zolofellow: severe WD Symptoms following sertraline

[zolofellow]

Update -

 

Day 10 after Reinstatement at 12.5 mg Sertraline (taking daily between 8.00 am and 8.10 am)

 

Improvements -

Sleep has improved  overall since the kindling (Despite the fact that Monday night I could'nt sleep even for a second). GP has prescribed 5 mg Diazepam which I sparingly use.

Had some streaks of normalcy for a few hours

The uncontrollable shaking of limbs while sleeping has subsided

 

Challenges -

Continuous feeling of hopelessness and anxiety

My hypochondria is now focused on withdrawal and AD's as in if I will ever be able to overcome this

 

In the mean time I saw a new GP and a Psychiatrist yesterday

GP - Said this is relapse since the medicine was not available in the blood stream for quite some time. Suggested that I do 25 mg for 2 weeks and then ramp to 50 mg

Psych - Said its my anxiety and not the drug that is the problem. He suggested that my symptoms appeared 2 months after I stopped and intensified almost 3.5 months after stopping so the drug cant be blamed. Suggested exactly what the GP has said. 

 

So overall both the docs wanted me to take an approach that I did not want.

 

What are your suggestions? Shall I updose after two weeks on 12.5 mg to 15 mg or 18.5 mg?

 

Once stabilization is achieved when should i start to microtaper again?

 

 

 

[Gridley]

 

19 minutes ago, zolofellow said:

 

Day 10 after Reinstatement at 12.5 mg Sertraline (taking daily between 8.00 am and 8.10 am)

 

What your GP and psych said are typical.  They will always say withdrawal is relapse.  That's what they're taught.  

 

You reinstatement seems to be working well. The goal of reinstatement is not total cessation of symptoms but rather to bring them down to a tolerable level.  I would hold where you are at 12.5. Taking too much can be more your system to handle and can destabilize you.

 

I would hold there at 12.5 for a least a month to allow your system to stabilize. At that point, if you feel stable, you can begin a slow taper.

 

Why taper by 10% of my dosage?
 The general philosophy of gradual tapering

The slowness of slow tapers
Some people can tolerate tapering only by very small amounts over a long time.
 

[zolofellow]

Update - Day 13 of Reinstatement at 12.5 mg

 

Physical symptoms have subsided - sleeping well, heart rate has slowed down, sweating has reduced

Severe mood issues - this is new to me - anhedonia and severe hope lessness 

 

I have started having some anxiety around the whole reinstatement and tapering process itself. Can someone advise if this has happened to them? The whole idea that I am putting the same chemical that put me in this place is making me a bit anxious.

 

Do you have some advice on that?

 

 

[Altostrata]

Please review the improvements. Clearly, reinstatement has helped. I would not increase the dosage, you risk kindling worse symptoms.

 

Do you have a ramp up in symptoms at any particular time of day?

 

You may still have symptoms in The Windows and Waves Pattern of Stabilization

 

While you have these symptoms, you would to well to learn self-calming techniques, which will be useful for the rest of your life:

 

Neuro-emotions

 

Non-drug techniques to cope with emotional symptoms

 

Easing your way into meditation for a stressed-out nervous system 

 

Music for self-care: calms hyperalertness, anxiety, aids relaxation and sleep

 

Health anxiety, hypochondria, and obsession with symptoms 

 

Ways to cope with daily anxiety

 

Dealing With Emotional Spirals

 

After you stabililze on 12.5mg Zoloft, which may take some months, you would gradually taper off. Reinstatement is a way through withdrawal syndrome, so you can come out the other side.

 

Sadly, like most, those doctors you saw know nothing about withdrawal syndrome.

[India]

On 3/1/2019 at 10:39 AM, zolofellow said:

. Are there support groups here locally in London that you can introduce me to?

There are none in London. They shut the only one down and it was run by MIND. You can call the “Bristol Tranquilliser Project” helpline for support .

[zolofellow]

@Gridley @Altostrata @India  thanks a ton for your response!! You are really so helpful in these really tough times!

 

Update -

Day 15 of Reinstatement Zoloft 12.5 mg 

- Periods of stability 

- Basic background anxiety

- Sleep is improving (some days i get the insomnia bout and don't get even a second of sleep)

 

Other Coping mechanisms -

- starting breathing exercises 

- starting basic meditation practices

 

Plan to start some light physical activity activities.

