Witsend: desperate for advice

[Witsend81]

Hi Sassenach 

 

The GP agreed it sounded that the sertraline was making things worse and said that I could stop it.  He then prescribed mirtazepine.

 

However, I haven't decided what to do yet - and I certainly don't want to start the mirtazepine. 

 

These are the options I am deliberating on:

 

1.  Stop the sertraline and restart very small dose of citalopram 

2. Lower the dose of sertraline to see if the side effects ease off, then take it from there.

 

 

[Boris]

Hi Witsend

 

I've just registered to say I went through something similar years back but with Seroxat (Paxil, paroxetine) and I am also in Manchester (I also have a 9 year old son) I finally managed to taper off 2 years ago (still another med to go).

 

Can you get referred to the crisis team? I found these quite helpful but I was living in the city which has better support.

I think there is also some charity services which are helpful around the city.

 

Through my problems with the drug I was continually offered other anti depressants/anti psychotics/benzos which I had to refuse and wait to stabilise on Seroxat (I did start pregablin which I think may have helped but now I have another taper to finish).

 

Anyway my point is I was taken off my original drug and moved round anti depressants/drugs initially and had the worst reactions but I survived and eventually got off Seroxat with more or less the symptoms you are describing. It took time but eventually I got off it.

 

I need to post my very long story eventually.

 

I'll most likely go through something similar with the Pregablin or not if I'm lucky.

 

Keep posting mate.

[Sassenach]

@Altostrata, @ChessieCat @brassmonkey

 

Hi Witsend

 

When do you take your antidepressant?

I will refer your current situation to the senior mods.

You should remember you have chosen to ignore their advice once.

Their only interest is to help and they are very busy.

I will let you know or they will contact you direct.

If you are really feeling out of control then the crisis team may be able to help.

 

Sassenach

Edited July 1, 2019 by Sassenach

[Sassenach]

Hi witsend

 

How are you feeling now

[Witsend81]

I take it about 6.30am each day.

 

I sincerely regret not following Alto's advice - but if I could have their input it would be much appreciated. 

 

I haven't made any changes as yet.  

 

Thanks for the up-date.  

[Witsend81]

I'm feeling a little better actually - the on edge feeling has receded a bit - I've picked my son up from school and he's keeping my mind off things.   

 

How's your day going?

[Sassenach]

Hi

I know you are feeling lousy and probably frightened.

We all start there and not knowing which way to go is terrible.

As you should be able to see I have referred your thread to three of the senior mods on here.

They are all on the other side of the world so it will be discussed overnight.

All the recent med changes have left your brain very sensitised and it takes their level of knowledge to decide whether a hold or change is the best option.

I will not pretend it is going to be easy but if you read some of the other threads and forums on here you see that you can get better.

It does take determination and support. The support you can get on here as long as stick with the advice you will always find someone to listen, even if you only want to vent. It really helps sometimes.

If possible tonight have a hot bath, do not watch violent TV, even better calming music or mindfulness if you know how.

I hope you can sleep as this when your brain gets a chance to begin healing.

Sleep well

 

Sassenach

 

[Sassenach]

I am OK thanks.

Glad you are a bit better.

Kids do keep you occupied, which is good.

[Witsend81]

Hi Boris

 

Just saw your post.  I'm not under the crisis team despite A&E attendance and several trips to the GP.  Apparently the service is overstretched and I'm guessing that because I've not made an attempt to take my life or self harmed, I'm not a priority.

 

It's good to hear that you have successfully managed to get through a similar experience; that gives me hope 🙂

 

I wish you luck getting off the pregabalin x

 

Witsend

 

 

[Sassenach]

Good morning Witsend.

 

Not yet got a response from top mods, busy night.

How are you feeling today?

Did you get any sleep?

Sassenach

[Witsend81]

Hello.

I actually didn't sleep too badly and woke at about 6am which is later than usual.

I'm feeling nervy and on edge again 😞

I actually felt ok last night, I was hoping that the meds had kicked in again and that I'd wake up back to my normal self...no such luck.

 

I suppose last night was a 'window'.

