Scotty

[Scotty]

Drug History

2002 - Started Zoloft 100mg. 

Gradually reduced to 50mg, intending to come right off.

2009 - Went back up to 100mg - no ill effects.

2011 - Began slowly reducing again.

2017- Down to 25mg.

October 2017- Dose increased to 50mg.

 

 

I started taking Sertraline 100mg in 2002 because I’d developed panic disorder after a stressful mature-age college course. The medication worked immediately and continued to help me - I was well for 7 years with no anxiety. I gradually reduced to 50mg, but in 2009 went back up to 100mg with no ill effects during a life crisis. In 2011 I determined to come off again and began reducing very slowly with no ill effects. By October 2017 I was down to 25mg. I went to my GP to get a counselling referral. I was quite well with no anxiety, but she advised me to go back up to 50mg to mop up any underlying depression I might have. So I did - one of the worst decisions of my life! 

 

Within 24 hours I developed horrible symptoms... terrifying anxiety/dysphoria, palpitations, severe insomnia. I was certain they were caused by the increased dose of sertraline but my GP denied that this was possible ‘on such a small dose’. She said I woud soon adjust. So I stupidly continued to take it for 2 more weeks before another doctor in the practice told me to go back to my normal dose immediately.

 

I was expecting that I would then return to ‘normal’ but I did not - instead I continued to suffer bouts of toxic anxiety as well as the other symptoms. I consulted other GPs and a psychiatrist - all reluctant to link my symptoms to the increased meds and instead going with the ‘pure anxiety’ diagnosis. Recently I found a GP who was willing to listen and referred me to a psychiatrist who tested me positive for clonus and hyperreflexia. He said that on the basis of these together with my other symptoms I definitely have non-acute sertraline syndrome. Although it is unusual, he thought it was triggered by the increased dose of medication in my system. He told me to titrate down fortnightly in 5mg increments using a solution. However when I got down to 15mg last week I soon developed withdrawal symptoms including ataxia, burning, nausea. But then yesterday I started to feel much better - almost normal!

 

So this is my dilemma. I’m told that serotonin syndrome disappears soon after the medication is withdrawn. If that’s the right diagnosis then I should follow the 5mg taper and get off as soon as possible. But if this quicker rate gives me severe withdrawal then I should stick to the much slower 10% monthly regime - thereby possibly prolonging the agony.

 

What to do? Can’t go forward, can’t go back! I’m so confused. I’d appreciate any help the forum can give me.

 

Edited March 9, 2018 by ChessieCat
added spacing

[ChessieCat]

Hi Scotty and welcome to SA,

 

I'm going to leave answering your post to the more knowledgeable mods.  But to get you started ...

 

We ask all members to create a drug signature.  This appears below every post you make.  Please update it whenever you make a change.  This is the preferred format which makes it easier for us to see your drug history at a glance:

 

A request: Would you summarize your history in a signature - ALL drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly?

• Please leave out symptoms and diagnoses.
• A list is easier to understand than one or multiple paragraphs. 

• Any drugs prior to 24 months ago can just be listed with start and stop years.
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago)
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016.
• Link to Account Settings – Create or Edit a signature.

[Shep]

On 3/8/2018 at 8:03 PM, Scotty said:

However when I got down to 15mg last week I soon developed withdrawal symptoms including ataxia, burning, nausea. But then yesterday I started to feel much better - almost normal!

 

So this is my dilemma. I’m told that serotonin syndrome disappears soon after the medication is withdrawn. If that’s the right diagnosis then I should follow the 5mg taper and get off as soon as possible. But if this quicker rate gives me severe withdrawal then I should stick to the much slower 10% monthly regime - thereby possibly prolonging the agony.

 

Hi, Scotty.

 

Welcome to SA from me, too.

 

How are you feeling now? It's possible that lowering down to 15 mg relieved enough of your symptoms from serotonin syndrome and you may now want to proceed with a slower 10% taper. 

 

Here are some links to give you more information on AD withdrawal:

 

Why taper by 10% of my dosage?

