VinceC: Zoloft Nightmare

[VinceC]

Hi Vince, 

 

I'm sorry that the reinstatement hasn't completely brought you relief.  Could you give us your current symptom pattern by time throughout the day?  Are you keeping notes on paper?  Alto is especially good at teasing out what is going on and whether reinstating more at this point would be a good idea.  I don't have that wisdom, but know that 17 days has been a good shot so maybe another little uptick would help. I'm simply not sure.

 

As to questions

 

1)  Raising your dose will give your nervous system a new challenge to respond to.  I doubt it has found homeostasis yet, given all your symptoms, so the question is, will the up-dose bring your system closer to homeostasis or cause more destabilization.  I don't know the answer, not sure any of us do.

 

2) Same amount of time as what?  It would take four days for the new level to become steady state in the blood, and then x amount of time for your nervous system to know what to do with it.

 

3)  Sure, it's possible. I'm of the feeling that the dose you started with undershot where your nervous system was in its healing process, but it had to be so small to be sure an adverse reaction wasn't triggered.  I'm concerned about the fatigue that seems to have been triggered by the up-dose; it wasn't there before that, right?  i'm not sure what that was about, so I'd like Alto to weigh in again.

 

There is no magic formula to figure out what the right dose would be.  I like npanth's formula in principle, but as the others mentioned, there are so many other variables at play that make that formula problematic in practice.  You could keep doing small up-doses hunting for the magic number but it's a dicey area with no certainties.

 

SG

 

Thanks for your response SquirrellyGirl, much appreciated! 

 

I have been keeping a journal of my symptoms for a little over a month. Most days are pretty similar:  I wake up randomly every morning at 6ish then have to pee, I fall back asleep then wake up an hour later. I lie in bed for a hour not wanting to get up. While i'm laying there, my heart rate raises and I feel like there's a "background" panic going on. I change positions in bed constantly unable to sit still through this hour and have to keep moving my legs/feet. At about 10:00ish I finally feel like getting out of bed. For the next few hours my back, neck and shoulders are stiff and killing me. I think this is causing tension headaches and a really weird dizzy/off-balance feeling. There is a bit of panic through this but its mostly dizziness and lightheartedness.

 

The rest of the day is different everyday. Sometimes I'm hit by massive panic attacks, other times its a constant depressed feeling in my chest. the worst days its both at the same time. No matter what though, I'm dizzy off-balance and light headed. The past few days Iv been getting extremely bad headaches in the evenings, where my head feels like its going to explode and my eyes are heavy and groggy. I also feel really tired from lunch till bedtime, like I'm just waiting for night to come so i can sleep. Once i go to bed I cant sleep, I just lay there for a while like my energy levels are through the roof. My thoughts do seem clearer at this time, Like its the real me thinking again, but it doesn't always happen. 

[Altostrata]

Vince, you must be careful not to add to your chemically-induced symptoms with your own worry that you're not doing it right.

 

How has your symptom pattern changed since you reinstated 6.25mg sertraline? What time of day do you take it? Any symptoms after you take it? How's your sleep?

 

Are the evenings better than the mornings?

 

It sounds to me like you may be reacting to the morning cortisol spike, which is triggered by the sun. You might do better if you block out the light in your bedroom with blackout curtains to reduce this stimulation.

 

Or, you might get up for the day at 6 a.m., this is a normal human circadian rhythm. Could be your body is saying it wants to reset its clock.

[VinceC]

Vince, you must be careful not to add to your chemically-induced symptoms with your own worry that you're not doing it right.

 

How has your symptom pattern changed since you reinstated 6.25mg sertraline? What time of day do you take it? Any symptoms after you take it? How's your sleep?

 

Are the evenings better than the mornings?

 

It sounds to me like you may be reacting to the morning cortisol spike, which is triggered by the sun. You might do better if you block out the light in your bedroom with blackout curtains to reduce this stimulation.

 

Or, you might get up for the day at 6 a.m., this is a normal human circadian rhythm. Could be your body is saying it wants to reset its clock.

