My daily diary: Starting doses-first timer...
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Hello Everyone,
As many of you in here, helped me through this starting process and your positive stories has been inspiration to me, so i decided to write my diary, so that it may help somebody who will be in the same situation like me, scared, anxious and starting with SSRI for the first time...
I just started taking sertraline for my anxieties, mainly health anxiety, but also few others too. Depression and sad mood is a part of this too. Never take any SSRI Ads like this before, this is my first time. Also i am not using any sleeping pills or benzos etc. during this starting treatment. GP prescribed 50mg without any instructions, but i started slowly from 12.5 gradually upping my dose to avoid side effects, because i am too sensitive to meds.
I will try to update this diary in future whenever i can...
Here is my starting daily diary of Sertraline (Lustral or Zoloft) :
Day 1: Starting dose 12.5mg, Sertraline brand: Lustral by Pfizer, taken at 8:30am. Also i am using B complex and iron supplement daily.
Being already anxious and nervous from fear of the side effects which i was reading before i took sertraline. I expected to feel sick and horrible, but hour later i just felt little bit calm and tired, two hours later i started to feel energetic, positive, but it seems to me that that was just false placebo effect. 8hours later i started yawning a lot, my mood changed to sad and i became lethargic. 10hours later started to feel little anxious, which is my usual 5-6pm anxiety time and my teeth are chattering a little. 12hours late i was calm and ok. Slept around 7 hours non stop which was a progress from previous night time wake ups.
Day 2: 12.5mg at 8:30am
Feeling calm, relaxed and tired. Mood is sad, in afternoon i have very short wave of anxiety which was suddenly switched to good mood, strange feeling... Later during the day i was tired and little anxious till' evening, also started to feel little nauseous and i lost appetite, not hungry at all... Around 9pm i was ok, my mood was positive, but i was unable to go to sleep, barely slept 4hours in total.
Day 3: 12.5mg at 8:30am
I am feeling very cold, tired, nauseous and unable to eat, laying in bed. Feeling sad and anxious, but then again it disappeared again?! Later: Tiredness, dizziness, chills, cold feeling, i have to put on jacket while i am in bed, no fever or any other symptoms. not hungry. Frequent urination in late afternoon. At 11pm i felt a little better and was able to fall in sleep, wake up once around 4am, but i was able to get back to sleep.
Day 4: 12.5mg at 8:30am
Wake up around 8am, calm, feeling ok. Later around noon feeling tired but mood is ok, feeling more confident for a short time. Around 5pm back to feeling anxious, tired, still not much appetite, don't feel cold like yesterday, but health anxiety causing me a hard time... Again feeling cold from 8pm till' 11pm ,also frequent urination from 5pm. From 9pm anxiety disappeared and i am feeling ok but tired. Going sleep at 1am and sleeping till' 7am.
Day 5: change dose to 25mg at 8:30am
Feeling very tired, visual disturbances not see things clearly, no energy at all, feeling dizzy. Still not hungry, nauseated, pushing myself to eat some crackers etc. In the bed reading sertraline forum from this website, trying to find positive stories and informations to calm my anxiety down. Lot of yawning, frequent urination in late afternoon. But not feeling cold anymore. Over all not great day at all... Not able to do much except bury myself in sofa under duvet... Jump from 12.5 to 25mg was definitely felt...Slept 6hours.
Day 6: 25mg at 8:30am
Wake up with morning anxiety, feeling dizzy, no appetite, don't feel well, scared, questioning myself if i should continue and push through this, but reading through sertraline positive stories helps me to decide that i will continue with treatment. Feeling very tired, exhausted, energy is completely drained, drinking probiotics, eating crackers, trying to eat a soup... Then back under duvet... feeling dizzy. At 5pm starting to feel little better and around 8pm i am feeling fine for the rest of a day, another switch?! Wake up at 4am unable to go back to sleep...
Day 7: 25mg at 8:30am
Slept only 4hours, but strangely i am feeling ok, some change going through me, but i can't explain it... Feeling energetic. From 10am starting to feel again tired but energetic as well, no nausea, calm and quiet. From 2pm more tired, little dizzy, calm and numb feeling with little headache. From 5pm mood changed to sad and anxious and very tired. 11:45pm Feeling ok, but tired, sleeping 8hours, wake up once at 2am, but get back to sleep shortly after.
