Singa: Severe Paroxetine withdrawal or reaction to Sertraline

[Singa]

 

I have been on antidepressants for most of my life, starting at around age 12 due to extreme panic attacks and anxiety. Therapy alone wasn’t effective for me, so I continued using medication. I took 20mg of Paroxetine for about 10 years and later reduced it to 10mg. In 2012, I decided to try living without medication and tapered off Paroxetine completely. I went without medication for about a year but eventually, anxiety and depression returned, leading me to resume Paroxetine at 10mg, which made a significant positive difference.

In 2023, my partner and I began considering having a baby. I was concerned about the potential effects of Paroxetine during pregnancy on the baby's development, so I decided to switch to Sertraline (25mg) in October 2023. At the same time, I also had my IUD removed. Unfortunately, my GP advised a direct switch between the medications without a cross-taper. As a result, I experienced side effects similar to those I had felt when missing doses of Paroxetine, such as dizzy spells and vivid dreams, and my anxiety worsened significantly. However, after increasing the Sertraline dosage to 37.5mg, my mental health stabilized.

This stability lasted until late February 2024, roughly four months after the medication switch. It began with flu-like symptoms, sinus pressure, stabbing sensations in my ears, and an unusual form of dizziness/brain fog. Suspecting an ear infection, I was prescribed antibiotics, but they didn’t alleviate my symptoms. The headaches intensified, and I became extremely sensitive to sounds, bright lights, and screen exposure. I also experienced derealization, poor sleep, and difficulties reading, as it would worsen the brain fog and headaches. It felt like my brain was struggling to process information.

Feeling miserable and unsure of the cause, I started experiencing panic attacks again. Lacking confidence in my GP, I turned to extensive online research, eventually discovering a website where people described symptoms similar to mine, which I suspected were withdrawal-related. After consulting another GP, I increased my Sertraline dose to 50mg, hoping it would help. While my anxiety lessened somewhat, the withdrawal symptoms persisted.

Believing that Paroxetine withdrawal was the root of my symptoms, I hoped they would gradually subside over time. I’m trying to cope with the symptoms by making adjustments, such as wearing a hat in sunny conditions and listening to audiobooks instead of reading. Structure is important to me when I’m anxious, so I’ve continued working, although my symptoms often worsen throughout the day as I spend a lot of time on the computer.

As of today, I am still experiencing the following symptoms:

• Brain fog, extreme sensitivity to sounds and bright/sunlight.
• Headaches and sensory overload when focusing on reading/writing or screens, which also distorts my eyesight (everything appears to have more contrast, and I have to make an effort to focus my eyes).
• A constant feeling of not really being present, difficulty focusing, and problems with memory. All these symptoms seem to be related to the way my brain processes information.

Some weeks I can accept how I feel, hoping the symptoms will eventually disappear. However, on particularly bad days, I consider going back on Paroxetine. But after reading so many negative stories about it, and considering that I’ve been off it for over nine months, I’ve hesitated to return. The uncertainty of whether these symptoms will ever go away and how long I should continue trying to manage them is very stressful. I know there isn’t a simple answer, but I would appreciate any advice or shared experiences.

Additionally, since my symptoms are so similar to the withdrawal symptoms described by others, I initially assumed they were related to Paroxetine withdrawal. However, since they don’t seem to be improving over time, I’m starting to wonder if they might be a delayed response to Sertraline.

I’m also considering switching to a different SSRI (such as Citalopram or Prozac) to see if the symptoms are related to Sertraline. Does anyone have any advice or experience with this?

Edited August 17 by Emonda
Name to title

[LotusRising]

Hi @Singa

 

Welcome to SA.

 

Could you please help us out by creating a signature. How to Create a Signature. This ensures that your history appears at the bottom of every post and makes it easier for others to assist. 

 

You are correct, these symptoms sound withdrawal-related, likely a result of making that direct switch, but it would be helpful to see the timeline from your medication history. I'm particularly interested to know exactly when you started sertraline and how your symptom pattern changed.

