fixstern: Help for teenage daughter - with withdrawal from sertraline

[fixstern]

Hi,

I am seeking help in this forum for my teenage daughter. She has been on sertraline - first 50mg (Dec 2020) then 100mg from July 2021. Her new psychiatrist proposed to get her of the drug at her appointment on 6. of April. He was not the prescribing Doctor, the former doctor retired after a heart attack last July. Her new doctor is very critical about the meds.

 

She should reduce to 75mg and after 3 weeks to 50mg. In autumn 22 he wants to taper it to zero.

So far all was good until 5 days ago,she was still on 75mg, but then she had a crisis - I had to pick her up from school with a panic attack,she was crying all the time,feeling tired. A day after she felt first muscle twitches (Wednesday) that looked like hick ups, those grew stronger, the next day she said...'my body is not responding to what I tell him. she manages to walk,barely, her motoric skills are corrupted in her legs.the legs are slow and her body is spasming from the center,imbalacing her on top - she looks like doing dance movements, but the motoric movements of the legs are also not normal,it's like a Parkinson patient,somehow.

It gets worse when she is tired. Today, Sunday,she went out with my husband,she managed to go to a flea market with her body still spasming and walking weird,she got tired after 1.5 half hour. So somehow her better energy level helps, but I don't see change or improvement in the symptoms. She seems a bit more upright in her body.

 

I will have an appointment with the doctor this week...so but I am seeking any kind of advice possible,also to be well informed about what next steps could be. She cannot go to school or have a social life or do any sports at the moment. Mostly she is lying in her bed.

Good thing,she seems emotionally much better,the crying stopped and she is less tired. Of course the thought of being disabled for a period of ??? Time is very threatening to a teenager coming out of a depression so I am very worried how i can help her deal with the situation.

 

I am asking myself, how come the reaction is that late (3 weeks) after the dosage was reduced - she had not problem other than feeling a bit more tired and she was slightly aggressive.

 

unfortunately I have not known about tapering strategies as advised on this site 😓.

I would like to know what could be the next steps, also to be better prepared for the discussion with our doctor. 

Thank you for all your input.

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  I'm sorry that you and your daughter are going through this.  It sounds to me as though the doctor is tapering her off this drug too fast.  We at SA suggest a taper of only 10% of the current dose, no more often than every 4 weeks.  Some of our members taper even slower than this.  

 

Is there any way possible that your daughter could create her own account, and talk with us directly?  If she is able to, this would be the best and most efficient way to help her.  I will share with you some links to read that can help you understand why we suggest such a slow taper.  

 

Here is some important information about how these drugs actually work.  This explains why we get symptoms from going off of these medications, and why it's so important to taper slowly and carefully, and be very cautious about changing our doses: 

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

Video on Recovery from Psych Drugs

 

Windows and Waves Pattern of Stabilization

 

 

Tapering is best done extremely slowly, and we generally taper by 10% of the current dose no more than once every 4 weeks, so that the reduction becomes exponentially smaller.

 

 Why Taper by 10% of my Dosage  

 

Here is a link on how to talk to the doctor about psychiatric drugs, to explain to him/her why we taper this way: 

 

How to Talk to a Doctor About Tapering and Withdrawal

 

We hope to hear back from  you, and also from your daughter.  Please let us know if for any reason she is unable to communicate with us directly. 

Edited May 4, 2022 by getofflex

[fixstern]

Hi, thank you very much for all the information. I will talk to her, she knows I am in this Forum (since she did not have the energy to do this when it started and we wanted to get advice as soon as possible to help with the situation) and I will ask her, if she maybe now wants to go on herself. She is in hospital right now being checked out for her neurological symptoms, withoput any results. Of course doctors are waving of my argument about the tapering and all, so we have to go on with it using all the information and support from this site and your experience. She is a little better today, which gives me hope. I will do all the reading!

[getofflex]

I would suggest you not let her continue to reduce her sertraline in the meantime.  Her nervous system is already struggling from having gone from 100 mg to 75 mg, which is a 25% drop, and much faster than we suggest here in the forum.  The doctors are very notorious for doing this, and then denying that the patient is in withdrawal. That is why this forum is so big and active.  I very glad to hear that she is a bit better today.  I'm concerned that the hospital will try to put her on more psych drugs.  That would put her at risk of getting worse.  Just keep in mind, you have the choice whether or not to take drugs that are prescribed.  

 

29 minutes ago, fixstern said:

She is in hospital right now being checked out for her neurological symptoms, withoput any results.

