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

[Altostrata]

7 hours ago, Kernol said:

C677T: C/T

A1298C: A/A ( intermediate activity )

 

I don't know what this means. You could be heterozygous for these 2 alleles. This is pretty normal, at least 40% of the general population is heterozygous for one or more.  I am myself.

 

There's a lot of hubbub over MTHFR, but it's really nothing, those are normal mutations, not dangerous mutations. Eating leafy greens will compensate for any folate absorption issues, which makes any related folate deficiency a lifestyle issue, not a disorder. We don't eat enough veggies in our modern diets.

 

Disregard the notes about serotonin production, nobody knows what that means. It is irrelevant. The vast majority of serotonin in your body is produced in your gut, to aid digestion.

 

Did the progesterone cream help? I would not worry about its relationship to GABA. Yes, you would have to taper off, but you just use less and less cream to do that. Half-life is very short, about 5 hours.

 

It sounds like you are pre-menopausal?

 

Lorazepam utilizes different liver enzymes than diazepam so I'm not surprised you find it more effective. I still view your symptoms mostly as a failed substitution of diazepam for lorazepam, possibly with an adverse drug-drug reaction between diazepam and sertraline. Good to hear reduction in sertraline doesn't seem to make you feel worse. If you converted to lorazepam twice a day, you'd probably do better with the withdrawal symptoms.

 

[mdwstrx]

Hi @Kernol

Coming over from another thread, I recopied your question below.

• hi @mdwstrx - so did you take it from your conversation with him that he know longer believes this to be common occurrence and that people who have been on Ads for more than 10 years do have hope of recovery?  I wonder if he realizes how damaging his words can be although I respect his work. 

I can't speak to what the Dr. believes. However, I know that there are long term AD users on this site that have followed a different protocol than what the Dr. had seen prior to our correspondence 2 years ago. Specifically, they've done longer, slower tapers, and they seem to be doing ok, like @Gridley.

 

I'm familiar with how awful withdrawal akathisia is. On a scale of 1-10 (10 being unbearable) it was a 9.99 in my book. Having resumed tapering these last two years, I can assure you I've had nothing like it - thank the Lord! I'm a person with faith in Jesus, so I know that I'm covered regardless. My faith gave me strength dealing with the akathisia and gives me peace in tapering. I'm saying prayers that you find the same peace Kernol. 

 

md

[Kernol]

Hi @Altostrata I am just checking in and looking for some advice on my tapering method. I have been continuing with no improvement in symptoms - I am now down to 8.4mg sertraline -  (or at least that’s what I think) after I discovered an issue with the accuracy of my Gemini scales. My husband has always measured my dose for me and only when I started doing it myself I noticed the weight is varying by as much as 10%. You can weigh the piece 10 times and if will give readings varying by this much. I have tried Calibrating it, using the weight in the middle, made sure surface is level - all of the tips on the thread on scales here but noting makes it accurate. 
 

so this means on a daily basis I could be going up or down by 5 - 10% based on readings I have seen - which is obviously not good news.

 

as I am in the Uk we only have 50mg tablets, no compounding pharmacies and no liquid version so I guess that only leaves me homemade liquid titration and I just wanted to check my method before I do this:

 

1. dissolve 50mg tablets in 50ml of water

2. using 10ml syringe draw 8.4ml and drink it 

3. store in fridge for 3 days and repeat 

 

is that right? I am rubbish at maths 

 

thanks for any help 

[Altostrata]

Kernol, are you getting any withdrawal symptoms after you reduce sertraline? If your symptom pattern isn't changing, whatever dosage variance you might have is not causing a problem.

 

A liquid will enable you to taper by small amounts more accurately. @brassmonkeywill check your math.

[Kernol]

Hi @Altostrata Thanks that’s a relief in some way! I have had the same withdrawal symptoms now since I did my too fast taper down dose to 8mg then re updosed 5 weeks later to 16mg in September 2019 - the only difference now is perhaps the mental symptoms are a bit more intense and I have some new physical symptoms the last 6 months - the constant nausea and chills/shivers.  It doesn’t seem to matter if I hold or do 5% or 10% drops I seem to suffer regardless. I never notice a definite pattern from each reduction
 

thanks @brassmonkey for checking my maths! 

[brassmonkey]

Your math is fine.

 

When changing from a solid to a liquid we frequently recommend doing a crossover taper over the course of several weeks. Sometimes the direct change can shock the body and people end up having problems with the liquid. This would usually involve reducing the solid by 25% each week while increasing the liquid by 25% a week. There is more information around the forum, a site search should bring it up for you.

