Quitting SRI's -- what to expect?

September 18, 2006 4:57 AM

I'm about to quit taking Zoloft, tapering down from 50 mg daily. I starting taking it because I was having problems dealing with a specific situation, which is now over, and because I tend towards depression. I'm a bit scared to quit. Any advice on quitting? What should I expect? Anecdotes welcome.
posted by anonymous to health & fitness (17 comments total)

I felt a little fluey. But then I did it cold turkey.

Have you discussed this with your doctor?
posted by konolia at 5:15 AM on September 18, 2006

I don't know if it's true with all SRIs, but it can be dangerous for real to quit them cold turkey without supervision. I always assumed this to be general super-cautious advice, until I met a woman who developed epilepsy after quitting Prozac suddenly. The prozac people said it could happen, and sure enough it really happens.

So, IANAD, but I've seen the results and why they warn you, so don't mess around on this one.
posted by cloudscratcher at 5:30 AM on September 18, 2006

I quit Zoloft cold turkey once several years ago after being in a similar situation to yours, although I think I may have been taking more than 50 mg. I remember that I'd get this fleeting light-headed feeling for a split second every once in awhile for a week or two after I stopped. I don't recall any other major side effects, and I felt fairly normal after a few weeks. IANAD, YMMV.
posted by ludwig_van at 5:48 AM on September 18, 2006

I quit Zoloft cold turkey after taking some samples (with doctor's advice). I felt paranoid, incredibly on edge and seriously unstable, so for me it was a good decision. There were no ill effects to speak of. After a short break I re-started on moclobemide, again on doctor's advice. The moclobemide had much better results with none of the paranoia, which was just great!

At least keep in touch with your doctor.
posted by flutable at 5:49 AM on September 18, 2006

When I quit, I bought a pill splitter and took half the previous week's dose for a week; by the end of 3 weeks I was done. Aside from the occassional "head flash" I felt fine. It was a pretty painless process to be honest. Don't be afraid! But do talk to your doctor. (I didn't but you probably should.)
posted by miss tea at 5:53 AM on September 18, 2006

you could check out crazymeds.org, where they have a lot of info on why to take meds, why not to and how to quit. some of it seems kind of worst case scenario, but its good to be informed, and it seems more honest than a drug's webpage.

you should be quitting under a doc's supervision. sometimes people have a hard time getting off one med and they'll give you something else to use for a week to make the transition easier (when i went down on my effexor, they gave me prozac for a couple days, since its half life is very short)

do it as slow as you can. cut pills in half. stay at a dosage for at least three days, probably a week if you can stand it. and if you feel really sick, tell your doc.

withdrawal symptoms range from annoying to alarming, and its not something you want to do on a whim. if you had weird effects getting on, expect them when going off (this is not a rule). I personally experience dizziness, nausea, headaches, night sweats and the occasional bout of dyslexia. it took me two weeks to adjust to a single drop in my effexor dose, although effexor is supposedly a pain to deal with. (unfortunately, its the only one that works for me) good luck, and be careful. patience is a virtue, in this case.
posted by gilsonal at 6:03 AM on September 18, 2006

it's not very fun getting off. i had the dizzies and the nausea for the most part.

if you're interested, i have a whole category on my blog called 'zoloft bye bye' that details me getting off it.

it didn't suck as much as it could have or as much as i expected it to.

for what it's worth, i also had similiar w/d experiences from prozac and paxil (though paxil was by far the worst).
posted by misanthropicsarah at 6:16 AM on September 18, 2006

Crazy Meds has some really useful info on this sort of thing, and comes across as much more credible than most "official" listings of side effects and risks, owing to the fact that it reads like it was written by a layperson. That, of course, has its own pros and cons... IANAD, and I don't think this guy is, either.

Personally, I've had some horrible experiences with SSRI discontinuation syndrome. Effexor was godawful to stop taking: I followed the doctor's advice, and titrated down to half then quarter doses, and that last jump from 1/4 to 0 was still almost unbearable--horrible feelings of disassociation and dizziness, a complete lack of physical and mental energy, and strong feelings of irrational paranoia for the better part of a week. Luckily, that was in high school, where such things are almost par for the course.

Just last week, I decided to try to stop Lexapro cold turkey--also a bad decision. It wasn't as bad as the Effexor, but starting in day 3, the disassociation and headaches were there, and vertigo bad enough that I would get really disoriented from something as simple as swiveling around in a chair. Since this ain't high school any more, it became bad enough that I wouldn't have been able to maintain it at work... I gave up and went back up to a full dose for a couple of days to try to smooth things out, and am now trying to titrate off like most places seem to recommend.

So, long story short, your mileage may vary significantly--if you have an easy time of it, more power to you, but plan for the worst. Talk to your doctor, and (if possible) try to have the option of taking a couple of days off for the worst of it.

