panda: well this is scary

[panda]

In 2001, after 9/11, I went to a psychiatrist suffering from acute anxiety and depression. I had also suffered from "social anxiety" for quite some time, and had seen commercials for paxil. I asked the right question, and paxil was immediately prescribed. I was 19.

 

After trying - disastrously - to taper off of paxil in 2008 (terrible discontinuation syndrome), I was temporarily prescribed prozac. After experiencing flat emotions on that, my Dr tried zoloft. After a few years on that, I wondered if I could find something "better," leading my Dr to prescribe celexa (not much help), then effexor. I stayed on effexor for several years, then suggested to my Dr that I try zoloft again, because I suffer from terrible insomnia (see ambien history in signature) and knew people who slept great on zoloft. He prescribed it. My Drs over this time had very little opinion or guidance, and basically prescribed whatever I asked for.

 

In mid-December of 2018, amidst a major life change, I realized that I wasn't even sure what the drugs were treating anymore. It had been so long since I'd been without them, I wondered if my initial issues had been temporary, or if they could have been more easily resolved with talk therapy or CBT. In this light, I chose to begin a taper. Sadly, I had not discovered this website yet, so simply followed the conventional wisdom of halving your dose each step down. I went from 100mg zoloft to 0mg in three months.

 

Initial symptoms were consistent with discontinuation syndrome and manageable. The week after my last dose, I had some heightened depression, but was able to manage by using the support of friends and family. All was going just fine, I thought. Tough, but fine.

 

4 weeks following my last dose, I began experiencing extreme anxiety. I cried at any stimulation, in public places, at the drop of a hat. I stopped finding enjoyment in social activity. I would find myself just staring at the wall or window for a long time, or sat in my parked car, unable to figure out where to go.

 

5 weeks in, it hit the fan. I found a lump in my breast and everything spiraled. Although it turned out benign, I fell into the hell of wd nightmare - nonstop panic, loss of appetite/diarrhea, stomach pain, persistent thoughts of death. I have been ultra sensitive to smells, sounds, and light. Too panicked to read or watch tv, I would just stare, wide-eyed, in terror for hours.The worst of it, though, has been the dp/dr - I have felt like I'm stuck at the bottom of a well, reaching out at the tiny window of the world I used to know, that now looks foreign to me. I have never felt such hell. I wish this on no one. Although I haven't felt the "s" word, I am not surprised that people do. It is a waking nightmare.

 

On the advice of a knowledgable Dr who was kind enough to respond to my terrified email, I reinstated at 25mg on Wednesday, April 24, 2019. I felt worse until today, Saturday, April 27th. I finally feel as though I am - tenuously - connected to the real world. I am still having trouble getting out of bed, and have had waves of anxiety, but am hopeful that perhaps I will be functional again.

 

The Dr has suggested that I increase my dose to 50mg tomorrow or Monday (day 5 or 6 of reinstatement). After reading about adverse reactions to updosing here, I am nervous to, but also desperate to feel better. I have a round of important job interviews in the next week and a half and am terrified I won't be adequately functional for them. I have an initial appointment with the good Dr a week and a half from now, but could really use some guidance and support until then. He - understandably - doesn't want to give me extensive medical advice until he has evaluated me in person, I think. Unfortunately, in the ensuing period, I have to find a way to be as functional as possible. I need help. I also am traumatized by this and terrified about what the future holds - with all luck, I'll live another 40 years. Will I be a prisoner to these drugs for the rest of my life?? Do I have any chance of healing the damage that has been done? Does anybody get through this unscathed? I can't imagine ever going through the hell of the past few days again.

 

Oddly, I have been able to drift off to sleep in the past two nights (and days, whenever I close my eyes). With my regular insomnia, this has never, ever been the case. I am sure it's not advised, considering the other drug wd I'm managing, but I haven't had to take my usual ambien the past two nights; I've been able to sleep without. I don't know if this has to do with my overtaxed CNS needing rest or a strange reaction to the reinstatement of zoloft. That said, it is insanely hard for me to wake up, let alone get out of bed. It takes hours, then I still find myself drifting off if I sit on the couch.

 

Any advice or support is greatly appreciated.

[Songbird]

Hi Panda, welcome to SA!  I'm glad you've found us.  Thanks for creating a signature.

