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apace41: tapering Zoloft / sertraline


apace41

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I've been watching on and off on this site for a while, lurking I suppose is the more derogatory parlance, and thought it was time to do my introduction.  Very impressed with this group as it has a lot of very thoughtful, well-spoken, knowledgeable and caring people among its members and mods.  I arrive at the board in the midst of a taper from 100mg of sertraline which follows a 2 year taper off of .5 mg of clonazepam, having been on both drugs for more than a decade.  Clonazepam dosage was at .375 for most of that period increasing to .5 when I went (unknowingly) into tolerance when it was increased to no effect and I decided to taper.  The sertraline dosage was, similarly, at 50mg until my pdoc thought an increase was warranted to 100mg so that I was on  100mg for less than a year. 

 

As an aside, it's interesting that those in the benzo withdrawal world swear by all things holy that you must taper your benzo before your AD if you are on both.  Clearly, after spending some time on this site, that advice is not what one starting here would follow.  To some degree, however, that is water under the bridge and I can't look back with regret since I can't do it over in any event.

 

My taper off clonazepam was conducted primarily with the help of people on the Benzo Detox Recovery website which has since been shut down.  It was a two-year taper using a milk-based solution and, while it had some ups and downs, it was at least reasonably manageable as I worked throughout and managed to live my life (at least for the most part).  The people there remind me of the people here in that they were caring, smart and insightful and some posted on rare occasion and some posted regularly.  All were accepted.  The ups and downs included a blood clot (unrelated to the meds), several surgeries and a botched procedure that led to 8 days in the ICU and coming close to losing an arm, all of which made it difficult to taper as I was not able to mix my "benzo-milk" during that period.  The benzo taper also included a point at which I convinced myself my problems were from the sertraline and not the benzo so I tapered the sertraline rather quickly (over 2-3 months) but then reinstated very soon after that all of which seemed to have no material effect on my general condition.  This sertraline taper took place in summer/fall of 2013 (about 15-18 months ago) and I believe had no significant lasting effect.

 

With that history, I began to taper the sertraline in December and was planning to simply model my taper after the one I had done in 2013 while on the benzo which had been a 25mg reduction each of 3 months.  I went to 75mg for a month but then started thinking I should go slower and then went to 62.5 for a month.  Overall, I didn't have any terrible symptoms but I haven't really felt "great" for as long as I can recall (which is most likely from long term use of these drugs).   At the beginning of February I moved to 50mg and while I have not had any major symptoms, I have modestly increased anxiety and some palpitations (PVC, PAC or something).  Based on what I have been reading on the site, continuing at the rate I planned could prove to be dangerous.  There is probably some likelihood that being on the benzo when I tapered in 2013 "cushioned" the sertraline taper so that I could do it fairly rapidly and that it might not go as smoothly as it did a second time.  Of course, there are people who don't have problems at all getting off benzos or ADs but it seems foolish to tempt fate.

 

My plan is to stay on the 50mg to the end of February and see where I am and how I'm feeling.  Most likely, to try to be safer, at the end of the month, rather than going to 37.5 like my pdoc suggests, I would get a Rx for the liquid form of the medicine and microtaper the remaining 50mg over a much longer period (time frame to be determined).  Having experience with the liquid microtaper from my benzo days makes that a viable approach for me (I have my chemistry set at home still!).

 

I wanted to solicit comments from those with more experience on this plan with the understanding that if I were to feel increased symptoms with my current reduction to 50mg I could increase it and then start the microtaper after stabilization at 62.5mg.  As a related question, does the fact that my taper in 2013 was smooth and relatively fast suggest I could/should go faster this time as well or is the polydrug nature of that taper sufficient to call such an approach into question?

 

Any thoughts or input welcome. 

 

I hope I can contribute to others as much as reading your collective posts has helped me.

 

Andy

Sertraline 50mg and Clonazapam .375mg from 2000 -- symptoms of dizziness Spring 2012

increased to .5 Clonazapam and 100mg Sertraline -- no improvement

Benzo microtaper from November 2012 to November 2014 (followed benzo sites "taper benzo first")

Started Sertraline taper in December 2014 cut by 25mg to 75mg; 62.5mg 1/1/15 and 50mg on 2/1/15

Held at 50mg through April 5 to use liquid 
Reduced dosage in 10% or less drops from 50mg to 25mg -- at single tablet of 25mg on 10/5/15

Transitioned to all liquid for accuracy while tapering -- Horrible insomnia -- back to 25mg liquid and held until October 1, 2016

10/16 -- 11/18 tapered very slowly to 10.6mg.  No real improvement and never really stable so updosed to 12.5mg (1/2 a pill) for convenience and long hold.

After 8+ months of holding with no noticeable improvement decided to add .4ml of liquid Prozac (about 1.5mg) to see if that improves the situation

Supplements, Magnesium, D3, Omega 3, curcumin, Valerian, 81mg Aspirin, L-Theanine, Vit. C,

 

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Hi Andy

 

Welcome to SA. Great to see you have been reading and thinking through your strategy. I would think having tapered off a benzo is enough to support the slow and steady approach. Maybe you could go faster but why risk it?

 

My inclination would be to hold longer here. Your drops have been quite big, 50 percent in two months! Sometimes there can be a delay in withdrawal kicking in. Again better to be safe than sorry. The key task is to avoid going into withdrawal. Yes you might be able to updose if that happens and that often resolves the symptoms but often people are left with residual effects that the undoes doesn't address. Best focussing on avoiding or minimising wd rather than responding to it with an up dose. If it was me I would hold here for two months or more to see if you can address your modest symptoms and to make sure you're not having a delayed reaction.

 

Dalsaan

Please note - I am not a medical practitioner and I do not give medical advice. I offer an opinion based on my own experiences, reading and discussion with others.On Effexor for 2 months at the start of 2005. Had extreme insomnia as an adverse reaction. Changed to mirtazapine. Have been trying to get off since mid 2008 with numerous failures including CTs and slow (but not slow enough tapers)Have slow tapered at 10 per cent or less for years. I have liquid mirtazapine made at a compounding chemist.

Was on 1.6 ml as at 19 March 2014.

Dropped to 1.5 ml 7 June 2014. Dropped to 1.4 in about September.

Dropped to 1.3 on 20 December 2014. Dropped to 1.2 in mid Jan 2015.

Dropped to 1 ml in late Feb 2015. I think my old medication had run out of puff so I tried 1ml when I got the new stuff and it seems to be going ok. Sleep has been good over the last week (as of 13/3/15).

Dropped to 1/2 ml 14/11/15 Fatigue still there as are memory and cognition problems. Sleep is patchy but liveable compared to what it has been in the past.

 

DRUG FREE - as at 1st May 2017

 

>My intro post is here - http://survivingantidepressants.org/index.php?/topic/2250-dalsaan

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  • Moderator Emeritus

Hiya apace , welcome and congratulations on doing your introduction.

 

I agree with dalsaan - you've just done big cuts , and we know this can be very unsettling.    There's no hurry here.  Go  s-l-o-w 

Good plan to sit where you are for another 4 weeks , then reassess.

 

Best wishes ,   Fresh

1987-1997 pertofran , prothiaden , Prozac 1997-2002 Zoloft 2002-2004 effexor 2004-2010 Lexapro 40mg

2010-2012Cymbalta 120mg

Sept. 2012 -decreased 90mg in 6months. Care taken over by Dr Lucire in March 2013 , decreased last 30mg at 2mg per week over 3 months. July 21 , 2013- last dose of Cymbalta

Protracted withdrawal syndrome kicked in badly Jan.2014 Unrelenting akathisia until May 2014. Voluntary hosp. admission. Cocktail of Seroquel, Ativan and mirtazapine and I was well enough to go home after 14 days. Stopped all hosp. meds in next few months.

July 2014 felt v.depressed - couldn't stop crying. Started pristiq 50mg. Felt improvement within days and continued to improve, so stayed on 50mg for 8 months.

