Has anyone tried Zoloft or Sertraline as a benzo crossover?

Hey guys,

I know I might get the eponymous "crap shoot" answer, but I'm considering Sertraline or Zoloft as an option to rid myself of the benzo Valium that I have been on for six months.

Has anyone had any positive experiences with Zoloft?

Dave.

I’m on Zoloft right now and took it before my tapering because my doctor thought the sxs were caused by the anxiety disorder. But the good news is Zoloft might have helped me to avoid the feelings of anxious and depressed a lot, but the bad news is Zoloft cannot replace the benzo it can only help for some withdrawal symptoms e.g. depression.

 

And Zoloft is another SSRI meds may cause the withdrawal symptoms, before you decide to take it please consult your doctor

I’m on Zoloft right now and took it before my tapering because my doctor thought the sxs were caused by the anxiety disorder. But the good news is Zoloft might have helped me to avoid the feelings of anxious and depressed a lot, but the bad news is Zoloft cannot replace the benzo it can only help for some withdrawal symptoms e.g. depression.

 

And Zoloft is another SSRI meds may cause the withdrawal symptoms, before you decide to take it please consult your doctor

Thanks Shashal! 

I have consulted with my doctor and psychologist - both want me to wean off Valium first, but it's Hell's Gates trying to come off just 5mg.

My psychologist suggested Citalopram or Celexa, but I'm very 50/50 to try another SSRI.

Dave.

FYI:

 

The most commonly prescribed antidepressant barely relieves symptoms of modern depression, a major study reveals.

 

The largest independent investigation ever undertaken found patients taking sertraline experienced negligible improvements in mood.

 

Published in the Lancet Psychiatry, the study comes amid mounting controversy over increased use of antidepressants by GPs in recent decades, with roughly 7.3 million people in England issued a prescription each year.

 

Its authors said they were “shocked and surprised” by the results, and called for the development of new classes of medication.

 

https://www.telegraph.co.uk/science/2019/09/19/common-antidepressant-barely-helps-improve-depression-symptoms/

 

 

Surprised?

 

Not me.

FYI:

 

The most commonly prescribed antidepressant barely relieves symptoms of modern depression, a major study reveals.

 

The largest independent investigation ever undertaken found patients taking sertraline experienced negligible improvements in mood.

 

Published in the Lancet Psychiatry, the study comes amid mounting controversy over increased use of antidepressants by GPs in recent decades, with roughly 7.3 million people in England issued a prescription each year.

 

Its authors said they were “shocked and surprised” by the results, and called for the development of new classes of medication.

 

https://www.telegraph.co.uk/science/2019/09/19/common-antidepressant-barely-helps-improve-depression-symptoms/

 

 

Surprised?

 

Not me.

Thanks Al Sharp! Will steer clear of Zoloft then.

Dave. 

Here’s another article about the Lancet study from MedPage ...

 

Surprising Mechanism Behind Sertraline's Short-Term Benefit

Hint: It’s not the antidepressant effect

https://www.medpagetoday.com/psychiatry/depression/82266

 

When there is clinical uncertainty about whether antidepressants should be prescribed in primary care settings, the presence of anxiety symptoms may indicate an increased chance of benefit, a randomized trial found.

 

In a group of 550 primary care patients with mild to severe depressive symptoms, sertraline (Zoloft) did not reduce depressive symptoms at six weeks compared to placebo as measured through the 9-Item Patient Health Questionnaire (adjusted proportional difference 0.95, 95% CI 0.85-1.07, P=0.41), reported Gemma Lewis, PhD, of University College London in England, and colleagues.

 

However, there were mild improvements in depressive symptoms at 12 weeks, with a 13% reduction in PHQ-9 scores (difference 0.87, 95% CI 0.79-0.97) as a secondary outcome, the authors wrote in Lancet Psychiatry.

 

Secondary analyses also found that sertraline was associated with reduced anxiety symptoms at 6 weeks and 12 weeks compared to placebo, as well as improved functioning and self-reported mental health, they noted.

