Skylark1980: Insomnia - Sertraline withdrawal or relapse?

June 20, 2018

Hi everyone,

I took the minimum recommended dose of sertraline /zoloft (50mg) for a year to help with post-natal insomnia (Nov 16 - Nov 17). It worked and I slept well. I tapered off from Nov 17 - March 18 (about 4 months). This was more gradual than what is recommended by the NHS so I thought I was being extra careful! I reduced my dose by half a pill (25mg) a week. Anyway, 6 weeks after my final dose I started experiencing insomnia (my original symptom), physical anxiety & brain fog - despite not being consciously anxious or worried. It has come and gone in waves every few days over the last 3 months. At least once a week I'll get only an hour or 2 of sleep, then I have a good night and then some nights where I get maybe 5-6 hours which I can just about cope with. Last night was a 1 hour sleep night and I'm sick of it. I thought my original symptoms were coming back but now I've found this site, I'm wondering if it's withdrawal symptoms. They are just about bearable if I know that they will improve. However, the insomnia is affecting my day to day life and can't go on indefinitely. So do I:-

a) Tough it out - I've already made it 3 months without realising these are potentially withdrawal symptoms

b) Start taking a tiny dose - maybe quarter of a pill a day (12.5mg)

c) Take sleeping pills short term just to get through this temporary period (I take half a Temazepam 10mg tablet when really desperate - this is a last resort and my GP does not like to prescribe them)

I do yoga and meditation to manage it but would welcome any other suggestions for rebalancing the nervous system without upping the drugs again.... Accupuncture was recommended by someone??

I should mention that I also took the same dose for the same symptoms the year after my daughter was born (April 14 - April 15) and tapered in the same way. I remember briefly getting a resurgence of unexplainable anxiety but then I was back to my old self for a year or so with no ill-effects.

Please help, insomnia is my nemesis!! 😭😱

June 21, 2018

Hi Skylark, welcome to SA. My journey with ADs also began with post-natal problems - I think there are quite a few of us here.

It would be helpful if you could create a signature with your med history, including all drugs, doses and dates (starting and stopping). This will help us to help you as best we can. You can edit your signature under your Account Settings. See this topic for more info: Please put your withdrawal history in your signature

It's great that you are able to manage your symptoms with yoga and meditation. Here are some more tips for sleep: Tips to help sleep - so many of us have that awful withdrawal insomnia

Toughing it out is an option if withdrawal is bearable and you are coping okay. It is possible that reinstating a tiny dose might help to alleviate symptoms to some degree. After three months off, you might be better to start with a smaller dose to begin with (e.g. 5mg) to make it easier for your system to adjust and reduce the risk of an adverse reaction. See: about reinstating and stabilizing to reduce withdrawal symptoms

Please post your updates and questions here in your introduction topic.

June 21, 2018

Hi Songbird,

Thank you so much for your quick reply. I've added my signature (I think that actually I may have only been on sertraline for 6 months with my first child before beginning to taper which might account for it being easier that time?!)

Yoga and meditation help with anxiety symptoms but don't touch the insomnia (mindfulness does help with the frustration but doesn't help me to fall asleep). I've learned pretty good sleep hygiene from previous insomnia, I'm not consciously worrying, but I lie awake until 5am on a bad night! I can cope on 6 hours sleep if I have to, but I've just had 2 consecutive bad nights and feel rubbish (one with 1 hour sleep, one where I took 5mg Temazepam as a last resort & got 5 hours). I know the risks of sleeping pills and am already feeling guilty I had to resort to it.

I really don't want to reinstate but I have 2 young children to consider. My pills are 50mg so would be too fiddly to cut into 10ths for a 5mg dose! Does anyone know if you can get liquid sertraline on the NHS?

I'm also looking into Somatic Experiencing - does anyone have any experience with this? I'm new to it but have had it recommended by a friend. It apparently works by processing stored emotions/trauma/energy in the body to enable the nervous system to re-establish homeostasis (I have a history of anxiety back to childhood for various reasons and a lot of physical tension).

I already take magnesium but will start Omega 3 as recommended on here.

I'm still not completely sure this is protracted withdrawal as it could just be old anxiety surfacing - but I usually can see a pattern where my ruminating brain creates insomnia. This time my life is (thankfully) going relatively smoothly but this has come out of nowhere and is a complete mystery. No ruminating (except now worrying about insomnia, but the insomnia came first.)

Thank goodness I found this site - I've been so confused about what's going on with my body and no one around me gets the torture of insomnia

Any advice welcome x

June 21, 2018

8 minutes ago, Skylark1980 said:

I think that actually I may have only been on sertraline for 6 months with my first child before beginning to taper which might account for it being easier that time?!

I had a similar experience - got off the AD pretty easily the first couple of times after about six months on. The third time I was on longer, and got stuck.

10 minutes ago, Skylark1980 said:

I'm also looking into Somatic Experiencing - does anyone have any experience with this? I'm new to it but have had it recommended by a friend. It apparently works by processing stored emotions/trauma/energy in the body to enable the nervous system to re-establish homeostasis (I have a history of anxiety back to childhood for various reasons and a lot of physical tension).

