Husband picked up new script for sertraline (more 25mg tablets) and note from PCP for school. She wrote just what I asked for:
To whom it may concern:
_______ was diagnosed with depression over a year ago. She is currently making some changes with medications. During this process, she may experience some physical and emotional symptoms. Please excuse her absences from school during this time.
Sincerely....
When I let Honey read it, I could see some different emotions. Relief, yes, there was certainly relief, but also something else, almost like "I am different" or "there really is something wrong with me" not sure, but I will have to talk with her about it.
I am strongly considering beginning the steps toward a 504 plan meeting. I have contacted her counselor with my thoughts. I need to get back to her as she asked "what kinds of modifications were we thinking of? Sometimes, we do some simple accommodations without a 504 plan.
I am not sure yet what to ask for, except some homework deadline relief (work done, but handed in at her own pace, allowance for medically necessary absences (work made up) and...?? I will talk with Honey about it when she is feeling better and ask her counselor for some suggestions as well... research, research right now-- that will help me a lot.
Showing posts with label withdrawal symptoms. Show all posts
Showing posts with label withdrawal symptoms. Show all posts
Monday, March 19, 2007
Honey's supportive doctor
I talked with Honey's PCP a while ago on the phone.
I am always impressed with the time she gives Honey and I both on the phone and in the office. I never feel like I am wasting her time nor do I feel like she is thinking that I need to stop telling her (PCP) what I need.
I had a couple goals concerning our conversation.
First, I wanted to update her as to what is going on (that we had not started reducing, that Honey was still trying to transition from tablets to liquid (while maintaining "stability"), and wanted her to know that Honey is just now feeling completely "normal" since the TEVA form of sertraline experience. I told her that I thought "Honey must be pretty sensitive to this medication". I feel if I say this (instead of saying the drug/poison "sucks" and is killing people) that I will not put her on the defensive and still have her seeing that my ideas about tapering really slow and cautiously is best for "Honey".
That goal met.
Second goal was to express my concern over transitioning to the liquid and shared with her my "information" regarding the possibility that the liquid might also trigger withdrawal symptoms (like the TEVA did for Honey) and that I wanted to transition slowly (from tablet to liquid) as well as keep her on at least 12.5mg of the tablet while decreasing the liquid.
Goal met-- she probably thinks I am nuts, but she said she definitely was okay with that and would continue to write refills for both the liquid and tablets as long as needed- would I just keep her updated- I almost thought it sounded like she meant "Keep educating her on this process".
Third goal: Ask PCP if she would write a note for school to inform school of Honey's diagnosis and let them know that she was having medications adjusted and the adjustments might cause physical and psychological symptoms. This is what I asked her to write (or something along those lines)-- we will see what we get. I also asked if she would be willing to help out as needed as far as school goes and she said "Certainly".
third goal met (haven't seen the note yet, but anything at this point from her that informs school of her diagnosis and med changes and knowing that PCP will back us as needed is all I need to get things started with school.
I feel like I accomplished something.
Honey continues to do well. We have started daily documentation as far as dosage, Honey's moods and any physical symptoms- so we will have a good baseline to go by when we start reducing and making poison (med) changes as far as form (tablet to liquid). This is our plan for now:
Currently (for the past 10 days 3/10- 3/19) she is taking 37.5mg Zoloft - 12mg liquid (.6ml) and 25mg tablet.
Starting tomorrow 3/20 she will take ¾ of a 25mg tablet (18.75mg) and 19mg liquid (.95ml) She will continue this for 10 days (until 3/29) as long as there are no withdrawal symptoms.
At that point (on 3/30- Thursday) we will try ½ tablet (12.5mg) and 25mg liquid (1.25ml). After 10 days (starting 4/9) on this ratio of tablet to liquid, I would like to start reducing the liquid (as long as she is baseline). We will reduce at 5% (actually just a bit more) of the total dose of 37.5 (actually reducing 2mg/.1ml). We plan to have her stay at this dose until she feels baseline or better. (at least 2 weeks on this dosage) and will reduce from there as tolerated.
