SelmaLady: How do I do this?

[ChessieCat]

Hi SelmaLady, thank you for updating us.

 

Great work getting off the Clonidine.  It sounds like you have had many symptoms improve.

 

Here's the link.  Don't forget to click on Save at the bottom!  Account Settings – Create or Edit a signature

[Carmie]

Hi SelmaLady, 

 

How are you doing? Was glad to read that your akathisia is very rare now.

 

Sending hugs🤗

[SelmaLady]

Tapering after adverse reaction to Zoloft

 

I think I am having an adverse reaction to the Zoloft I've been taking for 40 years.  I am in a very bad place right now and need to know how to taper or if to taper.  I had a broken arm in November and was given fentanyl, morphine, vicodin for the pain.  I was ok with that for a few weeks but then my w/d symptoms all started to return until now, I'm having intense akathisia and my DR/DP is horrific.  I can't eat anything w/o getting a reaction.  This morning when I took the .060 grams that I normally take, I had an immediate reaction:  it felt as tho I had stuck my finger in a socket and my akathisia and other symptoms jumped way up.  How do I go about tapering this drug when in the past if I have tried to get below the .060g I immediately had an increase in my symptoms  I realize this post probably belongs on my original thread but I can't seem to find out how to post on it.

 

Edited April 15, 2022 by ChessieCat
added Intro topic title before merging with intro topic

[Altostrata]

What drugs are you taking now, at what times o'clock and dosages?

 

Since it seems you have taken quite a few drugs in the last several years, why do you think the Zoloft is causing problems now?

 

Please put ALL your drugs in this Interactions Checker and post the report or a link to it in this topic.

[SelmaLady]

1. Drug Interactions Checker
2. Search
3. Report

Print

Drug Interaction Report

This report displays the potential drug interactions for the following 2 drugs:

• Zoloft (sertraline)
• doxepin
• Add another drug

• Consumer
• Professional

Major (1)

Moderate (0)

Minor (0)

Food (1)

Therapeutic Duplication (1)

Interactions between your drugs

Major

doxepin

sertraline

Applies to: doxepin, Zoloft (sertraline)

Before taking doxepin, tell your doctor if you also use sertraline. You may need dose adjustments or special tests in order to safely take both medications together. This combination may increase the effects of doxepin in your body. You should notify your doctor if you have symptoms of sedation, dry mouth, blurred vision, constipation, or urinary retention. You might also have altered consciousness, confusion, poor muscle coordination, abdominal cramping, shivering, pupillary dilation, sweating, high blood pressure, and high heart rate. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

I've only been taking the Zoloft at .060 grams and Doxepin at about 18mg for the past several weeks since I broke my arm.  I take the Zoloft at 9:00am and the Doxepin at 8:00pm.

 

[Altostrata]

7 minutes ago, SelmaLady said:

I've only been taking the Zoloft at .060 grams and Doxepin at about 18mg for the past several weeks since I broke my arm.  I take the Zoloft at 9:00am and the Doxepin at 8:00pm.

 

What milligram dosage is 0.060 grams Zoloft? Is that the pill weight??

 

Have you skipped any doses of either drug since November or taken them off-schedule?

 

On 4/15/2022 at 7:46 AM, SelmaLady said:

I had a broken arm in November and was given fentanyl, morphine, vicodin for the pain.  I was ok with that for a few weeks but then my w/d symptoms all started to return until now, I'm having intense akathisia and my DR/DP is horrific.

 

How long were you on fentanyl, morphine, vicodin and how and when did you go off?

[SelmaLady]

On 4/17/2022 at 6:53 PM, Altostrata said:

 

What milligram dosage is 0.060 grams Zoloft? Is that the pill weight??

 

Have you skipped any doses of either drug since November or taken them off-schedule?

 

 

How long were you on fentanyl, morphine, vicodin and how and when did you go off?

 

[SelmaLady]

Just now, SelmaLady said:

 

I'm sorry that I haven't gotten back to you but I've been very, very ill.  .060 grams is pill weight.  No I haven't been skipping.  The fentanyl and morphine were given to me on the 26th of Nov as pain meds for my broken arm--I was given an add'l fentanyl on Nov 28 to reset my cast.  I took Vicodin for about two weeks, tapered off.  None since mid Dec.  My symptoms of DR/DP have been increasing steadily for the past few weeks along with sobbing spells and intense pacing and mental akathisia  My sleep has been getting worse for the past few days.  Also, feeling as tho my brain is exploding--I have times where I just have to scream.  I sometimes have to shuffle to walk at all.   Is it possible to have Zoloft become a suddenly become adverse after 40 years of taking it ?

