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SertralineAnxiety: can't cope with Sertraline withdrawal, should I increase dose?

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SertralineAnxiety

Hi, I am 31 years old, and been taking Sertraline 50mg since 2005, for generalised anxiety disorder. 

 

I attempted to taper several times in the past, all unsuccessful.

 

In January 2018, I thought I was mentally in a good place to try and reduce the dose again.

 

I started tapering by taking 25 mg 1 day a week(50 mg 6 days) for one month, then 25 mg for 2 days a week for another month etc. I have now been on 25mg everyday since June 2018. 

 

Initially I had occasional, mild withdrawal symptoms like vertigo and sensory sensitivities.

 

But I had major, unexpected negative life changes and multiple bad news over the summer of 2018, and have been (understandably) more and more emotional. My anxiety has been getting more, and now it has become unbearable for me. I keep randomly crying, and feel extremely worried All. The. Time. 

 

I cannot relax or calm down, and feel a shortness of breath most of the time. Random anxiety attacks followed by diarrhea have become a regular thing. I am worried about leaving the house on my own. 

 

I am thinking about increasing the dose again, as I just can't cope with the debilitating fear and worry anymore, but then I will have suffered all these months for nothing.

 

I thought I was in a stable point in my life when I started the taper, but now, after having dealt with a very difficult year(unrelated to the taper), I feel like now is actually the worst time for this. I have no support as all my family live abroad(and my parents&close relatives themselves could do with emotional support right now), my kids are very young and they constantly need me(and nursing a toddler is draining as it is...), we are in the process of selling our house and moving (not sure where to yet), I haven't had therapy or counselling in years and don't really have anyone to confide into...

 

Should I just give up, go up to 50mg and try again when my life is stable? Has anybody had life events interfering with their taper like this? 

 

Edited by ChessieCat
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ChessieCat

Hi SertralineAnxiety and welcome to SA,

 

5 hours ago, SertralineAnxiety said:

I started tapering by taking 25 mg 1 day a week(50 mg 6 days) for one month, then 25 mg for 2 days a week for another month etc. I have now been on 25mg everyday since June 2018. 

 

Thank you for creating your drug signature.  The information you have provided (quoted above) is not very clear.  Please add the dates and doses to your signature like this:  date dose, date dose, date dose etc. so we can see exactly what changes you have made.  This will give us a clearer picture and allow us to make a suggestion about what dose you could try.

 

Dr Joseph Glenmullen's Withdrawal Symptoms

 

Please note, if you have been taking 25mg sertraline every day since June 2018, do not go back up to 50mg.  It will be too much for your brain and may cause major issues.  Please read Post #1 of this topic which relates to updosing as well as reinstatement:  About reinstating and stabilizing to reduce withdrawal symptoms.  It is better to increase by a small amount (eg 1mg - these drugs are strong, and we can't tell how much your brain has already adapted) to see if things improve than to risk taking to much.  It takes about 4 days for a dose change to get to full level in the blood and a bit longer for it to register in the brain.  You can increase by another small amount if needed.  The idea of reinstating isn't to get rid of withdrawal symptoms all together, but to bring them to a bearable level.  Keep notes on paper of your symptoms so you can see how updosing is helping your symptoms and can help you decide if you need to updose. 

 

It is important not to panic, but to try and stay calm and patient and not updose again too quickly or by too much.  It's helpful to learn and use Non-drug techniques to cope.  This topic explains how to get small doses of your drug:  Tips for tapering off Zoloft (sertraline)

  

SA recommends tapering by no more than 10% of the previous dose followed by a hold of about 4 weeks.  Why taper by 10% of my dosage?  This is a harm reduction method which allows the brain to adapt to not getting as much of the drug.  The withdrawal symptoms occur when the drug is taken away too quickly.  This is because when we take the drug the brain changes.  This might help you to understand what and what this is happening:

 

On 8/31/2011 at 5:28 AM, Rhiannon said:

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.


This is your own Introduction topic where you can ask questions and journal your progress.

