Newbie89: getting off sertraline - advice needed

[Newbie89]

Hi All,

 

I'm reaching out to this forum as I would like some advice for coming off Sertraline. I've been suffering from social anxiety since secondary school (I'm 29 now), which usually takes the form of sweating, shaking, racing heartbeat and unclear mind. These symptoms usually subside after a period of time but can flare up at a moments notice. What can set it off? Anything from eating/drinking in front of others, sitting in groups to doing something as simple as signing a piece of paper in front of someone. In all these situations before anything has happened, I'm on edge as mind/subconscious is interpreting the scenario negatively. I should also mention this anxiety tends to shift from one thing to the next. For instance, when I was younger I would get nervous when walking in public. 

 

In my early 20's I tried CBT to help but unfortunately it did not work. When I turned 26 I was very depressed because of this and suffered an extreme anxiety period which made me feel as if I was going crazy. That experience was completely new to me so I went to my GP who prescribed 50mg Sertraline. Because of the state I was in (was accompanied by a family member) I didn't know what I was being given, or how it would affect me in the long run. After the first two weeks of treatment I was back to good being more like the person I wanted to be.  I went back to work and had a better time in social situations. However I didn't like being on AD's and so after 6 months I asked to come off the tablets, but my GP said to stay on them to avoid a relapse, and also, as they were continuing to help with my social anxiety... I took this advice and continued to take them for the next 3 years. They worked well and I suffered (apart from a little extra weight) no debilitating side effects. The social anxiety was still there, but the tablets kept a lid on it. 

 

Back in 2018 my grandmother past away and I felt that I wasn't as emotional as I should be.  I felt guilty about not being able to express my emotions as I would have expected. I was also seeing a girl who I had been interested in for months but found little motivation/feelings when dating her. I realized that the AD's were probably suppressing my feelings (my GP confirmed this). I told my GP that I wanted to come off the tablets again.  This time the doctor advised to take 1 tablet every other day for a week before stopping completely. I was told that for the next 3 weeks I would experience withdrawal symptoms (which I did) and after that the medication would be out of my system. I found these 3 weeks moderately difficult but found exercise helped to get through it. However for the next 3 months after this I experienced a whole range of cognitive and memory problems as well as a feeling of detachment. During this time I returned to my GP several times to discuss these symptoms.  The doctor was pretty dismissive and put it down to my general state of anxiety.  I had never suffered in this way with anxiety before I took the Sertraline so I was unsure about the diagnosis. I was given beta blockers to help but these gave me insomnia so I stopped taking them. During this time I was becoming increasingly agitated and by the 13th week I was waking regularly throughout the night suffering from surges of adrenaline, dry mouth, and vomiting... This continued for the next couple of days.  As a last resort, I returned to my GP to request help and was prescribed Sertraline. Which I agreed to out of necessity and not because I wanted to, as I suspected they had in some way, caused these additional symptoms; perhaps in coming off them over too short a period? My GP also scheduled a brain MRI scan (which came back normal) to alleviate my concerns.

 

Taking Sertraline again after a 3 month break was not the same as having them the first time.  The side effects were extreme - hot flushes, surges of adrenaline causing agitation and sickness. Looking back 5 months ago I'm amazed I persevered with those initial 2 weeks. In the months after I've been less outgoing and more reclusive. I make excuses to not go out with friends as physically and mentally I don't feel up to it. However I recently went for a meal and drinks with some good friends. I don't know why but before I even went out the house I felt drunk even though I had not had any alcohol. My mouth and throat was dry, my head felt strange (feeling of being disconnected) as if I was watching myself from a distance. Although I did not show any outward signs of anxiety like shaking or sweating during the time out, I really do not want to be like this either.

 

Since going out several days ago, my head still feels strange. I suffer some surges of adrenaline, loss of appetite, minor hot flushes and cognitive issues (the list goes on). I'm feeling certain that this is due to the tablets and not my anxiety as I was never like this before I started taking them when I was 26. I want to stop taking the tablets as I feel they are causing extra problems on top of my existing SA. When I next go to my GP (who will no doubt blame my anxiety for my recent symptoms and tell me to stay on the medication) I'm going to request to come off them over a period of one month, instead of a week (as before).

