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Kernol: was doing well on my sertraline taper but now in hell and doc reinstated


Kernol

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Hi @Altostrata yes I did today 

10 years on Sertraline 100mg. 75mg Dec 2016 - Apr 2017, 50mg May 2017 - Oct 2017, 37.5mg

 

2018 - Sertraline 25mg Mar -  July 2018, 13.75mg Aug- Sept 1.5 month (‘not accurately measured), came off completely 10 October, reinstated by doctor on 10 November 25 mg. 25 November raised to 50mg 2 December 100mg 11 December 150mg 30 November. Lorazepam started 2mg x daily 1 November

2019 - Sertraline reduced  to 100mg 5 Feb, 23 Feb 75mg, 18 Mar 50mg, 23 Apr 37.5mg, 1 Jun 25mg, 3 Jul 16mg, 3 Aug 8mg, updosed on 1 Sept to 16.67mg 

20 Feb lorazepam 2mg x day crossed over to diazepam 20mg x day over 2 week period to taper. diazepam reduced by 1mg every 2/3 weeks got down to 3.5mg in August. 

22 Sept resorted to taking 1mg lorazepam after sertraline destabilisation instead of diazepam. took lorazepam 1mg  x day 22 Sept - 28 Sept then returned to diazepam on 29  Sept 4mg,, 30 Sept 4.5mg  1 Oct 5mg 2 Oct 5mg  16 Nov 4.75mg. 15 Dec 5mg 29 Dec 4.75mg   Vortioxetine 5mg started 1 July. 14 July 10mg -Reduced on 20 July to 5mg. 12 Sept reduced to  3.75mg, 19 Sept reduced to 2.5mg, 15 Oct reduced to 2mg, 22 Oct 1.9mg, 29 Oct 1.8mg reduced down every 3 days and then daily stopped on 2 Dec

2020 - sertraline  8 Apr - 16mg 29 Apr - 15.5mg 13 may - 15.25mg may 19 - 15mg may 22- 14.75mg 22 Jun 14mg 6 July 13.3 - 20 July 12.6 - 3 August - 11.97 - 17 August 11.37. Held. Then started 2.5% fortnightly drops. 9.5mg 4 Dec

diazepam 19 Apr - 4.25mg 20 May - 4mg 20 Jun 3.75mg  4.25mg 22 Sept 4.5mg 29 Sept. 4.75ng Oct 5 Nov 10 4.5mg

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Let's see what it does.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Ok thanks @Altostrata I will do. 

10 years on Sertraline 100mg. 75mg Dec 2016 - Apr 2017, 50mg May 2017 - Oct 2017, 37.5mg

 

2018 - Sertraline 25mg Mar -  July 2018, 13.75mg Aug- Sept 1.5 month (‘not accurately measured), came off completely 10 October, reinstated by doctor on 10 November 25 mg. 25 November raised to 50mg 2 December 100mg 11 December 150mg 30 November. Lorazepam started 2mg x daily 1 November

2019 - Sertraline reduced  to 100mg 5 Feb, 23 Feb 75mg, 18 Mar 50mg, 23 Apr 37.5mg, 1 Jun 25mg, 3 Jul 16mg, 3 Aug 8mg, updosed on 1 Sept to 16.67mg 

20 Feb lorazepam 2mg x day crossed over to diazepam 20mg x day over 2 week period to taper. diazepam reduced by 1mg every 2/3 weeks got down to 3.5mg in August. 

22 Sept resorted to taking 1mg lorazepam after sertraline destabilisation instead of diazepam. took lorazepam 1mg  x day 22 Sept - 28 Sept then returned to diazepam on 29  Sept 4mg,, 30 Sept 4.5mg  1 Oct 5mg 2 Oct 5mg  16 Nov 4.75mg. 15 Dec 5mg 29 Dec 4.75mg   Vortioxetine 5mg started 1 July. 14 July 10mg -Reduced on 20 July to 5mg. 12 Sept reduced to  3.75mg, 19 Sept reduced to 2.5mg, 15 Oct reduced to 2mg, 22 Oct 1.9mg, 29 Oct 1.8mg reduced down every 3 days and then daily stopped on 2 Dec

2020 - sertraline  8 Apr - 16mg 29 Apr - 15.5mg 13 may - 15.25mg may 19 - 15mg may 22- 14.75mg 22 Jun 14mg 6 July 13.3 - 20 July 12.6 - 3 August - 11.97 - 17 August 11.37. Held. Then started 2.5% fortnightly drops. 9.5mg 4 Dec

diazepam 19 Apr - 4.25mg 20 May - 4mg 20 Jun 3.75mg  4.25mg 22 Sept 4.5mg 29 Sept. 4.75ng Oct 5 Nov 10 4.5mg

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@Kernol, how are you doing?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Hi @Altostrata thanks for checking. I am still suffering very severe destabilisation and unable to sleep last couple of nights due to the terror and emotional pain all night long maybe my period is making it worse. I have electric shock feelings in my brain now too. I am at my wits end just praying for this to settle even a little. The diazepam is not helping so far 

10 years on Sertraline 100mg. 75mg Dec 2016 - Apr 2017, 50mg May 2017 - Oct 2017, 37.5mg

 

2018 - Sertraline 25mg Mar -  July 2018, 13.75mg Aug- Sept 1.5 month (‘not accurately measured), came off completely 10 October, reinstated by doctor on 10 November 25 mg. 25 November raised to 50mg 2 December 100mg 11 December 150mg 30 November. Lorazepam started 2mg x daily 1 November

2019 - Sertraline reduced  to 100mg 5 Feb, 23 Feb 75mg, 18 Mar 50mg, 23 Apr 37.5mg, 1 Jun 25mg, 3 Jul 16mg, 3 Aug 8mg, updosed on 1 Sept to 16.67mg 

20 Feb lorazepam 2mg x day crossed over to diazepam 20mg x day over 2 week period to taper. diazepam reduced by 1mg every 2/3 weeks got down to 3.5mg in August. 

