Katzin: Need support with the endgame - sertraline

[Guest]

Hello all! 

I've been reading this forum for 2 years now. 

As I arrive in the very small dosages of my lovely drug, I thought it was time to have/give some support.

 

My story is nothing special. Burnout, put on escitalopram (no major issues with it but I was never able to take more than 5mg (migraines)) and bromazepam on demand (major issues, paradoxal reaction). Stopped escitalo cold turkey and appart from weird thoughts, I was ok. Started taking bromazepam 10mg daily to sleep and became half crazy (anger issues)

A hellish tapering left me with a massive anxious "pressure" in the plexus area and my doc prescribed me Serlain (sertraline) 50mg. 

Quite frankly I don't remember my time on it between 2017-2020, I was unable to find a work, navigated between sickleave and benefits (I am based in Europe so it was somehow an easy life as I didn't have to fight for a living - having no rent to pay helped as well - living with my parents not so much as I used to be very independant), back pain and brain fog, anhedonia... I saw all the specialists possible and of course nothing was wrong about me. I knew that but back then thought it was  protractive withdrawal symptoms from the bromazepam taper. So did my GP.

I was only able to do what I like: travel and blog about travelling. 

In 2020, I was hit by a major depression episode. Covid and personal issues surely didn't help but I wonder if I didn't stop the AD cold turkey at the end of 2019. When I saw a psychiatrist in the fall of 2020, I remember him telling me "the ad is working" during our second appointment. 

Then I saw a bunch of useless psychologists who couldn't understand I had no psy problems and that I was able to explain my physiological issues very thoroughly (I am HP, so need for someone understanding how my brain works and couldn't find anyone - sidenote saw one last Sept who told me "it is very long for a taper. Are you sure it is not long Covid?". Needless to say, never saw her again).

But I disgress. 2022, the heavy pressure in my plexus stopped so I thought it was a good time to stop serlain. I also started to experiment weird manic episodes. I was too sociable, too happy... 

I spent a few months at 25mg, only had heavy legs, migraines and back pain suddenly stopped. Then 12.5mg. Same. Stopped and ahah spent an afternoon planning my suicide. Went back to 12.5mg, it stopped a few hours later. 

I then stabilised at 12.5mg but not long enough and at 9mg a few months later, I hit a wall and had to go back to 12.5mg. I think it is then that I found this forum.  

I experimented windows and waves, single episodes of depersonalisation, derealisation, dysmorphophobia, paranoia, bladder sensitivity (side note - I took omega 3 for 1.5years, stopped it in september because I had no refill, and when I started again, the bladder issue came back. Same when using valerian to sleep). I took oxybutinin for the bladder and it worked well. Bladder calmed down at 2.6mg I think.

Brain fog started to lift last May, coming back from time to time. I have blurry vision that gets worse every time I lower the dose, tinnitus (from the burnout though), bits of hyperphagia from time to time (It was constant from 2016 under bromazepam until I tapered sertraline at 8mg, and since last January I've lost some 25kilos without dieting).

Last september I tapered too fast because I was feeling great and had SI for the first time of my life. Not recommended.  Have finally found a good doctor who knows what is happening with me and I am lucky that the social security doctor who follows my sickleave aknowledges the existence of what I am experiencing, giving me time to go as slow as needed.

All in all I would say I am ok-ish, have projects, started a few courses on Coursera, can feel my brain working again (even started Japanese as it needed a challenge) and can travel again without being overwhelmed by the "what if". But I still have ruminations (never had any before the AD) especially about how to find a job after so long out the job market (success stories and tips are welcome because it is truly my main rumination subject). Crying spells are common too. Funny thing: the bromazepam taper was physically painful, this one is psychologically painful. Well, I prefered the first taper!

I have had almost all the symptoms listed on the AD notice during the tapering.

 

As for other meds and supplements

Lysanxia (prazepam) on demand (I need it as it is the only thing that calm that fight and flight feeling ending in SI or rumination or paranoia).

I stopped zolpidem (ambien) last month (I did taper - never had issue stopping that one), using some equivalent to benadryl now. I do have the morning cortisol rush but I sleep in pitch dark already.

Magnesium

1/2 a pill of B vitamins

1.6mg serlain as of tomorrow.

 

My future ex doc (not the good one, one I still have to see for admin reasons) put me on tryphtophan to "help". Did not work at all.  Didn't want to believe my thyroid issues were linked to the taper (my endocrino said it was ffs), put me on Thyrovance. Impossible for me. Wanted to put me on hormones, I said NO! I had a vitD deficiency. He put me on high dose, almost died. So my policy now is less is better and I see him only if I have a cold! I have an appointment with my endocrino in January for a full check up and I will see the other doc when I am at 1mg sertraline.

 

My pharmacy is making my doses btw. I adjust the lenght according to how I feel but I usually lower the dose every 3 weeks. In Belgium, withdrawal symptoms are aknowledged, but the taper plans proposed are still too fast. 

 

Now, I am going to see how to add the signature. 

 

Thanks for reading my roman. Didn't even have to use chatgpt this time, yeah me!

 

Edited because the fact that I did start using lysanxia from dec 2019 as per my calendar does suggest a stop from sertraline.

 

[Emonda]

Welcome @katzin

 

I'd be very careful of taking some of the drugs you mention 'on demand'. You don't want to find yourself dependent on them.

 

As to sertraline, I can see a line of doses you have taken in 2024; however, there are no dates. We need to see the date/dose, to be able to be able to provide any comments. I see you make the comment you usually drop every three weeks. The approach here is a maximum of 10% every 4 weeks. When people taper too fast, it can catch up with them.

 

If you were doing 10% every 4 weeks, I'd expect you to be around 2.6mg, however you are at 1.6mg. That would suggest you have been reducing by close to 14% per month...more than the recommended on this site.

 

Once you add some details, we will try to assist.

 

Emonda

[Guest]

Hi Emonda,

Thanks for your reply.

I taper between 8 to 12%. Won't do it again. At some doses, I am able to taper faster so I am not following a strict 3 weeks schedule. Sometimes it is faster, sometimes slower. Symptoms appear in the first 2 weeks.

I did messed up in September though, and it did catch up with me beginning of October. I won't go that fast again!

 

As for lysanxia on demand, I know the risk but I am willing to take it. I know the recommendations here are the slower the better but I just can't go that slow.  I usually stabilise when I travel, staying on the same dose for 2 months. The doc I see recommands I use lysanxia when the "fight and flight" feeling starts and it worked well so far. I don't use it for other symptoms.

 

I've updated my signature.

 

 

Cheers

[Guest]

.

[BillDz]

Hi,

 

Thanks for sharing how things are going!

 

I just wanted to mention something about Lysanxia since it’s a benzo—it can be easy to become dependent on it, even when using it on demand. I totally get that it’s helpful for those “fight or flight” moments, but over time it could make it harder to manage anxiety without it.

 

It’s good that you’re working with your doctor and staying mindful of the risks. Maybe it could help to try some other techniques for those intense moments, like grounding exercises or deep breathing, to rely on the meds a bit less.

 

You’re doing great—tapering isn’t easy, but you’ve got this!

 

Take care,