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Oceanrat: tapering Zoloft

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Oceanrat

Thx bubbles!!

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Oceanrat

Just updating, still trying to figure out if I’m able to stabilize, feeling so out of control. Just revved beyond belief, with all the very tough psychological symptoms known to man. Can’t figure out why I can’t stabilize. It’s like Groundhog Day, day after day. 

Currently 40mg Zoloft from compounding pharmacy 

15mg temazapam (in tolerance)

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ChessieCat

Please copy and post the following (it's a copy of your current one) into your drug signature so that it doesn't take as much space and is easier to read.  Thank you.  Account Settings – Create or Edit a signature

 

17 years on Zoloft, 47 years old now
3 years on Ativan for sleep cold turkeyed in 2014
Reinstated after 1 week, cold turkey again 1 month later with phenobarbital. Dp/dr, intrusive thoughts, insomnia, depression, still able to work, exercise heavily, be a parent
After 4 months went to doc, wanted off of Zoloft, didn’t know risks, starting dose 100mg
Rapid taper, got down to 35mg in 6 weeks.  hit real real trouble, akathesia, terror, awake for 6 weeks, hospitalization, put me in 15 temazapam to put me asleep, transfered to some swanky ocean front place in Malibu Ca. Massive polydrugged, got sicker and sicker
10mg zyprexa for 5 months, then tapered
1000mg depakote for 8 months, 10 month taper
Still on 15mg temazapam 
Start SSRI taper in jan.

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Oceanrat

I’m sorry chessiecat I tried, my brain isn’t working very well, I can figure it out right now

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Oceanrat

Can’t figure it out

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Shep

For the AD mods, please note Oceanrat started a benzo topic here

 

On 9/7/2018 at 2:48 PM, Oceanrat said:

Using a compound pharmacy I cut from 60mg to 55, held for 90 days, then 55-50, held for 2 months, then 50 to 45 held 2 months, cut 45-40 been holding 2 months, 3-4 weeks ago symptoms got incredibly tough, been very acute, akathesia, terror, intrusive thought etc, for 3 weeks. I though I was going super slow but my brain has taken lots of damage from everything. I take 40mg Zoloft at bout 10:30 A.M. everyday. I take 15 mg temazapam at bout 1am.

 

 

I asked the other moderators to look over your thread. One of the other mods mentioned you may have reached the point on your antidepressant taper where the receptor occupancy drops below 80% (for more, please see Why taper? SERT transporter occupancy studies show importance of gradual change in plasma concentration).

 

If this is the case, you may benefit from an updose of the Zoloft. 

 

You also may be suffering from interdose withdrawal from the benzo, as you are dosing once a day and temazepam has a half-life of 8-22 hours and you are only dosing once a day. So you may benefit from splitting out your benzo to two or more times a day.

 

However, before suggesting any changes, we need more information. 

 

Please start a daily drug and symptoms journal in the below format. I'm not sure if you're dealing with a benzo issue or an antidepressant issue, and I'd like to get more feedback from the antidepressant moderators before making any suggestions. 

 

 

On 9/27/2016 at 2:49 PM, Altostrata said:

Keep notes on paper about your drug dosages and daily symptom pattern

 

What we need to see for every single day over several days is what symptoms you get before and after you take your drugs. If you're not taking any drugs, we need to see your symptom pattern throughout the day: Are symptoms worse at any particular times of day?

 

The time of day, dosage, and severity of symptoms are essential information. Include:

- Time and dosage for drugs taken in morning, with time and description of any symptoms in the morning
 
- Time and dosage for drugs taken in afternoon, with time and description of any symptoms in the afternoon
 
- Time and dosage for drugs taken in evening, with time and description of any symptoms in the evening
 
- Time and dosage for drugs taken in middle of the night, with time and description of any symptoms in the middle of the night (such as waking)
 
And so forth. A diary, in chronological order, looking something like this:
 
6 a.m. Woke with anxiety
8 a.m. Took 2.5mg Lexapro
10 a.m. Stomach is upset
10:30 a.m. Ate breakfast
11:35 a.m. Got a headache, lasted one hour
12:35 p.m. Ate lunch
4 p.m. Feel a bit better
5 p.m. Took 2.5mg Lexapro
6 p.m. Ate dinner
9:20 p.m. Headache
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Feeling dizzy
10:30 p.m. Fell asleep
2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")
2:45 a.m. Fell asleep
4:30 a.m. Woke but got back to sleep

 

An appointments diary is perfect for this and can be bought at stationery stores. They have a page for each day with times for appointments which can be filled in with doses, symptoms etc as shown above.

