@Erimus our stories are slightly different, in that after a few months on a drug I thought I could just taper off over a month, so I am fortunately not still taking it.

 

However, I can certainly relate to a few months of a drug just utterly destroying me and my health with no warning.

 

I am aware that you have always believed that sertraline is main culprit for the symptoms that you experience. Do you think that there is any interplay between this and the other drugs you are taking, particularly mirtazapine? If I'm understanding your signature and early SA posts correctly this was added in for insomnia and is still taken in the evenings?

 

I really hope that something helps at some point.

 

 

4 hours ago, Luke said:

@Erimus our stories are slightly different, in that after a few months on a drug I thought I could just taper off over a month, so I am fortunately not still taking it.

 

However, I can certainly relate to a few months of a drug just utterly destroying me and my health with no warning.

 

I am aware that you have always believed that sertraline is main culprit for the symptoms that you experience. Do you think that there is any interplay between this and the other drugs you are taking, particularly mirtazapine? If I'm understanding your signature and early SA posts correctly this was added in for insomnia and is still taken in the evenings?

 

I really hope that something helps at some point.

 

 

I have no doubt the other drugs are interacting and contributing to this mess.

 

The sertraline is just the most toxic. Some of the adverse effects I experience now began shortly after taking it, before I added mirtazapine in.

The only reason I keep the mirtazapine is because I physically can’t sleep without it now. Sertraline withdrawal just seems to cause total insomnia for me. 
 

I can only taper one at a time and I’d rather all that time be invested in reducing the sertraline as much as possible, to try and reach a point where it’s less toxic to my brain. 

 

Edited April 2Apr 2 by Erimus

9 hours ago, Erimus said:

I have no doubt the other drugs are interacting and contributing to this mess.

 

The sertraline is just the most toxic. Some of the adverse effects I experience now began shortly after taking it, before I added mirtazapine in.

The only reason I keep the mirtazapine is because I physically can’t sleep without it now. Sertraline withdrawal just seems to cause total insomnia for me. 
 

I can only taper one at a time and I’d rather all that time be invested in reducing the sertraline as much as possible, to try and reach a point where it’s less toxic to my brain. 

 

 

Understood.

 

Just to be clear, I wasn't advocating tapering mirtazapine, just wanted your thoughts on the interplay between them.

19 hours ago, Erimus said:

I’ve been waiting for 15 months now to get back to withdrawal normal, hence why I’ve tried small reductions over the last 12 months. 

Im really hoping you can keep these up going forwards. Even if it at least makes you feel like your are doing something, I don't think that is a bad thing. Less stuck.

 

19 hours ago, Erimus said:

It’s a good job we can’t see into the future, because if somebody had told me 5 years ago today that I would still be suffering in 5 years time, I wouldn’t have survived. 
 

It’s almost exactly 5 years to the day since I first tried dropping from 100 to 50mg.
 

At the time I had been on the drug for just a few months, and wrongly assumed I could just drop the same way I titrated up.

 

This led to what can only be described as the most horrific experience a person can endure. 

I think this often. If I knew 2 years later I would be still struggling day to day so much, Im not sure how I would have dealt with that information. It is much better to not know the future.

 

I am so sad to see you like this. Nothing stays the same and you will find your way eventually. Hang in there Erimus. Your body is like everyone elses, it wants some balance. Wish there were obvious answers for you.

I am currently experimenting with a low-carb/keto diet. I am hoping to lose some weight as I had become extremely miserable with the binge-eating habits caused by the drugs, and have slowly gained weight since 2022.

I was hoping the anti-inflammatory nature of the diet might also aid some of my symptoms but so far there has been no change. I don't even feel any different whatsoever, and I am 2-3 weeks in so far.

The scales tell me I have lost around 14 pounds (6.3kg), but I can't say I can tell. I assume a lot of it is the water weight that sheds in the first few weeks of this diet. I'm not sure if the stubborn stomach and waist fat will be possible to lose due to the drugs, but I am trying.

At least the carb cravings have stopped. All refined sugar is gone from my diet, as well as all the processed and ultra-processed junk.

Edited June 28Jun 28 by Erimus

@Erimus this is a great step forward. It might not feel like there is any benefits as yet, but there will be some to come no doubt. Your making a more solid platform to heal from. Im impressed, it is not an easy thing to do, the food cravings and sedentary life WD often delivers makes keep weight off hard for many.

