I was prescribed Sertraline (Zoloft) in 1998 when I had postnatal depression. I was told to take it for a year to 18 months. I went from deep depression/anxiety to euphoria in the space of about two weeks, I felt pretty damned fantastic, there was nothing I couldn’t handle. As time went on I continued to feel well but my emotions were dampened down, so I was functioning well, no depression, but no “joy” either. After a few months of feeling well I decided I didn’t want to be on Sertraline anymore, didn’t read the patient information leaflet or talk to a doctor, not that that would have helped anyway. I just stopped taking them. My head felt terrible, it began to feel water logged, if I turned my head there was a time lag between my eye balls catching up with the fact that my head had turned, so dizzy, gradually intense sadness would kick in, really really intense sadness and anxiety, oh the anxiety, pumping adrenaline and nerves shot to bits. I went back on the Sertraline.
The doctor told me to do the alternate day thing, alternate days for a fortnight,then every third day for a fortnight, then one tablet a week, I did this various times over the next few years to no avail. I tried a pill cutter and halving the tablet, it wouldn’t break down easily without crumbling so that was unsuccessful. Every time I tried something, I ended up in worse shape than the time before, it was all getting steadily worse. I tried meditation, healing, exercise, cognitive behavioural therapy, counselling, fish oil capsules, NOTHING touched it. I pressured my surgery to refer me to a psychiatrist for advice,but the psychiatrist had no clue and could only recommend switching to another drug. I did switch to Citalopram for a while, and Mirtzapine, I felt constant fatigue on Mirtzapine, and then back to Sertraline. Yet another psychiatrist recommended halving my dose of Sertraline and taking diazepam to mitigate the withdrawals, so replace one powerful drug with an even more powerful addictive drug.
This is my description of how withdrawal felt from my blog, I only recently found out that what was happening had a name,akathisia:

“5am and for about the 3rd night in a row I’ve barely slept, I can’t stop the adrenaline pumping round my body, my stomach is tightly knotted, I’ve barely been able to eat properly it makes me feel sick. I’m clammy, sweating and crying and P is trying to reassure me, but he has to go to work. I get up and drag myself through all the motions of the day and making sure boys get to school, I feel like the living dead, I make sure they get fed and make sure they and no one else is aware of what’s going on, I don’t hang around at the school gates. Oh I do kind of tell a few people I’m not really feeling right but I play it down.
The constant adrenaline is tormenting me on the inside and I can’t stop it.It’s been building up over a period of months and I’ve been fighting and fighting the feelings but it seems to have reached a peak of exquisite torture.It’s like being at the top of a roller coaster that never stops. Someone else mentioned birdsong, and it was a funny thing, the torture was worse in the mornings and over the summer months while it was slowly building, birdsong in the morning outside the window had become a kind of torture as well. I had to go to work only 2 days a week and God only knows how I managed it. I had taken
my last Sertraline tablet months ago, and come off it as per the doctors instructions, and now my depression/anxiety was back tenfold to punish me for daring to presume I could stop taking it. I must be wired up wrong, no one else feels like this do they? What is wrong with me? Maybe I really am insane, maybe I just can’t cope with life without my tablets, how come everyone else can cope with life, and I can’t? There must be something fundamentally wrong with me. By now the Orwell Bridge was beginning to look a bit attractive and I just wanted to escape the adrenaline surges torturing me, my nerves were in shreds”.
This was 2003,at the end of 2003 I gave in and went back on the sertraline.

In 2006 I attempted another withdrawal, but at the same time we found ourselves going through a stressful life event, I tried to tough it out but ended up back on the Sertraline again.
So here I was, several years later and no further forward, and not for wont of trying! Everytime I went in a book shop or library I would try and find anything I could about antidepressants and depression, but nothing really enlightened me. I rummaged around on the internet but couldn’t find the answers. Until one day, I was browsing around Waterstones, and “Coming off Antidepressants” by Joseph Glenmullen jumped out at me, I read it avidly, and discovered TAPERING!!! But, all the examples in the book referred to liquid Seroxat or Prozac, I was really upset to find Sertraline was not available in liquid form. Armed with my new information about the simple concept of tapering, further digging led me to Dr Healy’s protocol of switching to the equivalent dose of liquid Prozac. These two pieces of information became my secret hope, I latched onto them. I decided to take a leap of faith and switch to liquid Prozac. At the beginning of 2007 I marked up my calendar with a schedule, I was going to go down from 5ml to 4.90ml the first week, 4.80ml the next week and so on, as my sons would say “epic fail”. By about mid February the nightmare was unfolding again and I had to give in and go back to the top of my Prozac dose, I was devastated.
Still I hadn’t given up hope, P was sympathetic but he couldn’t understand why I didn’t just give it up and accept I “needed” the drugs like a diabetic needs insulin. After lots more research, and P having interesting and enlightening conversations with a client who was a pharmacist about my problem, I started my taper again in May 2008, this time much much slower and here I am four years later down to 1ml liquid Prozac and still sucessfully tapering. It has needed a lot of self-discipline. I kept this blog/diary of my progress; I’ve been amazed to meet a few others who have been tapering longer than me. Nowadays my withdrawals are fairly benign, but I still feel a bit scarred from the experience,the akathisia has left me still feeling like my nerves are quite raw and very close to the surface but I can live with that now.
There is a huge assumption that these drugs are benign and harmless, they are not; they can cause extreme agitation and internal torture. They are dished out like smarties and people left to deal with the results. Starting them is like playing a game of Russian Roulette, you might be a lucky one who can take them and come off them with ease, or you might not. My understanding was that they were meant to be taken for only a year or so after you feel “well” but many many people are stuck on them for years or forever, I know many people who’ve given up hope of coming off SSRI’s and I hear many people say “oh I’ll be on these the rest of my life”. There is NO support or advice in place through doctors or psychiatrists on how to taper safely off the drugs.....if anyone does find any help in the UK, please let me know, although it’s a bit too late for me now as I’ve almost done it myself, but I know a lot of other people who might like to know!