After first week:
I would say at the beginning, first two days, not much happened, but then the side effects like nausea, dizziness, tiredness, lethargy, loss of appetite, blurry vision, clenched jaws, frequent urination, elevated anxiety and depression started and it was a not great feeling, not being able to do much, mostly stuck on sofa, eating crackers, soups, fruits, probiotics and drinking lots of water... Couple of short mood switches (from anxious to calm, from sad to ok) which lasted anything from 1hour to 4hours. Overall I would say 1st.week it's doable even without calming/sleeping/benzos meds. I started slowly from 12.5mg for 4days then to 25mg after to avoid side affects as much as i could. Dosage change to 25mg was significantly felt and added more strength to the existing side effects for about next three days.
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Day 8: 25mg at 8:30am
Take a short walk 30min on beach, but felt tired and dizzy, don't feel great... Back home feeling tired, sleepy, but ok. From 2pm mood changed to sad i am trying to go to sleep, but no, another switch! I became energetic from nowhere and started with some project i had. Mood is calm and i am feeling better. 8pm Heath anxiety, but shortly after disappeared then i stayed calm and feeling numb. Yawning and frequent urination. From 9pm i am feeling ok. Wake up twice during the night slept almost 7hours.
Day 9: 25mg 8:30am
Wake up at 8am don't felt any anxiety. Mood is calm and numb and feeling tired. All day feeling sleepy, dizzy lot of yawning and again nauseated. Then anxiety and depression hits me big time till' 8pm. From 9pm sad mood, but not nauseated. 10:30pm Feeling ok and calm. That was one of the worst days since i started sertraline...Slept 6.5hours.
Day 10: 25mg 8:30am
Little morning anxiety, but managed well, breakfast... Little anxiety in the car just for few minutes and it disappeared shortly after. Later on feeling little lightheaded, headache, but is better than yesterday. From 7pm feeling ok for rest of the day. Went to sleep at 1am slept 6hours. It was much better day than yesterday.
Day 11: 25mg 8:30am
Feeling ok, slept fine, no more yawning, hungry,cravings for junk food... being able to do things around me, i don't feel tired anymore. Mood normal, not happy but not sad, all day. Thinking now, if is it a good time to upping the dose... Its strange to not being able cry, smile just being numb, but still better than anxiety...Sleeping fine no more wake ups...
Day 12: 25mg 8:30am
Same feeling like yesterday, no side effects or anything, just feeling numb... No yawning, feeling hungry, keep thinking about the dosage, if is it good time to go up to 50mg now, hopefully numbness disappear soon. Otherwise it's a almost third day i don't feel any side effects. I don't know if is it a good idea to prolong a 25mg dose as it looks to me that my side effects are gone and maybe is time to start prescribed 50mg dose now. I know this may puts me back to day 1 for some time, but if i stay on 25mg it might leave me soon stuck without any treatment...
Day 13: 25mg at 8:30am
Last night i have a good mood and was chatty after a long time, i didn't sleep well, wake up couple of times around 4am, 5am, 6am and felt little anxious, sweaty, but then all calmed down. During the day i was fine, no side effect, mood was normal, not tired and not numb anymore like days before. Eating normal. Early evening there was a little health anxiety, but nothing to compare with my anxiety before...In the late evening my mood changed and i became a little depressed and sad. Then from around 10pm i was ok. Scared to upping my dose to 50mg i was thinking to go with 37.5mg from day 15, but then again i would have to upping my dose to 50mg which means i will have to go through side effects twice...I don't know, i can't decide yet...
Day 14: 25mg at 8:30am
Didn't sleep well, wake up couple of times again around 4am and once again i was sweating like hell. In the morning i was little anxious and felt little dizzy, but not as much as at my first days. After breakfast i felt better. Later on in the afternoon i was stressed and unable to relax for no reason, but it calmed down and my mood became sad and depressed and felt little dizzy for a short time. In the evening i am not tired it looks like its a best time of the day for me. There are no physical side effects anymore, it all looks like to me that either 25mg is not enough anymore or my body still going through some process. I know it is still early, today is the end of the second week, tomorrow starting a third week, but most of the people switch to 50mg by the end of the first or second week. I feel like yo-yo, different moods keep switching through this second week...