22 Sept resorted to taking 1mg lorazepam after sertraline destabilisation instead of diazepam. took lorazepam 1mg  x day 22 Sept - 28 Sept then returned to diazepam on 29  Sept 4mg,, 30 Sept 4.5mg  1 Oct 5mg 2 Oct 5mg  16 Nov 4.75mg. 15 Dec 5mg 29 Dec 4.75mg   Vortioxetine 5mg started 1 July. 14 July 10mg -Reduced on 20 July to 5mg. 12 Sept reduced to  3.75mg, 19 Sept reduced to 2.5mg, 15 Oct reduced to 2mg, 22 Oct 1.9mg, 29 Oct 1.8mg reduced down every 3 days and then daily stopped on 2 Dec

2020 - sertraline  8 Apr - 16mg 29 Apr - 15.5mg 13 may - 15.25mg may 19 - 15mg may 22- 14.75mg 22 Jun 14mg 6 July 13.3 - 20 July 12.6 - 3 August - 11.97 - 17 August 11.37. Held. Then started 2.5% fortnightly drops. 9.5mg 4 Dec

diazepam 19 Apr - 4.25mg 20 May - 4mg 20 Jun 3.75mg  4.25mg 22 Sept 4.5mg 29 Sept. 4.75ng Oct 5 Nov 10 4.5mg

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Dear kernol, As a fellow sufferer of sertraline, I send you all my best wishes.  I'm so sorry you're having to go through this.  I'll be holding you in my heart.

Arbor

Zoloft: 1995 - 2015

Prozac: 2015 - 2018 (tapered from 40mg x day on July 31 to 30mg on August 31 to 20mg on September 31 to 10mg October 31 to 0mg on  December 15, 2018

Gabapentin: 2016 to 2019  (tapered from 300mg x day to 150mg on August 31, 2019 to 75mg on September 15 to 50mg on September 31 to 25ishmg on October 15 to 0mg on December 1, 2019

Enalapril: 2010 - 2019

Lipitor: 2017 -2017

Metformin: 2000 - 2020

Liothyronine: 2007 - 2019

Levothyroxine: 2000 - 2022

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  • Administrator

Kernol, hang in there. Not sure what's going on. Your menstrual cycle has brought worse symptoms in the past.

 

My theory now is that you have had benzo withdrawal since reducing diazepam in the summer of 2019. Around 15mg diazepam substitutes for 2mg lorazepam, you reduced diazepam too fast and to too low a dose. clincalc.com/Benzodiazepine/

 

The timing coincides with what you recall of sertraline destabilization. Both things can be happening, but those rescue doses of lorazepam indicate you are not taking enough benzo to compensate for the withdrawal symptoms.

 

Removing the vortioxetine temporarily increased the amount of diazepam in your bloodstream, but the withdrawal reasserted itself.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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On 9/22/2020 at 2:22 PM, Altostrata said:

Did you increase diazepam to 4.25mg?

 

On 9/22/2020 at 2:32 PM, Kernol said:

Hi @Altostrata yes I did today 

 

5 hours ago, Kernol said:

Hi @Altostrata thanks for checking. I am still suffering very severe destabilisation and unable to sleep last couple of nights due to the terror and emotional pain all night long maybe my period is making it worse. I have electric shock feelings in my brain now too. I am at my wits end just praying for this to settle even a little. The diazepam is not helping so far 

 

Kernol, please update your signature to reflect the change in diazepam back up to 4.25 mg.

 

Account Settings - Create or Edit Your Signature

 

You increased the diazepam from 3.75 mg to 4.25 mg on September 22. And then today, September 27, you're reporting that the past couple of nights have been bad (but it could be hormonal). 

 

Did you get any relief starting on September 22 until the past couple of nights when things got worse? 

 

 

 

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10 hours ago, Shep said:

 

 

 

Kernol, please update your signature to reflect the change in diazepam back up to 4.25 mg.

 

Account Settings - Create or Edit Your Signature

 

You increased the diazepam from 3.75 mg to 4.25 mg on September 22. And then today, September 27, you're reporting that the past couple of nights have been bad (but it could be hormonal). 

 

Did you get any relief starting on September 22 until the past couple of nights when things got worse? 

 


hi @Shep no it did not bring any relief at all unfortunately. 

10 years on Sertraline 100mg. 75mg Dec 2016 - Apr 2017, 50mg May 2017 - Oct 2017, 37.5mg

 

2018 - Sertraline 25mg Mar -  July 2018, 13.75mg Aug- Sept 1.5 month (‘not accurately measured), came off completely 10 October, reinstated by doctor on 10 November 25 mg. 25 November raised to 50mg 2 December 100mg 11 December 150mg 30 November. Lorazepam started 2mg x daily 1 November

2019 - Sertraline reduced  to 100mg 5 Feb, 23 Feb 75mg, 18 Mar 50mg, 23 Apr 37.5mg, 1 Jun 25mg, 3 Jul 16mg, 3 Aug 8mg, updosed on 1 Sept to 16.67mg 

20 Feb lorazepam 2mg x day crossed over to diazepam 20mg x day over 2 week period to taper. diazepam reduced by 1mg every 2/3 weeks got down to 3.5mg in August. 

22 Sept resorted to taking 1mg lorazepam after sertraline destabilisation instead of diazepam. took lorazepam 1mg  x day 22 Sept - 28 Sept then returned to diazepam on 29  Sept 4mg,, 30 Sept 4.5mg  1 Oct 5mg 2 Oct 5mg  16 Nov 4.75mg. 15 Dec 5mg 29 Dec 4.75mg   Vortioxetine 5mg started 1 July. 14 July 10mg -Reduced on 20 July to 5mg. 12 Sept reduced to  3.75mg, 19 Sept reduced to 2.5mg, 15 Oct reduced to 2mg, 22 Oct 1.9mg, 29 Oct 1.8mg reduced down every 3 days and then daily stopped on 2 Dec

2020 - sertraline  8 Apr - 16mg 29 Apr - 15.5mg 13 may - 15.25mg may 19 - 15mg may 22- 14.75mg 22 Jun 14mg 6 July 13.3 - 20 July 12.6 - 3 August - 11.97 - 17 August 11.37. Held. Then started 2.5% fortnightly drops. 9.5mg 4 Dec

diazepam 19 Apr - 4.25mg 20 May - 4mg 20 Jun 3.75mg  4.25mg 22 Sept 4.5mg 29 Sept. 4.75ng Oct 5 Nov 10 4.5mg

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11 hours ago, Altostrata said:

Kernol, hang in there. Not sure what's going on. Your menstrual cycle has brought worse symptoms in the past.

 

My theory now is that you have had benzo withdrawal since reducing diazepam in the summer of 2019. Around 15mg diazepam substitutes for 2mg lorazepam, you reduced diazepam too fast and to too low a dose. https://clincalc.com/Benzodiazepine/

 

The timing coincides with what you recall of sertraline destabilization. Both things can be happening, but those rescue doses of lorazepam indicate you are not taking enough benzo to compensate for the withdrawal symptoms.