 

Please do not use spreadsheets, they are difficult to read online and some of us don't have Microsoft Excel to look at them.


 

 

 

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Oceanrat

Thx shep I’m having a heck of a time since I started cutting at less then 10% Zoloft and holding for months now. I’m just not sure the problem cuz I’ve created so many, over the past few years. But since compounding or cutting it’s gotten very out of control 😪. I just used my Gemini scale to weight my compound capsules. I’m not sure the conversation in mg cuz it only reads grams etc. but the variance was a lot I think. This was all in the G setting for grams

0.343g

0.386g

0.358g

0.352g

0.378g

0.358g

0.343g

0.363g

0.347g

0.375g

0.397g

0.354g

not sure what that is in mg. Maybe someone can help ease my mind or give direction 

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Oceanrat
10 hours ago, Shep said:

For the AD mods, please note Oceanrat started a benzo topic here

 

 

 

I asked the other moderators to look over your thread. One of the other mods mentioned you may have reached the point on your antidepressant taper where the receptor occupancy drops below 80% (for more, please see Why taper? SERT transporter occupancy studies show importance of gradual change in plasma concentration).

 

If this is the case, you may benefit from an updose of the Zoloft. 

 

You also may be suffering from interdose withdrawal from the benzo, as you are dosing once a day and temazepam has a half-life of 8-22 hours and you are only dosing once a day. So you may benefit from splitting out your benzo to two or more times a day.

 

However, before suggesting any changes, we need more information. 

 

Please start a daily drug and symptoms journal in the below format. I'm not sure if you're dealing with a benzo issue or an antidepressant issue, and I'd like to get more feedback from the antidepressant moderators before making any suggestions. 

 

 

 

 

 

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Altostrata

Oceanrat, the compounding pharmacy puts filler in the capsules. The active ingredient (Zoloft) is only a fraction of the weight. You might phone them and ask them about the variance, it may not mean anything. Or, they may agree somebody made a mistake, which might explain your symptoms from their product.

 

As ChessieCat advised, we do need your daily notes to see if one of your drugs may be causing your symptoms.

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Oceanrat
12 hours ago, Shep said:

For the AD mods, please note Oceanrat started a benzo topic here

 

 

 

I asked the other moderators to look over your thread. One of the other mods mentioned you may have reached the point on your antidepressant taper where the receptor occupancy drops below 80% (for more, please see Why taper? SERT transporter occupancy studies show importance of gradual change in plasma concentration).

 

If this is the case, you may benefit from an updose of the Zoloft. 

 

You also may be suffering from interdose withdrawal from the benzo, as you are dosing once a day and temazepam has a half-life of 8-22 hours and you are only dosing once a day. So you may benefit from splitting out your benzo to two or more times a day.

 

However, before suggesting any changes, we need more information. 

 

Please start a daily drug and symptoms journal in the below format. I'm not sure if you're dealing with a benzo issue or an antidepressant issue, and I'd like to get more feedback from the antidepressant moderators before making any suggestions. 

 

1 hour ago, Altostrata said:

Oceanrat, the compounding pharmacy puts filler in the capsules. The active ingredient (Zoloft) is only a fraction of the weight. You might phone them and ask them about the variance, it may not mean anything. Or, they may agree somebody made a mistake, which might explain your symptoms from their product.

 

As ChessieCat advised, we do need your daily notes to see if one of your drugs may be causing your symptoms.

 

Thx guys!! I just got off the phone with the compounding pharmacy, he said they have a 5-10% variance legally, but are usually exact on there measurements etc. he was very kind, said he would make me a new batch, weigh the old ones, send them off to a third party to test that they are making them exactly perfect. My daily list is complicated cuz I haven’t had a real window in almost a year. I’ll try:

5:30 am awake (if I sleep) trembling, pins and needles, chemical terror 

6:30 A.M.-pacing around the house, maybe lay in the shower for relief 

7:30am-pacing, walking, do some breathing work

8:30am-super nauseous, maybe throw up

9:00am-make breakfast, eggs, veggies, water

10:00am- try to lay down and get my body still. Take my 40mg Zoloft 

12:00pm- symptoms start to really ramp up

agitation, ruminating thoughts, more pacing 

1:00pm try to eat something but super nauseous, usually salmon, chicken, veggies, blueberries 

2:00pm- flood gates are wide open

pins and needles, feels like I’m on street drugs, fragmented thoughts

just goes and on. 

