Georgina: introducing myself

[Georgina]

Hi all,

 

I'm really at a loss of what to do - do I stay at 1mg liquid, which I have been since 8 December 2019, and see if the dystonia gets better? I'm almost sure the dystonia started around the same time I switched to a liquid solution last year March (2019). Or should I just stop taking the Sertraline altogether and see what happens as I'm only on 1mg - however, I'm very afraid of destabilising my nervous system more? Maybe it improves? Then I'm thinking maybe I should updose and go back to the tablet form and take as close to 1mg tablet form as possible (the Gemini scale isn't so willing to register such low amounts however). I'm really confused here and I'm finding these physical symptoms very difficult to cope with. 

 

Thanks

[Georgina]

I have decided to not take Sertraline for 7 days and see if there is improvement or a worsening of symptoms. If symptoms worsen I will reinstate at 1mg liquid which is what I’m on now. I think this is the most sensible approach to see if my physical symptoms are caused and/or exacerbated by the liquid solution. 
 

On a separate note, for the past year I have been diluting my Sertraline in water. I hope this is ok as I saw a post earlier saying it should be diluted in vodka. 

[Gridley]

18 minutes ago, Georgina said:

I have decided to not take Sertraline for 7 days

 

Jumping off at 1mg is a good bit higher than we advise and could  result in withdrawal symptoms the duration of which we can't predict

 

2 hours ago, Georgina said:

take as close to 1mg tablet form as possible (the Gemini scale isn't so willing to register such low amounts however).

 

1mg active ingredient of tablet weighs much more (perhaps ten times more) than 1mg, putting it within the accuracy range of the the Gemini scale.  It's important to distinguish between mg active ingredient (maai) and mg pill weight (mgpw).  We weigh using pill weight and keep track using active ingredient.  The scale is accurate to around 4mgpw, which would get you much lower than 1mgai, allowing you to switch back to the pill, which is a much less risky proposition than jumping off at 1mgai.

 

I've been tapering Lexapro using 20mgai tablets, which weigh 200mgpw.  So there's a 10:1 ration of pw to ai.  That's pretty standard.  When I was at 1mgai Lexapro, I was weighing 10mgpw of powder, well within the accuracy range of the scale.

 

Before you do anything, I suggest you weigh your tablet and see if this makes sense to you. 

[Georgina]

Hi Gridley, 

 

I don't understand this at all - the last way I weighed my tablet was the following way: 0.153/50 * 2 = 6. So, 0.153 (weight of tablet) divided by 50mg (50mg tablet) times 2mg (when I was on 2 mg) would equal 6 on the scale. Anything lower than this (6) the scale really battles to pick up or keeps jumping around. 

[Gridley]

11 minutes ago, Georgina said:

I don't understand this at all - the last way

 

I don't understand your methodology.  I've asked Brassmonkey, who's one of our moderators and is an expert on the Gemini scale, to take a look at your situation.

[Georgina]

Thanks, I haven't taken Sertraline today and really need some help here because I'm feeling a little desperate to be honest. 

[Gridley]

7 minutes ago, Georgina said:

I haven't taken Sertraline today

Take it now until we've straightened this out.  It doesn't matter that you're taking it at a different time today.

[Georgina]

Thanks - I just did take it - the liquid form. I'm really worried about this because I've been taking the liquid for a year now and don't know if that's what sparked my dystonia, which started around the same time as I switched to liquid, and maybe I've left it too late to go back to tablets. 

 

I'm really a bit freakout out - I even paid £30 now for a consultation on an anxiety website but changed my mind and asked for my money back. I'm all over the place. I'm struggling with intrusive thoughts on top of everything as well. The dystonia really freaked me out because yesterday a friend "helpfully" commented "I can see your neck is giving you trouble. You must sort it out!". I thought it wasn't that obvious but obviously it is. 

 

Thanks for helping. 

[Gridley]

2 minutes ago, Georgina said:

 

Thanks - I just did take it - the liquid form. I'm really worried about this because I've been taking the liquid for a year now and don't know if that's what sparked my dystonia, which started around the same time as I switched to liquid, and maybe I've left it too late to go back to tablets. 