After Week 2:
First two days i felt horrible due to dose change to 25mg, but then i felt ok. I would call this week false week, as it makes me feel good, but that was not for long by the end of the second week i started feel anxious, sad and depressed. Good thing was, that there was no more side effects and i was able to eat and do few things around. Started thinking that dosage should be upped now, but still not sure about that. Overall, second week was better than first week.
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2 likes, 34 replies
rob55013
Edited
Update:
Day 20: 50mg at 9am
Day 2 on 50mg
In the morning i felt ok, but i don't want to get up from the bed, don't feel sleepy, just lazy... Don't feel any side effects or anything as i did before when i started on 25mg.
Feeling hungry bit more than usual. In the evening, everything is fine too, clenching teeth and feeling little muscle tension, but no other side effects, so far, it looks like i was worry from upping my dose to 50mg and nothing major happenned yet... Mood is ok, no anxiety or depression. Not tired, but not energetic either. Not sad and not happy, just normal. It feels like any anxious thoughts are somehow blocked...at least for now. Went to sleep early and once again i was wake for a few minutes around 3am, but i was able go back to sleep.
Day 21: 50mg at 9am
Day 3 on 50mg
Wake up bit early, but don't have any morning anxiety or any side effects. I don't feel sleepy, or lazy like yesterday morning. Teeth clenching and little teeth trembling around 11am. Checked my blood pressure and heart rate, all normal. Don't feel that much hungry like yesterday, but it's still too early to say...In the noon, triggered by a stressful information, but dealing with it calmly as much as i can, feeling little shakiness, its more like a little twitching in my right foot and my jaws are bit tight, but is nothing major.
I think i spoke to soon...in the late afternoon around 5pm, my anxiety came back, together with clenched jaws and little shakiness, its not great, but its manageable. Around 6pm i am feeling a little bit dizzy, but not as much as on 25mg when i started. 7pm feeling bit tired, jaws and muscles are still little bit tense. 8pm Starting to feel better, clenched jaws eased a bit, so does muscles, so i would say that from 5pm to 8pm when i was feeling anxious with those side effects is the time when sertraline is at max. peak in my body/system and because my system is not adjusted yet to that dose, it is causing these side effects, especially at "sertraline peak time". I can simply take 2mg of diazepam, because it is also works as a muscle relaxant, but like i said, i am avoiding them as much as i can and "rolling with a punches..."
Sertraline Plasma peak concentration:
6-8 hours after i take sertraline, it should be working at its max. peak (plasma peak concentration) , which means from around 3-5pm sertraline will have max. concentration in my system, since i took sertraline at 9am.
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Week 3 Summary:
Week 3 was mostly about a scary jump from 25mg to 50mg, didn't know what to expect, so many people describing 50mg with bad feelings/experiences and with so many side effects, but so far i would say is not that bad, didn't feel much elevated anxiety or not that many side effects so far. I don't know, maybe it was because i gave my body/system longer time to get used to sertraline? (4days on 12.5mg then 14days on 25mg), therefore 50mg didn't caused any "major" shock to my system? , also my jump is only by 25mg. I am using branded Sertraline (Lustral by Pfizer), some people have explained, that generic sertraline may cause more side effects and make you feel sick. Also before i take sertraline in the morning i eat a little and drink some probiotics. Then i take B-complex and iron supplements. All of this could be the reasons why i didn't feel that many side effects after upping to 50mg, but i can't proof or guarantee, that this will work for everyone, if anyone, maybe i was just lucky...
So far i am starting to feel some benefits, my anxiety is now more manageable and less frequent, i am starting to have a few good moments from a few hours in some days to even a whole day. Social anxiety and agoraphobia is getting better too, i am starting to be able to do things, that i would normally avoid. Depression and sadness is little bit better, but this will take a much more longer time to fix this. Sleeping before sertraline was bad, i think it changed a little bit too, i do wake up sometimes in the night, but i am able to get back to sleep shortly after, which was not possible before sertraline. From now on i will try to update my diary once every week, so next time it will be at the end of week 4, which should be my halfway to start to feeling some more benefit and good moments from sertraline.
rob55013
Edited
Update
Week 4: 50mg at am.