 

Here is a link to the actual Lewis et al study (which was published in The Lancet Psychiatry) followed by the Interpretation section from the study:

 

The clinical effectiveness of sertraline in primary care and the role of depression severity and duration (PANDA): a pragmatic, double-blind, placebo-controlled randomised trial

https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(19)30366-9/fulltext

 

Sertraline is unlikely to reduce depressive symptoms within 6 weeks in primary care but we observed improvements in anxiety, quality of life, and self-rated mental health, which are likely to be clinically important. Our findings support the prescription of SSRI antidepressants in a wider group of participants than previously thought, including those with mild to moderate symptoms who do not meet diagnostic criteria for depression or generalised anxiety disorder.

 

 

 

Crown,

 

I am not a doctor.  I am not prescribing anything.  I have studied neuroscience, and I can give you better than a crap shoot answer.  Zoloft may help you, but not yet.  Regardless of what reports you read might say, it does things to your nerves and their chemistry.  Biopsies of rats treated with Zoloft proves that it does things.  Here's what it does:

 

First, it slows down serotonin transport (SSRI), meaning you have more serotonin at the synapse.  Serotonin is our feel good hormone, and in most mildly depressed or mildly anxious but otherwise neurologically typical people, this makes them feel better.  My brother took it for a while. It helped him, but he does not need it any more.  My father is 89, still takes it and it still helps him.

 

But here's the kicker, serotonin at the glutamate receptors revs people up.  Zoloft specifically also slows glutamate transport down.  In spite of what you might have read, GABA is a small part of our pain.  Most of it is glutamate.  A neurologically typical person starting Zoloft feels "a little revved for a few weeks" while he adapts. You would probably feel like you have been hit by a truck.  No one can know that for sure, but if you are having a problem cutting your benzo, I would take that bet. 

 

But.

 

When you do get off those last 5 mg, and log a few months clean, there is some pretty good evidence that LOW DOSE Zoloft can speed recovery by exactly the mechanisms I described above.  More serotonin and glutamate at the synapse will coax those glutamate receptors away.

 

In short, hang in there, cut slowly, there may be a med that could help at our stage (tapering), but so far I have not found it.

 

Ramcon1

Your personal neuroscientist reminding you to hang in there, and when you are going thru hell, keep going!

Crown,

 

I am not a doctor.  I am not prescribing anything.  I have studied neuroscience, and I can give you better than a crap shoot answer.  Zoloft may help you, but not yet.  Regardless of what reports you read might say, it does things to your nerves and their chemistry.  Biopsies of rats treated with Zoloft proves that it does things.  Here's what it does:

 

First, it slows down serotonin transport (SSRI), meaning you have more serotonin at the synapse.  Serotonin is our feel good hormone, and in most mildly depressed or mildly anxious but otherwise neurologically typical people, this makes them feel better.  My brother took it for a while. It helped him, but he does not need it any more.  My father is 89, still takes it and it still helps him.

 

But here's the kicker, serotonin at the glutamate receptors revs people up.  Zoloft specifically also slows glutamate transport down.  In spite of what you might have read, GABA is a small part of our pain.  Most of it is glutamate.  A neurologically typical person starting Zoloft feels "a little revved for a few weeks" while he adapts. You would probably feel like you have been hit by a truck.  No one can know that for sure, but if you are having a problem cutting your benzo, I would take that bet. 

 

But.

 

When you do get off those last 5 mg, and log a few months clean, there is some pretty good evidence that LOW DOSE Zoloft can speed recovery by exactly the mechanisms I described above.  More serotonin and glutamate at the synapse will coax those glutamate receptors away.

 

In short, hang in there, cut slowly, there may be a med that could help at our stage (tapering), but so far I have not found it.

 

Ramcon1

Your personal neuroscientist reminding you to hang in there, and when you are going thru hell, keep going!

 

Is it just about down regulation of receptors, or is there more to this syndrome? If it is all about gaba receptor down regulation then why do other receptors up regulate way quicker?

Our condition is mostly about glutamate receptor UPregulation and dysfunction.  We have too many glutamate receptors that fire too easily (at too low a voltage) and the ionotropic ones let too may Calcium cations thru.  Upregulation is easy.  We are designed to grow and repair.  Glutamate upregulation and potentiation is actually how we learn.

 

Your GABA receptors grow back after you stop taking benzos.  It is DOWNregulation that is a difficult unnatural process and why some people take so darn long to heal.  And why something like Zoloft may help that process at some point.  Lots of studies in rats.  Not sure it will help everyone, and certainly not sure it can help while still tapering, but it shows promise.

