Josh: 1 month off sertraline - repeating words and earworms

[Josh]

15 April 

 

7:25 - woke up, slept well 

 

08:09 - laying in bed, feel a bit anxious today. Very low level. Also tummy feels a bit sick and nauseous. Legs also feel the tiniest bit tingly and restless but it’s so mild and able to relax them 

 

09:07 - had a shower, got ready satnont be sofa, low leve tinnitus in left ear begins

 

09:11 - feel tired, tired chest, tension around my head creeping in 

 

09:26 - bad anxiety creeping in that is making my chest hurt 

 

09:33 - exhaustion, really realising that my physical symptoms can flare up if even if I am feeling good after exerting a lot of energy 

 

09:54 - excessive belching, after my red bush tea. 

 

9:58 - 0.11ml taken, 

 

10:04 feel like my head is hurting a bit more since taking it. Electric feelings in skull, and annoying ear pressure is back

 

10:26 - tinnitus is still low, anxiety is mild and the pain has gone away mostly 

 

12:32 - are some spinach and ricotta ravioli with butter Parmesan and ketchup. Tinnitus is much less noticeable. Just feel exhausted, under the weather feeling, ear pressure and some head pressure 

 

14:00 fish oil 

 

14:58 went for a little walk to the shops , headachey, foggy, a bit dizzy 

 

17:44 cleaned the kitchen and swept the floor, had a shower and really tired and exhausted. Body back hurts and feel like I’m breathless 

 

18:40 - beetroot burgers with

May lettuce avacado and broccoli with crispy chilli oil and garlic. Feeling really rubbish, foggy, run down, ear pain and pressure is really uncomfortable 

 

19:23 went and bought some gum for my ears, hoping it will help Eustachian tube dysfunction, the ear fullness is making me restless I’m so uncomfortable 

 

20:00 had a bath, ears driving me crazy. Went and got into bed with a hot towel against my head. Let’s also have a slight burning feeling in them as well, this is new, but it’s mild

 

22:03 managed to feel a bit better about my ears by relaxing in bed, legs feel sort of okay now. Tinnitus is coming in a little before bed. But I am okay, ready to do another day. 
 

 

Hi @Emonda, here is my symptoms for today. Think I might try 0.12ml tomorrow. 
 

I have been measuring it with a micro pipette and putting it in a small glass of water and drinking it straight away - is this a fine method or shall I be making a dilution as recommended by mark Horowitz - let me know what you think! 
 

 

[Emonda]

Hi Josh,

It would be easier if I could glance at your signature and see that it uses the same measuring format as your posts. 

 

Your signature says you are at 0.4 (can you add "mg" after the 0.4, please). However, your post says you are going to increase to 0.12ml (from 0.11ml, I think, from reading a previous post). It would be best to stick with the same format so we can avoid confusion.

 

So it's been ~3 weeks at your current dose? Overall there has been improvement? 

 

As to the size of the increase in the proposed dose, small is a safer way to test the waters.

 

As to the way you are taking your mediation, I'd have a read of this:

 

 

 

 

 

[Josh]

Hi @Emonda

 

apologises I’ll clarify it here and then update my signature 

 

I started reinstating at 5ml (20mg) of

prozac for 5 days, that was too much - took one day off then started reinstating at 0.1ml (0.4mg) which I held for 16 days. 
 

Then for 9 days I have been on 0.11ml (0.44mg a 10 % increase). 
 

i am looking to go up to 0.12ml (0.48 mg) today.

 

when I started the 0.11ml I had two really bad days, intense anxiety and chest pains that felt related to the upped dose bout 4/5 days in, The other days have also been tough but mild anxiety and mainly

physical and cognitive symptoms. It did feel like it went down and I wasn’t activated for

long. I have been experiencing some windows in the morning before my dose and I’m the evenings sometimes when I have relaxed. 
 

i think so far so good. And I feel like I am strong enough to go up slightly again. 
 

I will read the article you put above, im

assuming it works the same in reverse?
 

 

[Emonda]

23 hours ago, Josh said:

the constant tinnitus is very jarring. It’s strange, when I started getting withdrawals after my first spike it lessened gradually and became really manageable. Since reinstating it’s getting more persistent - will there be a chance it settles again as I stabilise? What was your experience of it? 

