Kalagirl: Protecting the integrity of my nervous system. Is it being compromised?

[Kalagirl]

Dear All, this is my first post and I hope it is in the correct area. I also hope my signature has my drug history in it - it did take a while to craft.

I, like so many here have been blindsided by this horrible withdrawal process. My story is profoundly similar to you all. Needless to say: one and off for serval decades, believing the 'top-up' version of serotonin. Acknowledging the authority of the GP that an antidepressant is the answer for my now and into my future, experiencing years of minor checking in for repeat prescription. ... Friends suggesting that I would be silly to go off them etc. Repeat, repeat, rep.. Yet I was putting on weight, I was frustrated that there was no sexuality in me and I was getting more scatty. MY Life however was very good, issues were behind me.  Time to leave the tablets behind. 

So after an apparently fast taper off Sertraline  (not that I understood that at the time - I thought I was being responsible) - originally 100mg for several years then 50 mg for 6 months, then 25mg for a month, then ceased Nov 1st 2023 - I experienced the world of horror that is invisible to everyone else.  Panic set in and  I decide to reinstate so I can come off properly (hindsight knowledge). I scour the world for advice. CAUTION is what I read. Three GPs say 'its simple' go back on 25 or so then 50 back to 100. SA and Quora comments say go low and slow. I have sought advice from Dr Horowitz email address. I have searched tapering sites. and other forums/Facebook groups. I have read SA reinstatement info (but I am not taking much in particularly well). SO I recommenced Sertraline two weeks ago. 

First 6 days - 5mg 

Next 6 days - 10mg

Last 2 days - 15mg

I have had tiny several hours of peace on the days I introduced or increased the doses then dread and tension join me again. 

• Are these  good signs or not? I aim to get back to 50 mg at least - my last stable dose. But how to do this?
• Have I reintroduced Sertraline back into my body sufficiently that I can make a larger jump or should I continue this 5mg increments?
• Am I exacerbating/compromising the beautiful nervous system of mine more by these low doses?
• Has the gate closed on Sertraline for me - now 9 or so weeks out?
• Do I take Lorazapam in tiny amounts while waiting for the Sertraline to take effect?
• Etc??

I am keeping clear of all substances except for a probiotic daily. I cannot work properly in this state I have crashed into. My daughter is too frightened to talk to me although she texts with loving thoughts. One sister, who has NO idea about this, keeps me company at times and for this I am grateful. I yearn for a companion of this reinstatement journey. Please may I have some advice if it is out there.

Peace to you all...

Edited January 2 by FireflyFyte
Updated title

[FireflyFyte]

Hi Kalagirl,

 

Welcome to SA. Your signature did not save so please follow the instructions at How to Summarize Your Drug History in Your Signature. Would recommend that you be on the computer while creating your signature versus a mobile device.

 

9 hours ago, Kalagirl said:

Are these  good signs or not? I aim to get back to 50 mg at least - my last stable dose. But how to do this?

 

What is your aim to get back to 50mg? To be stable?

 

9 hours ago, Kalagirl said:

Have I reintroduced Sertraline back into my body sufficiently that I can make a larger jump or should I continue this 5mg increments?

 

For reintroductions, we recommend very small amounts and holding to see if the smaller amount is enough to result in stability. You can read more about this at About reinstating and stabilizing to reduce withdrawal symptoms. I would remain at 15mg, or even consider dropping back down to 10mg, and holding there to see if your windows (periods of feeling well) increase. It is important to understand The Windows and Waves Pattern of Stabilization.

 

9 hours ago, Kalagirl said:

Do I take Lorazapam in tiny amounts while waiting for the Sertraline to take effect?

 

We are a site dedicated to safely tapering off of psychiatric medication. If you want to discuss adding more medications to your mix, it is best to speak to your doctor about this course.

 

Thanks,

Firefly

[Kalagirl]

Thank you Firefly.

I have added my signature. 

I am wanting to stabilise so very much and I thought that by going back  to 50 would be the amount to aim for. 

