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

[Kernol]

Thanks @Shep I will try and get more consistent with my eating. I note it says the peak concentration is between 1.25 hours - 2.5 hours depending on eating. That seems to correlate with the duration of anxiolytic effect I get from it - would that seem right? As I mentioned I have never had a long duration effect from it despite the long half life. 

[Kernol]

26/11

 

8.00am got up, feel more panicky heart racing and some chemical anxiety feeling in stomach, teeth are sore from clenching, vision blurred when reading 

9.00am take 2mg diazepam

9.30am have veg smoothie

10.00am do some work emails, feel a bit calmer now

11.00am do some housework 

12.30pm chemical anxiety starts to rise on looking at photo online of an outdoor scene in summer - I have no idea why sunny scenes are setting off this bizarre reaction. Feel worried this is still happening 

1.30pm have sandwich

2.00pm do some work emails, still feel chemical anxiety. Take 0.75mg

3.00pm take 0.35mg vortioxetine 

4.00pm do some online quizzes 

5.00pm getting quite a few memories which is causing anxiety

6.00pm have Dinner

7.00pm take 2mg diazepam

8.00pm able to do some online shopping which was unthinkable earlier 

9.00pm take 16mg sertraline 

11.00pm can’t sleep

12.00am - 4.00am horrible dreams and anxiety 

5.00am teeth clenching starts and strong cortisol rushes that feel more burning in stomach than usual

7.00am get up feel a bit panicky also with the chemical anxiety feeling and tingling in head 

 

27/11

 

8.00am got up had shower, again feel more heart racing with a chemical anxiety burning feeling in my heart / stomach, vision blurred when reading 

9.00am take 2mg diazepam, have a cereal bar 

10.00am do some work emails, feel a bit calmer 

11.00am do some quizzes 

12.00pm doing some work emails

1.00pm have sandwich 

2.00pm take 0.75mg diazepam 

2.30pm still able to work ok despite anxiety 

3.00pm take 0.3mg vortioxetine
4.00pm still able to do work and have a work call

5.30pm have dinner

6.00pm notice chemical anxiety rising. I look at an innocuous brochure of a golf club and the photos of the greens in it make me feel this bizarre anxiety. Feel crazy that a photo of a golf course could do this.

6.30pm try and watch Big Bang theory bit get very strong chemical anxiety feeling and strong doom. Get upset I can’t even watch a comedy without this happening.

7.00pm take 2mg diazepam 

7.40pm watch football on tv with husband, feel a bit calmer

9.00pm looking online at bathroom furniture 

take 16mg sertraline 

10.30pm feeling the chemical anxiety in stomach rising again. 
12.00am - 3.00am - awful nightmares and wake with strong teeth clenching at 3am. vision is a bit flickering in the dark 

3.00am-6.00am - horrible emotive dreams of death feel very real. Wake up with teeth clenching and panicky with strong emotions from the dream 

 

 

 

 

[Shep]

22 hours ago, Kernol said:

Thanks @Shep I will try and get more consistent with my eating. I note it says the peak concentration is between 1.25 hours - 2.5 hours depending on eating. That seems to correlate with the duration of anxiolytic effect I get from it - would that seem right? As I mentioned I have never had a long duration effect from it despite the long half life. 

 

Correct, yes, I think you're responding to the peak plasma concentration which is what's giving you the anxiolytic effect. 

 

It looks like you're putting too much meaning into the memory flashbacks and other reactive emotions to certain pictures. Please work on learning some mindfulness skills so you can detach your thoughts from the memories and images. You'll feel a lot more relaxed once you master these types of mindfulness techniques. 

 

In this post What is happening in your brain?, Altostrate is quoting an article by Parker who gives a really good description of the reason you're having these kinds of flashbacks due to the benzo (and people withdrawing from antidepressants also have similar experiences). I've quoted the parts on the amygdala and hippocampus in the quote box below, but when you're up to it, you may want to read the entire article. 

 

Basically, the fear center of your brain has gone on high alert and it's searching for anything in your memory center to match up to that level of fear. This can cause you to re-live very painful times in your life or simply feel intense fear for no reason at all. 

 

It's important to work on self care and learn some mindfulness skills, such as not attaching your thoughts to these flashbacks. Simply let them happen as if they are a disturbing tv show. It's not real, just your brain going in feedback loops.

