mtmalaka: Hello! Tapering from Zoloft 12mg to zero - need some advice

[LotusRising]

On 6/22/2024 at 11:51 AM, mtmalaka said:

The panic is so severe at times that I cannot seem to cope with it without a crutch such as Ativan,

Have you tried using any coping skills to handle the panic?

[mtmalaka]

Thanks @LotusRising

[mtmalaka]

5 minutes ago, LotusRising said:

Have you tried using any coping skills to handle the panic?

 

Yes, I have a few in my toolbox. Fortunately the panic is seldom. I'm hoping I can make a safe landing with the ativan and heal up with just the 12.5mg of Zoloft. 

 

I'll look on the site for additional coping skills. 

[mtmalaka]

The interesting thing about this withdrawal anxiety, atleast for me, is that the anxiety / panic tends to ramp up considerably the further away I get from a meal. This causes me to panic eat, in order to quell the anxiety. Just a note. Wondering if anyone else experiences this and of there are any running theories. 

 

My current hypothesis is that the energy my body is using to manifest symptoms, is then diverted temporarily to digest food. 

[LotusRising]

16 hours ago, mtmalaka said:

The interesting thing about this withdrawal anxiety, atleast for me, is that the anxiety / panic tends to ramp up considerably the further away I get from a meal. This causes me to panic eat, in order to quell the anxiety. Just a note. Wondering if anyone else experiences this and of there are any running theories.

@mtmalaka Does this happen with all meals? What are you eating? I wonder if it's a blood sugar balance thing?

[mtmalaka]

Possible. The anxiety seems to quell with carbs. Otherwise I eat a fairly low processed diet, eliminating all sugars and most processed carbs. Albeit when I do eat processed carbs, the anxiety seems to calm a bit. I know this will fade. I'm thinking out loud for sake of convo. 

[LotusRising]

I've really had to up my carb intake throughout this whole process. The body uses a lot of energy for healing, so if you're noticing an improvement when you eat carbs, maybe you need to increase your overall carb (complex) intake.

[mtmalaka]

 

Ah...That's very interesting. Yes, oats, rice, and organic cereals seem to help. The healing / energy angle is also interesting. If we're not giving the body proper energy it can't do it's work.   

[Tulip52]

20 hours ago, mtmalaka said:

The interesting thing about this withdrawal anxiety, atleast for me, is that the anxiety / panic tends to ramp up considerably the further away I get from a meal. This causes me to panic eat, in order to quell the anxiety. Just a note. Wondering if anyone else experiences this and of there are any running theories. 

 

My current hypothesis is that the energy my body is using to manifest symptoms, is then diverted temporarily to digest food. 

@mtmalaka I tend to feel that way when I’m in withdrawals, too.  After a taper my sugar seems really wonky.  What helps a lot is staying hydrated with electrolytes.  The first week,  sometimes two weeks after I taper I have atleast one Gatorade zero a day and it helps to keep my sugar balanced.  When my blood sugar is fluctuating I feel terrible.  Google the “adrenal cocktail”, also.

[mtmalaka]

Interesting. Thanks for the reply. Do you monitor your blood sugar at all? 

[LotusRising]

10 hours ago, mtmalaka said:

Do you monitor your blood sugar at all? 

No, I don't. Just the regular yearly test a doctor would do.

[mtmalaka]

Does / did anyone experience hypnic jerks when falling asleep? This is the core reason for my insomnia. I chalk it up to the side effects of the re-intro of the medication, but it could also be withdrawal effect. Hard to tell..

[Dahlia50]

@mtmalaka I don't have it now. But had it once before when I went back up in dose after a reduction.

[mtmalaka]

@LotusRising

 

I am on day 2 of Ativan taper dosage 0.25mg and have some bad insomnia - 1-2 hours of sleep per past 2 nights. I believe this is the after-effects of lowering dosage? 

 

Should i keep course or go back up to 0.5mg? 