I think I read on another thread you have seen a slight reduction in symptoms. Is that correct?

6 hours ago, Chippy said:

I think I read on another thread you have seen a slight reduction in symptoms. Is that correct?

I've had some periods of reduced akathisia and jolts in the last month.

Edited June 29Jun 29 by Erimus

16 hours ago, Erimus said:

I've had some periods of reduced akathisia and jolts in the last month.

That is really great to hear @Erimus hopefully the start of some improvement for you.

14 hours ago, Chippy said:

That is really great to hear @Erimus hopefully the start of some improvement for you.

Unfortunately the cost of stability is increased muscle pain and mobility problems.

I just can’t win.

Still feel too unstable to taper but starting to struggle with pain again.

10 hours ago, Erimus said:

Unfortunately the cost of stability is increased muscle pain and mobility problems.

I just can’t win.

Still feel too unstable to taper but starting to struggle with pain again.

Im so sorry @Erimus you have to endure so much, it really is not fair. Hopefully some further improvements come your way soon.

On 6/28/2026 at 1:01 PM, Erimus said:

The scales tell me I have lost around 14 pounds (6.3kg), but I can't say I can tell. I assume a lot of it is the water weight that sheds in the first few weeks of this diet. I'm not sure if the stubborn stomach and waist fat will be possible to lose due to the drugs, but I am trying.

It's hard to say without knowing how big you are, but 6+ kg of water weight would be quite a lot. It might be a bit of both.

If you can keep it up at a manageable rate hopefully it will just come in time while you focus on other things.

11 hours ago, Luke said:

It's hard to say without knowing how big you are, but 6+ kg of water weight would be quite a lot. It might be a bit of both.

I started at 13st7lb (~85kg) and am down to 12st6lb (~79kg). My original goal was 12.5 stone but I think I might aim for 12 now, given that I still have around 22.5% body fat.

My BMI is down to 23.0. It was into the overweight category before I started.

Regardless of weight loss, I think the keto approach is just a healthier way of eating for most of us in the western world because it removes all the ultra processed junk.

I removed gluten months ago and I think this is just a continuation of that process. Less inflammatory foods for my highly stressed gut, body and mind.

I don't think that that is so big that it can all have been water weight, personally.

Regardless of this, hopefully losing some weight and eating clean is likely good for you overall.

I'm not sold on keto for myself, I tried it long before I got sick, but I think that everyone is different and that it might work well for others.

8 hours ago, Luke said:

I'm not sold on keto for myself, I tried it long before I got sick, but I think that everyone is different and that it might work well for others.

The main advantage for me is I no longer binge eat carb heavy foods and snacks.

If you can resist junk food and still eat potatoes and rice then you are fine, I just couldn’t.

Edited July 3Jul 3 by Erimus

I'm not knocking it, it just doesn't work for me.

19 hours ago, Luke said:

I'm not knocking it

I know

Since January 2023 I have been recording my symptoms, when I deem them severe enough to warrant being noted in my diary.

This has left me with 3.5 years worth of data tracking my three worst symptoms, myoclonus (jolting), akathisia (restlessness), and chronic muscle pain (myalgia).

I compiled this information into a spreadsheet, with the value for each symptom, each month, being representative of the number of times it was recorded that particular month. I've also added in the net dose change (of sertraline) for each month.

When I first began tracking I mainly suffered from pain (purple), and had been free from akathisia for a few months at that point. The two 5mg increases in February and March 2024 made no difference to the chronic pain, as is evident.

You can see the first major depression in the green line, which is when I began reducing, and the massive up-tick in symptoms that this, and the eventual crash in August 2024, caused. The failed taper of 2024 was the first time I realised that the drug was the thing causing all the pain.

Another interesting part is Jan 2025, when I dropped 4.5% of my total dose. This sent my system into complete chaos, for 18 months and counting, but it's the only thing that has brought prolonged pain relief over the last 3.5 years.

In the last couple of months the pain readings have slowly began to increase again, which implies I will have to try reducing soon. It's impossible to balance reducing the drug to stop pain, and not causing extreme protracted withdrawal.

