Thank you, @Fullhealing, for your words of hope to everyone of us. Your advises to the other suffers help me to keep one's head above water. There are not words to describe this Hell on Earth we go throughout.

14 hours 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.

Im so sorry to read this. I can understand you wanting to carefully try something to help yourself. Breaks my heart reading tbh.

What are your plans? RI the dose in a couple of days when things have calmed down and hope that keep WD at bay?

14 hours ago, Erimus said:

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.

Yes, and often once someone has had emergency care, that's the end of the road for them in terms of medical care, or at least anything further is often very poor and with long waiting times.

I'm really sorry to hear about all of this.

Do you any observations from skipping doses of sertraline?

9 hours ago, Chippy said:

What are your plans? RI the dose in a couple of days when things have calmed down and hope that keep WD at bay?

9 hours ago, Luke said:

Do you any observations from skipping doses of sertraline?

As of right now, I still feel wired with serotonin.

I tried 12.5mg sertraline at 1400 today, but I am already regretting it.

I don’t feel like I’ve missed doses at all. The serotonin level seems to have gone so high that my brain can sustain for some time without more sertraline.

My research tells me that CBD basically blocks the enzyme that metabolises sertraline, causing huge increases in blood concentration.

Apparently, it can take anywhere from 3-7 days for the CBD/THC to fully clear from my system.

On top of that, my body has to metabolise all the extra sertraline that accumulated.

Reintroduction of the drug seems like it’s going to be a nightmare.

I’m trying to drink lots of water and eat plenty fibre to remove it faster, but from what I’ve gathered it’s mostly time that clears it.

This is the worst mistake I’ve made in the ~5.5 yrs since I began tapering.

Edited August 28Aug 28 by Erimus

5 minutes ago, Erimus said:

As of right now, I still feel wired with serotonin.

I tried 12.5mg sertraline at 1400 today, but I am already regretting it.

I don’t feel like I’ve missed doses at all. The serotonin level seems to have gone so high that my brain can sustain for some time without more sertraline.

My research tells me that CBD basically blocks the enzyme that metabolises sertraline, causing huge increases in blood concentration.

Apparently, it can take anywhere from 3-7 days for the CBD/THC to fully clear from my system.

On top of that, my body has to metabolise all the extra sertraline that accumulated.

Reintroduction of the drug seems like it’s going to be a nightmare.

I’m trying to drink lots of water and eat plenty fibre to remove it faster, but from what I’ve gathered it’s mostly time that clears it.

This is the worst mistake I’ve made in the ~5.5 yrs since I began tapering.

Im so sorry to hear about the suffering youve had to endure.. this is news to me that cbd would cause such a horrible time when on ssris as i used to take cbd gummies at times while on escitalopram before all this WD stuff. Its natural to want to find something that could possibly help so please dont blame yourself.

16 minutes ago, Erimus said:

As of right now, I still feel wired with serotonin.

I tried 12.5mg sertraline at 1400 today, but I am already regretting it.

I don’t feel like I’ve missed doses at all. The serotonin level seems to have gone so high that my brain can sustain for some time without more sertraline.

My research tells me that CBD basically blocks the enzyme that metabolises sertraline, causing huge increases in blood concentration.

Apparently, it can take anywhere from 3-7 days for the CBD/THC to fully clear from my system.

On top of that, my body has to metabolise all the extra sertraline that accumulated.

Reintroduction of the drug seems like it’s going to be a nightmare.

I’m trying to drink lots of water and eat plenty fibre to remove it faster, but from what I’ve gathered it’s mostly time that clears it.

This is the worst mistake I’ve made in the ~5.5 yrs since I began tapering.

I’m sorry. What a nightmare.

Just a thought. Have you considered the possibility of ri a low dose when you’re ready and seeing if that is enough to keep back the worst of wd instead of a full dose?

2 hours ago, Chippy said:

Just a thought. Have you considered the possibility of ri a low dose when you’re ready and seeing if that is enough to keep back the worst of wd instead of a full dose?

Yes. My biggest concern right now is my brain adapting to the higher levels or serotonin, and then going into severe withdrawal when I resume taking my usual dose.

Historically, my brain has adapted to increases in dose really quickly, to the point it will not allow the removal of them after a matter of days to weeks.

7 hours ago, Erimus said:

Yes. My biggest concern right now is my brain adapting to the higher levels or serotonin, and then going into severe withdrawal when I resume taking my usual dose.

For sure.

7 hours ago, Erimus said:

Historically, my brain has adapted to increases in dose really quickly, to the point it will not allow the removal of them after a matter of days to weeks

So you think the low dose ri wouldn’t be sufficient, 3mg or something like that, to keep your brain stable but reduce the negative effects of being on a ‘full’ dose?

Hey @Erimus ,

I’m so so sorry this happened to you. I thought I would comment to offer support as someone who has also been through serotonin syndrome, it was rough and so so scary and mine was classes as “mild/mod” because I didn’t have seizures. The hospital didn’t even recognise it and actually a nurse told me I needed to calm down when experiencing serotonin induced akathesia.

