Lakelander82: Sertraline general query and tapering info

[Lakelander82]

Sort of worries me that very few on here have this problem - makes me think I'm different to everybody else on here and I've some sort of endogenous Depression that causes me to oversleep. If anybody else is affected by hypersomnia I'd be glad to hear from you. In a way it's just as debilitating as insomnia.

[herewego]

Hi Lakelander82,

I don't know much about meds or the one you are on, but the one I am on - olanzapine really knocks you out. On the higher doses it felt like I could have slept all day. Even on the lower doses my body wants to sleep 12 hours but I can't do that - I have kids to feed and care for - but if I had no one to care for I would be very tempted to keep sleeping on this med. I have to really fight the grogginess. Before I was on meds I was an average sleeper 7 - 9 hours. I have had insomnia before when coming off medications and I can't seem to tolerate medications that are activators as they seem to make me crawl out of my skin. I expect I will struggle with some insomnia during tapering and once I am finally off, but I also suspect as I go lower on my doses the extreme morning grogginess will go away. Before finding this site I had cut my dose in half to taper and the morning grogginess did go away but then I got insomnia and anxiety and a ramped up CNS too! I expect as you continue to taper your sleepiness will lessen and gradually you'll find your body craving less sleep. Just don't go too fast when you get to the lower doses or you will get bad insomnia.

[scallywag]

Lakelander, I have had hypersomnia as a what I consider a depressive symptom. I too am much more a "night owl" than a "lark" and your comment about time at uni rang all the bells.

 

I seem to be going through a period where I need more sleep, though it doesn't feel the same as the depressive hypersomnia where I would sleep hours and hours but was always exhausted.

 

The fact that you're waking up frequently but able to go back to sleep may be a clue.  Is sleep apnea a possibility?  My late partner didn't know that was a problem for him until we started bedsharing often enough for me to notice.

[Lakelander82]

I don't really understand sleep apnea tbh, I'm aware it's something to do with an obstructed airway but that's about the height of it! I don't think I have any predisposing factors to this condition, as I'm physically fit and not overweight!

[scallywag]

Excess body weight and lower fitness level are often found with sleep apnea.  They aren't necessary conditions though.  Sometimes it's an issue with tongue, larynx, and trachea structure when relaxed/sleeping.

[Lakelander82]

One week of my third reduction. Still doing not too bad, could be a hell of a lot worse. Get crying spells quite regularly, but they're good crying spells if you know what I mean - releases emotions and pent up tension and I find and I feel much calmer and more relaxed after wards. Sometimes when there's a lot of emotions bubbling below the surface, I intentionally force myself to cry so I will feel than bit more chilled out afterwards. Other times there isn't a whole lot emotions going on, but the tears seem to be constantly on the surface in which case I just turn the tap on myself and they just come. It's weird at time, feels like it's just pure cortisol coming out.

[ChessieCat]

No takers for this over on the Using an oral syringe thread so I'll give it a go here -

 

I'm flummoxed by something. Today as usual I took my usual 40.5 mg dose. I dissolved my 50 mg tablet in 50ml of water (dissolved it first in about 5-10mls of that water then added the rest). I withdrew my 40.5ml dose and so in theory there should be 9.5mls left in the jar but to my surprise there was barely 3mls left. I'm very precise with my method so I'm totally bewildered as to the discrepancy. Can anyone enlighten me?

 

Hi Lakelander,

 

Did you ever figure this one out?  If you did, it might be a good idea to post a response over on the other topic you posted in.

[Lakelander82]

 

No takers for this over on the Using an oral syringe thread so I'll give it a go here -

I'm flummoxed by something. Today as usual I took my usual 40.5 mg dose. I dissolved my 50 mg tablet in 50ml of water (dissolved it first in about 5-10mls of that water then added the rest). I withdrew my 40.5ml dose and so in theory there should be 9.5mls left in the jar but to my surprise there was barely 3mls left. I'm very precise with my method so I'm totally bewildered as to the discrepancy. Can anyone enlighten me?