 

Hi Alto, 

 

I understand what you mean. There are times when I feel like my mind is "calm" and I'm only dealing with the dizziness and off-ballace that is ever constant. But when the panic attacks and depression hit my thoughts are on a constant loop, and they just keep getting worse and worse. I try so hard to ignore them but its completely paralyzing, no matter what I do more hurt and pain is inevitable. 

 

The first week and a half of my reinstatement, the only change was an overwhelming sedative effect. no matter how much rest I got I felt like I had not slept in months. And when I lied down I felt almost tranquilized. That has worn off drastically at this point. I believe my minds clarity has improved since I reinstated, But its hard to tell because of how constantly my emotions change from hour to hour. As for the dizziness and light-headed feelings, those have stayed relativity the same. I am always off balance and have massive pressure built up in my head no matter what time of day it is. When I leave the house I still feel like the world is fake and have that unreality feeling. 

 

I take the zoloft at 7pm. I did that to help combat the drowsiness I had in the beginning. I'm not sure If i imagined it but 2 hours after I took it I felt more "energy" at first, but now I notice no change. Evening are actually "sometimes" better. especially when Im actually in my bed, Sometimes I fell like myself in bed until I fall asleep. once i'm asleep I don't have any issues sleeping, iv been having pretty vivid dreams since my reinstatement as well.  

 

I read your topic on cortisol a few weeks ago and Iv been actually sleeping with an "eye mask" which blocks out all light. I take vitamine C before bed and the second I wake up. (leave it on the night stand) I also wear sound proof earmuffs because any nose will wake me up instantly and I sometimes cant get back to sleep if i do wake up. 

[SquirrellyGirl]

Vince, it sounds like there is some improvement from this reinstatement, though there are lingering symptoms.  Some here feel it is best to hold where you are in that case, that stabilization may take a couple of months to come but that it is best to not keep throwing things at your nervous system.  However, you are the one living with your experience, and only you know if that is a livable recommendation.  

 

The other option is to up-dose again, an equally small amount, maybe just another 2 or 3 mg even, knowing that it could also go paradoxical.  That is why we suggest small increases, so that if they are problematic, it isn't as disruptive as it could be.  I wish it were easier to give a firm stance, that doing A will lead to B, but we just don't have that kind of certainty when it comes to reinstating.   We know with certainty that a 10% taper is far better than what most doctors will have you do to come off these drugs, but when it comes to pulling out of withdrawal, it gets pretty grey...It's a feel your way along kind of process.

 

Ultimately, we want you to be safe, so please stay in communication regarding your thoughts and feelings on this.  It is your choice and we will support you in whatever you choose to do.

 

SG

[Altostrata]

Vince, you will get waves of symptoms, which should get fewer and less intense as time goes on.

 

Dizziness and depersonalization are common withdrawal symptoms.

 

You might do some stretching when you get out of bed. Acupuncture might be able to help the upper body pain, which is probably due to muscle tension from the cortisol surge.

 

Are you taking fish oil and magnesium supplements, see
http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/
http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/

 

Magnesium can relax muscles.
 

[VinceC]

Vince, it sounds like there is some improvement from this reinstatement, though there are lingering symptoms.  Some here feel it is best to hold where you are in that case, that stabilization may take a couple of months to come but that it is best to not keep throwing things at your nervous system.  However, you are the one living with your experience, and only you know if that is a livable recommendation.  

 

The other option is to up-dose again, an equally small amount, maybe just another 2 or 3 mg even, knowing that it could also go paradoxical.  That is why we suggest small increases, so that if they are problematic, it isn't as disruptive as it could be.  I wish it were easier to give a firm stance, that doing A will lead to B, but we just don't have that kind of certainty when it comes to reinstating.   We know with certainty that a 10% taper is far better than what most doctors will have you do to come off these drugs, but when it comes to pulling out of withdrawal, it gets pretty grey...It's a feel your way along kind of process.

 

Ultimately, we want you to be safe, so please stay in communication regarding your thoughts and feelings on this.  It is your choice and we will support you in whatever you choose to do.

 

SG

 

 I have given it some thought and have decided I will up my dose a little bit. When I first reinstated the only adverse effect that changed in my symptoms was an overwhelming sleepiness. hopefully that's the case again if i add a little more. I just cant risk undershooting the amount I need to become functional again. 

