Erimus: my introduction and journal

[Erimus]

Hi all,

 

I guess this is here for others to view and associate with in their own struggles and battles, and also for me to come back and check my progress as the months go by.

 

I started sertraline 50mg in Oct 2020 after a bad mental break due to ongoing stress and I guess my already anxious personality really showed it’s face. Also added in mirtazapine 15mg in late November 2020 as my main problem was insomnia before starting either drug. You can see the rest of my drug history in my signature.

 

Fast forward to December 2021 and I am seemingly now fighting the affects of said drugs rather than the reasons with which I originally started the medications. All the problems for which I actually started the medications are gone through my work on my mental health and a great journey of understanding.

 

My nervous system now appears to be very unhappy from the catalogue of medication changes in the last 8 months approx. As of December 6th 2021 I am still very much struggling with the physical and mental problems caused by the drop from 75mg to 50mg on September 17 2021. This was originally done to try and aid my awful reflux and indigestion problems, but only appears to have made them worse, temporarily at least. 
 

In my bid to reach stabilisation on this dose I am reluctant to change the medication again as I know the ramifications this will have on me, but it is so incredibly hard to wear a brave face and keep going on many days at the moment due to the crippling GI issues. My goal is to reach 6 months on this dose and I am currently at 2.5.

 

Prior to my mental breakdown I was already taking 20mg omeprazole for stomach troubles but had never experienced acid reflux until increasing sertraline from 50mg to 100mg in December of 2020 (last year). I am now on 40mg omeprazole but my GI issues are ongoing.

 

I hope one day I will come back and read this in a different place completely. Currently it is hard to see the sun once again rising with each day that passes. I am doing at least 60  minutes of deep relaxation each day which helps force my body to relax. I have set myself a goal to do this on each day for the entirety of December.

 

It is so demotivating when my nervous system flares up every week or 2 and my stomach and skin are upset with each time this happens.

 

Hopefully if I remember to come back and update in a months time things have changed.

 

For now, thanks to anyone who has read this and I wish you luck through this process. We are all so mentally strong.

 

Erimus

 

Symptom Tracker (Intensity /10):

 

Indigestion/acid reflux (9/10)

Anxiety waves (7/10)

Shortness of breath (7/10)

Tension headaches (5/10)

Hot flushes/sweating (5/10)

Constipation (5/10) 

Insomnia (3/10) 

Sweaty palms (4/10)

Muscle tension in shoulders/neck (3/10)

Inability to concentrate (5/10)

[Erimus]

The indigestion and reflux is so bad I am unsure I can continue swallowing this sertraline pill each day. Could just be me going mad but I feel that when I start a new box of tablets my stomach is susceptible to flaring up my GI issues. Will speak to doctor tomorrow (8th dec 2021) to try and find a solution to this pain.

Is it possible to begin a 10% taper when not exactly stable? At this point I’m struggling to see a point at which I’m stable enough to begin said taper.

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  I'm sorry you are dealing with these symptoms.  I believe that they are being caused by several factors.  For one, there is a good chance your nervous system is destabilized from the various changes you have made to your sertraline dose.  However, there is also a major drug interaction between sertraline and mirtazapine, and you may be experiencing serotonin syndrome.  Here is what I found on www.drugs.com in the interaction checker: 

 

Interactions between your drugs

Major

sertraline  mirtazapine

Applies to: sertraline, mirtazapine

Using sertraline together with mirtazapine can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. 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. It is important to tell your doctor about all other medications you use, including vitamins and herbs. 

 

Several of the symptoms you mention, including the sweating, muscle tension, and GI issues, are described above.  It's a good thing that you plan to taper off.  The trick is going to be tapering off the drugs without triggering major withdrawal symptoms.  Here is a link about serotonin syndrome on our site: 

 

Serotonin Syndrome

 

 

Thank you for giving us your drug history in your signature. 

 

 

Here is some information about how these drugs actually work.   This explains why we get symptoms from going off of these medications, and why it's so important to taper so slowly and carefully, and be very cautious about changing our doses: 

 

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

 

Windows and Waves Pattern of Stabilization

 

 

Tapering is best done extremely slowly, and we generally taper by 10% of the current dose no more than once every 4 weeks, so that the taper becomes exponentially smaller.

 

 Why Taper by 10% of my Dosage  

 

Tips for Tapering Sertraline

 

 

Also, 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 is a link with checklists of common WD symptoms: 

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

 

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

 

 

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. 

[Erimus]

Hello @getofflex, I hope this message finds you well. I am looking for some assistance/advice regarding my best course of action when you get a spare moment.

