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Author Topic: My Sertraline journey.  (Read 1438 times)

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Offline bababel

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My Sertraline journey.
« on: December 27, 2013, 06:20:19 PM »
Hi Everyone!

I am a 32 year old female who has suffered from a crippling panic disorder and GAD for years now. I was in a sort of "remission" for a couple of years and I felt great. I had never gone on a medication for my anxiety before. I somehow managed to get over the worst of it (after multiple ER visits) on my own. Well, now here I am, 5 years later with a toddler to look after and my anxiety has returned full force.

My anxiety revolves almost exclusively around my health. I worry all the time about there being something wrong with me, and with anxiety symptoms and panic attacks feeling like they do, I always have this sense of impending doom. It is ruining my life and I am not the mom I could and should be for my son.

So I finally made an appointment with a psychiatrist at the end of November. He was very reassuring and told me that this not my fault and I am not making it up. He said it is an illness that CAN be treated. So he prescribed Sertraline for me along with Xanax as needed.

I decided not to take the pills at first as I felt pretty good after the appointment, but I regret that decision now. I had major anxiety leading up to my period and decided enough was enough. I took my first dose of Sertraline (25 mg) 8 days ago, so today was my 9th dose. I am supposed to go up to 50mg within the next couple of days, but my anxiety is so bad right now that I am afraid to.

I have been having really bad panic attacks at night that I take Xanax for. .25mg of Xanax doesn't help at all, so I will have to take .5 tonight if I get one. I don't take any during the day as I don't want to become dependent and I can generally deal with the anxiety better when I am awake and moving around.

So far I have had all sorts of side effects, the worst being a complete loss of appetite. I have also had loose stools (sorry, TMI), and increased anxiety. Sometimes I feel okay, other times I feel like crap.

Does anyone have any positive experiences they can share with me? My psychiatrist told me to avoid horror stories that are all over the internet. I need to know that hanging in there despite the side effects will pay off.

Thank you all!
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Offline bababel

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Re: My Sertraline journey.
« Reply #1 on: December 27, 2013, 06:40:22 PM »
I forgot to mention that my sleep has also flown out the window. I can fall asleep at night but I wake up with a panic attack every morning between 3-5am. I have been going on about 5 hours of sleep per night if I'm lucky. It's rough but I heard it can get better.
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Offline insights

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Re: My Sertraline journey.
« Reply #2 on: December 27, 2013, 07:23:14 PM »
I have been having really bad panic attacks at night that I take Xanax for. .25mg of Xanax doesn't help at all, so I will have to take .5 tonight if I get one. I don't take any during the day as I don't want to become dependent and I can generally deal with the anxiety better when I am awake and moving around.

So far I have had all sorts of side effects, the worst being a complete loss of appetite. I have also had loose stools (sorry, TMI), and increased anxiety. Sometimes I feel okay, other times I feel like crap.

Welcome to AnxietyZone,

Unfortunately, these side-effects are fairly typical of most SSRI antidepressants. They can't be totally eliminated but starting on a low dose can make them tolerable. Fortunately, your doctor has done the right thing and prescribed you a benzodiazepine to ease you through the rough spots, many don't. I'd wait until the heightened anxiety diminishes before upping the dose, however, be aware that it will almost certainly return for a while each time the dose is increased.

Xanax and the other benzodiazepines are not good sleeping pills as tolerance to the sedation develops fairly quickly, often within a couple of weeks. Small doses of the sedating antidepressant trazodone (Desyrel) would be a better long term bet. While it is an effective antidepressant in its own right, these days it is almost exclusively prescribed to counter SSRI induced insomnia. It doesn't function as an antidepressant at doses below 150-225mg, so won't interfere with the sertraline at the 25-50mg doses prescribed or insomnia.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline bababel

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Re: My Sertraline journey.
« Reply #3 on: December 27, 2013, 10:26:42 PM »
Thank you so much for your reply, Ian. I appreciate it!

My psychiatrist SWEARS that starting an SSRI does not heighten anxiety temporarily, but from what I have read, it is a typical side effect as you mentioned. Because he was so dismissive of my suggestion that it is the Sertraline that is causing my nocturnal panic attacks, he got me wondering if my anxiety is coming from the fear of being on an SSRI or the SSRI itself. I guess I don't really know, but hopefully the Sertraline will kick in soon.

Thank you for the advice about the Xanax. I am only using it to beat my nocturnal panic attacks, but you are right, it does sound as though I need something specific for night time to help me with the insomnia. I will talk to my psychiatrist about it in early January when I see him next.

Thank you again!
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Offline insights

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Re: My Sertraline journey.
« Reply #4 on: December 27, 2013, 11:19:53 PM »
My psychiatrist SWEARS that starting an SSRI does not heighten anxiety temporarily, but from what I have read, it is a typical side effect as you mentioned.

Oh, it definitely does as million of patients will testify. Maybe he should take one for a few weeks to test his hypothesis! It is caused by the temporary increase in serotonin activity that most antidepressants trigger (its also responsible for many of the other initial side-effects). However, after a few weeks the body responds by down-regulating serotonin synthesis and expression and levels within the brain fall back to back to baseline or well below in those areas associated with anxiety (and depression), see: Serotonin: The 'chemical imbalance' myth

Quote
Because he was so dismissive of my suggestion that it is the Sertraline that is causing my nocturnal panic attacks, he got me wondering if my anxiety is coming from the fear of being on an SSRI or the SSRI itself.