It's good she is being checked out.  Is she doing this on an outpatient basis?  Since the tests are coming out negative, it's likely that her issues are from the withdrawal.  We see this here quite a bit too - people being checked out, and the doctor finds nothing on their tests.  

[fixstern]

Hi, she is stationary in the children's  department of the hospital and there are no psych docs involved,they are not at all thinking,it's drug related but a kind of 'tick' (which is in fact not at all wrong,but they do not relate to withdrawal syndrome) they are not at all talking drugs,just time,since she shows improvement. I will today hopefully talk to the head neurologist and also point him to the scientific papers.

 

I could get the head children doctor interested in the scientific papers,she is open to the idea and will read up.

We think she will be released tomorrow.

 

Her Psy Dr. who also excludes connections of the symptoms to the dosage being lowered is thinking in direction stress induced emotional crisis (eg conversion neurosis - but to me the symptoms don't fit,but he has not seen her,it was just an idea of his) and recommend she should first of everything see her psychotherapist as much as possible and as she can of course, he is not thinking drugs,bcs he is very drug critical,so i don't see a actual danger of new drugs being on the table.

I think she had a stress introduced crisis, but as a result of the withdrawal...and therapy is good for her,so that is also think he will not make problems,if my daughter wants to stay at her dosage now and to taper slower at another time in the future (no idea,when this is the best moment,but guess we will see in a couple of months).

 

So it's up to us and we want to follow advice given here, which if I understand right means keeping her on her dosage for a couple of months. She was actually VERY good before they reduced the drug and aside from not tapering correctly also timing was bad, the end of the school year is a hard and stressful time for kids. 

 

I am now seeing she improves in an environment of no stress, so i will try to find a way she can get that regarding school (she wants to finish the year,it's important for her and she puts pressure on herself,it's not coming from us parents). 

 

Next steps?

Would you recommend rather stay on her 75mg if we see now improvement,even if slowly or would you recommend a slight rise to see if it stabilizes her? I am happy to do anything that is the most reasonable and healthy way for her to get better.

[Faure]

Sorry to hear about this and to think the doctor did it at a stressful time in the school year as well. Just unacceptable.  
 

Please do listen to advice on here rather than doctors. This forum sees doctors causing problems *all the time* because they taper patients too fast and then deny withdrawal symptoms.  I hope your daughter continues to recover and when she is ready has a smooth taper. I am having great success with the BrassMonkey slide☺️

[getofflex]

At what date did your daughter reduce from 100 mg to 75 mg of sertraline?  If you don't remember the day, was it early, mid, late month?  And which month was it?  

 

Can you please give us specific information in your signature about her drug history for all drugs your daughter is on and has been on, especially for the past 18-24 months?  It would be especially helpful to have the details of her drugs in a concise vertical list (no symptoms), only drug names, specific dates (as best you can say for example early March if you don't recall the day) and dosages of each medication decrease or increase.  Use this format:

 

Drug name: date, dose, date, dose, date, dose…

Drug name: date, dose, date, dose, date, dose…

Etcetera

 

Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Drug History in Signature

 

 

16 hours ago, fixstern said:

they are not at all talking drugs,just time,since she shows improvement.

This is very good news.  I'm glad she is showing improvement, and that they are not administering drugs.  Just remember, you and she have the right to refuse drugs, even in the hospital. 

 

16 hours ago, fixstern said:

he is not thinking drugs,bcs he is very drug critical,so i don't see a actual danger of new drugs being on the table.

I'm glad to hear this, too.  

 

16 hours ago, fixstern said:

if my daughter wants to stay at her dosage now and to taper slower at another time in the future (no idea,when this is the best moment,but guess we will see in a couple of months).

Yes, I would suggest, as I did before, to stay at her current dose of 75 mg for a while, since that was a 25% drop.  If you read my previous links, especially the first one, you see why the brain needs lots of time to adjust to the lower dose.  She could hold for even longer than 2 months, if necessary.  It's good to wait until she achieves good stability for at least a couple of weeks: 

 

Stability

 

16 hours ago, fixstern said:

Would you recommend rather stay on her 75mg if we see now improvement,even if slowly or would you recommend a slight rise to see if it stabilizes her? I am happy to do anything that is the most reasonable and healthy way for her to get better.

What other symptoms is she currently having?  How is her eating, and her sleep?  If her symptoms are bearable, she could stay on the 75 mg for a while.  If not, we can talk about a slight updose.  But first, I need to know when she made the dose reduction to be able to suggest a good updose amount.  

 

Here is a link with checklists of common WD symptoms: 

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

Stability is really important when we are tapering off psych meds.  Please read the link about stability:

 

Keep It Simple, Slow, and Stable

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

Omega 3 Fish Oil

 

We look forward to hearing back from you.  

