Sadmedik's Sertraline Journey

[sadmedik]

Hi! I just found out about this forum and am really glad to be here!

 

I was put on sertraline 150mg when I was 12 years old in 2007 for OCD. My compulsions were pretty bad so I think it was the right choice. Within a year or two, the anxiety related to doing compulsions faded away and I was able to stop. But what I did develop was an overwhelming dysphoria that I could never explain. It was a constant hatred for myself that seemed to have no source and had no reason behind it (spoiler: it was meds). I was young so I chalked it up to puberty.

 

In 2010, unrelated to medication, I developed some general anxiety, mostly around severe phobias. The anxiety and phobias went away by 2013 through self driven exposure therapy.

 

In summer 2018 I was put on Vyvanse 50mg because I was having trouble sitting in lectures for long periods of time. Stayed on it for half a year - it helped for focus but would cause such mood swings when wearing off that I wanted it gone. Going off it made me more exhausted than ever before but it got better within a month or two. As was expected from an amphetamine taper.

 

In summer 2019 I decided to try my first taper off sertraline because I was tired of feeling dysphoric all the time and I just wanted to see what I would be like without it, seeing as I had not had anxiety since 2013 (Was the OCD and/or anxiety still there?). The taper was quick (over a couple months) and besides feeling a little crappy and dizzy/brain zaps, it got done. I hit 0mg on August 1st 2019. By mid October 2019, I noticed an increase in rumination. I had one instance of anxiety and decided to run back to the meds.

 

But once I was back on, I realized how numbing the meds were. How I'd felt actual joy while I was off them, how I'd been able to laugh and for the first time, NOT hate myself. How I'd suddenly cared about people and felt empathy. I also realized how sleepy the meds made me. The rumination never fully went away (which made sense, as the meds were more helpful than a fix-all) but did get a bit better.

 

In 2020, I worked with my doctor to find an adjunct (on top of my sertraline) that could reverse the anhedonia and give me more energy/reverse the sleepyness. I tried Vyvanse again but the side effects were the same. Wellbutrin for 5 months, but it gave me wicked anxiety (worse than anything ever felt before) and a brutal headache with little effect on mood. I tried Foquest (Ritalin XR) for a month with no effect.

 

I then started Fetzima (SNRI) in summer 2021 while starting to taper off sertraline. It was done slowly, and I noticed no change in mood, just that I started getting heart palpitations and sweating. That led to both being tapered, and by Nov 1 2021 I was off Sertraline, and by Dec 1 2021 I was off Fetzima.

 

Then we start the fun part. The taper effects themselves were short-lived and just general crappyness. But symptoms of systemic inflammation started to creep in, like old injuries all hurting, puffy eyes and face, frequent infections, extreme fatigue, slow healing. I developed a mole around this point on my stomach that turned out to be melanoma (found out this Jan 2023). I did notice the same rumination increase, and by Jan 2022 I developed an extreme anxiety I'd never felt before. I chalked up my physical symptoms to longer withdrawal symptoms and the anxiety to a maybe-relapse, despite never feeling that kind of anxiety before. I'd only ever been off the meds for a couple months at a time so I didn't have a lot of info to go on.

 

I went back on sertraline by Feb 1 2022 due to the anxiety. What was weird was that going on the meds made my anxiety worse for a week or two, and continued to do that each interval increase until 200mg. It took me all the way until June 2022 to stop feeling panicked all the time, leading me to wonder if sertraline ever really helped the anxiety much to begin with - maybe it only ever helped the rumination. This would explain why I developed anxiety years after going on the meds while the OCD got better. Ah well.

 

It definitely helped the rumination by making it harder and slower to think. Like the time before, I noticed a huge dip in empathy, a major drop in motivation, a chronic sleepyness (at least I could sleep!), and anhedonia. The self hatred came back. But hey! At least my body felt good. Like all the times I'd been on it - no inflammation. No infections. No illness. No constant ache: and pains. No bone-deep fatigue.

 

But I wanted to feel things.

 

So I started tapering (even slower!) August 2022. Completely off of it by mid-November 2022. And like deja-vu, all the same things happened.

 

Brain zaps, dizziness, nausea during the taper that went away a few weeks after 0mg. Rumination starting to creep in as the dose lowered. And a few days after 0mg, symptoms of systemic inflammation (that's just what I'm calling it). All my injuries starting hurting. Major back pain, which I'd never had before. Puffy eyes. Acne, and slow to heal. I caught Covid and 2 other colds in the last 6 months, whereas I was NEVER sick before. Infections, too. Fatigued worse than I've ever been. And low mood, too. And of course, an anxiety flareup come January 2023.

