WatchingTV426--withdrawing from Zoloft, miserably

January 22, 2015

http://www.onetreeyoga.org/YogaNidraMeditation_LFleming.mp3

January 22, 2015

Looks like the yoga nidra link didn't post but Google yoga nidra MP3 and there are some free ones. Contemplate this.org has a bunch

January 22, 2015

It seems that anxiety can follow two paths: 1) fear of death or feeling like you're having a heart attack. 2) fear of losing ones mind/going crazy.

I fall into thinking I'm really going crazy. Sometimes it would get so bad I would think, "this is it!" and almost expect it overtake me right then and there. It never did. Someone pointed out to me that if indeed I was going crazy I wouldn't think I was, because truly crazy people don't believe they're crazy.

In all seriousness, that feeling that your losing it seems pretty common with withdrawal. Right now that I'm stable I am amazed at some of the thoughts I had during my "crash." Not just the thoughts, but how intensely true I thought they were. In a wave all those ruminations, fears, intrusive thoughts seem justified and the negative outcomes we imagine Over and over seem unavoidable, like they are the only possible outcome. Our thinking becomes so distorted. It's amazing the tricks our brains can play on us during withdrawal!

You're not going crazy, watchingTV, and you're not going to go crazy. You're not. You're just going to worry that you will... Even after reading this .

January 22, 2015

You're a Star Addax.

January 22, 2015

You're right. I'm still worried, Addax. So worried. Fell asleep listening to Harry Potter sometime after 10:00, woke up after a minute or so, registered that I was hearing the audiobook, got panicky, thought, "Is he living with his aunt/uncle b/c his mother died? Am I going to die and leave my child?" Eventually calmed down and fell asleep a good while later, my mother insists for a half hour b/c she didn't see me moving at all on the couch, though I thought for much less time, this time when I woke up, it was instant panic flooding my body b/c the light was out and no one was up with me and it was only 11:30 p.m. and I couldn't believe there was so much of the night left. I ran upstairs and saw my mom had not yet quite gone to bed, she came downstairs, I paced and we talked till almost 1 a.m., then I laid down on the couch, feeling so exhausted it was unbelievable, couldn't sleep, eventually slept, for maybe 10? min., woke up by myself, panic again, had to run upstairs at 1:50 a.m. to wake my husband up b/c I couldn't bear being alone.

Trying to lay there with him calming down, feeling like a raw nerve, and I keep thinking about death and it's freaking me out majorly. So tired so I need to rest, but laying there with my thoughts is so bad. Everything is so exhausting and stimulating or somehow brings my thoughts to bad places--like every books manages to make me think of something upsetting, it's impossible to avoid at this stage. Maybe I need to do like luv does and find some game shows to watch. I'm in such a bad state.

January 22, 2015

3:57 a.m. now, tried to lay, paced some, talked to hubby some. Need to let him get an hour more of sleep before he has to do the long drive and work day. Just tried to watch a show on Netflix through my comp and wanted to tear out of my skin within 3 minutes. The akathisia's coming back, I can tell, but I'm so exhausted that pacing through it is difficult to manage. And of course laying still and resting is impossible when I feel like this. The unending fear of the exhaustion/insomnia continues. Feels like this is all going to destroy me and I am never going to come out on the other side.

I did manage to eat a banana about a half hour ago--eating so little these days, I've got to take what I can get down when I can get it. I'm now going to see if I can stomach Pride and Prejudice on Netflix, at least for an hour. It's my niece and my sister's favorite, and I've never read nor seen it. Gotta be by myself here a while, so I can let this guy get some sleep. Hate being by myself so bad when I'm feeling so ill.

January 22, 2015

Hi Wtv426.

Maybe this is way out of the recommendation from this board. But I understand that you freak out not being able to sleep. I would too! Is it out of the question to take a very small dose of sleeping pill, just to get some rest? Sometimes I take just a 1/4 of Imovane (zopiclone). Being sleep deprivated just feel worse to me then sometimes, once or twice per month, take a sleeping pill. But maybe that's just not recommended here.

