holli: messed up Zoloft tapering?

[holli]

hi, i'm thankful to have found this site but i really wish i would've found it at the start of my medication journey. i'll give some background on everything before i describe my situation now.

 

so i started zoloft/sertraline in october 2019 when i was 19 years old, i was put on 25mg to start because i was essentially having one long panic attack that lasted several weeks and as a result i became agoraphobic because of how terrified i was of what was happening to me.

 

i had a house visit from my doctor who prescribed me zoloft (i'd actually been prescribed diazepam too a couple days prior, i refused to take it and thank god i did because i dread to think how that could've turned out). it's funny looking back, my doctor told me word for word "this is the ssri that causes the least side effects, you will probably feel nauseous for 2 weeks and thats it". boy, she was so wrong. i started 25mg (took me a while because i was terrified of medication) and the next month involved awful nausea, debilitating dizziness and worse anxiety. i also had these strange instances of complete dread, i had moments where i couldn't even look out of my window because of the intense fear i was feeling. my memory of this time is foggy but i believe by december i was already on 50mg.

 

i then spoke to my doctor again in january and expressed my worry that i was still nauseous and i was still having awful panic attacks, her response was to stick it out and to also bump up to 100mg. i really dont remember much from when i was on 100mg, i just know i didint feel real and i came back down to 100mg a month later. from feburary 2020 to september 2020 i managed to stay on 50mg of zoloft, however throughout this time i was still experiencing nausea, occasional bouts of dizziness and really intense panic attacks. i was also insanely sensitive to everything, sometimes even a notification on my phone would send me into a panic attack spiral that would take 2 hours to come down from. needless to say, none of this helped my agoraphobia and arguably made it worse. i really dont know why i stayed on zoloft despite all this, my doctor just kept telling me to stay with it so i believed that it would get better. 

 

in september 2020 i rang my doctor again because i couldnt take the panic attacks anymore, her idea was to raise me to 75mg. the next 8 weeks on this dose was awful, i experienced awful dissociation everyday, i would look at my own hands and be terrified because i didn't believe they were mine. so novemeber 2020 i came back down to 50mg again and i stayed on this dose again until februrary 2021. in february, my panic attacks got worse out of nowhere, i was once again have long attack and sometimes multiple a day and i couldn't take it anymore. i rang my doctor and she swaped me to citalopram and i was to do a cross taper. in retrospect, i really think this was done wrong? my cross tapering schedule was this:

 

- day 1: 35mg zoloft

- day 2: 35mg zoloft

- day 3: 25mg zoloft

- day 4: 25mg zoloft

- day 5: 25mg zoloft and 5mg citalopram

- day 6: 25mg zoloft and 10mg citalopram

- day 7: 15mg zoloft and 10mg citalopram

- day 8: 10mg citalopram

 

this seems so fast and to make it worse, even after this i only stayed at 10mg citalopram for 5 days before i went to 20mg citalopram. this was all under my doctors orders. needless to say i didnt stay on citalopram long, it made me feel so ill that i was essentially stuck in bed the whole time and i also had a couple days where for the first time in my life, i experienced suicidal thoughts so i knew at that moment i desperately had to get off. i got back on 25mg of zoloft mid may, this time just a direct switch. i actually spoke with a different doctor to check this was okay and his recommendation was just to cold turkey the citalopram and not get back on anything to which i said a strong no. 

 

so from mid may 2021 to july 2021 i stayed at 25mg zoloft and i knew i just wanted off all medication at this point because i was fed up of messing with my system. the whole time i was on this 25mg, i guess i was going through withdrawal? i had constant brain zaps, awful nausea, fatigue and dizziness plus a lack of appetite and still really awful anxiety/panic attacks. at the time, i just thought i was not adjusting well to being back on sertraline so i just desperately wanted to get off zoloft. my doctor told me to alternate 25mg and 12.5mg for a week, take 12.5mg for a week, alternate 12.5mg and nothing for a week, then just come off. this terrified me intensely but i still tried the alternate 25mg and 12.5mg for a week but this really messed me up, i felt so ill doing this so i decided to just stick with 12.5mg. so this is where i am now, i have not made any changes since. i've been at 12.5mg for 2 months trying to stabilise and i dont even know how to move forward after this, this whole experience has just exhausted me and terrified me to do any more adjustments to doses.

 

my withdrawal has also been really bad so far, i've experienced: dizziness, vertigo, muscle weakness/intense fatigue, tremors, going hot/cold, sweating a lot, nausea, loss of appetite, unsteady when i stand and walk, out of body feelings, brain zaps, spikes in my anxiety or sometimes just whole days of anxiety, headaches... im probably forgetting some but that's all i can remember right now. i've spent the past two months just curled up on the sofa getting through the waves and trying to distract, waiting for windows which i do sometimes get but lately its mostly all waves. my withdrawal had a moment too at about 4 weeks where i thought it was better, my appetite came back for about a week, and then i crashed again and i've been in that wave since. 

 

also another note is that my doctor refused to give me liquid sertraline or 25mg tablets, so currently i'm cutting a 50mg tablet into quarters, so am i even getting a stable 12.5mg dose? probably not. 

 

anyway apologies for the long introduction post but i feel my whole messed up history of dose changes is needed because i'm not sure my body ever really adjusted to anything ever. but it would be lovely to get any advice on how to move forward, i'm still going to hold at 12.5mg because my dizziness and brain zaps are not as bad as they were a month ago so i'm scared that reinstating would bring that back, but i'm happy to stay at 12.5mg though i'm not sure when to tell when i should taper again?