 

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SertralineAnxiety

Dear Chessicat, thank you for your very quick response. I wrote my signature as this:

2005-2018: Sertraline 50mg

January 2018: Started taper

Since June 2018: Sertraline 25mg

 

The full taper history would be:

January 2018: 50 mg 6 days a week, 25 mg 1 day a week

February 2018: 50 mg 5 days a week, 25 mg 2 days a week

March 2018: 50 mg 4 days a week, 25 mg 3 days a week

April 2018: 50 mg 3 days a week, 25 mg 4 days a week

May 2018: 50 mg 2 days a week, 25 mg 5 days a week

June 2018: 25 mg everyday

 

I did this taper before I came across Survivingantidepressants. I am not planning on reducing the dose any further at the moment.

I read through all the links in your post. I am trying non-drug techniques, but it is extremely difficult when I know I have underlying issues from my childhood and ideally need therapy, or at least someone to talk to. I am not getting any help from doctors, they kept advising me to increase the dose to 100mg, so I haven't even mentioned the taper at all.

Since I have been taking 25mg for over 4 months, I assume the anxiety is a relapse rather than withdrawal. I recognise these feelings and worries from before I started taking antidepressants.

The only thing I would label a "symptom" of something is the constant shortness of breath and excessive yawning. This got worse in September and not got better since. 

The only time I felt like this in the past was when I had iron deficiency 4 years ago, and it was cured with prescription iron tablets. But last month I had my iron,ferritin, B12  and Vit D levels checked and they are not that low. I might have some other deficiency, as I had two pregnancies and have been breastfeeding non stop for the last 6 years, so I started a multivitamin supplement last week, just in case. I also had full blood count and ultrasound, and physically all my internal organs appear fine. So I can't find a reason for the shortness of breath other than stress and anxiety :( 

 

After reading your post, I decided not to go up to 50mg, but to increase by just 2mg for a week or two, and see what happens. I just want to be able to breathe normal again :( 

I am worried about doing yoga breathing exercises because I read about something called Buteyko Method and taking deep breaths is actually supposed to make shortness of breath worse and that we all need to breathe shallower and not deeper? So much information out there that I don't even know where to start sometimes.

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jozeff

Hi sertralineanxiety,

 

Welcome!

 

When did you get this randomly crying? As soon as you started taking 25 mg one day per week? 

As soon as a tragic event happens your WD symptoms get worse. I've had some personal disappointments while tapering citalopram and that ramped up my symptoms immediately.

 

My wife got pregnant very surprisingly and that scared the hell out of me. Immediately I had  symptoms like panic, nausea etc. We have a 7y old boy so I know what it's like😉

 

I understand how you tapered. You thought of this method and just started tapering. Unfortunately your method causes daily fluctuations that we want to avoid. 

 

I started a citalopram taper in April 2018 and decreased 0.1 mg every day. After 85 days I crashed so I stayed on 16.5 mg for a couple of weeks. I felt so bad that I updosed to 18 mg to feel better. That didn't really help because my body had to get used to that dose also. I'm on 18 mg citalopram now since August 14th 2018. 

 

I created this taper myself but unfortunately it was too fast. Found this website after that...

 

 

You halved your dose in 6 months with this method and that is not crazy fast but too fast for you probably and not the best method.

 

i hope someone can give you some proper advice about dosage. Since you still take 25mg it might be possible to updose somewhat. I don't know about this.

 

The crying is a typical WD symptoms I have noticed. I cannot cry but I have the feeling which is nasty.

 

Having young kids is intense! Together with WD this is very tough I can imagine. I hope you'll find a way to deal with this. What helped me was not to pay too much attention to the symptoms. This sounds hard and it is. Sometimes I think: the hell with the symptoms it's just not me!! This helps me sometimes to push the symptoms to the background.

 

You will heal! You probably just went too fast. It takes time and strength!

 

Hold on and keep on moving!!

 

I wish you the very best and I hope someone gives you some good advice about your medication.

