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  1. Hello everyone, This is my first post and I want to apologize for my poor English, I’m a French Canadian. I will try my best! My story started in 2007, when my GP put me on mirtazapine because I was suffering a big bout of insomnia, following a stressful year. I was a young 27 year old woman without any health issue and I was very naive at this time. I trusted my GP a lot. Big mistake! I went to see a psychologist and did some cbt. This allowed me to taper down my mirt, so after 5 months of tapering, I stopped mirtazapine. Of course, no one has told me about withdrawal syndrome, so I thought that the rebound of insomnia (from mirtazapine) was a relapse. This is where my GP decided that I had a general anxiety disorder. I was now labeled. She put me on celexa 20mg (with seroquel 25mg). 4 months later, I got pregnant, so my dear GP asked me to quit Celexa and seroquel asap. I immediately stopped seroquel and I tapered down celexa from feb 2009 and stopped it by July 2009, at 6 months of pregnancy (My GP assured me it was safe for my baby). I already had the intuition that a rapid weaning was not a good idea. I didn’t suffer any w/d symptoms at that time and finished my pregnancy in pretty good shape. Few months later, 2 months after giving birth, I had a relapse of anxiety in the form of my dear insomnia coming back. Of course, my GP wanted to put me back on AD. This is where we started to have trouble finding an AD that was working for me. Celexa wasn’t working anymore. I tried cymbalta and it wasn’t working either. I tried Paxil and it finally worked. I stayed on Paxil for four years and a half. By mid 2014, after some stressful events, I started to feel that it wasn’t working anymore. My GP asked me to quit Paxil fast then switch to mirtazapine. So I quit Paxil within 3 weeks. After the last dose, I had very hard time for the first 3 weeks. Then she put me on mirtazapine 30mg and Pristiq 50mg. I stayed on this cocktail for some years. At some point, I asked my GP if I could stop my AD, but she explained to me condescendingly that I was like a diabetic with insulin, I couldn’t live without those meds. She was destroying my self confidence. In 2018, I decided to stop Pristiq because I wanted to have only one AD to take. I taper down Pristiq , by switching to effexor, relatively slowly (but more than 10%) and stopped it by January 2019. My GP upped my dosage of mirtazapine to 45mg to compensate. This is where problems started. I didn’t feel any w/d symptoms in the beginning, but slowly, during the next months, I started to feel more and more anxiety. By May, I had a big relapse of anxiety related insomnia. I overcame my insomnia with cognitive behavioral therapy, without any meds. This gave me some confidence so I decided to wean myself of any drugs. I started a slow taper of mirtazapine . I decreased my dose by 10% each 2 weeks. In august, I reached 30mg of mirtazapine and decided to make a little break from tapering and stayed on that dose for few weeks. Unfortunately, during that break, I’ve had the biggest relapse of anxiety of ALL my life! Of course, my GP asked me to return at 45mg of mirtazapine. But it didn’t improve my mood. Since then, I’m struggling with a lot of anxiety and I’m not able to get rid of it. I’m experiencing big mood swings. Sometime I see some improvement, then the next week I fall again in a deep hole of anxiety. I don’t understand myself anymore. It’s like I’m a stranger in my own body! Worst of all, 4 weeks ago, I started to have OCD like obsessive thoughts and that’s very unusual to me, because I never had OCD before and I'm 40! I’m actually seeing a good psychologist, but even with that, I’m not able to cope. So I’m here and I really don’t know what to do. I’m very desperate because I don’t understand what’s happening to me. I have the feeling that mirtazapine is pooping out and that it causes some of my problems. Maybe I’m always on the rebound of stopping Pristiq to. Who knows! This is why I would like to stop this drug and heal myself from all this toxic stuff!! Sorry, I had a lot to say... Thank you
  2. Before describing my situation, I want to start by thanking all those who have posted here, particularly those few who keep it updated and try to organize it. Even though today I'm in at a really low point, the information I've found here has been extremely valuable. I hope that I can not only continue getting good information, but that maybe my story might help somebody else sometime. Apologies in advance if I am too long-winded or detailed. CASE HISTORY AND WD SYMPTOMS: I'll skip the ancient history. In short I started taking citalopram in my twenties for depression., and I'm now 46, so it has been around 20 years. I can't recall dosages, but for the last few years I've been on only 10mg. Finally feeling like I was in a fairly stable place in my life, I thought I'd see if I could go off them. I knew this had to be done "slowly", but what this meant exactly was pretty vague. I dropped down to 5mg, and stayed like that for a long time (6 mo?), with no ill effect. I had the impression that this was the lowest medically effective dose, so I could do no more tapering. I may have done a couple weeks of every-other-day, but in February 2020 I stopped altogether. I thought (wrongly, it seems) that was tapering enough. I recall having a couple of weird initial weeks, but I'd describe the withdrawal symptoms as manageable (no depression, just dizziness, lightheadedness, nausea and what I now know to be "brain zaps"). My doctor had given me 0.25mg tablets of Alprazolam (Xanax, "benzo") and I was instructed to take 1/2 a tablet only when feeling sufficiently bad, but I tried to take that as little as possible. These symptoms mostly lifted, and, if I recall correctly, I proceeded to have a couple of quite decent months. It was a lovely spring in spite of Covid, I was focused on my work and quite happy overall. But there were some odd things: I was irrationally irritable and easy to anger. Idiotic things (the sound of food being chewed, etc.) were extremely irritating to me. Then, at the end of April, I had a really horribly depressed day out of nowhere, and my sleep started to fall apart. I would wake up every