I plan to keep her on 12.5mg of the tablet (½ tablet) as she reduces the liquid. I will have to worry about making a transition with the remainder of the tablet later. (Once she has reduced a good deal of the liquid)
I have never felt this way before... like a pioneer? I feel like Honey and I are creating a map. We can talk to other pioneers, who have been this way before, but their map might be different or maybe they have not been "here" before. Weird. I dont like being here and I dont like being here without a proven map. Honey hates it. But in a way (?) it is actually empowering (?) (I am sure I will take this "empowering" thing back)
It is also weird trusting my gut to this degree. Trusting it over science and mainstream practice. I am proud of my intuition/gut and proud that I listened, as it knew to go slow with the liquid, even before I understood that there might actually be theory behind it (might bring about withdrawal symptoms??- theory/thought)
Uchenna Agu (as in Uchenna and Joyce from Amazing Race All-Stars (yes, I watch)) said something on last night's episode that I loved. I dont have his exact words but it went something like this: By not trusting your instinct/gut/intuition, you are basically telling God or the Universe that He (God) is wrong. Like I said, I got his exact words wrong, but I think I got the gist of it correct. I am going to look for his exact words, because they were great.
I am always impressed with the time she gives Honey and I both on the phone and in the office. I never feel like I am wasting her time nor do I feel like she is thinking that I need to stop telling her (PCP) what I need.
I had a couple goals concerning our conversation.
First, I wanted to update her as to what is going on (that we had not started reducing, that Honey was still trying to transition from tablets to liquid (while maintaining "stability"), and wanted her to know that Honey is just now feeling completely "normal" since the TEVA form of sertraline experience. I told her that I thought "Honey must be pretty sensitive to this medication". I feel if I say this (instead of saying the drug/poison "sucks" and is killing people) that I will not put her on the defensive and still have her seeing that my ideas about tapering really slow and cautiously is best for "Honey".
That goal met.
Second goal was to express my concern over transitioning to the liquid and shared with her my "information" regarding the possibility that the liquid might also trigger withdrawal symptoms (like the TEVA did for Honey) and that I wanted to transition slowly (from tablet to liquid) as well as keep her on at least 12.5mg of the tablet while decreasing the liquid.
Goal met-- she probably thinks I am nuts, but she said she definitely was okay with that and would continue to write refills for both the liquid and tablets as long as needed- would I just keep her updated- I almost thought it sounded like she meant "Keep educating her on this process".
Third goal: Ask PCP if she would write a note for school to inform school of Honey's diagnosis and let them know that she was having medications adjusted and the adjustments might cause physical and psychological symptoms. This is what I asked her to write (or something along those lines)-- we will see what we get. I also asked if she would be willing to help out as needed as far as school goes and she said "Certainly".
third goal met (haven't seen the note yet, but anything at this point from her that informs school of her diagnosis and med changes and knowing that PCP will back us as needed is all I need to get things started with school.
I feel like I accomplished something.
Honey continues to do well. We have started daily documentation as far as dosage, Honey's moods and any physical symptoms- so we will have a good baseline to go by when we start reducing and making poison (med) changes as far as form (tablet to liquid). This is our plan for now:
Currently (for the past 10 days 3/10- 3/19) she is taking 37.5mg Zoloft - 12mg liquid (.6ml) and 25mg tablet.
Starting tomorrow 3/20 she will take ¾ of a 25mg tablet (18.75mg) and 19mg liquid (.95ml) She will continue this for 10 days (until 3/29) as long as there are no withdrawal symptoms.
At that point (on 3/30- Thursday) we will try ½ tablet (12.5mg) and 25mg liquid (1.25ml). After 10 days (starting 4/9) on this ratio of tablet to liquid, I would like to start reducing the liquid (as long as she is baseline). We will reduce at 5% (actually just a bit more) of the total dose of 37.5 (actually reducing 2mg/.1ml). We plan to have her stay at this dose until she feels baseline or better. (at least 2 weeks on this dosage) and will reduce from there as tolerated.
I plan to keep her on 12.5mg of the tablet (½ tablet) as she reduces the liquid. I will have to worry about making a transition with the remainder of the tablet later. (Once she has reduced a good deal of the liquid)
I have never felt this way before... like a pioneer? I feel like Honey and I are creating a map. We can talk to other pioneers, who have been this way before, but their map might be different or maybe they have not been "here" before. Weird. I dont like being here and I dont like being here without a proven map. Honey hates it. But in a way (?) it is actually empowering (?) (I am sure I will take this "empowering" thing back)
It is also weird trusting my gut to this degree. Trusting it over science and mainstream practice. I am proud of my intuition/gut and proud that I listened, as it knew to go slow with the liquid, even before I understood that there might actually be theory behind it (might bring about withdrawal symptoms??- theory/thought)
Uchenna Agu (as in Uchenna and Joyce from Amazing Race All-Stars (yes, I watch)) said something on last night's episode that I loved. I dont have his exact words but it went something like this: By not trusting your instinct/gut/intuition, you are basically telling God or the Universe that He (God) is wrong. Like I said, I got his exact words wrong, but I think I got the gist of it correct. I am going to look for his exact words, because they were great.
