Cruizer: sertraline / Zoloft nightmare

[Cruizer]

14 minutes ago, JesusSavemefromWD said:

I didn’t realize u were referring to my thread . There are also other SA members who are rapid metabolizers and mention difficulties withdrawing. I have also heard a talk from a foreign psychiatrist (can’t remember unfortunately her name) claiming that rapid metabolizers are prone to severe side effects as much as are slow metabolizers. Good luck to your next steps. 

The stupid thing is, is that I have always had issues on this drug. From day 1 in 2009 I had significant issues. Unfortunately it was all blamed on my "declining mental health" and my "condition"

I just kept going along for 6 years until eventually I researched and found Dr Breggins book "anatomy of the epidemic" and it was like a light bulb moment. Unfortunately within a few months of tapering I was having issues with instability. The longer I held a dose the worse I would feel which happened in 3 holds. Once I started tapering again I would feel better but since I have reached 4.5mg I haven't been able to get stable. It is the not knowing what to do which is the difficult thing. I haven't stabilized and have been getting worse to the point where just waiting is not an option as something else has to be happening here. I feel I could wait if I was not on anything as at least I would know I am recovering whereas at the moment I could be actually making myself worse by holding on Sertraline. 

[Altostrata]

What happened at the beginning, when you started sertraline?

[Cruizer]

2 minutes ago, Altostrata said:

What happened at the beginning, when you started sertraline?

Extreme agitation, cortisol spikes and then started having crying spells etc. All of which I have had through the dosage changes and holding doses. I can hand on heart say that a wave back 10 years ago when on a full dose can be the same as a wave now at 4.5mg. Same symptoms. 

 

The only thing that has greatly changed since hitting 4.5mg is the head symptoms. Pressure and headaches plus brain fog is what came at the start of my crash and gotten worse whilst holding for 20 months. 

I would say the extreme agitation is rare now. But I still get cortisol spikes that pop up for maybe a week and then go for a while. 

[Cruizer]

On 7/17/2020 at 11:00 AM, ChessieCat said:

Also see:  doses-twice-a-day

 

Some members experience interdose withdrawal because of the half life of their drug.  This can happen if the half life of the drug is less than 24 hours.

 

Some members may experience interdose withdrawal if the half life of their drug is about 24 hours and they are a fast metaboliser.

 

Sometimes interdose withdrawal can occur when the member has to change from extended release to immediate release to get the doses they require.

 

Another situation when interdose withdrawal needs to be considered is when extended release tablets are compounded.  Even with a slow release formula added when the tablets are compounded, the shorter half life may cause interdose withdrawal.

 

Some members might experience interdose withdrawal when they get to a low dose of a drug.

 

If you suspect that you are getting interdose withdrawal the first thing to do is to do a search on the internet to try to find out the half life of the drug you are taking.  If you can't find this information check the Tips for Tapering topic for your drug.  The information may be there.  If not, then ask in your Introduction topic and one of the mods or members might be able to provide the information.

 

The easiest way to work out if you are experiencing interdose withdrawal is to keep daily symptom notes for several days.  If you can see a daily pattern of when your withdrawal symptoms increase related to the time you take your dose then it might from the shorter half life of your drug, or you being a faster metaboliser.

 

This is an example of how to keep daily notes:

  

 

IMPORTANT NOTE:

 

Only make one change at a time.  That is, if you are splitting your dose DO NOT make a dose reduction/increase, add/stop supplement, change brand or form of drug etc at the same time you are splitting your dose.

 

If you want to split your dose the gentlest way to do this is to move part of your dose, usually 1/2 of the dose, by 1 hour each day.  If you feel anxious about dose splitting you could move it by 1/2 hour each day.  You will need to observe your withdrawal symptoms and especially your sleep during this time.  If you find that your sleep is starting to be affected then you could move your second dose to the previous dose time, that is back or forward 1 hour or 1/2 hour and observe for a few days or longer to see if things settle.

 

So if you are currently taking your drug in the morning you would move a portion later each day.  If you are currently taking your drug in the evening you would move a portion earlier each day.

 

To keep the drug level consist in your body, generally it would better if your dose was split into 2 equal parts and taken 12 hours apart.  However, this may not always be possible, either because you are not able to split the dose evenly (eg compounded capsule doses won't allow it) or your sleep is affected if you take the dose too close to bed time (for an activating drug). 

 

If you do have to split the dose into unequal amounts, I suggest that you take the smaller dose in the evening so that if you do experience any withdrawal symptoms they are more likely to be whilst you are sleeping.  However, this may not be appropriate for a sedating drug.

 

Please note that there are no hard and fast rules about how to do this.  This is why it is important to observe your symptoms to see how the dose splitting affects you.

 

I find this post from Chessie most interesting.

@Altostrata do you think I should updose back to 4.5mg to get a better gauge on my daily symptom pattern? It's just since dropping the head symptoms have ramped up so dropping when I wasn't stable is probably going to have effected this and will effect what I am writing in the next few days compared to say the last 12 months if you get what I mean. 

[JesusSavemefromWD]

29 minutes ago, Cruizer said:

The stupid thing is, is that I have always had issues on this drug. From day 1 in 2009 I had significant issues. Unfortunately it was all blamed on my "declining mental health" and my "condition"

I just kept going along for 6 years until eventually I researched and found Dr Breggins book "anatomy of the epidemic" and it was like a light bulb moment. Unfortunately within a few months of tapering I was having issues with instability. The longer I held a dose the worse I would feel which happened in 3 holds. Once I started tapering again I would feel better but since I have reached 4.5mg I haven't been able to get stable. It is the not knowing what to do which is the difficult thing. I haven't stabilized and have been getting worse to the point where just waiting is not an option as something else has to be happening here. I feel I could wait if I was not on anything as at least I would know I am recovering whereas at the moment I could be actually making myself worse by holding on Sertraline. 

So many similarities… I felt horrible from day 1 on 25mg, doctor said “stay strong, side effects will subside”. Side effects became worst after 3 weeks, so I started tapering 5mg per week. I had hell hard time for 5-6 days following each drop, but stabilized till I reached 4.5 mg…. That was when whole hell broke loose and I d have only 2-3 hrs of feeling ok each day. I couldn’t understand this hell/ok switch every day and I couldn’t take it anymore, so I quit thinking I was having adverse reaction. But now I am convinced I was having interdose withdrawals and the low levels of drug were enough to feel ok for a few hours per day. I understand how hard it is to decide what to do, i thought the best thing to do was quit, I was in it for so short time that I thought I d be ok… turns out completely quitting was the worst thing I could have done. If I could turn the time back I would have either split my dose in two daily doses or try to switch to Prozac (risking adding another drug but at least I am a normal metabolizer for it)…. I can’t advice u what to do since each individual is different but I am pretty sure at least one of ur issues is due to the rapid metabolizing of Zoloft. I am a living example that Quitting completely and expect to heal can be a really bad choice, and I was just on it for weeks, ur on it much longer than I was. I am sharing my experience hoping u can take as many info as u can from my severe Zoloft triggered hell and decide the best way moving forward and finally away from this poison. Praying for both of us to heal, this is inhuman and needless suffering….

[JesusSavemefromWD]

20 minutes ago, Cruizer said:

I find this post from Chessie most interesting.

@Altostrata do you think I should updose back to 4.5mg to get a better gauge on my daily symptom pattern? It's just since dropping the head symptoms have ramped up so dropping when I wasn't stable is probably going to have effected this and will effect what I am writing in the next few days compared to say the last 12 months if you get what I mean. 

Yes, that’s what I was saying I have experienced interdose withdrawl at low doses 

[Cruizer]

13 minutes ago, JesusSavemefromWD said:

So many similarities… I felt horrible from day 1 on 25mg, doctor said “stay strong, side effects will subside”. Side effects became worst after 3 weeks, so I started tapering 5mg per week. I had hell hard time for 5-6 days following each drop, but stabilized till I reached 4.5 mg…. That was when whole hell broke loose and I d have only 2-3 hrs of feeling ok each day. I couldn’t understand this hell/ok switch every day and I couldn’t take it anymore, so I quit thinking I was having adverse reaction. But now I am convinced I was having interdose withdrawals and the low levels of drug were enough to feel ok for a few hours per day. I understand how hard it is to decide what to do, i thought the best thing to do was quit, I was in it for so short time that I thought I d be ok… turns out completely quitting was the worst thing I could have done. If I could turn the time back I would have either split my dose in two daily doses or try to switch to Prozac (risking adding another drug but at least I am a normal metabolizer for it)…. I can’t advice u what to do since each individual is different but I am pretty sure at least one of ur issues is due to the rapid metabolizing of Zoloft. I am a living example that Quitting completely and expect to heal can be a really bad choice, and I was just on it for weeks, ur on it much longer than I was. I am sharing my experience hoping u can take as many info as u can from my severe Zoloft triggered hell and decide the best way moving forward and finally away from this poison. Praying for both of us to heal, this is inhuman and needless suffering….

Thanks for the insight. I appreciate it. 

If it makes you feel any better I would have done the same thing you did. 

Adverse reactions do seem to take a while to get over but does eventually change so long term I feel you will be fine as will we all. 

At this point I seem to be so fragile and all changes including batch changes of my compounding tablets are causing uptick in symptoms. This should have gotten better the longer I held unless of course I am having interdose withdrawal which is why I am not stabilising. 

