Hello, Headaches, and Healing (and Anxiety)

Hi all,

My name is Joel. I've always been an overly stressed person — a Type-A personality with a penchant for perfectionism. I had my first panic attack in 2013 shortly after getting married and losing a job. Like many of you can probably relate, it's not a fun feeling. I'd always been health anxious before that. My dad had pancreatic cancer when I was younger and I have had minor random health issues growing up that sensitized me to health problems overall. The year before getting married, I was worried I was having heart issues. Turned out to be a pulled muscle. I had pains for a few days in my abdomen. Thought for a few days I might have pancreatic cancer too before the pain went away.

It's no surprise to me now that my tightly-wound mental state led to those panic attacks. I thought I could get through the attacks on my own, but I sought help at the end of the year as they increased in frequency around Christmas. My doctor prescribed 25mg sertraline, and within a week my life changed. 2014-2017 were great years. I had two beautiful kids, bought a house, got two dogs, and got a fulfilling job. I stopped the meds in late 2016, and, apart from an occasional mild nocturnal panic attack, I did great.

In 2018, things got rough. I felt panicky my first night on a work trip to Africa, and not understanding the mechanisms of how SSRIs work, took one of the sertraline pills from an old prescription because they always help me sleep. A few days later, I had what could only be called an extended stress response. Not a panic attack, but a 4-hour long feeling of pain, dizziness, and frequent urination. I immediately started taking the rest of the old prescription I had and felt better within a few days. A month later, I ran out of the pills and went off them. Things were generally fine until my good friend was fired from my workplace at the same time I was having an early mid-life crisis about vocation and salary. I then began to have panicky feelings throughout the day. Not panic attacks, but general anxiety.

My doctor restarted me on 25mg at my request in July. I noticed immediately that it was a different generic. I took them for two months and went back to the normal me for the most part. My wife and I found out we were expecting our third, went on vacation, and looked forward to enjoying the fall.

Then the headaches started. At first, I just started feeling ill. Worn down, a bit nauseous. Within a few weeks, I started having constant, all day pressure in my temples, cheekbones, and top of my head. Not sharp or stabbing, but the same droning, dull pain, like someone had put their thumb on my forehead from the time I woke up to the time I went to bed. I had a video consult with a doctor (because it was cheaper...) and was prescribed an antibiotics for a sinus infection. The headache then went away for a week. Then it came back. I started getting paranoid about my health again. Was it a tumor? A resistant infection? At no point did I consider anxiety or the sertraline. Finally, I had a day with very high blood pressure and went to the hospital to get checked out. All blood tests and CT scan came back clear.

I felt like an idiot. I told my wife I was so stupid for being paranoid. I went to my doctor again and he decided I should try 50mg sertraline since most of my symptoms/worry was anxiety-related. The next few days changed my life. I woke up in the morning after taking 50mg of the different generic with my whole body tingling. I felt like my brain and eyes were shivering, but I wasn't visibly shaking. Over the next few days, I began feeling weaker and weaker. Every morning I felt like the whole world was buzzing and I couldn't relax. I felt like ants were crawling in my skin — and the term akathisia entered my vocabulary for the first time. Horrified and in pain, I went cold turkey off the sertraline. The next few weeks were bleak. I'd never experienced depression before, but everything seemed black and I felt fragile. I started seeing a counselor to do CBT, realizing I needed to learn how to fix my illogical thought processes feeding my anxiety.

After a month, I was feeling better, but knew I was still sick and anxious, so I wanted to try the sertraline again. I took 12.5mg before bed, and within an hour, felt like I was on speed. My brain was on fire and I couldn't sleep. Over the next three weeks following that day, I continued to have burning nerve pain, pounding heartbeats, adrenaline surges, and a jolt every time my brain tried to drift off. I finally went to go see a psychiatrist, sure I was losing my mind. I had been a slightly anxious but fully functioning father, husband, and friend a few months prior. I then felt like a puddle of mental goo. The psychiatrist gave me a diagnosis of general anxiety and prescribed trazodone and lexapro to help with sleep and to get the anxiety back under control. After two months, I was sleeping, but I still wasn't feeling steady. I'd still have palpations and adrenaline. The trazodone also gave me very bad side effects. He recommended I come off them cold turkey and try something else.

Fire. That's what my body felt like when I tried this. Stopping the lexapro didn't seem to affect me too much, but the trazodone withdrawal made my whole body feel like someone had lit a fire from the inside out. I felt compelled to move, like I couldn't sit still. I went back to my primary doctor and got on a tapering schedule. More importantly, I also talked with him about research I had done and a pharmacist I'd talked to about the generic sertraline I'd been on. I had found testimonies from other people that my new generic (made by a company called Aurobindo in India) had made them feel like they were on speed and had really bad side effects. My pharmacist, who used to work for sertraline's creator, Pfizer, confirmed I had been on the Zoloft generic (Greenstone) previously and that she had heard of bad reactions when switching to other generics. I am now back on the 25mg of the Greenstone sertraline I was on for several years.

It's now been 10 days since I stopped the trazodone completely and I am relying on low doses of Klonopin to stop the burning/electric pain and akathisia from withdrawal. As I've been withdrawing, however, I've noticed the same dull/pressure headache that I had back in the fall on the Aurobindo sertraline. Trazodone, which shares many characteristics with TCA antidepressants, can suppress headaches, and my wonderful/stupid health anxiety now is that the sertraline is causing it and that it won't go away. My anxiety is ratcheted up from feeling this same pressure and I'm doing all I can to relax, know that this will pass, and stick to the plan. I'm paranoid about becoming dependent on the Klonopin, but it helps me function so well that I've accepted I need it a few days a week for these first few weeks off the trazodone.

I'd wonder if anyone here has any experience with trazodone withdrawal or side effects on different brands of sertraline. I'm coming to this forum partially as well because I've been a chronic "googler" these past few months. I've found I actually can't stop googling and researching for answers — that it has become a source of both comfort and anxiety for me. I want to stop it, and I'm hoping being part of a forum with other people to talk to will help me to stop scouring the internet for answers and instead learn to relax and float through whatever comes in the coming weeks of adjustment. I have a baby arriving in a month and I want to be well, but part of that is learning to embrace the suck as it is right now and enjoy each day!