Tristana: from sertraline 100 to hellish withdrawal

[tristana]

Hi all and sorry we meet on this forum.

 

I was put on sertraline 100mg when my husband entered his midlife crisis in 2014. I tried to quit them the next year but could not cope with the withdraw symptoms so I decided to take them again. So I had been on sertraline 100 mg for 3 years when a few months ago I decided that since my husband's state of mind improved significantly and we were a solid couple again, it was time to try to quit again.

 

My gp recommended I should reduced the dosage to 50 mg for 2-3 months, then reduce the dosage every week (once every other day, then once every two days and so on).  I wwent a bit quick on this last part and got it over in about 3-4 weeks. The first symptoms appeared during this last faze (reducing the dosage every week). I had one week on insomnia and I got ill with a strange virus that kept me off work for one week. I would get very irritated by my employer's impulsive decisions at work and my husband's messiness at home. During the PM period I had strange moments when I felt so anguished I wanted to scream. At some point I could identify that there was this part in my brain that was anchored in the present, which was like a lid covering a boiling pot. Every now and again I had thoughts (about the past or the future) that made me anxious and I would reject them.

 

I have been off sertraline for about 5 weeks now. A few days ago I was due to fly back to my home country (I am an expat in Ireland). The anxiety had been taking my mind over little by little every day. The day when my flight was due coincided with a full moon and the PM period. I simply could not get on that flight. It felt like that boiling pot exploded. I have been going through this wave for a week now. Every morning I wake up with terror and fear. I would do anything to be calm and detached again, to have peace. Every morning I want to go back on sertraline. With this occasion I identified clearly that all these years my psychological issue has separation anxiety. During the moments of clarity I know that I learnt something while taking sertraline, which is that one can be happy if they focus on the present. But that seems a distant memory now, as the anxiety caused by withdraw is excruciating. The anxiety feels like a program  that has been switched on and it took over my mind. It is a familiar feeling though, it is the old childhood trauma of separation.

 

Exercise seems to make things better. Also, cleaning around the house, making a plan for the day, watching a film. Sadly, when I moved to Ireland I found it very difficult to make friends in a culture where drinking prevails, I am still working on that. I can talk to my family on skype and my husband, who is doing his best to support me, but I can tell that the whole situation is new to him and he finds it draining. A couple of days ago I woke up annoyed, it felt like when one had a broken leg and wants to feel fine and keep waling. Today I felt so anxious I agreed to see my gp for advice. Most likely she will just put me back on sertraline, as all testimonies point to on this forum. Of course, when I feel better I want t hang on and go through this to see the light at the end of the tunnel.

 

I have read the basic information on this forum and I can see that most of you have been going through far worse than me, for a longer time. I hope that given the low dosage and the relatively short time I have been on sertraline, this period will end sooner then later.

 

 

 

Edited November 9, 2017 by baroquep

[Gridley]

Welcome to Surviving Antidepressants.  I am glad that you found the site.  

 

At Surviving Antidepressants, it is recommended that a person taper by no more than 10% of their current dose with at least a four week hold in-between decreases.  

The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.  Some people may have to taper at a more conservative rate as they are sensitive to even the smallest drops. The taper your GP prescribed for you was far in excess of our recommended rate; and skipping doses is never recommended as your central nervous system needs stability.  When a drug is reduced too quickly or there are too many changes it throws our central nervous system into chaos and results in the withdrawal symptoms that you are now experiencing which is also referred to as withdrawal syndrome (see link below).  Given the circumstances, what you are experiencing is completely normal.

 

Without having more information with respect to your drug/tapering history it will be difficult to make any recommendations.  We ask all of our members to fill out a signature so that all of your information can be read at a glance.  This helps moderators determine you current situation and we would ask that you follow the instructions at the link below.  Please give all dose changes and dates.  

 

Instructions:  Withdrawal History Signature

 

 •    Please leave out symptoms and diagnoses.
 •    A list is easier to understand than one or multiple paragraphs. 
 •    Any drugs prior to 24 months ago can just be listed with start and stop years.
 •    Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago)
 •    Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016.

