WarriorPrincess: Sertraline withdrawal severe anxiety

May 25, 2021

I’m currently tapering off Sertraline. I went from 100mg in September to 62.5mg in January. In hindsight this was too fast, but I can’t do much about that now. I felt fine until late February when I started to get some anxiety. I didn’t drop anymore after I started feeling the anxiety, so I’m stuck at 62.5mg. Since then the anxiety has gradually got worse with the waves getting longer and the windows shorter. I’m also now reacting to other medication and anything I take to help with the anxiety makes me feel worse. I can barely function at the moment and I am spending a lot of time in bed, the anxiety is so intense. I have been in touch with my doctors and they have been helpful, on the whole, although I spoke to one today who was very patronising and not helpful at all. My iron levels have been low for a long time so they are testing everything they can to see if there’s anything else going on. I just wanted to reach out for some encouragement that things will eventually get easier. I’m struggling to get through each day at the moment with severe anxiety almost constant. I’m also struggling to know what supplements to take since I seem to react to everything. I was wondering if anyone had tried supplement sprays and whether I would be less likely to react.

May 25, 2021

Hello, and welcome to SA. We are a peer owned and run forum of people who have been or are getting off of psychiatric drugs. I'm very sorry to hear that you are having this severe anxiety. Are you having any other symptoms?

3 hours ago, WarriorPrincess said:

I’m also now reacting to other medication

What is the name and dosage of this medication? Are you still on it?

Can you please make your drug history in your signature in a list format with only the dates, drugs and dosages? No info about symptoms, no descriptions, etc. Please be as specific as you can, especially over the past 18-24 months. Thank you. Here is an example:

Sertraline: 2020: early Sep 100 mg, early Oct 90 mg, mid Nov 80 mg, mid Dec 70 mg. 2021: Jan 19 62.5 mg

How to List Drug History in Signature

Here is some information about how these drugs actually work.

How Psychiatric Drugs Remodel Your Brain

This helps you understand what withdrawal syndrome is:

Video on Recovery from Psych Drugs

What is Withdrawal Syndrome?

Also, as we are recovering, we suggest keeping things slow, simple, and stable. This is extremely important.

Considerations About Stability Stop Jumping Around

Keep it Simple, Slow, and Stable

When we recover, there are times of feeling OK mixed in with times of feeling bad. This is called windows and waves.

Windows and Waves Pattern of Stabilization

Here are some techniques to cope with symptoms. These next 4 links are especially helpful with anxiety:

Audio: First Aid for Panic (4 minutes)

CBT Course: An Introductory Self-Help Course in Cognitive Behaviour Therapy

Audio: How to Recover from Anxiety - Dr Claire Weekes

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help ...

Non Drug Ways to Cope with Withdrawal Symptoms

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you.

Magnesium

Omega 3 Fish Oil

I've given you quite a bit of information here. Please read through it, and mull it over, and we will take it from there. In the meantime, take care of yourself, and take heart. We in this forum have been through this, and we understand first hand the pain and discomfort you are going through. Please know that the brain is amazing in it's healing abilities. It takes time, but healing can and will happen.

Edited May 25, 2021 by getofflex

May 25, 2021

Hi, thank you for your reply. I’ll try and answer as best I can, but forgive me if my answers are incomplete as my concentration is not so great at the moment. My main symptom is anxiety, agitation and restlessness, but I also have no appetite, probably caused by the anxiety and some stomach discomfort and constipation. I don’t really have any other symptoms. The other medication I’m reacting to is Quetiapine 50mg, which I usually take to help me sleep. It does make me feel tired but it gives me a terrible sense of doom and a kind of ache and heaviness in my chest at the same time.

I’ll change my signature. I did read the instructions, but it was hard to take it all in. Sorry about that. Once again thanks for your reply, I really appreciate it.

May 26, 2021

I’m thinking of increasing my Sertraline dose very slightly to see if that helps. Would another 6mg be ok do you think?

May 26, 2021

How are you feeling now? I got on here and searched for "anxiety" because I'm experiencing a ridiculous amount of it, too and your thread came up. I'm sorry you're having such a rough time.

Do you meditate? Have you tried EFT/tapping? Or have any other anxiety-reducing practices? These things may not cure it but they sure do help, at least in the moment. I'm working on "not trusting my thoughts" when the spiraling worrying gets really intense and tells me I'm not safe. It's really hard when it is constant and you're accustomed to it. I had a friend who CT'd off Xanax and had a paradoxical reaction and couldn't take any calming supplements because they would actually make him feel worse, and he was excruciatingly anxious and borderline obsessive-compulsive and thought he would never feel normal again...that was last year, and now he's doing great. So it may take some time but you will heal. Your body will recover.

