☼ trouper prolonged Zoloft / sertraline withdrawal

[trouper]

hello!

i've been reading this site for awhile now and finally decided to contribute. the information here has helped me immensely as i've been going through this. hopefully i can add something that may help someone else as well

in college i was put on zoloft in 1996 for generalized anxiety disorder. i also have traits of a highly sensitive person. i tolerated zoloft well except for some side effects that i learned to live with. i stayed on lower doses ranging from 25mg-50mg. i went up and down in those ranges over the years unsupervised and never noticed any issues, although if i forgot the take my pill the night before i would get brain zaps in the morning.

in january 2013 i decided to try to get off of zoloft after 17 years to see how well i could tolerate the world med-free. before doing so, i learned CBT and mindfulness meditation so i thought i had it under control. i met with a psychiatrist who put me on a taper plan. while going down, i did have bouts of being very emotional, depression, anhedonia, anxiety/cortisol spikes, brain zaps and other feelings I've never experienced before and are hard to describe. the psychiatrist told me it was normal and would go away in a few days. the smaller increments under 10mg were the hardest. i had the worst brain zaps (hundreds a day) and i did slow down the taper a bit but she again said it would go away in a few days. at that point i was just trying to power through it. funny, i remember thinking "this can't be normal and must be causing some damage." too bad i trusted her instead of my gut and didn't research or find this site sooner.

 

my symptoms at first 6 months:

- constant painful headaches

- brain zaps

- physical "headaches" (which i call "ickiness"- head pressure like i have a heavy wet blanket on my head, hard to concentrate, depression, fuzzy, hard to focus, painful stiff neck and fullness in ears)

- daytime cortisol spikes

- sensitively to sound that makes me want to cry

- an eye twitch on my right eye lid

- lack of motivation

- waves of anxiety, depression, anhedonia and the other feelings.

 

symptoms that developed after i had an anxiety attack 6 months in:

- all symptoms above

- very strong cortisol/adrenaline spikes mostly starting between 2-4am and cutting in mid morning

- nerves feeling like they are supercharged

- underlying anxiety reoccurring with some ocd

- fatigue

- tinnitus

- exhausted when i talk sometimes 

- struggling with real depression

- twitches in finger of right hand (about once a month it will pick a different finger)

 

currently, 10 months since last dose, I'm in the worst and longest wave I've even been in. i believe i had a paradoxical reaction to some supplements i was given from a naturopathic doctor last month. i was also very very stressed out and at the start of a wave so it may have been that too or a combo of both. after months of thinking some of my symptoms were healed or drastically weakened, they've all come back and incredibly strong. in the earlier months i actually had 1-2 weeks a few times of feeling normal between a few weeks of feeling bad. it gave me the illusion i wasn't that bad and kept expecting the windows to get longer. i haven't had a full week of feeling better since august. now I'm lucky to get a full day or 2. frequently i feel better in the evenings so i don't want to discount that. I know i shouldn't have expectations but i really hope after this bad wave ends (or "if it ever ends" is how i feel right now) these super strong symptoms will subside and i will feel like I'm making progress once again. i can't wait. is anyone familiar with recovering from paradoxical effects? its been over a month now for me and when i feel its getting better it just morphs into something else. i just started to see a psychiatrist who is familiar with withdrawal and is trying to help me but its a slow process.

 

i'm on a low sugar, high protein diet. i'm still learning how to do better at this. i don't drink alcohol or coffee. i walk at least 30 minutes every morning and try to do yoga and pilates once a week. i go to acupuncture weekly as well. i try to be mindful and meditate but not very good about keeping it up. somehow i've managed to keep my job but worry i may need to take a medical leave. 

 

what i currently take daily:

- 2400mg omega 3 (the red label from trader joes)

- 200mg magnesium (calcium magnesium citrate in a bottle, if someone recommends something better, let me know)

- multi vitamin pill

- i just started l-theanine under doctor's orders

 

as needed:

- i take advil when i have the headaches or the ickiness headaches. sometimes it works, sometimes it doesn't.

- i used to take a little bit of espresso to help cut the headaches and that would help sometimes but i haven't done that for awhile.

