North: difficult experience with sertraline and other ADs

[North]

Hi everyone,

I am a 31-year-old guy in London, UK. I was going through difficult times in life around six or seven years ago and was put on sertraline. This decision was made over a short GP appointment. If I had known what followed I would have never started taking antidepressants. 

 

I don't remember the exact dates but I was on sertraline for several months. The worst side effect it caused was waking up too early. However, circumstances in my life gradually got better so I thought I could live with that. After a few months I decided to change to another antidepressant, escitalopram. Things were not too bad but there were some side effects.

 

A cycle of going on one antidepressant to another had started. For the next few years, I was on various antidepressants, none of which made me feel great. I was made to believe by a family member and medical professionals that antidepressants are good and worth trying. In my case, that was a mistake.

 

In 2020 I was put on sertraline again. This time, I stayed on it roughly for a year. I was experiencing waking up too early again and this caused a lot of fatigue. Things in life were going alright and I decided to gradually stop taking sertraline. I had no major issues for a while but after a few weeks I started experiencing such bad fatigue that I could barely manage going grocery shopping. My legs got so tired I couldn't manage longer walks. At this stage, I had no clue that this could be caused by withdrawal. I nearly lost my ability to work and look after myself. I tried all kinds of supplements and forced myself to exercise even if I was exhausted. None of this helped anyway.

 

After a few months of living my life like this, I was offered sertraline once again. I decided to try it and I noticed that my energy levels started improving. I started thinking I must be addicted to sertraline as the change was noticeable. However, my sleep was getting very disturbed again. I stopped taking sertraline. Some weeks passed by and the fatigue was getting so bad I spoke to the GP and mentioned that I felt like there seemed to be some kind of physical dependency on sertraline. I was told this is very unlikely the case as it had already been several weeks since I stopped taking it. I asked if I could go on a lower dose, 25mg but the answer was that it's less than the recommended minimum dose. I was told doses lower than 50mg are normally only prescribed for elderly people. The GP agreed to prescribe a lower dose anyway. It gave me some temporary relief but after a while I was feeling physically exhausted again. Again, I decided to go on a higher dose and and it was gradually increased from 25mg to 200mg. Nothing seemed to make me feel better so I thought I might as well try higher doses.

 

At this point, I was waking up at 4am and couldn't get proper sleep. One day I ended up finding this forum. I decided to reduce my dose gradually and within around four weeks I was off sertraline. It has now been six weeks since I stopped taking it. My sleep has improved but I am still exhausted.

 

I have decided I will not go on antidepressants again. I would have stopped earlier if I had known it is possible to have withdrawal symptoms after months.

 

I feel slightly anxious writing about all this so I apologise if at some point I will delete this post.

Thank you for reading.

[Altostrata]

Welcome, @North

 

I am sorry to see you have had these difficulties. 

 

On 10/10/2022 at 8:02 AM, North said:

I decided to try it and I noticed that my energy levels started improving. I started thinking I must be addicted to sertraline as the change was noticeable. However, my sleep was getting very disturbed again. I stopped taking sertraline. Some weeks passed by and the fatigue was getting so bad I spoke to the GP and mentioned that I felt like there seemed to be some kind of physical dependency on sertraline.

 

Yes, of course you had developed physical dependency on sertraline and you got withdrawal symptoms when you went off it. Withdrawal can last many months.

 

That your symptoms got better when you were taking a low dose of sertraline suggests the fatigue was a withdrawal symptom. However, the escalation of your sertraline dose up to 200mg caused adverse effects. 

 

We often suggest a very small dose for reinstatement, such as 5mg or even 1mg. This may have helped resolve withdrawal symptoms without breaking up your sleep. We expect this very low dose to assist a little at first, allowing your nervous system to slowly repair itself ff  months. Then, you'd very gradually go off the low dose by tiny amounts.

 

As you say, you do not want to take an antidepressant again. You will need to patiently allow your system to recover. Gentle exercise each day can assist. Many people find these to be helpful:

 

Magnesium, nature's calcium channel blocker 

Omega-3 fatty acids (fish oil) 

 

You might try a low dose of one at a time to see what it does for you.

