Ruthie0210: short term Sertraline taper (existing hypersensitivity)

[Ruthie0210]

Hi everyone,

 

I started taking 25mg Sertraline roughly four weeks ago and pretty soon decided it wasn't the right thing. I took 25mg for a week, then 25mg every other day for the next two weeks and have taken 25mg every three days for the last week. Can anyone recommend if I should now just stop, or should I get a liquid so I can drop down further and more consistently? 

 

There haven’t been any major WD symptoms so far but the first week of taking it I experienced sleep disturbance and extreme agitation/palpitations, which has got better since I started tapering it. My feeling is adding it to the Mirtazapine is not a good idea despite the doctor’s advice to try it for my Chronic Fatigue Syndrome symptoms (they’ll never admit drugs might be part of the problem..).

 

I'm really nervous, even about a short term taper, as in hindsight I believe the Mirtazapine taper I did between Nov 2015 and Aug 2016 (45mg to 33mg), then reinstating 45mg, has resulted in a hypersensitive nervous system. I'm also starting to suspect the CFS is partly caused by long term AD use (8 years on Sertraline before changing to Mirtazapine). I want to get off all this stuff one day! 

 

Me and my battered nervous system very much appreciate any comments/advice!

Edited February 23, 2017 by Petunia
tags added, font changed for easier reading

[Petunia]

Welcome Ruthie,

Thank you for joining, for sharing your story and for adding your signature. I'm sorry you've had such a rough time, but it sounds like you made a good decision to not continue with the addition of Sertraline. Unfortunately, the way you have been tapering is not recommended, skipping days tends to destabilize the nervous system and as you said, yours has already been battered enough.

 

This topic explains how to taper Sertraline safely:   Tips for tapering off Zoloft (sertraline)

 

You haven't been taking it for very long, so don't want to be stretching your taper out for months, but if you can complete the final part of your taper in a more consistent way, it may protect you from further destabilization and increased symptoms. Using liquid now is and option, or you could make your own liquid from your tablets. This topic explains how: How to make a liquid from tablets or capsules

 

If I were you, I would try and stabilize on about 8mg per day for a week or so and see how you feel. Take the same amount at the same time every day.

 

We usually recommend tapering by no more than 10% of the current dose every 4 weeks. But because you were only taking it for 4 weeks, you may be able to taper faster. Be guided by your own body and symptoms.

 

Why Taper By 10% of My Dosage?

 

Its good that you haven't experienced any withdrawal symptoms so far, hopefully you will be able to avoid them completely.

 

I'm confused about your drug history. Were you taking Sertraline previously, for 8 years before starting on Mirtazapine in 2010? If so, please would you add this to your signature. Also, please would you add the most recent addition and taper.

 

Its interesting that you suspect long term AD use is contributing to CFS. Evidence is starting to show that long term use of psychiatric medications ultimately does more harm than good. I'd highly recommend reading Anatomy of an Epidemic by Robert Whitaker. Psych meds can cause harmful side effects and long term, they can worsen health, increasing the risk of other illnesses.

 

But coming off them too fast, especially if they have been taken for longer than a week or two, can cause even worse problems.

 

You can use this thread as your ongoing journal to track progress, write about symptoms, ask questions and communicate with the community, add to it whenever you want. Its a good idea to bookmark it or follow it, so its easy to find again.

 

Please stay in touch and let us know how you are doing.

 

Petunia.

[Ruthie0210]

Hi Petunia,

 

Thanks so much for your detailed response - this is a great site 

 

I'm also hoping the withdrawals won't be bad after such a short time but will look into making a liquid if they are. The doctor said I could only have a liquid on an expensive private prescription (I don't think she was being difficult but genuinely isn't allowed to prescribe it on the NHS). Really I've known this for some time, but it's still a shock to realise the medical profession thinks tapering isn't necessary.

 

She's a comparatively sympathetic doctor who is respecting my experience but you can always see them kind of glaze over and harden when the question of long term withdrawal or long-lasting effects come up - we could really use their support! Maybe one day they'll cotton on..

[Altostrata]

Welcome, Ruthie.

 

If I were you, I would not skip doses of sertraline, especially with your nervous system sensitivity. However, you've gotten this far with an irregular dosing pattern. If I were you, I would take 7.5mg sertaline every day, stabilize on that for a month, then (if all is well, relatively) start the 10% reduction as Petunia kindly described above.

[ChessieCat]

Hi Ruthie,

 

This graph shows the difference between Skipping Days vs Every Day Dosing

 

It is possible to make your own liquid from your tablets.  Please see Petunia's post above for the information links.

 

These helped me to understand SA's recommended taper of 10% of the previous dose followed by a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug:

 

Brain Remodelling

Video:  Healing From Antidepressants - Patterns of Recovery

[Ruthie0210]

Hi,

 

I started on Sertraline, added on top of Mirtzapine a month ago, didn't like its effect and tapered very erratically - I deeply regret this but here we are.

 

I took 25mg for a week, then every other day for two weeks, then every three days for another week and then jumped off.

 

After three weeks I started getting unbearable withdrawals - extreme body jerks, tensing up of the face and twitching, violent shaking and reinstated at 25mg (has been 6 days now). Since then I'm unable to sleep at all and am in a constant hyperaroused state. I went to hospital today with suspected serotonin syndrome but was told I didn't have that. I'm constantly going from hot to cold and getting steadily weaker with no sleep.

 

Can anyone advise what they would do at this point?

 

Many thanks

[ChessieCat]

In Post #4 above Alto suggested taking 7.5mg each day.  It would seem that you have updosed with too high a dose.

 

I will ask the other mods their thoughts on whether you could reduce to a lower daily dose.

 

If you are currently taking both Sertraline and Mirtazapine it is possible that it may be serotonin toxicity.

 

Interactions between your selected drugs

 

Major sertraline mirtazapine

Applies to: sertraline, mirtazapine

Using sertraline together with mirtazapine can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea.

[ChessieCat]

Alto has suggested that you drop to 6.25mg -- one-quarter of a tablet, taken daily.