May 26, 2021

On 5/25/2021 at 3:30 PM, WarriorPrincess said:

The other medication I’m reacting to is Quetiapine 50mg, which I usually take to help me sleep.

If you are taking this on again off again (not every day) this could be causing a problem. The proper way to prescribe this is it should be taken every day, but some doctors prescribe this on an as needed basis. (Doctors make lots of mistakes.) This could very well be causing significant problems for you. It is important not to skip doses of this drug, and to take the same dose each day at the same time. The same is true for the Sertraline.

Let me know about your quetiapine before we decide to updose on the sertraline. Please don't make any changes to sertraline just yet. Hang in there. I know this is very tough, but eventually, your nervous system will sort itself out, and you will feel better.

May 26, 2021

On 5/25/2021 at 3:30 PM, WarriorPrincess said:

The other medication I’m reacting to is Quetiapine 50mg, which I usually take to help me sleep. It does make me feel tired but it gives me a terrible sense of doom and a kind of ache and heaviness in my chest at the same time.

There is a moderate drug interaction between the quetiapine and the sertraline. Here is the information from drugs.com:

Interactions between your drugs

Moderate

sertraline QUEtiapine

Applies to: sertraline, Seroquel (quetiapine)

Using QUEtiapine together with sertraline can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone. Avoid driving or operating hazardous machinery until you know how the medications affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs.

Let me confer with the other staff here, and one of us will get back to you soon.

May 27, 2021

19 hours ago, KittenLePurr said:

How are you feeling now? I got on here and searched for "anxiety" because I'm experiencing a ridiculous amount of it, too and your thread came up. I'm sorry you're having such a rough time.

Do you meditate? Have you tried EFT/tapping? Or have any other anxiety-reducing practices? These things may not cure it but they sure do help, at least in the moment. I'm working on "not trusting my thoughts" when the spiraling worrying gets really intense and tells me I'm not safe. It's really hard when it is constant and you're accustomed to it. I had a friend who CT'd off Xanax and had a paradoxical reaction and couldn't take any calming supplements because they would actually make him feel worse, and he was excruciatingly anxious and borderline obsessive-compulsive and thought he would never feel normal again...that was last year, and now he's doing great. So it may take some time but you will heal. Your body will recover.

Hi, I’m a little better today thank you. That’s really encouraging to hear about your friend. I’m clinging on to every positive story I hear at the moment and trying to ignore the terrible ones! At the moment I’m doing daily breathing exercises, trying to rest as much as I can, listening to relaxing music/stories, taking baths and drinking hot drinks. Basically anything I can to calm my nerves! It seems to be helping a bit. Sorry to hear your suffering too. How are you feeling today?

May 27, 2021

18 hours ago, getofflex said:

If you are taking this on again off again (not every day) this could be causing a problem. The proper way to prescribe this is it should be taken every day, but some doctors prescribe this on an as needed basis. (Doctors make lots of mistakes.) This could very well be causing significant problems for you. It is important not to skip doses of this drug, and to take the same dose each day at the same time. The same is true for the Sertraline.

Let me know about your quetiapine before we decide to updose on the sertraline. Please don't make any changes to sertraline just yet. Hang in there. I know this is very tough, but eventually, your nervous system will sort itself out, and you will feel better.

My doctor did tell me not to vary the dose. He’s suggested weaning off it but I’m unsure because that would be another withdrawal for my body to cope with, although it’s a low dose. It’s strange because it doesn’t always affect me in the same way. If I’m not feeling too bad anxiety wise I seem to be able to cope with it, but if I’m really anxious it makes me feel worse. The doctor seemed to think this was in my head, but I don’t think it is because the feeling I get is very physical.

I probably haven’t been taking it very consistently because I was scared of the reaction, but I’m also scared of withdrawing from it so I’ve been taking it when I can tolerate it. I will try and be more consistent with it for a bit and see if that helps. Would it be better to take it at a different time than the Sertraline to see if that affects my reaction?

Thanks for your reply

May 27, 2021

1 hour ago, WarriorPrincess said:

I probably haven’t been taking it very consistently because I was scared of the reaction, but I’m also scared of withdrawing from it so I’ve been taking it when I can tolerate it.

This could be causing a lot of your problems. Even though you are not skipping doses to taper, taking psych meds inconsistently can cause major problems. If I were you, I would take this (quetiapine) very consistently, every single day, same dose. What do you mean by "when I can tolerate it"? Please read

Never Skip Doses

Also, did you read the section I posted about the rare but potentially serious heart issues these two drugs combined could cause? I'm concerned that you are having aching and heaviness in your chest. I would have this checked out by the doctor ASAP.

