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ADMIN NOTE See prior discussion here Post-withdrawal nervous system hypersensitivity, hyper-reactivity and kindling Hypersensitivity and Kindling What causes hypersensitivity? Some people may experience minor difficulty in stopping a psychiatric drug one time, but the next time they start, startup symptoms are much worse, and the next time they stop, the withdrawal symptoms are worse. The nervous system can become destablilzed or sensitized from repeated adverse drug effects and withdrawal events. If someone goes on and off multiple psychiatric drugs, they may be in a state of overlapping withdrawal reactions and often a persistent hypersensitivity. In One Theory of Antidepressant Withdrawal, Altostrata writes: What is kindling? Kindling is a neurological reaction where repeated withdrawal or adverse drug reactions cause hypersensitivity, then hyper-reaction when the same drug or a different drug is introduced. The kindling response is an exaggerated adverse reaction to exposure to a drug. You may be vulnerable to kindling if you have a history of repeated rapid taper or cold turkey withdrawal and / or a history of heavy or chronic alcohol use, especially binge drinking -- in effect, going on and off the drug, with hyper-reaction when the drug is taken again. Generally, kindling is an activation reaction -- a sense of overstimulation, which may be an inner electrical feeling, anxiety, nervousness, panic, or at the extreme, akathisia, which includes an urge to move to relieve intense inner agitation. Here is an excellent explanation on the Benzodiazepine International Coalition website: Benzo Kindling. While the exact mechanism of kindling is unknown, some of the details on kindling have been written about in papers on alcohol withdrawal, which like benzodiazepines, affects GABA (here is one such paper - Kindling in Alcohol Withdrawal). While this phenomenon has been documented in the scientific literature for benzodiazepines for a long time, any drug that effects the nervous system and causes dependency can have a traumatic impact on the nervous system when changes are made often and abruptly. Research is now also pointing to kindling in antidepressant use. In the article Expertise from outside the Academy: tapering off antidepressants, Dr. Mark Horowitz cites a study by Dr. Giovanni Fava: Example: Hypersensitivity when tapering a benzodiazepine A benzo works by increasing GABA. Long-term exposure to benzos causes GABA receptor down-regulation and glutamate receptor up-regulation. For a more thorough description of GABA and glutamate during benzo withdrawal, see What is happening in your brain? A slow and careful taper makes it easier for the receptors to gradually return to their pre-benzo state. But when there's a history of prior withdrawal, hypersensitivity may result in increased neuro-excitability, creating worsening withdrawal symptoms upon even very small dosage reduction. The risk of this is much higher with a rapid or cold turkey benzo withdrawal. When tapering a benzo, this withdrawal reaction can even include seizures due to a lowered seizure threshold. Stimulants and some antidepressants (such as Wellbutrin) also lower the seizure threshold. If someone is dealing with antidepressant withdrawal in addition to benzo withdrawal, neurological hyper-reactivity may be even more intense. And with serotonin needed to release GABA and glutamate (see Serotonin as a Modulator of Glutamate- and GABA-Mediated Neurotransmission), the interplay of all of this neurotransmitter dysregulation can make hypersensitivity more likely. Example: Kindling in benzodiazepine use Some short half-life benzos (such as Halcion) and z-drugs used for sleep may cause kindling because much of the drug is eliminated in between nightly doses, a mini-withdrawal effect. Over time, this can sensitize the nervous system with repeated exposure and withdrawal in between doses. When a dose is introduced again or increased, it may paradoxically cause kindling -- an activation instead of sedating effect. Repeated instances of going on and off drugs, adverse reactions, cold turkey, etc. seem to build neurological hypersensivity to drug and dosage changes, resulting in worsening adverse reactions, usually some form of activation. The same may be true of the short half-life antidepressants. After a gap in dosing, a new dose, even if tolerated before, can cause a hyper-reaction. Skipping doses to taper may have the same effect, every re-introduction of the drug causing progressively worse withdrawal symptoms. (See How about taking my medication every other day to reduce my dosage? and NEVER SKIP DOSES TO TAPER). Hopefully, more research will be published in the future regarding kindling in antidepressants, antipsychotics, drugs used as mood stabilizers, and drugs for pain. Kindling in antidepressants, for example, may involve the damage caused to the serotonin receptors by repeated on and off use of one or more of these types of drugs and the effect this has on the overall nervous system. A note on dopamine receptor supersensitivity If you've been exposed to neuroleptics (antipsychotics), you can become hypersensitive to endogenous dopamine (the dopamine your body makes naturally) when the drug's dopamine blockage is removed. As opposed to benzo and antidepressant withdrawal caused by down-regulation of receptors, dopamine receptor supersensitivity is caused by up-regulation. However, dopamine receptor supersensitivity is not kindling - the symptoms of dopamine supersensitivity can occur without additional introduction or reinstatement of a drug or substance. You may experience dopamine receptor supersensitivity after coming off only one neuroleptic but not experience kindling. For more on dopamine receptor supersensitivity, see: Chouinard, 2017 Antipsychotic-Induced Dopamine Supersensitivity Psychosis: Pharmacology, Criteria, and Therapy While dopamine supersensitivity psychosis is specifically a neuroleptic withdrawal symptom, switching neuroleptics or making abrupt dose changes to the same neuroleptic can also lead to kindling. So it's important for people tapering neuroleptics to taper slowly to decrease the chances of both dopamine receptor supersensitivity and kindling. A note on limbic or psychological kindling In this article on limbic (or psychological) kindling, the concept of being "hard-wired" for hypersensitivities is explored. If in addition to psychiatric drugs, you are also dealing with trauma, exposure to other drugs, pollutants, or chemicals, etc., you may already be in a state of chronic stress or what is also called the "flight or fight" state. Whether this directly translates to kindling is not clear - it may be related to learned responses, especially for those who have a history of trauma. Either way, learning how to self-soothe and calm the limbic system can be very helpful. See Non-drug techniques to cope with emotional symptoms. Steps to reduce the damage and mitigate hypersensitivity and kindling: Come off stimulating drugs first. Taking multiple psych drugs? Which drug to taper first? Consider a slow and mindful symptoms-based micro-taper. Micro-taper instead of 10% or 5% decrease The Brassmonkey Slide Method of Micro-tapering The slowness of slow tapers Allow withdrawal symptoms or adverse reactions to settle down before attempting another drug change. If you reinstate a drug or introduce a new drug, start at a very low dose. About reinstating and stabilizing to reduce withdrawal symptoms The Windows and Waves Pattern of Stabilization The rule of 3KIS: Keep it simple. Keep it slow. Keep it stable.

Hi I am new here, I was on citalopram for 9 years at 40mg and I thought it wasn’t working as well as previous so asked my dr for some cbt to try help but instead he switched me to mirtazapine on a 10 days switch taper(I had no knowledge on tapering at the time). I felt awful for the next 8 weeks so he then switched me back and I had an allergic reaction to the citalopram this time so he switched me to sertraline 100mg which still didn’t help and he then told me to stop with just a 2 week taper. I am now 4 months on nothing and have so many withdrawal/kindling symptoms. *constant heart flutters especially if I get adrenaline rushes or take any different medications or exercise * fast heart rate a lot * GI issues. * off balance, on a boat or drunk feeling * reactive to some foods and drinks *chest pains *brain fog *anxiety and panic *eye floaters and blurry vision *tremors and internal vibrations *weight lose, no appetite And more I just want to know if this is all normal and has anyone else had all the heart symptoms. Fast, fluttering and feeling weird. I get it a lot more if I do anything physical or eat sugary foods.

