Sertraline dose increase - intolerable side effects

[Anna208]

Hi all,
I've been on sertraline since March this year for panic disorder, GAD, ocd, health anxiety and the secondary depression from dealing with that poorly managed heady cocktail for so long.
Add to that my psychiatrist also thinks I'm neurodivergent (adhd/ autism traits yet to be formally assessed).
I have been on 30mg mirtazapine since December due to a mental health crisis which saw me having rolling panic attacks, insomnia and food aversion for 6 weeks - lost a lot of weight but have now gained it back plus another 3 stone thanks to mirtazapine 😫 (but that's another story!)

Anyway, I began in March by taking 25mg for 2 weeks the bumped up to 50mg two weeks later - minimal side effects and achieved almost complete remission in about 4 weeks- great, I thought.
Various life stressors then hit me over a period of 6 weeks- grandfather had a massive stroke and died, dealing with taking my employer to a tribunal and lo and behold my anxieties all came back with a vengeance.
Psychiatrist made a plan to get me up to 100mg again in 25mg increments over the course of 4 weeks only this time a jump of 25mg was far too much too soon so we decided to do a more gradual titration of 12.5mg increase every 2 weeks. I reached 87.5mg and none of my symptoms were abating, in fact I was more anxious than ever so I held my dose steady for 3 weeks and exactly at the 3 week mark I felt so much better.
Met with the psychiatrist and agreed to complete the titration up to 100mg this Wednesday and after 24 hours I had intolerable side effects from that tiny additional 12.5mg jump - profuse sweating the likes of which I've never experienced before, teeth grinding, panic attacks, insomnia, nightmares.
I have reverted back to my original dose today as im going on holiday to Spain for a week tomorrow and the last thing I want is to be an anxious wreck on holiday as I feel that would set me back further.
I'm just looking for some guidance/ reassurance on how to get to this target dose without losing my sanity. Ive queried a micro titration of 2 weeks x 6.25mg does then the full 100mg but I cant get a tablet large enough to reliably split with a pill splitter.
Has anyone else has experience of such a struggle with what is seemingly a tiny dose increase?
Thanks in advance
A xx

Why didnt your GP offer you the 50mg dose? This is what I started on and then 6 months later I am on 100mg which is fine for me.

I started on 50mg sertraline in March this year.
I've been working my way up to 100mg in 12.5mg increments over the course of a few weeks due to me being extremely sensitive to any changes in my medication. I am currently at 87.5mg and tried to do the last 12.5mg jump up to 100mg on Wednesday but the side effects have been impossible to tolerate so I've had to revert back to 87.5mg

I would keep talking to the GP. It took me 3 different types of medicines (and different dosages of each) to get on the right one. GPs tend to start with sertraline but it may not be right for you. I’m now on duloxetine. I’m on 60mg. Starting dose is 30 and at one point I was on 90 but I went down as the tiredness side effects were too much.
ADs seem to be trial and error. I hope you find the one for you. Good luck x

Thanks for your message. The psychiatrist said if i wasn't showing any benefit from sertraline then duloxetine is the next option.
Sertraline had been beneficial in quite a few ways - its reduces down my rumination and anticipatory anxiety and when I was initially put on it in march it virtually fixed me - I'd not felt that stable in years so I don't necessarily think its the drug per se, just that I need to get the dose right and give it sufficient time at a therapeutic dose to work, its just the titration process that is really painful for me - if there's a side effect going I'm guaranteed to get it.
With re to duloxetine, would you mind giving me some info on how it has worked for you?
Thanks again.
Anna