[Kernol]

11 minutes ago, brassmonkey said:

Your math is fine.

 

When changing from a solid to a liquid we frequently recommend doing a crossover taper over the course of several weeks. Sometimes the direct change can shock the body and people end up having problems with the liquid. This would usually involve reducing the solid by 25% each week while increasing the liquid by 25% a week. There is more information around the forum, a site search should bring it up for you.

Thanks @brassmonkey I definitely do not want to shock my body so will try and do that although I will struggle to get the solid dose accurate as the smaller it goes the more the scales vary but I am not sure there is much I can do about that having tried all the tips and hints. Unless I buy a lab scales but they seem to cost over £1000 but it would be worth it if I could guarantee more accuracy 

[Terry]

@KernolHi, I've been thinking about you and wondering how you are.  I haven't seen you post anything in a long time.  I hope you are experiencing some progress and relief from the difficult side effects of tapering.

 

Wishing you well,

Terry

[Kernol]

Dear @Altostrata @Gridley I hope you remember me! I have been a long time off this site quietly tapering down off the sertraline at 10% a month and am now down to 1mg for last 5 weeks. Torturous the entire way as it was before but even worse and so much so my Benzo use has increased 2 fold unfortunately just to survive my severe mental symptoms. 
 

My question is where do I go from here in my complex situation where I have never stabilised not even when holding and slow/faster taper appears to make little difference .no improvements in last 28 months of my 37 month withdrawal after being reinstated.  Just worse. 
 

When and how should I jump off this last bit?? I know I could get a tiny bit lower on my scales I could go to 0.9 and then down to 0.7mg but it’s quite inaccurate and I don’t really want to cross to liquid titration. I had thought 1mg was ok to come off but now I read on here it should be lower which is ok for some people but In my specific situation I cannot face much more tapering time. I want to come off as quickly but safely as possible 

 

I feel like the major damage to my brain and cns was done 28 months ago when I dd the huge drops down from 25mg and nothing has changed in all that time since except deterioration - not a single symptom has got better not even during a 7 month hold so stabilisation is not an option for me. 

 

as my case is extremely severe and protracted in length I just can’t face prolonging this much longer? I understand for people with some level of stability but I just don’t have that. My life is spent living in torture in my bedroom as I can no longer even leave it as I just feel so deeply disturbed and like I’m on a permanent bad acid trip and this is my 4th Xmas in bed in a dark place of horror. Plus the longer this goes on the higher my Benzo use is becoming which I am incredibly upset about. 
 

will I ever heal now or am I too damaged? 
 

thank you so much for any advice as always and I wish you a Merry Christmas. 

[Altostrata]

Good to hear from you, @Kernol. I am sad you are still having such a difficult time.

 

On 12/25/2021 at 8:38 AM, Kernol said:

I know I could get a tiny bit lower on my scales I could go to 0.9 and then down to 0.7mg but it’s quite inaccurate and I don’t really want to cross to liquid titration.

 

Why do you not want to use liquid titration? Liquid sertraline is available in the UK by special order from your doctor. The other option is tapering strips.

 

What drugs are you currently taking now, at what times o'clock and dosages? What is your daily symptom pattern?

[Kernol]

Hi @Altostrata thank you for replying.  I just cannot do another 10 months more of tapering - I had thought all of this year that 1mg was the goal and that then I could finish this year and I would at least be off it and that was literally the only thing keeping me going that I would enter 2022 no longer on the drug but it was only when I read here that advice has changed I am devastated. I simply cannot do another 10 months of tapering to get down to 0.1mg - its just not an option for me psychologically as I have suffered so badly for so long and in my mind I was thinking that maybe just maybe the healing process would start when I had finished and was off completely. Secondly, I just cannot see that going much lower is going to do anything to ease this process for me - I just cant do it - I feel totally spent with it all.

 

My dosages are as follows:

 

8am 2mg diazepam

10.30am 2mg diazepam

1.00pm 2mg diazepam

3.00pm 2mg diazepam

5.30pm 2mg diazepam

10.00pm or whatever time I go to sleep 0.96mg sertraline

 

This is on a day when my symptoms arent so ovewhelming that I feel unsafe. On the days I feel so unsafe I cannot carry on another minute, I take 1mg lorazepam on top of some of the diazepam doses although I dont take as many diazepam. Its a total mess I know.  The doses of lorazepam I maybe take 10 a month however this month has been so so so bad I have taken 16 over the last 4 weeks. This is how bad things are and I HATE taking it, but I would simply not be here without it. I could well be suffering interdose withdrawal from the lorazepam I know this but I have no choice and I dont want to take it continuously as a) the doctor wont give it to me b) it makes me feel hazy and my memory of the day is bad c) I developed tolerance to it very quickly 3 years ago when I was on it daily before I crossed over to diazepam.