 

Distraction can also be helpful, such as learning to "change the channel" so you don't go into an emotional spiral. Here's information on this on other related issues:

 

Change the channel" -- dealing with cognitive symptoms

 

Dealing With Emotional Spirals

 

Neuro-emotion

 

On 12/26/2015 at 2:37 PM, Altostrata said:

BRAIN STRUCTURES
amygdala  - This is the FEAR center in the brain. It's a tiny part in the middle of your brain. Fear is protective and it's GREAT if you need to assess something that is dangerous and to ACT  - like if a rabid dog were chasing you. - but it's hard in recovery when it's all you feel for months! But the FEAR is not truly in your MIND. It's in your BRAIN.  There is too much glutamate acting here in the amygdala and not enough GABA. So the nerves are firing off in the fear center when nothing scary is really there in your environment.  It is normal for that to happen given the circumstance physiologically. But it feels awful, doesn't it?  I know.  But it's just a brain structure. This can account for fear, agoraphobia, fear of water, fear of anything.  It's not that you're really "scared" of the moon - it's that you're in almost constant fear because this brain structure is healing. The glutamate is pruning back. The GABA receptors are opening back up.  It may or may not continue for awhile. It will abate. Then come back. But eventually, the brain will get it right. 

Hippocampus - This is the "memory" center of the brain. It ties in old memories to emotions.  The same thing is happening here that is happening in the amygdala with GABA and Glutamate. So - voila. You get intrusive memories from ALL times in your [...].  It's wild and wicked and wooly. But it can't hurt you. And if you can learn to visualize this as what is happening - then you can learn to be objective and realize it's normal.  And like the amygdala - it will come and go and frustrate you, but it will go away when the physiology is restored.

 

 

[Kernol]

Thank you @Shep I found these quotes incredibly helpful and reassuring and I read the entire article - it’s amazing!! and even mentions visual disturbances which I have been having too. Thank you for sharing.

 

i am working on acceptance and mindfulness - I will keep practicing. 
 

 

[Shep]

4 minutes ago, Kernol said:

i am working on acceptance and mindfulness - I will keep practicing. 

 

Yes, exactly - it is a "practice." Just like you hear those who teach yoga or mindfulness and call it "my practice." 

 

If you can look at these intense fear experiences with gratitude for giving you the opportunity to practice, it's transformative because it give these experiences meaning and purpose. 

 

Eventually, you'll no longer fear them, but welcome these experiences. This is when your symptoms become your Teachers. 

 

And by keeping in mind that this is a practice, you won't beat yourself up during times when you aren't successful. It's a process that when practiced over the years that it takes to recover, you can master in time. 

[Altostrata]

On 11/26/2019 at 1:26 PM, Kernol said:

It is just coming up to 9.30pm I took 2mg diazepam 2 and a half hours ago and I don’t have any of the chemical anxiety stuff I get at lunchtime so I don’t know why I would only get a paradoxical reaction to the morning dose but maybe it has to do with the fact it’s nearing bed time as opposed to morning. Also why some mornings the diazepam dose doesn’t seem to do anything is also strange.

 

The diazepam you take in the morning overlaps with the diazepam dose you took the previous evening, most of it is still in your bloodstream. This may be too big of a diazepam load in the morning, which affects you several hours later after the morning dose peaks.

 

Please do eat more regularly, as @Shep has observed, low blood sugar may be confounding your symptom pattern. Put some undenatured whey protein powder in your smoothie, or have complex carbohydrates with it. Protein and complex carbs help keep your blood sugar steady.

 

Not sure what's causing the teeth clenching. Is it the same as when you were taking 3.75mg vortioxetine? It seemed the bruxism was decreasing.

 

At any rate, it does not appear that reducing vortioxetine is making your symptom pattern any worse, which is good, at least it will be out of the mix. As it has a very long half-life, benefit from going off may take weeks to gradually appear.

 

I think the eye focus issues might be a side effect of diazepam. Please hang in there through the side effects.

[Kernol]

Hi @Altostrata thank you I will add the complex carbs and protein in. 
 

the bruxism was decreasing yes. It is not as bad as it has been when I could feel myself slamming my jaw down, that seemed to be happening when I was on 2.5mg vortioxetine and 2mg vortioxetine.  Prior to that when I was on 3.75mg it was probably about the same level as it is now. I recall the bruxism first started at the beginning of August after reducing to 5mg vortioxetine but this was also when I had made a big cut in sertraline from 16mg to 8mg so I suppose it’s possible it might be sertraline and not vortioxetine causing it but I really hope not!! Incidentally this is when I also first noticed some visual disturbances like the pattern on the rug moving. 
 

I definitely feel that things are changing in terms of some of my symptoms. The chemical anxiety is still very high but each day it feels just a little bit different in the way it manifests physically and emotionally not better but not worse either just different so I’m hoping this might be a good sign. 
 

The depression has not been present the last few days so think that may have been hormonal and the head vice feeling and fatigue have also improved. I have not noticed as intense skin burning sensations in the last few days or head burning/ tingling which have always been my hallmark sertraline withdrawal symptoms so I am hoping in the background maybe the sertraline might be settling. But as with all these things - I am hesitant to say something has improved as it may return the next day! 
 