 

Removing the vortioxetine temporarily increased the amount of diazepam in your bloodstream, but the withdrawal reasserted itself.


hi @Altostrata I agree I am not taking enough anywhere near enough Benzo to mask the withdrawal symptoms but I believe honestly with all my gut that this is sertraline destabilisation - I just know it Inside of me I recognise all the symptoms and the signs some of which are right from the start of my first withdrawal when I wasn’t taking a Benzo - there may be some Benzo withdrawal in there too but this crash I truly believe is predominantly sertraline related and I think the destabilisation in September was the same as I went down to 8mg— it is the low doses I just can’t seem to get off it.  I don’t know how I will ever get off it.  

10 years on Sertraline 100mg. 75mg Dec 2016 - Apr 2017, 50mg May 2017 - Oct 2017, 37.5mg

 

2018 - Sertraline 25mg Mar -  July 2018, 13.75mg Aug- Sept 1.5 month (‘not accurately measured), came off completely 10 October, reinstated by doctor on 10 November 25 mg. 25 November raised to 50mg 2 December 100mg 11 December 150mg 30 November. Lorazepam started 2mg x daily 1 November

2019 - Sertraline reduced  to 100mg 5 Feb, 23 Feb 75mg, 18 Mar 50mg, 23 Apr 37.5mg, 1 Jun 25mg, 3 Jul 16mg, 3 Aug 8mg, updosed on 1 Sept to 16.67mg 

20 Feb lorazepam 2mg x day crossed over to diazepam 20mg x day over 2 week period to taper. diazepam reduced by 1mg every 2/3 weeks got down to 3.5mg in August. 

22 Sept resorted to taking 1mg lorazepam after sertraline destabilisation instead of diazepam. took lorazepam 1mg  x day 22 Sept - 28 Sept then returned to diazepam on 29  Sept 4mg,, 30 Sept 4.5mg  1 Oct 5mg 2 Oct 5mg  16 Nov 4.75mg. 15 Dec 5mg 29 Dec 4.75mg   Vortioxetine 5mg started 1 July. 14 July 10mg -Reduced on 20 July to 5mg. 12 Sept reduced to  3.75mg, 19 Sept reduced to 2.5mg, 15 Oct reduced to 2mg, 22 Oct 1.9mg, 29 Oct 1.8mg reduced down every 3 days and then daily stopped on 2 Dec

2020 - sertraline  8 Apr - 16mg 29 Apr - 15.5mg 13 may - 15.25mg may 19 - 15mg may 22- 14.75mg 22 Jun 14mg 6 July 13.3 - 20 July 12.6 - 3 August - 11.97 - 17 August 11.37. Held. Then started 2.5% fortnightly drops. 9.5mg 4 Dec

diazepam 19 Apr - 4.25mg 20 May - 4mg 20 Jun 3.75mg  4.25mg 22 Sept 4.5mg 29 Sept. 4.75ng Oct 5 Nov 10 4.5mg

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Do you feel you can handle an increase to sertraline to 12mg?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Hi @Altostrata I don’t know - I feel like psychologically increasing my dose will feel like an even bigger step backwards. I am not sure what to do.  The flu symptoms are a bit of a concern for me now to feel physically so unwell on top of the mental symptoms - I know flu symptoms are common and I should try not to worry that they will last forever but somehow I find myself fearing I am going to be stuck like this feeling sick with chills and extreme fatigue as it started on August 25th and I worry that my bruxism started a year ago and never went away.. I just hope and pray they pass soon. 

10 years on Sertraline 100mg. 75mg Dec 2016 - Apr 2017, 50mg May 2017 - Oct 2017, 37.5mg

 

2018 - Sertraline 25mg Mar -  July 2018, 13.75mg Aug- Sept 1.5 month (‘not accurately measured), came off completely 10 October, reinstated by doctor on 10 November 25 mg. 25 November raised to 50mg 2 December 100mg 11 December 150mg 30 November. Lorazepam started 2mg x daily 1 November

2019 - Sertraline reduced  to 100mg 5 Feb, 23 Feb 75mg, 18 Mar 50mg, 23 Apr 37.5mg, 1 Jun 25mg, 3 Jul 16mg, 3 Aug 8mg, updosed on 1 Sept to 16.67mg 

20 Feb lorazepam 2mg x day crossed over to diazepam 20mg x day over 2 week period to taper. diazepam reduced by 1mg every 2/3 weeks got down to 3.5mg in August. 

22 Sept resorted to taking 1mg lorazepam after sertraline destabilisation instead of diazepam. took lorazepam 1mg  x day 22 Sept - 28 Sept then returned to diazepam on 29  Sept 4mg,, 30 Sept 4.5mg  1 Oct 5mg 2 Oct 5mg  16 Nov 4.75mg. 15 Dec 5mg 29 Dec 4.75mg   Vortioxetine 5mg started 1 July. 14 July 10mg -Reduced on 20 July to 5mg. 12 Sept reduced to  3.75mg, 19 Sept reduced to 2.5mg, 15 Oct reduced to 2mg, 22 Oct 1.9mg, 29 Oct 1.8mg reduced down every 3 days and then daily stopped on 2 Dec

2020 - sertraline  8 Apr - 16mg 29 Apr - 15.5mg 13 may - 15.25mg may 19 - 15mg may 22- 14.75mg 22 Jun 14mg 6 July 13.3 - 20 July 12.6 - 3 August - 11.97 - 17 August 11.37. Held. Then started 2.5% fortnightly drops. 9.5mg 4 Dec

diazepam 19 Apr - 4.25mg 20 May - 4mg 20 Jun 3.75mg  4.25mg 22 Sept 4.5mg 29 Sept. 4.75ng Oct 5 Nov 10 4.5mg

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  • Administrator

Have you had a test for covid-19? That could be a cause of prolonged flu-like symptoms.

 

August 2019 was when you reduced diazepam to 3.5mg. However, you had reduced sertraline at the same time. It may be that the withdrawal symptoms you have attributed to sertraline all along were from too-fast benzo reduction -- but it could be both.

 

You also recently reduced diazepam while reducing sertraline.

 

I am still leaning towards benzo withdrawal as the main cause of your symptoms.

 

Can you get one of those genetic tests for drug compatibility? The interaction of sertraline and diazepam is still suspicious. I wonder if you are a poor metabolizer via cyp2C19, which would not be a factor for lorazepam, which does not utilize cyp2C19, it mainly relies on cyp3A4.

 

https://go.drugbank.com/drugs/DB01104

Quote

The metabolism of sertraline is mainly catalyzed by CYP3A4 and CYP2B6, with some activity accounted for by CYP2C19 and CYP2D6.22

 

If sertraline is blocking cyp3A4 and you are a weak metabolizer via cyp2C19, you may not be metabollzing diazepam to its active metabolites, which give it its long half-life. Lorazepam may b more effective for you (even though sertraline competes for cyp3A4 as well).