 

Ramcon1 

Our condition is mostly about glutamate receptor UPregulation and dysfunction.  We have too many glutamate receptors that fire too easily (at too low a voltage) and the ionotropic ones let too may Calcium cations thru.  Upregulation is easy.  We are designed to grow and repair.  Glutamate upregulation and potentiation is actually how we learn.

 

Your GABA receptors grow back after you stop taking benzos.  It is DOWNregulation that is a difficult unnatural process and why some people take so darn long to heal.  And why something like Zoloft may help that process at some point.  Lots of studies in rats.  Not sure it will help everyone, and certainly not sure it can help while still tapering, but it shows promise.

 

Ramcon1

 

So you’re saying that as we take the drug or start tapering that the body increases glutamate receptors? Would only Zoloft possibly help with this or any antidepressant?

Our condition is mostly about glutamate receptor UPregulation and dysfunction.  We have too many glutamate receptors that fire too easily (at too low a voltage) and the ionotropic ones let too may Calcium cations thru.  Upregulation is easy.  We are designed to grow and repair.  Glutamate upregulation and potentiation is actually how we learn.

 

Your GABA receptors grow back after you stop taking benzos.  It is DOWNregulation that is a difficult unnatural process and why some people take so darn long to heal.  And why something like Zoloft may help that process at some point.  Lots of studies in rats.  Not sure it will help everyone, and certainly not sure it can help while still tapering, but it shows promise.

 

Ramcon1

 

 

 

So you would not advice taking this when already in a state  of high fear from withdrawal, and still tapering, but might help afterwards , Would that be when the anxiety has eased off ?

 

I tried a tiny piece of an SSRI I used to be able to take before the Valium taper, with no problem and it sent me into a state of terror beyond words with dry heaving,

 

Before it was more just a case of feeling slightly off before it got into my system ,

 

I guess it citalopram did this  then sertraline would too

 

I am stuck with this mess now I guess till I can free myself and hopefully my body with repair,  but I am terrified I wont,

 

I am way to old for this at 74,

 

Any suggestions on how to bring this down . I can manage the evenings  but it starts all over again from about 3-4am in the morning,

 

I am now at .56mgs of Valium and want to be free, tapered very slowly and suffered all the way

 

 

Greek,

 

Yes.  As we take benzos, our body responds by making more glutamate receptors, and the ones they make do not work properly.  Taking a medication to reverse this effect is controversial.  And I am being very careful not to "prescribe" anything.  Here is what I can tell you.

 

I have read a tonne of papers about benzo damage, other conditions of glutamate receptor damage, and experiments on rats to reverse that damage.  I started a thread on "discussing the cure" in the protracted section.  Ways shown in the papers to reverse the damage are:

an increase in serotonin, done in the papers with Zoloft/sertraline

https://www.jneurosci.org/content/25/23/5488

 

Lithium

https://psychscenehub.com/psychinsights/lithium-mechanism-action-synopsis-visual-guide/

 

The first paper is a bit deep.  The second is just a guide, but I dug deeper and found the mechanism by which it could work, and it is reasonable.  I got a copy of a reference, but I cannot put it up as a link.

 

Here is the deal. The hard line on benzobuddies is taper off, get clean, stay clean, and in a year or two you will be better.  This works for most people.  It does not work for everyone.  It did not work for me.  So I reinstated, got much sicker, and need to taper off again AND find a way to reverse this damage before I lose my ability to try.  I cannot and would not tell anyone what to do.  Many people think Zoloft is poison too.  I do not think so, but that is my OPINION.  I will tell you what I am going to do myself.

 

When I get clean I am either going to try low dose lithium, first the supplement lithium orotate which is very low dose, building to the lowest dose of the med lithium carbonate.  NOT the doses used to treat bipolar disorder.  Just the lowest dose which translates to 28 mg Lithium ion (Li+) here is a chart for the equivalents of Li+ in the salts, and no matter what anyone tells you, the only thing that matters is the amount of Li+ in whatever form of lithium you take, so 5 1/2 120 mg orotate pills = One 150 mg carbonate pill:

 

https://psycheducation.org/treatment/mood-stabilizers/the-big-three-for-bipolar-depression/lithium/lithium-orotate/#Microdosing_how_much_actual_lithium_in_each_form

 

Or, I will titrate liquid Zoloft up VERY slowly, literally a few milligrams at a time using a diabetic syringe as a measuring device.  Zoloft is good that way because it is the only SSRI available as a liquid.

