Hi there,

I’m 4.5 months into my GP stopping my SNRI (Pristiq 100mg) cold turkey after 14 years.

I was then put on Mirtazipine 30mg for 35 days, then was stopped, then put on Zoloft 50mg.

I have since been titrated up to 200mg and have been on this dose for 10 weeks. Whilst increasing the dose of Zoloft, two antipsychotics were also added and stopped during this time.

Basically, In the space of 4.5 months, there have been 5 major medication changes. I’m suffering from depression (mostly sadness), brain fog, short term memory issues, sleep and eating issues and anxiety (constant fear, a pit in my stomach, tight chest).

I’m so defeated and miserable, I don’t know if I’ll ever feel better, does anyone know if these symptoms are normal? Do I give the SSRI longer to work. Very little information in my country about withdrawals and multiple med changes.

Any advice or support would be appreciated 🙏🏻

Welcome to the forum!

 

This is a volunteer-run, community forum aimed at helping those who are tapering and/or experiencing difficulties with psychiatric medications and withdrawl syndrome. We are not medical professionals and cannot offer medical advice. We simply offer support and opinions which you could use as talking points with a medical provider knowledgeable in withdrawing off psychiatric medications.

 

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Please make sure your signature is kept up to date with your drug history. This will allow members to see some basic information about your drug history and situation so that they may help you best. Information on how to do this is located in the FAQs section above, but here is a direct link: Update Signature

Once this is done, future posts made by you will have this signature turned on by default. For this reason please keep it clear but condensed as possible.

Please use the format outline here Preferred signature/drug history format

I'm so sorry to read about the tough time you've had recently you will find plenty of support here for sure.

3 minutes ago, Dee86 said:

I’m 4.5 months into my GP stopping my SNRI (Pristiq 100mg) cold turkey after 14 years.

I am very sorry to hear. This will have caused WD, often the symptoms of WD are misdiagnosed by doctors as a worsening of your original condition. When stopping an AD, particularly when you have been on it a long time it is important to taper off slowly. Tapering Information

4 minutes ago, Dee86 said:

I was then put on Mirtazipine 30mg for 35 days, then was stopped, then put on Zoloft 50mg.

I have since been titrated up to 200mg and have been on this dose for 10 weeks. Whilst increasing the dose of Zoloft, two antipsychotics were also added and stopped during this time.

What then happens is exactly this, they try to 'treat' those symptoms with a cascade of different drugs or increasing doses. This is very common. Unfortunately this makes the already upset nervous system worse. Hypersensitivity and kindling

 

6 minutes ago, Dee86 said:

I’m suffering from depression (mostly sadness), brain fog, short term memory issues, sleep and eating issues and anxiety (constant fear, a pit in my stomach, tight chest).

I’m so defeated and miserable, I don’t know if I’ll ever feel better, does anyone know if these symptoms are normal? Do I give the SSRI longer to work. Very little information in my country about withdrawals and multiple med changes.

Any advice or support would be appreciated 🙏🏻

Unfortunately these symptoms are very common. They do tend to flucuate in a pattern we call waves and windows. The Windows and Waves Pattern of Stabilization

What you do now is a tricky one. Your brain/body is hurting for a few reasons.

1. WD from Pristiq, essentially your brain is missing the drug and it takes time to readapt to it not being there. Reinstatement can ease this, but as you are on a big dose of Sertraline I wouldn't recommend doing this whilst still taking Sertraline. Reinstating an Antidepressant

2. Injury caused from the CT and continuing off the drug, this will take time to heal.

3. Further injury from the additional drug changes that have happened.

So you can see that it is hard to say what you should do at this point. I'm not sure when you started Zoloft? The longer you are on a drug the more dependant you become. As you have not been taking the higher dose that long you could try coming down much quicker then normally suggested to get that dose lower. Say 25% per month and get that drug load down a bit. Or you could try to cut a bit quicker say 50% for the first month down to 100mg (high amounts of the drug don't have that much effect on the brain compared to lower doses, see our tapering doc for more info, but side effects from high doses can be an issue), then perhaps down to 50mg the next month and then hold here. This might be just too hard for you to do.

It could be you can manage to do a 25% linear taper and get off the drug in a few months. Some might then suggest a very low dose RI of Pristiq to try and help settle things and then hold. We have had people in this situation and come to us off all drugs (they stopped abruptly before finding us) and then we would suggest considering a low dose RI of the orginal drug, but we don't like to suggest CT at pretty much any cost for obvious reasons.