Began taper 28 Feb. 2015. Pristiq 50mg down to 45mg. Had one month of w/d symptoms. Started CES therapy in March. No w/d symptoms down to 30mg.

October 2015 , taking 25mg Pristiq. Capsules compounded with slow-release additive.

March 2016 , 21mg

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Thanks for the feedback, Dalsaan and Fresh.  Your advice is wise and one of the reasons I decided it was time to solicit input.  It can be so easy to get caught up in "being done" that you make a mistake and pay for it for a long time.  Compounding that is the fact that I was getting a blood draw (relating to the surgery I had last year and unrelated) so I asked my GP, who is also a cardio, about the PVC/PAC issue.  I suggested that it might be related to the Sertraline taper and his reaction, not much of a surprise, was "you are on such a small amount that's not likely to be the cause."  I really only asked because I was there since I'm 95%+ sure that IS the cause and because I don't want to miss something that could be a "gamechanger." 

 

In any event, I think the feedback is exactly what I needed to hear.  I think I will stay at 50mg until I feel like I'm ready to move on and then go with the liquid approach.  It's the same thing as benzo tapering -- don't ever do it by the calendar -- listen to your body.

 

Thanks again to both of you!

 

Andy

Sertraline 50mg and Clonazapam .375mg from 2000 -- symptoms of dizziness Spring 2012

increased to .5 Clonazapam and 100mg Sertraline -- no improvement

Benzo microtaper from November 2012 to November 2014 (followed benzo sites "taper benzo first")

Started Sertraline taper in December 2014 cut by 25mg to 75mg; 62.5mg 1/1/15 and 50mg on 2/1/15

Held at 50mg through April 5 to use liquid 
Reduced dosage in 10% or less drops from 50mg to 25mg -- at single tablet of 25mg on 10/5/15

Transitioned to all liquid for accuracy while tapering -- Horrible insomnia -- back to 25mg liquid and held until October 1, 2016

10/16 -- 11/18 tapered very slowly to 10.6mg.  No real improvement and never really stable so updosed to 12.5mg (1/2 a pill) for convenience and long hold.

After 8+ months of holding with no noticeable improvement decided to add .4ml of liquid Prozac (about 1.5mg) to see if that improves the situation

Supplements, Magnesium, D3, Omega 3, curcumin, Valerian, 81mg Aspirin, L-Theanine, Vit. C,

 

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  • Moderator Emeritus

Thanks apace.

I haven't been able to do an intro. thread yet and you've inspired me....this week for sure.

1987-1997 pertofran , prothiaden , Prozac 1997-2002 Zoloft 2002-2004 effexor 2004-2010 Lexapro 40mg

2010-2012Cymbalta 120mg

Sept. 2012 -decreased 90mg in 6months. Care taken over by Dr Lucire in March 2013 , decreased last 30mg at 2mg per week over 3 months. July 21 , 2013- last dose of Cymbalta

Protracted withdrawal syndrome kicked in badly Jan.2014 Unrelenting akathisia until May 2014. Voluntary hosp. admission. Cocktail of Seroquel, Ativan and mirtazapine and I was well enough to go home after 14 days. Stopped all hosp. meds in next few months.

July 2014 felt v.depressed - couldn't stop crying. Started pristiq 50mg. Felt improvement within days and continued to improve, so stayed on 50mg for 8 months.

Began taper 28 Feb. 2015. Pristiq 50mg down to 45mg. Had one month of w/d symptoms. Started CES therapy in March. No w/d symptoms down to 30mg.

October 2015 , taking 25mg Pristiq. Capsules compounded with slow-release additive.

March 2016 , 21mg

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  • Moderator

So, last couple of days a little rough. I guess somewhere in my mind I was afraid of that and it prompted me to post my intro thread. Significant increase in palpitations and some stronger anxiety. Since I made my latest cut a week agouti seems to be a pretty direct response. The hard part is that I went to my internist for a blood draw related to my surgery last year and suggested my taper as the cause and he responded with the classic "you're on such a small dose, that can't be it." So, I wore a holter monitor last night and this morning until it fell into the toilet and stopped working! Ugh.

 

Anyway, I think the logical cause of the palms is the withdrawal. I suppose there's no downside to confirming (I hope) the palms are benign, but I'm not anxious to repeat it if the monitor was broken. Just looking for reactions to my thoughts and docs comment.

 

Thanks.

Sertraline 50mg and Clonazapam .375mg from 2000 -- symptoms of dizziness Spring 2012

increased to .5 Clonazapam and 100mg Sertraline -- no improvement

Benzo microtaper from November 2012 to November 2014 (followed benzo sites "taper benzo first")

Started Sertraline taper in December 2014 cut by 25mg to 75mg; 62.5mg 1/1/15 and 50mg on 2/1/15

Held at 50mg through April 5 to use liquid 
Reduced dosage in 10% or less drops from 50mg to 25mg -- at single tablet of 25mg on 10/5/15

Transitioned to all liquid for accuracy while tapering -- Horrible insomnia -- back to 25mg liquid and held until October 1, 2016

10/16 -- 11/18 tapered very slowly to 10.6mg.  No real improvement and never really stable so updosed to 12.5mg (1/2 a pill) for convenience and long hold.

After 8+ months of holding with no noticeable improvement decided to add .4ml of liquid Prozac (about 1.5mg) to see if that improves the situation

Supplements, Magnesium, D3, Omega 3, curcumin, Valerian, 81mg Aspirin, L-Theanine, Vit. C,

 

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  • Moderator Emeritus

I'm not that bright apace , what are "the palms"?   Also , what is a halter monitor?

1987-1997 pertofran , prothiaden , Prozac 1997-2002 Zoloft 2002-2004 effexor 2004-2010 Lexapro 40mg

2010-2012Cymbalta 120mg

Sept. 2012 -decreased 90mg in 6months. Care taken over by Dr Lucire in March 2013 , decreased last 30mg at 2mg per week over 3 months. July 21 , 2013- last dose of Cymbalta

Protracted withdrawal syndrome kicked in badly Jan.2014 Unrelenting akathisia until May 2014. Voluntary hosp. admission. Cocktail of Seroquel, Ativan and mirtazapine and I was well enough to go home after 14 days. Stopped all hosp. meds in next few months.

July 2014 felt v.depressed - couldn't stop crying. Started pristiq 50mg. Felt improvement within days and continued to improve, so stayed on 50mg for 8 months.

Began taper 28 Feb. 2015. Pristiq 50mg down to 45mg. Had one month of w/d symptoms. Started CES therapy in March. No w/d symptoms down to 30mg.

October 2015 , taking 25mg Pristiq. Capsules compounded with slow-release additive.

March 2016 , 21mg

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  • Moderator

I'm not that bright apace , what are "the palms"?   Also , what is a halter monitor?

Oops! Palms are "palps" or palpitations when Apple autocorrects for you. Holter monitor is one you wear for 24 hours (or more) so the doc can see your heart rhythm over an extended period (since they never catch it in the office).

Sertraline 50mg and Clonazapam .375mg from 2000 -- symptoms of dizziness Spring 2012

increased to .5 Clonazapam and 100mg Sertraline -- no improvement

Benzo microtaper from November 2012 to November 2014 (followed benzo sites "taper benzo first")

Started Sertraline taper in December 2014 cut by 25mg to 75mg; 62.5mg 1/1/15 and 50mg on 2/1/15

Held at 50mg through April 5 to use liquid 
Reduced dosage in 10% or less drops from 50mg to 25mg -- at single tablet of 25mg on 10/5/15

Transitioned to all liquid for accuracy while tapering -- Horrible insomnia -- back to 25mg liquid and held until October 1, 2016

10/16 -- 11/18 tapered very slowly to 10.6mg.  No real improvement and never really stable so updosed to 12.5mg (1/2 a pill) for convenience and long hold.