 

Is there anyone out there who has can identify with what has happened to me and can provide some explanation?  How did you deal with your situation? When I do come of the tablets again, is there anything I can do to mitigate the cognitive, memory and detachment problems I experienced before? Is it possible to get through all this?

 

Thanks for your time in reading this.

 

[Gridley]

Hello, Newbie89, and welcome to SA.  I'm sorry about the delay in responding to your post.

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.

 

Account Settings – Create or Edit a signature.

 

The taper your doctor advised was far too fast and caused the withdrawal symptoms you experienced during the three months you were off the Sertraline and probably your current symptoms.  

It is not "the return of the underlying condition."  Doctors know nothing about tapering or withdrawal symptoms from antidepressants and almost invariably advise a far too rapid taper.  We strongly advise against alternate day dosing, which is further destabilizing to the brain.  We recommend tapering at no more than 10% of current dose every four weeks. Some have to taper more slowly.  The month-long taper you mentioned is also far too fast.  

 

Did your symptoms change after you reinstated the Sertraline?  How are your symptoms now compared to when you reinstated the sertraline?

 

Please read:

 

Why taper by 10% of my dosage?

 

These links explain the importance of a slow taper.

 

Brain Remodelling 

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

This link is specifically about tapering sertraline, including how to obtain the nonstandard doses you will need for a slow taper.

 

Tips for tapering off Zoloft (sertraline)

 

Here is some information on withdrawal.  Please read:

 

What is withdrawal syndrome.

 

Glenmullen’s withdrawal symptom list.

 

When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

 

This explains it really well:

 

   On 8/30/2011 at 2:28 PM,  Rhiannon said: 

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Please research all supplements first and only add in one at a time and at a low dose in case you do experience problems.

 

This is your introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community.  I hope you’ll find the information in the SA forums helpful for your situation.  I'm sorry that you are in the position that you need the information, but I am glad that you found us.

 

 

 

 

 

 

 

 

 

[Altostrata]

Welcome, Newbie.

 

When did you last take the original run of 50mg sertraline? When did you start this current run and at what dosage?

 

What we see is that going on and off psychiatric drugs and experiencing adverse effects such as withdrawal symptoms can make the nervous system sensitive to drugs, even the same drug. You may find a lower dose of sertraline to be more tolerable. If you can stabilize on it for a while, you might taper off very gradually later. See Tips for tapering off Zoloft (sertraline)

 

Skipping doses as your GP recommended is a very poor way to go off the drugs, often leading to withdrawal symptoms that can be severe. Your GP should not have been so perfunctory about withdrawal symptoms. Medicine widely dismisses them as trivial but they are unnecessary stress on your nervous system.

 

PS You may find desensitization therapy more helpful for your self-consciousness in social situations.

[Newbie89]

Hi both,

 

Thanks for the answers, very informative. To answer some of your questions;

 

1 hour ago, Gridley said:

Did your symptoms change after you reinstated the Sertraline?  How are your symptoms now compared to when you reinstated the sertraline?

Since I've reinstated the Sertraline I've not got back to how I was before and even had moments of new problems like trouble speaking. 

 

Regarding the 10% taper every 4 weeks, that (If my math serves me) would mean I come of the tablets completely by February next year? I'm not sure I could wait that long as I don't feel great at the moment. Am I able to do say 10% a week?

 

49 minutes ago, Altostrata said:

When did you last take the original run of 50mg sertraline? When did you start this current run and at what dosage?

The original run of 50mg sertraline was when I turned 26 and ended a month before I turned 29, so just shy of 3 years. This current run began in November last year at the same dosage. 

 

I shall have a look at desensitization therapy, thanks for the heads up.

[Altostrata]

What dose of sertraline are you taking now? Since you reinstated sertraline in November, how has your symptom pattern changed? What symptoms are better and what are worse?