You could just hold this dose and wait to stablise.

I am very sorry you have found yourself in this situation, we are here for you.

In the mean time this is what I would do if I were you:

 

-Stay Hydrated 

 

-Eat a good clean whole food diet, avoiding processed foods and sugars.

 

-Stay away from caffeine, alcohol and antihistamines and any other psychoactive substances.

 

Supplements are to be avoided initially, as they often irritate our nervous systems. Try to get your nutrition through food.

 

Down the line, you may wish to introduce Fish Oil and Magnesium. Those who can tolerate them have found them calming to the nervous system. Be careful try one at a time and start low and see how you get on should you choose to try them.

 

A daily walk is very important as much as you can manage, if you can manage it. Gets you your fresh air and Vitamin D does wonders for your mind!

 

You are very welcome here and I hope you find the site supportive.

Chippy

Thanks @Chippy you sound more educated than my medical team. It’s good to know these symptoms are expected, it’s just so scary to feel like a shell of yourself 😞 I’m so sad.

Would I benefit from reinstating the pristiq if it has already been 4.5 months.

Also looking to reduce the Zoloft, I don’t know if the lack of emotion and connection is the withdrawal or high dose of medication.

This Is a crazy ride.

13 minutes ago, Dee86 said:

Thanks @Chippy you sound more educated than my medical team. It’s good to know these symptoms are expected, it’s just so scary to feel like a shell of yourself 😞 I’m so sad.

My pleasure! We are just injured folk who have learned from being in the community! Those medical professionals who do know about WD, learn from the community too! Crazy right! I know, it is awful to not be your normal self. Very frustrating, you are not alone though x

15 minutes ago, Dee86 said:

Would I benefit from reinstating the pristiq if it has already been 4.5 months.

It is possible. We can't know if it will make you better or worse. My experience is generally it helps, but there is a risk it won't and it can make you worse. The longer off the drug the more risk. I have seen people longer off than you and it helps. We always suggest a very low dose which mitigates that risk.

We don't normally suggest you try if you are on a different drug. We have once recently but the lady a plan to get off the second drug and she was very bad so we felt a very low dose was worth a try. There are no absolutes in any of this I am afraid!

18 minutes ago, Dee86 said:

Also looking to reduce the Zoloft, I don’t know if the lack of emotion and connection is the withdrawal or high dose of medication.

Very hard to know. Could be a bit of both. Certainly emotional numbing is a side effect of these drugs, can also be a WD symptom too.....

18 minutes ago, Dee86 said:

This Is a crazy ride.

It is, but we are here for each other!

Thanks @Chippy appreciate you! I meet with my doctor tomorrow and I’ll discuss some options.

4 minutes ago, Dee86 said:

Thanks @Chippy appreciate you! I meet with my doctor tomorrow and I’ll discuss some options.

Ok great, don't be surprised if he doesn't understand/agree anything we have said!

Hi @Dee86! Welcome to the forum. Just wanted to introduce myself because we've been on similar journeys. I switched quickly from an SNRI (Cymbalta) to Zoloft last spring and that was the start of a pretty horrific journey for me. I thought I was losing my mind, ended up starting and CT'ing a few different meds, then finally reinstated Cymbalta about 7-8 months later (but at much too high a dose, before I found this forum and really figured out what had been going on). I'm now waiting to stabilize on my current meds before starting to taper them down.

Anyways, you're not alone! Hope your doctor is supportive and you can figure out a good path forward. I'm not as knowledgeable about the technicalities of all this as @Chippy and some of the other good folks on here, but feel free to reach out anytime if you need support or just want to vent 😊

Hi Dee86, I am sorry for what you are going through. It is a hard journey.

If you need some literature for your doctor, the RACGP have endorsed the Mordsley Deprescribing Guidelines. Which are exactly what it says, Guidelines for doctors to help their patients get off these meds.

Just google "RACGP Maudsley Deprescribing Guidelines" and it comes right up. Hopefully he will be interested in learning about the correct way to deprescribe.

I hope that things start to settle for you soon.

Wombat

Thank you @SarahMc and @Wombat 🙏🏻😊

It’s incredibly difficult in Australia to find anyone who knows anything! I tried to warn the doctor about going cold turkey and also the fast dose increase of the new med, they brushed me off. I will go in with this info tomorrow.