 

 

Good.  Let's wait until Brassmonkey comments and we can see if going back to the tablet is a good option.

[Altostrata]

On 9/8/2019 at 11:45 AM, Altostrata said:

....Do you do a lot of mousing with your right hand at the computer?

 

 

Are you right-handed? Do you do a lot of repetitive movement with your right hand and shoulder? Are you able to do any gentle stretching of your right arm and shoulder?

 

I asked because in withdrawal I developed a severe pain syndrome in my right shoulder, arm, and hand, with spasms in my right upper back and shoulder, sometime traveling to my neck, which lasted for 1.5 years. I had numerous chiropractic treatments but all the symptoms completely resolved with one acupuncture treatment.

 

I believe all of this arose because withdrawal hypersensitivity combined with hours of right-handed mousing, which ordinarily might have caused a much milder repetitive stress injury. My chiropractor gave me some exercises which I do occasionally to this very day to relieve my bad RSI habits. One is "pea-picking", where you reach up as high as you can with both arms, as though you're picking peas off a tall vine.

 

Are you taking any other drugs? Do you have any other symptoms? Do your symptoms follow any daily pattern?  Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms throughout the day. You can post 24 hours of notes at a time in this topic, in a simple list format with time of day on the left and notation (symptom or drug and dosage) on the right.

 

If I were you, I would hold on my drug dose for now.

 

[brassmonkey]

I think a slight updose and long hold will be more effective.

 

The shoulder pain starts before the switch to liquid by a month or so according to your signature. A good indicator that it's not the liquids fault.  Also if you review your taper schedule starting in January of 2018 you'll find that by decreasing at a set  amount the percentage increases out of range quite quickly. The first few reductions are not too bad being in the 10% range, but by September you are decreasing by 12%, then 13, 15, 17, when the pain starts and then 20%.  This is followed y 10% and 12%. A lot of this being done on a four week schedule.  I think the shoulder pain started by decreasing too much too fast and the continued reductions haven't allowed it to resolve and heal.

 

A small updose, I'd try 1.8mgai for a few weeks and see what happens then maybe go up to 2mgai, and hoId. I wouldn't expect the shoulder to  clear up immediately with the updose, it could take several months to resolve, and may come back in a windows and waves pattern. While you're waiting it out I would try massage, letting the hot water run on it in the shower, mild stretching and movement through out the day, and a hot pack in the evening.  There are plenty of instructions on line for making them.  Those are the things I've been doing for mine and they seem to help.  Mine is more of a physical problem caused by age and abuse, but methods to relax the shoulder are still the same.

[Georgina]

Hi Altostrata, 

 

Thanks for replying. I am right handed but don’t really do repetitive movements I don’t think. I can stretch fine - I did see someone who did acupuncture in May last year but she focussed more on my shoulder than neck. 
 

I’m only taking Sertraline 1mg per day, in the morning, in a liquid suspension I make myself. I’m not certain about a daily pattern but I will keep a diary and that might shed some light. In terms of other symptoms - I have a lot of intrusive thoughts and sometimes think I’m hearing things that are actually there but then wonder if they actually are or not. It freaks me out a bit. I also cry a lot. 
 

Do I post the simple list format here, in introductions and updates? 

[Georgina]

12 minutes ago, brassmonkey said:

I think a slight updose and long hold will be more effective.

 

The shoulder pain starts before the switch to liquid by a month or so according to your signature. A good indicator that it's not the liquids fault.  Also if you review your taper schedule starting in January of 2018 you'll find that by decreasing at a set  amount the percentage increases out of range quite quickly. The first few reductions are not too bad being in the 10% range, but by September you are decreasing by 12%, then 13, 15, 17, when the pain starts and then 20%.  This is followed y 10% and 12%. A lot of this being done on a four week schedule.  I think the shoulder pain started by decreasing too much too fast and the continued reductions haven't allowed it to resolve and heal.