 

Also, the underlying 'akathisia' effects are showing up more prominently now that the Ativan is being removed. This is being caused by my reinstatement of Zoloft 12.5mg I think. I am wondering if I should start my slow-taper sooner  in order to mediate these symptoms as they interfere with sleep.  I could hold longer and see if the symptoms resolve but my sleep is at risk now and this really is affecting my well-being. Thoughts on starting now? 

 

 

[LotusRising]

1 hour ago, mtmalaka said:

I am on day 2 of Ativan taper dosage 0.25mg and have some bad insomnia - 1-2 hours of sleep per past 2 nights. I believe this is the after-effects of lowering dosage? 

Yes, this would be an expected effect when coming off ativan. Do you have any other symptoms? How did you feel at 0.5mg?

 

 

[mtmalaka]

Thanks for the reply. I felt as if I were sleeping better at 0.5mg. Should I power through the taper and hope my body gives in and falls asleep? 

[mtmalaka]

No other symptoms that I can read. 

[LotusRising]

1 hour ago, mtmalaka said:

I felt as if I were sleeping better at 0.5mg. Should I power through the taper and hope my body gives in and falls asleep?

It's difficult for me to give you a definitive answer.

 

The longer you're on it, the harder it may be to come off it. But, if you feel the symptoms are too difficult to handle, then the other option would be to do a slower taper. This would require you to be on the medication for a longer period of time though and obtaining further prescriptions isn't always easy to come by. 

[mtmalaka]

No problem. Thanks for the reply. I'm wondering if I'm delaying the insomnia by staying on the 0.25mg? I have a few more days at this dose then I'd have to cut again if I can... 12.5mg

[mtmalaka]

3rd day, this time less than an hour of sleep. I went up to 0.5mg Ativan but didn't seem to help. I think the 12.5 of Zoloft is too activating for my natural sleep. The inner restlessness and twitching is what is keeping me up. I'm hoping this is just a side effect and subsides. 

 

Something has to give. I can hardly function. I might ask my GP for a non-Benzo sleep aid to help get me over this hump, otherwise if I'm not sleeping, recovery is futile.

 

Between a hard place and a rock. 

[Happy2Heal]

On 6/26/2024 at 7:28 PM, mtmalaka said:

Does / did anyone experience hypnic jerks when falling asleep? This is the core reason for my insomnia. I chalk it up to the side effects of the re-intro of the medication, but it could also be withdrawal effect. Hard to tell..

 

I had these off and on for years and never really knew what they were called, but they did ramp up some in early withdrawal

 

Cutting out caffeine helped and getting more rest during the day also helped

I think if you have really bad insomnia for chunk of time, even though it's usually advised not to nap during the day, I think it's a good thing to nap when ever you can or just rest, even if you don't sleep

WD recovery is hard on the body.

 

 

 

 

[LotusRising]

3 hours ago, mtmalaka said:

I went up to 0.5mg Ativan but didn't seem to help. I think the 12.5 of Zoloft is too activating for my natural sleep. The inner restlessness and twitching is what is keeping me up. I'm hoping this is just a side effect and subsides. 

I probably already said this, but try to stick to a good morning routine (get outside with sun hitting your eyes, no sunglasses), as this is our body's biggest cue for regulating circadian rhythm. And good night time routine too. If the increase in ativan didn't work, I would stick to the 025mg for now. The restlessness and twitching will fade with time.

 

3 hours ago, mtmalaka said:

Something has to give. I can hardly function. I might ask my GP for a non-Benzo sleep aid to help get me over this hump, otherwise if I'm not sleeping, recovery is futile.

Do what you have to do, but know that even non-benzo sleep aids can be habit-forming. 