 

How psychiatric drugs remodel your brain

 

What is withdrawal syndrome? 

The Windows and Waves Pattern of Stabilization

 

The rule of 3KIS: Keep it simple. Keep it slow. Keep it stable.

 

Healing from antidepressants. Patterns of recovery video (4 minutes)

 

You may also want to read the reinstatement thread, as it explains why you may be more sensitive to your AD now:

 

About reinstating and stabilizing to reduce withdrawal symptoms 

 

It will help if you would keep a drug and symptoms journal. This will help us figure out if you still are getting symptoms from the serotonin syndrome or if they are withdrawal symptoms, although sometimes they do overlap. 

 

Keep notes on paper about your drug dosages and daily symptom pattern

 

If you could post your symptoms journal for a few days, we can better help you decide how to continue on with your taper.

 

[ChessieCat]

On 09/03/2018 at 12:03 PM, Scotty said:

I’m told that serotonin syndrome disappears soon after the medication is withdrawn.

 

Serotonin toxicity reduces as your dose gets lower.  You don't have to be off the drug completely.  I suffered mild serotonin toxicity and as I reduced my dose the serotonin toxicity lessened.

 

6 hours ago, Shep said:

It's possible that lowering down to 15 mg relieved enough of your symptoms from serotonin syndrome and you may now want to proceed with a slower 10% taper. 

 

[Scotty]

Hi ChessyCat and Shep,

 

Firstly thanks to you and all involved in producing this website. Antidepressant withdrawal can be a lonely business, so it’s reassuring to know that such a great resource is out there. 

 

At present I’m quite unwell and feeling pessimistic about the future. I’ve only recently started keeping a diary of my symptoms - so here goes:

 

All medication taken at 10pm the previous evening. Tapered from 20mg to 15mg three days before diary started.

 

Wednesday 7 March

15mg. Slept 5 hours. Woke with ataxia, dizziness, face and body burning (one of my worst symptoms). Continued all morning. Out shopping - had anxiety attack and sensation that that head crushing in - but completed my tasks. Felt better on return. Burning and ataxia returned approx 6pm then vanished at 9. Felt completely well and calm until bed at 1pm.

 

Thursday Mar 8

15mg. Broken sleep approx 5 hrs. Slight tremor and weariness in morning but no other symptoms. Weak, burning symptom after shower. Receded - felt calm though weak all day.  Approx. 5.30 crushing constricted feeling in head and shoulders briefly returned. Nevertheless went to spend evening with a sympathetic friend. After half an hour with her felt totally well for rest of evening.

 

Friday Mar 9

15mg. 5hrs sleep. Severe symptoms - ataxia, burning, intense anxiety and dread. Slowly improved after lunch. Went out to run errands - again experienced feeling of crushing anxiety in head. Slowly improved. Friend came around for the evening - felt gradually better until by 9pm was feeling completely well and calm - my normal self - as though none of this had ever happened.

 

Sat 10/4.

17.5 mg - went up a small amount as I thought I may have come down too quickly. Woke sick and groggy, burning face. Severe anxiety attack in shower, but that eased off. Better in middle of day...burning and weakness returned late afternoon. Thought I would not be able to drive to my partner’s house but managed it. Felt completely well and calm all evening.

 

Sun 11/4.

17.5 mg. Longer tho broken sleep approx 7 hrs. Woke with poisoned sick feeling, severe burning and some slight palpitations which have continued all day. One of my worst days in fact.

 

In summary:

-my main symptoms are severe anxiety, burning flushing, a poisoned sick feeling, weakness and ataxia.

-there is often a pattern to the days...sick in the morning and some parts of the day then absolutely well in the evenings. I’d be very interested to hear whether anyone understands why this may be so.

-I’m definitely much worse now than when all this was triggered by increasing my dose on October 5 2017. I’m now limited in my activities and afraid to go out. 

 

The major puzzle for me now is what to do about my dosage. I certainly had an adverse reaction when the dose was increased. If I have seretonin syndrome as the psychiatrist diagnosed, am I continuing to poison myself with any further medication? Should I therefore come off immediately hoping to recover more quickly. That’s the advice of my GP. Or should I continue to titrate down in very small amounts?

