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Zoloft to Prozac and back to Zoloft? Please help.

hi, I've been on Zoloft for about 2 months and my doctor recently changed me to Prozac 4 days ago because she said she wasn't seeing much improvement in my somatic + conversion disorder. I am having the absolute worst side effects and would like to switch back. My doctor is the type of doctor who denies these medications have much side effects. I will message her in the morning with my intentions of switching back to Zoloft which did not give these severe side effects. I've been going through a chronic illness for 11 months now and cannot bear to put up with this. Severe vertigo, crying fits (crying about chicken earlier today) electric shocks, twitching, teeth chattering, nausea, period cramps with no period  night sweats, hot flashes, cold sweats, headache, muscle tension and many more. My question is do I have to quit the Prozac cold turkey and wait 4-7 days to take the Zoloft? I saw this somewhere on the internet. Bear in mind this is only the 4th day but since day 1 of taking it it's become unbearable I haven't left the house. I cannot imagine the living hell I will be put through without going a day of medication. Please help me understand the process. And any experiences you can offer. I stopped the Zoloft without tapering and took the Prozac per doctors orders. Thank you for any help. I am 46 kg and a female teen.
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Avatar universal
These do not sound like side effects of the Prozac, which really hasn't taken effect yet even for side effects.  These are instead classic withdrawal effects of quitting an ssri or snri.  Did you taper off the Zoloft slowly, or quit abruptly?  Not to say some of these might not be side effects of starting Prozac, but again, if you look up side effects of withdrawal when you quit one of these drugs, you'll see the ones you're describing -- crying fits, electric shocks, vertigo, nausea are withdrawal effects.  The sweats could come from any drug, so that might be withdrawal or it might be starting the Prozac.  Any of them can also cause muscle tension, as they interfere with magnesium absorption and because when you alter the way the brain deals with serotonin, that also helps to relax the muscles and is actually even more involved with digestion than it is with the brain.  I'm not a doctor, but I think you're in a bad withdrawal from the Zoloft.  What I would do if it were me, having been through a horrific withdrawal experience before, is stop the Prozac -- it's only been 4 days, you're not on it yet -- and go back on the Zoloft at the last dose at which you felt fine and taper off more slowly.  If you're using a regular doc, get a psychiatrist -- regular docs know little about medication as they handle so many problems they don't know a lot about any of them.  They're the front line in how we do medicine in the US.  A psychiatrist, or even better, a psychiatrist who is a psychopharmacologist, is the expert in these meds, though even then you will find most of them are clueless about withdrawal problems.  Good luck.
Hi, thanks for your answer. No I did not taper off the Zoloft, my doctor said to just stop it and take the Prozac and there'll be NO side effects. Never again am I following her instructions. She is a psychiatrist and I have been trying to get in contact with her and she will not answer on how to go back onto the Zoloft safely. I had a bout of gastritis in August-November 2016. The same exact feeling has come back have you ever heard of the possibility of gastritis from withdrawal or a side effect of an antidepressant? I don't know if I'm to stick this out and continue vomiting and in severe pain and risk losing even more weight or stop it and return to the Zoloft and potentially cause serotonin syndrome which I am terrified of. My appointment with her is not until next week and I'm not even sure if I want to go and see her after this. Thanks.
Serotonin syndrome is extremely rare and would only occur if you took both drugs at the same time.  If you stop the Prozac now, because you're not really on it yet, it's highly unlikely you'll feel any withdrawal effects, plus Prozac stays in the body a lot longer than the other saris and therefore withdrawals tend to be rarer and occur later.  And get a different psychiatrist -- this one will only cause you pain.  Gastritis doesn't mean anything -- it just means you have an inflamed gastric system but doesn't tell you why.  It could have been from something you ate, from stress, from medication, or anything.  And yes, nausea is a common withdrawal symptom, but it can also be a side effect of taking these meds, for the reasons I stated.  Many people call withdrawal the Paxil flu, because it feels like a really bad flu.  When it's really dangerous is when it causes emotional problems you never had before, which the crying jags might indicate, and when it lasts a long time.  The way to avoid that happening is to go back on the drug at the last dose at which you felt fine, but since you did not do any taper off of it you don't have a lower dose to go back on, so I assume you'd have to go back on it at the same dose you were on originally.  If you want to stick it out and see if it goes away, I'd still want to stop the Prozac until the withdrawal goes away, otherwise how are you going to properly evaluate how the Prozac makes you feel?  This is my opinion, but you have do it with a psychiatrist, and since your psychiatrist has already stated there would be no side effects, a statement that can't be backed up by any real world evidence given how prevalent withdrawal is, you've got a bad doctor.  Just having a degree does not a good doctor make.  Good luck whatever you decide to do.
Thanks again for your answer. Yesterday I ended up in the hospital for severe vomiting (vomited to the point only frothy acid was coming up) and severe dehydration. Dehydrated to the point i was fed up of the uncomfortable hospital bed and asked to leave after the current IV finished but they refused to let me leave as the two IVs were not even close to hydrating me, had to be put on another. Because of this I wasn't able to take the Prozac yesterday having severe vertigo today and now I'm just putting my foot down and going to go back on the Zoloft starting tonight. I'm going to take 1/2 of 25 and build myself up from there (was taking 50 mg for two months). I went through severe gastritis last year and it didn't clear up only until 4 months of vomiting almost everyday and I'm terrified this will happen again. I am just praying this will clear up much sooner. I don't know if withdrawal or starting has anything to do with this. I agree with you on my psychiatrist I have only been with her for two months. But due to a chronic illness I've been going through since august I've been through 6 psychiatrists who didn't help me like this one. This is why I am so disappointed and sad this has happened because I feel as if I've lost trust. Access to mental health services is limited here and I believe I've gone to almost all the departmental services there is. I think I am going to continue to see her but i have decided today I am done with being on a whole bunch of meds. I guess I'm going to have to try the functional medicine route. Please let me know if the idea of taking 1/2 of the 25 mg of the Zoloft in your mind is okay I am incredibly sensitive to medication so this is why I'd prefer to build myself up. My starting effects of Zoloft was diarrhea and weeks of vertigo but it had eventually gotten not too bad. Do you think I'll have to go over the whole starting process again? I hope not. Don't think my body can handle it right now. Been on the Prozac 7 days. Today I stop.
I can't tell you what will happen, but given you've only been off a short time your body should still be used to it.  We can only hope.  The way you describe your symptoms indicates something other than drug side effects -- that much vomiting and going on for so many years indicates to me something more like a hidden virus or celiac disease or something like that.  I hope your doctors looked into everything.  If you travel well and can cover the costs, it might be time for some place like Johns Hopkins or the Mayo Clinic where they won't stop until they figure it out with a team of specialists.  There are even people who have just worn out their probiotics and some gastroenterologisrts have had success transplanting fecal matter from healthy people into sick people to recolonize their intestinal tract.  Which is just to show there are docs out there who really care enough about patients to think through these things, but most docs don't do that.  It sounds like you need those kinds of docs at this point.  Good luck.
Serotonin Syndrome can happen with one drug only and can even happen when discontinuing a drug. You do not have to take two serotonin drugs to get serotonin syndrome although it will make it more likely.
Avatar universal
Prozac has a much longer half life than zoloft so a wash out period is definitely ideal. A lot of doctors will tell you to go ahead and take it the next day, but in reality you run a strong risk of serotonin syndrome or just feeling absolutely awful without doing a wash out period. You were on the zoloft for 2 months so without tapering you will feel withdrawals. On top of that, you will feel the new start up effects of the new drug. So combine those together is a nightmare. It's always better to taper and wash out. Especially anytime prozac is involved.

