daveyk - late summer/early fall nonsense, should i reinstate sertraline?

[daveyk]

you can see my full psych med history in my profile, abbreviated below in signature. 

 

i'm currently on 15mg mirtazapine nightly.  a few weeks ago, the psychs in the hospital unceremoniously CT'd my 3 day stint of 5mg fluoxetine.  before that, i took 1 pill of paxil, prescribed by GP after a 5 day stint of sertraline went south.  i'm pretty sure this all started after the sertraline, though.

 

i'm still plagued with suicidal thoughts, it feels like i'm plugged into an electrical outlet; the severe and weird psych symptoms have mainly passed (violent intrusive thoughts far beyond the bounds of my normal ones), but the anhedonia, brain fog, memory issues, and sexual issues remain.  my genitals, gut, and brain are severed from each other- my body lacks cycles connected to the circadian rhythm.  every single damn provider i've encountered has proclaimed, "that's just depression!", but i know my depression, and this ain't it.  they then respond, "symptoms change!", yeah, okay buddy.  i've never felt this psychologically and physically bad in my life.  my anxiety has never manifested the way it's manifesting now.  

 

i'm heavily considering reinstating 1-5mg of sertraline on top of the mirtazapine, considering it was the SSRI that started this whole house of cards.  the psych nurse in my PHP program seemed to think this was fine- she just said "try it", shrugged and walked away, but tbh i don't trust any of those people anymore.  i'll be exiting that program soon. 

 

i don't know what to do.  i can't think, i can't sleep, i'm about to lose my job as a software engineer, and if that happens, then the dominos tumble down.  if i knew then what i knew now, i never would have even _thought_ about reaching for the zoloft to help with the anxiety.  i found this site after this whole carny ride started.  i kick myself every day for trying to solve my problems with psych meds.

 

help me, mods of survivingantidepressants, you're my only hope.  shout out to alto for creating this site. 

 

another piece of information:  my T levels have crashed from about 350ng/dL to around 150ng/dL in the last 2 months.  i can't tell if it's related to the insomnia or SSRIs or anxiety, but just another piece of information. 

[LotusRising]

Hi @daveyk and welcome to SA,

 

It looks as though you've been on and off medication for many years, which after time can be destabilizing to the nervous system. Your nervous system is likely looking for stability. It might help to look at this link:

 

 

Why did you switch from citalopram to sertraline in Oct 21? Could you please add the dosages for this timeframe into your signature. 

 

Did you taper off the sertraline in Mar 22? What was it like?

 

If you haven't already, you can view this link on reinstatement Reinstating and Stabilizing. It's possible that the symptoms you're experiencing are from reinstating a dose of sertraline that was much too high, however there is no way to know this for sure. Please read Hypersensitivity and Kindling.

 

See also The Windows and Waves Pattern of Stabilization, which might help you understand how symptom patterns can change over time.

 

 

You started mirtazapine - has this helped any of the symptoms you describe?

 

[daveyk]

hello lotus, thanks for responding!

 

30 minutes ago, LotusRising said:

Why did you switch from citalopram to sertraline in Oct 21?

i checked myself into the hospital due to SI, and the psychiatrist there switched me unceremoniously from to sertraline, 75mg.  i didn't know about any of the information found here, so i just accepted it.  the switch was a bit painful- 2 months of onboarding symptoms which i thought, at the time, were just anxiety/depression, but now know to be symptoms of switching meds.

 

32 minutes ago, LotusRising said:

Did you taper off the sertraline in Mar 22? What was it like?

yes, although not as slow as this site recommends.  i vaguely recall tapering over a month or so, doing the "switch dose" method - 75mg, 25mg, 75mg, etc etc, until the taper was complete.  i also microdosed psilocybin to assist in the taper.  i felt GREAT for 1.5 years.  unmedicated and thriving. 

 

34 minutes ago, LotusRising said:

You started mirtazapine - has this helped any of the symptoms you describe?

kinda, not really though? i still experience SI every day, my sleep is still jacked up, but i'm feeling less "off".  i am, however, experiencing symptoms of PSSD, although i can't discern if these symptoms are because of anxiety or actually the result of the brief stint with SSRIs in august/september.

 

35 minutes ago, LotusRising said:

Could you please add the dosages for this timeframe into your signature. 

sure, one sec.

 

37 minutes ago, LotusRising said:

It's possible that the symptoms you're experiencing are from reinstating a dose of sertraline that was much too high, however there is no way to know this for sure.

yea, agreed, also i don't think the psilocybin helped.  it seems like my nervous system was in a more "fragile" state when i reinstated even 50mg, because i experienced extreme euphoria from the sertraline at that dose, when before i was taking 75mg.  even the lower doses at 25mg and 12.5 triggered some euphoria. 