[Pollyjay]

I can't help with your questions but I'm so very sorry that you are so ill. I hope you start to feel some improvements soon. I'm praying for you Selma Lady!  

[SelmaLady]

16 minutes ago, Pollyjay said:

I can't help with your questions but I'm so very sorry that you are so ill. I hope you start to feel some improvements soon. I'm praying for you Selma Lady!  

Oh thank you so much.  I'm truly beyond what is what I can bear and do so need God's help.  Prayer please!

 

[Pollyjay]

5 hours ago, SelmaLady said:

Oh thank you so much.  I'm truly beyond what is what I can bear and do so need God's help.  Prayer please!

 

You've got it, dear!  Prayer's the only thing that's kept me going this last 6 months. Hugs to you!

[SelmaLady]

I have to believe every second that God can and will uphold me.  I am worse this morning and know that the sertraline has become toxic but I don't know how to get off of it without going through extreme withdrawal.  Which is worse, tapering through a toxic reaction or coming off too quickly and facing intense withdrawals?  Which is better for my long term outcome?

[SelmaLady]

1 hour ago, SelmaLady said:

I have to believe every second that God can and will uphold me.  I am worse this morning and know that the sertraline has become toxic but I don't know how to get off of it without going through extreme withdrawal.  Which is worse, tapering through a toxic reaction or coming off too quickly and facing intense withdrawals?  Which is better for my long term outcome?

My husband and I have decided to begin tapering at 10% a month but I have no idea if that's the right thing to do.  I desperately need someone to get back to be with knowledge of this!

 

 

[Moonpie]

@SelmaLady I am sorry to hear you are having such a hard time.  I know the moderators will be able to direct you in your questions. Cold turkey is never good. The key to all this is giving your brain time to heal and and take over the job the drugs took from it.   As much as we hate it that is a slow process that needs to be done very very gradually. You can try 10% but that still may be too much for you.. If you find it is after a 4 days ( That is how long it takes our body to register the change). Go back to your original dose. @Frogie is this right? Then maybe try 5%. I weighed my crushed pills pills and I ended up doing .001 by weight every 4 days and I held until the symptoms until they went away. Sometimes that was a few days sometimes it was a couple of weeks. I have known people that have done that amount monthly because that was all they could handle. Let your symptoms be your guide on how fast you go. Your body  will let you know what it needs. Listen to it.   Do not be disappointed if 10% may be too much for you. Have you looked at  Brassmonkeys  sliding scale? I know that has helped a lot of people The goal here is not to get off the drug  quickly but to get off of it slowly and with the least amount of suffering.  The longer you were on it and the larger the dose the more time it will take. But that's OK isn't it?  Because all we ultimately want is to be safely off.  Picture aesop's fable of the tortoise and the hare.  We are the hare in our tapering. But we will win the race if we just keep going.   I will pray for you. I could not have made it through all this without the Lord  and how he directed me to this site that has given me so much support and wisdom.  I am so happy you are here. This group is a life saver and a blessing. 

[SelmaLady]

2 hours ago, Moonpie said:

@SelmaLady I am sorry to hear you are having such a hard time.  I know the moderators will be able to direct you in your questions. Cold turkey is never good. The key to all this is giving your brain time to heal and and take over the job the drugs took from it.   As much as we hate it that is a slow process that needs to be done very very gradually. You can try 10% but that still may be too much for you.. If you find it is after a 4 days ( That is how long it takes our body to register the change). Go back to your original dose. @Frogie is this right? Then maybe try 5%. I weighed my crushed pills pills and I ended up doing .001 by weight every 4 days and I held until the symptoms until they went away. Sometimes that was a few days sometimes it was a couple of weeks. I have known people that have done that amount monthly because that was all they could handle. Let your symptoms be your guide on how fast you go. Your body  will let you know what it needs. Listen to it.   Do not be disappointed if 10% may be too much for you. Have you looked at  Brassmonkeys  sliding scale? I know that has helped a lot of people The goal here is not to get off the drug  quickly but to get off of it slowly and with the least amount of suffering.  The longer you were on it and the larger the dose the more time it will take. But that's OK isn't it?  Because all we ultimately want is to be safely off.  Picture aesop's fable of the tortoise and the hare.  We are the hare in our tapering. But we will win the race if we just keep going.   I will pray for you. I could not have made it through all this without the Lord  and how he directed me to this site that has given me so much support and wisdom.  I am so happy you are here. This group is a life saver and a blessing. 

