Deevums: Off Zoloft for almost a month after 10 years, feel like dying

[Deevums]

I was prescribed Zoloft for my first pregnancy because of depressive thoughts, 50 mg. I took it throughout all 3 of my pregnancies. I've tried before to taper off only to go back on because the symptoms were so bad. This time I'm off for good, but the side effects are starting to scare me. First off, I have 3 children to take care of. Will I be able to do this? My poor husband has been through so much with me already. I didn't sleep at all last night because I was up panicking and crying. I don't want my kids to be hurt by this. Am I going to make it out of this without killing myself?

[Muddles]

Hi Deevums.

I'm so sorry you're going through this. Pretty much sounds similar to mine at the mo. Take it easy and don't be too hard on yourself.

[Muddles]

Maybe you need to go back on at a low dose. You may have come off it too quick.

[mammaP]

Hi Deevums, welcome to SA. I would reinstate right away and hold for a few weeks then taper 

very slowly.  You have found out the hard way like many of us here that cold turkey  can be a 

nightmare! Some people can do it but you obviously can't, like the rest of us here! 

 

It is possible to taper slowly and feel very little discomfort.  Here is the topic for tapering

zoloft. We recommend a reduction of no more than 10% of the current dose. Zoloft is 

available in a liquid which is much easier to taper. 

 

http://survivingantidepressants.org/index.php?/topic/1441-tips-for-tapering-off-zoloft-sertraline/

 

It would help if you can put your medication history in your signature strip, here is how to do that.

 

http://survivingantidepressants.org/index.php?/topic/893-please-put-your-withdrawal-history-in-your-signature/

 

I'm so glad you found us, there is no need to suffer the excruciating withdrawal that can last for months! 

[Deevums]

I guess I just need to know how bad it can get. Am I going to be functional? Will I want to commit suicide? I'm just so scared of what's ahead of me.

[bubble]

Hello Deevums,

 

so sorry you have to go through this but very happy for you you have found this forum.

 

All of us here have been in very similar situations like you and this is what actually brought us here. 

 

You are going to be functional and suicidal urges will go away but unfortunately it will take time and patience. 

 

The symptoms are telling you that your taper has been too quick for your central nervous system. There is a reason people here recommend taper for 10 % on the current dose every 30 days. You were dropping by 50 %...

 

Soon some of the more senior members will offer some advice but from my experience, no matter how we hate this thought of going back to ADs, when we are so badly hit with withdrawal, we have to reinstate. The sooner the better. Unfortunately, once you have removed this crutch, the system starts collapsing so gradually it gets worse instead of better. In other words, toughing out doesn't help. (I waited for 40 days and things were going from bad to worse).

 

reinstating means you take a smaller amount of the drug, give it at least 4 days to see how it will affect you and then wait for the symptoms to ease (most likely for months) before you can start 10 % taper that allows you to be functional.

 

When did you take your last zoloft? And what was the last dose you were stable on? This will play a role in deciding on how much to reinstate (which I would most warmly recommend). 

 

Here is an article written by one of the members which in my opinion beautifully explains why quick tapers (even when we think they were slow) don't work.

 

And also some very useful sites on withdrawal syndrome and reinstating to ease them.

 

You will receive a lot of friendly support here.

 

best,

 

bubble

 

A lot of people, including healthcare practitioners; in fact, I guess, most people-- are operating from entirely the wrong paradigm, or way of thinking, about these meds. They're thinking of them like aspirin--as something that has an effect when it's in your system, and then when it gets out of your system the effect goes away.

That's not what happens with medications that alter neurotransmitter function, we are learning.

What happens when you change the chemistry of the brain is, the brain adjusts its chemistry and structure to try to return to homeostasis, or biochemical and functional balance. It tries to restabilize the chemistry. 

For example: SSRI antidepressants work as "serotonin reuptake inhibitors." That is, they cause serotonin to remain in the space between neurons, rather than being taken back up into the cells to be re-used, like it would be in a normal healthy nondrugged brain.