[Sassenach]

Nervy and on edge is probably Cortisol a normal WD symptom.

We need your diary including times\ doses of meds.

When are you taking the Promazine and how much?

Did you feel better on the Citalopram?

 

Sassenach

[Witsend81]

Are you sure it's a WD symptom?  They only started when I restarted Ssris at the beginning of June (about 5 days after restarting the 10mg of citalopram).  My instinct is telling me that these are side effects of restarting with an over-sensitised CNS rather than WD, but I could be wrong.

 

I'll add my diary later which I've been keeping religiously - just got the school run.

 

BW

[Witsend81]

Sun 30 June

Hardly slept, awoke 5am

6.30am

50mg sertraline 

4ml promazine 

Crying, dark thoughts and restless

10.30am 2 mg promazine

Tired but unable to nap, keep getting dread and panic rushes 

12.30pm

Tearful, dark thoughts, skin crawling

4pm

Crying, dark thoughts, restless 

6pm

Gradually settled down, but still on edge

8pm 4ml promazine

9pm bed 

[Witsend81]

Monday 1 July 

Struggled to sleep.  Heart pounding, swearing.

6am Got up - sinking feeling, dread

50mg sertraline 

4ml promazine 

Dark thoughts 

10.30am

Jittery, burning in chest, rapid heart rate

Dread and restlessness.  Feel wired.

This begins to settle a little over the morning.

12pm

4ml promazine 

Bad feelings continue to settle over afternoon

7pm headache from jaw clenching.  Felt calmer, muddy headed, thinking more positively.

8pm 4ml promazine 

10pm Bed

[Sassenach]

Hi Witsend

 

Info on Sertraline

2. Key facts

• It usually takes 4 to 6 weeks for sertraline to work.
• Side effects such as feeling sick, headaches and trouble sleeping are common. They're usually mild and go away after a couple of weeks.
• If you and your doctor decide to take you off sertraline, your doctor will probably recommend reducing your dose gradually to help prevent extra side effects.
• Sertraline is also called by the brand name Lustral.

Waiting for info will catch up Late pm.

 

Sassenach

[Witsend81]

Thanks Sassenach 

I've been reading other people's experiences of taking sertraline - it can heighten fear and anxiety within the first two weeks of taking it and for most this passes.

Hopefully 🤞 I can stabilise on things as they are.  Yesterday afternoon and today, so far, have been more manageable and I've not changed anything.  

[Altostrata]

10 hours ago, Witsend81 said:

Hello.

I actually didn't sleep too badly and woke at about 6am which is later than usual.

I'm feeling nervy and on edge again 😞

I actually felt ok last night, I was hoping that the meds had kicked in again and that I'd wake up back to my normal self...no such luck.

 

I suppose last night was a 'window'.

 

Each time you take one of your drugs, do you feel better or worse afterwards? We need those daily notes, specifically how you feel before AND after taking a dose of either sertraline or promazine, plus your sleep pattern.

 

How many milligrams promazine are in a milliliter? Please express your dosage in milligrams, not milliliters.

 

About promazine https://www.medicines.org.uk/emc/product/6698/smpc

 

Promazine-sertraline interactions https://www.drugs.com/drug-interactions/promazine-with-zoloft-1948-0-2057-1348.html?professional=1

 

What did your doctor tell you promazine was supposed to do for you?

 

If, overall, you're feeling better now than 2 weeks ago, please stop panicking about the ups and downs. It make take a while for your nervous system to settle down.

[Sassenach]

Hi Witsend.

 

I was just replying to you when Alto's post came in succinct as ever.

Everything you need to know and do, to help us help you is in there.

Your brain needs time to adjust so stay on your present doses and times. Keep the diary so the mods can see how you are responding to the meds.

Alto mentions the ups and downs and they will continue and it will take time.

Always remember, never change anything  on a bad day you will it regret later.

If you are feeling lonely or unsure come on here, there will always be someone to talk to.

If you read some of the threads you will see how many are going through this due to medical ignorance.

GPs are taught to either up the dose or change meds, both of which are usually inappropriate.