 

 

Jozeff

 

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ChessieCat
9 hours ago, SertralineAnxiety said:

January 2018: 50 mg 6 days a week, 25 mg 1 day a week

February 2018: 50 mg 5 days a week, 25 mg 2 days a week

March 2018: 50 mg 4 days a week, 25 mg 3 days a week

April 2018: 50 mg 3 days a week, 25 mg 4 days a week

May 2018: 50 mg 2 days a week, 25 mg 5 days a week

June 2018: 25 mg everyday

 

Please put the above in your drug signature so that we can see exactly how you tapered.  Thank you.

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SertralineAnxiety

Thank you Jozeff. 

The crying started recently, I think the life events kept coming at me and the stress and anxiety got too much to cope with. 

I am trying to find a therapist, as my family members and friends really don't understand what I'm going through. All I need is some support and understanding, but I guess most people just don't know how to do that. They want to help me but sometimes things they say make me more worried and hopeless :(

 

My physical symptoms are better but mental ones are worse now. I really hope this is withdrawal and will eventually fade. I really wish that I had found this site earlier and tapered slower... 

 

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SertralineAnxiety

Hi,

I am feeling much better, and really glad that I didnt go back up to 50 mg. I'm staying here at 25mg for a while, as I don't want to risk hitting rock bottom again. The worst thing was the feeling depressed, because it wasn't "me". I never had anything like depression, and I could tell it was the withdrawal making me feel this hopelessness that just didnt come from me.  

I will do an extremely slow taper over a couple of years, hoping I can avoid the worst of the withdrawal. 

 

I get bad days or weeks with anxiety, weakness and sadness sometimes, but they are getting less and less. And at least I know about the windows and waves, so I just try to wait it out. 

 

Thank you so much for having this forum, without it I wouldnt know how to taper. And reading experiences and patterns makes it so much easier to put up with the withdrawal symptoms.

 

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Aquarius

Glad you are feeling better i virtually ct d sertraline10 months ago ...i was great for 6 months then it started to hit ...reluctantly i went on Mirtazapine recently which helped with sleep and appetite...unfortunately after three weeks i wish i hadnt and just carried on ...i think sometimes my mind is stronger than tbese pills i have to sometimes not listen to it as i will end up doing a ct again ...wish you all the best with your stabilisation...

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SertralineAnxiety

Hi,

I am starting a taper from Sertraline and I just realised that the box of tablets I will be taking from tomorrow has an expiry date of 03/19. 

I should be taking that box for the next 2 months...

Will it be okay, or would the potency be decreasing near the expiry date? 

I've had this particular box in the house since last August 2018. I always have 1 or 2 boxes spare, and I must have used newer ones and forgotten this at the back of the shelf.

I am worried that it will be weaker and this might have an affect on my taper?

Has anybody got any experience with this?

Should I use it or discard it? 

 

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ChessieCat

Alternating doses/skipping days to taper is not recommended.  The brain likes consistency.  Skipping Days vs Every Day Dosing Graph

 

This topic explains how to get the dose you need:  Tips for tapering off Zoloft (sertraline)

 

We have a topic here that you might like to post in:  storing-capsules-tablets-or-liquids-look-for-expiration-date

 

If it was me, I'd use them.  If they were 6 months past the expiry I'd be getting fresh ones.

 

However, if it concerns you and you are know it will make you worried and anxious, it would be better to get fresh ones, just so that you don't become stressed about it.

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SertralineAnxiety

Thank you ChessieCat. I think I will worry too much about it, so it might be best to use a fresh box to avoid more anxiety.

 

I am going to use Brassmonkeys slide method this time. I didnt know about this forum or anything about tapering before, otherwise I wouldnt have taken the risk of destabilising myself with alternating doses. Thank god I am a lot more informed now. 

 

I will try reducing 10% every 8 weeks, but will make smaller weekly reductions to reach the 10% , like Brassmonkey describes. Hoping this will be slow and steady enough. 

 

 

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SertralineAnxiety
On 2/8/2019 at 12:02 PM, Aquarius said:

Glad you are feeling better i virtually ct d sertraline10 months ago ...i was great for 6 months then it started to hit ...reluctantly i went on Mirtazapine recently which helped with sleep and appetite...unfortunately after three weeks i wish i hadnt and just carried on ...i think sometimes my mind is stronger than tbese pills i have to sometimes not listen to it as i will end up doing a ct again ...wish you all the best with your stabilisation...