 

I am struggling to understand if holding on my current dose of 50mg sertraline is my best course of action. I’ve been taking 50mg for 4 months and can’t tell if my symptoms are due to not being stable or an adverse reaction to the sertraline. Looking for some help with this conundrum.

 

Each day I take the dose at 11am and am often left with a myriad of symptoms that peak at about 330pm. Some of these symptoms include intense head pressure, an inability to concentrate, teeth chattering and grinding, mild tingling in my head occasionally, shallow breathing, restlessness. Around 4pm then begins what I can only describe as a ‘comedown’ of sorts as the symptoms ease slightly into the evening, I assume this correlates with blood plasma concentrations of the drug.

 

I’ve started a symptom diary including when I take what and will post each day for the next week.

 

I take mirtazapine at 9pm each night. I feel at my best (least intensity of symptoms) late in the evening and first thing in the morning, before the sertraline dose at 11am.

 

Sorry for the long passage of information and many thanks.

[Erimus]

Also wanted to ask about B complex. I know this can be activating but I started taking it before antidepressant use (about a month before). So it would probably be more detrimental to stop it and upset my nervous system more.

[Blossom71]

On 12/7/2021 at 7:05 PM, Erimus said:

The indigestion and reflux is so bad I am unsure I can continue swallowing this sertraline pill each day. Could just be me going mad but I feel that when I start a new box of tablets my stomach is susceptible to flaring up my GI issues. Will speak to doctor tomorrow (8th dec 2021) to try and find a solution to this pain.

Hi Erimus,

 

did your stomach issues get sorted out?

 

I am also on Omeprazole due to stomach issues from Sertraline.

Mine started when I had a batch of generic sertraline that I reacted to. Terrible GI issues, dizziness and my blood pressure went through the roof. I’m the Dr put me back in the branded ones (Lustral) rather than the generic ones and I haven’t had that problem since.

 

I was just wondering, do you have the same brand of Sertraline each time?

[Erimus]

Hello @Blossom71,

 

I only started having stomach troubles when I increased above 50mg in December 2020. I’m back down to 50mg now and I’ve actually gone a month with minimal GI issues which shows signs of improvement.

 

I’ve taken Lustral since I started and also find myself sensitive to brand changes. I tell the pharmacy not to change my brand anymore due to the slew of problems it has caused me.

[Blossom71]

Oh good, I'm glad the GI issues have calmed down again.  The odd time I've had one in my mouth and it's started to dissolve before I've got to the water. I couldn't believe the burning sensation on my tongue, so I'm not surprised our stomachs doesn't cope with them from time to time.

I think the saving grace is that 50g pills always Lustral. I don't think I've ever had those in a generic, it just seemed to be the 100g pills.

[Erimus]

@Blossom71

 

A doctor I spoke to about my GI issues back in January 2021 used the analogy that sertraline was like ‘paint stripper’ for our insides. No wonder it causes so much gastric distress. I’ll be relieved when I start my taper, hopefully in March this year. The drug has caused nothing but problems for me.

[Erimus]

In the last few days I think I’ve had my awakening from the mess which is modern psychiatry. I’ve come to the conclusion that the reason I’ve felt so sick, and never got back to normal since October 2020, is in fact the drugs.
 

They’ve made me nothing but worse, I spend my days laying on the sofa wishing my life away, waiting for something to change. When, in fact, the sertraline is what is preventing me progressing. I’ve lost who I am, my personality gone and permanently feeling numb, devoid of emotions. 
 

They’ve destroyed my sleep, my mind never relents, constantly whirring away. I’ve experienced OCD thoughts for the first time in my life, and became paranoid of human interaction. Everything I used to enjoy I no longer care for. I quit my job which I once enjoyed, suspended my university studies and withdrew from my friends and family. 
 

These drugs will not beat me. I have now been taking 50mg for 4 months, which is 50% of what I was taking in January of 2021. I hope to begin a taper in the next 2 months.

[Erimus]

Diary: 16th January 2022

 

1030: B complex and Vit D, jaw tense and painful;

1100: Breakfast, sertraline 50mg, woke with head pressure and urge to grind teeth;

1220: Head pressure and teeth grinding increases;

1310: mouth spasm;

1410: Dinner, still head pressure;

1525: Intense head pressure, mild tingling 20 seconds;

1615: Mild buzzing in legs;

1700: Omeprazole 40mg;

1720: Intense pressure face and eyes, body jolt;

1740: Sweaty palms 30 mins;

1815: Tea;

1905: Leg buzzing intensifies, restless, shallow breathing;

2025: Still pressure in head, restless;

2100: Mirtazapine 15mg, Magnesium 440mg, Ashwagandha 80mg;

2120: Still feeling activated;

2300: Bed and asleep by 2330

[Blossom71]

35 minutes ago, Erimus said:

n the last few days I think I’ve had my awakening from the mess which is modern psychiatry. I’ve come to the conclusion that the reason I’ve felt so sick, and never got back to normal since October 2020, is in fact the drugs.
 