 

Thanks for considering all this - I’d be most grateful for any advice or insights you may have.

 

Scotty.

 

Edited March 11, 2018 by ChessieCat
reduced font

[ChessieCat]

On 09/03/2018 at 12:03 PM, Scotty said:

By October 2017 I was down to 25mg.

 

Your signature is not showing the reductions you made.  Please update your signature.  We need to know what doses you took on what dates please.

 

A request: Would you summarize your history in a signature - ALL drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly?

 

• Please leave out symptoms and diagnoses.
• A list is easier to understand than one or multiple paragraphs. 

• Any drugs prior to 24 months ago can just be listed with start and stop years.
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago)
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016.
• Link to Account Settings – Create or Edit a signature.

 

Edited March 11, 2018 by ChessieCat

[ChessieCat]

Q:  Have any of your symptoms lessened since your reduced your dose?

[ChessieCat]

18 minutes ago, Scotty said:

All medication taken at 10pm the previous evening.

 

Q:  Are you taking any other drugs?

[Scotty]

I am taking Irbesartan for high blood pressure and Nexium 20mg for reflux. 

[Scotty]

Irbesartan and Nexium taken in the mornng.

[Scotty]

My symptoms have not lessened overall since reducing the dose. Their main characteristic is that they fluctuate from day to,day and during each day. Most often symptoms more severe in morning and completely gone in evening.

[Scotty]

2002 - started taking Zoloft 100mg

Gradually reduced dose to 50mg by 2009. 

2009 - dose raised back to 100mg due to life stress. No ill effects.

2010 - started reducing dose again very slowly.

2016 - 2017 - down to 25 mg. Stayed on this dose.

5 October 2017 - dose raised to 50mg.

20 October 2017 - dose reduced back down to 25 mg.

Continued on this dose until February 2018.

Feb 24 - reduced to 20mg

Mar 3 - reduced to 15mg.

10 Mar - dose raised to 17.5mg.

 

[Shep]

16 hours ago, Scotty said:

Sun 11/4.

17.5 mg. Longer tho broken sleep approx 7 hrs. Woke with poisoned sick feeling, severe burning and some slight palpitations which have continued all day. One of my worst days in fact.

 

Hi, Scotty.

 

Thanks for doing the drug and symptoms journal. Very helpful.

 

When you say "worst days" do you feel your symptoms are more like the serotonin syndrome symptoms and may be due to increasing the dose?

 

On 3/8/2018 at 8:03 PM, Scotty said:

However when I got down to 15mg last week I soon developed withdrawal symptoms including ataxia, burning, nausea. But then yesterday I started to feel much better - almost normal!

 

 

Please stop changing your doses. You really need to give yourself time to stabilize. You reported feeling "almost normal" on March 8, but then as soon as you had a wave, you updosed. 

 

It takes 4 days for your nervous system to register a change and then several weeks to stabilize, especially after so many changes. The fact that you were feeling better at 15 mg was a sign that you were on the right dose and were you on your way to stabilizing. Keep in mind how withdrawal works:  it's non-linear with lots of window and wave activity.

 

The Windows and Waves Pattern of Stabilization

[Scotty]

I started taking Sertraline 100mg in 2002 to help with panic disorder after a stressful mature-age college course. The medication worked almost immediately and kept working.  I was well for 15 years with no anxiety.  At one point I reduced my dose then increased it again with no ill effects. In 2016 I decided to come right off and began reducing slowly, again with no ill effects. By October last year I was down to 25mg. I went to my GP to get a counselling referral for some life issues, and she advised me to go back up to 50mg to help me through. So I did - bad decision! Within 24 hours I developed horrible symptoms... terrifying anxiety/dysphoria, palpitations, severe insomnia. I was sure they were caused by an adverse reaction to the increased dose of sertraline but my GP denied that this was possible ‘on such a small dose’. She said I woud soon adjust.