 

thanks for any help!

 

Edited October 17, 2021 by ChessieCat
added some spacing

[getofflex]

Hello Holli, and welcome to SA.  We are a peer owned and run forum of people who have been or are getting off of psychiatric drugs.  It sounds like you have been through the wringer with these psychiatric drugs.  I think you are very wise for wanting to come off of them.  You will certainly be able to come off of them - it will just take lots of time and patience. 

 

Here is some information about how these drugs actually work.  This will help you understand why you are feeling all the symptoms you are.  Your doctor has really been jumping you around on drugs and increasing and decreasing the doses.  If it were me, I would seriously consider finding another doctor.  

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

 Video on Recovery from Psych Drugs

 

What is Happening in Your Brain

 

It sounds as if you had adverse reactions to the drugs from the get go.  So your system is healing from that, and also from WD because of your brain becoming dependent while on the drug. Unfortunately, this dependency happens after only about 4 weeks on these drugs. 

 

For now, my suggestion to you is just to stay on your current dose of 12.5 mg of Zoloft, which is what you are doing.  If it were me, I would stay on this for at least 6 months to a year, and really give my system a chance to adjust and stabilize.  Our nervous systems are extremely complex, and healing is very gradual, and multifaceted.  When you get to the point that you feel stable, then we can talk about how to taper the rest of the way off.  We have very gentle ways of tapering that should cause a a minimum of WD.  Please do not vary or skip doses, this often causes big problems, as you've found out.  Take precisely the same dose at the same time each day.  This link will tell you how to measure your dose precisely, which is better for stability.  

 

Measuring and Tapering Zoloft

 

As we are recovering, we suggest keeping things slow, simple, and stable. 

 

Keep it Simple, Slow, and Stable

 

Considerations About Stability - Stop Jumping Around

 

 

Here are some techniques to cope with symptoms: 

 

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

 

 

On 9/13/2021 at 7:37 AM, holli said:

my dizziness and brain zaps are not as bad as they were a month

 

This is very good news! It means your brain is slowly finding stability.  Please be very gentle with yourself.  Try to avoid stress when you can, avoid intense exercise, try a gentle 1/2 hour walk if you can in the day, (not before bed), eat healthy, get plenty of water, rest as much as you can, and avoid negative, dramatic, toxic people.  All this will help you heal.   I know you feel very bad now, but you will get better!  This is a very challenging condition but it is not permanent.  You are young and this is to your favor.  I look forward to hearing back from you. 

Edited September 16, 2021 by getofflex

[holli]

hi @getofflex thank you for your reply! i really appreciate it!

 

yeah, i had a feeling that i may have been suffering an adverse reaction and just general suffering from jumping around so much, which makes sense on why i feel so rough. it’s nice to get confirmation on it though, since my brain often convinces me that surely it can’t affect me this much… but after reading many stories of people going through similar, i realise now the power of these drugs. crazy that one decision in a moment of panic can cause this much destruction!

 

i will do exactly what you said and keep my dose at 12.5mg for as long as i can, until i truly feel i’m ready to taper again. i’m also doing good at getting rest at the moment, i’m sleeping 7+ hours every night, eating as much as i can despite nausea and no appetite and i’m keeping myself busy with work and hobbies to avoid stress. so fingers crossed i see more improvement as time heals me. 

 

oh and i’ll also definitely find a new doctor! i have so much anger towards my old one that i don’t know if i could ever talk to her again anyway! and i’ll look through these links you’ve provided. thank you so much for your reply once again!!

[getofflex]

1 hour ago, holli said:

i’m also doing good at getting rest at the moment, i’m sleeping 7+ hours every night, eating as much as i can despite nausea and no appetite and i’m keeping myself busy with work and hobbies to avoid stress. so fingers crossed i see more improvement as time heals me. 

It's wonderful that you are getting good sleep.  This will help a lot towards your healing.  It sounds as though you are taking great care of yourself Hopefully you started reading the information in the links I provided.  I know there is a lot to read and digest.  Feel free to ask if you have any questions.  

 

Time will heal you, but it will require great patience.  Healing tends to happen in fits and starts (waves and windows).  So don't be too shocked if you have a setback, but rest assured, these setbacks are only temporary.  

 

Windows and Waves Pattern of Stabilization

 

1 hour ago, holli said:

oh and i’ll also definitely find a new doctor! i have so much anger towards my old one that i don’t know if i could ever talk to her again anyway!

This is completely understandable!  You have every reason to.  Here is a link with information about doctors who are familiar with withdrawal.  Even if you don't find one familiar with withdrawal, maybe you can find one who is laid back, and is willing to go along with the protocol here.  That is how my doctor is.  

 

Recommended Doctors, Therapists, and Clinicians

 

Hang in there.  I think you are going to recover from this, and be fine someday.   

 

Edited September 17, 2021 by getofflex

[holli]

just a lil update on withdrawal… is it possible that stress can throw you into a bigger wave? i was already struggling with symptoms before, but due to recent relationship issues and friends arguing and falling out around me, i’ve been getting increasingly worse. my body vibrates most of the day now and my muscles ache so much, plus my nausea seems to come back in waves now. plus i seem to have really obsessive thoughts now that come on randomly and they’re really upsetting, but i try tell myself “it’s okay, it’s just the withdrawal, let it pass”.

i felt i was making some steps to progress and now all this stuff is happening in my personal life that i would usually be able to deal with and it’s made me feel much more ill. so i guess i’m just looking for reassurance that minor stress can do this? i know you should avoid all possible stress, but can it really do this much damage?