night at almost exactly the same time, around 5am, and I'd be extremely hot (night sweats). I also started experiencing serious pain in the back of my neck, which I attributed to sleeping funny and a fall I had while skiing several months prior. At this point I had made no connection between these symptoms and coming off the SSRI, as I had never heard of SSRI withdrawal syndrome. But something wasn't right, and even the zopiclone I was given for temporary help sleeping didn't prevent the 5am wake up. I started keeping a journal, charting my sleep, exercise, sleeping-pill intake and so on. My strong feeling was that I didn't have a "mental" problem (not depression, not anxiety), I had a hormone problem causing sleeplessness. My mind might race a bit, but my symptoms all felt more physical than emotional. I recall forcing myself to get exercise (short runs) and eat healthy (lots of smoothies, etc). At this point I googled something about irritability and SSRIs, and made my way to this site. Here I learned (from "Altostrata" - thanks) that my nervous system was likely hypersensitized, and the 5am wake-up was caused by an over-reaction to the hormone cortisol, which is naturally released around dawn to start the wake-up process. This made a lot of sense, and explained my situation perfectly. (Thank you again!) THE IMPORTANT PART FOR ME NOW: I experienced several "windows" (term used on this site and elsewhere to indicate a period of mostly clear, good days, in contrast with "waves" of heavy symptoms), but by the end of July I began to think I needed to go back on something. My goal, then and now, is quality of life, and if that meant I did indeed need some small quantity of drug, so be it. (Just MY point of view, not a judgement of anyone else!). I read on this site about the dangers of going back on at a "normal" dose, like the 5mg recommended by the doctor. My particular situation was at high risk for "kindling", since by this point I'd been off the citalopram for around 6 months, and citalopram has a short half-life. (All this learned from this site!). I tried a 5mg tablet cut in 4 (about 1.25mg), but on day two felt like I was freaking out. After a few days, I tried again, an 1/8th of a pill, smaller than a grain of rice. I ordered a scale to weigh the dose, as suggested. By the second day I was experiencing GREATLY REDUCED WD SYMPTOMS, and felt like I was out of the woods. I wanted to create an account and tell everybody about my success story, to help others. But by a few days later, things started going downhill again. Was that just a window? The hot flashes and brain zaps were gone, but a general lethargy combined somehow with nervousness persisted. I thought perhaps I had adapted to the miniscule dose, and went up to 1/4 tablet. To cut this long story a bit shorter, I slowly progressed over the course of a few weeks up to 1/2 a tablet. I felt I was in the extremely difficult situation (for which I'm seeking the community's help) - Is my situation caused by too much drug (kindling) or not enough?? How to distinguish WD symptoms and symptoms caused by going back on the drug? I saw my doctor, who feels that anything less than 5mg is just not going to help. She suggested taking 5mg and warned me that the first two weeks were likely going to be difficult, so I should take .25mg of xanax as well for the first two weeks. I've tried this for the last few days, and indeed they have been difficult. But I'm not convinced that they'll get better in two weeks! Now, seeing all this in black and white, I think likely I've increased my dosage too quickly, and I'll do better to go back down to maybe 1/4 tab. I'm just so disappointed that there doesn't seem to be an obvious right answer that makes me feel better more quickly! So many other sites say "SSRI withdrawal syndrome can be cured in a couple days by going back on the drug" - but this doesn't seem to be the case. I feel totally lost and unsure of how to proceed. I'm so exhausted by trying to figure this all out, I just want to get checked into some magic rehab hospital where they knock me out and I wake up four months later feeling fine. Looking back I can also see that my symptoms have shifted very much from "purely physical" (like hot flashes) to the emotional. I've had whole days lost in front of the TV, or, like this morning, terrified to get out of bed or check my email. The insomnia is AWFUL - after 4am I can neither wake up nor fall asleep. If I try to wake I'm exhausted, when I try to sleep I can only seem to get to the brink, when some sort of nervous reaction zaps me awake again. Feelings of total despair, a strong sense that there is no way out of this (I seem to be damned if I take the stuff or not), and recently, hints of some very dark thoughts indeed, as I cannot imagine having to face mornings like this one for the rest of my life! On the plus side, I do have a very loving wife who is very supportive and understanding. I'm totally ashamed of all this, of who I am right now, and would give anything, everything to simply go back to that day when I decided to go off. Things were fine, or as fine as can be expected for me. But regret gets one nowhere, and we all have to remember that there ARE good days ahead, somehow. CONCRETE QUESTIONS for anyone who is able to chip in: 1) On the one hand it seems pretty clearly I've tried to reinstate too fast. Likely best to go back down, but not to zero? Try to stay at 1.25mg for at least two weeks? 2) How does the Alprazolam (xanax) fit into this? I read something about how it helps temporarily, but then you can go into a "benzo hangover", which is worse? 3) Am I just bailing out of the full 5mg dose too soon? My doctor said it would be a hard two weeks, maybe I should just try to tough it out? She's lovely, but I don't think this sort of thing is her specialization. 4) Should I find a psychiatrist (even though where I live it will likely be a month or more before I can get in)? Or will they just start saying I'm bipolar and pumping me full of other things? Anyway this is getting pretty rambly now so I'll stop. Thanks to anybody who reads this and has any thoughts. Anyone else going through hard times right now, just keep hanging in there - the only thing that is sure is that things will change.