Hello, I’ve been going through severe mental withdrawals symptoms for 2 months now after my last dose of Effexor 75mg that i only took for 4 days and 37,5mg for a week prior. So I’ve been on the medicine before and each time i try to go off of it i go through hell. This time though i decided to reinstate the medicine after being off of it for more than a year and a half (was on different antidepressants during that period at different times). I decided to go on it again because of a returning of panic and OCD symptoms (which was the reason i got on the medication). i started with 37,5mg for a week then 75mg for 4 days, but the reason i decided to stop it again is that I’ve been getting extremely suicidal each time i try a new drug in the last 2 years, which happened in this case too since i thought that was just the case with SSRIs or Tricyclic antidepressants. and I remembered how my personality changes on them a lot and i how become cold, very apathetic and anhedonic (i became like that within a week of restarting it). so I realised that i made a big mistake that’s why i took a rash decision and decided to stop immediately. thought it wouldn’t cause me bad enough withdrawals due to the short duration i took it, but after 2 days only i got typical withdrawal symptoms like nausea, sweating, lightheadedness etc and thought I’d power through because them and they’ll eventually resolve, but 2 weeks in and the symptoms hit me BIG time! Horrifying Depersonalisation/Derealization, more intense suicidal ideation, insomnia, crushing depression, dysphoria, nightmares, extreme anhedonia, cognitive impairment (thinking of words for writing this topic feels like it’s like hurting my brain), weird episodes where my brain felt like it was being severely deprived of dopamine where I’d get an urge to scream or punch my head through a wall or cause some destruction around (idk if it’s psychosis) and mild auditory and visual hallucinations when i close my eyes while trying to fall asleep. So right now it’s been nearly 2 months since this had started and I’m very afraid that i caused myself a bad case of brain damage and that i won’t recover. I’ve been really really suicidal because of this because i don’t think I’m able to emotionally or physically endure it. In the last 2 weeks though, i got 1-4 days of remission each week (first remission lasted 2 days non-consecutively but the second was and it lasted 3-4 days) i went back to normal and thought it was finally over, but then crashed again and went back to square 1 as if the symptoms just started all over. I need to mention thought a month earlier of restarting Effexor i decided to reinstate Anafranil 25mg for OCD and got bad depersonalisation and suicidality from the first dose! i couldn’t tolerate that for more than 3 days so i stopped it. Ended up with bad mental withdrawals for like 10 days and that was it. probably reinstating and discontinuing this rapidly has messed me up badly and is the reason I’m going through this or it could be just the Effexor idk. I’ve tried a lot of supplements like omega3, vitamin d3, methylfolate, methyl cobalamin, magnesium citrate and a multi but i felt the my symptoms even exacerbated..!! I’m afraid of reinstating and then ending up being worse. Also scared that my brain has been permanently damaged because of my stupidity and naivety and that things will only get worse and I’ll end up taking my own life because of the pain….I really don’t wanna stay like this so please please please help me get back to normal i feel so stuck and helpless!!! PS: Sorry i was unable to express myself better because English isn’t my first language and I’m having a really bad brain fog. Moe

Hello everyone, This is my first post and I want to apologize for my poor English, I’m a French Canadian. I will try my best! My story started in 2007, when my GP put me on mirtazapine because I was suffering a big bout of insomnia, following a stressful year. I was a young 27 year old woman without any health issue and I was very naive at this time. I trusted my GP a lot. Big mistake! I went to see a psychologist and did some cbt. This allowed me to taper down my mirt, so after 5 months of tapering, I stopped mirtazapine. Of course, no one has told me about withdrawal syndrome, so I thought that the rebound of insomnia (from mirtazapine) was a relapse. This is where my GP decided that I had a general anxiety disorder. I was now labeled. She put me on celexa 20mg (with seroquel 25mg). 4 months later, I got pregnant, so my dear GP asked me to quit Celexa and seroquel asap. I immediately stopped seroquel and I tapered down celexa from feb 2009 and stopped it by July 2009, at 6 months of pregnancy (My GP assured me it was safe for my baby). I already had the intuition that a rapid weaning was not a good idea. I didn’t suffer any w/d symptoms at that time and finished my pregnancy in pretty good shape. Few months later, 2 months after giving birth, I had a relapse of anxiety in the form of my dear insomnia coming back. Of course, my GP wanted to put me back on AD. This is where we started to have trouble finding an AD that was working for me. Celexa wasn’t working anymore. I tried cymbalta and it wasn’t working either. I tried Paxil and it finally worked. I stayed on Paxil for four years and a half. By mid 2014, after some stressful events, I started to feel that it wasn’t working anymore. My GP asked me to quit Paxil fast then switch to mirtazapine. So I quit Paxil within 3 weeks. After the last dose, I had very hard time for the first 3 weeks. Then she put me on mirtazapine 30mg and Pristiq 50mg. I stayed on this cocktail for some years. At some point, I asked my GP if I could stop my AD, but she explained to me condescendingly that I was like a diabetic with insulin, I couldn’t live without those meds. She was destroying my self confidence. In 2018, I decided to stop Pristiq because I wanted to have only one AD to take. I taper down Pristiq , by switching to effexor, relatively slowly (but more than 10%) and stopped it by January 2019. My GP upped my dosage of mirtazapine to 45mg to compensate. This is where problems started. I didn’t feel any w/d symptoms in the beginning, but slowly, during the next months, I started to feel more and more anxiety. By May, I had a big relapse of anxiety related insomnia. I overcame my insomnia with cognitive behavioral therapy, without any meds. This gave me some confidence so I decided to wean myself of any drugs. I started a slow taper of mirtazapine . I decreased my dose by 10% each 2 weeks. In august, I reached 30mg of mirtazapine and decided to make a little break from tapering and stayed on that dose for few weeks. Unfortunately, during that break, I’ve had the biggest relapse of anxiety of ALL my life! Of course, my GP asked me to return at 45mg of mirtazapine. But it didn’t improve my mood. Since then, I’m struggling with a lot of anxiety and I’m not able to get rid of it. I’m experiencing big mood swings. Sometime I see some improvement, then the next week I fall again in a deep hole of anxiety. I don’t understand myself anymore. It’s like I’m a stranger in my own body! Worst of all, 4 weeks ago, I started to have OCD like obsessive thoughts and that’s very unusual to me, because I never had OCD before and I'm 40! I’m actually seeing a good psychologist, but even with that, I’m not able to cope. So I’m here and I really don’t know what to do. I’m very desperate because I don’t understand what’s happening to me. I have the feeling that mirtazapine is pooping out and that it causes some of my problems. Maybe I’m always on the rebound of stopping Pristiq to. Who knows! This is why I would like to stop this drug and heal myself from all this toxic stuff!! Sorry, I had a lot to say... Thank you

Hi, Im 66 yrs old and I just know basic computer so this site is hard for me especially since im severely damaged from too fast a taper and not going slow taper so I know Im doing everything wrong. Please bear with me. I took 20mg Prozac for 26-27 years. Up to this point I was healthy and happy but wanted to get this drug out of my body. I cut the Prozac to 10mg starting Mar 2022 thru Aug 2022. finally stopped Aug 1st2022. During this time horrible insomnia and crazy energy but thought it would go away. Jan 2023 my already severe insomnia got worse averaging 14 hours each week, crazy energy, brain wouldnt shut off cant think, akathesia in body I dont have to pace all the time just some. In Mar 2023 I tried 20mg Prozac for 13 days but it made me more hyper so stopped. I also started getting many UTI's and took lots of antibiotics May 2023 I started getting severe anxiety(never had anxiety before) extreme severe depression, couple months ago started getting night terrors(never had this in my life) extreme suicidal ideation. Cant concentrate to read a book eyes dart back and forth. This is so unbearable day after day. Tiniest bit of stress sets me off. I know all the drugs that I tried were bad for me but I was desperate Ambian 7.5 and doubled dose took maybe 8 times only got 4 hours sleep and made depression worse so stopped. Belsomra 20mg put me to sleep 2 times but didnt work after that and caused depression tryed this about 5 times and stopped. Trazadone 300mg for sleep I got about 6 hours but caused worse depression so I stopped took this about 12 times. Klonopin .5 doubled dose Tried just about every supplement for sleep worked at first but stopped. Im hoping to please get support and looking for people who have taken the drug 25+ yrs and healing. Im fighting for my life

