Londoner: any help would be much appreciated

[Londoner]

Hello

 

I am based in Central London and have been dealing with the devastating effects of antidepressants for the last 10 to 11 years. I am now 30 years old.

 

I was first put on antidepressants by a GP when I was 19 years old for 'mild/moderate depression'. I was at university at the time and 2 years prior my father died. Looking back I certainly had high anxiety and periods of depression following my father's death but nothing to rival the devastating symptoms I experienced in the first two weeks after taking my first doses of Citalopram and the endless medication cycling that followed.

 

I spent about a year going up and down on various SSRI/SNRI's. I had a few brief periods of stability but spent most of that year dealing with crushing physical and mental side effects. After a year, I was on 100mg Sertraline and decided I was not going to change anything. Side effects remained. I dropped out of university but I was able to work on and off over the next 6 years. At some point during that time I increased my medication to 200mg. However, since 2017 I haven't been able to work at all, my social life has dwindled to nothing and I really haven't had any sort of life for the past 3-4 years. I've spent the vast majority of that time in bed.

 

I finally mustered the courage to come off Sertraline in August 2020., tapering by 50mg every 2-3 weeks per the advice of my psychiatrist. I have now been med free for about 7 weeks. I realise that is a quick taper compared to others I have read about on this site. I continue to feel pretty ill but not significantly more ill than I had been feeling on the medication. Indeed, the last 7 weeks have been better in some ways, despite some more severe symptoms that I wasn't experiencing before such as periods of intense rage.

 

For the past 3 years I have had infrequent appointments with a psychiatrist who I respect and like very much. He is far better than some other psychiatrists I have seen and generally is sceptical about the benefits of drugs. However, he isn't as open to the notion that these drugs can do real damage to people. Although I am very grateful for him, it would mean the world to me to find a professional in London who would say outright that they believe my account of what has happened, that they have seen it before and that they are going to help me through it. I have been searching for 10 years with no luck. Alternatively, some kind of antidepressant withdrawal support group in London would also be a great find.

Like many people, I have been bounced around all kinds of services, none of which really recognise the harm done by antidepressants. 

 

My main questions are -

 

What should I do now? Might I start to feel a bit better if I went back on a small dose of Sertraline and came down more slowly? (This doesn't seem an obvious route to me because I was feeling just as bad when I was on the medication.) Alternatively, I can just stay off the meds and hope it improves over time? How long might that take?

 

Are there any up to date lists of clinicians in London who have a good grasp of antidepressant withdrawal? I have contacted people over the years who have been mentioned in the media in connection with antidepressant withdrawal, but they don't tend to reply. 

 

Are there any antidepressant withdrawal support groups in London?

 

Thanks in advance for any advice. It really is appreciated.

 

Apologies also if the above isn't entirely coherent. My brain isn't what it was. Happy to answer any questions. Thanks.

 

 

 

 

[Altostrata]

Welcome, Londoner.

 

You had an immediate bad reaction to citalopram? What were the symptoms? What were the sertaline side effects?

 

Since you went off, what symptoms have improved? What remain?

 

Unfortunately, doctors who know anything about antidepressant withdrawal are few and far between. Some of the members of CEP-UK are in London.

 

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.

 

To help us out, follow these instructions Please put your drug and withdrawal history in your signature You may need to use a computer to do this.

 

[Londoner]

Many thanks for your reply Altostrata

 

3 hours ago, Altostrata said:

ou had an immediate bad reaction to citalopram?

Yes, I had 2 weeks of side effects followed by several weeks of feeling significantly better. The side effects I experienced in those first two weeks were many and varied. It's hard to list them all but some were: insomnia, extreme anxiety/agitation, intense headaches at the base of my head, suicidal ideation, nausea/vomiting/bloating, memory problems/brain fog, hair loss, fatigue/lack of motivation 

All of the subsequent medications I took resulted in similar symptoms with some variations such as night sweats, intense anger, disassociation, weight gain and weight loss. I have continued to have the above side effects to varying degrees throughout the last 10 years.

 

Since I came off the medication I have seen improvement in my energy level and motivation but I am still experiencing debilitating headaches accompanied by feelings of despair, nausea and stomach upset as well as the memory problems/brain fog. My circadian rhythm also remains somewhat disturbed.

Some days are better than others but the headaches are ruining a good 4-5 days of the week at the moment.

 

Thanks very much for the tip re. supplements. I will certainly read through those threads. The only supplement I am currently taking is CBD oil, which I think is helping a bit.

 

I will sort out my signature now. Thanks again!

 

 

[Altostrata]

What is your sleep pattern?

[Londoner]

My sleep pattern at the moment is quite disturbed. It is generally 2am -1pm. Then I have been getting extremely bad headaches in the evenings which tend to make me fall asleep. In total I'm sleeping about 14-15 hours a day. 

