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Mental Health  (Expert Forum)
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switching meds
Answered by
Roger Gould, M.D. - Mental Health, Wellness
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD) , bipolar disorder , dementia , electroconvulsive therapy (ECT) , learning disabilities, memory, obsessive compulsive disorder (OCD) , panic , personality disorders, phobias , post-traumatic stress disorder (PTSD) , schizophrenia , stress , transitions, and work problems.

switching meds

by lfox, Jan 17, 2006 12:00AM
I have been taking zoloft, 100mg, now for 8 years. I also started taking welbutrin in addition about 4 years ago. I have been feeling a slow decline with my depresion in the last year. We increased my wellbutrin from 150-300 and not much help. Put my self back into theropy to try to figure out why im starting to feel depressed again. My phycotheropist suggested that maybe the zoloft was not working that well any more and i should switch. So off to my physision to talk to him. We decide to taper off the zoloft and try lexapro. Ok i say untill now. I am all messed up trying to detox off the zoloft. My doctor has me taking 50mg for 5 days then 50mg every other day for 6 days then stop for one week then start the lexapro. A few days after going down to 50mg i am a mess. Depressed, crying off and on. Very dizzy, sick to my stomach, loosing weight and wondering weather changing meds is even worth this. Its day 8 and i can barly stand up with out feeling like im going to fall over. If I talk to someone I just want to start cring.
Any thoughts or input. My big delema is my medical insurance wont cover anything to do ith mental heath so money is an issue.
thanks

by Roger Gould, M.D., Jan 18, 2006 12:00AM
You should talk to your doctor about slowing down the weaning schedule if you are that sensitive to change.  Maybe go down to 75 for a while, then when you are ready down to 50...there is no real hurry, so talk to him or her about going on down in a comfortable way.
Member Comments (10)

by lfox, Jan 17, 2006 12:00AM
To: smallvoice
Hi
thanks for your feedback. Im having a hard time trying to find the info you suggested I look at.Im anxious to see it
Thanks

by SmallVoice, Jan 18, 2006 12:00AM
To: lfox
Hi, I'm not sure whether its the link to the thread (bring up another browser and copy-paste it into the Address bar, links don't 'work' on this site), or quite what you mean?

Its the thread a FEW down from yours called "Pregnant and Bipolar" (there's typos in the title, but it'll be clear) and after the blue bar that the resident dr posts in, all the stuff is under that.

The withdrawal advice itself I can post the link to direct here
(but again you'll need to copy paste it into the browser) and its a pdf file so needs acrobat reader to open it.

http://www.ssri-uksupport.com/files/protocolwithdrawalssris.pdf

but there's also other advice, articles on akathisia (severe agitation etc) and how to treat it if needed.


Let me know if you mean you have another problem accessing something and I'll try to help out.

I'll look in now and again to see if you've replied, but I'm in Europe and our time zones are quite some way out so if you post in 'my' nightime I'll not see it till the next morning here :-)

by lfox, Jan 18, 2006 12:00AM
To: forum M.D.
Is there an easier way to swith from one ssir to another with out having to go through such a process of withdrawel. At this point Im back to taking my 100mg zoloft. I just cant deal with the withdrawels right now.

by SmallVoice, Jan 18, 2006 12:00AM
In case the doc doesn't answer more than the one question paid for, yes there IS an easier way and thats by tapering down VERY VERY SLOWLY.

PLEASE print that Withdrawal Advice (pdf file) out and take it to your doctor so that he understands how to support you through the tapering process.

by SmallVoice, Jan 18, 2006 12:00AM
Even easier is for him to switch you over to LIQUID zoloft (which wasn't available Prof Healy wrote the withdrawal advice) and tapering with a syringe.  But he still needs the withdrawal advice so that he can see how difficult it can be for some people.

Hope that helps.

by lfox, Jan 19, 2006 12:00AM
To: smallvoice
Thanks so much for all you input

by SmallVoice, Jan 19, 2006 12:00AM
Ifox, you're welcome.  When things get bad on tapering, please remember that there are MANY people at any given period that are in the same situation, and that how you feel is not something bad or wrong with YOU but are effects of the drugs/withdrawals - and that if things get VERY bad then search out sites that can help.

Key words doing searches are

Antidepressant withdrawal.  
Antidepressant support.
SSRI support.
SSRI withdrawal support.
Prozac withdrawal.
Prozac support.

(Prozac support sites usually deal with all SSRIs, its just that they started at a time when Prozac was the only SSRI I think, and then have evolved to cover problems on the rest of the SSRIs which are basically clones of Prozac made by other companies.)

That kind of search  will bring up sites that will help with withdrawal and will also help with side effects when on the normal drug if you need it.  

Keep your spirits up and good luck.







by BonnieH, Feb 08, 2006 12:00AM
I know exactly how you feel, I was tapered off effexor over 5 week period after being on  it for about 7 years, I'm working my way back up again slowly, but it doesn't seem fast enough either. I had to discontnue it temorary because of surgery. I still feel very agitated and nervous especially in the morning, I don't want to do anything, but I'm trying to push myself, and I know its hard. I'm dpressed like you as well. We just have to be patient, and wait for the meds to work. Thet will I'm told, but it can sometime take up to 6 - 8 weeks i'm told. Hang in there,and let me know how you feel.
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