  3. Hey everyone, I'll try to keep this concise. Background: Currently early twenties student in university. In 2017, I was diagnosed with post-concussion syndrome (PCS). 40mg of Amitriptyline was prescribed by my neurologist to treat tension headaches. My first experience with rapid tapering of amitriptyline was in August 2018, when my neurologist asked me to switch from amitriptyline to valproic acid for PCS, at a rate of 10mg Amitriptyline tapered each week until I was fully cold turkey. Unfortunately, I found out around the 10/20mg range I wasn't handling withdrawal too well and was forced to stop and reinstate. In February 2019, I read about the link between dementia and cholinergic medications and went cold turkey by my own choice. This lasted for two months of difficulty where I struggled through my hardest semester of college. I ended up reinstating in April after a discussion with my therapist. Its important to note that at this point, for both aforementioned times I had attempted fast tapers I was not aware that withdrawal symptoms were a significant issue for antidepressants. Instead, I believed that once amitriptyline fully left my system I would be fine, and that all my symptoms were caused by PCS. In July 2019, I was able to recover from PCS after two years. A month later in August, I spoke to my physician about getting off amitriptyline. He prescribed me a somewhat slower taper at 10mg a month and 7 weeks for the final 10 mg. Thus, I began my taper from 40mg to 30mg. You can probably guess what happened next. This taper put me through hell and lasted a total of a little over four months before I stabilized. In December 2019, I discovered this forum and decided to give slow tapering a shot using liquid titration (water, not ethanol). In January 2020, I tapered from 30mg to 27 mg. It took me about two months start to finish to stabilize. I was mildly symptomatic, but my symptoms were manageable. In March, I tapered from 27 mg to 25 mg. This time, it took me nearly three months to stabilize. Even stranger, my I found that my symptoms were seemingly worse, even though the percentage tapered was still about 10%. In June, I tapered from 25mg to 24mg, hoping that a tiny dose reduction would alleviate most of my issues with tapering. Flash forward to today. Nearly three months after I had began that taper I find that my symptoms, while very mild at first seemed to have gotten worse over time. Furthermore, a three month long time span for a 4% reduction seems very unusual. Now I that school is starting and I am actively interviewing for internships, I am considering reinstating back to 24.5 or 25 mg. I'm unsure about why my withdrawals seem to get worse even though I try to reduce my taper amount each time. I can think of a couple theories, those being: Dissolving with water instead of ethanol causing issues somehow. I think this is unlikely because when I first was testing out a solution in water at my full dosage, I did not experience any withdrawal symptoms. Furthermore, when I switched to 1:10 ethanol:water solution for a couple nights while tapering, I did not experience any improvement in symptoms. Withdrawals from previous tapers coming back to bite me in my ass. I'm aware of the whole waxing and waning thing and I'm wondering if it's possible that when I began my last taper, I hadn't actually completely stabilized and am now dealing with prolonged symptoms from previous tapers. Not sure how likely this is. Kindling. This would make sense considering I have had three tried and failed fast tapers that each did a number on me. However, I'm struggling to find any sources regarding kindling in antidepressants to the point where I'm unsure if it's even possible. My symptoms are mainly just hypersensitivity, disheveled sleep/insomnia, and exhaustion. Thanks for reading this far.
