☼ James1987: I'm useless at topic titles

[James1987]

Hello one and all,

My name's James, and I've spent the last eight and a bit years on antidepressants for panic attacks.  Initially it was Citalopram at a dose of 60mg; that got replaced by 100mg of Sertraline, and I've been on the latter since Christmas 2010.  Now, I've tried a few times to escape the clutches of this stuff over the years without much success.  Far from helping, I was having multiple panic attacks a day while feeling generally abysmal, and I only improved on that front as soon as I fiddled around with my diet.  Suddenly, panic attacks were a thing of the past, yet here I was stuck on these pills.  From browsing the net and seeing sites like this, it became pretty clear that the "take 50mg for two weeks then drop to 25mg" professional suggestions were insanity, so I favoured instead a slow taper... not before being burnt by the more rapid approaches, sadly.

Fast forward to the present day and I've successfully made it down to 50mg, which is a point I never thought I'd reach, and I owe it all to the experiences of those who've gone before, so thanks for being a sensible alternative to the doctors.  It took me around ten months of dropping by 10% every six weeks to get here.  It was pretty painless, and I plan to stay here for a while to have a break from scraping pills and weighing miligrams.

Now, I've noticed that since making it down to 50mg, I've started to struggle a little bit.  I've been finding it difficult to get out and about, and have been having difficulty traveling too far from my comfort zone, if you like.  My main symptom is nausea - which was ALWAYS the trigger for my panic attacks.  There never was, to my mind, any anxiety caused by some mystical chemical imbalance; my fear of nausea, coupled with having it daily due to some dietary triggers, was always the culprit.  So yes, I'm currently pretty nauseous and anxious, and I'd appreciate some thoughts as to whether even after a smooth journey while tapering, symptoms can follow after as it catches up with you.  And if I hang around on this dose (which I always planned to anyway), will it pass with time?  Rocking the boat until I stabilise seems unwise...

 

Thanks!

[Rhiannon]

"So yes, I'm currently pretty nauseous and anxious, and I'd appreciate some thoughts as to whether even after a smooth journey while tapering, symptoms can follow after as it catches up with you.  And if I hang around on this dose (which I always planned to anyway), will it pass with time?  Rocking the boat until I stabilise seems unwise..."

 

Yes, absolutely. I call it "lag time." People very often (in fact, more often than not) get ahead of their nervous system's ability to adapt, while tapering.

 

I think it's the same process as when some people manage to come off their ADs pretty fast without too much trouble, and then three to nine months down the road they get hit with unbearable symptoms. There is something about the healing/adaptation/recovery process that seems to have that late-acting effect. Nobody's studied it systematically so we don't know what it is, but I've seen it hundreds and hundreds of times so I know it's real and not uncommon.

 

And yes, absolutely, the thing to do now is stay right where you are, don't change anything. Even if your symptoms get a bit worse. Actually, they probably will wax and wane for a while. Let them. Don't do anything. Give your brain a consistent, stable chemical environment, so that it can do its work of healing and readjusting everything.

 

Then, when you start again, start conservatively, with a smaller cut, perhaps 5-8% of your current dose (you have to make cuts based on your current dose, not your starting dose, because it's an exponential process, we have found, see this:http://survivingantidepressants.org/index.php?/topic/6036-why-taper-paper-demonstrates-importance-of-gradual-change-in-plasma-concentration/).  Then wait a solid four weeks at least, and keep a daily journal of your symptoms as they wax and wane. Once you're feeling consistently stable, do it again. This way you will be collecting data from your own experience. 

 

Once you've gathered information from your own experience you can adjust your taper accordingly, up or down. Your body is the expert and it doesn't know from calendars and calendar schedules, so a strict "this much percent and this many days" is just sort of a framework and should never be used as a rule. Your body is the guide. Gather information from listening to the expert, and shape your taper accordingly.

 

It's way better to risk going a bit slower than you could, than to risk a crash and burn by going too fast, trust me!

 

A couple more things:

http://survivingantidepressants.org/index.php?/topic/6447-best-of-sa/?p=91582

 

http://survivingantidepressants.org/index.php?/topic/6447-best-of-sa/?p=89767

 

and if you want still more reading, I highly recommend Anatomy of an Epidemic by Robert Whitaker. Pretty much anyone who has ever taken a psychiatric drug needs to read that book. I think it should be handed out along with the prescriptions, actually.

 

Glad you found us. You've done brilliantly so far. Many people have encountered what you're experiencing now (an exacerbation of symptoms as they get to lower doses in an otherwise quite successful taper). The solution, as you have already figured out for yourself, is to hold and not change anything and keep things as stable as possible. You will stabilize and the symptoms will pass and you will be able to continue your taper, albeit perhaps at a slightly slower rate.  

 

Welcome to the forum, and good luck to you!

[Petunia]

Hi James,

Welcome to SA, I'm sorry to hear that you have increased symptoms now you are down to 50mg.  I agree that holding is the best idea for now.

 

 

... Far from helping, I was having multiple panic attacks a day while feeling generally abysmal, and I only improved on that front as soon as I fiddled around with my diet.  Suddenly, panic attacks were a thing of the past, yet here I was stuck on these pills. 

.... My main symptom is nausea - which was ALWAYS the trigger for my panic attacks.  There never was, to my mind, any anxiety caused by some mystical chemical imbalance; my fear of nausea, coupled with having it daily due to some dietary triggers, was always the culprit.  So yes, I'm currently pretty nauseous and anxious,

 

What changes did you originally make to your diet which relieved the nausea?  I'm wondering if perhaps your diet has changed over time or perhaps you have become sensitive to something else.