 

So now I am back on a lot more benzos than I was for the majority of my taper which I am also devastated about.

 

So as for my symptom pattern it is all throughout the day, continuous acid trip type derealisation, continuous raw surges of horror like my nerves are electrified within my stomach, total emotional dysregulation, flashbacks, time travelling and overwhelming chemical feeling depression almost catatonic some days. The doses of diazepam mute the symptoms very slightly for about 1.5 hours which is why I have to dose so regularly. I also have a lot of physical symptoms for the last 18 months - intense nausea, sometimes vomiting, burping, food just not digesting - just sits in my stomach for hours, fatigue, headaches and many more but I dont know if these are all withdrawal or the perimenopause.

 

The one thing that has got much worse is the nights - the night terrors, hallucinations, surges of horror, burning nerves inside my chest/stomach that feels like I am being incinerated from the inside out are now every night for the last 2 months and I dread going to bed at night with the early mornings from 5am being the most horrific experience that I cannot even describe. They used to happen sporadically but this has now become every night unless I take lorazepam that day. 

 

I believe my nights are now so bad because I have always taken sertraline at night for all the years I was on it and my brain/nervous system just cannot sleep without it now that I am on this tiny dose.

 

So there it is, what do I do with the sertraline as 10 months more of tapering to 0.1mg I just cannot do - really I can't. I could maybe do a 2 or 3 more months to go down to 0.7mg or do I just hold at 0.96mg for a few months - I just dont know what to do.

[Terry]

Dear Kernol, I am so very, very sorry to hear of all the suffering you've been through.  I tapered off sertraline and used the liquid form to make cuts easier to measure.  Since you might be willing to taper for another 2-3 months, perhaps @Altostrata could give advice on a faster taper using a liquid prep.  That might possibly be better than stopping at 1 mg.

 

Remembering you in prayer,

Terry

[Kernol]

Bless you @Terry thank you for your help and for your prayers. I do hope you are doing ok. 

 

@Altostrata could I do a liquid titration in water for a few months just to get to 0.5mg maybe given my situation? Would that be better than coming off at 0.96mg? Thank you for your advice 

[Shep]

21 hours ago, Kernol said:

 

@Altostrata could I do a liquid titration in water for a few months just to get to 0.5mg maybe given my situation? Would that be better than coming off at 0.96mg? Thank you for your advice 

 

Kernol, do you feel any changes in symptoms when you make a sertraline decrease? Or is everything the same? 

[Kernol]

Hi @Shep things have got progressively a bit worse over the last few months yes especially the nightmares but mainly it’s exactly the same symptoms I have had for the last 27 months since I got below 25mg on my second withdrawal after the reinstatement and kindling. Which have been torturous the whole way to be honest and hence why I just can’t face another 10 months of tapering it - I just feel totally burnt out now 

[Shep]

You may want to make a slight decrease of the sertraline and see how you do. It sounds like you're a case of a crashed nervous system where there's nothing you can do to stabilize and the only way path is to come off the drug as best you can. At some point, the battle fatigue of staying on the drug is simply too much. 

 

Please let me know if this sounds right and if so, how you do with a decrease. 

 

Please be mindful of the periodic lorazepam use. As you wrote earlier, it's not an ideal fix, but if it's keeping away a crisis state, at this point, it may be the best you can do. But do be mindful of any rebound or interdose issues so they don't get conflated with sertraline withdrawal symptoms that might warrant a hold. 

[Kernol]

Hi @Shep yes that’s exactly right there has never been a period of stabilisation at any point even when I did that hold for 7 months late 2019-2020 - there was zero change in my symptoms at all.  
 

It seems like slow tapering has not eased anything for me unfortunately. Sometimes I wonder if I would be any worse off if I had stopped it much earlier - it is just endless. 
 

The question I am really asking is in my particular case when and how can I get off this last bit given I cannot stretch it out to the ideal 10% to get down to as low as 0.1mg. I feel like I just need to get off sooner rather than later because holding and slow tapers just haven’t helped for me and I don’t have it in me anymore - especially as I had thought 1mg was all I needed to get down to all year and that was all that kept me going to know I would be off it in 2021.

 

thank you for your help 

[Shep]

9 minutes ago, Kernol said:

The question I am really asking is in my particular case when and how can I get off this last bit given I cannot stretch it out to the ideal 10% to get down to as low as 0.1mg.