 

Wishing the very best to all of you in your journeys.

[zolofellow]

Update -

 

Day 19 of Reinstatement 12.5 mg of Sertraline

 

- 17,18,19 March were okay days with patches of anxiety, anhedonia and depression

- 19th March in the evening (8pm - 10 pm) I had a couple of hours of very severe hopelessness and depression. It was as if i could'nt feel anything ... with a chill down my spine

- 20th and 21st march seems like the anxiety is back and has gripped me again - serious wave with continuous background anxiety about everything (finances, job, withdrawal itself) this seems like its permanent as it hasn't changed in the last 48 hours at all ....hoping to wait it out

 

In other updates I was able to get a response from Dr. Duncan Double in the UK and hope to get an appointment with him asap.

 

Please share your thoughts and advise.

 

 

 

 

[RachelSusan]

Hi Zolofellow,

 

It sounds like you are on track. What you described is normal for the process.  Very painful yes, but very normal. The mods will of course advise you regarding any medication adjustments, but you know my opinion, hold, hold, and hold, unless the mods tell you other wise.

 

I am so sorry that you too got stuck in this awful situation.  It truly is terrible.  I haven't forgotten how much I suffered with it and I hate to see anyone else go through this. But do remember there is healing going on and you will get through this.

 

Warm wishes,

Rachel

 

 

 

 

 

[zolofellow]

Thanks Rachel!!! You and everyone on this forum is an inspiration for me. I have full faith in this community just that there are moments of desperation that force me to look for extra validation.

 

Quick Update - Journal Entry

 

22nd March - worst day since kindling with massive physical as well as mental symptoms with depressed mood and extreme fatigue (took a 5mg Diazepam to sleep)

 

23st March - Good day (8/10) with minor background anxiety

24th March - Good Day (7/10) with some background anxiety and depressed moods

25th March - Average Day (6.5/10) with depressed moods but improving as I write this at 4 pm UK time

 

[zolofellow]

Journal Entry -

 

26th March - Good Day (7.5/10) Moderate anxiety, fatigue in the second half of the day

27th March - Good Day (7.5/10) Low anxiety, depressed feeling for 1 hour

28th March - Good Day (7.5/10) Anxiety increased at a antenatal doctors appointment

[zolofellow]

Journal Entry 

 

4 weeks since RI 12.5 mg Zoloft on 2nd March

 

29th March - Good Day (7/10) - I think I was entering a wave towards the end of the day as I could feel some depressed moods and increased anxiety

30th March - Bad Day (4.5/10) - I think this I am in my next wave after being in a slightly stable period for almost a week. Anxiety is heightened and I am experiencing surges of emotions like anger along with low moods

 

Overall at the end of almost a month after reinstatement I would say I am making progress in the right direction with the help from all the great people from this forum.

[RachelSusan]

Hi Zolofellow,

It sounds like you are making very good progress. I am sorry about March 30 though.  It sometimes happens that a person will have a few good days and then a bad day.  Sometimes a person can even have a few good weeks and then a bad day or two and it's often frightening because it's normal to wonder if you are sliding backwards. I think you will continue to improve and hopefully will continue to feel closer and closer to whatever is your normal. Hang in there.

Warm wishes always,

Rachel

[zolofellow]

Thanks Rachel!!

 

I am in a little bit of a rut at the moment but I totally understand that its a part of the process! The last wave was spread over 4 days (was much more intense) and I am hoping this too shall pass 😀

 

I am able to sleep without diazepam and that alone is a great sign of progress for me! 

 

I am learning each day from this process. Each wave is so different and brings surprising emotions and experiences. You could feel that your nervous system is so raw still but that also gives you hope and will power to keep pushing forward.

 

The good thing is that I have looked at your taper schedule and believe it could be a great template for me to follow (obviously while listening to my own body and tweaking it to personalize).

 

Wishing you a very steady and safe healing! You and mods are a great source of hope! Keep spreading and keep healing!

 

 

[zolofellow]

Journal Entry -

 

31st March - Good Day (7/10) - medium Anxiety for small periods at 3 points in the day

1st April - Good Day (6.5/10) -  minor background anxiety throughout the day

2nd April - Good Day (7.5/10) 

3rd April - Good Day (9/10)

4th April - Good Day (9/10)

5th April - Good Day (8/10)

6th April - Bad day (5/10) Woke up with some anxiety which was severely accentuated after learning about my wife's Gestational Diabetes diagnosis. Again my mind got fixated on it and I was anxious thorough out the day. Gradually getting better though.