Here in Sweden there is also an antihistamine called Atarax (Hydroxizin), which could get you tired and have a good sleep. I havent used that for long, but it supposed to not be addictive at all.

I hear your desperation, Wtv426. I hope you find more peace soon. Take care.

January 22, 2015

I absolutely dont want to force this on you, but if you want I found a thread about sleep meds.

http://survivingantidepressants.org/index.php?/topic/7862-reasonable-use-of-z-drugs-for-sleep/

January 22, 2015

3:57 a.m. now, tried to lay, paced some, talked to hubby some. Need to let him get an hour more of sleep before he has to do the long drive and work day. Just tried to watch a show on Netflix through my comp and wanted to tear out of my skin within 3 minutes. The akathisia's coming back, I can tell, but I'm so exhausted that pacing through it is difficult to manage. And of course laying still and resting is impossible when I feel like this. The unending fear of the exhaustion/insomnia continues. Feels like this is all going to destroy me and I am never going to come out on the other side.

I did manage to eat a banana about a half hour ago--eating so little these days, I've got to take what I can get down when I can get it. I'm now going to see if I can stomach Pride and Prejudice on Netflix, at least for an hour. It's my niece and my sister's favorite, and I've never read nor seen it. Gotta be by myself here a while, so I can let this guy get some sleep. Hate being by myself so bad when I'm feeling so ill.

Hi WTV,

Pacing is stimulating your system. If you cannot sit still, why don't you try some light yoga stretches to a you tube video that will help you to wind down? Turn the lights off and light a candle. Make the room dark & cosy to slow your mind and do some yoga or listen to a guided meditation.

Your fear of being alone is being reinforced by every time you get someone to sit with you. There are people in the house if you needed them & we are here, so you are not alone. Try to get comfortable for longer periods of time to yourself in order to stop reinforcing your fear. I know how hard this is. I have experienced fears like this on start up of medication. I learned to be alone by realising that the fear stemmed from being alone with my my own thoughts which were racing, catastrophizing, negative thoughts. Once you learn how to tame those thoughts by distraction, relaxation or letting them wash over you, you will feel much more relaxed about being alone and feel a sense of control again.

Sleep deprivation will feed these thoughts and make you more anxious in response to them. Your thoughts are just that. Thoughts. They can't hurt you.Your mind is overtired, stressed and producing negative thought patterns which are being reinforced by tension that you are holding in your body. Your body is crying out for rest. Switch off the TV, which is overstimulating your mind and do something more conducive to rest.

Sleep is when the body heals. Please try to sleep. You are perfectly safe to go asleep. Nothing bad will happen. You will get the strength that you need to cope with your withdrawal.

Be kind to yourself.

Tilly x

January 22, 2015

On the subject of pacing, I might add that I also have CFS, and physically do not have the energy to stand for periods of time and/or pace. I have to settle for rocking in my rocker/recliner. If I'm exhausted enough, sometimes I will go to sleep sitting right there. If I startle awake, sometimes I am successful in moving to bed and going to sleep.

January 22, 2015

Horrible akathisia since 2 a.m., mixed with intense depressive feelings of guilt and being a horrible person. Have been having intense SI since before 7. So tired I an barely process things. Called the crisis hotline and she's talking about the psychiatric hospital even though I told her I don't want more meds. Feeling really like I cannot continue down this path. I have things to live for and want to live but everything inside me is at a lkmit and I just cannot get any sleep and its making things so much worse. Just writing tihs here because I'm so desperate. Only slept 2 half-hour stretches. My body just wakes me up, in a panic, I can't help it. Nothing calms me down.

I want to live for my familyand don;t want to live them with that kind of legacy and pain but I can't go on like this much longer. Day 7 of ithe reinstatement and this is as bad as the first day after I started it, and now maybe worse b/c Im the most tired I have ever been. Please, God, help me.

January 22, 2015

Praying this will pass for you soon, Watching. Unfortunately I have no advice on the reinstatement. Hopefully, a mod can give you advice as to whether this can be expected. Things are always worse when we are unable to sleep, but what to do?! Praying!