 

So that's why I'm here. I'm only 2.5 months from 0mg sertraline so I know that all these side effects could be from the medication, but I also have worries of "relapse." I know I'm more anxious and tend to ruminate, so I'm trying not to focus too much on my health symptoms, but it's hard when you feel so terrible all the time. It's like balance I'm trying to keep up - not fixate completely on my health symptoms as that worsens the anxiety.

 

I know that SSRI's are potent anti-inflammatories so I worry that I'm suffering rebound effects (body used to anti-inflammatories doing the job for it) causing all this inflammation.

 

And with my most recent diagnosis of melanoma, I'm terrified that all the inflammation will make it worse. I'm debating going back on but I'm just so tired of the back-and-forth.

 

Hoping to read other people's stories and hang in there, just to see if things change over the next few months for me. Maybe I'll have to be on sertraline forever and not feel anything, because at least that's better than the present, not feeling emotions AND struggling with physical issues (and anxiety!)

 

So thanks for listening! I'm proud of everyone going through medication changes, new meds, med tapers, etc. - it's not easy and there's not enough information on it. Know that you're not alone in the battle.

[Gridley]

Welcome to SA, sadmedik.  I'm sorry you're going through all this.

 

I need a little more information.  I'm going to lift some quotes from your post and ask a few questions about them.  Please edit your drug signature to reflect your answers.

 

On 1/27/2023 at 2:51 PM, sadmedik said:

in summer 2021 while starting to taper off sertraline. It was done slowly

What was your starting dose and your rate of taper?

 

On 1/27/2023 at 2:51 PM, sadmedik said:

Nov 1 2021 I was off Sertraline

Please put this in your signature.

 

On 1/27/2023 at 2:51 PM, sadmedik said:

 

I went back on sertraline by Feb 1 2022 due to the anxiety.

Dosage?  Please put in your signature.

 

On 1/27/2023 at 2:51 PM, sadmedik said:

What was weird was that going on the meds made my anxiety worse for a week or two, and continued to do that each interval increase until 200mg

Rate at which you increased and date you reached 200mg?  Please put in your signature.

 

On 1/27/2023 at 2:51 PM, sadmedik said:

So I started tapering (even slower!) August 2022. Completely off of it by mid-November 2022

Rate of taper?  Please include in your signature date you started the taper (Aug. '22), date finished (Nov. '22), and last dose in mg before you jumped to zero.

 

You've gone through a lot of dosage changes in the last couple of years.  Until I have your signature update, I won't know your taper rate but very likely it was much faster than we recommend.  We recommend tapering by no more than 10% of your current dose every four weeks.

 

Why taper by 10% of my dosage?

 

According to your post, you jumped to zero 2.5 months ago.  I can't say whether the symptoms you're experiencing are due to withdrawal from the drug or from other causes.  Here's information on the withdrawal that can result from a too-rapid taper of psychiatric drugs--

 

What is withdrawal syndrome.

 

Brain Remodelling 

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

Reinstatement of a very small percentage of your last dose before you jumped to zero is the only known way to eliminate or reduce withdrawal symptoms.  The other choice is to wait it out at zero, but there is no way to know how long this will take.  If you want to try reinstating, we can suggest a reinstatement dose once you've answered my question about your final dose in Nov. 2022.  Please do not reinstate without letting us suggest a dose.

 

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

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium (glycerinate is a good form) and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Add in one at a time and at a low dose in case you do experience problems.

 

Regarding withdrawal vs. relapse, this link might help:

 

How do I know it's withdrawal and not relapse?

 

This is your introduction topic -- the place for you to answer my questions, ask your own questions, record symptoms, share your progress, and connect with other members of the SA community.  I hope you’ll find the information in the SA forums helpful for your situation.  I'm sorry that you are in the position that you need the information, but I am glad that you found us.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Edited January 29, 2023 by Gridley

[littlebird]

Welcome, glad you're here!

[sadmedik]

Hello!

Thank you for your response! I really appreciate the feedback.

 

Here are the taper dates. The first two were pretty fast. The third was slower.