 

https://go.drugbank.com/drugs/DB00829

Quote

Furthermore, oxidation of diazepam is mediated by cytochrome P450 isozymes; formation of desmethyl-diazepam mainly by CYP2C19 and CYP3A and 3-hydroxy-diazepam (temazepam) and oxazepam by CYP3A. Because CYP2C19 is polymorphic, extensive metabolizers (EMs), and poor metabolizers (PMs) of diazepam can be distinguished 9,10. PMs of diazepam showed significantly lower clearance (12 vs 26 mL/min) and longer elimination half-life (88 vs 41 h) of diazepam than EMs after a single oral dose 9,10. Also, PMs had lower clearance, higher AUC and longer elimination half-life of desmethyl-diazepam 9,10.

 

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Hi @Altostrata thanks for all the info. The genetic test - would that also tell me if I was not absorbing sertraline well as well? I don’t think they do it here in UK But I think I heard someone say they knew someone who got it from the US - would you happen to know where in US might offer this? 
 

the flu symptoms are definitely withdrawal I also had them in Feb/March when I had a bad crash which is strange that I crashed then as I wasn’t reducing any drugs for a while but I know there is no pattern to these things. My teeth have not smashed down quite as violently  the last couple of nights although all other symptoms still intense but I am hoping at least something is calming down. I have increased diazepam to 4.5mg I am so disappointed to have done this but I didn’t know what else to do. 

10 years on Sertraline 100mg. 75mg Dec 2016 - Apr 2017, 50mg May 2017 - Oct 2017, 37.5mg

 

2018 - Sertraline 25mg Mar -  July 2018, 13.75mg Aug- Sept 1.5 month (‘not accurately measured), came off completely 10 October, reinstated by doctor on 10 November 25 mg. 25 November raised to 50mg 2 December 100mg 11 December 150mg 30 November. Lorazepam started 2mg x daily 1 November

2019 - Sertraline reduced  to 100mg 5 Feb, 23 Feb 75mg, 18 Mar 50mg, 23 Apr 37.5mg, 1 Jun 25mg, 3 Jul 16mg, 3 Aug 8mg, updosed on 1 Sept to 16.67mg 

20 Feb lorazepam 2mg x day crossed over to diazepam 20mg x day over 2 week period to taper. diazepam reduced by 1mg every 2/3 weeks got down to 3.5mg in August. 

22 Sept resorted to taking 1mg lorazepam after sertraline destabilisation instead of diazepam. took lorazepam 1mg  x day 22 Sept - 28 Sept then returned to diazepam on 29  Sept 4mg,, 30 Sept 4.5mg  1 Oct 5mg 2 Oct 5mg  16 Nov 4.75mg. 15 Dec 5mg 29 Dec 4.75mg   Vortioxetine 5mg started 1 July. 14 July 10mg -Reduced on 20 July to 5mg. 12 Sept reduced to  3.75mg, 19 Sept reduced to 2.5mg, 15 Oct reduced to 2mg, 22 Oct 1.9mg, 29 Oct 1.8mg reduced down every 3 days and then daily stopped on 2 Dec

2020 - sertraline  8 Apr - 16mg 29 Apr - 15.5mg 13 may - 15.25mg may 19 - 15mg may 22- 14.75mg 22 Jun 14mg 6 July 13.3 - 20 July 12.6 - 3 August - 11.97 - 17 August 11.37. Held. Then started 2.5% fortnightly drops. 9.5mg 4 Dec

diazepam 19 Apr - 4.25mg 20 May - 4mg 20 Jun 3.75mg  4.25mg 22 Sept 4.5mg 29 Sept. 4.75ng Oct 5 Nov 10 4.5mg

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I'm not sure if this is the type of testing which Alto mentioned.

 

genetic-testing-personalized-medicine-liver-enzymes-genotypes-genesightrx-genomind-etc

 

I noticed these posts:

 

On 6/16/2011 at 2:38 AM, squirrel said:

Wish i could but don't think is available here in UK.

 

On 6/16/2011 at 2:45 AM, Razzle said:

 

 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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I've checked that link for Roche and it doesn't go to anything.  I've looked at the site and can't find anything about gene/genetics testing.  You could ask your doctor or contact Roche directly.

 

Just found these:

 

https://www.nhs.uk/conditions/genetic-and-genomic-testing/

 

https://www.myogenes.com/

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • Moderator Emeritus

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Thanks so much @ChessieCat I just ordered it from myogenes! 

10 years on Sertraline 100mg. 75mg Dec 2016 - Apr 2017, 50mg May 2017 - Oct 2017, 37.5mg

 

2018 - Sertraline 25mg Mar -  July 2018, 13.75mg Aug- Sept 1.5 month (‘not accurately measured), came off completely 10 October, reinstated by doctor on 10 November 25 mg. 25 November raised to 50mg 2 December 100mg 11 December 150mg 30 November. Lorazepam started 2mg x daily 1 November

2019 - Sertraline reduced  to 100mg 5 Feb, 23 Feb 75mg, 18 Mar 50mg, 23 Apr 37.5mg, 1 Jun 25mg, 3 Jul 16mg, 3 Aug 8mg, updosed on 1 Sept to 16.67mg 

20 Feb lorazepam 2mg x day crossed over to diazepam 20mg x day over 2 week period to taper. diazepam reduced by 1mg every 2/3 weeks got down to 3.5mg in August. 

22 Sept resorted to taking 1mg lorazepam after sertraline destabilisation instead of diazepam. took lorazepam 1mg  x day 22 Sept - 28 Sept then returned to diazepam on 29  Sept 4mg,, 30 Sept 4.5mg  1 Oct 5mg 2 Oct 5mg  16 Nov 4.75mg. 15 Dec 5mg 29 Dec 4.75mg   Vortioxetine 5mg started 1 July. 14 July 10mg -Reduced on 20 July to 5mg. 12 Sept reduced to  3.75mg, 19 Sept reduced to 2.5mg, 15 Oct reduced to 2mg, 22 Oct 1.9mg, 29 Oct 1.8mg reduced down every 3 days and then daily stopped on 2 Dec

2020 - sertraline  8 Apr - 16mg 29 Apr - 15.5mg 13 may - 15.25mg may 19 - 15mg may 22- 14.75mg 22 Jun 14mg 6 July 13.3 - 20 July 12.6 - 3 August - 11.97 - 17 August 11.37. Held. Then started 2.5% fortnightly drops. 9.5mg 4 Dec

diazepam 19 Apr - 4.25mg 20 May - 4mg 20 Jun 3.75mg  4.25mg 22 Sept 4.5mg 29 Sept. 4.75ng Oct 5 Nov 10 4.5mg

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  • Moderator Emeritus
25 minutes ago, Kernol said:

I just ordered it from myogenes!