I am glad you said it may take weeks for the gradual improvements to appear after stopping Vortioxetine - as I was starting to wonder whether I should have seen more improvement by now so I feel better knowing it may take some more time.

[Altostrata]

Did we talk about a bite guard to protect your teeth against the bruxism? That would be a good idea.

[Kernol]

Hi @Altostrata yes I am wearing the flexible rubbery type mouth guard. I think you said this was the best type. Happy Thanksgiving by the way! 

[Altostrata]

Happy Thanksgiving to you!

[Kernol]

28/11

 

8.00am got up felt quite panicky, different to yesterday subtle change to feeling 

9.00am took 2mg diazepam and had oat bran 

10.00am still feeling quite panicky slightly wired but manageable 

11.00am still feel a bit wired, trying to do some online quizzes 
12.00pm have sandwich for lunch 

1.00pm do some housework 

2.00pm take 0.75mg diazepam 

2.30pm do some deep breathing 

3.00pm take 0.25mg vortioxetine 

4.00pm do some work still feeling background wired feeling but haven’t noticed as many of the bizarre reactions to things 

5.00pm still feel edgy, have a bath

6.00pm have dinner 

7.00pm take 2mg diazepam 

8.00pm calm down a bit 

9.00pm manage to watch a tv programme 

take 16mg sertraline 

10.00pm-4.00am sleep ok notice some teeth clenching and wake with night sweats

4.30am cortisol panic rushes start and get stronger until I have to get up

 

29/11

 

8.00am get up have shower, feel panicky edgy but again slightly different to yesterday 

9.00am take 2mg diazepam, have peanut butter on wholemeal toast

10.00am do some work emails, feel panicky but not overwhelming

11.00am do some housework, feel a bit wired

12.00pm have tuna salad for lunch 

1.00pm do some work emails, not noticed any bizarre reactions yet

2.00pm take 0.75mg diazepam 

3.00pm still feeling amped up but able to Carry on working. Take 0.2mg vortioxetine 

4.00pm start looking at Xmas presents to buy online 

5.00pm have a bath 

6.00pm eat dinner 

7.00pm take 2mg diazepam. Looking on internet for bathroom fittings, a few reactions but not as strong as previous days 

8.00pm manage to watch tv, some reactions but not as overwhelming 

9.00pm take 16mg sertraline 

10.00pm still watching TV

10.30pm-4.00am sleep ok some waking with teeth clenching and night sweats

5.00am onwards waking with strong panicky cortisol rushes and some disorientation 

 

 

 

[Altostrata]

That looks a little better? I wonder if we are seeing vortioxetine reduction in slow motion, with accompanying readjusting effect of all the other drugs. What appeared to be paradoxical reaction to diazepam has gone away?

[Kernol]

I am hesitant to say but yes definitely noticed a  lessening in some of the more bizarre reactions and random memories over the last 2 days!

[Kernol]

30/11

 

9.00am had porridge and took 2mg diazepam, feel a bit panicky but ok

10.00am did some online shopping - no bizarre reactions 

11.00am dealt with washing machine repair man - able to hold conversation ok

12.00pm - online shopping for new washing machine 

1.00pm have lunch

2.00pm watch football match on tv take 0.75mg diazepam. No bizarre reactions to anything yet. House feels like my house and it feels like a Saturday which is a nice feeling.

3.00pm take 0.15mg vortioxetine 

4.00pm more online shopping, no random memories yet today 

6.00pm have dinner 

7.00pm am watching tv without strong reactions. Take 2mg diazepam 

8.00pm still watching tv ok 

9.00pm take 16mg sertraline 

10.30pm go to sleep

11.00am-2.00am restless panicky sleep and woke with some teeth clenching 

2.00am - 7.00am more panicky waking but I am sleeping some. Teeth are clenching same intensity as last few nights so not worst I’ve had but has been milder 
 

1/12

 

9.00am have croissant and take 2mg diazepam, feel a bit more edgy this morning 

10.00am doing some online shopping ok

11.00am have a bath 

12.00pm notice a bit of rising chemical feeling anxiety. Feel a bit of derealisation and had some random memories of old dreams come in 

1.00pm have Tuna salad lunch

2.00pm take 0.75mg diazepam 
3.00pm watching football on tv but notice not as calm as yesterday and getting a few reactions to adverts. Also a few more random memories. take 0.10mg vortioxetine 

5.00pm go to do some deep breathing and try not to get disappointed that today some of the more chemical stuff has returned. Remind myself this is a non linear process

6.00pm have dinner

7.00pm lay down and take 2mg diazepam 

8.00pm am able to watch tv for 2 hours ok with some anxiety and a couple of more chemically feeling reactions but I accept them

9.00pm take 16mg sertraline 

10.30pm - 2.00am - sleep ok bit panicky restless and wake with teeth clenching 

2.00am - 6.00am more restless feels like cortisol rushes but coming much earlier so in and out of panicky sleep and some teeth clenching 