 

A small updose, I'd try 1.8mgai for a few weeks and see what happens then maybe go up to 2mgai, and hoId. I wouldn't expect the shoulder to  clear up immediately with the updose, it could take several months to resolve, and may come back in a windows and waves pattern. While you're waiting it out I would try massage, letting the hot water run on it in the shower, mild stretching and movement through out the day, and a hot pack in the evening.  There are plenty of instructions on line for making them.  Those are the things I've been doing for mine and they seem to help.  Mine is more of a physical problem caused by age and abuse, but methods to relax the shoulder are still the same.

 Hi Brassmonkey, 

 

Thanks for replying. So should I stay on the liquid then as I am and go to 1.8mg? I’m on 1mg now - isn’t 1.8mg quite a big jump? What does mgai mean? I guess mg is milligrams?

 

Altostrata suggested holding my current dose for now - so, I’m a bit confused. 

 

If I hold my current dose could this dystonia resolve eventually or must I increase? 
 

My drops are more than 10% at a time because that’s the only syringe I could get - in .2ml increments. So, the syringe starts at 0 then .2; .4; .6; .8 and then 1 and so on. I hope that makes sense. 
 

Should I just stay on the liquid and not go back to tablets? I mix 50mg tablet with 50ml water, shake, and refrigerate. When I draw out the liquid, I shake the bottle first, pour some liquid into the lid, withdraw immediately from the lid using the syringe, and drink. I put the remaining liquid from the lid back into the bottle. I do the same thing every time. 

[brassmonkey]

I see from your post that you are actually on 1mgai.  I was going by what your signature said when I suggested updosing to 1.8. Which you are correct in thinking is too much. You could hold like Alto suggested or you could try a small updose, more in the 1.2mgai range.  Either way your body needs stability and a long rest.  The updose would primarily be to  relieve some of the symptoms you are feeling. The hold is the important thing. As you hold the dystonia should start to resolve itself and lessen.

 

mgai means Milligrams Active Ingredient and refers to the strength of the dose. When people are using the dry cutting method with a scale there are two different weights that are involved.  The strength of the dose and the weight of the dose. Two different things but both weighted in milligrams. So we refer to the strength as mgai milligrams active ingredient and the weight of the powder or pill as mgpw milligrams pill weight.  It makes it a lot easier to understand what is being talked about.

 

I can see your point about dose sizes and the syringe size.  A fun thing about making your own liquid suspension is that you can play with the dilution ratio.  If you use twice as much water you get a liquid that is half as strong. So you have to take twice as much to get the same dose strength.  Using a 50mgai tablet and 50mL of water will give you a ration of 1/1 and is referred to as the AIC Active Ingredient Concentration. If you double the water you get a ratio of 1/2 which is an AIC of .5.  By using this new solution and your old syringe you would draw up say .2mL and that would give you the same amount of Active Ingredient as if you had a syringe marked in .1mL increments. Hope that makes sense.

 

Yes, I would stick with the liquid.

[Georgina]

24 minutes ago, brassmonkey said:

I see from your post that you are actually on 1mgai.  I was going by what your signature said when I suggested updosing to 1.8. Which you are correct in thinking is too much. You could hold like Alto suggested or you could try a small updose, more in the 1.2mgai range.  Either way your body needs stability and a long rest.  The updose would primarily be to  relieve some of the symptoms you are feeling. The hold is the important thing. As you hold the dystonia should start to resolve itself and lessen.

 

mgai means Milligrams Active Ingredient and refers to the strength of the dose. When people are using the dry cutting method with a scale there are two different weights that are involved.  The strength of the dose and the weight of the dose. Two different things but both weighted in milligrams. So we refer to the strength as mgai milligrams active ingredient and the weight of the powder or pill as mgpw milligrams pill weight.  It makes it a lot easier to understand what is being talked about.

