CeruleanSea: Introduction

[CeruleanSea]

My headaches have been gone since Friday, so I decided to reduce an additional 1.25 mg for now.

 

It was a good day, but I became very cranky at my child & even spanked her (albeit gently).  I never use corporal punishment & although onlookers agreed it was “deserved”, I am wondering if the reduction contributed to my frustration & crankiness. 
 

 

 

[CeruleanSea]

As this reduction continues, I’m starting to be more feeling, experiencing both more positive and more negative emotions.  
 

I’m also much more motivated.  I’m taking action towards achieving goals much more readily than I used to. 

 

I am waking up in the middle of the night, so I’m working through this.

[CeruleanSea]

Thinking back on recent weeks, I have had a notable amount of brain fog and forgetfulness. For example, yesterday I couldn't think of the name of my child's classmate's mother, who I had seen at a party a couple of months ago.   

 

Also, to another acquaintance, I repeated information I had told her in text prior.  I feel "slow."

 

This is frightening. I hope it truly is just down to SSRI withdrawal and not a tough to treat condition.

[CeruleanSea]

Thursday and already I’m feeling much better without the brain fog I’ve been experiencing.

 

The biggest difference has been, simply getting more sleep.  When my kids wake up at night, I’m the parent who cares for them. Thankfully they’ve started sleeping better. 

[CeruleanSea]

Today I'm more aware of more episodes of forgetfulness recently.  None of them are big, but things I would have remembered in the past come to me more slowly now.

 

The thing is: I wouldn't say I'm depressed at all.  I am feeling happiness, laughter, and motivation more than usual.  If anything, however, I'd say that my brain has come to rely on ssri's and the elevated signals they provide.

 

 

[CeruleanSea]

Doing well!   In the last few days I've dropped further to 30 mgs and it's going well.  I am feeling a burst of energy + motivation.    Mild forgetfulness.

 

 

[CeruleanSea]

Today I found myself crying in response to some bad news. And honestly? It was appropriate and such a relief to feel compared to the lack of feeling when overmedicated on sertraline.

[CeruleanSea]

I'm starting to feel ssri withdrawal effects about 20 hours after my last dose.   Even after such a slow taper since early 2022!!

 

The effects are basically, dizziness, mental fuzziness, fatigue, headache.   They clear up about an hour after I take my ssri.  

[CeruleanSea]

Once again, I am learning that I must reduce my caffeine intake.  It has gotten to the point that a normal enjoyable coffee gives me the jitters.   And I LOVE THE TASTE!  

 

Currently I am considering green tea. 

[littlebird]

6 minutes ago, CeruleanSea said:

Once again, I am learning that I must reduce my caffeine intake.  It has gotten to the point that a normal enjoyable coffee gives me the jitters.   And I LOVE THE TASTE!  

 

So tough!! I'm a tea person, and had to find an herbal replacement that tasted similar to my favorite black tea to get me to switch. Is there a decaf coffee that is tasty?

 

6 minutes ago, CeruleanSea said:

Currently I am considering green tea. 

 

I love Verdant Tea, and they have a 5 teas for $5 special for first-timers. Been a loyal customer for over a decade, their tea is the best I've tried.

[CeruleanSea]

16 minutes ago, littlebird said:

 

I love Verdant Tea, and they have a 5 teas for $5 special for first-timers. Been a loyal customer for over a decade, their tea is the best I've tried.

 

Hey @littlebird,great name you have there!  I am going to order some teas and try them out.   These look very high quality.   

 

I have ordered "Wean Caffeine" pills in the past, but they are colored bright blue + have l-theanine.  It would make more sense to switch to tea for the second+ cups/day. 

[CeruleanSea]

I am still frequently quite forgetful, more than usual.  Is anyone aware -- does this frequently/normally happen to individuals after a long time on SSRI?

 

 

[CeruleanSea]

Adding -- I am actually trying out some medication for ADHD, Adderall, today, and find that I am quite calm and focused on it.

[manymoretodays]

Hey there Cerulean Sea,

On 3/22/2023 at 12:44 PM, CeruleanSea said:

Adding -- I am actually trying out some medication for ADHD, Adderall, today, and find that I am quite calm and focused on it.