 

i'm really concerned because i'm also experiencing brain fog, memory issues, and sleep issues that may interfere with going back to work.  i don't really feel like myself at all either, i feel like some demented version of my old, unmedicated, sober self.  

[daveyk]

@LotusRising so mirtazapine was introduced 9/22, if i hypothetically reinstate sertraline, how long should i wait?  i'm really confused, my nervous system has been getting whiplashed these last few months, but the longer i wait to reinstate sertraline, the less likely it will work...

[LotusRising]

2 hours ago, daveyk said:

i felt GREAT for 1.5 years.  unmedicated and thriving. 

What prompted you to restart sertraline in August if you were doing well? 

 

On 10/13/2023 at 5:22 PM, daveyk said:

suicidal thoughts, it feels like i'm plugged into an electrical outlet; the severe and weird psych symptoms have mainly passed (violent intrusive thoughts far beyond the bounds of my normal ones), but the anhedonia, brain fog, memory issues, and sexual issues remain.  my genitals, gut, and brain are severed from each other- my body lacks cycles connected to the circadian rhythm.

 

Just to confirm, these symptoms all started when you reinstated the high amount of sertraline?

 

 

 

 

[daveyk]

53 minutes ago, LotusRising said:

What prompted you to restart sertraline in August if you were doing well? 

excellent question, i was actually experiencing 1-2 weeks of increased and intense anxiety around early august due to a culmination of a bunch of different life events, in addition to anxiously obsessing over an elective surgery that i was thinking about receiving.  one thing led to another, and my insomnia was triggered- i hit a couple 0 hour sleep nights, (starting 08/11/2023) and thought, "hey, my anxiety is increasing, let me reach for the zoloft because it helped me before". (first dose 08/13/2023) big mistake.  in retrospect, i should've probably treated the acute anxiety with a short term run of klonopin and propranolol, but i was freaked out because insomnia-induced depression sent me to the hospital in oct2021, like i mentioned.

 

short answer:  i was feeling great until i wasn't. 

 

53 minutes ago, LotusRising said:

Just to confirm, these symptoms all started when you reinstated the high amount of sertraline?

the symptoms actually shifted dramatically over the days/weeks after i _terminated_ the sertraline.  i actually recall feeling like myself on the sertraline, but it seemed to amp up the anxiety and insomnia.

 

in my journal, on 08/22/2023, i wrote "shaking whilst brushing teeth, no hope, no hope, no hope", so the hopelessness starts shortly after terminating the sertraline.  in my journal, up to about 8/25/2023, there are obsessions about cognitive processes and automatic reactions from myself and other people around socializing and behavior, and the nature of self ("weird" high/philosophical thoughts).  these aren't extraordinary for my mind- i've always thought about the nature of the mind and consciousness, and how other people act, but there is an extra level of anxiety imbued in these entries that was absent in my normal functioning. 

 

one dose, paxil, 12.5mg CR on 8/29/2023 but didn't continue because i realized the severity of withdrawal symptoms.  i was getting pressure from those around me to start another medicine because of my mental state.  another thing i regret.

 

my first mention of anhedonia is on 9/4/2023: 

Quote

 

i was severely anhedonic the past few days, as this moment i have energy (but also i'm tired?), and things seem a bit normal

 

 

between 9/11/2023 and 9/14/2023, i start to feel schizophrenic when i have never EVER felt that way before- violent intrusive thoughts, paranoid delusions about coincidences actually being planned behind my back, about people reading my mind.  again, i have NEVER had those thoughts ever before, there's no history of schizophrenia in my immediate or extended family.  this was highly disturbing but i reminded myself that those thoughts were actually a product of my own mind and they went away eventually.  but that was scary as hell. 

 

things just kept devolving until my partner brought me to the mental hospital, which also didn't help.  they swapped me from 5mg prozac (only taken 3 times) to mirtazapine.  

[daveyk]

seems like i should have reinstated low dose sertraline a few days after i terminated it, why were all these doctors throwing pills at me?  and why did i take them? 😔

[LotusRising]

4 minutes ago, daveyk said:

why were all these doctors throwing pills at me?

Unfortunately, this is all they know. 

 

It seems to me that your symptoms ramped up after you tried the high dose reinstatement of sertraline. The addition of more medications (and cannabis) destabilized your already sensitized system further, when what it probably needed was stabilization, and the chance to return to homeostasis. It seems to me that your system may just need time to settle out on its own. 

 

Did you read the windows and waves link I sent in the first post?

