Sertraline Withdrawal .. Does it go away?

Hi Legan, 

I am sorry you are going through this, for having been on the med for such a short time :-(  It isn't you, it's withdrawal, and it just goes to show how powerful these drugs are that they can cause this kind of disturbance even after such short usage.  Nobody realizes this when first going on, but how would we know?  We trust our doctors and they don't warn us.

This is temporary but I have no way of knowing how long it will take to come back to normal.  These drugs cause an imbalance in our brain chemicals which the body pushes back against by trying to re-establish homeostasis.  Then, when you come off quiickly, you are creating another major upheava in brain chemicals and that sets off the withdrawal effects you are experiencing.

If you feel you could seriously hurt yourself, please call your doctor or a crisis hotline. You might find relief by taking 1/4 of the dose you were on and then doing a very slow taper from there.  You are very sensitive to these drugs and a small amount maybe all you need.  Of course the drugs are not dosed to make it easy to do a proper slow taper.  I would talk to your doctor and see if you can get liquid Lexapro which can be dosed with  a syringe, making it easier to get the fractions.

I'm not sure about the sulpride, but you might need to do the same.  It was really too much trying to go off both at once so quickly.  See the topic Reducing Antidepressants using a 10% withdrawal method in this thread:

https://patient.info/forums/discuss/depression-resources-298570

That link takes you to Surviving Antidepressants, a non-profit free forum where you can post your situation and very experienced members will respond with advice better than your doctor can give. 

I would say that reinstatement is your best bet if the symptoms are debilitating.  Again, no more than 25 of your original doses, maybe even less would be enough to hopefully stabilize you. Otherwise, you can ride the withdrawal out, hopefully taking comfort in knowing that this is all caused by the abcence of the drugs, not "YOU."

I wanted to add that if you see your doctor, he's going to want to put you on another drug, because that is what they do.  Your system is super sensitive, and adding new drugs to the situation could very well go paradoxical and make you even worse.  The only drugs that can really help right now are the ones you came off of :-(

There is a genetic test called cytochrome p450 that identifies how you metabolize drugs, slow, medium or fast.  I would bet you are a slow metabolizer.  Did you have severe start up side effects?

 

Thanks betsy0603 for your reply .

Im only 30 years old. I cant belived what happened to me.

I do agree with you about yhe severe side effects i had when i started the meds for two weeks. I remenber i went back to tge doctor after 3 days starting the meds because of the side effects . He just told me that those will subside eventually . And i told him i cant tolerate the drugs . He said i give thoses dose to children . You should handle it . And this how ive been hocked .i hate hate this doctor . I was doing fair before . Now i cant function.

In fact i dont wanna get back to them even in very low dosage . I feel liittle bit better now than the first two weeks . But still cant fubction . I went to er two times . The said nothing wrong . You should see your doctor but i will not

I know pharmacist who helped me getting through these bad meds . Now he told me if you go back . You will be for life for them . Just keep fighting and at 6 weeks mark you should feel good difference .

I feel like my heart is very weak .i had high blood pressure 140+/100+ in the first two weeks But nothing unusual . Now my bp became norm

al still have around 100pm pluse .

I wanna add also that i felt sometimes like a liquid from my head go suddenly to all my body organs tge i became very very scared .

I feel like im healing but very very slowly .

Just know that it is all withdrawal.  The window for reinstating working is the first few months, so if your symptoms that far out are still crazy, you can still take just a little bit.  I know, most people want to be done with this; this is about minimizing harm.  If you think you can handle the level of symptoms you are having, that is fine, too.  Even pharmacists don't have a full clue about withdrawal :-)  Good luck to you and consider yourself lucky that you didn't end up polydrugged for years!  This experience will have made you stronger to handle whatever happens in your life here on out . 

Hi Betsy,

someone has posted on the sert page about a link between sert and raised cholesterol, any info about this ? Mine has increased since I started taking it but I hadn't thought it could be the sert

x

I put a link to a research paper for a study done for 12 weeks,  and it showed an increase in triglycerides and insulin, so it stands to reason that over a longer period cholesterol would also be affected.  Others responding said their cholesterol went down when they went off.  The trick is getting off without horrible protracted withdrawal, because the doctors have people taper way too fast and withdrawal symptoms off SSRIs and the like is horrific.