 

 

[Kernol]

2/12

8.00am get up , high cortisol panicky feeling, notice my vision is blurred again find it difficult to read my phone  

9.00am take 2mg diazepam and have Oat bran

10.00am do some work emails, calmed down a bit

11.00am do some online quizzes and ring my dad

12.00pm still feeling ok although a bit more anxious and a some random memories of old dreams 

12.45pm make lunch for myself and my husband 

1.00pm eat lunch

2.00pm take 0.75mg diazepam 

2.30pm do some work emails

3.00pm do some online shopping, get some stronger anxiety rising just looking at bathrooms online, feels chemical but not as strong as a week ago. Take 0.05mg vortioxetine

4.00pm do some online quizzes

5.00pm a couple of random memories

6.00pm make dinner 

7.00pm take 2mg diazepam 

8.00pm have some anxious reactions to places on tv but try and breathe through them 

9.00pm take 16mg sertraline, still watching tv although a bit of anxiety is there I don’t have to turn it off 

10.30pm -12.00am - slept with lots of panicky wakings

12.30am-6.00am - feel like I havent slept as my sleep has been so anxious and continuous waking but must have slept some bits. Almost like morning cortisol rushes but from the middle of the night. Teeth clenching same as previous couple of nights 

 

hi @Altostrata I think yesterday was my last dose of vortioxetine? I am glad to be off it. 

 

[Altostrata]

4 hours ago, Kernol said:

 I think yesterday was my last dose of vortioxetine? I am glad to be off it. 

 

Whew, that was a slog. Let's see what happens. You may be feeling effects of reductions in October, the half-life is that long. You may have symptoms irregularly from the changes, but I hope they gradually fade.

[Kernol]

Thanks @Altostrata for all your help in seeing me through getting off the stuff! I do hope to see some lessening of the symptoms in the coming weeks too! Do you still want me to write a daily journal? 

[Altostrata]

Yes, please continue to note your symptom pattern.

[Kernol]

3/12

 

8.00am got up had bath, feel lots of stomach sinking sensations of dread, strong but feels more like my own anxiety not so Chemical but very strong. Vision blurred when reading 

9.00am take 2mg diazepam have oat bran 

10.00am -12.00pm - doing online quizzes and some online shopping - feel a bit calmer 

12.30pm have lunch 

2.00pm start to feel a bit of a rise in reactions to things - bit of a chemical feel. Take 0.75mg Diazepam

3.00pm play some more quizzes and tidy house

4.00pm some chemical anxiety feelings but not overwhelming 

5.30pm have dinner

6.30pm watch football on tv

7.00pm take 2mg diazepam

8.00pm watch tv - a couple of strong reactions but able to keep watching 

9.00pm take 16mg sertraline

10.30pm - 6.00am - very anxious restless sleep. Less Chemical feeling, no nightmares more panicky stomach churning waking continuously in a startled state.Teeth clenching same as before. 
 

4/12

 

8.00am get up have shower, feel a bit of chemical anxiety, vision blurred when trying to read. 

9.00am - take 2mg diazepam and have 2 pieces of peanut butter on toast

10.00am - 12.00pm - researching bathrooms online looking at ideas, some anxiety but not too bad

12.30pm have sandwich for lunch and smoothie

2.00pm take 0.75mg diazepam 

3.00pm still online researching new Bathroom

4.00pm notice a stronger anxiety reaction when looking at bathrooms now and a feeling of chemical anxiety when I look at my own bathroom 

5.00pm - watching the news on tv. Notice a big spike in stomach churning dread feeling whilst watching fairly benign news item. The places look depressing and I feel my stomach sinking it’s very strong.

6.00pm have dinner

7.00pm have to go to bed as the stomach sinking is intense and I feel dread when I imagine myself going anywhere or doing anything. Take 2mg diazepam

8.00pm feel a bit calmer 

9.00pm take 16mg sertraline 

11.00pm - 6.00am - exactly as night before - continual waking with strong anxiety / panic -,feels less chemical more organic but v intense

 

 

 

[Kernol]

5/12

 

8.30am got up had bath, felt some chemical anxiety but not too strong

9.00am take 2mg diazepam and have oat bran

10.00am dad visits, able to have normal conversations 

12.00pm make us both lunch

1.00pm do some online Xmas shopping almost feel like Xmas won’t be as bad this year so not dreading it today 

2.00pm take 0.75mg diazepam 

3.00pm do some work emails, not feeling too bad 

4.30pm start to feel a little up kick in anxiety

5.30pm tv is on and start getting v strong anxiety feelings in my stomach to inocuous places on tv - reaction shocked me so much with the intensity of it I had to go upstairs 

