I was prescribed Sertraline (Zoloft) in 1998 when I had postnatal depression. I was told to take it for a year to 18 months. I went from deep depression/anxiety to euphoria in the space of about two weeks, I felt pretty damned fantastic, there was nothing I couldn’t handle. As time went on I continued to feel well but my emotions were dampened down, so I was functioning well, no depression, but no “joy” either. After a few months of feeling well I decided I didn’t want to be on Sertraline anymore, didn’t read the patient information leaflet or talk to a doctor, not that that would have helped anyway. I just stopped taking them. My head felt terrible, it began to feel water logged, if I turned my head there was a time lag between my eye balls catching up with the fact that my head had turned, so dizzy, gradually intense sadness would kick in, really really intense sadness and anxiety, oh the anxiety, pumping adrenaline and nerves shot to bits. I went back on the Sertraline.
The doctor told me to do the alternate day thing, alternate days for a fortnight,then every third day for a fortnight, then one tablet a week, I did this various times over the next few years to no avail. I tried a pill cutter and halving the tablet, it wouldn’t break down easily without crumbling so that was unsuccessful. Every time I tried something, I ended up in worse shape than the time before, it was all getting steadily worse. I tried meditation, healing, exercise, cognitive behavioural therapy, counselling, fish oil capsules, NOTHING touched it. I pressured my surgery to refer me to a psychiatrist for advice,but the psychiatrist had no clue and could only recommend switching to another drug. I did switch to Citalopram for a while, and Mirtzapine, I felt constant fatigue on Mirtzapine, and then back to Sertraline. Yet another psychiatrist recommended halving my dose of Sertraline and taking diazepam to mitigate the withdrawals, so replace one powerful drug with an even more powerful addictive drug.
This is my description of how withdrawal felt from my blog, I only recently found out that what was happening had a name,akathisia:

“5am and for about the 3rd night in a row I’ve barely slept, I can’t stop the adrenaline pumping round my body, my stomach is tightly knotted, I’ve barely been able to eat properly it makes me feel sick. I’m clammy, sweating and crying and P is trying to reassure me, but he has to go to work. I get up and drag myself through all the motions of the day and making sure boys get to school, I feel like the living dead, I make sure they get fed and make sure they and no one else is aware of what’s going on, I don’t hang around at the school gates. Oh I do kind of tell a few people I’m not really feeling right but I play it down.
The constant adrenaline is tormenting me on the inside and I can’t stop it.It’s been building up over a period of months and I’ve been fighting and fighting the feelings but it seems to have reached a peak of exquisite torture.It’s like being at the top of a roller coaster that never stops. Someone else mentioned birdsong, and it was a funny thing, the torture was worse in the mornings and over the summer months while it was slowly building, birdsong in the morning outside the window had become a kind of torture as well. I had to go to work only 2 days a week and God only knows how I managed it. I had taken
my last Sertraline tablet months ago, and come off it as per the doctors instructions, and now my depression/anxiety was back tenfold to punish me for daring to presume I could stop taking it. I must be wired up wrong, no one else feels like this do they? What is wrong with me? Maybe I really am insane, maybe I just can’t cope with life without my tablets, how come everyone else can cope with life, and I can’t? There must be something fundamentally wrong with me. By now the Orwell Bridge was beginning to look a bit attractive and I just wanted to escape the adrenaline surges torturing me, my nerves were in shreds”.
This was 2003,at the end of 2003 I gave in and went back on the sertraline.

In 2006 I attempted another withdrawal, but at the same time we found ourselves going through a stressful life event, I tried to tough it out but ended up back on the Sertraline again.
So here I was, several years later and no further forward, and not for wont of trying! Everytime I went in a book shop or library I would try and find anything I could about antidepressants and depression, but nothing really enlightened me. I rummaged around on the internet but couldn’t find the answers. Until one day, I was browsing around Waterstones, and “Coming off Antidepressants” by Joseph Glenmullen jumped out at me, I read it avidly, and discovered TAPERING!!! But, all the examples in the book referred to liquid Seroxat or Prozac, I was really upset to find Sertraline was not available in liquid form. Armed with my new information about the simple concept of tapering, further digging led me to Dr Healy’s protocol of switching to the equivalent dose of liquid Prozac. These two pieces of information became my secret hope, I latched onto them. I decided to take a leap of faith and switch to liquid Prozac. At the beginning of 2007 I marked up my calendar with a schedule, I was going to go down from 5ml to 4.90ml the first week, 4.80ml the next week and so on, as my sons would say “epic fail”. By about mid February the nightmare was unfolding again and I had to give in and go back to the top of my Prozac dose, I was devastated.
Still I hadn’t given up hope, P was sympathetic but he couldn’t understand why I didn’t just give it up and accept I “needed” the drugs like a diabetic needs insulin. After lots more research, and P having interesting and enlightening conversations with a client who was a pharmacist about my problem, I started my taper again in May 2008, this time much much slower and here I am four years later down to 1ml liquid Prozac and still sucessfully tapering. It has needed a lot of self-discipline. I kept this blog/diary of my progress; I’ve been amazed to meet a few others who have been tapering longer than me. Nowadays my withdrawals are fairly benign, but I still feel a bit scarred from the experience,the akathisia has left me still feeling like my nerves are quite raw and very close to the surface but I can live with that now.
There is a huge assumption that these drugs are benign and harmless, they are not; they can cause extreme agitation and internal torture. They are dished out like smarties and people left to deal with the results. Starting them is like playing a game of Russian Roulette, you might be a lucky one who can take them and come off them with ease, or you might not. My understanding was that they were meant to be taken for only a year or so after you feel “well” but many many people are stuck on them for years or forever, I know many people who’ve given up hope of coming off SSRI’s and I hear many people say “oh I’ll be on these the rest of my life”. There is NO support or advice in place through doctors or psychiatrists on how to taper safely off the drugs.....if anyone does find any help in the UK, please let me know, although it’s a bit too late for me now as I’ve almost done it myself, but I know a lot of other people who might like to know!

