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Summary Of Cymbalta Withdrawal Information

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#121 fishinghat



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Posted 19 July 2018 - 09:29 AM

Zoloft and Hypothyroidism and Leucopenia

Zoloft effect on TSH, T3 and T4

Radiation Exposure - Dec 2014 - March 2015
Start Zoloft - Oct 16, 2013
Notified of overexposure - May 15, 2015
First low WBC May 15, 2015

sertraline - TSH increased and T4 reduced.
Effects of various antidepressants on serum thyroid hormone levels in patients with major depressive disorder.

sertraline and fluoxetine showed reductions in TSH,T3 and T4 levels.
Peripheral thyroid hormones and response to selective serotonin reuptake inhibitors.

No changes in Thyroid TSH, T3 or T4.
Effects of selective serotonin reuptake inhibitors on thyroid function in depressed patients with primary hypothyroidism or normal thyroid function.

T3 increased and T4 and TSH not effected.
Effects of sertraline treatment on plasma cortisol, prolactin and thyroid hormones in female depressed patients.

Effects of long term treatment with sertraline (Zoloft) simulating hypothyroidism in an adolescent.
A 16-year-old depressed adolescent, who had received sertraline treatment for the previous 18 months, developed insomnia, daytime somnolence and lack of energy. His thyroid function tests revealed low levels of total T4 with normal levels of free T4 and TSH, and a normal thyrotropin-releasing hormone (TRH) stimulation test. Discontinuing sertraline resulted in improved sleep and disappearance of daytime somnolence. Although daytime somnolence and low levels of total T4 can mimic hypothyroidism, in this case sertraline only displaced the bound-fraction of total T4 and was not associated with true hypothyroidism

reboxetine - TSH reduced and T4 increased.
sertraline - TSH increased and T4 reduced.

sertraline and fluoxetine showed reductions in TSH,T3 and T4 levels.

Effects of long term treatment with sertraline (Zoloft) simulating hypothyroidism in an adolescent.

Treatment with sertraline for 4 weeks increased plasma cortisol levels, while 24 weeks of sertraline treatment increased plasma T(3) levels in depressed patients.

Peripheral thyroid hormones and response to selective serotonin reuptake inhibitors.

Patients on a stable dose of levothyroxine who are then started on a selective serotonin reuptake inhibitor, in particular sertraline (Zoloft), may show a rise in their TSH level and require an increase in their thyroid hormone dose

95,764 people reported to have side effects when taking Zoloft.
Among them, 618 people (0.65%) have Hypothyroidism

#122 fishinghat



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Posted 19 July 2018 - 09:37 AM

Zoloft and Hypothyroidism and Leucopenia (Cont.)

Other Adverse Reactions Observed During the Premarketing Evaluation of ZOLOFT
Other infrequent adverse reactions, not described elsewhere in the prescribing information, occurring at an incidence of < 2% in patients treated with ZOLOFT were:
Endocrine disorders - hypothyroidism
There was an increase in follicular adenomas of the thyroid in female rats receiving sertraline at 40 mg/kg (2 times the MRHD on a mg/m2 basis); this was not accompanied by thyroid hyperplasia.

Zoloft and Leukopenia
My WBC 3.8 Thous/mm3 (Low) and AbsNeut 1.6 Thous/mm3 (Low)
Continues to be low but at this time I do not see much hope of it rising, continue to monitor.
Sertraline-induced agranulocytosis. Agranulocytosis is a condition where the absolute neutrophil count is less than 100 per microliter of blood.

Sertraline- and mirtazapine-induced severe neutropenia.
Neutropenia associated with quetiapine and sertraline: A case report and review of literature.
Drug insert
6.2 Postmarketing Experience
The following adverse reactions have been identified during postapproval use of ZOLOFT. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
Hemic and Lymphatic – agranulocytosis, aplastic anemia and pancytopenia, leukopenia, thrombocytopenia, lupus-like syndrome, serum sickness
51,803 people reported to have side effects when taking Sertraline.
Among them, 213 people (0.41%) have Leukopenia
95,764 people reported to have side effects when taking Zoloft.
Among them, 571 people (0.6%) have Agranulocytosis
Sertraline-induced agranulocytosis.