 

 

Hi Lakelander,

 

Did you ever figure this one out?  If you did, it might be a good idea to post a response over on the other topic you posted in.

 

Hey chessie, I really don't know what happened that day tbh but ever since the amount left in the jar has been 9 -10 mls worth so my technique is bang on now. Feeling better and better, my nervous system isn't on a knife edge anymore and I don't get rattled or stressed as easily.

 

And if I can recover from this, ANYONE can because there were periods when I would do a drastic cut (before I knew about this website) and as a result would be a dysfunctional miserable wreck in the corner. I literally thought my brain was completely broken but now I am seeing serious signs of recovery.

[SquirrellyGirl]

I am so happy to read this last post, Lakelander!  Isn't it amazing to find that with careful tapering you can actual do even better, perhaps, than when you were on higher amounts of the drug?  At least that is the way it has been for me!  When I had done some big cuts of Effexor (not consciously trying to get off of it but trying to reduce my dosage maybe from 75 to 37.5, don't remember) I would have such extreme states that I thought I was going crazy, but that just doesn't happen now. 

 

Keep up the good work!  I'm glad the mystery discontinued LOL!

 

SG

[Lakelander82]

Today wasn't so good, but only because I picked up a bug last night that caused me to throw up a lot and go to the toilet quite a bit! This was accompanied by a killer fever, muscle aches and pains, sweating and a splitting headache. Feels a lot like a really bad flu which I would have got now and again as a young fella. The fever seems to ramp up the whole system, causing anxiety symptoms such as palpitations. Funny how things can hit you out of the blue and stall your progress, but I didn't let it overwhelm me, something that would have invariably happened in the past.

[scallywag]

Lakelander -- knowledge is power. What you write about your flu aggravating w/d symptoms is a great example of this.  Sorry you're feeling sick. Hope you can take it easy for a bit.

[Lakelander82]

So today I didn't feel great at all. It's probably the after effects of the flu/tummy bug combined with a reduction in medication combined with another bloody change in brand of medication - that's the third change in three months. Really pisssing me off. In theory all the generics are exactly the same, and I did check the excipients of each - there is a slight variation so you never know how it affects you!

[Lakelander82]

Feeling really depressed at moment, don't know whether it's a post flu thing, my latest cut or

Change of brand that had caused it. I would say the latter two reasons are unlikely. I was doing fine up until sat night when I took the bug.

[scallywag]

Lakelander -- getting the flu is bad enough on its own, let along having it while going through w/d.

 

You may want to consider holding your dose for a bit longer than a month this time, just to give yourself more time to recover from the flu and the formulation change. 

 

I'm going through what could be called a wave. Having read what others experience, I'll call it a ripple, feeling flat emotionally and having lower than normally low motivation.  I made a dose cut recently and will probably hold for longer on this level to see if things improve or if this is my new w/d normal.

[Lakelander82]

So we're both going through a wave so to speak. Hope we come out of it sooner rather later!

 

After a cut that has left one feeling less than powerful, it's hard not to get the feeling that maybe a smaller cut, say 5% instead of 10% would have been better but hindsight is a wonderful thing! Will give it a week or two at this dose and if no better, will up it by a few mgs.

[Lakelander82]

Hope I'm not becoming a pain in the arse here! :-)

 

I do find that my cognition levels drop when I'm depressed. I'm less sure of myself, need reassurance on everything and generally just not with it. Answers don't pop into my head as quickly, it's as if the energy has decreased in my brain and it has slowed down drastically.

I quizz quite regularly, do crosswords, sudoku etc and can do them with ease when firing on all cyclinders but when my mind is tired/down(eg because of last cut), they just frustrate me. The more I look at them, the harder they get and the more frustrated I become. It's constantly in my mind that if I were feeling good I'd breeze through this.

 

Is this just withdrawal or is my brain just permanently f*cked without the medication? There's always that bloody nagging feeling at the back of my mind that's it's not withdrawal, it's just my brain returning to it's depressed, non functional state without the medication and a slow taper won't make a blind bit of difference. Would be grateful to hear from anybody else who experiences this slowed thinking.

