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Hi there, So I've been lurking on here for the past few months, and some of the advice and reassurance I've been getting from reading threads here has really helped turn things around for me after a truly hellish time, so I wanted to lead with thanking you all for that. It's been nice just to not feel alone in all of this. Now, I'll get into some of my history. I started out taking 50 mg of sertraline after a deep depressive episode that I'd been trying and failing to fight through alone for years in about 2016. I took sertraline for a few years, and started having what brief blackouts for a few seconds or less. This was pointed out to me while I was driving with a family member, and ran a light that I hadn't even realised I'd gone past. After the sertraline struggles, I went on 75 mg of venlafaxine, which didn't really help my depression and I started to feel much worse mentally and really struggling with insomnia. In January of 2019, I was prescribed mirtazapine to help these symptoms, I started out on a low dose, and we later upped it to 30 mg. This helped greatly for years. I started sleeping fully, and gradually found some emotional stability, with maybe some minor side-effects, dry mouth, appetite fluctuations, morning grogginess, but that was about it. I still don't know if these two things are related or not, maybe I was just unlucky? However, in June of 2021, I was feeling extremely emotionally happy. But I started to notice tinnitus and a constant feeling of fullness and pain in my ears. I was prescribed a course of antibiotics, but they didn't really help. I later saw an ENT specialist who diagnosed me with eustachian tube dysfunction. A few months later, I started having a feeling of tightness in my chest, trouble breathing, irregular heartbeats, etc. A few ECG tests after a trip to my GP indicated I had pericarditis. After two weeks of ibuprofen, I was supposedly in the clear. And I was, for a little bit, but then I started having more chest pains, tightness, and palpitations again, along with frequent burping, abdominal discomfort, cycling between diarrhoea and severe constipation for several days at a time. I was also having a lot of vision problems (significantly increased floaters, particularly when I look at a bright or white light source, redness, dryness, and photosensitivity). A 72-hour ECG came back mostly clear, and doctors told me I probably had sinus arrhythmia, which is quite normal and usually completely asymptomatic. My blood pressure was normal too. I was put on omeprazole for acid reflux, which helped for a while, but I eventually ran out. Since my gastrointestinal symptoms had settled, I was told to just ride out the chest issues, and that they were likely anxiety. I tried this for a while, and then I started experiencing some other things, sudden leg and arm twitches, tremors, closed-eye hallucinations when sleeping, increased heart palpitations, neck stiffness, and headaches and tenderness at the back of my head. Having researched some of these symptoms to try and figure things out, I spoke to my doctor, who inspected me for signs of infection as a lot of these symptoms lined up, except for the closed-eye hallucinations and tremors. I was told there was nothing wrong. I brought up the potential of having an adverse reaction to the mirtazapine, and he recommended we wait a little longer. I came back a few weeks later with a lot of the same symptoms as well as sharp pain in my kidneys, increased urination at night, extreme anxiety and agitation, and a return of my gastrointestinal issues, whilst still having all of the other issues. I was given a prescription for a lowered dose of mirtazapine to 15 mg and told to taper over the course of a month. By now, it was December. I'd already started to try to improve my diet and improve some of my habits to manage my acid reflux after the pericarditis scare, no coffee (god, I miss it), no alcohol, much better eating habits, and daily exercise through brisk walking/jogging on the treadmill. This helped a little, but while exercising one night, I felt faint after only five minutes, and had severe chest pain, which hadn't happened before. I stopped and called my local hospital's non-emergency number and explained my symptoms and history. I was taken in via ambulance, inspected by paramedics and quickly examined. A brief ECG while I wasn't having palpitations and a blood test returned normal, so I was told something my chest pain and tenderness was "maybe something muscular" and released. I continued to take my lowered dose, and noticed an increase in whatever muscular chest pain I was having, an overall feeling of dullness throughout my body, increased tremors, acid reflux reaching my throat and causing vocal instability, temperature sensitivity, and a lot of brain fog. One night, I stayed up a little later than usual, and noticed that some of the brain fog and dullness eased significantly for a while. I took my dosage before bed and woke up the next day feeling as awful as I had before. I discussed this as a phone appointment with another doctor at my GP surgery, and was advised to stop the mirtazapine immediately without completing the taper. I did so, and felt significantly better for a few days. Then, I guess the withdrawal symptoms must have caught up with me, because a lot of the feelings I'd had returned with a vengeance. Although I stopped having the hallucinations, improved photosensitivity, tremors, full-body dullness, chest tightness, and brain fog, my acid reflux and indigestion got even worse, and I started having nerve pain, symptoms that seem to line up with peripheral neuropathy, constant gurgling in my legs, loss of appetite, extreme anxiety, heart palpitations that felt completely different to the previous ones, and a complete inability to sleep. After a few days of this, I had sharp chest pain after a sudden palpitation that radiated to my left arm. And then I started struggling to breathe. I returned to hospital, was inspected again, returned normal tests (although they had issues drawing blood from my arms), and was sent home again, being told that it was probably indigestion and my breathlessness was a result of a panic attack on the journey to hospital. After discussing my SSRI withdrawal, the hospital advised me to see my GP and restart omeprazole now that I'd been off my mirtazapine for a few days. It's been about a month since I was in the hospital there, and I can say with certainty that things are getting a lot better. I'm no longer having heart palpitations, my flank pain is mostly gone, I haven't had that full-body nerve pain for a while, my appetite's back, and my anxiety's at least manageable now, a lot of the peripheral neuropathy symptoms are improved, I'm sleeping for at least 4 hours on my worst nights, and I think my tinnitus is finally improving. I'm still suffering with increased urination at night, that gurgling sensation in my legs, irregular heartbeats/inconsistent heart rate, bradycardia, constant tiredness, acid reflux/indigestion (I'm on omeprazole again now, but I'm still having some symptoms), as well as some strange pains in my neck and back, mild muscular pains, a nasal drip and occasionally runny nose, an intermittent cough, and most recently a new kind of chest pain around my sternum that only seems to flare up occasionally (possibly costochondritis, or heartburn, but I'm medically undiagnosed at the moment so it's hard to say for sure). That's most of it, at least, there might be a few other minor things I'm forgetting or I don't think are related to withdrawal, but we're gradually unpicking all of these issues. As for things that have helped me, I'm taking a marine magnesium supplement every night that seems to really calm me and help me sleep, and prevent the nerve pain. I've also found that CBD oil or tea seems to help calm my anxiety and nerves during the day, a hot bath does absolute wonders, and the jogging was helping to stabilise my heart rate from some worrying inconsistencies into something manageable as well as calming some symptoms. It seems every week or few days or so, some old symptom goes away and a new one takes its place, and while I absolutely hate the uncertainty and constant change, things do seem to be getting better overall. That being said, I've felt pretty rough today, this new chest pain's been taking the wind out of my sails and got really bad after I used the treadmill yesterday, so I've decided to avoid that strenuous exercise until it settles. I've discussed it with my doctor and we're keeping an eye on it for now. Things still feel quite worrying and challenging, but nowhere near as terrifying as they used to be, for at least a solid month I had no idea what was going on, and I was convinced this all might kill me. The advice I've found here so far has really helped. I just wanted to share my story, provide some advice for anyone else who is still struggling, reassure anyone else out there that it does get better, and see if any more experienced people on this forum had any advice or similar experiences with the issues I'm still having. Thanks for reading and all the advice! Kairos