So this is what I have done so far:

2023 Dec 0.25ml CBD 6 days. No effect Commenced probiotic

2023 18th December, approx. week 8 out from ceasing Sertraline decided to reinstate, stabilise and ceased CBD oil. Profoundly nervous.
20th Dec – 25th Dec: 5mg, (half capsules). A couple of hours of peace on first day. No relief in following days
26 Dec – 31- Dec: 10mg   Full capsule. A peaceful evening. No relief in following days
2024 1 – 4 January: 15mg, 1 ½ caps. Short respite window in evening. Harsh days.
Experiencing increasing anxiety in morning. Insomnia increasing.

5^th Jan dropped to 10 mg Sertraline. Strong anxiety, some dry reaching, faecal incontinence while out walking (!!!!) I had no control of my bowel for goodness sake. (Fortunately I was not with company and close to home). What is that about?

I have quit my teaching job for the time being. I don't function well being alone. etc. 

 How to stabilise is my biggest dilemma. I am losing work, and overloading friendships

[FireflyFyte]

11 hours ago, Kalagirl said:

I am wanting to stabilise so very much and I thought that by going back  to 50 would be the amount to aim for. 

 

We often find that less is more when it comes to trying to stabilize. You have made a lot of changes since December 18th so you might want to try and hold for awhile to see if your symptoms decrease.

 

11 hours ago, Kalagirl said:

I have quit my teaching job for the time being. I don't function well being alone. etc. 

 How to stabilise is my biggest dilemma. I am losing work, and overloading friendships

 

It is important to learn Non-drug techniques to cope with emotional symptoms especially while waiting to stabilize.

 

[Kalagirl]

Thank you for this advice and would appreciate more. I have dropped back to 10mg for past three days (signature). I am experiencing awful depression throughout the day, settling down after 7pm. Perhaps there is an increase in intensity of negativity  about an hour after I take the capsule which continues into the day. Not sure. 

How long do I do this dose for? When do I increase again? What do I watch out for? An approximation of how long this takes to achieve stabilisation again would be so encouraging.

i am walking, resting, taking probiotics, weekly massages and  burdening family and friends with my ongoing anxiety. I am also looking at the subjects you referenced. 

I am seeing a psychiatrist in a weeks time. Hopefully they will know about the issues that a too fast taper does to a ssri-acclimatised cns, it’s withdrawal terrors and kindling issues on reinstatement. Perhaps they may recognise my too fast taper as causing this agony?  More than likely they will diagnose depression relapse. Moot point now. I have decided to go back on. 

Over the Christmas period there is little activity in the psych arena - so I began again on my own.

[Happy2Heal]

to answer some of your questions please check out this thread. You have made a lot of changes in a very short time. Symptoms of withdrawal do not go away quickly, there is no quick fix. 

 

as far as these symptoms go " Strong anxiety, some dry reaching, faecal incontinence while out walking " I had those as well early on in WD but did not post about the last one as I was so embarrassed. thank you for having the courage to share it. 

 

these symptoms will all go away in time, but you really need to not make changes so quickly. You may actually be making things harder for yourself

 

this process requires a lot of patience. 

 

also it is very unlikely you will find a dr who will recognize that you are in withdrawal and treat you appropriately. 

It would be wonderful if you did, but very few of us ever found anyone willing to even acknowledge that WD from these drugs exists

 

 

 

[Kalagirl]

Thank you for go low, go slow advice as applied to tapering off Zoloft (et al). I understand that to stabilise one must apply the same principle.   BUT I am not understanding how to do the up-dosing properly- not as slow as the hyperbolic taper surely? Your earlier message said sit on 10mg for a little while.  I wonder how long to leave it at that? What do I look for to ascertain when  I can/should increase? The neediness-nervousness-nausea-dry reaching is not lifting. Anxiety storms morning and afternoon. I have now been on 10 mg 8 days, from commencing reinstatement 25 days ago.   Is this dose too low? Should I increase? (I obtained 2mg Zoloft capsules recently.) Another piece of advice I read on this website was that to sort out my depression I would have to return to my last stable dose. That was 50mg. So how to get there? I would love to think I would stabilise out at a much lower dose. 

