Sapd: sertraline and long lasting side effects

[Sapd]

Hi there,

Just making this post to share what I’m experiencing and hopefully figure out some answers.

 

The TLDR of my history is this;

Panic attacks started around 18yo. I muddled my way through this but at 23, I found myself avoiding a lot of things, and came home early from a holiday. I went to the docs and was put on Citalopram. I can’t remember the dose, but immediately my libido disappeared. After a year I decided to wean myself off them because getting prescriptions was getting more and more difficult and I also felt completely emotionally numb. I was ok for a few months, my libido came back but then I completely nosedived and ended up being prescribed Sertraline because I was scared to the leave the house. Again my libido disappeared immediately, but this time it also affected my skin, so I was breaking out with acne which only started once I took the medication. After 3 years at 25mg daily, I was again emotionally numb, so started warning myself off over a 6 week period. Withdrawal period itself was fine. When I stopped the medication completely last September / October (2018), I found myself quite manic, excitable, busy, funny etc, which was more akin to my original personality. It was also around this time I finally got a concrete psychiatric diagnosis of panic disorder with intermittent depression, and elements of social anxiety. It was a relief to finally have an answer and I am actively working on this. 

 

After feeling so well during withdrawal / just after, since Christmas / January 2019, I’ve been really struggling with extreme anger. It’s completely out of character and not something I have ever experienced prior to taking these meds, but several occasions now I’ve been pacing around for an hour completely unable to calm down, literally angry over nothing. Additionally, my libido has not returned. It’s improved marginally but it is negatively affecting my relationship, and again, is totally out of character compared to before I took them. I am now taking 1mg CBD daily which seems to be helping somewhat with the anger but the past week or two I’ve been finding it hard again.

 

I have diagnosed low / borderline low vitamin d, zinc and iron levels. These are supplemented and now showing at within the normal range. I also take probiotics, magnesium and have just tonight started EPA and DHA on the advice of a dietician. I also have just had two blood counts come back with low neutrophil level. I’m being retested in May, but I can’t help feeling this is also connected to the SSRI and maybe my body is just taking a long time to recover and readjust.

 

Would be interested to hear people’s opinions / experiences, because right now I’m concerned these are permanent and my brain has effectively been rewired.

[ChessieCat]

Hi Sapd and welcome to SA,

 

I will give you some information which might help you to understand what is happening.

 

You have tapered too quickly and what you are experiencing are withdrawal symptoms.  SA recommends tapering by no more than 10% of the current dose followed by a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.  Why taper by 10% of my dosage?

 

When reducing using the harm reduction protocol we might experience mild withdrawal symptoms.  However if the drug is taken away too quickly the withdrawal symptoms may be more than mild:  Dr Joseph Glenmullen's Withdrawal Symptoms

 

I will provide you with the information about reinstating so that you know what your options are.  Please note that if you did decide to reinstate we would suggest a very small dose (possibly as little as 1mg) because you have been off the drug since October 2018 (5 months).  If you take too much it might make things worse.  It is better to start with a small amount and increase if needed than to risk taking too much.  Please read Post #1:  About reinstating and stabilizing to reduce withdrawal symptoms

 

 

Please create your drug signature using the following format.   Keep it simple.  NO diagnoses or symptoms please - thank you.

• details for last 2 years - dates, ALL drugs, doses
• summary for older than 2 years - just years and drug/s

Account Settings – Create or Edit a signature

 

 

I will provide some additional information in the next post.  This is your own introductions topic where your can ask questions about your own situation and journal your progress.

[ChessieCat]

Here's some additional information which might help you to understand what is happening:

 

Recovery isn't linear it happens in a Windows and Waves Pattern

 

Withdrawal Normal Description

When we take a psychiatric drug, we are adding chemical/s to the brain.  The brain then has to change to adapt to getting the chemical/s.  It might have to change something to do with A and then once that change has been made it affects B so another change has to be made and so on down the line.  It is a chain reaction, a domino effect.

 

The same thing happens when we take the drug away.  That's why it's possible to experience such a vast array of withdrawal symptoms, and they can change, and be of different intensity.

 

are-we-there-yet-how-long-is-withdrawal-going-to-take

 

These explain it really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

On 8/31/2011 at 5:28 AM, Rhiannon said:

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.

