KF2694: Severe psychological symptoms after 3 - 4 months of being on 0mg Zoloft - advice needed

[KF2694]

Hi all, 

 

I am 29F and trying to end my relationship with Sertraline/Zoloft but have been having difficulty in that I seem to be able to get to 3 - 4 months of 0mg before my mental health falls off a cliff and I become very mentally unwell. I don't know if this is some sort of delay in my brain realising it is without the additional serotonin and whether it is a temporary adjustment thing or permanently how I will feel without medication.

 

By way of background,  I was put on 50mg of Sertraline in 2017 for anxiety. Minimal discussion with my doctor about any side effects or how long I would be on the medication for. Stayed on the medication for 3 1/2 years until decided myself to taper down in 2020. I did research on how to taper and tapered over a number of months, reducing by 50% each time by splitting my pills until I got to 25mg and couldn't split the pills any smaller. During this time, I had minimal withdrawal symptoms, some headaches and digestive upset but nothing too debilitating and they usually went away after a week or two of the reduction in dose. 

 

Then in March 2021, following 3 months of 0mg, I had an intense mental episode where I became extremely anxious, depressed, intrusive thoughts and was very unwell. Looking back I notice that the mood had been dropping over the 3 months of 0mg but the symptoms worsened very suddenly. Following a month of difficulty, doctor advised restarting sertraline 50mg. Noticed some improvement upon restarting and then spoke to a Psychiatrist in July 2021 who advised increasing to 100mg and told me 'I could be on this medication for the rest of my life no problem'. The issue was now I didn't want to be on this medication and felt like I couldn't come off it. In particular, I noticed that I am flattened and blunted somewhat on the medication and had worries that this was stopping me feeling attraction or starting a relationship with anyone (don't know if anyone else has had issues or worries about this? I don't mean sexual symptoms in that I don't have no feeling in my genitals or difficulty orgasming - this is more in terms of actually having a romantic interest in someone in the first place). 

 

Maintained 100mg for about a year and then decided to reduce again, following the same pattern and again with minimal withdrawal symptoms. The same thing happened again, was largely fine for 3 months but then went away travelling in February 2023 and was struggling and ended up returning home early. From February to March 2023, I was struggling with anxiety and depression but not completely debilitating. Then in April 2023, again it was like my mood fell off a cliff and I had another severe mental illness episode with depression, anxiety etc. 

 

I suppose I am coming here looking for advice and support and to see if anyone else has had similar symptoms as I am not able to get answers from the medical community so questions as follows: 

- has anyone else had minimal symptoms throughout the tapering process and initial 3 months or so of being on 0mg, only then for severe psychological symptoms to set in around 3 months?

 

Due to the gap of time where I am ok (i.e. the 3/4 months), I think most medical doctors view this as a resurgence of original symptoms rather than withdrawal but the symptoms are much more severe than they were before I started medication. My issue I suppose is that I don't know whether this is a temporary thing as my brain is freaking out at no longer having the extra serotonin available and whether it will eventually adjust to the lower levels and therefore whether to push through and try to cope with the psychological distress in the hope it will pass or if I need to go back onto Sertraline. 

 

I suppose I'm looking for hope that if I just try and cope with the anxiety and depression, it will eventually lift and I'll get through it and I'll come out the other side but I can't seem to find any advice or information to give me this hope. 

 

Thanks, 

 

KF2694

Edited July 5, 2023 by manymoretodays
name to topic title

[Altostrata]

Welcome, @KF2694

 

Loss of libido and emotional blunting are very common effects of antidepressants. This continues as long as you take the drugs and may persist for some time after going off.

 

Withdrawal symptoms arise from tapering faster than your nervous system can adjust. Minimal symptoms during tapering tend to get more intense as the taper proceeds. We advise people to stop tapering should withdrawal symptoms appear, to let your nervous system settle down.

 

Your signature says your last pill was June 5? If withdrawal symptoms have not been improving, you might consider low-dose reinstatement of 5mg to start. It's possible this will be enough to stop the withdrawal symptoms. You'd stabilize for some months and taper later by tiny amounts.The liquid form of the drug is the most convenient way to accomplish this. See

What is withdrawal syndrome? 
 
About reinstating and stabilizing to reduce withdrawal symptoms 
 
The Windows and Waves Pattern of Stabilization

Tips for tapering off sertraline (Zoloft)

 

Please let us know how you're doing. 

[KF2694]

Thank you for the response Altostata, I definitely experience emotional blunting on the sertraline and hence one of the reasons I have come off it. 

