weemie: Is it too late to reinstate Zoloft after 7 months? Any alternative suggestions?

[weemie]

Hi everyone, 

 

My name is Weemie. Nice to meet you all! I hope you'll take the time to read this. I'm in really rough shape right now. a little bit of personal history; I'm 20 years old and have been on and off of sertraline a total of three times since the age of 14.

 

Each discontinuation period has been hellish for me because my tapering instructions were to basically just skip a dose every second day and keep increasing days in between doses until I felt better. I'd usually stop after about two weeks. my most recent taper had started and ended in the month of October 2020. I was pretty seriously depressed in late 2021 which resulted in a full blown insomnia induced breakdown in December.

 

In my desperation for anxiety relief I (regrettably) promised myself I'd start sertraline again. December 9th I took a 25mg dose of sertraline and didn't sleep that entire night which prompted me to take a half a dose of zopiclone that next day as instructed by my doctor. Something went awfully awry in my mind this week of December 9th. I became withdrawn and angry, started having racing thoughts and awful agitation/restlessness; which I now know to be symptoms of akathisia or an akathisia adjacent affliction known as activation syndrome. I ended up taking 4 more doses of sertraline sporadically throughout that month (this was me trying to work up the nerve to take it more regularly, stupid I know). On December 24th I had the most traumatic depersonalization experience of my life, so I took another sertraline that night, followed by one more dose on December 25th. I woke up the 26th feeling totally gone, severed from myself. 

 

Seven months after this experience, I do not feel like the same person I was prior to December 9th. I suffer from constant brain chatter that is almost subconscious. Looping and racing at a mile a minute. I can't distinguish my conscious thoughts from the unconscious. Its like an intersection between OCD and ADHD, constantly obsessing over thoughts but cant process them. I'm like a broken record. just an urge to keep thinking. on top of this everything just feels sinister and "off". words, songs and certain consonants are constantly stuck in my head. It makes me agitated, I haven't been able to relax for 7 months. I feel trapped inside of myself. I don't feel depressed or anxious exactly, but another third thing. dysphoric, sick and angry. On top of this I have anhedonia and dp/dr. I've seen very little improvement over these last seven months. these symptoms just scratch the surface of how difficult this adjustment has been for me. I have sort of habituated but recently its been difficult since coming to terms with my symptoms.  

 

I'm wondering, where do I go from here? I fear this could be Tardive akathisia, brought on by my attempt to reinstate in December. Or maybe some form of extended withdrawal. Whatever it is, it appears to be chronic. I'm seriously considering reinstating again and eventually doing a micro taper, but I fear this could ruin my recovery progress, if there is any being made. I risk my condition becoming much worse if I reinstate. Should I continue? give it a year? does the longer you wait to reinstate make it more difficult to do so? its just a gamble either way I suppose.

 

To everyone on this website, I'm sending so much love and resilience to you! I would so appreciate any advice or sharing of similar experiences. it would brighten my life so much. Any direction or encouragement would mean the world.

 

Thank you kindly

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.

 

Are sertraline and zoplicone the only psychiatric medications you have ever taken?  If not, please add them to your drug history in your signature.  Thank you. I'm terribly sorry you had these awful symptoms from taking the sertraline last December.  It sounds like your nervous system reacted badly to the sertraline when you reintroduced it, either because you only took it sporadically, which we do not suggest, or because you took too high a dose.   It could be that your nervous system was kindled (sensitized) from your previous fast tapers off of the sertraline.  Basically, kindling means that subsequent withdrawals from the drug will be more difficult and symptomatic.  Unfortunately, your doctor gave you bad tapering advice by having you skip doses to taper, as this tends to be very hard on the nervous system.  

 

Kindling

 

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. 

 

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

 

 

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

 

Finally, going back on a small dose of your drug, which we call reinstatement, is best done very carefully.  This is temporary, and after stabilizing you would then taper gradually off of this.  There is some risk involved.  I will confer with the staff, and see if it is advisable for you to try a reinstatement, given your severe bad reaction when you took sertraline last December.  Here is some information about reinstatement.  

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

I've given you quite a bit of information here.  Please read through it, and mull it over, and we will take it from there. In the meantime, take care of yourself, and take heart.  We in this forum have been through this, and we understand first hand the pain and discomfort you are going through.  Please know that the brain is amazing in it's healing abilities.  It takes time, but healing can and will happen. 

Edited July 17, 2022 by getofflex

[getofflex]

1) Have you been using alcohol in any amount, or any other mid altering substances?  We strongly suggest you avoid these things completely, as they tend to further destabilize the nervous system, and worsen your symptoms.  

 

2) Are you taking any supplements at all?  If so please describe what you are taking and how much in your signature box.  

 

3) I assume you haven't used any sertraline or zoplicone since last December - is this correct? 

 

You could try a tiny test dose of 0.25 mg of sertraline, to see if your body can handle this.  We suggest this, since you had a significant adverse reaction to it in December of 2021.  If this goes OK, then you could add a little bit more, and see how that goes, etc.  This link will explain how to measure such a small dose.  

 

Dosing and Tapering Sertraline

Edited July 17, 2022 by getofflex

[weemie]

Hi, thanks so much for your reply, all of your resources were very helpful. I've spent a couple of nights drinking over these past months and don't plan on doing so again anytime soon. it definitely worsened my condition. I'm not on any supplements currently and haven't taken any psychiatric drugs since December. I'm wondering, since I have a sensitized nervous system, could this be considered an adverse reaction, or rather a protracted withdrawal spurred by the attempt to reinstate in December? has reinstating proven to be helpful in scenarios similar to mine? I realize each experience is subjective and understand if you can't answer those questions for me.

