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painandnumb27: started sertraline in June now cold turkey with serotonin syndrome

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Hello everyone,


It is very good that I finally found a place to talk about my issues. 


Started sertraline in June, overdosed in August, now cold turkey with serotonin syndrome


So, as stated above, I've been going through many things in a short frame of time. 


I've had anxiety problems as long as I could remember. As a kid, I was anxious. As a teen, I was anxious. 


My anxiety problem got out of control this year, as I started university and many things that I couldn't control happened simultaneously (mainly family stuff - mum's verbally abusive, my sibling has a cognitive disability, and my dad has health issues). I was getting constantly frustrated and depressed, and ultimately developed a suicidal ideation around June. 


That is when I first went to a GP to talk about my mental issue and the GP prescribed me with 50mg of sertraline. 


At first, it helped me a lot with my anxiety but when I think about it now, what sertraline did was numbing all my emotions; tranquilising my mind. 


As soon as I started taking the pills, I had several side-effects, including severe insomnia and lack of appetite which never really disappeared until I went cold turkey. I could barely sleep for 4-5 hours per day for several months. 


From the beginning, I had problems with my dosage. A few weeks after initially taking pills, I increased the dose by myself to 100mg because it was during the exam period, I was extremely anxious and wanted to die because of the stress and anxiety. I've told my GP later and she said it'd be ok to continue taking 100mg if I'm good with taking it. So from then on, I took 100mg per day. 


However, I was going nuts as I wasn't getting enough sleep and there were persisting side-effects that kept me from being functional. I could barely concentrate on anything.


Although I believed I wasn't anxious anymore, I was seriously getting depressed due to the physical fatigue and other things that were going around me. 


I think I went through some personality changes as I started acting more impulsively without thinking about the consequences. Probably because nothing was rewarding as all my emotions were blunted due to the pills. 


I overdosed myself with sertraline during late August. It was during the exam period (again), I couldn't study properly because I couldn't concentrate, I was suffering from insomnia. I talked about the insomnia problem to my GP and she told me exposure to sunlight, drinking warm milk and exercising mindfulness activities would help... which didn't. I was also very depressed during that time. I took a blood test around that time due to irregular menstruation and the GP told me that there were two hormonal abnormalities and they could be either because I was too stressed/due to the antidepressant, or because I had PCOS and a tumour on my pineal gland. 


Everything accumulated and I was getting extremely anxious. So, without thinking much about the consequences, I started binge-eating my pills. I had no intention of committing suicide as I researched beforehand and the case study I read stated that overdosing a very high amount did not kill the person. Moreover, whenever I was getting anxious, I had cravings with my pills because I wanted to numb all my feelings (I still do sometimes, even after going through serotonin syndrome - so I started suspecting that the pill may be addictive despite what everyone's saying). Additionally, I had access to plenty of sertraline as I had 2 prescriptions - one for 50mg, and one for 100mg. Now when I think about it, one of the things that contributed me to overdosing was the generic pills; sometimes I went to other pharmacies and they only had the generic ones. Because I didn't know that the generic ones may have a different effect in terms of time, I just took generic ones and found them not as effective as the brand pills and took even more to gain the effect. I did know that sertraline did not have instant effects (well the side-effects were quite instant though). 


My highest overdose on 1 day was 450mg. I didn't take the pills at the same time; it was more like 100mg in the morning, 150 in the afternoon, and 200 at night. during that insane week, I took a total of 1500mg, which was more than double my supposed weekly dose (700mg). The effects of sertraline syndrome were instant. I've acquired high blood pressure (around 150) and fast heart rate, to the extent that I woke up in the middle of the night because my heart was beating so quickly and my blood vessels were constricting. My hands started to tremble constantly. 