 

My symptoms have worsened over the past 3 weeks. The fatigue and headaches are horrendous and I'm finding it hard to move from my bed even briefly. I feel like a vegetable.

 

It has been over two months since I stopped taking the medication following a 2 month taper from 200mg. 

 

Does anyone have any advice on if/how I should reinstate the sertraline? I am very scared of getting worse but I don't know how long I can tolerate the status quo. Is it too late to even try a reinstatement? And if I do, what amount should I go back on to? I'm sure I can source liquid sertraline from my GP. Is this the best method or is tablet cutting better?

 

Many thanks for your help 

[Gridley]

30 minutes ago, Londoner said:

 

Does anyone have any advice on if/how I should reinstate the sertraline? I am very scared of getting worse but I don't know how long I can tolerate the status quo. Is it too late to even try a reinstatement? And if I do, what amount should I go back on to? I'm sure I can source liquid sertraline from my GP. Is this the best method or is tablet cutting better?

 

 

Your taper was very fast, resulting in the withdrawal symptoms you're now experiencing. Your symptoms are typical of withdrawal.

 

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

Reinstatement of a very small dose of the original drug is the only known way to alleviate withdrawal.  The purpose of reinstatement isn't to eliminate withdrawal completely (though it does for some) but rather to bring symptoms down to a tolerable level.  Reinstatement works most predictably within 3 months of your last dose, so at 2 months out you're still with the window of opportunity.  Please read:

 

About reinstating and stabilizing to reduce withdrawal symptoms. -- at least the first page of the topic

 

If I'm reading your signature correctly, your last dose before jumping to zero two months ago was 50mg, correct?  I'd recommend you reinstate 2mg sertraline--no more.  The prescription liquid sertraline is the best method for reinstatement.

 

It takes 4 days for a reinstatement to reach full strength in your blood steam and a few more days to register in the brain.  Be patient and give the reinstatement a chance to work.  If you need to increase, it will be easy to do so very slowly using the liquid.

 

It's a good idea to keep daily notes on paper to track how the reinstatement is working.

 

 

[Londoner]

Hi there,

 

I'm sorry not to have replied sooner. I wasn't able to reinstate back in November as my GP refused prescribe me liquid Sertraline. I decided to persevere but as of this weekend, that seems to have been a massive mistake.

 

I've been in total crisis since Thursday and I've been taken to Accident and Emergency twice during this time. I've been having repeated waves of suicidal akathisia along with vomiting, diarrhoea, inability to eat and sleep. I have been having difficult symptoms up to this point but nothing so scary as the past few days. I am genuinely terrified that I will kill myself. It is now 6.5 months since I took my last dose of sertraline. The doctors have given me an antihistamine to try and take the edge off of this toxic adrenaline but it hasn't particularly helped. They have diagnosed this symptom as 'anxiety'.

 

I am speaking to my psychiatrist tomorrow who has agreed in principle to prescribing me liquid Sertraline with a mind to re-instate at 1mg. Does anyone have any thoughts? I feel I am left with very few options because this particular symptoms is just totally unbearable. Most of my symptoms up to now have lasted a few weeks and then subsided/morphed into different symptoms but I just don't think I can wait this one out.

 

I realise that re-instating is not a magic bullet but do you agree that that is pretty much my only option given what has happened? Are there any alternatives? Has anyone else experienced these acute feelings of akathisia? For me they seem to come on 2-3 times a day lasting approx 2 hours each and when I am in them, all I can think about is killing myself. The feeling is of sheer panic.

 

Any advice/guidance at this time would be so much appreciated. Thanks : )

[dirtvoid]

Your not alone I had the same thing - when I went cold turkey off Duloxetine at exactly 6.5 months off - the suicidal akathisia was so severe - I thought I had absolutely no choice but to reinstate because the thoughts were so intense and persuasive - I unfortunately didn't have this site as resource and reinstated a full dose - I did feel better immediately but it's made the 2nd taper and withdrawal absolutely brutal - the mods will advise you about what dose to reinstate but usually only a very small dose is needed. there is a topic for reinstatement in the tapering section I believe. 

[Londoner]

Thanks so much for your response Dirtvoid. I'm so sorry you had to go through that but I'm glad you were able to subsequently stabilise. Thank you for telling me of your experiences... it really does make me feel less alone.

I am still feeling very anxious but I haven't had a wave of akathesia since yesterday morning and I was able to eat a little bit yesterday and sleep for 10 hours last night. I don't want to tempt fate but it's plausible that that particular wave has receded for now. If that is the case, I'm left with the dilemma of whether to reinstate or not.

With your suicidal akasthesia, how long did it last for you and have you had it back since? When you reinstated, did it destabilise you in any ways? Did you continue to feel better until it came to tapering again?

I feel the last 4 days has been a big trauma and I'm worried that reinstating even a small amount of the drug could fuel further destability.

Many thanks to you again Dirtvoid. 

