Bad experience with Sertraline - can anyone please help me decide what to do with regard to medication?

[dontrunwithscissors]

I hope I don't annoy anyone here, I just can't get my head straight & decide what to do. I'll try to keep this brief....

I was diagnosed with PND in late March & prescribed Sertraline. I was in a pretty bad way, and less than a week later I was admitted to a Mother & Baby Unit. I stayed there for 6 weeks. I started to feel a lot better after 3 weeks or so, and really felt the Sertraline was helping, but I was suffering a lot from side effects. I've now been home from the Unit 7 weeks. About 4 weeks ago I started to get huge mood swings - I'd be bouncing off the walls (in DH's words), absolutely full of energy and almost euphoric. (Whilst I felt great, in retrospect it really wasn't normal behaviour.) An hour later I'd be pulling out a knife to try to kill myself. I really didn't give a damn about DD's or DH - I was utterly convinced I wanted to be dead. Anyway, the side effects of the Sertraline continued and 2 weeks ago my psychiatrist took me off it at my request. She gave me the option of staying off AD's or going on to Citalopram. To cut a long story short, I came off completely and found that those mood swings and suicidal thoughts went completely. I felt great, and really do think that the Sertraline was to blame. However, the last 4 or 5 days I think I've been sliding backwards. I'm snappy with the girls. I feel like I'm wading through mud all day. I have had to force myself out of the house. Strangely, I have this weird sensation that I'm watching myself when I'm playing with the girls (as if it's not quite real-never had that before.) I really don't want to go back on AD's after what happened last time, but I'm wondering if what's happening is just a blip or me going back down to where I started.

Sorry, I've written an essay. Anyone feel like telling me to pull myself together???

ohhh

sounds a bit manic switch-y

antidepressants very very dangerous in terms of destabilising mood, rapid cycling, worsening course of illness long term etc IF bipolar

bipolar often kicking off post-natally - am not for one minute saying I think you have it, but any antidepressant can induce mania - you'd have to wait and see if those symptoms recurred independently of antidepressants before seriously considering bipolar

just mention it as a possibility to bear in back of mind, any family history?

Hi there

I was diagnosed with mixed affective state, as my moods were all over the place. I spent nearly 3 months in a mother and baby unit.

Citlopram is in the same class as sertraline, it's an SSRI. Citalopram made me LOADS worse, I was pacing up and down and didn't sleep for 5 days.

Eventually I stabilised on lithium and olanzapine (mood stabilisers)

Have you talked to your psychiatrist about your mood swings, it sound to me like you are rapid cycling as MitchyInge says. You may need a mood stabiliser. Many mood stabilisers also have an AD effect BTW.

Telling someone to "pull themselves together" when they are suffering from a serious psychiatric illness is a bad idea

Thanks, Mitchy. No, there's no family history. Thinking about it, I did have one occasion of behaving this way just before I was diagnosed with PND, but it only lasted about 36 hours. Perhaps I'm wrong in blaming the AD's. I just don't want to go back to feeling that way.

Getdown I mentioned the mood swings to my CPN. I've been prescribed olanzapine (2.5mg) to help me sleep, but haven't taken it for a while. It's interesting to hear that citalopram made you feel worse. Just don't know what to do...

Sorry, what I said 'behaving this way' in my last post, I mean 'bouncing off the walls.' I remember talking constantly to DH, and telling him how wonderful everything was. I felt like I had so much energy, and didn't want to sleep. Sorry, not sure I'm making any sense....

2.5 of olanzapine is a very tiny dose, I doubt that would do anything for mood stabilising, or sleep for that matter.

I think I was on 10mg when in hospital and came down to 5mg, then 2.5mg over the course of a year or so.

Do you still have contact with the peri-natal psychiatrist, and with the unit?

My unit said I could call them for support for up to when my DD was a year old.

am firm believer in trusting your own perception and experience - not to disregard the dr point of view, but even if they witness firsthand the mood swings it's not inconceivable that they'll misguidedly chuck more of the same at you

antidepressants can and do induce bipolar-like mood swings in people who don't have the condition

if was me would want trial period of no meds, with as much support or external monitoring and a plan for what to do if symptoms of relapse arise, just to see

No, I haven't had contact with the Unit since I was discharged, although they did say I could ring them. I'd feel like I was being a hassle, though. I've been told that the chemical imbalance that started all of this off has been corrected by the Sertraline so I really feel that I should be OK now. I don't understand why I'm starting to feel crap again, to be honest. Other than perhaps I can't cope with two children.....

oh please please look at my podcast transcript for most recent opinions regarding 'chemical imbalance'

is in this area somewhere

Sorry, Mitchy, I've just read your post. I spoke with my CPN about the signs of relapse. The only option is to start the citalopram, I think. I suppose I won't know what will happen until I try it. I've been struggling more and more. Today's been particularly bad - the feelings I had of being physically unwell, and just wanting to run away have returned. It took me back to prior to being admitted to the Unit. I just don't want to give in and take the Citalopram if it is just a blip, and I especially don't want to make it worse. I might just try making it through the weekend....

PS will look at that post you've mentioned, thanks.