They’ve made me nothing but worse, I spend my days laying on the sofa wishing my life away, waiting for something to change. When, in fact, the sertraline is what is preventing me progressing. I’ve lost who I am, my personality gone and permanently feeling numb, devoid of emotions. 

It's a hard realisation isn't it?  But well done on the realisation and the determination to get to a better place.

 

I've had that awakening too over the last couple of months.   I've always thought the difference in me between then and now was caused by the breakdown (that caused me to be on the meds in the first place). I assumed that the trauma around that had changed me and i would never be the same again. Broken almost.

I have healed a lot since then but It has always felt like something is stopping me from getting the rest of the old me back.  I now believe that it is down to the meds, although maybe a part of me always knew that but was scared to accept it.  I'm finding that revelation upsetting and i feel myself mourning the loss of the old me and the 7 years that i have just been a passenger in my old life.

[Erimus]

On 1/19/2022 at 12:19 AM, Blossom71 said:

It's a hard realisation isn't it?  But well done on the realisation and the determination to get to a better place.

 

I've had that awakening too over the last couple of months.   I've always thought the difference in me between then and now was caused by the breakdown (that caused me to be on the meds in the first place). I assumed that the trauma around that had changed me and i would never be the same again. Broken almost.

I have healed a lot since then but It has always felt like something is stopping me from getting the rest of the old me back.  I now believe that it is down to the meds, although maybe a part of me always knew that but was scared to accept it.  I'm finding that revelation upsetting and i feel myself mourning the loss of the old me and the 7 years that i have just been a passenger in my old life.

Theres something amiss with modern approaches to mental health when the first course of action is to prescribe medication that numbs the emotions and feelings. Humans have survived without these drugs for thousands of years. In my time on sertraline I’ve lost

touch with reality, when I look back I realise I’ve just been living in a false sense of safety, like a fog in my mind. 
 

We often just accept we need these drugs when in reality there’s something causing the anxiety or depression. If we don’t deal with the underlying cause the medication will just mask our problems. 
 

Just be glad that we’ve come to our senses, it baffles me how many people take anti depressants. In my immediate family I can think of 3 people that have been on/off them for 20 years now. You just become a passenger in your own life. 
 

The real healing begins when you get off.

 

Edited November 19, 2022 by ChessieCat
edited at request of member

[Erimus]

Diary: 17th January 2022

 

0430: Woke, jaw tense and painful, drifted half asleep til 6;

0600-0800: Inner restlessness, predominately in forearms, urge to move them (RLS?);

1000: Got up;

1015: B complex and Vit D;

1100: Breakfast, sertraline 50mg;

1200: Activated feeling, increased shallow breathing 10 mins;

1300-1430: Head pressure, poor concentration, tense stomach;

1600: mild buzzing in legs, teeth clenching/grinding, dizzy upon standing;

1745-1820: Intense head/eye pressure 8/10, shallow breathing, feel wired;

1820-1850: Made and ate tea, feel a little better;

1930: Mouth spasm 3rd time today;

2030: Slightly more intense activation again;

2100: Mirtazapine 15mg, Magnesium 440mg, Ashwagandha 80g;

2130: Drink chamomile tea;

2230: Get into bed;

2330-0030: Inner restlessness in arms again;

0030-0045: Intense buzzing in legs 8/10;

0100: Asleep (I think)

[Blossom71]

1 hour ago, Erimus said:

 If we don’t deal with the underlying cause the medication will just mask our problems. 
 

The real healing begins when you get off.

I'm really struck by these 2 sentences.   I am looking forward to healing.   And we will heal.

[Erimus]

My problem with the sertraline has been I’ve received no therapeutic benefit from it in the ~15 months I’ve taken it, yet I still experience bad withdrawal from it. 