 

AND

 

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.  

 

[ChessieCat]

Important topics in the Tapering forum and FAQ

[Sapd]

Thanks for your reply; I was advised by GP to taper over 2 weeks due to already being on half a tablet daily. These tablets are so small it would be difficult to split them into 4 as they were oblong, and I chose to taper over 6 as I felt this gave me better control. I’m not sure how it would even be possible for me to split such a small tablet into 25ths. I’ll do some reading and consider it.

 

Edited March 20, 2019 by ChessieCat
removed quote

[ChessieCat]

Tips for tapering off Zoloft (sertraline)

 

Sertraline tablets can be dissolved in water.

 

You dissolve 25mg tablet in 25mL water and each 1mL = 1mg dose.  As the dose gets lower or you want to make it easier to get the dose you need then you can change to 25mg tablet in 250mL so each 1mL = 0.1mg dose.

 

Easy peasy.  And the liquid can be stored for several days covered in the fridge.

 

Always use the same method and equipment and even the same area of the table or bench to measure the liquid.

 

Where to get oral syringes

 

questions-and-answers-about-liquid-medications-use-by-date-expiry

 

how-to-make-a-liquid-from-tablets-or-capsules

 

using-an-oral-syringe-and-other-tapering-techniques

 

Edited March 20, 2019 by ChessieCat

[Sapd]

I hope it's ok to reignite this post!  I've been absent from the forum for a long time and wanted to give some updates as to where I'm at now, after watching Medicating Normal at the weekend.  It prompted me to return to the forum, and to be more open about my experiences, and support others rather than keeping it all to myself.

 

When I first posted and received the advice to consider going back on the meds and tapering slower, it was honestly not something I wanted to hear at the time and I found it really hard to consider doing.  If I had the opportunity to do it all again from the moment I started tapering, I'd certainly taper much slower than I did.  In the end though, I opted not to go back on the medication, because I felt that the risks to my health and sanity were too high to consider reintroducing it into my system again.  So I have now been totally free of antidepressants since 2018.  

 

Thankfully, the anger (I found an anecdotal article describing exactly what I felt and calling them rage attacks) has now stopped.  I took CBD daily for about 6 months until September / October time 2019, and upon stopping, the anger hasn't returned.  Reflecting on the past nearly 2 years since withdrawing from Zoloft, I feel like it temporarily halted my emotional development and processing capacity, and so when I stopped the medication, 3 years worth of emotion (and all my childhood trauma that wasn't dealt with) came exploding out.  I remember talking to a friend and feeling really profoundly immature and childish in the way I was reacting to things that were being said to me.  I've been working on that doing self therapy at home, learning about myself and who I really am, as well as having the support of a psychiatrist who is pro therapy (!!) and I've seen a huge growth in my emotional maturity, along with a greater capacity and willingness to experience all of my emotions.  I have also found a really great support group for my Panic Disorder and for the first time have friends who have the same diagnosis and are working on their recovery in the same way.  I truly feel that I'm now on the right path to recovery and living the way that is right for me.

 

I'm also taking a lot more time and care over my general wellbeing due to various chronic health niggles which I suspect now were exacerbated by taking antidepressants.  I have no concrete evidence for my theory beyond my symptoms appearing / worsening during the time I was on the Zoloft.  That could be coincidence, or age related,  docs etc have told me I was wrong, but lo and behold, I'm now finding anecdotal evidence online.  In particular I believe that it has made my immune system even more overreactive than it already was, and I feel that it has disrupted my hormone production.  I'm cautiously optimistic that time, nutrition and a better relationship with myself and others will assist my body in rectifying itself to a more stable state.

 

I am still, however, experiencing disruption to my libido and arousal levels.  I'm 31 this year, so it's possible that age is playing a part, but I am also actively working on it and hopeful that I can learn more from the forum from other women in particular who are experiencing PSSD.  

 

I hope everyone is doing well, and I just wanted to say thank you to ChessieCat in particular, even though I wasn't particularly receptive at the time.  You certainly opened the door to me trying to figure out what was going on even if I didn't take your advice.  I'm going to do my best to help others if I can!

 

On 3/18/2019 at 11:18 PM, ChessieCat said:

 

 

I will give you some information which might help you to understand what is happening.