Hey everyone, I'll try to keep this concise. Background: Currently early twenties student in university. In 2017, I was diagnosed with post-concussion syndrome (PCS). 40mg of Amitriptyline was prescribed by my neurologist to treat tension headaches. My first experience with rapid tapering of amitriptyline was in August 2018, when my neurologist asked me to switch from amitriptyline to valproic acid for PCS, at a rate of 10mg Amitriptyline tapered each week until I was fully cold turkey. Unfortunately, I found out around the 10/20mg range I wasn't handling withdrawal too well and was forced to stop and reinstate. In February 2019, I read about the link between dementia and cholinergic medications and went cold turkey by my own choice. This lasted for two months of difficulty where I struggled through my hardest semester of college. I ended up reinstating in April after a discussion with my therapist. Its important to note that at this point, for both aforementioned times I had attempted fast tapers I was not aware that withdrawal symptoms were a significant issue for antidepressants. Instead, I believed that once amitriptyline fully left my system I would be fine, and that all my symptoms were caused by PCS. In July 2019, I was able to recover from PCS after two years. A month later in August, I spoke to my physician about getting off amitriptyline. He prescribed me a somewhat slower taper at 10mg a month and 7 weeks for the final 10 mg. Thus, I began my taper from 40mg to 30mg. You can probably guess what happened next. This taper put me through hell and lasted a total of a little over four months before I stabilized. In December 2019, I discovered this forum and decided to give slow tapering a shot using liquid titration (water, not ethanol). In January 2020, I tapered from 30mg to 27 mg. It took me about two months start to finish to stabilize. I was mildly symptomatic, but my symptoms were manageable. In March, I tapered from 27 mg to 25 mg. This time, it took me nearly three months to stabilize. Even stranger, my I found that my symptoms were seemingly worse, even though the percentage tapered was still about 10%. In June, I tapered from 25mg to 24mg, hoping that a tiny dose reduction would alleviate most of my issues with tapering. Flash forward to today. Nearly three months after I had began that taper I find that my symptoms, while very mild at first seemed to have gotten worse over time. Furthermore, a three month long time span for a 4% reduction seems very unusual. Now I that school is starting and I am actively interviewing for internships, I am considering reinstating back to 24.5 or 25 mg. I'm unsure about why my withdrawals seem to get worse even though I try to reduce my taper amount each time. I can think of a couple theories, those being: Dissolving with water instead of ethanol causing issues somehow. I think this is unlikely because when I first was testing out a solution in water at my full dosage, I did not experience any withdrawal symptoms. Furthermore, when I switched to 1:10 ethanol:water solution for a couple nights while tapering, I did not experience any improvement in symptoms. Withdrawals from previous tapers coming back to bite me in my ass. I'm aware of the whole waxing and waning thing and I'm wondering if it's possible that when I began my last taper, I hadn't actually completely stabilized and am now dealing with prolonged symptoms from previous tapers. Not sure how likely this is. Kindling. This would make sense considering I have had three tried and failed fast tapers that each did a number on me. However, I'm struggling to find any sources regarding kindling in antidepressants to the point where I'm unsure if it's even possible. My symptoms are mainly just hypersensitivity, disheveled sleep/insomnia, and exhaustion. Thanks for reading this far.

I was on Paxil 10 mg for a decade, then Celexa 10 mg for 13 years. On September 1st of the year, I was switched to Lexapro 5 mg. It made me suicidal, panicky, nauseated and caused depersonalization. So after 7 days, I was told to direct switch back to Celexa 7.5 mg.. This is where my problems began. I could no longer tolerate the Celexa at that dosage. After extreme heart palpitations, 2 EKGs, an ER visit, and complete loss of appetite, my care team told me I need more---to get up to 10 mg. I did that for 4 days before telling them, not working. Then I was given a 5 mg Celexa and 5 mg Paxil cross taper with the thought that I needed to end up on 10 mg Paxil eventually. That lasted 3 days because I vomited all day. Told my care team today I am not trying any more of their suggestions. I kept telling them the Celexa -->Lexapro--> Celexa switch changed something and I need LESS of a dosage right now, not more. As of today, I am now remaining on 5 mg Celexa to stabilize for a month and may work to taper from there. My current issue is, each morning I wake up so anxious. I take the 5 mg and feel very ill for about 4 hours. Then I feel ok the rest of the day. I assume this is withdrawal symptoms.

Hi there- I'm looking for some kind of reasoning as I go about this new journey while I hope it's a quick one! I was on Lexapro in 2015 for 6 months prior to becoming pregnant. Weened off successfully. Got back on Lexapro (don't remember the dosage but probably 5/10mg) after my first child in October 2017. I was on Lexapro until my second pregnancy where I started Zoloft (as i was told it was safer for pregnancy) in January 2019. I got back on Lexapro October 2020 and was on until January 2023 after a successful taper (I tapered from 20mg). Through this time I don't recall having any issues or side effects. Here's where it gets tricky..... July 28th 2023 I was put back on Lexapro.... but through a miscommunication with my doctor I started right back on 20MG's. This completely messed me up... I felt like I was high on a drug, what I believe to be derealization or depersonalization (not confirmed) and tapered off due to the adverse effects over 5 weeks. I still felt the negative (mostly mental) effects from the Lexapro but with a HUGE increase in anxiety. I was put in a small dose of 5mgx2 of Buspar September 22nd and got off of it 2 weeks later due to adverse effects, it seemed I was sensetive to the meds. After a convo with my psyc I really wanted to give Lexapro a try again since I know it had worked for me for MANY years prior. I got back on them September 29th and again quickly experienced adverse mental reactions to the medicine and was taken off 2 weeks later. It's only been 5 days of being off the Lexapro completel but I can't help but to think I've done some permanent damage to myself with all this up and down the past year. I'm struggling with PTSD from the 20mg onset as it caused severe distress and I ended up with Seratonin Syndrome. Is there hope that i'll feel better soon?

During Ativan withdrawal, I did not sleep for two weeks. Doctors at a top-five hospital gave me Seroquel for insomnia, saying it would "calm my nervous system." I have taken it for close to six months. The drug has stopped working. I can barely fall asleep and wake up in the middle of the night with jerks and tachycardia every night. This started with my last cut of .5mg from 34.5 to 34mg, trying to wean off it. In addition to these side effects of the actual medication, four days after that decrease, I got a chest tremor, I started to have chest pains and muscle pains, leg shakes, and now I am having stomach and diaphragm pains. My diaphragm muscles get locked up, and I cannot breathe. And this is not anxiety. I know the difference. It happened after I ate last night. I am already 20 pounds underweight from the Ativan withdrawal and trying to gain weight, so this is now affecting my eating ability. I am shocked; to be honest, I feel terror now taking this medication every night, which adds another layer to this already difficult situation. Plus, I was told yesterday I am at risk for increased akasthesia coming off of it, which I slightly have already, and there is concern about tardive dyskinesia coming off the antipsychotic due to current jaw pain symptoms I have been experiencing and how my body has responded to such a small cut of the medication. I cannot believe this. I feel like I am back to square one of interdose withdrawal from Ativan -- but worse. I would be further along with the Ativan recovery if it were not for this. To make matters worse, the Ativan withdrawal gave me tinnitus. So I already feel like I cannot sleep or relax. Who knows if/when that will go away? More polypharmacy could mean more tinnitus, which has by far been the worst symptom to deal with. SO WHAT DO I DO? Seroquel is making me so sick. If I go to a hospital, they put me on polypharmacy, and I have the potential for even more problems. Plus, doctors will perceive this as a mental health problem when it is a physical medication issue, and there is no in-between. I was literally on my knees praying for God to have mercy on me last night. I don't know how or if I can or if my body will survive another withdrawal period. Let alone live through any additional physical symptoms. "Distracting" and "self-soothing" are now out the window. My distress symptoms are so high from the physical pain and suffering. I am already dealing with many of the most unpleasant side effects with no window. I am avoiding polypharmacy at all costs as this isn't any quality of life for a person. I have been bedridden for about ten months now from prescription medication withdrawals. I have lost everything to Ativan -- my health, happiness, relationships, finances, and work and now Seroquel is coming in to sweep up the floors after. I have been crying and crying for hours. Being in my own body feels like being tortured in a foreign prison. I do not want to lose my life to this medication and cannot live being bound to it or any pharmaceutical medications. If I could take them and be well, that would be one thing. But they make me sick and cause more problems than benefits. If you know of any other resources for help and support on what to do in this situation, please please help me. This literally feels like life or death now.