[scallywag]

Hey Lakelander, we all have difficulty with puzzles and sudoku, etc when we're tired. The cog fog that can come and go during tapering and withdrawal definitely adds fuel to that fire.

 

In all probability, it's just a wave of cog fog, and will resolve itself once you've been off the sertraline for a while.

[Lakelander82]

How come the slowed thinking doesn't come at higher amounts of sertraline then Scallywag? Is it seriously all just down to a wave? It does correlate that when I'm more jumpy/on edge I'm invariably more depressed which in turns correlates with poor concentration/ memory.

 

I've got to admit when I'm feeling low- ish, I lose faith in this whole tapering process and the theory behind it.

[scallywag]

The theory that seems to explain this is that it is the lack of or reduction in sertraline that is causing the symptoms, not the sertraline itself. 

 

It's tough for an analytical mind like yours or mine to let go of seeking cause and effect. If you really want to dig in to it, you might want to look at the studies that Alto and others have posted in the Journals forum.

[Lakelander82]

Think I'm going to move up a few mgs to 38 and see if that alleviates my symptoms. Never envisaged this latest cut causing me problems it has and I think it's foolhardy to try and ride them out. It seems when I get to the relatively lower doses, my mornings are always bad, mainly characterised by a slow sluggish brain, jumpiness and unwillingness to leave the house. Please tell me this is all withdrawal, I need confidence.

[scallywag]

Lakelander, your dose is, as ALWAYS, your decision; updosing is always an option. Remember, though, that changing dose in response to symptoms is like yanking the leash of your CNS (central nervous system), letting there be slack and then yanking again.  It's a lot of change to deal with. If you absolutely can't ride out this wave, then pick a dose and stay there for a while.  Sometimes it's hard to know whether symptoms are caused by a dose change or whether they would have occurred had you stayed at the previous dose.

 

Let us know how things go.

[SquirrellyGirl]

Hi Lakelander, 

 

Scally is right:  Please don't make the mistake that some of our other members are making by reactively updosing.  You JUST cut a few days ago; it is early days to make any decisions one way or the other!  If you feel that these 10% cuts once a month are really rocking your boat too much, then I strongly encourage you to try the 5% cuts every two to three weeks.  I have done 5% cuts of my mirtazapine every two weeks and don't notice it at all!

 

I'm feeling pretty darn good right now, and I am at 55% of my starting dose of venlafaxne (had reinstated at 37.5 mg 14 months ago), and 27% of my highest dose of mirtazapine.  Now, the cog fog/memory/concentration thing is still a bit whacky, but mood is good and I just roll with it.  I'm going to have to work harder at double and triple checking myself.    I think monkeying with our circuitry by taking away the drug is a big deal to the brain.

 

The frustration over Sudoku and the like, I get.  I'd been annoyed with just not seeing the solutions so hung it up for now.  At least you are having times where you feel you can function well there!  That's good!

 

I think the occupancy graphs help explain why we get affected more profoundly at lower doses; receptors are freeing up more precipitously once you get below the minimum effective dose.

 

SG

[ChessieCat]

"The frustration over Sudoku and the like"

 

I've found that since I've been reducing my dose I seem to go through periods where I can do word puzzles but not number puzzles and vice versa.  I've also not been able to do jigsaw puzzles for a while.  I also had a time when I wasn't able to skim read and get the main points from what I was looking at.

 

I've learnt to accept that it is what is it at that time.

[Lakelander82]

Thanks for the much needed advice. Felt very tired/lethargic/weak at times today, already had an hour and a half's nap and feeling like another one. "Dead head" syndrome is preventing me from leaving the house again, hope to feck it settles down in the next week. The dead head feeling as I call it definitely affects your confidence and willingness to leave the house and be around other people. It completely zaps your energy and vitality.

 

Strange how the first two cuts had no affect on me but the third had a profound effect!

[ChessieCat]

Have you seen this information?  Many members find the lower their dose gets the smaller their dosage drop needs to be.