 

Thank you Aquarius. From what I read in the forums here, the withdrawal seems to get to its worst after several months, which is what also happened to me. Cold turkey must have been a lot harsher, I hope you are feeling better on Mirtazapine, or is it not helping much?

 

 

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Aquarius

It has been five weeks on Mirt and its been a bit bumpy i think the wheels are starting to come off the doctor has advised i take the 40mg propranalol i was prescribed as well i think my system is still messed up from the sertraline ...have good days but am still having long crying sessions which seem to be getting worse 😥

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SertralineAnxiety

It's so so hard to cope with reduction, so I can't imagine how you feel after cold turkey...

Did you consider

if it would have been better to reinstate  small  dose  of Sertraline instead of other new meds? 

I had the sudden crying spells, and I do think it's best to cry when you can, it is very healing. It says on 'Psychology Today', that "...Dr Frey discovered that reflex tears are 98% water, whereas emotional tears also contain stress hormones which get excreted from the body through crying. After studying the composition of tears, Dr. Frey found that emotional tears shed these hormones and other toxins which accumulate during stress. "

https://www.psychologytoday.com/gb/blog/emotional-freedom/201007/the-health-benefits-tears

 

 

 

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Aquarius

I did consider it but felt under pressure to do something and at rhe time reinstating seemed too difficult as i was in a bad place ..i have done so much crying i think its a combination of all the traumas ive had in the last seven years and yes i have heard its a stress releiver ...todayactually is a good day im hoping the combination if the mirt and propranolol is actually kicking in ....im so Glad you are coming off sensibly ...i know we all get there in the end but coming off fast as i did was a big mistake so please don't hurry it if you are feeling ok ..when the time comes i will definitely be going slowly...i wish you all the best and take it slow....looking back i did stress over everything so as they say on here if you can just accept it it will may your journey a lot smoother ...

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Carmie

Hi SertralineA, 

 

Just wanted to wish you all the best with the brassmonkey slide. Keep us posted. 

 

Sending hugs🤗

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SertralineAnxiety

Thank you very much Carmie. 

I am on 22.5 mg Sertraline at the moment.

In the last few weeks I have been feeling itchy with dry skin every now and then, and had some health anxiety, worrying about allergic reactions. But I have no symptoms that prevent me from living a normal life at the moment. Also have some muscular issues, but I am having massage and physiotherapy and doing okay,

I have been having therapy, which helped massively. Also trying to have a good diet, sleep enough (as much as I can with the kids waking me up several times every. single. night. I feel very lucky to not have insomnia though.) and keep active. Been reading books from Katy Bowman, a biomechanist, and been trying to gently change the way I move/exercise in daily life. 

I haven't had any waves in ages, I think I stabilized well on 25mg because I was on that dose for 9 months. 

Hoping I haven't jinxed it, I will keep on Brassmonkey slide method. 

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Carmie

Hi SertralineAnxiety, 

 

You sounds like you have everything well in hand.💚

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SertralineAnxiety
Posted (edited)

Tablets inside/mixed with food?

 

Hello,

 

I was wondering, does anybody mix their pills with food at all? Not in dissolved liquid form. Just powder/crumbs mixed inside a small, bitesize piece of soft food like banana, boiled potato etc?

 

I am finding it hard to take the crumbs from my Sertraline tablets. I cut the tablet into small pieces, mix them around and then weigh what I need.

I do this, in case the active ingredient isn't evenly distributed among the fillers. 

 

However, small pieces stick to my tongue or inside of my mouth. I don't want to put them into capsules, as I find it very difficult to swallow big capsules, and they tend to give me indigestion. 

 

So, does anybody hide their pills within food? Is there a reason why they shouldn't be taken in this way? 

 

Thanks in advance.

 

 

Edited by ChessieCat
added topic title

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ChessieCat

It shouldn't be a problem, but don't put it into a hot food.  Also, I would only add the drug to the food immediately prior to ingesting.

