goonie: advice on tapering sertraline / Zoloft and lamotrigine / Lamictal

[goonie]

Hello all.  I've successfully tapered 2 medicines and have one to go (sertraline).  I'm 3 years off benzos and 6 months off lamotrigine.  I've been at 37.5mg sertraline for the last 5 years or so (1 and a half 25mg tablets).  I started in 2006 at 100mg (I think).  I decided to do a very slow water titration taper at the beginning of this year. 

 

For the month of January 2018:

I started by letting the half pill (12.5mg) dissolve in 25mL of water overnight.  The next morning at 9am I took the 25mg pill and the 12.5mg pill dissolved in water (after some swirling and shaking).  I did that for every day in January with no issues. 

 

For the month of February 2018:

I used the exact same method as January, but in the morning after shaking the drug water in the bottle using a syringe, drew out 2mL of drug water, discarded it, and drank the rest.  This would be a 1mg reduction (2.6% of current dose).  I was fine until about 2/16 when I started feeling odd, having some palpitations, which switched into head pressure, DP/DR, and some prickly/tingling sensations.  It feels reminiscent of the benzo withdrawal I experienced during that taper.

 

There is some residue in the bottle and some inside the syringe that I try to get out every time, but this was happening in January too and I had no issues.  I'm just not sure if my method is correct, if I need to start over and try again (going even slower), or what to do.  Am I starting this 3rd taper too soon after the last two?  I'm confused why these symptoms started 2 weeks after the reduction of only 1 mg.  My symptoms aren't severe (I've been there), but they are definitely elevated considering the small reduction and I did have to call out sick today.

 

Any advice/help/feedback would be much appreciated.

 

Thanks!

 

 

[goonie]

I didn't get any response so on 2/22 I just went back to my full dose (only up 1 mg).  Some of the head symptoms are better.  But I still have some twitching, sleep problems, and tension.  I've been holding for 2 weeks now.  How long should I hold?  A month or 2 and then reevaluate?

[wantrelief]

Hi goonie,

 

I don't have an answer to your question but wanted to congratulate you on successfully tapering off of two medications - that is super impressive (as well as getting lower on sertraline)!  I am also hoping this will bump up your thread so that a moderator can see your post and provide you with some guidance. 

 

 

[ChessieCat]

On 08/03/2018 at 8:20 AM, goonie said:

I didn't get any response so on 2/22

 

I can remember reading this post, but I could see no specific question/s that needed answering.

 

If you are writing a long, wordy post and there are questions please make sure that the questions can be easily seen.  For instance, writing them on a separate line or changing the font colour.  The mods are volunteers who are experiencing their own withdrawal and we often find it difficult to read a block of text.

[ChessieCat]

Keep Notes on Paper

 

Withdrawal Normal Description

 

after-reinstating-or-updosing-how-long-to-stabilize

 

Stabilising After a Reduction - What Does That Mean?
 

Windows and Waves Pattern of Stabilization

 

Edited March 9, 2018 by ChessieCat

[RachelSusan]

Hi Goonie,

 

I'm so impressed with how you dropped two drugs over a long period of time. You demonstrated great patience and perseverance, something I need to work on.

 

On 3/7/2018 at 1:20 PM, goonie said:

I've been holding for 2 weeks now.  How long should I hold?  A month or 2 and then reevaluate?

 

I'm not a mod and I don't know what the absolute correct answer is to the above question, but I can share with you what I do.  I wait for at least 30 days after all symptoms have cleared up before I even think about another taper. Sometimes I wait much longer, if the symptoms were what I consider severe. Only you can decide what severe is.

 

A 2.6% reduction sounds prudent.  I am wondering if there is the possibility that because of your other drug reductions it is too much for you and perhaps you need to try a smaller reduction next time? Or is there a possibility that something was off in your liquid system of delivery and you cut more than you thought?  Is it possible that the drug residue in the bottle and the syringe during January, while you were testing your method, was actually a cut, so that in February you had a second and larger cut than you thought? Perhaps before you attempt your next reduction you might want to review your method yet again, or perhaps use a different method? I was just wondering the same thing about my liquid reduction and reviewed it over and over with one of the mods until I felt comfortable with my method and my calculations.

 

By the way, I apologize for jumping in.  With your past experience it sounds like you are far more of an expert than I am. I only did it because sometimes when I am suffering taper symptoms I get a little cog fog and it helps me to hear from someone else to confirm what I am thinking, or to suggest something else.  I hope that if I ever have any questions you might be open to me coming to you.