Neutropenia Associated With Sertraline Use: A Case Report

Leukopenia and neutropenia caused by sertraline
Zoloft Withdrawal

Am J Psychiatry. 1994 Mar;151(3):450-1.
Withdrawal reaction after sertraline discontinuation.
Louie AK, Lannon RA, Ajari LJ.
No abstract

Sertraline withdrawal in two brothers: a case report.
Rosenstock HA.
withdrawal symptoms of (1) dysequilibrium (2) dysesthesias (3) dizziness and (4) a flushing sensation.

Irritability Agitation Dizziness Burning or tingling sensation anxiety Confusion headache insomnia Tiredness.

I get dizzy a lot, my vision seems blurry, I have these tingly feelings in my fingers and toes, and the worse part is the "electric shocks" that seem to run through my body all day. I feel sick to my stomach a lot and it's hard to eat. (3 days later) I'm getting a bit better. I'm sleeping better but I still have the dizziness and the "electric shocks". I used to wake up all sweaty but that doesn't happen anymore either.

I took Zoloft for 5 years in the past and over a week stopped taking them with NO withdrawal symptoms but not this time I guess I foolishly thought it would be the same this time.

#123 fishinghat



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Posted 19 July 2018 - 09:39 AM

Zoloft Withdrawal (Cont)

last time i tappered off the drug i was ok for about 2 months but then i was hit with a big bang of anxiety and dispair- i was forced to go back. currently im at 25 mg down from 50mg-- i'm hoping that in time i can just continue to tapper down until i'm totally off of it.

I have spent the last 6 months, slowly withdrawing from the medication, which I can no longer afford. For the past month, I have been without zoloft, but I am now having periodic anxiety attacks, and perseveration about random things, some paranoia, and now sucidial thoughts
past year I have been taking 25mg every other day, or even every third day, in preparation for stopping altogether.This past Friday, I took my last dose.
It is now Thursday. Since yesterday I have been suffering from brain zaps, disorientation, spatial/depth perception problems, inability to focus, nausea, dizziness, vertigo, and, beginning today, a feeling of deep sadness.

Week One: Alternate one day taking 50mg, the next 25 mg (half a pill)
Week Two: Take 25 mg daily
Week Three: Take 25 mg every other day
I completely quit after week three, and I haven't felt normal since.

I had been on zoloft for 2 years. As much as 150 mg , but in the last year it was only 50 mg. I thought I had done a good job of ramping down, over a few weeks. to 25 mg then 12.5 , and then 12.5 every other day. But now I've been withdrawing for a week and a half. It's good to know that this all fits in with what others have experienced though, and to know that it might be up to a month of this. Now I guess I just need to decide if I hang in or go back to a low dosage to maybe alleviate some of this.. But then exend the process.
when i first tried getting off of my 200 mg/day dose of zoloft (after being on it for three years), i'd never felt so AWFUL in my life. i followed internet instructions of dropping my dose by 25 mg every two weeks. obviously, this didn't work. i thought trying to wean myself off was futile, and that i would have to take it for the rest of my life. WRONG! it takes almost TWO YEARS to ween yourself off of a 200 mg/day dose
I am just starting tapering off of 100mg zoloft to 75mg two weeks ago. I was doing fine and everything until a couple days ago.
....i went 50 to 37mg to 30mg to 25mg to 18mg to 12mg then six every other day for two weeks it was fine except for the first two weeks i felt some nausea but no brain zaps and i totally know what you mean by feeling like you were in the clouds i finally feel back to myself and its great!!!!!!!!!!!!!
he increased it each time I went in until I was on 150 mg. Now I was sick, depressed, and going through menopause. But by far the worst part was being numb. I could care less about anything. When my friends and loved ones went through grief or sadness I could not cry with them. So they all probably think I am heartless.
Anyway I have began tapering and started in April by chipping away a little of my pills a little at a time because I've tried and failed so many times. I got down to 50mg and stayed 0n that for 1 month. Now I am shaving a little off that for a week until I'm down to 25mg, and I'll stay on that until I can cut that in half.

It took me two and a half years to taper off Zoloft from 300mg

my advise to those quitting.
from dosage 200, drop to 150mg for 1 whole week.
from dosage 150, drop to 100mg for 10 days.
from dosage 100, drop to 50/75mg for 2 weeks.
from dosage 50/75. drop to 25mg for 3 weeks.
from dosage 25, completely stop medication.
doing it this way if you have been on the medication for 1 year or more is advisable.

I was on 150mg for one year minimum. I dropped zoloft by 25mg each 3 weeks and I'm at 0 since a month. In fact, it's my 5th week right now. No problem for the first 2 weeks, then I got anxiety, insomnia, well almost everything in the side-effect list. But it was nothing compared to the 4th week and right now.