Day 22 (day 4 since dose change to 50mg)
First day of week 4 was already better than yesterday, no morning anxiety or lethargy, no morning side effects. Took a walk on the beach, it was not a long walk like i am used to, only around 30min. In the afternoon i started yawning a lot and feeling a bit tired. In the late afternoon once again, around 5pm, my jaws became bit tense, but it is less tense than yesterday and my muscles are not tense at all. Health anxiety thoughts keep bothering me during this time, but i am trying to keep them under control, also they are less intense than yesterday. At 8pm once again they are all gone and i feel ok. Slept ok.
Day 23 (day 5 since dose change to 50mg)
Next day i wake up fine, seems to me that mornings are mostly without any issues now, mood is normal (not sad and not happy) i don't feel numb. Afternoon i felt crashed around 2pm, but i am not going to take a nap... otherwise i wouldn't be able to sleep at night. Late afternoon again, same thing like days before during the sertraline peak time, felt anxious and depressed, but i can control it without needs for benzos. Health anxiety is playing with my head in the evening, but doing my best to turn my attention to something else, feeling bit dizzy, tension headache, teeth are trembling, sweating a little bit, feeling hot and then feeling cold shortly after and lot of yawning, around 10:30pm it all calmed down, waiting for night so that i can sleep on it and move to another day. Not feeling well tonight, my mood is not great either. Day 23 was definitely not a good day for me, but i did expected that, these good/bad moments/days, will be playing with my mind for a while until i'll get levelled.
Day 24 (day6 on 50...)
Well that was a horrible night... didn't sleep much, wake up at 1am, 3am, 4am, 5am... morning was ok, but i was tired, i can feel that this will shape up the rest of my day... By the noon i was like a zombie, tired, kinda waiting when these upped dose side effects subside... Few more days, week... who knows... It's afternoon now, feeling tired, have a headache, feeling a bit anxious again,dizzy and over all, don't feel great, not even hungry, all i want to do is wait for dark and go to sleep, still too long it's 3pm now...everything is going so slow, every hour feels like forever... Bad mood, depressed, upped dose adjustment is showing it's nasty side...Finally, it's evening, it's around 10pm and i feel fine, i am not even tired, that's crazy...after that long and bad day, i feel positive, energetic this is how i should be feeling during the day...these mood switches just proof that sertraline is adjusting and rebuilding slowly serotonin levels.
Day 25 (day 7 on 50...)
Finally my sleeping was better, did sleep all night, wake up bit early, but i am ok. It's raining a lot, everything looks grey outside today, but it doesn't bother me... I was reading again some good stories about sertraline in here and it seems that most of the people graded first two weeks as the most bad ones and i agree, they graded third week as a good week and week 4 and 5 again as a bad weeks, but not as bad as the first two weeks, so far it almost matches with my experience. Afternoon was great i was able to get to my hobbies and activities which i have not touched for a long time, good energetic positive mood. Evening is ok, much better than a few days before, actually this is one of the first days on 50mg when i am feeling fine without any side effects a whole day. That is seventh day since i upped dose...
Day 26 (day 8 on 50)
Wake up early, but didn't get up, feeling ok, no side effects or anything, looks like side effects from upped dose are gone now for at least two days. So it took me something around 7days to adjust to a new upped dose and to get rid off side effects, at least for me. At noon my mood switched to sad and depressed, didn't want to get out of the house, even going out with my dog causing me a lot of trouble today...anxiety and agoraphobia acting up... don't feel like to do anything, i would like to sleep through this mood swings and wake up when everything gets permanent, stable and levelled, but that would take at least another month...At 5pm i feel little bit better. Around 7pm i have a little headache and anxiety. At 10pm all is again better. All moods keeps switching a whole day and night...
Day 27 (day 9 on 50)
Vivid dreams, wow, that was a night... This is the first time since i started sertraline that i do remember my dreams, they were so realistic, nothing scary or anything like that, just very realistic, no wonder i wake up in the early hours, my heart rate was elevated, my blood pressure was slightly up too, i was screaming on my chemistry professor in that dream, its like physical symptoms of very short panic attack, that's why my brain wake me up with eyes wide open, at least now i know... Then i was able to go back to sleep, but the vivid dreams continued till' morning. In the morning i feel ok, but tired, its Sunday, took a sertraline, crackers and probiotics and went to back to bed, just reading and waiting for time to pass by.There are no side effects in the mornings anymore from upped dose. Feeling lazy again, just wish i can skip this Sunday. Noon, sad depressed mood, i just want to get back to a sofa and sleep over this. Afternoon, anxiety kicks in and in the evening everything is ok, this pattern keep repeating itself for a couple of days now...