Thank you so much for your help here.  I absolutely agree that I should go as slowly as possible but the problem is that I apparently am not having a toxic reaction to the Zoloft.  Every morning when I take my dose, my brain goes into a whole other state of shock and my symptoms of DR/DP and akathisia bolt upwards.  And it's accumulative.  I am far worse today than I was one week ago.  I just don't know which way to turn other than coming off of the Zoloft as safely as possible.  I also take Doxepin and I'm sure that is contributing to the serotonin/dopamine overload I'm apparently getting.  I'm hoping that one of the mods or Alto would have a better idea what is the best way to help me but I don't know how to tag anyone.  I am in utter agony.  I would go to the ER but I know there's nothing they could do other than give me benzos and I surely don't want to do that unless I end up with serotonin syndrome.

[Moonpie]

To tag someone @ symbol on front of their name.  No space. For example @Moonpie   As you type a little Box will drop down underneath and click on the name when it comes up. It took me a while to figure out how to do it, I am not real techy lol. It does sound like you could be having some kind of reaction.  A mod can help you for sure. 

[SelmaLady]

Thank you!

[SelmaLady]

8 hours ago, SelmaLady said:

I have to believe every second that God can and will uphold me.  I am worse this morning and know that the sertraline has become toxic but I don't know how to get off of it without going through extreme withdrawal.  Which is worse, tapering through a toxic reaction or coming off too quickly and facing intense withdrawals?  Which is better for my long term outcome?

@Altostrata

[SelmaLady]

On 4/20/2022 at 3:21 PM, SelmaLady said:

I'm sorry that I haven't gotten back to you but I've been very, very ill.  .060 grams is pill weight.  No I haven't been skipping.  The fentanyl and morphine were given to me on the 26th of Nov as pain meds for my broken arm--I was given an add'l fentanyl on Nov 28 to reset my cast.  I took Vicodin for about two weeks, tapered off.  None since mid Dec.  My symptoms of DR/DP have been increasing steadily for the past few weeks along with sobbing spells and intense pacing and mental akathisia  My sleep has been getting worse for the past few days.  Also, feeling as tho my brain is exploding--I have times where I just have to scream.  I sometimes have to shuffle to walk at all.   Is it possible to have Zoloft become a suddenly become adverse after 40 years of taking it ?

@Altostrata

[Pollyjay]

 I hope a mod can come soon and advise you on your best course of action SelmaLady.  I'm continuing to pray for you, I hate to see you suffering so much.  

[SelmaLady]

Thank you so very much.  I did have a much easier afternoon and evening yesterday -- akathisia was nearly -0- and was able to sit and watch TV and slept very well.  Things are ramping back up this morning but the Lord has gone ahead of us and will be with us no matter what.  So, so grateful for your prayers, Polly and please know that I am praying continually for you too.  Love to you.

[SelmaLady]

On 4/21/2022 at 3:54 PM, SelmaLady said:

@Altostrata

@getofflex  I typed a very long history of what I've experienced but lost it and I'm too ill to type it again. I really just need to know how fast I need to go to get off the Zoloft.  My reactions to taking the Zoloft both right after a swallow it and then 4 hours later are increasing in intensity as are all of my other symptoms.  This is continuing.  I NEED TO KNOW how to get off the Zoloft as safely as I can.  Please.

[SelmaLady]

I seem to be having a problem with posting a new message. 

[getofflex]

I'm sorry that you lost your post that you typed.  Are you still tapering the doxepin?  We suggest you only taper 1 drug at a time.  That way, when something goes wrong, we know the cause.  

 

Unless you are having SEVERE adverse reaction (organ damage, high liver counts, allergy) we suggest an exponential 10% per month taper.  

 

 Why Taper by 10% of my Dosage  

 

Tips for Tapering Zoloft

 

A gentler method is micotapering.  

 

Brassmonkey Slide Method of Micro Tapering

[SelmaLady]

48 minutes ago, getofflex said:

I'm sorry that you lost your post that you typed.  Are you still tapering the doxepin?  We suggest you only taper 1 drug at a time.  That way, when something goes wrong, we know the cause.  