 

[dirtvoid]

Remember the that you are the expert of your own body and experiences, if the wave has receded that is a very good sign that you are healing. I had extreme suicidal akathasia for about 3 months straight. I rode my bike for 6-8 hours a day, I couldn’t stomach food, and I couldn’t stop crying. I reinstated when it got the point that I had a definite suicide plan - I felt better immediately like within an hour of taking the pill my tear ducts closed up and I was able to attend a club night that basically reinstalled my will to live.
 

I felt ‘better’ but typical “anti-depressant” ‘better’ which is unable to feel or process emotional properly - basically emotionally blunted which is can be relief when you are super emotionally overwhelmed and destabilised. I only stayed on it 2 and half months before tapering again and it kindled me making this taper sheer hell at ever drop and I’m paying the price for it - I’m not sure if I did the best thing but it did keep me alive I guess. I think this is the risk ‘feeling better now’ (which isn’t even guaranteed with reinstatement) against feeling even worse later. Sometimes we do what we need to do now to stay alive but it can make our lives a lot harder later. a lot of learning to live without drugs is about learning this lesson that time takes time, and being patient for changes that takes time. 
 

I’m not sure if I should be giving advice since I’m in the middle of it as well but I totally understand how you feel. I know sometimes I just want someone to give me the answer that will relieve my suffering, but sometimes just having someone listen, relate and say “I know how you feel” gives me the strength to make my decisions

 

whatever you decide to do - I believe in you to survive this! Take a day at a time and one second at a time for really tough times! 

[Londoner]

Wow, you have real strength dirtvoid. To endure three months of that hell must have taken herculean effort. You truly are a wonder. I think all of us on this forum have endured such unimaginable pain and yet we are still here. I hope that when we both get through this we can look back with pride at how much strength it takes to get through withdrawal.

I'm so sorry to hear you're in a wave right now. Yet here you are, helping me. I can't tell you how much that means to me. Thank you.

I think I will talk to my psychiatrist this afternoon or tomorrow and attempt a 1mg reinstatement. Fingers crossed.

I'll be thinking of you and sending much courage your way. 

[Nomansland]

Hello Londoner,

 

when you talk to your psychiatrists, you can show him/her this official withdrawal leaflet by the UK Royal College of Psychiatrists to explain your situation and withdrawal.

Not many of the medical staff are aware of heavy withdrawal. This could help you and other patients of him/her!

 

Greetings

 

Nomansland

[Londoner]

Hello Nomansland,

Thank you very much for your note. I sent my psychiatrist a letter a few weeks ago detailing what had happened to me along with the RCP guidance and a few other research papers. I have only spoken to him once since and that was yesterday morning when I was in acute crisis but I did get the impression that he has taken what I said on board. He is a kind person. I am due to speak to him again today or tomorrow so hopefully he will be open to supporting me through an attempted reinstatement.

I don't know if it will help anyone but I'm going to copy and paste the body of the letter I sent my psychiatrist below. I think it was helpful for me to write to my psychiatrist but acknowledge it may be different for other people depending on how much of an arse their psychiatrist/Dr is. I agree though that for those of us who are able to better inform our doctors, it can be a worthwhile thing and perhaps can save future patients from withdrawal hell.

 

Dear Dr,

 

My name is .... You treated me over a period of several years and we spoke perhaps 5 or 6 times during that time both over the phone and in person.

You discharged me in the summer of 2020 but assured me that if I ran into further difficulties I could be re-referred to you. At the time I was tapering down from a dose of 200mg Sertraline in line with your recommendation. A drug I had been on for 10 years. As it turned out, when I did start to experience intense withdrawal symptoms at the end of my taper, my GP informed me that I would not be allowed to refer myself back to you because of some administrative changes that meant I was no longer in your service’s catchment area. We did speak over the phone one more time, I think in September/October 2020, where I got the impression that you felt there was not much else you could do for me, although you did say you would look into the possibility of prescribing a small dose of liquid Sertraline as this was something I had read may make the withdrawal symptoms more bearable. I did not hear from you again after that and my GP refused to prescribe liquid Sertraline.

 

The reason I am writing to you today is to update you on how I have been faring since, to ask if you can help me and, if that is not possible, to implore you to look into the research and new guidelines on antidepressant tapering strategies and withdrawal so that future patients may be spared the agony I continue to experience.