Thanks Thanks betsy603.

Ill keep fighting till it subside . Maybe ill take any thing bit not thoses meds.

Im thinking of alcohol . Would it help ?

Alcohol brings its own problems so I wouldn't recommend that.  It is recommended that you take 2 g of fish oil per day, and a magnesium supplement, preferrably one of the chelated mags.  I like magnesium glycinate and take 2 x 500 mg.  It helps with anxiety and sleep.  Also, inositol powder can be helpful, 15 g a day.  vitamin E as well.  Other than that, if you don't want to reinstate a small amount, the only thing that helps is time and patience.  Nothing else will speed the healing of your nervous system.  I was just chatting with someone who found a light box to be helpful.  Those are used for seasonal affect disorder but might be helpful here as well.

Thwnk you . You gave me hope while im in my darkest moments

The flow like symptoms is subsiding now does this mean the withdrawals subsiding or i might have another episode of flu like feeling ?

Hi there

well done to you for being persistent re your diagnosis. And brilliant that you are now off the sertraline, I'm down to 12.5mg and ok.

if you look further up this post you will see from Betsy that withdrawal can come out of the blue months after stopping,

good luck x

And yes, here I am to concur, Tezes!  

I'm so impressed with you, MissJayBee!!  You have shown such courage in your journey!

Yes, you are still in withdrawa from sert.  It is not a matter of the drug being out of your system. The drug actually caused physical changes to your nervous system.  When SSRIs block serotonin re-uptake and cause an increase of serotonin in the gap between nerves, the body doesn't take kindly to this imbalance and sets about making changes to regain homeostasis.  It adds more receptors to mop up that excess, slows down serotonin production because less is needed, and ups enzymes to break down excess serotonin.  The longer you are on the drug and the higher you go, the MORE of all this that happens.  Then, even when you taper down fairly slowly, the body is very slow to undo all these changes.

If you go to the SurvivingAntidepressants forum, you will see countless stories of protracted withdrawal.  You have entered the more cognitive phase, the physical symptoms for the most part behind you. The coming months are when many start to have depression, insomnia and anxiety hit with a level never experienced before, and because it happens so far out from jumping off the drug, everyone thinks it's a relapse of the condition you went on for. 

I would encourage you to hop over to SA so that you can read up what to expect and on the self-care section.  There are no drugs that can undo or speed up withdrawal recovery other than the drug you came off, like a junkie getting a fix. Sometimes people will get put on another drug thinking it is relapse and that drug might mitigate some of the withdrawal, but it is a gamble and you're ending up creating a new dependency.  

Recovery happens in a windows and waves pattern, where feeling bad will be followed by feeling good, followed by bad again.  Sometimes a wave later will be worse than one earlier.  There's just no rhyme or reason to it.  No one can tell you how long this will last as everyone is different, but we do know that you will over time get better and better; it just isn't as linear as we like.

I am doing a very slow taper after a failed atttempt to come off Effexor a year ago.  I was on it for 12 years and others before that, so my nervous system is very sluggish to change back and i now realize that it will take a couple of years to get off safely. These drugs are more powerful than anyone realizes.  I think all of us thought it was like taking aspirin, that the effect of the drug was only there while we took it and that we'd go back to normal once off.  Not at all the same!  Of course, the doctors don't warn us of this, and they won't even acknowledge protracted withdrawal!  You'd think they'd have the understanding of the physiological changes I described, but they don't even seem to understand that!

Anyway, I am putting a link here that has the 10% taper method in it, and if you follow that you will end up over at SA.

https://patient.info/forums/discuss/depression-resources-298570

 

Hey Betsey and Tezes

Guys, I just want to thank you so much for the time you've taken and the care you've shown me to reply to my 'essay'.

I send you both an angel to help with your own withdrawals.

