Dialing back Zoloft

[Anonymous]

Ds (14) has been on max dose of Zoloft for years. He's appears to never have highs nor lows, is pretty numb all the time.
Pre zoloft he had extreme outbursts of anger, anxiety even refusing to go to school most days.
Now he loves school, does well, has friends and is involved in some extra curricular activities.
But I can't helpmfeelinf that the max dose is too much. He isn't learning to self regulate because he never gets upset, never sad, never angry, never really happy, never very excites about anything.

We tapered down by 25% last week and sure enough, tonight he had a moment where he yelled at me and left the room. Dh feels like we should put him back on full dose but I feel like it was pretty normal teen outburst, especially for someone who isn't used to feeling his own emotions.

I would discuss with psychiatrist but our dear, smart psychiatrist moved a few months ago and his medication is now managed by a new psychiatrist who hasn't shown any interest in him as a person, doesn't ask many questions and is happy ro just keep things as they are.

Am I doing the wrong thing?

[Anonymous]

How will he learn to cope without meds? What is tut plan for weaning him off?

[Anonymous]

No don't let one instance discourage you. He's going to have a rough go at the tapper but that doesn't mean you should stop. He needs to feel life. Numb isn't a way to live life and just as you said he's not learning to self regulate which is a very important life skill. Keeping him on a high dose just to not make waves in the house isn't the best thing to do you know what they say the easiest thing to do is usually not the best. I think you should give it more time and once he's off of it completely give it 12 full weeks out of his system before reassessing the situation.

[Anonymous]

Anonymous wrote:How will he learn to cope without meds? What is tut plan for weaning him off?

He's been on the meds years during which time we've practiced coping and communicating strategies at every opportunity.
The plan is really to just even it out a bit to the point where he at least shows some human emotions. Judging by tonight's outburst we are probably at that point now. I'm upset thinking he'd overmedicated to make our lives easier and I'm upset thinking if I'm doing the wrong thing, I'm harming him (though we will certainly dial it back up if he seems out of control).
In a perfect world we would have our old psychiatrist working with us and monitoring but we are stuck without much help.

[Anonymous]

Anonymous wrote:No don't let one instance discourage you. He's going to have a rough go at the tapper but that doesn't mean you should stop. He needs to feel life. Numb isn't a way to live life and just as you said he's not learning to self regulate which is a very important life skill. Keeping him on a high dose just to not make waves in the house isn't the best thing to do you know what they say the easiest thing to do is usually not the best. I think you should give it more time and once he's off of it completely give it 12 full weeks out of his system before reassessing the situation.

Thank you for this. I really needed to hear that. I completely agree that it seems we've been doing what's "best" (read: easiest) for the adults. He certainly needed some help years ago and may still need some help now but it feels like we're doing what's easiest over what's right.

[Anonymous]

My kid was on a high dose of Zoloft for a little over a year (175mg) and it took us 9 months to taper it down. When we got down to 100mg I noticed more smiles and energy. The taper went smoothly until we got to 50mg then kid had lots of withdrawal symptoms, vision issues, brain zaps, etc. so we stayed at 50 for a month, then went down in increments of 5mg over months. The final 15 mg we went to liquid and went down very slowly. Kid has been off of it now for 6 months and is doing great. Good luck, and be patient with this. If your kid has been stable for a while, he deserves to have a trial without meds. You can always go back on a lower dose. My kid has lost weight and gotten more active off the meds. And has had and continues to have lots of therapy to address anxiety, etc.

[Anonymous]

PP here - fourteen year olds (at least all of mine) do have outbursts and yell at their parent occasionally. That is "normal" behavior unless you are a super duper parent with a shining star kid. *hormones*. In my experience, this goes away around 16.

[Anonymous]

Tapering an SSRI is no joke - it can make you really irritable. I think what you are doing makes sense. A lot of his improvement over the past years might be maturity not just meds. That said you do need a plan to handle outbursts at home.

Also, he’s old enough to be part of this discussion.

[Anonymous]

Yelling at you is NBD. That’s certainly not cause for medication. If he’s throwing furniture and refusing to go to school, then think about staying on meds but not for yelling occasionally and storming out of the room. I think you’re doing the right thing to wean him off or down. (And I say this as someone whose child is on meds.)

[Anonymous]

Anonymous wrote:

Anonymous wrote:No don't let one instance discourage you. He's going to have a rough go at the tapper but that doesn't mean you should stop. He needs to feel life. Numb isn't a way to live life and just as you said he's not learning to self regulate which is a very important life skill. Keeping him on a high dose just to not make waves in the house isn't the best thing to do you know what they say the easiest thing to do is usually not the best. I think you should give it more time and once he's off of it completely give it 12 full weeks out of his system before reassessing the situation.

Thank you for this. I really needed to hear that. I completely agree that it seems we've been doing what's "best" (read: easiest) for the adults. He certainly needed some help years ago and may still need some help now but it feels like we're doing what's easiest over what's right.

He really should be in therapy to help him learn to self regulate and to manage his feelings. Just cutting the dose and hoping for the best is a bad idea.

[Anonymous]

Anonymous wrote:My kid was on a high dose of Zoloft for a little over a year (175mg) and it took us 9 months to taper it down. When we got down to 100mg I noticed more smiles and energy. The taper went smoothly until we got to 50mg then kid had lots of withdrawal symptoms, vision issues, brain zaps, etc. so we stayed at 50 for a month, then went down in increments of 5mg over months. The final 15 mg we went to liquid and went down very slowly. Kid has been off of it now for 6 months and is doing great. Good luck, and be patient with this. If your kid has been stable for a while, he deserves to have a trial without meds. You can always go back on a lower dose. My kid has lost weight and gotten more active off the meds. And has had and continues to have lots of therapy to address anxiety, etc.

Thank you so much for this! Harvard published a guide for tapering each medication based on starting dose but it seemed a bit quick. They had each dose cut by mg. Your experience above seems like a better model for our situation, especially considering the length of time he's been at a high dose.
I'm so happy to hear about the positive outcome for your child! We will look out for the side effects, too.

[Anonymous]

Anonymous wrote:PP here - fourteen year olds (at least all of mine) do have outbursts and yell at their parent occasionally. That is "normal" behavior unless you are a super duper parent with a shining star kid. *hormones*. In my experience, this goes away around 16.

Definitely. I think Dad still has some fear that the hulk mode from earlier years (throwing furniture, etc) is going to return

[Anonymous]

Anonymous wrote:Tapering an SSRI is no joke - it can make you really irritable. I think what you are doing makes sense. A lot of his improvement over the past years might be maturity not just meds. That said you do need a plan to handle outbursts at home.

Also, he’s old enough to be part of this discussion.

Good advice! I definitely told him my opinion about tapering and why and listened to his opinion. He did agree and we talked last night about how his anger might seem new since he's not felt his emotions as strongly as usual lately but is normal. He feels pretty positive about how things are going so far

[Anonymous]

Anonymous wrote:How will he learn to cope without meds? What is tut plan for weaning him off?

Some people require lifelong medication and don’t need to learn to “cope” just like a diabetic doesn’t need to cope without insulin.

[Anonymous]

You need to find a new psychiatrist, one that has more interest in his or her patient.