[Believer]

Hey Cruizer,

Just popping by to see how you’re doing. I’ve been following your journey. Did you decide to updose, stay the course, or bridge to Prozac?

 

ive made two 5% cuts since late August. Finally getting some relief from pretty horrendous symptoms after my crash last February. So thankful for that.

 

Hope you are doing okay.

[Cruizer]

3 hours ago, Believer said:

Hey Cruizer,

Just popping by to see how you’re doing. I’ve been following your journey. Did you decide to updose, stay the course, or bridge to Prozac?

 

ive made two 5% cuts since late August. Finally getting some relief from pretty horrendous symptoms after my crash last February. So thankful for that.

 

Hope you are doing okay.

Hi Believer, thanks for popping by. 

Glad your feeling relief. 

For me, I did updose back to 4.5mg about a week ago. Unfortunately the symptoms grew very strong after about day 5 of the drop and I was trying to push through but by day 15 I was not functioning well at all. Felt like my brain had left the building and I just could not think at all. After updose the first 2 days sucked but by day 3 it improved and I'm not "brain dead" like I felt when I dropped. 

I am collating my daily symptoms for a couple of weeks to share with Alto on here. Just want to make sure I'm not keeping myself sick by something going on with tablet. I have all but conceded it is not poopout that I am experiencing but rather still withdrawal. I'm feeling very sorry for myself at the moment due to the fact that I haven't been able to move for 20 months. It's really hard to get in the right heads pace and accept what is going on when I'm still not sure what path I need to take. Hopefully in the coming weeks I can make a plan and get into the right head space. For the time being I am just getting though the days. Main symptoms are head related like light headed, some head pressure, brain fog etc. Anhedonia and apathy are consistent too. Anxiety is minimal and sleep is decent so grateful for that. I have 2 young boys and a wife and I work full-time. I try to focus on that and make my life about them as much as I can. 

Thanks for the encouragement. 

[Believer]

Hi Cruizer,

 

Sorry you are having such a difficult time going lower. Do you do a 1 day drop, or a slide? I have been doing a 5% drop, dropping 1% a day for 5 days. This has been easier than when I was doing the drop all at once. Just a thought.

 

I don’t know if I was in poop out, but my last couple of drops have been okay. I did note a slight ramp up in symptoms, but not much beyond my new WD normal baseline, which isn’t that great the past several months, but it didn’t get worse, so there’s that. 😬

 

I also have two boys, young men now. So much rowdy, crazy fun for me raising them.

 

I hope you can figure a good go forward plan after reviewing your notes. 
 

Stay strong!

[anna7887]

On 11/8/2021 at 9:25 PM, Cruizer said:

The stupid thing is, is that I have always had issues on this drug. From day 1 in 2009 I had significant issues. Unfortunately it was all blamed on my "declining mental health" and my "condition"

I just kept going along for 6 years until eventually I researched and found Dr Breggins book "anatomy of the epidemic" and it was like a light bulb moment. Unfortunately within a few months of tapering I was having issues with instability. The longer I held a dose the worse I would feel which happened in 3 holds. Once I started tapering again I would feel better but since I have reached 4.5mg I haven't been able to get stable. It is the not knowing what to do which is the difficult thing. I haven't stabilized and have been getting worse to the point where just waiting is not an option as something else has to be happening here. I feel I could wait if I was not on anything as at least I would know I am recovering whereas at the moment I could be actually making myself worse by holding on Sertraline. 

I am right there with you… on Setraline for over a decade and tapering for 3.5 years. All hell broke loose under 5mg and undergoing a procedure/anesthesia. Just know you’re not alone, this drug is so powerful. I’m only 34 newly married and had to leave my job😢luckily I found remote work but hope I can handle it. Hang in there… we’ll get to the other side!

[Cruizer]

Hi @Altostrata

Quick update: After reducing from 4.5mg to 4.4mg I lasted 15 days until I decided to updose. First 5 days were ok but by day 6 I was hit with anxiety for a bit but the most troubling symptom was the feeling as if my brain had left the building. I had no focus, mental clarity or anything to really give. I went along for about 10 days this way and ended up updosing. Took about 3-4 days to feel somewhat clearer and better. First 2 days were quite severe. 

Anyway I left it for a week to settle down and then starting taking daily notes like you asked as to try and identify what might be happening:

 

