Mostafa: adverse reactions to sertraline with lorazepam

[Mostafa]

Original topic title:  Adverse reactions to Sertaline w lorazepam, guidance and advice

 

Hello everyone and thank you very much for your time and this resource. I am in need of guidance as my mind works against me and, whilst I am still alive I feel very damaged and can’t engage/ focus on anything. I am a 25 year old male.

 

My story with psychiatry begins actually this year, I caught Corona virus late May and did my best to fight it. Unfortunately it was very heavy on my nervous system and to make story short I ended up with severe panic attacks.

 

prior to that month actually I had a personal history with eating disorder, due to allergies and gut problems that I had a lot of trouble with. So I was recovering from not eating well at all for a long time for a full month, before I got the virus.

 

I took the worst advice in my life and went to see a psychiatrist (I saw a neurologist but he dismissed me within 2 minutes and said virus doesn’t do anxiety or anything your brain is fine but your mind isn’t… anyways I didn’t know better and was told that psychiatry can help me.

 

Around june 12 I was prescribed Zoloft I think 25 mg something like that. I suffered very adverse reaction, looking back it might have been serotonin syndrome (I felt first panic attacks that were overwhelming, then really excessive surges of energy, having to move uncontrollably by day three I did not have control of myself and was I a severe panic…

 

i call 911, to make it short they recognized the medicine brought me there but instructed my parents to keep me on it (I actually did not know at the time and did not make the connection with the medication. I thought the problem was me (I was already in a tough state and not feeling like myself after corona that might have had to do with it)

 

I apologize if I am going too long. I stayed on the medicine because I was ignorant, I ended up becoming completely zoned out, always thinking very negative thoughts and very impulsive. Also fatigued and confused. Slow to understand things. I voiced myself as best I could to my doctor whom I used to really trust but he and the pdoctor said this is all anxiety and trust us. My personality changed (from being simple and gentle and enjoying the simple things to being constantly agitated and no empathy or feelings)…

 

After a week or two, I kind of forget, I was convinced that I needed to kill myself. My dad gives me a full mg of Ativan which calmed me down and took away the agitation but I was very fatigued. We sent urgent message to the psychiatrist and unfortunately I ended up staying on the medicine for a full month, using Ativan to counter it. I failed to make the connection with the medicine (the voice of reason in me was kind of kindled most of the time) and my dads cousin a big shot MD in Germany convinces me to stay on it. 

I was begging my parents to agree with me to stop the medicine, at the same time myself and they were scared of just stopping at on our own. We made a ‘deal’ to give it at least a week.

Fast forward, the stupid doctor at one months mark, after I explain to here my suffering (which we already had done basically) said oh, this medicine does come with a black box warning etc and tells me to just stop taking it. I do that. She was adamant throughout that because the med worked wonders for my dad (he was 50 at the time and just has a very different body than me) it must work for me. 

By that point I am on 3 mg of Ativan a day It kept me functioning and stable but when it would wear off I would panic, get confused, zone out, and have thoughts of hurting myself

 

i develop tolerance to Ativan and end up in the psych ward in an excellent hospital here, I undergo a very quick taper from it and switch to diazepam, at the same time introducing mirtazapim (first 15 mg then to 30). Those were dark days. I felt like my nervous system was running at 1000x, and experienced really intense physical and nervous symptoms. I could not make benefit at this point from any of the coping skills that we are taught (or that I had learned and used from throughout my life).

 

i genuinely did my best but my nervous system was overloaded. At about 8 days on mirtazapim I am completely zoned out, am in my own world basically and feeling suicidal and aggressive. My parents agree with me to stop the med. They want the old me back which is all I want. I did not taper but just cut it off (we’re told that’s safe to do).

I felt some relief the next night and thought maybe there is hope. I had one day this week I could get out and I felt maybe there is hope.

 

All the medication, and the tapering from Ativan and all this left me with the following symptoms I am suffering from: heavy anxiety (physical shaking has improved though), dark depression, being zoned out almost all the time it’s hard to describe this feeling, it’s actually not a feeling but a state, it’s like I’m too tired or broken to engage with the world that is right in front of me. I cannot look at my surroundings calmly ever and feel trapped in myself. At best I am ruminating over the past. Sometimes troublesome thoughts pop into my head which actually makes me spend most my time on screens or just trying to not be with myself.. it’s not healthy at all. There were some windows were I felt a little relief and could engage in proper dialogue with my family. Like I used to.

