Momoffour: Struggling Post-Sertraline CT

[Momoffour]

Hello everyone,
It has been hard to be able to look at the screen, so I will write briefly:

I was on several different psychiatric drugs from ages 7-17 because of my mother.  I can't remember all of them but have listed the ones I remember in my drug history. 
In 2020 I took Prozac because I was having depressive symptoms, it was for many months but hard to remember exactly how many.

In 2021 I took 25mg of Setraline for 2-3 weeks because of trauma resulting from seeing a family member commit suicide in front of me and then my mother in law died.

After taking Setraline for 2-3 weeks, I started to experience depersonalization/derealization.

I quit Sertraline cold-turkey because I did not like how I felt. Withdrawal symptoms started 2 days later. I tried to smoke weed to alleviate it and it made my symptoms worse. Morning cortisol kicked in and more and more symptoms are appearing or changing.  I don’t want to reinstate, but I am considering it. I am suffering badly and hope this ends soon. Are there any recommendations on what I should do? 
 

[Altostrata]

Welcome, @momof4

 

How have your symptoms changed since the end of November? How's your sleep?

[Momoffour]

@Altostrata
My symptoms are constantly cycling. I quit getting the morning cortisol rushes but now have this whole different form of anxiety. Where I cry feel anxious and just wanna die.. my sleep is still broken. I go to bed around 8-8:30 and wake up every hour sometimes every 2-3 if I'm lucky. I wake up at 5 every day. I also get worse after eating anything even salad and healthy stuff. My main symptoms that have stayed are brain fog and dp/Dr and now the doom anxiety everyday sometimes it's up and down and sometimes it lasts all day. I also get starving symptom and sometime heavy fatigue but they just cycle.
I also get random physical symptoms that cycle. 
I'm also starving even though I ate 3 hours ago. But I'm scared to eat and make stuff worse. I get the intrusive I'm always gonna be stuck like this symptom too. I don't know I have so many sometimes.

[Momoffour]

Not sure how I'm going to make it through this 😭 I have accepted this is withdrawal and nothing I can do.

I have tried distractions and resting however, its hard to distract myself with the brain fog, dp, dr, and what I am now thinking is inner akathisia because my body get this intense feeling before I get anxious and start crying feeling like there's no escaping.. it almost always comes with SI, intrusive thoughts. My mom is luckily here helping with my kids but it kills me that I can't be present for them and they are starting to notice we're not doing as many activities etc. While laying in my bed all day would be nice I don't seem to get comfort there either. I think everyone on this site is so brave because I'm not sure how they do it. I almost feel like I won't make it 

[ChessieCat]

Stressing about what we cannot might things worse.  Accepting that it is withdrawal is part of it but it is also important to learn how to relax and allow the recovery to happen without fighting it.  When you are in the middle of a bad period, it feels like it will last forever and it can also seem like there is no improvement but the brain is continually working on getting back to homeostasis.  Unfortunately during that time we can experience bad symptoms.

 

You have also experienced two major life stressors.   Even without the drugs your body may have gone into "shut down mode" as part of trying to cope with the trauma.

 

Your body is trying to cope with both stopping the drug and the grief/trauma.  If you aren't already doing so, I think it would be a good idea to see a trauma therapist.

 

Be gentle with yourself.  One day a time and if necessary one hour or moment at a time.  I suggest that several time a day you try to do some relaxation exercises.  It's not a magic cure but can help to reduce the stress that you body is going through.

[Momoffour]

@ChessieCat Thank you for your reply. 

I was seeing a therapist via telehealth (over video calls) she recently dropped me as a patient because I unintentionally kept forgetting appointments since withdrawal and I'm honestly okay with that. It was actually just extra stress. I have had plenty of trauma in my life and somehow got through it. Never been through withdrawal somehow. Unfortunately, I feel like withdrawal will have been the most traumatizing thing I have been through. I have been through DBT therapy before. I am considering buying a CBT book to help me for now at home. I have done mediations. I will probably start doing that again. I finally got some relief from the brutal anxiety feeling today. I'm praying it stays away. I try hard to take it moment by moment but seems sometimes I am forced to think about the future and what will happen but, I also tell myself to stop trying to figure it out because it is different for everyone. I am doing my best to relax. Telling myself that it could be worse, naming the things I do have to be thankful for. Withdrawal also feels so lonely so I'm mostly just venting and hopefully can find someone in a similar situation that I can talk to and maybe help each other. 

Also, I was wondering if I should stop taking my birth control? I'm not sure if it's helping or making things worse. 