Day 28 (day 10 on 50)
Ok, last day of week 4, finally. That was a long week, full of up and downs, yo-yo effect non stop. Today i am up early, slept better, but not without vivid dreams or a waking up. Seems to me that i am able to go to sleep much earlier, than i was used to, tired bit more and overthinking less. Great, another bank holiday, this week really doesn't want to end... Almost noon, feeling tired and lethargic. Afternoon sad and depressed, trying to push myself to take a walk and do something to make my mind to switch. Evening once again is fine, this is really not great week at all, week 4 really sucks, i know some things are getting better i can feel that, i don't cry anymore, but also i don't smile, just existing, i know these are depression caused thoughts, few intrusive too, i just want to feel ok, like others in here experience with sertraline, i know 4 weeks...is nothing, i have to wait it out..i am just mentally tired today...but i don't give up. It's a long journey, but tomorrow is a another day.👍💪🙏
Week 4 Summary
Upping dose to 50mg definitely set me back, spend 7 days waiting for some of the side effects to ease and subside from the upped dose, side effects like tension headaches, tense muscles, jaw clenching, teeth trembling, tiredness, sleeping troubles, vivid dreams, legs twitching. Some anxieties, depression, sad mood and overall, mentally i don't feel great either. Night sweating and nausea, loss of appetite does not came up this time during this upped dose adjustment. Not great week at all, but is not that bad like first week was. On the other hand i have a few good moments and even one good day in this week, mostly mornings and evenings are ok. For me, it was doable without benzos or sleeping pills, but there was a moment or two when i was trying to reach for diazepam, but in the end i didn't. I will keep going with this sertraline treatment and "roll with a punches" even if i will have to increase to 100 or more, i just want to get better... Week 5 should be same as bad as week 4, at least that is what people describing, will see how it will goes in week five, let's hope it gets better...
rob55013
Edited
Day 28 to day 29: WORST DAY SO FAR!!!
Most horrible night and day since i started sertraline. Whole 4 weeks which i am on sertraline can't match with last night. All started at 9pm, first i felt hot and cold flushes, so i checked my blood pressure it was slightly elevated 138/90, took propranolol 20mg to lower my blood pressure, 10min after my anxiety started and my blood pressure skyrocketed to 160s/104, i am also taking blood pressure meds, but when anxiety kicks in, it won't help to lower my blood pressure. Around 11pm my blood pressure calmed down, took diazepam and went to sleep, two hours later i wake up with high blood pressure 150/100 anxiety kicks in again, felt pins and needles all over my body, felt nauseated and with gastric problems, have to wake up somebody from family to stay with me till' 4am, i was scared. At that time i took another propranolol 20mg and fall in sleep while i was sitting, i slept till' 8am. Scared, i took only 37.5mg sertraline this morning, then i drive and felt like a zombie, around noon my blood pressure was again elevated to 150/100, so i took 30mg propranolol, hour later blood pressure calmed down, health anxiety and panics kicks in, after a long time, i started crying, scared of dying and what is gonna happen to my family if i die. Then later afternoon i felt ok, my blood pressure is under control. Everything i have written in here till' this day, now everything has completely changed by this single day event. I don't understand, why this is happening a month later, this is a start of fifth week, day 11 on 50mg and i am scared, like i never was before. Feeling lonely, i can't eat or sleep, now i really don't know what to do... Now i understand why so many give up on Sertraline.
rob55013
Posted
Day 30 (day 12 on 50mg) @ am Another bad one...