Do you have any further GP appointments?

You are among friends, take strength from it.

Have a good night.

 

Sassenach

 

 

 

 

 

[Witsend81]

Thanks Altostrata.  Will do.

 

The promazine was prescribed short term for the agitation, restlessness and nausea that were severe after I restarted the Ssris (I didn't want to take diazepam).

 

There is 5mg of promazine per 1ml, so I'll convert in future.  I need to start weaning this down soon as it's only meant for short term.  

 

Sassenach - thank you.  I'm beginning to think a bit more rationally now, think I must be starting to stabalise 🤞

 

Thank you both for your input and support

[Sassenach]

Witsend.

 

Please do not even think about tapering  the promazine yet.

We need to be sure about stability before you make any more changes.

Your poor brain is trying to hit a dozen balls at once, it does not need any more.

Alto's question is not because she does not know what the drugs are used for, but why they were prescribed in your particular case.

It is also why she pointed out in an earlier post that analysing med efficacy is time consuming.

There only a few on here who have that level of experience.

So can I repeat, don't change anything, we will be watching over you😇 and you can contact us.

Do you have any further GP appointments?

 

Sassenach

[Witsend81]

I will be due to go back within the next two weeks.

[Sassenach]

OK.

Remind me in advance please and we can discuss it then.

Fingers crossed you will be feeling better than yesterday.

Speak tomorrow.

 

Sassenach

 

[Altostrata]

Let's see those daily notes -- your symptom pattern will tell you what to do.

[Witsend81]

Good morning. 

Tues 2 July 

5.30am Slept better - still broken, less sweating, heart pounding less.

6am  Nervous/edgy/heart pounding/tingling/nausea 5/10

6.30am  20mg promazine, 50mg sertraline

8am  Symptoms from 6am 3/10

11am  Spaced out and sleepy 6/10

12 am  20 mg promazine

1pm  Spaced out and tired 5/10

7pm Low background anxiety 2/10

8.30pm 20mg promazine

9.30pm Tired.  Anxiety 0/10

10pm Sleep

[Witsend81]

Regarding the promazine.  I'm really worried about taking this medication for much longer:

1.  It's a 1st generation antipsychotic with nasty side effects if used longterm/stopped abruptly

2.  My doctor is expecting me to wean this off - so the prescription is limited 

3.  The less time I'm taking it, the less time my body will have to come to rely on it

 

So, I know my brain is trying to stabalise currently BUT I don't want it to get used to the promazine!

 

Does weaning the promazine by 5mg a dose every 4 days sound reasonable considering I've only taken it low dose for two weeks? Obviously I can hold if necessary/begin to get WD.

 

Witsend

[Witsend81]

Plus, I'm not sure it's actually doing that much.  

[Sassenach]

Hi Witsend

 

Bit of a rush at moment.

How much Promazine do you have left.

Are you feeling generally calmer than a few days ago?

Do you like walking, cycling swimming or outdoor activities?

Do you have open spaces nearby and if you spend an hour each evening with your son outdoors.

This would help you gain a natural sleep rhythm.

Do you take any supplements?

Drink caffeine free beverages.

Please answer the above and I will catch you late pm.

 

[Witsend81]

Hi Sassenach

 

About 125ml bottle - obviously the GP will have to prescribe another bottle if I'm still weaning when I see him next, but he does expect me to wean off it as it's a short term measure.

 

Before I got ill I was very fit (vigorous exercise every other day), but unfortunately I've not done any proper exercise since and have wasted away a bit.  I have been going out for daily walks, short ones.  I just haven't got the energy since I've not been eating properly.

 

Luckily I have a garden so we get plenty of outdoor time (when it's not tipping it down!  Manchester!).

 

I'm going for a swim this morning, but going to take it easy.  The nausea is easing off around lunch time so I am eating a bit more.

 

I completely stopped drinking caffeine when I got ill again as my agitation levels were so high (so caffeine withdrawal as well!).

 

I usually take omega 3 but since I got nauseous I couldn't bear to take them.  I'm going to restart with my dinner and also magnesium as well.