Anyway, as expected the doctors didn’t know how to help at all. It took me 3/4 days to come down off the serotonin high and I was told it would be 24 hours. I don’t know the next steps in terms of RI because I was an ADR case technically from only 3 pills. If you have any q’s though, I am 13 months out and happy to support! There’s a content creator - Jason Hernandez - who is in a similar position to you, trying to get off a drug but suffered serotonin syndrome. Might be worth reaching out?

All the best, G

4 hours ago, SparklingG said:

I thought I would comment to offer support as someone who has also been through serotonin syndrome, it was rough and so so scary and mine was classes as “mild/mod” because I didn’t have seizures. The hospital didn’t even recognise it and actually a nurse told me I needed to calm down when experiencing serotonin induced akathesia.

Thanks for the reply. Yes, I mentioned serotonin syndrome many times, as I immediately recognised what was happening to me. Seemingly nobody is well versed on it, which is alarming considering the number of people on serotonin drugs. When I finally saw the doctor, some 8 or so hours after it started, she did check for signs of it, by which point my system had calmed down somewhat.

4 hours ago, SparklingG said:

Anyway, as expected the doctors didn’t know how to help at all. It took me 3/4 days to come down off the serotonin high and I was told it would be 24 hours. I don’t know the next steps in terms of RI because I was an ADR case technically from only 3 pills.

I am over 3 days in now and still getting smaller episodes of the serotonin high throughout the day. As of now my plan is to avoid taking sertraline for as long as possible, until I enter back into withdrawal. Unfortunately I have no choice but to continue taking the drug given my protracted withdrawal and taper.

4 hours ago, SparklingG said:

ort! There’s a content creator - Jason Hernandez - who is in a similar position to you, trying to get off a drug but suffered serotonin syndrome. Might be worth reaching out?

Thanks, I will check it out.

Sending some love ❤️❤️❤️

I truly hope the flames continue to gently fade away @Erimus Hang in there, smoother, easier days are steadily heading your way.

17 hours ago, Erimus said:

I am over 3 days in now and still getting smaller episodes of the serotonin high throughout the day. As of now my plan is to avoid taking sertraline for as long as possible, until I enter back into withdrawal. Unfortunately I have no choice but to continue taking the drug given my protracted withdrawal and taper.

There's no clear and obvious right answer.

I would potentially start very small, when you do start, and then increase it if it clearly isn't enough as @Chippy suggested.

17 hours ago, Erimus said:

Seemingly nobody is well versed on it, which is alarming considering the number of people on serotonin drugs.

Even the clinical information you can read about it is extremely basic and sparse and it's pretty clear that medicine has gone "wow this is very dangerous and sometimes even fatal...oh well".

18 hours ago, Erimus said:

Thanks for the reply. Yes, I mentioned serotonin syndrome many times, as I immediately recognised what was happening to me. Seemingly nobody is well versed on it, which is alarming considering the number of people on serotonin drugs. When I finally saw the doctor, some 8 or so hours after it started, she did check for signs of it, by which point my system had calmed down somewhat.

I’m so sorry you had the same experience. It really is not studied enough. They literally told me I was having a panic attack 🙄. That came on shortly after taking a drug 🙄. The featured all the symptoms of SS without the seizures 🙄. That’s after effects have lasted 13 months and counting 🙄. Anyway, not surprised but very sorry for you.

18 hours ago, Erimus said:

I am over 3 days in now and still getting smaller episodes of the serotonin high throughout the day. As of now my plan is to avoid taking sertraline for as long as possible, until I enter back into withdrawal. Unfortunately I have no choice but to continue taking the drug given my protracted withdrawal and taper.

Thanks, I will check it out.

I hope it starts to ease off for you soon, it will. Many people find that they are unable to return to their drug due to adverse reaction though, I’m on a Facebook group for SS that has others experiences and it may be worth reaching out? SS seems to change the way your body processes these drugs, it’s a different type of receptor damage.

I’ve taken 12.5mg of sertraline for the last 3 days and am managing reasonably well.

All things well I will try 25mg, half my usual dose, tomorrow.

The withdrawal symptoms have been creeping back in yesterday and today.

Ideally I would like to be back on my normal dose no later than 7 days post reaction (this coming Wednesday), but I will see how my body responds.

Edited August 30Aug 30 by Erimus

I had 25mg sertraline in total yesterday, plus 12.5mg this morning, and it has been too much.

Obviously still too soon.

I'm sorry to hear that. It's going to be a balancing act, I think.

6 hours ago, Erimus said:

I had 25mg sertraline in total yesterday, plus 12.5mg this morning, and it has been too much.

Obviously still too soon.

Hi Erimus,

What symptoms are you getting when you try to updose? Are you able to do it more slowly? I’m so sorry you are going through this, it’s such a rock and a hard place situation.