Hi Everyone, I'm pleased to find this forum, but I am sorry that it is for the reason it is. It is amazing how many people are suffering from AD WD, and the symptoms and length of time it can take. I found this site from searching withdrawal symptoms, because today is my 10th day at my lower dose and I have been feeling worse today than at any time since I halved my dosage. Recently I became absolutely miserable about my aches and pains, which were stopping me from doing things around the house and causing sleep problems. I started wondering about them and then remembered that I had had to go off Prozac (about 20 years ago) when I got muscle weakness. St John's Wort also caused similar but not as bad muscle weakness so I stopped that too. I started researching AD symptoms and made (what seems to be) the connection that I have Serotonin Syndrome so I made the decision to reduce my Pristiq from 100 mg to 50 mg. The doctor suggested alternating between 100 & 50 for 2 months, but because the aches and pains are debilitating I decided to see how I went going straight to 50. After a couple of days I did get mild zapping / electric shock sensations, and also headaches for several days at the end of the 1st week. I slept a lot over the first 3 days (and was able to sleep at night). Then I had several nights where I had trouble sleeping. Last night I slept through for the first time. I had several days where I had an upset stomach which I had thought was a tummy bug but I now realise it is possibly from the withdrawal. At this time, I am feeling achy (a bit like the flu), different from being on the higher dose. This surpised me because I had been going well. Thinking back, the first few days I wasn't drinking coffee. Then I started having coffee in the morning again and yesterday I had one at breakfast and then another at lunchtime. What I have read on this site confirms my suspicion that it may be the cause of me not feeling as good as I had so no more coffee for me. Yesterday I decided that I need to started taking more care of my nutrition (I haven't had much of an appetite lately), and what I have read here confirms this. I am taking one day at a time, and I am not making any decision yet as to whether I will go off the Pristiq completely or stay on the 50 mg. At the end of last year I completed a free Government funded online workshop (I'm in Australia) which I found very helpful. Even though I had previously seen a psychologist, had done a lot of reading of books and internet articles and "knew" CBT (which I have nicknamed Change Bad Thinking) I found that doing the workshop (which was over 8 weeks) was very helpful because it was practising the CBT, instead of just knowing it. I'd like to take this opportunity to wish everyone all the best as you deal with whatever you are going through. Unfortunately, that is the hard part. We have to go through it ourselves. Thankfully, though, others can support us. Take care everyone. ChessieCat

Hello, My name is william. i am glad I found this forum. I have not been able to find much about what I'm going through and my doc's claim it's probably only rebound symptoms. I was hospitalized in early jun for suspected seratonin syndrome which was not fun. Removed from all of my meds and put on the ones for that specific thing for about a week. Ended up restarting all of my old ones except zoloft and staying on all the other ones as well. Also started imatrex (mod note: sumatriptan) around that time frame. It's been a few months now and my life is still in shambles. Migraines, vertigo, anxiety and depression and sex drive/function are far worse the before starting any of the meds. I want to try to taper back on Zoloft if only to be able to taper off properly but I am scared. The 6 days of being immobilized by most of my body clenching for hours at a time was not fun at all and painful! With all this going on I was transfered back from overseas to get care. So my life's in shambles but somehow have to find make it through all of that. Anyways that's my story up until now. As much as I would like to find someone who can relate i also hope no one has or will go through this. Thank you for your time. V/r William

Hi all, Brief overview. 6ft, 180pnds male from England. - Began Sertraline 9.21 after work-related stress brought me to my knees - Titrated up to 150mg by 2.22 in conjunction with my mental health nurse Around January of this year, I began to feel really, really unwell - diarrhea, muscle stiffness, tremors and roving-eye movements. The NHS in the UK is in a big crisis at the moment, and seeing anyone face-to-face is nigh on impossible. I was told it was just 'side effects, it will pass', then to increase dose/decrease dose etc. Later, tested for electrolyte disorder which was negative. Emergency ambulance called for me on 18th May after I thought I was genuinely dying. Finally, I was given a physical diagnostic assessment by two doctors who diagnosed moderate serotonin syndrome/toxicity. All in all, it had taken me 3 months to see somebody in person! - Told to immediately cease SSRI 19th May. Given diazepam and cyproheptadine. Within 48hrs I felt so much better and this continued for 3-4 weeks. All SS disappeared However, the brain zaps/sleeplessness/fatigue of withdrawal began around 5-6 days ago. I understand why I had to stop abruptly, but even so - 150mg to 0 overnight is a huge leap downwards. It has been just over 4 and a half weeks since I last took my SSRI. Should I reinstate at a lower dose? The cyproheptadine is designed to clear out excess serotonin, so may have had an impact. Based on what I have read here, would 25mg be a good number to try to stabilise on? Any help greatly appreciated! P.S. this is such a wonderful resource. My cousin is a psych nurse and her knowledge pales in comparison. P.P.S. Serotonin toxicity possibly caused by too high a dosage; more likely an interaction with an OTC sleeping tablet (diphenhydramine). No certain answer, however.