 

To help us out, follow these instructions Please put your drug and withdrawal history in your signature You may need to use a computer to do this.

[North]

Hi Altostrata,

Thank you for your comment.

I have decided I will not reinstate. I'm taking both magnesium and omega-3 fish oil but I still feel quite unwell. 

 

 

[Erimus]

You might find these useful @North. Welcome to the forum and I wish you well in your recovery.

 

 

[North]

I've not felt like myself for the last few days. It's been eight weeks now since I last time took sertraline. Fatigue is overwhelming. I feel like throwing up. My body aches. I'm a trauma survivor so it's sometimes been quite difficult for me to relax. Lack of supportive family makes things more difficult. 

[North]

Here's how my average day looks like: I spend most of my day in bed. I read a lot. I go food shopping normally twice a week. I'd like to get out and about more but it's difficult if my body feels really achy.

[Altostrata]

We don't have any remedies other than reinstatement. You'll have to cope with withdrawal syndrome while it slowly goes away.

 

Many people find these to be helpful:

Magnesium, nature's calcium channel blocker 

Omega-3 fatty acids (fish oil) 

 

You might try a low dose of one at a time to see what it does for you.

 

Before further discussion, Please put your drug and withdrawal history in your signature 

[North]

Update: It's been 10 weeks since I stopped taking sertraline. My energy levels have gone up a little bit and my sleep seems to have improved too. However, it's hard to feel better as my foot is in pain. I've had plantar fasciitis for some time now and it was getting better but now it's affecting me a lot again. Walking is difficult. It's really difficult when there's no family nearby to support you. Even going food shopping is difficult.

[Erimus]

Sorry you’re having a tough time. Withdrawal can exacerbate normal problems into huge issues. Can you get food delivered by a local supermarket? Most of the big ones offer delivery slots for a reasonable fee. 

[Altostrata]

On 10/23/2022 at 12:11 AM, Altostrata said:

Before further discussion, Please put your drug and withdrawal history in your signature 

 

[North]

On 11/4/2022 at 11:53 PM, Altostrata said:

 

I will not do this as I don't remember it very well.

[North]

Update: I've nearly reached 11 weeks without medicine. Things don't seem to be getting any easier but I'm confident they will sooner or later. I'm feeling nauseous quite a lot. My body also feels itchy. I've also experienced some back pain.

[ChessieCat]

Please make an effort to create your drug signature.

 

This will allow members and staff to see your drug history at a glance and not have to read through your very long first post to get the information.

 

The most important is for the last 2 years (details), anything older just a summary.

 

Thank you.

[North]

Update: Not feeling well at all. Intense lethargy. Nausea. Body feels itchy.

[North]

Update: Hugely struggling. My body feels sore.

[Altostrata]

The staff needs more information about your recent drug history in order to comment constructively.

[North]

Very severe fatigue. Also, feeling physically very tense. This feels awful. It's harder to cope as I'm struggling with money. No understanding family near me. Doctors who offered me antidepressants, thanks a lot, look what you've done.

 

I also have PTSD which makes things difficult. I'm almost never relaxed.

[Altostrata]

Drug history.

[North]

On 11/18/2022 at 5:28 PM, Altostrata said:

Drug history.

I mentioned I don't remember this. What I remember is in my signature now.

[North]

The last few days have been unbearable. I tried taking 5-HTP just to see if it would make me feel better. I felt slightly different but I'm not sure if it's fair to say it helped me a lot. The following day I took around 25mg of sertraline. All the pain was gone, I could go outside for a walk with relative comfort. 

 

It feels bad that I took sertraline again as I didn't want it. However, now I'm certain it's the withdrawal that's causing me all these issues. But it kind of breaks my heart. How do I know how much longer I need to live my life like this? How do I know the damage that antidepressants caused is not permanent?

 

After taking sertraline, my sleep was worse than before as it took longer to fall asleep and I woke up too early.