@SarahMc can I ask when you reintroduced the SNRI? I’m afraid I’ve missed the window and don’t want to do more damage. Also are you still on both the Cymbalta and tapering both or just the one? What symptoms did you experience? I’ve been basically housebound almost 5 months, I’m just miserable! How long before or if you noticed any relief? Aarrgghhh I’m sorry for all the questions! 😞

I know. It is really hard. You have to advocate for yourself, but you also don't want to get your doctor offside.

It's important that you are always able to get your prescription.

More and more doctors are beginning to understand, but it's taking awhile.

Time and patience will get us through.

Wombat

Edited June 11Jun 11 by Wombat

1 hour ago, Dee86 said:

It’s incredibly difficult in Australia to find anyone who knows anything! I tried to warn the doctor about going cold turkey and also the fast dose increase of the new med, they brushed me off. I will go in with this info tomorrow.

I’m in Canada and it’s the same here. When I raised concerns with my psychiatrist about switching multiple meds too fast he laughed. It’s wild! But I fully agree with @Wombat about needing to walk a careful tightrope so you can continue to get your meds.

1 hour ago, Dee86 said:

@SarahMc can I ask when you reintroduced the SNRI? I’m afraid I’ve missed the window and don’t want to do more damage. Also are you still on both the Cymbalta and tapering both or just the one

I switched CT from Zoloft to Pristiq, and then from Pristiq back to Cymbalta on the advice of my doctors, before I found this forum. The switch back to Cymbalta came around 7-8 months after I initially came off it, and I went right back up to a high dose. This is absolutely not what is generally recommended and I feel very lucky that it didn’t make me worse. I would listen carefully to what @Chippy and others say about reinstatement.

So right now I’m on 90 mg Cymbalta and 12.5 mg Seroquel (another med that I took on and off during this whole saga). I’m

not tapering anything yet because I’m still pretty unstable. I’ve been holding everything at the same dose for over two months and will probably be holding for quite a while longer until I feel stable enough to start a slow taper.

1 hour ago, Dee86 said:

What symptoms did you experience? I’ve been basically housebound almost 5 months, I’m just miserable! How long before or if you noticed any relief

I have intense brain fog, depression, anhedonia, some anxiety, cognitive issues, headaches, nausea, no appetite, etc. I’ve been holding my dose for over two months and I’d say I’ve noticed some very slight improvement in that time. The brain fog never goes away, but some days the other symptoms are pretty minimal. And my worse days are less intolerable than they were. So onwards we go!

2 hours ago, Dee86 said:

Aarrgghhh I’m sorry for all the questions! 😞

Please don’t apologize!! We’re all here to support each other 😊

On 6/11/2026 at 2:50 PM, Dee86 said:

It’s incredibly difficult in Australia to find anyone who knows anything! I tried to warn the doctor about going cold turkey and also the fast dose increase of the new med, they brushed me off. I will go in with this info tomorrow.

Very common unfortunately.

@Chippy linked you an informational post. Keep in mind that suggested reinstatement doses in communities such as this are typically far, far lower than what doctors do, which is just whack you back on a high dose assuming it'll be fine.

Doctor said he doesn’t recommend reinstating the SNRI since it’s been almost 5 months. He did however tell me to drop the Zoloft to 150mg from the 200mg. I’m just scared 😭

Hey @Dee86, I’m sorry you’re scared. I think all of us feel that way at times. You can definitely still recover without reinstating (and it’s uncertain whether and to what extent RI would be helpful anyways). It’s a horrible situation to be in, I know, but many folks have been down this road before and have recovered. For the moment all you need to do is keep taking care of yourself and use your coping skills to get through the day. We’re all here for you when you need us 💜

3 hours ago, Dee86 said:

He did however tell me to drop the Zoloft to 150mg from the 200mg.

Did he say to drop the Zoloft down to 150 mg in one go? I’m not super knowledgeable about these things, but that seems like a big drop to make when you’re already unstable. Maybe wait for others (like @Chippy) to comment before you do that.

Yeh in one drop, I’ve been on the 200mg for 10/11 weeks. I just wish more doctors knew about this 😩

Hey Dee, hang in there. Chippy is in England, so it is the middle of the night there. It will be a few hours before he sees these messages.

To make it easier to see the timeline, are you able to write down what you took when.

Eg

Pristiq: 2012 - 2026 (date you stopped) dosage

Mirtazapine: date start and stop dosage

If you remember the names of the other meds, pop them in here

Zoloft: start date and dosage

This can all be put into your signature.