May 27, 2021

Hello, @WarriorPrincess

How often do you take quetiapine? In what ways do you find it difficult to tolerate?

50mg is not an especially small dose.

What times o'clock do you take your drugs? What times of day are your symptoms worse or better? How do you feel before and after taking each drug?

May 29, 2021

On 5/27/2021 at 6:27 PM, getofflex said:

This could be causing a lot of your problems. Even though you are not skipping doses to taper, taking psych meds inconsistently can cause major problems. If I were you, I would take this (quetiapine) very consistently, every single day, same dose. What do you mean by "when I can tolerate it"? Please read

Never Skip Doses

Also, did you read the section I posted about the rare but potentially serious heart issues these two drugs combined could cause? I'm concerned that you are having aching and heaviness in your chest. I would have this checked out by the doctor ASAP.

Hi, thanks for your reply. I will take them more consistently from now on. I’ve tapered down to 62.5 mg for now to see how I go. I’ve been feeling a bit better the last couple of days and the Quetiapine doesn’t seem to have caused me any problems. Im on holiday for a few days, so I’ll see how I go and see/call my doctor when I get home. Thank you for the advice.

May 29, 2021

On 5/27/2021 at 8:41 PM, Altostrata said:

Hello, @WarriorPrincess

How often do you take quetiapine? In what ways do you find it difficult to tolerate?

50mg is not an especially small dose.

What times o'clock do you take your drugs? What times of day are your symptoms worse or better? How do you feel before and after taking each drug?

Thanks for your reply. I take it once a day, usually in the evening. Sometimes it causes me more anxiety and a kind of ache and heaviness in my chest, that’s what I mean when I say I don’t tolerate it. This is very recent reaction in the last few weeks. Considering some people take up to 600mg a day or Quetiapine I thought 50mg would be a small dose? My symptoms are usually worse in the morning and sometimes after eating. I hope that answers your questions.

May 29, 2021

Hi Warrior

I dealt with terrible anxiety during and after WD. I have a combination of OCD and anxiety, but I've learned to manage it with CBT, meditation, and simple exercise. I can reassure you that it won't last forever and you can recover. Things really do get better!

May 30, 2021

13 hours ago, mstimc said:

Hi Warrior

I dealt with terrible anxiety during and after WD. I have a combination of OCD and anxiety, but I've learned to manage it with CBT, meditation, and simple exercise. I can reassure you that it won't last forever and you can recover. Things really do get better!

Thank you, that’s very encouraging. Can you remember how long the worst of your anxiety lasted? I also get akathisia, which makes me feel very on edge and restless. I’m also learning to manage anxiety with deep breathing, prayer and counselling.

May 30, 2021

I'd say the worst period was about a year as I was finishing my taper and right after. I. too, saw a therapist who fortunately was well-acquainted with SSRI withdrawal and really helped me get through it. One very simple but powerful image he taught me was to think of my anxiety as a 10-pound (or kilo) ball I carried around. My mind wanted to find a reason for my anxiety, so I kept moving the ball from place to place, trying to find a cause, like some disease or impending disaster. He taught me the real solution is to make the ball smaller, from 10 to 5 to 2 and so on, so I hardly notice it anymore. Sometimes when I'm feeling anxious and I meditate, I use the image of a literal series of balls: beach ball, basketball, baseball, ping-pong ball, marble; each one smaller than the one before. It really does help me get some perspective!

May 31, 2021

On 5/29/2021 at 11:20 AM, WarriorPrincess said:

Sometimes it causes me more anxiety and a kind of ache and heaviness in my chest, that’s what I mean when I say I don’t tolerate it. This is very recent reaction in the last few weeks.

This sounds like a paradoxical reaction to quetiapine, indicating it's too sedating for you. I would start to very gradually reduce it. See Tips for tapering off quetiapine (Seroquel)

June 5, 2021

I’ve been thinking about the kindling issue. I think this may be is what’s happening to me. I’ve been a bit slapdash with the use of my Quetiapine the last few months and i’m really scared it’s damaged me. I didn’t realise what I was doing as I always I thought I could use it a bit like Valium, as in when I needed it, although I did always try to keep my dose as consistent as I could. Any tips on how to get through this. I’ve been so dependent on Quetiapine to sleep and generally function and it looks like I’m going to have to at least cut it down now.

June 6, 2021

Just an update, please don’t read if you are in a sensitive place it may be triggering...