[Faure]

Hi holli, absolutely stress can exacerbate withdrawal, it is yet more for your central nervous system to cope with when it is already struggling with WD. I’ve read many people hold their taper at stressful times such as Christmas.  Take care☺️

[getofflex]

3 hours ago, holli said:

just a lil update on withdrawal… is it possible that stress can throw you into a bigger wave?

Yes, absolutely.  The very same thing happens to me when I get stressed.  

 

3 hours ago, holli said:

due to recent relationship issues and friends arguing and falling out around me, i’ve been getting increasingly worse.

I don't know about you, but I find situations like this majorly stressful.  Just speaking for myself, I've had to eliminate some toxic people from my life to help myself in recovery.  The stress from this was just firing up my nervous system, and that was the last thing I needed.  These people were bringing me nothing positive, just stress, drama, and negativity.  It just wasn't worth it to keep them in my life.  I don't know if this applies to you - perhaps you could find a therapist or counselor to help you deal with these issues, and figure out how to set some healthy boundaries with them.  

 

3 hours ago, holli said:

my body vibrates most of the day now and my muscles ache so much, plus my nausea seems to come back in waves now. plus i seem to have really obsessive thoughts now that come on randomly and they’re really upsetting,

This may be a combination of WD and stress, which of course compound each other.  Here is a technique to help with obsessive thoughts:  

 

APPLE Technique

 

I just came across a very nice technique that really helps me.  It's called APPLE. I have printed it and have it where I can see it every day and be reminded of it so I internalize this technique. 

 

A - Acknowledge Notice and acknowledge the thought or uncertainty as it comes to mind. 

 

P - Pause Don't react as you normally do.  Don't react at all.  Just pause and breathe.   

 

P - Pull Back Tell yourself this is just the thought or worry talking, and this apparent need for worry or analysis or certainty is not helpful and not necessary.  It is only a thought or feeling.  Don't believe everything you think.  Thoughts are not statements or facts.   

 

L - Let Go Let go of the thought or feeling.  It will pass.  You don't have to respond to it.  You might imagine the thought floating away in a bubble or cloud.   

 

E - Explore Explore the present moment, because right now, in this moment, you are OK.  Notice your breathing and the sensations of your breathing.  Notice the ground beneath you.  Look around and notice what you see, what you hear, what you can touch, what you can smell.  Right now.  Then shift your focus of attention to something else - on what you need to do, on what you were doing before you noticed the thought or worry, or do something else - mindfully - with your full attention.  

[holli]

thank you for your reply @Faure, that makes a lot of sense! i hope you’re well!

 

and @getofflex wow thank you for that apple technique! i think i’ll write that down, maybe i’ll make a little poster and decorate it with those words just to spend some time distracting and to really help me remember that. 

 

i’ve been doing some reflecting on the relationship stress (maybe not ideal to constantly think about it because i’m probably doing more damage lol) but i think i’m just going to try cut some people out or at least distance… it doesn’t help that they severely undermine my withdrawal and almost mock me for it? so yeah i think while they’re still in my life, recovery could be rocky. it’s a little sad but i’m also thinking of it as one big healing process, healing from withdrawal and the toxic people in my life!

[getofflex]

39 minutes ago, holli said:

i think i’m just going to try cut some people out or at least distance… it doesn’t help that they severely undermine my withdrawal and almost mock me for it?

They may be toxic people.  Mocking you for your withdrawal?  They sound hateful.  There are many good resources on the internet and YouTube for dealing with and setting boundaries with toxic people.  You don't need people undermining your withdrawal.  I think you are doing the right thing.  Good luck, and let us know how you are doing in the future.  

[holli]

hi guys, just an update. if any mods or anyone could help me with this one i’d really appreciate it.

 

i’ve had appetite issues (decreased & literally no appetite) since i tried citalopram in march. i came off that med pretty fast and switched back to zoloft, hoping my appetite would come back… for a while i really thought it would but it literally never has and it’s now october. 

 

as you can understand, this is really stressful which isn’t helping my appetite in one bit. i really have to force myself to eat, some days it’s better than others and sometimes i literally struggle not to throw up. i’ve always been a petite girl, but now because of my appetite i’m losing weight and it’s looking really noticeable and it’s extremely distressing for me to notice and feel.

 

i tried sitting around, continuing to eat as much as i can, hoping that my appetite would come back but it’s getting really hard and i don’t know what to do. 

 

that’s where i have a question. i know there’s some meds that increase appetite (neither zoloft or citalopram did this for me) but i was wondering if it’s an option for me to ask my doctor to switch me to one of these and it hopefully fixes my appetite, i stabilise and then taper safely using the methods here. or is my cns too distressed for this? i’m just at a loss at what time do, i’m really not in a good place right now, any help would be greatly appreciated.

[holli]

just to add to above, i’m hopefully going to see my doctor about this but because stress makes my appetite worse, i’m worried they’ll simply give me another ssri because they think it’s purely anxiety. but obviously if i went on another, it wouldn’t work right?

 

im really at a loss for what to do

[getofflex]

 

19 hours ago, holli said:

hat’s where i have a question. i know there’s some meds that increase appetite (neither zoloft or citalopram did this for me) but i was wondering if it’s an option for me to ask my doctor to switch me to one of these and it hopefully fixes my appetite, i stabilise and then taper safely using the methods here.