 

The timing of your symptoms seem to be what I experience after a cut of Zoloft as well.  I sometimes start the symptoms 3 to 4 days after a cut but at other times it can be two weeks or more.

 

Please keep posting, even when you are feeling good, I think your story is very inspirational.

 

Again, my apologies if I have over stepped my boundaries.

 

Warm wishes,

Rachel

[ChessieCat]

RachelSusan, some excellent thoughts in your post.

 

Here are some topics about slower taper rates:

 

Brass Monkey Slide

 

Micro-taper instead of 10% or 5% decreases

Rhi's "Start Small, Listen to Your Body" Taper Plan

[goonie]

Thanks for all of your input guys.  I'm sorry I've been late to respond, but I've been bad off.  I'm still at my original dose and been there for 3 weeks now, and I've had some okay moments and periods through the day, but mostly it's been bad.  The symptoms are all over the place.  Muscle spasms have eased up though.  Today was rough with squeezing brain for a few hours then it kinda let go around 3.  I've been crying and pacing not really able to do anything productive.  Sleep is hit or miss.  I don't know what went wrong or what to do now.  I wish I would've never tried to taper, but I thought 1mg from 37.5mg wouldn't hit me that hard.  Maybe I'll level off at some point if I keep holding.  I'm at a loss.  Please help.

[goonie]

Just an update.  Yesterday wasn't bad.  Today I'm in hell again.  I slept well last night at least.  I've got severe dizziness and I'm overstimulated.  Went on a walk and that was too much.  Still at my original 37.5mg, 22 days and counting.  I'm not pacing/crying so much anymore.  I'm just trying to get stable again.  I have a pain that comes and goes in my lower right side now that is bothering me now.  I wouldn't think I'd have kidney problems from any of this.

 

I'm not sure what anyone can tell me, I'm just updating my thread here.  If anyone knows if I will stabilize if I just stay put, please let me know.

[RachelSusan]

Hi Goonie,

Are you still using your liquid system of delivery or did you go back to the hard pill?

RS

[goonie]

Thanks for replying.  Back on just the pill.

[RachelSusan]

Just a guess here, but it sounds like your only choice would be to stay where you are dosage wise. It appears that something happened when you went on the liquid delivery.  And I use "appeared' because we don't know for sure. I wish we could figure out what happened because we would then know for next time.  You seemed to have done everything right, and I do mean everything.

 

I don't have a crystal ball however I think you will stabilize.You slept well last night and the pacing and crying has slowed down. I am so sorry you are going through this. I've been through these symptoms and they are h*ll.

 

It appears ChessieCat has been advising you.  I've seen her posts, she's brilliant. It looks like on Friday she was suggesting that you read: Windows and Waves Pattern of Stabilization among other things. I don't know if you were up to looking at it, but if you haven't maybe it would be of some help?

 

Again I am so sorry to hear what you are going through. Please keep posting, even if you feel better. I want to hear how you are doing.

 

RS

 

 

[goonie]

Thank you Rachel.

[Altostrata]

Hi, goonie. How long have you been back to 37.5mg this last round?

 

It sounds like you shouldn't make any changes for a while.

 

On 2/19/2018 at 4:11 PM, goonie said:

I used the exact same method as January, but in the morning after shaking the drug water in the bottle using a syringe, drew out 2mL of drug water, discarded it, and drank the rest.  This would be a 1mg reduction (2.6% of current dose).

 

Your method was correct. How long were you keeping the liquid? Was it refrigerated?

[goonie]

Hi Alto, thanks for your reply.  So I've been back at 37.5mg for 3 weeks now.  I was dropping the pill in the water before bed and taking in the morning so keeping it for 12hrs max.  No I didn't refrigerate.

 

Since I've been back on my original dose, my pacing/crying/agitation/insomnia has diminished as well as the muscle twitching at least for now.  I'm mainly left with  hypersensitivity to light/sound, head pains and dizziness.  I can't really do much.

[Altostrata]

It may take some time for all the symptoms to fade. Please be patient.

 

You'll be able to make another run at it in the future.

[goonie]

Ok thanks so much!  Ill be holding for several months.

[goonie]

Just an update.  I've been back at 37.5mg for almost 4 weeks now.  Things are no better than last week.  I've been sleeping okay all things considered, but I didn't sleep last night, had hypnic jerks keeping me awake and too much adrenaline flowing.  I'm going to stay with my parents for a couple of days to get a change of scenery (I work from home).  I've been taking small doses of Drammamine to try and help some of the symptoms temporarily, but it is really hit or miss whether it helps or not.  I've got some Fish Oil coming today.