Hello everyone, I’d like to start off by saying thank you. The people of this forum have inspired much hope and understanding in the ways of antidepressant medication. I am grateful. I’ve been on Zoloft since the spring of 2015. Things had been going wonderfully well. I felt like myself but disconnected/ unplugged just enough to cope far better. Better mood, alertness and mental focus were a nice change of pace. Around the end of May 2017 I’d been taking BCAAs for working out for around 2 months. One Sunday, after lifting weights and mowing the yard I took a nap and woke up feeling off. I had low blood sugar issues for about a day, I couldn’t handle warm temperatures, couldn’t sleep well, and suffered hot flashes for the next few days. For a while I though I was sick. I took an lorazepam one evening (3 days later) and an extra zoloft because of horrible anxiety. I countinued to take my now double dose with my doctor’s permission. The next 6 weeks were h*ll. I had no idea Zoloft could do such things since I had no negative effects when I started. I could write a novel (as I’m sure we all could) but I’ll try and hit the main points. About week 6 I stabilized. I hadn’t found this site yet so many mistakes were made. i only stayed at 100mg for a week or so before I jumped to 75mg (I felt too apathetic about things, needed to lower). By this point I realized it was the Zoloft causing my problems. The next few weeks were quite uncomfortable but things went really bad when working out on the 3rd week caused me to crash...hard!! I switched doctors as I couldn’t seem to get anywhere with my other one. My new P.A diagnosed me with serotonin syndrome (a short 3 day stint of trazadone while doubling my dose no doubt contributed, different doctor) she dropped me from 75mg to 25mg of Zoloft. I felt so much better and for the next two weeks got to the point of feeling amazing. Then week three came and some light cardio pushed me over the edge and I crashed again. I also noticed I would have horrible low blood sugar issues for a day or two after crashing. after a week of misery. I bumped my dose to 50mg (I found this site by then). I felt immediate improvement. I began to heal but also began feeing strong sensations of numbness/ pins and needles in my hands and feet, weakness also. I am currently 7 weeks at 50mg. I’ve been struggling with tight & weak calves / ankles since, sporadic internal tremors and fatigue. Had back spasms for a bit about a week ago but not since. I’ve begun to sleep better in the past few weeks (7 hours on a good night but not consistently). I typically wake up around 5-6 hours after falling asleep but I don’t NEED medicine to help me fall asleep anymore (a few months of needing it). I would rather keep this short but I want you all to know my history. I saw a psychiatrist tonight at the recommendation of my PA (she was surprised when my reinstatement actually helped, she was convinced I hadn’t dropped too low too fast. She is a wonderful PA and God worked through her, saved my life when I had serotonin syndrome.) The psychiatrist on the other hand... I have mixed feelings. I flat out refused any other medication. She believes my first incident was serotonin syndrome. Maybe so? BCCA actually inhibit triptophan uptake but then again my workout protein powder did have triptophan in it (I have quit taking all workout supplements months ago). The psychiatrist also thinks I’m suffering from serotonin syndrome now. (Currently weakness in legs, pins and needles in hands and feet, stiff feeling calves and maybe hands, hands and feet more susceptible to being cold) what do do you all think? Do I continue to continue to tough it out at 50mg? Is this a sign my body is too sensitized for this dose? (I was at 25mg for one month before reinstating to 50mg) I will work on my signature as soon as I figure out how to do it. Thank you for your time. I trust you all more than the medical “professionals”

Hello everybody 😊, this is my first post! I didn’t know how to add a signature, can somebody please help me? I‘m from Germany, so please excuse my mistakes. In 2020, I had increasing back pain, worse than I had ever before. I think it was a burnout due to a severe illness of my mother and my workload (I‘m a MD in a hospital). It resulted in surgery in July (my first mistake). Unfortunately, the pain didn’t get better, I developed a very severe depression. Like frozen inside, no emotions at all, I was like a zombie. I was in hospital for nearly 6 months. For a long time, I refused to take AD, but in Jan2021 I started with escitalopram 5mg, because I felt I had nothing left to lose. My psychiatrist increased the dosage in March to 40 mg and added venlafaxine 150 mg. I tried very hard for a few weeks, but the side effects were intolerable so I reduced both AD, in retrospective much too fast. My second fault, but at that time, I didn’t know better. Now I take 50 mg venlafaxine (since 29.6) and 25,5 mg escitalopram and had/have severe withdrawal effects (anxiety, brain fog, brain zaps, joint pain, fatigue, sweating, headache, vertigo etc) so I started increasing escitaloprame again. 20.9. 25,3 mg, 30.9. 25,5 mg. Sweating and headache is better, anxiety unfortunately increasing, the rest is the same. It’s horrible, but who am I telling this… And now I don’t know how’s the best way to continue… Should I increase the dose further? If so, how soon? I can no longer differentiate between what is still depression, what are side effects and what is withdrawal 😟 Thank you in advance for every answer!

Hi All - I won't repeat my story (in my signature), but this year has been both the best and worst of my life. I had a sweet baby boy who I love so much, but I am suffering from non-stop medical issues and feel devastated that I cannot be the mother I envisioned myself being. I'm not sure exactly what I am looking for here...strength, support, hope, clarity? My situation is not so straight forward as I also have Chiari Malformation Type I. I had two brain surgeries in 2005 and 2010, but since 2005 I have been pretty much asymptomatic from a neurological standpoint. Many of the symptoms of Chiari also overlap with conditions like psychotropic withdrawal, lyme disease, chronic fatigue syndrome, etc., so now that I am feeling so terrible I feel confused about what is really causing it. Is it withdrawal? Is it Chiari? Could it be something else? Have any of you pursued additional workups like looking for lyme disease or being evaluated for chronic fatigue syndrome? My main symptoms currently are brain fog (like my eyes won't focus or almost like I'm not fully present in a room), general malaise, fatigue, tension-type headaches, and limb weakness. Like so many of you, I fear this is my new normal and my new life. I don't know how I will cope with that. I was an active woman, I worked in the medical field, I loved to travel with my husband and socialize with friends, I loved to spend time outdoors and try new activities. Now, each day feels like an uphill battle. I feel too anxious to plan any activities or trips because I don't know how "bad" I will feel any given day or any given moment of a day. It has been 4 months which I realize is probably short in the scheme of things. Would appreciate any advice. Thank you so much.