  4. Hi guys, I have been on amitryptyline 2 years now. It was for my stomach disorder. 2 months ago I started weaning off and developed severe migraines. Ended in ER and they gave me IV antiemetic that caused severe akathisia. I landed in psych ward. They upped my ami doze back and gave me meds to calm down and I was fine. When I came home I started weaning off ami again, but slower. Unfortunately it wasnt slow enough, I went down from 15mg to 13,5mg and 10 days later from 13,5mg to 12mg. And I developed severe migraines again. I didnt know what to do, painkillers wasnt working, so today, 10 days after weaning the doze to 12 mg I took 15mg again. And I developed severe akathisia back, Im so agitated and restless. I took propranolol, which was helping some before, and it helpes some, but its not a cure. Can You tell me whats the safetest option now to do? Should I take tomorrow 15mg again and try to stabilize on that doze? Or take 14mg, something between previous 12 and 15? I cant go back to 12 cause migraines were so severe that I was vomiting and was non functional, but also cant handle akathisia and if 15mg will give me permanent akathisia I dont know that to do. It wasnt my offending drug, Im shocked I reacted that bad 😞
  5. MOD NOTE: This is Gemma92's topic. Before Gemma joined SA her sister icerose posted requesting assistance. I've merged the two topics so that all of Gemma's history is in one place. _________________________________ Hello. I am new here, and I’m posting on behalf of my 26 year old sister who has been in a psychiatric unit for a week. My sister has a history of mild depression and functionable anxiety. She had occasional bouts of anger, periods of intense fatigue, and nightly hallucinations usually during sleep paralysis. She started having occasional panic attacks a few years ago. (The only psychiatric medication she had been on prior was Prozac during her childhood.) Despite her struggles , she was generally happy and enjoyed life. In August 2017, she had her right thyroid removed due to the growth of a large, benign nodule. Her anxiety slowly seemed to increase over the months and she experienced a panic attack after taking Benadryl (something that never happened before when taking Benadryl.) To help combat her anxiety, she started taking 10 mg of Lexapro in May 2018. Not knowing the danger of taking it intermittently, she took it whenever she remembered. Her doctor increased her dose to 20 mg which she took daily for 2 weeks. In early July, she developed strep symptoms, but tested negative for strep throat. Her doctor diagnosed her with laryngitis. Her throat hurt so bad, that she cold turkeyed off Lexapro because it hurt to swallow the pills. She continued to show symptoms of strep throat and was finally diagnosed on July 4, 2018. After 2 doses of Penicillin (and a couple days off Lexapro) she experienced an episode lasting a couple hours where her moods alternated between intense fear (needing to hold Mom’s hand, impending doom, confusion, depersonalization, terror from Hell) and fits of giddiness (giggling, silly talk). She hallucinated once during this episode (shadow in kitchen.) She stopped taking the Penicillin because she thought it caused the episode. Her doctor told her the strep would probably go away on its own. A week later, she noticed swollen lymph nodes on her neck (near collar bone.) She started another antibiotic which she finished. She started noticing increasing anxiety in the morning that would subside at night. She took Effexor for 5 days, but cold turkeyed because she thought it was worsening her anxiety. She lost her appetite around this time and had to quit her job. At the end of August 2018, she admitted herself into a psychiatric unit for 5 days. On one of the days, she had a fever and sore throat. It was not addressed. They put her back on Lexapro at 5 mg which she took daily for 1 month. During this time, she also took 0.5 mg of Lorazepam as needed. (10 pills over the course of a month) She cold turkeyed again off the Lexapro and Lorazepam because of bad heartburn and no help with anxiety. After this, she developed physical symptoms such as bad night vision, light sensitivity, ear ringing (stopped as of now), cold sweats (stopped as of now), bone chilling cold, dizziness, nausea, poor appetite, extreme weakness, chest pain (went to ER twice because she thought it was a heart attack), and mucus in her stool which was ongoing since before Lexapro. Her mental symptoms increased as well. Her anxiety became “anxiety from Hell” that resided in the pit of her stomach. She experienced impending doom (worse upon waking up), crushing depression, hopelessness, and inconsolable crying spells where she appeared to be very agitated. She obsessed over her health and started doing research. She self diagnosed herself with Lexapro withdrawals, adverse reactions, kindling, neurotoxicity, and brain damage. After seeing a psychiatrist on October 23, 2018, she started 15 mg of Mirtazapine. It dulled the massive anxiety, but brought out rage, verbal aggression, and threats directed at her family. She cold turkeyed the Mirtazapine after 6 days (last day was 7.5 mg). Her rage went down and her anxiety went back up. A few days later, she had a few hours a day where she felt like herself. (Was it the Mirtazapine starting to work?) A couple days before Thanksgiving, she went to the ER after a day of inconsolable crying, anxiety, and impending doom. They sent her home saying “there are too many questions marks in this case so follow up with your psychiatrist.” She had another intense crying/anxiety episode the following day where she was begging for help and immediate relief. She had stopped eating and drinking as was planning her suicide by starvation or going out to the woods to die. She went back to the ER via ambulance and was admitted into the psychiatric unit. After almost a week of refusing meds, she agreed to try 7.5 mg of Mirtazapine. It’s been 3 days since then and she is experiencing numbness in her head and discomfort on the ride side of her body. They are suggesting an antipsychotic (Zyprexa) or electroshock therapy. Since this nightmare began, she never stabilized on any medication and cold turkeyed off everything. She keeps calling me and begging me for advice. I don’t know what to do because I don’t know what’s wrong. No one has an answer. I thought maybe she had Lyme but her test came back negative. I thought maybe she had PANDAS because of the strep. Or maybe it is the fact she never stabilized on medication and kindled her brain. I came here for hope though because I’ve been lurking for a month and I know many of you have recovered from many years of psychiatric drugs and withdrawals. She wasn’t even regularly on anything for more than a month or two at a time. So we need to get her stabilized and we can begin to treat underlying issues. My question is how do we do that?