It was the psych meds that caused you the problem in the first place.  We do not suggest people go back on psych meds to fix problems caused by psych meds.  There is no way to "fix" withdrawal symptoms, other than time, patience, and taking care of oneself.  It is very slow and gradual process.  Even if going back on a med helped with appetite, you run the risk of incurring other withdrawal symptoms, kindling, and making your situation worse.  I'm glad you will see your doctor to see if there could be other causes for lack of appetite other than WD.  If it is WD related, it will eventually resolve.  Check out siderale intro thread.  She had this, and it resolved and she is doing better.  I know going through WD is hard, and scary, it truly is.  The trick is to try not to stress over the symptoms, because this leads us into a downward spiral, and makes things worse.  The following link talks about radical acceptance.  Read at least the first part of this, and let me know what you think.  

 

https://www.dbtselfhelp.com/html/radical_acceptance_text.html

 

19 hours ago, holli said:

ust to add to above, i’m hopefully going to see my doctor about this but because stress makes my appetite worse, i’m worried they’ll simply give me another ssri because they think it’s purely anxiety. but obviously if i went on another, it wouldn’t work right?

Yes, the doctors are likely to add another drug, perhaps an SSRI. That is what doctors do.  Big drug companies spend billions of dollars brainwashing doctors to rely on drugs to give to their patients.  Perhaps your lack of appetite is caused by anxiety.  There are many non drug ways to reduce anxiety other than drugs, including psychotherapy.  Cognitive behavior therapy (CBT) is one mode of therapy that is good for anxiety.  

 

Here are threads on lack of appetite: 

 

Total Lack of Appetite

 

Loss of Appetite

 

Here are some links to help 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 ...

Please hang in there, and let us know how you are doing.  This WD is very challenging, but it does eventually resolve and go away.  

Edited October 4, 2021 by getofflex

[holli]

thank you replying as always @getofflex, i really appreciate your help!

 

you’re right, i don’t want to risk trying another antidepressant because the past nearly 2 years of constant changes nd swapping really messed me up and like you said, i think it would just make me worse. 

i think i honestly asked that out of desperation and anxiety? im sure many other people would agree that it’s frustrating being in withdrawal and not being able to find one thing that “cures all”… would be a miracle huh?

 

im still going to get this checked out for peace of mind, but currently i’ve come down with some sort of cold or flu and i’m awaiting a test to check for covid. it really wouldn’t surprise me if getting sick is making me much worse, because i’ve actually thrown up twice in the past week which is something i haven’t done in 8 years! i think all the stress and anxiety is going straight to my stomach.

 

i will check out those links and siderales story, i think i’ve already read it before but i’ll look it over again for reassurance. thank you, i hope you’re having a good day!

[holli]

hi again, i have a question about reinstatement. 

 

on oct 11th, it has been 3 months since i stopped doing alternate doses of 25mg & 12.5mg of sertraline and stuck with 12.5mg in the hopes of stabilising (which looking back, i probably should’ve kept with the 25mg dose shouldnt i?). i can safely since then, i have gotten considerably worse. i’m barely functioning, the last two weeks i’ve been barely able to get out of bed because of the crippling fatigue and POTS like symptoms i’m having. getting up and going downstairs to the bathroom is an extreme sport for me at this point and it’s really bringing me down. it’s my 21st birthday tomorrow, and while most 21 year olds would have a crazy night out on the town, i will be spending the day in my bedroom trying to manage my symptoms because of how awful they are now.

 

so that leads me to me question, is reinstatement worth trying? i’m only 3 months out from the last change and i seem to be getting worse, i’m just wondering whether it’s even worth trying to tough out these severe withdrawal symptoms or try reinstatement while it’s still potentially an option. i’m just scared that if i don’t try it, in 3 months will i still be suffering this much and be kicking myself that i didn’t try? i’ve read stories of people finding SA too late and wishing they gave reinstatement a go but it was too late, so instead they suffered for longer. i found SA in a time that i can still make adjustments, so is it possible?

 

i would love to hear any ideas or knowledge on reinstatement. i know it won’t take my withdrawal symptoms away, but from what i’ve read they can help with the severity and my symptoms are pretty severe and leaving me non-functional.

[getofflex]

When you were on Zoloft, you were on doses ranging from 25 mg to 100 mg.  What was the lowest dose at which you had the adverse reaction?  What exactly were the symptoms of your adverse reaction at this dose?  

 

When you were on the citalopram, you were also on various doses.  What was the lowest dose at which you had the adverse reaction to citalopram?  What exactly were the symptoms of your adverse reaction at this dose?  What were your symptoms on the higher doses of citalopram? 

 

What time o'clock do you take your 12.5 mg of Zoloft?  How do you feel before, and then after, you take this?  What specific symptoms are you currently having, and when?  

 

What I'm trying to assess is how much of your symptoms are from adverse reaction to the Zoloft, and how much is from withdrawal. In order to help me do this, please keep a daily journal as instructed here.  Please be sure and expand the quote in this post to read the instructions.  

 

Recording Drug Schedule and Symptoms to Track Patterns

 

Please copy and paste the results in here, and we can further advise you.  In the meantime, please don't make any changes to your drugs, thank you.  

 

 

Edited October 15, 2021 by getofflex

[holli]

3 hours ago, getofflex said:

When you were on Zoloft, you were on doses ranging from 25 mg to 100 mg.  What was the lowest dose at which you had the adverse reaction?  What exactly were the symptoms of your adverse reaction at this dose?

it’s tricky to answer this as on all doses of zoloft i had symptoms. 50mg seemed to be when i was the most stable and functional, all i had was the occasional nausea, dizziness and then panic attacks that would almost always be around 7 hours after the dose but i was living and 80% of who i was before medication. 100mg and 75mg just left me feeling completely zombie with dp/dr. when i dropped to 25mg i got new symptoms such as fatigue and brain zaps, plus vertigo and the usual dizziness and nausea plus loss of appetite.