I went to my GP on that following Monday. And... the interesting thing was that the GP advised me to keep taking my usual dose (100mg) because she was worried about the withdrawal syndrome. She told me that the symptoms should cease several weeks later. Well, I should've realised that GPs don't have much knowledge regarding the psychiatric drugs because I saw her searching up about sertraline on her computer. Anyways, I kept taking the usual dose, thinking that I would get better within a few weeks. Then like a week later I self-decreased my dose to 50mg because the symptoms were getting severe. The trembling spread through my entire upper limb. I've developed bilateral upper limb clonus, spasticity, and hypertonia - I was jerking my upper limb violently all the time except when I was asleep. All my upper limb muscles (including the rotator cuff muscles) were contracting involuntarily. I was suffering from constant muscle ache, tendon ache as well as severe insomnia. 


So, in mid-September, around 3 weeks after the overdose, I finally decided to go to the hospital emergency department although I initially planned to wait until I see the psychiatrist in mid-October. Serotonin finally screwed up my autonomic nervous system as well - I developed problems breathing and regulating my body temperature. I was in constant agony as I had neuromuscular, cardiovascular, respiratory, ANS problems as well as insomnia and other antidepressant side effects. Muscle spasticity finally started to spread to my lower limbs as well. Because of those problems I was very depressed at that time. 


I finally went to the emergency department and the doctors and people from the toxicology department assessed me. I was given a pill of valium and IV fluids. The doctor there advised me to stop taking the pills and told me that my problems are probably a combination of serotonin syndrome and withdrawal syndrome (from overdosing then quickly decreasing my dose). From then on, I was cold turkey with sertraline. 


The week after the trip to the emergency department, my dad took me to his GP. I told him (the GP) that I went to the hospital, and had serotonin syndrome. I also told him that I had insomnia. 


My dad's GP gave me a weeks supply of valdoxan (aglomelatine - melatonin based antidepressant) and told me that I could start taking it from that day (although I raised concerns about taking new antidepressant while having serotonin syndrome) because it won't interact with serotonin and it doesn't have many side-effects. But the funny thing about valdoxan is that you need to get blood test done every month to check your liver enzyme level. It can potentially damage and fail your liver but isn't it ironic how the doctors say it doesn't have many side-effects?!?


I started taking valdoxan but had to quit it after 4 days because the side-effects were immense. It could've been serotonin syndrome but as soon as I started valdoxan, I had constant dizziness, nausea, headaches (brain zaps?) and severe fatigue for several weeks even after I quit it. The only good thing about valdoxan was that it instantly fixed my insomnia; I no longer have sleeping problems which I had for several months. So, around late September to mid-October, I had serotonin syndrome, withdrawal syndrome, and the side-effect from the new antidepressant at the same time  - which was excruciatingly painful. 


Then around mid-late October, I finally met the psychiatrist. I booked the appointment like 3 months before... then finally saw him. He asked me about my family issues, where my depression and anxiety stemmed from, but he didn't really discuss with me about all the pill-related issues. Whilst he agreed with me in not prescribing any psychiatric pills, when I told him about my upper limb trembling due to the serotonin syndrome, he told me that I can't have serotonin syndrome because it's been a while since I stopped taking it and the trembling must be because of my anxiety issue. The thing I don't get is that I still do have trembling, as well as bilateral clonus, spasticity, and muscle hypertonia right now as I write this down. I can't fully stretch some of my fingers because they are curled up!!!! IT'S A NEUROLOGICAL PROBLEM, NOT SIMPLY ANXIETY STUFF. I didn't tremble all day because of anxiety before I started taking pills, even though I was struggling with anxiety! 


Now, I'm currently having CBT with a clinical psychologist which is also my university lecturer of the psychology course. It's going well, but I'm still suffering a lot from the pill side-effects. I still have neuromuscular issues and other issues I've acquired since starting sertraline - hypersensitivity with food, fatigue, and many other things. Before taking pills, I at least knew why I was depressed. Nowadays I get depressed out of blue. I think taking sertraline made my mood-swings and depression worse. I'm not anxious anymore, but I don't know if it's because my anxiety has been cured by the pills or it's just that I don't care anymore about my original problems which made me depressed because the pills made me really sick. 