15-Nov

6am	Woke in Bed after solid 7-8 hours sleep
7:30am	Bowl of cereal with Banana. Felt hungry
8am	Took medication 4.5mg Sertraline (4mg compounded tablet + 0.5mg liquid)
8:15am	Left home / dropped son to school / went to work
8:45am	Felt head symptoms / slightly foggy / srunching face/lifting eyebrows
8:50am	Had a coffee (2 shot latte) Lift in clarity
10:30am	Felt a dip in motivation/ mild anx.
12:30pm	Ate lunch (Chicken casserole and banana bread)
3:00pm	Some head symptoms present (pressure in side of head).
3:05pm	Coffee (1 shot latte)
4:30pm	Bit spacey upon leaving from work to home.
	Mood ok today, farely focussed on work and getting things done
5:30pm-7pm	Played with my kids on trampoline and went to park. Quite spacey and some head pressure
8:00pm	Ate dinner (Pork and lettuce rolls). Quite hungry and also ate cashew nuts and dark choc.
10:30pm	Went to bed after watching a movie. Mood ok but quite lethargic last hour or so.
	Day was ranked as a 2. Not a lot of up and go but anx and dep minimal.
16-Nov
6:30am	Woke in bed after a solid 7 hours sleep
7:00am	Had 2 crumpets and a banana/strawberry smoothie. Mood ok with some irritation present
8am	Took medication 4.5mg Sertraline (4mg compounded tablet + 0.5mg liquid)
8:15am	Left home to drop kids off at school. In decent mood
8:40am	Noticed the head symptoms start / foggy / spacey and scrunching face/eyebrow lifting
9:10am	Had a coffee (2 shot latte) Clarity picked up within 15 minutes
11:15am	Head symptoms / Eyebrow lifts / a little fuzzy
12:15pm	Ate Lunch (Chicken casserole full of vegies) + cashew nuts and dark choc (35g sugar approx.)
1:30pm	Felt quite fatigued and lethargic. Foggy head
2:30-4pm	Very flat, irritated and can't be bothered doing much. (Have been seeing customers for last hour)
4pm	Coffee (1 shot latte)
5:30pm - 6:30pm	Played with my kids. Went to park and again was lethargic, spacey and somewhat disinterested.
6:45pm	Ate dinner. (Pork and coleslaw rolls) Was hungry. Felt a lift after eating.
11:30pm	Went to bed after watching tv.
	Day was ranked as a 2. Very similar to yesterday in not very motivated. Fatigue in the arvo and foggy
17-Nov
7:30am	Woke later today as my son slept in.
7:45am	Ate breakfast (2 pieces of toast)
8am	Took medication 4.5mg Sertraline (4mg compounded tablet + 0.5mg liquid)
8:30-9am	Mood seemed good and was thinking clearer.
9:10am	Noticed the head symptoms start / foggy / spacey and scrunching face/eyebrow lifting
10:00am	At work but feel the anxiety festering. Not too bad but not focussed on work very much
11:30am	Seemed in a bit better spirits
1:00pm	Ate Lunch (Crumbed chicken with coleslaw and peas + Banana)
1:30pm-3pm	Just felt flat with no motivation / irritation / brain fog
3:45pm	Coffee (1 shot latte)
4:15pm	Mood and clarity better, slight head pressure in temples
5:00pm	Left work for the day. Bit flat on leaving
5:30pm	Ate dinner (Beef mince and salad wraps). Quite hungry. Also had banana and berry fruit drink
5:45pm - 7:30pm	Played with my youngest son and felt more connected with him despite a bit of brain fog.
8:00pm-10pm	Watched Netflix (Had some chocolate and cheese on crackers) Quite hungry tonight
10:30pm	Went to bed
	Day was ranked as a 2. Similar to yesterday. Bit better mood at night. Really focussed on kids.
18-Nov
6:10am	Woken by my son. In an out of sleep until 6:45am (Felt quite tired)
7:20am	Ate breakfast (2 pieces of peanut butter toast and a fruit smoothie)
8:00am	Took medication 4.5mg Sertraline (4mg compounded tablet + 0.5mg liquid)
8:10am	Left for work and school drop off. In a decent mood and relatively clear.
8:40am	Noticed the head symptoms start / foggy / spacey and more head pressure/ lifting of eyebrows
9am	Coffee (2 Shot latte)
9:30am-12pm	Felt like a slight lift in clarity and motivation. Visited 2 customers of mine and felt clearer.
12pm	Ate Lunch (Chicken and coleslaw role + Almonds and Cashew nuts. (Quite hungry)
1pm-2:30pm	Visited a customer for a meeting and felt a fog come over and felt spacey and lethargic.
2:45pm	Seemed to lift in clarity and motvation.
2:50pm	Ate apple cake slice.
3:20pm	Coffee (1 shot latte)
3:30pm - 5pm	Relatively focussed at work doing emails and following up things.
5:20pm	Went home from work and ate plenty of dinner. (2 x Pizza and beef mince salad)
6:00 - 7:30pm	Felt off (may have eaten a bit much) was playing with kids outside and felt spacey with headache.
8-10pm	Watched Netflix but felt flat and slightly depressed
10:30pm	Went to Bed
	Day was ranked as a 2. Up and down with motivation and spaciness.
19-Nov
7am	Woke after a decent 8 hour sleep. Some disturbance during the night from my son
7-8am	Decent mood getting ready for work
8am	Took medication 4.5mg Sertraline (4mg compounded tablet + 0.5mg liquid)
8:15am	Left for work and school drop off. In decent mood and talking with kids etc.
8:40am	Noticed the head symptoms start / foggy / spacey and more head pressure/ lifting of eyebrows
9:30am	Drove to my accountant and had a coffee (2 shot latte)
10:30am	Fogginess lifted somewhat and I was clearer in meeting with accountant.
11:30-1:30pm	Visited my parents and was quite talkative
1:30pm	In decent mood and stopped for lunch at KFC. (Ate chicken burger and chips + 7Up drink
2:30pm	Felt mood and clarity drop
3:30pm	Coffee (1 shot latte)
4:45pm	Left work and went home. In ok mood upon getting home.
5:45pm	Left for my footy club for players meeting. In decent mood listening to music in car
6pm - 6:30pm	A little uneasy to start as everyone was drinking beers and I was not
6:35pm	Ate dinner (2 sausages in bread)
6:45pm-9pm	Mood lifted and felt clearer. Spoke to group of 40 guys and was laughing in conversations
9pm-11pm	Returned home in decent mood. Watched Netflix and went to sleep at 11pm
	Day was ranked as a 2. Felt good and talkative for periods but then some fogginess and apathy in others
20-Nov
6:20am	Was woken by my son. Was a little resltess and slightly high pulse early.
6:40am-8am	Got up and was in a decent mood. Making breakfast for kids etc.
8:00am	Took medication 4.5mg Sertraline (4mg compounded tablet + 0.5mg liquid)
8:40am	Felt flat / foggy and irritated (Had coffee around this time also)
9:40am	Left home with family and went for a haircut. Felt flat / foggy and slightly depressed
11am	Visited an adventure playground. Flat to start with but then mood lifted and I was playful with the kids
1:00pm	Had lunch (Fish and Salad + chips)
1:10pm - 2:30pm	Was tidying up my yard, mowing lawns etc. Felt in decent spirits.
2:30pm	Dropped significantly in motivation and was flat and disinterested.
2:40pm	Coffee (1 shot latte) Felt lift quickly.
2:45-4pm	Continued working in the yard shoveling dirt and mowing front lawn.
4:00-5:30pm	Hit another flat /spacey and now headache. Went to park with kids but lacked energy
5:45pm	Took panadol for headache
6:00pm	Got home and cooked dinner. Ate steak and salad. Felt good after this
8:00pm	Put kids to bed and felt flat and slightly depressed.
11pm	After watching Netflix I went to bed.
	Day was ranked as a 2. Pushing a 3 at some stages with flatness and apathy.
21-Nov
7:00am	Woke after a solid 7 hours sleep
7:00-8:00am	Mood decent and doing things around the house.
8:00am	Took medication 4.5mg Sertraline (4mg compounded tablet + 0.5mg liquid)
8:10am	Ate Breakfast (2 pieces of toast and banana/strawberry/spinach smoothie)
8:40am	Felt the head symptoms and fogginess start.
9:30am	Had coffee (2 shot latte) and took my kids to a bmx park
9:30am -10:30am	Mood decent and having fun with my kids
10:40am	Felt a bit spacey and lethargic.
11:00am	Spaciness past and was talkative to some of my sons school parents.
12:30pm	Ate Lunch (Turkey / salad sandwich)
1:30pm	Went to dump and shovelled a trailor load of dirt out.
3:30pm	2nd coffee (1 shot latte) and went to shops for Santa photos. Mood decent.
6:30pm	Ate Dinner (Pasta) and was very hungry
8:00pm	Did a gym workout at home (Lifting weights) first work out in 8 months. Felt great when doing it.
10:30pm	Went to bed after watching netflix.
	Day was ranked as a 1. Better motivation and feelings of connection with the kids for longer. Enjoyed workout
22-Nov
6:20am	Woke from my son. Pretty decent mood on getting up.
7:30am	Ate breakfast (2 pieces of toast)
8:00am	Took medication 4.5mg Sertraline (4mg compounded tablet + 0.5mg liquid)
8:35am	Felt some fogginess and slight head pressure start. Arrived at work
8:50am	Had coffee (2 shot latte).
9:00-10:30am	Motivation pretty decent at work.
10:40am	Felt a headache coming on. But seemed to pass
12-12:30pm	Felt pretty spacey and foggy with lifting eyebrows etc.
12:30pm	Ate lunch (Beef and salad sandwhich + pasta). 4 squares of chocolate - felt somewhat better.
1:15pm	Fuzzy feeling in head and again lifting eyebrows etc. Mood ok though.
2:00pm-4:00pm	Had a decent window of feeling upbeat, listening to music in car etc.
4:00pm	Drank a coke zero
5:00pm	Felt a little spacey and headache coming on.
5:30pm	Ate dinner (Chicken and rice) Felt better for about 20 minutes after eating.
6-8pm	Flat, headache festering with head pressure in sides. (fell asleep for about 20 minutes when putting kids to bed)
10pm	Took Panadol for headache and went to bed.
	Day was ranked as a 2. Up and down with head symptoms and headaches. Mood decent though just head.

 

appreciate this is a lot to go through but I am desperate for direction. 

I have all but ruled out Poopout as my issue as I have not felt better since my crash in March 2020 and every attempt to drop causes an increase in symptoms not a decrease. 

I'm interested in Interdose withdrawal as I am a ultra rapid metabolizer and am wondering if this might be why I am not stabilizing. @ChessieCat I read something you wrote about low doses and rapid metabolizers having issues with interdose withdrawal so would appreciate your input. 

My main symptoms that are with me most days (fluctuate in intensity) is:

- apathy and anhedonia. 

- head symptoms (swishy head, cog fog, pressure in side and temples plus sinus pain). 

I do have other symptoms but they are much more infrequent and generally ramp up in a "wave".

Final point, after my workout 4 days ago I noticed significant increase in head symptoms for 2 days and then that switched to irritability, anger and severe apathy.

 

Thanks for your help in advance. I've noted that a lot of people on this forum that qere or are taking Zoloft seem to have very delayed onset of symptoms. I think my initial 5-9 months from the crash were filled with a lot more swings (waves and windows) but since about December last year it has been far more constant with some small improvement in certain areas. 

[ChessieCat]

9 minutes ago, Cruizer said:

I read something you wrote about low doses and rapid metabolizers having issues with interdose withdrawal so would appreciate your input. 

 

I am not going to try to assess your notes, which actually might not be very helpful at this time because you have only recently made the reduction and updose.  I have explained how you might be able to see if interdose withdrawal is happening in Post #1 of the topic link below, which is the same suggestion that Alto previously gave here:

 

cruizer-sertraline-zoloft-nightmare/comment=560050

 

dose-splitting-for-interdose-withdrawal-from-short-half-life-drugs

[Cruizer]

19 minutes ago, ChessieCat said:

 

I am not going to try to assess your notes, which actually might not be very helpful at this time because you have only recently made the reduction and updose.  I have explained how you might be able to see if interdose withdrawal is happening in Post #1 of the topic link below, which is the same suggestion that Alto previously gave here:

 

cruizer-sertraline-zoloft-nightmare/comment=560050

 

dose-splitting-for-interdose-withdrawal-from-short-half-life-drugs

Ok so Alto suggested to take the notes on the post you just linked which is what I did. 

I was really just doing the notes so I could ask for help and show what I go through. What I posted is quite similar to the past 12 months. 

So when should I take daily notes that will be worthwhile someone going through? 

 

[ChessieCat]

Alto might find those notes helpful.

 

I am having trouble seeing when you made the reduction from 4.5mg to 4.4mg and then updosed to 4.5mg that you mentioned at the top of your last post.  It does not seem to be the same reduction at the end of your drug signature because of the number of days you mention.

 

If your drug signature is up to date and you have been on 4.5mg since January 2021, then the notes will be relevant regarding interdose withdrawal.

 

However, if the reduction was fairly recent they you might need to wait for a little bit to ensure you are at withdrawal normal.

 

Please update your drug signature if needed.

[Cruizer]

6 minutes ago, ChessieCat said:

Alto might find those notes helpful.

 

I am having trouble seeing when you made the reduction from 4.5mg to 4.4mg and then updosed to 4.5mg that you mentioned at the top of your last post.  It does not seem to be the same reduction at the end of your drug signature because of the number of days you mention.

 

If your drug signature is up to date and you have been on 4.5mg since January 2021, then the notes will be relevant regarding interdose withdrawal.

 

However, if the reduction was fairly recent they you might need to wait for a little bit to ensure you are at withdrawal normal.

 

Please update your drug signature if needed.

Ok thanks. I had not updated signature. The reduction and updose was recent (start of this month). 

I did feel that I was at about withdrawal normal though when taking the notes. 

I'm just so sick of trying to work this crap out. I just want to rule out things so I have direction. My symptoms seem to be still withdrawal and quite common and I can't seem to taper at all at the moment so suggests I am still very sensitised. Not being able to exercise without an increase of symptoms seems to back that up too. 