 

when cortisol is high:

- vitamin c pill

- some homeopathic drops (i have 2 different ones i alternate, Relaxtone and a tincture my naturopath made)

- i have lavender pills my naturopath gave me but i'm not sure if they do much so i stopped taking them. i'm curious if anyone has experience with these

- tulsi/holy basil tea (you can get it at whole foods)

 

i guess that is it for now. thank you for reading and happy healing!

[mammaP]

Hi Trouper, welcome to SA.  I'm sorry you are in protracted withdrawal, it is a nightmare

for everyone who finds themselves with it and is so frustrating that it is usually after following

doctors orders.  

 

Have a good look around the forum, especially the symptoms and self care forum, you will find

lots of info and experiences that people have had with supplements and complimentary therapies,

some good some not so good. 

 

I'm glad you found us, it's good to have others who understand what you are going through.

[Nikki]

Hi...

 

How did you finish up your zoloft taper?  Was it quick?  That can have alot to do with it.  Then again most people do go thru a one to to two year period of protracted wd.

 

You are doing everything you can.  Supplements can cause adverse effects.  I had that happen last week.  You have come a long way.

 

Some of the others will be along to speak with you.....it is wd - your symptoms are classic wd.  As far as supplements go, if you stop them and see how you feel, you can always go back on them if there is a difference.

 

Nikki

[trouper]

thank you mammap

 

nikki,

thank you i wish i took better notes when i was tapering but i never imagined it would be a long term issue as at that point i never heard of protracted withdrawal. maybe i took a month to go down after 10mg? i remember thinking it was too fast but was following doctor's orders.

 

as for the supplements the NP gave me, i stopped taking all of them once i realized i was having a reaction. the reaction sent my adrenals in super overdrive. the cortisol/adrenaline was higher than I've never endured and all of my arsenal of cortisol lowering treatments barely did anything. eventually i just ran out of juice. i have been dealing with this horrible wave since. now i am only listening to my psychiatrist who started me off on 1 supplement and at a very low dosage.

[mammaP]

Many supplements make things much worse as you have discovered!

Would this be the same psychiatrist that had you tapering too fast? 

 

There are some excellent topics on supplements in self care.  Some members have

had success with some of them while others have found them overactivating or have reacted to them.

Here at SA magnesium and fish oil are the ones recommended and help most people, I see you are 

already taking those. Magnesium glycinate is the one Alto recommends. 

[trouper]

mammap,
no way on the old shrink.    My new psychiatrist is one alto recommended to me so I have much trust and respect with him.
I will look into switching magnesium. I thought the extra calcium would be good so that's why I was taking the cal-mag citrate.
thank you

Edited February 24, 2014 by mammaP
As requested

[Altostrata]

Welcome, trouper.

 

I'd like to hear more about how the new doctor has assessed your condition.

 

Calcium tends to cancel out the calming effects of magnesium, so it's best to take them separately. Mag glycinate is easier on the gut and you'll be able to take it more often each day.

[trouper]

i had a meeting with my new psychiatrist. here are some updates:

- i started zoloft when i was 22. he said the brain is still adolescent until ~26 so he's theorizing the neuroplasticity was against me as my brain grew with it causing protracted withdrawals when i stopped.

- my brain has been in what he calls a "live cycle" where the cortisol/adrenaline goes up, then the glutamate/ickiness counters and goes up, then repeats. this has been much worse since my paradoxical effect about a month and a half ago, which still hasn't calmed down yet. he did say the paradoxical effect set me back. i knew this but just sucked hearing it. now I'm just waiting for it to go back to where it was while still trying not to get my anxiety and stress up.

- his plan of action for now is to try to get the glutamate situation under control which in turn he thinks will calm the adrenal situation. that is why he put me on l-theanine. l-theanine would inconsistently affect me. sometimes it made me calm if i was feeling decent (like evenings), but not so much if my anxiety/cortisol were up (like mornings.) sometimes it would dull the head ickiness and a few times it even cut it. sometimes it wouldn't feel like it was doing anything. my sleep was getting worse but my cortisol starting kicking in too so wasn't sure if the l-t was to blame. after a few days on an upped dosage my symptoms were still oscillating and unfortunately it was affecting my sleep as i was waking up every hour so he started me on lamotrigine. 