 

You're welcome.  I've added the links for what i found to the relevant topic.

 

It would be really helpful if you post your experience with myogenes in that topic once you've dealt with them.  Please state that you are in the UK.  Thanks.

 

genetic-testing-personalized-medicine-liver-enzymes-genotypes-genesightrx-genomind-etc

 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • Administrator

Yes, those are the genetic tests. Please note that the claims for them on the Myogenes Web site are vastly exaggerated.

 

They will indicate which drugs you cannot metabolize, not which drugs will help with whatever condition.

 

Kernol, the slight reduction in symptoms could be the sertraline reduction is settling in, or it could be the diazepam increase, or both. However, you may still need to increase diazepam somewhat to make more of an equivalency with the lorazepam you were taking in summer 2019. Is your GP up to this? Are there any private doctors in your area who can help?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Hi @Altostrata Thanks for all your help.

 

so the myogenes one will still give the information we need though despite its other claims?
 

my gp has given me more diazepam to allow me to go up to 5mg but he might allow me more if he thought it would allow me withdraw off the sertraline easier - I would need to speak to him

 

i just have a couple of questions:

 

1. would I not be at risk of kindling goiNg back up on diazepam again having been on a lower dose for a longish time now?

 

2. if it is the sertraline causing the withdrawal issues and not Benzo withdrawal would there still be merit in going back up on the diazepam to mask the sertraline symptoms a bit more in order for me to taper off the sertraline easier?

 

 

 

 

10 years on Sertraline 100mg. 75mg Dec 2016 - Apr 2017, 50mg May 2017 - Oct 2017, 37.5mg

 

2018 - Sertraline 25mg Mar -  July 2018, 13.75mg Aug- Sept 1.5 month (‘not accurately measured), came off completely 10 October, reinstated by doctor on 10 November 25 mg. 25 November raised to 50mg 2 December 100mg 11 December 150mg 30 November. Lorazepam started 2mg x daily 1 November

2019 - Sertraline reduced  to 100mg 5 Feb, 23 Feb 75mg, 18 Mar 50mg, 23 Apr 37.5mg, 1 Jun 25mg, 3 Jul 16mg, 3 Aug 8mg, updosed on 1 Sept to 16.67mg 

20 Feb lorazepam 2mg x day crossed over to diazepam 20mg x day over 2 week period to taper. diazepam reduced by 1mg every 2/3 weeks got down to 3.5mg in August. 

22 Sept resorted to taking 1mg lorazepam after sertraline destabilisation instead of diazepam. took lorazepam 1mg  x day 22 Sept - 28 Sept then returned to diazepam on 29  Sept 4mg,, 30 Sept 4.5mg  1 Oct 5mg 2 Oct 5mg  16 Nov 4.75mg. 15 Dec 5mg 29 Dec 4.75mg   Vortioxetine 5mg started 1 July. 14 July 10mg -Reduced on 20 July to 5mg. 12 Sept reduced to  3.75mg, 19 Sept reduced to 2.5mg, 15 Oct reduced to 2mg, 22 Oct 1.9mg, 29 Oct 1.8mg reduced down every 3 days and then daily stopped on 2 Dec

2020 - sertraline  8 Apr - 16mg 29 Apr - 15.5mg 13 may - 15.25mg may 19 - 15mg may 22- 14.75mg 22 Jun 14mg 6 July 13.3 - 20 July 12.6 - 3 August - 11.97 - 17 August 11.37. Held. Then started 2.5% fortnightly drops. 9.5mg 4 Dec

diazepam 19 Apr - 4.25mg 20 May - 4mg 20 Jun 3.75mg  4.25mg 22 Sept 4.5mg 29 Sept. 4.75ng Oct 5 Nov 10 4.5mg

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  • Administrator

The Myogenes results can indicate whether more diazepam is worth pursuing, or whether you have an inability to metabolize sertraline. Those are important clues to what's going on.

 

10 minutes ago, Kernol said:

....

1. would I not be at risk of kindling goiNg back up on diazepam again having been on a lower dose for a longish time now?

 

2. if it is the sertraline causing the withdrawal issues and not Benzo withdrawal would there still be merit in going back up on the diazepam to mask the sertraline symptoms a bit more in order for me to taper off the sertraline easier?

 

You'll have to increase diazepam cautiously to minimize the danger of kindling. So far, it appears you have room to increase it. Good to hear your GP will be helpful.

 

If you are unable to metabolize sertraline -- which would be exacerbated by taking diazepam or lorazepam at the same time -- increasing diazepam probably would be the best route to going off it; if it is effective, it will help mask sertraline withdrawal symptoms -- a desirable effect, as this will allow your nervous system to settle down.

 

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • Administrator

@Kernol, how are you?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Hi @Altostrata thanks for checking on me - I appreciate it. Still pretty much same here - the nausea and chills are the worst of the physical symptoms and all the mental ones the same- intense and without respite. Sleep is difficult due to the continuous nightmares and skin burning/feeling like I’m being electrocuted so I’m afraid to close my eyes at night. My doctor suggested I could try a small dose of amitryptyline as thought it might help the burning nerve pain and might also help me get some sleep.  
 

10 years on Sertraline 100mg. 75mg Dec 2016 - Apr 2017, 50mg May 2017 - Oct 2017, 37.5mg

 

2018 - Sertraline 25mg Mar -  July 2018, 13.75mg Aug- Sept 1.5 month (‘not accurately measured), came off completely 10 October, reinstated by doctor on 10 November 25 mg. 25 November raised to 50mg 2 December 100mg 11 December 150mg 30 November. Lorazepam started 2mg x daily 1 November

2019 - Sertraline reduced  to 100mg 5 Feb, 23 Feb 75mg, 18 Mar 50mg, 23 Apr 37.5mg, 1 Jun 25mg, 3 Jul 16mg, 3 Aug 8mg, updosed on 1 Sept to 16.67mg 

20 Feb lorazepam 2mg x day crossed over to diazepam 20mg x day over 2 week period to taper. diazepam reduced by 1mg every 2/3 weeks got down to 3.5mg in August. 