 

End April 2019: 40mg Vyvanse --> 30mg

Start of April 2019: 30mg Vyvanse --> 20mg

Mid April 2019: 20mg Vyvanse --> 0mg

June 4 2019: 150mg sertraline --> 100mg

July 13 2019: 100mg --> 50mg

July 27 2019: 50mg --> 0mg

Oct 16 2019: Started 50mg sertraline

Jan 4 2020: 50mg  --> 100mg

May 25 2021: 100mg --> 150mg

Aug 3 2021: 150mg --> 100mg

Aug 5 2021: Started Fetzima 20mg

Aug 7 2021: 20mg Fetzima --> 40mg

Aug 31 2021: 100mg sertraline --> 50mg

Sep 1 2021: 40mg Fetzima --> 60mg

Oct 13 2021: 50mg sertraline --> ~25mg

Oct 17 2021: 60mg Fetzima --> 40mg

Oct 27 2021: ~25mg sertraline --> 0mg

Nov 19 2021: 40mg Fetzima --> 20mg

Nov 29 2021: 20mg Fetzima --> 0mg

Feb 3 2022: Started 50mg sertraline

Apr 5 2022: 50mg --> 100mg

Apr 24 2022: 100mg --> 150mg

Jun 1 2022: 150mg --> 200mg

Aug 3 2022: 200mg --> 175mg

Aug 17 2022: 175mg --> 150mg

Aug 31 2022: 150mg --> 125mg

Sep 14 2022: 125mg --> 100mg

Sep 28 2022: 100mg --> 75 mg

Oct 12 2022: 75 mg --> 50mg

Oct 26 2022: 50mg --> 25mg

Nov 9 2022: 25mg --> 0mg

 

Supplements:

- 2-3000 IU Vitamin D (Vitamin D deficient bloodwork) and 1 tsp fish oil every couple days since Dec 1 2022

- 200mg magnesium glycinate at nighttime since mid-Jan 2023

- 75mg iron bisglycinate (iron deficient) every couple days since Jan 2023

 

 

[Gridley]

9 hours ago, sadmedik said:

Aug 3 2022: 200mg --> 175mg

Aug 17 2022: 175mg --> 150mg

Aug 31 2022: 150mg --> 125mg

Sep 14 2022: 125mg --> 100mg

Sep 28 2022: 100mg --> 75 mg

Oct 12 2022: 75 mg --> 50mg

Oct 26 2022: 50mg --> 25mg

Nov 9 2022: 25mg --> 0mg

 

Thanks for the information.

 

This is an extremely fast taper.  If you'll look at my first response to you, you'll see the link about our recommendation that you taper by only 10% of your current dose every four weeks.  The symptoms you're experiencing are almost certainly withdrawal caused by the fast taper.

As I wrote in my earlier post, reinstatement of a very small percentage of your last dose before you jumped to zero is the only known way to eliminate or reduce withdrawal symptoms.  The other choice is to wait it out at zero, but there is no way to know how long this will take.  If you haven't already, please read the link I supplied:

 

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

 

You're still within the time frame when reinstatement more predictably works, up to three months.  If you decide you want to reinstate, I suggest a dose of 1mg Sertraline--no more.   This may seem small, but your system is destabilized and very sensitive and too much can overwhelm your brain.  The following link about tapering Sertraline gives information about how to obtain the small dose you'll need for the reinstatement.  The methods are using a scale to measure powder from your pill, making your own liquid from the pill or using a prescription Sertraline liquid.  The prescription liquid is the easiest but does require a prescription and the cooperation of your doctor, whereas the first two methods can be done using pills you likely still have from your taper.

 

Tips for tapering off sertraline (Zoloft)

 

We need to see how 1mg affects you. It will take about a week for it to get to steady-state in your bloodstream, the effect should get stronger during that time.  If 1mg is enough, it still may take some weeks or months for your nervous system to settle down. You probably will continue to have waves and windows (ups and downs) , but symptoms won't be as intense. If it seems you need a higher dose, it will be easy to very carefully increase it.

 

Please keep us informed how you're doing.  You can tag me by typing @Gridley and then clicking on the rectangle when it pops up.

 

 

 

Edited January 30, 2023 by Gridley

[sadmedik]

Thank you, I appreciate it. I'm already past the 3 month mark and honestly doing poorly (physical symptoms still present and what feels like just nervous system fragility - very anxious, cry at the drop of a hat, depression, no libido whatsoever) so I may consider trying out the small dose, or going back on a higher dose at the recommendation of a doctor.

 

I went off the medication because I hated feeling so flat all the time (I went on with OCD/anxiety but no depression). But I've been downright depressed since I've gone off, worse than I've ever been. So it's hard to see the theoretical "light at the end of the tunnel," if there even is one. Each day that things don't improve, I wonder why I went off the medication in the first place and consider going back on.