January 22, 2015

The options here seem to be doing something drastic to myself, getting taken to the psych hospital and getting drugged according to their whims, or talking to my doctor and making some new medication decision in order to avoid the first two options. Can someone please advise me what to do re: a new medication decision based on my history?

Go up to 25mg? Try a new SSRI or some other drug? Start taking mirtapazine which barely worked at 15mg but then was emotionally blunting? Dr. also suggested Doxepin for sleep or Seroquel. I don't want ot kll mseyfl I really don't so I have to make some kind of decision here before it gets worse, this is the worst I haev ever felt in my life. I am too close to the edge, thinking about calling the hospital.

Would the Lamictal be a possibility for this kind of situation? Even though I take Topamax? I'm not sure my pdco knows about this--is it a pdoc or neurologist who does this? Does anyone have a doctor who consults over the phone.

Here's my brief history: Zoloft and Lexapro too alerting, make me unable to sleep. 12.5mg of Zoloft reinstatement not helping after a week. Currently taking 15mg Deplin and 100mg Topamax. Not sleeping at all, constant cortisol, probably also have adrenal fatigue but couldn't make it to the doctor to get test results.

Please help me, I want to be in control of this situation instead of having the doctors at the hospital pumping me ufll of things.

January 22, 2015

Watching TV, I wish I knew how to console you. I hear your desperation and remember feeling as you do this fall. I asked here and anywhere I could think of about how much to reinstate, what to reinstate, for how long, and on like that. I just didn't think I could bare what I was feeling and even fantasized about what it would be like to be hospitalized... I feel for you and where you are right now.

Here are things I was told or read when I was at the point you are now:

1) reinstatement isn't a sure thing and could exacerbate symptoms

2) it's not a good time to try a new medication. If you're going to reinstate, reinstate the worked (in your case it was Zoloft)

3) feeling the benefits of reinstatement can take a few weeks, with full effect taking as long as it took to work the first time ( 4-6 weeks?)

4) it's quite possible you'll feel worse before you feel better when Reinstating

Here's my experience:

1) reinstatement to 10 mg of prozac didn't seem to work, but looking back there were improvements. The anxious ruminations/obsessing softened slightly. It was still bad but not as bad. I was at 10 mg for a week or two then updosed.

2) reinstatement to 20 mg: I initially felt worse. More agitated, more inner vibrations and restlessness, more anxiety for about a week, but those horrible, negative ruminations began to subside significantly. Unfortunately I was so focused on the physical symptoms I didn't notice The improvements until later. There was improvement in sleep and the 2 am panicked awakenings became just 2 am waking a to check the time. I was at 20 mg for about 2 weeks...

3) I was so impatient and desperate I hastily updosed again and went to 30mg. Within 3 days I felt enormouse relief and nearly normal but still trembled. It was a week and a half before I saw that reaching baseline was going to happen.

In retrospect I don't believe it was the updose to 30 that made the difference. It was time. Had I remained at 20 mg I probably would have felt that same relief 3 days later.

This is just my experience and my intention isn't to promote what I did. Everyone reacts differently and Many people have had very different experiences.

What is the reason you are taking topomax?

Seroquel is an anti-psychotic medication used off label as a sedative to help with sleep. I don't know its side effects, but it's not simply a sleeping aid.

I don't have the background knowledge or experience to answer your other questions. Truthfully no one will know what will definitely work for you or how you'll react.

I really wish I knew what to say to ease your mind right now. I know how desperately you relief to happen quickly. It will happen, but it takes time.

January 22, 2015

Watching TV, I wish I knew how to console you. I hear your desperation and remember feeling as you do this fall. I asked here and anywhere I could think of about how much to reinstate, what to reinstate, for how long, and on like that. I just didn't think I could bare what I was feeling and even fantasized about what it would be like to be hospitalized... I feel for you and where you are right now.