After 8+ months of holding with no noticeable improvement decided to add .4ml of liquid Prozac (about 1.5mg) to see if that improves the situation

Supplements, Magnesium, D3, Omega 3, curcumin, Valerian, 81mg Aspirin, L-Theanine, Vit. C,

 

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  • Moderator Emeritus

I've had bad heart palpitations in withdrawal , it often felt like my chest would burst.     My vote goes to fall-out from your recent cut.    Hope it resolves

quickly for you apace. 

1987-1997 pertofran , prothiaden , Prozac 1997-2002 Zoloft 2002-2004 effexor 2004-2010 Lexapro 40mg

2010-2012Cymbalta 120mg

Sept. 2012 -decreased 90mg in 6months. Care taken over by Dr Lucire in March 2013 , decreased last 30mg at 2mg per week over 3 months. July 21 , 2013- last dose of Cymbalta

Protracted withdrawal syndrome kicked in badly Jan.2014 Unrelenting akathisia until May 2014. Voluntary hosp. admission. Cocktail of Seroquel, Ativan and mirtazapine and I was well enough to go home after 14 days. Stopped all hosp. meds in next few months.

July 2014 felt v.depressed - couldn't stop crying. Started pristiq 50mg. Felt improvement within days and continued to improve, so stayed on 50mg for 8 months.

Began taper 28 Feb. 2015. Pristiq 50mg down to 45mg. Had one month of w/d symptoms. Started CES therapy in March. No w/d symptoms down to 30mg.

October 2015 , taking 25mg Pristiq. Capsules compounded with slow-release additive.

March 2016 , 21mg

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  • Moderator Emeritus

So, last couple of days a little rough. I guess somewhere in my mind I was afraid of that and it prompted me to post my intro thread. Significant increase in palpitations and some stronger anxiety. Since I made my latest cut a week agouti seems to be a pretty direct response. 

 

I agree.  I think this is withdrawal.  At this point you have two options, stay your current course and see if your symptoms abate or increase your dose to see if that addresses these symptoms and then decrease at the slower rate.   Given your very fast taper, if it was me I would go the second option and updose.   How were your symptoms on 62.5?   Given that our systems can sometimes become sensitised to drug increases during withdrawal you might want to start by updosing to say 55.  

 

This is a conservative strategy to see how your body responds, it may not be enough if your withdrawals actually relate to the earlier drops from 100-75 and then to 62.5.   It might be that this slight increase will address your current symptoms.

 

D

 

 

 

D

Please note - I am not a medical practitioner and I do not give medical advice. I offer an opinion based on my own experiences, reading and discussion with others.On Effexor for 2 months at the start of 2005. Had extreme insomnia as an adverse reaction. Changed to mirtazapine. Have been trying to get off since mid 2008 with numerous failures including CTs and slow (but not slow enough tapers)Have slow tapered at 10 per cent or less for years. I have liquid mirtazapine made at a compounding chemist.

Was on 1.6 ml as at 19 March 2014.

Dropped to 1.5 ml 7 June 2014. Dropped to 1.4 in about September.

Dropped to 1.3 on 20 December 2014. Dropped to 1.2 in mid Jan 2015.

Dropped to 1 ml in late Feb 2015. I think my old medication had run out of puff so I tried 1ml when I got the new stuff and it seems to be going ok. Sleep has been good over the last week (as of 13/3/15).

Dropped to 1/2 ml 14/11/15 Fatigue still there as are memory and cognition problems. Sleep is patchy but liveable compared to what it has been in the past.

 

DRUG FREE - as at 1st May 2017

 

>My intro post is here - http://survivingantidepressants.org/index.php?/topic/2250-dalsaan

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  • Moderator

 

So, last couple of days a little rough. I guess somewhere in my mind I was afraid of that and it prompted me to post my intro thread. Significant increase in palpitations and some stronger anxiety. Since I made my latest cut a week agouti seems to be a pretty direct response.

 

 

I agree.  I think this is withdrawal.  At this point you have two options, stay your current course and see if your symptoms abate or increase your dose to see if that addresses these symptoms and then decrease at the slower rate.   Given your very fast taper, if it was me I would go the second option and updose.   How were your symptoms on 62.5?

 

 

D

Thanks for the input Dalsaan. I think that is a good assessment. I had occasional palps at 62.5 but not really very noticeable. Thursday/Friday were worse than yesterday and today. I'm inclined to see if this is a trend and as I adjust to the last cut the symptoms improve. If they get worse (repeat Thursday/Friday) I will updose, probably to 62.5 since I don't have liquid at this point to do an interim increase like 55.

 

Thanks again,

 

Andy

Sertraline 50mg and Clonazapam .375mg from 2000 -- symptoms of dizziness Spring 2012

increased to .5 Clonazapam and 100mg Sertraline -- no improvement

Benzo microtaper from November 2012 to November 2014 (followed benzo sites "taper benzo first")

Started Sertraline taper in December 2014 cut by 25mg to 75mg; 62.5mg 1/1/15 and 50mg on 2/1/15

Held at 50mg through April 5 to use liquid 
Reduced dosage in 10% or less drops from 50mg to 25mg -- at single tablet of 25mg on 10/5/15

Transitioned to all liquid for accuracy while tapering -- Horrible insomnia -- back to 25mg liquid and held until October 1, 2016

10/16 -- 11/18 tapered very slowly to 10.6mg.  No real improvement and never really stable so updosed to 12.5mg (1/2 a pill) for convenience and long hold.

After 8+ months of holding with no noticeable improvement decided to add .4ml of liquid Prozac (about 1.5mg) to see if that improves the situation

Supplements, Magnesium, D3, Omega 3, curcumin, Valerian, 81mg Aspirin, L-Theanine, Vit. C,

 

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  • Moderator Emeritus

Hi Andy,

 

As per this thread, it is possible to make your own liquid and many people do - http://survivingantidepressants.org/index.php?/topic/1441-tips-for-tapering-off-zoloft-sertraline/

 

The liquid opens up many more dosing options for you.

 

All the best,

 

Dalsaan

Please note - I am not a medical practitioner and I do not give medical advice. I offer an opinion based on my own experiences, reading and discussion with others.On Effexor for 2 months at the start of 2005. Had extreme insomnia as an adverse reaction. Changed to mirtazapine. Have been trying to get off since mid 2008 with numerous failures including CTs and slow (but not slow enough tapers)Have slow tapered at 10 per cent or less for years. I have liquid mirtazapine made at a compounding chemist.

Was on 1.6 ml as at 19 March 2014.

Dropped to 1.5 ml 7 June 2014. Dropped to 1.4 in about September.

Dropped to 1.3 on 20 December 2014. Dropped to 1.2 in mid Jan 2015.

Dropped to 1 ml in late Feb 2015. I think my old medication had run out of puff so I tried 1ml when I got the new stuff and it seems to be going ok. Sleep has been good over the last week (as of 13/3/15).

Dropped to 1/2 ml 14/11/15 Fatigue still there as are memory and cognition problems. Sleep is patchy but liveable compared to what it has been in the past.

 

DRUG FREE - as at 1st May 2017

 

>My intro post is here - http://survivingantidepressants.org/index.php?/topic/2250-dalsaan

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  • Moderator

I've been reading a lot on the board and it's opened my eyes to that fact that a lot of my chief complaints over the past "however long" may be attributable, at least in part, to the sertraline.  For example, I have a long history of some mild "health anxiety" driven in large part by an overprotective mother and prematurely ill father (heart disease, stroke).  For the most part, I thought I had come to terms with this issue.  Lately, however, I've found myself doing some catastrophic thinking whenever I feel a random pain in my neck, chest, etc.  Kind of like, "I just know I'm going to collapse on the floor in the office and that would be awkward."  Ties a little into the more general anxiety stuff and can be somewhat distracting.

 

Just musing and wondering if others feel the same thing?

