Lizzybetty86: 50mg - 25mg Sertraline 10 months ago, still suffering

[Lizzybetty86]

Hello!

 

A little about me. I was on citalopram 2012-2013 and weaned the ‘GP’ way eg just halved then quartered. It was fairly problem free, aside from brain zaps which went after a fortnight. I was then on Citalopram again 2014-2017 and weaned again fine, just brain zaps (each time for anxiety). 

 

Most recently, I’ve been on Sertraline from 2017. I was on 50mg and last September dropped to 25mg. This experience has been wholly different to citalopram. Since dropping to 25mg some 10 months ago, the brain zaps have never left. They make it feel as though my brain is back flipping or levitating, I get vertigo for hours after and it feels like most days are filled with buzzing, shocks and bizarre sensory disturbances (including a strange desire to constantly move my tongue, which sounds bizarre when written down!) Obviously,  I react with more anxiety. 
 

I tried to drop again, alternating 25mg and 12.5mg in March, but it was a disaster. Sensory disturbances galore.

 

I have a young toddler (2.5) and just can’t afford to be so unsteady and zappy around him. 
 

I feel stuck. The brain zaps seem permanent - despite being on this 25mg dose for nearly a year. I panic that the sertraline has permanently damaged my brain and I’m stuck in this hinterland forever. My GP doesn’t get it and I’m stuck with 50mg tablets. 
 

I’m aware there’s a wealth of info here to read through, but will need some time when I haven’t a toddler asking me to play with him! 
 

Any reassurance would be amazing.

Edited June 24, 2023 by manymoretodays
name to topic title

[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 believe you are having brain zaps and it's harder for you to get off the drugs now, because each time we go on and off and then back on psych meds, our nervous systems tend to get more and more sensitized, and the harder it becomes to taper off drugs subsequently.  Let me give you some basic info.  Did you reinstate back to 25 mg per day after the disaster in March?  We strongly suggest you do not alternate or skip doses to taper - this is very hard on the nervous system. 

 

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

 

March 12, ’22: Lexapro 5 mg, Xanax 0.5 mg, Trazodone 50 mg

March 29, ’22: Lexapro 4 mg, Xanax 0.5 mg, Trazodone 50 mg

April 17, ’22:  Lexapro 3.8 mg, Xanax 0.5 mg, Trazodone 50 mg

May 19, ’22:  Lexapro 3.8 mg, Xanax 0.5 mg, Trazodone 25 mg

 

 

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

 

How to List Your Drug History in Your Signature

 

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  

 

Tips for Tapering Sertraline

 

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

 

When we find out more details about your drugs, and what dose you are currently on, we can give you some more suggestions.  I would suggest you find someone to watch your toddler for you at times, so that you have time to educate yourself about these drugs, and how they affect the brain.  I would prioritize reading the link about how these drugs remodel our brains.  There is hope, if you follow our suggestions, and take good care of yourself, but it will take a lot of time.  Please let us know how you are doing.  

[Lizzybetty86]

Thanks so much for the response. 
 

I’ve added what I hope is a fairly concise signature! 
 

The links you sent are all incredible helpful and extremely reassuring.

 

I am realising to reduce by 10% I need to persuade my GP to issue me with either 25mg tablets (currently they will only provide 50mg for cost reasons….) or a liquid alternative? 
 

My current concern is around the brain zaps. I’d have hoped after 10 months at 25mg my brain may have started to adjust to this new normal & so they may have abated. I’m not sure if my ill-advised plunge to 12.5mg in March has worsened them. I also know brain zaps can also occur without withdrawal, as a result of anxiety or chronic stress - so it may be that.

 

Either way, they’re really impacting my quality of life and I find myself ruminating on them, which of course does nothing for my mental health at all!

 

I’ve been so tempted to just go back to 50mg to see if that deals with them, but realise that is not the point here.