The more I think about it, the more I see how powerfully detrimental medication is. We know so little about the brain and its infinate intricacies, to so finitely mess around with its biochemistry is the definition of craziness itself I think.

There really is no substitute for focussed nutrition, exercise, talking therapy, vitamin and mineral supplementation and the time and space to heal.

Sadly, medication (for me at least) robbed me my ability to access any of these things. Sertraline made be desire the worst kinds of foods that fuelled and exacerbated my already desparetely unbalanced biochemistry.

Exercise was laborious as I had no stamina and no balance. I became increasingly sedentary.

I was apathetic to the benefits of talking therapy as I belived that taking a pill was a 'fix-all'. I was so lost into myself and thinking I was fixed that I felt nothing. Nothing at all. Nothing could touch me. 5 years in limbo. Nothing gained. Nothing achieved. Swallowing the pills down and barely acknowledging that life was moving on around me.

The terrifying realisiation that this had occured in my 'absence' whilst under the AD spell was in my 1st wave physical withdrawal and was absolutely horrifying. I was now 34 years old with nothing to show for the past 5 years was, excuse the pun, a bitter pill to swallow.

Doctors actively discouraged me from researching the adverse effects of Sertraline. When I queried with the Phyciatrist why I'd literally ballooned, he claimed that Sertraline 'was not a weight sensitive drug'.(I think there's enough of us on here that can testify that this is NOT the case) When the top level amount of the drug ceased to effect me and with heartbreak and alcohol thrown into the mix he diagnosed me with a Personality Disorder because he didn't know what else to do. 

Whilst Western medecine rampages onwards with the beligerance of a bull in a china shop.......I really truly hope that someone reads this and recognises themself in my crappy little journey and finds the tools to get free of these drugs. 

In my earlier post I mention the supplements I take.

Betsey, thanks for the info re: what to expect for the rest of my withdrawal. Currently, my motor skills and mental agility are impaired. I am praying that this will pass and not be a permanent reminder of my time spent under AD's. And yes, I do mean 'under'. Trapped under.

I'm thinking about the stages of my life. 

Depressed & Unmedicated: unhealthy (recreational drugs and alcohol)

Depressed & Medicated: 

Depressed & Withdrawing

 

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MissJayBee, you so eloquently summed up my life on ADs as well.  If only I had learned about doing the work that was needed, with all the self-care you mentioned as well, before I took that first Prozac, I am sure my life would have been totally different, more full of joy.  Thank you for sharing your insights.

All we can do is press forward to be free, and the journey is unpredictable.  I feel you have the inner strength to succeed, and we have each other for support as well.

Sending you an angel back, and hugs, too!

Betsy

Holy mackerel - thank you for the physiological explanation! - I know I'm in sertraline wd, but understanding why this is happening does help. I'm ITCHY!! Claw at myself itchy! Doc started me on 25mgs in Oct, too much (I'm a drug lightweight), so I backed down to 12.5. My depression and anxiety were situational, so I also was given Xanax to take as needed. I upped the sert after a couple of weeks, then tried to go to 50 (too much) and never got over 37. Got sick of the headaches, forgetting things, and generally feeling like I was wrapped in mental celophane, and i was really developing a hankering for more food, and good Lord, wine! I had to start weaning off about 5 weeks ago - i had the jitems sND fid nor feel lIke me. So I jumped back down to 25. And I'd forget to take it sometimes. Well, that's when the real fun started. The ear-ringing and itchy rash are driving me NUTS - flu-like muscle and joint pain near debilitating, pins and needles, my skin looks like crap, and I won't bother the men with the female issues.... (Haven't touched the Xanax, but I'm so sorry I went down what I thought was the better road - an occasional 1/2 of one of those would have served me better.) Now I'm back down to 12.5 of the sert and i'm resolved that this garbage isn't going to get to me. I'll do this for 2 more weeks and that's it.

So, advice, please! I'm thinking:

2 good omegas 2x/day

Vit B Complex with extra b12 (since all I've wanted to do is sleep)

Bioflavenoids and garlic for the ear-ringing

? Saffron supplements, which I've read do something to stop the chemical cascade?