 

As you may remember, for a number of years under your care, I refused to change the medication I was taking at all. At the very start of my treatment in 2010, I had had a year of going up and down on various medications resulting in extremely painful symptoms. Thus, for many years I was terrified that if I was to come off the Sertraline that I would have a similar experience. I was terrified despite the fact that after many years on a high dose of antidepressant I was very much functionally impaired mainly as a result of chronic fatigue, mental fog and apathy. The weight gain frustrated me too. This research paper by Giovanni Fava about the possible consequences of long term antidepressant use sums up my experiences during those later years very well: https://journals.sagepub.com/doi/full/10.1177/2045125320970325

 

However, in Spring/Summer 2020, I did finally agree to taper down the Sertraline and we planned to come down by 50mg every 2-3 weeks. This I did with tolerable symptoms until the very end of my taper when I began to experience extreme withdrawal effects including brain zaps, Akathesia, suicidal thoughts, homicidal thoughts, crying for no reason, muscle weakness, palpitations, chest tightness, tremor, chronic headaches, gastrointestinal problems, dizziness, fatigue, anxiety, despair, nausea, sweating, intrusive thoughts, unexplained feelings of fury, brain fog, memory problems.

It is now 6 months since I took my last dose and these symptoms continue to plague me. This week, for example, I have been trying to survive the symptom I find most unbearable, Akathesia. When I say survive, I mean it in the literal sense. If I didn’t have hope that one day I would be the person I was before ‘treatment’, dying would be the obvious course of action and the sweetest relief.

 

It is important to me that I tell you this. It seems many doctors are under the impression that patients are not at risk of withdrawal symptoms and that any such symptoms are mild and short-lived. Perhaps you are simply not able to follow up with your patients to find out what happened. This is why I wanted to tell you.

 

More and more research is being published about antidepressant withdrawal and in 2020 the Royal College of Psychiatrists updated their guidance on antidepressant withdrawal to acknowledge the extreme and prolonged withdrawal syndrome some people experience and to recommend longer term tapering strategies. The RCP guidance is quite detailed and there is a section on tapering for people who have been on the drugs for many years as well as examples of tapering plans.

I believe that had I taken this approach, I may have been spared at least some of this suffering. The guidance can be found here: https://www.rcpsych.ac.uk/news-and-features/latest- news/detail/2020/09/23/new-information-on-stopping-antidepressants

I once sent you a number of research papers on antidepressant withdrawal that you didn’t get round to reading. More have been published since and I have compiled a short list at the end of this letter. I have chosen just a few of the more recent ones that I found particularly interesting, but there are plenty of others. I also included one short article by Joanna Moncrieff but again, there are many others available online.

 

You were by far the best psychiatrist I had. I found you to be empathetic and intelligent. But it did deeply hurt me that I never felt that you believed my fears of coming off this medication were justified. My impression was that you viewed my fear of coming off as though it were a phobia. Despite the fact that I had already quickly come off many medications in 2010, an experience that was so traumatic I had never attempted it again. I am now left with those same symptoms I had back then and, once again, no professional support. When our sessions came to an end I decided not to seek out another psychiatrist through the NHS. You never know what type of person you’re going to get and I fear that they would not recognise or help me with withdrawal symptoms and may, god forbid, diagnose me with something else.

 

The biggest regret of my life is accepting antidepressant treatment from a GP at age 19 following their diagnosis of ‘mild to moderate anxiety and depression’. (I learnt many years later that SSRI’s had only been shown to be (marginally) effective in severe depression and even then, treatment duration should be 6-9 months.)

Nonetheless, I find it easier to forgive that initial treatment than I do the next 10 years of doctors’ denial regarding the potential for significant adverse effects and withdrawal symptoms. It would have made the world of difference to me had I found just one doctor who believed me, recognised my symptoms, reassured me and supported me through a very gradual taper.

 

I hope that when you next encounter a patient like me, knowing my experience will help you to help them.

Yours sincerely, 

 

 

Davies J, Read J (2018) A Systematic Review into the Incidence, Severity and Duration of Antidepressant Withdrawal Effects: Are Guidelines Evidence-Based? Journal of Addictive Behaviorshttp://prescribeddrug.org/wp-content/uploads/2019/02/Davies-and-Read-final.pdf

 

Guy, A., Brown, M., Lewis, S., and Horowitz, M., (2020) The ‘patient voice’: patients who experience antidepressant withdrawal symptoms are often dismissed, or misdiagnosed with relapse, or a new medical condition, Therapeutic Advances in Psychopharmacology Sage Publications, 2020, Vol. 10: 1–15https://journals.sagepub.com/doi/10.1177/2045125320967183

 

Horowitz MA, Taylor D. Lancet Psychiatry 2019. Tapering of SSRI treatment to mitigate withdrawal symptoms.https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(19)30032-X/fulltext

Guy, A., Davies J., Rizq, R. (Eds.) (2019). Guidance for psychological therapists: Enabling conversations with clients taking or withdrawing from prescribed psychiatric drugs. London: APPG for Prescribed Drug Dependence.
https://prescribeddrug.info

 

Persistent withdrawal and lasting damage from prescribed drugs by Joanna Moncrieff

https://joannamoncrieff.com/2019/04/01/persistent-withdrawal-and-lasting-damage-from- prescribed-drugs/

[Londoner]