6.30pm lying down with no tv and no phone - every time I look at phone, photos are setting me off so I decide to just deep breathe and tell myself this is not linear just because I have had a stronger reaction today than the last couple Of days it doesn’t mean it’s not going to get better again 

7.00pm take 2mg diazepam and have dinner

8.30pm feel a bit calmer and can look at online content again so decide to turn tv on. Able to watch reality show ok some anxiety but nowhere near as strong as earlier in the evening 

9.00pm take 16mg sertraline 

10.30pm - 6.00am restless sleep with anxiety waking - teeth clenching a bit but maybe slightly less 

 

 

6/12

 

8.30am get up have Bath, feel a bit of stomach sinking dread, vision blurry when reading 

9.00am Take 2mg diazepam and have peanut butter on toast

10.00am do my hair and actually straighten it and make it look nice 

11.00am man comes to install washing machine - able to deal with him okay

12.00pm make lunch for husband and myself 

1.00pm make a dinner for later from scratch, some anxiety but able to do it

2.00pm take 0.75mg diazepam 

3.00pm do some online quizzes 

4.00pm looking at online pics of new bathrooms and notice suddenly I am getting a bizarre anxiety reaction to them like I did earlier this week. Start to feel strong dread and stomach churning and has a bit of a chemical feel. I notice some intrusive memories of old dreams coming in 

5.00pm husband puts tv on and it’s golf in the Bahamas and I can’t bear looking at it as it all looks unreal and strange. I feel upset the bizarre reactions are still there but tell myself it’s to be expected for a while 
6.00pm having difficulty watching tv so turn it off and eat dinner I made earlier

7.00pm take 2mg diazepam and lay down

8.00pm able to watch some tv with some anxiety but not so overwhelming that I can’t continue 

9.00pm take 16mg sertraline 

10.30pm - 6.00am restless panicky sleep with some vivid disturbing dreams and some teeth clenching but not too strong 

6.00am - 8.00am - stomach is wrenching with anxiety almost like I can feel the stress hormones flooding through me - the whole world seems disturbing it is so strong, I cannot find a comforting thought to self soothe so I just lie and deep breathe. 

 

 

[Kernol]

7/12

 

8.00am Wake up with strong anxiety have oatbran and try and watch cooking programme on tv but gives strong anxiety reaction and feels a bit chemical so turn it off. Vision is still blurry when trying to read 

9.00am take 2mg diazepam, takes edge off a bit . Turn programme back on and able to watch it with some anxiety but not overwhelming. 

11.00am have bath, background anxiety is stronger than this time last week

12.00pm prepare lunch, eat lunch but feel very anxious at the table my mind is going all over the place. Random memories and my stomach is churning over very intensely. I lose my appetite.

1.00pm notice a couple more random memories  and anxiety is building. Every thought I have is giving rise to an anxious reaction

2.00pm take 0.75mg diazepam 

3.00pm watch football on tv. Anxiety is still strong my stomach is wrenching with it like yesterday 

4.00pm I notice a strong de ja vu feeling whilst watching football

5.00pm anxiety is now becoming overwhelming. I am trying not to despair or think about why it is worse than a week ago but I can’t help it. 

6.00pm try and eat a small dinner

6.45pm go up to lay down as it’s so relentless 
7.00pm take 2mg diazepam 

8.00pm tiny bit of edge taken off but not much - still can’t think of anything without an Intense anxious reaction. 
9.00pm try and watch the reality show I have been watching recently. I watch it but I notice some strong anxiety and chemical reactions to the scenery. take 16mg sertraline 

10.30pm trying to get off to sleepy lots of old memories coming that feel so real I can remember the smells and sounds of my grandmother house - so surreal it causes strong anxiety 

11.30pm - 6.00am - restless sleep waking with very strong anxiety feels like my own anxiety not so chemical but much more intense. Some teeth clenching 

6.00am woke up with a strong chemical anxiety feeling with an image of a field on a sunny day - so random it scares me these are still happening 

[Kernol]

8/12

 

8.00am get up feel very strong anxiety it is there whatever I think about. I try and think of the new bathroom but I’m no longer interested in it. Vision blurred when reading 

9.00am have 2mg diazepam, takes the edge off slightly am able to put some laundry on

11.30am anxiety is working its way up again, so strong much stronger than last week

12.30pm Manage to eat lunch but my stomach is churning and strong jolts of fear running through my stomach continuously I can’t think straight 

1.30pm anxiety is relentless. Trying not to add second fear but it’s so hard when it had been marginally better and now it is so intense

2.00pm noticing a few random dreams. Take 0.75mg diazepam 

3.00pm watch a bit of football on tv but anxiety is very strong. I am disheartened because I could usually always watch football 

3:30pm try listening to music, have the most intense anxious reaction from listening to one of my favourite bands. This upsets me.