? St. John's Wort (to pick up mood elevation)

I take 5mg melatonin to help with sleep, (although I occasionally wake up with my mind racing)

Vits D-3, E and C just because...

Am I missing anything? What can I do for the ITCHING????

Thank you all for your incredible honesty. I don't know where I am in this process, but I'm afraid this going to suck for some time.

Odd - I've NEVER been an addictive type. Quit smoking cold turkey years ago, had no problems dropping off the oxy's post surgeries, etc. What the hell is this crap and how is it legal?? I'm never going back on any of these things again - I feel stronger and more confident just knowing I can take 1/2 an X if need be....thank God I found this forum. Ugh!

Hi Coolbeans, as I explained in my reply to Tezes, it isn't about having an addictive personality, it's about the physiological changes that occured when your nervous system down-regulated to adjust for the action of the drug; the nervous system wants homeostasis.  So, when you taper the drug too fast or do a cold turkey, the drop in drug outpaces the nervous system's ability to change back.  The symptoms are caused by the IMBALANCE created by taking away the drug!   The longer you were on it, like me for 12 years plus, the more slowly the nervous system adapts back.

These drugs also have block histamine receptors, acting as an antihistamine, so as you reduce, those receptors are freeing up and allergy symptoms become a problem.  You could try a benedryl type allergy pill ("Claratin or the like), but take maybe half a dose.  When in withdrawal you become sensitized and a lot of over-the-counter meds can go paradoxical on you.  Some people find the supplement quercetin helpful for the itching.

Be careful with the St. John's Wort as it is serotonergic and can cause serotonin syndrome when taken with SSRIs.  Also, they do act like an SRI, apparently, and so can cause the same down-regulation of serotonin as the SSRIs.  

I took tryptophan, 5-htp and Sam-E when I was in withdrawal, and none of them did any good.  I still had a horrendous time.  Maybe it would have been even more horrendous - I shudder to think!

Fish oil is great for brain recovery, and I've heard it helps with brain zaps.  B vitamins are good, unless they are too activating, which some have a problem with.

I would strongly encourage you to hold where you are at a good while to allow your nervous system to catch up with the cuts you've already made.  Withdrawal symptoms mean you are already destabilized, your nervous system scrambling and in chaos.  To continue to cut will just add on top of that.  If you do hold for at least a month, for sure until you don't have symptoms, it would be best to then taper by 10% per month, of the previous dose. It sounds ridiculously slow, but it is the best way to allow the nervous system to adapt back and hopefully reduce the severity of withdrawal when you do jump off.  If you want more information, let me know and I'll point you in the right direction :-)

Great info, thank you so much Betsy! Gotcha on the physical changes, on the histamine blocking (now THAT'S a drag!) and the St. JW heads up. Makes perfect sense. So we're on a 12.5 journey for a couple of weeks and I guess stepping down again before full quits...yes, I thought this was going to be more like aspirin....I am angry at the medical establishment - had I ANY idea...I'm so ITCHY! Grrrrrrrr....

Just found a great article on theroadback

More eye openers and help with Zoloft withdrawal. Looking at saffron supplements next.

Curious, when the doses get really small, extending the time between sounds more accurate than fussing with tiny, not quite so precise dosages. ? I hate feeling beholden to this nightmare and at least that would make me feel more in control.

Ugh! I am astounded at all the energy we're all having to put forth to get away from something that's supposed to "help." My situation was so acute (dealing with mum's illness, getting the house on the market, taking over her business, all in a couple of months) it probably didn't warrant this med if this is what quitting it entails! (I probably would done better with the 1/2 Xanax when I felt the anxiety or doom feelings coming. That or an extra pint!).

All this info has been great, and while a bummer to find I really screwed up by unintentionally rewiring my body, there's a light at the end. Thank you again!

OK, so one week later --

Working on taking about 10 mg/s of sert/day (I realize this isn't a lot, but my body reacted hugely to starting at 25 and steping up to 50 (which I couldn't handle). So now, I'm taking with some success at feeling less of the w/d symptoms

~ Quercerin (Vit c?) 