So the brain, which wants to re-establish normal signaling and function, adapts to the higher level of serotonin between neurons (in the "synapse", the space between neurons where signals get passed along). It does this by removing serotonin receptors, so that the signal is reduced and changed to something closer to normal. It also decreases the amount of serotonin it produces overall. 

To do that, genes have to be turned on and off; new proteins have to be made; whole cascades of chemical reactions have to be changed, which means turning on and off OTHER genes; cells are destroyed, new cells are made; in other words, a complex physiologic remodeling takes place. This takes place over time. The brain does not grow and change rapidly. 

This is a vast oversimplification of the amount of adaptation that takes place in the brain when we change its normal chemistry, but that's the principle.

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay.

When the drug is removed, the remodeling process has to take place in reverse.

SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. 

It's a matter of, as I describe it, having to grow a new brain. 

I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long. 

With multiple drugs and a history of drug changes and cold turkeys, all of this becomes even more complicated. And if a person is started on these kinds of drugs at an early age before the brain has ever completely established normal mature functioning--well, it can't be good. (All of which is why I recommend an extremely slow taper particularly to anyone with a multiple drug history, a history of many years on meds, a history of past cold turkeys or frequent med changes, and a history of being put on drugs at a young age.)

This isn't intended to scare people, but hopefully to give you some idea of what's happening, and to help you respect and understand the process so you can work with it; ALSO, because you are likely to encounter many, many people who still believe these drugs work kind of like aspirin, or a glass of wine, and all you need to do is stop and get it out of your system. 

Now you can explain to them that no, getting it out of your system is not the issue; the issue is, you need to regrow or at least remodel your brain. This is a long, slow, very poorly understood process, and it needs to be respected. 

http://survivinganti...rawal-syndrome/

 

http://survivinganti...rawal-symptoms/

 

http://survivinganti...0-of-my-dosage/

[bubble]

I hope Alto (who is a great expert on this medication) will suggest the dose you could reinstate. 

 

I think you will immediately feel relief. Unfortunately I could only give you a wrong information and it will depend on how long you were off...Maybe 25 mg but let's wait for Alto.

[Altostrata]

Welcome, Deevums.

 

If I were you, I'd try taking 5mg Zoloft right away to stop the withdrawal symptoms. It comes in a liquid so you can do this more precisely. mammaP gave you a link to more information.

 

Then, hopefully you can stabilize on 5mg for a month or so and taper from there.

[Deevums]

I am going back to the doctor today to go back on and slowly taper. I will ask for Zoloft in a liquid form, but what dose should I start out on? I've been Zoloft free for almost a month, I was on 50 mg to start, and ended on 12.5. I will ask the doctor this, but I guess I just don't know where to go from here and how long I should wait to try and taper again.

[mammaP]

Alto suggested starting at 5mg asap and see how it goes from there. It might take 3-4 days to 

take an effect or you could feel better in hours.  If it helps then you should stay at that dose for a few weeks

until you have stabilised before starting to taper.  Sometimes when someone has been off the med for a while

the dose they were on is too much to go back on because the nervous system has become sensitised. 

Starting low is the best way forward and then you can increase if necessary.  Starting too high can have some

unpleasant side effects, starting low will avoid that.

 

Hope the doc appointment goes well and that he prescribes the liquid for you. 

[Deevums]

Well, I went to the doctor. They advised me to stay on Zoloft for the rest of my life. This was not my intention, but I feel like the risk is too great for me to try and taper and perhaps become suicidal. I feel great when I'm on Zoloft, and if I'm a slave to it, it's better than putting me and my family through a nightmare. It's not the ideal situation but I can't put me and my family through any more pain, it's already caused too much.

[mammaP]

Deevums, that is what the doctors always say! My doctor told me the same thing but 

I became so ill on the meds I did some research and decided to come off them. 

 

He told me I would need them for life and then told me that the dose I was on was

too low to be therapeutic but couldn't increase it because it would cause mania!