Morning was anxious, felt nauseated, loss of appetite, sad mood feeling bad. Afternoon my blood pressure 150/100 heart rate 66-82bpm, feeling anxious without trigger, feeling panicky, feeling anxious, blood pressure stayed high till' evening from 130/90 to 150/100, propranolol 30mg didn't help much, diazepam didn't calm me quick enough and when it did it was just for hour. At 5pm took my blood pressure medication Ramipril 7.5mg and it kicks in 3hours later. Around 9pm my blood pressure was back to normal. Felt better, but not great, this sertraline playing with my blood pressure even when i am under blood pressure meds is not good and is not safe for me. On Monday in 4 days i have a appointment with my doctor, only logical option now is to lower my dose to 25mg until i will have more information from my doctor. Tommorow i will go with 25mg and if my blood pressure still goes up i will stop taking it next day, i am only 30 days on them. Slept ok.
rob55013
Posted
Day 31 lowered dose to 25mg
Another anxious morning, feeling sad, not hungry and nauseus. Panicking outside and feeling anxious, don't feel good. I don't want to checking my blood pressure, took sertraline 25mg, took propranolol 20mg and 2mg diazepam, in the noon staying in the line with my son for his Covid vaccination, trying to mask and hide my anxiety and panic, sweating a lot, feeling warm. Waiting for diazepam and propranolol to kicks in. In afternoon i am back home at 2pm my bp is low 92/61 heart rate 76. at 4pm will take my bp meds, yawning a lot feeling tired, sad. I am upset that the medication causing me serious issue with my blood pressure on the last 3 days, i was really looking forward to get better with sertraline, but so far it looks like week 5 changed the whole situation and i have to start re-consider possible sertraline change to something else or completely leave antidepressants behind me. I pray that this evening and night will be ok, so that i can stay at least on 25mg.
rob55013
Posted
Day 32: 25mg @ am
Since yesterday when i lowered my dose from 50mg to 25mg everything returned back to normal, my blood pressure is under control no more spikes and everything is getting back to normal and any anxiety is manageable now if any happened.
This morning i wake up positive and energetic and felt good, afternoon is good so far, few sad thoughts, but they are manageable, no more clenched teeth, or headaches, or any side effects.
I think 25mg is my correct dose for now, 50mg causing lot of problems, tried 50mg for 2weeks,but it became too dangerous as it was played with my blood pressure (168/104) and even my blood pressure medication was unable to correct it. Diazepam and propranolol doesn't helped much either during these bad moments.
Will talk to my doctor in a few days and will se if they decide to let me continue on 25mg or if they switch to something else.
rob55013
Posted
Nope. Its 7pm same day, my bp is up again 154/104 its not good, bp meds doesnt work to lower it down, So even with 25mg lowered dose it doesnt helped. I guess this is it, setraline and my body dont work together. I hope i will survive tonight and tommorow i am quiting this treatment. Thank You all and stay safe.
rob55013
Posted
Day 33 no setraline taken
I was taken by ambulance to a emergency room in hospital due to symptoms of a heart attack, my blood pressure was 183/134, i had tense jaws, my left side and muscles were very tense. All my vital organs were functioned fine, ecg was clear, all blood tests came negative. Diagnosis was hypertension caused by anxiety with advice from cardiologist to my doctor to immediately review my meds as they dont working and make my blood pressure meds absolete.
Day 34 no sertraline taken
Still in hospital further tests done, same results all clear. No heart or any vital organs issues, it' s all good. Gave me meds which helped me with bp. They let me go home and contacted my doctor.
Day 35 no sertraline taken
Finally home, three days off of sertraline, feeling much more better, blood pressure normalized, blood pressure medication working again as it should and did for three years before sertraline. So far after 5 weeks no withdrawal side effects from sertraline. It is a unique situation which happen to only a few people with hypertension medication, so i would not say anything bad about sertraline as it is me and my unique metabolism which does not agree with sertraline, I will update further if there will be any withdrawal issues.
rob55013
Edited
Day 36 to day 39
6 days off of sertraline, no withdrawal side effects. Feeling better without it, few intrusive thoughts, couple of short health anxiety triggers, but nothing major, Blood pressure is in much safer levels now, currently wearing 24 hour blood pressure monitor so that doctor can figure it out and change my current bp meds. It's a shame that sertraline did not worked for me and caused this ambulance/emergency experience with this extreme high blood pressure which none of my bp meds was able to lower it down and this include diazepam which did nothing. I had big expectations from sertraline or at least to help me to get to the right directions, but each of us is unique individual and meds may work differently on each of us. In my case it caused serious blood pressure problems and they showed up on fourth and fifth week of the sertraline treatment.