![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 29 to 53 of 350. Go back in thread:
Posted by IB on October 13, 2000, at 18:25:33
In reply to withdrawal symptoms coming off zoloft, posted by Shelly on May 4, 1999, at 17:37:51
> I have just gradually taken myself off of zoloft. I know I should have done this through my doctor, but well that's another story I won't get into.
> My question for anyone who can help is has anyone had side effects from withdrawal from this drug? I am experiencing dizziness, chills and I am extremely aggravated most of the time. Anyinfo. would be helpful....
I have recently stopped taking zoloft and i came
online to see if anyone else has experienced
dizziness or nausea as a result of withdrawal.My symptoms are mild but it's reassuring to know that
they are common. However, I'm really sorry to see a lot of people suffering so much in attempts to
be free of zoloft. I 'weaned' myself of zoloft over a six month period(at least). My original dose was 50mg. I began by alternating50mg one
day/37.5mg the next and so on for a while.Then
I did 50mgone day/25mg the next and so on.
Eventually, i was on 12.5mg a day...then every
other day..thenevery few days 'til I stopped
completely. I had great health care professionals
who supported my desire to try to get off zoloft
and to do it SLOWLY. It's a big change in body
chemistry so it's best done gradually and kindly
to yourself especially if you've used it for a while. Also, think about other ways of keeping your serotonin levels up ( exercise,foods,
breathing techniques etc ) as you come off zoloft.
I hope this might be helpful to someone..........
Best Wishes...
Posted by AlS on November 21, 2000, at 9:56:21
In reply to Re: withdrawal symptoms coming off zoloft, posted by IB on October 13, 2000, at 18:25:33
A few summers ago I went on a 9-day canoeing trip to Quebec. I'd been taking Zoloft (50 mg daily) for a few years at that point. At the beginning of the trip, my medications got wet and were not usable. For most of the rest of the trip, I had symptoms similar to what I've been reading about here---dizziness, and a crackling in my head. It was not fun (for me or my canoeing partners!) to have these symptoms on a wilderness trip! Since then, I've been sure to make several stashes of my medications--generally I'll give one to my wife to carry.
Posted by Alexl on April 14, 2001, at 20:06:02
In reply to withdrawal symptoms coming off zoloft, posted by Shelly on May 4, 1999, at 17:37:51
Just looking for verification from someone else.
I was on Zoloft for a little over a month 12.5mg for a week and then up to 50mg. I had headaches, night sweats, sorethroat, jaw pain, general tired, muscle aches, joint aches too. All this was on the way up.
I more or less quit cold turkey. I took 12.5 for about 2 days. Skipped a day then took 12.5. (enormous headache)
For about the last 3 weeks or so I have still had muscle aches and joint aches. It slowly seems to be gettin better. My Dr. said it may last a month to 2 months. Does this sound about right?
I just want to be sure of it.
Thanks
Alex
Posted by Lance on April 17, 2001, at 23:50:20
In reply to Re: withdrawal symptoms coming off zoloft, posted by Alexl on April 14, 2001, at 20:06:02
At the age of 50 started on Zoloft to help deal with depression and obsessive-compulsive behavior. It helped immensely but (6 yrs. later),I now am seeking 'natural' alternatives. I tried ST.John's Wart last year and it was a disaster so after a month I had to get back to the Zoloft. This year I have been tapering for a month and experiencing the light-headedness, power surges and flu-like feelings. But I am also trying to switch to SAMe at the same time. So far, there is no definitive indication of how effective this will. If I have to back to the Zoloft. We'll see. Has anyone tried to use SAMe for depression?!
Posted by SalArmy4me on April 18, 2001, at 15:22:40
In reply to Re: withdrawal symptoms coming off zoloft, posted by Lance on April 17, 2001, at 23:50:20
Read the Los Angeles Times front section today for the announcement of the ultimate study which proves that St. John's Wort has no efficacy in treating depression.
> At the age of 50 started on Zoloft to help deal with depression and obsessive-compulsive behavior. It helped immensely but (6 yrs. later),I now am seeking 'natural' alternatives. I tried ST.John's Wart last year and it was a disaster so after a month I had to get back to the Zoloft. This year I have been tapering for a month and experiencing the light-headedness, power surges and flu-like feelings. But I am also trying to switch to SAMe at the same time. So far, there is no definitive indication of how effective this will. If I have to back to the Zoloft. We'll see. Has anyone tried to use SAMe for depression?!
