kajayjay: introduction and questions about fatigue and temperature dysfunction

[kajayjay]

Hi there 😀

 

I was on 150mg Zoloft for 8 months in 2017, then on 20mg Paxil for 6 months in 2018, then 60mg Buspirone for 6 months in 2018, and then back on 150mg Zoloft in 2019- all for PTSD. I came off of the Zoloft over the course of a month as recommended by my GP (way too fast I know now!) and had horrible withdrawals for a few months so my GP prescribed me Paxil for a month. I did not want to go back on Zoloft because it was making me so tired. I finished my month of Paxil in June 2020. I’ve had horrible hot flashes and chills since then. I’ve read the temperature dysregulation thread on here and am comforted in knowing this is a common withdrawal effect, especially since I was worried that I potentially had COVID. The thing that surprised me, however, is that I was extremely tired on Paxil and that 5 months after I discontinued it, I still am. With Zoloft, I wasn’t tired anymore a few days after going off it. With Zoloft, I was confused as to why I was so tired so I got bloodwork done and my hematocrit was low. I would get bloodwork done now except every time I do it makes my withdrawals much worse (has anyone else experienced this?). Has anyone had fatigue last this long post-SSRI discontinuation? If so, did it slowly go away? I am graduating as a veterinarian in June and do not see how I can practice feeling like this, which is very sad considering how hard I worked to get here. Thanks in advanced!

 

Edited October 24, 2020 by ChessieCat
Move from different forum (first post), intro (second post)

[kajayjay]

Hi there 😃

 

I'd like to introduce myself. I was diagnosed with a psychogenic fever triggered by various life changes in 2017. I was on 150mg Zoloft for 8 months in 2017, then on 20mg Paxil for 6 months in 2018, then 60mg Buspirone for 6 months in 2018, and then back on 150mg Zoloft in 2019. I came off of the Zoloft over the course of a month as recommended by my GP (way too fast I know now!) and had horrible withdrawals for a few months so my GP prescribed me Paxil for a month. I did not want to go back on Zoloft because it was making me so tired. I finished my month of Paxil in June 2020. I’ve had horrible hot flashes and chills since then. I’ve read the temperature dysregulation thread on here and am comforted in knowing this is a common withdrawal effect, especially since I was worried that I potentially had COVID. The thing that surprised me, however, is that I was extremely tired on Paxil and that 5 months after I discontinued it, I still am. With Zoloft, I wasn’t tired anymore a few days after going off it. With Zoloft, I was confused as to why I was so tired so I got bloodwork done and my hematocrit was low. I would get bloodwork done now except every time I do it makes my withdrawals much worse (has anyone else experienced this?). Has anyone had fatigue last this long post-SSRI discontinuation? If so, did it slowly go away? I am graduating as a veterinarian in June and do not see how I can practice feeling like this, which is very sad considering how hard I worked to get here. Thanks in advanced! 

 

[SandCastle]

Is the fatigue all day long or does it come and go throughout the day? I had episodes of acute fatigue daily after quitting Sertraline for probably 3 months before it started to calm down. I didn’t have all day fatigue, but I would feel it come on suddenly and it would last anywhere from 20 minutes to a couple hours and would happen 5 or more times a day. I’ve been off about 5 months now, and I barely ever get that at this point, but I do still get plenty of other symptoms this far out. I have had blood drawn since all this started but I couldn’t really tell you if it made things worse because I was in the full swing of symptoms when I did that.

[kajayjay]

Yeah it’s fatigue all day long. If I go to bed any later than 9pm, I feel tired the whole next day. It started when I was on Paxil, so I don’t think it’s a withdrawal issue but a side effect that hasn’t gone away. 
 

Did your blood work show anything that would explain why you were tired? I’m glad it went away after 3 months! It always scares me when things last months because I wonder if it will last forever which I know is catastrophizing but sometimes I can’t help it. 
 

Yeah it’s the weirdest thing how I feel way worse after bloodwork. It’s happened twice now. I’ve had to reinstate an SSRI both times. My theory is that it removes a small amount of serum serotonin which normally doesn’t matter but we are so sensitive to changes in serotonin during withdrawal. 

[ChessieCat]

Hi KJJ and welcome to SA,

 

Please create your drug signature by following these instructions:

 

Instructions:  Withdrawal History Signature
Account Settings – Create or Edit a signature

 

This is your own Introduction topic (1 per member) which is the best place to ask questions about your own situation and journal your progress.  This way your history will be in one place.

[ChessieCat]

Please reply with a post advising they you have created your drug signature so that we know that you have done it.  Thanks.

[SandCastle]

Some of the side effects I had when I started Sertraline are still with me too so that makes sense. One thing I got immediately after starting was joint pain with a feeling of loose joints, as if they could dislocate easily, and I still have that today 5 months after stopping. I wonder if that will ever go away too.