22 Sept resorted to taking 1mg lorazepam after sertraline destabilisation instead of diazepam. took lorazepam 1mg  x day 22 Sept - 28 Sept then returned to diazepam on 29  Sept 4mg,, 30 Sept 4.5mg  1 Oct 5mg 2 Oct 5mg  16 Nov 4.75mg. 15 Dec 5mg 29 Dec 4.75mg   Vortioxetine 5mg started 1 July. 14 July 10mg -Reduced on 20 July to 5mg. 12 Sept reduced to  3.75mg, 19 Sept reduced to 2.5mg, 15 Oct reduced to 2mg, 22 Oct 1.9mg, 29 Oct 1.8mg reduced down every 3 days and then daily stopped on 2 Dec

2020 - sertraline  8 Apr - 16mg 29 Apr - 15.5mg 13 may - 15.25mg may 19 - 15mg may 22- 14.75mg 22 Jun 14mg 6 July 13.3 - 20 July 12.6 - 3 August - 11.97 - 17 August 11.37. Held. Then started 2.5% fortnightly drops. 9.5mg 4 Dec

diazepam 19 Apr - 4.25mg 20 May - 4mg 20 Jun 3.75mg  4.25mg 22 Sept 4.5mg 29 Sept. 4.75ng Oct 5 Nov 10 4.5mg

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  • Moderator Emeritus
On 9/30/2020 at 7:32 PM, Kernol said:

I just ordered it from myogenes! 

 

Have you got the results back from this?

 

3 hours ago, Kernol said:

My doctor suggested I could try a small dose of amitryptyline

 

Instead of adding in a new drug, it might be worthwhile waiting for the results of the test

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • Administrator

As you know, my guess is the skin burning sensation is from benzo withdrawal, you have mistaken it for a sertaline withdrawal symptom, and you may benefit from a higher dose of diazepam.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Hi @Altostrata I know you believe it to be a Benzo withdrawal symptom but I still feel it is sertraline as I had burning before I was ever on a Benzo both in my first withdrawal from sertraline it came and went in 2017 as my only withdrawal symptom before I even knew what withdrawal was and then became much worse when I was reinstated on the drug having come off it at the end of 2018. It is almost as if all my nerves are electrified. It is also in exactly the same places on my body as it was then so I can’t help but attribute this to sertraline. Also when  I was reinstated on sertraline I was then put on 2mg of lorazepam for 4 months and the burning was unrelenting then for most of that time so the higher benzo did not even help it then. 
 

I truly feel that sertraline has always been the problem from the start and I have destabilised each time the drug has been dropped down to low doses. Unfortunately it seems that with each subsequent try to get down to the low doses the symptoms have become worse and new ones have emerged. Ie. The new flu type symptoms I am currently suffering from these last couple of months. 
 

i feel so stuck as I am so sick on the drug, I don’t appear to stabilise even when holding for long periods and tapering hits me like a ton of bricks. 
 


 

 

10 years on Sertraline 100mg. 75mg Dec 2016 - Apr 2017, 50mg May 2017 - Oct 2017, 37.5mg

 

2018 - Sertraline 25mg Mar -  July 2018, 13.75mg Aug- Sept 1.5 month (‘not accurately measured), came off completely 10 October, reinstated by doctor on 10 November 25 mg. 25 November raised to 50mg 2 December 100mg 11 December 150mg 30 November. Lorazepam started 2mg x daily 1 November

2019 - Sertraline reduced  to 100mg 5 Feb, 23 Feb 75mg, 18 Mar 50mg, 23 Apr 37.5mg, 1 Jun 25mg, 3 Jul 16mg, 3 Aug 8mg, updosed on 1 Sept to 16.67mg 

20 Feb lorazepam 2mg x day crossed over to diazepam 20mg x day over 2 week period to taper. diazepam reduced by 1mg every 2/3 weeks got down to 3.5mg in August. 

22 Sept resorted to taking 1mg lorazepam after sertraline destabilisation instead of diazepam. took lorazepam 1mg  x day 22 Sept - 28 Sept then returned to diazepam on 29  Sept 4mg,, 30 Sept 4.5mg  1 Oct 5mg 2 Oct 5mg  16 Nov 4.75mg. 15 Dec 5mg 29 Dec 4.75mg   Vortioxetine 5mg started 1 July. 14 July 10mg -Reduced on 20 July to 5mg. 12 Sept reduced to  3.75mg, 19 Sept reduced to 2.5mg, 15 Oct reduced to 2mg, 22 Oct 1.9mg, 29 Oct 1.8mg reduced down every 3 days and then daily stopped on 2 Dec

2020 - sertraline  8 Apr - 16mg 29 Apr - 15.5mg 13 may - 15.25mg may 19 - 15mg may 22- 14.75mg 22 Jun 14mg 6 July 13.3 - 20 July 12.6 - 3 August - 11.97 - 17 August 11.37. Held. Then started 2.5% fortnightly drops. 9.5mg 4 Dec

diazepam 19 Apr - 4.25mg 20 May - 4mg 20 Jun 3.75mg  4.25mg 22 Sept 4.5mg 29 Sept. 4.75ng Oct 5 Nov 10 4.5mg

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13 hours ago, ChessieCat said:

 

Have you got the results back from this?

 

 

Instead of adding in a new drug, it might be worthwhile waiting for the results of the test


hi @ChessieCat I have just sent off the test I think it will be a week or two to get the results. I won’t add anything before then 

10 years on Sertraline 100mg. 75mg Dec 2016 - Apr 2017, 50mg May 2017 - Oct 2017, 37.5mg

 

2018 - Sertraline 25mg Mar -  July 2018, 13.75mg Aug- Sept 1.5 month (‘not accurately measured), came off completely 10 October, reinstated by doctor on 10 November 25 mg. 25 November raised to 50mg 2 December 100mg 11 December 150mg 30 November. Lorazepam started 2mg x daily 1 November

2019 - Sertraline reduced  to 100mg 5 Feb, 23 Feb 75mg, 18 Mar 50mg, 23 Apr 37.5mg, 1 Jun 25mg, 3 Jul 16mg, 3 Aug 8mg, updosed on 1 Sept to 16.67mg 

20 Feb lorazepam 2mg x day crossed over to diazepam 20mg x day over 2 week period to taper. diazepam reduced by 1mg every 2/3 weeks got down to 3.5mg in August. 