 

The only known solution at this time to decrease or eliminate withdrawal syndrome is to reinstate a very small amount of the Sertraline back into your system and then to hold until you stabilize, then taper down slowly. We will need to see your withdrawal history signature before making any specific recommendation.  I will attach the links on reinstatement to give you an idea of the process involved and something I think you may want to consider.

 

About reinstating and stabilizing to reduce withdrawal symptoms
What to Expect in Reinstatement (James Heaney article)

  
To get you started, and familiarized with the protocols followed by SA, I am linking a few topics so that you have a better understanding of what is recommended here.

 

What is Withdrawal Syndrome?
Why taper by 10% of my dosage?

 

Once you have completed your withdrawal history signature and have had a chance to review the links that I've attached, please let us know if you are interested in a small reinstatement of Sertraline to help alleviate symptoms.  My understanding is that you have not taken the drug in five weeks, but I do not know your final dosage nor how long you were on it.

 

[DC112]

Tristana,

 

you are not alone with your struggles with withdrawel. There are many people here who are in a similar situations. I hope you feel better soon! 

 

Dan

[DMV64]

Tristana

I relate to the terror feeling. I can just say mine has gotten slowly better but I am early in my taper and did reinstate after a too fast withdrawal.

Wishing all the best for you!

-D

[Ali4]

Welcome to S.A. 

 

I can relate to your anxiety, not something I would wish on anyone, I'm sorry your going through this, as I know just how bad it can get. What drugs are you on? What dosage and for how long? You have tapered half in a month? I would go by what this site states as a reduction of only 10% holding for 4 too 6 weeks, or withdrawal can get worse in some people, you don't need that. Maybe reinstate a small portion and see if it helps at all, I'm no expert and would wait for  mod to say, but that's what I think, you just tapered way too fast. I dropped way to fast and ended up in hell, I had to reinstate and man I'm so glad I did. Now I can follow this group and do it proper. Take care and again welcome 😃 Ali 

[tristana]

Thanks a mil to all of you for welcoming me to this forum and for your feedback, it means a lot.

Gridley, I have edited my signature, it would be fantastic if you could help me with the decent reinstating plan.

 

I had a better day today, less anxious in the morning and I got some crafting done.

Also, I have seen my GP today and, although her advice was predictable the whole thing left me in a low mood. Although it looks like I lost truck of time and discontinued the AD even faster than she had recommended, she said that did not matter. I know from reading the information on this forum that it is in the line with the report they have at the moment. She put me back on Sertraline 50 mg (the discontinuation dose, my usual dose was 100 mg). I read the articles you sent me and I took 25 mg. Just to let you know that that is the lowest dose in Ireland, and the pills can be easily halved.

Gridley, could you please let me know your recommendations.

 

My GP saw my determination to quit these pills, so she mentioned the usual good sense advice that you have on this forum too - exercise, healthy eating, therapy. 

I have started taking Magnesium and Vit B a few days ago, so I hope that will improve things too.

 

I would be very grateful if you could let me know which plan suits me to go on from here. Many thanks in advance and have a wonderful weekend!

 

Edited November 10, 2017 by tristana
I reinstated the treatment according to the recommendations on this forum.

[Gridley]

Tristana,  I have asked the other moderators for their input as to how much to instate and I'll be back with you as soon as I've heard from them.

 

The magnesium is a good idea.  I would start with a low dosage and work up.  You might want to reconsider the vitamin B.  Vitamin B can have an activating effect and can produce anxiety.

 

 

[tristana]

Thanks very much!

[Gridley]

Tristana,

 

Two questions:

1. What dosage were you taking on September 9 when you quit?

2. Are you now taking 25 mg?  If so, when did you start and how are you feeling with this dosage?

 

Please don't make any more changes until I can get back to you with a recommended dosage for reinstatement.   When we are in withdrawal, the central nervous system craves stability--as few changes as possible.

 

Gridley

[tristana]

Hi Gridley,

 

Back on 9 Sep I was still on 50 mg, that is the lowest dose available as a pill in Ireland.

