'Berlin': Bad reaction to Sertraline and possible withdrawal from St. John's Wort

[Berlin]

Hello everyone,

 

First, I will start with a brief introduction, followed by my story, and finally, I will describe how I am feeling today.

-English isn't my first language.-

 

I am a 32-year-old man, a teacher who has studied psychology. I want to share my story because I found a lot of support in reading stories on this website, especially the success stories.

 

Throughout my life, I have been battling anxiety. It's important to note for the upcoming story that I have never experienced depression. I've always been a very sporty, energetic, emotional, and motivated person. My anxiety mainly manifested as hypochondria, and I began therapy for it around the age of 18. This helped me a lot. I am still undergoing therapy with the same person—a psychiatrist who works both in a hospital during the day and as a private practitioner in the evening where he gives psychotherapy(which is somewhat unique in my country).

 

At around 19 years old, I used Sipralexa (also called Escitalopram/Lexapro) for about 6 months. I felt a bit less excited and experienced sexual side effects, such as delayed ejaculations, it required a lot of effort to reach orgasms. I decided to stop the medication without tapering off, and fortunately, I didn't experience significant symptoms after quitting. About a year later, I started taking St. John's Wort (Sint Jans Kruid) at a dosage of 900mg per day, divided into three doses of 300mg each. I continued with St. John's Wort until the day my story begins.

 

My story

 

I still can't believe that what I am about to write happened to me and is still happening. I know it's a bit unusual to spoil the story, but yeah, I can do what I want with my own story: I'm actually getting better.

 

 

24 October 2022, Appointment with My Therapist, who is also a Psychiatrist

 

After complaining about increased anxiety and stress, my therapist suggested trying something stronger than the St. John's Wort I was using. It was just a suggestion. Initially, I declined, and we didn't delve into it further during the session. However, at the very end, and to my regret, I said, ‘you know what, actually I am almost always stressed and anxious, let me try those meds: Sertraline it was.’

 

26 October 2022, My First Dose

 

I was prescribed Sertraline 25mg/day, to take in the morning. On this day, I stopped taking the 900mg St. John's Wort and took my first 25mg Sertraline in the morning. A few hours later, I already noticed the delayed ejaculation as described earlier in my story. Later in the evening, during a university class, I experienced a moment of confusion and detachment. For a brief period (a minute or 5), I couldn't see the point of being in class or even being alive. I knew in my head why I was in class and why I am in this world, but I couldn't feel it. Those 5 minutes were the worst thing I have ever experienced. Later that evening, I had to leave the class due to a panic attack, larger than any I had experienced before. (I had never left class before).

 

The day after, in the morning, while working on my computer, I couldn't focus. The letters on the screen seemed too much, and they were a bit 'dancing,' like when you move your phone while trying to read a message. I texted my psychiatrist and was told it could be a side effect that possibly goes away (at this point, I didn't talk about that weird 5 minutes in class).

 

Then, a few days later, I wanted to surprise my dad while he was fishing, as I always did, because it made him very happy. However, this day was different. I arrived at the lake, and there he was, my dad, already smiling because he had a feeling I would come and sit with him for the rest of the day. As he grabbed another chair out of his car, because he always brings one for me, he said, 'aaaa here is my son!!' Normally, that would make me feel so happy, but I couldn't feel it. I couldn't imagine why sitting there would make me happy, and it broke me completely. To see my dad confused when I said, 'No dad, thanks. I'm feeling very tired. Just wanted to say hi. I'm going home now.'

 

4 November 2022, The Day Hell Broke Loose

 

Due to the sexual side effects and the weird moments of 'mood drops' - not feeling connected or seeing the point - I decided to quit Sertraline. My last 25mg tablet was the morning before (3 November). I had taken it for 10 days.

 

10 AM: I went to the barber, felt anxious, and couldn't relax for a second. I was in continuous fight or flight mode.

 

13 PM: I arrived home and experienced pure horror, a feeling that hurt more than anything I could imagine. I didn't want to live for another minute with this feeling, not a second. It was too hard. I ran into my big brother's room and said, 'I don't know what's going on, I can't take this anymore.' He asked, 'What?' and I replied, 'I don't know, I have this feeling I can't live with.' I tried to explain as best I could and said, 'I would rather be in a wheelchair without legs for the rest of my life than endure one more minute with this feeling.' (To be clear, I don't want to compare situations of suffering; it just came to my mind at that moment to try to find words for what I was feeling). But now I know, you can't describe this feeling with words; only the people who have experienced it will understand. Later that evening, I felt a bit of relief, but still in pure hell. This is actually a very clear trend/lifeline in my story: the evenings are (almost) always better.