Stay strong. There are many people just like you going through the same thing.

Wombat

2 hours ago, Wombat said:

To make it easier to see the timeline, are you able to write down what you took when.

@Dee86 this would be really helpful.

14 hours ago, Dee86 said:

Doctor said he doesn’t recommend reinstating the SNRI since it’s been almost 5 months

So is he refusing to prescribe Pristiq?

17 hours ago, Dee86 said:

He did however tell me to drop the Zoloft to 150mg from the 200mg.

Generally tapering guidelines suggest no more than 10% of your previous dose every 30 days. However there are two things for you to think about it you want to get off or reduce Sertraline.

1. You have not been on all that long, over 8 weeks but under 6 months, so spending years tapering a drug that you are not stable on doesn't really make sense in my opinion.

2. At such a high dose the effect on the brain is proportionally less for each 1mg extra. To give you some idea Receptor occupancy at 100mg of Sertraline is 85% when you get to 200 mg its just 89%, so a very tiny increase, it is possible you could drop to 150 mg and that may be around 2% reduction in receptor occupancy. So essentially you can potentially reduce your dose quite quickly for minimal penalty at first. Of course this is all theory and that may not be your experience making that reduction.

Tapering when not stable is never a great idea, but you need to have a think about what you want to do, balance the short term nervous system dysruption with the benefits of reducing the dose or even coming off completely.

You could hold this dose and wait to stablise, but IMO Sertraline is not going to answer your brains call for Pristiq so this may be a difficult task for it to do. Either way I think there are merits to getting the dose as slow as possible even if you then hold at that lower dose.

As I said before we often have people in this exact situation as you but they have already come off their 'second' drug when they find us, sometimes they choose to then RI their 'Original' drug at a low dose at this point and it helps cushion things.

We are not medical professionals on here and can only share our thoughts and observations from the community, ultimately you have to choose what path you want to take, we are here to support you in this process where often doctors can't.

Im really sorry you are in this predicament, you can recover from this, just a few moves to decide apon. Do remember our bodies are designed to heal.

Does the brain ever get the chemical that Pristiq was helping with back on its own?

I truely hate this, but I appreciate you all ❤️

4 hours ago, Dee86 said:

Does the brain ever get the chemical that Pristiq was helping with back on its own?

I truely hate this, but I appreciate you all ❤️

The brain adapts back slowly over time, this process can be quite drawn out, but it is always working towards homeostasis, it never stops.

Hi @Dee86 I’m from Australia as well so I definitely understand your frustration with healthcare professionals here, it’s extremely hard getting anyone to listen or help properly.

The medication which caused my issues was Zoloft and I’ve been on 200 milligrams for a good stint myself so I definitely know the drug, and I’ve been where you are right now.

It sounds to me like your original medication has caused a disruption and probably heavily dysregulated your nervous system and now you’re being pumped on everything and anything. I myself came off Zoloft originally and then put on Venlafaxine right in the midst of peak acute withdrawal and I know that adding a second drug only further kept me dysregulated and suffering tremendously.

Hard to say exactly what you should do because you’re on a few different medications at this point. But it’s probably best to determine where you need to be on these or not decide whether you’d rather come off and try healing or stay on and see if you can stabilise to some degree.

I didn’t start healing or recovering until I chose to come off all the medications altogether and allow my nervous system and brain to slowly recover. This will take time, and depending on how disrupted your nervous system became from the initial withdrawal and how long you were on the drug for can sometimes determine how long the recovery could take. Nothing is guaranteed, nothing is facts, it’s purely unique and some recover quickly, others take time.

The medical world really doesn’t know much about this stuff nor will you find much answers from them, you will have to come to decision for yourself. Recognise that you’re currently experiencing a form of withdrawal syndrome and make a decisive decision on whether you’d rather come off the medications and try healing or stay on and stabilise. You can stabilise first and then try slowly tapering off to minimise as much discomfort as possible but regardless you will have to ride this out unfortunately…

Thanks @Jack @Chippy im so over it. It’s just the constant feeling of doom and dread making hard to function. Appreciate you guys x

9 minutes ago, Dee86 said:

It’s just the constant feeling of doom and dread making hard to function.

I’m sorry. I know it can be hard. It’s not forever.

@Dee86 how are you doing? Did you end up lowering the Zoloft?