[ChessieCat]

Your new topic has been moved to an existing topic.  There are many existing topics on SA, and we like to keep similar information in one place to make it easier to find.  Before creating a new topic, please search to see if one already exists:

 

shortness-of-breath-and-other-breathing-issues

 

[Altostrata]

On 11/22/2022 at 11:54 PM, North said:

The following day I took around 25mg of sertraline. All the pain was gone, I could go outside for a walk with relative comfort. 

 

Not a surprise. Strongly suggest you get a prescription for liquid sertraline and take 5mg per day for a while, maybe 6 months.

 

Please read this again.

On 10/13/2022 at 1:04 AM, Altostrata said:

We often suggest a very small dose for reinstatement, such as 5mg or even 1mg. This may have helped resolve withdrawal symptoms without breaking up your sleep. We expect this very low dose to assist a little at first, allowing your nervous system to slowly repair itself ff  months. Then, you'd very gradually go off the low dose by tiny amounts.

 

As you say, you do not want to take an antidepressant again. You will need to patiently allow your system to recover. Gentle exercise each day can assist.

 

[North]

Thank you for your advice. I really would rather not go back on sertraline so I'm going to see a few more weeks how I get on. To go back on it for six months feels like a very long time.

[North]

Update: Difficulties with breathing became quite bad in the last few days so I have been taking tiny doses of sertraline yesterday and today. I am going to ask the doctor to prescribe me liquid sertraline as reinstatement seems to be the only way to keep myself somehow functional. I still have all these questions in mind: If sertraline makes me lose my ability to sleep, would it be better to go on a very low dose of some other antidepressant? How much longer will all of this last? Currently, I can only do very limited type of work, I'm barely able to look after myself. I'm 31 now, will I have to wait until my fourties to have any kind of functional life? Also, if I reinstate now, will it just put me into this vicious cycle where I'll never be able to get off sertraline? Am I just too damaged to function normally without sertraline? Every day is nearly unbearable and I don't know how much longer I will live if things don't start getting better soon. Sorry for oversharing but this is how I feel.

[Faure]

5 hours ago, North said:

If sertraline makes me lose my ability to sleep, would it be better to go on a very low dose of some other antidepressant?

It would probably be a bad idea. Your system is sensitised and adding another drug to the mix will likely further destabilise you, make you feel worse and drag things out even longer

 

5 hours ago, North said:

How much longer will all of this last?

Unfortunately this is a question no one knows the answer to. I’m afraid it is a matter of waiting, looking after yourself very carefully - eating clean food, getting plenty of rest, avoiding stress & strenuous exercise and avoiding any drugs (prescribed or not) alcohol and other mind altering substances. Sadly there is also no magic pill that can make things better. 
 

5 hours ago, North said:

if I reinstate now, will it just put me into this vicious cycle where I'll never be able to get off sertraline?

This is unlikely. Reinstating a LOW dose may save you a lot of pain and suffering and may mean you can get a little bit back to normal.  Don’t go thinking a full reinstatement will be a magic bullet. I thought that and was exhausted for about 18 months, able to work less than 10 hours a week at home.  When you have stabilised (which will take time) and been so for several months you will be able to do a micro taper and gradually get off he drug. I am doing this very successfully. 
 

You are very close to the window where reinstatement of a low dose may be too far out to hell so do try to get liquid meds asap. Or order scales & a pill grinder and weigh out 5mg. I can help with that if necessary. I don’t know how sertraline comes - in a pill form or in a capsule and is already a powder….
 

5 hours ago, North said:

Am I just too damaged to function normally without sertraline

No! Many people here think the same thing. It isn’t true. Your system has become dependent on it and needs time to recover from the WD symptoms. You will recover, unfortunately we just don’t know how long that will take.
 

I can recommend Tesco home delivery for food - very easy you just type in a list, select what you want and so long as you spend over £40 you only pay around £3-4 for a delivery, esp if you take a flexible slot which you probably can as you’re home a lot at the moment. I usually order enough for 2-3 weeks and it’s easy to reach the £40 🙂

Edited November 28, 2022 by Faure

[North]

Thank you so much for your reply Faure.