 

Sorry, I know insomnia is really hard. Here if you need support ❤️

 

[mtmalaka]

Thanks for the input! Yes my circadian rhythms are in swing, as much as I can help it. I should make an update: I did cave in and take 0.5mg of Ativan early this morning as an emergency. I wrote above that it didn't work but I spoke to soon. It did actually help me sleep a few hours. Now I'm afraid I have 2 dependencies as I will need to go back onto 0.5mg tonight for sleep, and the next night etc. 

 

I understand your comment about implimenting a new drug with dependencies, but something non Benzo related would be preferable to an Ativan dependency? 

 

 

[mtmalaka]

3 hours ago, Happy2Heal said:

I think if you have really bad insomnia for chunk of time, even though it's usually advised not to nap during the day, I think it's a good thing to nap when ever you can or just rest, even if you don't sleep

 

Thanks! When you had insomnia, did you have consecutive says with only 1-2 hours of sleep? How did you manage this? I felt like I was on the brink of a breakdown. 

[AliBrace]

@mtmalaka 

Hi there! I’m also experiencing hypnic jerks since reinstating. It’s terrible, I know how you’re feeling:( I’ve reinstated 10mg of Prozac after being off for 3 months or so and the jerking has been going strong. I’ve been reinstated now for about 3 1/2 months and they seem to vary nightly. If I take any sort of sleeping pill it almost resets my progress and they get worse for a bit of time, but it’s hard to get sleep because of them. I struggled at the beginning only getting about 2-3 hours of sleep per night due to the jerking preventing me from falling asleep. Melatonin helped for a bit, but stopped working so now I’m not really taking anything except magnesium glycinate here and there, but I also experience a paradoxical reaction to that. It’s very distressing. I haven’t moved in my dose yet as I’m hoping with time it’ll just stabilize. But may decrease by 10% if it continues in hopes it’ll help. I haven’t found a lot of information on here or others that are also dealing with the jerks since reinstating, mostly after getting off completely. I wish I had more answers for you, but you’re not alone in this! I’m getting about 4 hours of sleep per night, 5 if I’m lucky. 

[Happy2Heal]

5 hours ago, mtmalaka said:

Thanks! When you had insomnia, did you have consecutive says with only 1-2 hours of sleep? How did you manage this? I felt like I was on the brink of a breakdown. 

 

I hesitate to give you a truthful answer to this as I'm afraid it will scare you.

I had several months of never sleeping more than 20 mins a night. I had several more months of sleeping maybe 90 mins each night, and then got up to a maybe sleeping 90 mins twice a night

 

I did all kinds of different things to try to manage it, some things helped, others did not

I was sure that something awful was going to happen to me due to lack of sleep but I read some books on sleep and in one of them it explained that even when you think you're fully awake, sleep is SO essential for your brain, at least some parts of your brain do actually sleep.

So then I stopped being afraid of the insomnia...
I also decided to rest whenever I was tired and since for me, those first few minutes or hour and a half of sleep were the most restful- I wouldn't let anything get in the way of me laying down when I felt ready and able to sleep.

I spent many nights sleeping from 9 pm to 10:30 and then being up all night.

 

And I just took it one day at a time. 

 

It does get better though, and eventually you'll be able to sleep great again and this will be off in the rear view mirror

 

hang in there... and take it day by day.

 

 

[mtmalaka]

Thanks @Happy2Heal... Doesn't scare me but gives me some courage knowing that someone out there has endured far worse. 

[Happy2Heal]

9 hours ago, mtmalaka said:

Thanks @Happy2Heal... Doesn't scare me but gives me some courage knowing that someone out there has endured far worse. 

I'm not the only one believe me.

but you see it can be done

 

that does not make it any easier for sure

 

 

trying not to be too upset about it does help.

at the very least you're not adding additional upset to an already unhappy state, right?