 

Thanks,

 

Andy

Sertraline 50mg and Clonazapam .375mg from 2000 -- symptoms of dizziness Spring 2012

increased to .5 Clonazapam and 100mg Sertraline -- no improvement

Benzo microtaper from November 2012 to November 2014 (followed benzo sites "taper benzo first")

Started Sertraline taper in December 2014 cut by 25mg to 75mg; 62.5mg 1/1/15 and 50mg on 2/1/15

Held at 50mg through April 5 to use liquid 
Reduced dosage in 10% or less drops from 50mg to 25mg -- at single tablet of 25mg on 10/5/15

Transitioned to all liquid for accuracy while tapering -- Horrible insomnia -- back to 25mg liquid and held until October 1, 2016

10/16 -- 11/18 tapered very slowly to 10.6mg.  No real improvement and never really stable so updosed to 12.5mg (1/2 a pill) for convenience and long hold.

After 8+ months of holding with no noticeable improvement decided to add .4ml of liquid Prozac (about 1.5mg) to see if that improves the situation

Supplements, Magnesium, D3, Omega 3, curcumin, Valerian, 81mg Aspirin, L-Theanine, Vit. C,

 

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I'm so glad you found this site before dropping any more :)

2000 - sertraline for job anxiety low confidence (17 years old) ..which turned the next 16 years into nightmare!

 

On/off sertraline severe withdrawals every time. 2014 - felt better as reduced dose of sertraline no more inner restlessness. Doctor rushed off again. Hit severe withdrawal. Lost the little I had in life. Couldn't get stable again on 12.5mg. Was switched to prozac. Had severe reaction to prozac..came off in November 2015 at 6mg as felt more confused and damaged on it..Even more withdrawal ..rage, depression, dyphoria, near constant suicidal ideation, self harm impulses, doom, concrete block in head, unable to do much of anything with this feeling in head..went back on 6mg of sertraline to see if would alleviate anything. It didn't..reduced from December to June 2016 came off at 2.5mg sertraline as was hospitalised for the severe rage, suicidal impulses, and put on 50mg lofepramine which in 2nd week reduced all symptoms but gave insomnia which still have..psych stopped lofepramine cold turkey..no increased withdrawal symptoms new symptoms from lofepramine except persistant insomnia which has as side effect.

 

Taking Ativan for 8 months for the severe rage self harm impulses 1-3 times a week (mostly 2 times a week) at .5mg. Two months (I'm unsure exactly when the interdose started to happen) ago interdose withdrawal seemed to happen..2 days I think after the Ativan.

 

 

Nightmare that could have been avoided!

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  • Moderator Emeritus

Andy, you sound sensible and reasonable, and with your experience with the benzo taper, I think you're going to do fine with this one too.

 

There are a couple of differences that I've noticed between benzo tapering and WD and antidepressant tapering and WD. The main one is that with AD withdrawal, people can get past the acute phase and do okay for a while, then get hit with a delayed effect rather suddenly somewhere between three and nine months out.  I don't recall seeing that with benzos (before I came here I was on benzo boards for a few years). The other difference is that reinstatement seems to be more straightforward and predictable (as far as helping or not) with ADs than with benzos.

 

It's not at all difficult to make a water suspension for tapering, but it sounds like you did basically that with a milk suspension, so you already know. I definitely recommend it so that you can totally control the increments you reduce by.

 

If you think you can ride this out it's probably okay, but you'll need to plan a good long hold to stabilize before you restart your taper at a more modest pace. A small reinstatement could be helpful. Did you go back up to the 62.5 yet? Keep us posted.

 

I would be cautious about assuming that because your previous taper was okay fast that you can go faster this time. There are a couple of reasons for this.

 

First, as you yourself have already thought about, the clonazepam was covering you before, and it's not there any more.

 

Second, we find that when people have recently come off any psych med, even from a different "family," they tend to be more likely to have a bumpy taper with the next med, especially if they try to start tapering really soon. You just came all the way off clonazepam in November; that's just yesterday! Your brain and nervous system are still doing a lot of remodeling, turning some genes on and others off, adjusting, etc. Since you did a slow taper that's probably all going well, but it's still not a fully stable condition. If it were me I actually would either do an extremely slow taper now off the AD or just wait and not even start tapering yet.

 

Third, it appears that instead of past success predicting future success, with AD withdrawal (and probably other psych meds as well) it's actually more common for people to have an easy time of it for one or two or three times and then suddenly to run out of "slack" and really get hit hard the next time. We see people in here all the time who've been caught by this. Alto says our nervous systems are not made of rubber, which is a good way of putting it. Whatever it is, we don't know exactly what causes it, but it's a consistent phenomenon. So you can't assume that an easy taper in the past predicts an easy one later, unfortunately.

 

I think you're going to be a success story. Just dig deep and find that patience again. It's a long, slow walk, but if you go slow enough you'll feel good and be able to enjoy your life while you taper. And as the dosage goes lower, you'll find that the drug effect is greatly reduced, so you'll be feeling better and better-- as long as you go slow enough to allow your brain to regrow and remodel as you go.

 

Just--don't rush it. Personally I think it's early days to even be starting another taper yet. I'd take more time to heal from the clonazepam taper first.

Started on Prozac and Xanax in 1992 for PTSD after an assault. One drug led to more, the usual story. Got sicker and sicker, but believed I needed the drugs for my "underlying disease". Long story...lost everything. Life savings, home, physical and mental health, relationships, friendships, ability to work, everything. Amitryptiline, Prozac, bupropion, buspirone, flurazepam, diazepam, alprazolam, Paxil, citalopram, lamotrigine, gabapentin...probably more I've forgotten. 

Started multidrug taper in Feb 2010.  Doing a very slow microtaper, down to low doses now and feeling SO much better, getting my old personality and my brain back! Able to work full time, have a full social life, and cope with stress better than ever. Not perfect, but much better. After 23 lost years. Big Pharma has a lot to answer for. And "medicine for profit" is just not a great idea.

 

Feb 15 2010:  300 mg Neurontin  200 Lamictal   10 Celexa      0.65 Xanax   and 5 mg Ambien 

Feb 10 2014:   62 Lamictal    1.1 Celexa         0.135 Xanax    1.8 Valium

Feb 10 2015:   50 Lamictal      0.875 Celexa    0.11 Xanax      1.5 Valium

Feb 15 2016:   47.5 Lamictal   0.75 Celexa      0.0875 Xanax    1.42 Valium    

2/12/20             12                       0.045               0.007                   1 

 

I'm not a doctor. Any advice I give is just my civilian opinion.

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  • Moderator

Great post and input, Rhi!  Thanks so much for your thoughts.

 

There's a little bit of a "rock and hard place" issue going on here for me.  On the one hand, I recognize from my benzo days/years that slow is the mantra and there is a lot to be said for the idea that starting the SSRI taper shortly after completing the benzo taper was questionable.  Having said that, I have the deep-seated (irrational?) feeling that the Sertraline is "making me sick" and that getting off of it is important to my overall healing.  Striking the balance between the two is, of course, the "art of the taper."

 

I have not increased back up to 62.5 as my symptoms have been mostly static and, to the extent they have moved on the spectrum, they are improved.  I think that based on all that I've seen, heard and read, I'm inclined to hold here (absent a significant move to the downside) for a while (at least a couple of months) and then reassess come my April Fool's Birthday.  By that time, I will have a better handle on how I'm feeling and will have had a chance to consult further with my pdoc so that I can have liquid Sertraline ready for a taper.  I appreciate that it can be done in water but if there is a liquid out there that can be readily used you don't have to deal with issues of "suspension" v. "solution" and completeness of dissolving of the med which I dealt with for so long in my clonazepam taper.  As an aside, the fact that I don't have to use whole milk is a big plus!  After a while, clonazepam-milk is kind of gross.

 

What you mention about symptoms appearing much later with AD withdrawal is a little on the frightening side.  While I would not describe the benzo taper world as "strictly linear", I would say that the windows and waves tend to follow a smoothed out graph for most people.  The idea that the AD "sword of Damocles" hangs over you for an indeterminate time period is fairly troubling.  The whole idea of the microtaper with benzos was to allow the upregulation of the GABA to try, as best as possible, to match the reduction in the benzo supporting the GABA.  On paper it was perfect -- in reality somewhat less so but still better than other methods (e.g. Ashton). 