 

1 hour ago, Faure said:

exhausted for about 18 months, able to work less than 10 hours a week at home.

Sounds a lot like my life currently.

 

1 hour ago, Faure said:

You are very close to the window where reinstatement of a low dose may be too far out to hell so do try to get liquid meds asap. Or order scales & a pill grinder and weigh out 5mg. I can help with that if necessary. I don’t know how sertraline comes - in a pill form or in a capsule and is already a powder….
 

I will most likely do this.

 

1 hour ago, Faure said:

No! Many people here think the same thing. It isn’t true. Your system has become dependent on it and needs time to recover from the WD symptoms. You will recover, unfortunately we just don’t know how long that will take.

I so hope you're right. I just sometimes think because I had PTSD for years before going on antidepressants and I've been a poor sleeper my base level of health wouldn't be fantastic. I hope that is not the case.

[Faure]

Hi @North, you asked by private message what scales to buy. We recommend these ones at SA. They are not the cheapest but as they are recommended by those that know, they are the most suitable cheapest ones. I am very happy with them and replace the batteries once a year to be in the safe side. 
 

I have a whole lot of blurb about measuring etc, let me know when you’d like to read it! I take it the pills are already in capsules as you haven’t asked about that. 

 

16 hours ago, North said:

I just sometimes think because I had PTSD for years before going on antidepressants and I've been a poor sleeper my base level of health wouldn't be fantastic. I hope that is not the case

 

You will need to deal with whatever caused you to be prescribed ADs in the first place. I spent about 15 years trying to find out what had happened to me (by visiting therapists). Unfortunately it wasn’t till the last one I finally found someone who could help.  Walk away from any therapist that doesn’t listen to you / minimises what you want to talk about. You know deep down what to say even if you don’t why and if they don’t listen and explore that they are not the right person for you. I wasted a lot of time and money on one person like this 🙁If you can’t afford one atm don’t worry they are not much use till you’re well enough to take on board what they say, discuss upsetting events, deal with being even more upset. 
 

I see The Body Keeps the Score recommended a lot here. I’ve read it but it was a bit late for me as I was recovered by then. Once you deal with the ptsd life will be a lot better. 
 

Those of us in WD learn a LOT along the way about what we need and meeting our needs so this may well be a growth opportunity for you, unwanted and miserable though it is. You’ll need to learn non drug coping techniques to help you through. The best one I ever did is meditation. I’ve been doing it since the first lockdown and it has transformed me my thoughts, my life. I do this one most days. Do give it a go when you’re feeling a bit better. It’s not so useful when you’re in severe WD but it will help you build a solid base for yourself. 
 

You might find something helpful in self care part the forum:

 

https://www.survivingantidepressants.org/forum/8-symptoms-and-self-care/

 

[Thorin]

Can confirm you will need good therapy if you have PTSD and want to resolve what made you choose meds in the first place. It’s hard work but worthwhile.

[North]

47 minutes ago, Thorin said:

Can confirm you will need good therapy if you have PTSD and want to resolve what made you choose meds in the first place. It’s hard work but worthwhile.

I chose meds because a doctor made me believe they will be helpful. I now think I never would have needed them. I knew very little about antidepressants back then.

[North]

1 hour ago, Faure said:

Hi @North, you asked by private message what scales to buy. We recommend these ones at SA. They are not the cheapest but as they are recommended by those that know, they are the most suitable cheapest ones. I am very happy with them and replace the batteries once a year to be in the safe side. 
 

I have a whole lot of blurb about measuring etc, let me know when you’d like to read it! I take it the pills are already in capsules as you haven’t asked about that. 

 

 

You will need to deal with whatever caused you to be prescribed ADs in the first place. I spent about 15 years trying to find out what had happened to me (by visiting therapists). Unfortunately it wasn’t till the last one I finally found someone who could help.  Walk away from any therapist that doesn’t listen to you / minimises what you want to talk about. You know deep down what to say even if you don’t why and if they don’t listen and explore that they are not the right person for you. I wasted a lot of time and money on one person like this 🙁If you can’t afford one atm don’t worry they are not much use till you’re well enough to take on board what they say, discuss upsetting events, deal with being even more upset. 
 