  6. Potatoghost

    Potatoghost: Long story

    Potatoghost Hi sorry this is going to be a bit long but I'll try and keep it as short as possible. I was originally on citalopram 20mg for 5 years. It worked amazingly well for me after a bad bout of anxiety and depression. It seemed to stop working after 5 years so my GP added in mirtazipine 30mg. After 6 weeks of being on mirtazipine I felt severely depressed to the point I didn't want to carry on any more. And it would give me waves of dread and despair. So my GP took me off mirtazipine and put my citalopram up to 40mg. I slowly started having waves of feeling better and anxiety and depression free. At 12 weeks I had a big blip and the GP said they arent working for me anymore so switched me to sertraline 50mg. I only lasted six weeks on sertraline as I was getting worse and worse the whole time i was on it to the point i went to a crisis centre who got in contact with a different GP. Who said that 12 weeks wasn't long enough to see if citalopram was working after changing meds. So i was put back on citalopram. I made my way up to 30mg and stayed there for 6 months and had no relief in anxiety it seemed to get worse. Muscle aches Diarreah Brain fog Headaches Blurry vision Weakness Palpitations 24/7 Depression. Resting heart rate of about 160. I tried to power through because I knew I had to just ride it out but at 10 weeks the depression came back on and off but every time it resurfaced it was worse than the time before until I had a full breakdown again after 6 months of feeling so unwell.. So I have been switched to lexapro as they thought it might work as it's similar to citalopram which worked for me originally. I am 10 days into 10mg of lexapro and my depression is severe again. I'm fed up of being changed all the time and just want to feel better as this is no life to live. My partner and I are expecting a baby in 4 months and this has put the fear of god in me that I wont be well enough to look after the baby x Thank you and sorry it's such a long post
  7. MOD NOTE: Ihateeffexor created a membership and another person helped her to type the first couple of posts. Ihateeffexor is now able to post for herself. ________________________________________________________________________________________ Hello, I am actually writing on behalf of my friend who is in a very bad shape right now. She was on effexor for 1,5 years and tapered for 3 months 45 mg to 0. She had really bad withdrawal symtoms for 2 months after the last pill but then started to feel better. A couple of weeks ago she had some alcohol and partying with friends and ever since her symtoms has come back and they are much worse now. She was ok for 3 months but the alcohol seems to have made the symtoms come back, the day after she was drunk. Is this what you call kindling? And is there a chance she will recovrr from this? She is bedridden atm. Thank you all!
  8. 32 male Ok so gonna try and keep this simple but detailed if makes sense...Reinstated 6 weeks ago after nasty month long WD symptoms mainly tight chest and tremours towards the end and immediately felt good as soon as I took the drug one eve. I reinstated 5mg every other day then noticed a bad 2 days after a week which I thought was odd?? so took it every day. After 1 good week noticed a 3 bad days?? I decided to gradually increase to 10mg over space of 2 weeks as I read on here if having WD symptoms slightly increase a bit but not much but had bad insomina so went bk to 5mg! YES I KNOW BAD MOVE With in 2 days had the worst WD ever akathesia, no sleep, no eat, pure panic attacks that last 3 days! I stuck to 5mg and after 3 days felt really good again like nothing happened for 5 days till....last 4 days been having same problems but slight less akathesia but pure anxiety all day followed by panic attacks in the middle of them all with intrusive thoughts my questions- why the hell am I getting more bad days then good lately? Literally can’t function not working at the mo. Yes I know I yo-yo’ed but still I have stuck to five now for 2 weeks solid and not stable at all! judgin by my story yes I shouldn’t of gone down to 5mg maybe stayed at 8mg or something after reaching 10mg . But why am I gettin these crazy symptoms? Is my CNS sorting it self out? should I make my way slowly bk to 10mgs over the next few weeks-could run the risk of more disturbance? Or 20mg where I came from? ( currently packing for holiday freaking out how I am going to feel for week abroad in Spain but don’t want upset GF) All theories welcome 🙏 any questions please ask thanks
  9. Hey Everyone I am knew to this group and trying to find some understanding in what is going on with me. I recently went off Lexapro 3 months ago (was on for 6 years) I started getting very random heart flutters when I started it and that’s the main reason I went off of it. Now im experiencing weird brain crap and not just zaps. It seems to happen at night when im trying to fall asleep. It wakes me up and scares me it scares me. Some are brain zaps, some are like fireworks, some are weird sensations or noises- I feel like im loosing my mind. Any help or experience would be greatly appreciated.