I also did labs and my vitamin D was low so I have been taking that and a probiotic in a yogurt smoothie in the morning. 

Thank you for the support. 

[Altostrata]

Rather than cycling, does this better describe your symptoms: The Windows and Waves Pattern of Stabilization

 

If so, that would be "normal" for withdrawal.

 

Going on and off drugs tends to make the nervous system hypersensitive to drugs and drug changes. We know that cold-turkey off psychiatric drugs elevates the risk of withdrawal syndrome. Appears you cold-turkeyed Abilify in September 2021 and sertraline in November 2021 and maybe 40mg Prozac in 2020. Why did you go off Prozac, what happened afterward?

You've had withdrawal syndrome for perhaps 3-5 months. We see it very slowly goes away over many months. A very low dose reinstatement of an SSRI like sertraline may reduce the withdrawal symptoms. See About reinstating and stabilizing to reduce withdrawal symptoms 

 

You are taking a pretty high amount of vitamin D. What time o'clock do you take it? How do you feel afterward? Same with your birth control.

[ChessieCat]

SNAP! - Alto had the same thought about the following:

 

Q:  Do you take the Vit D in the morning; it is a daytime vitamin and is best not be taken later in the day?  I suggest that you have it re-tested because you might be able to reduce the dose.

 

 

[Momoffour]

@AltostrataI don't want to risk getting worse by reinstatement.. isn't that a possibility? what do you think I should do?

Just trying to get better for my kids and family.

By cycling I mean the symptoms like change every so many minutes to a different one. But my most prominent right now are the ones I named.

I always have bad mornings before taking anything and sometimes I have okay mornings. So i'm not sure if and how the vit d and birth control is effecting me. I wake up usually around 5 sometimes sooner i drink the smoothie with probiotic after waking

I try to eat breakfast at 6 and then take the birth control and vitamin d 

 I was unaware that was a high amount my doctor instructed that amount (not that i trust her whatsoever) she wont retest my vitamin d again until April. and she has avoided me since this has started mostly.

There's only one doctor i believe in my area that knows about antidepressant withdrawal and sadly i cannot afford to see him. I was asking about the birth control because I had found a group on facebook and some people are going through withdrawal after stopping theirs.

Nothing happened when I stopped the Prozac i stopped because I felt It didn't do anything for me. I already hated meds and my doctor swore i needed the abilify after witnessing what i had it gave me restless legs after the first few weeks...so I stopped she then was persistent on me starting zoloft I even waited a month almost two to start because I had a bad feeling about starting it. While on it i felt high and even maybe slight dp/dr then? so hard to describe but nothing like withdrawal. 

 

I was just remembering in about 2015 they gave me a 150 mg trazadone (just one) and i had an awful reaction to that however it only lasted one night and heart palps for maybe a couple weeks after i should probably add that to my drug history I am not realizing with what im going through that could have been withdrawal? my memory is so foggy too. So i'm trying hard to remember everything.

 

Thank you so much for your time! 

[NeDaytoDayMJ]

It’s challenging and so hard to distract, accept, cope etc with those symptoms.  They are always there.  I get it.  It seems not fair.  It’s affecting Our lives!  It sucks. 
We just have to believe it will get better.  I’m in the same boat.  This will pass, your kiddos still love you.  Focus on yourself.  

[Momoffour]

@NeDaytoDayMJThank you for the encouragement, i appreciate that. I'm doing my best to cope and distract... Do you ever feel slightly better at night? That seems to be the only time I feel SOME relief from the awul terror, anxiety, or maybe its inner akathisia I'm unsure.

[Altostrata]

Some people have bad reactions to birth control pills. Please look up the adverse effects of your drugs and consider whether some of your symptoms might be due to that.

 

It sounds like you have normally miserable protracted withdrawal. Brain fog is very common. You don't have to reinstate, you can continue to cope with symptoms, your choice.

 

Many people find these to be helpful:

Magnesium, nature's calcium channel blocker 

Omega-3 fatty acids (fish oil) 

 

You might try a low dose of one at a time to see what it does for you.

[Momoffour]

@Altostrata I ordered a scale and asked my doctor to call me in sertraline. If I reinstate how long does it take to work? I've been off the meds I believe 74 days. Have you seen more success with reinstating than not? I'm so desperate right now. 

[Momoffour]

@Altostrata also how will I know if the reinstatement worked and when to stop if it didn't? Sorry I tried to read the file but the brain fog makes me feel really stupid. 