 

At this point, I was without Sertraline or St. John's Wort: the mood drops and sexual side effects were definitely caused by the Sertraline because I did not experience them on St. John's Wort. The next day, I started taking St. John's Wort again.

 

The next months are pure hell, feeling almost nothing (except pure horror) during the day to feeling relief in the evening. Let me explain in more detail:

 

-I will regularly add dates to my story so it is easier to follow. (I always used to count months in the success stories to compare to myself; I know everybody has their own timeline of recovery, but I still compared.)-

 

4 November - 13 November, The first week without Sertraline,

 

With 900mg St. John's Wort/day again, I didn't notice any improvements and called almost every day to the Psychiatrist (PSY) to tell him I can't live with this feeling. Due to my psychology study, I made sure to include that I am not feeling suicidal. This was a lie, but I was sure I was not going to do it. My psychiatrist made sure I could come and visit at least one time every week and could call or text him at any moment. I count myself lucky to have a person like him as my therapist. The first thing he said was, 'I never had someone telling me about these problems, and it is not described, but that does not mean that you are not feeling this. I am here and I am not too old to learn.' This made such a big difference.

 

14 November 2023, I told my PSY about possible withdrawal

 

'I think it's withdrawal!' I said and was told that this is very unlikely because I was only on the medication for 10 days and that it didn't reach my blood-brain barrier. But also, he asked about my theory, how the medication could cause me to feel this way. I told him I can't really explain, and we consented that if it would be withdrawal, it would go away when the medication is reinstated. He prescribed me a magistral preparation of 5mg Sertraline so I could take this instead of 25mg. I will add a schedule, maybe it could be of importance for anyone:

 

14/15/16/18 NOV: 10mg Sertraline, no St. John's Wort. While writing this, it is getting clear to me that I got even worse: Almost no sleep, more horror.

18 NOV: 25mg Sertraline + 1 tablet of 'Deanxit': never took it afterward (this day I was really bad and called the doctor and psychiatrist on the same day).

- As you notice, I actually start going up with the medication hoping it would make this horror go away)-

19 NOV - 30 NOV: 25mg Sertraline

- Getting worse, so quick taper-

1 DEC: 20mg

2 DEC: 15mg

3/4 DEC: 15mg + 1 St. John's Wort (300mg)

5-11 DEC: 10mg + 1 St. John's Wort

12 DEC: 5mg Sertraline + 2 St. John's Wort (600mg)

- the lower I went with the Sertraline, the better my sleep got-

13 DEC: 0mg Sertraline + 3 St. John's Wort (900mg)

 

1 January 2023, goodbye to life as I knew it

 

In the following months, the feeling of pure horror is starting to fade a bit and it gets replaced with anhedonia and depression: not able to enjoy anything and not feeling the motivation to do anything. Switching from almost not feeling (except anxiety and just feeling bad) to feeling a little bit of emotion. In the evenings, it always got a little bit better, and I had an occasional laugh but not the same as before where I would really laugh. Important to know is, I couldn't enjoy ANY activity, I actually did things just to distract (try) myself from this empty filthy numb feeling.

 

Example: I used to love photography. I went from a little idea to finding myself miles away in the city to work out a creative photo project. I couldn't wait to get home and share my pictures with friends and family. 'Oh, is it already time to sleep? I want to edit a bit more!' But at this point, I just walk and walk. I don't want to walk... why do I even hang this camera around my neck? ..., why take pictures..., let's go home... why home? What will I do there, waiting and hoping I will feel better one day.

 

Also, I am not able to work anymore at this point due to what I am going through.

 

June 2023, it got a little bit less intense, 8 months into this.

 

As the months went by, I noticed that bad got a little less bad and the evenings got a little bit better: for me, this was huge, but don't expect much of it. Examples:

-5 minutes without thinking about all this

-5 minutes without surviving

-Brief thoughts about getting back to work (before I was very sure I would never work again)

 

In the evenings, I was able to relax a bit and feel positive. Example: Morning,I can't take it anymore VS  Evening, it will all be alright one day...

 

Also, I noticed that I am getting DEEP pain when I think about my family or my grandma who passed away many years ago: I start crying, like deep suffering, howling like a wolf for sometimes hours. I will come back to this later.