Posted by Smiley on April 19, 2001, at 18:30:34
In reply to withdrawal symptoms coming off zoloft, posted by Shelly on May 4, 1999, at 17:37:51
I went off Zoloft (150 mg, wt. 92 1bs.) without weaning myself off it due to lack of funds for my prescription co-pay. I experienced severe headaches, and excrutiating pain. I also experienced flu-like symptoms. The headaches made going to work intolerable, light intolerable, and noises and sounds intolerable. I would advise anyone thinking of going off Zoloft to wean themselves off it slowly and do so only with their Dr.'s prior permission. My family doctor was unaware of the side effects of Zoloft and gave me a nerve pill instead, he said my headaches were due to stress, and I thought I had the flu.
I wish I would have been warned about the severe headaches ahead of time (withdrawal) and did not realize it myself until I started looking up withdrawal effects from Zoloft. Seems their were others like me out there, and I thought I was going crazy, so did my family doctor, I guess. That headache pain was real. It made me scared to try another ad. But I didn't like being depressed and went to Celexa (only made me feel worse depressed), now my psych doc has me on Remeron. Good Luck to you!
Posted by Brenna on May 15, 2001, at 7:10:49
In reply to Re: withdrawal symptoms coming off zoloft, posted by Smiley on April 19, 2001, at 18:30:34
I'm so happy Zoloft withdrawal is finally being acknowledged.......I withdrew 2 years ago from Zoloft and saw 5 doctors who all thought I had something like a brain tumor....They ordered cat scans, blood tests etc The whole time I was telling them I was sure it was the zoloft withdrawal but NONE of them believed me or agreed.
I am now about to go off it again. I am on 50mg daily and I would like to know if I will get withdrawal symptoms when I reduce to 25mg? How long would anyone suggest I stay on 25mg before going off totally? I'm sooo scared of the withdrawal symptoms because they are so severe and I can't function and look after my kids when I am so sick.
Thanks for posting all your stories, I don't feel so alone anymore!
Posted by Linda C on June 18, 2001, at 20:10:36
In reply to Re: withdrawal symptoms coming off zoloft, posted by Brenna on May 15, 2001, at 7:10:49
I was prescribed Zoloft for stress and PMS two years ago. I was taking 100MG/day. It
was wonderful the first year. I felt like I was crazy not to have sought medical help
sooner. I did gain about 20 lbs. and lobido issues but the benefits seemed worth it. After a
year, my doctor wanted to try taking me off it to see if I could do without it. She had me
cut my dose from 100 to 50 MG/day. I tried this for a month. I became a witch to live
with and I hated myself because I felt so out of control. I was worse than I had ever been
prior to starting the Zoloft. She put me back up to 100MG/day and my moods stabilized
again. However, I started gaining weight like I had when I was first put on it, no matter
how hard I tried to lose it. I finally asked to have my thyroid checked after about 8 months
of consistent weight gain. I was convinced that it couldn't be the Zoloft and had to be
something else. When my thyroid & glucose tests came back normal, the doctor said she
felt the weight gain was a side effect of the Zoloft. I decided to get off the Zoloft because
I was not happy with all the weight I had gained, a total of 50 lbs. over 22 months. I did
not want to go off fast like the doctor had started to do before, so I decided to titrate
myself down slowly. I went from 100 to 75MG/day for 2 weeks, then to 50MG/day for 3
weeks, then to 25MG/day for 2 weeks and then nothing. I thought this would be slow
enough. I felt good psychologically. However, during the 2nd week of 25MG/day, I
started experiencing dizzy spells. I thought it was from the extreme heat we had been
having. The 3rd day with no Zoloft, I got a sudden migraine. I had not had one of those in
years. Again, I blamed the heat. I had no idea that Zoloft withdrawal could be the culprit. I
have now been off Zoloft completely for 7 days and I have been having severe dizzy
spells, tingling up and down my arms and waves of fatigue. I went to the ER today
because I was concerned they may be heart related symptoms. They did blood work and
all was normal. The doctor there told me that I could be experiencing Zoloft withdrawal
symptoms and that I should follow-up with my regular doctor. I told the ER doctor that I
had titrated slowly done over 7 weeks and was surprised that I would have withdrawal.