 

I'm not certain what the best stopping point is for sertraline, so I've asked the other staff more familiar with this drug. 

[Kernol]

Thank you @Shep ❤️

[Shep]

On 12/27/2021 at 4:54 AM, Kernol said:

I believe my nights are now so bad because I have always taken sertraline at night for all the years I was on it and my brain/nervous system just cannot sleep without it now that I am on this tiny dose.

 

I just noticed this from an earlier post. If sertraline is helping with sleep, why do you wish to come off it at this time? How many hours are you sleeping at night? 

[Kernol]

Hi @Shep Its not that It helps I have always had nightmares and very intense early cortisol surges and hallucinations all the way down and even actually when I came off it in my first withdrawal I had nightmares start then. I have just noticed that they are now more frequent nightmares and also the trippy half sleep/wake state has been bad for last 27 months where I am dreaming vividly before I am even asleep old dreams on a loop from years ago coming at me one after the other it’s so so weird and terrifying every single day for 27 months this has happened and same on waking - so it’s not like I’ve been getting restful sleep on it and the only thing that improves the sleep is if I have had lorazepam that day. I sometimes get 6 hours sleep I would say but interspersed with horror surges and nightmares most nights. 

the reason I want to come off it is because I am one step away from giving up battling this living hell day and night. I have spent last year on my bedroom floor surviving minute to minute with these relentless mental symptoms and now last 18 months I now have physical symptoms ( thr intense nausea all day long chills shivers etc) and I have to hope that healing might begin when I come off it completely. so even if it was helping with my sleep I still couldn’t stay on it. 

 

[Altostrata]

On 12/31/2021 at 8:46 AM, Kernol said:

....

@Altostrata could I do a liquid titration in water for a few months just to get to 0.5mg maybe given my situation? Would that be better than coming off at 0.96mg? Thank you for your advice 

 

Yes, you could do this.

 

1 hour ago, Kernol said:

I now have physical symptoms ( thr intense nausea all day long chills shivers etc)

 

When did these symptoms come on? They sound like withdrawal symptoms. 

 

What is your current daily drug schedule, with dosages?

[Kernol]

3 hours ago, Altostrata said:

 

Yes, you could do this.

 

 

When did these symptoms come on? They sound like withdrawal symptoms. 

 

What is your current daily drug schedule, with dosages?

Hi @Altostrata 18 months or so ago the physical symptoms started.

 

daily dosages are: 

 

My dosages are as follows:

 

8am 2mg diazepam

10.30am 2mg diazepam

1.00pm 2mg diazepam

3.00pm 2mg diazepam

5.30pm 2mg diazepam

10.00pm or whatever time I go to sleep 0.96mg sertraline

 

Edited January 1, 2022 by ChessieCat
Resized font

[Kernol]

Hi @Altostrata so I have 2 options as I see it I continue with scales which will allow me to go: 

 

0.63mg

0.32mg (at a push but that’s the lowest the scales will register anything 0.001g) 

 

but no inbetween as it won’t register. 

or I do liquid water titration to get down to 0.5mg over next 3 months  before stopping however I’m just checking this would mean I would have to use a 50mg tablet every couple of days using the below method as it doesn’t last long in the fridge? 
 

1. dissolve 50mg tablets in 50ml of water

2. using 1ml syringe draw 0.9ml and drink it 

3. store in fridge for 3 days and repeat

[Altostrata]

7 hours ago, Kernol said:

My dosages are as follows:

 

8am 2mg diazepam

10.30am 2mg diazepam

1.00pm 2mg diazepam

3.00pm 2mg diazepam

5.30pm 2mg diazepam

10.00pm or whatever time I go to sleep 0.96mg sertraline

 

Why so many doses of diazepam? At most, you need to take it only once or twice a day.

 

Please, @Kernol, you need to stay on a consistent schedule with sertraline, especially at this very low dosage.

 

Do you still have the jaw tension? Has it changed as you've reduced the sertraline?

 

Have you had the same symptoms while you're reducing, with no clear withdrawal symptoms?

[ChessieCat]

3 hours ago, Kernol said:

this would mean I would have to use a 50mg tablet

 

You are already weighing.  You would weigh out a smaller amount and add that to water instead of a 50mg tablet.

[Kernol]

15 hours ago, Altostrata said:

 

Why so many doses of diazepam? At most, you need to take it only once or twice a day.

 

Please, @Kernol, you need to stay on a consistent schedule with sertraline, especially at this very low dosage.

