FantastiqueNeuroplastique: introduction ... sertraline and L-methionine

[FantastiqueNeuroplastique]

Hello everyone,

 

Thank you for accepting me into this peer support group!  I discovered SA a few weeks ago and have read many compelling and informative threads. I feel like I truly understand my situation now.  Thank you to all!

 

Discovering in my late-20s that ‘adult ADD’ was the cause of my anxiety and impulsivity, I tried Ritalin, wellbutrin, paxil and finally 50 mg of zoloft.  I found that SSRI’s really focused me and reduced my anxiety.  I was on Zoloft from 2004 to 2013 and tapered myself off the drug over the course of a year.  I experienced the usual acute symptoms over the next month or so but then I seemed to recover.

 

Roughly 4 months later I began experiencing severe prolonged AD withdrawal symptoms and ended up essentially house-bound with insomnia, high anxiety, OCD symptoms…I eventually lost 30 pounds.  I was a professional musician at the time performing a rock opera and had to cancel all remaining shows.  It essentially ended my career as a performing musician.  A nurse practitioner at the time urged me to begin taking Zoloft again and in July of 2013, I was prescribed 50mgs.  

 

Eventually my symptoms subsided and I went back to school in 2014.  One of the WD symptoms that remained with me was a case of body dysmorphia, which became manageable due to cognitive behavioral therapy.

 

In 2015, I read “Nutrient Power” by William Walsh and discovered the joys of methylation and L-methionine, which I added to my decreased dose of Zoloft (35mg from 50mg). The side effects of taking both were increased dry mouth/lips etc along with increased water retention.  But I noticed that I was much sharper and even more relaxed socially.  

 

Fast forward to March of 2018 and I’m in my 2^ndsemester in medical school (as a 40+ year old) and I decided that I just couldn’t take the combination L-methionine with the Zoloft anymore because of the dry mouth and other symptoms.  After a week of not taking L-methionine, I began experiencing horrible WD symptoms:  insomnia, anxiety, deep depression, brain fog, body dysmorphia etc…It never occurred to me that an amino acid would cause withdrawals like a benzo or an SSRI!  I had to drop the semester and was later placed on medical leave of absence.

 

During this time, I thought I was having a nervous breakdown due to prolonged exposure to medical school stress…but I was doing well.  I did try to restart L-methionine again in April but experienced a spike in anxiety, adrenaline and dry mouth.  It was too much.  I find I’m reliving the same nightmare of my previous WD experience in 2013…thanks to my ignorance.  My insomnia is better after taking Seriphos and now Kavinace.  But thanks to SA, I know that I will have to start a slow taper off the phenibut.

 

I am now at almost 4 months since I stopped L-methionine.  I still take Zoloft but have reduced the dose from 35 to 25mg. After all I’ve been through, I don’t think I will taper the ssri now.  I experience a significant degree of social anxiety, which has caused me to isolate.  The social anxiety is closely related to my body dysmorphia.  It seems a bit worse than a few months ago…  My wife is very understanding and I feel more stable in public with her by my side.  

 

I have enrolled in an oriental medicine program this fall (11 credits only) and have a wedding to go to overseas in August.  My dilemma is that isolating seems to make my social anxiety worse but getting out in the world can bring fresh trauma!  However, my social anxiety tends to decrease the more time I spend in public and socializing with friends/family.  I have read here during AD WD that minimizing stress is an important factor…but in my case, it comes at the cost…safe isolation.

 

Thank you for your help. I look forward to engaging this community and offering my support…I’ve learned so much so far.  

 

Edited July 3, 2018 by ChessieCat
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[Altostrata]

Welcome, FN.

 

Your experience with L-methionine is interesting. It must affect your metabolism.

 

As side effects tend to be dosage-related, as a general rule, we tell people to lower dosage to reduce side effects. This works with supplements, too.

 

Now that you're on 25mg Zoloft, has your withdrawal syndrome abated?

 

It sounds like your "social anxiety" might be reduced with exposure therapy. You might work with a therapist who specializes in phobias and anxiety for coaching in this. It sounds like it's a habit of mind that you can change.