 

Do you have any coping skills in place for handling difficult life events? 

[daveyk]

7 minutes ago, LotusRising said:

Did you read the windows and waves link I sent in the first post?

i've actually read that one before!  i've been creeping on this site since about ... mid-september?  before i started the prozac, i was super resistant to that but i caved to the pressure.

 

7 minutes ago, LotusRising said:

Do you have any coping skills in place for handling difficult life events? 

i thought i did before all this happened.  now it's completely thrown out the window- i used the exercise and stretch, get regular sunlight, take omega3s, the whole shebang, notice my thoughts, etc.  now that i am totally dysregulated and don't even know what to do without triggering my nervous system.  even if i walk strenuously i seem to have an anxiety reponse.  do you suggest any coping skills in particular?

 

@LotusRisingso it sounds like you are not recommending reinstating a small amount of sertraline?  i tried stabilizing over those 10 days before i consume that one stupid pill of paxil, but it seemed i was only getting worse.  i hate the way i feel on mirtazapine but i don't wanna stop it because, like you said, i'm so destabilized. 

[LotusRising]

There's a lot of great resources in the Symptoms and Self-care topic.

 

SA doesn't recommend a lot of supplements, but some members find magnesium helpful, and it sounds like you're already taking omega 3's. 

 

Personally, I stuck with gentle exercise like walking and yoga. I wasn't, and am still not able to handle strenuous exercise. Have you tried meditation? Insight timer is a free app with guided meditations for relaxation and sleep. I used it endlessly when I had insomnia. Otherwise, eating a healthy, clean diet, avoiding alcohol and practicing good sleep hygiene are all helpful. Not sure how accessible nature is for you, but I found it helped break up the anxiety and dark thoughts.

 

2 hours ago, daveyk said:

it sounds like you are not recommending reinstating a small amount of sertraline?

 

I can't say definitively what will work for you, but it does sound like you've had a lot of med changes very recently and your nervous system is upset with that. To me, it makes sense to back off on the changes. Plus, that's just one more drug that you would need to taper from.

 

But you will have to weigh out your options since you are the one that knows your body best.

[daveyk]

1 hour ago, LotusRising said:

SA doesn't recommend a lot of supplements, but some members find magnesium helpful, and it sounds like you're already taking omega 3's. 

right on, i've been taking magnesium sporadically, should probably commit or not with it. 

 

1 hour ago, LotusRising said:

Personally, I stuck with gentle exercise like walking and yoga.

i can't even do beginner's yoga without upsetting my nervous system.  i used to love yoga. 

 

1 hour ago, LotusRising said:

Have you tried meditation?

i meditated for two years, 2017-2019, and it's partially the reason i'm in this mess...i had my first breakdown 5 months after i CT'd citalopram and tried fixing anxiety with meditation.  my first encounter with insomnia actually, i realized that meditation was teaching me how to _not_ fall asleep when i was sleepy.  the teachings also messed me up in other ways, but that's another story.  

 

1 hour ago, LotusRising said:

Otherwise, eating a healthy, clean diet, avoiding alcohol and practicing good sleep hygiene are all helpful.

i've been doing this for years

 

1 hour ago, LotusRising said:

Not sure how accessible nature is for you

i live in a large city, so this is the one thing i'm missing!

 

1 hour ago, LotusRising said:

Plus, that's just one more drug that you would need to taper from.

exactly.  i want to avoid polypharmacy, but i also want to be a functional human.  too bad i can't take work off for a year and go detox on an island somewhere.

 

1 hour ago, LotusRising said:

But you will have to weigh out your options since you are the one that knows your body best.

understood, thanks @LotusRising. this feels like an unsolvable problem.  

 

people here ever try TMS? 

[LotusRising]

1 hour ago, daveyk said:

i can't even do beginner's yoga without upsetting my nervous system.  i used to love yoga. 

Have you tried yin yoga? It's just long holds and breathing, no "flow" sequences ... 

 

1 hour ago, daveyk said:

people here ever try TMS?

You could trying doing a quick google search of the site for other members' experiences tms:survivingantidepressants

[daveyk]

11 hours ago, LotusRising said:

Have you tried yin yoga?

not in a while, but that's a good reminder, thanks lotus.

 

11 hours ago, LotusRising said:

You could trying doing a quick google search of the site for other members' experiences tms:survivingantidepressants

right on, thank you. 

[daveyk]

hey @LotusRising, i've been on mirtazapine as of today for exactly 34 days.  the side effects are uncomfortable at best- overwhelming brain fog that only lifts later in the evening, the hunger is beyond all comprehension, and the dreams/nightmares are just way too realistic and intense.  i'm frequently waking up 45 minutes after falling asleep with intense nightmares (btw how is that even possible, i thought you need to pass through an extended phase of deep sleep before arriving at REM?).