I haven't heard of it, but it sounds interesting. I would be cautious about starting something like this while in a destabilized state, as the body does not always respond in normal ways during withdrawal.

14 minutes ago, Skylark1980 said:

I really don't want to reinstate but I have 2 young children to consider. My pills are 50mg so would be too fiddly to cut into 10ths for a 5mg dose! Does anyone know if you can get liquid sertraline on the NHS?

I don't know, but if not, there are ways to create the doses you need by making your own liquid, or using a digital scale.

how to make a liquid from tablets or capsules

using a digital scale to measure doses

June 21, 2018

Skylark, I'm not sure if this is an option for you with the NHS, but here in Australia my doctor writes me a private prescription for whichever odd dose I'm up to (down to) of sertraline and I have a compounding pharmacy fill it. The price can vary from pharmacy to pharmacy, I gather, but I've stayed with the same one all the way down so far.

June 21, 2018

Hi Songbird & Bubbles, thank you for your replies.

I'm already feeling a bit better just to have found a place to share.

Very good point regarding Somatic Experiencing, don't want to make things worse! The practitioner I've emailed says it can be very useful for helping 'disregulation of the nervous system' but I'll reply to say that it might be SSRI withdrawal and see what he says. It's not hypnosis or anything like that, more like learning to reconnect with your body in a meditative way I think (and I've done a lot of mindfulness meditation over the years so hopefully it will be ok).

If you're interested, here's some info I've found.... http://www.seaustralia.com.au/what-is-somatic-experiencing/how-does-somatic-experiencing-heal-trauma/

1 hour ago, bubbles said:

Skylark, I'm not sure if this is an option for you with the NHS, but here in Australia my doctor writes me a private prescription for whichever odd dose I'm up to (down to) of sertraline and I have a compounding pharmacy fill it. The price can vary from pharmacy to pharmacy, I gather, but I've stayed with the same one all the way down so far.

The joys of a partially private system! (I lived in Sydney for a while, should have made the most of it!) I doubt the NHS runs to that but if necessary I'll invest in some digital scales....

I know this is a 'how long is a piece of string' question but does anyone have any idea how long the insomnia might last? I've come off a low dose that I was only on for a year (which seems relatively short compared to some people). It's been intermittent for 3 months - a couple of fairly good sleeping days then a couple of bad. Any personal experiences (preferably hopeful!)

I feel like I've strained my nervous system! I get really over-stimulated and tired by the slightest thing. But years of anxiety may have contributed, not just the meds....

Thanks again for your replies x

PS Yes or no to napping? I sometimes have to nap if I've had virtually no sleep but try to keep it to 20 mins....

June 22, 2018

Quote

The joys of a partially private system! (I lived in Sydney for a while, should have made the most of it!) I doubt the NHS runs to that but if necessary I'll invest in some digital scales....

Yes, I've heard that the NHS is a whole different beast. A liquid sertraline exists in the US, but I can't get it here in Australia. I don't know if it is available in the UK. I do pay extra for my compounding compared to buying a box of sertraline "off the shelf" (but of course still with a prescription), but it isn't too bad. It did encourage me to taper slowly! Capsules come in a minimum amount to be reasonably economical, so I've been more inclined to try to use a decent amount instead of discarding them too quickly!

June 22, 2018

Skylark,

I've recently started Somatic Experiencing myself and I don't think there is any harm if you already have experience with mindfulness or breathing exercises. I've only gone a few times and I'm sure every practictioner is different but mine just gently coaches me through becoming aware of different sensation in my body, observing them and occasionally doing a few specific techniques to see how they change. I think it's worth trying.

I went off of Paxil/Paroxetine 6 months ago and am also suffering with bouts of anxiety and insomnia. It's hard and difficult to explain to anyone who hasn't experienced it. Good luck to you!!

June 22, 2018

Yes - a good excuse to taper slowly!

So I'm already taking magnesium citrate and have now got some omega 3 - can anyone point me to info on suggested doses and times of day to take them to help with insomnia?

I had a slightly better night last night. I fell straight to sleep, woke 30 mins later full of adrenaline and then took a couple of hours to go back to sleep but overall got a relatively deep chunk of sleep (I listened to a yoga nidra track to help me drift off and took an anti-histamine).

Thanks for any advice on supplements...

June 23, 2018

14 hours ago, Skylark1980 said:

So I'm already taking magnesium citrate and have now got some omega 3 - can anyone point me to info on suggested doses and times of day to take them to help with insomnia?

Thanks for any advice on supplements...

It's best to start only one thing at a time, that way if you have any problems (or improvements), you'll know the cause. Magnesium is generally calming, whereas Omega-3 can be stimulating, so I would start with the magnesium first, starting with a low dose to see how your body reacts. Here's our magnesium topic - most of the info is in the top post: magnesium, nature's calcium channel blocker

June 23, 2018

On 6/22/2018 at 11:15 AM, Laurame said:

Skylark,

I've recently started Somatic Experiencing myself and I don't think there is any harm if you already have experience with mindfulness or breathing exercises. I've only gone a few times and I'm sure every practictioner is different but mine just gently coaches me through becoming aware of different sensation in my body, observing them and occasionally doing a few specific techniques to see how they change. I think it's worth trying.