Here are things I was told or read when I was at the point you are now:

1) reinstatement isn't a sure thing and could exacerbate symptoms

2) it's not a good time to try a new medication. If you're going to reinstate, reinstate the worked (in your case it was Zoloft)

3) feeling the benefits of reinstatement can take a few weeks, with full effect taking as long as it took to work the first time ( 4-6 weeks?)

4) it's quite possible you'll feel worse before you feel better when Reinstating

Here's my experience:

1) reinstatement to 10 mg of prozac didn't seem to work, but looking back there were improvements. The anxious ruminations/obsessing softened slightly. It was still bad but not as bad. I was at 10 mg for a week or two then updosed.

2) reinstatement to 20 mg: I initially felt worse. More agitated, more inner vibrations and restlessness, more anxiety for about a week, but those horrible, negative ruminations began to subside significantly. Unfortunately I was so focused on the physical symptoms I didn't notice The improvements until later. There was improvement in sleep and the 2 am panicked awakenings became just 2 am waking a to check the time. I was at 20 mg for about 2 weeks...

3) I was so impatient and desperate I hastily updosed again and went to 30mg. Within 3 days I felt enormouse relief and nearly normal but still trembled. It was a week and a half before I saw that reaching baseline was going to happen.

In retrospect I don't believe it was the updose to 30 that made the difference. It was time. Had I remained at 20 mg I probably would have felt that same relief 3 days later.

This is just my experience and my intention isn't to promote what I did. Everyone reacts differently and Many people have had very different experiences.

What is the reason you are taking topomax?

Seroquel is an anti-psychotic medication used off label as a sedative to help with sleep. I don't know its side effects, but it's not simply a sleeping aid.

I don't have the background knowledge or experience to answer your other questions. Truthfully no one will know what will definitely work for you or how you'll react.

I really wish I knew what to say to ease your mind right now. I know how desperately you relief to happen quickly. It will happen, but it takes time.

Perfect post.

January 22, 2015

Hi all this is WatchingTV's husband. Thank you all for your support of my wife during this nightmare.

Things have managed to get still worse. The akathisia has been daily, and really bad every morning. Today has been the worst day yet and really since last night it hasn't stopped.

Her SI has gotten much worse from a few days ago of just feeling like she didn't know how she could go on to now talking about suicide, picturing how she would do it, thinking about making plans to do it etc. She's been adamant about staying off all psych drugs and only doing this reinstatement of Z and then ultraslow tapering. But now, with how she's been feeling (and the horrible insomnia is only getting/making things worse) she's open to doing whatever she can to not die.

Some questions for you all:

Mirtazapine - she took it once (15mg) a few days ago and while it only got her 3 hours of sleep it did help her during the waking hours most of the next 20ish hours I'd say. She felt kinda drugged etc and, while miserable, was never SI or desperate. At my and her mom's urging she took 7.5 mg a little bit ago so that she can hopefully get a little sleep and get through this horrible day.

Can taking mirtazapine - at 7.5 or 15mg every third day lead to dependance/a need to taper off at some point?

She feels like her options are these: 1. go on something else other than Z at a therapeutic dose and stabilize there and then microtaper off 2. get admitting to psych hospital 3. the worst thing

Also, she's reinstating at 12.5 of the Z, should she go up to 25 to see if that helps sooner?

All these drugs are poison - but are there any that would be the least of the evils if she has to go on something else? From what I've seen effexor and paxil are to be avoided at all costs.

if we have to take her to the hospital what should we expect? how can we keep them from dxing her as bipolar (or anything else that she is not) since they're unlikely to recognize antidepressant withdrawal as a real thing?

thank you so much

January 22, 2015

If she is suicidal then first and foremost safety must be addressed. She should not be left alone. If she does not feel she can keep herself safe or you doubt her ability to do so OR are unable to ensure she is safe then a trip to the ER may be the only option. Is there a crisis mental health team in your area? That's another option. They can come to the home and assess.