17 hours ago, SparklingG said:

Hi Erimus,

What symptoms are you getting when you try to updose? Are you able to do it more slowly? I’m so sorry you are going through this, it’s such a rock and a hard place situation.

Just milder versions of the symptoms I experienced during the reaction last Wednesday, which is still pretty terrifying.

Based on the fact I have not entered severe withdrawal yet, there is obviously still more than enough sertraline circulating in my blood.

When the sertraline level drops below what my body expects I should enter withdrawal, and be able to updose.

Right now I am taking 12.5mg, split into morning and evening, as usual.

Edited September 1Sep 1 by Erimus

Still struggling to take more than 12.5mg per day at this point.

Between Wednesday and Friday this week I ended up skipping 4 doses in a row, the symptoms of serotonin overload were just too much.

By the end of the second day I was noticing withdrawal symptoms so added 12.5mg back in.

I don’t really know what I’m doing. I’m frightened about still not being on my usual dose, and I’m frightened about taking too much and my brain adapting to more serotonin than usual.

I’m 11 days post-reaction.

I just want to be back on my normal dose, and suffering from my normal withdrawal hell. I don’t like the inconsistency and chaos of this.

Edited September 6Sep 6 by Erimus

4 hours ago, Erimus said:

Still struggling to take more than 12.5mg per day at this point.

Between Wednesday and Friday this week I ended up skipping 4 doses in a row, the symptoms of serotonin overload were just too much.

By the end of the second day I was noticing withdrawal symptoms so added 12.5mg back in.

I don’t really know what I’m doing. I’m frightened about still not being on my usual dose, and I’m frightened about taking too much and my brain adapting to more serotonin than usual.

I’m 11 days post-reaction.

I just want to be back on my normal dose, and suffering from my normal withdrawal hell. I don’t like the inconsistency and chaos of this.

I’ve never commented on your thread before, but I’ve read some of your history and just want you to know I’m thinking of you 🙂

14 hours ago, Erimus said:

Still struggling to take more than 12.5mg per day at this point.

Between Wednesday and Friday this week I ended up skipping 4 doses in a row, the symptoms of serotonin overload were just too much.

By the end of the second day I was noticing withdrawal symptoms so added 12.5mg back in.

I don’t really know what I’m doing. I’m frightened about still not being on my usual dose, and I’m frightened about taking too much and my brain adapting to more serotonin than usual.

I’m 11 days post-reaction.

I just want to be back on my normal dose, and suffering from my normal withdrawal hell. I don’t like the inconsistency and chaos of this.

Hi Erimus,

I’m so sorry you are still struggling to get up to your dose. Gently, it is my anecdotal experience (of the SS groups I am part of) that some people are not able to tolerate serotonin based medication at normal doses again. I believe SS is a different type of injury than withdrawal, many people don’t experience a “withdrawal” after SS but they still are unable to tolerate serotonin based meds again.

Most are advised to CT because of SS, from the group I’m in I’ve only seen a very small handlful that were able to successfully get back onto psychiatric meds, however, as mentioned many didn’t have the intense need due to lack of withdrawal. Have you tried asking on one of the SS groups? I know this is a really scary prospect but if the body simply will not tolerate the medication anymore is it possible to try splitting the dose more and lowering? Acute SS symptoms are horrific and scary, I’m so so sorry you are going through this. There is no playbook for this bit but just know we are all here for you whatever you do. Have you reached out to any of the professionals? Thinking of you Erimus 🫂

15 hours ago, Erimus said:

Still struggling to take more than 12.5mg per day at this point.

Between Wednesday and Friday this week I ended up skipping 4 doses in a row, the symptoms of serotonin overload were just too much.

By the end of the second day I was noticing withdrawal symptoms so added 12.5mg back in.

I don’t really know what I’m doing. I’m frightened about still not being on my usual dose, and I’m frightened about taking too much and my brain adapting to more serotonin than usual.

I’m 11 days post-reaction.

I just want to be back on my normal dose, and suffering from my normal withdrawal hell. I don’t like the inconsistency and chaos of this.

Sorry things are so tough still.

I can understand how scary this must be. I have to admit I can't help but think @SparklingG is right. We see so many CT these drugs, then RI small amounts, this is enough often to prop up their nervous system. I can't shake the idea that this could be a way to help deal with the SS and keep the WD more at bay better than a straight CT would.

Thinking of you @Erimus

I would caution against being too dogmatic about being on your "normal dose".

You might find this settles at a tolerable, stable state but at a lower dose. That's not necessarily a bad outcome. Perhaps you will need to go back up to it, but if you end up stable but not at it, that's potentially ok.

I'm sorry I don't have anything to add I've just been thinking about you since I read about this incident a week ago and before this happened I always just hoped you'd catch a break because you're the last person that needed any more on his plate. Maybe something about CBD and other products causing this issue might be posted somewhere to warn people so some good can come out of this mess.

Edited September 7Sep 7 by N2deep