Sertraline - please help

[Yubaa]

I’m late 30s and suffered with anxiety all my life. It’s been pretty horrendous. Somehow I’ve managed to hold down a job and on the outside it looks like I have my life together. But I have huge bouts of anxiety which tips me into anger and sadness. I’m sick of living like this.

I have always resisted meditation, I suppose because that in itself makes me anxious. I also now have a toddler and I’m a single parent and I worry that taking sertraline could give me side affects which could in some way impact my child.

Ive tried talking therapies, cbt, etc and the worry and intrusive thoughts and anxiety remained.

ive been prescribed sertraline but I just don’t know what to do, has anyone had any experience please?

@flossymuldoon thanks for sharing. What are the withdrawal symptoms you get/why can’t you cut it out?

I take Sertraline, a low dose, and I’ve been taking it for over two years, since being diagnosed with cancer. I tried to manage by myself for quite a long time with the help of a specialist psychologist (NHS) but I do find it helps.

Hi OP. I had an awful childhood, somehow coped with awful anxiety, husband, house, kids , job. After a ectopic a few years ago, GP prescribed Sertraline 50mg. But due to DHs and my own ignorance and the stigma, I refused to take it and be yet another person on AD's. Dragged on and on with life attempting to sort anxiety out with exercise, good diet, meditation, yoga, decent sleep etc. Felt a bit low and always blamed peri menopause or kids being challenging, or it being winter time. Then out of the blue over New Year, I had a mental breakdown at work. Disassociated as if I was watching myself from above. Came home, crying, shaking, talking gibberish and having very very dark thoughts. GP put me on Sertraline 50mg and Valium. It saved my life that day. Been off work since New Year whilst I sort the Sert dosage out. After 4 weeks GP put me up to 100g (50 am and 50pm). I had awful side effects - nausea, and a very low low mood, insomnia, upset tummy. Thought I will be like this forever and I should just been sectioned. Then slowly chunks of positivity startee to appear for a few minutes. This slowly increased. But then there were days where I felt back to square one and was so disheartened that the "positivity moments" hadn't happened. So day 30 now, and the mood lift today was at 1pm. Even logged into work to check some emails. Started 100mg a couple of days ago, so this may be a placebo effect and then the low lows start again like the first time. But I am determined to stick it out another month. I start psychotherapy this week, but just had to put it on the credit card as I HAVE to get back to being a mother and go to work. Pls feel free to pm me as I kept a daily diary when I started Sert and happy to share.
I have been listening to Dr Russ Kennedy, The Anxiety MD. He posts a lot of free podcasts and YouTube. His theory is that we need to heal the younger version of yourself. Anxiety is actually an alarm in your body. I know it all sounds abit "woo" I know, but scientifically it makes sense that the body holds trauma. Xx

I’m sorry you are going through this. I’ve had real issues with SSRIs and currently like you going down by tiny amounts. Nearly 4 weeks in bed this reduction so far. It’s so shitty!

I REALLY don't want to derail your thread OP, but please could some of the posters who have teenagers on Sertraline let me know how on earth you got it - @arcticpandas you were one who mentioned your son is on it.

Our daughter has a professional psychiatric private diagnosis of OCD, anxiety, suicidal and intrusive thoughts, wastes so many hours on rituals etc. She previously had an eating disorder than thankfully we caught early.

Home life is hell. Our marriage is in tatters as is my relationship with my daughter. The only thing keeping me from suicide is our older children who I have a really good relationship with and are both lovely people.

No one will give her sertraline or any other type of medication. The GP says no because she is under 18 (she's 16), the private psychiatrist said no because we all argue too much (because of the awful anxiety/OCD our family dynamic is completely broken) and the support isn't in place.

Camhs are not interested and the GP doesn't reply to my messages which is why we paid 1K for a private assessment. She also sees a therapist once a week privately but I can't see it's helping much.

Can anyone offer any help as to where we can get sertraline to see if it helps her. She is very keen to try it because she, like us is desperate.

I'm happy for a DM.

