Fallout: Sertraline hell

[Fallout]

Hi

 

Ive suffered from depression in the past and have been on various antidepressants, been admitted to hospital and had ECT...this was all in the early 90s. 

 

In the intervening years I have suffered depression on and off and was happy to take Fluoxetine 20mg, I'm not sure if the Fluoxetine kept the depression at bay or I would have been OK without it, but as I was feeling well I kept taking the Fluoxetine as a prophylactic.

 

During this period I went cold turkey several times for various reasons...I suffered absolutely no withdrawal symptoms at any time...I consider myself very lucky. Ive only just discovered the danger of CT via this website and others.

 

So far so good, but in 2015 I was diagnosed with cancer and endured gruelling chemo and radiotherapy and was given the all clear in April 2016...one line of text...so much pain!

 

After the treatment finished I began to suffer from depression again, a kind of post trauma effect, my doctor recommenced increasing my Fluoxetine to 40mg, which I agreed to. This didnt really make much difference...my doctor then suggested switching to Sertraline 50mg,  I agreed and started a very steep tapering to come off the Fluoxetine (one month)...I did actually feel quite well at the end of the taper and did not start taking the Sertraline. However some months later in December 2016 the anxiety and depression became so severe I OKed it with my doctor to start the Sertraline.

 

I took the first tablet and in a very short time I experienced some terrible side effects, dizziness, headache, confusion and a level of anxiety I did not believe was possible, I went to bed for the rest of the day. I knew it would take a while of the side effects to settle, so took the second tablet the next day, again the same effects plus the start of the sexual side effects. I took one more tablet the next day and decided enough was enough and stopped taking the Sertraline…(Just 3 doses!) I assumed the side effects would subside soon after stopping…how wrong I was!

 

Its been 7 months and the effects below are still with me:

 

Tinnitus

Cognitive and memory problems

Insomnia...1.5 sleep per night

PSSD, no libido, poor and difficult to achieve erections, reduced semen volume and a kind of emotional disconnect with the opposite sex.

 

One effect which did remit was the sensation of looking down on myself from above...a very disturbing experience.

 

So here I am in a bit of a mess. I wonder what the best way forward is?

 

I seem to be very sensitive to any drugs or supplements...Ginkgo Biloba and Maca root caused havoc after one dose!

 

Ive tried Acupuncture and Homoeopathy with some limited success...at least nothing negative!

 

Im finding this very difficult emotionally, especially the sexual side of things.

 

Ive been following similar cases here (and the PSSD forum) and there seems to be quite a bit of despair often with the OP just vanishing...I find this worrying.

 

Trying to keep positive

 

Regards

 

 

 

 

 

 

[mammaP]

Hi Fallout, welconme to SA. It is interesting that you managed to C/T fluoxetine several times over the years without any withdrawal effects. Research has now shown that people can come off drugs but suffer delayed withdrawal which can show up months or even a year after stopping. People believe it is a relapse of depression when it is in fact withdrawal, which is usually helped very quickly by reinstatement.  Often the drugs stop working or start to have side effects, we call this 'poop out'  AKA tachyphylaxis. This can often be helped by starting to reduce the drug by very small amounts.  Very often people feel better as the dose lowers

 

Withdrawal or relapse

http://survivingantidepressants.org/index.php?/topic/14870-withdrawal-or-relapse-or-something-else/

 

When you tried sertraline in December you were suffering from fluoxetine withdrawal and the dose of sertraline was far too high, once the nervous system is compromised people cannot tolerate drugs the same way as they have done in the past. 

You could try a very very small dose of fluoxetine, it is available in liquid form for small doses, or you can make a liquid from tablets to get a small dose. You could try just 1mg, I know it doesn't seem like much, but it will be a test as to whether you can tolerate it. There are no guarantees after such a long time off but might help. I would like to stress though that it needs to be a very very small dose after the reaction to sertraline.  

 

If you decide against reinstating you WILL get better, your brain and nervous system have to reset themselves and that takes time. Many people find supplements problematic, the ones that help most people are magnesium which is calming, and fish oil which has been proven to be beneficial for the brain. Good fresh food and gentle exercise are essential. Avoiding alcohol and caffeine helps most people too. 

 

Try not to focus on the PSSD, it will get better but it is important to leave well alone and not try to force the feelings to come back. They will come back in time all on their own! People do disappear from the boards very often when they have started to feel better and get on with life. They don't want to hang around here any longer, and who can blame them?  No news is good news for us, we are happy when people move on with their lives. 

 

I will post some links that might help you to understand what is happening to you. Well done beating the cancer by the way, you have been through a lot and will get through this too. 