I think the whole experience with antidepressants really lowered my pain tolerance threshold and now I'm in constant, chronic pain. My muscles still contract involuntarily all day, my hands and arms still tremble, and there's nothing I can do about the pain right now except taking painkillers which are effective for a few hours. I don't think the GPs and the psychiatrist can do much about it either. Any recommendations? Anyways, thanks for reading my long post. 


Edited by ChessieCat
added title to post and reworded to reflect addition

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Hi painandnumb and welcome to SA,


We ask all members to create a drug signature so we can see their drug history at a glance.  This will appear below every post you make.  Please follow these instructions.  Please make it nice simple (NO diagnoses or symptoms please - thank you):

  • details for last 2 years - dates, ALL drugs, doses
  • summary for older than 2 years - just years and drug/s

Account Settings – Create or Edit a signature



The only supplements which SA recommends are Magnesium and Omega-3 Fish Oil.  Many members find them helpful.  Try a small amount of each, one at a time, to see how you respond.


You might find this list helpful:  Dr Joseph Glenmullen's WD Symptoms Checklist



8 hours ago, painandnumb27 said:

I'm currently having CBT with a clinical psychologist


It's good that you are doing this.  SA suggests learning and using non drug techniques.  I did an 8 week online supported CBT course about 4 years ago and have found it very helpful.  I've also learned some other things from SA.


You might find Claire Weekes helpful.  She was a doctor who suffered from anxiety and learned and taught ways of coping.  There are videos available on YouTube.


This is SA's topic:  Claire Weekes' Method of Recovering from a Sensitized Nervous System


And here are some links to other things which you might find helpful:


Non-drug techniques to cope





Acceptance and Mindfulness

"Change the channel" -- dealing with cognitive symptoms

Change cognitive framing - Redirect - Another Way

Cognitive Behavior Therapy (CBT) for anxiety, depression


Audio:  First Aid for Panic (4 minutes)
Resources:  Centre for Clinical Interventions (PDF modules that you can work through, eg:  Depression, Distress Intolerance, Health Anxiety, Low Self-Esteem, Panic Attacks, Perfectionism, Procrastination, Social Anxiety, Worrying)

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

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14 hours ago, painandnumb27 said:

I think the whole experience with antidepressants really lowered my pain tolerance threshold and now I'm in constant, chronic pain. My muscles still contract involuntarily all day, my hands and arms still tremble, and there's nothing I can do about the pain right now except taking painkillers which are effective for a few hours.


Whereabouts are you feeling the pain?  Is it muscle pain or joint pain or nerve pain?  What painkillers are you taking?  If it is muscle pain then magnesium might be helpful - you could try magnesium cream, or epsom salts baths.

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Thank you very much for the comments!


I will try magnesium. The pain mainly consists of muscle pain and joint pain - I used to have nerve pain when the serotonin syndrome + withdrawal symptoms were very severe as my wrists were jerking way more than their normal range of movements and ended up impinging my nerves, giving me really sharp pains. However, nowadays it's more of blunt, uncomfortable pain on my muscles and joints as my muscles are always tense. 

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Welcome, painandnumb.


23 hours ago, painandnumb27 said:

The doctor there advised me to stop taking the pills and told me that my problems are probably a combination of serotonin syndrome and withdrawal syndrome (from overdosing then quickly decreasing my dose). ....


That doctor was probably correct.


As I read your first post, it is apparent to me that you always had adverse reactions to sertraline, which can cause anxiety and sleeplessness. The more you took, the worse it got. And your deliberate overdose made it all quite serious, it knocked your nervous system very much off course.


Muscle tension is governed by the autonomic nervous system. Yours has been dysregulated and needs to settle down. What we see here is that such post-withdrawal symptoms -- overtense muscles among them -- very, very gradually decrease, in fits and starts, over many months.


While you're not longer taking sertraline, you're recovering from nervous system upset. Very commonly, people in this state become hypersensitive to all neuroactive drugs, supplements, and sometimes even foods.


We advise people to avoid other drugs as much as possible, as they can trigger more symptoms. Taken regularly, pain drugs can incur genuine addiction. Then, if you don't take the drugs on the schedule decreed by your addiction, you can get withdrawal symptoms from that. That's an endless spiral, we don't deal with opioids and other pain drugs here.