 

So I stupidly continued to take it for 2 weeks until another doctor in the practice told me to go back to my normal dose immediately. I was expecting that I would then return to ‘normal’ - but I didn’t. I continued to suffer bouts of toxic anxiety as well as the other symptoms.

I consulted other GPs and a psychiatrist - all were reluctant to link my symptoms to the increased meds, instead going with the pure anxiety diagnosis. Recently I found a more open-minded GP who referred me to a psychiatrist who diagnosed non-acute sertraline syndrome due to an adverse reaction to the increased dose. He recommended I come off over 5 weeks in 5mg increments using a solution. However when I got to 15mg last week I developed extra symptoms including ataxia, burning, nausea. The insomnia goes on. Now I have found this SA website which recommends a much slower taper of 10% per month or until symptoms ‘stabilise’ and become bearable.

 

Now I’m not sure what to do. It’s hard for me to find that stable point because I was already sick with various symptoms before I started my taper. I don’t know exactly what is causing the symptoms - seretonin syndrome or withdrawal. Maybe this is now a meaningless distinction, but if my problem is seretonin syndrome perhaps it’s better to taper more quickly to reduce the toxic level. I’m very confused and would appreciate any advice members may have.

 

Drug History

 

2002 - started taking Zoloft 100mg

Gradually reduced dose to 50mg by 2009. 

2009 - dose raised back to 100mg due to life stress. No ill effects.

2010 - started reducing dose again very slowly.

2016 - 2017 - down to 25 mg. Stayed on this dose.

5 October 2017 - dose raised to 50mg.

20 October 2017 - dose reduced back down to 25 mg.

Continued on this dose until February 2018.

Feb 24 - reduced to 20mg

Mar 3 - reduced to 15mg.

10 Mar - dose raised to 17.5mg.

12 Mar - went back to 15mg.

 

Edited March 13, 2018 by ChessieCat
added space

[ChessieCat]

I've merged the new Intro topic you created with your original Intro topic.  Each member has only 1 Intro topic where they can ask questions about their own situation and journal their progress.  This keeps your history in one place.

 

Please do not create any more Intro topics.  Thank you.

 

Edited March 13, 2018 by ChessieCat

[ChessieCat]

On 12/03/2018 at 10:04 AM, Shep said:

Please stop changing your doses. You really need to give yourself time to stabilize. You reported feeling "almost normal" on March 8, but then as soon as you had a wave, you updosed. 

 

[Scotty]

Apologies - I thought the profile and the introductory  topic were separate things. My brain isn’t working too well at present....

[Vonnegutjunky]

Your story sounds like mine except I didn’t abruptly stop my med - I stayed the course with a slow taper through the horrific adverse reaction (my story is exactly like yours in every way) I got my AR at 20mg of Paxil - I am now down to 7.8mg - I am doing better but still have waves and windows - and the waves leave me feeling like I am living in a nightmare - best of luck to you 

[Scotty]

Hi Vonnegutjunky - thanks so much for your response. It’s reassuring to know that there is someone else out there who has had the same bewildering experience. The adverse reaction was so quick and powerful - I’m still scratching my head and wondering how that could possibly have happened. Five months down the track I’m still holding on 15mg - but hardly stable as the symptoms remain severe. For example - the day before yesterday I was very sick...burning, tremor, nausea, high anxiety - had one of my worst nights ever with only about 2 hours sleep. Next morning felt close to death - but after lunch it flipped around...late afternoon felt well and quite normal, and went on to have a great evening. These fluctuations are bizarre and make it impossible to plan anything. It’s also hard to plan a taper rate when you can never stabilise and feel ok. I’d appreciate any advice or comments you might have - and once again thanks so much for your post. Best of luck to,you too.

[Gridley]

The last dosage in your signature is October 2017 50mg.  When did you drop to 15mg?  Did you taper or just drop?  Please indicate these changes in your signature.  Here's the link:

 

Account Settings – Create or Edit a signature.

[Scotty]

Hi Gridley - thanks for the prompt. I thought I had updated my signature but obviously did not do it correctly. Cheers.

