go easy for a while and not make a bunch of social, work, or even self-care commitments.

Oh, and last: i picked up my liquid Zoloft today, and got two oral syringes, a 1 ML and a 5 ML. I feel like a mad scientist! I won't go down to 20 mg until I know I'm stable here. Scheduled date for that was Mar 23, but as you all have advised, I'll let my body/symptoms determine the actual taper date.

Thanks to everybody here who has offered me advice and support through this wave/withdrawal/reinstatement/whatever. Alto, Rhi, Jemima, MammaP, Bubble, Karma, Narcissus, Tezza ... I appreciate you!

March 5, 2014

That's great, rpg! Even if it's a window, it implicates healing is taking place. Don't get too disappointed if you don't feel as well tomorrow or whenever, just remember, "I am healing".

LOL, it can make you feel like a mad scientist. I say, lol...because, now anytime I think about prescription meds, I have a little mental image of a small, elderly, white-haired, balding in the middle man wearing a white coat, working feverishly.

March 10, 2014

Hi everybody! Hope everyone is doing well.

I've been blessed with several good days in a row, and am ready to switch over to the liquid version of Zoloft so I can begin to taper.

My plan was to switch over and take a 20 mg dose. By way of reminder, I'm taking 25 mg of the pill now, but cutting a 50 mg in half via pill cutter so it's imprecise, and believe it may have been a bit high to reinstate at this level.

So, given that I'm stable, do you think I'm ok beginning the liquid at 20 mg, or do I need to switch to the liquid first, adjust to that, and then make a cut? I know some people have difficult adjustments between manufacturers, but if I can survive it, I'd like to do both at the same time. I think it'll do me some good psychologically to see forward momentum on the taper.

If you all think it's ok, I'll begin the liquid and do the cut tomorrow. Yikes! Yippee! I'm sure I'll be back for support and with with questions.

Thank you for your generosity of spirit, and for all the advice and support.

P.S. I cancelled my follow-up appt with the doc who wanted to follow the Mood Cure protocol. Decided I am just going to stick with the approach recommended here, and don't need any more input!

March 10, 2014

Hi Rpg,

If you drop from 25mg to 20mg, that would be a 20% cut, we recommend no more than 10%. Some people do have problems when switching from pills to a liquid, for various reasons, if it were me, I would make a straight switch to make sure I'm not going to react badly, then you would know if its symptoms from the cut or from the change to liquid.

Petu.

March 10, 2014

helloooo

I started reading from your thread at the point where you were desperate, thinking of starting Lexapro and then Jemima sent you that beautiful post, you followed the advice and experienced a miracle

wow! so great to read about it! absolutely agree with Petu. We can never be cautious enough and longer holds strengthen us fr further tapers. Also some people need to adjust when transferring to the liquid form...

very happy for you

will give my fish oil another try but slowly...

March 11, 2014

I would either do a straight switch, see how you do and adjust liquid dosage if need be.

March 11, 2014

Hi everybody. Hope you are all having nice days.

Well, I took your advice and kept my dose the same when switching to the liquid. I took 25 mg of it yesterday for the first time. It was kinda' hard to measure exactly in the oral syringes (got some bubbles, even with the 1 ML syringe I found it hard to get the extra .25 ML exact, etc). Oh, and the alcohol taste was terrible! But the real downer was I felt anxious yesterday and last night again ... after many days of doing so well.

I didn't feel like I could afford to go backwards right now (with work demands), so this morning I went back to the 25 mg pill. I have been cutting a 50 mg in half but this morning emailed my doc for a RX for 25 mg so if the liquid doesn't work, I can just do my titration with a 25 mg pill. Perhaps I would stabilize on the liquid ... but I definitely had that uneasy, anxious, irritable feeling that I remember vividly from withdrawal. I could give it some time, but I just didn't feel this was the week to do that with other work stresses.