Rather than pain drugs, for muscle pain, we recommend non-drug treatments, such as Epsom bath soaks (magnesium sulfate), magnesium oil, physical therapy, hydrotherapy (if you can tolerate the heat), acupuncture, chiropractic, massage, and osteopathic manual therapy (if you can find it).


Gentle stretching at home can help. You must make sure not to hunch over the computer for hours at a time, such postures can exacerbate pain in hands, arms, shoulders, back. We have too many people here with pain in their mousing arms and shoulders!


It's also important to get good sleep. What is your sleep pattern?


I also urge you to get coaching in learning techniques to cope with the stressful life situations that led you to the self-destructive gesture of overdosing sertraline.

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These might be helpful:


Non-drug techniques for dealing with physical pain


Acupuncture - Posts #6 & #8 (not detox or stimulation)


Sleep problems - that awful withdrawal insomnia


On 10/16/2015 at 5:01 AM, brassmonkey said:


Acknowledge, Accept, Float.  A concept stolen from Claire Weekes.  It is a process for handling situations that you have no control over.  Acknowledging the situation/symptom, getting to know it on a personal level.  Accepting that the situation/symptom is there, its real and there is nothing you can do about it. Letting the Situation/symptom Float off as you get on with your life as best as you can.  It's sort of like dealing with an unwanted house guest.  At first you get to know them and make them comfortable.  Then you realize they are not making any effort to leave and there is nothing you can do, but ignore them as best as you can until they go away.


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Thank you ChessieCat for the useful information - I'll make sure I go through them all.


Also, thank you Alto for the platform where I'm given a voice (unlike my previous appointment with the psychiatrist in which my concerns regarding serotonin/withdrawal syndromes were simply

dismissed) and able to access a plethora of useful information. I wish I'd found SA earlier... 


17 hours ago, Altostrata said:

We advise people to avoid other drugs as much as possible, as they can trigger more symptoms. Taken regularly, pain drugs can incur genuine addiction.


I've been avoiding all kinds of drugs recently, letting the body to heal itself. I managed to stop taking pain drugs for a few weeks after I found myself finishing a whole pack in 3 days. Nowadays I try to distract myself from the pain by going outside or meeting people and socialise. 


On 11/10/2018 at 7:01 PM, Songbird said:

If it is muscle pain then magnesium might be helpful - you could try magnesium cream, or epsom salts baths.


Today, I went to a shopping mall and bought some magnesium supplements. I'll see how it works on my muscles. 


17 hours ago, Altostrata said:

Rather than pain drugs, for muscle pain, we recommend non-drug treatments, such as Epsom bath soaks (magnesium sulfate), magnesium oil, physical therapy, hydrotherapy (if you can tolerate the heat), acupuncture, chiropractic, massage, and osteopathic manual therapy (if you can find it).


Actually, I'm a physiotherapy (physical therapy in the US) student. Since all my lecturers, tutors and many other people I see on a regular basis are physiotherapists, I think it'll be quite easy for me to get some advice from them. In the past (a few months ago) I was solely relying on my GPs... and I've finally realised that they don't have much knowledge about ADs as much as I did, especially regarding withdrawal symptoms and overdoses. I think consulting a physiotherapist would benefit me more as we must take neuroanatomy and regional anatomy (musculoskeletal system) as parts of our course. Although I'm only in the 1st year of the course (and need to redo some courses next year because I couldn't use my arms which are vital for the course) I think learning physiotherapy and anatomy helped a lot to understand my condition as I had some symptoms which I learnt as clinical scenarios. 


I was thinking of getting into medicine course after I graduate from the physiotherapy course, but now I'm thinking of studying neuroscience, after my overdose and subsequent adverse syndromes. It seemed like the medical professionals I've met were indoctrinated with the chemical imbalance theory and the evidence that supports that theory. If I become a psychiatrist (although I would need to pass all those exams first), I may be able to cater to the needs of the patients because of what I've learnt from my experience, but I wouldn't be able to stop other people from making their patient go through things that I've experienced due to their lack of knowledge. So, there's some motivation for me to study :D


17 hours ago, Altostrata said:

It's also important to get good sleep. What is your sleep pattern?