I went off of Paxil/Paroxetine 6 months ago and am also suffering with bouts of anxiety and insomnia. It's hard and difficult to explain to anyone who hasn't experienced it. Good luck to you!!

Hi Laurame,

Sorry, I only just saw your reply above. Great that you're having Somatic Experiencing - do you think it's making any difference so far? I mentioned possible withdrawal syndrome and was reassured by his reply:-

"As for the insomnia – SE uses a titrated approach – so works carefully and slowly in bringing more organisation and coherence to the nervous system and other system is interacts with (ie respiratory, digestive, endochrine etc). From my experience

it helps lift symptoms, making them more manageable. In sessions it may be that pockets of more challenging feelings come up , but normally there is a greater sense of energy, aliveness and connectedness once these releases have happened. Deep healing is a complex

process, so its not possible to predict what would happen for sure – but the underlying direction empowering the bodies innate ability to healing itself".

I have my first session next week so will report back.

How soon did your anxiety come on after you completely finished Paroxetine? Is it slowly getting better with time? I can see from your signature that you're now on sertraline. I'm sorry you're experiencing insomnia too - you're right, it's difficult to explain how bad it can be. I really don't want to reinstate sertraline so I will try Somatic Experiencing first..... Mine comes and goes - a few bad days and then a better few days (yesterday I had a full night of sleep after only taking an antihistamine so today I feel like a new person!) Often I feel physical anxiety/insomnia for no reason at all. Sometimes it's triggered by the tiniest thing, like my nervous system is over-stimulated.

Songbird - thanks for the advice on supplements, I had no idea that Omega 3 could be stimulating!

June 23, 2018

30 minutes ago, Skylark1980 said:

Hi Laurame,

Sorry, I only just saw your reply above. Great that you're having Somatic Experiencing - do you think it's making any difference so far? I mentioned possible withdrawal syndrome and was reassured by his reply:-

I've only gone a few times but I've found it helpful. It's about re-training your nervous system so that it doesn't go into the hyper-alert "fight or flight" state unnecessarily. I have found that to be the biggest problem since going off Paroxetine. It's a lot of gentle body awareness and mindfulness exercises. I always feel relaxed at the end and often call upon the exercises at other moments when I'm feeling anxious.

How soon did your anxiety come on after you completely finished Paroxetine? Is it slowly getting better with time? I can see from your signature that you're now on sertraline. I'm sorry you're experiencing insomnia too - you're right, it's difficult to explain how bad it can be. I really don't want to reinstate sertraline so I will try Somatic Experiencing first..... Mine comes and goes - a few bad days and then a better few days (yesterday I had a full night of sleep after only taking an antihistamine so today I feel like a new person!) Often I feel physical anxiety/insomnia for no reason at all. Sometimes it's triggered by the tiniest thing, like my nervous system is over-stimulated

The full-blown anxiety started a month after I stopped it completely and it comes in waves. I might have a good week or two and then wake up in the morning with a knot in my stomach and feel anxious throughout the day. I'm also working with a psychotherapist but it doesn't really feel like the anxiety comes from thinking or emotional triggers. It is much more like a physical sensation that appears and then causes me to start thinking obsessively or worriedly. It does seem to be decreasing in intensity over time and I've continue to work and socialize and function outwardly normally during this time.

My insomnia comes and goes in waves too. I sometimes think it is related to the hormonal fluctuations of my menstrual cycle as it always seems worse around the time I get my period. I mostly try to just cope with getting 4 hours of sleep for a few nights but I also ocasionally take a pill, Lorazepam, when I feel like I'm verging on collapse and just need one good night's sleep.

.

30 minutes ago, Skylark1980 said:

Songbird - thanks for the advice on supplements, I had no idea that Omega 3 could be stimulating!

June 23, 2018

Hi Laurame,

Your symptoms are so similar to mine, I could have written your post! The physical anxiety or insomnia comes first, then causes anxious thought about it. Before I was on medication, it was my ruminating mind that caused the physical symptoms and I've done a lot of mindfulness work to decrease this. That's why Somatic Experiencing appeals - to get deeply into the body and undo this automatic fight or flight response. I read somewhere that you can retrain your mind but that your body takes a while to catch up so things linger.

Like you, I try to cope with the insomnia and occasionally take half a Temazepam when on verge of collapse. I'm really trying to avoid those and use anti-histamines instead.... Sometimes I'm so tired I feel it clouds everything and it's like living with a chronic condition. But on a good day, I feel normal. My brain still gets easily overloaded though,

I've been anxious since childhood so there are many contributing factors to this over-sensitive fight or flight response.... I just want a nice stable nervous system!!

June 24, 2018

On 6/23/2018 at 6:52 PM, Skylark1980 said:

Hi Laurame,

Your symptoms are so similar to mine, I could have written your post! The physical anxiety or insomnia comes first, then causes anxious thought about it. Before I was on medication, it was my ruminating mind that caused the physical symptoms and I've done a lot of mindfulness work to decrease this. That's why Somatic Experiencing appeals - to get deeply into the body and undo this automatic fight or flight response. I read somewhere that you can retrain your mind but that your body takes a while to catch up so things linger.