 

You could use apple puree or custard or yoghurt.  Maybe use baby food which come in small containers.  If you find that too expensive you could buy a larger container and freezer into ice cube trays.  Do not add the drug to the ice cubes.  Apple puree and yoghurt would freeze okay.  If you have a blender you could puree tinned peaches or apricots or mangoes.  You would probably only need 1/2 of an ice cube for 1 dose so you could either put less in the ice cube tray or fill and use for 2 days.  I would take out the ice cube and put in a covered container in the fridge so it is thawed ready for the next day's dose.

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SertralineAnxiety

Thank you very much ChessieCat, really appreciate your help. I will continue with this method then, until I switch to DIY liquid at some point the future... Can I also ask you, is there any way of adding tags like "Zoloft" or "Sertraline" to my topic? I use tags a lot now, and noticed I didn't add them to mine when creating the topic. 

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SertralineAnxiety

Not doing great.

Mild dizziness, fullness in ears, teeth grinding, temperature regulation issues and blood sugar drops. All very mild though. I probably wouldn't think much of them if I didn't know about withdrawal. But they cause health anxiety sometimes.

 

More problematic are the sudden intrusive thoughts and accompanying anxiety. 

I should have expected it though.

I received a couple of bad news recently, and had some stressful time. I had to stop therapy for a while unfortunately. And I had to end a close friendship. Also had some other private issues, all of which contributed to feeling like poop... Yet I have two little kids to look after, and have no family nearby, so I don't get a chance to process negative events or just feel sad. No wonder it all accumulates and forces me to acknowledge that I need to just take a break...

 

Anyway, I have to admit that it feels like relapse more than anything. The intrusive thoughts are all very familiar core fears in new disguises. They are slowly returning now that the numbing effect of Sertraline is less. I am so glad to be tapering slowly, which gives me time to learn to deal with it. 

 

I'll hold my current dose of 20.5 mg for a while. 

Then I'll probably slow down the taper, to around 2% every month. I just need to keep reminding myself that there is no rush. Feeling as normal as possible is the priority, especially because I don't even know what kind of person I am without Sertraline. I was 17 when I started, and I'm 31 now, so I've never been an adult without the drug. If it was up to the doctors, I'd be on it forever. Just because it's easier. 

 

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brassmonkey

Hi SA--  I'm sorry to hear about all the "real life" problems that have sprung up lately.  They can be such a problem especially during a taper. If things are adding up too much an extra several weeks of hold might help.  Why throw symptoms on top of everything else.  When Life settled down a bit and you've had time to process things you could start back up with the taper.

 

I would be careful with putting your dose into food to take it.  There is a good possibility that some of the dose could be missed in that manner.  Have you tried getting some empty gelcaps and putting your dose in them?  They are inexpensive for a bag of 1000 from amazon, and make things a lot easier.

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SertralineAnxiety

Thank you for your post Brassmonkey. I haven't been on for a while, things have been very busy. I have started taking the pieces of the tablets on their own again, as I am worried about the change in absorption rate when taking them in a different form. 

 

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SertralineAnxiety

I am going through a big wave right now. We moved to a different country last week.

The months before the move were very difficult. We had to sell all our furniture as well as repair and clean the rental house that we were in, with our 2 little children constantly on our case, because we have no family or friends nearby who could help us. 

Luckily we managed everything and left for the journey to the new country.

We drove all the way in a car, and the journey took 7 days(we only drove 6-7 hours a day, due to the children). The journey was extremely stressful and tiring. 

 

I managed to get through the journey without any incidents. But a couple of days after we arrived in our new home, my anxiety slowly went out of control. It started with some diarrhea and nausea. Then health anxiety. Then full blown panic attacks. 

I feel like I'm running on adrenaline for the last couple of days. 

I feel cold, I feel hot, I feel like crying, I feel tired, I feel restless.

I get periods of depersonalisation & derealization. I try to push past it and act normal.

It's all just so overwhelming, I don't know where to start with anything. 

 

 

 

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