 

if i was on the drug only for 34 days, is the standard 10% monthly decrease still recommended?  because from my calculations, weening from 15mg -> 0.5mg will take 33 months... O_O for 34 days!

 

i wonder if a factor can be introduced that reflects the amount of days/weeks/months on the drug? 

 

or just increase the percentage drop (drop 20% instead of 10%, which would take 16 months)? 

 

or maybe the factor in the half life of the drug?  "drop X% and wait for 2X of the max reported half life" -> in this case, "drop 10% and hold for 2*40 hours".  i chose the 2 factor arbitrarily.  if that's the case, 15mg -> 0.5mg with 10% drops, and holding at 80 hours would take 33*80hours = 2640 hours = 110 days = 3.67 months.  which isn't bad?  it seems a bit more nuanced, too, than the blanket 10% drop each month.  

 

thoughts? 

[LotusRising]

You could certainly try a faster taper over a number of months, but there's of course no guarantee that you won't run into trouble. Your brain will have already started making adaptations to the drug, and potentially from previous medications you've taken since August. 

 

If it were me, I would still start with a 10% reduction to see how it went. 

 

I found the below info on the forum:

 

 

 

[daveyk]

thanks @LotusRising, yeah, i guess a conservative approach is always best.  i know the next psych i see is gonna wanna whiplash my brain left and right.  how do you stand your ground in front of these people? 

 

sucks we have to deal with this.  sucks even further that i put myself in this situation.  i've never had such an extreme reaction to ADs until this year.  just absolutely wild.  wish i had found this site 4 months ago.  could've saved my life. 

[LotusRising]

1 hour ago, daveyk said:

how do you stand your ground in front of these people? 

That's a great question! I know for me, I gave up early on trying to make my doctor understand. A lot of doctors are narrow-minded and uneducated about withdrawal so trying to communicate with them about our experiences can feel like wasted energy. At the end of the day, all you really need is your prescription so you can continue tapering. There are some resources on the site that you can show your doctor, but not everyone is up for that. The below link has info that you can give them:

 

 

1 hour ago, daveyk said:

sucks even further that i put myself in this situation

 

I think you need to give yourself some grace here. When you know better, you do better. There's no way you could have known how you'd react. I had never had a reaction either, until I did. But I've learned a lot in the process and won't make the same mistake again.

 

Keep us updated so we know how you're doing  

[daveyk]

34 minutes ago, LotusRising said:

I think you need to give yourself some grace here. When you know better, you do better. There's no way you could have known how you'd react. I had never had a reaction either, until I did. But I've learned a lot in the process and won't make the same mistake again.

thank you lotus 🥹 lots of my support network have been telling me that, too.  feels good to hear it around these parts as well.  

 

35 minutes ago, LotusRising said:

Keep us updated so we know how you're doing  

will do, thank you lotus!  i feel really supported here, it's great.

 

unfortunately, i think i may need to hop on the med merry-go-round again.  i'm still feeling generally unstable, good days are rare, SI is rampant.  i have a psych appointment this saturday with someone connected to the university near here.  hopefully she can help me stabilize.  whatever happens, i want it done cautiously.  which means slow.  which means, i hope she listens to me. 

 

we'll see what she says.  

 

@LotusRising can i still post here if i'm getting _on_ meds?  might be good to chronicle the experience for others to see?  i could potentially be weening off mirtazapine, i guess that qualifies under the purpose of this site! 

[daveyk]

BTW @LotusRising what did you have a reaction to? 

[daveyk]

wow, it happened to me. 

 

told doctor L about the adverse drug effects i experienced, he immediately prescribed me lamotrigine and said he _isn't_ labeling me bipolar as he doesn't believe in labels.  symptoms exist on a spectrum.  but you know, if that doesn't work, we'll try lithium.

 

wink wink. 

[LotusRising]

So, he obviously didn't endorse the WD symptoms, which isn't surprising, and is trying to "fix" your situation with more medication.

 

How did you feel, and what was your response, or did you just let it go?

 

 

[daveyk]

felt amused and completely unsurprised, given what i've read here. 

 

my response:

me: "what if you didn't diagnose me as bipolar and instead-"

him: "i told you i don't like using diagnoses" with a smile

me: "okay, would you change your treatment modality if i told you i thought i'm experiencing adverse affects of antidepressants"

i don't remember the answer, but of course it was basically "no", because then he'd have to think about something beyond his little treatment algorithm of "euphoria when taking SSRIs" -> "bipolar!!!"