 

You can get off them safely, it is withdrawal that was making you sick. 

If you go back to the full dose consider Alto's advice to start low and build back up to the 

full dose. When you have been off for a while it can be too much to reinstate the full dose

at once.   We are all here for you  if you do decide to taper. 

[Jemima]

It's up to you, of course, but it sounds to me like your doctor has bought into the "chemical imbalance" theory of psychological disorders, a theory which has never been proven and has, in fact, been renounced by the American Psychiatric Association. It can be very detrimental to your health to take SSRI antidepressants for long periods of time.

 

The symptoms you've been experiencing are due to coming off of the drug way too fast.  A slow, careful taper would largely avoid those experiences.  Please do read up on the hazards of long-term SSRI use before deciding.

[Altostrata]

Yes, very few doctors understand that what you get is withdrawal syndrome when you go off these drugs, not relapse.

 

If I were you, I'd try 5mg to see if that's enough. No need to take 50mg if 5mg relieves the withdrawal symptoms. Then, you don't have as far to go to taper off completely.

[Deevums]

Well, after 5 weeks of being back on Zoloft, it has been hell. It does not affect me in the same way anymore. I went from suicidal to now zombie. I am completely determined to taper the right way. My question is, having already been through a horrible withdrawal period, will I be able to taper successfully and be OK without drugs? This will be my 4th attempt to taper. Does Zoloft permanently alter/damage the brain?

[Altostrata]

It sounds like you're taking too much.

 

Yes, you'll be able to taper, see

http://survivingantidepressants.org/index.php?/topic/1441-tips-for-tapering-off-zoloft-sertraline/

 

Try to get the Zoloft liquid. It will be much easier to reduce by 10%. Any doctor can prescribe it, make your request calmly, firmly, and repeatedly until you get it.

[Deevums]

After Zoloft turned on me, I had unbearable anxiety, so bad that I was admitted to the hospital. They switched me directly to Effexor XR, 75 mg. I have been on it for two weeks and feel completely flat. My goal is to be drug free. My concern with tapering is, I don't know for sure if Zoloft is still in my system as well as Effexor. I had been on and off it for over ten years, and for a period of about two months before being switched to Effexor. Will I in essence be trying to rid my system of two drugs?

[Altostrata]

Hello, Deevums.

 

The Zoloft is out of your system. You don't need to worry about tapering 2 drugs at once.

 

How did you go off the Zoloft? How are you feeling now, physically?

[Deevums]

I didn't go off, they switched me directly to Effexor. No side effects from the switch, but now that I'm on Effexor I'm totally flat. No emotions. These drugs are ruining my life.

[Altostrata]

We see a lot of people having problems going on and off antidepressants. It wears on the nervous system.

 

You may wish to stabilize on the Effexor and then very slowly reduce it.

 

Do you have any physical symptoms?

[Deevums]

The only thing I feel now is flatness, no emotion. No other physical symptoms. Today I opened a capsule and took out half the granules, so it would be equivalent to 37.5 mg. That was about 10 hours ago and I feel fine. If I've only been on it two weeks, how long should I take to completely taper?

[dalsaan]

Deevums

 

I'm concerned you are not making good decisions for yourself. You have already had the experience of a failed withdrawal. This would have disturbed your nervous system, the you had a switch with no crossover and now you want to drop by 50 percent. You need courage and patience to withdraw successfully. Courage to face symptoms if and when they come - patience to listen to your body and take as much time as it needs. If you do this you are likely to have less symptoms to face.

 

If it was me I would take the other half of the dose, stabilise my nervous system as alto suggested, read up on how to withdraw off Effexor and gather the will to do this right rather than doing it quickly

 

Dalsaan

[Altostrata]

The emotional anesthesia you feel may be a post-acute withdrawal symptom from going off Zoloft.

 

Has the Effexor helped you at all?