 

My bloodwork did show slight anemia but that’s been a problem for me most of my life, so I don’t think that was causing the fatigue. It started almost immediately after CT, and it was such a specific feeling. It reminded me of when I was a kid and would spend all day at a water park or something equally energetic and when I’d finally sit down in the car for the ride home, I’d feel like I could pass out. It came on that suddenly and strongly and then disappeared usually when I got distracted by something else. I’ll have to pay attention if I get blood drawn again in the future and see if it makes my problems worse!

[kajayjay]

14 hours ago, ChessieCat said:

Please reply with a post advising they you have created your drug signature so that we know that you have done it.  Thanks.

I have created my drug signature, thanks. 

[Sleepless]

16 hours ago, kajayjay said:

Yeah it’s fatigue all day long. If I go to bed any later than 9pm, I feel tired the whole next day. It started when I was on Paxil, so I don’t think it’s a withdrawal issue but a side effect that hasn’t gone away. 
 

Did your blood work show anything that would explain why you were tired? I’m glad it went away after 3 months! It always scares me when things last months because I wonder if it will last forever which I know is catastrophizing but sometimes I can’t help it. 
 

Yeah it’s the weirdest thing how I feel way worse after bloodwork. It’s happened twice now. I’ve had to reinstate an SSRI both times. My theory is that it removes a small amount of serum serotonin which normally doesn’t matter but we are so sensitive to changes in serotonin during withdrawal. 

I have fatigue also.  I’m also hypothyroid and have low b12.  It’s been extremely hard trying to correct these issues while dealing with WD.  Have your levels been checked?

[kajayjay]

Yeah I’ve had bloodwork. I’m normothyroid and have normal b12. I also am anemic so I receive IV iron. My hematocrit has been consistently lower since going back on Zoloft and Paxil this year. It’s not iron deficient anemia which I know can be a side effect of SSRIs because of my iron infusions.

 

I’ve read that SSRIs can suppress red blood cell production in general so I suspect that’s what is happening with me, but I really hope I start to recover because I’m barely functioning. 
 

I’m so sorry you’re going through low b12 issues and hypothyroidism. Do b12 supplements help? Have you ever had a b12 shot? 

[Sleepless]

26 minutes ago, kajayjay said:

Yeah I’ve had bloodwork. I’m normothyroid and have normal b12. I also am anemic so I receive IV iron. My hematocrit has been consistently lower since going back on Zoloft and Paxil this year. It’s not iron deficient anemia which I know can be a side effect of SSRIs because of my iron infusions.

 

I’ve read that SSRIs can suppress red blood cell production in general so I suspect that’s what is happening with me, but I really hope I start to recover because I’m barely functioning. 
 

I’m so sorry you’re going through low b12 issues and hypothyroidism. Do b12 supplements help? Have you ever had a b12 shot? 

I have a prescription for b12 shots.  I was able to take a few before my nervous system  didn’t like them.  So I’ve stopped.  I’m at a point in my WD where everything triggers anxiety.

[Altostrata]

Welcome, kajayjay.

 

Yes, fatigue can be a post-acute withdrawal symptom. Like other long-term withdrawal symptoms, it most likely will very gradually go away over months.

 

If you have low vitamin B12, you may wish to take supplements. Very often, withdrawal syndrome makes people hypersensitive to drugs and even B vitamins, as @Sleepless found.

 

You may be able to very ramp up on B12 supplementation by taking a tiny crumb of a sublingual methylcobalamin tablet to start and gradually increase the size of the crumb over months, depending on your reaction. Don't take so much that it causes anxiety. This may be helpful for @SandCastle, too.

 

Many people find fish oil and magnesium supplements helpful, see
https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/
https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

You might try a little bit of one at a time to see how it affects you.

[kajayjay]

Thanks so much. I appreciate your post. The interesting thing is that the fatigue started when I was on the SSRIs. So I suspect that they have affected my hematopoiesis in a long lasting way. But I still think all of your suggestions can be applied- because they could have affected my b12 absorption/metabolism or other vitamins/minerals necessary for healthy red blood cell production in such a significant way that I am still recovering from it. My hematrocrit was low the entire time I was on SSRIs. But my iron was normal so I know it is not an iron deficiency anemia. Has anyone had something similar happen to them? 

[Altostrata]

Fatigue is also a common adverse effects of SSRIs.

 

These drugs have effects throughout the body. Could be your low B12 was coincidental, but if you can remedy that now, you might feel better.

 

Expect improvement to be very gradual.

[kajayjay]

Thank you so much Altostrata. It makes sense that since SSRIs have long-term effects via changes in gene expression which can lead to withdrawals, their side effects can last long after you discontinue them as well. I am taking B12 supplements, along with a multivitamin, omega 3, magnesium, copper, and echinacea. 

 

I am curious- do you (or anyone else) know physiologically how SSRIs affect our hematocrit? There is not a lot of literature on this and so it is hard to know what exactly to supplement and the timeline for improvement. Has anyone experienced fatigue due to SSRIs that have not gone away after discontinuing? If so, how long did it last?