[RachelSusan]

Hi Zolofellow,

I am sorry to hear about you wife's Gestational Diabetes. I do understand your concern. I am pleased to hear you had some good days though.  Let's hope that the discomfort that developed today goes away quickly. It does appear that you reinstatement is starting to work.  This is very good.

Warm wishes,

Rachel

[India]

On 3/1/2019 at 10:39 AM, zolofellow said:

Are there support groups here locally in London that you can introduce me to?
 

 

Hello, please look up the Bristol Tranquilliser Project. It has a helpline. Run by Ian Singleton. He was really helpful . Sadly, the only support group in London, run by Camden Mind, was closed. I was told this by Ian. No organisation seems to want to touch it. ( Realise I have mentioned this before).

 

 

 I know I would love a support group but I personally don’t have the strength to run it, it seems no one else does either. Unfortunately, no one wants to touch this and until the NICE guidelines change it is quite hard to find gps/psychiatrists who accepted the existence of withdrawal.  

 

You could try  Will Hall’s Icarus Project . Also, Surviving Antidepressants has now been credited by a paper by Horowitz ( search this site) as being the best resource for WD. It is way ahead of the knowledge of most psychiatrists/GPs. 

 

As for alcohol, I had been slipping .. having the odd irregular night , a few glasses of wine. I cut it out completely for at least 7 days and noticed I had my first tiny little window a day ago . I drank last night after attending an event and the anxiety is back. I aim to carry on completely alcohol free. I realise , for me, at least, it really helps to not imbibe. 

 

You talk of what I call zero stress intolerance. As if my brain and body cannot distinguish between minor and major threat. It’s a very bizarre feeling but one lots of ppl here experience. 

 

 

My experience of updosing by just 1 mg was not a good one. I felt so ill. Despite the fact that  on my initial introduction to Citalopram I was able to go straight on 20mg with no adverse reaction . Your system behaves so differently once sensitised. 

[India]

On 3/21/2019 at 9:22 PM, zolofellow said:

In other updates I was able to get a response from Dr. Duncan Double in the UK and hope to get an appointment with him asap.

That is so exciting. Let us know. 

[zolofellow]

Thanks for your thoughts and advise everyone!

 

But these seems like a tough wave! I am a bit confused by the fact that since it was intensified by my wives Gestational Diabetes diagnoses is possible that this is my original hypochondria or a mix of my original health anxiety and withdrawal?

 

This has been the toughest wave in the last 16 days. 

 

7th April - (3.5/10) High Anxiety and Insomnia, Mind fixated around my condition and my wife's newly diagnosed condition, no sleep despite taking 5 mg Diazepam (I took Diazepam after almost 15 days)

8th April - (3.5/10) High Anxiety, Fatigue and headache from not sleeping

 

This wave is feeling really hard as it has come after a long window when I was assuming that I have almost stabilized and will start tapering shortly.

 

Have any of you experienced a situation where a stressful situation (jobloss, family health concern etc, financial worries) caused or intensified a wave? Do such waves last longer and are more intense symptom wise?

[zolofellow]

hi All -

 

i am writing in a very desperate state! my wave is getting worse by the day and now it seems my original health anxiety (for with i went on the ADs is also back). Since my wifes Gestational Diabetes diagnoses my mind has fixated on diabetes and that i migh have it.

 

till now i was totally confident that this was withdrawal and I will soon have a window and  the wave will gradually go away but now it feels like the very reason I started the ADs is back.

 

I am feeling very anxious and panicky and mind is getting fixated on that one illness.

 

has some one else experience hypochondria-cal symptoms during withdrawal?  Any suggestions and advise would be welcome ... its been 4 days and the situation seems like its worsening.

[zolofellow]

@RachelSusandid you have windows and waves while stabilizing on your 12.5 mg Sertraline updose in Dec 2016? 

 

I had a decent run where I was fairly stable between 23rd March to 5th April with minor ups and downs and it was totally manageable.

 

However, since 6th April my symptoms have worsened and its really very horrible after falling into this mess since the last one week. It difficult to accept that I was so stable last week that I was actually planning to start my taper in a month.

