Saturday, March 17, 2007

Possible problems switching from Zoloft tablets to Zoloft liquid concentrate- I wonder if I could be any more confused?

I have some new concerns (what's new??)- this time with a potential problem switching from sertraline in tablet form to liquid form. I am learning that there is a possibility of moderate to severe withdrawal symptoms( something like what Honey experienced with the TEVA form of sertraline or worse). So, a couple of ideas/questions/plan of action that I am pondering.

First, being that Greenstone (pharmaceuticals) is a subsidiary of Pfizer, ***what are the chances of Greenstone sertraline being identical (inactive ingredients as well) to the Pfizer Zoloft tablet? I think they are identical, aside from the Greenstone version not having “Zoloft” printed on them. The colors and shape are the same for at least the 25 and 50mg tablets, I guess I have not seen a 100mg of either. (The U.S. government requires that the drug look different so it won't be mistaken for the original. This prevents fraud.)

***So, I have to imagine that the reason Honey had problems with the TEVA version of sertraline could have something to do with inactive ingredients?

***So then, I have to imagine that the reason she may have problems with Zoloft liquid could be the same issue? Different inactive ingredients?

***So, then, I have to wonder if her chances of being successful with the liquid (without serious withdrawal symptoms) might be increased if she remained on a bit of the tablet?
(Looking back at the TEVA experience, when she first started the TEVA setraline, Honey was taking ½ of a 50mg TEVA tablet and ¼ (12.5mg) of a 50mg Greenstone sertraline tablet, because I had a number of ¼ tablets remaining of the Greenstone. Once I ran out of the Greenstone ¼ tablets, she was taking just the TEVA, it was really then a matter of days (5?) before we noticed the withdrawal symptoms that continued to increase until back on the greenstone)

I guess I am going to continue on with going to liquid, but will keep her on at least 12.5mg of the tablet (using a slow change-over to get to that point). I will do this over time and see how she does and will in no way hesitate to go back to where she is now. At that point (going back to just tablets), I would wait until school was out for the summer and work it that way.
My plan at this time (actually in a few days/this coming Monday - going to give the current liquid/tablet ratio 10 days) is to go to ¾ 25mg tablet (18.75mg) and 18.75mg liquid (Honey is currently taking 25mg tablet and 12.5mg liquid) and she how she does and without hesitation, if withdrawal begins to look like the TEVA withdrawal, I will reinstate the previous setup (what she is taking now). IF all goes okay, (after several days (10) of feeling baseline) I will again try to take a ¼ tablet away and replace it with liquid. I am thinking if she can successfully get down to just a ½ 25mg tablet with the remainder being liquid, and is stable and ready, we will start reducing the liquid (and keep the ½ tablet (12.5mg) in place. Then, I can decide what to do later about the 12.5mg tablet.
I spent the entire night thinking this through. I did not sleep. This is all making me just about lose my mind
Honey continues to do well and she has noticed that her problems with concentration have decrease to just about “normal for her”.
I realize all of what I am talking about above are my own theories and could have nothing to do with fact. I know there is a strong possibility that I will be wrong. I know we could just as easily wait for school to be out to start this process- but Honey wants to press forward. I will try it as long as Honey is for the most part symptom free. (All the more reason to get myself together and get a note from PCP and talk with school counselor/possibly school Principal.

3 comments:

soulful sepulcher said...
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Honey's mom said...

Stephany, thanks for your great advice!
It was always the plan that once she started reducing/tapering that we would chart her dosage/physical and psych symptoms (using a chart like thing that Joseph Glenmullen has in his book "The Antidepressant Solution") but I keep thinking how stupid I am not to be charting/documenting all of the changes we have made (manufactures/dates/drug forms/dosages) all along, because I am sure things would be much more clear and I think there would be patterns to see that would be useful later. I am going to have her start using the chart TODAY and stop thinking that it wont be useful.
thanks again, Stephany!

soulful sepulcher said...
This comment has been removed by the author.