 

Many people do better with fish oil and magnesium supplements, see
http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

http://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

A lot of people find them helpful. Try a little bit of one at a time to see how it affects you.

 

Magnesium in particular is calming.

 

[FantastiqueNeuroplastique]

Thanks for the feedback Altostrata,

 

I currently take 2-3 omega 3's a day but will look at dosage and increase.  I also supplement with magnesium calm as well

 

Beginning in 2014, I saw a cognitive behavioral therapist for about a year after my first AD withdrawal.  We worked on exposure therapy and other exercises...very helpful.

So now its 4 years later, I'm in a different state and just found another behavioral therapist.  It will be interesting to see what effect therapy will have during my period of WD

 

Regarding zoloft/sertraline, I had been on 35mgs since 2015 and I never stopped taking it.  I decided to reduce and HOLD my dosage to 25mg for now.  

When I stopped taking L-methionine in March, my daytime cortisol levels went off the charts.  High cortisol can produce dry mouth, dry skin, excessive thirst etc...I initially attributed this to my dose of zoloft.  This is why I reduced it from 35 to 25mgs.  

 

According to the book, Nutrient Power (William Walsh...Dr Carl Pfeiffer), supplementation with SAM-e/L-Methionine increases methylation, which inhibits gene expression of neurotransmitter transporter proteins.  These are the proteins that "remove neurotransmitter molecules from a synapse for reuse in future cell firings" (Walsh, 40).  The more transporter proteins in play, the less neurotransmitter activity occurs in synapses.  Methylation essentially reduces gene expression of these transporter proteins.  Methylation is in direct competition with Acetylation, which increases gene expression of transport proteins.

 

According to the book, SSRI's work by attaching to transporter proteins, making them inactive.

 

This is why I started supplementing with L-methionine/SAM-e along with remaining on a low dose of zoloft.  I assumed that two different mechanisms were acting on these transporter proteins.  My mistake was stopping L-methionine suddenly and not understanding that (thanks to SA), any mood altering amino acid should be tapered and can cause the same nasty wd symptoms as an SSRI

[Altostrata]

It sounds like you have a fairly developed theory of how all this works. As this is a site for going off drugs, not sure how we can help. Perhaps you should be looking for a Walsh practitioner?

 

Why are you taking Kavinace for sleep? Please note this contains a benzo-like ingredient and must be tapered.

[FantastiqueNeuroplastique]

I have decided not to take L-Methionine or SAM-e again...the dry mouth, skin, lips, water retention, weight gain side effects are not worth it.

 

I am committed to (re)discover who I am and how my brain functions without AA's or AD's...adult ADD be damned!

 

Regarding zoloft, i will probably hold on 25mgs until I feel safe enough to start tapering.  I'd like to finish school first

 

I started taking Kavinace in mid-April because Seriphos didn't seem to work for me.  From mid-march to mid-june, I slept 2-3 hours a night...sometimes 4-6.

 

When I had my first delayed WD symptoms from zoloft in 2013, I tried Seriphos for about 3 months, taking a 24 hour break every month per the company's recommendation.  I then tried Kavinace and might have been on it for 3+ months.  I don't think I experienced WD symptoms but I can't remember.

 

I will certainly taper Kavinace now...10% every 2 weeks?  Do you have any recommendations for sleep during the taper?

 

For sleep I take:

 

1. Sleep Minerals II (Nutrition Breakthroughs) - Vitamin D (400 iu), Calcium (667mg), Magnesium oxide & citrate (333mg), Zinc (7mg)

2. Passionflower, solid extract - 1/2 tsp

3. Kavinace

 

[Altostrata]

What is your sleep pattern? When did your sleep break up?

 

See

 

Tips to help sleep -- so many of us have that awful withdrawal insomnia

 

Waking with panic or anxiety -- managing cortisol spikes

 

What is the sleep cycle?

 

Melatonin for sleep: Many people find it helpful

 

TV or computer use in evening can disrupt sleep: Bright light signals the brain that it's daytime

 

and other topics in our Symptoms and Self-care forum  -- search for Kavinace and phenibut.