I have an appointment with a psychiatrist and mental health nurse on Monday (15th Jan 2024). I will attempt to understand their position on withdrawal. More than likely they will recommend an updose. How to ask for my over-sensitised nervous system to be nurtured through this stabilisation process. 

 

'23 18th December, at approx. week 8 out from ceasing Zoloft decided to reinstate.  (ceased 5 days of low dose of CBD oil. Profoundly nervous.)
20th - 25th Dec: 5mg, (half capsules). A couple of hours of peace on first day. No relief in following days
26- 31 Dec: 10mg   Full capsule. A peaceful evening. No relief in following days
'24 1 – 4 Jan: 15mg, 1 ½ caps. Short respite window in evening. Harsh days. Experiencing increasing morning anxiety and  Insomnia increasing.

5 Jan >10 mg Sertraline. Strong anxiety, some dry reaching, faecal incontinence while out walking (!!!!) 6 Jan 24 >10mg, 7Jan 24>10mg, 8 Jan 10mg, 9Jan 10mg, 10 Jan 10mg, 11Jan 10mg, 12 Jan 10mg, 13 Jan 10mg.

Experiencing depression episodes morning and afternoon. Some reprieve after 7pm. Wake early - but about 6 hours sleep.

[Kalagirl]

I asked a question last Saturday 6th Jan on the same topic of reinstating - a topic i began recently.  I am wondering if anyone has seen it?I am not sure how to interact within this group yet. I hope not to burden people. Just a bit more advice about stabilising and how to do it. I had a conversation with  a psychiatrist yesterday. He indicated he had no experience of up dosing to stabilise. He was very familiar with Benzo withdrawal - not SSRI withdrawals. He listed drugs that may help. Fluoxetine, Mirtazapine, MOIs, Quetiapine.

We settled on keeping with the reinstatement plan of Sertraline as negotiated with the GP - who suggests i may be going too slow. She is totally unaware of withdrawal syndrome but committed to stabilising the depression whatever the origin. 

I have commenced 12 mg as of 15h Jan. An okay afternoon of the day of increase. Sleep poor. Next day familiar anxieties. 

How do I keep in the loop of support here on this website please. 

I am very keen to tell my success story - yet it feels a way off at present.

Thank you for your help

[FireflyFyte]

12 hours ago, Kalagirl said:

I had a conversation with  a psychiatrist yesterday. He indicated he had no experience of up dosing to stabilise. He was very familiar with Benzo withdrawal - not SSRI withdrawals.

 

As Happy2Heal mentioned, very few doctors recognize withdrawals so am not surprised that he is unfamiliar.

 

 

12 hours ago, Kalagirl said:

How do I keep in the loop of support here on this website please. 

 

We ask that you keep your posts here on your introductory thread.

[Kalagirl]

Dear All, thank you very much for taking time to talk to me. I am aware that I need your insights very much as I reinstate, stabilize and negotiate the future.

I have indicated that I am reinstating. I am currently on 16 mg of Zoloft + a probiotic daily. This is day 2 of 16mg. Previous to this it was a week of 14mg, prior to that a week of 12mg and prior to that 2 weeks of 10mg. My mood has improved significantly in these weeks. I am now feeling quite level - with a low grade depression sitting in my stomach/body that intensifies several times a day and disappears in the evening. I am not experiencing any of the condemning dreads that were so terrifying in Nov/December. 

I have the attention of a GP - whom I visited today.  While they recognise my improved state on this low dose they believe I should go up to 50mg. Their explanation is that the dosage I am taking is too low - this is an insufficient amount sertraline in my system to be doing much good - ie. subclinical level.  I should persist with a larger updose.  They do reluctantly accept that I wish to reintroduce slowly. They however do not appear to recognise that  I am attempting to protect my poor unstable CNS  by doing this small-step updosing.  

I don't know if my low mood, nausea and gut symptoms  is withdrawal or are reinstatement problems. 