 

 

it does improve over time, some faster than others but mainly it does seem to happen gradually for most folks to be honest

 

to me this makes it even more important to be watching for when it IMPROVES and to not continually mention how long it's been with this problem nor moan about how little sleep you're getting, It's understandable to want to do that but I really believe that is counter productive

 

watch for even the smallest positive change and relish it and you will see more and more of those good changes every day

 

as bad as the first few months of acute WD recovery were, I was able to find at least one small thing- sometimes many more! good things that were improving, even a little bit

I gives you even more hope because it's what is happening for YOU 

You can celebrate each and every gain you have

 

it will def brighten up your days to do so

 

 

[LotusRising]

On 6/28/2024 at 10:26 AM, mtmalaka said:

I understand your comment about implimenting a new drug with dependencies, but something non Benzo related would be preferable to an Ativan dependency?

Non-benzo would be preferable, yes. Just making sure you're aware of needing to taper another drug.

 

Insomnia is an incredibly difficult symptom to deal with. I could really only sleep 30-60 minutes at a time, for a really long time. It really will get better , even though it doesn't feel that way right now. Do what you need to do to be able to function. 

 

Keep us updated how you're doing.

[mtmalaka]

I have an appt. with my psych tomorrow. I will ask for a non-benzo sleep aid but will most likely not take anything. Just to have in my back pocket. 

 

Sleep has improved. Benzo taper will be  0.125mg starting tonight. I don't have any signs of intetdose depenancy as far as I can tell. Only the insomnia from a few days ago. 

 

The Zoloft reintro has been very activating but I'm hoping that subsides. I'd like to come down slightly in dosage soon to see if the activation minimizes some. 

 

I will get liquid zoloft from my psych tomorrow. Does anyone have any recommendations or instructions with cross dosaging from pill to liquid form to test the waters? 

[mtmalaka]

Thanks @Happy2Heal- your words are always encouraging and worth their weight in gold during these times. 

[LotusRising]

@mtmalaka

 

1 hour ago, mtmalaka said:

Sleep has improved.

This is really good to hear  

 

Our general recommendation for a crossover, whether from new brand to old brand generic or tablet to liquid is:

 

3/4 old, 1/4 new for 3 to 7 days 

1/2 old, 1/2 new for 3 to 7 days

1/4 old, 3/4 new for 3 to 7 days

all new thereafter

 

Stay at the same dose during the crossover period.

[mtmalaka]

Thanks @LotusRising

 

8 minutes ago, LotusRising said:

@mtmalaka

 

This is really good to hear  

 

Our general recommendation for a crossover, whether from new brand to old brand generic or tablet to liquid is:

 

3/4 old, 1/4 new for 3 to 7 days 

1/2 old, 1/2 new for 3 to 7 days

1/4 old, 3/4 new for 3 to 7 days

all new thereafter

 

Stay at the same dose during the crossover period.

 

I am currently down to half a 25mg pill of Zoloft (scored in half). Breaking down that  pill further will prove to be difficult. Is water solution then recommended? Maybe I can do half and half for 7 days and see? I can probably manage to cut the 12.5mg in halves but that's probably it. 

[mtmalaka]

On second thought, I think I'll just buy a scale, measure the weight of my 12.5mg pill, divide that into 3, then shave off what I need accordingly with a file. 

 

I only have a few weeks of this so might be the most simple solution. 

[mtmalaka]

Insomnia seemed to get better as my body adjusted to the 0.25mg, after 5 days I went to 0.125mg and the insomnia is back. That is an indication that the Ativan has a hold on me. I will continue another 5 days then drop to zero. Hoping that goes smoothly. 

 

I know I was warned here previously, but had no idea Ativan could be so depenancy forming in such a short amount of time. Could this be due to my extra sensative nervous system? 

[LotusRising]

On 7/1/2024 at 12:04 PM, mtmalaka said:

Could this be due to my extra sensative nervous system?

It's not clear why some develop dependence quickly and others do not. But benzos seem to be particularly dependence-forming quite quickly.

 

It seems like you're body is responding well to the reductions though. Insomnia would be expected, but seems to be getting better between reductions?