4.00pm try and calm myself down, it’s hard I can’t think of anything without an anxious reaction. Try and tell myself it’s temporary and it will pass

5.30pm go up and lie down and cry a little bit because I’m scared the feeling of anxiety is so strong and doesn’t leave all day 

6.30pm force some food down for dinner 

7.00pm take 2mg diazepam 

8.00pm play a game with husband, Tiny bit of edge taken off but still feels like it’s a volcano of fear in my stomach erupting all the time 

9.00pm take 16mg sertraline 
10.00pm - fall asleep 

11.00pm - wake with nightmare and night sweats 

12.00am -4.00am restless sleep waking with some teeth clenching

4.30am wake with second nightmare this time with the burning nerve sensations down my back and tingling in head, not had this for at least a week or longer

5.00am - lay awake with strong surges of anxiety belting out of me, almost like panic surges, everything in the world seems distorted like I’m viewing it through this lens of fear. Even the sunny day outside makes me feel anxious - I feel crazy.

 

hi @Altostrata a bad couple of days. Anxiety has ramped up to become overwhelming having been slightly improved generally over the last week to ten days. I am trying to just accept it as best I can. Nightmares returned last night and seem to be more intrusive memories in the last couple of days as well. I am still really hoping this is just the vortioxetine withdrawal but it’s hard when you have a bit of hope and then it is back albeit it has a different feel to it. I must have been better to have been thinking about Xmas and designing new bathrooms, now I can’t think of either of these things, I just feel dread. 

[Kernol]

9/12

 

8.00am laying awake with intense emotional anxiety, feels so strong and raw. I notice some head tingling is back not had this for a week or so and song loops in my head. Vision is still blurry when trying to read 

9.00am get up and have a bath. The anxiety is strong like everything I think of feels discomforting. Take 2mg diazepam 

10.00am edge is taken off a bit and I manage to do some laundry and housework and a couple of work emails 

12.00pm the anxiety is kicking up again a bit and the whole world feels like I’m looking at it through a lens of fear. Getting lots of memories not sure if they are intrusive or just because my mind is used to going to them now 

1.30pm anxiety becomes overwhelming and I break down and cry. I am scared after having some windows of light the last week or two that this is now gone. I tell myself I can’t know that and I must accept as best I can

2.00pm take 0.75mg diazepam 

3.00pm play a coupe of online quizzes. Still lots of painful emotional anxiety but dampened slightly 

4.45pm anxiety is now reaching unbearable levels I think of my sister in law and feel deep dark intense anxiety and depression for no reason. I tell myself it is just because I am highly sensitised and I will be able to think of things/people normally again but it’s hard 

5.30pm crying in the corner of my bedroom as the emotion of the anxiety is so intense

7.00pm take 2mg diazepam 

7.45pm am able to eat some dinner and I can think of sister in law without the intense reaction 

8.30pm do some deep breathing

9.00pm take 16mg sertraline 

10.30pm - 5.00am slept with some waking due to teeth clenching and bad dreams not chemical nightmares just dark emotions. 
5.30am lay awake notice a small amount of back burning and head is tingling- these had gone for a week or so 

6.00am feel the terror rising at the thought of facing another day with the world distorted by this overwhelming emotion. My stomach is wrenching in emotional pain

 

hi @Altostrata day by day things seem to be getting a little worse to the point where the anxiety is relentless and intensely emotionally painful. I am scared I can’t help it as I was so hopeful things were getting a bit easier. Is this likely to be the vortioxetine even though things were better when I was reducing down and now worse? The only other thing that has changed is that we had a different manufacturer name on the sertraline packet over the last 5 days but I rang the company and they assured me they have just had a company name change as they have been taken over but the tablets would have been manufactured in the same place in the same way. 

 

[Kernol]

10/12

 

8.00am - feel intense anxiety and my stomach feels burning and strong gut wrenching emotion of fear 

9.00am - take 2mg diazepam. 
9.30am - Manage to have peanut butter on toast 

10.00am edge has been taken off a bit and so some online quizzes

11.00am - do some laundry 

11.30am - manage a couple of work emails 

12..00pm - Effect of diazepam has worn off and my mind is drawn to catastrophic thinking about morbid things and I feel intense fear in my stomach 

12.30pm manage to force a tuna salad down

1.30pm I have to take the 0.75mg diazepam a bit earlier as it is so unbearable I don’t know what to do. I notice the stomach and back burning sensations have returned

2.30pm able to do some online quizzes although still lots of anxiety. 
3.00pm My mind is checking to see how certain people or situations make me feel and I get stomach churning but not as intense

4.30pm start to feel nauseated the anxiety is becoming so strong. I keep thinking if my grandmother dies I won’t be able to go to her funeral as thought of going anywhere makes me feel deep dark fear

5.30pm i am now pacing trying to calm myself down but the waves of anxiety in my stomach are so strong they make me wince 

6.30pm I have to take my diazepam a bit earlier as I don’t know what to do

7.30pm bit calmer, world does not seem as dark and distorted again. Plumber comes round and able to have conversation with him about the bathroom.