She said many people have these symptoms and sometimes find it helpful to go every
other day and then every third day before going down to no medication. Since I've been
off the Zoloft for 7 days now, I hate the thought of taking any of it again. I'm afraid it will
just put me that much further behind in overcoming the withdrawal symptoms. Does
anyone have experience with this? If I take a little now, will I just be back at square one?
How long do these symptoms last? I plan on calling my prescribing doctor tomorrow to
let her know what's going on. I had done this weaning on my own, although I know she
would have supported my going off since it was me who had originally requested staying
on the medication. I thought my weaning was better than what she would have advised me
to do based on passed experience. Any thoughts?
Posted by julielynne on June 19, 2001, at 9:34:21
In reply to Re: withdrawal symptoms coming off zoloft, posted by Linda C on June 18, 2001, at 20:10:36
Linda, if you can deal with the withdrawal symptoms, you may want to stay Zoloft-free. The withdrawal
will go away -- I can't say how long it will take though. In my earlier post (10/13/00) I mentioned
how I was taking Xanax to get me through the Zoloft withdrawal. Xanax is also an anti-depressant but it
works immediately; however, it is highly addictive. I've been on it for years though and only take it
when absolutely necessary (usually during PMS). When I went off Zoloft, my doc switched me to Wellbutrin
which has been working well. AND I've lost the weight I gained on Zoloft! Wellbutrin is sometimes
prescribed to people as a weight-loss med. Depression/anxiety runs in my mother's family, so I will probably
be on something forever!
My 7-year-old son recently went through something that upset him badly and he was obsessing over it,
crying every night, and having anxiety attacks. (For anyone who has had these attacks, imagine watching
your child experience it! It sent me to the bottle of Xanax for myself!) His pediatrician was concerned
and put him on something called Busporine, an anti-anxiety drug that works differently from other
benzodiazepines and is non-addictive. He's been on it for less than a week and is doing much better.
She only wants him on it for two weeks. I think she said it is a fairly new drug. I mention this because
I can't deal with the way I felt without being on something, and if you're the same, you may want to
look at other options.
Posted by dana on June 20, 2001, at 19:43:35
In reply to Re: withdrawal symptoms coming off zoloft, posted by julielynne on June 19, 2001, at 9:34:21
Linda, I went off Zoloft COLD TURKEY ..! ughh!! what a big mistake. I had been down to 25mgs so thought it was low enough to just be able to stop...........
My dizziness in the first week was so severe.....I had to go to the Emergency Doctor at the Hospital..... I freaked out.......luckily he was a DRUG Addiction Specialist, and immediately recognised it as WITHDRAWAL.......he prescribed XANAX....but because I was just so relieved to know that I wasn't dying.....I haven't filled in the prescription.
I have had severe bouts of CRYING for what seemed no reason...and still am after SEVEN WEEKS.....because I was withdrawing from a highly effective drug that was in my system for two years.
The dizziness this week has pretty much gone now.....it's been SEVEN WEEKS......... and I have been lead to believe it can in some cases takes weeks and weeks to finally get it out of your system. Everyone's different so it's hard to say exactly how long it takes......could be six months ....who really knows...!
So hang in there...........oh by the way.......my appetite is now that of a 'normal' person... I have started losing weight ....so there is a good side to it all !!.....
Dana
Posted by KMC on June 20, 2001, at 22:43:25
In reply to Re: withdrawal symptoms coming off zoloft, posted by Linda C on June 18, 2001, at 20:10:36
Hi Linda,
I've been on Zoloft for nearly a year, so I haven't yet dealt with withdrawal issues, but I can say that I had the reverse happen to me on the way up to 150 mgs. My first psychiatrist started me way too fast, which for me was 25 mgs/day. He was of no help or support, so I fired him and went elsewhere. My current doc started me on 25 mgs. every other day, for two weeks, then going up to 25 mgs every day, and so on in 25 mg. increments until I hit 150. I had a lot of your symptoms the first time around, w/ the first doc. It might make sense to go back to 25 mgs. every other day for a couple of weeks, but in any case, I'd talk to your doctor about it and if she's not helpful or is not listening to your concerns, find another one who will.