Today I woke up after a really tough day yesterday with anxiety through the roof. I put on a brave face, got up, got dressed, even went out for a walk. When I got back from the walk I wanted to go grocery shopping but thought I would do some breathing exercises first. I was feeling very low and quite hopeless about my situation, but while I was doing the breathing this got to an overwhelming point and I was so scared I was going to do something to escape this torturous reality I find myself in. I want to live but I doubt my ability to live through these intense feelings when living even one minute in my body feels like torture. I’ve had trauma before involving psyche meds and emotionally and mentally I am in that place of trauma again. I don’t know how to escape from this place.

I didn’t feel able to talk to my husband about how I was feeling and for his sake and the sake of my 3 kids I knew I had to keep myself safe. My first thought was to go to hospital, but then I decided to call my friend first as I didn’t want to go alone.

Nearly 4 years ago this happened and I ended up on more meds which I’ve since reduced, but I feel I’m back at that place again. I hate the meds but I can’t live without them because the withdrawal just breaks me. If someone could say to me you’ll feel like this for x amount of time and then you’ll feel better then it would be easier. My mind tells me this will never end and the feelings of terror and anxiety make it feel like this is true. I’m ready to throw my hands up in defeat because I truly can’t keep doing this.

I spent most of the day in the hospital with my friend and the crisis team are calling me soon with the intention of seeing me tomorrow. I can hang on until then, just about, but then what? I’m trying not to think about that. I believe in God and thought I had a strong faith. I know God wants to help me but somehow we just cannot reach each other.

I’m probably going to cave and accept more meds because I really don’t know what to do at this point. Even that terrifies me because whatever I do at this point seems to make things worse.

June 6, 2021

Hello Warrior Princess,

I am so sorry you have to go through this.

But it s true: Youre going to get better. Its just a matter of patience and time. Believe that.

Its ok to give up sometimes. I m sending you positive Vibes and a big warm hug.

June 6, 2021

@WarriorPrincessI'm really sorry you are in this extremely difficult place right now. I just want to share my own experiences, I don't know it it will help.

Yesterday, I had one of those really terrible days. I was filled with anger and rage, I felt very depressed and in despair, and I was extremely tired from poor sleep the night before. (I had been overactive the previous day, so I was overstimulated hence sleep trouble). My poor husband, all I did was b**** and complain. However, I managed to get a decent nights sleep, and now I feel better today. No anger or rage, and I'm not exhausted and miserable.

Did you see altostratas advice above, saying that you might be having a paradoxical reaction to the quetiapine? That means that the medicine does the opposite of what is is supposed to do. Alto suggested that you slowly taper off the quetiapine. Have you been doing that?

3 hours ago, WarriorPrincess said:

My mind tells me this will never end and the feelings of terror and anxiety make it feel like this is true.

Perhaps this is your monkey mind speaking to you. The monkey mind is the part of us where the negative thoughts come from. It is the part of us that tells us we will never get it right, we can't do this, we always have the bad luck, etc, etc. Our monkey minds tend to blow things out of proportion, and make us think we can't take it. This article tells a bit about the monkey mind:

https://www.psychologytoday.com/us/blog/the-empowerment-diary/201709/calming-the-monkey-mind

Here are some simple things that can help you to ease the fear and terror.

Audio: First Aid for Panic (4 minutes)

CBT Course: An Introductory Self-Help Course in Cognitive Behaviour Therapy

Audio: How to Recover from Anxiety - Dr Claire Weekes

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help ...

I've been in some really painful and unbearable (or so I thought) situations. Or at least, I thought they were unbearable. Someone said to me, can you stand feeling like this for one minute? I said yes, I can stand it for one minute. Then, the next minute, can I stand it for that next minute? Yes, I can. And so on. Just try to take it one minute at a time. Try to distract yourself with a simple, mindless easy physical task. Try to get your mind off your symptoms, and the withdrawal. Also, remember that recovery occurs in windows and waves, and you could be at the very low point of a bad wave. This will not go on forever!

3 hours ago, WarriorPrincess said:

I’m probably going to cave and accept more meds because I really don’t know what to do at this point. Even that terrifies me because whatever I do at this point seems to make things worse.

You don't necessarily have to do that. Because yes, more meds might just make things worse. You have the option of toughing it out. I know, it really sucks to have to go through this. I remember in my early days, when I would lay awake most of the night feeling like I would jump out of my skin at any moment, asking God to just get me through it. And, He did. And now, I feel much better than I did in those early days.

Here is a thread on meditation, that can soothe and calm an anxious nervous system.

Easing Your Way Into Meditation

Try reading some of the success stories. We have members here who have been through some awful stuff, but they hung in there and didn't give up, and they made it, and they now are doing much better. Try reading some of those.

Success Stories

Please don't give up! Hang in there, and I hope you try some of the ideas here. I'm praying for you. Reading the Bible helps me a lot. I don't know if you are open to that.