 

Has there been much experience with AD microtapers?  Given my experience doing that, I was just sketching out a schedule that would have me tapering the remaining 50mg over a period of about a year at .15mg daily with the notion that it would be subject to adjustment and holds for various reasons and might take somewhere in the range of 15-18 months when all was said and done.

 

Curious as to any feedback on the microtaper subject.  I will research on the site when I have some more time.

 

Again, Rhi, greatly appreciate your input!

 

:)

 

Andy

Sertraline 50mg and Clonazapam .375mg from 2000 -- symptoms of dizziness Spring 2012

increased to .5 Clonazapam and 100mg Sertraline -- no improvement

Benzo microtaper from November 2012 to November 2014 (followed benzo sites "taper benzo first")

Started Sertraline taper in December 2014 cut by 25mg to 75mg; 62.5mg 1/1/15 and 50mg on 2/1/15

Held at 50mg through April 5 to use liquid 
Reduced dosage in 10% or less drops from 50mg to 25mg -- at single tablet of 25mg on 10/5/15

Transitioned to all liquid for accuracy while tapering -- Horrible insomnia -- back to 25mg liquid and held until October 1, 2016

10/16 -- 11/18 tapered very slowly to 10.6mg.  No real improvement and never really stable so updosed to 12.5mg (1/2 a pill) for convenience and long hold.

After 8+ months of holding with no noticeable improvement decided to add .4ml of liquid Prozac (about 1.5mg) to see if that improves the situation

Supplements, Magnesium, D3, Omega 3, curcumin, Valerian, 81mg Aspirin, L-Theanine, Vit. C,

 

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  • 1 month later...
  • Moderator Emeritus

How are you doing apace?     Update?

 

I finally did my intro. thread , please check it out.

 

I'm hoping you're feeling so much better that you haven't even thought about this site for a while.

 

:)

1987-1997 pertofran , prothiaden , Prozac 1997-2002 Zoloft 2002-2004 effexor 2004-2010 Lexapro 40mg

2010-2012Cymbalta 120mg

Sept. 2012 -decreased 90mg in 6months. Care taken over by Dr Lucire in March 2013 , decreased last 30mg at 2mg per week over 3 months. July 21 , 2013- last dose of Cymbalta

Protracted withdrawal syndrome kicked in badly Jan.2014 Unrelenting akathisia until May 2014. Voluntary hosp. admission. Cocktail of Seroquel, Ativan and mirtazapine and I was well enough to go home after 14 days. Stopped all hosp. meds in next few months.

July 2014 felt v.depressed - couldn't stop crying. Started pristiq 50mg. Felt improvement within days and continued to improve, so stayed on 50mg for 8 months.

Began taper 28 Feb. 2015. Pristiq 50mg down to 45mg. Had one month of w/d symptoms. Started CES therapy in March. No w/d symptoms down to 30mg.

October 2015 , taking 25mg Pristiq. Capsules compounded with slow-release additive.

March 2016 , 21mg

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  • Moderator

How are you doing apace?     Update?

 

I finally did my intro. thread , please check it out.

 

I'm hoping you're feeling so much better that you haven't even thought about this site for a while.

 

:)

 

Thanks for checking in, Fresh.  I read your intro thread.  I can't even express how much I feel for you and what you went through.  You are so strong to have made it through that and to be starting to really flourish on the other side.  So happy for you.

 

Up until a day or two ago I'd have said you were spot on and that I hadn't been on the site for a while because I was just "living life."  Things aren't perfect but they were pretty good.  I may have mentioned that I've been having some pretty difficult hip pain from osteoarthritis and have been struggling with how to proceed. Yoga, supplements, physical therapy all seem to have failed.  Went to my orthopod on Thursday and he gave me a steroid injection which provided only modest relief.  In the aftermath of seeing him I was fine on Thursday and Friday and most of Saturday.  Felt "off" on Saturday night and crappy yesterday.  Today, again, I feel like my head is underwater. 

 

Not sure if this is just typical waves and windows and I was in a pretty decent window and this is the wave or whether the injection has caused some short-term impact.  Not much choice but to push on through.

 

At present I am holding and intend to do so through the rest of March.  Assuming I feel better, I will begin to taper again at the start of April using a liquid titration method.

 

Andy

Sertraline 50mg and Clonazapam .375mg from 2000 -- symptoms of dizziness Spring 2012

increased to .5 Clonazapam and 100mg Sertraline -- no improvement

Benzo microtaper from November 2012 to November 2014 (followed benzo sites "taper benzo first")

Started Sertraline taper in December 2014 cut by 25mg to 75mg; 62.5mg 1/1/15 and 50mg on 2/1/15

Held at 50mg through April 5 to use liquid 
Reduced dosage in 10% or less drops from 50mg to 25mg -- at single tablet of 25mg on 10/5/15

Transitioned to all liquid for accuracy while tapering -- Horrible insomnia -- back to 25mg liquid and held until October 1, 2016

10/16 -- 11/18 tapered very slowly to 10.6mg.  No real improvement and never really stable so updosed to 12.5mg (1/2 a pill) for convenience and long hold.

After 8+ months of holding with no noticeable improvement decided to add .4ml of liquid Prozac (about 1.5mg) to see if that improves the situation

Supplements, Magnesium, D3, Omega 3, curcumin, Valerian, 81mg Aspirin, L-Theanine, Vit. C,

 

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  • 2 weeks later...
  • Moderator Emeritus

Hmmm ,   I feel a birthday coming on . . . 

 

:wub:

1987-1997 pertofran , prothiaden , Prozac 1997-2002 Zoloft 2002-2004 effexor 2004-2010 Lexapro 40mg

2010-2012Cymbalta 120mg

Sept. 2012 -decreased 90mg in 6months. Care taken over by Dr Lucire in March 2013 , decreased last 30mg at 2mg per week over 3 months. July 21 , 2013- last dose of Cymbalta

Protracted withdrawal syndrome kicked in badly Jan.2014 Unrelenting akathisia until May 2014. Voluntary hosp. admission. Cocktail of Seroquel, Ativan and mirtazapine and I was well enough to go home after 14 days. Stopped all hosp. meds in next few months.

July 2014 felt v.depressed - couldn't stop crying. Started pristiq 50mg. Felt improvement within days and continued to improve, so stayed on 50mg for 8 months.

Began taper 28 Feb. 2015. Pristiq 50mg down to 45mg. Had one month of w/d symptoms. Started CES therapy in March. No w/d symptoms down to 30mg.

October 2015 , taking 25mg Pristiq. Capsules compounded with slow-release additive.

March 2016 , 21mg

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  • Moderator

Hmmm ,   I feel a birthday coming on . . . 

 

:wub:

Thanks, Fresh. It's coming up for sure. I wish I didn't feel older than my age.

Sertraline 50mg and Clonazapam .375mg from 2000 -- symptoms of dizziness Spring 2012

increased to .5 Clonazapam and 100mg Sertraline -- no improvement

Benzo microtaper from November 2012 to November 2014 (followed benzo sites "taper benzo first")

Started Sertraline taper in December 2014 cut by 25mg to 75mg; 62.5mg 1/1/15 and 50mg on 2/1/15

Held at 50mg through April 5 to use liquid 
Reduced dosage in 10% or less drops from 50mg to 25mg -- at single tablet of 25mg on 10/5/15

Transitioned to all liquid for accuracy while tapering -- Horrible insomnia -- back to 25mg liquid and held until October 1, 2016

10/16 -- 11/18 tapered very slowly to 10.6mg.  No real improvement and never really stable so updosed to 12.5mg (1/2 a pill) for convenience and long hold.