Hello! I am a 23 year old female. I have been on 100mg of Zoloft for exactly 2 years now (literally, I'm coming up on my anniversary). A couple weeks ago my roommate bought us some "magic mushrooms" (psilocybin). I have felt insanely frustrated and stuck with my inability to be productive or creative - for years! - so I hoped it would help. I could blame the SSRIs on that but personally there are some other factors for me too. I knew that psilocybin will get blocked by SSRIs so I've had 2 different "trips" where I temporarily went cold turkey for a few days (first was 2 weeks ago it was 8 or 9 days cold turkey, this time around I am on day 5). I've always been very angry at psychiatry for putting me on so many pills from such a young age , but I kind of figured that it wasn't worth it for me to try and go off. The zoloft does help somewhat and honestly, I've researched it before, gone down rabbit-holes and the information I've found made me feel hopeless. It sort of seemed like you'd have chronic problems whether you were on the meds or off of them. I feel so stupid now but honestly, I went off because I kind of just wanted to have a fun psychedelic experience and party. After my first ill-advised "cold turkey" experience I actually felt really great. It wasn't perfect but I was kind of shocked by how nice it was to feel things again. I didn't mind crying easily or getting mild full-body jitters or night sweats. I planned on just toughing it out. My parents are fairly emotionally abusive and stress me out a lot. I hate being around them. On day 9 of withdrawals I was out in public with my mother and snapped at her because I was no longer totally numb to her presence. She was upset (rightfully, although I was kind of just trying to communicate that I wanted space from her and was too sensitized so came on strong) and I let slip that I'd gone off the Zoloft trying to explain myself. She freaked out and began threatening to put me in the psych ward, saying she was going to call my therapist and psychiatrist and tell them that I'm "going off the rails." To put her and my therapist at ease I just went right back to 100mg and was totally fine. My roommate and I had a big event planned (the one we had bought the drugs for in the first place) so last week I did a couple days cold turkey. I barely felt any difference until today. We went out yesterday and had a good time. Now, I just got to my office job this Monday morning and suddenly feel like my head is made of cotton balls and everything is making me want to cry. It hits me: Withdrawals. I wonder what I should do to be safer this time, and kind of am considering a taper process because even amidst withdrawal symptoms I realize that I've been a zombie and not even realized it. so I start going down Internet rabbit holes. I've spent 4 hours now reading forums about how dangerous what I've done is. Now I can't tell what's worse: Going back on the SSRIs or continuing cold turkey...... I am young, broke, I have no college degree, and no close friends with an abusive family. It would NOT be worth it for me to risk the kind of withdrawal that "blows your life up," the tiny amount of independence I've been able to get from my family is so delicate. I'm already constantly terrified of even having something like a physical injury because I would end up unemployed and living with my family again being tortured. I've spent years of my life being "the crazy one," I can't have another breakdown and wind up back under my mother and father's full control. Reading about "kindling" is in particular freaking me out a lot. I'm sitting at my desk absolutely freaking out about how to proceed safely. I am so so sorry if I have broken any of the forum rules but as I said my head is slightly full of cotton balls. I am a bit of a hypochondriac, I know I have made a mistake and I really feel like an idiot, I just want to know how to be safe as I proceed.

kindled after 3 successful tapers 2010-2020. On nothing until Covid when I developed major DR/DP. Put on 4 MG. Ativan and couldnt cross over to taper, and have been sitting in tolerance as docs tried on e thing after another (it's been a year of tolerance). Doc tried 750 mg of depakote in January and came down to 375 by april (after going up and down). I am losing all memory and brain function--was feeling that way before the depakote too. Desperate. DOn't know how to get off depakote. Have the capsules and the sprinkles. No way to compound and every day I'm losing more understanding of how to do anything. Please help. If I hold my ativan taper and taper depakote, won't that be like ripping the ativan away? That's what I was told. Thanks

Ive been on various ssri's for 25 yrs - I tried to get off Prozac relatively quickly in order to get into a clinical trial on psilocybin at Yale about two yrs ago and had horrible withdrawals so I had to go back on the Prozac -- I started taking esketamine at Mt Sinai hospital in NY which has helped me a lot - I was feeling good so about 3 weeks ago I decided to try and come off the Prozac again, this time very slowly - I went from 60mg to 50mg and within 5 days the horrible withdrawals started again (massive spike in anxiety, feel like bugs crawling all over me, couldn't concentrate or think clearly, etc) - now I feel stuck on these meds and dont know what to do - I have a therapist and psychiatrist who help me but was looking for more guidance - If possible to talk further that would be great - thanks ! I have a ton more detail I can share ...

Hi, I am 29 y.o. guy with a total history of about 6 yrs medication on and off. I started taking Sertraline and had two attemps to quit which was diagnosed as relapses. I had no idea about a thing called withdrawals until the 2nd week of my last reinstatement which was in a high dose excceded to 100 after 25 then 50 then 75 within some days. Which I believe resulted in bad reactions and kindling as my insomnia got worse, I had back pain, induced anxiety and many other issues. The sleep problem never went away even during the third use. Every two times, I reinstated I had a bad pain in back of my head left side down to my neck for some reason as well. I was desperately looking for help to taper down and as I recently moved to Finland I was switching between doctors. One of them told me that theh don't say people about withdrawals and since I am sensitive let's taper in 12 weeks which I did. But I was feeling ok just sleeping problems while quitting, a few weeks later I became like a zombie which lasted till now more or less. I developed new symptoms and mostly having severe cognitive issues and problem with learning. I said to myself this will pass and months has gone by. But I'm a PhD student here and I live alone. I can't do my work and I'm worried sick. Sorry if my English is not good, I hope you got my point. I'm going on a part time sick leave for 3 months but I think this would last long. Since it's been a few months since I came off I'm not sure if it's a good idea to reinstate or not. I have a red mark in my belly and also rash and eczema in my lower lip area since last year on and off almost every which might indicate an adverse reaction of drug or withdrawal symptom. I have a persistent sleeping issue which didn't subside much during third round of medication, the only difference was I could sleep for a few hrs. I used to take my pill in laste evenings but third I was taking it in the morning because of sleeping issue, taht was the only change I made. I was feeling weird thing happeing in my head like releasing some substances for sometime while going on them last time which was weird. All of these makes me worried because I don't want to loose my job and I'm worried if I don't try reinstatement if that could relieve some symptoms, new symptoms may arrive. I never quit cold turkey but always in a months but linearly and not properly. Last time, I guess I came off even faster than two other times. Currently, I have severe insomnia, vision problems, hypersensitivity to sound, hot flushing, burning sensations, nerve pains, wired sensations not painful though on my head (especially that part that was in pain while reinstating each time), feeling of my skull is expanding or maybe its some inflammation, genital numbness, eczema, anxiety, feeling slowminded and kinda retarded, awful memory, unable to write and think clearly, bloated bowl and sometimes anxiety and feeling stressed out. They come and go. I used to have bad nightmares too. What do you suggest? I am worried that my situation doesn't subside before I have a chance to pass my midterm review and later complete my phd. I need to be able to settle down otherwise everything would go for worst and I would end up crashing and coming back to my home country which is not a perfect place to live. Does every reinstatement certainly means expriencing more severe withdrawals while tapering or it depends on how one tapers? I am worried that I'm too hypersensitive or damaged because of the last round of medication that I would exprience more horror if I don't do things wisely whether it's by doing nothing or small reinstatement. Thank you.

