apace41: tapering Zoloft / sertraline

[AmyK]

I sometimes feel the drop the same night. But nowadays day two. It is absolutely related!

[apace41]

I sometimes feel the drop the same night. But nowadays day two. It is absolutely related!

 

Thanks for the confirmation and reassurance, Amy!

[apace41]

So, time for another update in my journal.

 

Today I reduced by dose (after 3 more weeks) to 25mg.  Down to a single pill -- yay!  It will be nice to not have to do the liquid Sertraline for a while.  I intend to hold at this level until after the new year in the hopes of stabilizing as completely as possible before heading down for the last 25mg over the next year plus. 

 

The good news -- I am still functional and making it through work, life, stress on various fronts, etc.  I am still able to exercise (to the extent not limited by my hip pain).  I am surviving.

 

The bad news -- I just don't feel all that great.  Symptoms for the most part:

 

• I'm not awful but I have a fair amount of random pain that seems to come and go all over. 
• I have some generalized anxiety that can ramp up at any time without much warning
• Some general feelings of hopelessness and fear this will never get better
• Brain fog and "heavy-headedness"
• General exhaustion
• Health anxiety that leads me to believe symptoms are more significant than they are
• Periodic restlessness (not to the level of akathisia but annoying nevertheless)
• Some level of insomnia -- not horrible but sleep is not great

Overall, as you can see, I feel "not normal but not horrible."  I suppose it is to be expected given that I:

 

• tapered off of a benzo over two years prior to starting (immediately) to taper the SSRI
• went from 100 in November 2014 to 75 in December and down to 50 by February 1 before I realized that was too fast to cut (essentially 50% over 2 months)

In all honesty, from the time I started "not feeling good" in June 2012 that prompted me to decide I needed off the psych meds, I just haven't felt "right".  Ever.  There have been ups and downs along the path but the general trend has been flat to down.  I'm hoping that over time it starts to turn around so that my graph goes upwards as I get lower.

 

Sorry if this isn't an "upper" post.  I'm a little down about this process of late. 

 

Encouragement would be appreciated.

 

Best to all,

 

Andy

 

[tgirl]

Hey Andy,

I think your doing great!

It's awesome that you are able to work and live.

 

Good luck to you. You will be fine!

Tgirl

[apace41]

Hey Andy,

I think your doing great!

It's awesome that you are able to work and live.

 

Good luck to you. You will be fine!

Tgirl

 

 

Thanks, tgirl!  I appreciate you checking in.

 

"Fine" would be, well.... FINE!

 

 

Andy

[PapaBear]

Hi Andy,

 

I think you accomplished a lot during the last months and though you still have several annoying problems I also think that you will be fine.

 

Many people have severe problems reducing a benzo alone and you managed this and are already very far with the SSRI.

 

I share some of your "bad news" including the health anxiety but by re-reading posts and stories from co-sufferers I am still very optimistic that we will finally get better. I also hate this state of not feeling normal (not horrible as you said but also not really good) but at least there is change and (incremental) improvement.

Coming down from 100mg to 25mg is I believe an improvement itself if the wd symptoms haven't increased too much.

So as tgirl already said I think you are doing great and the rest will come as well.

Don't give up,

PB

[apace41]

Thanks, PapaBear.

 

I appreciate your support.

 

I know you've dealt with some struggles but you are making great strides as well.

 

Hang in there.

 

Best,

 

Andy

[Altostrata]

Hi, Andy. Yes, the process is slow and frustrating. I think your plan to hold at 25mg is a good one.

 

You may wish to work on your sleep, see Important topics about symptoms, including sleep problems

[apace41]

Hi, Andy. Yes, the process is slow and frustrating. I think your plan to hold at 25mg is a good one.

 

You may wish to work on your sleep, see Important topics about symptoms, including sleep problems

 

Thanks for your input, Alto.

 

The challenge for me is, at least in part, that I am a CPAP user for apnea.  I do not fall into the typical apnea sufferer category in that I am not overweight but, instead, have been blessed with an oversize (17 inch) neck (oversized because I'm only 5'8" (leaves me built sort of like, well... a fire hydrant?) that has led to structural apnea.