I don’t have track of time, very severe exhaustion and weakness, overly focused on myself which makes all of this worse (I can’t relax and engage in the things I used to how hard I try. I am a very simply person, I had history of ocd (part of my personality but if not for eating disorder was not an issue at all for me) and very rare episodes of depression which I feel were related to not eating well, but at heart I am a simple person who found meaning in everything and enjoyed the very simple things in life, such as the nature around me and the blue sky, especially nature i live in California, also traveling, and my dear families company which I just can’t for some reason.) also just connecting with people. I can’t… Whether I am in my room or with my family or outside I am basically zoned out, and very uncomfortable. I can’t think deeply which is very important to me…

is there hope for a case like this?

 

also the Zoloft made me very tired, zoned out, dark thoughts, and very impulsive for some reason. I am repeating myself please excuse me for that. My mind (I can’t imagine more toxic thoughts) made me think throughout this period that hope is lost. I have no future. I am fighting that notion but my own mind got hijacked (it really feels) and says this to me…

 

is there hope for a case like this and what can I do in the meantime?

 

Thank you for whoever reads this…

 

- I am right now on 10 mg diazepam around 9:30 pm am doing slow taper from it…

 

Edited September 19, 2022 by ChessieCat
added topic title before shortening, added spacing

[Altostrata]

Welcome, @Mostafa

 

We have a number of people here who have had fairly immediate severe adverse reactions to antidepressants. After they stop, they have symptoms very much like protracted withdrawal, but it's not withdrawal. However, recovery is slow and gradual, like protracted withdrawal syndrome. See Adverse reactions to an antidepressant within a few doses -- how long for recovery?

 

What times o'clock do you take your drugs, with their dosages? Are there any times of day you feel better or worse?

 

[Mostafa]

On 9/19/2022 at 12:30 PM, Mostafa said:

 

Hello and thank you very much for accepting me… when I was discharged from the hospital I was taking 15 mg diazepam with I think 30 mg mirtazapim at 9:30 pm. I stopped the mirtazapim as I mentioned and as of 2 nights ago I am on 7.5 mg diazepam 9:30 pm.

 

What scares me about my situation is, well not only that I continued on the medication (as I mentioned it took me to reach a crisis point when I realized that I was being altered by an inappropriate drug) I stayed on it for a month, then I stopped abruptly as that is what the psychiatrist said to do… I didn’t know better. The mirtazapim was too high a dosage for me and I ended up with the symptoms of serotonin syndrome (even dilated pupils etc) 

i am basically fazed/ zoned out most of the time. I have very hard time putting my focus to a thing and distracting myself… 

no matter what I have been through in my life I never felt despair. But I can’t actually fight that feeling now. The best I can do is try to ignore it. I also almost always feel an absence of myself, and my connection to people, it really scares me the possibility of staying like this.

The days in which I would feel better I would feel some relief from like midday for a few hours, and sometimes some relief in the evening. It is not predictable… I think the drop in diazepam (which I already had tolerance to) adds to the difficulty lately. Actually it makes big difference. Other than that I would feel some relief in the midday and for a little bit in the evening.

 

 

Sorry for writing excessively. I can’t get beyond the fear that my brain will not heal (“the damage is done” I have literally said this) but nevertheless I am trying to do the baseline healthy things and what else could I do in a situation like this?

Thank you…

[Mostafa]

Also for however reads my post I apologize for an excessively negative post I don’t mean to be this way, it’s not really in my control. I re read my post and realized it excessively heavy/ negative I don’t mean to be that way…

 

Other than ocd tendencies (which for most of my life was under control, until the eating disorder got excessive) that was due to food allergies and gut issues, I do not have history at all of serious mental illness. I do have history of being told that my health issues are all psychosomatic… Even the food allergies which would cause asthma attacks with hives; I eventually got to the root cause of those issues…

thank you for any advice….