Edited May 5, 2022 by getofflex

[fixstern]

Good morning and thank you for answers,links and help, it is very appreciated. She is slightly improving,the spasms are less severe and often,her energy level is better the tremor is all gone.

The walking is still severely effected,her right foot especially pointing slightly inwards,she can only make tiny steps and not for long or far.

 

She can eat normal, sleeps actually well (she always needs her melatonin spray though).

 

She still is not up for school yet, it's about energy level - concentrated work/reading makes her tired - although I see lots of improvement there. But she is worried about it as well wants to be back doing her routines and organsitional things she does as a volunteer in school. emotionally she is good and strong.

 

I give her Magnesium and Fish Oil capsules. On Wednesday she has her Doctors appointment,where we try to discuss strategies how to go on with school and everything, he offered help with that and advise therapy. 

 

[getofflex]

I'm glad to hear about the improvements.  It's great that she can eat and sleep normally.  Let her hold on her 75 mg sertraline for a while, and continue to improve and stabilize, before doing any reductions.  When you see the doctor, please be aware the vast majority of doctors do not know how to slowly and properly taper off of psychiatric drugs.  Here is a link with info that you can print off and share with her doctor.  

 

How to Talk to a Doctor About Tapering and Withdrawal

 

These links will give you a good idea of what we mean by stability, and how to gauge her recovery.  

 

Stability

 

WD Normal

 

[Faure]

You might want to take this leaflet from The Royal College of Psychiatrists that talks about a 10% taper. Whatever you do don’t listen to the doctor if they tell you withdrawal isn’t real, doesn’t last…it is very real, it causes untold suffering and can be minimised through a careful methodical taper as advocated here. You may find you need to do a taper without telling him. 

[getofflex]

Faure has given excellent advice!  

[fixstern]

Hi, yes, I already made that plan, we need the doc to help us manage everything concerning school absences etc. we do not count on him concerning further tapering advice  which is why I decided for myself just to not go down this road....as long as he does not oppose our idea of slow tapering, which I actually do not think. I will keep you updated about what is happening. Actually she seems to get slightly better at her current dose and of course we leave it there for the next 2 or 3 months...whatever it takes. I read all the papers, studies and sheets on how to and will follow the advice given through the group and its materials. Thank you all for helping...it is really hard to feel left alone out there by all health professionals.

[fixstern]

@Longroadhome I am trying to find out how I can book a consultaion for my daughter with Bylissa Frederick? It seems not possible over the website. She (my daughter) looked at the site and asked me to, to help her with her WD process. Possibly its not available, if youa re not a client already? Thank you , Daniela

[Longroadhome]

3 hours ago, fixstern said:

@Longroadhome I am trying to find out how I can book a consultaion for my daughter with Bylissa Frederick? It seems not possible over the website. She (my daughter) looked at the site and asked me to, to help her with her WD process. Possibly its not available, if youa re not a client already? Thank you , Daniela

Hi there 

Baylissa puts dates up periodically. None  available at the moment . 
keep checking www.baylissafrederick.com

hope this helps 😊

[fixstern]

Thank you for the information, ok, that is unfortunate...my daughter needs support soon. If anyone can recommend somebody else I'd be very happy. Thank you for your getting back to me though!

[Longroadhome]

@fixstern

Yes I can fully recommend Dr Jennifer Leigh. She’s American  and does zoom coaching sessions. She’s been through withdrawal herself and is lovely. You will be able to book a coaching session with her.

Just Google her name and her website will come up.

 

[Longroadhome]

6 minutes ago, Longroadhome said:

@fixstern

Yes I can fully recommend Dr Jennifer Leigh. She’s American  and does zoom coaching sessions. She’s been through withdrawal herself and is lovely. You will be able to book a coaching session with her.

Just Google her name and her website will come up.

 

@fixsternI contact Jenni when Bay is not available as she is studying and only puts out random dates here and there. 
I FaceTime Jeni.
There is also a man on here known as elbee who has now recovered and does counselling sessions. He seems very nice. 

[ChessieCat]

@fixstern and @Longroadhome

 

I've moved your discussion from Arti's topic.

[fixstern]

@Longroadhome thank you very much, i found Dr. Leigh's Website,it says benzo withdrawal,but I guess she also covers SSRI?

 

[Longroadhome]

23 hours ago, fixstern said:

@Longroadhome thank you very much, i found Dr. Leigh's Website,it says benzo withdrawal,but I guess she also covers SSRI?

 

Yes she does. She will help your daughter.