Saturday, 29 October 2011

So we have reached an impasse - 1.50ml (6mg)

So it was our youngest son’s 13th birthday this week, which also marks the 13th anniversary of my being on and off (mostly on obviously) Lustral/Zoloft or Prozac.

So anyway, I, or we’ve reached a bit of an impasse with my withdrawal plan. I’ve been tapering slowly and steadily every 5 or 6 weeks for the past 3+ years. I am now stuck at 1.5ml.

1.50mls!! have you thought about how teeny tiny that dose is every morning? At this stage of the game it would be SO easy and tempting for me to just stop dead, but I know from past experience that that way madness truly lies (and I don’t mean “The House of Fun”) and my current healthy mental state would unravel with the withdrawal. I proved countless times in the past that I am obviously very sensitive to SSRI reductions. It’s crazy how powerful this tiny drop of liquid is.

In many ways I am amazed that I ever got as far as I have, a few years ago I thought I was on Prozac for life, I thought that it wasn’t physically possible for me to cope with life without it, but deep down I could never truly accept that I would be on it for life, because of the side effects I’ve always had a very strong inner drive or compulsion to get myself off this stuff, it refused to go away no matter how much I tried to convince myself to stay on it. Some inner voice I couldn’t ignore kept telling me I needed to get off the pills and kept driving me on, and still does. I like to think I could be happy sticking with a low low dose but deep down I know I’m not really.

So anyway, after 3 months at this dose I am feeling that I would like to now proceed with another reduction, I am now very stable. Peter is very ambivalent about this and I think it’s the first time we’ve disagreed on this issue. I understand his point of view, we have been and still are under financial pressure and both working hard. He also has the pressure/burden of an industry exam to pass. He is also the one who has to cope with me when a withdrawal hits. The last time it happened I am embarrassed to admit I burst into tears in his office and I couldn’t stop, and there was no obvious reason, it was a withdrawal pure and simple, but I just couldn’t stop crying.

So there we are....an impasse.

Any comments welcome.

Prozac reduction timeline


Carol said...

You are doing so well really! I understand how you feel, but have resigned myself to just being on my pills. I think your doc gave you awful tablets, as mine don't make me feel numb, just normal.
Big hugs to you, stay strong, keep going. xxx

SMH said...

The thing is we are all different in how we react to and metabolize drugs so yours may suit you. You feel positive about taking them as well. New reduction coming up!

Altostrata said...

I admire your discipline. I know exactly how hard this is!

Wanted to ask -- after you make a reduction, how do your symptoms change over time so you feel confident you can make another drop? It seems sometimes you need longer to recover. Are the withdrawal symptoms similar from one drop to another or are they changing over time?

I guess this is a request for a post about your symptom recovery patterns!

SMH said...

Hi Altostrata, I log any withdrawals on here as I go, but the truth is and the good news is, because I'm going so slow the withdrawals are very transient now, Peter says I tend to have a day or two of being extremely manic, for instance I'll clean the house from top to bottom and find a million other jobs to do on top, my energy shoots up and then I straighten out and fly right. I wouldn't say they are changing over time, I get the odd freaky day where something triggers a crying fest and I can't stop crying but then it passes. I get a bit of transient sadness but nowhere near as crippling as it used to be when I withdrew too fast. I have just finished reading Ann Blake Tracy's book, Prozac Panacea or Pandora, I had a real big lightbulb moment when I read the chapter on akathisia and I plan to write about this in one post, and then follow up with another about withdrawals as they are now in comparison if that makes sense.