[Altostrata]

I don't see any interdose withdrawal. You seem to feel best in the morning, after the prior day's sertraline has worn off and before you take your next dose. Whatever this is

 

Quote

Noticed the head symptoms start / foggy / spacey and scrunching face/eyebrow lifting

 

appears to be an adverse effect of the sertraline dose.

 

Since you've had adverse effects from sertraline since you first took it, it's not surprising you continue to have adverse effects from it. Rather than the activation you experienced at higher doses, you're having different symptoms at lower dosages. Depending on what time of day these symptoms occur, fogginess, apathy etc. could be drug adverse effects -- not withdrawal symptoms.

 

For you, the lower the dose, the less the activation and the more sedation. Some people find SSRIs to be quite sedating.

 

I'm not sure what symptoms you were chasing with the updose to 4.5mg. You're looking for less sedation? I see you're a heavy caffeine user, are you trying to get out of sertraline-induced foggy brain?

 

What you might do is gradually move your 8 a.m. sertraline dose later by an hour each day until you're taking it about 8 p.m., so the worst of the fogginess occurs while you're sleeping instead of during the day.

[Cruizer]

On 11/27/2021 at 2:44 PM, Altostrata said:

I'm not sure what symptoms you were chasing with the updose to 4.5mg. You're looking for less sedation? I see you're a heavy caffeine user, are you trying to get out of sertraline-induced foggy brain

Hi @Altostrata, I updosed as the apathy, anhedonia and brain fog increased significantly over the course of 10 days to the point of not functioning well. I likely contributed to it slightly with remuneration of what was happening, but it was a clear increase. 

Caffeine definitely helps with the fogginess and apathy. It helps for an 1-2 hours and then I dip back. 2nd coffee in afternoon generally helps as well. 

 

The daily notes I took is what I feel consistently on an average day. This does go up and down though. Example, after doing a gym workout 7 days ago I have had significant increase in all the symptoms I listed in my daily notes. Symptoms are worse in morning though after taking dose. 

On a better day I still find a shift normally around 45 minutes after tablet but it just passes sooner. On a more severe day I can wake and feel flat and apathetic but generally the head symptoms don't start until after I take the morning dose. 

 

The increase I get within 45 minutes in taking the morning dose is very consistent though (80-90%) as I have been writing it in my journal even before my crash in March 2020. 

 

In the past 20 months I have had some periods of a week or so where things like anxiety, cortisol spikes, insomnia and nausea ramp right up, but I would say maybe 4 times this has happened to me so is pretty inconsistent and never last more than a week or so. 

 

The head symptoms/fuzziness, apathy, brain fog and head pressure are the most consistent and ramped up after about 8 months of holding and really haven't let up in the past 12 months aside from small periods of 3 or 4 days. 

 

So plan from here Alto is to move dose to 8pm at night (move made gradually an hour a day). I will then give this a few weeks to settle and take another week to 2 weeks of daily notes and assess from there. Does that sound like a good plan?

 

Thanks for taking the time to look into this for me. I really appreciate it. I do not speak to anyone else aside from members on this forum for advice. 

 

[Altostrata]

Yes, I would try taking it later.

 

1 hour ago, Cruizer said:

The increase I get within 45 minutes in taking the morning dose is very consistent though (80-90%) as I have been writing it in my journal even before my crash in March 2020. 

 

I need to know stuff like this. Please continue daily notes.

[Cruizer]

Little concerned with the sertraline tablets I am buying. Just wanted to note on here that I went to fill my script today which is 50mg sertaline tablets that I make my 0.5mg liquid dose from. 

Firstly the pharmacy gave me a different brand without saying anything but when I went to pay I saw the different box. They ordered in the same brand for me and have noted on my file that I prefer that brand. (Makes me wonder how many times they may have switched me up with my compounded capsules now also.) 

I collected my preferred brand tonight but I noticed it was a smaller packet. Then I noticed on the front of the box it says "new appearance, new formulation". 

That concerns me greatly but I have no other option but to use them. It is the same brand. 

Hopefully the fact that it is only 0.5mg of my 4.5mg dose it won't effect me too much. Plus I have no idea whether the last 4mg tablets I had compounded were the new formulation anyway. 

 

[Cruizer]

On 11/27/2021 at 2:44 PM, Altostrata said:

I don't see any interdose withdrawal. You seem to feel best in the morning, after the prior day's sertraline has worn off and before you take your next dose. Whatever this is

 

 

appears to be an adverse effect of the sertraline dose.

 

Since you've had adverse effects from sertraline since you first took it, it's not surprising you continue to have adverse effects from it. Rather than the activation you experienced at higher doses, you're having different symptoms at lower dosages. Depending on what time of day these symptoms occur, fogginess, apathy etc. could be drug adverse effects -- not withdrawal symptoms.

 

For you, the lower the dose, the less the activation and the more sedation. Some people find SSRIs to be quite sedating.

 

I'm not sure what symptoms you were chasing with the updose to 4.5mg. You're looking for less sedation? I see you're a heavy caffeine user, are you trying to get out of sertraline-induced foggy brain?

 

What you might do is gradually move your 8 a.m. sertraline dose later by an hour each day until you're taking it about 8 p.m., so the worst of the fogginess occurs while you're sleeping instead of during the day.

 Hi @Altostrata. I hope your well. 

I thought it was about time I updated you on what has happened in the past 2 months since we spoke last and you suggested you thought I might be experiencing adverse effects rather than Withdrawal. 

So I have maintained daily notes (a lot of data so won't post it all). 

I started moving forward my dose by half an hour per day for 2 days and had a poor day of anxiety ( however I was putting my dog down so that might have been a bit of natural stress). 

I waited a few days and then from the 7th of Jan until the 2nd of Feb (26 days) I moved forward 15 minutes per day every day. 

During this 26 days I had a pretty decent patch. No severe days and had many periods through days of higher motivation and better connection with my kids. It wasn't all roses but overall the 26 day period was better. I noted during this 26 day period that the "head symptoms" (scrunchy face, eyebrow raising, foggy) seemed to continue to kick in about 40 minutes after I took the dose as well as the same time frames it use to when I was taking at 8am. It was quite consistent so it was pretty clear to me that the dose is doing something to effect me I.e. adverse effect. 

Anyway I decided that I would pause pushing the dose 15 minutes forward per day so I could take some more notes and really make the connection. So I paused and am currently taking 4.5mg at 3:30pm.

However within 2-3 days of pausing, I noticed a significant increase in symptoms and I by day 3 felt significantly worse in terms of motivation, anhedonia, irritation etc. I continued to hold at 3:30 and they continued to get worse and rival when I dropped a few months back but then updosed. It's been 12 days now of severe symptoms which now includes anxiety, depressed and cortisol spikes in the morning. 

It is almost similar to back in 2019 when I had held for a long period and made a small reduction  and felt good initially and then was hit with very severe symptoms which Brass suggested back then I needed to continue tapering a little faster which really helped. (Maybe poopout or adverse effects)

 

I have also noted the following which may be useful from my note taking over the last 23 months of this hold. 

1) Any exercise like weights, jogging, golf, strenuous gardening/digging feels good at the time but within a day or so I get a major increase in head symptoms, apathy, brain fog etc. This has gotten worse since the start of the hold. 

2) Everytime I have a batch change from my compounded tablets, I feel a significant increase in the same symptoms. This is very consistent. It's like my body takes it as an updose or something. 

3) Any change that is not continued I.e. small drop or change in time taking meds seems to cause a massive increase in symptoms which has happened many times in the past at higher doses. In fact it has happened everytime after a long hold. 

4) What I am calling head symptoms and eyebrow raising and scrunchy face could also be described as facial grimeses. Similar to Tardive dyskinesia only I wouldnt say they are involuntary movements as I control when I do it. It's more an irritation in my face so I tend to move it. 

5) I rate my days from 0-4. Anything I rate as 1 or 0 I classify as a fairly mild symptom day. In the first 11 months vs the second 11 months of my hold I am almost exactly the same amount of mild days (85 vs 88). This suggests to me I am not improving at all which kind if backs up the "adverse effect" theory. 

6) my main symptoms that are consistent through the last 23 months are: brain fog, apathy/anhedonia, fatigue and the head symptoms (facial grimises), sinus pain over right eye and tingle in my back near shoulder blade. All of which aside from head symptoms I had back in 2019 after I held for 13 months back then. Facial grimising use to come when I would change dose and within a day or so. Now they are constant and are worst after I take the daily dose. 

7) From as far back as I can remember (around 2015) I have always noticed that if I experience something good and have a positive feeling about it and a good day, it has then been met within a few days with an increase in symptoms. (Even before tapering and at a full dose). It's like the meds "pull me back". Example recently was back in September last year my team that I coach won an important final to get us into the grand final. I was on the most natural high I can remember for about a day and a half. Than 2 days later smashed with severe anxiety, cortisol spikes and nausea. I remember thinking it at the time saying "can't wait for this high to finish and crash" 

 

Alto I've been holding for 23 months now at 4.5mg and I would say things have gotten worse not better or at the very least stayed the same. I starting tapering back in 2016 so I have in no way been in a hurry. I was always prepared to hold if I thought it was needed but every hold seems to make things worse not better. 