I see The Body Keeps the Score recommended a lot here. I’ve read it but it was a bit late for me as I was recovered by then. Once you deal with the ptsd life will be a lot better. 
 

Those of us in WD learn a LOT along the way about what we need and meeting our needs so this may well be a growth opportunity for you, unwanted and miserable though it is. You’ll need to learn non drug coping techniques to help you through. The best one I ever did is meditation. I’ve been doing it since the first lockdown and it has transformed me my thoughts, my life. I do this one most days. Do give it a go when you’re feeling a bit better. It’s not so useful when you’re in severe WD but it will help you build a solid base for yourself. 
 

You might find something helpful in self care part the forum:

 

https://www.survivingantidepressants.org/forum/8-symptoms-and-self-care/

 

Thank you for your answer. I have sertraline tablets so I just cut them.

 

I've read the book and I think it's pretty good. 

 

Thanks for all the advice and recommendations!

[Faure]

Hi North, I was just walking home from work thinking about your pills and remember that Gridley (a Mod) wrote this on my thread about not cutting but making a powder:

 

Quote

It is better to make powder from your tablets than to cut slivers.  There is no way to tell the standards that the manufacturer of your brand uses to make sure the active ingredient is evenly distributed throughout the pill.  If you cut into slivers, there may be more or less active ingredient in your sliver than in slivers from other parts of the tablet, putting you at risk of taking inconsistent doses.  If you grind into powder and stir thoroughly with a toothpick (or a powder measuring spoon, available on Amazon), that will ensure that the active ingredient is evenly distributed throughout the powder and thus in each dose.  

So it may be worth you getting a pill grinder and capsules as well. Let me know if you want a recommendation 😊
 

I also remember another member was having trouble being destabilised, went to a liquid and had a very bad time, so it’s probably best if you can stay with your current brand (I stock up from my pharmacy when I can) and when the time comes use those to make a liquid. 
 

I hope you have a good night 😴

Edited November 29, 2022 by Faure

[North]

Update: I'm currently taking 5mg of sertraline per day. My breathing is getting more and more difficult again. I'll be able to get a prescription for liquid form sertraline next week. 

 

I don't know how much longer I can deal with this. It's nearly unbearable. I am in pain 24/7.

[Faure]

I’m sorry you are in such pain. I’d be very wary of switching to a liquid when you are feeling so bad. Any change in your medication might lead to worse symptoms. If it were me I’d probably stick with the meds in pill form, ideally from the same brand until things have settled down for you. Then, when you have been stable, or WD normal for some weeks you could do a slow cross over to a liquid. The liquid is the purest form of the medication and can cause issues for people. 

[North]

1 hour ago, Faure said:

I’m sorry you are in such pain. I’d be very wary of switching to a liquid when you are feeling so bad. Any change in your medication might lead to worse symptoms. If it were me I’d probably stick with the meds in pill form, ideally from the same brand until things have settled down for you. Then, when you have been stable, or WD normal for some weeks you could do a slow cross over to a liquid. The liquid is the purest form of the medication and can cause issues for people. 

I would do this but I don't have the money to buy a scale.

[Altostrata]

Strongly recommend that you use the prescription liquid, so you can measure consistently. You've only recently attempted reinstatement, so the change probably won't be noticeable.

[North]

Update: Spoke to a doctor. Apparently sertraline in liquid form is unlicensed here so I'll be getting more tablets. I wonder if there's someone in the UK who can confirm this.

 

I can't afford buying a scale at the moment. If anyone is able to recommend an affordable one I would appreciate that.

 

My recent thoughts: I still don't know whether what I am doing is the right thing to do. I am going to stay on 5mg for now. It doesn't feel great to know that I am still taking this poison that caused the problem in the first place. I am thinking I could stay on 5mg for a month, then reduce to 4mg for another month, then 3mg for a month etc. It was suggested earlier I should stay on 5mg for the next six months. Maybe that's what I should do. But I am not sure. Sertraline affects my sleep quite severely.