 

Do you still have the jaw tension? Has it changed as you've reduced the sertraline?

 

Have you had the same symptoms while you're reducing, with no clear withdrawal symptoms?

hi @Altostrata diazepam is only effective for me for 1.5 -2 hours always has been and that’s why so many split doses. It know it has  a long half life but for the small relief it gives I’m afraid that only lasts a very short time. I have a few friends on Diazepam who have exactly the same experience so I don’t think I’m alone in it only having a very short efficacy duration.  I have experimented earlier in withdrawal taking the same daily dose but in fewer higher individual doses throughout the day but again the effect only lasts 1.5 - 2 hours so didn’t work for me. 

 

I have the bruxism severely every night for 27 months now since it started after I did my large drop mistake and updose. No change at all. My bite has now totally changed and I have a lisp but this is of course the least of my concerns in my state. 

 

I don’t know exactly what you mean by your last question? I have pretty much the same symptoms for last 27 months of my 38 month second withdrawal after the high reinstatement of the sertraline they are just even more intense now as I get to the end and that’s why I had to raise the Benzo and am confined to my bedroom.  And of course the physical symptoms which started 18 months ago. 
 

Basically I have severe acute symptoms all the time no windows no breaks and I just feel like when I look at my symptoms they are very similar in severity and nature (time travelling, flashbacks, acid trip type symptoms to name a few)  to those that have cold turkeyed but at least they are hopefully on their way to healing off the drug whereas dragging out this slow taper does not seem to have helped me and nor did the 7 month hold it just  added more time to my unbearable suffering. Perhaps this was because I was reinstated and got kindled on it.  
 

i just have to get off the sertraline and quickly. As Shep mentioned in her post above  my case is a nervous system crash and there is nothing I can do to stabilise and my best bet is to get off the drug. 

 

[Altostrata]

So you have had no withdrawal symptoms while reducing sertraline over the last year?

[Kernol]

Hi @Altostratai have had the same withdrawal symptoms for 27 months then 18 months ago physical ones started. In the last year maybe a bit more intensity especially the nightmares more frequent which I expected as I had them when I came off completely in my first withdrawal but overall just same type of acute unbearable symptoms.

 

I am not sure if I am answering your question correctly?! 

[Altostrata]

It would seem the newer physical withdrawal symptoms are from the reductions of sertraline you've been doing over the last year.

 

If you find those symptoms tolerable, it probably doesn't matter how you go off the last milligram.

 

The background symptoms may be from benzo withdrawal incompletely masked by the diazepam, as we've discussed before.

[Kernol]

hi @AltostrataMy withdrawal symptoms from 27 months ago the acute ones exactly coincided with the large dose drop and then updose in sertraline within 2 weeks of that drop the symptoms came all at once literally overnight. So I am 99% certain they were not from Benzo withdrawal but were in fact from the injury caused at that exact point from the huge drop and then double updose of sertraline and unfortunately that injury has never healed. 
 

I think you are right it probably makes no difference now how I come off this last 1mg.

 

should I just come off now at 0.96mg do you think or go to 0.63mg as my last drop on my scales? and that way I don’t need to alter anything with the water titration which in itself may cause a shock to the system as brass monkey mentioned to me a while back. 
 

 

[Altostrata]

2 hours ago, Kernol said:

go to 0.63mg as my last drop on my scales

 

I would go to 0.63mg, hold for a while and see if symptoms are as usual, then cut that in half.

 

If you had sertraline withdrawal syndrome, theoretically some amount of sertraline would have relieved it, but this does not seem to have happened since reinstatement April 2020.

[Kernol]

Hi @Altostrata I was reinstated in November 2018 not April 2020 but at 5 x the dose I had been on for the whole year before I came off it so I think that might have been why reinstatement did not work and instead led to kindling and then my disastrous drop/updose in August 2019 was what really escalated everything to the scenario I described above with the overnight development of the acid trip type symptoms, bruxism etc but I guess that’s all immaterial now in any case. April 2020 was when I stopped the 7 month hold after there was no relief from the symptoms and resumed the taper. 
 

ok will go to 0.63mg for 4-6 weeks then if all the same will cut in half. Hopefully it wont have any other nasty surprises for me and then at least I can finish the taper even though I know I still have a long road ahead it will be a milestone in some way at least.

 

thanks for all your help I really appreciate it 

[Altostrata]

I wish I could do more. Hang in there.

[Arti]

@Kernol How are you ? 

Were you able to tapper down the sertraline ?

 

[Iecc]

How are you?