Living Nightmare. Bad Reaction to Sertraline

[anxiousbat]

Hi,

I'm hoping I can get some support here, as I can't get it anywhere else :weep:

I've always been anxious. In the past I was referred to a counsellor, which helped me loads. I've been very stressed out at work and it's meant that I've been feeling a bit low and anxious again. I think some of it is linked into my menstrual cycle, as I am worse just before and during. Then more upbeat for the rest of it.

I went to my gp and they put me on 50g of Sertraline. I was told it might make me feel a bit sick and to see them again in 2-3 weeks. By day 3 I was climbing the walls, not sleeping, massive panic attacks, so anxious and depressed. By day 5 I felt suicidal, had horrible thoughts floating around in my head, I couldn't take it any more. I feel like a drama queen for typing this, but I would have killed myself if I had stayed in that state. I have never felt that bad before. I managed to get an emergency appointment and saw a different gp who told me to just stop taking it. I haven't taken another tablet since. They wrote me a prescription for 40g fluoxetine, but after my experience on sertraline I'm not sure I want to go there again.

That was about 10 days ago. I have not slept now for about two weeks. I feel much better than I did on the tablets. I still feel low and anxious. I have weird pulses in my brain, like red hot pins/needles. I had them on the tablets but much worse. I feel like I am shaking inside, my muscles are a bit twitchy. I was meant to see my gp yesterday but had my appointment cancelled. I feel so alone and helpless. Will I return to how I was before? I was miserable but not like this. I would just like to sleep again. I wish I had never tried these tablets!

Thank you.

[panic_down_under]

Hi,

Welcome to No More Panic, :welcome:


I went to my gp and they put me on 50g of Sertraline.

Okay, mistake number one. The recommended sertraline starting dose for those with anxiety/panic is 25mg, and given your strong reaction, 12.5mg would be even better.

The problem with SSRIs and other antidepressants which inhibit serotonin reuptake is that the initial increase in serotonin activity causes a spike in anxiety. It usually doesn't last long, generally only a week, or two. There is no way of preventing it, but starting on a low dose and ramping it up by the same amount at weekly intervals until the target dose is reached will usually keep the anxiety spike and other side-effects at a tolerable level. Small doses of diazepam (Valium) would also help.

They wrote me a prescription for 40g fluoxetine,

And there is mistake number two which is even worse than the first one. The recommended fluoxetine starting dose for anxiety/panic is 10 mg/day. Furthermore, this is generally the most stimulating of the SSRIs so given your experience with sertraline an even more stimulating antidepressant is probably the last thing you need.


That was about 10 days ago. I have not slept now for about two weeks.

...I would just like to sleep again. I wish I had never tried these tablets!

I'm confused. You seem to be saying you can't sleep because of the sertraline, but also say it has been two weeks since you slept, however, you took the sertraline only 10 days ago.

Anyway, the sertraline is unlikely to be still causing your insomnia, or the "red hot pins/needles" pulses in your brain. It would have been completely eliminated within 6 days of the last dose. However, there may be an ongoing psychological reaction from the incident.

It may be that you'd do better with a noradrenaline reuptake inhibitor rather than one affecting serotonin. Either nortriptyline (Pamelor), or desipramine (Norpramin) would be good choices, however, these are tricyclic class antidepressants (TCAs) and most GPs would be reluctant to prescribe them in light of the suicidal thoughts you had on sertraline as TCAs are less safe in overdose than most SSRIs. The SNRI milnacipran (Savella) is another possibility, but I don't know whether this is available on the NHS.

I think your best option is probably to ask/demand a referral to a psychiatrist.

[anxiousbat]

Thanks for your reply.

I'm not touching fluoxetine with a barge pole. After reading your comment I trust my surgery even less than I did before this.

I do feel deeply scarred from the whole experience. I'm on the waiting list for private counselling. It could be a few months before I get to see anyone.

After day 3 I found my sleep pattern disturbed. I now feel quite unsettled in the evenings and dread going to bed. I had one of my panic attacks in the evening, so this could still be playing on my mind.

I have been prescribed a sleeping tablet. zopiclone 7.5mg. I'm too scared to take it as I don't know if I'll have a nasty reaction to it.

[Tom1992]

I started off on sertraline 50mg,too. The side effects are pretty brutal.

[Mpower7]

I was started on 50mg Sert and I could only handle it for 2 days , I decided to half the tablet to 25mg and most of the side effects disappeared and still felt good. Then the go has been upping the dose on every visit. I'm now on 100mg with hardly any side effects

[panic_down_under]

I have been prescribed a sleeping tablet. zopiclone 7.5mg. I'm too scared to take it as I don't know if I'll have a nasty reaction to it.

You're unlikely to have any side-effects beyond the intended sedation. At least none from the med itself, though an anxious mind is quite capable of creating a catastrophe of epic proportions if given an opening.

The main problem with zopiclone and the other 'Z' hypnotics is tolerance tends to build quickly with nightly use, sometimes within a fortnight, so they should only be used occasionally. However, you may only need to take zopiclone for a couple of nights just to break the cycle you're in.