 

I try to avoid napping in the day as well - mostly because when I wake up I get awful cortisol spikes, confusion and incoordination for about half an hour! Also affects sleep in the night.  I used to love an afternoon nap before I got ill 😞

 

Hope you have a good day 🙂

[Witsend81]

If I compare myself today to this time last week, I am calmer, definitely.  

 

Each day I seem to be a degree better than the last, that might fluctuate I know, but 🤞

[Sassenach]

Hi Witsend

All the right answers.

Sorry to be so long getting back to you but read your post and knew there was no urgency.

If you have already had your dinner this may be too late.

You would be better restarting one supplement at at a time, never make more than one change at a time as my hospital consultant has been telling me for 17 years.

There is a tendency to assume that what worked for us before will be ok now.

It is not always the case and may only be a matter of timing, but the adage still holds.

Don't push yourself with exercise, do as much as you enjoy.

The garden is great. Is there fresh air in Manchester, always seemed better in White Rose county to me?😈

The cortisol spikes are normal but they will disappear completely, just can't tell you when.

11 hours ago, Witsend81 said:

Does weaning the promazine by 5mg a dose every 4 days sound reasonable considering I've only taken it low dose for two weeks? Obviously I can hold if necessary/begin to get WD

@Shep

I have referred this to Shep as she is much more knowledgeable than me, I would have thought your proposed taper is too fast and could risk interfering with your recovery.

I will be interested to know.

I realise you want off this drug and so does your GP, but he has hardly covered himself in glory, so please allow the expertise on here to guide you.

The whole point of the site is to help people get off this poison, but only safely.

Have a good night.

 

Sassenach

[Altostrata]

13 hours ago, Witsend81 said:

Regarding the promazine.  I'm really worried about taking this medication for much longer:

1.  It's a 1st generation antipsychotic with nasty side effects if used longterm/stopped abruptly

2.  My doctor is expecting me to wean this off - so the prescription is limited 

3.  The less time I'm taking it, the less time my body will have to come to rely on it

 

So, I know my brain is trying to stabalise currently BUT I don't want it to get used to the promazine!

 

Does weaning the promazine by 5mg a dose every 4 days sound reasonable considering I've only taken it low dose for two weeks? Obviously I can hold if necessary/begin to get WD.

 

Witsend

 

Hello, Witsend.

 

I suspect the promazine is making you tired. It is also a high-risk drug. Since you're taking 60mg a day (please verify this is so), your taper of 5mg every 4 days sounds reasonable to me. I would eliminate the morning dose first, then work on the afternoon dose.

 

Be sure to keep daily notes while you're doing this. If you get withdrawal symptoms, you'll have to go lower.

 

Please let us know how you're doing.

[Witsend81]

Altostrata - 60mg is correct

 

Sassenach - I'm on the outskirts, we can just about breathe here 🙂

 

Thank you both for your input.  I will keep you updated.

 

 

[Witsend81]

Greetings from sunny Manchester

Wed 3 July

Awoke 6am.  Slept well.  Anxiety/jittery/nausea 5/10

6.20am Promazine 20mg

6.30am Sertraline 50mg

9am Nervy 5/10

10am Swimming

12pm Promazine 20mg

2pm  Nervy 4/10.  Tired.

5pm Tired and irritable.

7pm  Nerves subsided

8pm  20mg promazine

Headache

10pm  Bed

[Sassenach]

Hi Witsend

 

Good call on your taper.

I believe you are going to be fine.

You do your research so stick to your guns with the GP and do what is the best for you.

Keep in touch and good luck.

 

Sassenach

[manymoretodays]

Hi Witsend,

And good job with doing some daily notes.  Keep them coming!

And I agree with Sass, above post.

On 7/3/2019 at 2:31 AM, Witsend81 said:

If I compare myself today to this time last week, I am calmer, definitely.  

 

Each day I seem to be a degree better than the last, that might fluctuate I know, but 🤞

 

And yay on this!  So great to hear.

 

Love, peace, healing, and growth,

mmt