 

Symptoms that have left since back to original dose:

twitching, full blown insomnia, muscle soreness/tightness, pacing

 

Remaining symptoms: 

Head pain/dizziness, Light/noise sensitivity, Anxiety with intermittent insomnia

 

 

[goonie]

Guys... I feel really bad.  I'm almost totally nonfunctional.  Can someone please offer some reassurance?

[wantrelief]

I am so sorry you are feeling so badly.  It can take awhile to stabilize but you will.  Hang on to the improvements you've noticed, it proves your brain is trying to get back to normal functioning even if it doesn't feel like it.  It sounds like you had a bad night last night in terms of adrenaline keeping you up so you might be feeling worse off today recovering from that.  You are going to be ok.

[goonie]

Thank you.  I need to hear this.  I feel like I'm not anywhere near stable.  Ive been bedridden for a month over this tiny cut/updose and losing hope.  I'm just pacing around and around now freaking out.  I've got support but they don't understand.  Everything is too much.  My brain is damaged and I'm losing it.  I feel like I'm gonna end up on some other crap med.

 

What is going on with me guys?  2 months ago I was fine!

[goonie]

Yesterday wasn't bad.  I stayed with my parents and was overstimulated, but I was able to deal with it.  I didn't sleep at all last night and now I'm back in hell.  I'm suffering guys.  My wife made an appt with a psychologist who specializes in psychosomatic pain stuff.  Everyone is trying to help me, but they don't know what to do.  I've been holding on my original dose for a month and it's just this merry-go round of symptoms. 

 

I'm holding on, but does anyone have a timeframe as to when things usually settle?

[goonie]

Bump, can anyone provide reassurance?  No sleep last night again, all symptoms are back.  Not functional.  I'm thinking crazy thoughts now.  I may have to try some other med to get me through this at least short term.  I don't know what else to do.

[Hibari]

Hi goonie, 

 

Because there is no rhyme or reason to stabilizing, it can be extremely scary.    My theory is, and it's only my opinion based on my own wd journey, is that tapering two meds creates a super sensitive nervous system  I too have tapered off two meds and trying to taper my third, Lamictal.  I have been in a terrible up and down wave since I dropped to 10mgs in February.   I have been thrown by how difficult it has been but lately I been getting (by tuning in that my system is really traumatized by the two prior med tapers.  Not traumatized beyond repair, but just that I have to recognize that my nervous system  has been through something. 

 

I too have felt like a crazy person and seriously questioned whether I will have to go back up or stay on this med for ever.  I know that when I think this way it's because I feel frightened and out of control.  My control is that I want to drop every 4 weeks but I can't.  I am now going to have to hang here till I stabilize even more.  And that means feeling wildly emotional. crazy and physically sick .

 

All this to say is that my good friend FreeSpirit on this site, counseled me to stay the course when I am in a panic because panic makes us make extreme decisions that can tip our system even more. 

 

You are not alone goonie.  All I can offer is to hunker down and do everything possible to distract yourself while being compassionate.   I do acupuncture, which has been helpful but I also take lots of baths (notating in the water)  sit on the couch and go to Alanon meetings when I can. 

[Hibari]

I meant, nothing in the water. 

[merry]

Hi Goonie,

 

I am so sorry I cannot offer you re-assurance, because I am in the same hell that you are.  One tiny drop, and I'm stuck in WD for months.  What helps me is this: live in the moment and accept where you are just then.  I find myself worrying if I'll ever get better (who know what the future will hold?) or upset that I didn't hold longer in the past (can't change that now!) but when I stay in the present those worries are not with me.

 

There are loads of us who have long-term insomnia.  I hope yours clears up quickly.  The way I have been able to live for years like this is just accept that my sleep is crappy, and adjust to it, sleeping or just resting whenever possible.  No worries about when stuff will settle.  This is what is happening right now.

 

I hope you are able to find peace of mind, and most especially some restful, restorative sleep!

[goonie]

Update...

 

Thank you all who have written here.  I'm sorry I haven't been replying, but I read and reread your words all of the time.  I'm still bad off.  I had 2 appts with a therapist and a psychiatrist last week.  I was prescribed 5mg Saphris to help with sleep.  I very reluctantly took 1/4 of a tab a week ago and it did allow me to sleep and I felt a little better last week, but the heart racing side effects were too much even on that little dose.  I don't think I can take that.  I was also prescribed Remeron if the Saphris didn't help, but I haven't filled that one.  I still have flank pain from time to time.  I cancelled the trip we had planned and the replacement trip we had planned.