I wonder if anyone can advise me about my reinstatement. I am currently considering reinstating 1mg Sertraline. It has been 6 months since my last dose following a fast taper. I had planned to endure my severe withdrawal symptoms up until this weekend when I had suicidal akathisia. I am now pretty set on attempting a re-instatement at a small dose. I know that the general consensus is to re-instate with the drug that you have come off, in my case Sertraline. However, my situation is that the Sertraline had not been working for many years and I believe that for 5 years at a dose of 200mg I was experiencing poop out/withdrawal symptoms/adverse effects of being on a high dose. The main symptoms of those years were chronic fatigue, apathy, brain fog, depression. Nonetheless, I was not being rushed in to hospital during those years despite being very functionally impaired (I haven't worked in 3 years).

Thus, my question is, would it be too high risk to consider reinstating a different SSRI such as Prozac at 1mg? I have never taken prozac before so I don't know how it would effect me. The main reason I suggest it, as opposed to other SSRIs, is that it may be easier to withdraw from when the time comes.

Does anyone have any experience reinstating with a different drug at a low dose? How did it go for you?

[Londoner]

Is there any way of asking AltoStrata if she has time to consider my above post regarding reinstatement? Sorry to ask

[DaBro]

@Londoner You need to tag Alto as I have tagged you here. 

 

For what it’s worth I had a horrific time at 12-18 months out. I went to the doctor and got some sertraline to reinstate. I still have the box - unopened. I’m doing good now, just 1 or 2 days a month and Akathesia and dark thoughts are pretty much gone. 

 

You know yourself best. For me I decided reinstating was just restarting the clock and potentially losing and having to go through the 6 months you’ve just survived twice. 

 

 

[Londoner]

Hi Dabro,

Thanks for your message. You've certainly summed up my dilemma. This evening I'm feeling less optimistic about reinstating and wondering whether I should just continue and try to stabilise after the horror of the last few days. It was just so frightening. I haven't had an attack of the suicidal akathesia since yesterday morning and they were coming every 4-5 hours. Instead I just feel super sensitive, tingling throughout the body and anxiety with less intense waves of panic. I am able to eat a little bit though. It's really helpful to hear your experience.

 

@Altostrata if you get a chance, I'd be really grateful if you could advise me on whether a reinstatement (Sertraline or prozac) is something I should consider this far out and following several days of total crisis. Sorry to pester you.

[ChessieCat]

I am writing this so that you can make an informed decision, not to scare you.  As you may already understand nobody knows what is the better thing to do or whether it will be successful.  The important thing is to be cautious and do things gradually.  We have members here who have panicked and have not given the drug enough time before increasing the dose and/or taken too high a dose and made things worse.  Sometimes they can reduce the dose and stabilise again, but it might take a few to many months, and some never stabilise fully.

 

Here is the relevant topic.  Please read Post #1:

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

Q:  How long have you been taking the CBD oil?  Please consider whether that (or something else) may be causing issues and/or making things worse before you take a psychiatric drug.  It might be worthwhile for you to observe your symptoms over a few days or more to see if you notice any connection.

 

If you feel certain that the Zoloft / sertraline had reached tolerance (which seems likely due to the fact that the dose was doubled and then additional drugs were tried) then it may not be wise to reinstate that.

 

Please be aware that whatever drug you decide to take it is better to start with a tiny dose to test to see how you respond.  That is not to see if the withdrawal symptoms reduce but only to see if it does not make things worse.  If after testing a tiny dose you do not feel worse then you would increase by a small amount and wait for 1 or 2 weeks before increasing by a small amount more.

 

Also note that the idea of reinstating or changing to a different drug is not to get rid of withdrawal symptoms completely but to bring them to a bearable level.  You will need to compare how you feel after taking the drug with how you felt at your worst, not how you felt at your best.

 

There are a couple of options you might consider if you want to try an AD.  The two drugs that are possible alternatives are citalopram (please note this is NOT escitalopram which is much stronger; citalopram is a gentler sibling of escitalopram) and Prozac.  You state you have not ever taken Prozac.  If you have tried citalopram previously, consider whether it caused any problems.

 

Please be aware that Prozac has a very long half life and it can take 10-14 days for it reach its full effect.  That being the case, you would need to be very careful that you did not increase too soon or by too much.  If you increase by too much it can take a while before you notice it and then when you reduce it takes a while for things to settle down, if they did in fact settle back down.

 

See Post #1 of this topic which explains how Prozac builds up over time:

 

tips-for-tapering-off-prozac-fluoxetine

 

The above topic also explains how to get doses of Prozac as does the following for citalopram:

 

tips-for-tapering-off-celexa-citalopram

 

 

 

Edited March 30, 2021 by ChessieCat

[Ebee12058]

19 hours ago, DaBro said:

@Londoner You need to tag Alto as I have tagged you here. 

