zoloft withdrawal

[Gayle]

I have been taking only 25 mg of zoloft for about four years.  My doctor prescribed it because of unending headaches.  It really helped and I felt fairly well the whole time I've been taking it.  However, in reading recently that permanent changes in the brain are showing up on people with longtime use of antidepressants (particularly serotonin reuptake inhibitors) I have decided to stop taking it.  I realize now you must do this by a schedule.  I don't know how to go about this and wonder if you could even suggest something that would be sensible.  I tried cold turkey and by the fifth day, I was weeping and angry for foolish reasons, my heart was beating in  strange ways, particularly if I turned my head from side to side.  I felt like how I've felt before I was about to come down with the flu.  This is frightening to me.  Can you please suggest something to make this a more gentle process.  I tried cutting the half of the 50 mg tablet in half and got a bunch of crumbs.  How can we take 12 and 1/2 mgs without that happening.  And is that what I would do.  Start taking
12 1/2 mgs. for a length of time.  Then where do I go from there?  

Thank you for any help

[will]

If you can live without something like Zoloft, then do your best to because the side effects are such a trade off to make,

[CCF Neuro[P] MD, RPS]

Dear ksb:

Remeron is a tricyclic antidepressant medication and not a SSRI.  Yes, although very rare, it can cause extrapyramidal signs (abnormal movements).

CCF Neuro MD

[KimB]

Are there any known dystonia effects from remeron (not sure what class this is)?  Just curious because docs put me on a 6 month course following some MS symptoms and BAD sleep problems last fall.  During the course of this I had some what I think may be dystonia-like symptoms (fingers and toes wanting to curl up).  I attributed it to the MS symptoms I was having because it all occurred on the right side.  But I found this blurb interesting.  Where can I read up on this antidepressant/dystonia link (assuming Remeron is in the same class)?  

An aside, I came off the Remeron 3 weeks ago because it was no longer helping me sleep (primary reason for taking it).  I feel WONDERFUL!  Odd as it may sound, I do think the Remeron was CAUSING depression!  I have so much more energy and patience now and feel like a whole new person!

[Bonnie]

Will stopping 50 mg. Zoloft cold turkey cause side effects like nystagmus & vertigo immediately? (like the next day?)  I've taken it for 2 years & every now & then forget to take it for a day & never had those things happen.  I'm dx with relapsing remitting MS. Could it be an MS thing instead?
Thanx!
(I jumped in here since the discussion was about stopping Zoloft& that is my concern also!)

[CCF Neuro[P] MD, RPS]

Dear Gayle:

There are many medications for migraine headache.  One you might try is an old medication that we have found works well, that is doxepin or elavil (both tricyclic antidepressants) without some of the side effects of decreased sex drive and theoretical possibilities of dystonia.

I hope all works out well.

Sincerely,

CCF Neuro MD

[Gayle]

What a prompt and helpful reply!  I had read on some of the zoloft forums that very very slow withdrawal is necessary, but again I am taking so few mgs (25) , perhaps the process would not be as long.  Thank you for your input, and I will make that appointment to see my doctor.  I might add here another reason I was happily willing to try zoloft was, not only the headaches, but a natural tendency to depression (which runs strongly in the family on my mother's side--uncle committed suicide, mother had severe deep, silent depression), and the medication helped my much milder form of it.  I will have to face that, too, when I finally stop taking it.  You might wonder why then I'd want to stop taking a medication that helps.  I don't want brain changes that are negative.  That would be the proverbial insult to injury.

[CCF Neuro[P] MD, RPS]

Dear Gayle:

There are plenty of medications out there to use for headaches.  So, I hope you will find the correct medication.  There are a few reports of patients who have taken the SSRIs and have some dystonia.  However, it is not known if the SSRI was the initiator or something else.  There is a theoretical concern and there is a fraction who thinks longterm treatment is not a good idea.

I would suggest that you talk to your prescribing physician.  See what he/she says.  I usually start by going to a every other day dose for 2 weeks, then twice a week for 2 weeks and then finally once a week for two weeks and then off.

Sincerely,

CCF Neuro MD