Good luck... email's in my profile if you want to talk offline, since we'll probably be in the same boat for the next week or so.
posted by Mayor West at 6:26 AM on September 18, 2006

I never had any problem. The drug side-effects went away, that's about it.
posted by frenetic at 7:01 AM on September 18, 2006

I'm familiar with the crazymeds guy (I know him from an old forum of mine) and he is reliable. Good info. I cannot recommend his site enough!
posted by konolia at 7:27 AM on September 18, 2006

Taper taper taper. About a year ago I started tapering off Paxil verrrrrrryy slowly. It took about a month to go from 30 mg. to 20 mg. without withdrawal symptoms. Ultimately I got depressed again so went back on my original dose -- fortunately I don't have many of the side effects some people report on Paxil so going back on was okay with me.
posted by ClaudiaCenter at 7:57 AM on September 18, 2006

Going from 100 to 50 of zoloft was too sudden for me. I got dizzy and tired in the afternoons. My doc then advised I try 100 one day and 50 the next for two weeks until I was at 50. That worked with a minimum of side effects. (Mostly feeling a little down in the evenings with big sugar and caffeine cravings.)

I'm still at 50, so I can't advise anything more specific to your situation. Except do it under a doc's supervision if possible. If not, at least taper, maybe switch off 50/25 for two weeks then stay at 25 for a bit, then do 25/0 for two weeks.
posted by callmejay at 8:37 AM on September 18, 2006

I quit paxil cold turkey. I knew it was wrong (though I was on a minimal dose so it was less problematic) but I just wanted to get it over with. The withdrawal effects were annoying but my attitude was "this is just some temporary physiological adjustment, like having a cold" and psychologically it didn't bother me much. A few weeks later all was well and though I wouldn't recommend it (too many variables) I don't regret it. But tapering down is no doubt a better strategy for the wiser and more patient person than me.

But be prepared to possibly find out that taking the pills was reducing ordinary day to day depression more than you expected. I have to work harder to deal with myself than I did on the pills. Again, I have no regrets - I think the cognitive work is ultimately more fruitful than the chemical intervention. So in a sense I feel I'm finding positive outcomes despite some negative onese (more frequent and more acute episodes of depression than when on the pills - but critically, still less frequent and accute, and particularly exerting less negative influence on my overall ability to conduct and enjoy my life, than before I got treated for depression at all).

Of course, operate under the advice of a physician (I did even though they advised against my withdrawal "method"), don't mess around with major depression or suicidal thoughts, immediately seek help. But you will probably be fine: try not to take any symptoms as more than minor and temporary annoyances, and look for positive lessons i.e. this is an opportunity to work on dealing with normal daily issues in a healthy way, just a bit more mano a mano than when you were taking the pills. Good luck!
posted by nanojath at 10:13 AM on September 18, 2006

(I feel like I should doubly emphasize that pretty much everything I read indicates that it is a terrible, terrible, awful idea to go off paxil cold turkey and absolutely nobody should emulate me).
posted by nanojath at 10:27 AM on September 18, 2006

It's vitally important to DO THIS UNDER YOUR DOCTOR'S SUPERVISION.

SSRIs often take a long time to ramp up and an equally long time to taper down. If you start bouncing off the wall, you can't stop it quickly simply by increasing the dose again, but there are things your doctor knows about and can prescribe to bring you back in control.

You had, and to a certrain degree may still have, a chemical imbalance. There's nothing shameful about taking medication for it, or to go off the medication when you no longer need it. However, you need the doctor's training and familiarity with your response, just as much now as you did when you went on the Zoloft.
posted by KRS at 10:51 AM on September 18, 2006

Really think about whether you want to quit. I was on and off SSRI's twice before I realized that I actually really should have stayed on them. It was the same sort of thing for me--when things in my life just happened to start looking up, I, of course, was suddenly happy again and thought "I don't need these drugs!" Twice I cycled through that.

But earlier this year it came back to bite me in the ass, and I realized that regardless of how my life is going, I have a permanent chemical imbalance in my brain.

Perhaps it is a misunderstanding, but I've always been under the impression that true chemical-based depression isn't an episodic affliction. The symptoms may, and often do, ebb and flow, but the condition is, for lack of a more optimistic word, permanent.

I recently outgrew my initial dose, and was suddenly reunited with the symptoms that led me to seek help in the first place, and let me tell you that while you are on your SSRI it is easy to forget what depression feels like, and when you are reaccquainted it can be VERY difficult.

In short, please talk to your doctor, and please don't forget why you wanted to be on medication in the fisrt place.

And Tom Cruise can kiss my goddamn ass, ranting about the alleged horrors of psychiactric drugs. My life is MUCH nicer than it was before I was unable to control my anger and sadness.
posted by Darth Fedor at 11:51 AM on September 18, 2006

I went from a low dose (50mg, I think) to nothing, against doctor's advice. Instead of splitting pills, I just began skipping days. This probably wasn't as bad as cold turkey would have been.

The worst part of it was what I called the "electricity effect", which basically meant that I felt like I was getting a mild electric shock in my brain. This happened on and off for weeks. It was unpleasant, and made me feel a bit dizzy. I wouldn't have wanted to drive a bike, but for some reason I continued to drive.

Oh yes, and narcolepsy. Can't forget the narcolepsy. It was like I was back in college at an 8am philosophy class. Occasionally, I literally could not keep my eyes open. I had to pull my car over to the side of the road more than once.

So, here's one vote against manually tapering off.
posted by Invoke at 4:16 PM on September 18, 2006