Antonie1967: Sertraline or Prozac to taper?

[Antonie1967]

Hello people. I've been on efexor/venlafaxine for 20 years and since a couple of months on 37,5 mg. Never was able to get off AD, because of the horrible withdrawel etc. Two weeks ago my doctor swiched me to 50 mg Sertraline. It went well and almost no withdrawel from efexor. I'm supposed to taper down Sertraline but I want my doctor to switch me on to prozac. I expect no problems since switching from efexor to sertraline went well. I hear more succes storys from people who switched on to prozac and finally succeeded in tapering of to zero AD. Prozac has pills to 10 mg and it's available fluid. My plan is to taper prozac very slow, but I'm not sure if my doctor will let me have prozac. I asked it two weeks ago and she wasn't to happy about it and gave me sertraline. Is this a good plan? or do you think I should stay on Sertraline? Thanks for your help. Antonie

[Petunia]

Welcome to SA Antonie,

 

I moved your post from the prozac bridging topic to here because your question was related to your specific situation rather than being about the prozac bridging method.

 

[bubble]

Welcome Antonie from me too.

 

What will help us give you advice and suggestions is putting your drug history in your signature: 

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

 

I don't have personal experience with Effexor but from people who have been taking it I know it is a short acting drug which triggers withdrawal quickly, especially after 20 years of use. However, withdrawal symptoms kick in quite some time after the drug left our system and bridging doesn't always work so I'm glad you have found us.

 

I don't want to scare you but I wouldn't be surprised if you were yet to experience withdrawal from Effexor despite the bridge.

 

What I would advise you most warmly is not to make any changes for some time. Give your brain the chance to adjust to this great change and wait for it to see how it will react. We usually recommend tapering from the drug you have been on longest. I don't know all the details but what makes sense for me is that they simply don't hit the same receptors so even if you started taking another drug, you might still experience withdrawal from the one you stopped taking.

 

Monitor how you feel, keep us posted and use that time to inform yourself on what we found to be the safest way to come off these drugs so that you can make more informed decision for yourself.

 

I would recommend these threads for a start but there is lot more valuable information.What is antidepressant withdrawal syndrome?

http://survivingantidepressants.org/index.php?/topic/603-what-is-antidepressant-withdrawal-syndrome/

 

Why taper by 10% of my dosage?

http://survivingantidepressants.org/index.php?/topic/1024-why-taper-by-10-of-my-dosage/

 

Also feel free to post any question you might have. You will find  a lot of friendly support here.

 

best,

bubble

[Antonie1967]

Dear Bubble, Petu,

 

Thanks for your warm welcome. Well, I'm now on Sertraline 50mg for two weeks and I had no withdrawal from efexor. I think I'm one of those persons who can switch easily between certain AD's. Sertraline however gives me a more numbed feeling then efexor. My plan is switching to fluoxetine (prozac) and stay on that for a while and then start tapering of 10% of the dosage. I'll take my time to taper off fluoxetine. I realise that it will be an emotional rollercoaster but I want to try to live my life without AD. kind regards Antonie

[Altostrata]

Welcome, Antonie.

 

There is no way to predict how you might react to a switch from sertraline to Prozac. Every drug switch incurs its own risk, the more you go on and off psychiatric drugs, the more likely you will suffer adverse effects from a drug change. Your nervous system is not made of rubber. You cannot tell when it will break.

 

Every single person here who is suffering bad withdrawal symptoms was confident they could tolerate a drug change.

 

We recommend that people try to taper directly from sertraline first rather than incur the risk of a switch to Prozac.

 

Since you made the switch from Effexor to sertraline only 2 weeks ago, the most prudent course would be to stabilize on sertraline for at least a month, then very gradually reduce it. See this topic http://survivingantidepressants.org/index.php?/topic/1441-tips-for-tapering-off-zoloft-sertraline/

[Antonie1967]

Thanks Altostrata for your advice. Maybe you are right and it's best to stay on Sertraline for a while. I have this feeling that 50 mg is to much however. I'll discuss it with my doctor and maybe I'll start taking a little less Sertraline and see how that goes for a while. I wish they had pills less then 50 mg, but that's not the case with Sertraline, only a fluid. Another reason for me to switch to prozac is because the pills go down to 10 mg. It's easier to taper of, but I'm not sure anymore if it's wise to switch again after two weeks. After 20 years of AD It's difficult to find a balance, but thanks for your advice. It's most welcome. Kind regards, Antonie

[Altostrata]

Yes, the liquid makes it easier to take smaller amounts and make precise reductions.