22 Sept resorted to taking 1mg lorazepam after sertraline destabilisation instead of diazepam. took lorazepam 1mg  x day 22 Sept - 28 Sept then returned to diazepam on 29  Sept 4mg,, 30 Sept 4.5mg  1 Oct 5mg 2 Oct 5mg  16 Nov 4.75mg. 15 Dec 5mg 29 Dec 4.75mg   Vortioxetine 5mg started 1 July. 14 July 10mg -Reduced on 20 July to 5mg. 12 Sept reduced to  3.75mg, 19 Sept reduced to 2.5mg, 15 Oct reduced to 2mg, 22 Oct 1.9mg, 29 Oct 1.8mg reduced down every 3 days and then daily stopped on 2 Dec

2020 - sertraline  8 Apr - 16mg 29 Apr - 15.5mg 13 may - 15.25mg may 19 - 15mg may 22- 14.75mg 22 Jun 14mg 6 July 13.3 - 20 July 12.6 - 3 August - 11.97 - 17 August 11.37. Held. Then started 2.5% fortnightly drops. 9.5mg 4 Dec

diazepam 19 Apr - 4.25mg 20 May - 4mg 20 Jun 3.75mg  4.25mg 22 Sept 4.5mg 29 Sept. 4.75ng Oct 5 Nov 10 4.5mg

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  • Administrator

I'm sorry, Kernol. It does not seem going up on the sertraline is the answer. You are having problems decreasing it. So adjusting sertraline seems to be out. But you have room to increase diazepam.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Hi @Altostrata but to what end if I can never get off the sertraline - I am not sure how increasing the diazepam is ever going to help me taper the lower doses of sertraline? Does this mean I have no hope of ever getting better? If I am so sick on sertraline but also  cant taper it? I am so scared / it’s been nearly 2 years and I am no further on in my taper than this time last year. I feel so devastated. Is there no chance that amitryptyline might help calm the nervous system a bit or something else?  I don’t feel like I have many options left now 

10 years on Sertraline 100mg. 75mg Dec 2016 - Apr 2017, 50mg May 2017 - Oct 2017, 37.5mg

 

2018 - Sertraline 25mg Mar -  July 2018, 13.75mg Aug- Sept 1.5 month (‘not accurately measured), came off completely 10 October, reinstated by doctor on 10 November 25 mg. 25 November raised to 50mg 2 December 100mg 11 December 150mg 30 November. Lorazepam started 2mg x daily 1 November

2019 - Sertraline reduced  to 100mg 5 Feb, 23 Feb 75mg, 18 Mar 50mg, 23 Apr 37.5mg, 1 Jun 25mg, 3 Jul 16mg, 3 Aug 8mg, updosed on 1 Sept to 16.67mg 

20 Feb lorazepam 2mg x day crossed over to diazepam 20mg x day over 2 week period to taper. diazepam reduced by 1mg every 2/3 weeks got down to 3.5mg in August. 

22 Sept resorted to taking 1mg lorazepam after sertraline destabilisation instead of diazepam. took lorazepam 1mg  x day 22 Sept - 28 Sept then returned to diazepam on 29  Sept 4mg,, 30 Sept 4.5mg  1 Oct 5mg 2 Oct 5mg  16 Nov 4.75mg. 15 Dec 5mg 29 Dec 4.75mg   Vortioxetine 5mg started 1 July. 14 July 10mg -Reduced on 20 July to 5mg. 12 Sept reduced to  3.75mg, 19 Sept reduced to 2.5mg, 15 Oct reduced to 2mg, 22 Oct 1.9mg, 29 Oct 1.8mg reduced down every 3 days and then daily stopped on 2 Dec

2020 - sertraline  8 Apr - 16mg 29 Apr - 15.5mg 13 may - 15.25mg may 19 - 15mg may 22- 14.75mg 22 Jun 14mg 6 July 13.3 - 20 July 12.6 - 3 August - 11.97 - 17 August 11.37. Held. Then started 2.5% fortnightly drops. 9.5mg 4 Dec

diazepam 19 Apr - 4.25mg 20 May - 4mg 20 Jun 3.75mg  4.25mg 22 Sept 4.5mg 29 Sept. 4.75ng Oct 5 Nov 10 4.5mg

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  • Administrator

The diazepam should help you go off the sertraline by addressing the symptoms. The increase in symptoms is what stops you from reducing it.

 

Giovanni Fava and his colleagues in Italy routinely use benzodiazepines to aid antidepressant tapering.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • Mentor

Hi @Kernol....I’m sorry you still suffer so much... I send to you all of my hope 🙏

 

Yes @Altostrata, I know this about Italian psychiatrists (I’m followed by a colleague of Dr. Fava)... But I don’t know what to think....Taking benzo during AD withdrawal can develope the possibility of another addiction, don’t?

July 2015: the 20mg citalopram for great stress begins

After two years I start tapering (slow but without medical advice) and I guess wrongly. First up to 10 mg, then 5 mg and 2 mg (liquid solution) and skips

January 2020 (I don't remember exactly the day): off citalopram (last dose 2mg).

June 2020: adrenal crash. The beginning of Hell on Earth

 

Current supplement:

- saffron pill (20 mg) + vit. E, omega 3 (EPA + DHA) 2g, magnesium bisglycinate 300 mg, iron , vitamin D3 (2500ui) +K7 (50 ui), vitamin C (1g) + quercitin (25 mg), theanine (as necessary).

 

Try meditating / mindfulness, walking every day, CBT/ACT, massage.

 

"E quindi uscimmo a riveder le stelle" ("And so we went out to see the stars again")

(Dante Alighieri, Divine Comedy , Inferno, XXXIV, 139)

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  • Administrator
1 hour ago, Leila said:

Taking benzo during AD withdrawal can develope the possibility of another addiction, don’t?

 

Yes, of course. But the person can taper off the benzo later. This is not an ideal solution, but when people have gotten stuck in withdrawal syndrome, it is often effective.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Hello @Kernol....  I’m sorry you are having such a hard time.  I had to do a rapid taper from 12.5 mg of sertraline as it was poisoning my body.  It was causing my skin to burn in patches and caused my shoulder and neck muscles to spasm all the time.  The skin above my knuckles on my hands would stay red as if inflamed.  Once I stopped the medication, the joint redness and muscle spasms went away.  So I know that it was the medication.  I still have some burning patches. Since I’ve stopped the medication, I have developed protracted WD symptoms.  So I can’t advise you as to what to do.  I just wanted to let you know that I understand the pain you are going through.  

Paxil 2001- 2016.  Came off of it on a slow taper.  After 9-12 months, I was put back on Paxil because I was unable to function. Paxil reinstatement triggered a rash.  I was then placed on 20 mg of Cymbalta on 2018.  I chose to take 10 mg.  I then had to be taken off of Cymbalta due to it causing cardiac issues in 2019.  I was placed on Seroquel and it caused a rash.  I was then moved to 12.5 mg of sertraline  where I did a fast taper which ended April/May of 2020.  I had to fast taper because of joint pain and joint redness.  August 2020, I was considered presumptive positive.  Since then, I’ve been prescribed Atenolol and Diazepam for withdrawal symptoms of tachycardia and massive anxiety.  I take these very sporadically and less than 1/4 of a tablet at a time.  I was given metformin in September 2020 for diabetes and it triggered massive anxiety after 1/4 of a pill.  I attempted to reinstate 1 mg of sertraline on 9/20/20.  I am supposed to be taking B12 injections and prescribed vitamin D.  I will stop these for now.  On 9/29/20 I was moved from 75 mcg generic levothyroxine to 88 mcg Synthroid.  This triggered anxiety approximately 2.5 hours later.