5:30-6pm- feels mostly like I cold turkeyed 

7:00pm eat red meat/lamb/fish/veggies I drink tons of clean water all day. Zero sugar or grains

8:00pm-still moving, try to lay down, calm the terror, Laker game on in the background 

9:00pm nausea still 

try to lay down or do some light yoga poses 

10:00pm trying to hold on. 

Between 1-2 am take 15 temazapam, doesn’t work usually, sleep 25-30 min, wake up in bad shape, try to sleep again. Getting between 1-3 hours sleep broken up in segments. 

Morning starts/repeat . It’s been this way for bout 8-10 months 

 

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Oceanrat

I hope I did that right? I did my best

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Altostrata

Could be pharmacy error in the mix. Who knows, maybe someone new mixed up your batch.

 

As I posted in your benzo topic -- you rejected using prescription liquid Zoloft?

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Oceanrat

No I didn’t reject liquid Zoloft, I just hadn’t tried it

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DMV64
On 12/1/2018 at 6:55 PM, Oceanrat said:

I’m sorry chessiecat I tried, my brain isn’t working very well, I can figure it out right now

Hi Oceanrat! I am frequently in this position of brain not working. You are not alone! However sometimes it IS working!

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Shep
12 hours ago, Oceanrat said:

Between 1-2 am take 15 temazapam, doesn’t work usually, sleep 25-30 min, wake up in bad shape, try to sleep again. Getting between 1-3 hours sleep broken up in segments. 

 

Do you usually take the temazepam so late at night?

 

Please see:

 

What is the sleep cycle?

 

In the first post in that thread, Alto writes, "You can see in the chart below that we get closest to waking around 2:30 a.m. I often wake up around this time and may not get any more sleep until perhaps the early morning hours (thanks to my blackout shades and curtain)."

 

Try getting to bed before 10 pm and see if you can get more sleep. How is the rest of your sleep hygiene?  For more tips, please see:

 

Tips to help sleep: so many of us have that awful withdrawal insomnia

Edited by Shep
fixed typo

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Oceanrat

It’s tough to get in bed and rest with akathesia, I try hard to calm my body, it’s not easy, so I attempt many times a night or day to lay down and calm my system. I’ve always taken the temazapam late, cuz I’m so wired, it doesn’t touch it until maybe late. If I take at 10pm, I will not be calm enough to get any sleep. It’s a tough road with all my symptoms 

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Oceanrat

7am:slept 2 hour wake up tough thoughts

8am-eat breakfast did some breathing 

9-try to rest a bit and calm down

10-take compound Zoloft 40mg

trying to rest

12-130- seems my symptoms really ramp up!

terror/pacing, argoraphobic, dr/dp 

this continiues into around 6-7 lately, things calm down a bit

10-11pm things ramp up

no real stability 

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Oceanrat

Yeah it seems to really ramp up around 12pm to hi kookoo levels all day, level off a tiny bit in the 7pm range. Sorry to ramble, just suffering badly. Thx guys!!!

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Songbird
On 12/5/2018 at 4:05 AM, Oceanrat said:

It’s tough to get in bed and rest with akathesia, I try hard to calm my body, it’s not easy, so I attempt many times a night or day to lay down and calm my system. 

 

Calming your system is a good thing to do.  This video helped me a lot when I had severe akathisia:

 

https://www.survivingantidepressants.org/topic/6122-relaxation-exercises-guided-meditations-calming-videos-sleep-hypnosis/?page=2&tab=comments#comment-390065

 

I found it better than other relaxation exercises because it starts with movement and very gradually slows down.

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Oceanrat

Thx songbird! My brain feels like I have akathesia, it’s really hard to explain the desperation I feel😡

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Shep
14 hours ago, Oceanrat said:

7am:slept 2 hour wake up tough thoughts

8am-eat breakfast did some breathing 

9-try to rest a bit and calm down

10-take compound Zoloft 40mg

trying to rest

12-130- seems my symptoms really ramp up!

terror/pacing, argoraphobic, dr/dp 

this continiues into around 6-7 lately, things calm down a bit

10-11pm things ramp up

no real stability 

 

 

You may be getting interdose withdrawal from the Temazepam (please remember to list when you take it in your drug and symptoms journal). If you are still taking it around 1 AM, you may be getting interdose symptoms at 10 PM (Temazepam's half-life is 8 - 22 hours and 10 PM is 21 hours after your 1 AM dose). 

 

14 hours ago, Oceanrat said:

Yeah it seems to really ramp up around 12pm to hi kookoo levels all day, level off a tiny bit in the 7pm range. Sorry to ramble, just suffering badly. Thx guys!!!