[Antonie1967]

Spook with my doctor today and we decided that I'll start with liquid Sertraline. I'll not switch to another AD. I have a feeling that 50 mg is to much for me so I'll switch to 40 mg liquid Sertraline this week and stay with that for at least 4 weeks. Then I'll taper off with 10% each 4-6 weeks. My doctor understands I need to do it in this slow way and that's a relief.  As long as I'm feeling okay and the withdrawal symptoms stay away, I'll continue, otherwise I'm staying longer on the last dose. I think this is a good way of tapering of my AD. I'm feeling confident about it, but I realize that it will be difficult because with tapering off the AD my feelings will be more intense and I have to live with that. I hope I can feel the difference between more intense feelings and withdrawel symptoms. Time will tell. Many thanks for all the helpful information on this site!

[mammaP]

Glad your doctor was helpful, not many are and it's refreshing to hear about one who is

happy to prescribe what you need to taper. 

You will most likely have some withdrawal symptoms along the way, when they happen just hold

until you've been stable for a few weeks before another taper. 

 

Hope it goes well for you, let us know how it's going 

[Antonie1967]

Thanks MammaP. I expect to experience some withdrawal a long the way, but I hope I can handle them, because I want my life and my job to continue. In the past I've had some bad experiences with withdrawal and had to take more AD because it was to difficult to go to work and I hope with tapering slowly I'll be able to keep the withdrawal symptoms very low. Are you now free of efexor? or still on 4 beads? Are you feeling okay on this dose? Antonie.

[Antonie1967]

I have another question. I'm off efexor since 2,5 weeks (37,5mg) and switched to 50 mg Setraline. It went pretty well but I had a low day today. I felt very tired and nothing mattered to me. Last week I also had exactly a day like that. The next day I felt okay. I thought I'm on to much setraline but I read on this site some topics and was asking myself if this could be a wave period. Because of my switch from efexor to sertraline I'm having withdrawal from efexor and this is why I have such an offday (wave period). I can handle it, it's not so bad that I can't function in daily life, but I need to understand this so it will help me in my tapering off Sertraline. It's a scary feeling that you seem helpless regarding to your feelings and if I read storys about people with withdrawal symptoms and have good periods (window) and bad periods (wave) then I'm a little more afraid of the future when I start taper off Setraline. Everyday I learn more on this website. Thanks. Antonie.

[Antonie1967]

I have a question about tapering. I'm now on 40 mg sertraline. My doctor put me on liquid sertraline (Zoloft) and I'll start taper of and take my time. In the past I never had to much problems with tapering efexor to a smaller dosages. For example I could taper of from 75 mg to 37,5 mg in a fast tempo with not to much withdrawel, but when the dosages became smaller, the difficulties began. I wonder if I could taper off faster with the sertraline to 25 mg and then start with tapering 10% of the last dosage. Is this a wise thing to do? Or should I be patient and taper slowly by reducing 10% of the last dosage now I'm on 40mg? Thanks Antonie. 

[Antonie1967]

I need to share something. I'm thinking a lot about tapering off my AD after 20 years and I wonder if some of you share the same anxiety as I do. What if I have to discover that I cannot live without a small dosage of AD? I'm highly sensitive and daily life with work, being social etc sometimes puts a high strain on me. I feel all kinds of things and my emotions can be like a rollercoaster. That's the reason why I went on AD 20 years ago. Life was to difficult. It's like two bad choices; one with a AD and feeling numbed most of the time but coping with life or the other without AD and feeling all these feelings/emotions from anxiety to depression and happiness. I worry if I can make it without AD and I fear for it and it can make me sad. Hopefully you can understand what I'm trying to say. I love to hear your thoughts on this one. Antonie.

[Karma]

I have a question about tapering. I'm now on 40 mg sertraline. My doctor put me on liquid sertraline (Zoloft) and I'll start taper of and take my time. In the past I never had to much problems with tapering efexor to a smaller dosages. For example I could taper of from 75 mg to 37,5 mg in a fast tempo with not to much withdrawel, but when the dosages became smaller, the difficulties began. I wonder if I could taper off faster with the sertraline to 25 mg and then start with tapering 10% of the last dosage. Is this a wise thing to do? Or should I be patient and taper slowly by reducing 10% of the last dosage now I'm on 40mg? Thanks Antonie. 

 

Hi Antonie

 

I merged this post from the Tapering forum into your introduction thread because it is specifically about your situation.

 

You should be patient and taper slowly by reducing 10% of the last dosage you are on.  This is a harm reduction method.  You may have thought you could taper more quickly before, but these drugs have a cumulative effect when we decrement too quickly.  You think you are fine and then your get hit with serious withdrawals.