 

lets see how this goes. for the past several days i've been getting the icky waves in the middle of the night waking me up. this used to be uncommon as usually higher cortisol usually would wake me. also my tinnitus seems to be worse. my ear canals seem to be getting smaller too over the past few months. its been harder to put in my ear plugs but this waxes and wanes. i'm not sure if these new changes are just the life cycle of this bad wave or if the attempt to work on the glutamate is affecting me.

[mammaP]

I  think that if a supplement makes things worse then I would stop it. everyone is

different and what works for one causes more discomfort for others. Some here have had 

success with taurine for sleep, I tried it and it did nothing for me, so next time increased 

the dose. That night I couldn't sleep at all! Same with melatonin.  I am a little concerned that

the doctor has prescribed another med.  I hope you don't get side effects from that one too! 

[Altostrata]

Interesting, trouper. Please keep us posted.

[trouper]

will do, alto

 

mammap,

thank you for the feedback yes, I'm not too excited that the l-theanine wasn't working out and i had to move onto meds but i did read this article:

http://survivingantidepressants.org/index.php?/topic/392-one-theory-of-antidepressant-withdrawal-syndrome/

 

and i do believe my doctor is one who is knowledgeable with lamotrigine. fingers crossed.

 

i'm pretty sensitive mentally when i take supplements/medications. all my alerts turn on with every feeling i get and I'm constantly scanning. it makes matters worse but i'm trying to be mindful about it. 

 

i started lamotrigine on saturday. on monday i noticed stronger tinnitus and my sensitivity to sound was high which lasted most of the day. usually it would only last a few hours in the morning. i wasn't sure if it was the lamotrigine so yesterday i took 6.25mg instead of the 12.5mg. also over the past few days I've been cutting back on the l-theanine so i could sleep better, which i had been until last night. i also cut back because i wasn't trying to conquer as much ickiness lately. i was actually finally feeling more normal which was a first in almost 2 months. my alert system finally calmed down as well. i wasn't sure if i was getting out of this wave finally or if it was meds. i forgot to ask my doc if i would feel the effects instantly from lamo or if it would take a long time like SSRIs do. unfortunately, yesterday evening it all ramped up again and i had a bad night's sleep and now an anxious morning. needless to say i took 12.5 again this morning. also took l-theanine again.

 

the first day of feeling icky after a little break is always the worst. it completely knocks me down and throws me off and takes me a few days to stabilize every single time. i try to be wary and keep my guard up but it still gets me. luckily i have acupuncture scheduled for today.

[trouper]

i was sensitive to noises all day again so i believe it is the lamo. boo. the noises seem to grate on my nerves and make me tense and a bit anxious, which then somehow triggers the glutamate ickiness, negative thoughts and hyper alertness. i briefly talked to my doc who told me to split my dosage in half and take twice a day and to stick with it for a bit. wish me luck.

[Altostrata]

That would be 3.125mg twice a day?

[trouper]

he wants me to stay at 12.5mg/day for awhile so 6.25mg twice a day. my pills are 25mg as his attempt was to have me go to 25mg a day. cutting up tiny pills again. fun times. based on the thread on lamo I'm surprised he started me so high. i'm afraid to ask. but it is working. i just have to try to figure out dosage and deal with side effects in the meantime.

[Altostrata]

Good to hear it's working.

 

Yes, it can be tricky to find just the right dose of lamotrigine. I had mine compounded into a liquid and was calibrating to hundredths of a milligram.

[trouper]

unfortunately I'm still having issues with the sensitivity to sound and tinnitus lasting all day.  i think i read somewhere that meds that can cause this may leave a permanent problem so i'm reluctant to power through (especially after going through withdrawal). plus, i hear it all night long too so its even harder for me to go back to sleep when i wake up, which is every 2 hours lately. i have a call into my doc to see what he suggests. its a real bummer as i really felt some positive benefits from it.

[tezza]

Hi trouper,

 

I'm sorry about the tinnitus and sleep issues. It can be difficult to cope with WD symptoms.

 

Are you keeping notes, a log of your symptoms on a daily basis? This would help you determine if symptoms get worse or better when you add something new. Rate the symptoms on a scale like 1-5 or 1-10 in whatever order is best for you.

 

Hope you feel better soon. Welcome to the forum!