June 7, 2021

Thank you both for your replies. I’ve been through some trauma when my daughter was born regarding medication withdrawal. It was an horrific situation and I’ve realised I’ve not properly dealt with that, so when I feel so bad it brings back that trauma and it feels like I’m reliving it. Today I’ve felt slightly better, a bit less anxious, at least not all day. I had the mental health team round today and tomorrow I’ve got an appointment with a psychiatrist to discuss my medication. I’m hoping they’ll give me an alternative to the Quetiapine and keep the Sertraline the same. I have started to reduce the Quetiapine now, although only the last few days. I think I was in denial as it used to help me a lot and it was part of my coping strategy for withdrawal. It was like having the stabilisers taken off, the thought of not having it. I hate that I am so dependent on medication.

June 7, 2021

18 hours ago, getofflex said:

Please don't give up! Hang in there, and I hope you try some of the ideas here. I'm praying for you. Reading the Bible helps me a lot. I don't know if you are open to that.

Thank you for all the information, but especially for the prayers! I love the bible, it’s my life, but at the moment it’s very hard to concentrate. I do still try though. I like listening to Scripture Lullabies and Healing scripture on YouTube too. They do help normally but yesterday nothing was helping!

June 7, 2021

34 minutes ago, WarriorPrincess said:

I love the bible, it’s my life, but at the moment it’s very hard to concentrate. I do still try though.

Hi Warrior

I enjoy reading the Bible as well. At times like this, I try to remember St. Paul's words in @ Corinthians: "My grace is enough for you." Its tough to accept, especially when you're in the depths of a wave, but I still believe there is a purpose to all of this. Looking back, it made me more empathetic to others' suffering, among other things. You will recover!

June 7, 2021

Just wanted to stop by and say sorry you are having such a difficult time.

I would like to provide a story of my taper that hopefully may be beneficial.

There may be some triggering content:

I was doing a very cautious taper trying to do everything right. I accidentally updosed for a few weeks. To this day I still dont know exactly how much I updosed, but it probably was a very small amount. I didnt know my body would have the kindling effect.

It sent me into a 2 year wave with no windows. The entire time I experienced severe derealization where I felt like my whole existence was a dream. Also pretty constant feelings of dying. Anxiety was off the charts, stomach was no longer processing nutrients properly.

If was absolutely terrible. I am a person who is optimistic and looks forward to life. During this time life became too painful to enjoy.

But...after about 2 years it all started to fade away and things started to finally feel like real life again. Now 2.5 years post starting to come out of that i continually make improvements to where i feel mostly back to normal.

There is no time frame for healing and as you know it can be painful. A lot of the people on this site are in the midst of their worst moments, but hopefulling you can look around and see stories like mine that you will make it through.

June 8, 2021

18 hours ago, Rusty1 said:

Just wanted to stop by and say sorry you are having such a difficult time.

I would like to provide a story of my taper that hopefully may be beneficial.

There may be some triggering content:

I was doing a very cautious taper trying to do everything right. I accidentally updosed for a few weeks. To this day I still dont know exactly how much I updosed, but it probably was a very small amount. I didnt know my body would have the kindling effect.

It sent me into a 2 year wave with no windows. The entire time I experienced severe derealization where I felt like my whole existence was a dream. Also pretty constant feelings of dying. Anxiety was off the charts, stomach was no longer processing nutrients properly.

If was absolutely terrible. I am a person who is optimistic and looks forward to life. During this time life became too painful to enjoy.

But...after about 2 years it all started to fade away and things started to finally feel like real life again. Now 2.5 years post starting to come out of that i continually make improvements to where i feel mostly back to normal.

There is no time frame for healing and as you know it can be painful. A lot of the people on this site are in the midst of their worst moments, but hopefulling you can look around and see stories like mine that you will make it through.

Thank you Rusty1. The thought of going through this for 2 years is terrifying, I’m amazed you’re still here. It is an encouraging story though. It doesn’t matter how low you go you can always come back up again!