 

As for being concerned that you will need to stay on a small dose of AD for the rest of your life, I think that is a common fear when we are in the grips of these drugs.  Rhi and I have both found that as we taper down we feel so much better that even if we had to stay on a small amount of AD our lives are so much brighter at the lower dosages that it is a decision we could accept. 

 

Don't worry about something you cannot possibly decide right now.  You don't know that you are going to feel the same as you do now as the drug begins to lose its grip on you. Start your taper slowly, monitor your systems and go at a pace that allows you to feel stable.

 

Karma

[Antonie1967]

Hi Karma,

 

Thanks for your kind answer. I'll get the message and it's clear; slow tapering (19% of last dosage) is the best thing to do. I'll stick to that. It's nice to find people hear who understand and take the time to answer my questions. Antonie.

[Antonie1967]

I"m now almost 3 weeks on 20 ml Zoloft liquid. I have no withdrawel effects, so this goes well. My feelings however are stronger and that's a good thing, because I feel more alive right now. On the other hand I sometimes feel anxious and experience all this feelings and it's sort of a deep fear for living life. I'm afraid of failing and letting people down and that puts a high strain on myself. It's difficult to relax and not to overdramatize things at work etc.  It seems like all the topics I had to work on with myself are coming back to me at once. It's overwhelming sometimes, but I understand that it has nothing to do with withdrawal but with coping with life...something I didn't do the last couple of years and the AD numbed my feelings and it was okay.But now it isn't anymore. Does anybody make sense out of this? Can somebody relate to this? Antonie

[Petunia]

Hi Antonie, thank you for updating, I'm glad to hear you are not having any withdrawal symptoms.  But what you describe could possibly be withdrawal related.  I'm not sure, but I think you may still be tapering too fast.

 

If 20ml of Zoloft liquid contains 40mg, then that was a 20% cut, we suggest only reducing by 10%.

 

Please would you add dates in your signature to when you made changes, as time passes, its impossible to know when you actually made those changes.

 

When we are coming off these drugs, that have been part of our lives for so long, its difficult to know how much of our difficulties in dealing with life are old issues which we may have been avoiding, or what are strong feelings being created by withdrawal.  There is a term for those withdrawal induced feelings, they are called neuro-emotions, there is a discussion about it here:

 

http://survivingantidepressants.org/index.php?/topic/137-neuro-emotion/

 

When I first went into withdrawal, it seemed like  lot of my old issues came back, especially when I was in a bad wave.  But I found that when I wasn't feeling too bad, when my symptoms reduced, as they often did in the evenings, my old issues seemed to have disappeared, so for me, I think its more related to withdrawal.  But I had a lot of counseling and therapy while I was on medication, so that may be why.

 

Perhaps this is something which would help you manage your life issues now that you are tapering of your medication.

 

Petu.

[Reflex]

Hi Antonie

I can so relate to what you are saying. I too was put on sertraline after nearly 9 years on citalapram.

I experienced the return of emotions but at the time saw this as a positive. It certainly is in comparison to the the emotions I experienced 8 weeks later when I came off the A.D.

 

I think we have to look for the positives however small and hold onto them when things get bad.

 

Thank you for mentioning that sertraline is in liquid form this has helped with my dilemma when I return to the doctor tomorrow.

 

If you are feeling well today make the most of it and do something you enjoy.

[Antonie1967]

Thanks Petu for sharing this topic about neuro emotion with me. I read this and it gave me some relief. Although I must say I recognize the emotions I'm experience right now, because I have had them all of my life. In fact it was the reason why I went on AD. I always felt all these feelings and life became to big of a struggle for me, because I felt anxious all the time. I always felt this fear of living underneath my feelings. But I do understand now that tapering off my AD can bring back the emotions (which is a good thing) but the intensity is not real and has everything to do with tapering off my AD. I must keep that in mind whenever I feel anxious again. It's an eye-opener for me!

Reflex experiencing emotions again is a good and positive thing, but it can be a struggle when negative emotions are hitting in hard. It's a bit like living on a roller coaster when tapering off AD. I'm now on Zoloft liquid Sertraline and it works for me so far, because it's much easier to taper off slow. I had no problems with switching from a pill to liquid Sertraline. In fact, I have this feeling that Zoloft liquid is better for me. Maybe it works for you to! You can easily reduce your dosage if necessary. I hope your doctor will work with you on this one.

[Altostrata]

Antonie, you may wish to work with a psychotherapist regarding the emotions you're feeling now you're not so numb. This could be a journey of learning and growing for you.