Collecting the data certainly seems to have helped you at least see the patterns and draw conclusions.

Of course this doesn't take away from how difficult it is for you to balance reducing the dose with increases in other symptoms (besides pain), but this would be incredibly difficult to unpick without the tracking.

15 hours ago, Erimus said:

Since January 2023 I have been recording my symptoms, when I deem them severe enough to warrant being noted in my diary.

This has left me with 3.5 years worth of data tracking my three worst symptoms, myoclonus (jolting), akathisia (restlessness), and chronic muscle pain (myalgia).

I compiled this information into a spreadsheet, with the value for each symptom, each month, being representative of the number of times it was recorded that particular month. I've also added in the net dose change (of sertraline) for each month.

When I first began tracking I mainly suffered from pain (purple), and had been free from akathisia for a few months at that point. The two 5mg increases in February and March 2024 made no difference to the chronic pain, as is evident.

You can see the first major depression in the green line, which is when I began reducing, and the massive up-tick in symptoms that this, and the eventual crash in August 2024, caused. The failed taper of 2024 was the first time I realised that the drug was the thing causing all the pain.

Another interesting part is Jan 2025, when I dropped 4.5% of my total dose. This sent my system into complete chaos, for 18 months and counting, but it's the only thing that has brought prolonged pain relief over the last 3.5 years.

In the last couple of months the pain readings have slowly began to increase again, which implies I will have to try reducing soon. It's impossible to balance reducing the drug to stop pain, and not causing extreme protracted withdrawal.

This is very interesting and valuable for you from what I can see. I have started to think tracking symptoms for the most part doesn't help and maybe is more hassle/opens the door for hyper focusing on them then it is worth, however here it is clear it is helping you make some sensible unique choices. I hope you are able to cut this rising pain off sooner as a result with a reduction that doesn't cause you too much WD @Erimus

On 8/11/2026 at 8:07 AM, Chippy said:

I have started to think tracking symptoms for the most part doesn't help and maybe is more hassle/opens the door for hyper focusing on them then it is worth

For me I find it a useful coping mechanism for when symptoms are extreme.

It's not a daily symptom tracker, which I would find obsessive. I often go many days without writing, but it's always there when I need it.

I use it to see how my symptoms respond to things like diet change, supplement change, and any other psychoactive substances (like caffeine) I interact with.

I think when I started it I was hoping I would look back in a few years and see how drastically things had improved, sadly it just ended up being a catalogue of my deteriorating condition. It's helpful when medical professionals ask questions, at least, because my memory is rather spotty.

Edited August 12Aug 12 by Erimus

12 hours ago, Erimus said:

For me I find it a useful coping mechanism for when symptoms are extreme.

It's not a daily symptom tracker, which I would find obsessive. I often go many days without writing, but it's always there when I need it.

I use it to see how my symptoms respond to things like diet change, supplement change, and any other psychoactive substances (like caffeine) I interact with.

I think when I started it I was hoping I would look back in a few years and see how drastically things had improved, sadly it just ended up being a catalogue of my deteriorating condition. It's helpful when medical professionals ask questions, at least, because my memory is rather spotty.

I can see the benefit to your approach @Erimus

I do hope eventually you will be able to look back at the symptoms you do record and see progress. I think given enough time you will. Always wishing you well.

Bad news.

I have been trying CBD oil to try and help with the crushing pain I experience. I had been building up from 0.1mg over the last few weeks without trouble, until yesterday, when I tried 0.5mg for the first time.

Unfortunately, after yesterday’s dose, I developed moderate serotonin syndrome 1h45m post-ingestion, and spent 12 hours in hospital after an ambulance journey.

Apparently it can block the enzyme responsible for metabolising sertraline, and led to a massive overload of the drug and serotonin in my brain.

It was horrific. My heart rate went crazy and was elevated for a good few hours, body temp was high, blood pressure dropped, and I was lightheaded for hours. It was all the symptoms of serotonin toxicity I experience regularly, just magnified by 100. I felt like I’d taken 500mg.

It’s been over 27 hours since I took the CBD oil, and 33 hours since last sertraline dose, and I’m still getting waves of symptoms.

I had to skip my evening dose of sertraline yesterday, and based on symptoms, will have to skip both doses today.

