I don’t know what to do about my sertraline prescription

[thenewaveragebear1983]

I have been having ongoing health issues over the last few years: chronic fatigue, palpitations, hair falling out, anxiety, general low mood. I eventually went back to my gp and said I’m so sick of feeling like this all the time, and she has said to try sertraline. However, I have just read the leaflet (and a thread on here) and oh wow, I am now terrified of the side effects. She did not mention that I could feel so much worse for several weeks.

i’m actually feeling a bit better. I saw her 5 weeks ago and since then I have stopped eating gluten which has made a huge impact on my anxiety and I have stopped falling asleep mid afternoon. Quite frankly, the intensity of side effects people are reporting, and these are things the leaflet says are common (1 in 10) SE, I wonder if I am foolish to try it. I am really surprised she didn’t mention the possibility of such intense side effects, and I do not want to be struggling at work or at home when actually at the moment I am starting to feel a bit better. she prescribed the sertraline over a phone appointment yesterday.

i really don’t know what to do now 🤷‍♀️

Anecdotal only, but I had zero side effects on sertraline apart from being a bit zombie like the first couple of days. Coming off it was a nightmare for me though. It definitely served its purpose and got me through a patch where I wasn’t coping very well at all. I felt like you, nervous about trying it, but was glad I did in the end when it kicked in.

Setraline was life saving for me. I'm on a 200mg dose and probably will be forever. My only side effects when I started were intense dreams, jaw clenching and yawning a lot. Everyone is different of course.

Thank you both. Did you start on half a tablet or did you go to the full dose? I have been prescribed 50mg. I just really really don’t want to go back to that awful gripping anxiety, I have worked so hard since the summer to manage it better.

I suppose my other question if anyone knows is if you do experience side effects do you have to ‘battle through’ or do you stop, and if you stop how quickly do the symptoms subside?

I started Sertraline a few years ago, and it has absolutely saved my life. I started on 50mg, then moved up to 100mg.

Side effects were minimal and faded in about a week - unless they’re unbearable, it’s worth persevering as they do go away.

I always find starting new meds scary, but I can honestly recommend Sertraline.

No side effects for me either. But as a PP said, coming off is an absolute nightmare and took months.

I would battle through if the side effects are manageable but you can stop and ask to try a different ssri if they’re not. The side effects of sertraline were horrible for me for the first 2 weeks but I battled through, I had brain fog, dry mouth, loss of appetite, insomnia and nausea but they didn’t make my anxiety or low mood any worse. The side effects did mostly subside after a few weeks apart from the dry mouth which I had the whole time I was on them.

Escitalopram however I stopped taking after a few days because my anxiety and intrusive suicidal thoughts increased and I really didn’t want to risk trying to ‘battle through’ those effects as I felt like a danger to myself. Once I stopped taking them I don’t think the effects lasted more than a day or two. All SSRIs affect different people differently, the ssri which works for one person may not for another. Sertraline tends to be the first choice but it’s not the only choice, if you’re able to battle through the side effects it is worth doing but if the side effects feel unmanageable or like you will be unsafe continuing it is okay to stop taking them and ask to try a different one.

I didn’t find the side effects too bad. Increased anxiety for a few weeks then it settled. About 6 weeks in I felt great.
Was on 50mg for a few years. Came off no issues.
Restarted about a year or so later. I’m on 200mg now.,

I'm on 150mg sertraline. I find I get a bit of mild nausea when i increase the dose and a dry mouth but that's it.

What’s your B12, vitamin D and iron levels. Iron needs to be 70 for hair. While the NHS have a very low pass rate for B12, so you can be ill but the nhs will consider your levels fine

Gluten can inhibit vitamin absorption

@LondonGirrrrl my iron is 40 (tested 2 weeks ago) I know this is low but they won’t prescribe me anything as it’s normal. B12 is also low, can’t remember the number. But it was low and folate was high.

They’ve treated me for thyroid and all the other things. I’m on HRT. I did actually give up gluten around 6 weeks ago and overall I feel considerably better and have had a lot less anxiety which is why I am so reluctant to start something that will potentially increase it again. Any other side effects I think I’d be ok with but I am just worried that I am back to where I was over the summer, I have really struggled and this was the end of a 2 year long battle with it. But on the other hand this battle has exhausted me and I want something to help me.

its really tough, I am so grateful for all your inputs thank you. I am going to ponder it a bit more and potentially start them on Thursday

@thenewaveragebear1983 how has stopping eating gluten made a huge impact on your anxiety?? Absolutely no correlation whatsoever.

