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Author Topic: 200mg Zoloft (Sertraline) Tapering Schedule.  (Read 421 times)

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Offline nicolem_animefan

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200mg Zoloft (Sertraline) Tapering Schedule.
« on: December 09, 2013, 10:51:53 PM »
Hello everyone,

I have been taking Zoloft 200mg for about nine months to combat my anxiety and now I am feeling so much better. However, I am here because I am desperate for help.

My doctor says I can't come off Zoloft and she doesn't believe I can function without it. But, I now have a stable life at college and holding down a job; I feel tons better and I really want to try to combat anxiety with the techniques I've learned. No matter how many times I've brought it up to my psychiatrist (an MD) she says I have to be on it for "at least a year" before I am allowed to taper it, which sounds like a load of BS. This drug makes me feel weird in ways I can't explain, and I have had enough. I know it's dangerous to do it on your own or stop Cold Turkey. I've tried seeing like five other therapists in my area and NO ONE wants to help me taper off the medicine...but it's my body and my choice. I feel like I'm in a maze with no exit, and out of options.

Would anyone be able to suggest a safe way to taper off this medicine that I could maybe ask my PC Doctor to help me with? To be clear, I am not asking IF I should do this, I am asking HOW to do it. I've made up my mind and that's that.

It would mean the world to me if someone could help, thank you. ._____.
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Offline insights

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Re: 200mg Zoloft (Sertraline) Tapering Schedule.
« Reply #1 on: December 09, 2013, 11:53:12 PM »
My doctor says I can't come off Zoloft and she doesn't believe I can function without it. But, I now have a stable life at college and holding down a job; I feel tons better and I really want to try to combat anxiety with the techniques I've learned. No matter how many times I've brought it up to my psychiatrist (an MD) she says I have to be on it for "at least a year" before I am allowed to taper it, which sounds like a load of BS.

Treatment guidelines do recommend anxiety and depression patients take antidepressants for at least a year so I can understand the reluctance to have you quit early. A lot of research has gone into the guidelines.

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but it's my body and my choice. I feel like I'm in a maze with no exit, and out of options.

Yes, it is your body and choice and you should insist if you feel so strongly about it. Your doctors are you employees, not your masters.

I suggest you reduce by no more than 25mg and dropping the dose no faster than every 7-10 days. You will probably find that getting down to 50mg won't be too difficult, but reduce it by less and slow the rate if side-effects become a problem. The last 50mg is often the most difficult so cut back in smaller steps if you have to, 12.5mg, or even 6.25mg if you have 25mg tablets, at a time.

Final point, there is growing evidence that antidepressants become progressively less effective every time they are stopped and restarted, requiring higher doses to achieve the previous level of control. They may also produce more severe, and sometimes different, initial side-effects. According to one study the chances of antidepressants working after each restart drops by nearly 20%. Note that this applies to all antidepressants, not just the one/s you've taken in the past. 

Ian

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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline Abraham2007

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Re: 200mg Zoloft (Sertraline) Tapering Schedule.
« Reply #2 on: December 10, 2013, 12:21:24 AM »
I think your doctor has a very good reason to warn you not to quit Zoloft, after just nine months.   Remember, psychiatrists have four years of an undergrad degree, four years of medical school and four more years in psychiatry.  That is twelve years of training, in addition to their on the job experience, so they must know something valuable about psychiatric medication on how to guide you to use it.

Btw, 200 mg is the highest recommended use of Zoloft.  If you needed that much to feel the way you do now,  you're going to really work your cognitive exercises to mangage your brain's response to stress.  Why put yourself through extra daily effort at doing regular CBT exercises, when you can let the medication assist the brain for you?

If you don't like the way Zoloft (Setraline) feels, do know, you have the option to swtich to another SSRI, which may not have the same side effects that you have now.  Have you considered Luvox (Fluvoxamine) or Vibryd? I'd switch first, before quitting.  Just sayin' .
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Offline AncientMelody

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Re: 200mg Zoloft (Sertraline) Tapering Schedule.
« Reply #3 on: December 10, 2013, 04:42:31 PM »
Hello everyone,

I have been taking Zoloft 200mg for about nine months to combat my anxiety and now I am feeling so much better. However, I am here because I am desperate for help.

My doctor says I can't come off Zoloft and she doesn't believe I can function without it. But, I now have a stable life at college and holding down a job; I feel tons better and I really want to try to combat anxiety with the techniques I've learned. No matter how many times I've brought it up to my psychiatrist (an MD) she says I have to be on it for "at least a year" before I am allowed to taper it, which sounds like a load of BS. This drug makes me feel weird in ways I can't explain, and I have had enough. I know it's dangerous to do it on your own or stop Cold Turkey. I've tried seeing like five other therapists in my area and NO ONE wants to help me taper off the medicine...but it's my body and my choice. I feel like I'm in a maze with no exit, and out of options.

Would anyone be able to suggest a safe way to taper off this medicine that I could maybe ask my PC Doctor to help me with? To be clear, I am not asking IF I should do this, I am asking HOW to do it. I've made up my mind and that's that.

It would mean the world to me if someone could help, thank you. ._____.

Well, I wouldn't hold that against the therapists. Some may be very well versed in medications, but not all are. And at the end of the day, they aren't the ones studying and prescribing these meds in depth. They probably feel they would be overstepping their bounds.