 

 

And I see this ^

Just for the day, your trial?  Or have you become somehow convinced of a latent ADHD, or that this was really your problem 20 or so years ago?

And I trust you got your thyroid thoroughly checked out with lab work, and any resultant drug change with that, and all of that is just peachy.  I mean that's beyond my scope, but could require patience and some wait time.

And you finally settled on what dose of sertraline and when?  Last in your signature is that 33.75 mg in December of 2022.

Do keep that updated.

 

 

Do use Drugs. com to check for interactions.  And here is what comes up with your SSRI and Adderall.

Drugs.com Sertraline and Adderall

It's one of those situations where the 2 should not be prescribed together, yet we see it happening all the time

I would totally expect that yes, you might have an initial just groovy response to Adderall.  Where that might lead I don't know.  Might not be any solution for the long haul, and may create it's own problems sooner or later.  I'd expect dependency to develop rather more quickly than the SSRI's too.

 

So I take it you had a doctor prescribe this for you based on a newly made diagnosis?

I know it's frustrating if you are still doing your job as a computer programmer and attempting to be the best Mom or Dad, and holding through the perils of tapering.  Still, somehow I think you'd be better off just doing a long hold of the sertraline, rather than this adding Adderall.

This additional stimulant medication, although calming now........may disrupt some of the progress you've made altogether too.......in slowly getting back to homeostasis with your nervous system.

 

Update your signature please.   Direct link to your signature. When you wish to taper again, perhaps we can be helpful. 

 

Are you staying on it?

 

Oooh.  I know it's hard.  I hope you'll get back to just tapering sertraline.  I do. 

 

And best.  L, P, H, and G,

mmt

 

[CeruleanSea]

@manymoretodays several mental health professionals & family members have suspected that I have adhd. I do have some symptoms. I think I’ve succeeded all my life despite these symptoms but that withdrawal has worsened them.

 

that said, I came to a similar conclusion about taking Adderall medication —too much to add to the mix with another psychoactive medication.  I saw a small benefit on the medication, but not enough to (in my mind) make the risks worth it.

[Shep]

20 hours ago, CeruleanSea said:

@manymoretodays several mental health professionals & family members have suspected that I have adhd. I do have some symptoms. I think I’ve succeeded all my life despite these symptoms but that withdrawal has worsened them.

 

that said, I came to a similar conclusion about taking Adderall medication —too much to add to the mix with another psychoactive medication.  I saw a small benefit on the medication, but not enough to (in my mind) make the risks worth it.

 

Your signature is missing some details - the many decades of using psych drugs that you have listed in your opening post going back to 1995, that along with thyroid problems. I'm very glad to read you're not going to add in another psych drug. 

 

It wouldn't surprise me if you can get off all psychiatric drugs once and for all and give yourself a few years to completely heal, a lot of the attention problems will likely resolve. From what you've written, it looks like you've succeeded in your life not despite ADHD, but despite the number of psych drugs you took. In other words, better days are ahead, CeruleanSea. A lot to look forward to. 

[CeruleanSea]

I'm down to 27.5 mgs of sertraline a night as of April 1.   

 

So far, I don't note many symptoms at all.  I am feeling unusually cold, and I do believe this sense of cold is related.    I am also having vivid dreams and feeling a slight sense of more motivation. 

 

 But I am aware I have a long way to go with this dose and this month.

 

I feel excited to hopefully get down to 1 pill in my dosage next month.  Although most of the effect of the treatment is in the first 25 mgs, this is a significant moment for me.   

[CeruleanSea]

I just reviewed the Serotonin Transporter Occupancy of sertraline, and I feel disappointed that in terms of occupancy effect, I haven't gone far at all in reducing sertraline.  In 2 years, I've gone from about 80% to (at most) just above 70%. 

 

At times despite the apparently small reduction in receptor occupancy, I had real disequilibrium and emotional effects.  Yet I can see that I have adjusted all the way down.

 

It is quite the leap of faith to hope for the next year or so to go smoothly as I reduce further.  Fingers crossed.

[CeruleanSea]

I'm about 3-4 hours before my next dose, and I am feeling stronger withdrawal symptoms than I've had all day.