 

I know above is a lot to go through, but I need direction as I feel I am going nowhere. Thanks

 

 

[Altostrata]

Please post your daily notes in an easy-to-read list format. The last time you did this was late November. This will help us see what the drug is doing.

[Cruizer]

Hi @Altostrata. I have posted a significant amount of daily symptoms below. I have done this in week blocks but thought it was important to show the difference from when I was moving the dose forward 15 minutes per day and feeling ok with more motivation at times, to when I stopped moving forward 15 minutes and had a large increase in problems. 

 

4th Jan
7am	Up early and went fishing in my brothers boat. In good mood (away on holiday)
7:15am	Had instant coffee and vegemite sandwich
7:30am	out on the water fishing and in a good mood
9:00am	Took medication 4.5mg. Sertraline
9:40am	Felt head symptoms creep in and mood sank a little.
12pm	Back from fishing feeling a little flustered.
12:30pm	Ate Lunch. Left over bbq food
1:30pm	Went to beach with kids and felt reasonable.
3pm	took my eldest out on the boat fishing and felt decent.
4pm	Had second coffee for the day
5pm	In a good mood down at the beach with kids etc.
7pm	Ate dinner. In good mood listening to music
11pm	Went to bed after chatting with family for an hour or so. In good mood
	Day rated as 1 (Mild)
5th Jan
7am	Woke after a decent sleep (in caravan on holiday)
8am	Ate breakfast (bacon and eggs) plus coffee. In a decent mood
9am	Took medication 4.5mg Sertraline
9:40am	Felt dip in clarity and some head symptoms present.
10am	Packing up caravan and heading to see my wife’s nana (half hour drive)
12pm	Cooked lunch (bbq) feeling a little spacey and off. Ate plenty though
1-3pm	Felt a little off but not too bad
4-7pm	Drove home (2.5 hour car drive) mood ok but tired
8pm	Ate dinner (McDonalds). Mood ok
10pm	After cleaning up a bit went to bed.
	Day rated 2 (Moderate) due to spacey head
6th Jan
7am	Woke and was feeling in decent mood for first day back at work
8:30am	Coffee (1 shot latte)
9am	Took medication 4.5mg Sertraline
9:30-12pm	Worked in our warehouse. Felt a little spacey and dazed but mood ok.
1pm	Ate lunch (Chicken roll)
1-4pm	Continued working in our warehouse. Mood decent, just spacey
5pm	Went home from work and played with my kids (monopoly and swim in pool)
6:30pm	Ate dinner (Pasta)
8:00pm	Watched tv after kids were in bed. Mood decent.
10pm	Went to bed.
	Day rated as 2 (Moderate) only due to head symptoms - mood ok
7th Jan
7am	Pretty flat on waking and slightly irritated on waking.
8:30am	Had a coffee (2 shot latte)
9:15am	Took medication 4.5mg Sertraline. Started moving meds 15 minutes fwd. per day
9:30-12	Felt very spacey and unclear. Finding it hard to string sentences together.
12:30pm	Ate lunch. Pork roll. Appetite ok
1-5pm	Working away but lacked clarity and quite foggy and irritated
3:30pm	2nd Coffee
5:30pm	Ate dinner (Tacos)
8-10pm	Watch Netflix then went to bed.
	Day was rated 2 (Moderate) due to irritation and quite ordinary brain fog and fatigue
8th Jan
6:30am	Woke a bit flat and tired but not too bad after a solid 7 hours sleep
7:30am	Ate breakfast (2 pieces of toast)
9am	Went out for coffee at a local café. After coffee mood picked up and in decent spirits.
9:30am	Took medication 4.5mg Sertraline
10am	Felt dip and head symptoms start.
11:30am	Went to my parents and was in decent mood and talkative.
12:30pm	Ate lunch (sandwich)
1pm - 3pm	Head symptoms dropped and I worked in the garden mowing lawns etc. in good mood
3pm	2nd Coffee
4pm	Noticed a dip in mood and felt flat. Head symptoms also ramped up again
7pm	Ate Dinner
8pm-10pm	Watched some TV. Head symptoms and mood lifted
10:30pm	Went to Bed
	Day rated as 2 (Moderate) bit up and down with mood and head symptoms
9th Jan
7am	Woke and was in decent spirits early.
7:30am	Ate breakfast and had a coffee (2 shot latte).
9am	Went for a walk around our area with family and in good spirits.
9:45am	Took medication (4.5mg sertraline)
10:25am	Almost exactly 40 minutes after taking meds felt the head symptoms start and went foggy
11am - 2pm	Took my youngest son for some one on one time to a big indoor garden. Felt good and great
	connection with him.
12pm	Ate Lunch and a cake.
4pm	Had a swim in the pool with my kids and felt good connection with them. Mood decent
	Head symptoms still ordinary though.
6pm	Ate Dinner (Chicken and Veg)
8pm-10:30pm	Watched TV and was in decent mood
	Day rated as 1 (Mild) despite head symptoms being bad. Mood was decent and felt some good
	connection with my son for large periods.
10th Jan
7am	Woke after a solid 8 hours of sleep
7:30am	Ate Breakfast
8:30am	Left for work in good mood
8:45am	Had first coffee (2 shot latte)
9:30-10am	Some small flutters of giddiness right before I took meds
10am	Took Medication 4.5mg Sertraline
10:40am	Head symptoms (scrunchy face/facial grimaces) hit but only lasted a short time (half hour or so)
12pm	Ate lunch (Pork roll)
3pm	Second Coffee (1 shot latte)
5pm	Home from work
5:30-7pm	Had a real clear patch of feeling great. Took kids down to the park and then in pool.
8pm	Noticed a bit of a dip after the clear patch. Bit flat etc.
10pm	Went to bed
	Day rated 1 (Mild). Decent mood and head symptoms a little less. Noted the real clear patch
	I had for an hour or so felt like it does when I get a significant dip after.

 

[Cruizer]

11th Jan

 

7am

Woke after a solid 7 hours of sleep.

7:30am

Cereal for breakfast

8:30am

Dropped my car down for a service. Bit fatigued but then had a coffee which helped

10:15am

Took Medication (4.5mg Sertraline)

10:55am

Felt the head symptoms kick in.

12pm

In the office felt slightly giddy and tingles (bit like low blood sugar).

12:30pm

Ate lunch. Giddiness stopped after food but head symptoms remained thick for the rest of the day

1pm-4pm

Working in the office doing emails. Motivation a little low but ok. Little irritated

3pm

Second Coffee

5pm

Picked up my car from service

6pm

Ate dinner.

10pm

Went to bed

 

Day rated 2 (Moderate) due to thick head symptoms and brain fog.

 

 

12th Jan

 

7am

Woke from solid sleep.

7:30am

Cereal for breakfast

8:30am

Went to work (Mood quite good)

8:45am

Had a coffee (2 shot latte)

9-10:30am

Decent mood just working away

10:30am

Took medication 4.5mg

11:10am

Almost exactly 40 minutes after meds felt the jolt of head symptoms

11:30am-2pm

Mood relatively good and productive at work. Ate lunch

2:15pm

Noticed a dip in mood and an increase in head symptoms (foggy and facial grimaces) + fatigue

3pm

second coffee

5:15pm

Left work for home and by this stage I was pretty grouchy and irritated. Snappy at my kids

6:30pm

Ate dinner

8:30pm

Felt like my mood lifted significantly and I enjoyed watching tv show

10:30pm

Went to bed

 

Day rated as 2 (Moderate) due to increase in head symptoms and irritation through afternoon

 

 

13th Jan

 

7am

Woke ok and slept well.

9am

Collected my dogs ashes from the vet which upset me and made me teary.

9:30am

Had a coffee (2 shot latte)

10am

Feeling a little apprehensive and some mild/mod anxiety.

10:45am

Took medication 4.5mg Sertraline.

12pm

Ate lunch

1:45-2pm

Noticed the thick head symptoms hit me. Very unclear.

 

Note: I have noted that the head symptoms that use to hit me at approx. 11am when I was taking

 

meds at 8am, seem to be hitting me at 1:45-2pm which is the same 3 hours from when I take the med

3pm

Had 2nd coffee

5pm

Went home from work

5:15pm

Ate dinner.

5:30pm - 7:30pm

At football training. Bit flat and foggy but had an ok time.

8pm

Home. Watched some TV and went to bed by 10pm

 

Day rated 2 (Moderate) due to significant head symptoms / lack of enthusiasm and fogginess

 

 

14th Jan

 

7am

Woke after solid sleep. Felt a bit crabby and irritated.

7:30am

Ate breakfast (cereal)

8:30am

Left home for work.

8:45am

Had coffee (2 shot latte)

9-11am

Mood quite decent and more productive at work.

11am

Took medication 4.5mg Sertraline

11:40am

Felt the usual rise in head symptoms around 40 minutes after taking meds. This time not overly bad

12:30pm

Ate lunch (chicken club sandwich)

3:00pm

Hit a wall with some flatness as well as a headache.

3:30pm

Had second coffee

5pm

Went home for the day from work

6pm

Had dinner

10pm

Went to bed

 

Day rated as 2 (Moderate) Ok in morning and then flat with headache in arvo.

 

 

15th Jan

1st day of 2 weeks off work

7am

Woke after solid sleep.