Like you, I try to cope with the insomnia and occasionally take half a Temazepam when on verge of collapse. I'm really trying to avoid those and use anti-histamines instead.... Sometimes I'm so tired I feel it clouds everything and it's like living with a chronic condition. But on a good day, I feel normal. My brain still gets easily overloaded though,

I've been anxious since childhood so there are many contributing factors to this over-sensitive fight or flight response.... I just want a nice stable nervous system!!

A nice stable nervous system sounds like a dream come true!!! I've always thought my primary problem was depression, not anxiety, and in fact I was afraid that it would come back when I went off Paroxetine. The anxiety was surprising to me, especially because as you say, it doesn't come from a ruminating mind but from a physical sensation. I suppose this points to withdrawal being the culprit and suggests that it will get better over time. Good luck with the somatic experiencing!

I actually got a spice in the anxiety today and had to take a .5 mg of Lorazepam. It always seems to happen right around my menstruation. I suppose it's the hormones?

Are antihistamines safer to take for sleeping?

June 25, 2018

The antihistamines are just an over the counter sleeping remedy that make you drowsy. I know there are warnings against taking Temazepam longterm as it's so addictive so I'm trying to only use very sparingly (and I assume Lorazepam is similar as it's also a benzodiazepine). I'm having more success with antihistamines this time as I'm taking them 20 minutes before bed (as directed on the packet), whereas in the past I've only taken them after lying awake for ages and then they don't seem to work. But 20 mins before bed seems to make me drowsy enough to drift off into sleep - so far anyway. I'm just going to take them for a few days to break the insomnia cycle (which seems to be working- I've now slept well for 3 days!) But then it seems to come in waves so who knows if it's the pills that are actually working....

I'm not sure if mine is worse with my cycle but I know of friends who get more anxiety/insomnia just before their period....

July 17, 2018

Hello,

Help and support needed after 3 bad nights of sleep

Just an update. I've felt largely better over the past 3 weeks. I've been charting my sleep and while nights where I sleep all night are a minority, most nights I have around 5 hours and can jut about cope. But I'm so easily triggered into a night of 1-2 hours and then feel I just can't function - last night was one of these and I feel terrible It's made me come back here to research reinstating. I really don't want to as I've now had a few Somatic Experiencing sessions and I feel it's going to be really helpful for making me feel physically safe again (my nervous system is trapped in the fear response, whether due to withdrawals or past trauma I'm not sure). But I can only have one more session before a long summer break, plus is isn't a quick fix, and this morning I feel at the end of my tether! Then again, some nights I go out like a light and feel normal during the day. It's so up and down and I feel trapped in this cycle

So UK sertraline/zoloft people, how did you taper using your NHS pills? What's the lowest dose I can get from the Dr and then can I divide it up with a pill cutter? Suggested minimum doses? (I was on the lowest prescribed dose of 50mg for a year and have been off for 4 months with withdrawal insomnia in cycles for 3 months).

Help!

July 17, 2018

Update for the post above: I went to the GP and she prescribed Zopiclone for sleep for a few days and suggested going back on sertraline if insomnia continutes. She wasn't sold on the idea that this could be a withdrawal effect - she said people might try to believe that to avoid facing the fact that the underlying issue has resurfaced and it's a relapse. She said I could go back on 25mg rather than the 50mg and that any smaller doses 'just sounded homeopathic'. Any thoughts?

I'm not keen to take the Zopiclone as it's adding another med into the mix, so might just stick with the antihistamine sleeping pills that do seem to work some nights without ill effects.... Anyone had luck with Zopiclone as a temporary anxiety measure?

If it's withdrawals, I've coped for 3 months and may be able to keep going if I know it will pass, but otherwise I think I'll have to reinstate. Could I go back on with 12.5mg (quarter of a tablet)? I don't want to cause any more shocks to my nervous system, especially as I have hopes that eventually the Somatic Experiencing may help me to re-balance.

Also, has anyone tried the supplement ashwagandha (Withania somnifera)? It's an adaptogen that apparently supports cortisol reduction.... I've been recommended it by a friend....

July 17, 2018

Hi, Skylark. Very few doctors know anything about withdrawal.

Do you have symptoms other than sleep problems? What is your daily symptom pattern? Please keep daily notes on paper about your symptoms, when you take your drugs, and their dosages. Use a simple list format with time of day on the left and notation (symptom, drug information) on the right.

Have you found any of these tips helpful?

On 6/21/2018 at 4:35 AM, Songbird said:

Here are some more tips for sleep: Tips to help sleep - so many of us have that awful withdrawal insomnia

I would try the sleep hygiene techniques -- darkening the bedroom, using a sleep mask -- plus a little melatonin before trying zopiclone, which can incur dependency, or reinstatement, which is dicey.

July 17, 2018

Hi Alto,

Thank you for your reply. The info Songbird linked to, plus other info on this site has been very useful. I don't think melatonin is available in the UK. I do practice good sleep hygiene (no TV an hour before bed, no caffeine after midday, magnesium baths & supplements, etc)

I've kept a sleep diary since discovering this site and find I have cycles of 2 or 3 bad nights and then about the same good nights. Really bad nights like last night seem to be only every couple of weeks and I still get a few nights where I go out like a light and sleep right through (usually with a bit of help from an over the counter antihistamine). I have two children and one is teething so that's not helping! Plus it's extremely hot in the UK with no air con which is affecting everyone's sleep.