 

What is withdrawal syndrome?

http://survivingantidepressants.org/index.php?/topic/603-what-is-withdrawal-syndrome/

 

About reinstating to stabilise.

http://survivingantidepressants.org/index.php?/topic/7562-about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms/

 

Fish oil and magnesium 

 

http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/?view=findpost&p=100596&hl=magnesium

 

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

 

 

[Fallout]

mammaP

 

Thank you so much for your reply to my post, I must admit that I shed a few tears because you listened and knew what I was talking about, as opposed the usual "impossible" "Ive never heard of that" "this must be due to x,y,z." trotted out by all medical professionals spoken to recently.

 

Thank you for the detailed information.

 

There are a few things I did, that I did not mention in my original post, that may be relevant.

 

1. During an extended period of travel in 2010 I ran out out Fluoxetine and effectively went cold turkey, returning home, in July I developed Chronic fatigue syndrome (CFS) which left me virtually house bound, this continued for 6 months until it suddenly ended...I went to bed one afternoon and woke up an hour later fully back to normal!

This remission lasted for a year before it returned suddenly...this time it lasted for 5 years...I am of the opinion that the chemotherapy received for my cancer cured me from this (for the moment!)

I have read that AD can be responsible for CFS...

 

2. After I took the 3 Sertraline tablets in December 2016 and getting the bad reaction, my doctor recommended that I re start the Fluoxetine 40mg I did this for a week but decided for my self that I didnt want anything more to to with psychiatric medicine, I reduced the dose to 20mg then down to zero in little more than a week. No more meds after this.

 

Not sure how this will affect the advice you kindly gave me.

 

It looks like I am too late to re instate with the 1mg of Fluoxetine...this would be 13 months after the discontinuation....if I did do this, where would this lead...would I have to reduce the 1mg gradually after a period.

 

I prefer to take no more drugs and tend towards letting my brain recover naturally...I have noticed in the past few week that I have been able to put names to faces...which was quite difficult before...this seems to be a move in a positive direction.

 

With reference to the spontaneous remission of the CFS, it seem like anything is possible at any time. 

 

I will look into Magnesium and Fish oil...they seem innocent enough!

 

Does this affect any of the advice given?

 

Thanks again mammaP

 

Regards

 

Fallout

 

 

 

 

 

 

[mammaP]

It is fine if you do not want to reinstate, no one EVER wants to go back on a drug, and it may not help after so long but there is a small chance that it could. It is entirely your decision and you seem to have a good understanding of withdrawal so will be prepared for the ups and downs. We often see people here with CFS and fibro that are drug related, either side effects or withdrawal.  You will get better, and seem to be improving which is a very good sign. Keep us updated how things go, we like to see the priogress people make as well as help them through the hard days.  

[PoetJester]

Hey Fallout

 

welcome to sertraline hell.  if you go looking on this site you can find a lot of stories of usually younger guys developing PSSD from just a few doses of sertraline or Zoloft.  the pssd can last upwards of a year.  I had a somewhat different experience with Zoloft.  it was the first med I started, so it was like your fluoxetine experience, I could function on it, but at the same time wasn't really sure I needed it.   I quit Zoloft cold turkey 3 1/2 years ago and reading your post about decreased semen, reminded me of the last 10 years or so on sertraline (I was also on zyprexa) where I had super small ejaculations.  Often, the semen barely came out at all and sometimes ejaculations were painful.  I was single all those years so I didn't think about it all that much, plus I didn't have internet service so I couldn't read other people's stories to understand what was happening to me from the pills.

 

once I quit sertraline and olanzapine, my libido came back and my ejaculations went back to normal, but then I was left to deal with the insomnia that I am sure you are all too familiar.  It's brutal.  I went a year or two with the crappy 3-4 hour sleeps and depressed, vivid dreams.   a libido doesn't do much good when you can't sleep and are losing cognitive functions as a result of the sleep deprivation.  for some of us, the sleep patterns never seem to normalize after quitting these drugs which is extremely depressing and frustrating.

 

my sleep never really came back.  magnesium powder worked one night for me, but then never again.   long, brisks walks have helped at times, but it was if my brain had been plunged into a permanent depression. after all the years on the drugs, my body became acclimated to them as part of my sleep habit and taking them away was like some reverse pavlovian thing, where comfort in bed has gone away altogether once I stopped the pills.  a lot of people do get better over time, so don't lose hope. 

 

I think what you read about these pills causing CFS is probably the truth.  I never had problems with fatigue, until I started taking the meds.  I was ok on the meds for about 3 years, although I got into the habit of taking afternoon naps every day, and then I developed a major gastrointestinal problem and  after that it was full blown fatigue all the time.  Sleeping 15 hours a day and hardly ever having the energy to leave my apt.  for 10 years, the first thing on my mind when I got out of bed each day was anticipation of taking a nap later on.  not much of a life, really. 