 

48 minutes ago, Singa said:

It began with flu-like symptoms, sinus pressure, stabbing sensations in my ears, and an unusual form of dizziness/brain fog.

You mentioned these symptoms occurred in the beginning. Have they gone away?

 

58 minutes ago, Singa said:

However, since they don’t seem to be improving over time, I’m starting to wonder if they might be a delayed response to Sertraline.

If you haven't read through the The Windows and Waves Pattern of Stabilization link yet, you might start there. WD symptoms have a way of changing over time and some can hang on for longer than others. Do you track your symptoms?

 

 

 

[Singa]

Dear LotusRising,

 

Thank you for your response. I have added my signature. 

To answer your questions:

You mentioned these symptoms occurred in the beginning. Have they gone away?

These symptoms stared about 4 months after the switch. Something I obviously did not expect to happen after such a long time after the switch. The flu-like symptoms, the ear pain, sinus pressure and head twitching are mostly gone. I do still experience most of the other symptoms.   

 

If you haven't read through the The Windows and Waves Pattern of Stabilization link yet, you might start there. WD symptoms have a way of changing over time and some can hang on for longer than others. Do you track your symptoms?

I have been tracking my symptoms since March. I do see some improvement in certain symptoms, as I mentioned above, but the overall feeling of brain fog and impaired sensory processing is still very much present. It’s worse at certain times, but it doesn’t feel like it’s getting any better. 

 

Thank you for providing the link to the article. I have read the article before, but will read it again. I also found this tread about Zoloft: 

The symptoms Dahlia50 describes are very similar to mine, which make me think it might be a reaction to the Sertraline. I take my meds before bedtime so hard to tell if my symptoms get worse right after intake. But I wonder if such symptoms can appear 4 months after starting the medication.

 

Warm regards,

 

Singa

[Singa]

On top of the existing symptoms, I have been experiencing severe panic attacks again. I would very much appreciate it if my content could be posted as I can really use the support!

[LotusRising]

2 hours ago, Singa said:

I would very much appreciate it if my content could be posted as I can really use the support!

Hi @Singa, sorry it has taken longer to respond. The site has been very busy, we have limited moderators and personally, I am not on the site as frequently over the weekend.

 

On 8/16/2024 at 6:52 PM, Singa said:

But I wonder if such symptoms can appear 4 months after starting the medication.

 

I think it's more likely that your symptoms are a result of nervous system destabilization from stopping paroxetine, direct switching to sertraline and having your IUD removed all at the same time. However, it would not be unheard of for at least some of these symptoms to be related to sertraline. 

 

Do you recall any symptoms on initial start-up of sertraline?

 

[Singa]

Dear @LotusRising,

 

Thanks once again for your response  and taking the time to think along. I didn’t mean to be impatient, it’s just that the panic attacks make me feel very desperate and anxious. 
 

To answer your question, I can’t think of any symptoms I experienced when starting Sertraline other than a dry mouth, sweaty palms and increased anxiety. But these went away after a couple of weeks.    

I am going to start taking magnesium supplements this week. I am hoping this will alleviate the panic attacks a bit. 

 

[LotusRising]

5 hours ago, Singa said:

I didn’t mean to be impatient, it’s just that the panic attacks make me feel very desperate and anxious. 

No worries at all. I understand the frustration. Have you tried any breathing exercises?

 

Have a look at these threads. You might find some useful tips:

 

 

 

[Singa]

@LotusRising This is incredibly helpful—thank you so much! I’ve tried so many techniques to calm myself, but during a panic attack, I struggle to focus on my breathing. However, reading these threads encourages me to keep trying.

[LotusRising]

The breathing exercises get much easier with practice. But another strategy I found really effective was simply getting out for a walk -- really helped to get my breathing regulated enough to practice the exercises in a more relaxed state.