I don't have any other symptoms except a bit of physical anxiety some days. Both this and the insomnia seem largely physical. I've experienced insomnia due to a ruminating mind before and this seems different. But I am now tempted to reinstate a low dose as I am feeling overwhelmed and losing my temper with my kids. I felt so frustrated and desperate when still awake at 5am this morning . Having said that, I felt like this 3 weeks ago when I discovered this wonderful site - and I haven't been that low since. Largely I'm coping but it's a bit of a struggle as I'm so up and down. It's a weird cycle that doesn't seem to coincide with what's going on in my life (which is relatively smooth although very busy) which is why I'm thinking more withdrawal than relapse - although little things do overwhelm me & trigger anxiety when I'm sleep deprived.

I'll stick with the antihistamine sleeping pill tonight and hope for a better sleep..... If I was to reinstate, what dose do you suggest starting on? I finished tapering from 50mg in March.

July 22, 2018

Help, please can an admin reply, I’m desperate 😔.

Following more nights of 2-3 hours sleep, I went back to different doc and got referral for sleep clinic. She also gave me temazepam 10mg for a couple of nights. I had a great sleep on Friday but last night I don’t think I slept at all!! Is there something seriously wrong if even temazepam doesn’t work? (I know the risks of benzos, but I also don’t want to go insane or reinstate before going to the sleep clinic). I took half a pill at bedtime and then another half a couple of hours later when I still wasn’t asleep. Maybe this had something to do with the pill not working?

i also started a supplement I’ve been recommended last night called Neuro Rest which has magnesium, 5HTP and L-tryptophan. Could this have anything do with it?

Can anyone reassure me that this is not going to send me insane or make me physically ill? I feel under so much strain. I’m trying acupuncture later in the week but I just don’t know how I can go on over the next few days and weeks until I can get to the clinic....

Also has anyone had luck with CBTi? Apparently that’s what the sleep clinic tend to recommend.

Please help..... 😔

July 22, 2018

1 hour ago, Skylark1980 said:

i also started a supplement I’ve been recommended last night called Neuro Rest which has magnesium, 5HTP and L-tryptophan. Could this have anything do with it?

please throw this supplement in the bin immediately, it has 5HTP in it which is basically another antidepressant, you will end up kindling yourself,

also temezpem will just upset your nervous system even more,

hope you see some relief soon

July 22, 2018

1 hour ago, Skylark1980 said:

i also started a supplement I’ve been recommended last night called Neuro Rest which has magnesium, 5HTP and L-tryptophan. Could this have anything do with it?

It's not uncommon for supplements to have paradoxical effects when in AD withdrawal. Tryptophan and 5-HTP are particularly dicey as they are serotonin precursors. See: 5-HTP (5-hydroxytryptophan) and l-tryptophan. I'd ditch this immediately and stick to just magnesium.

On 7/18/2018 at 4:27 AM, Skylark1980 said:

Also, has anyone tried the supplement ashwagandha (Withania somnifera)? It's an adaptogen that apparently supports cortisol reduction.... I've been recommended it by a friend....

As above - the reason we don't recommend many supplements here is because in withdrawal our systems can be very sensitive and react in unexpected ways to supplements. Individual responses also vary a lot, so what works great for one person could cause a bad reaction in someone else.

On 7/18/2018 at 7:15 AM, Skylark1980 said:

I don't think melatonin is available in the UK.

You can't buy it OTC, but I think it is available on prescription. I believe you are also allowed to import it for personal use.

On 7/18/2018 at 7:15 AM, Skylark1980 said:

I've kept a sleep diary since discovering this site and find I have cycles of 2 or 3 bad nights and then about the same good nights. Really bad nights like last night seem to be only every couple of weeks and I still get a few nights where I go out like a light and sleep right through (usually with a bit of help from an over the counter antihistamine). I have two children and one is teething so that's not helping! Plus it's extremely hot in the UK with no air con which is affecting everyone's sleep.

I don't have any other symptoms except a bit of physical anxiety some days. Both this and the insomnia seem largely physical. I've experienced insomnia due to a ruminating mind before and this seems different. But I am now tempted to reinstate a low dose as I am feeling overwhelmed and losing my temper with my kids. I felt so frustrated and desperate when still awake at 5am this morning . Having said that, I felt like this 3 weeks ago when I discovered this wonderful site - and I haven't been that low since. Largely I'm coping but it's a bit of a struggle as I'm so up and down. It's a weird cycle that doesn't seem to coincide with what's going on in my life (which is relatively smooth although very busy) which is why I'm thinking more withdrawal than relapse - although little things do overwhelm me & trigger anxiety when I'm sleep deprived.

It looked like you were doing relatively okay. You were saying even though it is a bit of a struggle you are coping. I wouldn't risk a reinstatement which could potentially make things a lot worse. Let me repeat that - it could be much worse. I would invest time into non-drug coping techniques such as relaxation exercises, yoga, meditation and so on. You could also look at ways you could reduce stress in your life.