I was on sertraline 75mg for 2.5 years for postpartum depression. During that time I sought counseling and my therapist diagnosed me with bipolar 2 because I had irritability along with my depression. My therapist referred me to the Psychiatric NP in the same practice. The NP told me to "wean" off the sertraline within a month so she could introduce latuda. She put me on 20mg of latuda and increased it to 80mg within 4 months. At 80mg, I immediately experienced heightened anxiety, insomnia (I still haven't had more than 2-4 hours of sleep per night since December 2016 and some nights ZERO sleep!), and SEVERE akathisia. When I brought up the adverse reactions, the NP assured me these were side effects that would eventually subside - she was wrong. I suffered entire month and begged her to come off of latuda. She finally agreed and told me to taper 20mg every 2 weeks. My taper looked like this: 60mg to 40mg to 20mg then off. With each decrease I noticed my anxiety would spike and I'd go into an emotional tailspin about 4-5 days after a drop in dose and then stabilized a bit. I assumed once I tapered off the latuda I'd be able to sleep again, my anxiety would lessen and the akathisia would go away. I was partially right, the Akathesia went away as I lowered my dose, but the insomnia and anxiety remained. The NP had also put me on 100mg of lamictal two months after introducing latuda. I wanted to come off this medication as well, but she told me to stay on it because she thought it would prevent mania or depression while coming off the latuda. She was wrong again. One week after my last dose of latuda, I had a complete emotional breakdown and was severely suicidal. I voluntarily checked myself into a psych hospital. There I was told that I had been misdiagnosed by the NP and was abruptly taken off the lamictal. Then they reintroduced sertraline 150mg to bring me out of my depressive state. That seemed to stabilize me so I was released with a Rx for sertraline 150mg. A week after I was home from the hospital I knew instinctively something wasn't right. Instead of steadily improving, I felt worse physically (mentally I was actually doing ok). I began to have muscle twitches, tingling throughout my body, my eyelids kept twictching, my heart was racing, I would get hot and cold flushes radiating over my entire body, my skin felt like it was burning, headache, weakness, and the left side of my face was completely numb. I went to the Psychiatric urgent care where the NP diagnosed me with break through anxiety. I told her she was wrong and that I believed I was suffering from serotonin syndrome. She looked dubious, but sought out the medical director who conducted a neurological test and concurred with me. I was placed in psych hospital again and taken off the sertraline. I felt better within a day. They gave me remeron 7.5mg that knocked me out for almost two days. Needless to say, I refused to take another dose. A day before my release, the doctor and I discussed reintroducing sertraline at a very low level - 25mg to 50mg. I was sent home with a Rx for sertraline 50mg. Within 1 hour of taking the sertraline, all the serotonin syndromes came back so I had to stop taking sertraline with no possibility of reinstatement. All this time, I believed my insomnia, anxiety and akathesia were related to the Latuda. I also believed that my emotional distress and depression stemmed from latuda withdrawal, but now I'm wondering if it was actually protracted withdrawal from the first time I weaned off of sertraline 75mg and the weaning off latuda being merely coincidental. I did not experience any acute withdrawal symptoms with the exception of a little Weepiness from time to time. Is it possible to experience withdrawal symptoms from sertraline SIX months after the last dose? It's been 3 weeks since my last dose of sertraline 50mg and I've experienced the following: headaches, muscle twitching, shivers, tingling, internal restlessness, body aches, a general feeling of being unwell, severe mood swings: rage, depression, apathy, suicidal thoughts, hypomania, uncontrollable crying, and anxiety. I've had some good functional days, followed by days of being physically & emotionally incapacitated. Is the what's known as waves & windows? I'm trying to figure out if this is withdrawal from the latuda & lamictal or a continuation of the the possible withdrawal of the sertraline. I'm also hoping that the reintroduction of sertraline followed by the abruptly stopping won't prolong whatever it is that is going on. I am also worried because after doing much research I realized that I did the first taper much too fast, but there is absolutely nothing I can do about it now due to the serotonin syndrome. Any advice, insight or shared experiences are most welcome. This site makes me feel less alone. My new psych told me I shouldn't be experiencing any withdrawal and I was just having breakthrough symptoms.

Drug History 2002 - Started Zoloft 100mg. Gradually reduced to 50mg, intending to come right off. 2009 - Went back up to 100mg - no ill effects. 2011 - Began slowly reducing again. 2017- Down to 25mg. October 2017- Dose increased to 50mg. I started taking Sertraline 100mg in 2002 because I’d developed panic disorder after a stressful mature-age college course. The medication worked immediately and continued to help me - I was well for 7 years with no anxiety. I gradually reduced to 50mg, but in 2009 went back up to 100mg with no ill effects during a life crisis. In 2011 I determined to come off again and began reducing very slowly with no ill effects. By October 2017 I was down to 25mg. I went to my GP to get a counselling referral. I was quite well with no anxiety, but she advised me to go back up to 50mg to mop up any underlying depression I might have. So I did - one of the worst decisions of my life! Within 24 hours I developed horrible symptoms... terrifying anxiety/dysphoria, palpitations, severe insomnia. I was certain they were caused by the increased dose of sertraline but my GP denied that this was possible ‘on such a small dose’. She said I woud soon adjust. So I stupidly continued to take it for 2 more weeks before another doctor in the practice told me to go back to my normal dose immediately. I was expecting that I would then return to ‘normal’ but I did not - instead I continued to suffer bouts of toxic anxiety as well as the other symptoms. I consulted other GPs and a psychiatrist - all reluctant to link my symptoms to the increased meds and instead going with the ‘pure anxiety’ diagnosis. Recently I found a GP who was willing to listen and referred me to a psychiatrist who tested me positive for clonus and hyperreflexia. He said that on the basis of these together with my other symptoms I definitely have non-acute sertraline syndrome. Although it is unusual, he thought it was triggered by the increased dose of medication in my system. He told me to titrate down fortnightly in 5mg increments using a solution. However when I got down to 15mg last week I soon developed withdrawal symptoms including ataxia, burning, nausea. But then yesterday I started to feel much better - almost normal! So this is my dilemma. I’m told that serotonin syndrome disappears soon after the medication is withdrawn. If that’s the right diagnosis then I should follow the 5mg taper and get off as soon as possible. But if this quicker rate gives me severe withdrawal then I should stick to the much slower 10% monthly regime - thereby possibly prolonging the agony. What to do? Can’t go forward, can’t go back! I’m so confused. I’d appreciate any help the forum can give me.