 

Unless you are having SEVERE adverse reaction (organ damage, high liver counts, allergy) we suggest an exponential 10% per month taper.  

 

 Why Taper by 10% of my Dosage  

 

Tips for Tapering Zoloft

 

A gentler method is micotapering.  

 

Brassmonkey Slide Method of Micro Tapering

Thank you for answering me.  While I am not having that type of severe reaction, I am experiencing extreme reactions within 4 hours of taking the Zoloft including gasping for air, extreme feelings of both suicide and homicide, extreme need to pace, screaming and sobbing and intense mental akathisia as well.  Nothing like I have ever experienced before.  Today I did not take the Zoloft and my system did not amp up to unbearable pressure and panic.  While I know that stopping the Zoloft suddenly puts me in a very serious place of protracted w/d, I can't seem to survive the reaction I get when I take the Zoloft.  This morning I was going to the hospital but realized that there's really nothing they can do.  I have stopped tapering the Doxepin with the hopes that it will at least enable me to sleep.  If I am having these horrific reactions to taking the Zolft, does continuing on with it increase the brain's destabilization?  I feel as tho I am crushed between two horrendous choices.   Do you know of anyone who has developed an adverse reaction to Zoloft after taking it w/o problems for decades?  If you are able to read any of my previous posts here, you will see that I went through an agonizing recovery from a simple nose spray and subsequent overdose of Valium.  It took me 3 years to become functional again tho I did recover to my basic baseline and have been leading a normal life.  But ever since the fentanyl and morphine, my brain has been sliding into what now seems to be a rejection of the Zoloft.  Tonight while I still have the intense DR/DP and the akathisia, I am at least not screaming and sobbing.  I don't want to c/t if there is any possible way to avoid it. 

[Frogie]

@SelmaLady

 

In your signature you say on 1/13/19 Zoloft 21 mg, then 12/2121, you say Zoloft 0.60 grams by weight. When did you start tapering the Zoloft, and how much did it weigh originally?

[ChessieCat]

12/2121   Zoloft .060 grams by weight

 

So that we don't get confused please change your drug signature so that it states the mg dose that you are taking.

 

Edited April 26, 2022 by ChessieCat

[SelmaLady]

13 hours ago, Frogie said:

@SelmaLady

 

In your signature you say on 1/13/19 Zoloft 21 mg, then 12/2121, you say Zoloft 0.60 grams by weight. When did you start tapering the Zoloft, and how much did it weigh originally?

I began tapering Zoloft in 2014 but incrementally as I was in complete brain chaos at the time.  On 12/21/21 my dosage was .060grams by weight or 20mg.

[SelmaLady]

11 hours ago, ChessieCat said:

12/2121   Zoloft .060 grams by weight

 

So that we don't get confused please change your drug signature so that it states the mg dose that you are taking.

 

I tried several times to update my signature including recent drugs and add'l notes but system won't let me add or edit.  I'm really ill right now so I need help.

[SelmaLady]

13 hours ago, SelmaLady said:

Thank you for answering me.  While I am not having that type of severe reaction, I am experiencing extreme reactions within 4 hours of taking the Zoloft including gasping for air, extreme feelings of both suicide and homicide, extreme need to pace, screaming and sobbing and intense mental akathisia as well.  Nothing like I have ever experienced before.  Today I did not take the Zoloft and my system did not amp up to unbearable pressure and panic.  While I know that stopping the Zoloft suddenly puts me in a very serious place of protracted w/d, I can't seem to survive the reaction I get when I take the Zoloft.  This morning I was going to the hospital but realized that there's really nothing they can do.  I have stopped tapering the Doxepin with the hopes that it will at least enable me to sleep.  If I am having these horrific reactions to taking the Zolft, does continuing on with it increase the brain's destabilization?  I feel as tho I am crushed between two horrendous choices.   Do you know of anyone who has developed an adverse reaction to Zoloft after taking it w/o problems for decades?  If you are able to read any of my previous posts here, you will see that I went through an agonizing recovery from a simple nose spray and subsequent overdose of Valium.  It took me 3 years to become functional again tho I did recover to my basic baseline and have been leading a normal life.  But ever since the fentanyl and morphine, my brain has been sliding into what now seems to be a rejection of the Zoloft.  Tonight while I still have the intense DR/DP and the akathisia, I am at least not screaming and sobbing.  I don't want to c/t if there is any possible way to avoid it. 