 

Wish me Luck!   

 

Vince, you will get waves of symptoms, which should get fewer and less intense as time goes on.

 

Dizziness and depersonalization are common withdrawal symptoms.

 

You might do some stretching when you get out of bed. Acupuncture might be able to help the upper body pain, which is probably due to muscle tension from the cortisol surge.

 

Are you taking fish oil and magnesium supplements, see

http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/

 

Magnesium can relax muscles.

 

 

Hi Alto, 

 

 My back has been an on-going problem for the past 8 years. So has the disorientation. I just recently (this year) realized that they were related to withdrawal. I have been to endless amounts of acupuncture, physical therapy, massage/trigger point release, and chiropractors. Over the years every time my back has hurt and i have got "randomly" dizzy/disoriented I now believe was because I missed a day or a few days of my SSRI's. The whole time I never new that missing doses here and there can cause havec on you. 

 

Supplements I take daily are: Vitamin B complex, Vitamin B12, Cod liver oil, magnesium, Vimamin C, and Gaba,  

Oh and occasionally Epsom sea salt baths (but they make me dizzy sometimes )    

[JanCarol]

Hey Vince - while B vitamins are excellent for mood - they are sometimes difficult in withdrawal.  Please see:  Vitamin B3 (niacin, niacinamide) and Vitamin B12

and http://survivingantidepressants.org/index.php?/topic/1068-vitamin-b-complex-supplement-reaction/

 

These can be discontinued immediately, and you will know pretty quickly whether they were causing problems for you.  Many people in withdrawal find them overstimulating.

 

Additionally, there are a few things in Cod Liver Oil which can be reactive, like the Vitamin A.  It is better to take Omega-3 fish oil for the nerve soothing, anti-inflammatory properties

 

GABA can contribute to drowsiness and lethargy - more information can be found here:  http://survivingantidepressants.org/index.php?/topic/5567-gaba-gamma-aminobutyric-acid-tablets-capsules-liquid/

 

NORMALLY, your supplements, for a healthy normal person - even a depressed person - would be fine.  And, in fact, antidepressants tend to rob us of B12, so the thought to supplement would NORMALLY be okay.  But once the withdrawal symptoms start, it's best to 3 KIS's Keep It Simple, Slow, Stable

 

Why don't you consider getting rid of the B-Vitamins first, to see if that helps.  Switch from Cod Liver to Omega-3 Fish oil.  And maybe drop the GABA, too.  You might be surprised to find that you might not need an updose, after all!

 

If you still do, that is always an option.  But try eliminating the vitamins, first. Some people (as you read on those threads) will find that they get same day relief from dropping the brain "enhancing" supplements.  

 

Then, if you want to add back individual ones, like B12 or Niacin, you can, later.  But let's get you to feeling better, first!

[VinceC]

Hey Vince - while B vitamins are excellent for mood - they are sometimes difficult in withdrawal.  Please see:  Vitamin B3 (niacin, niacinamide) and Vitamin B12

and http://survivingantidepressants.org/index.php?/topic/1068-vitamin-b-complex-supplement-reaction/

 

These can be discontinued immediately, and you will know pretty quickly whether they were causing problems for you.  Many people in withdrawal find them overstimulating.

 

Additionally, there are a few things in Cod Liver Oil which can be reactive, like the Vitamin A.  It is better to take Omega-3 fish oil for the nerve soothing, anti-inflammatory properties

 

GABA can contribute to drowsiness and lethargy - more information can be found here:  http://survivingantidepressants.org/index.php?/topic/5567-gaba-gamma-aminobutyric-acid-tablets-capsules-liquid/

 

NORMALLY, your supplements, for a healthy normal person - even a depressed person - would be fine.  And, in fact, antidepressants tend to rob us of B12, so the thought to supplement would NORMALLY be okay.  But once the withdrawal symptoms start, it's best to 3 KIS's Keep It Simple, Slow, Stable

 

Why don't you consider getting rid of the B-Vitamins first, to see if that helps.  Switch from Cod Liver to Omega-3 Fish oil.  And maybe drop the GABA, too.  You might be surprised to find that you might not need an updose, after all!