 

Since you're taking the Zoloft at 10 AM, you may be feeling the effects of the peak plasma levels, which occurs between 4.5 - 8.4 hours. So around 7 PM it's leveling off. 

 

Would you be open to spacing the benzo out during the day? It might help with interdose withdrawal, which may be worse due to the Zoloft ramping up symptoms. 

 

If so, you could split the Temazepam in half and move it earlier in the day by one hour a day. We recommend this type of gradual move - just one hour a day - because it's gentlest on the nervous system. 

 

So you could take 1/2 dose at 1 AM and 1/2 dose at midnight for one night.

 

The next night, take 1/2 dose at 1 AM and 1/2 dose at 11 PM. 

 

And then the next night, take 1/2 dose at 1 AM and 1/2 dose at 10 PM.

 

And so forth until you get that early dose to the time you're most comfortable taking it. You could space it out an even 12 hours apart over the course of 12 days. 

 

And of course, continue with the non-drug coping skills. 

 

11 hours ago, Songbird said:

Calming your system is a good thing to do.  This video helped me a lot when I had severe akathisia:

 

 

Songbird, that's a GREAT video!  I'm getting relaxed just watching the beach imagery. 

 

OC, are you sensitive to magnesium? If not, you might want to try an epsom salt bath in the evening, followed by the video that Songbird posted. Could help ease you into a more relaxed evening. 

 

Please post your thoughts on spacing out the benzo. 

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Oceanrat

Thx shep for the response!!! Temazapam is a hypnotic, it would be kinda weird taking it during the day. Also it comes in 15mg capsules, not sure how to split? My prescriber is very hesitant of changes and writing them, cuz of my state🤦🏻‍♂️I’m literally a blue of “how to do everything wrong while trying to get off these meds”. I was so naive to there power, I went back to compounding pharmacy yesterday. I’ve had a hell of a time since restarting my Zoloft taper, switching from pill to compounding capsules. There is so much variance in weights. But they showed me how they’re made. But lotta room for error with the compounding pharmacies. They make a batch of like 60, take 10-15 pills to get an average 🤦🏻‍♂️. I’m sure, when your system has been as taxed as mine over the past few years, I’m super paranoid and scared, cuz I keep feeling worse. Who knows at this point. I appreciate any input and support. I’m just hanging on by a thread 

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Oceanrat

I think my body and brain are just rejecting all these poisons and want them gone

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Oceanrat

Sorry to keep posting, but I take my compounding Zoloft at 10am, since journaling my symptoms, around noon, it gets very very bad, dystonia in my face, burning head, revved beyond belief, bad state. I haven’t seen anyone have this reaction to compounding?? Been 6 months since last about 8% cut and just get way worse. Any advice or thoughts?

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Shep
19 hours ago, Oceanrat said:

Thx shep for the response!!! Temazapam is a hypnotic, it would be kinda weird taking it during the day.

 

Do you find Temazepam sedating? From what you've posted, it doesn't seem to be having any effect as far as sedating goes. 

 

19 hours ago, Oceanrat said:

Also it comes in 15mg capsules, not sure how to split?

 

Please see your benzo thread for information on using a scale.

 

Oceanrat: Temazapam taper, lost

 

As far as how to split, already explained in your intro thread here:

 

On 12/6/2018 at 6:23 AM, Shep said:

If so, you could split the Temazepam in half and move it earlier in the day by one hour a day. We recommend this type of gradual move - just one hour a day - because it's gentlest on the nervous system. 

 

So you could take 1/2 dose at 1 AM and 1/2 dose at midnight for one night.

 

The next night, take 1/2 dose at 1 AM and 1/2 dose at 11 PM. 

 

And then the next night, take 1/2 dose at 1 AM and 1/2 dose at 10 PM.

 

And so forth until you get that early dose to the time you're most comfortable taking it. You could space it out an even 12 hours apart over the course of 12 days. 

 

 

You don't have to space it out that far if you don't want. You might want to split it so that you're taking 1/2 around 8 or 9 PM and then the other 1/2 at 1 AM. This may help prevent the uptick in symptoms you're getting at 10 PM and set you up for a better night's sleep. 

 

But do so an hour at a time, which is gentlest for your nervous system.

 

19 hours ago, Oceanrat said:

I was so naive to there power, I went back to compounding pharmacy yesterday. I’ve had a hell of a time since restarting my Zoloft taper, switching from pill to compounding capsules. There is so much variance in weights. But they showed me how they’re made. But lotta room for error with the compounding pharmacies.

 

Alto makes a great point here. Might want to check into getting liquid Zoloft. 