[Meimeiquest]

Hi Trouper, I have intermittent sound sensitivity (and if the sound continues I am very likely to go off on my family) from benzo and assorted GABA/Glutamate affecting drugs. Niacin, about 100mg of the slow-release version, seems to help. But it did nothing when I tried it last year for Wellbutrin WD. According to Dr. Google, it can enhance GABA (glutamate's opposite) crossing the blood-brain barrier. Given the complexity of your situation and you doc's knowledge of things like this, I wouldn't try it without discussing it with him/her...just wanted to throw the idea out there. Hang in there!

[trouper]

hi tezza,

thank you i do have an excel sheet i try to update daily. i should take better notes though and note food and supplements. right now I'm pretty sure its the lamotrigine as thats when it started. :/

 

hi meimeiquest,

sometimes when the glutamate ickiness is really bad and when i'm almost asleep, i get sound hallucinations (keep thinking i hear my phone, or a door knock, etc) which startles me awake. rather disturbing, but i read elsewhere on this site the niacin helps with that too. i have a small dose of niacin in my vitamin pill but i think its like 20mg (100% rda). i will definitely bring it up when i talk to him next. thank you.

[trouper]

taking the lamo twice a day messed up my sleep and the sensitivity and tinnitus was still an issue so my doctor had me go down to 5mg. i realized i was getting a new symptom of waves of 1 second dizziness spells while i was even sitting still or trying to sleep. i stayed at 5mg for about 4 days and decided to go down to 2.5mg. my doc is out of town so i haven't talked to him about it yet, but it seemed logical. i really hope i can find a good dosage and stick with lamo as it has really helped in a lot of ways. i've noticed less glutamate spikes which are much less severe, my alert system has calmed down a lot, and the waves of anxiety and depression have cut back. i even felt the anhedonia lift a bit. also, my sleep has been a bit better as well.

i do get a little wooshy/dizzy about a half hour after i take it but it usually passes in a half hour or so. mornings i still feel kind of out of it and a bit icky so i wait until that cuts a bit before taking the lamo. i still take l-theanine when i feel icky too which seems to help. i still get tinnitus which is worse in mornings but still comes in evenings too. I'm still sensitive to sounds and have ear plugs in when I'm out and about. i still feel glutamate activity so i don't think the wave has ended but its nice to get some relief.

[Petunia]

Hi trouper,

 

I'm glad you are feeling a little better now.

 

sometimes when the glutamate ickiness is really bad and when i'm almost asleep, i get sound hallucinations (keep thinking i hear my phone, or a door knock, etc) which startles me awake. rather disturbing,

 

I was getting a lot of this happening during the first few months of withdrawal, but as my nervous system slowly started to settle down, it subsided and now I rarely get these sound hallucinations.  Occasionally I will get a loud whooshing sound in my head while I'm falling asleep, but not often.

 

Recovery can take some time, but every little improvement is evidence that its happening.

 

Petu.

[trouper]

thank you for your response, petu. its comforting to hear others get this too and that it should go away. it seems the sounds usually happen when I'm really in the thick of the glutamate waves at night.

 

i'm realizing there are so many different parts to withdrawal for me: adrenals on overdrive, glutamate on overdrive, nerves/cns on overdrive. the nerve waves can happen with adrenal waves or glutamate waves but its rare the adrenal waves and glutamate waves happen at the same time. usually when my adrenals are hyperactive, the glutamate stays at bay until the adrenals calm down. before this year, the glutamate waves would only happen for a few hours for like a week or so and eventually calm down. since this year though after my adrenal wave calmed down, i've been in a glutamate wave for almost 2 months now. they also last a lot longer during the day instead of a few hours. then i had the hyperactive alert system going on. it wasn't until i took the lamotrigine that this finally calmed down.

it seems the waves of low moods/depression/odc/negative thoughts/anhedonia/apathy/lack of motivation happen with the higher glutamate activity as well. I'm not quite where where the hyperactive alert system comes in but i think its with the glutamate wave, unless its just another leg of my withdrawal symptoms.

 

i guess i was naively thinking after this bad wave ends i would go back to where i was in december but I'm starting to realize I bumped myself into a deeper level of withdrawal so all my waves will probably be based on all these now. boo.