Hello to all. Thank you for this site. I'm sorry to all who are suffering through this. Back in August I was down to 112.5 mg of effexor from 187.5 when my doctor put me on 30 mg of prozac to help with my taper. Over a few weeks I developed seratonin syndrome and had to stop both at once on Sept 19th. I've been going through withdrawal ever since with it getting worse every morning. It is extreme in the mornings now. I found a fb group and started reintroducing effexor starting with 8 beads on Thursday Oct 15th. My main most disabling symptoms are extreme nausea, vomiting, dry heaving, diarrhea, and feeling extremely hot and prickly electric type shocks to my body. Any advice that anyone can offer would be greatly appreciated. I plan to hold at this dose for a week and then go up if not stable.

I'll try to keep this kind of short. I've finally decided to post an intro today after reading posts on this site for a few years now which has helped a lot with understanding what's going on since most doctors just told me my SSRI discontinuation/withdrawal symptoms-which were unlike anything I'd ever experienced before and physically and emotionally worse than I'd ever felt-were a return of my depression & anxiety or possibly a bipolar disorder according to one doctor. I knew for a fact that it was not my original anxiety & depression, but I had no idea what was happening in the beginning or how to explain it. I had social anxiety, depression, & general anxiety since age 12 and was not allowed to drive/take the bus/go out or do much by myself other than going to school (because everything was too dangerous) by controlling, religious parents with their own high anxiety and agoraphobia. I was never allowed to receive counseling for these issues & when I went off to college, it was an extremely difficult struggle going from not being allowed to do almost anything to suddenly being responsible for figuring everything out on my own. I was also not great with time management skills & knowing how to plan ahead. (I actually relate to a lot of symptoms of ADD & Asperger's, which both greatly affect social skills & ability to get through college and would explain a lot of problems I've had. I have learned more about them in the past year, but can't afford to get diagnosed right now so I've just been looking at support groups for days when my nausea is lessened.) I felt overwhelmed all the time and all my negative thoughts worsened severely. I didn't see the free counselor at college during this time either because I was embarrassed about everything and about asking for help. I finally decided I wanted to try to make a change and try counseling the summer after sophomore year of college at age 20 and was at rock bottom, desperate to not feel depressed. I knew someone who said their antidepressant helped them, so I asked a doctor for medicine and they prescribed sertraline. After taking the first pill, I had a surge of anxiety and racing thoughts that made it impossible to concentrate. Within the first couple days on 25 mg of sertraline, I was gagging and dry heaving over and over for at least 20 minutes as soon as I ate anything. I would also throw up multiple times in a short timespan after one snack or meal. I called my Dr & was told to skip a dose and then change the time I took the dose from morning to night. After a week of this (dry heaving & vomiting all meals) on 25 mg, and another call to the doctor, I was told that digestive issues are a possible starting symptom and to increase to 50 mg. As soon as I increased, the gagging & vomiting increased even more. After 6 days of this, I called the doctor again and was told I could stop taking it altogether since it had been such a short amount of time on it. And to come in for a different medicine Rx after the weekend. The very first day that I didn't take the sertraline, I felt the worst nausea I had ever felt in my entire life. I ended up asking a friend to drive me to the ER because I felt so sick. I told the Dr how I had just stopped sertraline. The doctor said that my pupils were dilated and my reflexes were overactive. Then, he listed off illegal drugs & asked if I had taken those. (No, I've never tried any drug before). He said "You need to tell me what else is going on because the antidepressant couldn't have caused this." And I said "I don't know" and started crying. I do know that people in my family are highly sensitive to medicines and have since found out I have a gene that causes me to metabolize slowly so things build up for longer in my system. Anyway, the Dr left the room and at one point I was given Ativan in an IV by the nurse which did ease the nausea. When the Dr came back, he told me I had SSRI discontinuation syndrome, (he didn't explain what that meant), that I could never try another SSRI, and gave me a Rx for a small bottle of Ativan. My mom said he mentioned something on the phone to her about serotonin syndrome which dilated pupils and overactive reflexes are symptoms of, but I don't remember him saying anything about it directly to me. He also mentioned reinstating a small amount might help but my mom didn't pass this on to me until much later because she didn't want me to take it. After that, I experienced: -more dry heaving which gradually lessened in frequency -random times of vomiting after eating and after exercising when I wasn't sick & the food wasn't bad (or sometimes nothing was left to vomit & only a small amount would come up) -continuing debilitating nausea & dizziness -olfactory hallucination (putrid smell that wouldn't go away, would intensify around strong scents such as soap & car exhaust) -uncontrollable crying at every tiny thing (neuro-emotion, not regular sadness) -uncontrollable rage (neuro-emotion) -intrusive thoughts & floods of bad memories which I "word vomited" in texts to my sisters -didn't want to be around people who I associated with bad memories because it would greatly intensify neuro-anxiety. (I'd guess the feeling is similar to what people mean who talk about experiencing bad drug trips and how it's important to be with people you trust) -nightmares -paranoia/suspicion/distrust (felt like my mom & sister were not really my mom and sister even though logically, I knew it was them. Things feel creepy & sinister -almost like a horror movie sometimes. A post I read here compared the sinister feeling to a bad LSD trip. I have never tried LSD, but I understood what they meant & is the closest way I found to describe it. -cognitive fog (thinking, processing speed, & reaction time is noticeably slower) (I was a slow thinker/processor before, but it feels like I have brain damage now) -memory problems (I was somewhat forgetful before, but am even more so now) -depersonalization ("it feels like the medicine changed who I am & I don't have an identity/sense of self which I still hadn't fully formed before sertraline) -derealization (feel emotionally disconnected & distant from people/atmosphere. I know things are real, but they don't feel real. Sometimes it feels like consequences won't matter or there is no sense of helpful anxiety even in a potentially dangerous situation. Logically, I know they do matter and still want to do the right thing) -anhedonia/apathy/emotionally numb (don't care about things or have the same amount of passion for interests or feel empathy for other people's emotions or feel spiritual even though I had some spiritual beliefs before. Couldn't feel hopeful about anything/future or feel love towards or from anyone. These emotions have slowly returned to a certain degree since then & levels of ability to feel them have changed at different courses of time) -blurred/cloudy vision (when DR was at most intense, vision was different. Hard to explain) -eye floaters ( random black specks & lines) Didn't notice these until a year after DC-ing -constant yawning/air hunger -stomach/digestion issues -burning, tingling, itching, numbness, redness in feet -brain zaps/"crackles" (sometimes annoying, sometimes painful, but my most tolerable symptom) -head pressure/tightness, feels like head is being squeezed -headaches There was also a period of 6 months where I thought certain symptoms were over and after that period, the dizziness returned. Those are most of the symptoms I've experienced in the past approx 3.5 years. They're not in order. I'm 24 now. A few have gone away for the most part (vomiting, olfactory hallucination, yawning) and most are less intense. I have really improved a lot, I don't mean to sound overly negative. But, I still have the issues I went on the SSRI for & I have trouble accepting where I am & worrying about where to go from here & the uncertainty of how long this lasts because it has put lots of areas of my life on hold (I wasn't able to go back to college, I hope to someday) and ended up making things harder to deal with when I was told it would make them easier. (BTW, I am now seeing a counselor). I don't understand why people say SSRI's are not technically drugs when they have this much of an effect on your mind, mood, & perceptions. Sorry if I have over shared, I might need to post a shorter version of this at some point that's easier to read. And I'm still figuring out the layout of the website & where to post about certain questions & topics. I just know that sometimes other people's explanations made me feel better because I had some understanding of what was happening & words to describe feelings I'd never had before and didn't know how to explain. I've also had other stress & health issues and a few (physical health) medicines that have affected my withdrawal progress, but I guess that's a topic for a separate forum. Any advice, similar experiences, recommendations, tips for using the site, or insight into what happened to my brain is appreciated if anyone feels so inclined :)