[Vonnegutjunky]

18 hours ago, Scotty said:

Hi Vonnegutjunky - thanks so much for your response. It’s reassuring to know that there is someone else out there who has had the same bewildering experience. The adverse reaction was so quick and powerful - I’m still scratching my head and wondering how that could possibly have happened. Five months down the track I’m still holding on 15mg - but hardly stable as the symptoms remain severe. For example - the day before yesterday I was very sick...burning, tremor, nausea, high anxiety - had one of my worst nights ever with only about 2 hours sleep. Next morning felt close to death - but after lunch it flipped around...late afternoon felt well and quite normal, and went on to have a great evening. These fluctuations are bizarre and make it impossible to plan anything. It’s also hard to plan a taper rate when you can never stabilise and feel ok. I’d appreciate any advice or comments you might have - and once again thanks so much for your post. Best of luck to,you too.

I am the same way - I have crazy windows and waves - my waves leave me feeling as though the windows were never there - so I can’t plan anything - 

 

I got my adverse reaction at 20mg of Paxil (10 mg was my normal dose for 10 years) 

 

i am now down to 7.8mg and, like you, trying to stabilize so I can properly taper. 

 

I do do feel better and better as I lower, however I am now experiencing a lot of anxiety, panic and depersonalization - it’s better than it was- but I am still not able to go back to work full time at this point.

 

i continue to do a very excruciatingly slow taper so I don’t get horrible withdrawal on top of everything else - 

 

i may in fact be experiencing withdrawal symptoms at this point, or maybe the after effects of an adverse reaction, I can’t tell anymore - but I do have better days than I did and I am very grateful for that - 

 

i am afraid that I won’t get better until I’m completely off the medication, because it’s going to take me so long to get off - so I live day by day and hope for the best -

 

my only advice  is this - 

 

dont try anither medication- it won’t help - not right now - I have heard of others trying a med successfully during withdrawal, but never ever during an adverse reaction- it’s because of the reason you had the adverse reaction, will be the same reason your going to have a bad reaction to anything you try - it will prolong your suffering - trust me I’ve seen it in groups on Facebook - the merry go round of meds - and they are spending years to no avail - 

 

the other advice is still continue to taper slow as you can- the less changes you make to your brain, the easier it is for it to find some stability 

 

and lastly - your going g to have waves where you feel worse than you ever did - especially after a particularly good day- don’t be scared - that’s part of getting better - your brain is starting to fluctuate again - and that is Good!! 

 

Take care and and keep us updated on your progress-!! 

[Scotty]

Thanks again - particularly for your advice about avoiding other medications. A few doctors have advised me to switch to Mirtazapine while trying to taper. My instinct was strongly against this, for the reason you give - that an excess of these drugs made me sick in the first place - so it doesn’t make any sense to add another one. It’s really helpful to have you confirm that instinct.

I’ve been feeling quite a bit better over the past 3 days - have slept through the night for the first time in 5 months, and the symptoms have decreased. Remains to be seen whether it’s just an unusually long window or a genuine improvement. The psychiatrist said it was possible that I might fully stabilise on a lower dose. I’m trying not to get too hopeful and steel myself for another wave.

My very best wishes to you - yes, let’s keep in touch.

 

[Scotty]

Hi everyone,

It's been a rough journey since I last posted in March. I tapered down from approximately 15mg of Zoloft, finally stopping completely on June 1st - too quickly, I acknowledge. However my problems were initially caused by a severe adverse reaction to an increased dose in October 2017, so I guess I was desperate to get the hated poison out of my system. 

So I've been completely off for almost 4 months. The first three months were grim with the usual suspects: severe anxiety...dreadful insomnia...fatigue...I won't catalogue the symptoms at length as I'm sure you're familiar with them! However days were often manageable with blessed windows, particularly in the evenings. While not living the full life I had before the AR, my journal shows that I was reasonably active with friends and family (I'm retired).