As far as what to expect if you go to the hospital, I don't think anyone can tell you exactly what to expect beyond a clinician doing an initial assessment for risk. They will diagnose what they feel her symptoms are most consistent with and it depends on the clinician wether thay are willing to consider differential diagnosis. Antidepressant Discontinuation Syndrome (995.20) is a legitimate diagnosis listed in the DSM5 as is Medication-induced acute Akathisia (333.99). You could suggest these or mention them but there's no guarantee they will use these diagnosis. If nothing else you can insist that they note your suggestions in her file.

I don't have the knowledge, background or experience to be able to recommend a drug or amount to reinstate or whether there is risk of dependency. ITS sort of a crap shoot as far as what will work and/or how much will do the trick. Regardless what she takes, Z or something else, even if it does eventually help she will likely not get relief for several days or longer.

Someone else may chime in and be more helpful....

January 22, 2015

Welcome your wife made a great choice in you. Not many have a spouse as proactive in attempting to find a way out of this mess.

I am so sorry that things are worsening.

My own feeling is that an updose to the 25 is the best way to go perhaps even higher ...she tapered from the looks of it from 200 mg to 0 in about 6 months that really is a kamakazi taper. Its best to ri and taper from the drug you were previously on.

Personally i think dont add more drugs to the mix ...a trip to the hospital will no doubt result in polydrugging.

So sorry you and the family have to go through this.

January 22, 2015

Mirtazapine is also called remeron this is also associated with withdrawal symptoms ..personally i would avoid it and updose more on the zoloft. Better the devil you know than the one you dont. Remeron is one of the newer ads ...that does mean safer... withdrawal reactions can also be very serious.

All these drugs are poison - but are there any that would be the least of the evils if she has to go on something else?

No sadly they are all the same ...thats why imo its best to stay on the drug you were on and dont open the door to another addiction ...often the new drug doesnt cover the wdl from the previous one and people end up in a mess and going back to the prior one anyway. imo This take also appears to be reflected in the drug history.

From what I've seen effexor and paxil are to be avoided at all costs.

You are definitely right there. Sounds like you are onto it.

Just had another look at the drug sig the taper off zoloft was more like 5 and a bit months. I'm not familiar with zoloft but if it equates in strength to equivalent amount of paxil ie 20 mg z = 20 mg p then 200mg was an extraordinary high dosage. The 10 % taper method applied to a start dose of 200 mg would work out to a 52 months (4.25 years) of tapering. Yet she did this in 5 months. These are brain altering drugs and the brain cannot cope with this sudden alteration. It needs slow small drops to rebalance and adjust.

Also, she's reinstating at 12.5 of the Z, should she go up to 25 to see if that helps sooner?

This is where i would put my money. Answer yes.

I dont want to say anything against the policy of this site as i am new here but i feel it could be 25 may be too low and a higher dose still is needed.

I am so so sorry you are in this predicament.

January 23, 2015

Also there are what's called "mental health advanced directive" that a person can fill out which state what medications you DONT want to be put on and if you choose not to have ECT.

Not sure what state you are in, but here is an example:

https://www.nami.org/Content/Microsites59/NAMI_of_Southwest_Louisiana/Home56/Resources12/Advance_Directive_for_Mental_Health.pdf

It does require 2 witnesses not related by blood or marriage to sign, but just another option to consider.

January 23, 2015

Hello MrWTV,

What was WTV's reaction to the Mirtzapine at 7.5 mg?

As Addax said the key thing is to make sure she is safe. Will someone be with her at all times? Is there any face to face support she can access outside of the hospital setting?

I'm sorry you are both going through this.

Dalsaan

January 23, 2015

Hi WatchingTV's husband,

I'm so sorry your wife, you and family are going through this. The unfortunate truth is that some of the symptoms caused by these drugs, during start up and in withdrawal can be unbearable for some people. As others have advised, please make your wife's safety your main priority now.

There has been some mention of increasing the dose of zoloft. In some situations, that might be recommended, but in your wife's case I'm hesitant to agree for two reasons. From what has been written so far, it seems that zoloft has always been activating and has prevented sleep, so it seems like it has never suited your wife, so increasing it now would most likely increase the sleep problems.

Since reinstating at 12.5mg, she has become much worse. We usually advise updosing after a small reinstatement if someone has had no improvement or a small improvement, but not if symptoms have become worse.