 

For what it’s worth I had a horrific time at 12-18 months out. I went to the doctor and got some sertraline to reinstate. I still have the box - unopened. I’m doing good now, just 1 or 2 days a month and Akathesia and dark thoughts are pretty much gone. 

 

You know yourself best. For me I decided reinstating was just restarting the clock and potentially losing and having to go through the 6 months you’ve just survived twice. 

 

 

Hi DaBro,

I too, am debating reinstatement and going through horrible, awful withdrawals from years of stopping & starting lexipro, and recently, buspirone, which sent my CNS crashing. I wanted to ask, you say you are feeling much better now: how long from when you stopped your antidepressant are you? Did you CT or do a gradual taper? I'm only 7 weeks into withdrawl after a quick month taper, & very torn about reinstatement.

[Londoner]

Thanks ChessieCat,

Thanks very much for all of that useful information.

I haven't been taking the CBD oil for several months now because I didn't feel it was making any difference, plus at the time I didn't have so much anxiety.

 

I am having very deep panic and suicidal akathisia for the last 6 days and just trying to weigh up my options. They seem to be either to try going back on a low dose 1mg of SSRI (either Prozac or Sertraline) or alternatively restarting a Benzo. The antidepressant option is very worrying for me. I have never really been stable on antidepressants and have just stayed on them for ten years because I was terrified of coming off them.

The other option of the Benzo is tricky as well. I was on Valium for 7 years at increasing doses. I didn't have obvious problems with them in the same way that I did antidepressants. No start up problems or obvious side effects, although it's a little hard to tell given I got side effects from my antidepressant the entire time I was on them so some of those could have been from the valium. I came off slowly over a year or more and did not notice significant problems.

Nonetheless, they are dangerous drugs and certainly may have caused side effects that I attributed to the SSRI.

Does anyone have experience with re-instating a Benzo to counteract SSRI withdrawal after they have already been addicted to said drug and successfully tapered off?

 

I know none of the above options are very good but the only reason I'm considering any of them is because I am desperate for relief from these symptoms. I'm not trying to find a way a quick way to functionality,  I'm more trying to survive this unbearable panic.

[DaBro]

10 minutes ago, Ebee12058 said:

I too, am debating reinstatement and going through horrible, awful withdrawals from years of stopping & starting lexipro, and recently

 

Hi @Ebee12058  I fast tapered from 25mg to zero over a couple of weeks, so effectively CT. WD came late, building from 6 months after zero and peaking at 12-18 months. I turned the corner at 2 years and am now coming up to 2.5 years.....but everyone is different. 

[ChessieCat]

8 hours ago, Londoner said:

alternatively restarting a Benzo.

 

This is not a good idea.  Benzos only work, and only supposed to be used, for a very short period of time.  People end up staying on them long term not because they work but to stop withdrawal symptoms.

 

Check out the Ashton Manual:

 

https://www.benzoinfo.com/wp-content/uploads/2020/08/Ashton-Manual.pdf

 

Benzos are renowned for kindling.  There are links in Post #1 of this topic:

 

post-withdrawal-nervous-system-hypersensitivity-hyper-reactivity-and-kindling

 

[Altostrata]

On 3/30/2021 at 9:04 AM, Londoner said:

I know that the general consensus is to re-instate with the drug that you have come off, in my case Sertraline. However, my situation is that the Sertraline had not been working for many years and I believe that for 5 years at a dose of 200mg I was experiencing poop out/withdrawal symptoms/adverse effects of being on a high dose. The main symptoms of those years were chronic fatigue, apathy, brain fog, depression.

 

You have been off sertraline since September 2020. It is not relevant any more that you experienced "poop-out". Your nervous system is in an entirely different configuration now.

 

Since you are familiar with sertaline, you may find it more comfortable to experiment with 1mg reinstatement of that drug. At 1mg, it is unlikely to cause the adverse effects you experienced on a much higher dosage. If you feel 1mg is too high, you might try 0.5mg or even 0.25mg.

 

You could try Prozac instead, but since you don't have any experience with it, there's no way to predict how it will affect you. A bad reaction to it will last longer than one to sertraline because of fluoxetine's longer half-life.

 

Another SSRI, citalopram, has an intermediate-length half-life. It is also available in liquid form.

[Londoner]

Thanks Altostrata and Chessicat,

 

I think I will try to reinstate a small dose of Sertraline in the coming days. The difficulty at the moment is getting my hands on liquid Sertraline. I'm staying at my mum's on the other side of London to where my psychiatrist is based but I'll hopefully be able to access it early next week.

Re. the benzos, I completely agree with you chessiecat and I'm trying my best avoid them. The only reason I have considered taking them is to keep me alive during this period of acute akathisia and panic. I am still getting waves of debilitating agony and I have been taking the antihistamine that I've been prescribed but only out of sheer desperation. I don't want to take that either.