 

If you still do, that is always an option.  But try eliminating the vitamins, first. Some people (as you read on those threads) will find that they get same day relief from dropping the brain "enhancing" supplements.  

 

Then, if you want to add back individual ones, like B12 or Niacin, you can, later.  But let's get you to feeling better, first!

 

WOW.. Iv Been taking these supplements specifically for my nervous system. I did't take them before this started. I'm definitively going to stop taking all of them and see if it helps! I do have "Omega red 100% Wild salmon oil" Is that ok instead of the cod liver oil?? Should I continue to take my Magnesium Citrate and vitamine C??

 

Also every morning I eat oats and make a spinach and banana smoothie. I read that oats and spinach are great for healing the nervous system. Should I stop the spinach to??? I think Its high in B vitamins!! 

 

Sometimes when I'm having a panic attack I drink calming tea's (Kava, Passionflower, Chamomile) are these ok for me? And when I cant sleep at night I sometimes use Melatonin is this another no-no? 

[SquirrellyGirl]

Hi Vince, 

 

I wouldn't worry too much about the spinach unless you are eating tons of it, because I think it has relatively low amounts compared to a supplement.

 

I would step down on things in a systematic way so that you can determine if they were harmful rather than helpful.  Start with the most likely suspects like B and cod liver oil. Yes, the salmon oil should be much better.

 

I guess you have to decide which is causing more trouble, the sedation or anxiety, for instance.  If anxiety is more problematic, I'd drop the B and cod liver oil first.  If sedation is the greater issue, perhaps drop the GABA first.  Try each change for a couple of days to see if there is cause and effect.  If you drop everything all at once, you won't know what made the difference!  On the flip side, if you are really suffering, you could drop it all and then add back one at a time looking for cause and effect.  On principle, chamomile should be calming, but there always seems to be someone that finds a link with problems.  Perhaps use Google to search each one out on SA to see what peoples' experiences are.  For instance, Google "survivingantidepressants.org chamomile" to get the most relevant results.

 

SG

[VinceC]

Hi Vince, 

 

I wouldn't worry too much about the spinach unless you are eating tons of it, because I think it has relatively low amounts compared to a supplement.

 

I would step down on things in a systematic way so that you can determine if they were harmful rather than helpful.  Start with the most likely suspects like B and cod liver oil. Yes, the salmon oil should be much better.

 

I guess you have to decide which is causing more trouble, the sedation or anxiety, for instance.  If anxiety is more problematic, I'd drop the B and cod liver oil first.  If sedation is the greater issue, perhaps drop the GABA first.  Try each change for a couple of days to see if there is cause and effect.  If you drop everything all at once, you won't know what made the difference!  On the flip side, if you are really suffering, you could drop it all and then add back one at a time looking for cause and effect.  On principle, chamomile should be calming, but there always seems to be someone that finds a link with problems.  Perhaps use Google to search each one out on SA to see what peoples' experiences are.  For instance, Google "survivingantidepressants.org chamomile" to get the most relevant results.

 

SG

 

 I see what you mean. If theirs a chance that I can get even a bit of relief, I'm going to just stop everything other then then the fish oil and spinach for now. If they are causing any issues id rather not deal with them at this point because my withdraw is to unbearable. Id rather save experimentation for when I'm not suffering as much. 

[SquirrellyGirl]

Sounds like a plan.  As always, keep notes on paper so you can see trends.  I hope you get some relief!

 

SG

[SquirrellyGirl]

Hey Vince, how are you traveling today?

 

SG

[JanCarol]

Hey Vince - Squirrelly mostly addressed your questions, but I may have a slightly different bent than she does, so here goes:

 I do have "Omega red 100% Wild salmon oil" Is that ok instead of the cod liver oil?? Should I continue to take my Magnesium Citrate and vitamine C??

 

Also every morning I eat oats and make a spinach and banana smoothie. I read that oats and spinach are great for healing the nervous system. Should I stop the spinach to??? I think Its high in B vitamins!! 

