How do doctors typically "wean" a patient off Zoloft?

Question:

Answers:
When weening off a drug you do it in steps by lowering your dosage to the next level and stay on that for 2 weeks then repeat until you are completely done. It still takes 2-3 weeks for your system to be completely void of the drug after your last dose..

Other Answers:
Decrease dose (mg) and frequency

YUP. DECREASE THE DOSAGE VERY SLOWLY.

By Charly Groenendijk
The Netherlands
2000 - 2006

Tapering Off (SSRI/SNRI) Anti-Depressants

Take notice that also non SSRI anti-depressants (such as SNRI's targeting the neurotransmitter nor-epinephrine (nor-adrenaline) and even Ritalin) may interact (primary or secondary) with the serotonergic system in the brain.

Go to General Side-Effects SSRI/SNRI/SSNRI Antidepressants: cases, reviews, articles & studies
Go to Surviving a Negative Reaction to an Antidepressant
Go to Introduction

IMPORTANT MESSAGE 2006!
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It is critically important to stay alert and be informed, especially regarding your rights as a parent and a child. We urge everyone who wishes to protect their family to visit the following websites in order to educate themselves and to spread the word. Do NOT under any circumstances let your child participate in any survey linked to the Government/Pharmaceutical arrangement called TeenScreen®
KNOW YOUR RIGHTS: SAY NO TO FORCED MEDICATION, SAY NO TO TEENSCREEN®.
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Each person will respond differently to stopping serotonin boosters, or Selective Serotonin Reuptake Inhibitors (SSRI's). Whilst some people experience mild side-effects when stopping the drug, others will have horrendous side-effects from just lowering the dosage, since the neural seroto(ni)nergic system in the brain has become dependent on the actions of the (SSRI) anti-depressant (blocking the re-uptake carried out by "transporter proteins" carrying "mis-fired" serotonin across the plasma membrane back into the synapse of the firing serotonergic neuron).
By stopping cold turkey, serotonergic activity will drop drastically. Hence withdrawal side-effects may appear such as electrical surges/shocks in the head (brain shivers) and/or body, pins and needles on the skin, feelings as being on the verge of losing consciousness, blackouts, short term memory problems, etc.. Above mentioned side effects refer to epileptiform activity, or electrical discharges, in the brain. When dosages are cut back, (withdrawal) side-effects are at least minimized. No one should stop taking their medication cold turkey, but anti-depressant use should be tapered off very, very slowly.

The Right Way to Wean Off an (SSRI/SNRI/SSNRI) antidepressant
How should I taper off and how long should I take to taper off?
Work closely with a doctor. Don't go off medication without medical supervision. The best way to minimize withdrawal side effects is to wean off the medication. By reducing the dosage in small increments, your serotonergic system can gradually take over it's own natural serotonin producing activity and slowly adapt to living without the drug. This process may take up to a year or longer. Some doctors are halving the dose every week or two. We do not recommend to taper off that fast. Nor do we recommend to skip daily doses. Taper gradually with an absolute maximum of 5% per week. When it gets down to the smallest dose, (10mg capsule), you can try "The Orange Juice Bit", "Cutting Tablets" or "Oral Suspensions-Liquid Preparations":

"Orange Juice Bit"
pour a glass of orange juice
pull apart the capsule and stir into the orange juice
drink 9/10 of it and repeat this every day until the 7th day
the next week drink 8/10 of it until the 14th day, then 7/10 until the 21th day, 6/10 until the 28th day, and so on.
repeat the "orange juice bit" several weeks until you've totally come off your (SSRI) antidepressant.
Never ever use Grapefruit Juice. Grapefruit juice is an inhibitor of the cytochrome P-450 enzymes. These enzymes are known to metabolize (break down) (SSRI) antidepressants in the liver. Drinking grapefruit juice whilst you are taking an (SSRI) antidepressant can create a serious toxic reaction, because the chemical ingredient will build to toxic levels in the bloodstream! For more information click here.
"Cutting Tablets"
If you don't take capsules but tablets, you can try to chip smaller doses off the tablets. Unfortunately this is a very uneasy task. You could order a pill cutter or pill splitter at your local pharmacist to facilitate this procedure. Pill-cutters aren't that expensive.
"Oral Suspensions-Liquid Preparations"
A much better way to wean off when it gets down to the smallest dose is simply to turn to your doctor who can provide you a liquid preparation (oral suspension-10 mg./5 ml.) of Paxil, Prozac or Zoloft and possibly more liquid versions of other SSRI's. Most people don't know about it, or don't consider it because it's supposedly for kids. It's very easy to use and more reliable then chopping up tablets. Ask your doctor for it !
Take notice that even this process of slowly tapering off could be too fast for you to avoid withdrawal reactions or other serotonin related side-effects. This will be different for every individual.

I was weaned off Klonopin. I was on two .5 mg tablets. It was cut to one and a half tablets for two weeks, then 1 tablet for two weeks, then half a tablet for two weeks followed by not taking it. Ask your doctor any questions you have about this process and pay attention to what your system is telling you during the weaning process. Report any abnormalities to your doctor ASAP. Hope this helps!!

they just stuck me on two new anti-depressants. and my doses always rose too.

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How do doctors typically "wean" a patient off Zoloft?

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