 

I have now survived a week of these symptoms. I hope it will let up soon. 

[Londoner]

Is there anyone who can give me some encouragement regarding the akathisia? I feel so terrified and suicidal

[ChessieCat]

2 hours ago, Londoner said:

I think I will try to reinstate a small dose of Sertraline in the coming days. The difficulty at the moment is getting my hands on liquid Sertraline. I'm staying at my mum's on the other side of London to where my psychiatrist is based but I'll hopefully be able to access it early next week.

 

It is possible to make a liquid from tablets.

 

tips-for-tapering-zoloft-sertraline

 

[mva96]

2 hours ago, Londoner said:

Is there anyone who can give me some encouragement regarding the akathisia? I feel so terrified and suicidal

 

Hi mate, i've had bouts of akathisia. Maybe not as bad as yours but it was still unbearable at times. Remember - It WILL pass. I know its incredibly hard for you right now, but keep reminding yourself that. It is not permanent. Do whatever you have to do to make it through. Take very hots baths, go for walks/runs, lie in bad and hide under the covers. Just keep going.  There are many in this forum who have been through it and come out the otherside. At times i would go for fast walks and literally just talk to myself outloud, sometimes venting and raging, sometimes coaching myself. I'd probably have looked insane if anyone saw me. 

 

Stay strong, you will get through this.

[Londoner]

Thanks so much MVA96 and as always, Chessicat for your wonderful guidance.

 

I'm sorry I keep on reaching out this week... it's just that it's been so horrendous and I'm totally at a loss of how to deal with it. My body constantly feels like there is a huge amount of adrenaline surging around it and when it peaks into these periods of panic and suicidal akathisia, I can't seem to think straight. All I can seem to think of is to ring the emergency services... particularly when meditation and tapping doesn't seem to touch it. In the moment it's just very difficult for me to remember that those peaks do pass. They last between 1-7 hours and I am getting 2 a day. The worst ones tend to be at 5am after I wake up.

Has anyone found anything that helps with severe panic? I had my first Epsom salt bath this evening....not sure it helped. Are there any supplements that could take the edge off it for me? I am trying not to take the propranolol and the antihistamine, particularly the latter, but during that panic I genuinely feel like I'm on the verge of dying/killing myself.

[Londoner]

Hi @ChessieCat

 

I have now organised to get some 25mg Sertraline tablets today and I have also ordered some 1ml,5ml,10ml,50ml syringes that should come today as well.

I am going to try to make my own liquid. My plan is to:

Carefully crush the 25mg tablet

Dissolve the crushed tablet into 50ml bottled water

Leave it to dissolve for how long?

Draw up 2ml of the solution to get a 1mg dose

Then do I syringe it right into my mouth or add it to some more water?

 

I'd really appreciate your advice on the above plan. So sorry to take up more of your time. I'll try to find the answers to my above questions on the forum threads in the meantime, in case you are too busy.

Many thanks

[Londoner]

I reinstated 1mg Sertraline this evening. I guess it's too early to tell whether it's going to have any effect, positive or negative?

What a week. After 6 months of hellish but bearable symptoms, this wave has almost killed me. But I do need to remember it is a wave. Right now, in the evening, I can remind myself of that but the daytime Neuro emotions, particularly those of panic and suicidal impulses, just seem so overwhelming at the time. Up to this wave, the alerting symptoms of panic, insomnia, inner restlessness/akathesia have not been a major feature of my withdrawal symptoms. I had more been getting the feelings of deep despair, lethargy, fatigue as well as suicidal thoughts but not an urgent sense that I was going to do it there and then. 

Did anyone else get this 6.5 months switch up in symptoms? Particularly with the panic and suicidality etc? How long did it take to dissipate? 

I've called emergency services 3 times in the last week, which I feel awful about because of course there's really nothing concrete they can do. Nonetheless, I genuinely think they have saved my life. Waiting for them to come has and having them talk to me has stopped me running to the kitchen for a knife to plunge into my chest. When the evening comes, my feelings often totally change and although I still feel awful in many respects, I definitely do not want to die. I really want to survive this. I have been reading Success Stories all day and one day I want to be writing one.

Thank you to everyone who has helped me so far. It means the world.

[Ebee12058]

18 hours ago, Londoner said:

I reinstated 1mg Sertraline this evening. I guess it's too early to tell whether it's going to have any effect, positive or negative?

What a week. After 6 months of hellish but bearable symptoms, this wave has almost killed me. But I do need to remember it is a wave. Right now, in the evening, I can remind myself of that but the daytime Neuro emotions, particularly those of panic and suicidal impulses, just seem so overwhelming at the time. Up to this wave, the alerting symptoms of panic, insomnia, inner restlessness/akathesia have not been a major feature of my withdrawal symptoms. I had more been getting the feelings of deep despair, lethargy, fatigue as well as suicidal thoughts but not an urgent sense that I was going to do it there and then. 