 

The difficulty is that I have been extremely compliant with my machine over the years but, of late, I've grown tired of it.  I suspect that withdrawal has played a role in that as I don't have the patience I used to for dealing with it.  I also find that some of the sensations I have in withdrawal, e.g., numbness and tingling, are irritating to me and impact sleep.  Overall, my sleep is better than many on this board so I don't want to overstate.

 

Best,

 

Andy

[apace41]

Finding it really hard to deal with the ups and downs (can't really call them windows and waves I don't think -- maybe tiny cracks?).  Sunday was at least a decent day and I was thinking "maybe I'm heading in the right direction?"  By today I woke to a numb right hand, high anxiety and generally just in a bad place.  Nothing to say here other than to vent a little frustration.  Need to center myself and move forward.  I have a dinner meeting tonight that I was hoping I'd be in a decent frame of mind for -- perhaps worrying I wouldn't has helped bring this on.

 

Well, just some musings.  Good day to all.

 

Andy

[Sertramean]

Hi Andy, just popped in to offer some support and to say keep going. I'm sure the dinner will be fine. Just eat a lot so you don't have a mouth empty enough to speak and then just nod in the right places! You'll be home before you know it.

[apace41]

OK.  So I had to post this study but didn't want to put it on the more technical studies area because this is like the MOST OBVIOUS STUDY in the history of studies:

 

http://www.psychiatrist.com/jcp/article/Pages/2015/v76n01/v76n0106.aspx

 

It tells us that in the Baltimore, MD area approximately 70% of people on anti-depressants are not clinically depressed.  Shocker!!

 

I post it because it validates what we know on this site and that most of us got here even though we had "some other issue" than major depression to begin with.

 

Andy

[Fresh]

It's the same in Australia Andy , they prescribe ad's for a whole range of normal life events.    Good to hear you're

going to sit on one little pill for a good stretch . . . you deserve a tapering holiday.

 

I started taking MSM last week and thought it may help your hips . . . check it out.

 

Keep on keeping on , and happy halloween .  

[apace41]

It's the same in Australia Andy , they prescribe ad's for a whole range of normal life events.    Good to hear you're

going to sit on one little pill for a good stretch . . . you deserve a tapering holiday.

 

I started taking MSM last week and thought it may help your hips . . . check it out.

 

Keep on keeping on , and happy halloween .  

 

 

Thanks, Fresh!

 

I appreciate you keeping an eye on my symptoms!

 

Yes, the joint pain formula I am taking includes MSM along with several other things. 

 

http://www.targetednutrients.com/products/viewproduct/jubilee-3-joint-relief

 

So what exactly is in Jubilee 3™?

Here's what you get in every bottle of Jubilee 3™:

• Glucosamine and Chondroitin sulfate - This "dynamic duo" of natural joint healing promotes the repair of damaged cartilage and relieves arthritis pain better than the prescription drug Celebrex!
• Methyl-Sulfonyl-Methane (MSM) - This powerful natural source of biologically active organic sulfur supercharges the repair of joints and cartilage!
• Hyaluronic acid - This powerful natural joint lubricant - often called the "WD-40" of the joints - helps restore natural lubrication, dramatically boosting flexibility and mobility!
• Type II Collagen - This special form of collagen helps maintain the integrity of the cartilage matrix where cartilage tissue is manufactured!
• Boron - This frequently overlooked dietary mineral has been known to miraculously reverse arthritis symptoms once it is added to one's diet!

Next logical question -- does it work?

 

I think it has provided some help.  I ran out and didn't refill right away as I was feeling somewhat better.  It felt worse so I refilled.  I'm feeling better again.  Not perfect but better.  So, I think it's a good product based on my N of 1. 

 

 

Andy

 

[Fresh]

Ahh , interesting (and expensive!).    Do you know how much MSM is in each tablet?

[apace41]

Ahh , interesting (and expensive!).    Do you know how much MSM is in each tablet?

 

True, but only about a dollar a day if it helps!

 

Looks like 1000mg.

 

 

Supplement Facts Serving Size: 3 Capsules Servings Per Container: 30 Each Serving Provides:

Glucosamine Sulfate (Potassium) 1500 mg *

Chondroitin Sulfate 400 mg *

MSM 1000 mg *

Cartilage Support Factors - a blend of :    

Hyaluronic Acid 50 mg *

Type II Collagen 100 mg *

Boron 3 mg *  

 

Suggested Use: 3 capsules daily as a dietary supplement preferably with meals or as advised by your health professional.