See: Non-drug techniques to cope with emotional symptoms

You might try some relaxation exercises, which are great for calming the nervous system, helping to reduce anxiety and encouraging sleep. For example: progressive muscle relaxation, gentle yoga, calming breathing exercises, meditation, guided visualisation, etc. I like to use recordings with gentle music and an instructor's voice telling me what to do so I don't have to think about it. I do my progressive muscle relaxation just lying in bed, and it usually helps my system to calm down so I can fall asleep. You could try a few and see what works for you. If you do these daily, they should help more over time. See: Train yourself to sleep: guided meditations, calming videos, sleep hypnosis.

July 22, 2018

Thank you so much for your quick replies! Ok I’ll ditch the supplements (they are indicative of my desperate need for relief!) Is melatonin safer? A friend from overseas can give me some....

I already do Yoga Nidra recordings on repeat but will look at others on here - thank you for the link. (They don’t tend to get me fully to sleep but do help me to rest).

I have a long standing mindfulness practice and have largely been better at accepting it lately, but this is the longest stint consecutive bad sleep so far since it began 3 months ago. I can cope if I get a couple of good nights a week but this has been about 7 days in a row. It’s probably partly due to some disturbed nights with my son and also an incident last week that made me fear for his safety and has left residual anxiety.

I know I’ve got stuck in a fear loop and I’m hoping to get CBTi for this but I’m not sure how long I’ll have to wait. Plus acupuncture on friday...

I guess I really need reassurance that prolonged insomnia won’t cause me to go insane or make me ill - those are my key fears at night 😔.

Believe me, I don’t want to reinstate and have to go through this again further down the line! But I also don’t want to go mad or get sick. And I slept really well on

sertraline.

Thank you again for your replies,

I feel no one understands quite how lonely and frightened I feel right now (no sleep plus drug hangover is not helping!) xx

July 22, 2018

In general, less is more with melatonin. I would try 0.25mg or 0.5mg. I found 2mg had a paradoxical effect. You might need to experiment a bit to find the best dose for you. See: Melatonin for sleep.

We do understand, believe me, most of us here have been there at times. When I get into that fearful thinking mode I find it helpful to repeat positive affirmations to myself over and over like a stuck record. "I am safe" is a good one. I also like "I relax and I let go" - a good one when you wake with morning anxiety.

July 22, 2018

1 hour ago, Skylark1980 said:

Thank you so much for your quick replies! Ok I’ll ditch the supplements (they are indicative of my desperate need for relief!) Is melatonin safer? A friend from overseas can give me some....

I already do Yoga Nidra recordings on repeat but will look at others on here - thank you for the link. (They don’t tend to get me fully to sleep but do help me to rest).

I have a long standing mindfulness practice and have largely been better at accepting it lately, but this is the longest stint consecutive bad sleep so far since it began 3 months ago. I can cope if I get a couple of good nights a week but this has been about 7 days in a row. It’s probably partly due to some disturbed nights with my son and also an incident last week that made me fear for his safety and has left residual anxiety.

I know I’ve got stuck in a fear loop and I’m hoping to get CBTi for this but I’m not sure how long I’ll have to wait. Plus acupuncture on friday...

I guess I really need reassurance that prolonged insomnia won’t cause me to go insane or make me ill - those are my key fears at night 😔.

Believe me, I don’t want to reinstate and have to go through this again further down the line! But I also don’t want to go mad or get sick. And I slept really well on

sertraline.

Thank you again for your replies,

I feel no one understands quite how lonely and frightened I feel right now (no sleep plus drug hangover is not helping!) xx

i find this melatonin the most effective for me, its 0.3mg and time released so it is better at keeping you asleep than regular melatonin, i order from this site and never had a problem with it being imported to UK,

https://uk.iherb.com/pr/Life-Extension-Melatonin-6-Hour-Timed-Release-300-mcg-100-Veggie-Tabs/47832

July 22, 2018

Thank you so much Songbird and dj2010 for rescuing me today - you have been more helpful than you know. 😊 It's been such a relief to know that someone was listening (I had to ring a helpline at 4am - not feeling suicidal but just so frustrated and desperate that I needed to hear a sympathetic voice).

Yes I meant that no one in my family or friends understands how bad insomnia can be - I'm quite sure that you both understand as it seems such a common side effect .

I'll try low doses of melatonin and no more other drugs or supplements (except magnesium)......