 

after that, i just let it go.  he prescribed lamotrigine and it's waiting for me at the pharmacy.  not sure when/if i'm gonna pick it up.  problem is, i'm not getting any better on this 15mg of mirtazapine after 37 days of treatment, and i don't know what the next course of action should be. 

 

i know alto suggested a microdose of lamotrigine to help stabilize the nervous system when dealing with withdrawal, but at this point, i'm experiencing more "depressive" symptoms, not necessarily an activated nervous system (although that's there, too)- the worst of which is brain fog, a completely f*cked up sleep schedule, ED, and chronic constipation that doctors are uninterested in actually solving. 

 

none of these damn doctors want to think holistically about my problem, even though I KNOW all my symptoms are connected to SSRIs completely wrecking me.  at this point i feel like i'm more in the territory of PSSD than PAWS.  feel hopeless, like my life is ruined, and i'm never gonna get better.  

[daveyk]

I also noted that sertraline is weakly dopaminergic and wondered if that could cause euphoria, of course he had no clue about this.  

 

Too bad I can't present anecdotal evidence from the internet as a convincing argument to docs.  I've seen multiple reports of euphoria on sertraline for non-bipolar people.

[LotusRising]

I understand the frustration when there seems to be no answers. I've been there and it's discouraging.

 

1 hour ago, daveyk said:

i'm not getting any better on this 15mg of mirtazapine after 37 days of treatment, and i don't know what the next course of action should be.

 

I will confer with the other mods to see what might help your situation.

 

LotusRising

[daveyk]

6 minutes ago, LotusRising said:

I will confer with the other mods to see what might help your situation.

oh snap, okay cool, thanks lotus. i know y’all aren‘t doctors and all that, but any ideas would be helpful.  especially any ideas on convincing doctors that these drugs have harmed me in some way, rather than my symptoms presenting as a mental illness.  they really cannot see outside their limited box. 

 

i’m just incredibly wary of putting any other psychoactive substance in my body that isn’t already there. 

[Altostrata]

On 10/29/2023 at 3:13 PM, daveyk said:

at this point, i'm experiencing more "depressive" symptoms, not necessarily an activated nervous system (although that's there, too)- the worst of which is brain fog, a completely f*cked up sleep schedule, ED, and chronic constipation that doctors are uninterested in actually solving. 

 

@daveyk please explain more about these symptoms. Do any particular thoughts accompany the "depressive" symptoms or what you call SI?

 

When did the constipation start?

 

Quote

* 8/13/2023, 50mg Sertraline (self-started because of my previous experience with Zoloft, bad idea, pure euphoria, laid in bed 4 hours smiling)
* 8/15/2023, 25mg Sertraline (called GP, obtained to new prescription, agreed to lower to 25mg, probably way too fast)
* 8/16/2023, 25mg Sertraline
* 8/17/2023, 12.5mg Sertraline
* 8/18/2023, 12.5mg Sertraline+300mg psilocybin (another bad idea, i felt pretty good in the morning, mild akathisia later in the afternoon)
* 8/29/2023, 12.5mg Paroxetine CR (only took once, too scared of withdrawals to continue)
* 9/1/2023, Sporadic anhedonia starts, intense brain fog, memory issues, attention issues, unclear if related to SSRIs or insomnia/anxiety
* 9/11/2023, last consumption of cannabis
* 9/13/2023-9/18/2023 (5 days), 10mg Hydroxyzine (prescribed by psych nurse at PHP program)
* 9/20/2023-9/22/2023 (3 days), 5mg Fluoxetine (prescribed by psych nurse at PHP program)
* 9/22/2023-now, 15mg Mirtazapine (prescribed in psych ward, nightly between 9-10pm)

 

This is from your signature. As I understand it, you some unpleasant symptoms switching from citalopram to sertraline in October 2021, but were fine from March 2022, when you went off sertraline, to August 2023? And in August 2023, you pursued psychiatric drug treatment for distress caused by life events?

 

It's well documented, but apparently unknown to your doctors, that antidepressants can cause hypomania or euphoria. Zoloft may have had an unusual effect on you after the initial dose in August 2023 because your nervous system had changed a lot since you last took Zoloft. It's also very common that antidepressants cause insomnia. 

 

When did the insomnia start? What effect do you feel from mirtazapine?

 

The decreases in sertraline you made from August 13 to August 18 were very low risk for withdrawal symptoms, but it appears you had an adverse reaction to psilocybin, another serotonergic, which may have sensitized you to the drugs that followed.