I've been tapering since the spring, from 200mg and am currently at 112.5mg. I've been on it for about 15 years, between 200 and 250mg. I've gained probably 25lbs, gradually, but have lost about ten, since reducing to my current dosage of 112.5mg hs. My first two reductions of 25mg were smooth, the third reduction was rough, the fourth smooth, but this current reduction of only 12.5mg has been hard, again. Most recently I reduced by 12.5mg a couple of days ago from 100mg, so am happy to be in the double digits now more or less. I plan to reduce again by 12.5mg in a couple of months or more. I stayed at 100mg for about 4 months, making sure I felt well and stable. Within about a week, with each reduction I feel ill, as I do now - with nausea, weakness, occasional crying spells, a bit down, slow, gastrointestinal issues, hard to focus... I made the mistake I think of initially starting this recent reduction by alternating doses of 75mg one day and 100mg the next ( for about two weeks), so I had a day where I felt fine and a day where I felt horrible. I started with the 87.5mg today, so will take awhile I suppose to stabilize. I also switched to taking it in the morning today. I started at 250-300mg a year ago and am now at 75mg for about a month and a half and still having withdrawal effects from that last taper (from 87.5mg down to 75mg). I felt fine for about 10 days and then massive NAUSEA, insomnia, sweating, aching joints and muscles, gastrointestinal pains and problems..Though even at 5% tapers now, I still seem to be hit with the w/d. I'm now at 70mg, from an original dose that wavered between 250 and 300mg (for 17 years). I have read that the length of time to get off an antidepressant should be at least one month for every year you have been on it. I was last at 50mg August 15 and have tapered by 6.2 since then, every 9 days or as soon as I felt stable and I felt very well those two weeks, but now it's hit me, again- all the flu-like withdrawal symptoms. Just wanted to leave an update of where I'm at in my tapering off Zoloft. About a year and a half ago I was at 250-300mg Zoloft, and am now at 37.mg!! I'm now at 31.2mg Zoloft. Only five more tapers of 6.2mg to go until I'm done. I've been nauseous for the past ten days with a new withdrawal symptom (for me) of left-sided headache nearly twenty-four hours a day, but seems to be easing since yesterday. Often I feel on the verge of vomiting, and am achy but that is easing up again for this 6.2mg taper. Taking a lot of ibuprofen and Gravol. I taper by 6.2mg. From an original dose of 300mg max, I'm now down to 25mg. Still get very sick -achy, nauseaus, headache, irritable, diarrhea/gastroparesis, vomiting (occasional) with each taper. Unbelievable. It will be two years in February since I began tapering off. I'm just looking at my journal and I see I went from 50 to 43.6mg (by tipping out 1/4 of the powder in a 25mg capsule + taking with another 25mg). I stayed at 43.6mg from August 16/10 to August 22/10 (not that long relative to my more recent reductions). On August 22 I went down by another 6.2mg to 37.5mg (roughly) and stayed there until Sept 14. Sept 14 I went down by another 6.2mg to 31.2mg and stayed there until November 22ish. You see I haven't been tapering too fast, because each time I suffer the same symptoms- nausea, headache, achy muscles, joints etc., upset digestive system, eventual insomnia...These all do eventually pass, but I am surprised each time I am hit with the same symptoms, same intensity.

I just ordered a scale which measures down to .001 grams....got it on ebay for around $25.
I understand that these scales are great for accurately measuring meds.I'm about 5 weeks into 25mg and still don't feel stable, mostly physically- achy, digestive slowing, nausea, hard to focus...but manageable. My next four reductions will be by roughly 6mg, by dividing the 25mgs of powder into 4.I've been at 25mg for 7 weeks and finally feel stable for a few days in a row- no nausea, much less achy, no stomachache. Finally! I won't do another taper though for awhile, just so sick of feeling sick.Was finally feeling better after 7 weeks at 25mg, from 31mg (original dose of 300mg two years ago). Now I feel sick again with same digestive system problems, nausea, aches, headache for the last 8+ days. I was last at 25mg for over four months, waiting for terrible withdrawal of mainly nausea, stomachaches and body pain, to subside. I became very frustrated two weeks ago with the constant nausea so thought I would try taking pill in pm rather than am. Well, the day I missed the dose I began to feel better and better as the day went on- the nausea, pain and stomachache subsided. I still cannot believe it and am angry, but I haven't taken any since and have felt much better, fine in fact. I quit the Zoloft altogether about 3 weeks ago. It was going well until I started crying a lot, maybe a week ago. I could deal with that, but then the rest of the symptoms crept up one or two at a time in the last three days and feel nearly unmanageable. Nearly all my usual withdrawal symptoms have returned full force- pain (upper, then lower back that migrates back and forth), in muscles, achy, as well as clicking joints and bones everywhere, which maybe are displaced by tight muscles, nausea, insomnia to 2:00 to 4:00am, sweating, chills, then massive shaking most nights, out of proportion anger and tears interfering with work... Stomach hurts too, bowels still working this time, no sinus headache this time, so far. Hopefully tomorrow will be better. I hoped this wouldn't happen. I was feeling so well. No intention of taking Zoloft to ease this hell, not yet.