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.
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.
Wednesday, March 7, 2007
Teva Announces Launch of Generic Zoloft
Is Teva sertraline/generic sertraline equivelant to Pfizer Zoloft?
Well, this makes all the sense in the world (if it is true?- wonder how I find out?)
Honey has been on this Teva form of sertraline and I think she is having withdrawal symptoms... well, it is not our imagination and I am not going to blame my poor pill cutting skills anymore. The above link is to a message board - a conversation others are having on the difference between Teva sertraline, Greenstone sertraline (greenstone being a Pfizer subsidiary) and Pfizer Zoloft. There are 379 comments concerning this issue. Most of them in agreement that something is wrong with the generic form- that they are having symptoms of withdrawal (though many of them dont know what is happening to them)
I also found some interesting thoughts here
and here at crazymeds.org on generic vs. brand.
Well, I think I have resolved one issue- Honey is in withdrawal and it is because of the freaking drug (teva form of sertraline)
So now, wonder what I do?
Do I continue with 37.5mg doses?
I have no idea what she has been getting. But yes, she needs to get stable again.
This is my plan (if we get what we need from the doctor today):
(But wondering now if doctor can give me a mix of these two forms of zoloft?)
oral concentrate form of zoloft
I also plan to ask for a script for 25mg Zoloft tablets – hoping for a couple weeks worth. Honey would take 1.5 of these tablets. I know it is going to be a short wait for the liquid (if she gets it) since it is not stocked where I plan to go for her rx. (It wasn’t stocked regularly anywhere around here). I am done with Teva. So she will need tablets until the liquid is available for us. I thought about this-
Tablets until liquid is ready then:
1 tablet and 12.5mg of the liquid (.62ml- haven’t quite figured it out yet) for a couple days, then ½ tablet and 25mg of the liquid until I am out of tablets. I just feel like it should be a gradual shift from tablet to liquid.
But, what do I know… well, I guess I know I need to trust my gut.
Well, this makes all the sense in the world (if it is true?- wonder how I find out?)
Honey has been on this Teva form of sertraline and I think she is having withdrawal symptoms... well, it is not our imagination and I am not going to blame my poor pill cutting skills anymore. The above link is to a message board - a conversation others are having on the difference between Teva sertraline, Greenstone sertraline (greenstone being a Pfizer subsidiary) and Pfizer Zoloft. There are 379 comments concerning this issue. Most of them in agreement that something is wrong with the generic form- that they are having symptoms of withdrawal (though many of them dont know what is happening to them)
I also found some interesting thoughts here
and here at crazymeds.org on generic vs. brand.
Well, I think I have resolved one issue- Honey is in withdrawal and it is because of the freaking drug (teva form of sertraline)
So now, wonder what I do?
Do I continue with 37.5mg doses?
I have no idea what she has been getting. But yes, she needs to get stable again.
This is my plan (if we get what we need from the doctor today):
(But wondering now if doctor can give me a mix of these two forms of zoloft?)
oral concentrate form of zoloft
I also plan to ask for a script for 25mg Zoloft tablets – hoping for a couple weeks worth. Honey would take 1.5 of these tablets. I know it is going to be a short wait for the liquid (if she gets it) since it is not stocked where I plan to go for her rx. (It wasn’t stocked regularly anywhere around here). I am done with Teva. So she will need tablets until the liquid is available for us. I thought about this-
Tablets until liquid is ready then:
1 tablet and 12.5mg of the liquid (.62ml- haven’t quite figured it out yet) for a couple days, then ½ tablet and 25mg of the liquid until I am out of tablets. I just feel like it should be a gradual shift from tablet to liquid.
But, what do I know… well, I guess I know I need to trust my gut.