 

Tired, unmotivated, unfocused, and chills.   This is very unlike me.  

 

 

[CeruleanSea]

I'm facing a frustrating conundrum with tapering SSRI's.

 

At the same time as tapering, I am going through menopause with occasional hot flashes.

 

Yet, tapering will sometimes provoke hot flashes and word-finding problems. The same problems as menopause.

 

My MD is open to my using hormone replacement therapy for the menopausal symptoms.

 

My question is: which is which?  how do I know if I truly require hormone replacement therapy, or if this is menopause that should be treated? 

[LotusRising]

@CeruleanSea

 

I'm perimenopausal and facing a similar dilemma. There is absolutely no way to know what is what and tapering can mimic so many symptoms that also align with peri/menopause. I've decided to wait until my taper is complete before exploring options like HRT. 

 

Have you considered getting your hormone levels checked through a functional or naturopathic doctor? You may be able to balance your hormones naturally with nutrition in the meantime.

[CeruleanSea]

@MedRN thanks so much for the support!  

 

My MD is both an MD and a functional medicine doctor!  I am fortunate.   

 

I am intrigued about balancing hormones with nutrition.  Are you referring to phytoestrogens? or Vitamin E?

 

I am in touch with my MD, and we are going to do some testing. 

 

At the same time, however, I am keeping an eye on the link between a reduction and symptoms. I am thinking, if a hot flush starts to come on within 2 weeks of a reduction, it is likely transient due to the reduction.    

[LotusRising]

@CeruleanSea

 

Oh wow, you are very lucky!

 

As far as nutrition goes, it would depend on where the imbalance is. I'm learning that a lot of us deal with estrogen dominance, which is mostly what I'm dealing with, so I try to eat foods that help me detox the estrogen. There are supplements too, but I realize that can be tricky when tapering. Navigating hormones is such a dance and they're constantly fluctuating!

 

It's my understanding that the DUTCH plus is the best test for determining hormone function and also includes cortisol, which is an indicator of adrenal function and can influence balance of progesterone/estrogen. 

[CeruleanSea]

I’m going back up to 30 milligrams, my last dose, and holding for a bit.

 

I’m going through a very stressful time. Kids have needed medical appointments, husband has struggled with his mental health.  The house needs a lot of repairs.

 

I found myself feeling joyless + obsessing over all the concerns.  I couldn’t let go.  I realized I’ve been that way all week.
 

Within an hour of taking my 30 mgs, I felt a soothing calm wash over me.

 

Perhaps I can continue with a reduction to 29 mgs. 

[Fifree]

Hi Cerulean Sea. I was shocked too when I realised the relationship between dose and SERT occupancy. You think you’ve come so far and then realise you’ve barely begun. I am on Escitalopram and have just got to around the minimum therapeutic dose too. I’m on the corner of the graph if you know what I mean - right before it goes onto a pretty much vertical drop. I’m planning to take my cuts below 10% going forward as I’m aiming to only cut by 2% SERT occupancy with each drop. It’s all theoretical of course but it gives me some sense of control of the taper. 

 

there are a lot of people on this site who are around the peri/post menopausal phase of their lives. It’s always a guessing game with the hot flushes, brain fog etc. That said I’ve seen men here also experiencing hot flushes and brain fog. At least they know it’s withdrawal I guess. 
 

As you’ve said before, the only way forward is through. 

all the best. 

[Blossom71]

Hi @CeruleanSea

 

How are things going?   I've been AWOL for a bit but just wanted to see how you are getting on?

 

Things look to have been a bit rough for you but you're still hanging in there!   It's been a while since you've posted so hope you're ok.

 

Btw, i was also diagnosed with ADHD recently and it explains the overwhelm that I've suffered with most of my life that i thought everyone else felt too!

[CeruleanSea]

Sorry for dropping off friends.

 

I was embarrassed. At the advice of a therapist, I went all the way back up to my old dose (50 mgs) of sertaline, about 2 months ago.

 

My 'symptoms' abated, but I now note a lot of forgetfulness, worse than the brain fog and anxiety that I had prior.