After 8+ months of holding with no noticeable improvement decided to add .4ml of liquid Prozac (about 1.5mg) to see if that improves the situation

Supplements, Magnesium, D3, Omega 3, curcumin, Valerian, 81mg Aspirin, L-Theanine, Vit. C,

 

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  • 3 weeks later...
  • Moderator

Just an update on my Sertraline taper.  I got a prescription for liquid Sertraline from my p-doc and started a liquid taper on April 5.  Each 1 ml is equal to 20mg of Sertraline so I started at one 25mg tablet plus 1 ml of the liquid for a total of 45mg to start.  I will do that for 3 weeks and if I feel well on 4/26 I will reduce to 0.8 ml of the liquid that will be equal to total of 41mg (25 mg pill + 16 mg of liquid).  Will look to drop by that amount every 3 week or so until I get to just the one 25mg tablet and then stay there for a couple of months before I decide on a taper rate for the last 25mg.  Absent any significant issues, that would get me from 50 at the beginning of April down to 25 sometime in later July.

 

So far nothing significant to report.  Some modest dizziness but I had that same issue while holding for several months at 50mg.  I have a lot of things going on in my personal life so I'm not super happy these days, and I don't know which came first in terms of the withdrawal feelings or the negativity.  I don't really have any sense that staying at the level I was at was going to make that feel any better so I think the slow taper makes more sense.

 

Thoughts on whether this approach seems reasonable would be welcome. 

 

Thanks in advance.

 

Andy

Sertraline 50mg and Clonazapam .375mg from 2000 -- symptoms of dizziness Spring 2012

increased to .5 Clonazapam and 100mg Sertraline -- no improvement

Benzo microtaper from November 2012 to November 2014 (followed benzo sites "taper benzo first")

Started Sertraline taper in December 2014 cut by 25mg to 75mg; 62.5mg 1/1/15 and 50mg on 2/1/15

Held at 50mg through April 5 to use liquid 
Reduced dosage in 10% or less drops from 50mg to 25mg -- at single tablet of 25mg on 10/5/15

Transitioned to all liquid for accuracy while tapering -- Horrible insomnia -- back to 25mg liquid and held until October 1, 2016

10/16 -- 11/18 tapered very slowly to 10.6mg.  No real improvement and never really stable so updosed to 12.5mg (1/2 a pill) for convenience and long hold.

After 8+ months of holding with no noticeable improvement decided to add .4ml of liquid Prozac (about 1.5mg) to see if that improves the situation

Supplements, Magnesium, D3, Omega 3, curcumin, Valerian, 81mg Aspirin, L-Theanine, Vit. C,

 

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  • 2 weeks later...
  • Moderator

Looking for input from those who know far more about this than I do.  I was reading some of the threads on here when it struck me that I may have spent a fair amount of time denying that my withdrawal is just that and have been chasing other possible causes for how I feel. 

 

For the better part of the last several years I have just not felt "right."  I've dealt with a fair amount of physical stuff that is clearly unrelated to the medicine, but in addition have felt the following:

 

  • feelings of slight dizziness like I'm just not "in sync"
  • constant exhaustion even though I don't have much in the way of insomnia
  • feeling very "heavy"
  • a decent amount of anxiety
  • something akin to a mild depression (feeling like it's all the same over and over -- in part because it is) and
  • the general sense of things being "off" and depersonalized.

Some of these things I had a long time ago before the meds.

 

I'm sure the fact that I weaned Clonazapam last year is part of the issue even thought the taper was slow and done via microtaper. 

 

As I've stated, I've restarted my taper 50mg using a combination of liquid and pills after a 2 month hold with the hopes of stabilizing.  During that 2 months I didn't feel markedly different and I am left feeling that, while I can certainly modify the rate at which I reduce the rest of the sertraline, holding doesn't seem to be the answer and that holding for 3 months rather than 2 wasn't likely to make me feel much better.

 

This post is somewhat rambling but, after reading some of Dr. Shipko's book last night, I'm feeling somewhat down and wondering if how I'm feeling is all related to withdrawal and, if so, is it likely to get better over time or has my 12-15 years of being on this stuff doomed me to this fogginess for the long haul?

 

I've been tested and been to lots of different kinds of docs and nobody says anything other than that I am very healthy.  Of course, you read about that all the time and then someone tests the thyroid, or the adrenals or... fill in the organ, and makes a tweak and then the person feels fine.  I imagine that holding on to that hope is more a matter of "fool's gold" and denying the fact that how I feel is the consequence of the withdrawal.

 

I guess I'm just feeling rather confused these days.

 

Thanks for listening and any thoughts.

 

Andy

Sertraline 50mg and Clonazapam .375mg from 2000 -- symptoms of dizziness Spring 2012

increased to .5 Clonazapam and 100mg Sertraline -- no improvement

Benzo microtaper from November 2012 to November 2014 (followed benzo sites "taper benzo first")

Started Sertraline taper in December 2014 cut by 25mg to 75mg; 62.5mg 1/1/15 and 50mg on 2/1/15

Held at 50mg through April 5 to use liquid 
Reduced dosage in 10% or less drops from 50mg to 25mg -- at single tablet of 25mg on 10/5/15

Transitioned to all liquid for accuracy while tapering -- Horrible insomnia -- back to 25mg liquid and held until October 1, 2016

10/16 -- 11/18 tapered very slowly to 10.6mg.  No real improvement and never really stable so updosed to 12.5mg (1/2 a pill) for convenience and long hold.

After 8+ months of holding with no noticeable improvement decided to add .4ml of liquid Prozac (about 1.5mg) to see if that improves the situation

Supplements, Magnesium, D3, Omega 3, curcumin, Valerian, 81mg Aspirin, L-Theanine, Vit. C,

 

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  • Moderator Emeritus

Hi Apace, I just read you thread and have to say that I agree with Rhi. I am hearing alarm bells telling me that you are tapering too fast, and so soon after the clonazepam taper too.  It's normal to want to be off the drugs, and to be in control but in reality when the drug has been used for many years it takes time and patience because your brain has to adjust with each drop in dose. You have cut by over 50% in 3 months which is very fast for an AD taper. Personally I would not make any more cuts for a few months to allow your nervous system and your poor brain time to adjust and heal, then start a very slow taper from the remainder. 

 

I went too fast but thought I had done a very slow taper that had taken a year. I then discovered that a year is not slow at all when it comes to tapering these poisons, especially after such a long time taking them.  They can cause many side effects that you have listed, effexor made me very sick but tests always came back fine. The side effects get better as the dose lowers, as they are usually dose related so you don't have to wait until you are off completely to feel better. 

If you go too fast as I did, you may need to reinstate, as I did! It then took a further 2 years to taper from the tiny dose I reinstated at, and suffering the windows and waves of withdrawal. If I had gone slower it would have been over quicker and without the withdrawal. 

 

Here are some links for you to look at.... 

 

Tips for tapering sertraline 

 

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

 

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

**I am not a medical professional, if in doubt please consult a doctor with withdrawal knowledge.

 

 

Different drugs occasionally (mostly benzos) 1976 - 1981 (no problem)

1993 - 2002 in and out of hospital. every type of drug + ECT. Staring with seroxat

2002  effexor. 

Tapered  March 2012 to March 2013, ending with 5 beads.

Withdrawal April 2013 . Reinstated 5 beads reduced to 4 beads May 2013

Restarted taper  Nov 2013  

OFF EFFEXOR Feb 2015    :D 

Tapered atenolol and omeprazole Dec 2013 - May 2014

 

Tapering tramadol, Feb 2015 100mg , March 2015 50mg  

 July 2017 30mg.  May 15 2018 25mg

Taking fish oil, magnesium, B12, folic acid, bilberry eyebright for eye pressure. 

 

My story http://survivingantidepressants.org/index.php?/topic/4199-hello-mammap-checking-in/page-33

 

Lesson learned, slow down taper at lower doses. Taper no more than 10% of CURRENT dose if possible

 

 

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  • Moderator

Thanks for your input, MammaP.  Given the advice by two mods I think it would be wise to hold where I am for the foreseeable future and take inventory of where I am and how I'm feeling along the way.  Hopefully, I will feel some improvement and then I can set out a course for the rest of the taper.