Yes I took my last dose of 25mg on 5 June. The last 2 times I've tried to come off, the withdrawal symptoms haven't been bad or long-lasting at first but then at about 3 to 4 months of being off the medication I 'crash' and have very severe depression and anxiety. This only appears after about 3 months off the medication. I have seen from other posts that this is quite common but makes it hard I suppose to know if you are suffering 'withdrawal' symptoms and whether you should reinstate or go slower in the taper when the withdrawal symptoms aren't instantaneous. 

 

However, slightly different to the last 2 times, I have found this time, particularly this week and last week, I have been having more traditional withdrawal symptoms, in that I have had headaches and digestive upset. I am taking magnesium and Omega 3 and the symptoms are not unbearable. 

 

Regarding re-instatement of a small amount, I live in Ireland and as far as I am aware, the liquid form of sertraline/zoloft is not available here. Thank you for sharing the link with a link to the tips for tapering off Zoloft. I may try make my own liquid solution. 

 

Do you recommend reinstating a small dose even if the withdrawal symptoms are not life limiting - i.e. I can manage the headaches and digestive symptoms at present - or should I just continue to deal with them in the hope the body adjusts? 

 

Thank you in advance for your help, 

 

KF2694

[DancingBee]

Hi KF2694:

 

So sorry to hear about all the symptoms you're having.

 

You're not alone in having a long delay between your last dose and symptoms starting. The first time I came off Sertraline/Zoloft (concurrent with Bupropion/Wellbutrin), it took a little over 2 months for me to have any symptoms—then they hit suddenly and hard (depression, anxiety, crying, very negative & self-critical thoughts, total despair). The second time I came off the same cocktail, I had a full 3.5 months of doing fine. I thought I was in the clear, but then the symptoms came on and within a few days were full blown.

 

As with so many other aspects of ADs, some people get symptoms within a couple weeks, but others of us have a really big delay.

 

Big hugs to you,

Dancing Bee

[Altostrata]

On 7/11/2023 at 5:02 AM, KF2694 said:

Do you recommend reinstating a small dose even if the withdrawal symptoms are not life limiting - i.e. I can manage the headaches and digestive symptoms at present - or should I just continue to deal with them in the hope the body adjusts? 

 

@KF2694 How has your symptom pattern changed in the last 2 weeks?

 

[KF2694]

Sorry for not responding to your last post Altostrata, I had missed the response come in. 

 

I am writing again as I am coming up to being 6 months off Zoloft which is the longest I have been off Zoloft since I started taking it in 2017.

 

However, I am really struggling. I am not having the same symptoms that I had previously and they do not appear to be traditional withdrawal symptoms that I experienced in my previous withdrawals which was mainly anxiety and panic based. I had really bad sort of apathy and anhedonia at times since September but it wasn't consistent whereas in the last month, I have been really struggling with consistently low mood and what resembles severe depression - no motivation or enjoyment, hopelessness in the future, feeling despair and regularly crying. Its all psychological symptoms too, no physical symptoms which I have experienced before as part of early withdrawal stages (i.e. within the first month). 

 

I don't know how long I can keep going like this. I really want to not be reliant on SSRIs but I feel that I have been permanently damaged and my brain can't cope without them and that therefore I need to go back on them. This in itself is causing me a lot of distress and I really don't want to go back on them but seems its the only option to get out of my current situation. I'm not able to do anything, I'm extremely depressed and nothing is making me feel better nor do i have any hope anymore that if I keep going and give it time, things will get better. I just feel these symptoms I'm having at the minute aren't 'withdrawal' but are instead depression but that this is as a result of my serotonin receptors being affected by taking Zoloft in the first place and now I can't survive without it. I'm so angry and wish I had never gone on the meds in the first place but don't know if i can be without them now. 

 

I suppose I'm wondering how to distinguish between 'withdrawal' and actual mental illness such as depression and what to do if it is depression? Do you guys recommend going back on meds, stablising and then trying to come off meds again using your suggested tapering method? I know you probably don't recommend going back on meds given the point of the website and I really appreciate all the help and support your website provides and I don't want to go back on meds but I am losing hope that there is a path forward the way I'm feeling right now. Even if I was getting waves and windows that would be giving me hope but I'm not, its all just bleak and so therefore I'm at a loss. 

[DancingBee]

I just wanted to write a quick note to empathize with your situation. You poor dear. Know that you're not alone. I have been in that place myself and know how very difficult it is. Hang in there, taking it one minute, one hour, one day at a time.

 

I hope you get some useful advice from the moderators to help make the best decision on how to proceed.