[Fresh]

1000mg equals 1g , yes?   The recommended dose (from my reading) is either 5-8mg or up to 20mg.

 

One study is cited that shows doses larger than 8mg produce no additional benefit.  One doctor/author has been

taking 90mg a day for many years.

I'm just so chuffed with the effect , and I've been taking 2 x 2mg daily.   

Re price ,  500mg cost me $26 , and that's more than 3 months supply. 

 

You're right , a dollar a day is a bargain if it helps.

I wish I had come across this mineral years ago.

[apace41]

1000mg equals 1g , yes?   The recommended dose (from my reading) is either 5-8mg or up to 20mg.

 

That's correct. I've seen recommendations for between 1500mg and 6000mg but I imagine some could say higher.  In the formulation I am taking the theory is that there are synergistic effects with the other ingredients so that 1000mg suffices.  It might be interesting to add another 1000mg and see if there is improvement.

[apace41]

So, I spent a little time rummaging through the site and I've come to some interesting theories about SSRI withdrawal.  I figured I'd use my thread as a place to post about it a little.  Kind of blogging here.  My two primary symptoms that are most frustrating are:

 

• dp/dr and
• mild dizziness/imbalance

So, I've done a lot of research on both.  In addition to research I bought Shaun O'Connor's book on the subject and have read through it and listened to it numerous times.  What I find most interesting is the hypothesis that in dp/dr one's amygdala gets "stuck" in the "fight or flight" state and does not reset to normal levels.  This causes ongoing anxiety even if one does not "feel" anxious and this, in turn, leads to the self-defense mechanism of dp/dr where the mind/brain is essentially "removing" you from the anxiety-causing situation and distancing you to protect you.  Interesting theory and one that totally resonates for me.  It argues that the core of the dp/dr is anxiety and that in the absence of the anxiety you can't have dp/dr.  In this situation, the brain has neuroplastically remodeled itself so that the amygdala does not need a real trigger as it is always triggered.  OK.  Hold that thought.

 

My dizziness started back in 1986 when I was on vacation and was sunning myself daily on a dock that was gently swaying in with the ocean.  Lovely except that after perhaps the 3rd or 4th day I got up from the dock and still felt the sense of motion.  I went for all kinds of testing and it never really was resolved.  It was for that I was first prescribed a benzo and, I believe, that the benzo led me to ultimately need an AD.  So, this dizziness "thing" is at the core of my situation in some way.  Over time I've looked at a lot of possible diagnoses but one that keeps coming back to me is Mal de Debarquement.  For those of you playing along at home, here is a link https://en.wikipedia.org/wiki/Mal_de_debarquement  In essence, this is a disease where the sense of motion continues in the absence of motion.  Again, the theory behind this is that the brain is unable to reset to its "non-motion" situation.  Not sure that's what I have and I have frequently wanted to view this false sense of motion/dizziness as a withdrawal symptom, however, it predated my initial foray onto psych drugs, so... that argues for some underlying organic condition (with the understanding it could be attributable solely to the anxiety and depression that existing beneath it all).  The similarity in the two, i.e., focusing on the brain not resetting is striking to me. 

 

Today as I was rummaging, I came across the following from a 2006 response from Dr. Shelton to Alto's email.  Dr. Shelton said the following regarding prolonged withdrawal syndrome (I've highlighted some particularly relevant passages):

 

The discontinuation effect is truly horrific in some people. The direct mechanisms involved in the genesis of the problem can't really be involved in it's persistance. So, what's up with that? In fact, there are long-standing adaptations that can take place in the nervous system. However, as with most things in the body, the problem is a variation of a normal process (otherwise, it wouldn't be there in the first place). There appear to be lots of variation in this reaction in people who develop persistent symptoms, but one salient feature that seems almost invariably present: They become intensely afraid during the experience. People may describe this in different ways, but the way the brain is reacting is an exaggeration of what the brain does during threat. The physical symptoms are consistent with that. So the "threat" systems are "turned on" and don't "turn off" easily. This can happen in a few ways, but has to occur pretty fast. In fact, it is a normal response. Think of a mouse living in a field somewhere. If there is an acute threat that occurs (e.g., chased by a cat) and the mouse escapes, the mouse's brain has to remember that and react. There are a couple of ways to do that. One is to synthesize proteins to "remember." That, actually, is slow (but happens). The second is to actually do something to the genes controlling the system itself: to induce chemical modifications to the genes or the supporting structure to activate some genes and inactivate others. The net effect is for the system to stay "on" so to speak. However, in this situation, it is purely adaptive. Going by the principle, then, that people vary in their response, some people seem particularly prone to have this to occur. That is why when people are exposed to a life threatening situation, some go on to develop post-traumatic stress disorder, and others don't. Now, one important thing is that most people develop trauma related symptoms immediately after an event (e.g., insomnia, dreams of the event, anxiety, etc., etc.). In the normal situation, these symptoms resolve within a month. But some people develop long-standing responses, in which the system is turned "on" and they can't turn it "off." I think that is what is at play here.