 

Sometimes when I'm having a panic attack I drink calming tea's (Kava, Passionflower, Chamomile) are these ok for me? And when I cant sleep at night I sometimes use Melatonin is this another no-no? 

 

"Omega Red","Wild Salmon" = sounds great, right?  Well, it's cleaner than cod liver oil, as it is a single supplement.  But if you read the Omega-3 fish oil thread, you will see that what matters is EPA / DHA density and ratios.  I used to take "Wild Salmon" too until I noticed it was lower in EPA/DHA than just plain fish oil.

 

But it's fine to take, and could even be considered a low-dose titration until you build up to taking more fish oil.

 

Magnesium is always a good thing to take if you can tolerate it.  It is essential in something like 400 chemical cascades, an essential nutrient.  And Vitamin C is a co-factor in so many good things that again - if you can tolerate it, keep it.

 

Your spinach smoothie - you are the best judge of that.  Does it feel good?  I know when I make a smoothie containing nutrients that I need - I can almost feel my cells singing as I drink it.  This goes for other foods, too - and I have to admit - "I must have needed that."  If, on the other hand, you feel you are choking down something because it's nutritious - then maybe the smoothie is not for you.

 

Getting your nutrients in food - fine.  You may find that you react to certain foods, and you will have to be your own guide through the food minefield that sometimes is part of the territory in withdrawal.

 

I will address the herbs in a separate post.

[JanCarol]

Now for the herb teas.   Kava and Valerian are contraindicated with antidepressants.  I know you didn't mention valerian, but it's commonly used in "sleepytime" sorts of things.

 

Kava is a controlled substance here in Australia, just to give you an idea of how potent it is.

 

Here's what drugs.com says:

Interactions between your selected drugs

Moderate sertraline  valerian

Applies to: sertraline, Valerian Root (valerian)

Using sertraline together with valerian may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate sertraline  kava

Applies to: sertraline, kava

Using sertraline together with kava may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate valerian  kava

Applies to: Valerian Root (valerian), kava

Using valerian together with kava may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

 

(OH HECK - SERVER JUST DELETED ABOUT 3 PARAGRAPHS for me to reconstruct!   )

 

Herb teas:  Chamomile is pretty mild, though can be a bit of a blood thinner.  Many people seem to tolerate Lemon Balm okay.  Some of us can enjoy a calming morning Green Tea (has some caffeine, but also theanine).  Herb teas are generally safe doses of these things.  

 

Melatonin - is another, trickier subject.  I'm guessing you would take a whole tablet, which is manufactured in 3-5 mg doses.  Melatonin is NOT a relaxant.  It is a trigger, to tell your brain that the sun went down, and it's time to sleep.  Mela = darkness.  The doses manufactured are way too high.  Some people take as little as .25 mg, with some success.  Others might take a similar small dose if they awaken in the middle of the night.    Some people can tolerate as much as 1-2 mg of it.  I know very few people who have achieved success taking a whole tablet of the stuff.  

 

I react to melatonin, quite badly.  My endocrinologist wanted to put me on "time release" melatonin, and when I contemplate the hangover the next day, the grumpiness, the depressed hopelessness, I said no thank you.  You might give it a miss for awhile, too.  If you want to, later, when you are feeling more stable, you may consider it, after you've learned how it works, and what to watch out for, and how others have done on it:  Melatonin for Sleep

 

There are other supplements to consider to help (nothing eliminates it) with anxiety, but I'd like to see you stable first before adding in any complications.  It is better that you focus on Non Drug Techniques for Coping with Emotional Symptoms, like this one:  http://survivingantidepressants.org/index.php?/topic/10964-the-dr-claire-weekes-method-of-recovering-from-a-sensitized-nervous-system/

 

So you see?  It is so difficult for us to wait in withdrawal, and do nothing.  But sometimes DOING NOTHING or doing less - can be DOING SOMETHING!  (clear as mud?  It was better in my first version of it!)  There is plenty you can work on, while you are waiting to feel better.  And you will feel better, the more you learn, let go, and grow.

[scallywag]

Hi Vince, how are things going?