 

Edited November 19, 2022 by ChessieCat
edited at request of member

[JesusSavemefromWD]

Classic stupidity from doctors that 25 mg isn’t a big difference…. I was on 25mg and was told it’s not a therapeutic dose and it’s not doing much … right well hell it did… changed me completely in few weeks. Sorry about what ur going through, my advice would be to taper very slowly down to a minuscule dose and u ll be ok 

 

Edited November 20, 2022 by ChessieCat
removed quote at request of member

[Erimus]

Diary: 18th January 2022

 

0800: Woke up to jaw pain 7/10, feeling activated;

1000: B complex and Vit D;

1100: Breakfast, sertraline 50mg, feeling lightheaded, shallow breathing;

1210: Pressured head/eyes 8/10;

1310: Enjoyed 20 min walk in sun;

1400: Dinner;

1445-1530: Restless legs 6/10, dizzy upon standing;

1600: Shallow breathing 7/10, difficulty concentrating and restless;

1700: Omeprazole 40mg;

1805: Tension headache, pressure around eyes, shallow breathing 6/10;

1830: Tea, calmed slightly;

1850-2030: mild buzzing in legs, pressure head/eyes;

2100: Mirtazapine 15mg, Magnesium 440mg, Ashwagandha 80mg;

2130: Chamomile tea;

2300: Into bed;

2330-0200: Restless legs and buzzing legs alternating until 2am 8/10;

0215: Finally dropped off I think

[Erimus]

Really struggling with restless legs, vibrating legs and inability to fall asleep these past few days. Unsure if having paradoxical reaction to sertraline. Lost as to wether best option is to continue on same dose for another 1-2 months in hopes of more stability; alternatively could begin micro taper now.

 

Worst window of the day appears to be 3-7pm which would correlate with peak plasma levels of sertraline I think. Also been having problems From around 10pm-1/2am this past week. Everything seems to activate me, absolute nightmare.

 

Going to skip taking the B complex today (19th January 2022) in hopes of some change.

[Erimus]

Diary: 19th January 2022

 

0945: Get up, jaw pain 7/10 after another disturbed night, legs still restless this morning;

1030: B complex and Vit D;

1100: Breakfast, sertraline 50mg;

1300: Head pressure/dry eyes 7/10;

1300-1400: Tense stomach, shallow breathing 7/10;

1445: Dinner, calmed slightly;

1530: Shallow breathing 8/10;

1600: Feeing wired 8/10;

1645: Mouth spasm;

1700: Omeprazole 40mg;

1900: Tea;

1915: restless, shallow breathing 8/10, difficulty concentrating;

1930: Legs vibrating 8/10;

2020: Tingling in head 1 min;

2100: Mirtazapine 15mg, Magnesium 440mg, Ashwagandha 80mg;

2130: Chamomile tea;

2200: Bed, feel sedated by mirtazapine;

2230- Asleep by this point I reckon

[Erimus]

It’s difficult trying to find a compromise between allowing my body to become as stable as it can on 50mg sertraline, and not staying on the medication for any longer than absolutely necessary.

 

I always try to do the right thing, but when the medication is responsible for making me feel bad it’s hard to continue with the process each day.

[Erimus]

Sometimes I find it difficult not to get caught up in the timescale of this difficult journey we have to embark on. When your life has grounded to a halt and you know you aren’t going anywhere fast; it can easily get on top of you and be overwhelming. Particularly with all the fluctuating emotions each day.

[Erimus]

Struggling really bad with jaw tension and teeth grinding this past week. I find myself grinding my teeth through the day and I do this through the night as well. One morning I woke up and saw I had bitten my tongue in my sleep which left a small blood blister. I have pain in the right side of my jaw which radiates into my right ear; this is normal worse after waking first thing. Jaw is very stiff and also clicks and cracks sometimes. 

 

Don’t know if this is cause for concern with me continuing on 50mg sertraline. The symptoms seem to be getting increasingly unmanageable, with body spasms, jerks and muscle twitches. It does worry me an awful lot.

[Erimus]

Still struggling with orthostatic hypotension as well. When I stand up I go dizzy for a few seconds then it corrects. My nervous system is destroyed it appears.
 

I think I’ll begin my taper 18th March, that’s 6 months from the last change. Can’t really bring myself to allocate any more time than that.

[HealthHopeHappiness]

Hi @Erimus thanks for your message of encouragement on my thread. I have had a read through your thread and am so sorry to hear how you too have been misled by your doctor and you are suffering as a result. This process is hard. I can relate to practically all of your symptoms - the buzzing, twitching, mouth spasms, GI symptoms, jerks. It’s awful. You’re not alone. I hope things settle for you shortly. 

[Erimus]

Thank you for your kind words @HealthHopeHappiness. The hardest part for me is finding meaning and patience through it all.