 

3 hours ago, getofflex said:

When you were on the citalopram, you were also on various doses.  What was the lowest dose at which you had the adverse reaction to citalopram?  What exactly were the symptoms of your adverse reaction at this dose?  What were your symptoms on the higher doses of citalopram? 

i started citalopram at 10mg and had intense nausea, i lost a lot of weight rapidly and i had vision issues and a sensation of feeling like someone was sandpapering my brain. this got worse when i upped to 20mg, i dropped to 5mg for one day and instantly felt suicidal. the whole time i was on citalopram i just had constant thoughts of “this is poisoning me”.

 

3 hours ago, getofflex said:

What time o'clock do you take your 12.5 mg of Zoloft?  How do you feel before, and then after, you take this?  What specific symptoms are you currently having, and when?  

i take zoloft at 12pm everyday, this never changed the whole time i’ve been on any medication. i wake at 11am lately because of trying to get maximum sleep so in that time before i take it, i only feel really awful morning anxiety and occasionally nausea. not long after i take the dose, i get tremors, my anxiety worsens in spikes, i get so nauseous that i’ve vomited in the past and i get dp/dr. most of this clears by 4pm. by 9pm all of those symptoms are either gone or very minor. however, i have constant 24 hour symptoms such as no appetite, jelly legs, muscle ache (though sometimes this clears at 9pm too), rapid heart rate, dizzy when standing, basically just POTS like symptoms and they don’t seem to vary in intensity throughout the day but they get worse if i let my anxiety get too bad. occasionally my appetite will randomly come back at 11pm, but lately it’s been gone 24/7.

 

4 hours ago, getofflex said:

What I'm trying to assess is how much of your symptoms are from adverse reaction to the Zoloft, and how much is from withdrawal. In order to help me do this, please keep a daily journal as instructed here.  Please be sure and expand the quote in this post to read the instructions.

just to be clear on this, shall i post my daily journal here? i can try do one of today below now, just to make sure i’m doing it right.

also to me it sounds like me and zoloft just don’t get along, but tapering isn’t an option for me is it? it’s tricky to know how to go in the right direction, but thank you so much for helping.

 

15th october:

4am - finally fell asleep, was struggling to sleep because of hot flushes and anxiety

11am - woke up extremely anxious and nauseous, drank some tea and opened my window, did some breathing to try calm down (worked only a little)

12pm - took sertraline 12.5mg and birth control

12:15pm - anxiety spiralled suddenly, threw up 

12:30pm - had a snack and sat up by my window for fresh air, dp/dr is setting in and i keep forgetting i’m awake?

1pm - intense tremors, i can’t keep my legs still and i feel extremely uncomfortable. still nauseous 

1:30pm - managed to have a small lunch and keep it down

2pm - tremors are still very intense, my mum actually sat on my bed and held my legs down to see how bad they were

3pm - anxiety has subsided a little bit, tremors have stopped and now my whole body aches and im exhausted from being so overwhelmed 

4pm - have some snacks, nausea is still around but not as bad. my body feels so much heavier 

5pm - i feel more awake, im taking notes for uni and chatting to family

6pm - eat a small dinner, nausea is making it hard. im also still sat by the window and still feeling hot, despite my parents saying how cold it is

7pm - anxiety is pretty much gone, dp/dr is significantly better, muscle ache is better but im still very tired

9pm (aka as i write this) - having some snacks, nausea is better but im still sat by the window like i have been all day

 

i hope those notes are okay! oh and just to note, 12-4pm is truly the worst of my symptoms, especially my anxiety and this has been constant throughout. i rarely ever get anxiety at night, i think i only had anxiety last night because i couldn’t sleep and a good nights sleep has been my only positive throughout so i panic that if i don’t get enough, i’ll suffer the next day, but then that makes my anxiety bad so i’ve been working on this by sometimes using sleep soundscapes and imagining i’m there to help me drift off. 

the anxiety is also so bad between 12-4pm that i constantly get thoughts of “i’m going crazy” and “i’m going to be hospitalised”, which never happen at any other time of day nor do they illicit a panic reaction in me. i also sometimes get depression in those hours too and my mum has always noticed that by 5pm i’m usually very talkative and bright. i hope some of that helps with patterns.

[getofflex]

Your daily journal looks great!  I take it you are not on any supplements.  If you are, please let us know, and include them in your drug sig, and include them in your daily journal with times o'clock you take them and doses.  

 

Are you drinking alcohol or using any other mood altering substances?  

 

Please continue to do a daily journal for the next few days, and report it here.  

 

From looking at today's journal, I tentatively say that you look like you are currently having an adverse reaction to the 12.5 mg Zoloft.  Fifteen minutes after you take it, your anxiety gets very severe, and is worse between noon and 4 PM. Then, you gradually feel better after 4 PM.  Let's see a few more days, so we can be sure this is a pattern, and not just a one day occurrence.  Then we can advise you.  

 

 

Edited October 15, 2021 by getofflex

[holli]

14 minutes ago, getofflex said:

Your daily journal looks great!  I take it you are not on any supplements.  If you are, please let us know, and include them in your drug sig, and include them in your daily journal with times o'clock you take them and doses.

okay good! i’ll post tomorrows probably a bit later so you can see a fuller day going forward. and no i’m not on any, i’ve been to hesitant to rock the boat with any so at this time i’m not on any supplements.