Nowadays, I have no problem with sleeping. While taking sertraline, I couldn't sleep more than 5 hours at once and my sleep pattern ended up being very fragmented. I had to take naps in the day which totally wrecked my sleep cycle. I believe drug-induced insomnia contributed greatly to my anxiety, depression and subsequent drug overdose (as I became very impulsive during that time and was not able to think clearly). 


Now I don't need to take naps, and my sleep is usually very deep. I was still struggling with insomnia right after I went cold-turkey with sertraline. I think taking Valdoxan, which is melatonin based, for 4 days somewhat magically fixed my insomnia. Nonetheless, it could've been my body shutting off as it had to deal with two ADs at once... any thoughts?


Finally, I have some questions regarding depression. As I did CBT with the therapist, I've been doing Depression Anxiety Stress Scales (DASS) regularly and last week, the therapist told me that my depression became quite severe, whilst my anxiety and stress levels were stable (light to moderate). I've been going through bad mood swings recently, but the thing is that the psychiatrist only diagnosed me with Generalised Anxiety Disorder, although depression was also a big part of my problem. Is there a need to see the psychiatrist again? 


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7 hours ago, painandnumb27 said:

I've been avoiding all kinds of drugs recently, letting the body to heal itself. I managed to stop taking pain drugs for a few weeks after I found myself finishing a whole pack in 3 days. Nowadays I try to distract myself from the pain by going outside or meeting people and socialise. 



This is a very healthy way of coping, also it gets you out and moving, which is very important.


Good to hear your sleep has recovered, that's very promising. Yes, insomnia can be an adverse effect of SSRIs, indicating too-high dosage or intolerance for the drug.


The diagnoses are immaterial. As you can see, your symptom pattern changes all the time. Some of it is iatrogenic. Some of it is growing emotional maturity. The rest requires some lifestyle changes from you and coping skills.


Please also note that "depression" is a common side effect of pain drugs. You might remind your CBT therapist about this.


You might find studying psychiatry to be very frustrating, as the doctrine is based on an alternate universe where drugs solve everything.


Sounds like you have lots of resources for exploring physiotherapy. You'll probably learn a lot from your own progress.

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Hello! It's been a while since I've visited SA. 

I had flu around a month ago, and I thought it would go away in a few days or weeks as most flu did before. 

It somehow turned into bronchitis. I guess the AD overdose and withdrawal really impacted on my immune system.


Because of that, my WD symptoms became severe as well; more hand tremors, hyperreflexia, clonus and hypertonia -  and my shoulder muscles randomly lift my shoulderblade when I'm not doing anything physical, which is very disturbing sometimes. However, I don't think I have as much of the fatigue or the GI tract problems as I did before, on the bright side. 


Last week, I had a CBT with my therapist and we went through the types of thinking errors that depressed people may have. I used to have most of those, which I believe exacerbated my depression significantly throughout this year. I realised that those kinds of thoughts were reinforced by a member of my family, who is very verbally and emotionally abusive. I'm pretty sure that she's the main reason I've acquired depression and anxiety in the first place. 

To be honest, one of the main reasons that I've overdosed was because she was constantly stressing me out (as well as the adverse AD side-effects). 


I wasn't really able to think clearly before I was clinically diagnosed, and while taking the ADs, but now at least my mind is clear although my physical state has deteriorated. I have the willpower to get myself out of this situation, and I believe that there were some positive aspects of going cold-turkey on sertraline (despite all those horrible withdrawal symptoms) because it made me realise that making my emotions blunt by using medication will not solve anything. Also, I'm not doing much self-blaming nowadays which is good. I know this won't be easy but at least now there's some hope. 


I hope you all have a great day! 



Edited by ChessieCat
deleted comments about abuse

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Hello everyone! I hope you are all enjoying the holiday season. 