 

Very jarring - I can't recall what I told you, but I developed tinnitus after reinstating Lexapro ~10 years ago at too high a dose (I hadn't found this website back then). It's never gone away. Most of the time, it is just background noise.

 

The WD symptom checklist lists tinnitus as a WD symptom of ADs. I dropped slightly more last month than normal, and it flared up my tinnitus...three weeks later, it's still jarring!

 

I guess what I am saying is that if reinstating the AD has caused your tinnitus, you'd want to be careful about increasing the dose further.

 

It's a fine line between getting stable and managing side effects.

 

I don't know what the right answer for you is. I hope my rambling is a little helpful.  

[Emonda]

3 minutes ago, Josh said:

Then for 9 days I have been on 0.11ml

 

It's your choice, but if you can give yourself another week, it might be worth trying.

 

Stability is key, and allowing plenty of time to adjust to small changes. I know at times in the past I've wanted to make a change out of desperation for relief. With encouragement, I held my dose and stability came.

 

I'm sorry you find yourself in this position.

 

[Josh]

@Emonda ah I am so sorry to hear that! It’s really unfortunate that tinnitus comes into play with this medication and withdrawals 
 

I actually experienced tinnitus coming off prozac in January, since reinstating it has aggravated it slightly and it’s coming more present, it was diminishing a lot during the few months I had it before reinstating and I really hardly noticed it. Now, it’s a lot more present - im concerned I may be causing permanent damage to it by reinstating. But I was concerned that I was going to crash even more late down the line and got scared. 

[Josh]

3 minutes ago, Emonda said:

 

It's your choice, but if you can give yourself another week, it might be worth trying.

 

Stability is key, and allowing plenty of time to adjust to small changes. I know at times in the past I've wanted to make a change out of desperation for relief. With encouragement, I held my dose and stability came.

 

I'm sorry you find yourself in this position.

 

 

hm, it’s really hard to tell what stability looks like. Is it just more manageable symptoms, or do I have to wait until I feel feel really good? 

it’s also hard as symptoms keep jumping around in their own timelines, like just as of yesterday I was becoming really distressed and  frustrated with my ears clicking and the pressure and pain that came with it. This has worsened recently, but other stuff has gotten better. It’s so hard to tell! 
 

im so torn between these decisions and so scared to do any more detriment to myself. 
 

should I wait for my tinnitus to settle a lot more before I go up? It has settled slightly and I’m able to ignore it a bit more but it’s still there. 
 

Im finding this self management scheme very distressing as I just feel damned if I do damned if I don’t 
 

 

[Emonda]

15 minutes ago, Josh said:

concerned I may be causing permanent damage to it by reinstating. But I was concerned that I was going to crash even more late down the line and got scared. 

 

The balancing act...I hear you.

 

For me, I take the fact that it changes in intensity as a good thing—it's not permanent. I assume if it were permanent damage, the noise would be constant/consistent in intensity.

 

12 minutes ago, Josh said:

hm, it’s really hard to tell what stability looks like. Is it just more manageable symptoms,

 

I read Brassmonkey (I think) talk about WD normal (I interpret that as meaning stability). You still have symptoms, but they are manageable, and you can go about your normal day.

 

15 minutes ago, Josh said:

it’s also hard as symptoms keep jumping around in their own timelines

 

Have a read of Windows and Waves again.

 

15 minutes ago, Josh said:

like just as of yesterday I was becoming really distressed and  frustrated with my ears clicking and the pressure and pain that came with it.

 

Distractions help

 

15 minutes ago, Josh said:

but other stuff has gotten better. It’s so hard to tell! 

 

If other stuff has improved, this is positive.

 

16 minutes ago, Josh said:

Im finding this self management scheme very distressing as I just feel damned if I do damned if I don’t 

 

It's an unpleasant situation we finds ourselves in, but there is lots of support and encouragement on this site. Have a read of the success stories for a boost.