Cureus Journal of Medical Science. 2018 Apr; 10(4): e2421. Published online 2018 Apr 4. doi: 10.7759/cureus.2421 Serotonin Syndrome Presenting with Concomitant Use of Tramadol and Diphenhydramine: A Case Report of an Unlikely Side Effect Salman Khan,Shakir Saud, Imran Khan, Muhammad Asif Osama Ismail,Arqam Salam, Tsu Jung Yang,and Kim J Norville Links: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5985917/ Abstract: Serotonin syndrome is a condition that occurs following the administration of serotonergic drugs. Interestingly, on rare occasions, it can occur with various drug combinations that can secondarily affect the serum levels of 5‐hydroxytryptamin. Tramadol is an analgesic that has mu opioid receptor agonist activity and has also been shown to inhibit the reuptake of serotonin and noradrenaline. Diphenhydramine is a first-generation histamine antagonist prescribed to treat or prevent allergic reactions and can also be used as a sleeping aid. Here, we demonstrate a case of serotonin syndrome following the administration of diphenhydramine for seasonal allergies in a patient on tramadol for neck pain. Interestingly, it is thought that tramadol’s analgesic effect is due to the inhibition of serotonin and norepinephrine reuptake in the CNS [2] and the risk of causing serotonin syndrome is currently well-recognized. Diphenhydramine, a first-generation antihistamine that acts as an inverse agonist on the H1 receptor [3] may also inhibit the reuptake of serotonin. It is known that SSRIs like Fluoxetine are analogs of diphenhydramine [4]. Although weaker, diphenhydramine does retain some activity at the serotonin receptor.

Hi there, I was on Paxil for less than two years this time around. I started taking antidepressants again when I became paralyzed from falling down the stairs. I suffered with serotonin syndrome symptoms for over a year. I was also taking another medication that is known to interact with Paxil. The doctor did not help me in this matter. He did not know what was wrong with me. I finally found another doctor and began tapering off the paxil slowly like I had done in the past . I was on Paxil two other times in my life and had been on it longer than this time around. I never had any issues tapering, but I also never had serotonin syndrome symptoms before either. The first week of tapering I started having withdrawal symptoms and they never went away. My whole life has been put on hold. I can't function. I can't understand what people are saying because I can't focus. My head and vision are distorted. I am very tired all the time. Can't get myself to do anything or go anywhere. I also have headaches, night terrors, and GI symptoms. My food just sits in my stomach after I eat now and nothing moves. The only symptoms that did go away were these quick wooshes in my brain and sometimes my brain felt like it was short circuiting. 3 doctors i spoke to all said the same thing that I need to go back on antidepressants to get rid of these symptoms. My doctor gave me an order for Wellbutrin. I didn't know if Wellbutrin would work since it doesn't work on the same receptors so I did some more digging online. I read that you have to go back on the same/similiar antidepressant for reinstatement to work. Then I read on here, that reinstatement doesn't always work and you have to do it immediatley for your chances of effectiveness to be good. I immediately panicked and took a low dose of my Paxil. I have been on Paxil 10mg for 4 days now and I can't tell if it is helping at all. (I used to be on Paxil 20mg) I still feel out of it. I notice when I eat my symptoms get way worse. Especially when I eat carbs. Maybe because it releases serotonin? So, I try to avoid foods that trigger like carbs and triptophan releasing foods. I can't stop taking another medication that also secretes serotonin. It isn't an anitidepressant, but I have to take it throughout the day. Could this be making my withdrawals symptoms worse? I think so. I know it was interacting with my Paxil making my serotonin syndrome symptoms worse. This drug ,alone, is known to cause serotonin syndrome in some people so it just makes sense to me that this would make my withdrawal symptoms worse and I don't think there is anything I can do about it because I can't stop taking it. Or is there? Pain I read here that I need to be patient for reinstatement to work and it could vary in the length it takes to work. Thank you for those answers. How long have withdrawals been known to last without reinstatement? This is so scary. It has been nearly impossible to live like this. Any help would be greatly appreciated. Thank you in advance. Hopefulpatti