Thanks again xox

July 22, 2018

PS. dj2010 I see from your thread that you also have young children - I sympathise

And that you experienced insomnia 3 months after your taper - how long did it last and are you still drug free? You came off so many drugs and it sounds like you've been doing really well! x

July 23, 2018

11 hours ago, Skylark1980 said:

PS. dj2010 I see from your thread that you also have young children - I sympathise

And that you experienced insomnia 3 months after your taper - how long did it last and are you still drug free? You came off so many drugs and it sounds like you've been doing really well! x

Hi, yes was looking after my 2 young kids and running a business through it, I see you are also looking after 2 young kids so I know how hard this is for you and how a night of little sleep makes looking after them extremely difficult, it forced me to remain active which I think helped,

the 3 months that i was med free before delayed withdrawal hit was the best 3 months of my life, I was at the gym twice a day and felt fantastic, then insomnia hit,

yes I am still drug free and vow never to go back on them, sleep is still a issue but is much improved from the early months of withdrawal, I now usually get between 5 1/2 - 7 1/2 hours a night,(had over 7 hours last few nights) some occasional nights I get over 8 hours, I am swimming most days and back at the gym, life is good and I am living it almost normal now,

if you have not tried epsom salt baths then I advise you to try these, they were a game changer for me, I have 1 every night 2 hours before sleep, you can get a 20kg bag from amazon for £18, this lasts a while, see link below:

https://www.amazon.co.uk/gp/product/B01CXJF1HC/ref=oh_aui_detailpage_o01_s00?ie=UTF8&psc=1

it looks like you are doing excellent, I am sure if you stick to a low dose of melatonin on nights where you are struggling to sleep and keep good sleep hygiene that you will get through this fine,

take care

July 23, 2018

Hi dj,

Well done for sticking it out, your signature shows you've had such a tough time with withdrawal! I can see from your thread that you had whole nights of no sleep too - it's the worst! My kids are 21 months and 4 years old. I also run a (very) small business too which adds to the stress but also keeps me going. It's encouraging that your sleep is better although it sounds like you had insomnia for a while. The second doctor I've seen this week (who referred me to the sleep clinic rather than saying to go back on sertraline) said that symptoms can last up to a year. The older doctor I saw earlier in the week was dubious that people even get withdrawals.

Yes I'm already having an epsom salt bath in the evening - although only about 1 hour before bed. I took 0.3mg of melatonin last night and slept pretty well thank goodness. I had a day in nature away from the kids to re-set yesterday and also re-read The Effortless Sleep Method by Sasha Stevens - it's a great book about the behavioural and psychological aspects of sleep and gives simple tips to help. So I feel more empowered that I have the strength to do this without drugs. I'm sick of the cycle though - feeling normal on any day where I sleep and hardly able to function on days that I don't.

I've just re-read my signature and realised that I have less brain fog now (even when sleep deprived) so I hope I'm heading in the right direction and that this particularly bad week is just a blip....

July 24, 2018

On 7/23/2018 at 8:58 AM, Skylark1980 said:

Hi dj,

Well done for sticking it out, your signature shows you've had such a tough time with withdrawal! I can see from your thread that you had whole nights of no sleep too - it's the worst! My kids are 21 months and 4 years old. I also run a (very) small business too which adds to the stress but also keeps me going. It's encouraging that your sleep is better although it sounds like you had insomnia for a while. The second doctor I've seen this week (who referred me to the sleep clinic rather than saying to go back on sertraline) said that symptoms can last up to a year. The older doctor I saw earlier in the week was dubious that people even get withdrawals.

Yes I'm already having an epsom salt bath in the evening - although only about 1 hour before bed. I took 0.3mg of melatonin last night and slept pretty well thank goodness. I had a day in nature away from the kids to re-set yesterday and also re-read The Effortless Sleep Method by Sasha Stevens - it's a great book about the behavioural and psychological aspects of sleep and gives simple tips to help. So I feel more empowered that I have the strength to do this without drugs. I'm sick of the cycle though - feeling normal on any day where I sleep and hardly able to function on days that I don't.

I've just re-read my signature and realised that I have less brain fog now (even when sleep deprived) so I hope I'm heading in the right direction and that this particularly bad week is just a blip....

Thanks Skylark , yes there has been some very tough times, your kids are younger than mine and your youngest be too young to put in nursery so it must be difficult not having a break, its good that running a small business, even though its stressful it forces you to use your brain which is important in recovery, need to keep exercising the brain to get it working properly again,

ive given up on doctors now, none I have seen have any knowledge of what i am going through and any of their solutions would just make things worse, unfortunately symptoms can last for many years, not just 1 year, there are some members on here drug free for 8 years and still struggling with symptoms,

good that you are having salt baths and glad to hear the melatonin worked, try to just use the melatonin on nights were cant sleep, if use every night then they may stop working, I find if I use more than 3 nights on a row they don't work much and have to have a break from them, also make sure there are no other ingredients in the melatonin you use as often they add vitamin B6 and 5htp etc,

I will look up that book you mention, it sounds interesting,

less brain fog shows healing, it took a long time for mine to go and only a couple of months ago was when the head pressure stopped,

you are doing excellent,

take care

July 24, 2018

21 minutes ago, dj2010 said:

unfortunately symptoms can last for many years, not just 1 year, there are some members on here drug free for 8 years and still struggling with symptoms,

Recovery time frame is very individual - to be still struggling after 8 years is not common. In general there is usually a lot of improvement over time - waves get shorter and less severe, windows get longer and better. I'm impressed that doctor was aware that withdrawal lasts more than a few weeks, that is quite rare.