It's been around 4 months since I've overdosed on sertraline and around 3.5 months since I went cold-turkey. 

So, today morning, I went to my dad's GP (who prescribed me with Valdoxan) with my dad, because I was wondering if I could acquire a document relating to my current condition.

I went there and told him that my main symptoms since the overdose, which are tremors, clonus, hyperreflexia, and subsequent muscle and joint pain, are still persisting. 


I've also told him that I had to quit Valdoxan after 4 days since I've started taking it, because of the symptoms of withdrawal syndrome from sertraline became so strong, and I was not sure which may have been caused by Valdoxan side-effect and which from sertraline. He seemed to be a bit pissed about that since Valdoxan is based on melatonin and it "doesn't interact with sertraline" - he didn't seem to understand how severe the withdrawal syndrome can be. 


Additionally, he was being really dismissive about the persisting symptoms of the withdrawal syndrome - I told him that the psychiatrist I've met told me that all of my disorders must've been due to anxiety without any physical examination and he told me that he agreed with the psychiatrist. I told him that I knew that anxiety could be a contributing factor when it comes to tremor, but sertraline could have affected the other symptoms like clonus, hyperreflexia, and joint pains because they are mainly related with neuromuscular lesions and disorders. I did expect to hear such responses because I've read what the SA members and other people went through with their doctors, but I've found it quite frustrating when that GP told me that the clonus, joint pain, and involuntary contraction of the shoulder muscles that I'm currently experiencing are from anxiety. I mean - I've been having these for 4 months, throughout day and night, and I find it quite unprofessional that the GP conclusively telling me that all those are from anxiety without conducting any examinations, and blaming me for telling him that the antidepressant may have caused them, especially when I overdosed on it and never had a chance to properly taper off. Also, I've been regularly checking my depression, anxiety and stress levels with my therapist and my anxiety levels were consistent. My depression levels were fluctuating severely due to pain. 


He didn't explain why anxiety could be a root cause of all the things that I'm suffering from, as if it's some kind of a magic word that can be applied everywhere when dealing with a psychiatric condition, and he just told me that it can't be sertraline because it's not how it "works". I asked him if I could be referred to a neurologist in the future and he told me that I should book an appointment for a proper examination and I can be referred to a specialist, although not much can be done with my case. I guess I got on his nerves by challenging what he was telling me, and he thought that all those were happening in my mind?!? Although I can clearly see my muscles involuntarily contract (and other people pointed out to me) and can pinpoint which joint hurts? I do know that nervous system related symptoms don't have an easy solution and can take a long time to heal, but I don't get how a GP who does not specialize in such area can make definitive statements like that. 


It's interesting how two of the GPs I've met immediately after my overdose were worried about the withdrawal syndrome and advised me to continue taking my usual dose of sertraline, yet the psychiatrist and my dad's GP neglected the very same withdrawal syndrome. 


So, later today I went to see a physiotherapist to get some assessments done. I found her more helpful as she gave me some actually helpful advice on where I can start to improve my health, as well as getting some actual physical assessments done. She told me that my muscle power and sensation are good, but pointed out how my muscle tone increased quite a lot while I was doing the muscle assessment. She did tell me that how the drug interferes with my motoneurons in the brain is out of her realm and recommended me to get specific assessments done to find more about how the drug affected my nervous system. 


Although the withdrawal syndrome has a significant impact on my daily living, I think it's good that I am figuring out what to do from now on. 


In 2019, I will:


1. Find a new GP (as I have lost trust in my current one - she advised me to keep taking sertraline after my overdose, and she prescribed me an inhaler even though I told her that I don't have asthma, and I went to another GP later after I was sure that I had a respiratory infection and he gave me penicillin - a sore throat and earache that I had for a month went away in a week)


2. Find a physiotherapist or exercise physiologist to work on exercise and improve my neck mobility and posture 


3. (Although I'm not sure if it will turn out well and I probably need to wait for months) Get a referral to a neurologist or related health professional so I can investigate further


4. Perhaps ask for medication which helps the muscles to relax as I have hypertonia?


Thanks again Alto and the members of SA; the fact that there are people who are/were going through the same thing that I can relate to is comforting as there aren't many people around me who understand my condition. I know this will be a long journey but at least I'm not as clueless and confused as I was before. 