Sertraline 50mg and Clonazapam .375mg from 2000 -- symptoms of dizziness Spring 2012

increased to .5 Clonazapam and 100mg Sertraline -- no improvement

Benzo microtaper from November 2012 to November 2014 (followed benzo sites "taper benzo first")

Started Sertraline taper in December 2014 cut by 25mg to 75mg; 62.5mg 1/1/15 and 50mg on 2/1/15

Held at 50mg through April 5 to use liquid 
Reduced dosage in 10% or less drops from 50mg to 25mg -- at single tablet of 25mg on 10/5/15

Transitioned to all liquid for accuracy while tapering -- Horrible insomnia -- back to 25mg liquid and held until October 1, 2016

10/16 -- 11/18 tapered very slowly to 10.6mg.  No real improvement and never really stable so updosed to 12.5mg (1/2 a pill) for convenience and long hold.

After 8+ months of holding with no noticeable improvement decided to add .4ml of liquid Prozac (about 1.5mg) to see if that improves the situation

Supplements, Magnesium, D3, Omega 3, curcumin, Valerian, 81mg Aspirin, L-Theanine, Vit. C,

 

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  • 2 months later...
  • Administrator
Altostrata

Hello, apace, how are you doing?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • Moderator

Hello, apace, how are you doing?

 

Thanks for checking in on my on my thread, Alto.  I guess I'm doing pretty well all things considered.

 

I've decided to do a monthly reduction of the liquid portion of my dose (per my signature) and have been making about 10% cuts monthly.  I feel well enough to continue working and doing most of the things I need to do in my day to day life.  I don't feel great but I'm moving forward one step at a time.  The only things that are really bothering me at this point are:

  • Periods of anxiety that crop up from time to time
  • Some paresthesia in my hands and feet which started about a month ago
  • Aches and pains in my hips and groins that has been diagnosed as arthritis (but I'm considering the possibility that it is SSRI-induced)
  • Some brain fog

I am working with an integrative physician to do a bunch of testing to rule out any other factors that might be causing any of my symptoms.  She was very impressive during my first appointment in early June and I see her for follow-up Tuesday.  I think she will be a good person to work with to (I) ensure that my sensations are attributable to the Sertraline and not some chemical or other imbalance and (ii) to provide any kind of palliative supplementation beyond what I'm currently doing as I continue to taper.

 

The whole thing is not easy to be honest.  I feel like I haven't felt "right" for the past several years and that I'm just rolling forward and using up valuable years of life being less than I'd like to be.  I'm working on being patient with myself and hoping that as time passes that I start to regain some of what I felt like several years ago.

 

Thanks again for asking Alto.

 

Hope you are well,

 

Andy

Sertraline 50mg and Clonazapam .375mg from 2000 -- symptoms of dizziness Spring 2012

increased to .5 Clonazapam and 100mg Sertraline -- no improvement

Benzo microtaper from November 2012 to November 2014 (followed benzo sites "taper benzo first")

Started Sertraline taper in December 2014 cut by 25mg to 75mg; 62.5mg 1/1/15 and 50mg on 2/1/15

Held at 50mg through April 5 to use liquid 
Reduced dosage in 10% or less drops from 50mg to 25mg -- at single tablet of 25mg on 10/5/15

Transitioned to all liquid for accuracy while tapering -- Horrible insomnia -- back to 25mg liquid and held until October 1, 2016

10/16 -- 11/18 tapered very slowly to 10.6mg.  No real improvement and never really stable so updosed to 12.5mg (1/2 a pill) for convenience and long hold.

After 8+ months of holding with no noticeable improvement decided to add .4ml of liquid Prozac (about 1.5mg) to see if that improves the situation

Supplements, Magnesium, D3, Omega 3, curcumin, Valerian, 81mg Aspirin, L-Theanine, Vit. C,

 

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  • Administrator
Altostrata

Nice job on your signature.

 

You may wish to keep notes of your daily symptom pattern on paper relative to drug dosages. Do they occur a certain time after a dosage reduction? This would indicate you need to taper slower, or try a hold on tapering for a couple of months.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • Moderator

Nice job on your signature.

 

Thanks.  LOL.  :D

 

You may wish to keep notes of your daily symptom pattern on paper relative to drug dosages. Do they occur a certain time after a dosage reduction? This would indicate you need to taper slower, or try a hold on tapering for a couple of months.

 

 

I started doing that but, to be honest, I really didn't notice a pattern. Most of the things I'm feeling are/have been pretty constant.  Not as in "all the time" but as in "most days".  I feel fortunate as I can work and function and I know a lot of people on the board are worse off than I am, but I am still frustrated and it's hard not to wonder, "is all of this due to w/d or is something else going on?"

 

How do you feel, Alto?  You are always there for everyone else -- how are you?

 

Andy

 

Oh, and lest I be remiss, HAPPY 4TH OF JULY!

Sertraline 50mg and Clonazapam .375mg from 2000 -- symptoms of dizziness Spring 2012

increased to .5 Clonazapam and 100mg Sertraline -- no improvement

Benzo microtaper from November 2012 to November 2014 (followed benzo sites "taper benzo first")

Started Sertraline taper in December 2014 cut by 25mg to 75mg; 62.5mg 1/1/15 and 50mg on 2/1/15

Held at 50mg through April 5 to use liquid 
Reduced dosage in 10% or less drops from 50mg to 25mg -- at single tablet of 25mg on 10/5/15

Transitioned to all liquid for accuracy while tapering -- Horrible insomnia -- back to 25mg liquid and held until October 1, 2016

10/16 -- 11/18 tapered very slowly to 10.6mg.  No real improvement and never really stable so updosed to 12.5mg (1/2 a pill) for convenience and long hold.

After 8+ months of holding with no noticeable improvement decided to add .4ml of liquid Prozac (about 1.5mg) to see if that improves the situation

Supplements, Magnesium, D3, Omega 3, curcumin, Valerian, 81mg Aspirin, L-Theanine, Vit. C,

 

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  • Administrator
Altostrata

I have my ups and downs, thank you for asking, Andy.

 

What we need to know is the time of your symptoms each day. Do you get certain symptoms in the morning and others at night? And at what times? That sort of thing.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • 2 weeks later...
  • Moderator

So, I've been doing a lot of thinking and reading this weekend, particularly in light of reading Whittaker's Anatomy of an Epidemic, some of the criticisms of that work and some of Dr. Shipko's writings.  I'm feeling generally down about the whole situation and trying to pull myself out of it. 

 

I preface this all by saying that I was fortunate in the fact that I suspected tolerance withdrawal of my benzo and didn't jump off of any of my meds c/t, tapering the benzo over couple of years and then starting this past November on the sertraline.  Thus, I fully recognize that I am not acutely ill as so many on this board are.  I have been able to continue operating at a high level in a very challenging job that requires me to spend 10-12 hours a day and my symptoms, described a little below, are not debilitating or, in most cases, continuous.  In some respects, therefore, I feel almost guilty complaining.  Having said that, I generally feel "less than whole."  By that I mean that for the past 3+ years I have felt like things simply weren't "right."  My enjoyment level is diminished in general.  Life feels like more of a chore than it should be.  This is all confounded by the fact that I have some things going on in my personal life (including my marriage) that leave a lot to be desired and that makes me wonder "how much is the meds and how much is my life generally and can I even separate the two at this point?"

 

I have some physical symptoms, as follows:

 

- some level of depersonalization (kind of an observer in the movie of my life at times)

- an increase in pins and needles in my hands and feet that I think may be tied to the last two monthly reductions in medicine in which case I will need to address speed of taper

- general feeling of tiredness (but I have crappy sleep habits which doesn't help)

- some sense of visual distortion (but I have an eye condition that exacerbates that) and I guess what might be described as "snow"

- periods of anxiety that wax and wane without clear triggers

- every so often a wave of "dizziness" or "disequilibrium" that leaves me feeling transiently anxious

- I get a lot of "random" pain that I can't really attribute to anything physical -- it kind of travels around my body, my head, etc.