  10. Hello. I want to begin my introduction with a detailed case report on my hypersensitivity to sertraline… I hope this helps someone. I am a 21-year-old childless female who, up till recently was taking 25 mg of sertraline every 6–8 days. Three months ago, I began seeking professional help for self-loathing, difficulty in trusting others, and intense fears of abandonment during certain social situations. There was only one psychiatrist in my area still on Blue Shield’s panel. She quickly diagnosed me with social phobia and instructed me to take 25 mg daily for one week, then to double the dose to 50 mg daily afterwards. After a mere three days, I found that I was completely unable to feel fear. (This may have started even earlier, however I was unable to evaluate my emotional state during the first three days due fatigue and sleeping in excess of 15 hours a day when I began the drug.) Were a raging grizzly bear to attack me, I would have no appropriate emotional reaction to it, or maybe even none at all. Combined with the fever (at least six hours long), increased heart rate (30 seconds long), and hand tremors (1 minute long) that I would experience 20–40 minutes after taking the sertraline (half of a 50 mg tablet), and non-existent appetite, I decided to try taking 25 mg only every other day. This was sufficient to prevent the tremors and increased heart rate, but the elevated body temperature and lack of appetite persisted at this dose. (When I later lowered my dose to 25 mg every three days, the fever disappeared and my appetite would partially return.) I called my psychiatrist’s office to inform her that I would be lowering my dose as I found the fear-blocking too effective and the other effects troubling. I emphasised that I had never experienced those symptoms at the times that human interaction caused me distress. But for the next three months, the psychiatrist would maintain that these were manifestations of my anxiety and insisted that I take the full 50 mg daily. She ignored the fact that I was entirely incapable of feeling fear for those three months. I had many peculiar reactions to the sertraline. To begin with, for the first two weeks, I really wanted to be “a good dad,” as if I were already a father and desired to remain a good and humane parent. (I am a 21-year-old childless female.) And whenever I took the sertraline, I would also feel as if my two of my closest human relations were still alive… I wasn’t (at least not by typical definitions) delusional, I knew they weren’t alive and I didn’t experience any hallucinations of their presence. But I was overwhelmed by the warmth of their company, a warmth that I thought I’d never feel ever again. …It felt like I had come home again, like my feelings could reach them and their feelings could reach me. I felt love as if all three of us were together again. These spells would last twenty minutes, and all I felt like doing was hugging something to my chest and telling them how much I missed them. When these occurred at work, I mustered enough self-restraint to take only a five-minute break and continue working afterwards. These would be the only instances I would feel any emotion for the next three months. My strangest reactions occurred after eating foods rich in tryptophan: a euphoric restlessness that was accompanied by a wonderfully pleasant burning sensation in my brain. My partner and I called these episodes “the cuddles”, because all I wanted to do was cuddle, very vigorously. (I now think this was a “happier” form of akathisia.) My partner perceived this as the return of my normally energetic, cheerful, and affectionate demeanour; I had always been a cuddler and my hugs and handshakes had always been very strong. But, I knew I was getting high, so I began timing my sertraline doses to take them before eating red meat—to guarantee the high. These foods also triggered some other reactions—eating tuna sashimi turned me into a happy drunk, I was laughing harder than usual and even turned “as red as a tomato”, according to my partner. Cheesecake would trigger a burning sensation in my frontal lobes so overwhelming and do pleasurable it was almost debilitatingly painful, I couldn’t focus on anything else around me and had to eat very slowly, as I felt as if my brain would fry if I ate the cheesecake any faster. Now when I see cheesecake I get anxious, and if it is on my plate I even have trouble lifting my fork because the anticipation makes me weak. I’ve always loved cheese—one of my most prized possessions is the World Atlas of Cheese—so whenever I asked my partner to buy me cheese he didn’t interpret it as substance abuse. (Cocaine is an illicit substance widely known for its addictive qualities. Cottage cheese is not.) After a particularly good meal, e.g. all-you-can-eat at the sushi bar, I would be high for hours! I had to eat instant ramen on my lunch breaks because I didn’t want to risk getting high at work. Some background. My aspiration of fatherhood was definitely drug-induced, but I do know where it came from. The older of my two friends, thirty-one years old, was a good, strong man who had to assume the responsibility over a preadolescent boy and was basically a single father. My other friend was his fourteen-year-old ward, a bright and sensitive jokester who came to insist that artists had a responsibility to be both humane and truthful. His mother became addicted to opioids, and her male “friends” abused him; he developed very little interest in relating to the people around him, but was very gentle to anyone falling on hard times. My friends both died as pedestrians on June 30, 2016, three months after I had moved back to California in search of employment, and eight months before I started seeking professional for what my psychiatrist diagnosed as “social phobia”, which stemmed from a physically and emotionally abusive childhood. I didn’t fully appreciate it at the time, but my friends had been helping me work through my fear of other people. My older friend was a very caring, incisive, and thoughtful person, qualities which he engendered in my younger friend. He had a serious interest in history, which was his favourite discussion topic second only to jazz music, and he could easily have become a history teacher—he was better than all the ones I had in school, anyway. When guardianship was thrust upon him, he took the time to read parenting books and material on child abuse. I don’t know if he knew it by name (I certainly didn’t), but he was teaching me the foundations of DBT. His boy became like a brother to me, and we discussed art and played video games together. After their deaths, my unresolved social phobia, which was compounded by grief, the unpleasant work environment at the hospital where I found employment, and the painfully close proximity of my entire extended family that had engraved into me my fear of human beings in the first place (I had moved out of California specifically to escape them!), understandably led to a worsening of my mental health. When I was finally starting to heal, I myself was hit by a car while crossing the