9.00pm I get strong jolt of intense fear when trying to look at bathrooms. I feel edgy and I am worried the window has well and truly gone. I worry about why? Is it the vortioxetine? Is it the sertraline? I try and tell myself it will pass but I feel scared. take 16mg sertraline.

10.00pm -12.30am - restless sleep with morbid dreams 

12:30am -3.00am I lay awake with a slightly different feeling emotion not one I recognise. It’s fear and depression together. I worry what the next day will be like as things are getting worse each day 

3.00am - 5.30am restless sleep with teeth clenching 

6.00am intense burning stinging sensation on back and stomach and head tingling. Also feel like I have Been singed by a cigarette lighter on left calf - this has always been place I have had this from sertraline withdrawals. I feel desperate but try and calm myself by telling myself not to add fear to the symptoms 

 

hi @Altostrata I hope you can help me. Day by day things are getting worse and I just wanted to get your thoughts on whether you think this is normal and to be expected from the vortioxetine or do you think it could be anything to do with the brand name change of sertraline- I have had issues with generic changes in the past but the company told me it is manufactured the same although who knows. 
 

I am having a dreadful unbearable time in between diazepam doses especially late afternoon when I guess I have less in my system. So strange as a week ago I was having to remember to take my doses which just shows I was doing better. 

[Altostrata]

When did you change the brand of sertraline? What are the two different brands?

[Kernol]

Hi @Altostrata it was Wednesday 4th and I changed back to the original one again Monday 9th. I mean the packet and tablets look and weigh the same it is just a brand name change. The 2 brands are aurobindo and milpharm. Apparently aurobindo have taken over milpharm. 
 

It may not be to do with that maybe it is just the vortioxetine withdrawal still and is affecting everything. The burning sensations and tingling etc are back and they have always been sertraline symptoms of destabilisation. 
 

My vision disturbances are getting worse there is much more blurry vision when trying to read especially on waking in the morning my eyes just can’t seem to focus. I never had any visual disturbances until August when starting vortioxetine.  Is it normal that side effects like this can intensify in withdrawal?

 

The worst is of course is the increase in intensity of anxiety. I am just hoping it will settle again as it is so unbearable again

[Kernol]

Sorry I meant I noticed the blurring of vision in July not August when I first started taking vortioxetine / it would actually start about an hour after ingesting the tablet. 

[Kernol]

 Hi @AltostrataJust looking at my notes  desperately trying to find a pattern - it seems like things started to improve around 29 November until 5 December. That afternoon things seemed to go downhill again and from that day getting more of the  bizarre reactions to things, intrusive memories, intense emotions, chemical anxiety spikes and then on 9 December all the burning sensations, skin pain and head/ brain tingling stuff came back (the burning tingling etc is usually my typical sertraline withdrawal symptoms)

 

teeth clenching fairly consistent moderate level over last week too. 

[Altostrata]

Withdrawal symptoms are very frustrating, they come in waves and then go away.

 

I think it's more likely you might be sensitive to some formula change in the new sertraline. Are you feeling better since taking the original tablets a few days ago?

 

The vortioxetine reductions from 6 weeks ago are just taking effect.

[Kernol]

Hi @Altostrata no I’m not feeling better from the change back to the other generic unfortunately. I would say each day has got a little harder and I have noticed more of the awful chemical anxiety. Perhaps it is just the Vortioxetine withdrawal. 
 

11/12

 

8.00am lay in bed with burning on back and stomach and strong chemical anxiety feeling in stomach. Fear just looking at sunny sky outside.  V intense. Try and read my emails on my phone but my vision is so blurred it can’t focus 

9.00am take 2mg diazepam and get up. Have no appetite but force some oatbran down.

10.00am a bit calmer so start to do some house work and online quizzes. Vision is better now 

12.30pm start getting the strong chemical anxiety surges one is so powerful and comes with a random memory and the tingling goes up into my head feels like my brains frying

2.00pm take 0.75mg diazepam and calm down a tiny bit 

3.00pm do some online quizzes. 
4.00pm start crying as I feel the strange emotions coming when thinking about normal things -,chemical feel is peaking in strong surges and with it the burning and head tingling

5.00pm speak to my mother in law on phone at least it distracts me for a while 

6.00pm go to lie down. The charity Santa Claus mobile comes down the street makes me feel sick With dread and also sick with anxiety as remember it as a child even though it was actually a very happy time I can only feel fear at moment. I tell myself it is just withdrawal and normal feelings and emotions will come back 

6.40pm take 2mg diazepam and calm down enough to eat dinner

7.30pm lie down and try and practice some deep breathing and stop my focus on worrying about the future and try and live in Day tight compartments 

8.30pm notice the skin pain on leg like I’ve been burnt and back and stomach are burning a bit. Face is also tingling all over 

9.00pm take 16mg sertraline 

10.00pm sleep not too bad until 4am some teeth clenching moderate. 
4.30am have anxious dream and wake with intense panic burning in stomach and back and brain frying tingling head feeling 

5.00am -7.00am - just lie in bed deep breathing as chemical anxiety is already strong. I tell myself i can’t do anything about it but accept it for now. 