I also have a family support question I've been meaning to ask the group. My mother (who really does mean well) keeps slipping into conversation how she and various people around us "just have chemical imbalances" and "need to find the right drug". This is really upsetting me, because I basically feel like she's undermining my effort and suggesting she doesn't think I'll be successful (e.g., I'll be a stressed out *****) once I'm finally off the Zoloft. Last week she was telling me how horrible a manager she was before she went on Lexapro and believes it has done only amazing things for her life for the past 20 years. The week before she was telling me about a friend's daughter who went on beta blockers and those finally worked for her anxiety. Then yesterday she started telling me about another friend she'd had breakfast with whose daughter was "a terrible ***** to live with" until she switched her thyroid medication and adjusted her hormones. This upsets me for so many reasons, not the least of which because I believe she is going around telling people I've been "a terrible ***** to be around" while trying to get off the antidepressant. And she keeps telling me how she's concluded with these other people that they just had a chemical imbalance. I've sent her to this forum and given her the name Peter Breggin, but is there anything you can suggest I have her read that would disprove the "some people just develop a chemical balance" theory? Or that would make her believe that I'm not going to be this horribly agitated and irritable person when I finally do taper off? She's making me feel like once I reach the promised land of being off Zoloft, that I am going to be stressed out, miserable, and impossible to be around. I would discount this completely, except for the undeniable fact that I do possess her genes, and she is decidedly "kinder" than she was in my youth, when she ran a stressful business and was not on an antidepressant.

Thanks for your advice and support.

March 11, 2014

http://survivingantidepressants.org/index.php?/topic/4291-again-chemical-imbalance-is-a-myth-stop-the-lies-please/

http://survivingantidepressants.org/index.php?/topic/914-ronald-pies-shocked-shocked-shocked-by-chemical-imbalance-allegations/

http://survivingantidepressants.org/index.php?/topic/1190-ronald-pies-says-doctors-tell-patients-the-chemical-imbalance-lie-as-a-favor/

You might also start a topic in our Family and Friends forum.

March 22, 2014

Hi everyone. Long time no post. 11 days! Feels like an eternity. I've been reading your updates, but sort of waiting for some progress to report before posting one of mine.

I've been taking the sertraline liquid since Mar 13, so 9 days. And WOAH, gotta say, that stuff is really not for me. Tastes like rubbing alcohol (I mix it with water), and it's nearly impossible get it down. Does anyone else take it? Beyond the horrible taste, I have also found that my morning dread is pretty bad -- sometimes I can't get out of bed till 10 am. I'm having a terrible acne reaction as well. And, I'm agitated. So, those are my usual withdrawal symptoms presenting. Acne, morning dread, and agitation. Those are my warning signs, and I need to always remember that. Self insight!

So, I think I am going to try to tinker with my strategy (again): I think I will move to a compound pharmacy to make my pills.

During the last week, I went through so much effort, getting a new Rx from my doc for the 25 mg pills (she was like, "I just prescribed you the liquid!"), and then the pills I got were a different manufacturer because I went to a pharmacy near work instead of my usual one. I didn't want to have another variable (changing manufacturers), so I went back to my usual pharmacy, got a refill, and insurance wouldn't pay because it was so close to the previous Rx fill, so I just paid out of pocket. Then I ordered the Gemini scale online. Once I got it, I learned the whole lesson about how a 25 mg pill does not weigh 25 mg, so it's not a straight cut, but an obtuse calculation you have to do! Wow, nothing is easy. I was in the kitchen trying to shave off milligrams of this pill with a kitchen knife. It was so ridiculous, and definitely not sustainable for a year-long taper.

So, now I am hoping to find a compound pharmacy who will cut the pills for me.

Also because, I know myself, and I'll want to cut more quickly than I should any time I feel moderately ok.

So, my questions for all of you:

- Do any of you use a compound pharmacy?

- Does insurance cover it?

- Is it a lot more money, even if the drug is generic?

- Does your doc just call in each reduction in dosage?

- Assume it means I have to switch brands (again)?

Thank you for being here, and for your helpful advice, as always. So happy to have all of you in the bunker with me

March 24, 2014

Hi RPG,

I can't answer any of your questions, bumping post so someone who can may be able to answer.

So, my questions for all of you:

- Do any of you use a compound pharmacy?

- Does insurance cover it?

- Is it a lot more money, even if the drug is generic?