 

It's great that you are already feeling some significant improvement from your reinstatement - that's a very encouraging sign, as is the ability to sleep easily.  I think you are sensible to be cautious about updosing at this point.  It takes about five days for the drug to reach a new level in your system so it may not have even reached "full strength" yet - I think it would be better to give it some time to see what this dose can do.  Since you've already had some improvement, I would be wary about jeopardising that by doubling the dose, which might turn out to be too much for your system at this point.  I'd probably hold on the current dose for a few weeks and see how that goes.  If it turns out that it doesn't do enough to alleviate withdrawal symptoms, you would still have the option of a dose increase later, which would be better done in small increments rather than doubling the dose.  I recommend a thorough read of our reinstatement topic, especially the top post: About reinstating and stabilizing to reduce withdrawal symptoms

 

I understand your worries about the future and being a prisoner to drugs.  I've found it best during severe withdrawal to focus on one day at a time (or even an hour or minute or second at a time when it's really bad) as worrying about these things just makes you feel bad and can ramp up anxiety.  You may find it beneficial to try some non-med coping techniques - we have a lot of information in this topic: Non-drug techniques to cope with emotional symptoms.

 

Please post all your updates and questions about your situation here in your introduction topic, and we will try to help you as best we can.

 

 

 

[panda]

Thank you for your response, Songbird.

 

I may have spoken too soon about improvement - last night, after a relatively good day, I fell back into a state of dp/dr and was unable to sleep all night. Very anxious and tired today. Dp/dr is slightly better, but still lurking.

 

I have a few questions:

 

1.  I am supposed to fly a few times in the next week. Is this advisable? I'm worried it will be a shock to my nervous system and cause an adverse reaction. One is a week from Monday for an important job interview, and I'm nervous that it will ruin me for it.

 

2. How do I find a Dr who is knowledgable about this? In my worst moments, I think I need to see someone very urgently, but I know the Drs who understand what is happening are few and far between. I am currently in Denver, but supposed to fly to LA this week. Any suggestions would give me peace of mind. Even telemedicine would be fine if that were an option.

 

 

[Songbird]

Try not to worry if you feel a bit worse, it's normal to have ups and downs for a while, as your body works to restabilise.  It can take some time to stabilise after a reinstatement, so you need to be patient and learn to ride the waves for a while.

 

I'm not sure about the flying.  How long is the flight?  Are you normally a nervous flier?  It's possible that just worrying about the flight will be worse for your nervous system than the actual flight itself.

 

Finding a doctor with any clues is a challenge for all of us.  The dilemma with seeing a doctor when in severe withdrawal is they may recommend something different to our suggestions, and you'll have to decide which way to go.  For example, it's common for doctors to switch and/or add drugs, trying all sorts of things attempting to "fix" the problem, and often making things worse.  We have a topic for recommended doctors here: Recommended doctors, therapists, and clinics.

 

 

[Altostrata]

Welcome, panda.

 

You are experiencing typical severe antidepressant withdrawal syndrome. You are going to experience waves of symptoms as your nervous system recovers from the shock. You will need to hang in and be patient.

 

It probably would be a good idea to reduce any unnecessary stress right now.

 

If I were you, I would not updose, let your nervous system settle down on 25mg Zoloft (is that the drug you're taking)? It appears reinstatement is working. Increasing the dosage might cause kindling -- much worse symptoms.

 

As Songbird pointed out, the 25mg reinstatement ramps up over at least 4 days. Signs are good so far, especially the sleep, but eventually you may find 25mg Zoloft is a little too much.

 

To ascertain if 25mg Zoloft is the right dose, please keep daily notes of times of day you take your drugs, their dosages, and your symptoms. You can post them in this topic with a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right.

[panda]

Thank you for your response, Alto. I can't tell you how grateful I am to have found you and your incredibly helpful site.

 

Yes, I am on 25mg Zoloft now. I was completely unable to sleep last night, and lost my window today. Am back to wide-eyed terror and dp. I am thinking of using 2.5 mg of ambien tonight to help me rest through this. I imagine the lack of sleep doesn't help things.

 

RE: updosing/kindling:

Is kindling temporary before an improvement, or possibly long-lasting adverse effects? The Dr I have been consulting - Dr Shipko - recommended that I increase to 50mg after 5 days, and thought that I wouldn't feel better until I did. I realize this may just be one of those instances where I have to make a tough choice.

 

My biggest fear is that I won't be functional for my job interview on May 6. I realize that this is a high-stress situation - they are flying me in to interview - but is a job I've been trying to get for a while. The timing couldn't be worse. I just want to be as clear-headed as I can possibly be for it.

 

RE: supportive pharma:

I have prescriptions of Xanax and propranolol at my disposal - I almost never use either of them. Has anybody had experience with using these drugs for support during the tough days? I know that benzos have their own slew of dangers, and would tread very carefully there.

 

I am taking magnesium, fish oil, exercising, going for walks, taking epsom salt baths. I realize it is early in this process and things take time, but I feel so desperate and scared.

 

RE: strange physical effects:

I am a regular, intense exerciser. Since w/d syndrome began, I have been sweating much more and very out of breath under mild exertion. Is this to be expected?

Also, unsure if this is related, but I've noticed that I've been losing hair lately - much more than usual since my last dose. Has this been reported by others?

[Altostrata]

Please discuss your concerns with Dr. Shipko.