 

Edited November 19, 2022 by ChessieCat
edited at request of member

[Erimus]

Diary: 20th January 2022

 

0230, 0430, 0530: Awoken;

0600-0800: Tense and restless;

0800-0900: Legs vibrating on and off;

0950: Get up, jaw pain 8/10;

1100: Breakfast, sertraline 50mg;

1200-1230: Shallow breathing 7/10;

1245-1345: Drive out to collect medication, weather is nice;

1400: Dinner, feeling tired;

1500-1630: Crashed, very tired;

1700: Omeprazole 40mg;

1730: Feeing more wired again, adrenaline has returned 6/10;

1815-1845: Restless legs;

1830: Tea, feeling a bit calmer;

1900: Shallow breathing 8/10, difficulty concentrating, intense leg buzzing 8/10;

1910: Legs restless and buzzing intermittently;

2015: Tense stomach, shallow breathing 7/10;

2100: Mirtazapine 15mg, Magnesium 440mg, Ashwagandha 80mg;

2130: Chamomile tea;

2210: Bed

2300: Asleep

[Erimus]

Sometimes I have brief glimpses where I remember who I used to be before all this mess. The emotions can be overpowering as I envy my previous life. I often feel unable to cry but sometimes I think it would be nice to release all the pent-up feelings trapped inside me and subdued by these drugs.

[Erimus]

I find it disturbing when I can’t get upset about things that should make me feel certain emotions. The numbness is probably one of the most unpleasant aspects of this journey. Then again, with all I’ve been through it is probably best if I don’t feel too much, or I’d be in tears most days.

[Erimus]

The keg buzzing has kicked in really intense at 1530 today, after a less intense outburst last night. Sometimes the symptom pattern makes no sense, it baffles me each day.

[Erimus]

Tonight I experienced what I think to be a panic attack for the first time in my life. The feeling accompanied by the anxiety were quite terrifying for a first time sufferer. It just seemed like it came out of nowhere, hit me like a ton of bricks.

 

Its been a rough day. Must keep battling

[HealthHopeHappiness]

2 minutes ago, Erimus said:

Tonight I experienced what I think to be a panic attack for the first time in my life. The feeling accompanied by the anxiety were quite terrifying for a first time suffered. It just seemed like it came out of nowhere, hit me like a ton of bricks.

 

Its been a rough day. Must keep battling

So sorry to hear that. Well done for surviving the day, it sounds like a really difficult one. From September-February last year I started having panic attacks after starting SSRIs, I didn’t realise at the time that this was the reason, and I ended up off work for 6 months. Panic attacks during WD are so hard to deal with as the fear is chemical and terrifying. There is lots of helpful advice on here for dealing with panic attacks. Hope today is a better day for you. 

[Erimus]

Thanks for the reassurance @HealthHopeHappiness. The hardest part is you want to take action in some way (ie dose and/or drug change). If anything it’s a sign I need to hold things for longer. I guess we all want a quick fix for our mental health but in reality there isn’t one.

[Erimus]

Diary: 21st January 2022

 

1015: Get up, slept better last night;

1030: B complex and Vit D;

1100: Breakfast, sertraline 50mg, arms aching;

1300: Head/eye pressure 7/10, teeth grinding 7/10;

1400: Dinner;

1430: 20 min walk;

1530-1630: intense leg buzzing 8/10, shallow breathing 7/10;

1650: mouth spasm;

1700: Omeprazole 40mg;

1730: legs buzzing, difficulty concentrating;

1830: Tea;

1850: Feeling a bit wired and restless;

1900-2000: Legs buzzing 8/10, Shallow breathing 8/10;

2030-2050: Panic attack for first time in my life, symptoms lingered;

2100: Mirtazapine 15mg, Magnesium 440mg, Ashwagandha 80mg;

2200: Calmed slightly;

2230: Bed;

2300: Asleep

 

[Erimus]

Diary: 22nd January 2022

 

1000: Get up, jaw pain 7/10, slept pretty good;

1010: B complex and Vit D;

Breakfast, sertraline 50mg;

1200: Feeling more activated;

1230: Some anxiety 8/10;

1400: Dinner;

1500: Arms aching and tired;

1530: Crashed, exhausted but adrenaline rushes when I try to drift off to sleep;

1745-1830: Make and eat tea, calmed slightly;

1900: Feeling restless 7/10, head/eye pressure 7/10;

1915: Eye pressure 8/10, legs buzzing 6/10;

2100: Mirtazapine 15mg, Magnesium 440mg, Ashwagandha 80mg;

2230: Bed;

2300: Asleep

[Erimus]

So, that wraps up a week of symptom tracking. It’s been quite an intense week in regards to symptoms, but I think they all are at the moment. Will update again after 5 and 6 months on sertraline 50mg.