@JasmineAllen hi, so sorry for what you are experiencing. I just wanted to say that whilst I can’t help about how you can get sertralline, other than absolutely hounding the GP and/or going to another one for it, that I was like this as a child. It was absolutely horrendous. I spent hours on rituals. This is where my problems began and whilst I don’t have physical rituals as such anymore, I do have mental rituals which are exhausting. Looking back I desperately wish my parents knew how to get me the help I needed (back then these things weren’t really talked about). If my child had these issues I would be repeatedly contacting the gp, pushing the point, going to another private doctor etc until I got the medication. It’s so hard and I hope things improve xxx

@JasmineAllen My son started with Sertraline when he was 10 years old. It can only be prescribed to children when it's aimed to treat OCD. My son wasn't depressed at all, just a prisoner of heavy OCD that made his life a living hell. I would like to understand why they are refusing to treat her with Sertraline. Can you call her psychiatrist- maybe there is a good explanation? Does she have any health condition that is not compatible perhaps ? This from the nhs website:
Who can and cannot take sertraline
Who can take sertraline
Most adults can take sertraline.
Children aged 6 to 17 years can also take sertraline, but only for obsessive compulsive disorder (OCD).
If you have diabetes, sertraline can make it more difficult to keep your blood sugar stable. Your doctor may recommend that you monitor your blood sugar level more often for the first few weeks of treatment with sertraline and adjust your diabetes treatment if necessary.
Who may not be able to take sertraline
Sertraline is not suitable for some people. To make sure it's safe for you, tell your doctor if you:
have ever had an allergic reaction to sertraline or any other medicine
have a heart problem – sertraline can make your heart beat faster or cause an irregular heartbeat (arrhythmia)
are trying to get pregnant, already pregnant or breastfeeding
have glaucoma – sertraline can increase the pressure in your eye
have epilepsy or are having electroconvulsive treatment – sertraline may increase your risk of having a fit or seizure
https://www.nhs.uk/medicines/sertraline/who-can-and-cannot-take-sertraline/#:~:text=Who%20can%20take%20sertraline,keep%20your%20blood%20sugar%20stable.

I would try seeing another psychiatrist @JasmineAllen . I so hope your daughter will find the treatment she needs for her and for you.💐

Hmmm, while lots of people are being evangelical about this drug, and I am very glad it works for them, this has not always been the experience of people around me.

My dad had a severe reaction to Sertraline in the first day or two and actually collapsed. I was there and called an ambulance for him.

I know someone else who had sexual dysfunction problems which continued even after they stopped the drug.

One more who said Sertraline didn't work but now happier on Citalopram.

And a couple more who really like it.

So quite a mixed bag, really. I'd be wary of GP's handing them out as the cheap fashionable drug these days. While no doubt they can and do work for some people, it's by no means universal. ⁰

I started to take it in September, I’ve always been quite anxious but was managing up until I had my son. I could then barely function I was so worried about everything, and obsessing over the smallest things.
I felt a bit sick for a week or 2 when I started taking it but it soon past and I feel 90% better than I did before I was on it. I do still have some anxious thoughts but it doesn’t affect or bother me in the same way it use to. I’m generally a lot calmer and happier now. I can’t really believe the difference it has made it my life thinking about it now. I just feel like the version of myself that I’m supposed to be if that makes any sense.

Give it a shot. In combination with CBT. It saved my sanity. I'm 10yrs in and only take 25 mg 5x days per week. It was trial and error to start but one day you wake up and that horrid blanket of anxiety and depression is gone.

Have you got an official diagnosis of generalised anxiety? Have you spoken to anyone around OCD? A lot of what you have said about intrusive thoughts, obsessing over thoughts and rituals etc. sound like Pure OCD. It would be worth seeing if you can speak to a psychiatrist who might be able to help with a more specific diagnosis and prescription.
I have always been an anxious person but after two kids, post-partum anxiety tipped me over the edge. Basically i got to the point I was sitting on the floor in my nightie unable to function. Thankfully the community midwives put in an urgent referral to the perinatal mental health team, and they very quickly got me on sertraline with a specific anti-anxiety medication quetiapine. Essentially the sertraline was to try and get me slowly back to a baseline, the quetiapine was to help the intrusive thoughts and essentially switch off so that I could get some sleep. It was only a couple of weeks in the psychiatrist mentioned OCD and completed a diagnostic tool with me. It really removed the wool from my eyes and a lot of things suddenly made a lot more sense.
I was on sertraline originally and then moved on to fluoxetine - something else to consider is give sertraline a try, see how it goes and then keep talking to the gp / psychiatrist. They will want to know how you are getting on and whether it is working for you - if it isn't, it doesn't mean another medication might not be effective.