 

[Ariel]

Hi @weemie

Welcome to SA. 

I'm sorry for what has brought you here and glad you found us. 

 

On 7/15/2022 at 8:32 AM, weemie said:

I'm 20 years old and have been on and off of sertraline a total of three times since the age of 14.

 

You might be interested in this topic. I post there, too, and find it to be a supportive thread. 

 

 

Good luck to you on your healing journey. 

In solidarity and support,

A. 

[weemie]

forgot to page @getofflex in my above comment!

[getofflex]

I'm glad to hear that you will give up alcohol entirely. This will allow your system to recover.  

 

20 hours ago, weemie said:

I'm wondering, since I have a sensitized nervous system, could this be considered an adverse reaction, or rather a protracted withdrawal spurred by the attempt to reinstate in December?

Was anxiety the only symptom you had prior to taking any of the sertraline tablets in December 2021?  If not, what other symptoms did you have then? 

 

From what you describe, it may be a combination of both.  You mention anxiety, which can be from a nervous system that is still in protracted withdrawal.  You had previously done 2 fast tapers, and your system may have been in protracted withdrawal from that, which can last for months, or even years in some cases.  Then, when you took the sertraline tablets, your symptoms flared up pretty badly.  This sounds like an adverse reaction.  

 

20 hours ago, weemie said:

has reinstating proven to be helpful in scenarios similar to mine?

Reinstatement often works, but I cannot predict whether or not it will work for you.  There is always a risk associated with it, which is why I gave you the link about reinstatement.  There is less risk when 1) the person has only been on the one drug, and not a variety of psych meds, and 2) if the person reinstates soon after the stopped the meds, and 3) if they have not jumped on and off and on and off their drug several times.  

 

That is why I suggested the very low reinstatement amount of 0.25 mg sertraline.  Let us know what you decide to do.  

[weemie]

I was experiencing ocd and anxiety symptoms prior to December, which are the conditions i'd been put on sertraline to treat in the first place. prior to taking the sertraline in December, I'd gotten this paradoxical insomnia or basically a fear of sleeping. I decided to use these drugs in a desperate sleepless frenzy, after getting the go ahead from my doctor, thinking my side effects were being caused by sleep deprivation and obsessive anxiety. for the longest time I was under the impression that 25mg was a low, harmless dose, because otherwise why would my doc be telling me to skip doses. it seems a lot of doctors around here use the skip-a-day tapering system. I'd heard stories from friends of kids becoming dependent on them after tapering and snorting/abusing them. awful.

 

Also, I had forgotten that I was double dosing high levels of b12 supplements at this time, as per my pharmacist's suggestion. soon after the ordeal In January I was also put on antibiotics for a tooth infection. really just ROCKED my nervous system. I think I'll continue to stay off of them. I hope I won't regret it. I've already spent so many years trying to free myself from them. If there is something salvageable here, I think sobriety and time will be a greater friend to me than reinstating.

[getofflex]

11 hours ago, weemie said:

soon after the ordeal In January I was also put on antibiotics for a tooth infection. really just ROCKED my nervous system.

Yes, some antibiotics can do this, check out this link: 

 

Antibiotics in Withdrawal

 

11 hours ago, weemie said:

prior to taking the sertraline in December, I'd gotten this paradoxical insomnia or basically a fear of sleeping.

This insomnia may have been from the protracted withdrawal.

 

 Protracted Withdrawal or PAWS

 

11 hours ago, weemie said:

I was under the impression that 25mg was a low, harmless dose, because otherwise why would my doc be telling me to skip doses. it seems a lot of doctors around here use the skip-a-day tapering system.

Unfortunately, most doctors are woefully unaware of how to properly get their patients off these drugs, as well as unaware of the severity of withdrawal that can occur when going off of them.  Skipping doses is a recipe for disaster.  It's like playing ping pong with your brain. 

11 hours ago, weemie said:

Also, I had forgotten that I was double dosing high levels of b12 supplements at this time, as per my pharmacist's suggestion

Hopefully you stopped doing this, as B vitamins can be activating to the nervous system, causing things like anxiety, insomnia, etc..  Most pharmacists are also unaware of these withdrawal issues. 

 

11 hours ago, weemie said:

I think I'll continue to stay off of them. I hope I won't regret it. I've already spent so many years trying to free myself from them. If there is something salvageable here, I think sobriety and time will be a greater friend to me than reinstating.

I think this is very wise, and I admire you for this.  If you get hit with waves in the future, it's best to tough them out, and use non drug coping techniques.  Please keep in touch, and let us know how you are doing. 

Edited July 21, 2022 by getofflex

[weemie]

After researching more about skipping doses on this site I'm fearful of how badly I compounded my protracted withdrawal. I've been in a biiiig wave since a night of heavy drinking at the end of June. hoping my relative youth will be more of a help than a hinderance in my recovery. entering 8 months in a few days. I'll keep you posted!

 

[getofflex]

21 hours ago, weemie said:

I've been in a biiiig wave since a night of heavy drinking at the end of June. 

Please, definitely stay away from alcohol!  Drinking can seriously derail your recovery.  It's not worth it.  Yes, your youth will definitely be a help!  Please also stay away from any other mind altering substances.  As long as you take good care of yourself, you will eventually recover.   Hang in there!

 

This thread may be very helpful: 

 

Steps for Managing WD Symptoms

 

Edited July 24, 2022 by getofflex