[Josh]

16th April 

 

7:20 - woke up - good ish sleep, a few scary dreams that woke me up but could go back to sleep.  Definitely have different slightly more awake sleep then usual. Very mild anxiety, and a bit of a sicky feeling in my stomach and colicky ears and mild tinnitus 

 

8:00 - bad stomach, on toilet for while 

 

8:26 - red bush tea 

 

10:07 - taken 0.11ml - holding just a little longer to see. Ear pain is better, slight fogginess and tension head ache 

 

11:11 got back from a walk. Feeling low, a bit suicidal but nothing worrying or overwhelming. Feeling lonely at home by myself not able to do much. Laying down and noticed tingling in legs, 

 

12:38 reallt avigtate today and feel so restless and trapped in my body. Can’t settle into doing anything 

 

14:00 - tomatoe and brioche bun and salt 

 

14:26 - obsessively been looking online at other people’s withdrawal stories, reinstatement and success stories. It’s soo much, my back is hurting and my tinnitus is worse cause I’m stressed. Having a break from jt all it’s becoming obsessive. So restless had to leave the house again 

 

14:43 left the house again to go and sit on a bench outside. Slightly dizzy, have a restless feeling in my body, double vision, foggy, tingling legs

 

16:29 - going to meet a friend , feeling pretty dreadful but really want to try and do it for myself 

 

16:33 - feel for the first time less emotional. Feel trapped in stress, not finding a lot of relief in the beauty around me: it’s very subtle so not

Going to focus on it.

 

17th April 

 

7:00 wake up, was slowly waking up for about an hour before - slowly waking up more 

 

10:00 am - 0.11ml 

 

11:00 am went for a swim and intermittent saunas, feeling good 

 

12:40 - tomatoe rye and rocket Parmesan cheese olive oil and honey sand which 

 

 

12:53 - feeling a little bit tension head and foggy, a bit achy and tired from my trip out, tinnitus is also present quite loud 

 

16:56 - fish oil 

 

18:13 been dealing with some intense flu symtoms, so run down, achey, head pressure, ear pressure, run down, not able to do much cause of feeling sh*tty. 

 

18:53 in bed early, tingly legs. Really bad ear pressure 

 

21:46 anxiety has increased and so has my tingly legs. Feeling the most restless I’ve felt since all of this. 

 

22:30 - asleep 

 

1:40 am - awake, anxious, so much energy

 

01:45 - feels like there is blood rushing around my arms while they hurt and tense,

Legs also feel tingly and hard to relax 

 

My upper back has also started burning and feels  really strange. And noticed upon waking up my upper lip started twitching.

 

18th April 

 

Think I managed to get around 4 hours sleep, managed to relax and lay there with my eyes closed going in and out of sleep but I was definitely partially awake the whole night, 

 

I’ve woken up feeling okay, anxious, head pressure which is slight but constant. 

 

Did a meditation and sitting out in the sun. Saw a post that someone’s ages to reinstate and had a cry.

 

09:50 - noticed after my shower my tension head ache is really present. Feels like a thick band wrapped around my bead

 

10:59 - lots of crying today 

 

11:10 - chamomile tea and honey. Pressured head and vision problems 

 

11:36 - such a thick skull. Feels like my whole head is surrounded by an icy layer. A lot of pressure as well, I am pulling on the left side of my face and it feels numb on the right hand side of my head and face going down my neck

 

11:50 got home, this numb thick skull is weighing me down, feel so sluggish, almost a bit lifeless. Laying in the sofa

 

13:23 - so cold, also pins and needles in hands 

 

13:25 had a banana so

 

16:42 - body pain think I’m doing too much 

 

18:21 in bed trying to recover from

All the action, my throat and stomach hurt, have no appetite either

 

18:56 - bad stomach 

 

19:54 -  rice aubergine and broccoli. Got back into bed as feeling so horrendous. Sweating, anxious, body feels so so weird like I’ve been hit by a truck 
 

 

 

 

@Emonda hey Emonda, these past few days have been rough. My physical symptoms are getting worse, honestly feel horrendous. Starting to really panic about them now - should I be concerned? Could this be a wave or am I doing harm? 
 

 

I’ve kept at the same dose of 0.11ml - I didn’t increase it 

[Josh]

Hi @Emonda - just adding to the above.

 

 

woke up today with bad depression. This is the first time I’ve had this since reinstating. I’ve been quite good at dealing with everything emotionally so far but now this feels bad. I think I’m going to be in bed all day. 
 

my brain feels like it’s not functioning at all. Cognitively my thoughts aren’t stringing together. 
 

I think I am going to hold at this dose for a while longer, hopefully this blows over 

[Josh]

Hi @Altostrata we haven’t corresponded yet but I thought I’d tag you for a second opinion. I’m struggling since reinstating, could you potentially look over my symptom log and see if I’m in the right track? Today feels like a turning point, feel the worst I’ve felt since this past month. The physical symptoms are intense and now I’m depressed and feel like I’m losing my mind. 
 

im going to hold at 0.44mg until I feel a bit of relief and then move up hopefully. 

