Just started..

[sandie]

Doze - you know my thoughts and experience with Sertraline, so there is little point in repeating myself. However, the start-up effects with Sert are almost guaranteed to have you shed some of the weight you will have gained while on Mirt.

The downside of course, is that for so many people, there other other more unpleasant start-up effects with Sertraline and it can really heighten anxiety and panic before it starts to help (this is what happened with me). I still wonder if I had been started on a MUCH lower dose, and had very small and gradual increases whether it might have been so bad, but alas this was not the case for me and so many others, hence the bad press that Sertraline receives.

Perhaps if you are persuaded to go down this route you should consider doing this, ie, starting at say, 25 mgs and remaining there for are least 3-4 weeks before going up to 50 mgs. The increasing after another 3-4 weeks to 75 mgs. I started at 50 mgs, and then 2 weeks later went up to 100mgs and it was way too much and too fast. Of course, the GP states you HAVE to be on 100 + mgs in order to get the therapeutic dose, but if it is hell in getting to this amount, then it can destroy any potential benefits.

I do not believe that there be only two ADs which clinicians feel are suitable for an individual; it may be that these new style SSRIs don't suit you - in much the same way they did not suit me; perhaps asking the GP or whoever is making decisions WITH you about meds, could look at some of the older style antidepressants ?

I suspect that your already considerable doubts about Sertraline will inevitably impair any positive thoughts you might otherwise have had about starting Sert, but before making any decisions, I think it might perhaps be best to go back to the GP and ask opinions on other ADs.

Keep us informed.

[Istherehope?]

Oh Doze I honestly can't believe that after all that, you are being headed back in the direction you were a few months ago...I'm a bit gutted for you to be honest. You've waited and done all the right things just to be back at square one. And then to be given ignorant 'you just need to do more' type advice about ME on top of it

I do know a couple of people who have hugely benefitted from sertraline but obviously they're not the ones posting here because they're doing fine....

Obviously I can't say what you should do because I have no idea and I don't think any doctor can really know until you try a different med, though your GP might be able to offer alternative suggestions and perhaps knows you best. I can't remember if you've been on an SSRI before? I would recommend the Mirt Ven combo as it's really helped me but my appetite has gone through the roof so you probably don't want to go that route.

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I could be a case study for your worry yourself thin book Unspoken! Hope working from home helps tomorrow. How are things for you, has the increased dose had much effect yet?

[Doze]

I don't think I'd want to try Venaflexine tbh Is. I don't really get on well with the Mirt and as far as I can tell Venaflexine is it's uplifting brother. One to pick you up in the morning and the other to bring you back down at night. If you can tolerate these kind of drugs well then that sounds like a good combination but for someone with CFS who is overly sensative to medication I don't think I could handle it.

The other go to option seems to be Setraline. It seems to have been deemed to have a lower negative profile than most SSRIs. But it's a "level one" medication so it's considered a step down from Mirt and Ven, for some reason. Same goes with Citalopram. I used to take another level one ssri paroxitine and did quite well on it, but it seems to be heavily out of favour now because so many people suffered on it.

It's a really hard decision to make isn't it. My recovery is going slowly but moving in the right direction, taking on new meds seems to threaten all that. But if I did I would definitely stick to a low dose. I only ever took the minimal amount of paroxitine and it worked, I would hope to do the same with Setraline, so I'd probably stop at 50mg.

I'm just really confused now tbh. It didn't help that in my conversation with the doctor yesterday we went over an edited highlights of adult life and some of the observations he made made me reflect of just how much of a hole I seem to have got myself into and how hard it will be to get out of it. I knew all of this really, but when you put it all out in front of you and couple that with my depressed mind set and hangover like fatigue from yesterday's over exhaustion.. Well, today is feeling rather grim and deflating.

[unspoken]

Doze, I am on Sertraline and I think it works for me as an antidepressant. It stops me crying all the time. I got through the initial stages because I was prescribed Temazepam at the same time. It does seem to make me need to wee a lot and gives me crazy dreams. I have met a few people who have found sertraline works for them, but nobody seems to stick with Mirtazapine. With Sertraline, I find it tends to reduce my repetitive negative thoughts and it makes me less emotionally sensitive which reduces my anxiety, but it doesn't stop the anxiety entirely. I am currently taking 50mg and it seems to be enough to stop me crying all the time.

My sister has ME, she's had it for about 15 years. She has seen lots of specialists and had CBT and all sorts of medication and tests. None of it helped. She is better than she was because she's learned not to push herself beyond what she can manage. My psychiatrist was telling me that she should call it Chronic Fatigue and kept saying that CBT can 'fix' it. I was really unimpressed by his attitude. Sadly there's some things people can't understand unless they have personal experience or close contact with it and ME is one of those things.

I feel awful. Today should have been a relaxed day but it's been horrible. I went outside to fill the bird feeders and discovered six dead frogs which seem to have caught a disease called ranavirus. It's like ebola for amphibians. It seems that any other frogs that visit the garden will catch it and die horribly too. I am really upset about it. It was gruesome and I also saw two dead pigeons today. I like watching the frogs, they're almost like pets, so seeing them all dead like that has really shaken me up. Some other stuff didn't go well. I made a stupid mistake at work that's going to be a pain to sort out. I've lost my appetite after seeing the poor dead frogs.