 

I've been holding steady on my sertraline dose for 6 weeks now and still not back to normal.  My main symptoms are not being able to relax, boatyness, crazy looping thoughts, flank pain, insomnia.  I'm at a loss.

[goonie]

Update...

 

I'm still not entirely functional though somehow I was able to make it out to get a haircut and out to lunch on Friday (4/6).  I'm doing better at night it seems as symptoms lessen around 6-7pm after which I'm able to sleep 5-6 hours.  I'm still having some boatyness/brain shivers, overly sensitive to all stimuli, and intermittent flank pain.  My vision is off still.  I'm really discouraged as to how long this has taken to resolve considering I barely changed anything.  I'm getting more unsure about my future as in if this will ever completely clear up so I can function and get on with things.

 

Would it be beneficial to updose slightly or reinstate a small dose of lamotrigine if things don't get any better?

 

Thank you Rachel, Hibari, Alto, Merry and all who have written here and supported me through this time, it means a lot.  I know you are all suffering too and I can't even bring myself to write on anyone else's threads, but I will as soon I as I get a bit better.  I'm going to log my symptoms today and post later.

 

 

[RachelSusan]

Hi Goonie,

 

I'm glad to hear that you are able to sleep a little better. Insomnia is a beast. I know exactly what you mean when you say "boatyness/brain shivers, overly sensitive to all stimuli."

 

As far as up-dosing, that is such a personal choice. Since you seem to be showing some improvement (the sleeping) would you be willing to give it another 3 or 4 weeks before you do that? I think the less changes the better.  If it's too awful to wait then you already have your answer.

 

Sometimes with these medications the slightest change will throw everything off. I was in the middle of a great taper last spring and summer and then suddenly, wham I got hit just like you with withdrawal symptoms, they were heavy for 3 months and then they started to slowly diminish the 4th month.  I did however recover from it and you will too.   It really stinks that you are going through this.

 

RS

 

 

[goonie]

Thanks for your input and reassurance Rachel.  I'm totally on board to wait another month before updosing or anything else.  The improvements are slow, but they are there.  It is not as excruciating as it was a month or so ago and for that I'm hopeful and grateful.

 

After going through years of benzo withdrawal AND lamictal withdrawal, I thought I had this tapering/withdrawal thing down.  I do not.  This slightest change threw me worse than anything in the other two.  Inconceivable! (princess bride?)  None of us deserve this. 

 

Looks like you're in the home stretch Rachel.  Here's hoping you have smooth sailing from here on out!

[Hibari]

Hi Goonie,

 

If you can hold, I would recommend it.   I have felt the same way you have a couple of times since my last cut.  I wondered if I should go back up but decided to wait it out (not easy).   I have stabilized a bit more and I also had an acupuncture treatment that was very helpful (very soothing and non stimulating).     I think the only way through are these excremental steps are sheer will combined with gentle self-care. 

 

Take care.  Hibari

[goonie]

Thanks Hibari.  I had every intention of going down 1mg a month until 25mg.  I couldn't even do the first drop before caving.  Been stuck at my same dose now for nearly 7 weeks with only minor improvements.  Still dysfunctional.  Updosing above 37.5mg is scary because I've been on this same dose for 5 years.  I'm gonna keep holding on for now though because at least I'm sleeping somewhat and not so agitated.  Sorry you're suffering as well.  It is just too much sometimes.  I think if I can get stable I'm gonna have to rethink whether I can taper this one at all.

 

Would a small dose of 5-HTP help at all?  I know the SS risk is there, just wondering if anyone knows if it had helped anyone stuck in hell on their same dose.

[ChessieCat]

You are noticing some small improvements and you are sleeping.

 

If it were me I would be holding and would definitely not even consider adding in anything new, especially something which is known to mess with brain chemicals.

 

5-htp-5-hydroxytryptophan-and-l-tryptophan

[goonie]

Yes I understand ChessieCat, thanks for your input and the link.  I had also found the Julia Ross' cures mentioned in the link which is why I brought up the 5-HTP. 

https://www.juliarosscures.com/the-updated-nutrient-therapy-withdrawal-protocol/

 

I don't want to add anything else, but this holding seems to barely be doing anything positive.  I guess I'm open to anything, but I'm also hesitant to take anything else.  The only other thing I can think of is a small dose of lamotrigine which seemed to help Alto and a few others.

