New to sertraline - my experience so far

[Stuz]

Hi

I've been suffering with panic attacks for about 10 months now. I've had them in various situations- driving, work meetings, trains, planes, restaurants, in queues, theatre. Lots of places!! Its a daily battle using CBT techniques to try and rationalise the physical sensations to try and prevent panic attacks occurring. For a while I felt I had it under control but in the last couple months the regularity of attacks have become a real problem at work and I have decided to try an SSRI. All these situations trigger panic symptoms and I'm finding my world becoming smaller, so must try all available options.

My GP prescribed sertraline for panic disorder. I have been taking Sertraline in the morning for the last 8 days, of which 6 days on 25mg and the last 2 on 50mg. The plan is to continue on 50mg and discuss with my GP at the end of July.

I've had some uncomfortable side effects every day so far - nausea, very tired/sleepy, spaced out and anxiety. Lots of anxiety! I have had panic attacks almost all of the last 8 days. Waking each morning feeling anxious. Maybe this would have happened regardless of starting sertraline but even my other half has said I seem much worse than before taking it.

I've read on the NMP forums some other user's experiences where things get worse before they get better. I'm hoping thats true for me too. I'm also hoping that the sertraline will be effective in treating my situational based panic attacks. The theory being if it can dull the fight/flight trigger and the anxiety enough i can then rebuild confidence in those situations again, retrain not to panic.

But its all early days as 8 days isn't very long to feel real benefits. And I've also read on NMP that 50mg is the minimum dose for therapeutic effect, so perhaps ive only just started on the correct dose. I guess I will stick with it for the advised 4 to 6 weeks and hope the side effects stop sooner!

Stuz

[Blondiexxoo]

Hi,
I started off at 25mg too and then went up to 50mg. I was on the 50mg for 3-4 years until I went back down for a year and now I'm considering going back up. I don't remember getting any side effects when I went up to 50mg but I believe my doctor had me take 25mg for 2 weeks and then go up to 50mg. So I would stop taking the 50mg and go back to the 25mg. I would take that for 2 full weeks and then go up to 50mg. 6 days isn't enough for your body to even get used to that dose. It takes up to 4-6 weeks until most people feel a difference. Hope this helps!

Also, I wouldn't suggest going any higher than 50mg. I have SEVERE anxiety and 50mg is all I need to take it away. I have had numerous doctors try to up my dosage to 75 and 100 when there's no need. All they ever try to do is have you go higher. 50mg is plenty, 75 is the max I believe anybody should ever be on. If you ever develop a tolerance to it and feel it isn't working as well, your doctor will try to up your dose. Just decrease the dose for 6 months instead.

[Magic]

I have been given 50mg of sertraline from GP.(I take mine at night)
The side effects are nausea ,spaced out, etc.
I took half a tablet to start off with, and the last 3 nights I have
taken the whole 50mg.
In the afternoon the nausea gets a bit better but I still cannot
drink tea or coffee. and lost my appetite
I am sticking with them though.
How people can deal with 100mg.I do not know.

[Stuz]

thanks for the replies. I'm now on day 13 and still having bad anxiety everyday, waking up in an anxious state, except for Wednesday where I went the whole day feeling pretty good. Not sure how I managed that! I'm going to stick with 50mg as thats what my GP has recommended but I understand your point of sticking with the minimum.

I am still having a couple near full panic attack moments each day which is worse than before starting sertraline. But I feel I am getting better at controlling the attacks and braver to stay in the situation rather than fleeing! Not sure if thats purely psychological or if there is some chemical benefit I'm getting.

13 days done and another 29 days (to make 6 weeks)

[Stuz]

Day 16 of 50mg sertraline. Most of the side effects have gone now, no more nausea or extreme fatigue/tiredness im pleased to say. Still had a couple near full on panic moments today (9 out of 10 on intensity scale) but managed to endure them. In the past I would have left the situation by any means ASAP so I feel things are changing for the better but only a little bit so far. I think the anxiety I'm experiencing now is at a level I am familiar with and had before starting sertraline. So the sudden increase in anx when starting sertraline is another side effect that is subsiding, which is good. But the daily anxiety is still there.