[Kernol]

Hi @Altostrata - oh dear it feels like I have destabilised my nervous system again. I feel very bad and it just seems to be getting stronger each day which is really frightening. I guess there is nothing I can do but hope it stabilises again. it’s such a pity as I was starting to look forward to Xmas only a week or so ago and now I’m dreading it as I was so ill last year I really wanted to be at least a bit better this Xmas.  I am trying all the acceptance I have but it is very tough at the moment.  
 

12/12

 

8.00am head tingling is so bad now it’s more like a feeling of sizzling all over my skull and my arms are all tingling with an intense electric feeling of anxiety in my stomach 

8.30am try and read emails on my phone but vision too blurred won’t focus 

9.00am I look in the mirror my eyes have that glassy look again I feel I look ill like a drug addict. Try and ignore that thought and have a bath and take 2mg diazepam. It only takes the tiniest edge off the strong anxiety. I have a piece of whole meal toast and peanut butter

10.30am I try and get my work emails out of the way whilst I have the diazepam coverage but even concentrating to write an easy email is spiking my anxiety 

11.30am I try and look at Xmas gifts but I can’t I just don’t care I feel so upset that I haven’t got the peace in me to look. I feel sick with dread 

12.00pm no appetite but manage some bread and cheese

12.30pm random memory comes and quite intense chemical anxiety surge in my stomach going right through to my back and my skull all sizzling and tingling. Try and calm myself 

1.00pm Try and do a work email. Have an even stronger anxiety surge with the sizzling in the brain so intense I cry. There was also like a half a random memory with it like a deja vu I don’t even know what it was. The emotion with it is awful.

1.30pm take 0.75mg diazepam. 
2.00pm just about calmed myself from the intense attacks but still got chemical anxiety feeling.

3.00pm play some online quiz games but pacing a bit and my heart is racing 

4.00pm speaking to mother in law on phone. I feel sick in my stomach with dread but try and talk normally. 
5.00pm put TV on. Big mistake. Some benign scene triggers my brain. Another strong anxiety surge with the brain sizzling.

5.30pm lying in bed. Can’t believe this has happened to me again. Tell myself it has and I need to accept it. I cry a little at the fact I have been so ill for more than a year. 
6.00pm doing some deep breathing.

6.40pm take 2mg diazepam hoping it will calm me enough to eat.

7.20pm able to eat dinner

8.00pm play a couple of online quizzes

9.00pm watch a bit of TV,  take 16mg sertraline 

10.00pm trying to look at bathrooms online but anxiety is so strong in my stomach and I’m getting strange random memories so I give up

10.20pm TV is still on but I haven’t been watching it. Someone mentions a place in London and I get strong doom feeling thinking about the place. No reason. Turn it off.

11.00pm -3.00am sleep ok bit restless but definitely slept. Teeth clenching moderate.

4.00am - very strong cortisol rushes with distinct chemical feel start and the brain sizzling feeling is so strong I just lie there trying to breathe through it. Tingling all over my face and down my arms.

5.00am - 7.00am have to keep myself awake because minute I fall asleep there are intense emotions and then I wake from them. I just breathe deeply. 

[Altostrata]

This seems due to the sertraline change. Can you increase sertraline to 17mg?

[Kernol]

Hi @Altostrata I can do yes - I’m slightly scared to do it but if you think it might help? 

[Altostrata]

I don't know. Your symptoms look like your sertraline withdrawal. If it was the vortioxetine, I don't think they'd be this pronounced.

[Kernol]

Ok thanks @Altostrata I will try that. I had hoped it was the vortioxetine these last few months causing this awful chemical terror feeling, random memories, bizarre reactions etc but maybe it was my destabilisation of sertraline from the rapid changes in August causing these all this time? Or perhaps it is still too early to tell? Certainly the burning sensations, skin pain etc seem to be my usual sertraline withdrawal

[Altostrata]

We can't tell which drug is doing what. But you had an adverse reaction to vortioxetine initially and seemed to have a bad time after you took it each day. That's gone.

 

The background sertraline withdrawal seemed to wax and wane, as we would expect. But this bad turn looks like you had a drop in sertraline. Could be the new formulation somehow has a weaker effect on your nervous system. I hope a slight updose corrects this.