 

I'm not entirely sure what all this means, but I do think it means something.  I think it suggests that in my case but perhaps in many of our cases, the brain is susceptible to overreaction and is unable to return from its overreactive state to its normal state.  This would explain why benzos help because it results in an overall dampening of the brain's response. 

 

The key, of course, is to find some kind of "factory reset" button like you have on your iPhone!  Not sure how to find that and whether the logical reset would be chemical or mechanical but it's definitely a place to look. 

 

Perhaps that is why people who have done TMS and CES have seen benefit?  I.e., they did a "mini-electro shock treatment" that caused the brain to move towards a reset?  Just speculating but interested in anyone's thoughts (if you've managed/bothered to read this far).

 

Thanks for indulging,

 

Andy
 

[nz11]

Yes i have read it. Very interesting.

 

Just wanted to say great stunning avatar...remember though 'no headers'.

Hey now there is something to look into....headers!!

 

nz11

Ban those headers.

And all Russian track and field athletes.

[apace41]

Just wanted to say great stunning avatar...remember though 'no headers'.

Hey now there is something to look into....headers!!

 

I recognize the levity of your comment, NZ, but I have LONG THOUGHT that some of my issues relate to many, many years of soccer playing and heading the ball.  Back when I was playing a lot there was no understanding of brain microtrauma and the repeated "mini-concussions" that undoubtedly take place heading a soccer ball descending from, at times, 50 or more feet.  I would have hoped that any such TBI would have healed over time but then you add the brain-altering substances like benzos and ADs and...

 

Who really knows.

 

Thanks for reading,

 

Andy

[apace41]

So, I'm posting to journal my frustration with the process. I'm on week 6 of holding at 25mg of Sertraline and I really figured that by now I would be feeling pretty good and certainly better than I did when I decided to start my hold.  Unfortunately, I'm definitely not improved and, if anything, have slid back a few steps.  Having more internal agitation, dp/dr, vision issues, health anxiety, etc.  Not dramatically worse, but enough that I'm noticing and I'm frustrated.  Not sure there's much that can be said other than "stay the course" and "time heals" but just needed a place to vent.

 

Thanks,

 

Andy

[Fresh]

Hi Andy , sorry you're not feeling better by now.  So frustrating , and you're right , all you can do is

"stay the course".

I sometimes wonder if your holds were long enough , but I understand you were keen to get down to

one single tablet.

 

Your post 163 was very funny for me to read - it explains so eloquently what I experience all the time.

Part of me is waiting in the wings in a defensive mode , just waiting to jump out as soon as I feel threatened.  

This is lessening over time , I'm less quick to react , but It's definitely still an issue.

 

Here's a recent example:  Ms X , who I've had numerous disagreements with , chair of the strata executive

committee where I live , recently moved out (yayy , I don't have to see her anymore , big relief !).  

She got tenants in but her and her partner still  hold 2 out of 5 positions on the committee . . . partner

has a proxy from a third member of the committee who owns 2 units.  

So there's this menage a trois running the show.

The week she moves , the garage door remote controls stop working on our door.  I tested mine on another garage door , still works , so it's not the device.  So I jumped to the conclusion that they've had the code changed , and I was furious.  

This inconveniences everyone else , and is exactly the sort of thing she would do.  I was sooo furious , enraged , probably disproportionate to the circumstance.  

 

I see this as a symptom on a dial , it can be turned up and down , rather than just on or off.

Perhaps one day it actually will be turned off . . . I'll have to wait and see.