Did anyone else get this 6.5 months switch up in symptoms? Particularly with the panic and suicidality etc? How long did it take to dissipate? 

I've called emergency services 3 times in the last week, which I feel awful about because of course there's really nothing concrete they can do. Nonetheless, I genuinely think they have saved my life. Waiting for them to come has and having them talk to me has stopped me running to the kitchen for a knife to plunge into my chest. When the evening comes, my feelings often totally change and although I still feel awful in many respects, I definitely do not want to die. I really want to survive this. I have been reading Success Stories all day and one day I want to be writing one.

Thank you to everyone who has helped me so far. It means the world.

@Londoner Prayers your reinstatement alleviates your suffering & that you may have a slow, steady, & smooth taper. 🙏❤

[Londoner]

Thank you so much Ebee! It really means a lot.

 

I've been reinstated on 1mg Sertraline for 24 hours now. It had an immediate impact on my mood and ever since I have been significantly more positive. This is a godsend because the suicidal thoughts were very overwhelming. However, none of the other major symptoms I've been experiencing the past week have been dented. Today I still got the 3 hours restless sleep, morning cortisol surge and subsequent panic, tremor, anxiety, intrusive thoughts, muscle pain in arm, feeling very spacey in my head and like it filled up with gas, confusion and slurred speech. I had those symptoms the day before reinstating as well. The difference is that my improved mood has made those symptoms more bearable and I managed not to take the antihistamine this morning, which I haven't been able to do since this wretched wave started. I have also been able to eat a bit more today.

I am truly grateful for the partial relief I have been afforded today and I hope hope hope that it continues to improve. I haven't called an ambulance today and I am truly grateful for that too.

I will be taking my second 1mg dose in an hour. I'll have to wait and see what happens next. 

[Ebee12058]

1 hour ago, Londoner said:

Thank you so much Ebee! It really means a lot.

 

I've been reinstated on 1mg Sertraline for 24 hours now. It had an immediate impact on my mood and ever since I have been significantly more positive. This is a godsend because the suicidal thoughts were very overwhelming. However, none of the other major symptoms I've been experiencing the past week have been dented. Today I still got the 3 hours restless sleep, morning cortisol surge and subsequent panic, tremor, anxiety, intrusive thoughts, muscle pain in arm, feeling very spacey in my head and like it filled up with gas, confusion and slurred speech. I had those symptoms the day before reinstating as well. The difference is that my improved mood has made those symptoms more bearable and I managed not to take the antihistamine this morning, which I haven't been able to do since this wretched wave started. I have also been able to eat a bit more today.

I am truly grateful for the partial relief I have been afforded today and I hope hope hope that it continues to improve. I haven't called an ambulance today and I am truly grateful for that too.

I will be taking my second 1mg dose in an hour. I'll have to wait and see what happens next. 

@Londoner I'm so glad you have found some relief with your reinstatement. I pray in the coming days, as the drug calms your CNS, that you find relief from your other symptoms as well. ❤🙏  I'd ask that you remember me in your prayers as well, that I would start to experience significant healing.

[Londoner]

Thankyou Ebee. I will certainly be thinking of you and sending much strength your way. We will emerge from this one day and be ourselves again and until then, windows will get us through.

[Altostrata]

Please let us know how you're doing with this trial reinstatement. It will take about 4 days for 1mg sertaline to get to steady-state in your bloodstream. It is possible its effects will increase as it ramps up.

[Londoner]

Thanks Alto,

 

I will certainly keep you updated. I have now taken 3 daily doses of 1mg. Initial effects seem to have been a significant improvement in mood, sleep, eating and vomiting, with many residual symptoms remaining but seeming to improve as the days go on. The symptoms that have continued in waves but seem to be lessening are: tremor, tension, anxiety, pumping heart, diarrhoea, mild pain in upper arm, numbness in face, tense jaw muscles, head feeling spacey, confusion, mild slurred speech, feeling blank and zombified. These were worst on the first day since reinstatement (Sunday) and improved a little yesterday and today. Most importantly, I haven't had a wave of suicidal akathisia since Friday or needed to take the antihistamine or the beta blocker since reinstatement.

 

Something that is very surprising to me is that my mood has improved to a level that is far more comfortable than that I experienced on 200mg. I have been on 200mg Sertraline for 5 years and during that time I've had a daily battle with fatigue, lethargy, depression as well as many other life ruining side effects. As I mentioned, I didn't change/lower the dose because I was just so terrified of what would happen.

 

I am hopeful that over the following weeks I will continue to improve but I have a very deep mistrust of these drugs and will always fear their ability to switch on me. So the plan is to continue to monitor the situation and do my best look after my CNS with low stress, healthy eating, epsom salt baths, sleep as well as not introducing anything new.

 

I'll check in again with updates soon. 

Thank you so much for all of your help. This forum has saved my life.