I'm taking sertraline for panic attacks/disorder not for depression, but there have been 3 or 4 times in the last 3 days where I've caught myself feeling happier than usual. Almost like an ever so tiny but noticable wave of eurphoric feeling occurring. Thats got to be the sertraline. Not that i'm complaining!

[Stuz]

I saw my GP on day 21 who said to increase to 100mg. We agreed not to go any higher and if sertraline turns out not to work we'll change to another AD. I still wake each morning with anxiety and now feel how I did before starting sertraline, i.e. normal panic levels rather than the increased anxiety the sertraline caused initially.

Day 24 - still getting anxiety leading to near panic attack level in the usual situations e.g. motorway driving, 8 or 9 out of 10 on the scale I'd say. So not sure how I rate the effectiveness of sertraline at the moment. I'm relieved the side effects have subsided so feel better for that at least.

I am reminded though that the benefits aren't usually felt until 4 to 6 weeks, so I've got a few more weeks to go yet.

[Stuz]

Today is the 3rd week (21st day) of taking 100mg sertraline. And 6th week overall.

Without wishing to jinx it I feel much better than I did 3 weeks ago. I have had several occaisons where i have felt "normal" and without anxiety. Last weekend I even managed to drive on the motorway and several busy A roads without panicking. Even when there was no hard shoulder or place to escape to! Thats a big achievement for me.

I have also felt inclined to exercise more and haved cycled 12 miles a day, for the last 3 weeks. Also I have read Dr Claire Weekes book "Self help for your nerves". I find repeating "Face, Accept, Float, Time" to myself helps to prevent the physical symptoms triggering a full blown panic.

I keep having a cheeky drink (beer) at the weekends which makes me feel worse for a few days afterwards as a result.

But yes in short I think the sertraline is helping and a 3prong approach is working:

1) Sertraline 100mg
2) Exercise every evening after work for at least one hour
3) Reading Dr Claire Weekes and trying not to fight the physical anxiety sensations to prevent a panic, by forcing myself into situations I fear trigger attacks and providing the opportunity to learn there is no reason to panic

[Rosiebee87]

Thanks for the updates. I'm on day 1, 50 mg. Already feeling abit spaced out. I've not read up on the side effects as I suffer with health anxiety but it's reassuring to read the hare working for someone

[fromthepebbles]

Stuz thank you so much for this! I've put off taking Sertraline after being prescribed it nearly a month ago because I'm terrified of what will happen. I know it will definitely help me eventually but not sure it's worth the pain beforehand.

One question - how have you carried on with your daily life with the horrible side effects? Are you able to go to work, socialise, do the food shopping etc as normal?

[Stuz]

Hi fromthepebbles - fortunately for me I was able to work from home for 1 week and then had 1 week off annual leave which was pre-arranged, so two weeks in total. At the time I was sure I couldn't have faced work during the first 10 days due to the lack of sleep and nausea. I was still able to food shop although did have moderate panic attacks in the supermarket, especially when in the queue. Didnt socialise much and avoided it where possible!

My advice, for what its worth, is if possible plan to start the sertraline when you have some time off work booked. Lots of people dont get side effects but in case you do its probably less stressful not to be at work as well. But on the flip side, maybe still working would do some people good as it keeps their mind on something productive and not dwelling on how rubbish it feels. I work in a busy, confined office so decided not being there was best for me.

---------- Post added at 22:30 ---------- Previous post was at 21:58 ----------

Next monday will be the 8th week on sertraline. Overall I feel like I'm almost back to normal. I still occasionally feel panic sensations but have more confidence in facing them down.

I'm contemplating how much this can be attributed to sertraline. Certainly the evidence is I feel much better than I did 8 weeks ago. And feel better now than I have done for almost a year! So something has changed.

In addition to sertraline I have been forcing myself to go cycling for one hour at least 4 times a week. As a result I've lost 6lbs which is great! I'm a couple stone overweight so been meaning to get around to losing it for years. The motivation to exercise however was because the physical sensations of exercise are similar to a panic attack: you sweat, your pulse races, you feel hot, maybe a bit lightheaded. This is a CBT technique where you force yourself to experience the sensations so that you have the opportunity to learn they aren't worth panicking about.

So the exercise must be helping too. Maybe the sertraline helped me get motivated and improved my mood enough to get me exercising. Either way as I said I feel a lot better than 2 months ago.