 

I can see your point about dose sizes and the syringe size.  A fun thing about making your own liquid suspension is that you can play with the dilution ratio.  If you use twice as much water you get a liquid that is half as strong. So you have to take twice as much to get the same dose strength.  Using a 50mgai tablet and 50mL of water will give you a ration of 1/1 and is referred to as the AIC Active Ingredient Concentration. If you double the water you get a ratio of 1/2 which is an AIC of .5.  By using this new solution and your old syringe you would draw up say .2mL and that would give you the same amount of Active Ingredient as if you had a syringe marked in .1mL increments. Hope that makes sense.

 

Yes, I would stick with the liquid.

Thanks very much for replying. Okay, I will stick with 1mg and hold it for as long as I need to start feeling better. I don’t think I’m going to write a symptom diary, however, because focussing too much on my symptoms seems to have a bad effect on my state of mind. I’ve just started a new job too (I’m a teacher) so this is probably also why I’m all over the place. I’m very grateful for the help here. 

[Georgina]

On reflection I think I might updose slightly to 1.2mg and hold that for some time. 

[Georgina]

Is there still a donate to SA option on this website? I can’t seem to find it. 

[Gridley]

@Georgina  Via PayPal.  See the very first post on this link.

 

Donations gratefully accepted - Surviving Antidepressants

[Georgina]

Hi all, 

 

I thought I’d give an update. I went back up to 1.2mg and the intrusive thoughts aren’t as bad although the dystonia is still bothering me a lot. I’m all over the place emotionally though - I think I want to leave my husband, then love him with all my heart the next second. It’s so very tiring. I’m also (and have been working on this for the past year) cutting down contact with my mother as I feel our relationship is unhealthy and sometimes I think she’s got narcissistic tendencies and is very mean to me, but then I think about all she has done for me and I feel terribly guilty. Especially since my dad died just under two years ago and he really loved her and I never wanted to disappoint him. So, many things going on. I’m just a bit concerned as my moods are all over the place and they’re very rarely happy. I just started a new job after being unemployed for a year so that’s helping to keep my mind busy. It’s a temp contract until May so a bit worried about thereafter. It’s a stressful job - still teaching- but I’m taking one day at a time. 
 

Thanks again for all the support on here. 

[Georgina]

Hi all, 

 

I’m going back down to 1mg tomorrow as I really feel that the Sertraline is causing the dystonia. My neck won’t stop pulling to the right and I keep having this facial spasm too. I’m going to speed up and get off Sertraline as soon as I can because the dystonia is causing me great distress. It’s worse since I went back up to 1.2mg. The intrusive thoughts are better though. I really feel like I have to stop as soon as I can so that my neck returns to normal. 

[IWantToHeal]

Georgina what's happening to you with your neck/head sounds very similar to what I experienced with Sertraline. My head was leaning to one side for a while. I had the facial spasms too. 6 months later and the neck issue is largely gone. It did persist after stopping Sertraline for a while though. Horrible drug. You are doing the right thing to taper slowly though.

 

 

 

 

[Georgina]

49 minutes ago, IWantToHeal said:

Georgina what's happening to you with your neck/head sounds very similar to what I experienced with Sertraline. My head was leaning to one side for a while. I had the facial spasms too. 6 months later and the neck issue is largely gone. It did persist after stopping Sertraline for a while though. Horrible drug. You are doing the right thing to taper slowly though.

 

 

 

 

Thank you for posting. The neck thing started for me around last April or so and started getting progressively worse. It’s really hard to cope with. I had a parents evening tonight and my face kept spasming and I couldn’t keep my head straight. I really do need some hope here. So thank you. 

[Georgina]

Hi, please can someone tell me whether it’s a safe option to take a bit of Benadryl to help with the dystonia symptoms and facial spasms I’m experiencing.  I don’t want to swap one drug for another and just want to know what the implications are. The tablets contain certitizine dihydrochloride 10mg. I took a quarter of one today and think it helped a bit. I’m currently on 0.3mg Sertraline. 
 