street, but escaped serious injury. I developed a reflexive hatred of all cars, my own insecurity and self-loathing was complicated by survivor’s guilt, and I considered suicide numerous times. I knew I needed help. I wanted psychotherapy, but all the mental health professionals whom I had wanted to see had been taken off of Blue Shield’s panel. I settled for the one psychiatrist in my area still remaining on their panel. At our first meeting, I was frank with her about my aversion to the idea of treating my problems with psychotropic medication, and discussed with her the objective vulnerabilities and subjective conditions that kindled my social phobias. She immediately prescribed me sertraline and said I that could obtain a therapist if the drug did not adequately treat my anxiety. I was disappointed, and remained firm in my believe that drugs would not resolve my issues. But at the well-intentioned encouragement of a close colleagues of mine (she has been diagnosed as bipolar and regularly takes prescribed psychotropic drugs), and out of the desire to meet this psychiatrist at least “half way”, I began taking the sertraline. It was in the first month that I began perceiving that I had lost all capacity to emotionally respond to anything at all, even the treasured jazz songs that my friends has introduced me to. I lost my creative spark, my interest in the world and art and everything else that I liked. Aside from my loyalty to my two friends who died, I lost all interest in other humans, and all capacity for empathy. At best, I felt apathy towards people in the same way a man might feel apathy toward livestock. At worst, I felt unequivocal annoyance and contempt, the kind of sentiment reserved for an annoying mosquito. The only reason that the people around me didn’t notice a change in my demeanour was because I was keen to keep up a perfect façade—if anyone had noticed a change, it would be more inconvenient dealing with that than with faking empathy and interest. I was aware of all these changes, and I knew that they were bad. However, I didn’t care. The only thing that caught me was the thought of my two friends. At times, I realised how sad they’d be if they saw how I’d changed, and for a little while, I’d try to be a better person. On my second appointment with my psychiatrist, a month after our first, I reported the apathy, the food highs, and the “dad” feelings to my psychiatrist. The entire time I explained the food euphoria, she looked at me as if I were crazy. I did not mention to her the “it feels like my friends are still able to experience life and that makes me so happy” feelings, as at the time they did not strike me as a bad or disconcerting thing. But I did voice the observation that perhaps even 25 mg every other day was too strong for me. But all that mattered to her was that the sertraline was effectively dealing with my anxiety, and she was pleased with that. As for the adverse effects, she insisted that I take 50 mg daily in order to “habituate” myself to the drug. I very diplomatically stood my ground, again raising concerns about how my heart rate would increase after taking 25 mg daily. She relented—but said that I should schedule my next appointment three months later instead of one month later, since I was taking such a low dose. I had enough sense to perceive that this was dangerously negligent in her part, and gently nudged her, saying, “OK. So three months is a good time to check in?” She changed her mind, made it two months. I didn’t tell her, but after this visit I began reducing my sertraline dosage to 25 mg every three days. After two weeks of this, I found that the food-highs were still too disruptive on my daily life, so I began taking it every four days. Even though I’d decreased the dosage, the apathy worsened, and my patience for people was shorter than before. I was beginning to actively dislike all the people around me. I looked back at my previous relations and memories with scoffing contempt. I mistakenly thought I was falling out of love with my partner. I even started enjoying being a psychopath; life felt easier if all that mattered was number one. In retrospect, had the sertraline been more stimulating—if I had only the compulsion or motivation, I would’ve been capable of committing the most horrific crimes without a shred of remorse or moral discomfort. After that second appointment with the psychiatrist, I began seeing the one local psychologist still remaining on Blue Shield’s panel. I expressed my desire to work through my childhood-rooted social phobia using talk therapy. I mentioned told her about the sertraline-induced personality changes with her. She quickly sidestepped the subject of medication and advised me to talk to my psychiatrist about any adverse effects. The psychologist said that the sertraline seemed to be dealing with my social phobia well enough, and suggested that I may naturally be an introvert and that the sertraline was allowing me to enjoy being myself, that I was too concerned with what other people thought of me and that I needed to focus more on myself. Though I didn’t care, I understood that her attitude grossly complacent. I saw this psychologist two more times afterwards, and each time she said I seemed fine and that there was nothing I really needed to work on (though my own drug-induced apathy would not have allowed me to benefit much from therapy anyway), except perhaps my grief—I refused, saying I wasn’t having any trouble grieving. I wasn’t being entirely honest. I said that partly because I doubted she would’ve been able to seriously help me, partly because the sertraline had stopped me from grieving or feeling much of anything, really. After two months on sertraline, I stopped listening to music entirely—it had done nothing for me and I gave up attempting to evoke any sort of emotional response in myself. I was determined to happily live out the rest of my life as a psychopath and enjoyed the highs that the drug afforded me. Ironically, the only thing that drove me to stop taking sertraline was my chasing of the next high—the last thing I wanted to become was habituated to the drug. At the end of my second month, I began tapering to 25 mg every six days for a period of eighteen days, with the intention of taking 25 mg sertraline daily for four days afterwards to get as high as a kite. But on this lower dose, I finally began to personally care that what I was doing was wrong and that it would be best if I stopped taking the drug at all. From every six days, I tapered to every seven, then every eight days… Interestingly, that dose was still enough to give me a buzz when whenever I ate a cream cheese wonton, and I began to want to be a psychopath again. (I think, as others have reported, that the steady discontinuation of the drug made me more sensitive to low doses.) But I sensed that I owed a debt to my friends—which I treated as if it were a business obligation, not a moral or spiritual one—, and persisted in trying to quit. While attempting to find other accounts of hypersensitivity to sertraline, and material on how to come off