Go down so slowly you are shaving off tiny parts of pills or just a granule or two of capsules.
Wait 3 days to a week before each new lowering so you have a chance to get back some emotional strength to face the next round.

A patient receiving sertraline for depression developed dizziness and orthostatic hypotension on repeated attempts to discontinue the drug. All other organic factors were ruled out. The hypotension was proved to be secondary to sertraline by repeated rechallenges. After a variety of attempted treatments, the agent was discontinued successfully through an extended titration period. This report should guide clinicians in treating patients with a similar problem.

Sertraline discontinuation syndrome presenting with severe depression and compulsions.

#124 fishinghat



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Posted 19 July 2018 - 09:49 AM

Contains - Sodium citrate dihydrate 230 mg
The following information from ...

A pH buffer used to neutralize acids. Also functiuons as an electrolyte providing sodium and Citrate ions to the body.
Industry Uses
Agricultural chemicals (non-pesticidal)

Consumer Uses
Agricultural products (non-pesticidal)
Automotive care products
Building/construction materials
Cleaning and furnishing care products

From Wiki


Sodium citrate is chiefly used as a food additive, usually for flavor or as a preservative. Its E number is E331. Sodium citrate is employed as a flavoring agent in certain varieties of club soda. Sodium citrate is common as an ingredient in Bratwurst, and is also used in commercial ready to drink beverages and drink mixes, contributing a tart flavor. It is found in gelatin mix, ice-cream, yogurt, jams, sweets, milk powder, processed cheeses, carbonated beverages, and wine, amongst others.

Sodium Citrate can be used as an emulsifier when making cheese. It allows the cheese to melt without becoming greasy.

As a conjugate base of a weak acid, citrate can perform as a buffering agent or acidity regulator, resisting changes in pH. Sodium citrate is used to control acidity in some substances, such as gelatin desserts. It can be found in the mini milk containers used with coffee machines. The compound is the product of antacids, such as Alka-Seltzer, when they are dissolved in water. The pH of a solution of 5 g/100 ml water at 25 °C is 7.5 – 9.0.

Medical uses
In 1914, the Belgian doctor Albert Hustin and the Argentine physician and researcher Luis Agote successfully used sodium citrate as an anticoagulant in blood transfusions, with Richard Lewisohn determining its correct concentration in 1915. It continues to be used today in blood collection tubes and for the preservation of blood in blood banks. The citrate ion chelates calcium ions in the blood by forming calcium citrate complexes, disrupting the blood clotting mechanism. Recently Tri-sodium citrate has also been used as a locking agent in vascath and haemodialysis lines instead of heparin due to its lower risk of systemic anticoagulation.[3]
In 2003, Ööpik et al. showed the use of sodium citrate (0.5 grams per kilogram of body weight) improved running performance over 5 km by 30 seconds.[4]

Sodium citrate is used to relieve discomfort in urinary tract infections, such as cystitis, to reduce the acidosis seen in distal renal tubular acidosis, and can also be used as an osmotic laxative. It is a major component of the WHO Oral Rehydration Solution.

It is used as an antacid, especially prior to anaesthesia, for caesarian section procedures to reduce the risks associated with the aspiration of gastric contents.

Boiler descaling
Sodium citrate is a particularly effective agent for removal of carbonate scale from boilers without removing them from operation[5] and for cleaning automobile radiators.

Do not use with antacids containing aluminum, aspirin, salicylates, lithium or quinidine.

Check https://www.drugs.co...um-citrate.htmlfor further information.

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