 

. In the normal situation, these symptoms resolve within a month. But some people develop long-standing responses, in which the system is turned "on" and they can't turn it "off." I think that is what is at play here

[apace41]

Thanks for responding, Fresh, as always.    You are a gem among gems.

 

I don't know about the "holds" on the way to where I am.  You could be right but, to be honest, drop to drop it was mostly "no change."  I felt pretty much the same all along the way.  Some were better and some were worse but none caused me to say, "uh-oh."  It is entirely possible that the cumulative effect of those drops is being felt now in some sense, but there was really no warning sign or way to know to do it differently if that was the case.  It is highly likely that the back-to-back tapers of the benzo for 2 years followed immediately by the AD stressed my CNS to the point where it is like the proverbial "dog that's been beat too much" (apologies to Mr. Springsteen).  I'm hoping that the hold which I planned to go for another 6 weeks will suffice to see things stabilize so that I can start the taper of the last 25mg.  Only time will tell,

 

Again, thanks for jumping in and, just to be clear, if it were MY garage door and she DID change the code, I might have OFFED her!  Not that I'm prone to overreaction or anything!

 

 

Andy

[Fresh]

LOL , thanks Andy.  I initially reacted childishly , using the visitor parking instead of the garage.  But it's hot

here , and better to park in the shade.  Probably good she's moved out so there's no risk of her car/motorbike

getting accidentally scratched as I walk past ,  .

When I'm can be calm enough I need to email the Strata very politely. Even now my heart is thumping thinking

about it. I hate these games.  But I love that I'm well enough to RESPOND rather than just REACT.  

 

Re Traumatic Brain Injury ,  does anything show up on an MRI?   I'm curious enough that I'd want to see.

[starcontrol2]

Hi Andy,

 

Sorry you are having a little rough times. You have been great support to me and i just want to say(and I have said it before) that considering the length of time you are on these meds you are doing very well!

 

SC2

[apace41]

Thanks, Star.

 

I appreciate your coming to my thread to offer support.  Hoping it is just the annual "pre-holiday season" too stressed out combined with an overly sensitive CNS that is causing some waves for me.

 

Much appreciated.

 

Andy

[PapaBear]

Hi Andy,

 

nice picture. What position did you play?

I am sorry to hear about your current situation. I hope it will improve soon!

From what about I read about TBI or CTE following high impact sports it seems to be more related to football, rugby or boxing but only in very few cases to soccer. So even if you used your head often I woulnd't worry too much about possible consequences.

[PapaBear]

...pressed 'Post' accidentially :-)

I also read the piece from Dr. Shelton with interest and I always had a similar theory in mind after reading several articles about a potential cure for PTSD found by a Dr. Lipov (https://en.m.wikipedia.org/wiki/Eugene_Lipov) who is argueing that the symphatic nervous system is adapting to stress (I guess wd is stress) by permanently increasing its efficiency. Thus after some time it will simply remain in a state of higher functionality which I assume could be true for some of us.

Anyway I really hope that you are feeling better soon and that the coming holiday season will bring relief to you.

PB

[bromor]

I hope you're feeling better today.  I appreciate you stopping by my journal & for your advice.  Was going to ask ~ do you take whole food Vit C with your mag?  I read on the FB mag page that the whole food Vit C will help the mag to be absorbed better.  Yes, I know...completely off topic.  Have a good weekend.

[apace41]

Thanks for your posts, PB and bromor.

 

I recently started Vit C and I use spray on as well so that gets absorbed either way, I imagine.

 

Update is that Friday and Saturday were good days.  Had some brief periods of feeling better -- hesitate to call them "windows" but definitely better.

 

Today, not so much.  Trying, as we all do, not to get down on the backslides but that is hard.

 

Hanging in as I hope we all are.

 

Happy Thanksgiving to all my US friends.

 

Andy

[Orangecat]

Hi Andy! I'm also tapering Sertraline- just got through a hold of about a month at 29. It was discouraging to feel I had to hold so long. I wasn't feeling great, and earlier tapers had been relatively painless. Then after a while... I felt ready to taper again. Fingers crossed.

 

Don't discount the effect of winter weather and light on things. I inevitable feel different this time of year. Might affect you too. Taking a walk in the early morning is great for me, if I can hack it- the light and exercize are so helpful.