June 8, 2021

I hope you don’t all mind me keeping this as a diary. I’m not always expecting responses but it helps me to log my progress or lack thereof! I had an appointment with the psychiatrist today. These people seem to have been produced in a factory, may be they’re robots. Any highly intelligent medical worker does not seem to have any bedside manner in my experience! She kept suggesting things like coming of the Sertraline or just stopping the Quetiapine. I don’t know how many times I had to tell her my body is super sensitive right now. Oh and of course the usual, may be need to be on medication. There was no acknowledgement at all that what I was experiencing was withdrawal, although she didn’t catagorically deny it. She offered me Mirtazapine to replace the Quetiapine which I’m having a bad reaction to. I haven’t decided what I’m going to do yet, but whatever I do it will be baby steps. I am pleased that this is what she offered me though because I’ve tried it before and it’s made me hungry, which I really need at the moment and it helped me sleep. I need to do something as last night, after a much better day, when I took my meds I was up all night with waves of anxiety, which have lasted into today. Yesterday evening I before i took the meds I managed to do a bit of gardening, some ironing, help cook tea and spent the rest of the evening doing a jigsaw and watching tv! Then bam, in torture again! I know more meds is rarely the answer but I do need something to replace the Quetiapine, at least until I stabilise. I’ll keep you posted on how it goes!

June 8, 2021

On 6/8/2021 at 8:55 AM, WarriorPrincess said:

I hope you don’t all mind me keeping this as a diary.

No problem - that is one of the purposes of your thread. These serve as case studies for researchers, so your diary could prove very valuable to someone.

On 6/8/2021 at 8:55 AM, WarriorPrincess said:

These people seem to have been produced in a factory, may be they’re robots.

LOL!! I love your sense of humor. 😆 I couldn't agree more! I'm sure you know this by now, but just in case, please don't "just stop" any psych med. I disagree with these doctors - I think few of us "need" to be on these meds.

Please don't be too worried about being in a 2 year wave - this is pretty unlikely.

On 6/7/2021 at 10:47 AM, WarriorPrincess said:

I love the bible, it’s my life, but at the moment it’s very hard to concentrate.

I get that, I have the same problem. Usually, I forget what I read in 5 minutes, but it still calms me down, and is very reassuring.

On 6/8/2021 at 8:55 AM, WarriorPrincess said:

I need to do something as last night, after a much better day, when I took my meds I was up all night with waves of anxiety, which have lasted into today.

It sounds like getting off the quetiapine could help you for sure.

On 6/8/2021 at 8:55 AM, WarriorPrincess said:

Yesterday evening I before i took the meds I managed to do a bit of gardening, some ironing, help cook tea and spent the rest of the evening doing a jigsaw and watching tv!

I'm glad to hear this! I sounds like you are doing better now that when you first posted, as you reported being bedridden them.

Edited June 10, 2021 by getofflex
edited to remove going along with her docs suggestion to go to mirtazapine

June 8, 2021

9 hours ago, WarriorPrincess said:

Thank you Rusty1. The thought of going through this for 2 years is terrifying, I’m amazed you’re still here. It is an encouraging story though. It doesn’t matter how low you go you can always come back up again!

Thank you. You are absolutely right in that we can and will get better. Our journey is unpredictable with these medications, but their impact on us will slowly fade away!

June 9, 2021

22 hours ago, WarriorPrincess said:

She offered me Mirtazapine to replace the Quetiapine which I’m having a bad reaction to.

Please do not add in or crossover to mirtazapine. Please read Alto's post here:

On 5/30/2021 at 8:57 PM, Altostrata said:

This sounds like a paradoxical reaction to quetiapine, indicating it's too sedating for you. I would start to very gradually reduce it. See Tips for tapering off quetiapine (Seroquel)

You likely are dealing with a pardoxical reaction. The best way to handle a paradoxical reaction is to reduce the dose.

Some more information about quetiapine may be helpful for context. You posted this earlier:

On 5/29/2021 at 2:20 PM, WarriorPrincess said:

Considering some people take up to 600mg a day or Quetiapine I thought 50mg would be a small dose?

Quetiapine is an odd drug - at higher doses (above 125 mg or so), this drug affects dopamine. At lower doses, it affects histamine. So at 50 mg, you are solely being affected by the histamine effect. This is why the lower doses are sedating and are prescribed for anxiety and insomnia.

Mirtazapine also affects histamine. For more, please read the first post of this thread - Tips for tapering off mirtazapine (Remeron)

Getofflex already posted the drug interaction report for sertraline and quetiapine as having a "moderate" drug interaction. But sertraline and mirtazapine have a "major" drug interaction (see Drug interaction report - quetiapine and sertraline).

So another reason not to cross over to this drug.

On 5/27/2021 at 11:44 AM, WarriorPrincess said:

I probably haven’t been taking it very consistently because I was scared of the reaction, but I’m also scared of withdrawing from it so I’ve been taking it when I can tolerate it. I will try and be more consistent with it for a bit and see if that helps.

Since you weren't taking the quetiapine consistently, you may have had less in your blood stream when you started to take it every night (so taking it every night at 50 mg may have been too much of the drug). The paradoxical reaction may resolve by reducing it a bit. You could start by making a 10% reduction in the quetiapine and see how you do.