~ 2 Krill Oil omegas 2x/day - yes, my head is more clear, and while my short term memory isn't great, it's showing signs of improvement. 

~ Vit B Complex with extra b12 (still need more energy)

~ Bioflavenoids and garlic for the ear-ringing (seems to help, but not immensely)

~ Saffron supplements, which I've read do something to stop the chemical cascade that does liver damage -> one interesting comment regarding sert and alcohol - bad combo because the two together apparently cause the liver cells to suffer quick self destruction (apoptosis) and the saffron helps prevent this by interfering in that chemical reaction. I don't know if having that glass (or bottle) of wine was part of the problem of this reaction fallout (or if I'm just sensitive but never realized it until my seratonin went imbalanced), but I'm not NEARLY as itchy. I've also gone from red to white wine, which might also lessen any sensitivities I'm experiencing while detoxing from this drug.

~ St. John's Wort (to pick up mood elevation) - I've been taking this in the afternoon - I've found that this plus the quercerin seems to calm the the itching, which makes sense if the StJW acts like the sertraline.

~ Still taking melatonin to help with sleep, (although I occasionally wake up with my mind racing - this is my anxiety acting up....)

~ and Vits D-3, E and C just because...

Hanging in there, and now more annoyed than suffering.

I did not experience brain zaps, but I do have pin pricks, itchiness, cramping (assorted body parts, but mostly back, and of all things, left arm). My skin looks awful (bumpy rashy splotchy), and I think I will need a good 2 week overall cleansing once this stuff is out of my system. My head is significantly clearer though. Might a sauna and lots of drinking water help?

Hi Coolbeans

Hi my name is Michael and I have been on sert for the last year 100mg was my max dose, I have been tapering off sert since november and I

Sorry coolbeans dont know what happened there, I am now down to 12.5 mg and in the middle of WD for the last two weeks so I will be staying here for another few week till things level out, anyway can you tell me how you get you sert down to 10mg as I am cutting my 50mg into 4 at the moment and they are pretty small, I am the same as yourself I just want this drug out of my body but know it will take time, If you want to talk anytime just drop me a line as its good to talk to someone in the same boat.

Hi Michael ditto with the tapering and am currently taking the quarter piece of a 50mg tablet. Been tapering since last October. I planned to cut the quarter in half next month, need a sharp pair of scissors, if that doesn't work I thought I might try shaving it in half !!

Hi Michael - This process is brutal, isnt it? I cut my 25s in half, then into quarters. Clearly not exact science, but it's working well enough. I understand that you can get smaller liquid doses that are by far more exact. I wasn't on the drug long (Oct), and I was not able to tolerate moving from 25 to 50, (took 25 plus half another) so I'm hoping I won't have to do this for much longer....the smaller doses seem to have different w/d symptoms, but I'm working through them with all the supplements. Let us know if you're able to get more manageable dosages and how your doing. Hugs and prayers as yih ho through this

It is true that you can get a liquid or even make your own.  For those who are very sensitive and find that they have big withdrawal effects after dropping a quarter tab, liquid titration is better.  You can get a script for a liquid concentrate, or make your own.  I'm not sure off hand if sert will dissolve readilty in water; if not, you'd need a way to powder it, such as a pill crusher or mortar and pestle.  Also, you'd need something to measure mLs, and a syringe that can measure the appropriate amount  You could mix a 25 mg tablet with 25 mL water for a 1 mg/mL solution.  Be sure to shake the solution well before drawing up the dose so the powder doesn't settle and give an uneven dose.

Getting off of these drugs safely and sanely sometimes requires going to these extra lengths.  An interesting fact is that at the minumum effective dose, these meds occupy 80% of your receptors (serotonin re-uptake inhibitors blocking serotonin receptors).  That is still a large number.  As you drop down from there, the occupancy drops off precipitously - the more receptors being freed up, the greater the withdrawal symptoms.  That is why it is important to go slower the lower you get. 

If you do go by quarters, it would be best to hold at each level for at least a couple of months to let your system adequately adapt to the absence of the med before being challenged by another cut.