Hello everyone Very sorry for everyone struggling here I have been tapering off Zoloft for months and transitioned to natural supplements (l theanine & fish oil) to finish my jump but I did it at WAY too high a dose I also was doing a deep cleanse and think I really exacerbated things with the chlorella and spirulina In any case, I have been having extreme withdrawal (to the point where I thought I was in Serotonin Syndrome as the symptoms nearly mirrored it, but the opinion of two physicians is withdrawal and not serontonin syndrome. I have been having ataxia and extreme mood swings. The nausea have passed and diarrhea, and getting some segments of sleep. Disturbance in gait. All tests normal from ER visits. Swinging between extreme depression and emotional bluntness. I would write more but can't tolerate the screen very well. My question. Would it be better to reinstate and attempt to negate symptoms, stabilize, then restart, or should I just push on and work with where I am at. The extreme anxiety is starting to pass, and I am getting some sleep. But, the facial numbness and muscle ataxia symptoms are disturbing. I was off for about three weeks before the extreme symptoms started. Horrible nausea and diarrhea has negated. Any advice would be greatly appreciated Thank you very much ROse

Before describing my situation, I want to start by thanking all those who have posted here, particularly those few who keep it updated and try to organize it. Even though today I'm in at a really low point, the information I've found here has been extremely valuable. I hope that I can not only continue getting good information, but that maybe my story might help somebody else sometime. Apologies in advance if I am too long-winded or detailed. CASE HISTORY AND WD SYMPTOMS: I'll skip the ancient history. In short I started taking citalopram in my twenties for depression., and I'm now 46, so it has been around 20 years. I can't recall dosages, but for the last few years I've been on only 10mg. Finally feeling like I was in a fairly stable place in my life, I thought I'd see if I could go off them. I knew this had to be done "slowly", but what this meant exactly was pretty vague. I dropped down to 5mg, and stayed like that for a long time (6 mo?), with no ill effect. I had the impression that this was the lowest medically effective dose, so I could do no more tapering. I may have done a couple weeks of every-other-day, but in February 2020 I stopped altogether. I thought (wrongly, it seems) that was tapering enough. I recall having a couple of weird initial weeks, but I'd describe the withdrawal symptoms as manageable (no depression, just dizziness, lightheadedness, nausea and what I now know to be "brain zaps"). My doctor had given me 0.25mg tablets of Alprazolam (Xanax, "benzo") and I was instructed to take 1/2 a tablet only when feeling sufficiently bad, but I tried to take that as little as possible. These symptoms mostly lifted, and, if I recall correctly, I proceeded to have a couple of quite decent months. It was a lovely spring in spite of Covid, I was focused on my work and quite happy overall. But there were some odd things: I was irrationally irritable and easy to anger. Idiotic things (the sound of food being chewed, etc.) were extremely irritating to me. Then, at the end of April, I had a really horribly depressed day out of nowhere, and my sleep started to fall apart. I would wake up every night at almost exactly the same time, around 5am, and I'd be extremely hot (night sweats). I also started experiencing serious pain in the back of my neck, which I attributed to sleeping funny and a fall I had while skiing several months prior. At this point I had made no connection between these symptoms and coming off the SSRI, as I had never heard of SSRI withdrawal syndrome. But something wasn't right, and even the zopiclone I was given for temporary help sleeping didn't prevent the 5am wake up. I started keeping a journal, charting my sleep, exercise, sleeping-pill intake and so on. My strong feeling was that I didn't have a "mental" problem (not depression, not anxiety), I had a hormone problem causing sleeplessness. My mind might race a bit, but my symptoms all felt more physical than emotional. I recall forcing myself to get exercise (short runs) and eat healthy (lots of smoothies, etc). At this point I googled something about irritability and SSRIs, and made my way to this site. Here I learned (from "Altostrata" - thanks) that my nervous system was likely hypersensitized, and the 5am wake-up was caused by an over-reaction to the hormone cortisol, which is naturally released around dawn to start the wake-up process. This made a lot of sense, and explained my situation perfectly. (Thank you again!) THE IMPORTANT PART FOR ME NOW: I experienced several "windows" (term used on this site and elsewhere to indicate a period of mostly clear, good days, in contrast with "waves" of heavy symptoms), but by the end of July I began to think I needed to go back on something. My goal, then and now, is quality of life, and if that meant I did indeed need some small quantity of drug, so be it. (Just MY point of view, not a judgement of anyone else!). I read on this site about the dangers of going back on at a "normal" dose, like the 5mg recommended by the doctor. My particular situation was at high risk for "kindling", since by this point I'd been off the citalopram for around 6 months, and citalopram has a short half-life. (All this learned from this site!). I tried a 5mg tablet cut in 4 (about 1.25mg), but on day two felt like I was freaking out. After a few days, I tried again, an 1/8th of a pill, smaller than a grain of rice. I ordered a scale to weigh the dose, as suggested. By the second day I was experiencing GREATLY REDUCED WD SYMPTOMS, and felt like I was out of the woods. I wanted to create an account and tell everybody about my success story, to help others. But by a few days later, things started going downhill again. Was that just a window? The hot flashes and brain zaps were gone, but a general lethargy combined somehow with nervousness persisted. I thought perhaps I had adapted to the miniscule dose, and went up to 1/4 tablet. To cut this long story a bit shorter, I slowly progressed over the course of a few weeks up to 1/2 a tablet. I felt I was in the extremely difficult situation (for which I'm seeking the community's help) - Is my situation caused by too much drug (kindling) or not enough?? How to distinguish WD symptoms and symptoms caused by going back on the drug? I saw my doctor, who feels that anything less than 5mg is just not going to help. She suggested taking 5mg and warned me that the first two weeks were likely going to be difficult, so I should take .25mg of xanax as well for the first two weeks. I've tried this for the last few days, and indeed they have been difficult. But I'm not convinced that they'll get better in two weeks! Now, seeing all this in black and white, I think likely I've increased my dosage too quickly, and I'll do better to go back down to maybe 1/4 tab. I'm just so disappointed that there doesn't seem to be an obvious right answer that makes me feel better more quickly! So many other sites say "SSRI withdrawal syndrome can be cured in a couple days by going back on the drug" - but this doesn't seem to be the case. I feel totally lost and unsure of how to proceed. I'm so exhausted by trying to figure this all out, I just want to get checked into some magic rehab hospital where they knock me out and I wake up four months later feeling fine. Looking back I can also see that my symptoms have shifted very much from "purely physical" (like hot flashes) to the emotional. I've had whole days lost in front of the TV, or, like this morning, terrified to get out of bed or check my email. The insomnia is AWFUL - after 4am I can neither wake up nor fall asleep. If I try to wake I'm exhausted, when I try to sleep I can only seem to get to the brink, when some sort of nervous reaction zaps me awake again. Feelings of total despair, a strong sense that there is no way out of this (I seem to be damned if I take the stuff or not), and recently, hints of some very dark thoughts indeed, as I cannot imagine having to face mornings like this one for the rest of my life! On the plus side, I do have a very loving wife who is very supportive and understanding. I'm totally ashamed of all this, of who I am right now, and would give anything, everything to simply go back to that day when I decided to go off. Things were fine, or as fine as can be expected for me. But regret gets one nowhere, and we all have to remember that there ARE good days ahead, somehow. CONCRETE QUESTIONS for anyone who is able to chip in: 1) On the one hand it seems pretty clearly I've tried to reinstate too fast. Likely best to go back down, but not to zero? Try to stay at 1.25mg for at least two weeks? 2) How does the Alprazolam (xanax) fit into this? I read something about how it helps temporarily, but then you can go into a "benzo hangover", which is worse? 3) Am I just bailing out of the full 5mg dose too soon? My doctor said it would be a hard two weeks, maybe I should just try to tough it out? She's lovely, but I don't think this sort of thing is her specialization. 4) Should I find a psychiatrist (even though where I live it will likely be a month or more before I can get in)? Or will they just start saying I'm bipolar and pumping me full of other things? Anyway this is getting pretty rambly now so I'll stop. Thanks to anybody who reads this and has any thoughts. Anyone else going through hard times right now, just keep hanging in there - the only thing that is sure is that things will change.