 

On 12/3/2018 at 5:57 PM, Altostrata said:

Your choice. But you have more control over a liquid. You can transition with a combo of tablet, or part of a tablet, plus liquid.

 

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Andie

Hi Oceanrat

 

I am having my medication compounded too. Has your Pharmacy informed you of whether the time release in your compounded medication is the same as the orginal? 

 

I ran into trouble a few months ago and I  am much better now after splitting my dose across the day. The time release additive my pharmacy uses only lasts between 4-10 hours. 

 

I am just sharing what happened to me as I went into anxiety overdrive when I couldn’t work out what was going on with my medication. My main issues were muscle spasms and twitching. I still have them but they are getting better. 

 

This is may not be the case with you, but I just thought I’d share what happened with me. 

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Oceanrat

Thx Andy for replying! They said they only use “microcrystalline cellulose” powder to mix with the sertraline/Zoloft active ingredient. Not sure what’s in the regular pills I was taking. Whatever the changes have been have been pretty gnarly for me. The heavy agitation, with all the other symptoms haven’t let up. Not really sure what to do. Doc wants me to go back to pills and weigh myself🤦🏻‍♂️I’ve created quit the mess. He doesn’t want me to switch to liquid cuz of my sensitive system and the liquid is sometimes hard to get he says. Thoughts?

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Andie
6 minutes ago, Oceanrat said:

Thx Andy for replying! They said they only use “microcrystalline cellulose” powder to mix with the sertraline/Zoloft active ingredient. Not sure what’s in the regular pills I was taking. Whatever the changes have been have been pretty gnarly for me. The heavy agitation, with all the other symptoms haven’t let up. Not really sure what to do. Doc wants me to go back to pills and weigh myself🤦🏻‍♂️I’ve created quit the mess. He doesn’t want me to switch to liquid cuz of my sensitive system and the liquid is sometimes hard to get he says. Thoughts?

I know what those feelings are like, believe me. The agitation is the worst and I would just end up in a flood of tears and racing thoughts. My system is also very sensitive to changes too.

 

 I do think it’s worth asking your pharmacy very specifically about the time release of your compounded capsules. I had to be very specific in asking mine how it was being added and how it compared to the original. My pharmacy uses methocel (I am in Australia) to add the time release back to the medication after it’s been crushed. 

 

If  it’s not the time release, there is no harm done in asking and you have good options going forward with cutting the tablets and the liquid being available. I wish mine came in a liquid, it would make things so much easier. 

 

 

 

 

 

 

 

 

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Oceanrat

I did ask, he was adamant, that they only use the cellulose powder and the Zoloft that comes in bulk powder from the manufacturer. I’m the first one to admit I’ve made every wrong move in this process. But this has been pretty extreme, even by my standards for 6 months! My last cut was over 6 months ago. 10% cut, still no stability 🤦🏻‍♂️I was so naive to all this stuff 

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Andie
26 minutes ago, Oceanrat said:

I did ask, he was adamant, that they only use the cellulose powder and the Zoloft that comes in bulk powder from the manufacturer. I’m the first one to admit I’ve made every wrong move in this process. But this has been pretty extreme, even by my standards for 6 months! My last cut was over 6 months ago. 10% cut, still no stability 🤦🏻‍♂️I was so naive to all this stuff 

Hmm. Mine is the same, just the cellulose and the active ingredient. 

 

 Did they say how long each dose lasts in the body? This is really important. 

 

Your compounded medication won’t last 24 hours if it’s made in the same way as mine is. You will get a dose dump that is released over 4-10 hours so over 24 hours in the day your blood levels of the medication aren’t stable.

 

Some people aren’t sensitive to this, but I am and splitting the dose to keep things stable has done wonders for me. 

 

 

 

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Oceanrat

That’s interesting! I’m not sure

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Oceanrat

So disheartening to have akathesia for 6 months now and only be down the 40mg😪

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Andie
23 minutes ago, Oceanrat said:

That’s interesting! I’m not sure

It would be good to know so you can either eliminate this as a problem, or address it if it is and then find a work around. If your Pharmacist can’t tell you, ring or email other pharmacies. I had to do this. 

 

31 minutes ago, Oceanrat said:

So disheartening to have akathesia for 6 months now and only be down the 40mg😪

I developed akathisia when I first started Pristiq and was hospitalised for a month. It’s really awful and I feel for you, but you will eventually turn a corner. 

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Oceanrat

Thx andie!!!

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Andie

Do you know if the setraline powder used by the compounder comes from the same manufacturer as the generic tablet you were taking? 

 

 

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Andie

 I had issues for a while with my Compounding but it’s all sorted now.

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