>I went from 100 to 75MG/day for 2 weeks, then to 50MG/day for 3
> weeks, then to 25MG/day for 2 weeks and then nothing. I thought this would be slow
> enough. I felt good psychologically. However, during the 2nd week of 25MG/day, I
> started experiencing dizzy spells. I thought it was from the extreme heat we had been
> having. The 3rd day with no Zoloft, I got a sudden migraine. I had not had one of those in
> years. Again, I blamed the heat. I had no idea that Zoloft withdrawal could be the culprit. I
> have now been off Zoloft completely for 7 days and I have been having severe dizzy
> spells, tingling up and down my arms and waves of fatigue. I went to the ER today
> because I was concerned they may be heart related symptoms. They did blood work and
> all was normal. The doctor there told me that I could be experiencing Zoloft withdrawal
> symptoms and that I should follow-up with my regular doctor. I told the ER doctor that I
> had titrated slowly done over 7 weeks and was surprised that I would have withdrawal.
> She said many people have these symptoms and sometimes find it helpful to go every
> other day and then every third day before going down to no medication. Sin > < HR >< H3 >Transfer interrupted!< /H3 > ays now, I hate the thought of taking any of it again. I'm afraid it will
> just put me that much further behind in overcoming the withdrawal symptoms. Does
> anyone have experience with this? If I take a little now, will I just be back at square one?
> How long do these symptoms last? I plan on calling my prescribing doctor tomorrow to
> let her know what's going on. I had done this weaning on my own, although I know she
> would have supported my going off since it was me who had originally requested staying
> on the medication. I thought my weaning was better than what she would have advised me
> to do based on passed experience. Any thoughts?
Posted by gilbert on June 21, 2001, at 18:32:35
In reply to Re: withdrawal symptoms coming off zoloft » Linda C, posted by KMC on June 20, 2001, at 22:43:25
Linda,
I have been on all of the ssris and have had to use xanax for start up effects and xanax for withdrawal. The only one without withdrawal was prozac....came of that farily easy. I have quit benzos easier than stopping ssris. But let the benzo tapering method be a guide for ssri users. Don't rush off the drug. taper down by 12.5mg per week. I have come off and on xanax over the last 2 years without any withdrawal symptoms by simply following some good advice from this board......Stop slowly so your system isn't shocked by a lack of seratonin. The rebound depression and anxiety from stopping quickly will make you feel like running for Betty Ford Clinic. I think we are beginning to realize that drug dependency has many forms and that those dirty little benzos are not the only drugs out there with rebound and withdrawal problems......So go sloooooow. Or get some xanax to help you through it but you may prefer to just go slow.
Gil
Posted by help on July 19, 2001, at 0:28:14
In reply to Re: withdrawal symptoms coming off zoloft, posted by dina on May 4, 1999, at 21:06:42
My friend has been on zoloft for 3 years now and takes 200mg and 250mg a day, are there any side effects, are there any life threathing issues that should be thought about. Her dosage has not changed since she started usuing the drug. Please get back to me cause I really love her.
Andrew
andrew@malvernprep.comHave a wonderful day and there is hope for everyone out there.
Posted by SalArmy4me on July 19, 2001, at 0:32:28
In reply to Zoloft Dangers (help), posted by help on July 19, 2001, at 0:28:14
I once took 400 mg of Zoloft per day and turned out alright.
from: http://www.dr-bob.org/tips/split/SSRI-maximum-doses.html
Date: Mon, 15 May 1995 22:13:39 +0059 (EDT)
From: scole@world.std.com (Stanley Cole)
Subject: SSRI maximum dosesOn Mon, 15 May 1995, Sergio Henao wrote:
It has been said in this group that patients sometimes respond to SSRI doses beyond the usually recomended ones. For instance, sertraline has been given in doses of up to 600 mg a day with success. I checked with some of my colleagues (psychopharmacologists) in Houston and they never heard of it and would not recomend it. In view of this I decided to call the medical information department at the manufacturing company. Their physician told me that for that particular drug the response curve has been flat and for this reason they would not recomend or support going beyond 200.