 

Good to hear you're feeling all right on a lower dose of sertraline.

[Antonie1967]

Thanks Altostrata! It's indeed a journey of learning and growing and I'm glad the time is right for it. It will not be easy sometimes but I want to make this journey and that's very important. Thanks for your message! Antonie

[Antonie1967]

I got a message in my mailbox from survivingantidepressants. I looked up my page here. I haven't responded in years. I never succeeded in tapering off Sertraline and I'm still on it.

Since a couple of weeks my daily use is a 50 mg pill. Before that I took 3/4 of one pill of 50 mg (about 37,5mg). I cut of a little bit of a pill of 50 mg. Since I felt not to good lately, I decided to take some extra for a couple of weeks. I accepted that a live without anti depressants is not in the books for me. I hope everybode is doing fine.

[nz11]

Antonie

Glad you got the email and have returned to sa to give an update.

That email was about completing a very important survey regarding withdrawal off these drugs. Your voice would be valuable to the survey.

Would you be so kind to do the survey. Tell them off your difficulty getting off this drug and share with them your current thoughts.

 

Thanking you in advance

nz11

 

 

[Antonie1967]

Dear NZ11,

 

I forgot to mention it, but I did fill in the survey. I think research is very important and ofcourse I want to share my experience with AD.

So I already have filled in the survey. Kind regards Antonie

[bubble]

It was nice to hear from you! Thank you for feeling in the survey and updating us.

 

Remember: slow turtle wins the race.

 

My husband started his taper off 37.5 my Effexor in January 2014. He is reducing slowly and taking long holds. He virtually has no symptoms but doesn't want to risk anything with his job or otherwise. Still he is taking only 7 mg which is less than 1/5 of what he was taking 3 years ago.

 

I see people whose goal is to take as low dose as possible of as few drugs as possible do much better than those who get fixated on coming off. The first group actually succeeds in coming off entirely.

 

Good luck with everything you decide to do.

[Antonie1967]

Dear Bubble,

 

Thanks for sharing your story about your husband. It triggers me and I think, maybe I have to give it a try to again (tapering) in near future.

I started in 2014 with a liquid (Zoloft), but then it wasn't available anymore and I had to take another brand (Sandoz) and they had no liquid Sertraline.

I cut up pills but it is never as accurate as you want. This brand Sandoz has no pills of 25 mg. The smallest dose is 50 mg. How does your husband taper of to 7mg? 

There are no pills of that dose? The pharmacist is not to keen to help over such a long period over here. I would love to here it from you. Antonie.

[bubble]

Effexor is tricky for measuring doses because it comes in different complicated forms such as beads, XR and so.

 

Zoloft is easier. What my husband and I are doing is we make our own liquid from pills. It surprisingly easy, accurate and effecient. A lot of people here do it. The instructions are on the first page of tapering.

 

But basically all you need is a small jar with a lid and a few syringes (I use 10 ml, 5 ml and 2 ml to get tiny doses).

 

You can for instance put a 50 mg pill in 50 ml of water (5 syringes of 10 ml). Wait a few minutes for the pill to disintegrate, stir it and draw out 5 ml and throw it away. You will be left with 45 ml to drink and in that way get 10 % reduction.

 

Sometimes I notice a cut after 4 days, sometimes 10. My symptoms are usually high anxiety, irritability, disrupted sleep and fatigue. They stay bad for some 5 days after they appear. Sometimes more, sometimes less. That's what we call getting familiar with your pattern: know what to expect and when.

 

After things have settled down and I am back to my withdrawal normal, I let my brain rest for another week or two before the next cut. If there is a stressful period or something that requires more energy,  I hold longer. Holding is the most important part of the process. It is the time during which our brains are rebuilding.

 

It seems you entered tapering without informing yourself sufficiently. Maybe you didn't ask enough questions. This is a great community: studied every detail under the sun about this process. If you had come here when that liquid was withdrawn, we would've repeated the info about doing your own liquid

 

Knowledge is power. With enough information and more patience than you ever thought you had you can make it happen

[Antonie1967]

Thanks so much for your information Bubble. You got me thinking a lot about myself with your message and I think you are right I started tapering without informing myself properly. I also think it went way to fast by now. My doctor was helpful but the fact is that she also doesn't know enough about tapering. She understands now that a lot of people need far more time to build of the medication, but it's not enough. 

 

After my last time tapering in 2014 I said to myself; you probably will stay on AD for the rest of my life. I had very bad withdrawal symptoms and couldn't cope with these while working all day.