- Does your doc just call in each reduction in dosage?

- Assume it means I have to switch brands (again)?

March 24, 2014

I also don't know.

There is a link somewhere to a site listing all compound pharamacies. I tried it but there were literally only 3 in the whole of Europe.

The only thing I can say before somebody who has the answer comes along is that you could google for a compound pharmacy near where you live and give them a call and they will be able to answer all your questions

(for all these reasons I've been making my own suspension for 5 months and now it works like a piece of cake for me).

I got a bit lost: we were talking about zoloft but now you mention sertraline liquid... Is that a different name for the same thing?

Regarding your previous issue of whether to go down (especially by such large amount), I would say, no please don't.

I went through the reinstatement after 40 days. But I didn't expect it to fix all my problems immediately or even within a specific time frame. What i hoped for and the way I so the reinstatement was working for me was a very slight reduction in my symptoms, very gradually over literally months I would feel more bearable. Only 4 months of holding I started tapering by 5 % one of the two drugs.

So the best we can do for ourselves is be patient and SLOW, painfully slow because it is the slow turtle that wins the race.

Also it's not a matter of precision but constancy. it's ok to make mistakes with measuring provided you make THE SAME mistake every day. What distabilises us are variations of all sorts (it's like you have ahealing bone and then you continue to bump it all the time).

Sorry I wasn't following the whole process more acurately so I might be missing the point now.

all the best!

bubble

March 24, 2014

See this topic about compounding pharmacies http://survivingantidepressants.org/index.php?/topic/1425-compounding-pharmacies-us-uk-and-elsewhere/

March 24, 2014

HI everyone. Bubble, sertraline is just the generic name for Zoloft.

I called a compound pharmacy near me. Unfortunately, sertraline is apparently very expensive in a powder. At first she said most pills are $45 a month. But a one-month supply of sertraline pills at 10 mg is $350. So getting pills compounded for a probably a year-long taper would be $4000 or something. Arg! They can't even price it and see if insurance will cover it until I get them the Rx. And knowing my insurance, it won't cover it.

For two days I've been off the liquid sertraline and back on pills, just cutting down a 25 mg pill as precisely as I can and measuring it on a milligram scale. I feel much better not on that gross liquid with the alcohol in it, and the acne is already pretty much gone, so I am pretty sure it was from the liquid.

But each pill that I try to cut down and weigh is different -- it's definitely not consistent.

Ugh, none of this is easy. Feeling very frustrated. And like giving up. Now I have to go back to my doctor AGAIN and ask her for ANOTHER rx. She must think I am bonkers. I have now asked her for Wellbutrin XL, Wellbutrin XR, Zoloft in a liquid, Zoloft in 25 mg pills, and now I'm going to ask her to go to a compound pharmacy, which I may not be able to sustain at that price.

I know I can't but really wishing I could just go off and deal with the withdrawal symptoms for a few months and be done!

March 24, 2014

That cost doesn't sound right. All they do is take generic tablets and grind them up.

Walgreens has sertraline on its generic drug list for around $10 per month. There are several Walgreens in San Francisco that do compounding.

April 1, 2014

Hi everyone, quick update. I did get a compounding pharmacy to order a generic form of Zoloft (sertraline), by the manufacturer I take, so they will make pills for me at the dosages my doc calls in, and apparently add some kind of filler made of tree bark to the capsule. I believe these will be about $49 for a 30-day supply. That's 5x what I pay now for regular non-compounded pills, but it's SO much better than the $350-$500 they were quoting me before! So I'm happy about that.

I also saw a very informed new pyschiatrist today. He talked about 4 potential strategies for me. One is to do the taper slowly on my own over years. The second is to do a prozac bridge. The third was to add lamotrigine (Lamictal) at VERY low dose (12.5 mg). The fourth was another drug to add that started with an N.

He recommends we try Door #3. Thought it was the best case for me given my background, symptoms, etc. Talked about this being a pretty straightforward glutamate-GABA imbalance. I need to ask him more about that. I guess because I started taking the drug so young, at 20 years, and because my withdrawal symptoms present as anger, anxiety, overwhelm, acne, etc. It seemed a pretty straightforward case. I really need to get more info so I can intelligently report back.