 

You may already know this but ginger can help with nausea and sometimes probiotics.

 

Here is a topic discussion about nausea which may give you some more ideas:

 

http://survivingantidepressants.org/index.php?/topic/4632-nausea-queasy-stomach-lamictal/

 

I hope you feel better soon.

 

Petu.

[James1987]

Firstly, a thank you and an apology to the two kind posters who got back to me.  I can't remember why I didn't reply, but there was a lot of withdrawing into myself going on back then.  A lot of people (including friends and family) didn't see much of me.

Anyway, I was thinking about this site earlier, and thought I'd add my updated situation to proceedings.  

 

Recap:

 

I was put on Citalopram for panic attacks (60mg) in 2005.  I switched to Sertraline (100mg) in 2010, and this was the real beginning of my battle to get off the medication due to the effect it started having on me.  It was comfortably the most terrifying period of my life; one where I no longer felt fully in control of myself.  A time where my brain would randomly, and with no relation to any depression or sadness, decide that it was time for me to die.  Or that someone else had to die.  It was like I wasn't the only one at the controls in my subconscious, and the fact that I was aware of the battle made it even more terrifying.  Had I messed my mind up with these things?  Come tomorrow morning, will I have taken another step in the wrong direction, and am now closer to falling into this chasm?  I don't think I'll ever know fear like that again.  

I phoned the experts, begging for help.  Trying to make them understand that I wasn't like this before, and that they needed to help me.  The answer was to be another prescription.  That was the point I realised that I was on my own, and started trying to get off them.  I followed the doctor's suggestion of fortnightly quarterly drops.  No success.  I tried to bite the bullet in one and went cold turkey.  That was even worse, and would result in my taking more than my prescribed dose when it got too much - very bad idea.At some point (can't remember exactly when), I did a very slow taper, halving my dose to 50mg and staying there until June 2016.

 

Away from the drugs briefly, my panic attacks were always caused by chronic nausea.  I'd be on the verge of throwing up literally all day long, and when it got especially bad, it would spill over into panic attacks.  The fear of throwing up, and of the panic attacks themselves, snowballed into not going out, and, before you know it, you're collecting prescriptions.

 

Anyway, there were a few instances of celiac disease discovered in my immediate family.  I was never checked (because I wasn't going out at the time), but I started avoiding gluten, too.  Just to see.  My nausea vanished within a fortnight, and my panic attacks largely faded away, too.  I've still never had it confirmed, but when I eat it, I feel as sick as a dog... so I just don't eat it.  Much-improved, but it wasn't all sunshine and roses.  I'd learned to instinctively avoid literally every challenging situation for a very long time (pre-medication), so it wasn't easy to just start functioning like everyone else.  

 

June 2016:

 

After a couple of stomach viruses courtesy of my niece, I'd kicked my fear of nausea and throwing up.  I'd also decided to kick the Sertraline once and for all.  The pill-shaving and 10% drops had worked so well previously, but it took a long time, and this would take longer: A drop down to 45mg over six weeks; then down to 40.5mg; etc.  With this in mind, and a strange confidence and sense that it was time, I made the silly decision to go cold turkey.

 

I felt physically awful for a couple of months, and the mood-related symptoms stayed longer.  I was dizzier than I'd ever been in my life; standing up was hard work, and I couldn't have walked in a straight line if you'd paid me.  I was burning up and icy cold at the same time.  Lots of nausea and sickness.  Exhaustion, and then bags of energy and restlessness.  None of that was fun, but the mental side was the worst of it.  I remember catching sight of myself in the mirror and laughing until I started screaming.  My companion at the controls I referenced earlier returned.  I recall one night in bed, my mind made the (completely random) suggestion that I throw myself down the stairs, and to make sure I break my neck while I'm at it.  It would tell me that if I went to sleep, I'd never wake up again.  And because it felt like it was 50% of my subconscious at the time, I half-believed it.  That was always the scariest part of these drugs for me: that battle between myself and the interloper for control.  

 

I think I got off quite light on the physical stuff.  I've certainly read others having it worse, and for much longer.  The mental side was tough.  I'd feel unbelievably angry... on the verge of punching my lovely grandmother in the face angry.  I found omega 3 helped.  I don't know why, but if I had it for a couple of consecutive days, I'd be noticeably calmer; if I missed it, I'd be raging again.  

 

So, I'm off the drugs, which once felt impossible.  They (and the panic attacks) dominated my life completely for just over a decade, at the expense of everything else.  Relationships; friends; career prospects; etc.   The punchline is that I'm more depressed now (at how much I've missed) than I ever was before I was told I had a chemical imbalance.  My life feels a little like a smoking ruin after all this fun, but ruins have potential for renovation.

[Altostrata]

Thanks for updating your Intro topic, James. Good to hear you've survived cold turkey.

 

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"Is it always going to be like this?"

 

The importance of recognizing you're feeling good

 

Creating a new self after withdrawal

 

What does healing from withdrawal syndrome feel like?

 

Since it seems you're out of the withdrawal syndrome woods, this calls for our cheerful "here comes the sun" symbol ☼ to be added to the title of your Intro topic, to show you're recovering.

 

Please continue to let us know how you're doing. I hope you will add your story to our Recovery Success Stories eventually!