Mirtazapine 22.5mg is making me clumsy and I hate it. The psychiatrist said I should come off one of the antidepressants and I think I'd rather keep sertraline as it seems to work in some way for me. I feel far too sensitive to cope with life.

[Doze]

Thanks for your thoughts Unspoken. I hope you had a good weekend after the frog thing.

I know what you're saying about the Mirt making you clumsy, I'm 12 weeks in and still I'm struggling to think straight in the mornings. The Dr said a lot of the time people put the responsibility of any negative feelings/reactions etc on the meds, often erroneously. I'm willing to concede that there is some truth in that, but it's also reductive Dr logic. The meds can help and hinder in their way and the Mirt most definitely makes things foggy and impedes concentration.

[unspoken]

I know what you're saying about the Mirt making you clumsy, I'm 12 weeks in and still I'm struggling to think straight in the mornings. The Dr said a lot of the time people put the responsibility of any negative feelings/reactions etc on the meds, often erroneously. I'm willing to concede that there is some truth in that, but it's also reductive Dr logic. The meds can help and hinder in their way and the Mirt most definitely makes things foggy and impedes concentration.

I decided to take the Mirtazapine down to 7.5mg. I was getting depersonalisation again, for a while I felt like I was a puppet which was weird, and the haze in my mind was causing me to act without thinking things through. When I got angry with myself it got really bad and I hurt myself - not too badly, but I was getting all these thoughts about hurting myself badly and I didn't feel I had the control to stop myself. I will talk to the psychiatrist about it tomorrow. I never hurt myself on Sertraline alone and I never felt like I wasn't controlling my body.

Despite this, I managed do some things this weekend. Today I woke up and decided I wanted to go to the seaside, so I went to Brighton and took some photos on the beach. I stayed there for the sunset and watched thousands of starlings flying around in a murmuration and it was pretty magical. I'm feeling better for getting out somewhere different, but my moods change so fast that I don't know if it'll last.

[Istherehope?]

Hi Doze and Unspoken, I've had a busy weekend and just catching up with this thread.

Have things become any clearer for you Doze? I really feel for you with trying to decide what's best...it seems so often there's no way of knowing until you try with these meds, but the last thing we need is something making it worse. I still find myself wondering if Mirt caused depression on top of anxiety or if it was an inevitable part of my condition. Guess I'll never know and at least I now find myself in a much better place.

Finding all those frogs sounds horrible Unspoken, that would leave me shaken at the best of times. I'm sorry you went through that. I can relate to feeling too sensitive for this whole life thing though. Have you ever come across the book The Highly Sensitive Person? I found it really helpful for understanding and affirming the 20% of people the author says have highly sensitive traits.

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I'm sorry you were feeling so angry/bad at the weekend. I really hope dropping the Mirt helps. I feel that Mirt took me to a place I'd never been before - I started looking up suicide techniques and was hoping to die all the time....I think most of us on this thread believe it's quite possible these drugs can trigger some horrible stuff for some as well as really helping other people.

Hope today was Ok for you both.

[Doze]

Thanks Is. It's great to see you doing so much better. I'm still up and down. I seem to start the day on a low, being kind of muddle headed and anxious, trying to figure out what to do but not really knowing top from bottom. Then as the day progresses I get better, my head starts to clearer and I feel a whole lot more positive. I'm kinda certain it's the effect of the Mirt causing the confusion in the mornings, but it could just as likely be causing the positive mood in the evening. But we can all endlessly go over and over these things, which I think it also just a symptom of the illness. I guess I either have to accept it or try something else. And I think I've come to terms with that I must try another med, cause the Mirt ain't for me. Plucking up the courage to follow through with it is another thing entirely.

[unspoken]

I'm also glad to hear you're feeling better, Is.

I spoke to the psychiatrist and told him how Mirtazapine made me feel and how the depersonalisation was really troubling me. He agreed I should reduce the dose of his and try slowly increasing the dose of Sertraline, first to 75mg. I was on 100mg Sertraline for about 5 years so I should be ok going back to that level. I'm just waiting to hear back on when I can start some private psychotherapy to try and sort out the things that are causing me to feel so awful. I did identify that I am scared of confrontation, so I tend to internalise anger. Somebody made me angry last week and I didn't know how to deal with it other than by getting angry with myself and I ended up hurting myself. I just really want to get on and tackle this.

I'm struggling a bit with getting my brain in gear for work but this might get easier as I reduce my mirtazapine intake. I realised I haven't had a night's sleep without taking one or more sedative drugs since mid December. I am struggling with working the full number of hours I'm contracted to, but I don't want to admit I'm struggling for fear my employer will want me to get signed off again. I'm hoping I'll get more used to it as time goes on.

[Shazamataz]

Hi guys, sorry I haven't checked in for a while. I went offline for a bit as I felt I was focusing too much on the anxiety by being on here. Had a brief patch where I felt a bit better and was thinking I'd be ready to go back to work on 14th March but now this past week or so has been a disaster with insomnia and anxiety getting worse and worse each day to the point I haven't been able to leave the house alone for 4 days!

I decided last weekend I was going to have to resign from work, which I did on Monday, and since them anxiety central and insomnia central!

Gosh this disease is a ******* isn't it?

I'll have a proper read back at your posts when I feel I can focus but just wanted you to know I haven't forgotten about you all

xx