Hi guys, I have been on amitryptyline 2 years now. It was for my stomach disorder. 2 months ago I started weaning off and developed severe migraines. Ended in ER and they gave me IV antiemetic that caused severe akathisia. I landed in psych ward. They upped my ami doze back and gave me meds to calm down and I was fine. When I came home I started weaning off ami again, but slower. Unfortunately it wasnt slow enough, I went down from 15mg to 13,5mg and 10 days later from 13,5mg to 12mg. And I developed severe migraines again. I didnt know what to do, painkillers wasnt working, so today, 10 days after weaning the doze to 12 mg I took 15mg again. And I developed severe akathisia back, Im so agitated and restless. I took propranolol, which was helping some before, and it helpes some, but its not a cure. Can You tell me whats the safetest option now to do? Should I take tomorrow 15mg again and try to stabilize on that doze? Or take 14mg, something between previous 12 and 15? I cant go back to 12 cause migraines were so severe that I was vomiting and was non functional, but also cant handle akathisia and if 15mg will give me permanent akathisia I dont know that to do. It wasnt my offending drug, Im shocked I reacted that bad 😞

Original topic title: Reinstated dose didn't work, Tried increasing - Kindling reaction. Decreased again, feeling HOPELESS. Protracted Withdrawal I was on 10 mg / 20 MG Escitalopram for 2 years. On 8th January 2021 I went to 5 MG from 7.5 mg, After 3 weeks bad Withdrawal Symptoms started. Went to doctor he prescribed me Etilaam 1.5 MG ( similar benzo to help with symptoms) took it for one month, it helped somewhat. After one month, he told me to stop and i had unbearable anxiety and other symptoms. Went to doctor, he told me to get back at 10 MG, beyond the original dose. He said it's not obvious that everyone can make it. Took 10 MG for a week, felt like robot. Dead emotions, no sense of joy. Switched to 7.5 mg after a week of 10 mg. And then after taking 7.5 mg, took 6.25 MG the next day and stayed on it for 15 days until 2 April 2021. I was doing good with 6.25 MG until Protracted Withdrawal started. 2 April 2021 - Severe withdrawal symptoms started. Next day went to 7 MG, had Dissociation and Derealization. didn't help. 4 April 2021 - Went to 7.5 MG, started having anhedonia and depression. Sad for no reason, crying and crying. Didn't help either, and i had sensitive nervous system. Alerting symptoms of anxiety, panic, sleeplessness. I thought increasing the dose will help * 7th April went to 10 MG Anhedonia and depression increased, severe Derealization and Dissociation. Sad for no reason, crying again. 8th April went back to 7 MG again and now I'm staying on 7 MG for 4 months no matter what. But I still have all the symptoms, and my anxiety has increased a lot. I feel I am trapped here forever. * Please, A valuable reply is much appreciated * My current symptoms are - Dissociation, - Memory disruption, zoning out every 5 seconds *feels like brain traveling around places and unstable af* weird thoughts disorder, Depersonalization, Derealization, Muscle Spasms, Shaking, Head Tremor, Anxiety, Agitation, Nausea and Extreme nervousness, Dizziness, Vertigo, Balance Problems, Can't walk properly, Acid reflux, IBS, Bloating, Severe brain fog, Sinusitis, Chills, Sweating, Can't stop crying, Sad for no reason, Severe Depression, Burning Sensations all over the body and head, Chronic Paresthesia, Feeling that I'm trapped forever, Visual Problems - Shimmering of lights, zig zag lines, eye floaters, weird visual color patterns - can't explain. AND MUCH MORE. This is literally mental torture.

Hi all, I've just signed up, have been a member of benzo buddies for last few months as I thought my problems were from benzos, but as I'm improving I've realized it's more antidepressants. Long story short I've been on and off Citalopram for past 15 years, each time reached tolerance and came off, only to have what I now know to be withdrawal and reinstated. I can't believe nobody tells you this. Got diagnosed with fibromyalgia (withdrawal), tried Valium, Xanax, ativan, cymbalta, Prozac all stopped CT. Final wammy was stopping Valium for the 3rd time and trying to up my Citalopram which by this point was only 5mg. (I was on 40mg at 1 point a few years ago and couldn't work out why I couldn't take it anymore.) Had to go to the ER, now unable to tolerate any medication as kindled on both benzos and AD. I've found even eating ginger puts me into a wave as it affects serotonin. I've been in hell for 6 months and desperate for anything that may help. Have tried to reinstate twice, but even 0.5mg is too much and takes a month to return to baseline Anyone else as damaged as me, and found any relief?

Potatoghost Hi sorry this is going to be a bit long but I'll try and keep it as short as possible. I was originally on citalopram 20mg for 5 years. It worked amazingly well for me after a bad bout of anxiety and depression. It seemed to stop working after 5 years so my GP added in mirtazipine 30mg. After 6 weeks of being on mirtazipine I felt severely depressed to the point I didn't want to carry on any more. And it would give me waves of dread and despair. So my GP took me off mirtazipine and put my citalopram up to 40mg. I slowly started having waves of feeling better and anxiety and depression free. At 12 weeks I had a big blip and the GP said they arent working for me anymore so switched me to sertraline 50mg. I only lasted six weeks on sertraline as I was getting worse and worse the whole time i was on it to the point i went to a crisis centre who got in contact with a different GP. Who said that 12 weeks wasn't long enough to see if citalopram was working after changing meds. So i was put back on citalopram. I made my way up to 30mg and stayed there for 6 months and had no relief in anxiety it seemed to get worse. Muscle aches Diarreah Brain fog Headaches Blurry vision Weakness Palpitations 24/7 Depression. Resting heart rate of about 160. I tried to power through because I knew I had to just ride it out but at 10 weeks the depression came back on and off but every time it resurfaced it was worse than the time before until I had a full breakdown again after 6 months of feeling so unwell.. So I have been switched to lexapro as they thought it might work as it's similar to citalopram which worked for me originally. I am 10 days into 10mg of lexapro and my depression is severe again. I'm fed up of being changed all the time and just want to feel better as this is no life to live. My partner and I are expecting a baby in 4 months and this has put the fear of god in me that I wont be well enough to look after the baby x Thank you and sorry it's such a long post

MOD NOTE: Ihateeffexor created a membership and another person helped her to type the first couple of posts. Ihateeffexor is now able to post for herself. ________________________________________________________________________________________ Hello, I am actually writing on behalf of my friend who is in a very bad shape right now. She was on effexor for 1,5 years and tapered for 3 months 45 mg to 0. She had really bad withdrawal symtoms for 2 months after the last pill but then started to feel better. A couple of weeks ago she had some alcohol and partying with friends and ever since her symtoms has come back and they are much worse now. She was ok for 3 months but the alcohol seems to have made the symtoms come back, the day after she was drunk. Is this what you call kindling? And is there a chance she will recovrr from this? She is bedridden atm. Thank you all!

32 male Ok so gonna try and keep this simple but detailed if makes sense...Reinstated 6 weeks ago after nasty month long WD symptoms mainly tight chest and tremours towards the end and immediately felt good as soon as I took the drug one eve. I reinstated 5mg every other day then noticed a bad 2 days after a week which I thought was odd?? so took it every day. After 1 good week noticed a 3 bad days?? I decided to gradually increase to 10mg over space of 2 weeks as I read on here if having WD symptoms slightly increase a bit but not much but had bad insomina so went bk to 5mg! YES I KNOW BAD MOVE With in 2 days had the worst WD ever akathesia, no sleep, no eat, pure panic attacks that last 3 days! I stuck to 5mg and after 3 days felt really good again like nothing happened for 5 days till....last 4 days been having same problems but slight less akathesia but pure anxiety all day followed by panic attacks in the middle of them all with intrusive thoughts my questions- why the hell am I getting more bad days then good lately? Literally can’t function not working at the mo. Yes I know I yo-yo’ed but still I have stuck to five now for 2 weeks solid and not stable at all! judgin by my story yes I shouldn’t of gone down to 5mg maybe stayed at 8mg or something after reaching 10mg . But why am I gettin these crazy symptoms? Is my CNS sorting it self out? should I make my way slowly bk to 10mgs over the next few weeks-could run the risk of more disturbance? Or 20mg where I came from? ( currently packing for holiday freaking out how I am going to feel for week abroad in Spain but don’t want upset GF) All theories welcome 🙏 any questions please ask thanks

Hey Everyone I am knew to this group and trying to find some understanding in what is going on with me. I recently went off Lexapro 3 months ago (was on for 6 years) I started getting very random heart flutters when I started it and that’s the main reason I went off of it. Now im experiencing weird brain crap and not just zaps. It seems to happen at night when im trying to fall asleep. It wakes me up and scares me it scares me. Some are brain zaps, some are like fireworks, some are weird sensations or noises- I feel like im loosing my mind. Any help or experience would be greatly appreciated.