I trust him completely. But I'm a little afraid of adding another drug. For all the reasons we discuss here: side effects, getting addicted to something new, potentially being on something else the rest of my life, not to mention that I can't help but worry if this means I'm bipolar.

Has anyone else added this and had success with it in withdrawal?

April 1, 2014

FWIW, He also said I might want to add CoQ10. And eat breakfast to stop the cortisol spikes! Even just a banana within 30 mins of waking counts as eating breakfast. And fish oil, religiously.

April 1, 2014

Lamictal was prescribed to me but wasn't a good drug for me at all. Actually, I was given Trileptal, too. The doc never told me what he DXd me as to prescribe me four meds.

I began having anger outbursts and lowering the 200mg dose of Lamictal stopped that. 12.5 is a low dose but you could try to start with less, if you choose #3. I've gotten off it now and my mood improved greatly.

Very low doses have helped some people but I'm not knowledgeable enough to suggest a good starting dose.

The Prozac bridge also works for some but not everyone. There's just no way to know how you (or anyone) would respond to anything new.

April 1, 2014

What I've learnt very painfully: one drug is big trouble, two are not only double trouble but even more so ;(

then you have to taper two and the only thing that helps with WD is stability and time, there is no quick fix, especially not with drugs. drugs are what got us here in the first place...

April 1, 2014

What was the drug starting with an N?

April 1, 2014

Wish i could remember, Alto. I tried to call him back with Qs yesterday and will try again today.

April 1, 2014

Hi Tezza, Bubble and Alto -

I spoke to him briefly this morning with follow-up Qs. The reason he suggested adding Lamotrigine is that I have clear signs of excessive glutamate activity. Said I won't be able to read much on this online or in textbooks; this is his knowledge and experience, and more from neuroscience than psychiatry. If I try to taper off on my own without a bridge strategy, I will probably run into the same anger/rage issues when I get to the low doses, and/or it will take several years. Past attempts to get off, plus the age at which I went on (20), plus the number of years I have been on, plus my typical withdrawal symptoms = a pretty obvious pattern.

The fourth strategy, Alto, was adding Nefazodone.

April 1, 2014

Hmmm, well, why not see if the lamotrigine will work first?

April 1, 2014

I'd also consider giving patience a try, in the mix...

not trying to be snarky, but changing things around all the time really does just aggravate the situation. You don't actually know yet how you would respond to a slow taper if you gave it a chance. Why not try that first, before adding in another drug that may or may not help and will definitely have to be tapered and has its own set of side effects and potential dangers? (Personally I find Lamictal to be the very devil to taper, so I'm a bit prejudiced.)

If after doing a slow taper for six months you decide you still want to try Lamictal, I'm sure they'll still be marketing it.

I've just seen so many of these "add a drug" approaches fail miserably. This guy does sound more knowledgeable than most if he realizes that a taper can take years, so maybe this won't be like the other ones.

Oh, and as for your family, have them read Anatomy of an Epidemic by Robert Whitaker, and tell them you won't even engage in any conversation about ADs or other psych meds until they do. If they won't do that, they can't talk to you about it, period, end of story, you leave the room as soon as they open their mouths. A friend of mind did that with her family regarding her decision not to have her sons circumcised, and it worked. (You have to read it yourself for this to work though...)

April 24, 2014

what has been happening with our reluctantpharma girl?

would love to read an update.

best,

bubble

June 23, 2014

Me, too.

June 23, 2014

Hi Alto and Bubble, thanks for checking in on me.

I'm doing ok. i'm at 15 mg now. Holding here. it's been two months and I am not going down any time soon. Work is too stressful. Anxiety is too high. Personal relationships are very taxed. That's the short version. Will update more when I have a bit more time. Sorry to be brief here but just wanted to respond quickly because I know I've been away so long! Thanks so much for your support and for checking in on me.

March 28, 2015

Just read your thread and wondering what's going on for you nowadays. If you ever check in again, let us know!

reluctantpharmagirl: From Zoloft to Wellbutrin

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