 

November 2023, am I really getting better? 13 months in

 

It is hard to talk about this now because I just told my whole story, and I am very much reminded of all I have gone through, so I feel exhausted, empty, and scared. Actually, I do feel scared every time I want to say something positive because I think it will all be bad again.

 

I noticed that sometimes I (just a little bit) wanted to go to my family in the evening because I knew it would make me feel better (before it was just killing time, hoping to distract myself). The deep cries and suffering I told you about are giving me relief. WHAT RELIEF? I didn't expect to ever get that again.

 

How Am I Feeling Today

 

1 January 2024, the day of writing this Story. 14 months in

 

Happy New Year to all of you. I am proud of all of you for still being here, and my biggest wish for this year is for everyone, including me, that is suffering, to say: 'Happy New Year again in 2025, and who knows it really is happy then.’

 

For me, it was difficult to see all the people celebrating and being happy, but then I reminded myself that if I am in a group of people giving kisses and saying happy new year, no one would know that I am actually not that happy. I think this is a beautiful thing: I will always remind myself that a lot of people struggle, and I want to be here for them.

 

At this point, I am able to play games and laugh a bit, watch series and enjoy it a bit. There are moments where I feel good without thinking too much. The mornings and the bad moments aren't that bad anymore, and the better moments can actually be a bit good sometimes. I am looking for a new job because teaching, standing in the spotlight all day, isn't for me anymore. And when I think about a possible new job, I really see it happening (don't know if I am already capable), but seeing it happen is a HUGE thing considering what I am going through.

 

I Am Tapering SJW

 

In the months before, I also noticed that I am feeling worse after forgetting to take one or two tablets of SJW, and I decided that I want to quit SJW. I made a plan according to the tapering instructions on this website: 10% drop every 4 weeks. I am now at my second drop of 10%, that means 2 tablets and 236mg* of a tablet. *The weight of a tablet is not the same as the active ingredient: 1 tablet weighs 555mg and contains 300mg of the active ingredient SJW. I am calculating my 10% drops on the active ingredient. I am now at 742mg/day SJW (active ingredient).

 

SJW is not known for withdrawal, but 2 days after every drop, I feel (a lot) worse: no motivation, more tired, not enjoying things, mood swings and after about 6/7 days, it feels back to before the drop. So, I am sure I had an adverse reaction to Sertraline, and also the SJW is giving me withdrawal (I used it for more than 10 years, as you can see in my story).

 

The End, for today:p

 

I still have a long way to go, and there will be a lot of moments/days/weeks where I think I will never get better, but I am grateful for the progress I have made so far. To actually believe that maybe one day I will feel good/normal again gives me a lot of relief and hope.

 

One thing that always makes me feel better is to be able being there for people who are suffering, so I will write updates and answer questions if any.

 

Finally, I would like to take the time to thank everyone who is building this community, especially Altostrata: I admire your power to get through all the suffering for so many years and afterwards helping so many people like me. Please know that your work, together with my family and my psychologist, made me stay.

 

Kind regards,

Berlin

 

 

[LotusRising]

Hi @Berlin and welcome to SA,

 

I'm glad you found us. It sounds like the information on this site has informed your tapering of St. John's Wort, which is good to hear.

 

I believe there are other members tapering st. john's wort. You might try to connect with them by doing a search of the site.

 

 How to Do a Site Search on Surviving Antidepressants

 

It sounds like you've been getting some improvements, which is good. Have you seen the below links:

 

The Windows and Waves Pattern of Stabilization

 

Keep it simple, slow and stable

 

Please reach out if you have any questions, and again, welcome  

[Berlin]

4 minutes ago, LotusRising said:

Hi @Berlin and welcome to SA,

 

I'm glad you found us. It sounds like the information on this site has informed your tapering of St. John's Wort, which is good to hear.

 

I believe there are other members tapering st. john's wort. You might try to connect with them by doing a search of the site.

 

 How to Do a Site Search on Surviving Antidepressants

 

It sounds like you've been getting some improvements, which is good. Have you seen the below links:

 

The Windows and Waves Pattern of Stabilization

 

Keep it simple, slow and stable

 

Please reach out if you have any questions, and again, welcome  

Hi @LotusRising, Thank you for the warm welcome and for sharing more information with me!

Have a nice day. 