 

[Georgina]

Hi, please can someone advise: 
Hi, please can someone tell me whether it’s a safe option to take a bit of Benadryl to help with the dystonia symptoms and facial spasms I’m experiencing.  I don’t want to swap one drug for another and just want to know what the implications are. The tablets contain certitizine dihydrochloride 10mg. I took a quarter of one today and think it helped a bit. I’m currently on 0.3mg Sertraline. 

[Rosetta]

Hi Georgina,

 

I have had dystonia, too.  It was in my neck and face, also.  I still feel it part of the time, but it’s much less intense.  It will go away eventually.  Benadryl does seem to help, but you can’t take it every day.  Only occasionally.    You can become dependent, and it will stop helping.

 

For me, dystonia got worse after I quit sertraline cold turkey, so I would not recommend that as a solution.  I didn’t taper, but I understand that reducing the last milligram is a slow process.  I don’t  think sertraline is causing it to be worse.  The fact that you took sertraline probably caused it to appear, but you can’t necessarily stop dystonia by stopping sertraline.  It’s not a side effect that is guaranteed to go away if you CT.  In fact, CT is the last thing you need just as a fast taper is.  You should stabilize and then go slow.

 

Please try to ignore the feelings about your husband for right now.  You can’t trust your feelings at this time.  Don’t make any decisions now.  Stay the course, and you will know what you feel after you stabilize.  It is all a part of the brain being rattled by the WD.  

 

Best of luck, Rosetta

[Georgina]

7 minutes ago, Rosetta said:

 

Hi Georgina,

 

I have had dystonia, too.  It was in my neck and face, also.  I still feel it part of the time, but it’s much less intense.  It will go away eventually.  Benadryl does seem to help, but you can’t take it every day.  Only occasionally.    You can become dependent, and it will stop helping.

 

For me, dystonia got worse after I quit sertraline cold turkey, so I would not recommend that as a solution.  I didn’t taper, but I understand that reducing the last milligram is a slow process.  I don’t  think sertraline is causing it to be worse.  The fact that you took sertraline probably caused it to appear, but you can’t necessarily stop dystonia by stopping sertraline.  It’s not a side effect that is guaranteed to go away if you CT.  In fact, CT is the last thing you need just as a fast taper is.  You should stabilize and then go slow.

 

Please try to ignore the feelings about your husband for right now.  You can’t trust your feelings at this time.  Don’t make any decisions now.  Stay the course, and you will know what you feel after you stabilize.  It is all a part of the brain being rattled by the WD

 

Hi Rosetta, 

 

Thank you so much for replying. I really needed a bit of help with this - especially understanding if Benadryl is safe. I won’t take it every day. I am going to try and hardly take it at all as I don’t need another problem. I’m on 0.3 mg Sertraline now and have been withdrawing the last 1mg since December 2019. I will stay on 0.3 mg for another week and then drop. I do feel like it’s taking me too long now. I’m trying to be as stable as I can. 
 

Things are a bit tough at the moment. There are good moments and bad moments. 

[Rosetta]

Ok.  You have been doing this for quite a while.  I suppose you have heard that the effects of the drops can pile up on each other, and you can be suddenly hit with bad symptoms?  That may be what happened when the facial spasms started in December of 2019.  People go along just fine and suddenly find that they can’t drop by 10% any longer or that they need longer holds.  

 

Did the dystonia get worse after you reached 1 mg?  Is it too hard to measure the doses in order to decrease by 10 percent (or less) of the last dose?  If you keep feeling bad you might want to consider holding longer between drops maybe. 

 

I’m concerned that you might have problems other than dystonia.  I haven’t read your entire thread.  

 

Some people find the last milligram to be very different than the previous mgs.  They have to slow way down, and some drop by tiny amounts if they can figure out how to do it.   I assume it’s very hard to do, but I’m worried because my dystonia got quite bad.  It was in my foot and leg, and I kept falling down the stairs.  However, I had problems bigger than that.  I developed akathisia.

 

 

Well, there’s my unsolicited advice.  I hope it’s not like that for you.

 

Take care, Rosetta

[Georgina]

Thanks for the advice. I really appreciate it.