Why do you need to understand it? Just give it ago and see. You've tried everything else. I was the same then I tried sertraline and realised I'd wasted so many years of my life being anxious about nonsense. You are far more likely to have a negative effect on your child currently.

Very few people understand exactly why medicines work the way they do but that doesnt mean they wont work

@Yubaa and @arcticpandas thank you very much for your replies.

@Yubaa I'm so very sorry to hear you've had this issue since you were a child. It really is debilitating and I hope, should you try the medication, it really helps you.

Our daughter has no existing health conditions and the psychiatrist, despite suggesting sertraline at our first meeting (for the OCD which she diagnosed), decided by our second meeting (about 6 weeks later) that we didn't have enough support in place for it to be prescribed which was frustrating. Apparently it needs lots of family support and monitoring and the school fully involved monitoring which she said she wasn't sure about. She also said we should try every available alternative and a change to parenting style. After 8 months of therapy I'm not sure what else we can try and the comment re: parenting style felt like a low blow considering we've also managed to raise 2 well balanced children to adulthood.

TBH I feel like we've wasted 1K just to get a formal diagnosis that was obvious to everyone because of the rituals, suicide threats, anxiety, anger, unreasonable behaviour etc.

ATM I am contacting the GPs on a weekly basis so I think I'll continue with that until I at least get a response but after that I really don't know what to do. I've read about something called NAC which we might try and Magnesium apparently can help with OCD as well.

I'm hoping Camhs might help, but I'm not holding out any hope as the waiting list is so long she'll be under adult care by the time she's at the top.

Everything spinning, the floor moving under me, bad hip pain, really bad tinnitus and morning cortisol rushes. It even happened on drops of 10% of previous dose so I went really low at 2%. That is manageable and I only get mild tinnitus and cortisol rushes. Unfortunately it means that I can only drop 6mg per year. The drops between 150 and 50 were not great but manageable, but once I got to about 50mg the drops had a much bigger effect

I’m so sorry you’re suffering. I started doing 10% reductions and the cumulative effects of those were just too bad so I had a 3 month break then started 2% drops which is approx 1/2mg month. Obvs as I get lower that becomes a larger percentage so I envisage at some point I’ll need to reduce that. I just wish I’d have known when I started ☹️

if you are missing doses you may be setting yourself up for more problems down the line when you come to reduce. I am
on a forum for people trying to get off them and inconsist dosing is a common theme amongst the people who are having the lose trouble as it means you never really get stable on a dose

Thank you @flossymuldoon Yes I think I’m going to have to slow my reduction. I’m only on a tiny dose but I think it’s going to be close to a year to get off it. Problem is my side effects from the medication are so bad that I’ve had to go part-time at work (about 2 days) and so my job/salary is at risk the longer this drags out. Withdrawal also awful, severe fatigue (mainly bed and house bound) and nausea.

To the OP- I would worry less about why the medication works and if it will work for you. These are unknowns and dwelling on that is just fuelling your anxiety (I’ve been there do totally get it!) Unfortunately SSRIs are a bit of a gamble. As you’ve seen from PPs it can make a huge difference to a lot of people. However, you might have to try a few to get something that works/they may not work for you. There’s also the risk of some serious and ongoing side effects and withdrawal can be very hard. I would focus on weighing up the pros/cons based on reliable information on the risks and benefits, ideally from a knowledgeable GP/prescriber.