I have a number of patients who respond only to relatively high doses of SSRIs. One patient walked in one day and finally reported relief from his depression only after reaching fluoxetine 120 mg qd. I have other patients on sertraline who respond only to 350 mg. I have checked levels frequently to see if I was really giving toxic doses of meds, but the combined levels (including the nor-metabolite) were relatively low. Either these are rapid extensive metabolizers, or they are not absorbing the meds or there is an unmearsured metabolite that is very high. (These are patients whose compliance I trust.)
Posted by JK on August 17, 2001, at 13:13:27
In reply to withdrawal symptoms coming off zoloft, posted by Shelly on May 4, 1999, at 17:37:51
> >I've been on Zoloft for about 8 months. Man, what a strange experience this whole thing has been. My doc put me on this after I complained of anxiety, nervousness, panic feelings, and jumbled thoughts. I had gone through a number of life changes (moving, changing jobs, having another child, my dad getting sick). Now I know why I was such a mess and if I would have realized it then, maybe I could have avoided the drug altogther by "right" thinking. Anyways, I have just weaned myself off for the past month or so and have just recently (the past day) felt the side effects. The nerves have returned and the head rushes are unique to say the least. But the beauty of all of
this is that I KNOW what it is now! This realization eliminates much of the fear that was eating me up inside. For me, positive thinking and keeping busy have opened the door for me and provided hope (without the aid of drugs). I've grasped whatever it takes to sooth your mind. I never was a big "self help" person but now I
love hearing about methods to live and think healthier. Thanks for showing me that these pesky symptoms are normal and even better that they WILL GO AWAY--remember that! As you can tell, I'm trying to be very confident.
Posted by tsean on August 21, 2001, at 7:45:09
In reply to Re: withdrawal symptoms coming off zoloft, posted by Laura Jane on September 3, 2000, at 10:56:07
> I have been off of Zoloft completely for about a week. I am getting these weird head spins and they are making me nauseous. My sex life has been great since I stopped (the Zoloft put a damper on it). But, these spins are making me sick! Is this from Zoloft? HELP!
Posted by sjharve62 on September 2, 2001, at 22:33:03
In reply to Re: withdrawal symptoms coming off zoloft, posted by tsean on August 21, 2001, at 7:45:09
I took zoloft for about 18 months, and got off with the help of Pfizer. My withdrawls were what they called "rare" and I filled out a questionaire for them. My withdrawls were what I could only describe as "shocks" that radiated from my chest to the tips of my fingers, and out the top of my head. Now, even six years later, I am still having them if I don't get anough sleep, If I get too much sleep, and especially if I get awakened suddenly. I cannot afford tests, so if anyone has any suggestions, I would greatly appreciate it. My head also feels like it is "full", like I cannot possibly take in anymore information for about 20-30 minutes after the shocks start. HELP!!!
Thanks
Posted by SalArmy4me on September 3, 2001, at 7:34:52
In reply to Re: withdrawal symptoms coming off zoloft, posted by sjharve62 on September 2, 2001, at 22:33:03
There's no way to get rid of what you have without getting diagnosed for an illness, possibly Myoclonic/Myoclonus type stuff. You may be able to use cyproheptadine to control the shocks: http://www.dr-bob.org/tips/split/Cyproheptadine-for-myoclon.html
Posted by glass_snake on October 2, 2001, at 11:41:45
In reply to Re: withdrawal symptoms coming off zoloft, posted by sjharve62 on September 2, 2001, at 22:33:03
Don't believe what they're telling you. I have a friend that works in the Psychiatric ward of one of the top 10 hospitals in the US. He got all of the data he cool from Psychiatry and pharmacy on the drug. According to the company line there is no withdrawal symptom. I had been taking Zoloft for anxiety and was tired of it messing with my life. So, being as bold as I am, I went cold turkey. I was ok for a day or two and then started to show symptoms that I've seen posted a hundred times over since I went looking for them: dizziness, tingling across the body, "shockwave" sensations, fatigue, headache, etc. I called some people I knew in the medical field and they thought it sounded like severe hypotension (a sudden drop in blood pressure). After it persisted for several days I searched the Internet for two simple words "Zoloft withdrawal". You would not believe the number of hits that flew right up - all from people complaining of the exact same symptoms. About two weeks later everything got pretty normal again, but that may vary from person to person. Either way, don't believe Pfizer, et al. Zoloft DOES have withdrawal symptoms. Don't be too alarmed by them, they will pass. If it looks too bad, see a doctor.