You said you have somatic conversion disorder? Have you ever been to an endocrinologist to have your hormones checked and an erray of other tests or were you just brushed off? The sickness symptoms you say you have had for 11 months are very consistent with a problem with the endocrine system. And believe me it is very tough to get the right hormone tests, much less a referral to an endo. You have to keep pressing and fight hard for it. If you have actually been checked out and that is suspected, then Elavil will actually be a much better drug of choice for that disorder which is an old school tricyclic med. Reason being is Elavil is also very good for certain types of pain.

But honestly any type of antidepressant should be your absolute last resort. Especially, being as young as you are.
Again, people, please do your own research.  Scared has shown up putting up a lot of info that goes against everything I've researched.  Shorter half-life drugs are harder to quit, not easier.  Prozac is considered the easiest drug to stop taking in this category precisely because it takes a while to leave the system completely.  This gives the body a natural taper off of it.  In head to head studies, Prozac had far fewer withdrawals than Zoloft and Paxil, both of which have much shorter half-lives than Prozac.  Withdrawal isn't caused by the drug being in your system, it's caused by the drug being out of your system and the brain's difficulty waking up serotonin receptors that have shut down because of how these drugs work.  It takes time for some people for their brains to adapt to working naturally again, and for some this is easy and for some it's very hard.  As for pain, the only antidepressants FDA approved for pain control are snris such as Cymbalta, and I doubt they really do that, they probably just make the person not care as much.  Tricyclics are well known for causing muscle pain, cramps, and also constipation and dry mouth which can lead to long-term dental disease.  Again, folks, do your homework, don't rely on a website like this one except for support and ideas for further research.  None of us are experts, but we do have experience, and having been on tricyclics, I can tell you, I wouldn't take them for pain control because of their strong effect on magnesium metabolism.  Truth is, all these drugs effect magnesium metabolism as they use the magnesium pathway to get past the blood/brain barrier, but you can all look this up for yourselves.  And please, don't fear serotonin syndrome -- it's incredibly rare and it isn't caused by quitting a drug, obviously.  These drugs don't increase the amount of serotonin in your system, they alter the way your brain processes and uses what you have naturally.  But combining drugs can cause it in some unlucky individuals by completely shutting down the body's attempts to evacuate used serotonin.  
Oh, and a "washout" period, and this is my opinion, should always be used.  This is called a taper off a drug.  It just seems to me and from some of the books I've read that if you don't wait until any withdrawal from a drug is over to take a different drug, there is no way to know if any side effects you get are from withdrawal or from the new drug.  You want to know this so you know if the new drug will be right for you, and if you're having withdrawal, especially if your doctor is one of the many who pooh pooh the very idea of withdrawal, you're going to be feeling crummy.  You want to get past that before starting a new drug so you know it isn't the new drug taking you feel crummy.
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