IS IT POSSIBLE TO TAPER THROUGH A PARADOXICAL REACTION    I NEED TO KNOW SO THAT I CAN RESUME THE ZOLOFT

[SelmaLady]

5 hours ago, SelmaLady said:

IS IT POSSIBLE TO TAPER THROUGH A PARADOXICAL REACTION    I NEED TO KNOW SO THAT I CAN RESUME THE ZOLOFT

@getofflex

[ChessieCat]

10 hours ago, SelmaLady said:

I tried several times to update my signature including recent drugs and add'l notes but system won't let me add or edit. 

 

Thank you for advising the mg dose.  I have added a note to your drug signature.

[ChessieCat]

Q:  Are you aware of the SERIOUS drug interaction between Zoloft and Doxepin?

 

If the symptoms your are experiencing are because of the drug interaction, then the solution is to reduce the drug/s.

 

Serious - Use Alternative

• sertraline + doxepin

  sertraline and doxepin both increase serotonin levels. Avoid or Use Alternate Drug.

• doxepin + sertraline

  doxepin and sertraline both increase QTc interval. Avoid or Use Alternate Drug.

Minor

• sertraline + doxepin

  sertraline will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

[ChessieCat]

From what I understand you are currently taking:

 

Doxepin:  20mg

Zoloft:      20mg

 

Q:  Is this correct?

 

Alto posted this at the start of 2015:

  

On 1/1/2015 at 8:17 AM, Altostrata said:

 

As you reduce the doxepin, the drug-drug interaction with Zoloft should decrease.

 

[Altostrata]

What exactly are you taking now, at what times o'clock, in what milligram dosages?
 

On 4/17/2022 at 11:53 PM, Altostrata said:

....

Have you skipped any doses of either drug since November or taken them off-schedule?

....

 

Referring to doxepin and Zoloft. Still need an answer to this.

 

On 4/21/2022 at 5:09 PM, SelmaLady said:

Thank you so much for your help here.  I absolutely agree that I should go as slowly as possible but the problem is that I apparently am not having a toxic reaction to the Zoloft.  Every morning when I take my dose, my brain goes into a whole other state of shock and my symptoms of DR/DP and akathisia bolt upwards.  And it's accumulative.  I am far worse today than I was one week ago.  I just don't know which way to turn other than coming off of the Zoloft as safely as possible.  I also take Doxepin and I'm sure that is contributing to the serotonin/dopamine overload I'm apparently getting.  I'm hoping that one of the mods or Alto would have a better idea what is the best way to help me but I don't know how to tag anyone.  I am in utter agony.  I would go to the ER but I know there's nothing they could do other than give me benzos and I surely don't want to do that unless I end up with serotonin syndrome.

 

When did this apparent reaction to Zoloft start?

 

On 4/24/2022 at 9:43 PM, SelmaLady said:

@getofflex  I typed a very long history of what I've experienced but lost it and I'm too ill to type it again. I really just need to know how fast I need to go to get off the Zoloft.  My reactions to taking the Zoloft both right after a swallow it and then 4 hours later are increasing in intensity as are all of my other symptoms.  This is continuing.  I NEED TO KNOW how to get off the Zoloft as safely as I can.  Please.

 

You can, of course, simply quit. If you are having a life-threatening adverse reaction, it makes sense to take your chances with withdrawal. It's up to you to judge how severe your symptoms are.

[SelmaLady]

3 minutes ago, Altostrata said:

What exactly are you taking now, at what times o'clock, in what milligram dosages?
 

 

Referring to doxepin and Zoloft. Still need an answer to this.

 

 

When did this apparent reaction to Zoloft start?

 

 

You can, of course, simply quit. If you are having a life-threatening adverse reaction, it makes sense to take your chances with withdrawal. It's up to you to judge how severe your symptoms are.

I have been taking the Zoloft at 9am and the Doxepin at 8pm.  This adverse reaction started mildly the first of the year and escalated to intense akathisia about April 14th.  I tried to take it yesterday at a reduced level (10% reduction to about 18.5 mg) and this morning the akathisia has increased to such a point that I have spent most of the morning screaming.  No one could endure the extent of this.  My husband is with me constantly otherwise I don't know how I could last throughout this day.  I have no choice but to stop.