Hello. I want to begin my introduction with a detailed case report on my hypersensitivity to sertraline… I hope this helps someone. I am a 21-year-old childless female who, up till recently was taking 25 mg of sertraline every 6–8 days. Three months ago, I began seeking professional help for self-loathing, difficulty in trusting others, and intense fears of abandonment during certain social situations. There was only one psychiatrist in my area still on Blue Shield’s panel. She quickly diagnosed me with social phobia and instructed me to take 25 mg daily for one week, then to double the dose to 50 mg daily afterwards. After a mere three days, I found that I was completely unable to feel fear. (This may have started even earlier, however I was unable to evaluate my emotional state during the first three days due fatigue and sleeping in excess of 15 hours a day when I began the drug.) Were a raging grizzly bear to attack me, I would have no appropriate emotional reaction to it, or maybe even none at all. Combined with the fever (at least six hours long), increased heart rate (30 seconds long), and hand tremors (1 minute long) that I would experience 20–40 minutes after taking the sertraline (half of a 50 mg tablet), and non-existent appetite, I decided to try taking 25 mg only every other day. This was sufficient to prevent the tremors and increased heart rate, but the elevated body temperature and lack of appetite persisted at this dose. (When I later lowered my dose to 25 mg every three days, the fever disappeared and my appetite would partially return.) I called my psychiatrist’s office to inform her that I would be lowering my dose as I found the fear-blocking too effective and the other effects troubling. I emphasised that I had never experienced those symptoms at the times that human interaction caused me distress. But for the next three months, the psychiatrist would maintain that these were manifestations of my anxiety and insisted that I take the full 50 mg daily. She ignored the fact that I was entirely incapable of feeling fear for those three months. I had many peculiar reactions to the sertraline. To begin with, for the first two weeks, I really wanted to be “a good dad,” as if I were already a father and desired to remain a good and humane parent. (I am a 21-year-old childless female.) And whenever I took the sertraline, I would also feel as if my two of my closest human relations were still alive… I wasn’t (at least not by typical definitions) delusional, I knew they weren’t alive and I didn’t experience any hallucinations of their presence. But I was overwhelmed by the warmth of their company, a warmth that I thought I’d never feel ever again. …It felt like I had come home again, like my feelings could reach them and their feelings could reach me. I felt love as if all three of us were together again. These spells would last twenty minutes, and all I felt like doing was hugging something to my chest and telling them how much I missed them. When these occurred at work, I mustered enough self-restraint to take only a five-minute break and continue working afterwards. These would be the only instances I would feel any emotion for the next three months. My strangest reactions occurred after eating foods rich in tryptophan: a euphoric restlessness that was accompanied by a wonderfully pleasant burning sensation in my brain. My partner and I called these episodes “the cuddles”, because all I wanted to do was cuddle, very vigorously. (I now think this was a “happier” form of akathisia.) My partner perceived this as the return of my normally energetic, cheerful, and affectionate demeanour; I had always been a cuddler and my hugs and handshakes had always been very strong. But, I knew I was getting high, so I began timing my sertraline doses to take them before eating red meat—to guarantee the high. These foods also triggered some other reactions—eating tuna sashimi turned me into a happy drunk, I was laughing harder than usual and even turned “as red as a tomato”, according to my partner. Cheesecake would trigger a burning sensation in my frontal lobes so overwhelming and do pleasurable it was almost debilitatingly painful, I couldn’t focus on anything else around me and had to eat very slowly, as I felt as if my brain would fry if I ate the cheesecake any faster. Now when I see cheesecake I get anxious, and if it is on my plate I even have trouble lifting my fork because the anticipation makes me weak. I’ve always loved cheese—one of my most prized possessions is the World Atlas of Cheese—so whenever I asked my partner to buy me cheese he didn’t interpret it as substance abuse. (Cocaine is an illicit substance widely known for its addictive qualities. Cottage cheese is not.) After a particularly good meal, e.g. all-you-can-eat at the sushi bar, I would be high for hours! I had to eat instant ramen on my lunch breaks because I didn’t want to risk getting high at work. Some background. My aspiration of fatherhood was definitely drug-induced, but I do know where it came from. The older of my two friends, thirty-one years old, was a good, strong man who had to assume the responsibility over a preadolescent boy and was basically a single father. My other friend was his fourteen-year-old ward, a bright and sensitive jokester who came to insist that artists had a responsibility to be both humane and truthful. His mother became addicted to opioids, and her male “friends” abused him; he developed very little interest in relating to the people around him, but was very gentle to anyone falling on hard times. My friends both died as pedestrians on June 30, 2016, three months after I had moved back to California in search of employment, and eight months before I started seeking professional for what my psychiatrist diagnosed as “social phobia”, which stemmed from a physically and emotionally abusive childhood. I didn’t fully appreciate it at the time, but my friends had been helping me work through my fear of other people. My older friend was a very caring, incisive, and thoughtful person, qualities which he engendered in my younger friend. He had a serious interest in history, which was his favourite discussion topic second only to jazz music, and he could easily have become a history teacher—he was better than all the ones I had in school, anyway. When guardianship was thrust upon him, he took the time to read parenting books and material on child abuse. I don’t know if he knew it by name (I certainly didn’t), but he was teaching me the foundations of DBT. His boy became like a brother to me, and we discussed art and played video games together. After their deaths, my unresolved social phobia, which was compounded by grief, the unpleasant work environment at the hospital where I found employment, and the painfully close proximity of my entire extended family that had engraved into me my fear of human beings in the first place (I had moved out of California specifically to escape them!), understandably led to a worsening of my mental health. When I was finally starting to heal, I myself was hit by a car while crossing the street, but escaped serious injury. I developed a reflexive hatred of all cars, my own insecurity and self-loathing was complicated by survivor’s guilt, and I considered suicide numerous times. I knew I needed help. I wanted psychotherapy, but all the mental health professionals whom I had wanted to see had been taken off of Blue Shield’s panel. I settled for the one psychiatrist in my area still remaining on their panel. At our first meeting, I was frank with her about my aversion to the idea of treating my problems with psychotropic medication, and discussed with her the objective vulnerabilities and subjective conditions that kindled my social phobias. She immediately prescribed me sertraline and said I that could obtain a therapist if the drug did not adequately treat my anxiety. I was disappointed, and remained firm in my believe that drugs would not resolve my issues. But at the well-intentioned encouragement of a close colleagues of mine (she has been diagnosed as bipolar and regularly takes prescribed psychotropic drugs), and out of the desire to meet this psychiatrist at least “half way”, I began taking the sertraline. It was in the first month that I began perceiving that I had lost all capacity to emotionally respond to anything at all, even the treasured jazz songs that my friends has introduced me to. I lost my creative spark, my interest in the world and art and everything else that I liked. Aside from my loyalty to my two friends who died, I lost all interest in other humans, and all capacity for empathy. At best, I felt apathy towards people in the same way a man might feel apathy toward livestock. At worst, I felt unequivocal annoyance and contempt, the kind of sentiment reserved for an annoying mosquito. The only reason that the people around me didn’t notice a change in my demeanour was because I was keen to keep up a perfect façade—if anyone had noticed a change, it would be more inconvenient dealing with that than with faking empathy and interest. I was aware of all these changes, and I knew that they were bad. However, I didn’t care. The only thing that caught me was the thought of my two friends. At times, I realised how sad they’d be if they saw how I’d changed, and for a little while, I’d try to be a better person. On my second appointment with my psychiatrist, a month after our first, I reported the apathy, the food highs, and the “dad” feelings to my psychiatrist. The entire time I explained the food euphoria, she looked at me as if I were crazy. I did not mention to her the “it feels like my friends are still able to experience life and that makes me so happy” feelings, as at the time they did not strike me as a bad or disconcerting thing. But I did voice the observation that perhaps even 25 mg every other day was too strong for me. But all that mattered to her was that the sertraline was effectively dealing with my anxiety, and she was pleased with that. As for the adverse effects, she insisted that I take 50 mg daily in order to “habituate” myself to the drug. I very diplomatically stood my ground, again raising concerns about how my heart rate would increase after taking 25 mg daily. She relented—but said that I should schedule my next appointment three months later instead of one month later, since I was taking such a low dose. I had enough sense to perceive that this was dangerously negligent in her part, and gently nudged her, saying, “OK. So three months is a good time to check in?” She changed her mind, made it two months. I didn’t tell her, but after