 

15 minutes ago, getofflex said:

Are you drinking alcohol or using any other mood altering substances?

nope! i haven’t drank alcohol at all while on medication and i don’t use any substances

 

16 minutes ago, getofflex said:

From looking at today's journal, I tentatively say that you look like you are currently having an adverse reaction to the 12.5 mg Zoloft.  Fifteen minutes after you take it, your anxiety gets very severe, and is worse between noon and 4 PM. Then, you gradually feel better after 4 PM.  Let's see a few more days, so we can be sure this is a pattern, and not just a one day occurrence.  Then we can advise you.

i agree, i’ve always found it weird that it’s worse at those times and then around 4pm it’s like someone flicks a switch. but i will continue to post like you said, thank you for your help as always!

[getofflex]

Ok, when I see a few more days of journals, I will probably bring some of the other staff in here to help advise.  I hope you are doing OK.  

[holli]

2 hours ago, getofflex said:

 

Ok, when I see a few more days of journals, I will probably bring some of the other staff in here to help advise.  I hope you are doing OK.  

 

okay, sounds good! i hope you’re doing well too

 

here’s my journal for today, i’m realising now that it’s quite detailed as i was writing it in my notes app as symptoms happened so i might’ve got carried away. please let me know if it’s too detailed and if more concise notes would be better and easier to read!

 

 

16th october:

2:30am - finally got to sleep after feeling too hot and restless

5am - woke up drenched in sweat but cold, immediately went back to sleep

11am - woke up with anxiety, nausea and aching all over 

11:30am - drinking tea by the window, still anxious and nauseous, just feeling generally uncomfortable throughout my whole body

12pm - took 12.5mg sertraline and birth control

12:15pm - went really hot, anxiety spiked and i started gagging, could feel that my stomach was upset, tremors started 

12:30pm - eating a snack, still have tremors, also had a weird feeling in my body almost like a rush where it felt “off” then it felt like i was falling (i’ve had this before), head is also very hot and heavy

1pm - dp/dr is starting to hit, i feel outside of my body and looking around feels weird. tremors have calmed but keep coming back in surges 

1:30pm - small lunch, nausea is still bad and my stomach still feels upset. tremors still coming back in surges but further apart. racing thoughts but i’m trying to ignore them, just keep telling myself that i will calm in a couple hours. anxiety is making me very restless

2:15pm - feeling very agitated, really hot, head feels “off”, still have tremors, when speaking to my mum i had a rush to my head of like panic 

3pm - i just feel overall unwell. i still have nausea, tremors in surges, my head still feels off and i keep getting surges of panic. i just want to sleep off these symptoms and wake up calm. feels like my whole body is vibrating 

3:30pm - a little calmer, starting to really get flu like symptoms, my head feels congested and breathing through my nose kinda stings/feels raw plus my head feels like it’s full of cotton

4:30pm - most of anxiety has subsided, dp/dr has been replaced with feeling really tired, tremors are gone and now muscles just ache, still have the flu like head

5pm - had some snacks, aches are not as bad now, flu like symptoms has eased a little, anxiety is mostly gone as is nausea

5:30pm - went downstairs to use the bathroom, when i came back up and sat down i now have internal vibrations in my arms and chest, occasional tremors in my back 

6:30pm - ate dinner, feeling calm still a bit achey but im playing a game my sister bought me and enjoying it so it’s helping distract 

7:30pm - head still feels off but most of earlier symptoms have calmed down

8:30pm - all symptoms from earlier gone, just feel sleepy and extremely hot and sweating

9:30pm - finally cooled down a bit

11:00pm - sipping tea and relaxing before bed, had about ten minutes where the room felt like it was spinning but it’s subsided

 

constant symptoms: no appetite, increased heart beat, jelly legs, not being able to stand up long/walk, really hot almost feverish

[getofflex]

I strongly suspect you are having an adverse reaction to the Zoloft.  I will bring this to the attention of the other staff, and one of us will suggest a course of action soon.  

[Altostrata]

@holli, this looks like an adverse reaction to sertraline, not withdrawal. I know reducing the dosage may scare you, but you might do better on substantially less sertraline. 

 

Would you be able to lower your dosage to 11.25mg? This is a 10% reduction on 12.6mg.

 

This would be easiest if you used the liquid form. Are you able to get the prescription for liquid sertraline now? If necessary, I would go over you doctor's head to get it. She deserves a formal complaint for failing to recognize adverse effects of sertraline.

 

Also, would it be possible to move taking your birth control pill to noon, by taking it an hour later each day? The birth control pill may be adding to nausea.

[holli]

hi @Altostrata, i agree it seems i’m having a reaction to it and i suspected that lowering would be the answer. 

9 hours ago, Altostrata said:

This would be easiest if you used the liquid form. Are you able to get the prescription for liquid sertraline now? If necessary, I would go over you doctor's head to get it. She deserves a formal complaint for failing to recognize adverse effects of sertraline.

i’m not able to get liquid sertraline, i don’t think they do it in the uk and when i asked my doctor about liquid or possibly 25mg tablets (i currently have 50mg), they said it was not possible to get them. 

 

i suppose i could make my own liquid right? 

 

9 hours ago, Altostrata said:

Also, would it be possible to move taking your birth control pill to noon, by taking it an hour later each day? The birth control pill may be adding to nausea.

i’m not sure what you mean by this because i already take my birth control at noon, but i can move it further back to see if that makes a difference.

 

thanks for your help!

[Altostrata]

My mistake, I meant gradually move your birth control until you are taking it some hours from the sertraline.