Thursday, February 8, 2007
withdrawal symptoms called "return of depression" by doctor
Honey, my daughter was having extreme crying spells, seemed so anxious, unable to fall asleep or stay asleep once she finally did, unable to concentrate or focus on simple tasks, poor appetite and strange and vivid dreams and nightmares. She also later described what we now feel were panic attacks- especially in loud, visually stimulating environments (school, shopping malls). Her symptoms were *different* than the inital symptoms she experienced that led us to medical help. Sure, the symptoms *could* have been considered depression (until one sees the larger picture)
So, still as naive as ever about SSRI antidepressants, we returned to the doctor who originally prescribed Zoloft. The doctor asked Honey (my daughters psuedo name for this blog) about her symptoms, when they "returned" and thought it a good idea to restart the antidepressant. Honey started at 25mg, (though was prescribed 50mg/day) took her first dose that evening and by the next morning her symptoms had improved drastically. The drastic change (for the better) in Honey's symptoms shook me a bit. Antidepressants generally take a few weeks to provide relief of symptoms and 12 hours later, my daughter seemed like a new person. It made me think of a drug user, desperately trying to get a fix and finally.... relief when more of their drug of choice is found. Was my daughter somehow addicted to Zoloft (it is non-addictive so the drug information says!)? Did her body somehow *need* this drug? That was when my search for information began.
Though the crying spells became less frequent and less dramatic once back on the Zoloft, many of the other symptoms remained and the panic attacks became more dramatic.
I started gaining information-- I started to understand that Honey's current symptoms were most likely related to withdrawal rather than "depression". I also started to understand more about the effects of SSRI's on the human brain, emotions and inhibitions.
I also found a someone who had so much experience helping people get off of these medications and go forward to live a "normal" life. Without her, I am not sure where my daughter Honey would be.... mostlikely taking a lot more antidepressants with symptoms only getting worse.
We are still in the midst of a nightmare, but now feel we have the support that our doctor failed to give.
We are working to prepare Honey physically, mentally and spiritually to begin withdrawaling from Zoloft. I wanted to have a place to document the "journey" -- maybe only to have a record for my daughter later on? or maybe someone else will be encouraged or benefitted by her experience. I dont know, but I do know that I felt compelled to write.
It is a hard road, as a parent, to travel. Many nights I would wake from nightmares of suicide. I would hurry to Honey's room, half expecting to find her hanging in her closet or some other nightmare-- always thankful to find her (peacefully?) asleep.
I read of many horror stories of teens on antidepressants full of violence and tragic endings. I cant find yet, a story of a teen no longer using antidepressants with a happy ending. I hope to have one to share. As for now, I know that the hardest might be ahead of us. I constantly think of how much I want to take this trial away from her and wear it on my back instead. What a way to start your life.... brain already scrambled by a drug that was supposed to "help".
So, still as naive as ever about SSRI antidepressants, we returned to the doctor who originally prescribed Zoloft. The doctor asked Honey (my daughters psuedo name for this blog) about her symptoms, when they "returned" and thought it a good idea to restart the antidepressant. Honey started at 25mg, (though was prescribed 50mg/day) took her first dose that evening and by the next morning her symptoms had improved drastically. The drastic change (for the better) in Honey's symptoms shook me a bit. Antidepressants generally take a few weeks to provide relief of symptoms and 12 hours later, my daughter seemed like a new person. It made me think of a drug user, desperately trying to get a fix and finally.... relief when more of their drug of choice is found. Was my daughter somehow addicted to Zoloft (it is non-addictive so the drug information says!)? Did her body somehow *need* this drug? That was when my search for information began.
Though the crying spells became less frequent and less dramatic once back on the Zoloft, many of the other symptoms remained and the panic attacks became more dramatic.
I started gaining information-- I started to understand that Honey's current symptoms were most likely related to withdrawal rather than "depression". I also started to understand more about the effects of SSRI's on the human brain, emotions and inhibitions.
I also found a someone who had so much experience helping people get off of these medications and go forward to live a "normal" life. Without her, I am not sure where my daughter Honey would be.... mostlikely taking a lot more antidepressants with symptoms only getting worse.
We are still in the midst of a nightmare, but now feel we have the support that our doctor failed to give.
We are working to prepare Honey physically, mentally and spiritually to begin withdrawaling from Zoloft. I wanted to have a place to document the "journey" -- maybe only to have a record for my daughter later on? or maybe someone else will be encouraged or benefitted by her experience. I dont know, but I do know that I felt compelled to write.
It is a hard road, as a parent, to travel. Many nights I would wake from nightmares of suicide. I would hurry to Honey's room, half expecting to find her hanging in her closet or some other nightmare-- always thankful to find her (peacefully?) asleep.
I read of many horror stories of teens on antidepressants full of violence and tragic endings. I cant find yet, a story of a teen no longer using antidepressants with a happy ending. I hope to have one to share. As for now, I know that the hardest might be ahead of us. I constantly think of how much I want to take this trial away from her and wear it on my back instead. What a way to start your life.... brain already scrambled by a drug that was supposed to "help".
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