 

PS Ideally, we would raise our serotonin by natural means.  Meditation and exercise do this.  Tryptophan CAN, but the metabolic process to turn tryptophan into serotonin is so complex it is far more likely to bite us in the a$$ than help.

 

That is my plan so that I hope I will be better in less than 2 years.  Will it work?  I will not know until I try.  I will see if anyone else is trying the things we discussed there, but I do not think so.

 

Hope that helped.

 

ramcon1

YPN, RYTHIT, AIYAGTH, KG! (Your personal neuroscientist, reminding you to hang in here, and if you are going thru hell, keep going!)

Chinchuck,

 

Remember, I am not a doctor, but you just proved what I posted.  An SSRI will rev us up while we are in a fragile state, so yes, as I posted below, I do not think it is a good idea while tapering.  I am (and you and everyone else really, are) going to have to find a way to get to zero, stay at zero, and work from there.

 

PS During my last taper, I found mirtazapine/Remeron VERY helpful, especially for sleep, but I am still on it, it does not work as well as it used to, and many here find it a difficult drug to taper.  I do not know about that as I have never tried to taper off.

 

ramcon1

(YPN, RYTHIT, AIYAGTH, KG!)

Chinchuck,

 

Remember, I am not a doctor, but you just proved what I posted.  An SSRI will rev us up while we are in a fragile state, so yes, as I posted below, I do not think it is a good idea while tapering.  I am (and you and everyone else really, are) going to have to find a way to get to zero, stay at zero, and work from there.

 

PS During my last taper, I found mirtazapine/Remeron VERY helpful, especially for sleep, but I am still on it, it does not work as well as it used to, and many here find it a difficult drug to taper.  I do not know about that as I have never tried to taper off.

 

ramcon1

(YPN, RYTHIT, AIYAGTH, KG!)

 

 

I wish I had not touched the Valium as I am suffering so much with unrelenting terror, down here in the trenches, 

 

I cannot see a way forward but to keep tapering of the last .56mgs, Valium, 

 

I am told by Bristol Tranquilliser project that this is normal for those they deal with at this dose and that stopping at .5mgs does not usually produce any worse symptoms than now, but it's such a desperate place to be ,

 

Do you find the mirtazapine helpful ?

 

I have tried it twice whilst taking Valium low dose, but gave up ,

 

I am wondering if a very low dose would help a little, I just don't know ,

 

I have been trying to do this without anything and the journey is beyond words bad with fear,

 

I was hoping I could use sertraline, but if I react the same way as citalopram then I know I cannot take it , 

 

I am lost what to do as too low in dose now  to do much else but get free now and pray , I am out of ideas,

 

 

 

 

Chinchuck,

 

I can feel the desperation in your post, and I feel so bad for you.  Here are my OPINIONS.  Note, I am not stating any thing as fact, nor am I suggesting you DO anything.  That is between you and your doctor.

 

I do not think an SSRI of any kind will help a super sensitized benzo person.  I do think that after a few months, a VERY low dose may help healing.

 

I do not think there is anything to be gained by cutting 0.01 mg for 56 more days, but some people swear by the turtle taper till the end.  One could test this theory by taking 0.25 mg for 3 days.  If you feel exactly the same, you could jump from there.  If you feel 100 times worse, on day 4 go back to 0.55.  That is just a thought for a test.  You and your doctor should decide what is best for you.

 

As for mirt, when I was 1/2 way thru my last taper, I was sleeping 1-3 hours at night.  I was losing my mind with exhaustion.  Mirt saved me.  It makes you REALLY hungry and before I got sicker this last time I gained 25 lbs, but for 5 years I slept pretty well.  It did not help other symptoms, but the sleep that I got on it did.

 

I hope that helped.

 

Ramcon1

YPNRYTHIT, AIYGTH, KG!

Chinchuck,

 

Remember, I am not a doctor, but you just proved what I posted.  An SSRI will rev us up while we are in a fragile state, so yes, as I posted below, I do not think it is a good idea while tapering.  I am (and you and everyone else really, are) going to have to find a way to get to zero, stay at zero, and work from there.