FYI, I am NOT a doctor just someone that's done a little research, so don't take this as anything more than the advice of a peer lay person :)> I took zoloft for about 18 months, and got off with the help of Pfizer. My withdrawls were what they called "rare" and I filled out a questionaire for them. My withdrawls were what I could only describe as "shocks" that radiated from my chest to the tips of my fingers, and out the top of my head. Now, even six years later, I am still having them if I don't get anough sleep, If I get too much sleep, and especially if I get awakened suddenly. I cannot afford tests, so if anyone has any suggestions, I would greatly appreciate it. My head also feels like it is "full", like I cannot possibly take in anymore information for about 20-30 minutes after the shocks start. HELP!!!
> Thanks
Posted by bingo on October 9, 2001, at 15:14:09
In reply to Re: withdrawal symptoms coming off zoloft, posted by SalArmy4me on April 18, 2001, at 15:22:40
> Read the Los Angeles Times front section today for the announcement of the ultimate study which proves that St. John's Wort has no efficacy in treating depression.
>That's nonsense. I was on St. John's Wort alone for some months, and it helped me a great deal. I only left it for prescription meds because the efficacy of the Wort varied too much according to how empty my stomach was when I took it (have an eating disorder).
Posted by Daveman on October 13, 2001, at 23:27:07
In reply to Re: withdrawal symptoms coming off zoloft » SalArmy4me, posted by bingo on October 9, 2001, at 15:14:09
Well, I've been reading the posts about Zoloft withdrawal and there is definitely a common thread here; stopping "cold turkey" leads to a series of reactions such as electric shocks, also called "zaps"; flu-like symptoms, etc.
What I'm curious about is: Does tapering down help avoid these problems, and if so, how slow a taper is generally utilized? I've been on Celexa 40 mg/day since about last February and am doing so well that my doc and I are beginning to talk about reducing the dose and perhaps trying to stop it altogether. I admit to having some concerns about the potential withdrawal problems; elsewhere on the web, there is much discussion over the lawsuit filed against Paxil regarding withdrawal problems.
Are Paxil and Zoloft worse to withdraw from than Celexa due to their shorter half life (Paxil-15-20 hrs; Zoloft 24 hrs; Celexa 35 hrs; all according to Rx List). Have people found tapering to be an effective way to avoid withdrawal problems? I'd be interested in any responses.
Dave
Posted by Cam W. on October 14, 2001, at 0:48:27
In reply to SSRI Withdrawal-Does tapering help?, posted by Daveman on October 13, 2001, at 23:27:07
Dave - While I have heard of a few people who have seemingly gone through SSRI withdrawl while stopping Celexa™ (citalopram), the numbers have been nowhere near that seen with Paxil™ (paroxetine) or Zoloft™ (sertraline). Effexor™ (venlafaxine) regular (not XR) is by far the worst offender. Still, it best to taper down any SSRI fairly slowly. SSRI withdrawl affects those who have a polymorphism for the cytochrome P450-2D6 (many repeating copies of the gene in their DNA) metabolizing enzyme. This polymorphism seems to affect about 5% of those of European descent.
Tapering of the dose of an SSRI allows the body to adjust to lower levels, and allow the body to adjust to slightly lower levels of this neurotransmitter. More serotonin is being forced to be produced than at pretreatment time (ie. when you were depressed). SSRI therapy does force the body to produce more serotonin because the mechanism conservation of serotonin, via the reuptake pump, is blocked. It is hoped that by forcing the body to produce more serotonin, the body will naturally keep producing serotonin at a higher once the SSRI is withdrawn (ie. stopped). The body does need to adjust to the slightly lower level of serotonin in the gap (ie. the synaptic cleft - the space between neurons) because the reuptake pump is again drawing back into the presynaptic nerve ending from which it is released. The slower the block is taken off the reuptake pump, the more time the body has to adjust.
In your case, I believe dropping the dose of Celexa by 10mg per week is more than slow enough. Do confirm this with your doctor (or show him this post. In any case, your doc will probably only want you to decrease your dose to 30mg (possibly 20mg), so you could, in reality, drop directly to 30mg (or even directly to 20mg) without any problem. Usually, any drug that is taken once daily, and has a half-life of longer than 24 hours can be tapered fairly quickly.