 

You may wish to get your sleep hygiene in hand before reducing Kavinace. 10% every 2 weeks sounds reasonable to start, be sure to keep everything else steady so as not to confound the experiment.

 

I don't know much about the Walsh protocols, my conceptualization of tapering and withdrawal works on a different model altogether (autonomic nervous system function). I know one of our members, meimeiquest, went fairly deeply into Walsh, you might look up her posts.

 

 

[FantastiqueNeuroplastique]

Thank you for these links.

 

My sleep has mostly stabilized after 4 months WD.  I can fall asleep consistently but wake up 3 to 4 hours later to urinate.  Then it takes me awhile to fall back and I might get another 2-3 hours.  Sometimes I might sleep an hour more before the rising cortisol forces me out of bed.  I usually sleep 5-7 hours a night and wake up 2-3 times to urinate.   It's not perfect but much better than what I was getting before.

[Carmie]

Hi FN, 

 

How are you doing?💚

[FantastiqueNeuroplastique]

Hello Carmie,

 

Thank you for checking in.  I still read and research SAD posts weekly...it's a lifeline! 

 

Here's a snapshot of where I am now after 11 months:  Currently, I am still on 25mg sertraline, which I take at night and a few non-excitatory supplements (omega, vitamin D2, K2, liquid magnesium, zinc).  I am still withdrawing from kavinace...I now take about 1/2 a capsule nightly and am about to reduce another 10%.

 

When I initially stopped taking 1.5 grams of SAM-e last March, my immediate symptom was body dysmorphia (BDD) along with the usual SSRI w/d symptoms.  At that time, I also reduced from 40 mg sertraline to 25 mg.  After 11 months, my BDD has plateaued but is still a daily hinderance.  My BDD seems like an outgrowth of the social anxiety and hyper-vigilance fear I experience -> which is a result of my sensitized CNS and continued w/d symptoms.  Im sure that my brain is learning to adjust with less serotonin...but I'm hopeful that the up-regulation of serotonin receptors is inevitable and part of the slow healing process.

 

Currently, I'm a 40-something first year student in a school of acupuncture (I had to withdraw from medical school when I cold turkeyed SAM-e).  Interacting with classmates and observing patients at the clinic can be difficult sometimes due to my social anxiety/bdd symptoms.  I am hoping that I will get better by the time I start my clinic shifts in the fall of 2020... 

 

Pre-withdrawal, I had very little anxiety and was mostly comfortable in public, socialized with friends and family etc...I feel like a shell of my former self...but I do have good days though, a bit more than in the fall.

 

FN

[Carmie]

Hi FN,

 

Thanks for checking in. Could you please update your signature. Thanks so much.

 

It’s amazing how Sam-e can also cause withdrawals. People thing just because something is natural you can’t go through withdrawals. Sam-e effects dopamine, serotonin and GABA, so taking it away can certainly cause withdrawals. St John’s wort can cause withdrawals too. I’m so sorry it affected you. 

 

I’m glad you’re having some good days. Our brains are slowly healing with each and every taper and hold. 

 

It must be hard having to do a course when you have social phobia. I’m sorry that the withdrawals have caused this,but when your brain is healed your anxiety will get much better. It’s just such a slow process, isn’t it? Time to celebrate when we finally get there. 

 

Acupuncture would be fascinating to study though. Have you tried any of it on yourself to see if it helps you with certain symptoms? You no doubt have. 

 

Wishing you all the best with your continued recovery💚

 

 

[FantastiqueNeuroplastique]

Hi Carmie,

Thank you for your response and support.  SAM-e is serious stuff indeed.  During my acute withdrawal phase in June, I found a blog written by a woman who ended up in the ER for suicidal ideation after quitting SAM-e.  She claimed that it was no longer working and stopped it cold turkey.  I eventually found SA.org and read other accounts here of people having trouble after stopping it.