 

I'm not sure how to move forward. My family had a huge crisis going on, and my mood problems were making it worse.   On the high dose of the medication I was able to 'calm down' and work my way through it, but my memory is taking a huge hit.   I can tell. 

 

I am unsure how to proceed. I need changes in my life, changes and my medication, and to be a good parent and wife.   

 

I am unsure, do I restart the taper or go back to somewhere in between?  Can someone advise?  Thanks.

[Shep]

@CeruleanSea Please update your signature to reflect the changes you made since your last entry (your signature states 27.5 mg in April 2023).

 

If you've been at 50 mg for 2 months, if your system has already started adjusting to that increase, you may want to hold until you reach a strong enough baseline to handle tapering. Is 50 mg Zoloft the only drug you're taking? Are your supplements the same as those listed in your signature? 

[CeruleanSea]

I feel really good now, except that I need to build some natural supports in my life.

 

I moved to a new city in 2020, work from home, and making friends has been very slow. 

 

 

[CeruleanSea]

I am on the same supplements as before 

[CeruleanSea]

I can imagine trying 37.5, which is where I was for 8 months of 2022.

[Shep]

8 hours ago, CeruleanSea said:

I feel really good now, except that I need to build some natural supports in my life.

 

 

7 hours ago, CeruleanSea said:

I can imagine trying 37.5, which is where I was for 8 months of 2022.

 

Since you've stabilized at 50 mg, I wouldn't decrease by more than 10% from that 50 mg dose. It sounds like your nervous system has already adjusted to the updose. Please see:

 

Why taper by 10% of my dosage?

 

10 hours ago, Shep said:

Please update your signature to reflect the changes you made since your last entry (your signature states 27.5 mg in April 2023).

 

[DancingBee]

Hi @CeruleanSea:

 

I'm glad I found your thread. I too have been on ADs a long time—started at the 21 yrs old like you (I'm now age 50), initially went on due to depression, also have issues with anxiety and am currently menopausal.

 

I'm inspired by your steady taper and can relate to deciding to bump back to a higher dose when things get too hard. I'm sorry you're dealing with forgetfulness—I hope that abates, along with any other withdrawal symptoms you're dealing with.

 

I hope you find some calm and stability, as well as clarity on how you want to proceed. There's no shame in staying at your current dose. While I'd love to be off ADs completely, my current goal is to get to a place of taking as little as I can without my life falling apart. 

 

Warmly,

Dancing Bee

[CeruleanSea]

Hi @DancingBee, thanks so much for your kind message!  I'm going to be following you to support your in your progress.

 

For people in our age group, it's been quite the ride!  SSRI's were heralded as a huge answer.  When I first tried to come off them in my 20's, I was assumed to be in relapse when I described brain zaps and brain fog.   NOW the truth is coming out, isn't it?  

 

 

 

[CeruleanSea]

For two weeks now I've been back at 37.5 mgs.   This has been a good change. I have more motivation and am not overwhelmed by anxiety.

 

The downside: I do note being slower with recalling names and occasionally feeling that more precise words sometimes elude my vocabulary.   Although this is a common complaint for women going through menopause, it is worrying. 

[Shep]

Quote

June 50 mg August 37.5 mg

 

@CeruleanSea The above quote is from your signature. You went from 50 mg to 37.5 mg in the space of two months. This is a 25% decrease. You don't have the specific days in these months, though. Did this 25% decrease happen within a course of 60 days? If so, this is faster than the 10% reductions per month we recommend. 

 

For example, a 10% reduction from 50 mg would have been to reduce to 45 mg from June to July.

And then go from 45 down to 40.5 mg from July to August. 

 

Did the memory problems start recently? If you feel that it's connected to your taper, you may want to taper more slowly, even going for a micro-taper. Please see:

 

Micro-taper instead of 10% or 5% decreases
Decreasing your dosage by very tiny amounts more often might be more tolerable than 5% or 10% decreases. Know your symptom pattern first so you can estimate how often you can reduce.

 

The Brassmonkey Slide Method of Micro-tapering

One way you can micro-taper.

 

While age can certainly play a role in withdrawal symptoms, we can help mitigate that by slowing the taper rate down to lessen the impact of withdrawal symptoms.