Staying on the meds for at least a year if they are working for you has scientific evidence to back it up. Relapse rates are lower. That said, you obviously feel very strongly that this isn't what's best for you right now, and your psychiatrist should at least be more open to discussing your reasons. I'd talk to your primary care provider and get their input, and perhaps your primary would be able to refer you to a psychiatrist who would be a better fit for you. Good luck
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Offline nicolem_animefan

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Re: 200mg Zoloft (Sertraline) Tapering Schedule.
« Reply #4 on: December 10, 2013, 10:46:15 PM »
My doctor says I can't come off Zoloft and she doesn't believe I can function without it. But, I now have a stable life at college and holding down a job; I feel tons better and I really want to try to combat anxiety with the techniques I've learned. No matter how many times I've brought it up to my psychiatrist (an MD) she says I have to be on it for "at least a year" before I am allowed to taper it, which sounds like a load of BS.

Treatment guidelines do recommend anxiety and depression patients take antidepressants for at least a year so I can understand the reluctance to have you quit early. A lot of research has gone into the guidelines.

Final point, there is growing evidence that antidepressants become progressively less effective every time they are stopped and restarted, requiring higher doses to achieve the previous level of control. They may also produce more severe, and sometimes different, initial side-effects. According to one study the chances of antidepressants working after each restart drops by nearly 20%. Note that this applies to all antidepressants, not just the one/s you've taken in the past. 

Ian

Thank you Ian for bringing that to light. I've heard of people who have tapered sooner and they were fine, so I just assumed the doctor just wanted to keep me on it for back up.

The thing that bothers me about these drugs is that the longer I am on them the more my body will get addicted to them, and my brain is changing. I feel really bothered by that. Not because I'm scared of taking the SSRI because I've been on it for months now. The biggest concern is that my P-Doc will keep me on it for a year, and then another, than another...until years go by. Studies show that Sertraline is one of the hardest antidepressents to get off of. Ever read this book? This famous psychologist has shown me the horrors of how much we really don't know about SSRIs.

If I start tapering now will I be putting my body in danger?

Btw, 200 mg is the highest recommended use of Zoloft.  If you needed that much to feel the way you do now,  you're going to really work your cognitive exercises to mangage your brain's response to stress.  Why put yourself through extra daily effort at doing regular CBT exercises, when you can let the medication assist the brain for you?

It's a personal choice. I'd rather fight this the hard way. There's no cure for anxiety. Either people choose to suffer through anxiety attacks without medication or they take the medication and feel strange. I personally do not like the feeling of the latter. Ever since I started taking this SSRI I've felt wacked out, in a weird way I cannot describe.

Staying on the meds for at least a year if they are working for you has scientific evidence to back it up. Relapse rates are lower. That said, you obviously feel very strongly that this isn't what's best for you right now, and your psychiatrist should at least be more open to discussing your reasons. I'd talk to your primary care provider and get their input, and perhaps your primary would be able to refer you to a psychiatrist who would be a better fit for you. Good luck

Thank you, I really appreciate the support.
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Offline stephtronic

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Re: 200mg Zoloft (Sertraline) Tapering Schedule.
« Reply #5 on: December 11, 2013, 12:23:14 AM »
I would definitely recommend getting a qualified physician's advice about a tapering schedule if you're determined to get off of the Zoloft, but here is a link from Harvard Medical about tapering off antidepressants that includes a 200 mg Zoloft dosage schedule's tapering increments:

http://www.health.harvard.edu/newsletters/Harvard_Womens_Health_Watch/2010/November/how-to-taper-off-your-antidepressant

It's not clear on the time frame for the dosage reductions, just a general statement about doing it over a 2-6 week span (6 probably being the best choice).

I was on 200 mg of Zoloft every day for 3 years, and I didn't find it that hard to get off of it. I didn't have a physician behind my tapering schedule when I got off either. But I would recommend having someone qualified help if you can.
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Offline insights

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Re: 200mg Zoloft (Sertraline) Tapering Schedule.
« Reply #6 on: December 11, 2013, 02:20:10 AM »
The thing that bothers me about these drugs is that the longer I am on them the more my body will get addicted to them,

You won't ever become addicted, but you are probably already dependent on Zoloft (and no these are not the same thing). This is the case with many medications including antibiotics, blood pressure meds, etc, even supplements such as vitamin C. Take it at highish doses for a while and you may experience rebound scurvy if you quit it cold-turkey.

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and my brain is changing

Yes, it it is. Which is a good thing. Chronic stress kills brain cells in the hippocampal regions of the brain and prevents new ones from growing. This is thought to be the biological basis of anxiety and depression. Antidepressants reverse this damage by encouraging new brain cells to grow, survive and forge new interconnections. This is why antidepressants take several weeks to kick-in.

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Studies show that Sertraline is one of the hardest antidepressents to get off of.

No it isn't. It is usually one of the easier ones, especially compared to paroxetine and venlafaxine.

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Ever read this book? This famous psychologist has shown me the horrors of how much we really don't know about SSRIs.

Yes, well he would, wouldn't he. Antidepressants are bad for his business (plus there wouldn't be much money in writing books about how great antidepressants are). It is why psychologists are prone to publishing studies like the one I discuss here. While individual psychologists demonize antidepressants and other psych drugs, for many decades their associations have been campaigning behind the scenes for psychologist to have prescribing privileges. Peoiple have been taking antidepressants for nearly 50 years, some continually for that long (I have for 26 years at very high doses). If they were causing brain damage it would have become very obvious by now.

I'm not saying that antidepressants are the greatest thing since sliced bread, but they aren't the horror drugs you have been lead to believe either. If therapy works for you then great, but if it doesn't then antidepressants are a good alternative.

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If I start tapering now will I be putting my body in danger?

Not physically, but only time will tell what psychological ramifications there may be.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

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