But please do not cross over to mirtazapine. That will send you into quetiapine withdrawal and complicate your taper by adding in another histamine drug when you're already dealing with a paradoxical reaction from the one you're on.

On 5/27/2021 at 11:44 AM, WarriorPrincess said:

Would it be better to take it at a different time than the Sertraline to see if that affects my reaction?

What time(s) of the day are you taking your drugs? Are you taking sertraline at night or in the morning?

June 9, 2021

1 hour ago, Shep said:

You likely are dealing with a pardoxical reaction. The best way to handle a paradoxical reaction is to reduce the dose.

Some more information about quetiapine may be helpful for context. You posted this earli

"

1 hour ago, Shep said:

Please do not add in or crossover to mirtazapine. Please read Alto's post here:

Thank you for the reply. Do you mean not to add in mirtazapine at all and if so why? I am reducing the Quetiapine but I need something to help with the general anxiety and agitation I am feeling from withdrawing from the Sertraline as well as the immense anxiety from the Quetiapine I’m now experiencing. I am not coping at all with it. I am scared that I might react to the Mirtazapine as well but I don’t know what else to do. Do you think that’s likely, it’s that why you said not to take it? I was going to start really low at 3.75mg and work my way up. I know it’s not ideal to add something else in but I am really not coping and I’m on the edge right now.

1 hour ago, Shep said:

Getofflex already posted the drug interaction report for sertraline and quetiapine as having a "moderate" drug interaction. But sertraline and mirtazapine have a "major" drug interaction (see Drug interaction report - quetiapine and sertraline).

So another reason not to cross over to this drug.

I’m only on 62.5mg of Sertraline so I was hoping this wouldn’t be an issue particularly if I stay on a low dose of Mirtazapine. The Psychiatrist said it was ok?

2 hours ago, Shep said:

What time(s) of the day are you taking your drugs? Are you taking sertraline at night or in the morning?

"I take both Sertraline and Quetiapine in the evening.

Not sure whether I can ask this or if you can answer but do you have any suggestions of anything else I can take for the anxiety as I am really not coping with it? I’m trying everything I can that’s natural and non medical but I still can’t sleep or eat much or really function very well and I start to get suicidal when I get really bad.

Thank you you for your help.

June 10, 2021

11 hours ago, WarriorPrincess said:

the general anxiety and agitation I am feeling from withdrawing from the Sertraline as well as the immense anxiety from the Quetiapine I’m now experiencing.

My guess is a lot of this is caused by the paradoxical reaction to TOO MUCH quetiapine. Excessive sedations causes anxiety, that's why it's called paradoxical.

Some of the symptoms you attribute to withdrawal are adverse effects of the drugs you're taking. We see this all the time.

If you feel better as you reduce quetiapine, which you find too sedating anyway, you know where this anxiety is coming from.

June 10, 2021

23 hours ago, WarriorPrincess said:

Do you mean not to add in mirtazapine at all and if so why?

Exactly. Do not add in mirtazapine at all. Please re-read my previous post as to why, paying close attention to the word "histamine," as well as the link to the drug interaction report.

We don't advise adding in other drugs to fix withdrawal symptoms of the drug you're currently taking. Mirtazapine also causes withdrawal symptoms. Will you add in another drug to deal with that?

These are reasons we don't advise adding in other drugs. You'll stay on the drugging merry-go-round indefinitely that way.

23 hours ago, WarriorPrincess said:

I’m only on 62.5mg of Sertraline so I was hoping this wouldn’t be an issue particularly if I stay on a low dose of Mirtazapine. The Psychiatrist said it was ok?

While it is better to be on lower doses of these drugs, since your nervous system is already destabilized, you may suffer more intense drug interactions, even at lower doses. The best way to mitigate this is to separate the two drugs by two or more hours apart.

23 hours ago, WarriorPrincess said:

I take both Sertraline and Quetiapine in the evening.

Many people find sertraline to be an "activating" drug, meaning it can cause insomnia. If this is true for you, you should move the sertraline to the morning. Do this by moving it one hour a day. For instance, if you take it at 8 PM, take it at 7 PM tonight, 6 PM tomorrow, 5 PM the next day, etc. until you're taking it in the morning. By doing this gradually, it's less disruptive to your nervous system.

Then you'll want to reduce the quetiapine by 10% to reduce the paradoxical reaction.

23 hours ago, WarriorPrincess said:

Not sure whether I can ask this or if you can answer but do you have any suggestions of anything else I can take for the anxiety as I am really not coping with it? I’m trying everything I can that’s natural and non medical but I still can’t sleep or eat much or really function very well and I start to get suicidal when I get really bad.