 

Yes, liquid sertraline is available from NHS, your doctor is wrong again. Or, you can make your own, see Tips for Tapering Sertraline

[holli]

5 minutes ago, Altostrata said:

My mistake, I meant gradually move your birth control until you are taking it some hours from the sertraline.

okay, i took it one hour later today so 1pm and i’ll keep moving it probably until it gets to 8pm-ish.

 

7 minutes ago, Altostrata said:

Yes, liquid sertraline is available from NHS, your doctor is wrong again. Or, you can make your own

wow, i’m starting to realise just how badly i’ve been treated by my doctors. they were so adamant that they couldn’t get me liquid. i’m not even going to bother trying to call and argue back, it’s such a stressful experience every time.

 

as for making my own liquid, i took a look at that thread throughout today and it’s a little confusing. do i just dissolve a whole 50mg tablet in 50ml of water and take out 11.25ml? or is there a less wasteful way to do it, because that would mean there’s a lot of the drug left in that water and i remember reading that it doesn’t last very long when you make your own liquid. i have a 10ml syringe so i can do this as soon as tomorrow morning but i’m just really confused on how to make it. 

 

do i also need to split so i’m taking half the dose in tablet and half in liquid? or is that not necessary?

 

thanks again for your help alto!

[Altostrata]

1 minute ago, holli said:

dissolve a whole 50mg tablet in 50ml of water and take out 11.25ml

 

Yes. You need an oral syringe.

 

You can keep the mixture in a capped tinted container in the refrigerator for maybe 5 days. Be sure to stir gently before extracting each dose.

[holli]

7 minutes ago, Altostrata said:

You can keep the mixture in a capped tinted container in the refrigerator for maybe 5 days. Be sure to stir gently before extracting each dose.

okay super, that works with the dose anyway because i’d only be able to get 4 days worth.

 

i’ve looked at the oral syringe i have and i think the closest i can get is 11.2, that’ll be okay right?

 

should i put the contents of the syringe into a separate glass so i can fill it with water and take another sip so i can make sure i got everything, or should i just put the syringe directly into my mouth?

 

sorry for all these questions, it’s a little confusing for me and i want to make sure i’m doing this as accurate as possible. i think what i’ll do is take 12.5mg in tablet form again tomorrow, then do a test run of liquid zoloft because it’s currently quite late here now and i’m not sure i could handle doing this all in the morning when i wake up with intense anxiety. 

[Altostrata]

23 minutes ago, holli said:

should i just put the syringe directly into my mouth?

 

squirt the syringe into your mouth, or you can put the liquid in a glass of water and drink it all down.

 

What is the size of your syringe? You might want to dissolve a 50mg tablet in 25mL, you would have 2mg sertraline in 1mL. This may be easier for you to measure with an oral syringe. 

 

Be sure to keep notes about how you prepare your liquid and what the dosage equivalents are in mL.

 

[holli]

4 minutes ago, Altostrata said:

 

What is the size of your syringe? You might want to dissolve a 50mg tablet in 25mL, you would have 2mg sertraline in 1mL. This may be easier for you to measure with an oral syringe. 

the size of the syringe is 10ml. i could do it this way, so that means i’d draw up 5.6ml in the syringe for 11.25mg right? sorry if this is wrong, math was never a strength of mine lol

 

 

[getofflex]

20 minutes ago, holli said:

the size of the syringe is 10ml. i could do it this way, so that means i’d draw up 5.6ml in the syringe for 11.25mg right?

Yes, this is correct.  You are on the right track.  Keep us posted with how you are doing.  

[holli]

9 minutes ago, getofflex said:

33 minutes ago, holli said:

 

Yes, this is correct.  You are on the right track.  Keep us posted with how you are doing.

okay thank you, i’ll note this down! i’ll talk to my mum before we sleep tonight just to update her on this because i’ll need her help in the mornings taking it because my symptoms are so severe when i wake up. i’ll either start the reduced dose with liquid zoloft tomorrow or i’ll test making it tomorrow evening and start on tuesday. either way, i’ll keep this thread updated!

 

heres a daily symptoms log again just to document it all: 

 

17th october:

4:30am - finally fell asleep around this time, had trouble sleeping because i couldn’t get comfortable and i kept thinking about the adverse reaction. my body at this time of night also felt like it was full of lead, it felt so heavy and achey

11:00am - woke up with anxiety and nausea, plus i woke really hot so my head is kinda dizzy

12:00pm - took 12.5mg sertraline

12:15pm - tremors really strong throughout my whole body

12:30pm - having a snack but nausea is making it really hard to keep down, tremors are worsening and my whole body is shaking. i find the more i move, the worse nausea gets and the more i feel i’m gonna throw up so i’m propped up sitting on my bed staying as still as possible

1pm - took birth control, flu like symptoms starting to appear now, body is aching and i’m sweating a lot

1:30pm - small lunch, still trying not to move because of awful nausea, still super hot 

2pm - dp/dr is setting in, i feel very out of my body, tremors still happening and i’m very achey 

2:30pm - tremors still going strong, my head really feels “off” and i’m just constantly telling myself this will be over in a couple of hours 

3:00pm - still have pretty bad nausea, tremors are now more internal vibrations and my head feels like it’s burning

4:00pm - very achey, body feels heavy. still have bad nausea and burning head 

4:30pm - anxiety keeps coming back in surges, still have nausea and i just feel very rough. i keep having to remember to relax my muscles because i’m tensing them without realising

5pm - ate some snacks, feeling a little calmer. still very achey all over and head still kinda has burning sensation

6pm - feeling a lot calmer, managing to concentrate on playing game, aches have eased a little, so has burning head and nausea. just very hot and sweating