7:30am

Ate breakfast (cereal)

8:30am

Had a coffee (2 shot latte)

9:30am

Went out to a few shops buying some clothes and drill for holiday. A little spacey when out but mood ok

11:15am

Took medication 4.5mg Sertraline

12:30pm

Ate lunch

1-4pm

Spent time getting ready for holiday, packing caravan, doing the lawns and packing bags etc. ok mood

6:00pm

Ate dinner (burgers)

7-10pm

Still cleaning up things around home ready for going away tomorrow.

 

Day rated as 2 (Moderate) Could have been a mild day. Just a bit up and down but overall ok.

 

 

16th Jan

 

7am

A little crabby on waking but keen to go away on holidays.

7:30am

Ate breakfast and had a coffee.

8-9am

Packing the car. In decent mood

10-11am

Felt a little uneasy on drive up there.

11:30am

Took medication

11:50am

Went to bakery and felt very spacey in the line and a little giddy

12:20pm

Ate lunch, sausage roll and cake

1pm-3pm

Setting up caravan, seem to be in a better mood now.

3pm

Second coffee

3-5pm

Went in the pool and waterslides with my kids. Decent mood

6pm

Ate dinner (BBQ)

7pm

Back in the waterslides and mini golf. In good mood

8-10pm

Took my oldest son fishing and felt pretty good.

10:30pm

Bed

 

Day rated as 2 (Moderate) but could have been mild. Up and down in morning but decent in arvo.

 

 

17th Jan

 

7am

Woke a little crabby but had a solid sleep

7:30am

Working out breakfast for kids and felt a little stressed but ok mood.

8am

Breakfast (pancakes) and coffee

9am

Drove to a beach and felt in a decent mood

10am-11am

Explored a beach and felt connected with my kids

11:45am

Took medication (Didn’t notice too many head symptoms today)

2pm

Felt a little giddy and slightly anxious on arriving for lunch at a pub

2:30pm

Ate lunch (large chicken schnitzel) - After food I felt better

3:30pm

Second coffee

4pm-6pm

Spent time in pool and on water slides. Felt connected with the kids and had a good time.

6:30pm

Ate dinner (chicken salad) hungry and ate plenty

8pm-10pm

Took my eldest son fishing again and felt connected with him.

10:30pm

Bed

 

Day was rated as 1 (Mild) felt good connection with my kids today and had a good time. (New script noted)

[Cruizer]

18th Jan
7am	Woke after solid sleep and in a good mood straight up.
7:30am	Coffee and breakfast
9am-10:30am	Played on jumpy pillow at park with my kids and other kids from park. Had a great time
11:30am	My parents came and was chatty.
12pm	Took medication (Noted no real head symptoms today)
1:00pm - 4pm	Went out for lunch (green chicken curry) and second coffee. Then to a carnival with rides for kids.
	felt great and in a super mood.
4:30-6:30pm	Back at caravan park for more swimming. Felt really proud of my son for swimming on his own.
	cooked bbq and ate plenty. In good mood
8-10pm	Watched a movie with my wife then Bed
	Day was rated as 0 (None) a rare occasion where I felt great most of the day with very little symptoms
19th Jan
7am	Woke after solid sleep.
8am	Breakfast and coffee (Bacon and egg sandwich)
9am	Went on the jumpy pillow with kids. Noticed a slight shift in mood and feelings of irritation creeping in.
11am	Packing up caravan with some mild anxiety flutters. Nothing major.
12:15pm	Took medication
1:00pm	Went for lunch. Noticed a bit of a spacey feeling and some head symptoms
1:30pm	Ate yiros for lunch plus coffee
2-3:30pm	Fishing with my son. Felt ok but a little flat.
5:30pm	Left caravan park heading for home.
6pm	Ate dinner (KFC). Felt pretty decent on the drive home.
8pm	Arrived home and unpacked. Mood good.
10pm	Bed
	Day rated as 1 (Mild) a shift in mood noted which always comes after a "zero" day. Overall still in decent mood
20th Jan
7am	Woke from decent night sleep
8am	Breakfast and coffee
9-12pm	Up and down with motivation in morning. Cleaned out the caravan and putting things away.
12:30pm	Had lunch (Sandwich) and took medication
1-3pm	Went to neighbours house and watched my kids play. Was talkative to the neighbour and in a decent mood.
3:30pm	Second Coffee
5:30pm	Left for football training but was feeling pretty flat and disinterested
5:55pm	Pretty spacey on arrival and brain fog.
7:30pm	Finished football training and went for a swim in ocean. Felt ok but a little uneasy.
8pm	Ate dinner
10pm	Went to bed
	Day was rated 2 (Moderate) up and down with motivation and head symptoms. Felt spacey and foggy at times in arvo
21st Jan
6:30am	Up early after solid sleep.
7:30am	Drove to a friend’s house to pick up trailer and was in decent spirits.
8-12pm	Worked in garden doing a renovation. In decent spirits.
9pm	Had a coffee
10am	Had bacon and egg roll
12:15pm-1:15pm	Shovelled out dirt from a trailer at the dump. Heavy lifting and quite tired
12:45pm	Took medication
2-5pm	Felt quite spacey in afternoon period. Some brain fog and irritation present.
	Note: No notes taken after 5pm
	Day was rated as a 1 (Mild) in decent spirits but some head symptoms present.
22nd Jan
7am	Woke after solid sleep
8am	Had coffee and breakfast
10am	Went to garden shop and was looking at plants and garden materials for front yard. Mood ok but some fatigue present.
12pm	Took my kids to the park. Felt a little flat and fatigued but did some heavy digging yesterday so could be that.
1pm	Took medication
1:30pm	Ate lunch (Sandwich)
2-3pm	Played with kids in the pool and at home. Little flat and spacey
5-7pm	Fixed irrigation in the garden and planted trees. Felt in decent mood towards night.
7pm	Ate dinner
8pm	Watered garden and watched some TV.
10:30pm	Bed
	Day was rated as 1 (Mild) Up and down with motivation and head symptoms
23rd of Jan
7:30am	Woke after a decent sleep.
8am	Breakfast and Coffee
9am	Went up to a market which was about an hour drive. Felt in decent mood
10-12am	At markets and in decent spirits.
1:15pm	Took medication
2-5pm	Went significantly flat in afternoon and quite foggy.
3pm	2nd coffee
6pm	Ate dinner (Spaghetti)
7:30pm	Doing work in garden and broke pipe. Became extremely angry and irritated after this.
9-11pm	Watched TV and went to bed
	Day was rated as 2 (Moderate) Decent mood in the morning but flat and spacey in afternoon and angry at night
24th Jan
7am	Woke after good sleep but felt quite flat and irritated.
7:30am	Had coffee and breakfast
9am	Took kids down to a park near beach. Felt significantly flat and fatigued plus spacey for around 2 hours
11am	Took kids for ice-cream and had one myself. Lifted a bit after this.
12:00pm	Went to my mum and dads to pick up some gardening tools and was in a good mood
12:30pm	Ate lunch, Sandwich
1:30pm	Took Medication
2:30pm	2nd Coffee
2-4pm	Worked in garden and in a decent mood. Didn’t notice too many head symptoms in arvo
5:30pm-7:30pm	Went to football training and was in a super mood and quite clear all training.
8pm-10pm	Watched some Netflix and went to bed
	Day rated as 1 (Mild). Aside from 2 hours early in the morning with head symptoms, day was quite good.

 

[Cruizer]