 

Good luck! Happy Thankgivibg. I'm fleeing family this year and headed to relax with hubby all by ourselves, in a non American country!! Can't wait.

[apace41]

Hi Andy! I'm also tapering Sertraline- just got through a hold of about a month at 29. It was discouraging to feel I had to hold so long. I wasn't feeling great, and earlier tapers had been relatively painless. Then after a while... I felt ready to taper again. Fingers crossed.

 

Don't discount the effect of winter weather and light on things. I inevitable feel different this time of year. Might affect you too. Taking a walk in the early morning is great for me, if I can hack it- the light and exercize are so helpful.

 

Good luck! Happy Thankgivibg. I'm fleeing family this year and headed to relax with hubby all by ourselves, in a non American country!! Can't wait.

Thanks for checking in, Orangecat. Have a great trip!

 

Andy

[KarenB]

Hello Apace,

 

The soccer-ball caught my eye as both my daughters are soccer mad (ages 10 and 13).  Then your comments about brain injury from heading the ball jumped out at me.  Just recently word came down through our NZ soccer federation advising our young soccer players to avoid heading the ball, and definately not to practise it repeatedly.  Apparantly it is now of some concern...

 

I need to re-read your post about withdrawal theories and fight/flight etc.  I have PTSD, and that's basically having your fight/flight switch stuck on (so far as I understand it).  I've had it since before I was 5 years old - and it's an immense battle for me to operate in any other way.  So that would make sense of my being an especially sensitive withdrawer.  But I need to understand it better, cause it seems scary too.  I've been trying to get out of this place in my life generally because it is horribly unhealthy in all sorts of ways.  But that it might cause w/d to be extra long and difficult...

 

Gleep.  Okay, didn't want to be a big worrier on your thread, just trying to make sense of it.  I think it would be good for me to look further into how to turn it around somewhat, if possible.  Surely it's possible? 

 

I learned something called EFT which helps kind of re-set things in your brain/body/feelings. 

 

So I've got some thinking to do.  Thanks for sharing - I don't mind getting through a slightly scary new info if it gets me somewhere better in the end.

 

Hugs,

KarenB

[apace41]

Thanks for your post, KarenB,

 

The theories I have on microtrauma and TBI from soccer ball heading are not fully formed and while there are some studies done in Turkey on Italian professional players as I recall, there is not a lot of hard science that would suggest it is a major concern.  I do think that the NZ soccer authority is smart in limiting the practice in children whose brains are still forming.  I think the bigger issue that is usually identified is head to head contact during battles for balls in the air.  Far more likely to cause significant concussions.  Having said that, the theory of repeated head trauma at a lower level leading to problems is akin to what we see in the States in US football where lineman hit helmets play after play after play.  It's not a huge collision that would result in concussion, but it has been theorized to take a gradual toll over time.  Since one of the keys to brain injury in the form of concussion is allowing time for repair, the constant repetition would seem to promote repeated microtearing without much time for repair.  I'm not a neurologist but can't imagine that can be GOOD for you.  LOL. 

 

As far as the fight or flight and PTSD concepts, this is consistent with what I think is going on generally, i.e., that some people have brains that are more likely to get "stuck" in some hyperexcited state and need a longer time to rewire.  I think it happens -- just slower for some of us than others.  The question is whether we can find something that is safe but also allows for recovery at a quicker rate.

 

Best,

 

Andy

[brassmonkey]

Concerns about head trauma in sports have become a really big topic over here.  The primary thrust has been in American style football where it has become obvious over the years that the continued minor traumas add up to cause much greater problems.  It is not uncommon to see players pulled from the game to get checked after a particularly rough play.  I'm not certain, but pretty sure, that there are strict rules on "heading" in our the youth soccer leagues for the same reasons.  If you look at the "sport" of boxing you can see a very clear pattern of accumulative minor head traumas adding up to big problems.  The term "punch drunk" was the way to write it off for years.  I have seen the decline, over the years, in several friends who participate in such events.  With one friend you can tell how the weekend fights went by his cognitive abilities the next week and can also see that there is no "full recovery" each time.

 

To me, not heading the ball just makes sense, as the couple of times I've done it, it was just plain painful.  Has anyone seen my glasses, I can't find my glasses. What were we talking about? LOL