[trouper]

time for an update.

under doctor's orders, i stopped taking lamo on 3/10 because we wanted to see if my sound sensitivity/tinnitus/vertigo? (the feeling like I'm on a boat for a second or 2, even when I'm sitting still. not sure what thats called) was the meds or w/d. over the next few days the sensitivity side effects lightened up and by thurs it was about the best day I've had all year mood wise.. i was really thinking things were getting better and i was hopeful again. on friday i started to feel waves of ickiness again which was pretty disappointing. my doctor left message (we've been playing phone tag) saying lamo seems to go a long way with me and since it helps, he wants me to try to find the right dosage. he suggested 2.5mg every other day. since i was feeling better saturday and was hesitant to take lamo because of the side effects, i decided not to reinstate just yet. sunday was a low day but tolerable, monday a better day but on tuesday morning i worked myself up with anxiety (yay, GAD) in my half away/half asleep brain. i think that triggered the ickiness/glutamate stuff to kick on higher so i dealt with that the rest of the day. i decided to wait it out but the same thing happened wednesday morning. by wednesday night i was having a rather relentless icky wave that wouldn't lighten up. i decided to reinstate the lamo (2.5mg every there day) on 3/19. 

thursday i woke up with apprehension from the bad icky wave the night before. my mood was low, but by afternoon i got hit with a bad physical depression wave. do people have these? they aren't really triggered by my mood or thoughts (that i know of?)  but i just feel such a strong depression that alters my thoughts. so scary. it usually passes like a headache.. just slowly lightens up.... luckily it finally passed, but lasted about 4-5 hours. so rough.

today my anxiety is still acting up. i met with my therapist this morning and she says my GAD is hindering my recovery as i keep cycling. its true.. when my symptoms lighten up and I'm not focused on the physical part, i start thinking anxious thoughts and work myself up which is why my windows are usually pretty short. she wants me to address it with my doctor. truthfully, he knows i have anxiety but i don't think he knows how much i suffer and churn and think about this almost all day long. i think he's been focused on helping me feel better during withdrawals and hopes that would ease my anxiety but i don't think he knows how bad my GAD is. its probably worse since i am on medical leave now. I started out on a good foot with medical leave luckily but have been having a rough time lately. i put a call into my doc and plan to address this. i have many conflicting/mixed feelings about possibly going back on an ssri or another med but part of my GAD is fixations so this is kind of all i think about right now. this is my life. i have some little distractions but nothing is huge enough to take away from this right now. i try to get distracted and be mindful but when i feel like crap, my GAD seems to get worse. I'm hoping this is the w/d but a lot is familiar from before w/d so it scares me to think it may not be w/d but my underlying symptoms. hopefully the lamo will kick in and help with these feelings or hopefully my doctor has some good advice.. patiently waiting for the phone to ring...

[trouper]

on another note, i have a friend who found out about my condition and he opened up to me saying he went through this himself! he was on paxil for 6 years when he was younger and had to do a slow 2 year taper to get off. this was over a decade ago. now this is the 4th person I've heard about that has gone through this. wow.

[Altostrata]

trouper, you can have lamotrigine made into a liquid at a compounding pharmacy, this might help you find the right dosage. It could be less than 2.5mg or even 1.25mg a day.

 

You might talk with your therapist about cognitive-type techniques to manage your tendency to anxiety, or meditation. See http://survivingantidepressants.org/index.php?/topic/1112-non-drug-techniques-to-cope-with-emotional-symptoms/

 

Since you've had such a bad reaction to a psychiatric drug, you may be hypersensitive to all of them. They may never offer you a solution again.

[trouper]

alto,

thanks for the advice on a liquid form. will my doctor advise me on going up and down on those little doses or is that something that i am supposed to do on my own? I've never dealt with compound pharmacies. do i give them my pill bottle and they make something for me or do i need a new prescription from my doctor?

 

i took a lamo pill wed and again today. i feel some nerve stuff going on and some tiredness but it hasn't been too bad yet. you said it takes 4 days? have you tried taking lamo every other day? it may make sense based on the half life being longer.. or a smaller dose daily, which is where the liquid for comes in

 

when you mention the bad reaction to psych drug, are you referring to lamotrigine or do you mean the withdrawal from zoloft? while on zoloft i never had any issues. i only got off to see how i would do med free. :/ my therapist does encourage CBT and mindfulness. a lot of the time it helps when i remember but i guess she's just concerned that i need more than that. 

[Altostrata]

Yes, you'll need a prescription for a compounded liquid.