25th -26th of Jan	Missed taking daily notes but had rated both days as 2 (Moderate) and mentioned feeling flat, head symptoms also
	mentioned feeling flat later at night. Meds continued to be taken 15 minutes forward to previous day
27th Jan
7am	Woke after solid 8 hours sleep.
8am	Ate breakfast (toast and fruit drink)
8:30am	Left for the swimming centre with my 2 kids. Felt flat and some small anxiety and depression feelings.
9am-1pm	Spent 4-5 hours in swimming pool with kids. Felt pretty apathetic and numb but still had an ok time.
12:00pm	Ate lunch (Sandwich + fruit bar and hot chips)
2pm	Returned home after getting a trailer load of dirt for garden.
2:15pm	Took medication 4.5mg Sertraline
3pm	Second Coffee
5:20pm	Ate dinner (Pasta)
5:30pm - 7pm	Went to football training. Ok mood there
7pm	Head symptoms smashed me. Scrunchy face, hard to put sentences together etc.
8-10pm	Watched some Netflix and went to bed. Head symptoms large.
	Day rated as 2 (Moderate). Flat in morning and then severe head symptoms later at night after football.
28th Jan
7am	Woke after solid sleep around 7-8 hours. Felt pretty flat straight away.
7:30am	Ate breakfast. (Toast).
9am	Dropped my kids to my parent house to be looked after.
9:30am	Had coffee (2 shot latte). Feel quite flat.
10:30am	Had a zoom meeting for my business with 6 others. (Felt pretty foggy)
11:30am	Finished meeting and was very flat with some anhedonia.
12pm	Ate lunch.
12:30-2:30pm	Went back into front garden and shovelled some mulch around. Felt far better doing this and much clearer
2:30pm	Took medication 4.5mg Sertraline
3pm	Coffee
3:30-5pm	Played with my kids in pool and in backyard. In decent mood.
5:30pm	Ate dinner
7-9pm	Finished off front garden. In decent mood but feel quite fatigued now.
10pm	Shower and bed.
	Day ranked as 2 (Moderate) Flat and anhedonia in the morning but then more upbeat in early arvo when going into garden
29th Jan
6:45am	Woke after solid sleep. Felt in decent mood and upbeat
7:30am	Ate breakfast.
8am	Watered the garden out the front. Had coffee (1 shot latte)
10am	Left home heading out for a 2 hour drive to my wife’s Nanas house. In decent mood and talkative
12Pm	Arrived and ate lunch. Was quite hungry and ate pasties and sausage rolls plus fruit and chicken
1-3pm	Played around in the river with my kids and did some fishing. Mood quite good.
2:45pm	Took medication 4.5mg Sertraline
4pm	Went to a ceremony that was celebrating my wife’s Grandpa. Felt pretty decent here with some mild head symptoms
5-7pm	Drove home and ate dinner.
8-10pm	Watched TV and went to bed.
	Day ranked as 1 (Mild) Felt far more upbeat today and enjoyed swimming with my kids etc.
30th Jan
7:30am	Woke after solid 8 hours sleep.
8am	Ate breakfast and had coffee
9pm	Went to my investment property where I laid some more bark down. In good mood and talkative to the tenant
10pm	Played board games with my kids and drawing etc. in decent mood
12:30pm	Ate lunch (Sandwich)
1pm	Did some tidying up and ironed my clothes ready for going back to work tomorrow.
3pm	Went and had haircuts with my kids at the shops.
3pm	Took medication 4.5mg sertraline
4pm	Went to park with my kids and wife. Some spiciness and head symptoms
6pm	Home and ate dinner
7-8pm	Baths for kids and then put them to bed.
10pm	Went to bed
	Day rated 1 (Mild) In decent mood most of the day and talkative
31st Jan
7am	Woke after solid sleep.
7:30am	Ate breakfast and got ready for work
8:30am	Left for work (Mood pretty decent) First day back after 2 weeks off on holidays
8:45am	Coffee (2 Shot latte)
9-12pm	At my desk in front of my laptop sending emails and catching up on things.
12:30pm	Went home for lunch
1pm	Returned to work and continued emails etc.
3:15pm	Took medication
3:30pm	Had second coffee
5pm	Went home from work. Day was basically sitting at my desk doing emails.
5:30pm	Ate dinner (Chicken wraps)
6-7:30pm	Played with my kids and organised them for bed.
8-10:30pm	Watched a movie and went to bed.
	Day was rated as 2 (Moderate) but was more like 1.5 just felt a bit flat and fuzzy but staring at a computer all day when I
	haven't done that for 2 weeks is pretty normal. Also trying to use my brain more for work etc.
1st Feb
6:40am	Woke after a solid sleep. Noted I felt a little irritated and crabby from the get go.
7:30am	Ate breakfast
8am	Left home and dropped kids to my parents’ house to be looked after.
9:30am	Arrived at work. (Motivation a little low)
9:30am	Had coffee
10am-12pm	Set up a robot wrapping machine outside. Was ok doing this but felt a bit foggy and unclear.
12:30pm	Went home for lunch
1:30pm	Back to work (lacking much motivation)
3:30pm	Took medication 4.5mg
3pm	Second Coffee
5pm	Home from work. Feel pretty crabby and not overly interested in playing with the kids.
6pm	Ate dinner (Ate plenty of food)
6:30-8pm	Played with kids and organised them for bed.
8:30pm-11pm	Spent time on my phone and watched Netflix
11pm	Bed
	Day was rated as 2 (Moderate) Just quite flat and irritated through most of the day. Struggling to talk clearly etc.
2nd Feb
7am	Woke after solid sleep
7:40am	Ate breakfast
8am	Kids first day back to school. More upbeat and taking photos of them etc.
9am	Went to work
9:15am	Had coffee
9:30am-12pm	At desk emailing customers etc. Speaking on the phone I felt a little unclear and struggled to put sentences together.
	mind going blank at times.
12:30pm	Went home for lunch. Sandwich
3:30pm	Took medication 4.5mg Sertraline (Note 2nd day in a row at 3:30pm) - Decided to hold here and see what happens.
4:30pm	Noticed head symptoms increase
5pm	Left work for home
5:30pm	Head symptoms very severe. Heavy head, raising eyebrows (facial grimaces)
6pm	Ate dinner
7:30pm	Again noting the head symptoms very large
8pm	Head symptoms eased a little and I did some more work at home on my IPAD.
10:30pm	Went to bed
	Day rated as 2 (Moderate) More upbeat early in morning but fell flat again mid-morning and head symptoms massive after
	taking dose at 3:30pm

 

[Cruizer]

3rd Feb

 

6am

Woke for some reason but went back to sleep

7:15am

Woke and had not a lot of enthusiasm to get out of bed but did.

7:30am

Ate breakfast and got ready for work. Was ok mood

8am

Went to work and was ok but also feeling a little sick with flu symptoms. Bit of a headache and sniffly

9am

Coffee

9:30am

Feeling pretty apathetic and not interested in doing much.

10am-12pm

Working away at my desk slowly. Lacking clarity and motivation

12:30pm

Went home for lunch and was flat

1:30pm - 3:30pm

At my desk working away but struggling with focus and motivation

3:30pm

Took medication 4.5mg Sertraline

5pm

Home from work

5:30pm-8pm

Went to football training and had meeting after. Ok mood but still very foggy

8pm-9pm

Went to my mum and dads house. Quite talkative but felt foggy

9pm

Got home and started feeling quite depressed.

10pm

Went to bed feeling flat and depressed

 

Day was rated as 2 (Moderate) Up and down through the day and a little sick. Thick foggy head and motivation low

 

 

4th Feb

 

6:15am

Woke with a slightly higher pulse at 70BPM rather than the normal 58-60

6:30am-7am

Laid in bed with significant morning dread. Did not want to get up.

7am-7:30am

Up and ate breakfast.

8:15am

Out the door and dropping kids to school

 

No more notes taken aside from:

 

Day rated as 2 (Moderate) Similar to all this week. Feeling flat and anhedonia.

 

 

5th Feb

 

7am

Woke and was very irritated straight away

8am

Had coffee and breakfast

9am

Went down to local hardware store to buy some fence sheets. Very very foggy and swishy head

9:30am

Got back to car and was so irritated that I screamed in my car and punched the steering wheel.

11am

Home and mowed the lawns. Felt still severely irritated but better after finishing the lawns

1pm

Ate lunch

2pm

Went to a kids party with my family and was in an ok mood

3:30pm

Took medication

4:30pm

Foggy and mental clarity not good.

5-7pm

Ok mood, ate dinner and played with kids.

 

Day rated as 3 (Severe) First severe day in 38 days.

 

 

6th Feb

 

7am

Woke and felt in a bit better mood

7:30am

Ate breakfast and had coffee.

8am

Went outside and watered garden. Mood ok

9:30am

My Dad came over to help with some jobs (putting fence panels up)

10-12:30pm

Felt severely flat and anhedonia hit me hard. Irritated and not interested

1pm

Ate lunch (burger)

1:30-2:30pm

Resprayed mirror on my wife’s car

3:30pm

Took medication

4-7pm

Pretty flat and foggy

 

Day rated as 3 (Severe) Anhedonia and irritation was severe all day. Depressed later at night.

 

 

[Cruizer]

 

