Please Note: This is a detailed account of my personal experience and is purely for entertainment/educational purposes. If you’re thinking of making changes to your medication or are struggling with anxiety/depression, please consult with a medical professional.
I started taking Zoloft—a selective serotonin reuptake inhibitor (SSRI) antidepressant—in late-2016 after unsuccessfully trying to control my anxiety and panic attacks via any other method. My doctor prescribed 50mg/day to start, and I eventually worked my way up to 100mg/day, then 150mg/day, then back down to 100mg/day since the higher dose gave me migraines every day for a month.
In conjunction with as-needed Xanax, the Zoloft helped. I went from accepting that panic attacks were a part of my everyday life to only having to deal with them a couple times a week—maybe even less than that.
A year after my doctor prescribed them to me, she left that practice. I only found this out because I tried to make an appointment to get her to sign another letter about my emotional support animal (my dog, Benny) so I could take him on a flight to see my family in North Carolina.
“She doesn’t work here anymore. Would you like to see another doctor?” one of the admins told me over the phone. “No, thank you.”
Aside from the delay in a letter, I realized I would now have to find a new doctor. I was relying on multiple prescriptions to get me through life, and I was bound to run out of one of them soon enough.
Shouldn’t a medical office be required to notify all patients that their doctor no longer works there? Especially those of us who take ongoing prescription medication? And especially ones that are hard to get refills of because they’re sold on the streets as party drugs?
I eventually found a new primary care provider and got the refills with time to spare and no issues whatsoever. But what I began to realize is that the doctor who’d prescribed me the drugs to begin with and was supposed to be monitoring my progress and ensuring my care was no longer in the picture.
The thing is: we’d never talked about a long-term plan. Was I expected to take these drugs for the rest of my life? What would happen if I wanted to stop taking them?
I wouldn’t dive deeper into these questions for nearly another year—during which time I raised a three-month old puppy into the sweetest, most comforting dog ever; moved into an apartment with two friends and finally felt at home for the first time in LA; went to Europe finally and fulfilled a lifelong dream of eating authentic Italian food; got a promotion/changed direction at work; started a deep dive into my feelings and emotions; finished writing a book and set proposals out to literary agents; and decided to start a digital magazine. Things were looking up. I was comfortable and content—overall, in a great place with my mental and emotional health.
Knowing I had the support system I do now, my dog to comfort me with snuggles and kisses and playtime to distract me from unwarranted thoughts, the stability of a good home and job—I decided it was time to explore life after medication.
So, I started researching “stopping Zoloft” and “how to taper off Zoloft” and “how to stop Zoloft safely.” The general Google consensus: it wasn’t going to be easy.
First of all, stopping any medication that you’ve been on for an extended period of time is going to be a shock for your body. Ask any woman who’s decided to quit birth control. Other factors I’d be up against: I had been taking it for nearly two years, I was on a moderate dose, the drug was literally changing the way my brain processes things—and, here’s the kicker: because of its short half-life (26 hours; totally out of your system in ~5 days), Zoloft is one of the harder antidepressants to stop taking.
The same resource that provided the half-life comparison chart—Harvard Health Publishing—provided some tips on how to safely stop taking antidepressants:
- Take your time
- Make a plan
- Consider psychotherapy
- Stay active
- Seek support
- Complete the taper
In September 2018, I decided it was time. Having only gone through my primary care provider before, I choose to seek advice from a specialist. I made an appointment with a psychiatrist who actually accepted health insurance, waited a few weeks for my appointment date, and trekked out to West Hollywood (this required taking a random half-day at work). The office was not the glamorous but cold setting you see in the media (file that under things TV and movies get wrong about mental health professionals).
The building was old, the entrance unclear, and the elevator less-than comforting. The office, itself, was up a few floors and located at the end of a dimly lit hallway. Inside, I found a few pamphlets, some children’s books, and places for no more than five people to sit. The psychiatrist led me back to her office and sat down behind her desk, while I took a seat on the mid-century modern loveseat a few feet away. As we talked for the 30-minute intro session, she typed on her computer (again, a contrast from the legal pads or leather-bound journals of the movies).
I told her of my desire to taper off the meds now that things were stable in my life. And that, since getting a dog, I’d experienced waaaay fewer panic attacks and anxiety-ridden episodes. She was on board.