I have taken now two doses of 25 mg (yesterday and today morning). I cannot tell exactly how this affects me, I can't see a pattern yet. I think my mood was improving anyway, as the menstruation is coming to an end. I have experienced two extreme moods yesterday - from bliss to awful depression.

[Gridley]

Tristana,

 

I just heard from another moderator who recommends no more than 12.5 mg ( halving your 25 mg tablet) or even 5 mg.  If you go with the lower amount, could you halve the 12.5 half to get 6.25?

 

Another possibility is to make your Sertraline into a liquid.  If that is something that interests you, I can send you SA links on making a liquid. 

[tristana]

Many thanks Gridley! I am willing to do all that. I get the principle behind it, it's almost like homeopathy, of which I am a big fan, as it helped me a lot in the past. The question is, I have taken now three doses of 25 mg (I see no improvement, the usual ups and downs). Should I stick with this dose and decrease at some point or go down to the dose suggested by you guys?

[baroquep]

Hi Tristana, how have you been feeling since reinstating?  Do you find that 25mg has reduced your anxiety or increased it?

[tristana]

Hi baroquep,

 

I can't see any improvement, still cycling up and down.

[Gridley]

Tristana,

 

We suggest 12.5mg.  If it's not enough, we can guide you to a higher dosage.  

 

Give the reinstatement time to work.  The following is from the SA protocol on reinstatement:

 

How long should you give reinstatement?

• It takes at least 4 days for your body to fully register the addition of a neuroactive drug. Unless you have an immediate bad reaction, observe your symptom pattern for about a week to see if the reinstatement is helping. If you have an immediate bad reaction, reduce or stop taking the drug.
• After reinstatement, the amount of time needed to alleviate withdrawal symptoms (stabilizing) varies according to the individual. Relief can be felt immediately, after some weeks, or after some months.
• Once you feel withdrawal symptoms are reduced after reinstatement, give your nervous system time to stabilize before attempting dosage reduction. Think in terms of months, not days.
• Be patient after you reinstate. Reinstatement may not immediately eliminate all withdrawal symptoms. You may still experience waves of symptoms, which usually lessen as time goes on. Do not attempt to taper again until you feel symptom-free, or at least until your withdrawal symptoms are mild and tolerable.
• The dose needed for effective reinstatement varies according to the individual.

[tristana]

Hi again, it has been a while. Last time I was here I was going through a difficult time following the attempt to discontinue sertraline, as per my gp's instructions. I went back on half dosage and I have been taking sertraline 50 mg for a little over half a year. I now know that is need to be discontinued very very slowly, 10% per month or even more slowly. However, there is no liquid version of sertraline in Ireland, and the price of this medicine on the internet is ridiculous. I guess there is always the option of buying high precision scales. So far I have been skipping the pill on Thursdays, four times now. Planning to reduce the dosage to 25 mg every 6th days next.

Half dosage has kept me on the edge, so I have got used to intense feelings and to managing a tendency to panick attacks. 

I want to stop taking this medicine because it is clear to me that I get used to it and it has no effect on me anymore. 

[bubbles]

Are you able to access a compounding pharmacy? That’s how I’m reducing sertraline. This site typically advises against skipping doses...

 

[Madeleine]

Yes agree with bubbles the  compounding pharmacy is probably the best way imo.  But there are other ways too if you don’t have such a pharmacy near you 

 

Are you taking capsules with powder in them?  That’s what my sertraline/Zoloft pills are like.  

 

I am taking 55 mg having tapered down from 200.  I take 2 x 25 then open another 25 capsule and dissolve in 25 ml water.  I then take out 5 ml with a syringe and drink that. 

 

If your pills are powder maybe you can go the same.  Dissolve 50 mg on 50 ml water and take out 10 percent throw it out and drink the rest?  I think instruction to do this are on this forum in the tapering section.  There are also other ways depending on what your pills are like.  Check out the tapering Zoloft section for more info 

[bubbles]

Quote

 

Are you taking capsules with powder in them?  That’s what my sertraline/Zoloft pills are like.  