 

Lamotrigine has a half-life of only about 22 hours, so every-other-day dosing is going to be a bit uneven.

 

Are you cutting a 5mg tablet in half? Perhaps your doctor is trying this to see how you do on a low dose before going to the expense of compounding. You'll have to ask him.

 

Your withdrawal syndrome from Zoloft was a large neurological event that may make you hypersensitive for a long while.

[trouper]

yes, I'm slicing 5mg in half. i was on 2.5mg daily for 3 days before i stopped but the side effects still weren't lightening up at all. i thought the half life was longer, thanks for the clarification.

[trouper]

~ One Year Off Zoloft ~

i just wanted to acknowledge here that today is my one year anniversary off zoloft. i want to do a write up about where i am now 1 year later but i don't want to dwell on this much right now as I'm having a decent day. more later..

[alex]

Congratulations trouper!!

It takes a lot of B***S to get off these meds.

Now you are poison free and on your way to recover your life.

[Rhiannon]

Congrats, and glad to hear you were having a decent day!

[Altostrata]

Good to hear, trouper.  Where are you with the lamotrigine?

[trouper]

thanks, all it feels good to finally have a window lasting more than a day after so many months.

 

so here i am one year post a too fast taper. 

 

cortisol/adrenaline phase:

I'm not sure when this phase will end but i seem to be over the hump. during the really bad days (3 - 7 months ago) there were some nights i could barely sleep 2 hours at night and don't think i reached level 2 sleep. during that time i had cortisol/adrenaline rushing through my body all day and night with maybe a few hours of relief in the evening before the cortisol kicked back up.

i do still wake up pretty alert around 4am and have to use mindfulness and cbt to try to get another hour or 2 of sleep. i don't think i missed a ~4am waking in the past 7 months (since my withdrawals kicked in harder) except for maybe a day or 2. most mornings after getting up i'm alert and sometimes more anxious but i don't really *feel* the cortisol/adrenaline like in earlier days. i know its still there as i don't feel tired or calm at all until it drops around 11am-1pm.

on the days when i do feel calm in the mornings and miss the 4am waking, i, unfortunately, usually end up having a low mood/depression for a few hours. I'm guessing the cortisol undershot.

 

glutamate phase:

since the beginning, i would get glutamate ickiness in the head (head pressure/discomfort/pain, concentration issues, slow thinking and speaking, etc.) it would come in waves that lasted a few hours but it was never that severe until january of this year where i reached another deeper level of withdrawal. after over 3 months straight of this horrible scary wave (extremely high alert system, anhedonia, depression, crazy stuff at night, worse anxiety/ocd, etc.) i finally started to have a window again that lasted more than a day. i believe lamotrigine has helped with this. i still get a lot of the glutamate ickiness but at least I'm finally getting windows where the anhedonia lifts. I'm hoping these recent memories of "normalcy" will help when I'm in a bad wave again. going through this last phase, i started to get real depression and my anxiety sometimes gets out of control. this window is helping tremendously with both but i know there is still long road ahead.

 

daily helpers:

i take 2400mg omega 3, some magnesium at night, and a multivitamin pill. I'm on a very very low dosage of lamotrigine since it causes sound sensitivity issues for me. i still take morning walks for at least a half hour, i try to exercise with yoga, pilates, light hiking. i don't take in caffeine nor alcohol and i eat a lot less sugar than i used to. i try to avoid desserts and sweets but its hard to avoid all sugar. i go to therapy and acupuncture once a week and i'm working with a knowledgeable doctor. i try to practice mindfulness meditation and cbt.

[bubble]

thanks a lot for this description!

 

I feel very much the same very often but lack the words to describe it, that is make sense of it. so this will help me a lot to live through it all.

 

very happy four your window

[Altostrata]

I'm not familiar with a glutamate phase, can you explain?

[trouper]

when i explained the icky headaches and cognitive issues with head pressure, trouble concentrating, anhedonia, pressure/sensations in my sinuses and teeth, waves of depression and the other horrible/scary side effects to my doctor he said it was caused by glutamate activity. i interchange describing this as "ickiness" or "glutamate activity" (deepening who I'm talking to) so i called that section the glutamate phase assuming it will end at some point. if i misunderstood (which is likely), please let me know.