I knew about all the risks of taking other psychoactive substances, but after 3 years of pain I reached breaking point, and began to experiment, which just caused more suffering.

I don’t know when I’ll next be able to take sertraline.

I was chucked out the hospital even though I still felt terrible, and left with no advice or support on how to proceed.

It made me realise how alone we are, and how, particularly in the UK, you can’t afford to get ill, because the waiting times for ambulances and doctors in emergency departments, are 6-8 hours.

Edited August 27Aug 27 by Erimus

1 hour ago, Erimus said:

Bad news.

I have been trying CBD oil to try and help with the crushing pain I experience. I had been building up from 0.1mg over the last few weeks without trouble, until yesterday, when I tried 0.5mg for the first time.

Unfortunately, after yesterday’s dose, I developed moderate serotonin syndrome 1h45m post-ingestion, and spent 12 hours in hospital after an ambulance journey.

Apparently it can block the enzyme responsible for metabolising sertraline, and led to a massive overload of the drug and serotonin in my brain.

It was horrific. My heart rate went crazy and was elevated for a good few hours, body temp was high, blood pressure dropped, and I was lightheaded for hours. It was all the symptoms of serotonin toxicity I experience regularly, just magnified by 100. I felt like I’d taken 500mg.

It’s been over 27 hours since I took the CBD oil, and 33 hours since last sertraline dose, and I’m still getting waves of symptoms.

I had to skip my evening dose of sertraline yesterday, and based on symptoms, will have to skip both doses today.

I knew about all the risks of taking other psychoactive substances, but after 3 years of pain I reached breaking point, and began to experiment, which just caused more suffering.

I don’t know when I’ll next be able to take sertraline.

I was chucked out the hospital even though I still felt terrible, and left with no advice or support on how to proceed.

It made me realise how alone we are, and how, particularly in the UK, you can’t afford to get ill, because the waiting times for ambulances and doctors in emergency departments, are 6-8 hours.

So sorry for the horror you went through but very glad you got out of it @Erimus serotonin syndrome is no joke!

I also tried CBD which felt wrong including other experiences that only fueled the flame even more, it seems, unfortunately, that apart from a lot of time and piles of patience there is no effective safe solution which is extra challenging but more the system is given the clean condition the more we will get out without unnecessary delays.

I hope things will ease for you soon, hang in there, eventually it will get better.

Edited August 27Aug 27 by Fullhealing

2 hours ago, Fullhealing said:

So sorry for the horror you went through but very glad you got out of it @Erimus serotonin syndrome is no joke!

I also tried CBD which felt wrong including other experiences that only fueled the flame even more, it seems, unfortunately, that apart from a lot of time and piles of patience there is no effective safe solution which is extra challenging but more the system is given the clean condition the more we will get out without unnecessary delays.

I hope things will ease for you soon, hang in there, eventually it will get better.

I used to be much more diligent about avoiding all psychoactive substances. Unfortunately, for the last 2 years, I have loosened my grip as I battled relentlessly with violent withdrawal and adverse effects.

It’s so awful living on the edge every day, being one wrong supplement, food, drug, or household chemical, away from catastrophic reactions.

I think, when faced with the reality that I might not get off these drugs, I start to think about how at some points I will need to take things. Obviously, this time was my choice, but it might not always be in my hands.

1 hour ago, Erimus said:

I used to be much more diligent about avoiding all psychoactive substances. Unfortunately, for the last 2 years, I have loosened my grip as I battled relentlessly with violent withdrawal and adverse effects.

It’s so awful living on the edge every day, being one wrong supplement, food, drug, or household chemical, away from catastrophic reactions.

I think, when faced with the reality that I might not get off these drugs, I start to think about how at some points I will need to take things. Obviously, this time was my choice, but it might not always be in my hands.

truly awful indeed but as we know there is no such thing as good drugs, new ones will only keep you trapped in cruel cycle that you are so eager to get out of.

I get your frustration so very well believe me, although you have been through a torturous path which may feel lost, it is just a feeling, in reality, the system is in a constant healing process that occurs amidst overwhelming difficulty.

I wish there was a prediction unfortunately there isn't, all I know that many have suffered for very long time and have come out to a clean life very much worth living.

Hang in there, it is brutal but the intensities change and it has an end.

Edited August 27Aug 27 by Fullhealing