I left with a plan: starting the next day, I’d cut my dose from 100mg/day to 75mg/day for the next month or so. Over the next few months or an even longer period—“don’t feel like you need to be a hero,” she’d told me—I’d graduate down to 50mg/day, then 25mg/day, then 0mg.
I also left with 250 fewer dollars in my bank account—after insurance—and appointments for the next couple of months that I’d immediately cancel when I got home. Most of us who need help can’t afford to shell out $250 every time we need it. Thank you, America, for your shitty healthcare system and immensely lacking mental health services.
I knew that if anything went wrong, I could contact my primary care doctor or visit an emergency room. “What could go wrong?” you ask. Oh, here’s the fun part: antidepressant discontinuation syndrome. It’s basically a fancy name for withdrawal that can happen regardless of whether you stop abruptly or taper off gradually.
SSRIs like Zoloft can give you a whole assortment of awful symptoms, including: flu-like symptoms, headache, lethargy, abdominal cramping, abdominal pain, appetite disturbance, diarrhea, nausea/vomiting, insomnia, nightmares, ataxia, dizziness, lightheadedness, vertigo, blurred vision, “electric shock” sensations, numbness, paresthesia, akathisia, parkinsonism, tremor, aggression/irritability, agitation, anxiety, low mood.
Oh, is that all?
And the fun part, the psychiatrist warned me, is that these symptoms can happen every time you lower a dose—not just when you’re totally weaned off.
I expected the worst. I told my boss and HR that I’d probably need to work from home for a week or so in October and likely again in November, December, January. As a precaution, I worked from home for a couple days in October after the first lowered dose, but I didn’t notice any changes. Maybe I was a little more tired than usual, but I didn’t think so. The next few weeks were equally fine. Not bad, not bad.
Come November, I lowered the dose again—this time, on my own, to 50mg/day. Again, I felt fine for a while. Sometime in January—I waited a while because of some major financial issues and a roommate moving out—I lowered again to 25mg/day. Fine again. I saw my primary care doctor for a checkup and she supported my tapering off journey.
Despite the ease so far, I was scared to make the jump from something to nothing. I rode out the last refill as long as possible, deciding I’d stop when the pills ran out. That day was March 17, 2019—nearly 6 months after I’d started the journey to get off Zoloft. The day came and went. And all was well.
Until day 3 hit.
Day 3 burst my little serotonin bubble. I left work in the middle of the day because I felt like I could start crying at any moment (for no reason whatsoever). Later that night came the hot flashes, followed by the waves of lightheadedness. The on-the-verge-of-tears feeling subsided in light of these new symptoms.
But these symptoms stayed for days 4, 5, 6, 7, 8…nearly 2 full weeks.
The morning of day 6, I was able to get myself to the grocery store to stock up on food for myself and Benny. Midway through that grocery trip, the lightheadedness came back, and I had to rush to check out. I spent a few minutes in my car until it went away so I could drive back home safely.
Day 7 brought with it cabin fever. I hoped and prayed I’d feel better in the morning just so I could get a change of scenery and interact with people—other than my parents, who I’d been FaceTiming so I’d have someone to talk to in the middle of the day. So, that morning, I got up, got dressed, made a protein smoothie, took Benny out, and headed to work—sort of ignoring the subtle lightheaded feeling and thinking if I just got to work that things would be better.
They weren’t. Twenty minutes in, and I knew I’d made the wrong decision. Since I come home for lunch every day to take Benny out, I decided I’d just have to stay home and finish the rest of the workday remotely. I emailed my boss and HR to let them know the plan and that I’d have to play the rest of the week by ear. I worked from home—as best as I could, taking naps and hoping I wouldn’t fall over taking Benny out and ordering food delivery for multiple meals a day—for the rest of that week and remained isolated through that weekend.
It took a full two weeks to feel like a human again. During those rough days, I thought about calling my doctor up to refill the prescription and getting back on a lower dose for the foreseeable future. But I knew, somehow, that these symptoms wouldn’t last forever. I just needed to ride out the wave and wash up on a new normal.
This new normal involves a more vulnerable, more fragile, more emotional me. I cry at happy puppy videos now, apparently. I choke up watching dramatic scenes in cheesy dramas. I find myself getting more easily irritated—or maybe it’s just that I’m refusing to accept bullshit anymore. Who knows. Whatever this new “normal” is, I think it’s here to stay for now.