Sometimes reinstatement not only does not work, it causes an adverse reaction from a nervous system sensitized by withdrawal. If you have an immediate bad reaction, reduce or stop taking the drug.

If, upon reinstatement, you very soon feel worse, most likely you are sensitized to the drug and need to take a smaller dosage or, possibly, none at all.

About reinstating and stabilizing to stop withdrawal symptoms

If you could answer Dalsaan's question about Mirtzapine that would be helpful.

I hope your wife was able to get some sleep, please keep us updated.

Petu.

January 24, 2015

Hi all,

Thanks so much for all the responses and I've read them all and they're very useful. Quick update while I can. She took that 7.5 yesterday and it only helped her sleep for two hours (and even that was fitful) then she woke and was in just as akathisiatic state as before. When I got home we did decide to go to the ER because her suicidal thoughts were only getting worse, her physical misery was high, and it was all very scary and just unbearable. We finally got to the ER around 9pm and the strange thing is that the mirtazapine just then decided to start sedating her. So the ER doctors saw her in a VERY different state than she had been for the prior 20 hours.

They prescribed 50 mg benadryl every 8 hours to help with akathisia and to help with sleep. They said to take the mirtazapine also at night but she's leary of taking it so regularlay both because of then it would need to be weaned off and also because it would stop working at all eventually. We were both expecting her to be admitted but she was not and we came home last night and she slept on and off throughout the night with wakeups and intense anxiety.

Today has been better than yesterday because the mirtazapine is still sedating her some. But her anxiety is getting worse as the day wears on. She's very worried about her sleep and nothing helping now or ever. As I type her anxiety has spiked worrying about sleep and about nothing ever working. First SI of the day just now. We'll see. Likely we will end up in the hospital again in the next few days. As if benadryl could freakin help this. gotta go.

(above was written 6 hours ago but didn't post)

January 24, 2015

What contitutes an immediate bad reaction????? Things have indeed gotten progressively worse since she begain reinstating but how can one differentiate between the withdrawal continuing its natural downward spiral (until it can be checked by the reinstatement) VS the drug causing a problem??

January 24, 2015

Thank you. I read over this thread but didn't see any of that information. It seems like with your example these are more physical type symptoms. Does this normally stand true? Or could bouts of akithisia be a bad reaction to a drug (they began about a day and a half after beginning reinstatement - also she went from 3 hours of sleep to complete sleeplessness). My wife (watchingtv426) has had bouts of akithisia at varying times throughout different days. So, based on what you're saying above it doesn't seem to point to it being a reaction to the drug but instead withdrawal running its course. ??

I'm sorry - I don't intend to jack this general thread with specifics. Happy to continue the discussion on her intro thread where I have asked a similar question. Things are very bad here.

January 24, 2015

Hello, WatchingTV and WatchingTV's husband.

Is there a daily pattern to WTV's symptoms relative to when she is taking her drugs? (Keep notes on paper, please.) When does she take her drugs?

Were there symptoms that distinctly started soon after she reinstated 12.5mg Zoloft?

Please put ALL the drugs WTV takes in the Drug Interactions Checker http://www.drugs.com/drug_interactions.html and post the results in this topic.

January 24, 2015

WatchingTV's husband, I moved your post here from the Reinstatement thread.

Symptoms don't have to be only physical. It's easier to identify them when they're physical.

I would not call akathisia a psychological symptom.

WTV's varying pattern could be do to the irregular way she's taking various drugs, including occasional mirtazapine. We need those notes and that symptom pattern!

Also, I'd like to encourage WTV to read Important topics about symptoms, including sleep problems

Consider good sleep hygiene. Bright lights, especially the computer or hand-helds, can be activating at night and reduce sleep.

Soothing music all night, in the dark, can be helpful. Personally, I watch TV (at a distance) when I can't sleep, some program that's not exciting, like Antiques Roadshow.