What I am trying to understand is how to move forward. Do I:

1) hang on 16mg for several weeks to see if my mood improves  - I am already having a couple of window days each week - and the depression is lowish?

2) move to 20mg next week to try and eliminate this low mood altogether and protect against potential anxiety overwhelms?

I try and stay busy, avoid stress, am grateful for all the special opportunities that exist in my life, eat small and well and exercise. 

Currently (late Jan 2024) in Australia there is a bit of Press activity regarding problems associated with withdrawal from ssris. My GP however, is an extremely busy person who may not imbibe much topical media. But there is a bit more illumination on the subject.

I look forward to your advice and insight please. While I am not in crisis I am in need of encouragement...

Thank you

[Kalagirl]

Hello Surviving Antidepressants,

I am just wondering if my message has been seen? I am so unsure as to what dosage to stay on when reinstating Sertraline. See message above. Please will someone let me know how questions on this wonderful site get answered. Do I wait for a while? Is my question irrelevant? Has it been answered elsewhere?

I dont want to be seen as  needy yet insight is sought from people who recognise withdrawal issues ...

My GP and psychiatrist believe I am a depressive and should whiz up to 50mg Sert. According to the GP the 16mg dose I am on is insufficient to be efficacious. According to them 25mg is sub-clinical. Yet if my mood is currently relatively stable on a 16mg dose - without the awful harsh swings of a few weeks ago - what is happening? 

I would love a bit of insight please. 

[FireflyFyte]

On 1/29/2024 at 11:51 PM, Kalagirl said:

1) hang on 16mg for several weeks to see if my mood improves  - I am already having a couple of window days each week - and the depression is lowish?

 

I would stay at 16mg and see if your windows continue to expand. The idea is to stabilize on the lowest dose possible.

[mstimc]

1 hour ago, FireflyFyte said:

 

I would stay at 16mg and see if your windows continue to expand. The idea is to stabilize on the lowest dose possible.

Hi Kalagirl.  Just to reinforce what FireflyFyte said, try to move away from thinking about reinstatement.  I had two failed tapers before I committed to an organized schedule of tapering.  I also started learning and practicing coping techniques for depressive thought cycles and feeling that you need to withdraw from the world.  I went through a period of the same feelings; I just wanted to stay home and be alone.  But I found that was the worse thing to do because it allowed by anxious and depressive thoughts freedom to control me without any distractions to rob them of their power.  It wasn't until I started practicing coping strategies that I was able to quiet the thoughts and calm my body as well.  And that helped me commit to sticking with my taper. 

[Kalagirl]

Dear Mstimc and FireflyFyte, you are the best! Thank you. The encouragement is very much appreciated.

I have ordered the new Maudsley Deprescribing book. When it arrives it will assist me in leaving Sertraline. 

And yes, feeling depressed does not mean one stays at home - one gets out and does it anyway. Through these wonderful online communities I am learning to recognise my strength/s and strategies in overcoming depression. (Anxiety has not been here for a month or so - that is different again).

I am working at present and have a plan to visit Africa shortly. How good an incentive is that? I also have a therapist, I exercise and talk to people. And where I live, it is so easy, comfortable and beautiful, I am a fortunate woman.

[mstimc]

What a wonderful and hope-filled post, Kala.  You will make it!

[FireflyFyte]

On 2/4/2024 at 7:45 PM, Kalagirl said:

I am working at present and have a plan to visit Africa shortly. How good an incentive is that? I also have a therapist, I exercise and talk to people. And where I live, it is so easy, comfortable and beautiful, I am a fortunate woman.

 

This is all wonderful. It is important to savor the positives during the tapering process.

[Kalagirl]

Dear 

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support crew, how do I add my current pharma story to my history? At present it does not reflect my present status. 

I have been on 16mg for nearly 4 weeks and am in a stable place. Sleep is not particularly good but I am laughing at times and eating too much (again) and not consumed by the dreads. I am wondering if I drop down to 15mg...

My Maudsley book has not arrived as yet so still travelling blind. 

Best wishes all....