What "natural and non medical" things are you taking? Please list any supplements or herbs in case that may also be contributing to the paradoxical reaction you're having - the more you dampen down the nervous system (even with things that are "natural," the more your nervous system fights to stay alert. That is the paradoxical reaction).

I think if you can separate your two drugs, getting the sertraline to earlier in the day and then reducing the quetiapine, you'll feel a lot better without resorting to adding in anything else. @getofflexadded some links to some very good non-drug coping skills. Please check those out. They really can help.

Let us know how you're doing as you make the timing change for the sertraline and then reduce the quetiapine.

June 13, 2021

It’s been an extremely tough week and I’ve been trying to balance out the advice I’ve been getting on here with the advice I’m getting out here in the world, all the time trying to hear God’s voice in it all. I’m fortunate that I have supportive parents and husband who are not pressuring me. Earlier in the week I was ready to try the Mirtazapine because I was desperate for relief, and I did for a few days. I tried a quarter dose of the 15mg the doctor recommended and it did help me sleep. After a few days I think it was making me more agitated so I decided to hold off at least until I’ve realised reduced the Quetiapine otherwise I won’t know what’s causing what. I have reduced my dose of Quetiapine a bit and I actually managed to sleep a bit last night without any help.

This might sound a bit weird but yesterday I started speaking to my body to tell it to calm down. As a Christian I believe our words have power and that’s I have God’s power on the inside of me. I have been trying to access this power but my soul keep saying getting in the way as I’ve been even through through so trauma with this withdrawal. Anyway it did work somewhat yesterday and I believe this also helped me to sleep.

Yesterday the anxiety was more manageable so it was easier to think clearly and so i had an ok day. Part of this was also due to fasting I believe. I fasted all day Friday and all morning yesterday. I feel like every time I put something in my mouth I react to it, so sometimes it’s easier not to eat. I can’t keep doing this though as I’m loosing so much weight.

I feel like I’m in a nose dive at the moment, spinning out of control. I don’t know if it’s the same in an aeroplane as in a car but I know in a car you have to steer into the spin not try to steer away, so may be it’s the same in this situation: the more I try to do things to stop the spinning (anxiety) the worse it gets and the more out of control it gets, whereas if I just roll with it I will eventually stop. It’s hard in the moment and in the spinning to think logically and believe that I will eventually stop spinning and be ok.

Anyway I’m still here and still fighting. Hoping I’ll stop spinning soon.

June 13, 2021

11 minutes ago, WarriorPrincess said:

I feel like I’m in a nose dive at the moment, spinning out of control. I don’t know if it’s the same in an aeroplane as in a car but I know in a car you have to steer into the spin not try to steer away, so may be it’s the same in this situation: the more I try to do things to stop the spinning (anxiety) the worse it gets and the more out of control it gets, whereas if I just roll with it I will eventually stop.

Hi Warrior

yes--this a very important and valuable lesson. Anxiety is selfish and wants all your attention and energy. The more you try to fight it, the stronger it gets. Accepting that the thoughts and feelings may come, but they have no meaning except for what we attach to them. There are a lot of terms for this: being present in the moment; being an observer of your thoughts rather than a participant, acceptance therapy, etc. But they all involve recognizing that, for now, we can't stop the thoughts but we don't have to give them power over us. Its such a simple concept bit so hard to practice when you're in the middle of a wave. But you can do it!

June 13, 2021

I watched Spider-Man: Far from home last night with my family. I was pleased I managed to watch it all as watching anything as long as a film is difficult right now. It spoke to me about my situation. Spiderman becomes friends with another so called superhero called Mysterio. Spider-Man has just been given Tony Stark’s EDITH glasses with which he has control over a satellite in space containing thousands of drones. Spider-Man decides to give the glasses to Mysterio because he doesn’t feel like he’s up to the job and thinks that Mysterio would be a better person for it. Mysterio turns out to be a bad guy and ends up causing a lot of problems. He can also create illusions with some technology he has which makes everyone think he’s a hero. It spoke to me because when I was very young I put my trust in medication to help me out of a difficult situation. Since then I’ve put my life in it’s hands and that’s not turned out to be a very wise decision. My eyes have now been opened to the reality of this medication but I’ve now got a big fight on my hands to wrestle back the control from the tablets, which is obviously what Spider-Man has to do in the film with the glasses.

Also the fear and anxiety created by the withdrawal from the tablets is a bit like the illusions created in the film by Mysterio. The monsters he creates are big and scary looking, but if you dive right into them you just see lots of drones creating the illusion. The anxiety and fear I feel, are not really real.

WarriorPrincess: Sertraline withdrawal severe anxiety

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