 

Since September 13, it appears that you decided again to pursue psychiatric drug treatment for your problems, this time "Sporadic anhedonia starts, intense brain fog, memory issues, attention issues". From your history, particularly the adverse reaction to  psilocybin and possible Zoloft earlier, it's not surprising you developed these extremely common symptoms arising from adverse effects of psychotropics -- which tend to slowly go away on their own.

 

BTW, brain fog, memory issues, attention issues, emotional numbness are also very common effects of antidepressants such as mirtazapine.

 

As I see it, you might have done better if you had stayed off psychiatric drugs after your misadventure with psilocybin, and just let your nervous system settle down naturally. Now, since there have been other drugs introduced to irritate your nervous system, it probably will take longer to recover.

 

In the meantime, if it's not doing you any good, it's possible to adjust or go off the mirtazapine. After that is resolved, I strongly suggest you quit while you're ahead and stop asking psychiatrists to give you drugs to solve your problems. You'll have to be patient to allow your nervous system to return to normal.

 

 

 

[daveyk]

@Altostratathank you for looking at this thread 🥹

 

1 hour ago, Altostrata said:

please explain more about these symptoms. Do any particular thoughts accompany the "depressive" symptoms or what you call SI?

 

the depressive symptoms originate from a variety of sources, i think. 

- when i reflect on the state of my body, the ED, the mind/body disconnection, the constipation, i feel a deep sense of loss of my old self and basically spiral.

- i started experiencing anhedonia before the depression, so at this point, i cannot find respite from my current state in my old hobbies, like consuming/criticizing movies, reading books, etc; nor can i find respite in socialization, nor the smallest things like taking a hot bath or petting my dog.  then the SI starts because i'm reminded of my demented current state.

- i feel a deep sense of regret for ever reaching for the zoloft in the first place.  as my partner and @LotusRising tell me, i need to give myself grace, but this starts another spiral.  how could i do this?  a 43 y/o man, with a tight grip on life, on work, on my body and mind? 

 

the anxiety spikes are unlike my old anxiety, though- i have this occasional sense of inner restlessness that requires me to shake my hands, move my body, walk, move, pace, etc.  akathisia, i think.  how the hell did the past few months GIVE me brand new symptoms? 

 

1 hour ago, Altostrata said:

When did the constipation start?

around end of august, IIRC? 

 

1 hour ago, Altostrata said:

you some unpleasant symptoms switching from citalopram to sertraline in October 2021

the day or two following the switch was actually okay!  but onboarding zoloft really sucked for the next two months- i think this site would call them "neuroemotions"?  a different flavor of anxiety i've only experienced when taking zoloft.

 

1 hour ago, Altostrata said:

but were fine from March 2022, when you went off sertraline, to August 2023?

totally fine, living my best life actually.  was fully human and unmedicated, and happy. 

 

1 hour ago, Altostrata said:

And in August 2023, you pursued psychiatric drug treatment for distress caused by life events?

yes, unfortunately, to date the worst mistake of my life, hands down, without question.

 

1 hour ago, Altostrata said:

Zoloft may have had an unusual effect on you after the initial dose in August 2023 because your nervous system had changed a lot since you last took Zoloft.

yeah, that's what i now realize.  i had microdosed psilocybin a handful of times after i weened off the zoloft, between mar2022-aug2023, to no negative effect at all.  i should've known that my brain had changed using this substance. 

 

1 hour ago, Altostrata said:

When did the insomnia start?

the insomnia started *before* i reached for the zoloft.  i self medicated a bit with propranolol and klonopin (responsibly), but since the anxiety had been increasing before then for a couple weeks, i thought a longer term solution was necessary.  the zoloft made the insomnia WAY, WAY WORSE.  again, worst mistake of my entire life. 

 

1 hour ago, Altostrata said:

What effect do you feel from mirtazapine?

massively increased hunger, AFAICT a screwed up sleep architecture (i can dream 10 minutes after falling asleep), and i THINK brain fog, because i accidentally skipped it one night, and the next day i felt super anxious but clear minded enough. i don't know if it's helping with depression/anxiety, but i'm actually somewhat functional now, which is much different from a few weeks ago.  however, can never tell if my brain/mind started healing by itself, or the drug is helping. 

 

1 hour ago, Altostrata said:

The decreases in sertraline you made from August 13 to August 18 were very low risk for withdrawal symptoms, but it appears you had an adverse reaction to psilocybin, another serotonergic, which may have sensitized you to the drugs that followed.

yeah, the day i took the low dose of zoloft and psilocybin, i felt pretty good actually, i felt full of life and really happy, but in retrospect i may have flooded my system with too many serotonergic substances.  and yes, i could see that sensitizing my system.  if reaching for the zoloft was the worst mistake of my life, this was the second worst. 