 

Below is my daily log for yesterday:

3am -- woke up, couldn't go back to sleep, but slept fairly well for 6 hrs
6am -- took fish oil 1800mg EPA 1200mg DHA, vitamin E 1000IU, 200mg magnesium, 200mg l-theanine, 250mg vitamin c

paced around for 3 hours, laying down every now and then, head feels boaty, brain shaky

9:30am -- took 37.5mg sertraline
10am -- talked to wife about how I don't know what happened, crying, how much I've missed with her and the kids these past couple of months and how much that kills me
11:30am -- little window, made lunch, colored with kids
12pm -- took fish oil 900mg EPA 600mg DHA
1pm -- oversensitive stuff started happening, went to lay down, took bp/hr normal
3pm -- still laying down, anxiety about this whole ordeal, this is the worst I've felt all day, warm prickly feeling running through my blood, brain shivering
4pm -- pacing and panicking, brain feels damaged, vision is off, derealization, feel hopeless, cbt techniques not helping
5pm -- tried to interact with kids, just too stimulating, still in panic/agitated but heart rate is 64, why is that?

6pm -- went to bed, i usually don't go to bed this early, but this was a bad day and i was done, took 1.5mg melatonin

10pm -- woke up and didn't sleep much after, discouraging...

 

 

 

[ChessieCat]

30 minutes ago, goonie said:

I don't want to add anything else, but this holding seems to barely be doing anything positive.  I guess I'm open to anything, but I'm also hesitant to take anything else.  The only other thing I can think of is a small dose of lamotrigine which seemed to help Alto and a few others.

 

 

It looks like you still have the mindset that there is something out there that is going to make you feel better.  Whilst we continue to think like this we aren't accepting where we are at present and giving our brains the environment that it needs to heal.  Acceptance

 

The brain naturally works to return to its factory settings/homeostasis.  It is helpful to think of holding as doing something that you brain needs, even though it seems like you are doing nothing.

 

What Non-drug techniques have you tried?

 

You are sleeping and this is a positive.

 

Are you keeping a journal?  Not your symptoms journal, but a positive journal.  When you are feeling bad for so long it can be very easy to miss the very small improvements.  If you take note of whenever you have a tiny improvement you can use it to remind yourself that they do happen.

 

If there isn't an improvement which you can note down in your journal, make a note about something that you are thankful for.  It doesn't need to be a big thing.  It doesn't even have to be something which makes you feel good.  Start trying to notices things around you.  Something small like I cuddled the cat and it purred or I threw the ball for the dog and it made the dog happy or my child laughed at something today.  Doing this can help to change your thinking patterns.

 

And this is something that you might try:

 

Set an alarm to remind you to do this.

 

Throughout the day check in with yourself to see how you are feeling.  Hourly would be a reasonable period of time.  Sit quietly and do some concentrated deep breathing to still yourself and your mind.  I started doing this 2 years ago.  It became second nature to me and I do it when I find myself uptight in my body, or my mind starts racing.

 

The reason for setting the alarm is for a couple of reasons.  It means that you don't forget to do it and it also helps to bring yourself "back down a bit" before things build up too much.

[goonie]

Thank you for the links and suggestions.  I have a journal which I note the positive things (as well as everything else).  Not sure if that's the same, but I think it is.

 

Yes, I'm always looking for a drug/supplement solution.  I have a real problem with that.  This wave has gone on too long and I feel I've been more than patient with it.  I only dropped one mg (2.6%) and it threw me hard so I went back and I'm still a mess 7 weeks later.  I feel like my brain should've adjusted and stabilized by now as I'm on the same dose it has always had.

 

I do the deep breathing regularly and see a therapist once a week (going today).  The problem with the deep breathing, mindfulness, etc is that I can't seem to relax long enough for it to really help.  I know the breathing is supposed to help relax you, but I have so much agitation and adrenaline flowing now, it makes it quite difficult to focus on anything so I just end up pacing to get it all out.  I know it takes practice, but if my mind would slow down some, I feel it would be much more beneficial.  Right now if I start the deep breathing 4-4-6-2, my body wants me to immediately get up and start moving.  I can't quite overcome that at this point, however, recently there were a couple of times after 7pm where things started to settle and I could relax long enough to do it.

 

Again, thanks for the info.  I'm reading through it now.