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Hello, pandn, I'm sorry I didn't see this sooner.


Your new year's resolutions are excellent. Yes, your GP needs to be replaced!


Physiotherapy can be very helpful; it could very well be that some of your postural habits are triggering an over-reaction in some muscles. We see this quite often with withdrawal syndrome.


Have you looked into acupuncture? I found it quite effective for muscle problems. Like other fields, you may have to hunt for a good one, but it could be worth it.


Do you have access to osteopathic manual therapy? I've had some remarkable results from it.


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Hello, I hope you are all doing well.


@Altostrata I replaced my GP, and had some satisfactory results! 


On Thursday, I went to the GP who I thought would listen to me well. I had an appointment with him last year for my bronchitis after my usual GP prescribed me with an inhaler - despite the fact that I stated that I've never had asthma - he listened to me well and he explained to me a lot of things, even showing me a diagram. 


Thank you heaps @ChessieCat - the links you put on my thread helped me a lot when I was mentally rehearsing what to say to the new GP in my appointment. So, I've written a summary of my symptoms and the timeline of what's been happening, as well as medical documents that I've collected last year. I purposely did not tell him that I believed that I had antidepressant withdrawal symptoms because I was afraid he might act like my dad's GP who was on absolute denial because "it's not how SSRIs work" and blamed all kinds of neuromuscular conditions that I was experiencing were due to my underlying anxiety. I just wanted him to figure out what was wrong with me, using the evidence I showed him. 


I first told the new GP that I had several muscular issues. He did some tests on me and confirmed that I still had clonus and it is much severe in my upper limbs than lower limbs. He then told me to get some blood tests and that he'll write me a referral to a neurologist next week when the results are back. I really like this guy, since he gives me the opportunity to tell him things without interrupting - which the others were not very good at. He also told me that at this stage it is not good to give me any medication, which I liked. 


Anyways, that appointment made me feel very good because it feels like there has been some progress made, and I know that there's someone who acknowledges that there are some problems. When the psychiatrist and dad's GP told me that the neuromuscular abnormalities I was experiencing must be from my anxiety (because I was diagnosed with GAD) I felt like my suffering was denied and ignored. I found out something odd that day - after the appointment, my muscle tone significantly decreased to the extent I did not have as much muscle pain, and it was very relieving. I'm not sure if it's because my mood had elevated or my temperamental nervous system gave me some mercy.


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Finally, I want to talk about neuroplasticity. After going through a brief period (around 2 weeks) of depressive mood which I think was rebound depression from AD withdrawal - I don't think I feel depressed or anxious anymore, despite the ongoing and fluctuating withdrawal symptoms. I feel like the mechanisms of my depression and anxiety have been blocked. It's as if my brain actively prevents me from indulging into things that make me feel depressed or anxious, using the withdrawal symptoms and pain; like aversion therapy. What I've found out after my overdose and onset of the symptoms was that whenever I try to engage in those toxic behaviors - such as thinking about a traumatic or an embarrassing moment that happened in the past - I would instantly have painful muscle spasms as if I was getting punished. To reduce pain, I had to stop thinking. I think it prevented me from having a chain of catastrophic thinking; what GAD is mainly about. I think this reinforcement may have changed the way my brain works and has eliminated the negative neural pathways associated with sadness and anxiety. Could it be the work of positive neuroplasticity?


I know I'm not just thinking that I don't feel depressed or anxious, because there are behavioral changes that I can point out. For depression, I used to have this perpetual formation of suicidal ideations - I used to think about it for hours every day, especially when I was at the peak of my depression. Now I have none of that. Also, thinking about my personal traumas used to evoke so much emotional response, but it seems like they don't hold much emotional significance. I feel detached from them. Moreover, whenever I was anxious before, I would try to suppress it by making impulsive purchases or by binge eating. Now I don't do either of them. Whilst these changes are good for me, but I think some are a bit extreme. Currently, I don't feel hunger nor satiety even if I eat only once a day. I think it may be a neurological problem aroused from AD withdrawal since serotonin influences appetite stimulation and satiety induction. 