 

1 hour ago, Altostrata said:

Since September 13, it appears that you decided again to pursue psychiatric drug treatment for your problems

unfortunately i cannot deny my own free will in taking these drugs, but i was getting ... some pressure ... from those around me to take other drugs.  i was in a VERY BAD state even after the zoloft/psilocybin combo.  i didn't mention this story in my profile, but i'm somewhat familiar with buddhist teachings and practiced vipassana meditation from about 2017-2019, which never resulted in any major changes in my personality, fortunately.  however, while on zoloft and having a panic attack, i had what some would call an "insight experience" - direct knowledge of the lack of any enduring *I* in our minds.  this completely destabilized me, pushing my mind into states beyond my previous comprehension.  immediately after this, i felt my "cognitive center" blow apart, leaving the cognitive structure without a stabilizing, central executive.  sounds weird, i know, but that's the best i can explain it. 

 

1 hour ago, Altostrata said:

BTW, brain fog, memory issues, attention issues, emotional numbness are also very common effects of antidepressants such as mirtazapine.

some of these were happening before the mirt, although i'm not disagreeing that the mirt could be perpetuating them.  before:  memory issues, attention issues, emotional numbness.  but damn, this brain fog on the mirt is very bad.  seems to clear up at night.   

 

1 hour ago, Altostrata said:

As I see it, you might have done better if you had stayed off psychiatric drugs after your misadventure with psilocybin, and just let your nervous system settle down naturally. Now, since there have been other drugs introduced to irritate your nervous system, it probably will take longer to recover.

yeah  

 

1 hour ago, Altostrata said:

 

In the meantime, if it's not doing you any good, it's possible to adjust or go off the mirtazapine. After that is resolved, I strongly suggest you quit while you're ahead and stop asking psychiatrists to give you drugs to solve your problems. You'll have to be patient to allow your nervous system to return to normal.

funny you mention this, i've had this conversation with my partner many many times in the past couple weeks.  i'm pretty nervous about changing anything, though, because i don't want to destabilize further.  i just wanna feel good, with my old body, and my old mind.

 

@Altostrata the new psych prescribed lamotrigine, and i'm considering microdosing it to calm the nervous system down (without telling him), re: the thread here on SA about taking 0.5-1mg.  any thoughts around that?  i know you can't tell me definitively one way or another, just wanna consider your opinion. 

 

again thanks for chiming in. 

[Altostrata]

18 hours ago, daveyk said:

- when i reflect on the state of my body, the ED, the mind/body disconnection, the constipation, i feel a deep sense of loss of my old self and basically spiral.

- i started experiencing anhedonia before the depression, so at this point, i cannot find respite from my current state in my old hobbies, like consuming/criticizing movies, reading books, etc; nor can i find respite in socialization, nor the smallest things like taking a hot bath or petting my dog.  then the SI starts because i'm reminded of my demented current state.

- i feel a deep sense of regret for ever reaching for the zoloft in the first place.

 

These are not withdrawal symptoms. These are emotions arising from beliefs about yourself, which you could manage or resolve through psychotherapy or other self-exploration. If you want to believe this constitutes a psychiatric disorder for which you need drug treatment, that is also impelled by a belief system, not a necessity dictated by disease.

 

We do not provide treatment for psychological problems here, we provide peer support for tapering and withdrawal syndrome only. There is no way we can advise you on tapering that would resolve the beliefs you hold about yourself and your future. In other words, we can suggest ways to taper but only you can stop self-blame, etc. See

 

Dealing With Emotional Spirals 

 

Shame, guilt, regret, and self-criticism

 

Health anxiety, hypochondria, and obsession with symptoms

 

Non-drug techniques to cope with emotional symptoms

 

Easing your way into meditation for a stressed-out nervous system

 

Music for self-care: calms hyperalertness, anxiety, aids relaxation and sleep

 

Ways to cope with daily anxiety

 

"Change the channel" - dealing with cognitive symptoms

 

18 hours ago, daveyk said:

around end of august, IIRC? 

Constipation might have started when you went off sertraline and tried paroxetine. Suggest you drink plenty of water and consume lots of fiber (vegetables) to resolve it. A probiotic might help. Being fixated on it does not help.

 

18 hours ago, daveyk said:

the insomnia started *before* i reached for the zoloft.  i self medicated a bit with propranolol and klonopin (responsibly), but since the anxiety had been increasing before then for a couple weeks, i thought a longer term solution was necessary.  the zoloft made the insomnia WAY, WAY WORSE.  again, worst mistake of my entire life. 