[Momoffour]

@AltostrataI can't do magnesium because I had a bad reaction to it. I got horrible anxiety like I have now and it made more symptoms worse. The scale will be here Tuesday and I guess I will try reinstatement. 

[Momoffour]

@Altostrata sorry for so many posts. The scale will be here on Tuesday and my doctor's office opens tomorrow and I will wait for a reply from her. I also have no clue how to weigh these pills how much etc and I'm reinstating the sertraline correct? Do you think if I can get her to do liquid to make it easier that would be ok? Sorry so many questions. 

[Altostrata]

When you were taking Abilify in September 2021, were you also taking Prozac? How did you feel while you were taking Abilify? Why did you go off?

 

Did you feel better initially after you started sertraline in late November 2021? 

 

I am thinking you might reinstate Prozac, not sertraline.

[Momoffour]

@AltostrataI never had any issues after stopping the Prozac I haven't taken Prozac since 2019 maybe 2020? So hard to remember   I didn't feel anything actually on it. It did nothing that I can remember. 

 

On the Abilify I got restless legs and didn't like it so I stopped.

I took the sertraline and felt a little weird maybe dp/Dr but very minimal 

[Momoffour]

It had been many many months since I stopped the prozac before I started Abilify 

[Momoffour]

@Altostrata maybe almost even a year before I took the Abilify

[Altostrata]

Did you ever accidentally forget a dose of sertraline or other psychiatric drug, or take it off-schedule?

 

Did you take anything else while you were taking sertraline in fall of 2021? Since the fall of 2021, drink alcohol? Take antibiotics?

 

What were your symptoms after cold-turkey of sertraline at the end of November, prior to smoking weed?

[Momoffour]

@AltostrataNo I didn't ever skip I did halve the abilify 2-3 nights before stopping 

 

I think i took a 1  zofran nausea med during my time on sertraline while i had a stomach bug 

i took amoxicillin since being in withdrawal like a week off. Took it for around a week I didnt have any reactions from that 

 

My only symptom after the cold turkey from sertaline was DP/DR and really weird vision which i assumed was part of DP/DR nothing else that i can remember.

Please tell me there's some kind of hope for me reinstating. I cannot live like this .

[Altostrata]

3 minutes ago, Momoffour said:

i took amoxicillin since being in withdrawal like a week off.

 

You said that your symptoms started after you smoked weed. Was this the same time you were taking the antibiotic?

[Momoffour]

No, my symptoms started 2 days after I stopped... More symptoms started after smoking weed thinking that would help me...

 

I had no reaction from the amoxicillin.

[Momoffour]

@Altostratasymptoms started 2 days after I stopped the sertraline. I took the amoxicillin a week after symptoms started 

I smoked weed a few weeks into withdrawal and then new symptoms started. The symptoms didn't start getting worse until 2 months off which is recently maybe a couple of weeks ago.

[Momoffour]

@AltostrataSo, do I reinstate? which drug and how much? I have to email my doctor to ask for a script i already asked her for liquid sertaline. but i can email her again if need be. 

[Momoffour]

@Altostrata I know you're busy and there's so many people needing help but I am not good and losing all hope. What do I do 

[Altostrata]

On 2/12/2022 at 4:20 PM, Altostrata said:

A very low dose reinstatement of an SSRI like sertraline may reduce the withdrawal symptoms. See About reinstating and stabilizing to reduce withdrawal symptoms 

 

Suggest you might get the sertraline liquid and try 2mg to start.

[Momoffour]

@Altostrata okay, thank you.. my doctor is supposed to call me in about an hour. I will let you know what happens. 

[Momoffour]

@Altostrata If i'm already sensitive to sugar and magnesium etc is 2mg still safe to try?

[Altostrata]

If taking 2mg makes you nervous, you might try 1mg. I cannot promise you what it will do.

[Momoffour]

@AltostrataOkay, Thank you so much. I pray this goes well, my kids need me.

[Momoffour]

@Altostrata She gave me liquid its 20mg per ml how do i get 1 mg from that?

[Altostrata]

See Tips for tapering off sertraline (Zoloft) You may have to dilute the liquid with water.

 

Ask your pharmacist for a 1mL oral syringe and instructions about how to use it.

[Momoffour]

@Altostrata Okay, I think I've figured it out. .05 is 1mg and I've got some orange juice  I'm going to pick it up in the morning. I'll keep you updated. 

[Momoffour]

@Altostrata I just took the mg mixed in orange juice. I immediately felt a small wave of anxiety and I do feel a bit different but couldn't explain how. Not necessarily worse which is hard to tell because I feel like crap anyway.