It's most likely the SSRI. When sleeping many of the neurotransmitter systems operate in completely different ways than in the awake state and antidepressants can interfere with the changes that occur at different stages of the sleep cycle. It should settle down. A slightly longer acting benzodiazepine such as lorazepam (Ativan) may help until it does. Trazodone won't as at low doses it is only an antihistamine, though I guess there is a chance it will sedate you so well that you sleep through an attack.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline bababel

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Re: My Sertraline journey.
« Reply #5 on: December 29, 2013, 09:40:17 AM »
Thank you again, Ian. I am definitely going to talk to my psychiatrist about needing something more appropriate for sleep.

Two nights ago was the worst night yet. I got 2 hours of sleep. I woke at 1am and was awake until morning when I had to start my day. Needless to say I was a tired, groggy, nauseated mess all day.

Last night I slept a bit better, but was awake by 3:50am. I would love to have even 6 hours of sleep at this point.

Does the insomnia get better?

I also noticed that during my adrenalin rushes I kind of get a burning sensation in my arms. It doesn't hurt and it doesn't bother me too much, but was wondering if it's normal or not.
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Offline hikingchik63

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Re: My Sertraline journey.
« Reply #6 on: December 29, 2013, 09:49:10 AM »
Hi, when I started zoloft, I took 12.5mg, or 1/2 of 25mg pill. I also took .5mg klonopin at night. At this low dose, I didnt have side effects from the zoloft, after 2 weeks, I went up to 25mg and stayed there. But I also took klonopin every night. I still take klonopin, and tapered the zoloft after 2 yrs. But it was good for gad and panic. I did well on it. Good luck to u.
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"Frame your mind to mirth and merriment which bars a thousand harms and lengthens life."--Shakespeare

Offline bababel

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Re: My Sertraline journey.
« Reply #7 on: December 29, 2013, 12:06:41 PM »
Thank you so much for sharing your experience, hikingchik! I'm so glad that zoloft worked for you and at such a low dose as well!

I just took my first 50mg pill today and am hoping that the side effects won't be too bad after this dose increase. I don't want to go higher than 50mg so we will see how it works for me.
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Offline insights

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Re: My Sertraline journey.
« Reply #8 on: December 29, 2013, 04:16:02 PM »
Does the insomnia get better?

Often it does, however, I can't guarantee it will. :(

Quote
I also noticed that during my adrenalin rushes I kind of get a burning sensation in my arms. It doesn't hurt and it doesn't bother me too much, but was wondering if it's normal or not.

It could be either adrenaline or the Zoloft. The skin and its blood vessels make and use as much serotonin as the brain. Serotonin is critical to wound repair (blood platelets are saturated with it too) and it also regulates blood vessel constriction and dilation. Serotonergic antidepressants can upset the balance for a while causing burning skin sensations and rashes, but these usually settle down after a few weeks. However, some may also increase skin photo-sensitivity which can be long lasting so extra care is needed when tanning.  Use lots of high factor sunscreen.

But it can also be from adrenaline. The adrenaline rushes should diminish as the Zoloft takes effect. If they don't then a beta-blocker should stop them cold.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline kutekat

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Re: My Sertraline journey.
« Reply #9 on: December 30, 2013, 02:33:44 AM »
starting an SSRI is always rough. EVERY single ssri i've started i had increased anxiety starting, and and it was definitely not psychosomatic as i would feel fine the first 1-3 days then around the 4th day the increased anxiety would kick in. you should really go up to 50mg, better now than later! and don't be so afraid of taking the xanax when you really need to. maybe even take some benadryl to help yourself sleep at night, though personally i feel that aggravates my anxiety if i'm feeling any, but a lot of people say it helps them calm down (probably because you get so sedated!)
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Offline bababel

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Re: My Sertraline journey.
« Reply #10 on: December 30, 2013, 11:01:25 AM »
Thank you again, Ian. The burning sensation in my arms is totally fine by me. I notice it only happens during adrenalin rushes so it could be just that like you suggested. I will speak to my doctor on the 3rd about my insomnia and the adrenalin rushes I have at night. The hypochondriac in me is worried that I have something wrong with me like an adrenal tumor or mad cow disease (I know, I'm insane) especially since .5 Xanax doesn't help during those panic attacks, but I know I am being unreasonable. Night time panic attacks are the worst because my mind goes everywhere!

kutekat, thank you for sharing your experience. I have found that this is true for me too. I upped my dose to 50mg yesterday and felt okay yesterday but today I am anxious and shaky beyond belief. I am hoping this goes away in a few days. I slept about 5 hours last night but still had panic attacks in the early morning after 4am. :(
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Offline bababel

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Re: My Sertraline journey.
« Reply #11 on: December 30, 2013, 01:24:54 PM »
Ughhh.....day two of 50mg SUCKS. Panic attack after panic attack.

Also, I don't know if it is because I am so tired or because of the Sertraline, but I am hyper sensitive to touch right now. This happened on days 6 and 7 of 25mg as well. My bra feels like it is constricting me and it's driving me insane!

I need a nap. :(
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Offline bababel

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Re: My Sertraline journey.
« Reply #12 on: January 01, 2014, 10:44:00 AM »
Day 14 of Sertraline, day 4 of 50mg. Sleep is still out the window. I get about 2-5 hours a night and it's absolutely terrible. I don't get as many panic attacks during the day, but I am so tired from lack of sleep that I feel an overall jitteryness for most of the day.

I have no appetite, but still manage to eat 3 meals a day. No more loose stools and no more tummy aches and headaches. I am hoping that I begin to feel much better very soon!
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Online AncientMelody

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Re: My Sertraline journey.
« Reply #13 on: January 01, 2014, 10:56:08 AM »
Good luck!
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Offline Katiesue04

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Re: My Sertraline journey.
« Reply #14 on: January 01, 2014, 11:09:25 AM »
I am on zoloft 100mg and my psych prescribed me a sleep medicine called trazadone to help me sleep.  It has helped me a lot!  I can get a full nights rest without waking up once and I am able to fall asleep very easily.
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