[Berlin]

1-10 January 2024:

 

Had a good 10 days, the bad moments are much more easy to handle and i was able to relax and rest for most of the time. Emotions are more intens, not yet like before. 
 

The most important progress i noticed: i can say with confidence that i am getting better, never thought i would ever be able to say this.

 

Kind regards,

 

Berlin

[Dutchsarah]

That is great to hear! 

[Berlin]

Hello/ hallo Sarah,

Thanks for the support, i feel like i am really getting there(slowly).

 

I have read your story and it is recognisable! 
 

You can always reach out if you’d like to.

(Also in dutch)

 

kind regards!

 

 

[Dutchsarah]

Spreek jij ook Nederlands? 

 

Yes your story is recognizable to me as well. Im so glad to read that you are getting better. It definitely gives me hope 😊

[Gingerhead]

23 hours ago, Berlin said:

1-10 January 2024:

 

Had a good 10 days, the bad moments are much more easy to handle and i was able to relax and rest for most of the time. Emotions are more intens, not yet like before. 
 

The most important progress i noticed: i can say with confidence that i am getting better, never thought i would ever be able to say this.

 

Kind regards,

 

Berlin

Good evening,

 

I am sorry to hear that you have gone through this and can relate to alot of what your describing that you had to struggle with, I'm glad to read that as shown by your experience there is light at the tunnel. I was also put on sertaline but at a younger age and figured I could just stop it. It's sad that the doctors who are paid to know this stuff actually know very little about it. I also agree if it wasn't for this forum alot of people would be in a much worse place and I can't give enough thanks thus far for the support they have given me and hopefully will continue to give me as I journey to be able to "feel" again 

 

Kind regards

[Berlin]

@Dutchsarah

Ik spreek Nederlands! (but I'll try to use English so everyone can read the story and rep's)

 

You will get better!; I always used to believe that I was different, that I would be unique and never get better. However, like most people, i am getting better. Interestingly, many individuals who are on their journey of improvement tend to become less active in sharing their experiences." (because they want to leave the bad memories behind)

 

You can always contact me if you don't know what to do!

 

Kind regards

 

[Berlin]

1 hour ago, Gingerhead said:

Good evening,

 

I am sorry to hear that you have gone through this and can relate to alot of what your describing that you had to struggle with, I'm glad to read that as shown by your experience there is light at the tunnel. I was also put on sertaline but at a younger age and figured I could just stop it. It's sad that the doctors who are paid to know this stuff actually know very little about it. I also agree if it wasn't for this forum alot of people would be in a much worse place and I can't give enough thanks thus far for the support they have given me and hopefully will continue to give me as I journey to be able to "feel" again 

 

Kind regards

 

 

Thank you for your response. I've read your story too. I can relate to the 'feel again' aspect; for me, it was one of the last things to return. Once I started believing in my capacity to get better, I began to experience emotions bit by bit.

 

Feel free to reach out; I'll keep updating my story.

It's important to note that I'm not entirely in a perfect state, but every week or month brings a gradual improvement. At the moment, I find myself at an acceptable place in my journey."

 

Kind Regards!

[KenA]

17 minutes ago, Berlin said:

but every week or month brings a gradual improvement. At the moment, I find myself at an acceptable place in my journey."

This is great to hear!! Always keep chasing the positive!! You've got this!!

[Berlin]

On 1/11/2024 at 8:25 PM, KenA said:

This is great to hear!! Always keep chasing the positive!! You've got this!!

Thx for the support! 

[Berlin]

January 21, 2024:

About 8 days ago i dropped another 10% of my SJW, on day 3 i felt really bad so i added 5%.  After a drop i always feel worse again. I feel a lot more anxious, tired and can’t really enjoy things(numbed). Also when this hits i feel like never getting better again, but i am better already and in a few weeks it wel be ok again. Maybe i will give myself more time before i drop another 10/5%, so i can have a break. 
 

If anybody is interested in stopping SJW, i can add more details about it. 

 

kind regards,

Berlin

 

[Berlin]

Have been feeling a lot better last weeks, been making big steps! The upward trend is real.

 

Regards,

 

Berlin

[littlebird]

17 minutes ago, Berlin said:

Have been feeling a lot better last weeks, been making big steps! The upward trend is real.

This is great news! Thank you for updating us, happy to hear it's a positive one. 🥳

[Berlin]

7 minutes ago, littlebird said:

This is great news! Thank you for updating us, happy to hear it's a positive one. 🥳

Thank you littlebird! ❤️