 

 

I didn't know that sertraline sometimes came as a capsule!! Well, mine do, but that's because the compounding pharmacy crushes tablets and puts the dust into capsules for me. I've had regular sertraline at normal doses prescribed for me in two different countries, and they've been tablets each time. How interesting that they're different, in different places.

 

@tristana Liquid sertraline is available in some EU countries. I'm not sure how it works, but while Ireland is part of the EU still (actually, I guess depending where you are, that may continue to be the case), is it possible to fill your Irish prescription from another part of the EU? It's fairly pricey, depending on your dose (at 100mg dose, a bottle would only last 12 days), but it may be possible to combine, say, half a tablet with some liquid to get an intermediate dose without blowing the cost out too much. Just a thought, I don't know how these things work in Ireland, or even how things vary between the two regions.

 

[bubbles]

Oh, silly me, my brain only hung on to Ireland and completely missed Dublin!!!

[tristana]

I'm afraid sertraline comes in tablets here. Will have to look into the compounding pharmacy tip, thanks!

[tristana]

I have been going down slowly and I am almost down to 25 mg (from 50 mg). Meanwhile, it looks like I need treatment for hypertyroidism. They say that antidepressants have no such side effects...

The good news is that there was an article on the main page of BBC taking about antidepressants withdrawal, so it won't be long until this issue will be recognised. Another failure of the pharmaceutical industry. 

 

Happy New Year to everyone!  

[Altostrata]

Hello, tristana. Have your thyroid tests come back showing hyperthyroidism?

 

Otherwise, if you have anxiety and sleeplessness, it could be from your sertraline tapering. I would hold on reductions and see if those symptoms abate.

 

Please let us know how you're doing.

[tristana]

Yes, my blood tests showed that I have hyperthyroidism, I am meeting my GP in a couple of days. 

So far, each time I reduced the dose, I have stayed on the new amount for three months. It is going OK, may be I need to slow down as I am approaching half dose.

[Altostrata]

Hyperthyroidism can cause anxiety and sleeplessness.

 

My belief is that withdrawal can stress the thyroid. If you have a choice of treatments for hyperthyroidism, I would start with the mildest. It can be temporary. Some people even claim to be successful with herbal treatments.

 

What is your method for tapering sertraline?

[tristana]

I saw my gp last week and I have started on 50 micrograms of levothyoxine for hypothyroidism (not hyper, I was wrong). I saw on the leaflet inside the medicines box that sertraline can have an impact on levothyroxine, so will have to take one in the morning and one at lunch time or in the evening. I started taking the levothyroxine while on a bad flu, so I cannot be sure what is at fault for the depression increase. Will be able to know more when I get over the flu, I guess. 

 

As for the sertraline tapering, there is no liquid form here or compounding pharmacies here. Just measuring it on the scale, decreasing 10% every 3-4 months.

[ChessieCat]

18 hours ago, tristana said:

As for the sertraline tapering, there is no liquid form here or compounding pharmacies here.

 

It is possible to make your own liquid from sertraline tablets:  Tips for tapering off Zoloft (sertraline)

 

 

 

Edited January 9, 2019 by ChessieCat

[Carmie]

How are you doing Tristana?💚

[tristana]

I have been taking 25 micrograms of Levothyroxine (for hypothyroidism) for three months now, metabolism has improved and I am more awake.

 

At he same I am down to 25 gr of Sertraline (from 50mg). I am feeling quite anxious, running mind has been a problem for a while now. This seems to get worse as I reduce the dosage of sertraline. It is like a continuous buzz, songs or unimportant thoughts that keep repeating in my mind without me bringing them up. They just take over. Meditation works, but I have to make a big voluntary effort to dive into that peaceful void. 

 

So this is my update. I hope everyone on this site is doing well on their path.

😍

[tristana]

I have been going through all sort of symptoms that I experienced before while tapering. Depression, anxiety,  insomnia - waking up during the night for a couple of hours. I have a fixed one year contract where I work, which is due to expire in 4 months. Today I was told there won't be any more work after that. Needless to say, I am experiencing panic attacks, crying spell, high level of anxiety. While this is obviously not the end of the world,  surely there are worse situations in life, I cannot get over the feeling of helplessness. It will pass...