 

On September 1st - three months exactly - this changed dramatically. Symptoms redoubled their intensity, swamping me pretty well every day. Bless this site for informing me about delayed withdrawal, but it can't quite mitigate the raw reality of the experience.  I guess months of persistent insomnia and cortisol-driven palpitations have left me completely exhausted, and over the last few days it's become much worse. I find that even the smallest exertion exhausts me - putting the bin out, sweeping the kitchen floor. This is very frightening. Has anyone else in the community experienced such a symptom? 

I'd be very grateful for any insights you may have about this and/or your experiences of delayed withdrawal.

 

 

 

 

 

[ChessieCat]

Unfortunately it's not unusual.  This topic might help:  are-we-there-yet-how-long-is-withdrawal-going-to-take

 

And from this topic what-does-healing-from-withdrawal-syndrome-feel-like

 

On 12/4/2015 at 2:41 AM, apace41 said:

Basically- you have a building where the MAJOR steel structures are trying to be rebuilt at different times - ALL while people are coming and going in the building and attempting to work.

It would be like if the World Trade Center Towers hadn't completely fallen - but had crumbled inside in different places.. Imagine if you were trying to rebuild the tower - WHILE people were coming and going and trying to work in the building!  You'd have to set up a temporary elevator - but when you needed to fix part of that area, you'd have to tear down that elevator and set up a temporary elevator somewhere else. And so on. You'd have to build, work around, then tear down, then build again, then work around, then build... ALL while people are coming and going, ALL while the furniture is being replaced, ALL while the walls are getting repainted... ALL while life is going on INSIDE the building. No doubt it would be chaotic. That is EXACTLY what is happening with windows and waves.  The windows are where the body has "got it right" for a day or so - but then the building shifts and the brain works on something else - and it's chaos again while another temporary pathway is set up to reroute function until repairs are made.

 

[Vonnegutjunky]

Scotty, I also had an AR after reinstement - and now, I’m on a low dose (still tapering) and the exhaustion your talking about sounds like mine- I was recently diagnosed with Chronic Fatigue Syndrome/Mayalgic Encephalopathy- 

 

i don’t know if the AR caused it or if I had it before the Paxil and had the AR because of my CFS but it’s all related to a sever slowing of the metabolic system and and inability to effectively utilize energy - something to that effect - and this is somehow related to chronic CNS inflammation 

 

im not suggestion you have this syndrome but I do wonder if the discontinuation of an ssri creates an inflammatory process that mimics a sort of CFS like response - the reasoning is due to ssris having anti- inflammatory properties and then when it’s taken away, you become inflamed and have very very similar symptoms of CFS - 

 

Sometimes even thinking of doing things (things that I love) will throw me into what feels like wd/adver reaction symptoms - but if i stay in bed for days at a time I start to feel better and better - 

 

just a thought - take care 

[Scotty]

Hi ChessieCat - thanks so much for these links - both very helpful. BrassMonkey’ comprehensive essay is really impressive. Thanks to you also for all the work you’ve put in on this site, and on your own website which I’ve just referred to. It’s excellent - I plan to work my way through all the links.

I see that you are a fellow Aussie. Is it possible to make actual personal contact with other local members in this situation? I’m still not quite sure of the rules of the site and how it operates. Very best wishes to you. 

[Scotty]

Hi Vonnegutjunky

Thanks for your response. Yes, I too thought of CFS as a possibility - a rather scary one! I’ve been fatigued since all this started a year ago, after the adverse reaction. Natural enough given my severe insomnia. But this feeling of total weakness takes it up to a whole new level. It swept in about 3 weeks ago and seems to have replaced the anxiety as No. 1 Symptom. Right now I’m in denial mode, hoping that it may recede into the background as others have, only to be replaced by something equally unpleasant. I’ll see how it goes over the next few weeks. Partly this is about keeping my head in the sand - but part is my extreme reluctance to endure further medical tests at the moment because I find them so stressful. 

Best wishes to you.

[ChessieCat]

59 minutes ago, Scotty said:

Is it possible to make actual personal contact with other local members in this situation? 

 

G'day mate 😊

 

 

[Scotty]

Thanks mate!