After taking the AD again on normal dose for me at the time the symptoms dissapeared and I felt relieved. And life went on. I'm doing everything I must, but I don't really enjoy life. Somethimes I am okay but also very much tired, grumpy, etc. I saw the doctor the other day and now I take more AD. I explained I felt not that great lately. I have constant this feeling that I must do everything. I don't feel inspired or happy about life. I feel numbed about life. The solution was taking some extra AD, but now I realize I made a mistake. I take AD for around 25 years now and god knows what it means for my body and mind. Also the last three years I took one pill of 50 mg and cut off a little bit. I was supposed to take 37,5 mg a day, but since I cut the pill myself with a knife it wasn't exact 37,5 mg each day. I read that switching doses is not very good for your brain (ping pong effect). So maybe I had one day 40 mg and another day 34 mg. That's something that went on for the last three years. For the last two weeks I'm on 50 mg. I'm going to read about making my own liquid. As you wrote this seems very easy. I will make cuts of 10% each time and start listening to my body and trying to cope with withdrawal and not make any cuts before I'm stabilized again.

You and your husband can cope with everyday life while tapering of like this? You need to go to work etc. I'm living alone so maybe it's more difficult. I'm not sure. I'm not sure if I should start right away. I made an appointment with my doctor to stay on 50 mg for the following 6 weeks. I;m also going to see a caretaker for conversations about life. What would you advise? Start with tapering after this 6 weeks? or right away? Many thanks for your help. Kind regards Antony. 

[bubble]

Take your time for sure. Read a lot, ask questions. Wait till you get stable on this dose. 6 weeks sounds like a good starting point. After 6 weeks reassess.

 

Keeping a short log of the symptoms or states is very helpful since we tend to forget how we really felt.

 

Me and my husband are actually tapering by less than 10 % per month and yes, we go to work every day and we are alone cause he got a job on another continent! He was put on disability pension and is now working full time for the first time in 15 years while tapering!

 

I'm getting my emotions back, my zest for life only by having reduced 1 mg of my drug. So it is possible. The key is going very slow for us with long drug history and listen to your body very very carefully. Careful taper gives you full control of the process. I actually see it as a big achievement that I'm taking 70 % less of one drug and 25% of the other (rather than thinking oh my I'm taking two drugs and so long to go). I try not to think about time but am just happy with every little reduction.

[Antonie1967]

Dear bubble,

 

Thanks for your answer. What a good outlook on life with AD you seem to have. It's all about the journey while tapering and taking it slow and listen carefully instead of focussing of getting rit of AD. You say your emotions are coming back. Isn't that difficult somethimes? I mean anxiety and depression may kick in also. It's difficult to deal with that I suppose.

I decided to stay on 50 mg for 6 weeks. It's the same dose everyday for a couple of weeks and no ping pong effect like before with cutting the pills. After that I'll start tapering of 10% for starters.Thanks so much for your advice.I will keep in contact on this site and start reading more about tapering.

 

[nz11]

On 8/20/2017 at 10:05 PM, Antonie1967 said:

So I already have filled in the survey.

Thanks Antonie...youre the best.

[bubble]

A big part of coming off psychotropic medication is learning at the same time alternative ways of addressing whatever caused us to start taking them in the first place.

 

I never believed those drugs would fix anything. I have 20 years of talk therapy under my belt, lot of reading and learning how to heal from my traumas and manage myself better. Over the last few years I've worked on incorporating mindfulness meditation and yoga as my coping skills. There is so much one can do to deal with painful experiences...

 

Maybe after 6 weeks you don't feel ready. Throw away the calendar and tune in with yourself.

 

I would also warmly recommend starting with snaller cuts, let's say 5 %. Just to test waters. If that goes well, you can always pick up pace.

 

I like how you are thinking now. Like somebody who can come off successfully. Reading is very important. I'll copy some links when I get to my PC: brain remodelling and Rhi's Start small, listen to your body tapering plan.

[Antonie1967]

Dear Bubble,

 

I'm looking forward to your links. If I start tapering it's important to be prepared and take it very slow. I'm now 14 days on 50mg Sertraline and I'm actually starting to

feel better. More at ease at the moment. I know this from past experiences first you feel better and then after a couple of weeks on a higher dose I will start feeling more numbed and what I did in the past is starting to take less by cutting the pills like I always do lately. The ping pong effect! This time I'll start a slower tapering of 5 mg and see how it goes. I;m convinced now that is the only road to go. Taking it slow, listening to your body and keeping the journey in mind and not the final result. Thanks for your good advice!

[bubble]

Yes, you were playing ping pong with your brain

 

Here is the link:

 

 

[Antonie1967]

Thank you Bubble for the link.