Hello, here for support and advice. Insomnia came on gradually. Sleeping less, waking earlier. My hubby got laid off from his job, my cousin died & found out I needed a rootcanal with no dental insurance. I was in a tail spin. I had taken Paxil since 2002 & suspected it was pooping out on me & was having withdrawal symptoms even being on the drug. The insomnia got worse. Dr. prescribed Ambien but I took it at couple of times. The 2nd time I didn’t sleep at all. Also on Keflex for the root canal and it can cause anxiety. I had been tapering paxil over time, alternating days of 20 and 10 but when all these things happened, I thought I should take 20 again daily just to get through. Then my dr. upped it to 30. Big mistake! I landed in the hospital with possible serotine syndrome/sleep deprivation. All they did was lay me out with a big dose of Ativan. I did sleep and that was probably the last night I had a significant sleep. The Dr. there discontinued the Paxil & told me to take Prozac. One of the worse side effects is insomnia and I quit the Prozac…was also suffering terrible Paxil withdrawal with involuntary movements, anxiety, insomnia. The only relief is an Ativan which I am afraid to take because of the addictive properties but sometimes I get so desperate. My dr. gave me Trazadone to sleep. Worked for a few hours only. Then she reinstated me on the Paxil (smaller does) because of the withdrawal & those two together raise the risk for serotonin syndrome. I’ve continued to have symptoms, not sure if I am still withdrawing or if even a smaller does is heading me back to serotonin syndrome. I have bad involuntary muscle movements. For sleep, my dr. also tried hydroxyzine. Not very effective. I am at my wits end. I am trying to get over my fears of addiction to some meds as it might be better to be addicted than a nonfunctioning mess. When I get a little sleep, I can think more clearly. I need help badly. I had heard of Restoril. Scared of it but probably need it. That’s my dilemma and I need help.

Serotonin Toxicity vs. Serotonin Discontinuation Syndrome: I have had very severe chronic serotonin toxicity. Neuralgia and neuropathy developed over a 4 years period to include the entire right side of my body. Level 8-10 pain daily for 12 weeks before anyone figured it out. Given injectable IMITREX to" help" -- wrong, made it worse, could have killed me! The toxicity started wrecking my ANS: sweats, chills, loosing 1/2 - 2 lbs daily for months, high fevers, low fevers, high blood pressure, migraines, vertigo, bowel issues, at points inability to walk or voluntarily move my body. Basically, hell. The pain was so severe that I would dissociate — once for 3 whole days. Are there any resources here or elsewhere that offer in depth information about Serotonin Toxicity? The toxicity was caused by receiving TMS treatments. Transcranial Magnetic Stimulation. I had one round of 36 treatments 4 years ago, got me out of depression and "coincidentally" a developed neuraligia/neuropathy at the same time. Again had TMS this past December - February. The doctor who treated me is a leading researcher, psychiatrist, runs a program training other docs to give TMS treatments and I mean it -- a really a lovely woman, smart, and compassionate -- told me when I was asking if the TMS was giving me muscles spasms and increased nerve pain, "That's an issue for your neurologist." Previously she had also told me that one of the ways that TMS works, is it increases the effect of serotonin based medications. She didn't see Serotonin Syndrome sitting in front of her and asking her "What's going on here?" Today the pharmacist told me that TMS reduced the blood/brain barrier. WARNING: TMS + Venlafaxine caused serotonin toxicity for me, be cautious! Another smart compassionate and more curious woman and — my psychiatrist figured it out after I delivered her all the puzzle pieces I had been collecting. She told me to immediately stop the Imitrex and start a taper of Venalfaxine. VERY SLOWLY, though she didn't give me specifics on what slowly meant. I came up with what I thought was slow taper, and half way through had to double the length. I tapered Venlafaxine in 3 months from 225 to 0. I had taken it for 10+ years. Psych meds for 25 years. I had to, because it was quite literally killing me. But now of course, I'm ten days off and I'm feeling pretty sick: Parkinson-like movement symptoms being the chief concerning symptoms, especially when combined with the vertigo. I take a few moments to "Get going" when I want to move. And then I lurch around for another 10 seconds until my body remembers how to walk. I have the bruises to prove it! At times, just standing still my whole body shakes like a tree in the wind. I keep dropping things and have no strength in my hands. Can someone inform me what this is? Is this part of Discontinuation Syndrome? Its kinda freaking me out. I also have the usual! discontinuation symptoms! ringing ears, painful eyes, weird noises in my head, muscle twitches, nausea, diarrhea, brain fog, EMOTIONAL!, Over energized and completely fatigued. Visual disturbances. Muscle and joint pain almost everywhere. Swollen hands. Itching skin so bad I thought I was having anaphylaxis and went to the ER two days ago. Surprised I could remember all my symptoms, cause really the brain fog + zero memory issue makes it so this post took me several days to write, in several 1 hour sessions. I used to write semi-professionally. So this is actually a symptom as well. Last night, I had about 2-3 hours of uncontrollable rage (self directed violence) that was provoked by sensory overload. Embarrassing, terrifying. Is this part of Discontinuation Syndrome? I know the best remedy for "discontinuation syndrome" is reinstatement. I tried 3 mg prozac. Got nerve pain from head to toe within 4 hours (a symptom of Serotonin Toxicity). BUT, on the flip side the next day a started feeling better. My psychiatrist is going to look at all the possible SSRI and SNRIs to see which one might be possible in a micro dose. I spoke to my psychiatrist today and she suggested 20 mg non-extended release venlafaxine twice a day, with a a slower taper. I need to figure out what a slower taper would look like. I read 10% decrease per month? Is that correct? Any resources, advice on that? BUT, the thing is, I don't think any boosting of serotonin is a good idea for me right now given how extremely ill I got from serotonin toxicity. AND YET, my "discontinuation" is fairly severe, so I’ve decided to go back on. I’m choosing nerve damage because I don’t want to risk long term discontinuation syndrome. I will get myself ready to be in pain. What's worse: body wide neuropathy (nerve damage) in both CNS and ANS? Or Parkinsons like movement issues, vertigo, fits of rage, and the risk of long term discontinuation syndrome? OR??? Is there something I can do about discontinuation that will not raise Serotonin? I'm pretty freaked out by realizing I'm in between two really horrible things, and I do not know with certainty what to do. Please make any responses concise and focused on the above question. I've got major information processing issues. (In the end it took me several hours to write this post. I tried to keep it focused. THANK YOU! -------------- What I am doing: EXERCISE I am making myself go out and do gardening every day. Hard physical labor. Somehow this works for me. Can't explain it. I don't question it, though it is making my muscles sore from the work out. Figure I’m regaining the strength I lost with 4 years of nerve pain. Most days I use foam rollers and yoga therapy (my profession) to soften the rocks in my muscles. And ice baths (fabulous for my nerve pain and muscle spasms and migraines) DIET: I drink lots of water and coconut water, lemon, mint. Basic diet for past 5 months: DO EAT: above ground vegetables, meats, fish, eggs, seeds, nuts, water. DON'T EAT: grains, no fruits, no dairy, no root vegetables (EXCEPT gratefully purple potatoes, parsnips and turnips :-) ! RECENT DIET ADJUSTMENTS Reinstated coffee and it seems to help me move a bit more smoothly. :-). Added Rice and bananas as foods I can eat when I'm still horribly nauseous and ravenous simultaneously. HERBAL TINCTURES: burdock, kava, lobelia, turmeric, white willow, and valerian. CURRENT DAILY MEDS: Felodopine for High blood pressure Oxcarbazepine for nerve pain Naproxen (Aleve) as an antidepressant (anti-inflammatories do help) Levothyrozine (hypothyroid) Levothyronine (hypothyroid) Singular for asthma Medical Marijuana — PCP, neurologic and psychiatrist all endorse this. Cannabis (oral infusion in cocoanut oil 2-3 times a day and vaping) Helps with the nerve pain, anxiety and depression. Total game changer for allowing me to be physically active and do things I enjoy and need to do to feel like I’m actually living — i.e. gardinging, socializing. Question: is cannabis seroternergic? Anyone know? PRN MEDS * Valium 5 mg PRN for muscle spasms, and at this point for the anxiety, irritability. Usually take 0-4 each day, depending on how bad things are. I chart it every day. Aware it is addictive. * Bendydryl (two OTC pills) with Promethazine suppository for neurological pain and nausea. Works OK for pain. * Low dose Ketamine nasal spray when the neurological pain is beyond bearing (to stay out of the ER) I’m finding that a single dose really puts the brakes on the discontinuation syndrome and have been using it that way. Previous does for nerve pain were 4-16 depending on the severity of the pain. CURRENT SUPPLEMENTS: Methylated B vitamins (I lack 1 of the genetic pairs for methylation) Vitamin D 5000 iu. for depression Alpha lipoid acid for neurological issues N Acetyl Cystine for neurological issues Reservatrol for neurological issues CoQ10 for neurological issues PAST: 10+ years venlafaxine ER 25 years psych meds. First ten years took almost all of the possibly relevant ones. Side effects and ineffectiveness. Starting 2 years ago I started slowly weaning off meds. I've gone from 14 meds to 7. Diagnoses: PTSD Major Depression Anxiety Sleep disorder "Post Lyme Disease" An auto-immune system problem? Migraines (Serotonin toxicity?) Neuralgia and neuropathy through out the right side of my body Yours truly, UrbanFeral -------------------- Med / discontinuation history. 2002? to 2016 Venlafaxine ER. First antidepressant that worked. Alas due to combination with TMS (transcranial Magnetic Stimulation) I developed chronic serotonin syndrome, extremely ill since January 2016. Tapered over 3 months from 225 to 0. (too fast!) It was easy till I got to the 37.5, and then discontinuation kicked in. As of 6/20/16 going back on 20 mg non-extended release, twice a day and beginning a slower taper. 2012-2016. One at a time, slowly I eliminated medications from 14 to 7. DX Plaquenil which had been treating post Lyme non-specific autoimmune disorder. Safely got off it over a 4 month period. DX Spironolactone for heart arrhythmias and high blood pressure. No issue getting off it. Lunesta for insomnia, tapered off over a 4-5 month period. Ativan - stopped taking it when I started taking Valium this year to control severe muscle spasms. Cannot remember what else I got stopped taking. 1992-2002, over 20 different medications tried alone or in combination that were either ineffective or had bad side effects. I'm going to work on a complete list. It's going to be real piece of work.