[Scotty]

Hi everyone. As of today I’m facing a big decision. As I’ve described, last year I had a bad adverse reaction to a 25 mg increase in my dose of Zoloft, which abruptly threw me into seretonin syndrome. This blended into withdrawal as I tapered down over the next 8 months or so. On June 1st I discontinued completely, and the first three months went reasonably well. Then I was dumped by a huge wave of delayed withdrawal and have been very sick for the past month. Today my psychiatrist told me he wants me to reinstate a small dose to alleviate my symptoms. I’m at a loss - my instinct is never again to touch the drug that caused me so much suffering with the adverse reaction. Yet my symptoms are pretty bad without a window in sight. What to do? I’d be very grateful for any advice you may have.

 

 

 

[ChessieCat]

I've quoted some important points from Post #1 of About reinstating and stabilizing to reduce withdrawal symptoms below.  However, please ensure that you read the whole post carefully yourself before reinstating.

 

 

On 10/9/2012 at 10:17 AM, Altostrata said:

What is known about reinstatement
from my reading and from patient experience as posted on online support sites:

• According to medical knowledge, reinstatement is the only way to alleviate withdrawal symptoms.

 

On 10/9/2012 at 10:17 AM, Altostrata said:

When reinstating, start low to see what you need. You can always increase if necessary. If you've been off the drug for a month or more, many people can find some relief from antidepressant withdrawal symptoms by reinstating as little as 0.5mg - 5mg. Do not start at a high dose, your nervous system has been sensitized by withdrawal and you may make it worse -- see a fuller explanation below.

 

On 10/9/2012 at 10:17 AM, Altostrata said:

If you had adverse reactions while you were taking the drug, a low dose may not trigger the adverse reactions but still reduce withdrawal symptoms. Adverse reactions tend to be dosage-related: The higher the dose, the worse the reaction.

 

On 10/9/2012 at 10:17 AM, Altostrata said:

When to discontinue reinstatement
If, upon reinstatement, you very soon feel worse, most likely you are sensitized to the drug and need to take a smaller dosage or, possibly, none at all.

 

[ChessieCat]

Q:  Has there been anything that has changed, life circumstances, health problems, change in diet, that might have contributed to the symptoms increasing?

 

It is worth thinking about this, because if something like this has happened you may just be better off learning to cope with it until the situation passes or is changed.

[Scotty]

Hi ChessieCat - no, there has been no significant change in my life. On the site I’ve read quite a few accounts of waves of delayed withdrawal, commonly happening at about 3 months just as people were starting to become  a bit complacent. That’s exactly what this feels like. Not sure what else it could be. 

Thanks for all the material on reinstatement. After reading it I’m  inclined to tough it out for the moment - hard to be certain exactly what dose to reinstate, and I guess I’m terrified of risking another adverse reaction - which was triggered by a small increase in the first place.

Many thanks for replying to my post - it’s just so good to be in touch with someone.

[Altostrata]

Hi, Scotty. Well, that's an unusually enlightened psychiatrist.

 

I would ask him or her for liquid Zoloft and give a 0.5mg-1mg reinstatement a try, to test the waters. If you don't feel anything or feel a bit better, we can talk about increasing it.

 

It looks to me that you did not have serotonin syndrome, you had a bad reaction to too high a dose. You could call it serotonin toxicity, but a tiny dose should not have this effect on you.

[Scotty]

Hi Altostrata - many thanks for your reply and your advice about reinstatement. I hadn’t considered it until the psychiatrist’s suggestion. You also sound positive about its potential benefits.

However I must admit the prospect really scares me so I’m quite conflicted. My initial adverse reaction was severe, so I’m afraid it might happen again if even a grain of Zoloft gets into my system. Should I take a chance to lessen these horrible symptoms, or just plod stoically on in the hope that eventually this wave must end? This is my internal debate right now, and I’m not sure which way to jump.

Meanwhile I’m glad to have this chance to express my admiration for your achievement in creating this extraordinary website. The fact that you did it while you were unwell is incredible to me - most days I can barely get out the door to collect the post. I felt so relieved and consoled when I first came upon it - and obviously many thousands of others have felt the same. Congratulations and heartfelt thanks.