I’ve noticed some PPs saying they are planning to stay on these drugs for life. In theory that totally makes sense-if it’s broke don’t fix it! I would stay on them if I could as they do help with my OCD. Unfortunately as far as I know they were only designed, and all safety testing, is based on taking SSRIs for a short period i.e. months not years. If anyone is aware of any research on long-term use I’d be very interested. Or medical alternatives to SSRIs/SNRIs for anxiety and OCD. As I understand it there’s very little research into alternatives (apart from therapy).

@JasmineAllen Apparently it needs lots of family support and monitoring and the school fully involved monitoring which she said she wasn't sure about.

This is b-shit. My son was prescribed Sertraline at 10 years from Cahms psychiatrist and the only one informed was the school doctor in primary and then school nurse in secondary. That's it. Why would anyone else need to know? This doesn't make sense at all. I give him his Sertraline dose (125 mg) in the morning before school. Why would school need to "monitor"? They are not qualified to do any psychiatric assessment of your daughter. It's the prescribing psychiatrist who monitors with your help ofcourse. You start with a really low dose and gradually go upwards until you are at the optimal dose : where you can see it having an effect on her OCD.
Please contact another psychiatrist because I can't understand how threy can let your daughter suffer like this when there is help. Normally It's Sertraline+ therapy for OCD. Mine refuses therapy but he's autistic and hates talking about anything he's not interested in so it's only medication for him.

I agree and I don't get it either.

After the psychiatrist suggesting we discuss sertraline at the first assessment meeting (because GCSEs are coming up and time is of the essence to quote the psychiatrist) at the follow up meeting she's decided she won't prescribe anything because we have no support in place and suggested a referral to Early Help instead. Oh and she's offered to have a chat with the school and us minus DD to set up some 'small goals'.

How we're suppose to get DD to reach these goals I don't know because it's not like she has a mental health problem that defies logic and reason 🙄

I feel like it was an utter waste of money and I'm beyond angry and frustrated.

I'm working with my GP on this and have been doing so for 10 yrs. The medicine stays in your blood for a long time (26 hrs) I have had various CBT programmes along with medication and am doing just fine - with no intention to come off them. I started reducing them when I was on 50mg daily and eventually down to 25 mg daily - that did not agree with me. Now I take 50 mg on Mon Wed Fri and 25 mg on Tue and Thu - works out 28 (sorry not 25mg) daily. My GP is happy with that and so am I. It won't work for everyone though.

When I started feeling better I forgot to take a pill, withdrawal, so I took another, again forgot. So my coming off them was quite natural in line with my body. My GP was surprised. I think my bad memory was responsible.

Royal college of psychiatrists have guidelines for tapering off and they are now reflected in NICE guiidelines:
https://www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/stopping-antidepressants

I was on it for 2 years for severe depression and anxiety which started when I was pregnant. It genuinely worked. My thoughts didn’t seem like such a big deal anymore - an anxious thought which would have sent me spiralling into anxiety attacks just didn’t.

Only side effect I had was horrendous fatigue. I ended up taking myself off it after 2 years because I couldn’t take the tiredness anymore. I couldn’t function and that in itself was affecting my mental health as I didn’t have the energy to do anything.It was more than tiredness. I couldn’t get through a day without a nap (or two) and would panic on days I couldn’t work from home or had to travel as I didn’t know how I’d manage. This was especially worse when I went back to work after maternity leave. Even with a nap within a few hours of waking I was shattered, brain fogged and couldn’t keep my eyes open. I flagged it early on and doctors and psychologist all had reasons other than the Sertraline (“it’s the depression…”/“you’ve just had a baby”/“you’ve just gone back to work”). Until I’d had enough and my own research showed other people experienced this too. Within 6 weeks of coming off my tiredness had gone. And of course since coming off it, when I mentioned it to professionals, they all agreed that it was known to cause the extreme tiredness I had!

However, recently my anxiety is bad again and I am really struggling. I won’t ever go Sertraline again, but am debating trying a different SSRI because while I couldn’t manage the Sertraline side effect, I know there are other similar medications that may help me without the side effects I had on Sertraline. If I was you I’d try it - if it doesn’t suit you can always stop or try a different medication.