I hope that this post will assuage (cool word, huh?) any fears that you may have. - Cam
Posted by Daveman on October 15, 2001, at 23:56:58
In reply to Re: SSRI Withdrawal-Does tapering help? » Daveman, posted by Cam W. on October 14, 2001, at 0:48:27
Cam:
Thanks for your resonse. As usual, it was precise and to the point. I have printed it out for future reference.
It got me thinking- is this absence of serotonin in the synaptic "gap" responsible for the "electric shocks" or "zaps" that seems to be such a commonly reported side effect of withdrawal from Paxil and Zoloft? If so, what would be the phsyiological explanation for this? Just wondering I guess.
Anyway, thanks again for the response.
Dave
Posted by Cam W. on October 16, 2001, at 0:35:03
In reply to Thanks, Cam:) and a thought of my own » Cam W., posted by Daveman on October 15, 2001, at 23:56:58
Dave - I haven't seen any good explanation of the electric zaps, yet. My feeling is, is that most clinicians and researchers either don't believe that they really exist, or feel that they are unrelated to withdrawl. This is similar to the instances when I first heard complaints of delayed weight gain with Paxil. A few years ago, when I would broach the subject with clinicians, they would say that there was no connection. This was when the scientific community believed that just as many people lost weight with Paxil, as gained weight. Now we know (because it has been "proven" scientifically) that some people lose weight in the short term with Paxil, but a majority will gain that weight back (and then some) in the subsequent 3 or 4 months of therapy.
Most psychiatrists have no idea what I am talking about when I mention "brain zaps". That is the problem with Psycho-Babble; we are just too damn current with what medications actually do. Clinically, we are way ahead of the research.
My hypothesis of what is going on with the brain zaps is that during withdrawl, the lack of serotonin in general, is causing random, unsychronized firing of serotonergic neurons. I am not totally sure in which part of the brain or which serotonergic pathway this is occurring, but I would hazard a guess that it is in one of the pathways leading out of the raphe nuclei (possibly enroute to the frontal cortex). I really don't know what is going on, though. It could also be a temporal lobe thing, similar to the feeling people get before an epileptic seizure, or maybe like the prodromal symptoms of a migraine headache.
Every time I think I am getting a grasp on the brain's circuitry, a question like this arises, and I realize that I don't understand the brain, as well as I think I do.
I guess that we have to organize and make more noise within the research community, so that someone takes our observations seriously. Perhaps Dr. Bob could get one of the depression experts to give a presentation so that we could lob our observations at him/her.
As confused as ever - Cam
Posted by SLS on October 16, 2001, at 15:45:44
In reply to Re: a thought of my own » Daveman, posted by Cam W. on October 16, 2001, at 0:35:03
In re: brain-zaps.
It has been well over a decade since I had to undergo a withdrawal syndrome due to the discontinuation of clonazepam, but I recall experiencing brain-zaps that were very similar to those I experienced when discontinuing Effexor. I would be curious to know if this is an occurrence common to benzodiazepines in general or something specific to clonazepam. As I recall from early studies, clonazepam was often separated from the others by being ascribed pro-serotonergic properties. Perhaps this is the reason why it tends to be more effective for social-phobia and OCD. Clonazepam is also noted to have certain anticonvulsant (and perhaps anti-manic) properties not displayed by the other benzodiazepines. While searching Medline in an effort to confirm my recollections, I found some rather interesting relationships between myclonus, GABA, and 5-HT that I think support Cam W.’s ideas.
- Scott
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Adv Neurol 1986;43:629-43
Mechanism of action of clonazepam in myoclonus in relation to effects on GABA and 5-HT.Jenner P, Pratt JA, Marsden CD.
“Clonazepam is a potent anticonvulsant 1,4-benzodiazepine that controls some types of myoclonus. Its primary mode of action is to facilitate GABAergic transmission in the brain by a direct effect on benzodiazepine receptors. GABA receptors lie on the cell bodies of dorsal raphe neurons, and GABA acts to inhibit raphe cell firing, an action potentiated by benzodiazepines.”
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