Please help, 2 weeks ago I was prescribed 50mg sertraline for intrusive thoughts, but was not depressed. I took my first one and about 6 hours later I had a very bad reaction I had a fever my blood pressure was high, I had diarrhea and my mind was cray I knew instantly that I had poisoned myself, it wasn't until a week later I read up on serotonin syndrome and realized I experienced all the side effects and still suffer some of them to this day, here are my symptoms I have and have got worse short term Memory loss, agitation, irritability, muscle twitching, shivering, restlessness, sweating(up my neck and scalp mostly), hallucinations derealization/depersonalization, feel disoriented at times, muscle spasms which are painful at times, tingling/prickling sensations in my hands feet chest arms and legs, pressure at the back of my head. I don't get it I was a happy outgoing person until the doctor insisted the tablet would take away intrusive thoughts, not only do I still get them but get even worse! hallucinations! I don't want this Have I got the effects from serotonin syndrome or is this permanent nerve and brain damage? please help I am quite worried and no one wants to listen to me

Hi, Obviously I am new here. I am desperate for support and understanding. My life is falling apart. I am on so many meds. Every time I ask a new dr to help me wean off of Effexor, they say they will, but they add another Med first and I am STILL stuck on the Effexor! I am down to 37.5 mg, but even weaning down one bead at a time, I experience SEVERE withdrawal! Brain zaps, vertigo, exhaustion, rages, crying spells, hopelessness, mood swings. I am now on Effexor, Viibryd and Lamictal and I am worse off than ever!!!!! I am angry and hopeless. I am exhausted, irritable, having muscle twitches, hypertension, headaches, vertigo. I don't even know who I am anymore. I haven't been happy in years. The doctor on psycheducation.org says that everyone should have the opportunity to be off all the meds to find a baseline. I am diagnosed with depression and anxiety, not that I have ever had a proper screening. I believe I may be bipolar and it has been missed due to my adhd. But how can anyone know since I've been on these meds all these years?! And I have to wonder if I AM bipolar and these meds have made it worse or even initiated "kindling"!!! I can't find any doctors who understand or who can truly help me. I feel so helpless and I hate the person I've become! I need to know if this is really me or a monster created by these meds!!! My children are suffering and I believe that them enduring my mood swings and outbursts amounts to psychological abuse. My heart is broken for my girls. I need help and I can't find it anywhere.