January 24, 2015

Thanks for the reply. I will post the results from that in a sec. There does not indeed seem to be any sort of pattern. She has been taking her Z consistently at just around 8am every morning. She has had bad attacks of anxiety/akathisisa on different days at different times. The only consistency this last week (aside from misery) has been that whenever she does manage to sleep (even if for only a couple minutes) when she wakes she wakes in a panic. She has been sleeping basically not at all (some nights truly not at all - others less than an hour of interruped sleep).

The akathisia didn't start until about a day after taking her first reinstatement dose. She's seven weeks out from ending her Z taper and things have gone steadily downhill since then. Not that every day was exactly worse than the one before but it has been a trend downwards until now.

She has had some windows this past week but they have also been inconsistently timed and ranged from 20 minutes to 12 hours.

I'm gonna go put her drugs into that online tool now, brb.

January 24, 2015

We do need those notes of daily symptoms, with times and dosages of drugs.

If I were WTV, I would reduce the morning Zoloft to 6.25mg. It sounds like 12.5mg is too high for her.

January 24, 2015

She has been practicing really good sleep hygiene and taking epsom baths practicing guided meditation/sleep hypnosis etc. but to no avail.

She has been in such a state that she's been unable to find anything that's distracting for more than just a few minutes. We have tried a variety of things and things she normally would enjoy. Reading various things, watching various thing etc. etc. but never to any avail.

Also, while the akathisia is indeed partly physical for her it is also very mental - racing thoughts etc and also pretty much the only time she's having SI and defintely the only time when the SI is very bad.

The main reason she went off the Z was for the sleep disruption and between that long term disruption, being back on the Z for reinstatementt, and now the akathisia/panic it's now seems near impossible to get any sleep. It's just that her brain is intensely counteracting sleep

January 24, 2015

Yes, I understand, we see a lot of that.

January 24, 2015

Drug Interaction Report

Drug interactions for the following 5 drug(s):

Unsaved Drug List mirtazapine Benadryl (diphenhydramine) Deplin (l-methylfolate) Topamax (topiramate) Zoloft (sertraline) Interactions between your selected drugs

sertraline ↔ mirtazapine Major Drug Interaction

Applies to: Zoloft (sertraline), mirtazapine

Talk to your doctor before using sertraline together with mirtazapine. Combining these medications can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should contact your doctor immediately if you experience these symptoms while taking the medications. 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.

diphenhydramine ↔ topiramate Major Drug Interaction

Applies to: Benadryl (diphenhydramine), Topamax (topiramate)

Topiramate can cause increased body temperature and decreased sweating, and these effects may be even greater when combined with medications like diphenhydrAMINE. Heat stroke and hospitalization may occur in some people, especially in warm weather and during vigorous exercise. Children are more likely to experience this problem. Talk with your doctor before using these medications together. Drink plenty of fluids during warm weather and when exercising. Call the doctor if you have decreased sweating or a fever. You may also experience drowsiness, dizziness, or lightheadedness when taking these medications together. Avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. 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.

diphenhydramine ↔ sertraline Moderate Drug Interaction

Applies to: Benadryl (diphenhydramine), Zoloft (sertraline)

Using diphenhydrAMINE together with sertraline may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. 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.

diphenhydramine ↔ mirtazapine Moderate Drug Interaction

Applies to: Benadryl (diphenhydramine), mirtazapine

Using diphenhydrAMINE together with mirtazapine may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. 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.

sertraline ↔ topiramate Moderate Drug Interaction

Applies to: Zoloft (sertraline), Topamax (topiramate)

Using sertraline together with topiramate may increase side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience some impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with these medications. Avoid driving or operating hazardous machinery until you know how the medications affect you. 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.

No other interactions were found between your selected drugs.
Note: this does not necessarily mean no interactions exist. ALWAYS consult with your doctor or pharmacist.

Other drugs that your selected drugs interact with

mirtazapine interacts with more than 300 other drugs.
Benadryl (diphenhydramine) interacts with more than 300 other drugs.
Topamax (topiramate) interacts with more than 200 other drugs.
Zoloft (sertraline) interacts with more than 500 other drugs.