 

PS During my last taper, I found mirtazapine/Remeron VERY helpful, especially for sleep, but I am still on it, it does not work as well as it used to, and many here find it a difficult drug to taper.  I do not know about that as I have never tried to taper off.

 

ramcon1

(YPN, RYTHIT, AIYAGTH, KG!)

 

I was just going to ask if Remeron can do the job of Zoloft? I’m on Remeron right now as I’m tapering and it’s helping for now

Greek,

 

Remeron and Zoloft are two completely different meds.  Zoloft is almost a pure serotonin reuptake inhibitor, with some agonism (booster) at serotonin receptors, so it's serotonin serotonin and more serotonin.

 

Remeron is barely an antidepressant.  At low doses, it is an inverse agonist (blocker) of histamine receptors, which is one way it makes you sleepy.  It is an antagonist (slower) of serotonin at 5HT2A, which is why it makes you HUNGRY.

 

Serotonin effects glutamate which is why Zoloft can be painful, and Remeron doesn't do much at GABA or Glutamate, which is why it is considered safe in benzo w/d, although some claim it has its own withdrawal.  I have no ex[perince coming off it.  I have been on it for 7 years.  It does not work as well for sleep as it once did, and if I find a better (NOT BENZO OR Z DRUG) sleep med, I will cross and taper off.

 

Ramcon1

YPNRYTHIT, AIYAGTH, KG!

Thanks for the information! The info you gave about glutamate receptors also correlates with why Lamictal is prescribed and helps some in BWD due to its affect on glutamate. There’s a guy on youtube goes under the name of raining at 33 which introduced me to this drug.

I did not do well with Lamitcal, but some do. I think remeron is safer in acute and near acute bzd wd, but that is just my opinion.

My problem even before benzos was head pressure and vibrating in the brain causing rumination DPDR. This guy was the first person to describe my symptoms so accurately and he said the head pressure went away with the lamictal that’s why I became very interested. The Remeron works so far on the bodily symptoms but my brain still feels like cement and am always in some sort of derealized state. I don’t want to rock the boat though and find myself in a deeper hell.

Greek,

 

Remember I am not a doctor.  This is just neuroscience.  If one has benzo damage, inhibiting glutamate will slow healing.  But if you had head pressure before ever took a benzo?  Unless you abused alcohol, or smoked a lot, also glutamate modulators, I am not sure you do not have something else going on. 

 

Head pressure is a common bzd wd issue, and that is from glutamate.  And PS that is one way many NSAIDS work too (not acetaminophen, but the others) speed transport of glutamate.  NOT anywhere near like a benzos, but they do.

 

Remeron can help with many bzd wd issue, but if I were you, I would discuss the head pressure issue with a good neurologist.

 

Good luck bro.

 

Ramcon1

(YPNRYTHIT, AIYGTH, KG!)

Thanks Ramcon! I asked my psychiatrist about the head pressure and about doing a spect scan but he just brushed it off as a psychosomatic symptom. I was never a drinker, honestly had about 20 drinks a year, didn’t do any drugs except taking a few pulls from a joint the occasional time. Wasn’t on any other medication. I am however a long time smoker. I did an EEG fairly recently and they found that an area in my frontal lobe had below normal activity. This is the area responsible for planning, organizing, task completion etc. They asked me if I had multiple concussions in my past as this was a biomarker for age related deficits and or concussions. Another part of my brain was overactive. I think you’re right, I’m going to go see a neurologist.

Greek,

 

I think that is a good idea.  Don't discount the effects of tobacco on glutamate either.  It is both a source of glutamate, and a transport enhancer.  I don't know now much you smoke or for how long.  I know it effected my recovery, even though I did nit smoke a lot, and was part of my decision to reinstate on valium.  I wish I had tried niacin and niacinamide as glutamate calmers instead of valium, but what's done is done.

 

Just something to think about.

 

ramcon1 

Yes now what do we do? Now we’re on the pill train. Taking one pill to help with the effects of the other

If by pill train you mean Niacin and Niacinamide, they are vitamins.  Granted, even in low supplemental doses they work like meds, BUT, they  cannot hurt you the way benzos can, or even milder psyche meds can.  I wish I had tried them by themeselves first before valium.  Just a thought.