7pm - dinner, anxiety spiked a bit because i started thinking about how long it could take for me to feel better, tried to distract and remind myself to just take it a day at a time

7:30pm - internal vibrations back a bit, anxiety still low but there and the room is spinning a little

8:30pm - still have internal vibrations mostly in my arms but the rest has eased 

9pm - had some snacks, still feel a bit “off” and i have anxiety rushes now and then

10:30pm - drinking tea, internal vibrations still in arms and anxiety rushes, could be because i slept bad last night that my symptoms are still a bit bad or because i’m nervous about reducing my dose

 

once again 24/7 symptoms are: no appetite, jelly legs, increased heartbeat, not being able to stand/walk long, feeling very hot

[getofflex]

Thank Holli, for being so diligent to post your daily journals, and to keep up with everything.  I really think that as you taper off this Zoloft, you will feel much better!  It's good you are able to get sleep - that is important.  And it's great you have your mum to help and support you!  Please try not to worry or be anxious about reducing your med, and try not to ruminate about the adverse reaction.  It is very good to know what the problem is, which we do now, so that we can address it properly.  Just focus on the fact that this is only temporary, and you will get better!  You are young and have time on your side.  Hang in there! 

[holli]

thank you getofflex, it reassures me a lot to hear that  i agree, part of me is glad that there’s an answer to the problem that can be helped, because it’s better than sitting feeling awful and wondering when the window will come. however, the other part of me is extremely frustrated that i didn’t notice the pattern earlier and kept putting myself through this daily. but like you said, this is all temporary and the hope that reducing will help me feel better brings me great strength  

 

also a big thanks to you and alto for answering all my questions and spotting the adverse reaction, i’m extremely grateful!

[getofflex]

No problem!  We are happy to help.  We have both been there, done that, got that t-shirt as they say.  Alto is completely recovered, and I'm close to the end of my taper. We both are doing so much better, and someday, you will, too.  You can read the success stories, on the home page about halfway down.  They are very encouraging.  

Edited October 17, 2021 by getofflex

[holli]

hello, here with my daily journal! it’s been another rough one but i managed to make liquid zoloft this evening, so that’s ready and in the refrigerator ready to take tomorrow morning. i’ll probably move my dose 30 mins earlier though to 11:30am, just because my mum leaves for work at 11:45am and i need her to help double check i’m taking it right and to put it back in the refrigerator for me. i’m hoping 30 mins earlier won’t make much of a difference though?

 

18th october:

2:30am - fell asleep after being too hot for a while

9am - woke up briefly with no anxiety or nausea, just checked the time and went back to sleep, i remember thinking “wow this feels nice” and then i just peacefully & comfortably drifted back to sleep 

11:00am - woke up with intense anxiety and nausea

11:30am - minor tremors are already starting, drinking tea by my window trying calm

12:00pm - took 12.5mg sertraline

12:15pm - tremors are much more intense, stomach is very upset and moving makes me feel sick again

12:30pm - had a snack, nausea made it very hard and i’m really hot, tremors in surges but not as intense

1pm - tremors are getting intense again, feel hot and head feels “off”, nausea is really bad 

1:30pm - threw up half way through eating lunch, feel awful and really hot, tremors still intense

1:45pm - took birth control before i forget

2pm - ate the rest of my lunch, tremors still intense

2:30pm - nausea isn’t as bad after throwing up and stomach feels better, flu like symptoms and dp/dr starting. keep getting surges of anxiety throughout my whole body

3pm - tremors less intense and in surges, burning head, dp/dr, anxiety still in surges, feel very rough

3:30pm - tremors seem to have lessened, i feel very heavy and achey, generally unwell

4pm - feeling a little calmer, just very tired and still just feel rough/achey

4:30pm - nausea keeps coming back in waves but not as intense 

5pm - had a snack, anxiety keeps coming back in surges, feel overall uncomfortable and “off”

5:30pm - feeling a little calmer, playing a game but i’m noticing when i concentrate on it and then i stop focusing and look at something else, coming back to “reality” feels really weird an uncomfortable… could be dp/dr? i’ve experienced this a lot since dropping my dose back in july

6:00pm - calmer, still feel “off” and i have a little bit of a headache

6:30pm - dinner, internal vibrations in body but anxiety and dp/dr have eased a little

7pm - everything has kinda eased, i’m mostly just a little restless and my head is heavy

8pm - i just feel very… deflated? my mood is a little low, i’m just sad thinking about my situation and the mess i’ve gotten myself into

9pm - had a snack, really hot and sweaty and i still have the “off” feeling but me and my mum were talking and having a laugh so my mood lifted a little

9:30pm - still really hot despite being by my open window, moved a little and got dizzy, still have a bit of internal vibrations too

10:00pm - mood is low again and i’m nervous about taking the lower dose tomorrow, head is also tingling (i’ve had this symptom before), tired just want to sleep 

10:30pm - drinking tea by the window trying to cool down, feel quite restless and dizzy because of how hot i am but i’m hoping i cool down enough to sleep soon

 

all day symptoms: no appetite, jelly legs, unable to walk/stand long, increased heart beat, feeling very hot

 

is me throwing up so soon after the dose possibly my body rejecting the zoloft? i never know if i’m actually throwing up the dose either, i cant really look because i end up throwing up more. it’s just so strange that it’s only recently that i’ve been throwing up, i guess my body really doesn’t like zoloft at all anymore. 

[Altostrata]

You've been taking 12.5mg sertraline since July 2021 and had these symptoms all that time?