Wednesday, 29 May 2013

It's Getting Better all the Time (kind of)

I just wanted to log on here that I have stabilized at 8mg Prozac and I'm getting better all the time, it's not what I wanted, it's not where I thought I'd end up, I thought I was the "poster child" for tapering off antidepressant drugs in this excruciatingly slow style, it worked SO well for five years, I felt so well tapering for five years, until it all unravelled spectacularly last Autumn. I feel disappointed.

If you'd asked me, this time last year, I would've said I was doing really well, and well on course to be off Prozac completely in the near future. I was even thinking this blog would be all tied up and finished and left just floating around in cyber space.

At one point though, I was feeling so bad I was considering going back to the full dose and being done with it, the thing that stopped me was the thought of the horrible side effects, the numbing of libido and emotions, and there is a tendency to essential tremor in my family and I notice on the drug, full dose, my hands have a horrible tremor, and my handwriting gets really scruffy, and I'm enjoying my piano, so no I don't want to aggravate a tendency to a tremor which the full dose gives me.

P and I have talked over this so much, we've come to the following conclusions:

  • I have an underlying condition/predisposition to depression/anxiety.

  • The drug is too enmeshed in my brain/body after so many years which have included various attempts at cold turkey and alternate day withdrawals messing up my nervous system.

I genuinely feel that it's been too many years now, and I can't put myself through the misery of withdrawal any more, I'm sooo tired of it, it's not what I thought would happen but I'm going to stay at 8mg, possibly forever, I'm at a point where I want to keep quality of life, and after you've been through a period of depression and come out the other side, boy does life feel good, I think you never take "happiness" for granted if you've experienced depression.

I'd like to have got off Prozac fully, but it's not fair on me or my family to keep putting myself through the misery, and since I would probably have to go into "rehab" for a couple of years to do it which isn't an option on the NHS or living in the real world, I can't see it happening. As long as my surgery doesn't have an issue with prescribing the liquid so I can continue with 8mg.


Anonymous said...

Sometimes we have to be brave and accept what is as 'good enough'. Where you are now is 'good enough', perhaps not the ideal of complete withdrawal from the drug, but what you need for a good quality of life which counts for more in the long run. I wish you well for a stable future on your tiny maintenance dose, and remember, that is all it is! Cathy S-L

Peter said...

I think that SM has made a very brave decision and as her husband I recognise that this has been a very difficult decision. Depression is such a complicated condition, and it can be very tempting to blame the drugs and state that they have no beneficial effect. I’ve seen SM in a very dark place and know how the lack of sleep can bring tremendous strain together with the gut wrenching anxiety attacks.

Is that solely caused by the drug or is there an underlying condition - who knows?

I’m a pragmatist who believe that what people strive for is to feel as healthy as possible with the lowest dose of a drug. If an individual is able to get off a drug altogether than great but if getting off that drug destroys your own life and zest for life then surely getting back to a place where you feel well is more important.

My message to any partner of a person suffering from depression is to try and listen as much as possible as the best medicine is often talking. The other thing to recognise is without a doubt medication does have its side effects. Many of which are not explained by doctors, who are too keen to increase medication without really understanding the consequences in my humble opinion.

When SM was feeling particularly unwell and considering increasing her dose to 20 mg, we both attended a joint doctor’s appointment, where the doctor stated that the minimum effective dose of Prozac is 20 mg. Well, in my opinion SM has had a considerable improvement in overall mental health on just 8 mg of Prozac. So may be doctors should consider changing the overall approach to depression and consider micro-adjustments to get to the lowest dose possible to limit SIDE EFFECTS.

Surely taking the lowest possible dose of the drug with the least side effects is what all doctors should be striving for rather than stating that antidepressants are not addictive as I have heard so many times before.

When looking for information on Prozac withdrawal you will always get an opinion that either drugs are really bad or their effective at treating the condition. My opinion is very much in the grey on this subject as the drugs can have a positive effect but they also have long-term consequences. Judging which is best is very much an individual choice, but trying to make sure that you actually have a life to live is what we should all be striving for.

Live life as best you can - whether that’s with a drug or without - what we seek is peace of mind.

My message to all is keep talking, as in the long-term that is the best medicine!

Lots of love always P

Anonymous said...

Thanks you SM for sharing your experiences with this blog.
I came across it at 3am this morning while laid awake with the crippling anxiety and bouncy thoughts which come from Prozack withdrawal. I have been prescribed yet another drug to try to tackle my 20 years plus clinical depression but I am debating if to even bother as I'm now not sure which symptoms are depression and which are the drugs. Your blog has helped clarify that I am not going mad simply withdrawing from a highly dangerous drug. I sincerely hope you are in a good place at the moment and that you are coping well x

SM H said...

Thank you for your comment anonymous, I'm glad my blog helped you find a bit of clarity, it's so hard to see a way through isn't it? I'm feeling a lot more settled now thank you.