I'm very keen on trying to find out what caused my depression and anxiety go away and stabilised my mood. I don't think it's the antidepressant because I had very adverse reactions and ended up overdosing. I don't think it's my own self, because I didn't really make a lot of conscious input and actions (such as doing yoga, doing mindfulness activities, exercising etc.) to make myself not depressed or anxious because I've been fixated on my physical AD withdrawal symptoms. I did make a fair amount of lifestyle changes though. Nevertheless, my environment, stressors, and circumstances didn't change much.  


Despite being very good, I don't think CBT solely caused such changes because I've only had 5 sessions and I was ranting for the initial 3 sessions. It's very weird because I expected that I would get more depressed due to the withdrawal symptoms & its debilitating impacts to daily life since pain is usually involved with negative neuroplasticity. And it's only been around 4 months since my sertraline overdose. 4 months isn't exactly a short amount of time, but considering how depression and anxiety had been accumulating throughout the course of my life, I think it's a bit short to induce such a great amount of change. 


To be honest, I think I feel better (mentally) even compared to my pre-depression era. I feel more cognitively refined, focused and motivated. I really want to find out how it happened, because it seems a bit too strange. I recently found out that one of my university lecturers is a brain researcher whose works are mainly focussed on neuroplasticity and its effects in humans. I think it would be worthwhile to ask some questions to him. 


Thanks for reading my long post, and I hope you have a good day!


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I think I know why my depression and anxiety went away.

I've observed myself for around a month after I wrote the previous post, and it seems like all my emotions have been blunted. 

It's very similar to the emotional numbness I've gone through as one of the side effects when I started taking sertraline last June.

I have no desires, I am not happy nor excited, but I'm not sad either - I feel very neutral all the time. 


I am not depressed nor anxious anymore because I no longer put much emotional significance to pretty much everything. 

It's as if my brain's unable to associate or link external stimuli with certain emotions. If I eat something sweet, I can detect that it's sugary - but that's it; there's no 'pleasure' derived from it. 

I don't really feel hunger nor satiety either - so I've been only eating one meal and a fruit a day for a while. 


It's so weird since I've been off the AD for more than 5 months and I did not expect something like this to happen again. I wonder how much sertraline has impacted my nervous systems and my brain. 


Anyways, whilst the emotional numbness gradually became stronger, I haven't been experiencing fibromyalgia-like symptoms much - yet I do recognise that neuromuscular issues I've had since my overdose are still persisting. They are manageable but still quite annoying - I have trouble extending my little and ring fingers and I get joint pains because they are clawed. I've been assigned to a neurologist, so hopefully, I'll be able to find the extent of the damage that AD has caused within a few months' time. 

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p&n, how are you doing?

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Hello @Altostrata, I'm doing well. Thank you for asking! 


I recently had a neurologist appointment and I was diagnosed with functional neurological disorder (FND). It makes so much sense now.

So, what I assume happened is that after the initial wave of serotonin syndrome, instead of the symptoms settling down, my nervous system started to use the disorderly movement pattern (such as tremor and clonus) when signalling and that 'pattern' got stuck. So I'll be retraining my brain (this sounds somewhat funny, but that's what they told me) to use the normal movement pattern when I get referred to a clinic that specialises in FND. 


Getting diagnosed with FND explains how things like chronic fatigue and fibromyalgia-like symptoms started to emerge late last year. I've read some articles about FND and they have so many similarities with CFS and fibromyalgia. 


I think I still have a long way to go, but since I know where I'm heading, I feel more positive now. 


I hope you have a lovely day!

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No, that makes sense. Our nervous systems get scrambled by withdrawal. It sounds like you've gotten some help in gentle unscrambling.

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