July 24, 2018

Thanks for reassuring me Songbird. Yesterday I felt strong, cheerful, relaxed - back to normal after a good night (drug free), I had a really calm day and good sleep hygiene - inc melatonin 0.3mg. But I still only got 2 hours sleep! And am now back to feeling exhausted and desperate. I really don't want to reinstate but I don't want to end up with mental health issues caused by the insomnia! I am hanging onto the good behavioural and cognitive suggestions from the Effortless Sleep Solution to keep me going before CBT (which could take months to even start unless I can get some through husband's health insurance).

I know, it's enouraging to find a doc who understands. I deliberately went to a younger doctor who specialises in women's health (I also requested a blood test to rule out physical causes). She was also reassuring that I was on the lowest dose of sertraline before tapering and that hopefully it wouldn't go on for too long.

I think this probably began as withdrawals as the first bout came out of nowhere plus I had other symptoms (brain fog, etc.) but now I've got into a vicious cycle of anxious thinking about sleep. It's so draining with 2 little kids

July 29, 2018

I had another night of no sleep last night (except possibly a few mins of light dosing). This is very disheartening as I've had 4 nights of relatively good sleep. I had a relaxing day, the only thing I changed was going from 0.3mg melatonin to 0.6 (after 4 days on the low dose as suggested on here. Could that be the cause? I don't even know if this is withdrawal insomnia or a relapse as it was post-natal insomnia that caused me to go on sertraline in the first place. I don't have any other withdrawal symptoms now - but I'm stuck in a fear loop around sleep.

I've managed to get some therapy on health insurance (Acceptance & Commitment Therapy which I've had before but not for sleep) which starts on Tues so I was hoping to put off reinstating for a while longer and deal with the probable root cause (fearful thoughts around sleep).

I feel pretty desperate to not feel like this any more though. Is it too late to reinstate a low dose? (ie 12.5mg) I came off 4 months ago and alternated pill days so it's hard to know what my last minimum dose was - I was down to one half tablet (25mg) a week. GP said this was a fine way to do it, now I know different.

Is this lack of sleep likely to affect my long term mental and physical health? That's my main fear - that I'll go insane or get sick (my mum died of cancer and always said it was due to stress). It's been intermittent for 3 months now but the nights of 0-2 hours sleep are awful. 😪

July 29, 2018

It's possible reinstatement might help, but it's also possible that it might make things considerably worse. If most nights you are getting reasonable sleep and you don't have other withdrawal symptoms, I am inclined to think it may not be worth the risk (but it's your decision not mine). If you decide to reinstate, a very tiny dose (e.g. 2mg) could reduce the risk of adverse reactions.

I'm pretty sure you won't go insane. If you had 4 reasonably good nights in a row, that's actually pretty good! If 0.3mg melatonin was working for you, I'd stick to that. On the bad nights, acceptance works better than fretting about it. I used to trick my brain by telling myself that I would just rest because resting is still beneficial - that way it doesn't matter whether you actually sleep or just rest. I also used a lot of affirmations/positive self-talk, telling myself over and over that whatever happened I would be okay. Let it all be okay.

July 29, 2018

Thank you for your reply Songbird. Have you had nights of no sleep at all? Is it a common thing when withdrawing to not sleep all night - and for prolonged periods? I'm getting 1 or 2 nights a week of virtually no sleep, then the rest are prob 6-7 hours of slightly disturbed sleep (I do a guided meditation and tend to drift back off). Sounds like I should be grateful for the reasonable sleep which is largely getting me through ok with my little children.

Last night I was so full of adrenaline/physical anxiety that I didn't know what to do with myself as the guided meds, breathing, etc didn't work. My heart was pumping and it felt like my skin was crawling. I feel so low when I don't sleep (though on reasonable days I feel ok). I have always had occasional bad nights but usually sleep like a log - I experienced a similar insomnia cycle after the births of both my babies, but had no chance of re-balancing as had to be up at least every 3 hours to feed them, which is why I went on sertraline in the first place.

I guess if the insomnia is a withdrawal symptom, then it will gradually ease and if it's due to underlying patterns / anxiety, the therapy will hopefully help. Either way, I'll try to avoid reinstating - I'd need to get a good scale to do that anyway. Is there a link to an accurate one?

I only upped the melatonin to get a less disturbed sleep - could that have caused this?

Thanks again for your reply xx

July 30, 2018

Insomnia is an extremely common withdrawal symptom. I once didn't sleep for a whole week, and I was worried I would start hallucinating or go crazy, but I didn't. I think my brain started to micro-sleep. Then I started doing relaxation exercises, and using a sleep hypnosis CD, replaying it every time I woke up.

Are you getting regular exercise such as walking? That can help to "burn off" extra adrenaline. If meditation isn't helping, maybe something physical like gentle yoga stretches might be worth a try. If nothing is working, instead of lying there fretting, maybe try doing something to take your mind off it, e.g. reading a book for a while (make sure it's a light, positive kind of book, not scary, dramatic or suspenseful).

With melatonin, higher doses don't necessarily work better - some people find higher doses have a paradoxical effect. Lower doses are often more effective.

If you're getting 6 to 7 hours of sleep most nights, that's actually pretty good. You might try keeping a journal with notes about each day, to see if you can find any pattern to when the sleepless nights occur.

Skylark1980: Insomnia - Sertraline withdrawal or relapse?

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