 

Will be great if you can share your experience

[RachelSusan]

Hi Zolofellow,

 

I had mornings where I would be great only to have afternoons where I would have brain zaps, sweats and tremors.  I mostly had what seems like what was moment to moment, maybe hour to hour windows and waves There were a few times in the last 2.5 years where I would have three months of symptoms at a time but that was triggered after tapering too fast. The one thing I have found about this whole ordeal is that for the first year and a half symptoms seem to always surprise me. They would often show up when I had no idea why.  Then things settled down and when symptoms do appear now I can usually figure what is causing  them.  I did notice that back then any type of stress would make it a lot worse.  By stress I mean either physical stress on the body, such as not enough sleep, or exercise, and also emotional stress. As for emotional stress it was anything.  Even hearing bad news about someone I barely knew would instantaneously trigger symptoms.  Getting stuck in traffic would trigger symptoms. Just thinking about something bad would trigger symptoms. 

 

You probably have already decided to put your taper on hold for a little while.  But if not, I would suggest holding off until you have had at the very least 30 days of stability.  Three or four months of stability would be even better before starting your taper.

 

I read you were concerned about having diabetes. Have you been checked for it?  If not, is there anyway you could be checked?  I don't think you have it but perhaps getting that test might put your mind at ease. 

 

I'm not sure what is causing your uptick of symptoms, but it seems to me a common thing in the world of anti depressant withdrawal. Not that I am saying suffering is OK. It is not.  It's horrible, however there might not be a lot you can do about it but just wait for that next window. A moderator might be able to ask the right questions and give you more of an answer as to the why of it. 

 

I'm sorry that you are suffering.  It is a terrible thing to have to go through, but stability will come to you. Just get through each day as best you can.

 

If you have any other questions please feel free to ask. Anytime.

 

Warm wishes.

[RichT]

Hi Zolofellow,

 

i’m sorry to hear of your intense symptoms. I hope they pass soon.

 

I noticed you mentioned starting meditation.

 

I live in London like you and I find that meditating in a group is much more powerful than doing it solo. If you live in North London I can recommend the North London Buddhist Centre in Holloway Road. They teach two basic meditation practices (mindfulness of breathing and metta bhavana, which is a compassion-focussed meditation). While they are obviously Buddhist in outlook, they are not evangelical about it.

 

Now i’ve Learned the practices I go to the meditation toolkit sessions at the centre which have a longer meditation time and then a discussion session. This is more obviously Buddhist, but I find it very helpful.

 

There is another Buddhist centre in East London, but I can’t give you any personal feedback about that one.

 

I can also recommend books by Pema Chodron, again with a Buddhist flavour, but to me very helpful. She is a very compassionate writer.

 

I also think that trying out light physical exercise is a great idea, ideally outside in a green space! I find exercise enormously helpful.

 

best,

 

R

[RichT]

On 4/8/2019 at 12:35 PM, zolofellow said:

Have any of you experienced a situation where a stressful situation (jobloss, family health concern etc, financial worries) caused or intensified a wave? Do such waves last longer and are more intense symptom wise?

 

Hi Zolofellow,

 

yes, I’ve definitely experienced this. External stressors make symptoms worse without a doubt. 

 

R

[zolofellow]

@RachelSusan thanks a ton for sharing your feedback!

 

I know i dont have diabetes but my hypochondriacal brain which is in withdrawal makes me think about it as if there is an issue. this would happen anytime there is any discussion of any disease specially cardiac diseases. so that's just temporary.

 

The main issue is that my sleep is disturbed and I am having day long anxiety with symptoms of fatigue and anxiety in my body.

 

also, I read on James Heany's blog that if I would have tapered property I would have been at 12.5 mg in almost a year so that would mean November 2019 and that's when I should expect to stabilize. 

 

May be the mods can guide me if I should updose a bit as its been 6 weeks since reinstatement of the 12.5 mg (considering that I did have a good couple of weeks after reinstatement).

 

 

[zolofellow]

@RichT thanks again for stopping by! having horrible withdrawal despite reinstating 12.5 mg 6 weeks back. not sure what to do. no support from NHS or even private psychiatrists.

[RichT]

22 minutes ago, zolofellow said:

@RichT thanks again for stopping by! having horrible withdrawal despite reinstating 12.5 mg 6 weeks back. not sure what to do. no support from NHS or even private psychiatrists.