this visit I began reducing my sertraline dosage to 25 mg every three days. After two weeks of this, I found that the food-highs were still too disruptive on my daily life, so I began taking it every four days. Even though I’d decreased the dosage, the apathy worsened, and my patience for people was shorter than before. I was beginning to actively dislike all the people around me. I looked back at my previous relations and memories with scoffing contempt. I mistakenly thought I was falling out of love with my partner. I even started enjoying being a psychopath; life felt easier if all that mattered was number one. In retrospect, had the sertraline been more stimulating—if I had only the compulsion or motivation, I would’ve been capable of committing the most horrific crimes without a shred of remorse or moral discomfort. After that second appointment with the psychiatrist, I began seeing the one local psychologist still remaining on Blue Shield’s panel. I expressed my desire to work through my childhood-rooted social phobia using talk therapy. I mentioned told her about the sertraline-induced personality changes with her. She quickly sidestepped the subject of medication and advised me to talk to my psychiatrist about any adverse effects. The psychologist said that the sertraline seemed to be dealing with my social phobia well enough, and suggested that I may naturally be an introvert and that the sertraline was allowing me to enjoy being myself, that I was too concerned with what other people thought of me and that I needed to focus more on myself. Though I didn’t care, I understood that her attitude grossly complacent. I saw this psychologist two more times afterwards, and each time she said I seemed fine and that there was nothing I really needed to work on (though my own drug-induced apathy would not have allowed me to benefit much from therapy anyway), except perhaps my grief—I refused, saying I wasn’t having any trouble grieving. I wasn’t being entirely honest. I said that partly because I doubted she would’ve been able to seriously help me, partly because the sertraline had stopped me from grieving or feeling much of anything, really. After two months on sertraline, I stopped listening to music entirely—it had done nothing for me and I gave up attempting to evoke any sort of emotional response in myself. I was determined to happily live out the rest of my life as a psychopath and enjoyed the highs that the drug afforded me. Ironically, the only thing that drove me to stop taking sertraline was my chasing of the next high—the last thing I wanted to become was habituated to the drug. At the end of my second month, I began tapering to 25 mg every six days for a period of eighteen days, with the intention of taking 25 mg sertraline daily for four days afterwards to get as high as a kite. But on this lower dose, I finally began to personally care that what I was doing was wrong and that it would be best if I stopped taking the drug at all. From every six days, I tapered to every seven, then every eight days… Interestingly, that dose was still enough to give me a buzz when whenever I ate a cream cheese wonton, and I began to want to be a psychopath again. (I think, as others have reported, that the steady discontinuation of the drug made me more sensitive to low doses.) But I sensed that I owed a debt to my friends—which I treated as if it were a business obligation, not a moral or spiritual one—, and persisted in trying to quit. While attempting to find other accounts of hypersensitivity to sertraline, and material on how to come off SSRIs, I found Dr Peter Breggin’s The Antidepressant Factbook. I was very pleased to discover that people who produce inactive or “dud” forms of the CYP2D6 enzyme are unable to metabolise antidepressants at the rates most other people do. I have not gotten this or any sort of pharmocogenetic testing, and I don’t intend to as I will NEVER use a psychiatric drug again, but I suspect I may be one of those people. In my third and most recent appointment with my psychiatrist, I informed her that I had tapered off to 25 mg every eight days but that even this was enough to blunt my emotions and give me a little euphoria when I ate cheese or tuna. I mentioned that I had heard about the CYP2D6 enzyme and asked if she was aware of any good commercial genotyping facilities. She claimed that a blood draw for a liver function test would be enough and that I didn’t need to resort to genotyping… It was on that third appointment that she finally started to take my adverse reactions seriously. By a stroke of good luck, I expressed a new reaction to the sertraline that very same day, just before my appointment with her. Prior to seeing her, I had to attend a mandatory employee meeting at my workplace, and I experienced my first ever hallucination in my life. Among the audience was an older gentleman—didn’t seem odd, he was wearing glasses, a clean business shirt and tie, trousers, had a white beard, and he wasn’t acting out of place. And he seemed familiar—I must’ve seen him in passing, he actually might’ve worked at the hospital somewhere. The only reason I knew he was a hallucination was because he was floating two feet above the rest of the audience. He faded away like a ghost after three seconds. When I reported this hallucination to my psychiatrist, she pursued a line of questioning that indicated to me that she had tuned out and believed I was being paranoid and worrying for no reason about an actual living coworker—“So, no one else at the meeting seemed to notice he was there?” I nearly lost ALL my patience with this woman. My reply was immediate and firm: “He was floating two feet above the audience!” Her eyes widened and she asked me if I was taking street drugs. (“No.”) She began asking about all the other symptoms I had reported to her over the past three months. She ordered me to discontinue taking sertraline as quickly as possible (of course, she gave no advice on how to withdraw from such a small dose) and advised me against taking any other SSRIs. But she denied that the sertraline was responsible for ANY of the symptoms; she wrote an order for extensive blood work (without any diagnosis, so the next day I had to return to her office to have her secretary write it in…) and referred me to a neurologist to get an MRI of my brain. (I am still waiting for my scheduled appointment at this time.) When I saw that the order included thyroid function testing, I asked her if thyroid dysfunction could cause hallucinations. She responded, “I really have no idea what’s causing any of this. A thyroid problem could be the cause of your mood disturbances.” (I think she was referring to the tryptophan-rich food euphoria, but I’m really not sure.) The only thing that she admitted was that if these symptoms completely ceased after a month of being off sertraline, then we could conclude that they were drug-induced and not organic in origin. Since coming off the sertraline, I’ve begun to fully appreciate how I was emotionally unavailable to my partner, and how I took advantage him for three months; that I was unable to like people for three months; that in those three months I could’ve tortured and killed anyone, and I lacked only in inclination; that I hadn’t sang or grieved or felt anything… I am ashamed and guilty over what I became. I feel worse than before I sought and “received” that professional mental healthcare. All I want to do now is apologise to my friends. I know I haven’t done anything wrong, and I know I tried my best… But it’s difficult for me to accept that I’m still a good person. I feel like I’ve betrayed everyone behind their back. I’m trying to be gentle to myself, to think about what my friends would say if I could talk to them. I am trying to keep in mind that despite everything, I was able to honestly and objectively assess my own mental deterioration, and I acted as best as I could under the circumstances. I do not want to let those three months destroy my soul after the fact. I’m trying to live… I’m realising how much I missed out on everything. I forgot how much I liked the grass, and rocks, and kittens, and books. I forgot how nice it was to like other people, in spite of my fear that they’d never reciprocate those feelings. I forgot how much fun drawing was, and how funny my partner’s dumb jokes are. I hadn’t used smileys in my texts for three months, and I even walked differently! And I hadn’t realised how much of my acuity had dulled until I got off the sertraline. It’s like I have to live again for the first time in three months. I’m not as confident as I was three months ago, and I don’t like myself as much as I used to. My partner has been very supportive. I’m now experiencing sertraline withdrawal reactions. I get disoriented easily; the other day when I left my workplace building and when I reached the parking lot, I couldn’t place where I was at all; like which part of Earth I was located in, let alone which end of the campus. I’m noticing memory problems; subjects I’d just discussed with my partner I would raise again only a few minutes later. I used to be able to play my favourite songs in my head, especially the pieces that my friends introduced me to. For a while I couldn’t remember the lyrics, the titles, the artists, or even the melody. My memory is improving, but those songs play like a broken record, my brain skips over parts and I have to listen to the song again to recall it completely. My stomach hurts every now and then. I’m sensitive to light, and I get akathisia now. The first episode was bad enough to leave me writhing and crying in pain while clutching my head—as if something were clashing and tearing away from the inside of my brain. Now, it feels like a bunch of fleas jumping on and nipping at the surface of my frontal lobes, not debilitating, but annoying enough to prevent me from falling asleep at times. My appetite has returned, but increased to the point where I have to be careful not to overeat or risk massive weight. I’m thankful that I’m one of those odd people who hears rainstick noises near the top of their spine whenever they’re hungry; now I pay attention to that and ignore the empty feeling in my stomach. I have sudden spells of sadness and anxiety during which I cry a lot, which I didn’t have before taking sertraline. I’m worse off than before I started taking psychiatric drugs, but at least I’m no longer chemically lobotomised. I’m trying to exercise my brain by the throwing myself back into singing and reading, and I draw more seriously now. I hope this case history helps someone. I’m looking forward to weaning myself safely.