 

Is it possible that insomnia started after some other drug experiment? Do you drink alcohol? You may not be aware of this, but even "responsible" use of propranolol and Klonopin can cause paradoxical symptoms -- the exact opposite effect that you expect, often anxiety and insomnia.

 

18 hours ago, daveyk said:

massively increased hunger, AFAICT a screwed up sleep architecture

 

Appetite increase is a very common effect of mirtazapine, as is brain fog the next day. Does the mirtazapine help you sleep? What is your current sleep pattern?

 

18 hours ago, daveyk said:

 

@Altostrata the new psych prescribed lamotrigine, and i'm considering microdosing it to calm the nervous system down (without telling him), re: the thread here on SA about taking 0.5-1mg.  any thoughts around that?  i know you can't tell me definitively one way or another, just wanna consider your opinion. 

 

My opinion is that you are still pursuing miracle drug cures and not inclined to unpatient yourself. Good luck with psychiatric treatment.

 

If you want to reduce mirtazapine, see Tips for tapering off mirtazapine (Remeron)

[daveyk]

On 10/31/2023 at 3:52 PM, Altostrata said:

Constipation might have started when you went off sertraline and tried paroxetine. Suggest you drink plenty of water and consume lots of fiber (vegetables) to resolve it. A probiotic might help. Being fixated on it does not help.

this is actually resolving now, i started eating fiber gummies in addition to increasing my water intake and also started a probiotic. 

 

On 10/31/2023 at 3:52 PM, Altostrata said:

Is it possible that insomnia started after some other drug experiment?

no, the insomnia definitely started while i was free of medication- i have records stating as such through my daily log, a half-hourly spreadshee where i record symptoms i experience, sleep, liquid/foods/drugs i ingest, bowel movements, etc.

 

On 10/31/2023 at 3:52 PM, Altostrata said:

Do you drink alcohol?

haven't really drank since around jan2020, right before the pandemic.  great time to quit. 

 

On 10/31/2023 at 3:52 PM, Altostrata said:

You may not be aware of this, but even "responsible" use of propranolol and Klonopin can cause paradoxical symptoms

indeed i am aware of this, fortunately i'm not one of the lucky ones who experiences it. 

 

On 10/31/2023 at 3:52 PM, Altostrata said:

Does the mirtazapine help you sleep? What is your current sleep pattern?

maybe it does? sleep pattern is pretty trash, i lay down around 9pm and awake around 3am, unable to fall back asleep.  my partner is urging me to implement some sleep consolidation.  too bad i can't return to using cannabis as a sleep aid, i was getting a solid 8 hours with that.

 

On 10/31/2023 at 3:52 PM, Altostrata said:

Good luck with psychiatric treatment.

as expected, really not going well.  i decided to book appointments with a couple more psychiatrists, to gather an array of opinions.  the first line treatment from this latest doc is:  risperidone, an anti-psychotic.  says i am displaying bipolar features, and wants something to stabilize my mood quickly.  i said, my mood isn't unstable, i just feel like **** almost constantly.  of course i declined the anti-psychotics.

 

Quote

Common side effects include severe depression, movement problems, sleepiness, dizziness, trouble seeing, constipation, and increased weight.^[2][8] Serious side effects may include the potentially permanent movement disorder tardive dyskinesia, as well as neuroleptic malignant syndrome, an increased risk of suicide, and high blood sugar levels.

why would anyone take this if they didn't absolutely need it???

 

second line: lamotrigine, "no tapering needed".  are all these folks reading from the same book?  a book that doesn't include victims of the "craft" they practice? 

 

still considering tapering the mirtazapine, but not sure how i'm gonna stabilize myself without it.  really not in a great place mentally, overall.  i'm resisting medication as much as possible, to the detriment of my sleep, my relationship, work, etc.  i'm literally considering doing an at home FMT with a donor of my choosing, or maybe rTMS, although that looks pretty shady too.  it seems like there's just no good options right now...i really don't want to be polypharmacy'd.  even monopharmacy is too much for my liking.

 

btw thanks for the link for tapering off mirtazapine, alto. 

[Altostrata]

Sorry, we cannot advise you about what new drugs to try.

[HopefulToHeal]

I’m curious about your thoughts on FMT. I am considering doing one in the near future. I’m doing a bunch of GI testing before I consider anything. A dysbiotic gut surely can’t help the CNS get better quicker. I’ve heard many in WD have SIBO. Also, H. Pylori seems to be common. Antibiotics are not good though and I have my concerns about treating with them while I’m in protracted withdrawal. Message me if you wanna talk about the gut stuff. I think it’s really important to address during this process of healing, even if that just means a stellar diet and lots of good quality water.