[Deevums]

It has greatly helped with my anxiety, when the Zoloft turned on me, the second I would wake up I would ramp up into a panic and that would last about a half hour, then for the rest of the day I'd be in a constant state of fear. That was so unbearable I wanted to kill myself, which landed me in the hospital. They immediately switched me to Effexor XR which seemed to instantly take away my anxiety, but all the while that flat feeling was and is still there. I haven't laughed in five months. I feel like someone just took my personality away. I don't want my kids to have a robot for a mom. I don't have any interest in things I used to enjoy...singing, shopping, it's all gone.

[Muddles]

This is what I am experiencing at the moment. Like you, not so long ago I was in a right state but now totally numb and apathetic. I'm not quite sure which is worse? Lost all emotional connections with everything/everyone...even my children!

 

I think the only answer is to taper off very slowly. I wouldn't rush it. Your brain had got used to these changes made over time and needs time to re-adjust without anything.

 

Hope this helps. You're not alone in this.

[Altostrata]

Deevums, please be careful about the way you reduce Effexor. If you go too fast, your Zoloft withdrawal anxiety may come back.

 

See this topic for tapering Effexor http://survivingantidepressants.org/index.php?/topic/272-tips-for-tapering-off-effexor-and-effexor-xr-venlafaxine/

[cymbaltawithdrawal5600]

 

I don't have any interest in things I used to enjoy...singing, shopping, it's all gone.

 

I know you won't believe this but those feelings will come back some day. The hardest part is living inside the bleakness because it feels like it will be that way forever. But it lifts and better feelings come back in fits and starts until they are back for good. And then it will be life as usual, some good days, some not so good but overall, you have YOU back and can handle it without having to take pills to artificially change your moods.

 

I hope you can hang in there, we are all pulling for you.

[Deevums]

Thanks for all of your support everyone. I just got back from a visit with a psychiatric nurse practitioner. She diagnosed me as having a mild form of bipolar disorder, which explains why antidepressants weren't working. I was misdiagnosed. It also explains why I did things and couldn't explain why (I was arrested about 17 years ago for stealing money from my employer), I was always such a nice girl. She told me I have two options: 1, I could taper off Effexor and stay off drugs, or 2, I could taper off Effexor and go on Lamictil, a modd stabilizer. Of course my goal is to be drug free, and I don't worry about doing unethical things anymore, but I do worry about potential mood swings. From what I've read, it seems bipolar disorder can't be managed without medication. I'm hoping mine is manageable. Any thoughts?

[Altostrata]

Bipolar disorder is widely misdiagnosed. Most people who have been told they have bipolar disorder do not have it.

 

Why did this nurse practitioner think you were bipolar? A bad experience with antidepressants is not sufficient evidence for a diagnosis.

[Deevums]

Based on what I told her. The Zoloft and Effexor are not working, and from the things I did that I couldn't explain. I also had a manic period after I had my first child. I'm going to taper off Effexor and see where that leaves me. I'm praying I will be OK without having to manage it with drugs.

[Jemima]

Going off of antidepressants too fast can cause what appears to be a manic episode and this is often where people are misdiagnosed. I tapered off Lexapro too quickly over two years ago and went through several months of being extremely irritable, flying into rages, buzzing around like an over-charged robotic vacuum cleaner, and spending more money than I should have for things I don't even remember now except for an electric floor cleaner that I intend to throw away. I was unable to sleep for two to three days at a time. Ironically, these drugs often create the very symptoms they're meant to alleviate.

 

Yes, I think you can manage without drugs, but please be careful to go off of them slowly and gradually. Effexor is a different kind of drug from Zoloft. Either of them can take three weeks or more to work, so deciding that Effexor isn't working is premature.  I don't mean to discourage you from getting off of it, but please do so sanely. Cutting by 50% isn't sane, and you'll just end up feeling worse than before. Please read over the topics in the Tapering discussion.

[Altostrata]

I had hypomania for a month or so after I went off Paxil, and I am the least bipolar person you are likely to find.