Interactions between your selected drugs and food

sertraline ↔ food Minor Drug Interaction

Applies to: Zoloft (sertraline)

Consumer information for this minor interaction is not currently available. Some minor drug interactions may not be clinically relevant in all patients. Minor drug interactions do not usually cause harm or require a change in therapy. However, your healthcare provider can determine if adjustments to your medications are needed.

For clinical details see professional interaction data.

Drug Interaction Classification

The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2015 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

January 24, 2015

Well, now you know. The sertraline + mirtazapine combination is activating.

January 24, 2015

How horrible that watchingTV is going through this. I know reassuring her may seem fruitless, but tell her she will be able to sleep again. I can't even tell you how much of what you describe sounds like me a few months ago...

Cortisol is a major contributor to her anxiety and panic and the disruption of her sleep cycle. Cortisol seems to be at the root of much of the evil of withdrawal. Oxytocin is sort of cortisols arch enemy. It combats cortisol if you will. Where cortisol causes the panic (think fight or flight), oxytocin is soothing / calming (among many other things) One way to increase our oxytocin production is skin to skin contact. So the unorthodox suggestion is physical contact with your wife, like an extended massage. Cuddling too, but that may depend on how she's feeling. My suggestion here is based in science, not wives tales or pseudoscience. It won't hurt to try.

I know there are nasal sprays with oxytocin, but I don't know how effective they are outside of a laboratory setting. I'd stick with massage, cuddling, and/or even petting a dog (there's evidence petting a familiar dog can also promote an increase in oxytocin).

January 24, 2015

If going off the zoloft caused withdrawal and increasingly bad emotional disturbance and then reinstating has cauased this utterly horrifying akathisia then what is there to do? Hope that a very low dose of Z will help eliminate the withdrawal but won't cause the akathisia? What other hope would there be?

It's so very distressing to think maybe the reinstatement is what has caused all this. And it's such a difficult place to be in: either we continue at the higher dose of Z, waiting for relief or we discontinue it and suffer all of those consequences. They are mutually exclusive and if we choose wrong the consequences are dire and there's no way to know which way to choose.

any thoughts or suggestions are most needed

-wtv's husband

January 24, 2015

We do need those notes of daily symptoms, with times and dosages of drugs.

If I were WTV, I would reduce the morning Zoloft to 6.25mg. It sounds like 12.5mg is too high for her.

If I were in your wife's situation, this is the suggestion I would pay attention to.

WatchingTV426--withdrawing from Zoloft, miserably

Recommended Posts

Ssriwarrior

Link to comment

Top Posters In This Topic

Top Posters In This Topic

Ssriwarrior

Link to comment

Addax

Link to comment

Ever

Link to comment

WatchingTV426

Link to comment

WatchingTV426

Link to comment

AmyK

Link to comment

AmyK

Link to comment

Tilly

Link to comment

luv2knit

Link to comment

WatchingTV426

Link to comment

luv2knit

Link to comment

WatchingTV426

Link to comment

Addax

Link to comment

SelmaLady

Link to comment

WatchingTV426

Link to comment

Addax

Link to comment

nz11

I believe the ssri era will soon stand as one of the most shameful in the history of medicine. Healy 2015

Let people help people ... in a natural, kind, non-addictive (and non-big pharma) way. J Broadley 2017

Link to comment

nz11

I believe the ssri era will soon stand as one of the most shameful in the history of medicine. Healy 2015

Let people help people ... in a natural, kind, non-addictive (and non-big pharma) way. J Broadley 2017

Link to comment

Ssriwarrior

Link to comment

dalsaan

Link to comment

Petunia

Link to comment

WatchingTV426

Link to comment

WatchingTV426

Link to comment

WatchingTV426

Link to comment

Altostrata

Link to comment

Altostrata

Link to comment

WatchingTV426

Link to comment

Altostrata

Link to comment

WatchingTV426

Link to comment

Altostrata

Link to comment

WatchingTV426

Link to comment

Altostrata

Link to comment

Addax

Link to comment

WatchingTV426

Link to comment

Petunia

Link to comment