 

When I stopped SAM-e, I went from taking 21 credits and in class every day to: acute insomnia, anxiety, agoraphobia, weight loss (25 lbs in 2 months), BDD symptoms, zero attention span, high cortisol levels, depressed serotonin and elevated epinephrine/norepinephrine ratio etc...What else could have caused this severe reaction?  I must be in withdrawal.  I feel sometimes (like so many other here) that this is how i will be for the rest of my life...

 

What I find disturbing is how much attention and self-focus I have on how I feel every day.  Will this be a good day?  Do I have an excuse for feeling more anxious today than yesterday etc...?  ...was it something I ate?  Did I take enough magnesium?  Did I get enough sleep (rarely)?   I certainly hope this kind of hyper self-focus goes away along with my other WD symptoms.

 

Like many others, I feel much better after I work out, run or do yoga...it seems to take the edge off.  It makes going out to shows, dinner and events with my wife much easier.  I notice the same thing the more I'm around my classmates and teachers etc...In my situation, repeated exposure to social situations seems to erode my social anxiety/phobia.  But then I wake up the next morning and boom...I'm back to square one.

 

I went to my student clinic last March-April-May for a lot of acupuncture treatments.  Sometimes i felt better, sometimes worse.  Now I know that stimulating the CNS is a bad idea for those in withdrawal.  Now I'm learning all the points on the body and protocols to suppress the CNS, disperse anxiety...

 

I read elsewhere that you recently tapered...I hope you are doing well and adjusting.  Keep watching those period dramas!

 

Cheers,

FN

[powerback]

On ‎7‎/‎3‎/‎2018 at 3:51 AM, FantastiqueNeuroplastique said:

Beginning in 2014, I saw a cognitive behavioral therapist for about a year after my first AD withdrawal.  We worked on exposure therapy and other exercises...very helpful.

Hi FN nice to meet ,by reading your intro SA will have great input  from your knowledge .

In regards to the expose therapy ,does your therapist have a theory of what's behind this or were it originates .

I'm only admitting to myself I have this ,after years of drinking and meds [4 years sober] .

 

we definitely benefit as a species  with socializing [the science and research is there ] .

Take care .

[Carmie]

Hi FN, 

 

Yes, in withdrawals it’s so easy to become self focused and to continually focus on the symptoms, and how we are going to be from one minute to the next. I find distractions is what really helps me during waves, I do things that I love doing even if I can’t really enjoy them. It doesn’t matter how ramped up my symptoms are or how anhedonic I am, I still make myself do these things. 

 

I did recently taper from 7.50mg to 7.25mg. My symptoms have ramped up a bit, but I’m in good spirits. I have insomnia at the moment too, but I don’t get stressed about it, I just float through. I try not to focus too much on any of the symptoms. I have a chronic illness, so I’m stuck in bed a lot too, but I always have a million things I can do to keep me occupied.

 

Have you ever listened to Claire Weeke’s or read her books about floating through symptoms, and not adding fear on top of fear? She’s got quite a few videos on YouTube too. She’s got such a lovely grandmotherly voice.

 

I was going to acupuncture for a while, but I didn’t notice any difference in my symptoms. If my insomnia continues I might go back though and see if I can get some help with that. Let me know if you find any of the acupuncture points good for any of your symptoms. I know everyone is different, but I’m always interested what works for people. A lot of people have found acupuncture beneficial for certain things, including Alto. I’ve had benefits in the past too. 

 

Wishing you all the best with your continued healing💚

[FantastiqueNeuroplastique]

Hello Powerback,

On 3/18/2019 at 9:40 AM, powerback said:

In regards to the expose therapy ,does your therapist have a theory of what's behind this or were it originates .

My understanding of exposure therapy is that for most people, repeated exposure to something they want to avoid (people, places, things, social situations etc...), lessens the distress.  Exposure helps break the pattern of fear and avoidance...maybe it creates new synaptic connections and pathways.  

 

However, for those in withdrawal, exposure therapy might not be as effective, especially if the autonomic nervous system is aroused.  Until the brain & CNS regain balance and stability, the fight or flight response might be too intense for quality exposure therapy.  OR, exposure therapy may just take longer during a withdrawal process.