 

I wonder if there are any threads on healing a very over sensitised nervous system? Having a baby and the lurch I get when I think he has hurt himself or hearing him cry in the night, definitely has my nerves shot!

[getofflex]

Thank you for the drug signature.  I see that you reinstated to 25 mg sertraline.  That is good.  Please take this same dose each and every day, not skipping or varying your dose, at the same time of day.  

 

4 hours ago, Lizzybetty86 said:

I am realising to reduce by 10% I need to persuade my GP to issue me with either 25mg tablets (currently they will only provide 50mg for cost reasons….) or a liquid alternative? 

I would suggest switching to the liquid.  That will make it easy to measure the non standard doses, and to do small 10% (or less) reductions in the future.  When you switch to liquid, please cross over gradually like this: 

week 1 - 3/4 tablet, 1/4 liquid 

week 2 - 1/2 tablet, 1/2 liquid

week 3 - 1/4 tablet, 3/4 liquid 

week 4 and following - 100% liquid 

 

Please use a syringe, and not a dropper to measure your liquid medication, for dosage accuracy and consistency, which is important.  You can get them on amazon, or your pharmacy.  

 

4 hours ago, Lizzybetty86 said:

My current concern is around the brain zaps. I’d have hoped after 10 months at 25mg my brain may have started to adjust to this new normal & so they may have abated. I’m not sure if my ill-advised plunge to 12.5mg in March has worsened them.

I believe that your nervous system is probably destabilized further by your decrease to 12.5 mg in March.  It can take a long time for your nervous system to stabilize.  I strongly suggest you stick with the 25 mg sertraline for a long time, as in months, and wait until your brain zaps fully abate.  It is vitally important to allow your nervous system to heal, and rest, and fully adjust to the 25 mg dose, before doing any further tapering. 

 

4 hours ago, Lizzybetty86 said:

they’re really impacting my quality of life and I find myself ruminating on them,

Please work on trying not to ruminate on them, as this will probably send you into a spiral of anxiety, which will not help your situation.  Brain zaps are extremely common in SSRI withdrawal, and they will eventually go away, as long as you don't jump around on drugs and dosages, and take good care of yourself.  Please read these links, they are very helpful for rumination and anxiety.  

 

Techniques for Managing Withdrawal

 

 

Emotional Spirals

 

Acknowledge Accept Float

[getofflex]

5 hours ago, Lizzybetty86 said:

’ve been so tempted to just go back to 50mg to see if that deals with them, but realise that is not the point here.

I don't suggest you do this.   More is not better when it comes to reinstatement.   

 

Reinstatement

 

This puts you at risk of kindling, which will make you go from bad to worse.  You are at risk of kindling because of going on and off SSRI drugs several times in the past.  It's much better to learn and use non drug coping skills, and allow your brain to slowly adjust to the current 25 mg dose.  This link explains about kindling.  

 

Hypersensitivity and Kindling

 

The best way to heal an over sensitized nervous system is time, time, and more time, and lots of nature self care - healthy diet, lots of fluids, gentle exercise, like walking outside each day for 30 minutes (take your toddler along in a stroller or wagon, he'll probably love it), avoid stress where possible, avoid stimulating and upsetting books/films/games, good sleep hygiene, any activity that calms your nervous system. I find relaxing music very helpful. Check out my link in my first post on non drug ways to cope with WD symptoms. 

 

 

 

 

Edited June 27, 2023 by getofflex

[mstimc]

Hi @Lizzybetty86.  I can assure you the effects of WD, no matter how awful, are temporary.  I had a very difficult time weaning off Paxil which is notoriously hard to stop, and had multiple symptoms for several months.  Once I found a great therapist and started using CBT methods to manage my WD symptoms and my underlying anxiety/OCD, I did much better. Like you, I had life responsibilities during WD; my job provided the medical benefits for my family, and our son was going into his teenage years, so I had to be present for work and home.  It was a struggle sometimes but I got through it.  And so can you!