 

Why taper paper: dose-occupancy curves:  Especially Post #12 and Post #18

[Lakelander82]

Thanks chessie, I think I reached my oh -oh point with the latest reduction but the ship steadied the day somewhat. If you don't hear from me, take it that everything's back on track- so no news is good news! :-) Feeling kind of mellow tonight as I type this.

[Lakelander82]

Any of you take an SSRI for Social Anxiety? I noticed some elements of my Social anxiety return today, which is disheartening to say the least. I don't know if this is still an overactive nervous system caused by withdrawal or it's a return of my original bona fide Social Anxiety.

[ChessieCat]

Hi Lakelander,

 

Whether or not it's withdrawal or what you call your original social anxiety it is a good idea to learn non-drug coping techniques.  Claire Weekes was a doctor who suffered from anxiety so she understands it.  She recognised that there was a second fear, or a fear of the fear.

 

Check out the following:

 

1. Non-drug techniques to cope with emotional symptoms
2. Acceptance
3. Acceptance and Mindfulness
4. Claire Weekes' Method of Recovering from a Sensitized Nervous System
5. "Change the channel" -- dealing with cognitive symptoms
6. Change cognitive framing - Redirect - Another Way
7. Cognitive Behavior Therapy (CBT) for anxiety, depression
8. Cognitive Behavior Therapy lessons

[Lakelander82]

Two things that bother me about tapering technique is the drug residue left behind on the jar and at the top of my syringe after taking my dose. I'm wondering how much I'm losing in terms of my dosage, and for the latter case of the syringe, would it be better to wash through with water to get the remaining bit of residue at the top?

[ChessieCat]

I think when you are making your own liquid that the most important thing is that whatever way you do it to do it the same way every time.

[Lakelander82]

There's something about swimming that beats every other exercise hands down. It's so relaxing and calming, not even yoga or Pilates comes close for me. Must be to do with the weightlessness of the body in water, I find it also has a massaging effect on my body if I swim front crawl - it irons out all the knots and kinks in my back and shoulders. Tremendous exercise.

[AliG]

L.L. That is so true and yet we forget that. You could perhaps start a thread in Symptoms & Self care. Google first to see if we have one , but I don't think we do.

I agree. it sounds heavenly. Very therapeutic !

Ali

[SquirrellyGirl]

I think when you are making your own liquid that the most important thing is that whatever way you do it to do it the same way every time.

 

 

Agreed.  If you always have residue the way you are doing it, then your body is adapting to that much less.  Just keep doing it the same and that little loss will be built in so net inconsequential :-)

 

SG

[Lakelander82]

Anybody ever find themselves getting overly excited/hyper stimulated by watching sporting contests? I was watching the big Golovkin/Brook fight on Saturday night and it almost feels like I'm involved in the contest. All the usual accompanying signs of anxiety are there ie increased pulse, sweaty hands, feeling like something is bubbling up inside me etc.

 

Is this an example of a neuroemotion?

[ChessieCat]

When I was stabilising after reducing my dose by 1/2 and then updosing I found that I couldn't play Angry Birds because it was too activating for me.  I've also had to be careful about what movies I watched because some of them were too stimulating.  These days, since I started tapering, I very rarely have the radio on in the background when I am on the computer, when I used to always have it on.  I find it much harder to multi-task these days.

 

Here's a link to members discussing overstimulation:  overstimulation-and-increased-sensitivity-to-light-sound-etc

[Lakelander82]

Still battering away at this taper. All in all not feeling too bad. Went a short hop over the Irish Sea to see my brother and family in England during the past weekend. Some anxiety around the plane journey (not a great flyer) and awkwardness/anxiety in social situations but nothing major. Held a little longer this month and decided on a 5% cut this time instead of a 10% cut due to withdrawal effects at the last cut. Will see how I am in a few weeks and acess whether I'm ready for another 5 % cut, if not hold longer as they say.

 

Even though there's a long way to go at 20mg, I feel I will be in the home straight come this number.