Skyedog: multiple failed attempts to withdraw from sertraline

[Skyedog]

Evening all! I am sure you have heard this all before however I have been feeling stuck until I discovered this forum.

Back in 2015 my dad became very unwell and passed away in 2016, I found this time exceeding tough as I was daddies little girl. In 2017 we bought a house and in 2018 I got married to my wonderful husband. Over this time my anxiety over health had slowly declined and I was in denial that I was experiencing panic attacks. I had a bad panic attack over Christmas and suffer derealisation which was very frightening so I went to the doctor and he recommended 50 mg sertraline. 
the months that followed were nothing short of hell, my anxiety increased beyond belief, I couldn’t sleep, I was having panic attacks in my sleep and the depersonalisation was nothing I had ever experienced. This was the first time I had to take time off work for my anxiety. After a month the sertraline had stopped the panic attacks however I was left feeling not like myself, no feeling or love towards my family. I felt cut off from the world. 
I rebuilt my life over the coming months but I could shift this odd feeling of not being myself and connected to those around me. Therefore after 9 months I started trying to come off them and drop down to 25mg. Each increment I decrease I felt/saw a layer unpeel between me and the world. After several attempts I managed to get down to 25mg over the year. I stayed on this dose for a few months and then tried to decrease to 12.5mg. Everything seemed to be going well but by 3 months in the anxiety was horrendous and intrusive thoughts.  
so I went back to 25mg but it wasn’t a quick fix. I then decided I didn’t want to waste any more time and we had our beautiful daughter. 6 months postpartum I was feeling good although I did not feel like myself. So I started to slowly taper again. 12.5mg one day a week for a month before reducing to 2 days. Then at 3 months again the anxiety and depersonalisation wes awful. I then went back to 25mg. 
for the past year I have not been feeling myself with depersonalisation and derealisation. I am very sleep deprived thanks to my daughter that doesn’t help. 
However I finally went to the doctor and said I needed liquid sertraline to help manage my withdrawal as I believe part of the depersonalisation is due to the pills. 
So after this long explanation my question for you are.

- can withdraw get worse at 3 months? How to push past this?

- what should my taper plan look like with liquid sertraline?

- does what I have explained sound like medication/withdrawal? 
- any other advise or thoughts on what I have experienced?

 

Thank you for taking the time to read this post. The doctors just don’t believe me when I say I believe the medication is making me feel the way I do. 
 

Skyedog

[Altostrata]

Welcome, @Skyedog

 

A feeling of being cut off from the world, along with muffled emotions, are typical effects of antidepressants.

 

How long have you been on 25mg again? How do you feel now?

 

Here are our Tips for tapering off sertraline (Zoloft)

 

On 8/11/2023 at 12:50 PM, Skyedog said:

- can withdraw get worse at 3 months? How to push past this?

 

We advise people to taper slow enough to avoid withdrawal symptoms and not to taper if you get withdrawal symptoms. If you don't taper properly, mild withdrawal symptoms can get worse over time.

[Skyedog]

Hello, Thank you so much for your reply. 
 

I have been back on 25mg for 14 months. Stabilising from the intrusive thoughts and a dirty caused from the last withdrawal.

 

I feel much better, however the feeling of being cut of and not feeling like myself are driving anxiety. Therefore I don't think I can get any further with therapy until I come off the drugs as all my anxieties are due to the feeling from the pills (I believe). 
 

I have managed to persuade the doctor to give me the liquid form so I can reduce gradually. I have seen on some posts it suggests to use pills and liquid form. Do you recommend say doing alternate days of 25mg tablet and 22.5mg liquid for the first week to adjust? 
 

thank you! 
 

Skyedog 

[Altostrata]

3 hours ago, Skyedog said:

I have managed to persuade the doctor to give me the liquid form so I can reduce gradually. I have seen on some posts it suggests to use pills and liquid form. Do you recommend say doing alternate days of 25mg tablet and 22.5mg liquid for the first week to adjust? 

 

Please do not alternate dosages or skip days of dosing. You may wish to split a tablet in half, take half your dose in tablet form and the other half in liquid, taper from the liquid.

[Skyedog]

Hello, apologies I think I may have confused you. My plan was not to skip day of dosage. I already cut my tablets up. I had just read on hear that it may work better to split the dose between tablet and liquid. However this is not easy with already cutting tablets up. 

[Altostrata]

Please do not alternate 25mg and 22.5mg doses. Inconsistent dosing causes problems, as you found before.

 

You can get 25mg tablets to split.

[Skyedog]

Unfortunately the doctors would not give me 25mg tablets before so I don’t think they will now. I will just have to make the switch I think as any other option is likely to be even more inaccurate.

[Altostrata]

25mg tablets are available https://www.nhs.uk/medicines/sertraline/how-and-when-to-take-sertraline/

 

Suggest you get used to double-checking the NHS Web site about drug availability.

[Skyedog]

I am not saying these are not available, however the doctors would not prescribe it before and I had to fight tooth and nail to get hold of the liquid over years. 
 

I really appreciate your support and guidance however I just don’t think this will be possible to get from the doctors. 

[Altostrata]

You'll have to figure out alternatives, then.

[Skyedog]

Hello Altostrata,

I hope you are well.

I managed to figure out a way to take 12.5mg as tablet and 12.5mg as liquid. I have been doing this for a week. The last few days I have had some headaches, nausea and insomnia. Do you think this could be my body adjusting to the new form? Or is this me overthinking 😄

How long do you think I should wait until reducing my dose? When the symptoms have gone? 
thanks

Skyedog

[Altostrata]

8 hours ago, Skyedog said:

The last few days I have had some headaches, nausea and insomnia.

 

What times o'clock do you take your drugs, with their dosages? When do these symptoms occur?

[Skyedog]

I take my dosage first thing in the morning, as when I started taking the AD it affected my sleep. It seems to be a low level constant all day, tending to get worse throughout the day. 

[Altostrata]

Do you wake up with headache and nausea? What time o'clock do you take sertraline?

[Skyedog]

Hello,

These symptoms have now passed so I have started to reduce my dose from 25mg to 22.5mg from today. Hopefully this will go well. 
thanks

Skyedog 

[Altostrata]

I would be sure your system is well past those reactions before reducing.

[Skyedog]

How long would you say? It has been a week. 

[Altostrata]

That could be long enough -- you had those symptoms for only a day or two?

[Skyedog]

Only 2/3 days.

[Altostrata]

If you feel you are accustomed to it, you could reduce it.

[Skyedog]

Hello I am now coming to the end of week 4 of lowering my dose, I have had a few episodes of increased anxiety but I have been able to just ride thwse out quite easily. Some physical symptoms of hot flushes and lots of tinnitus recently. The anxiety seems to comes in waves. Do you think this is still withdrawal? I am going to keep the dose at this level. (22.5mg).

thank you!

[Altostrata]

Those are typical withdrawal symptoms. If I were you, I'd stay at 22.5mg until they go away completely.

[Skyedog]

Hello, I have recents dropped my dose to 21mg. After several months at 25mg. Today things have suddenly felt a bit more intense and real, as though I am a bit closer to the world. This was a little disconcerting as I have felt cut off for so long. Do you think this is a result of the drug reduction? Has anyone else had these sudden changes in vision/perception? 
Many thanks