- most annoying and restricting symptom is pain in the groin/hip area on both sides that has been diagnosed as osteoarthritis but I'm wondering (hoping?) that it might actually be withdrawal

 

I note that these symptoms are not all new and not all tied to recent reductions.  They have generally been "around" for parts or all of the past 3 years.  So, on the whole, while I am fortunate compared to many, I am operating at far less than what I would consider optimal.  I'm frustrated about this and simply hoping that by carefully tapering the rest of my Sertraline and giving it some time, I will find myself in a better place than I am right now. 

 

I appreciate all the people on this forum and all of the personal struggles that everyone is waging.  It is hard not to be angry about the disconnect between what the medical profession, does, what it knows and what is shared with the patient-victims.

 

Thanks for listening.  Needed to get that off my chest today!

 

Andy

Sertraline 50mg and Clonazapam .375mg from 2000 -- symptoms of dizziness Spring 2012

increased to .5 Clonazapam and 100mg Sertraline -- no improvement

Benzo microtaper from November 2012 to November 2014 (followed benzo sites "taper benzo first")

Started Sertraline taper in December 2014 cut by 25mg to 75mg; 62.5mg 1/1/15 and 50mg on 2/1/15

Held at 50mg through April 5 to use liquid 
Reduced dosage in 10% or less drops from 50mg to 25mg -- at single tablet of 25mg on 10/5/15

Transitioned to all liquid for accuracy while tapering -- Horrible insomnia -- back to 25mg liquid and held until October 1, 2016

10/16 -- 11/18 tapered very slowly to 10.6mg.  No real improvement and never really stable so updosed to 12.5mg (1/2 a pill) for convenience and long hold.

After 8+ months of holding with no noticeable improvement decided to add .4ml of liquid Prozac (about 1.5mg) to see if that improves the situation

Supplements, Magnesium, D3, Omega 3, curcumin, Valerian, 81mg Aspirin, L-Theanine, Vit. C,

 

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  • Administrator

Yes, the whole point of these drugs is to anesthetize your feelings. This has its drawbacks.

 

I would definitely look into physical therapy for the lower body pain. It could be from sitting a lot.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • Moderator

Yes, the whole point of these drugs is to anesthetize your feelings. This has its drawbacks.

 

I would definitely look into physical therapy for the lower body pain. It could be from sitting a lot.

 

 

Thanks for the reply, Alto.  I did a course of PT a few months back but I found that the manipulation they were doing of my leg/groin/hip was making things worse rather than better.  I've been trying to do some water aerobics to avoid the stress on the joints.  I try to get up from the desk as much as possible.  I have read enough stories of people on the board having some kind of joint pain as part of the process and having improvement over time.  I'm crossing my fingers that I will fall into that category.

 

The one question I would like input on is related to the onset and increase of fairly regular numbness, tingling, pins and needles in my hands and feet.  This started in very late May which was not tied to any reduction in the Sertraline.  I reduced at the beginning of each of June and July per my roughly 10% taper schedule.  The symptom has increased but has not been tied noticeably to the reduction.  It's certainly not debilitating -- just annoying.  I have other symptoms as listed in prior posts but that is the one that has been most prominent.

 

Any thoughts on the likelihood that this will dissipate over time and/or need to reduce taper speed from the 10%, hold where I am or updose would be welcome.  Like most I am not anxious to slow my schedule as I want to get off but I also want to be smart about it.

 

Thanks in advance,

 

Andy

Sertraline 50mg and Clonazapam .375mg from 2000 -- symptoms of dizziness Spring 2012

increased to .5 Clonazapam and 100mg Sertraline -- no improvement

Benzo microtaper from November 2012 to November 2014 (followed benzo sites "taper benzo first")

Started Sertraline taper in December 2014 cut by 25mg to 75mg; 62.5mg 1/1/15 and 50mg on 2/1/15

Held at 50mg through April 5 to use liquid 
Reduced dosage in 10% or less drops from 50mg to 25mg -- at single tablet of 25mg on 10/5/15

Transitioned to all liquid for accuracy while tapering -- Horrible insomnia -- back to 25mg liquid and held until October 1, 2016

10/16 -- 11/18 tapered very slowly to 10.6mg.  No real improvement and never really stable so updosed to 12.5mg (1/2 a pill) for convenience and long hold.

After 8+ months of holding with no noticeable improvement decided to add .4ml of liquid Prozac (about 1.5mg) to see if that improves the situation

Supplements, Magnesium, D3, Omega 3, curcumin, Valerian, 81mg Aspirin, L-Theanine, Vit. C,

 

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  • Administrator

Yes, it could be related to tapering. See Paresthesia: Pins & Needles, Numbness, Tingling, Burning Sensations

 

You might try acupuncture or osteopathic manipulation therapy, it's very gentle. It sounds like perhaps those physical therapists were not very knowledgeable.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • Moderator

Yes, it could be related to tapering. See Paresthesia: Pins & Needles, Numbness, Tingling, Burning Sensations

 

 

I can't really attribute it to anything else, Alto.  I'm not prepared to go down a rabbit hole looking for something neurologic unless it gets a lot worse.  The possible related cause would be anxiety (which people frequently report causing paresthesia) with the primary source of the anxiety being the withdrawal of the SSRI.

 

You might try acupuncture or osteopathic manipulation therapy, it's very gentle. It sounds like perhaps those physical therapists were not very knowledgeable.

 

I was doing acupuncture for about a 6 week pretty intensive period.  They did acupuncture, Chinese cupping and massage.  Felt great but only provided modest relief which dissipated quickly.  The PT was a fairly traditional PT and did what most would do in terms of stretching, manipulation, etc.  I think an osteo might be a good way to go.  I had been given a referral that I have yet to follow up on.  Or perhaps a good chiro might help.  It's frustrating because I feel like the ability to exercise would go a long way toward keeping me more well-adjusted mentally.

 

I appreciate your reply, Alto.

 

Hope you are well.

 

Andy

Sertraline 50mg and Clonazapam .375mg from 2000 -- symptoms of dizziness Spring 2012

increased to .5 Clonazapam and 100mg Sertraline -- no improvement

Benzo microtaper from November 2012 to November 2014 (followed benzo sites "taper benzo first")

Started Sertraline taper in December 2014 cut by 25mg to 75mg; 62.5mg 1/1/15 and 50mg on 2/1/15

Held at 50mg through April 5 to use liquid 
Reduced dosage in 10% or less drops from 50mg to 25mg -- at single tablet of 25mg on 10/5/15

Transitioned to all liquid for accuracy while tapering -- Horrible insomnia -- back to 25mg liquid and held until October 1, 2016

10/16 -- 11/18 tapered very slowly to 10.6mg.  No real improvement and never really stable so updosed to 12.5mg (1/2 a pill) for convenience and long hold.

After 8+ months of holding with no noticeable improvement decided to add .4ml of liquid Prozac (about 1.5mg) to see if that improves the situation

Supplements, Magnesium, D3, Omega 3, curcumin, Valerian, 81mg Aspirin, L-Theanine, Vit. C,

 

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  • Administrator

I just went through an effective course of physical therapy for my knee that involved no stretching, manipulation, etc. at all (except he did tape my knee for 2 days). It was all exercises to do at home.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Hi Andy,

how is your pins and needles at the moment?

Cheers, PB

- Paroxetine since more than 10years

- 20mg for the first five year, then 10mg since

- Several attempts to withdraw cold turkey following doctor's advise

- Last attempt in spring 2015 to reduce 10 -> 5 -> 2.5 -> 0mg within 2 months -> Extreme wd problems

- Reinstated with 10mg then down to 5mg again

 

04/01 5mg (tingling and muscle problems)

07/20 5mg (less problems)

08/20 4.95mg (muscle tightness, no more tingling sensations)

12/28 3.27mg (muscle tightness, numb feeling in feet and hands, light tingling sensations

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  • ChessieCat changed the title to apace41: tapering Zoloft / sertraline

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