 

So sorry to hear that. I think the medical profession in many cases are not up to speed with the reality of withdrawal. I think the mods on this site have a lot of wisdom to offer. Did you get an appointment with Duncan Double?

 

[Gridley]

22 minutes ago, zolofellow said:

 

 

 

 

 

 

May be the mods can guide me if I should updose a bit as its been 6 weeks since reinstatement of the 12.5 mg (considering that I did have a good couple of weeks after reinstatement).

 

 

 

From your posts, it seems that the reinstatement is working.  There will still be waves and windows, and I wouldn't let the wave discourage you and prompt you into making another change.

 

[zolofellow]

1 hour ago, RichT said:

 

So sorry to hear that. I think the medical profession in many cases are not up to speed with the reality of withdrawal. I think the mods on this site have a lot of wisdom to offer. Did you get an appointment with Duncan Double?

 

hi Rich - Not really! he is not in my region and NHS psychiatry is very region based. I have written to him again with an intention to see him privately, hope he replies.

[zolofellow]

1 hour ago, Gridley said:

 

From your posts, it seems that the reinstatement is working.  There will still be waves and windows, and I wouldn't let the wave discourage you and prompt you into making another change.

 

thanks Gridley! I desperately need to see a window ... its so hard

[RachelSusan]

On 4/12/2019 at 10:13 AM, zolofellow said:

 

also, I read on James Heany's blog that if I would have tapered property I would have been at 12.5 mg in almost a year so that would mean November 2019 and that's when I should expect to stabilize. 

Hi zolofellow,

I don't quite understand what you mean by the above.   Maybe we are using the word "stabilize" differently. To me stabilize means that you are stable on what ever dose you are on.  That would mean no symptoms or very low symptoms.  It sounds to me like you are already starting to stabilize. I know you are currently uncomfortable however you were having some good days too. Which is a very good sign.

Warm wishes always.

 

[zolofellow]

hi Rachel -

 

thanks for stopping by!

 

i was doing pretty good between 23 march - 5th april!

 

the wave that started on the 6th is till going on in full force. The intensity was almost as much as it was before the 23rd march.

 

it has kind off shaken my confidence in the windows and waves concept a bit. its been 9 days of incessant torture.

[zolofellow]

@ChessieCat @Altostrata really struggling with insomnia in this wave ... not even a single minute of sleep .... can you advise if i can take otc sleeping aids like Kalms (valerian root)?

 

I have heard Melatonin also helps to sleep. Is it a prescription drug or can it be obtained OTC? is it advisable to take some melatonin? I have some Diazepam but I am resisting the temptation for sleeping

[zolofellow]

@ChessieCat @Altostrata can you advise if I can use Valerian Root abstract (Kalms in the UK) and melatonin 1 mg with my Zoloft 12.5 mg?

 

I don't want to use Diazepam at all

[zolofellow]

hi mods - i am getting super desperate .... the anxiety is crazy high today ... the highest it has been till now I believe ..... its so hard to stay like this .... shall i go back to full dose of Sertraline at 50 mg ... i dont know what to do ....

 

i am just too desperate .... this wave is so unrelenting ... already on day 12 of continuous anxiety

 

 in the last wave my anxiety was usually related to something (job, health, wife's pregnancy) .... this wave it pure neuroanxiety ... i am just anxious ... the whole body is tight as a knot and i can sense my stomach in a knot .... all the physical symptoms of anxiety through the body

 

no support from the medical establishment at all

[zolofellow]

also, I got of the medication because I was feeling better and my original trigger i.e. health anxiety and panic attacks were significantly mitigated 

 

is there a correlation between withdrawal symptoms and original cause for which ADs were prescribed? For example will people with anxiety experience more anxiety and subjects with depression experience more depressive withdrawal?

 

i just dont know what to do at this point its getting unbearable

[marconyc]

@zolofellow I just want to chime in here and say that my waves are OFTEN triggered by stress. You’re expecting a child and your wife has gestational diabetes. How could you not be anxious, especially since you have health anxiety? My wife and I just found out she is pregnant (our first) and I am freaking out even though I’ve wanted this for a long time. Are you in therapy? If not, are you doing a self-help program for anxiety? I use a book called “Anxiety, Phobias, and Panic” by Reneau Peurifoy. It’s good and contains exercises that give you a sense of control.