[Sam_I_Am]

Hi guys,
I have just received a "tentative" diagnosis of Bipolar NOS, most likely Bipolar II. The bipolar hypothesis was there before I began seeing this new Dr 2 months ago, but it wasn't really "official" yet. I had, I guess what one could consider a mild hypomanic episode 4 years at age 21-- lasting about four months, then leading into a depressed or mixed state (more like an agitated depression, and then a regular depression). I have had depressive episodes before and after that, beginning at an early age (11 or so.) I've been on Zoloft for 2.5 yrs, at different doses, most recent being 75mg. I never really felt "better" on the Zoloft but I felt much worse when I tried to taper off-- no major side effects or manic effects, but I did have some hypomania/agitation on other SSRIs. I was still having quite a bit of symptoms (mainly, hypersensitivity to criticism, anxiety, "rage attacks," some depression.) So my last PDoc suggested trying Lamictal and built the dose up to 100mg over the course of 6 weeks. I noticed a drastic improvement in all of these symptoms even after a few days on 25 mg-- this is really the only med that I ever found "helpful" (aside from the benzos but just for knocking me out...can't function on a daily basis with them.) That was Feb 08. Stayed on the Zoloft because I felt comfortable and didn't want to change anything. Over the past 4 mos or so, I have been experiencing some rapid mood swings and increased sensitivity. I began seeing a new Pdoc (due to insurance changes), and he presented the whole "bipolar spectrum" hypothesis, which considering my Hx, makes sense to me. The plan was to go a little higher on the Lamictal, so we built up to 150 over 3 weeks. Then, to taper off the Zoloft, as he suspected that it may interfere with Lamical's mood stabilizing properties somewhat and be contributing to the moodiness (even though I didn't become immediately hypomanic on it.) Well, I had a little agitation/anxiety with the Lamictal increase, which was tolerable. Going from 75 to 50 mg on Zoloft was OK, actually felt a little better-- held at 50 for 2 weeks. But since getting to 25 mg, which I started last Monday, I have been slowly having some pretty distressing symptoms: crying over every little thing, feeling guilty and "judged" over every little thing, intense impatience and frustration when things aren't happening "fast enough" (which will then sometimes lead to crying), some rapid yet cloudy thoughts, anxiety and obsessive worrying, wanting to scream at the top of my lungs, not wanting to be around people but sometimes also talking a lot, fleeting suicidal thoughts (don't worry, won't act on them), and a subjective feeling of "being out of control" (or I worry that I'm going to lose control and "go crazy"). On the physical front, started experiencing some nauseanafter 6 hours after the first 25mg dose and just felt generally run down and tired all week, mild headaches and very caffeine sensitive. The mood symptoms started around Thursday and are getting progressively worse. I do know that some of these mood things can be symptoms of Zoloft withdrawal, and the timing of the physical symptoms correlates with the dose decrease. I'm just wondering if anyone has ever experienced these symptoms after a Zoloft (or other SSRI) decrease, especially someone with a bipolar spectrum diagnosis? Could it be that this is all just the withdrawal symptoms, or is this a sign that I really "need" Zoloft, that it was doing more for me than we thought it was? Or, I've read things about stopping antidepressants (or decreasing dose) sometimes triggering hypomanic or mixed states in people with bipolar tendencies-- could that be what's going on here, because it definitely feels very mixed-state-esque. (Of course, I'm fairly new to the whole bipolar thing, so I don't know if that would even qualify.)

[tarabug922]

Hi There,

I don't have bipolar and I've never taken Zoloft so I can't be of much help. But I did find this on the net. http://www.steadyhealth.com/Experien...al_t53162.html
a website where people are talking about their withdrawal symptoms. I also found this....Zoloft has a half-life of about one day. That means that for every day that passes without taking the medication the level in the blood falls by 50%. After one day the level is reduced to 50% of the original level, after two days to 25%, after three days to 12.5%, and so on.
When one stops Zoloft too rapidly a withdrawal syndrome may develop. Among the symptoms that may be experienced are nausea, tremors, lightheadedness, muscle pains, weakness, insomnia, and anxiety. The withdrawal symptoms usually last 1-2 weeks but in some instances they may gradually decrease over a period as long as a month. It is generally recommended that one taper off this medication gradually under a doctor's supervision. Check with your own personal physician for specific instructions.

I hope this helps somewhat.

Love and Hugs,
Tara

[Sam_I_Am]

Thanks for your input. However, I am tapering fairly slowly, and exactly the way the Dr suggested. I'm just getting really frustrated because I don't know if what I'm going through (esp the crying and severe depression) is because of withdrawal or because I "need" the medication... Even more frustrated b/c I haven't been able to get in touch with the Dr to discuss this...

<3,
Trista

[Berries]

Nothing brilliant to say. Just that I've been there and so have a lot of people with mental disorders. Hang in there. Unfortunately, this is a huge part of managing your illness. Experimenting with drugs and having to go through all the many wonderful affects of that. It BITES!!

Something is definitely going on. I'm not sure what either. Drugs are complicated. And everyone’s biochemistry is so different.

You need to keep trying to contact your doctor.

He/she is the best one to deal with this.

It may have nothing to do with the Zoloft at all, but could just be your illness progressing. It could have to do with the Lamictal increase. It could be the Zoloft decrease. It could be a combination of all of the above.

Whatever it is, you are in distress and I am sorry you have to go through that.

Keep trying to contact your doctor is the best advice I can give.
Good luck!!I'd like to know how this truns out. I hope you post and let us know.

[Sam_I_Am]

Thanks, guys, for your posts. I did end up getting in touch with the pdoc and in fact got in to see him the following day, took the day off work to do so. Due to my distress the evening that I wrote, I ended up rummaging through my med drawer (I don't throw away old psych meds, unless of course they are expired, because in the past couple years they've been changed so much, you never know when I'll go back on something again.) I ended up deciding to take 25mg Seroquel, which I had been given samples of almost 2 years ago (surprisingly not expired...good thing, b/c it's expensive) for sleep/anxiety but ended up not tolerating well. I know I shouldn't have taken something that wasn't officially "prescribed" at the time but my rationale was that I had been given it legally, it can be used to treat acute bipolar symptoms, and it was better than potentially doing something stupid/self-destructive. I told pdoc what I did, and he was okay with it-- in fact, he was thinking of recommending Seroquel to at least get me through the Zoloft taper. So now I am taking 25 mg Seroquel at night (and it has gotten more tolerable each night I take it...much less grogginess) while still at the 25 of Zoloft. I'll soon go down to 12.5 mg Zoloft, at which point I'll take 50 of Seroquel if needed or just stay at 25. I'm not thrilled with the idea of taking Seroquel long-term (although I will say, I have done pretty well in the 4 days of taking it...haven't cried once when it had been numerous times a day before that) I am comfortable with it for now. I'll be seeing pdoc at least once a week until i'm completely off the zoloft, and I guess we'll just be taking everything one day at a time from there.