[Altostrata]

18 hours ago, Mostafa said:

when I was discharged from the hospital I was taking 15 mg diazepam with I think 30 mg mirtazapim at 9:30 pm. I stopped the mirtazapim as I mentioned and as of 2 nights ago I am on 7.5 mg diazepam 9:30 pm.

 

When were you discharged from the hospital? Why are you tapering diazepam?

 

What new symptoms do you have since quitting mirtazapine 2 days ago? Please stop changing your drugs for now.

 

 

[Mostafa]

Hello there and thank you. I have gone back to 10 mg diazepam 9:30 pm today, I meant to say that as of 2 days ago I made change to 7.5 mg it is based on a tapering chart I think it is based on the Ashton method. Because I don’t want to stay on it indefinitely…

 

I was discharged at this point almost a month ago and a few days. I stopped mirtazapim ct about 7 days after that. Maybe was a mistake to stop ct… I was desperate because of the symptoms… I did find after that unfortunately find very severe fatigue, mental and physical… but depression eased temporarily, agitation most certainly eased… seeing very strange images before sleep went away… (very strange symptom I got after this med)…

 

I will hold with the medication I am on now, no more changes… I felt I was making some progress but this tapering was not right thing to do now… my body can’t handle it…

 

 

[Altostrata]

In your signature, please add the date you started taking diazepam, with the dosage, and your dosage changes since.

[PortugueseSea]

Hello Mostafa,

 

The damage is done. And it will be undone. You just have to get to a stable baseline.

Given that you were not on Mirtazapine for a long time, to have discontinued might not be a problem. We can only tell depending on your symptom pattern and how you evolve.

We are here to support you.

 

Follow Alto's instructions, the quicker we get the information we need the quicker we can act.

 

You are not alone.

[Mostafa]

Thank you sincerely for your kind words… i have to find the records, to find exactly when I made the changes, but I found that i started Diazepam 15 mg August 19 in the hospital, I take it at 9:30 pm… I will try to find exactly when the changes were made but the timing has been the same and I am now at 10 mg at night. We tried going down to 7.5 mg this week, and my nervous system did not handle it whatsoever. The advice of not making any changes now was very needed thank you.

I’m finding that the days are not consistent, maybe the changes that were made, and my history have to do with that I don’t know. Yesterday was relatively better though.

[Mostafa]

I spoke yesterday morning to my psychiatrist, scheduled follow-up, I voiced my symptoms and concerns as best as I could, and she is very confident that I have some type of mood spectrum disorder, or bi-polar disorder (based on my reaction to ssri’s) and wants me to take Seroquel at night (I think 25 mg). I have no intention whatsoever to do so…

 

Thankfully I have a therapist who is very kind and understanding, and of how medications aren’t a one size fit all thing for people. She says that I have a strong kind of trauma, due to everything that has happened and the goal is to get to a point of stability…

[Altostrata]

It is not unusual for a psychiatrist not to recognize adverse drug effects or withdrawal.

[PortugueseSea]

Seroquel, that's what I got dished out and a single dose had me racing around my apartment. Of course, the rationale was the same. "Probably a mood disorder", despite the fact that all my symptoms emerged after the offending medication was started.

 

Pouring gas into the fire, it set me back months. It seems that you are getting a similar script. Except that unlike you, I took the one dose of seroquel, and I stayed on the mirtazapine too, maybe I shouldn't have.

Again, if these symptoms developed after you started the medication it was likely the medication and, as Altostrata mentioned, it's not unusual for psychiatrists not to recognize drug side effects or withdrawal, specially protracted withdrawal.

 

Kindling is very real and all your nervous system needs now is stability, not an antipsychotic. That is what seroquel is.You are not psychotic. The absolute priority now is for you to feel grounded and stabilize. You need to settle on a dose of Valium and stick with it. Your family will see you through it and you will see those moments you are your old self will, over time, will become more common.

You mentioned that "your days are not consistent", I know it's scary, my days still aren't, that's to be expected. It's part of it all. As your CNS settles down things will become more predictable.

 

Dealing with trauma is also part of it, your therapist can help you with that.

 

Post as much as you want. We will help as much as we can.