10/5/20 less than 1/8 teaspoon of Benadryl 

10/7/20 & 10/8/20 .10ml Benadryl (stopped 10/2020)

10/9/20 3mg Atenolol  (stopped 11/2020)

10/16/20 started taking magnesium citrate during the day (stopped 10/2020 due to it triggering more anxiety)

11/9/20 grain of diazepam @ 2:30 am for muscle spasm pain (stopped 11/2020)

11/10/20 .50mg of metoprolol tartrate (stopped 11/10/20 due to nausea, weakness in arms & legs, anxiety)

11/11/20 using lidocaine patch on neck and chest for pain due to muscle spasms

1/1/21       1 drop of liquid b12 (stopped 1/4/21)

 

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Hey @Kernol, haven't dropped by in a while but wanted to say hello. Have been catching up on your thread.

If as you suspect the main issue is Sertraline, then I'd personally still go with Alto's advice. The extra benzo dosage will help you to get off it. And as Alto says, you can taper off the benzo later on. I guess it's not a solution you would have happily chosen. 

I'm sorry you've hit this patch, I also think you're incredibly tenacious. Sending good wishes to you, whatever you decide to do.

January 2008 to April 2015 Citalopram 20mg to 5mg, reducing in 50 per cent leaps. Jumped off at 5mg

March 2016 used MDMA triggered setback

April 2016 Citalopram 10mg October 2016 cut to 5mg, May 2017 cut to 2.5mg

May 2018 used MDMA triggered setback

June 2018 Citalopram 2.5mg up to 10mg, then back to 5mg

July/ August 2018 7.5mg, then 10mg

June 2019 updosed to 20mg Citalopram

August 2019 cold switch to Venlafaxine 75mg XR

Supplements; 1100mg fish oil daily; also 100mg Magnesium Glycinate. Tried Vagifem 10mcg from mid May 2021 to mid June 2021; caused depression, so stopped.

 

 

 

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Hi @Altostrata 

 

I have increased diazepam to 4.75mg a week ago. I notice that the Nausea and chills get really bad when it wears off from morning and lunchtime dose - I suspect this is because it is masking the sertraline destabilisation a little. I get some respite from the worst of the mental symptoms for about 1.5 hours from a 2mg dose then it’s back to pure hell. Also the nausea is so extreme throughout the day apart from those times i don’t know what to do - I’ve tried ginger It doesn’t do anything. I still can’t sleep much as I am being woken With off the scale anxiety panic intrusive memories and burning sizzling skin throughout. 
 

one  strange thing I have noted - so the 3 windows I had this year whilst tapering from April on sertraline - 2 of them only happened during the progesterone days of my cycle and then every month from day 4-12 without fail I become suicidal and physically I feel dreadful with overwhelming fatigue, and dark dark depression plus all my usual mental symptoms on top. That is apart from one month it was July and instead of getting my usual bad days on day 7 I started to notice a lessening of symptoms and by day 10 my ankles had swollen up and I was puffy like being swollen pregnant with strong breast tendeness and then for the rest of that cycle I started to feel better and better until day 21-24 when I literally didn’t have a single Mental or physical withdrawal symptom except the Bruxism. It was literally like a miracle had taken place. Of course as I got my period I then crashed and I have been sick and destabilised ever since August now and my hair is falling out everywhere just as it did this time last year in destabilisation and also in Feb/March this year when I had bad destabilisation. 
 

I had thought this was my own progesterone helping my withdrawals as I know it is cross tolerant to Benzos etc but it can’t just be progesterone as why would I have had that freak window from day 7 of my cycle when our bodies don’t produce progesterone. I am beginning to think I just had some bumper hormones those months? I know I am in perimenopause and have been for a long time. 
 

I am wondering what do I have to lose with trying bio identical estogen? I am low on options as we know and so far I am still suffering immeasurably on the increased diazepam and I am just wondering if it might help as that 3 week window with the puffy ankles  was definitely hormone related and so must the suicidal lows from days 4-12? 

10 years on Sertraline 100mg. 75mg Dec 2016 - Apr 2017, 50mg May 2017 - Oct 2017, 37.5mg

 

2018 - Sertraline 25mg Mar -  July 2018, 13.75mg Aug- Sept 1.5 month (‘not accurately measured), came off completely 10 October, reinstated by doctor on 10 November 25 mg. 25 November raised to 50mg 2 December 100mg 11 December 150mg 30 November. Lorazepam started 2mg x daily 1 November

2019 - Sertraline reduced  to 100mg 5 Feb, 23 Feb 75mg, 18 Mar 50mg, 23 Apr 37.5mg, 1 Jun 25mg, 3 Jul 16mg, 3 Aug 8mg, updosed on 1 Sept to 16.67mg 

20 Feb lorazepam 2mg x day crossed over to diazepam 20mg x day over 2 week period to taper. diazepam reduced by 1mg every 2/3 weeks got down to 3.5mg in August. 

22 Sept resorted to taking 1mg lorazepam after sertraline destabilisation instead of diazepam. took lorazepam 1mg  x day 22 Sept - 28 Sept then returned to diazepam on 29  Sept 4mg,, 30 Sept 4.5mg  1 Oct 5mg 2 Oct 5mg  16 Nov 4.75mg. 15 Dec 5mg 29 Dec 4.75mg   Vortioxetine 5mg started 1 July. 14 July 10mg -Reduced on 20 July to 5mg. 12 Sept reduced to  3.75mg, 19 Sept reduced to 2.5mg, 15 Oct reduced to 2mg, 22 Oct 1.9mg, 29 Oct 1.8mg reduced down every 3 days and then daily stopped on 2 Dec

2020 - sertraline  8 Apr - 16mg 29 Apr - 15.5mg 13 may - 15.25mg may 19 - 15mg may 22- 14.75mg 22 Jun 14mg 6 July 13.3 - 20 July 12.6 - 3 August - 11.97 - 17 August 11.37. Held. Then started 2.5% fortnightly drops. 9.5mg 4 Dec

diazepam 19 Apr - 4.25mg 20 May - 4mg 20 Jun 3.75mg  4.25mg 22 Sept 4.5mg 29 Sept. 4.75ng Oct 5 Nov 10 4.5mg

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