SSRIs, I found Dr Peter Breggin’s The Antidepressant Factbook. I was very pleased to discover that people who produce inactive or “dud” forms of the CYP2D6 enzyme are unable to metabolise antidepressants at the rates most other people do. I have not gotten this or any sort of pharmocogenetic testing, and I don’t intend to as I will NEVER use a psychiatric drug again, but I suspect I may be one of those people. In my third and most recent appointment with my psychiatrist, I informed her that I had tapered off to 25 mg every eight days but that even this was enough to blunt my emotions and give me a little euphoria when I ate cheese or tuna. I mentioned that I had heard about the CYP2D6 enzyme and asked if she was aware of any good commercial genotyping facilities. She claimed that a blood draw for a liver function test would be enough and that I didn’t need to resort to genotyping… It was on that third appointment that she finally started to take my adverse reactions seriously. By a stroke of good luck, I expressed a new reaction to the sertraline that very same day, just before my appointment with her. Prior to seeing her, I had to attend a mandatory employee meeting at my workplace, and I experienced my first ever hallucination in my life. Among the audience was an older gentleman—didn’t seem odd, he was wearing glasses, a clean business shirt and tie, trousers, had a white beard, and he wasn’t acting out of place. And he seemed familiar—I must’ve seen him in passing, he actually might’ve worked at the hospital somewhere. The only reason I knew he was a hallucination was because he was floating two feet above the rest of the audience. He faded away like a ghost after three seconds. When I reported this hallucination to my psychiatrist, she pursued a line of questioning that indicated to me that she had tuned out and believed I was being paranoid and worrying for no reason about an actual living coworker—“So, no one else at the meeting seemed to notice he was there?” I nearly lost ALL my patience with this woman. My reply was immediate and firm: “He was floating two feet above the audience!” Her eyes widened and she asked me if I was taking street drugs. (“No.”) She began asking about all the other symptoms I had reported to her over the past three months. She ordered me to discontinue taking sertraline as quickly as possible (of course, she gave no advice on how to withdraw from such a small dose) and advised me against taking any other SSRIs. But she denied that the sertraline was responsible for ANY of the symptoms; she wrote an order for extensive blood work (without any diagnosis, so the next day I had to return to her office to have her secretary write it in…) and referred me to a neurologist to get an MRI of my brain. (I am still waiting for my scheduled appointment at this time.) When I saw that the order included thyroid function testing, I asked her if thyroid dysfunction could cause hallucinations. She responded, “I really have no idea what’s causing any of this. A thyroid problem could be the cause of your mood disturbances.” (I think she was referring to the tryptophan-rich food euphoria, but I’m really not sure.) The only thing that she admitted was that if these symptoms completely ceased after a month of being off sertraline, then we could conclude that they were drug-induced and not organic in origin. Since coming off the sertraline, I’ve begun to fully appreciate how I was emotionally unavailable to my partner, and how I took advantage him for three months; that I was unable to like people for three months; that in those three months I could’ve tortured and killed anyone, and I lacked only in inclination; that I hadn’t sang or grieved or felt anything… I am ashamed and guilty over what I became. I feel worse than before I sought and “received” that professional mental healthcare. All I want to do now is apologise to my friends. I know I haven’t done anything wrong, and I know I tried my best… But it’s difficult for me to accept that I’m still a good person. I feel like I’ve betrayed everyone behind their back. I’m trying to be gentle to myself, to think about what my friends would say if I could talk to them. I am trying to keep in mind that despite everything, I was able to honestly and objectively assess my own mental deterioration, and I acted as best as I could under the circumstances. I do not want to let those three months destroy my soul after the fact. I’m trying to live… I’m realising how much I missed out on everything. I forgot how much I liked the grass, and rocks, and kittens, and books. I forgot how nice it was to like other people, in spite of my fear that they’d never reciprocate those feelings. I forgot how much fun drawing was, and how funny my partner’s dumb jokes are. I hadn’t used smileys in my texts for three months, and I even walked differently! And I hadn’t realised how much of my acuity had dulled until I got off the sertraline. It’s like I have to live again for the first time in three months. I’m not as confident as I was three months ago, and I don’t like myself as much as I used to. My partner has been very supportive. I’m now experiencing sertraline withdrawal reactions. I get disoriented easily; the other day when I left my workplace building and when I reached the parking lot, I couldn’t place where I was at all; like which part of Earth I was located in, let alone which end of the campus. I’m noticing memory problems; subjects I’d just discussed with my partner I would raise again only a few minutes later. I used to be able to play my favourite songs in my head, especially the pieces that my friends introduced me to. For a while I couldn’t remember the lyrics, the titles, the artists, or even the melody. My memory is improving, but those songs play like a broken record, my brain skips over parts and I have to listen to the song again to recall it completely. My stomach hurts every now and then. I’m sensitive to light, and I get akathisia now. The first episode was bad enough to leave me writhing and crying in pain while clutching my head—as if something were clashing and tearing away from the inside of my brain. Now, it feels like a bunch of fleas jumping on and nipping at the surface of my frontal lobes, not debilitating, but annoying enough to prevent me from falling asleep at times. My appetite has returned, but increased to the point where I have to be careful not to overeat or risk massive weight. I’m thankful that I’m one of those odd people who hears rainstick noises near the top of their spine whenever they’re hungry; now I pay attention to that and ignore the empty feeling in my stomach. I have sudden spells of sadness and anxiety during which I cry a lot, which I didn’t have before taking sertraline. I’m worse off than before I started taking psychiatric drugs, but at least I’m no longer chemically lobotomised. I’m trying to exercise my brain by the throwing myself back into singing and reading, and I draw more seriously now. I hope this case history helps someone. I’m looking forward to weaning myself safely.
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