You can buy iron and B12 over the counter, from the symptoms you describe, it does sound like that would be worth you trying.

@MujeresLibres I already do, I take them both daily and I have done for months.

@TheScreamQueen there’s a lot of research linking non coeliac gluten intolerance with a wide variety of neurological and mental health conditions. I actually didn’t stop gluten for that reason, I had Bell’s palsy at Christmas last year and I still have facial numbness on the affected side. I had read about gluten causing inflammation and decided to stop it. Within a few days my anxiety was significantly less and the constant chatter and intrusive thoughts much much less as well. I have now done 5/6 weeks and I am convinced the gluten has helped, it’s the only thing I’ve consistently changed in that time.

If you are interested take a look at Georgia Ede on YouTube, she is a psychiatrist who talks about the link between diet and mental health, one of those links is inflammation, which you have already mentioned.
Having already cut out gluten and notice a positive change, it might be worth reducing carbs and upping healthy fat and protein, as this can really help with mood and energy levels. A lot of people do not know that many hormones and neurotransmitters are made out of dietary fat and we, especially women, need to consume it.

@Sajacasthats also interesting, thank you, I have actually been trying to reduce my carbs (for weight loss) but this week I have really noticed I have felt a lot more energetic which I assumed was just because I’m off work. Would you do this alongside the sertraline?

Worked up to 100mg I think. Did 50 and that did nothing for me (so be prepared for that). 100 worked though.

My friend, in her 70s, has been on Setraline for about 5 years. She's had no side effects and feels great on it. I don't know the dose. What concerns me is that her GP just keeps giving out repeat prescriptions with no check. I suppose they think because of her age she's on it for life.

I battled through the side effects (which weren’t that bad mainly nausea dizziness and little zaps in my head like tiny electric shocks).

I know that sounds bad my mental health was really bad at the time and those physical side effects weren’t a patch on how I felt mentally so anything was worth a shot.

after a couple of weeks I didn’t notice the physical stuff anymore and the effects on my mental health shocked me (in a good way). I fully expected them to have no effect but it really cleared the fog for me and allowed me to live more fully.

wont be the same for everyone though. Word of warning, when I was coming off the pills (after several years) I was told not to half the pills because the drugs aren’t equally dispersed throughout the pill and therefore you aren’t necessarily getting a half dose if you cut the pill in half. Much better to just take what is prescribed. I also got specifically prescribed a 25mg to help taper off when I was coming off them

I started on 50mg and ended up on 200mg. The first few days were spent feeling rather drunk. No longer than a week. As for stopping them, I just stopped. No side effects and no issues.

This.
Especially check your ferritin levels and ask for your actual numbers.
GPS and doctors in general can be dreadful about saying levels are fine, when they don't meet NICE guidelines, especially in women.
Hair fall is a red flag for some kind of deficiency, but all your symptoms could also be attributed.
Have you been checked for coeliacs, you need to be actively eating gluten for the test to be accurate.

@Richardscaryisscary I had the full range of bloods done 3 weeks ago. My ferritin is 40. I’ve said about the hair fall being attributed to this but they still won’t prescribe anything, I have to buy it over the counter. I have also been previously checked for coeliac disease (before I gave up gluten) which was negative. I have honestly had every test going, multiple times. Thyroid, liver, cortisol etc everything normal every time except low iron and b12 (which they still class as normal)

it’s incredibly difficult to raise your iron if you’re still having periods, I did get it up to 60 but it’s now back to 40. I have an incredibly low resting heart rate as well, as low as 33bpm when I did a 24 hr trace which also massively contributes to my tiredness and low mood probably.

It might be well worth your while to hold off on the anti depressants for a while if you don't need them - if you are begining to feel better then hold off starting something that can come with side effects and have you having to taper up and then eventually taper off if you don't need to. You could file the prescription and have them for when/if you do decide you want to start them but I think you should think about getting a vitamin B12 shot (can do this at some healthfood stores) - it can make a big difference to your anxiety and mood if it is low. For Iron, its worth taking a supplement - but not every day - every other day as you don't absorp it properly otherwise. You could also take L Thianine as a supplement for times in the day you feel anxious/stressed - helps with this. Definitely work on lowering inflammation - so support your gut lining foods that support this and pre/pro biotics etc and avoid the histamine foods ( no processed food, fresh food, no pickles, mature cheese etc - you can google for the list of high histamine foods). Focus on regulating your nervous system via some fresh air/mindfulness/gratitude, restorative movement - walking, pilates, yoga and think about your life balance/pacing. Ensure your sleep is good and your environment/sensory input is helpful and maintain meaningful,valued relationships/connections. Should all help.