Emart

[Emart]

Good morning, wanted to introduce myself and reach out for some ideas/feedback. Been combing through the information here and it’s a lot to digest! My story with ADs begins when I was 15, and diagnosed with generalized anxiety disorder. I was prescribed sertraline by my family doctor and despite a few on & offs at the beginning have essentially been on 100mg of sertraline for the last decade. I tried briefly to wean off in 2016 and quickly went back on with the onset/return of anxiety/panic. Since that time I have been stable, feel “normal”, and experience basically no side effects from the sertraline. It has been very comfortable. Back in October I spoke with my doctor about getting off the meds and he agreed he thought it would be a stable time. On oct. 20 I cut my dosage to 50 mg with the docs instructions to sit at 50mg for 6 weeks and go to 25mg. After 8 weeks at 50mg (on December 19),I very quickly developed some bad insomnia, and had a panic attack (it had been years since I’ve had one). The severe insomnia (2-3 hours of broken sleep a night) persisted for a few days and I immediately reinstated 100 mg of sertraline on 12/22 (after 2 months of lowered Dosage) It has been about a week since reinstating at full dosage, anxiety and psychological symptoms have been basically manageable with some slight improvement but my fatigue and insomnia rages on. After discovering this website, I’ve learned a few things 1. I tapered way too fast 2. The timing and symptoms are consistent with withdrawal symptoms, 3. Reinstating at full dosage would likely not have been recommended by this group. 
 

My questions:

 

1. I’ve been reinstated at 100mg of sertraline for a week (a dosage that has historically been good to me), though not consistent with what would probably be recommended, I feel like stabilizing my body at this dosage for the next month or so would probably be the best, thoughts? 

 

2. I saw my doc yesterday and he prescribed me Ativan to help with sleep til my body stabilizes back on 100mg, given everything I’ve read, I’m scared to take it and would rather muddle through with a few hours of sleep than add another pill to the mix. Thoughts?

3. Sleep has been one of the most frustrating parts of this experience. I used to be a heavy sleeper and get 10 hours a night. Now I’m down to 5-6 on the best nights. I’m able to get very comfy and drowsy most nights but as I’m drifting off to sleep my body “jolts” me awake. It’s like the normal twitches that happen when someone falls asleep but my brain has them amplified and it startles me awake, does anyone else have this specific issue with sleep? 

 

if only I had researched coming off Zoloft a little earlier I think a lot of this could have been avoided/minimized. 
 

thanks, 

Evan

 

 

 

[Altostrata]

Welcome, Emart.

 

Yes, it seems you had classic withdrawal from sertraline. Skipping doses is a good way to trigger withdrawal symptoms.

 

Under the circumstances, 100mg is not unreasonable. What time of day do you take it? Has the insomnia gotten better or worse since you started it?

 

5-6 hours of sleep a night is not too bad in withdrawal; the jolts are typical. This should gradually dissipate. If you take Ativan regularly, you will need to taper it. Benzos often cause more problems than they solve.

 

For your information, Tips for tapering off sertraline (Zoloft)

[Emart]

I currently take the sertraline right when I wake up. Is this the best approach for sleep?
 

 Sleep seems to be slowly improving from last week. Hoping the sertraline is stabilizing things. 

[manymoretodays]

Hi Emart,

Welcome aboard.

And great to hear that sleep IS improving.

If that's what you've done with the sertraline, taking it right when you wake up, then that is fine.  Most of the SSRI's do tend to be a bit accelerating or stimulating for most.

 

And I'll just take this moment to give you some further links to some more information now too:

 

We take a harm reduction approach to tapering psychiatric medications.

 

*Why taper by 10% of my dosage?

 

When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made.  The CNS likes stability. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur. And sleep is really important.

 

What is withdrawal syndrome.

 

Brain Remodelling

 

Dr.Glenmullen’s withdrawal symptom list.

 

The Windows and Waves Pattern of Stabilization

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system.   And then, it's generally best to only try one new thing or change at a time.  That way you can get a better feel for what is doing what.  Best to start low too, in dosage or amount taken, and go slow in increasing to an effective help.

 

Magnesium, nature's calcium channel blocker 

Omega-3 fatty acids (fish oil) 

 

This is your introduction/journal page where you have now introduced yourself to the community, you can ask questions here regarding your tapering, give updates, and just keep a record of your journey.

 

Welcome again, and Best,

L, P, H, and G,

mmt

[Emart]

Welp, time to pop back for an update and maybe some advice. I reinstated to 100mg back around Christmas and by late January I was feeling much better and my sleep greatly improved. I decided to hold at 100mg for awhile and begin planning a better taper. However July/August have proved to be difficult months. Basically I’m 7 months out from my initial withdrawal symptoms from my too-fast taper, and fairly often , albeit more sporadically am having insomnia and panic attacks at night time. I get what feels like waves of cortisol pumping through my body that keeps me up all night. The annoying thing is I didn’t experience these symptoms from February-June after reinstatement.

 

I know people have mentioned the drugs don’t always work the same after a withdrawal and reinstatement. Could this be chalked up to that? If so, how do I combat that.

 

or perhaps this is just a “wave” 7 months out? 
 

I haven’t changed anything, still taking 100mg of sertraline. With the plan to hold Before starting a taper still in effect. But looking for Any insights y’all might have 

 

thanks!
 

 

[Emart]

Hey all, 

 

is there any good way to determine you’re developing a tolerance to the drug? I’ve been holding at 100mg for 7 months, and after 5 months of pretty much stability, am slowly having more frequent bouts of insomnia/anxiety similar to my acute withdrawal back in December. I was nearly ready to begin my taper before these last couple months have thrown me off. 
 

thanks 

 

[Emart]

Any thoughts? See my previous two comments. Seem to have a bout of insomnia ~2 nights a week. Can’t seem to tie it to any diet/lifestyle catalysts. 
 

would you guys recommend continuing to hold before starting to taper?

 

Thanks

[Emart]

Good morning, 

 

I am still sitting at 100mg of sertraline after my too-fast taper and reinstatement back in December. Though generally stable, I still am dealing with a handful of mild symptoms for the past month or so. I am wondering if it would be recommended to hold until these symptoms resolve or to start my taper.  
 

 

thanks