 

anyways, look around the site.  the Zoloft - PSSD connection is a pretty common one.  Oh, when you mentioned taking the fluoxetine as a prophylactic, I think you meant placebo.  made me laugh.  I make those mistakes all the time.  I can remember asking a friend once if he enjoyed his trip to Hungaria !  I had combined Hungary and Bulgaria in my mind.  oops.   these verbal slips become even more  commonplace in wd insomnia land. 

 

poetjester 

[Fallout]

Hi

 

I wonder if I can ask your opinion on vaccines?

 

I plan to go to Bangladesh in few months time, the following vaccines are recommended 

 

Hepatitis A

Combined Tetanus, Diptheria & Polio 

Malarone for Malaria

 

Are any of these going to upset my recovery? 

 

Thanks

 

Fallout

 

 

 

 

 

 

 

 

 

[raven530]

I know that Malarone is all good. I asked the same question a couple months ago. Just make sure you don't take Lariam, cause that can do you serious damage

Not sure about the others.

[Fallout]

Hi Raven

 

Thanks for that...yes, I remember the controversy about Larium a few years ago.... previously stable people wanting to take their own life after one dose, nasty stuff indeed.

 

Fallout

[powerback]

 ile second that about larium ,court cases going on in  Ireland over this stuff being given to soldiers

[Altostrata]

Welcome, Fallout. 

 

Vaccines should be okay. If I were you, I might spread out their scheduling.

 

You're considering traveling, is this something you do often?

 

Have you tried fish oil and magnesium? Many people find them helpful in healing.

 

King of supplements: Omega-3 fatty acids (fish oil)

Magnesium, nature's calcium channel blocker

 

Try a little bit one at a time to see how it affects you. Your system may be sensitized by going on and off psychiatric drugs, plus the cancer treatment and general health issues.

 

[Fallout]

Hi Alto

 

Thanks for your advice.

 

Yes, I think spreading the vaccines out over a few weeks would be a good idea...I'm really nervous about taking any more drugs or supplements....I tried maca root and ginkgo which had negative effects after one dose.

 

I currently take flaxseed oil which has omega 3 in it and doesn't seem to be having any negative effects. I tried magnesium a few months ago when I was away...this was recommended by a natural health practitioner I stayed with. This did seem to help with sleep. I'll try these again. Perhaps fish oil is a better source of omega 3 than flaxseed?

 

I've virtually eliminated alcohol and coffee, not seeing much improvement.

 

I find getting away from home volunteering/travelling helps my mood, but recently my PSSD has worsened...I'm doing all the right things... excercising, being social, being out in nature etc, but the slide into depression just seems to be relentless.

 

I've made some pretty dumb decisions recently, which have cost me emotionally and financially, which aren't helping my condition. One piece of advice I heard, "Don't make any big decisions when you are suffering from depression" just went right over my head....."oh, I know better" I said, anyone reading this...heed this quote.

 

Thanks for the advice Alto....I'll post how I get on with the vaccines.

 

Fallout

 

[Fallout]

Well I'm in a bit of a mess. Considering I'm now 14 months out after CT from Fluoxetine in June 2016....apart from the very brief Sertraline/Fluoxetine debacle in December 2016....my withdrawal symptoms have worsened over the past few weeks.

 

Emotionally I feel I am slipping deeper into depression, experiencing strange/un nerving thoughts about how society works/treats people. I'm feeling quite detached from everything. I force myself into social situations to prove to myself things are ok...but it just leaves me empty and looking for answers. My PSSD has worsened and sex holds no interest for me at the moment.

 

Is this still withdrawal so long after CT?.....because it's scaring me to death. I like to think I can hang on in there, but I'm reaching my limit.

 

Can anyone explain or give me some advice.

 

Thanks for reading this.

 

Fallout

[Fallout]

I am feeling dreadful!

 

It's now 9 months since taking those 3 wretched Sertraline tablets.

 

None of my original symptoms have remitted in the slightest.

 

1. Tinnitus still full on

2. Insomnia still the same 2 hours sleep max per night

3. Memory /cognition still poor

4. PSSD...no improvement....in fact it is now worse, I now have very little interest in sex...before although there was sexual dysfunction, I was still interested.

 

A few weeks ago my thumbs began twitching uncontrollably, this lasted about 2 weeks, it has now stopped.

 

The additional problem is that my depression/anxiety is now really high, with constant thoughts of killing myself...I'm right on the edge.

 

I just don't know what to do. Is this a normal reaction after that short exposure 9 months ago?

 

I have given up on all supplements...magnesium and flax seed oil..omega 3...they just didn't seem to be helping.

