(Read “My Second Attempt,” Part 1 here.)
(Read “My Second Attempt,” Part 2 here.)
My symptoms at the 6.5mg-stage of my taper had persisted for four weeks and were deteriorating. This is when I took the initiative to see someone who, I had been told, specialized in helping patients navigate the rough stages of tapering. This proved not to be the case — quite the opposite, actually — but, regardless, my situation was compromised enough that I put myself into the hands of this “expert” as a matter of blind trust.
At my first visit, this NP promptly changed my medication. She told me to stop taking Celexa and wrote me a prescription for Zoloft with instructions to reinstate at 25mg (25mg!?!) for one week and then to up the dose to 50mg after that.
My taper of Celexa had been so excruciating and done with such meticulous attention to detail, measuring each drop in dose by notches on a syringe — and, just like that, I was to be done with all that. When I registered concern about ending Celexa in one full swoop she dismissed it saying my dosage was so low it wouldn’t make any difference. Had she no clue of the anguish even a diminishment of even a single half of milligram inflicted on me?
I sat stunned and helpless. Of course I would reinstate, what choice did I have? She seemed to know what she was talking about, or least I told myself this. My taper was not working and I needed help. This was the help she was remitting. I left her office half-dazed to find myself in a situation I had not expected, nor was prepared for. Before I turned down the hall to leave, she leaned back in her chair and called out, “Don’t forget: 50 mg after a week.”
I knew instinctively in that moment that I would never up my dose to 50 mg and that my biggest challenge (apart from enduring the inevitable “period of adjustment”) was how I was going to deal with the follow-up visit in two week’s time, not having followed her specific instructions.
This had the feel of a very dark turn, and it was. Not only had I reinstated, but I had been put on a dose far greater than that which I had managed to get down to. Worse, she prescribed needed supplementary pharmaceuticals to “manage” the extraneous adjustment systems that afflict patients who are transitioning between meds.
I complied, but I despaired that my hard-won efforts to that point had been lost.
On that day, when I knew I would not be following this NP’s protocol, I crossed the invisible line of asserting some level of control over this process. This did not mean in my mind necessarily dismissing my doctor’s input or judgement. It was a willingness to allow that my own research and knowledge of the intricacies of my journey, too, were a valuable consideration of this complex journey. No one knows my body and brain the way I know it.
So on the day when I reinstated with 25mg of Zoloft, and was emphatically instructed to double that dose after a week’s time, I made my own calculations. I had found myself under orders of an insistent doctor who — right off, in the first visit — I was not sure I trusted.