Monday 7th Feb
6:30am	Woke after a solid 7 hours. Had some morning dread
7:30am	Felt ok getting ready for work. Ate breakfast of 2 pieces of toast
8:30am	Dropped son to school and went to work. Mood ok
9am-12pm	At work (had a coffee) Relatively productive sending emails. Little foggy but ok
1pm	Ate lunch which was butter chicken and a meat paddy.
3pm	Picked son up from school. Little spacey but ok.
3:30pm	Took Medication 4.5mg Sertraline
3:40pm	Had a coffee
4:30pm	Motivation dipped and head symptoms became more prominent
5:20pm	Home from work but flat as hell and had a lot of anhedonia and not clear
6:30pm - 8pm	Significantly depressed. Few tears in my eyes and felt awful. Head symptoms large.
10:30pm	went to bed after watching some Netflix for an hour. Feel quite down and depressed.
	Day rated at 3 severe
Tuesday 8th Feb
7am	Woke after a solid 7-8 hours of sleep. Still felt tired a bit
7:30am	Ate 2 pieces of fruit toast.
8am-8:30am	Dropped kids to school. Mood ok but a little flat and brain fog.
9:30am	Had a 2 shot latte, picked me up a little.
10:30am	Working away, not overly interested but ok. Anhedonia feeling
1:00pm	Ate lunch. Chicken and veg. Mood ok just flat and not a lot of get up and go
3:30pm	Took Medication 4.5mg Sertraline (New batch)
3:30pm	Had a coffee (Latte) which picked me up and I felt a little more interested and mood improved
5:00pm	Home from work and was feeling hungry
5:45pm	Ate dinner, Chicken schnitzel with chips and veg. (Felt starving)
6pm-10pm	Felt more interested in doing some jobs around home but had heavy head at times plus headache
11pm	Went to bed
	Day rated at 2 moderate
Wednesday 9th Feb
7am	Woke after a solid 7-8 hours of sleep. Mood ok on waking but had a bit of a swishy head.
7:30am	Ate 2 pieces of fruit toast
8:30am	Dropped kids to school and was more talkative with some of the parents. Mood seems better today
9am	Coffee (2 shot latte). Have had a lingering headache and sinus pain in recent days.
11am	Pretty apathetic, not really interested in doing much work. Some head symptoms but severe anhedonia
1pm	Ate lunch, roast lamb and cheese roll.
11am-2:45pm	Severe anhedonia and feelings of being dead inside. Just blank
3:00pm	Anhedonia lifted a bit and I had a coffee (1 shot latte).
3:30pm	Took Medication 4.5mg Sertraline
5:00pm	Finished work for the day and went home. Feeling a little flat with some head symptoms
5:30pm	Ate dinner, chicken rice and vegetables
6pm	Jumped in our pool which the cold water helps give me a bit of a boost in mood and energy
8pm	Feeling a bit flat and crabby. Watched a tv show
10pm	Went to bed
	Day rated as 3 severe
Thursday 10th Feb
7am	Woke after a solid 8 hours of sleep. Mood ok on waking
7:30am	Ate a bowl of cereal and banana.
8:30am	Dropped off my son to school and was talkative to other parents.
9am	Had a coffee (2 shot latte)
9-10:30am	Reasonably productive at work and in a bit better mood.
11am	Felt a bit of head symptoms and energy drop
11:30am - 1pm	Pretty reasonable mood going in and seeing customers. Bit of a heavy head though.
1:30pm	Ate lunch. Chicken and salad roll
3:30pm	Took Medication 4.5mg Sertraline
4:00pm	Noticed head symptoms increase , facial grimaces, brain fog increased
5:00pm	Finished work for the day, went home but was pretty flat.
5:30pm	left for football training pretty flat
6pm-8pm	At football training (coaching) spoke clearly to the group, jogging around setting up cones etc. Decent mood
8pm	Left football and had some significant head symptoms (facial grimaces) mood ok
8:30pm	Ate some chocolate and felt ok. Mood decent
10pm	Went to bed
	Day Rated as 3 (Severe)
Friday 11th Feb
6:30am	Woke after a solid 7 hours of sleep. Pretty irritated and slightly anxious from waking
8:00am	Dropped kids to school. Feeling pretty flat.
9am	Feelings of restlessness and mild to moderate anxiety. Some anhedonia to.
9:30am	Had coffee (2 shot latte)
10-11:30am	Not too bad a work. Working away.
11:30am - 12:30am	Had a 1 hour zoom meeting with a supplier. Felt quite decent and spoke clearly
1:00pm	Heavy head, brain fog and fatigue present. Anxiety dropped to basically nothing
1:15pm	Ate lunch which was ravioli pasta.
2pm-3:30pm	Real thick head, pressure in the side of my head, swishy head, feel dazed and confused
3:30pm	Took Medication 4.5mg Sertraline
3:30pm	Had a coffee. (1 shot latte)
4pm	Head symptoms continued and felt flat.
5pm	Left work and went to my sons basketball. Felt ok here but still flat
6:00pm	Ate dinner burger and pizza
8pm	Went and washed my wife’s car. Ok mood but still a bit flat
10pm	Went to bed
	Day Rated as 3 (Severe)
Saturday 12th Feb
6:30am	Woke after a solid 7 hours of sleep. Ok on waking
7:30am	Ate Breakfast (2 pieces of toast)
9:30am	Had first coffee and drove 2 hours to go fishing and pick up new dog.
11am	Ate a chicken sandwich
12:00-1:30pm	Went fishing and felt ok but quite flat and not overly interested
2:00pm	Collected new dog and then drove home (2 hour drive)
2:15pm-4pm	Felt significantly flat and depressed
3:30pm	Took medication 4.5mg Sertraline
4:20pm	Felt the head symptoms start. Scrunchy face (facial grimacing) thick head, fatigue and brain fog
	Note: these head symptoms were significant from 3:30-8pm.
6:30am	Ate dinner. Chicken salad
9pm	Took some Panadol as I had quite a bad headache and pressure in the side of my head.
10pm	Went to bed feeling depressed and head pressure
	Day Rated as 3 (Severe)
Sunday 13th Feb
2am	Woke with a slightly high pulse but went back to sleep within a few minutes
4am	Woke with a slightly high pulse but went back to sleep within a few minutes
6am	Woke with high pulse (cortisol spike) first one for around 6-7 weeks. Pulse around 80BPM
7:30am	Ate breakfast (cereal)
9:30am	Had coffee. Mood ok but still feel flat
10:30am	Started feeling pretty off and anxious plus some depersonalisation in recent days creeping in.
12:00pm	Took my new puppy to puppy school. Felt very off and anxious on getting there. Ok through the class
1:30pm	Feeling far less anxious, just a bit flat and nauseous
3:30pm	Took medication
3:30pm	My mum and Dad came over as well as my mother in-law. Felt off and very anxious
5:30pm	A little better in terms of anxiety but very foggy and flat
	Day Rated as 3 (Severe)

[CeruleanSea]

Hi Cruizer,

 

I’m just starting out with my sertraline withdrawal journey.   I’m going to be following you to support another sertraline head. 

 

I can very much relate to your moments of poor motivation & anhedonia + occasional irritability. I also love my coffee to give me wakefulness + motivation.  
 

I’m looking at your notes right now. It seems lately you note fogginess either just before or after your dose, most notably after.

 

Big question — how is your sleep?

 

 

[Altostrata]

Has moving the sertraline dose affected your sleep? If so, in what way?

 

What do you mean by face scrunching?

 

Did you always have an anger problem when you get frustrated?

[Cruizer]

17 minutes ago, Altostrata said:

Has moving the sertraline dose affected your sleep? If so, in what way?

 

What do you mean by face scrunching?

 

Did you always have an anger problem when you get frustrated?

Hi Alto, aside from a couple of nights sleep has not been affected much at all. I sleep a fairly solid 7 hours a night. Sleep only changed when I stopped moving dose forward 15 minutes. I'm finding I'm more tired and flatter at nights since I take the medication at 3:30pm compared to 8am. 

 

What I am calling head symptoms and eyebrow raising and scrunchy face could also be described as facial grimeses. Similar to Tardive dyskinesia only I wouldnt say they are involuntary movements as I control when I do it. It's more an irritation in my face so I tend to move it. Kind of like when you have been staring at a computer or a book or really concentrating on something for a while and then you get up or stop and your eye site is trying to adjust. 

 

I don't remember being angry at all before taking Sertraline. 

[Altostrata]

It appears sertraline makes you tired and flat. Gradually moving it to nighttime may help you sleep through this effect.

[Cruizer]

19 minutes ago, Altostrata said:

It appears sertraline makes you tired and flat. Gradually moving it to nighttime may help you sleep through this effect.

The fact that I was feeling better moving the dose forward 15 minutes per day and then took a nasty increase in anhedonia and flatness when stopping moving forward giving me a more consistent dose suggest to you this is adverse effects still?

The head symptoms seem to also be consistently coming 40 minutes to an hour after my dose and continue for around a 3 to 4 hour period which again to me suggests the meds are doing something and not withdrawal. Do you see that also? 

[Believer]

Hey Cruizer,

You haven’t posted on awhile, I hope that means things are going well for you. 😊

Believer

[Cruizer]

21 hours ago, Believer said:

Hey Cruizer,

You haven’t posted on awhile, I hope that means things are going well for you. 😊

Believer

Hi Believer, pretty much the same as the past 18 months here. After switching to taking my daily dose in the afternoon I had a really rough month. That has settled and I had a decent week. Now back to the norm of up and down through the days. Mood is ok but the head symptoms are pretty constant. I think at this point it's likely an adverse effect of the drug but any change seems to kick off a large spike in symptoms. I think that will likely be the case for the rest of my taper unfortunately. I am holding at the moment as I committed to coaching again in football so can't really do that with large spikes. I will reassess in September and begin a likely painful journey down. I hope your going OK. Thanks for touching base. 

[Cruizer]

Have now been taking my 4.5mg dose at 4pm every day since early Feb. Previous 12 years was always at 8am. 

I now find the night time harder in terms of head symptoms ramp up around an hour after dose and last for 3 hours or so. This is on a normal day.

What I continue to note and it seems to be getting worse, is the batch changes in my 4mg compounded capsules. When I get a batch of 60 capsules made up, the first 30 days is always far worse in terms of head symptoms (pressure, dazed, confused, brain fog, headaches) than what the second 30 days is. I have noted everytime in my daily journal that head symptoms ramp up within a day or two of new batch. 

There is obviously something going on with this. I first thought it was a coincidence, but now that I have noted it with around 10 batch changes, it is there in black and white. 

In Australia (probably the same in US) the tolerance for compounding pharmacies is within 10% as by TGA guidelines. 

I'm now at month 26 of holding at 4.5mg. The rough patches are getting rougher and more constant. Good patches are limited now to a few days if I'm lucky. 

I think now it is becoming pretty obvious that I'm having side effects from the meds or my compounded capsules are not consistent. I want to change to all liquid prior to tapering again. I was going to wait until after my coaching commitments finish in September, but if I feel this bad now and it is the meds doing it, than I am prolonging my suffering. 

Also the fact that I feel poorest now at night after I take meds when it use to be in the morning after taking meds suggest something is a miss also.