 

The vaccines I was given for an upcoming trip were spaced out well and I don't think these are responsible for my current feelings.

 

Any advice PLEASE??

 

Fallout

[1Day]

Hi Fallout,

 

Really sorry to hear you are feeling like this.  I am no expert in any of this, but of what I know having read a lot online, 9 months is not considered a long time off the drug (although it seems a long time).  I think there are very many people with withdrawal problems who at 9 months off, have/had not seen any improvements.  I am almost 9 months off too and suffering from PSSD.  I have had a few glimmers of improvement, but nothing solid.  And I have read other people say that things can sometimes get worse before they start to get better.  So I guess what I am saying is, your situation of things having not yet shown any signs of improving at 9 months off, is not at all uncommon (unfortunately). 

 

Hope you can see some sort of improvement very soon.

 

1Day

[potions]

How are you feeling now?

[Fallout]

Hi Potions

 

Thanks for your question. In fact Ive been following your posts for a while as one of your tags was PSSD, I'm so sorry that you have been plunged into this nightmare at such a young age.

 

So to give you an answer your question of how am I feeling now?

 

The main points mentioned in my earlier posts were:

 

Tinnitus: This is just about the same, Ive had a hearing test done by the ENT department at my local hospital, there is a bit of hearing loss above 6kHz, but nothing unusual for my age (60) They say there is nothing actually wrong with my hearing that is causing the tinnitus.

 

Memory problems: There has been quite a bit of improvement with my memory, I really do surprise myself at times! although not back to my old self. 

 

Sleep: Still poor, but I have gone from 1.5 hours per night to about 3-4 hours usually in two chunks...I used a daylight lamp for a few months between 6 and 8am, this may have something to do with it. 

 

Depression: Things have improved quite a bit, I no longer get that "chemical" feeling that I want to kill myself, this was probably the most terrible aspect. 

 

Sexual problems: Sorry to say they are about the same. i did go through a period of about 4 weeks when I was getting nocturnal and morning erections, but these have since gone away...this was about 2 months ago..I was quite excited by this, sadly it didnt last long.

 

My libido (not really sure of the terminology, I now see this as the interest or desire to have sex) is very variable, it comes and goes in cycles of about 10 days, 2 days of intense interest, then 8 days when I couldn't care less.... the couldnt care less feeling really bothers me....cognitively speaking I know I want sex, but emotionally there is no desire.

 

Arousal (reaction to visual or imagination of sexual stimulus ) is almost non existent, I feel nothing when I see a woman I know I am attracted to, again I know cognitively I am attracted, but again nothing emotionally. Again very this really bothers me.

 

Strangely if I cross my legs or touch my genitals things do improve a bit (sorry if TMI)

 

I have tried Macca root and Ginkgo Biloba, both with disastrous results, fortunately I did recover from both of these within a week. I now do not take any supplements for fear of a worsening of my condition.     

 

I have surprised myself in that I am far more outgoing now and find myself talking to women in a really relaxed way, whereas before I was really nervous. I have been thinking why this should be, and have come to conclusion its because there is no pressure of sex any more...I dont feel like Im flirting anymore, just having a good conversation, this has had the effect of increased interest from women, I guess they dont feel like they are being hit on (I wish I had discovered this before PSSD!)...as you can imagine this just causes more frustration!! I just cant win.

 

Before something like this happens you just take everything for granted because everything just flows and works so well, you never question it or imagine that anything could go wrong, its just how things are. Then BAM, pieces go missing, causing you to question everything and the realisation of the complexity of the whole system, followed by the horror and disbelief of what you have lost.

 

So there you have it, 15 months on from taking 3 doses of Sertraline 50mg and suffering a severe immediate adverse reaction, there have been some improvements, but naturally not as many or as large as I would like. 

 

Im still optimistic, which is what keeps me going..I hope you see some improvements soon Potions.   

 

[potions]

Thanks Fallout for the detailed update. I’m glad you’ve seen some improvements, even if not many. 

 

I also had the chemical feeling of wanting to kill myself and that’s improving and being replaced with a more logical consideration of suicide. I think the restless/anxious/agitation symptoms are the first to go, and the anhedonia/emotional blunting/pssd symptoms are the last, so maybe we’re on our way.

 

As for your PSSD, it seems you get consistent windows and waves. Is that right? That’s a really good sign, even if the windows are short. I think windows are the only sign that one will eventually recover from PSSD.

 

The fact that you have PSSD along with a host of other wd symptoms (while unfortunate) can prove that pssd might be related to wd, and it could go away just as all the other wd symptoms eventually do (as shown by the success stories.) Let’s hope together that we see some improvements soon