[Emonda]

Altostrata has stepped back from day-to-day involvement. Best not to tag her moving forward.

 

Unfortunately, the effects of stopping ADs CT are not nice (speaking from personal experience): Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

4 months after your CT, you reinstated at 20mg for 4 days, and that can make you feel terrible (been there, done that, too): Kindling

 

Reinstating is best done slowly, starting with a small dose to "test the waters" (I wish I had known this 10 years ago).

 

It's your choice if/when to increase, but you need to give yourself time to see how you adjust. If the reinstatement makes you feel worse, then more of the AD may be unhelpful. At the same time, you may just been feeling dreadful from the CT. 

 

I've read of people taking > 6 months to stabilise after gradually increasing their dose.

 

I know it's not nice, and I wish I could tell you when you'll start to feel better, but we all respond differently.

[Josh]

Hi @Emonda

 

thanks so much for this. This is definitely calming to know I’m not poisoning myself even more. I will hold here until I feel able to move up slightly. 
 

I think I definitely may have kindled after those 5 days at 20mg, but I don’t think I kindled quite as severely as some people have said when they experienced it. Some people sounded like they experienced hell for months from kindling. It’s hard to say if I have when I read up on these experiences,  because I came down slightly after that bad experience felt slightly better on some days and then since the lower reinstatement have been gradually getting worse these past few week. Maybe the medication is building up in my system and causing symptoms, and maybe it’s also from the CT.

 

I’ve managed to settle slightly today. I’m doing lots of self care and am feeling slightly more sane. 
 

But I am feeling in despair, I absolutely hate this is my life, I can’t believe I have CT twice in my life from false perceptions on being able to fix myself so easily with other SSRI’s. I wish I knew how fragile these were, I wish I knew what to do to help myself before I hurt myself. 
 

I feel like I may never be able to come off of these now once I stabilise because I have potentially kindled myself and been through two CT, my nervous system might not let me. I feel as if I’m doomed to withdraw painfully from these no matter how careful I am in the future. 
 

im sorry for the rant, just feel hopeless. 
 

again, thank you so much for your help. Thank god for this forum that is helping so many of us. 

[Altostrata]

Sorry, I am no longer active day-to-day on this site.

[Josh]

Hi @Emonda 

 

hope you are well! 
 

I’ve been holding at my dose of 0.11ml (0.44mg) of Prozac for 17 days now. 
 

I’ve seen a slight improvement in my symptoms. I’ve also been seeing a healer so that might also be helping.
 

the main symptoms I’m dealing with is the brain fog and cognitive functioning that is really quite bad, find it so hard to talk to people and hold conversations and I can feel it hurting my body at times. This seems to progress during the day after I wake up. I’m also dealing with a lot of anxiety when I wake up in the mornings now. 
 

im just wondering should I move my dose up higher or should I just stay on this dose as it is until I stabilise? Can I find stabilisation staying on a low dose? 
 

Let me know if you have any questions about how else I’m feeling and I can share with you to help your understanding 

 

thanks so much 

 

Josh 

[Emonda]

2 hours ago, Josh said:

I’ve seen a slight improvement in my symptoms

 

This is good to read.

 

2 hours ago, Josh said:

the main symptoms I’m dealing with is the brain fog and cognitive functioning

 

Highly likely from the October '23 CT...it'll take time.

 

2 hours ago, Josh said:

im just wondering should I move my dose up higher or should I just stay on this dose as it is until I stabilise?

 

It's your call. Stability is key. If you did increase, small increases are better so you can monitor for any adverse reaction, such as an uptick in your tinnitus.

 

If you increase, you'd want to hold again at the dose for 3-4 weeks to feel the effect of that increase.

[Josh]

Yes, I’m feeling a little bit more capable, and able to look after myself during the day which is good. 
 

the brain fog is really hard, but I am working on nailing myself to the present moment and accepting where I am. I really don’t want to make it worse and only want to get better, which is why I don’t want to up my dose at all. 
 

but I I’m just wondering if that might hinder me from finding the right dose to stabilise, could I potentially not find stability at all if I don’t find the right dose?