It's been a long time coming for me. I was prescribed sertraline in university around 2008. I have OCD and was not informed of any possible side effects or dependence when I started, was basically told I would need to be on these for life. 

 

Starting 2024 I realized this drug was doing more harm than good. I started working with a de-prescriber who has been helpful. 

 

I've made it from 150mg to 47 in just over a year. I had to pause for about ten months due to some nervous system and OCD issues. I have been able to cope with the symptoms fairly well except for the sleep disruption, which I have found hard, as I already have some anxiety around sleep. 

 

Last week I resumed with a conservative 1mg taper from 47-46. But for some reason this has really affected my sleep. Past three nights I've slept maybe three hours, so quite discouraged. I have a job I need to keep up, I can't be operating on that little sleep. I really don't have any other withdrawal symptoms other than maybe slightly elevated heart rate, not nearly as bad as 50-47. So not sure why this is happening. 

 

To be honest I'm rather discouraged; if I am reacting like this to a 1mg taper how the heck am I going to be able to get off? 

Sleep is the hardest symptom for me to cope with during this withdrawal. Even very small reductions seem to trigger sleep disruptions even when i don't really even feel other symptoms. Is this unusual? 

Hi @Nathan_C

 

Welcome to the forum!

 

This is a volunteer-run, community forum aimed at helping those who are tapering and/or experiencing difficulties with psychiatric medications and withdrawl syndrome. We are not medical professionals and cannot offer medical advice. We simply offer support and opinions which you could use as talking points with a medical provider knowledgeable in withdrawing off psychiatric medications.

 

Please familiarise yourself with the forum rules and the disclaimer located here: Guidelines

 

Please make sure your signature is kept up to date with your drug history. This will allow members to see some basic information about your drug history and situation so that they may help you best. Information on how to do this is located in the FAQs section above, but here is a direct link: Update Signature

Once this is done, future posts made by you will have this signature turned on by default. For this reason please keep it clear but condensed as possible.

I'm so sorry to read about the tough time you've had recently you will find plenty of support here for sure.

 

11 hours ago, Nathan_C said:

was basically told I would need to be on these for life. 

This is a common story, Im so sorry. In the UK these drugs are only supposed to be used for 6-12 months, yet people seemed to get stuck on them for years! When they try to come off, they have WD symptoms, and their doctors assume it's relapse, and that they must need the drug, so they should stay on.

 

11 hours ago, Nathan_C said:

Starting 2024 I realized this drug was doing more harm than good. I started working with a de-prescriber who has been helpful. 

 

I've made it from 150mg to 47 in just over a year. I had to pause for about ten months due to some nervous system and OCD issues. I have been able to cope with the symptoms fairly well except for the sleep disruption, which I have found hard, as I already have some anxiety around sleep. 

 

It looks like you have been taper very quickly. Tapering Information

 

Could you update your signature with all dose changes you have done particularly the recent ones in this format?

 

01 Jan 2025 Sertraline 100mg

02 Feb 2025 Sertraline 150mg

and so on......

 

It would be helpful for us to get a clearer picture of what happening 🙂 

 

It's really common to have problems in WD with sleep. I think youve read our post on sleep in WD but here it is again just in case. Sleep in WD

 

11 hours ago, Nathan_C said:

Last week I resumed with a conservative 1mg taper from 47-46. But for some reason this has really affected my sleep. Past three nights I've slept maybe three hours, so quite discouraged. I have a job I need to keep up, I can't be operating on that little sleep. I really don't have any other withdrawal symptoms other than maybe slightly elevated heart rate, not nearly as bad as 50-47. So not sure why this is happening. 

 

It's possible your system is still very irritated from what looks to be a fast taper off a drug you have used for many years. I would remain here for the minute if you are getting WD symptoms.

 

Are you experiencing anything else other than disrupted sleep? Daily Checklist of Antidepressant Withdrawal Symptoms (P

 

11 hours ago, Nathan_C said:

To be honest I'm rather discouraged; if I am reacting like this to a 1mg taper how the heck am I going to be able to get off?

I understand. It can be a frustrating process. One day at a a time. Did you have any other symptoms during your taper? Did they resolve?

 

I look forward to more information from you.

 

In the mean time this is what I would do if I were you:

 

-Stay Hydrated 

 

-Eat a good clean whole food diet, avoiding processed foods and sugars.

 

-Stay away from caffeine, alcohol and antihistamines and any other psychoactive substances.

 

Supplements are to be avoided initially, as they often irritate our nervous systems. Try to get your nutrition through food.

 

Down the line, you may wish to introduce Fish Oil and Magnesium. Those who can tolerate them have found them calming to the nervous system. Be careful try one at a time and start low and see how you get on should you choose to try them.

 

A daily walk is very important as much as you can manage, if you can manage it. Gets you your fresh air and Vitamin D does wonders for your mind!

 

You are very welcome here and I hope you find the site supportive.

 

Chippy

10 hours ago, Nathan_C said:

Sleep is the hardest symptom for me to cope with during this withdrawal. Even very small reductions seem to trigger sleep disruptions even when i don't really even feel other symptoms. Is this unusual? 

Hey @Nathan_C Ive moved this post to your intro topic. We like to keep all posts about our journeys in here 🙂 

 

Can you tell us more about your sleep issues?

6 hours ago, Chippy said:

Hey @Nathan_C Ive moved this post to your intro topic. We like to keep all posts about our journeys in here 🙂 

 

Can you tell us more about your sleep issues?

It was fast at the beginning; but really I had no issues till I hit 50mg. I paused for almost a year at 47mg and was feeling great. 

 

This time I'm not getting much in the way of symptoms other than elevated heart rate and 'wired' feeling which seems to persist even when I'm tired. I guess its nervous system activation. I can't seem to affect if whatever I do. I do end up sleeping but its never more than 3 hours. I've also got OCD so I tend to catastrophize. Usually it's been in waves then I crash. I'm looking for ways to mentally cope and try to ride this out without getting too panicked. I worry its going to make me lose my job, etc. 

16 minutes ago, Nathan_C said:

It was fast at the beginning; but really I had no issues till I hit 50mg. I paused for almost a year at 47mg and was feeling great. 

This is common. Couple of reasons for it.

 

- You were on a very high dose of Sertraline. At very high doses, effect on the brain is minimal. So you can take quite big drops and have no issues. As you drop the doses have a larger proportional effect on the brain.

 

-WD symptoms can be delayed in onset by many months. They can also stack so you they all build up and hit you later on when you arent  expecting it.

 

-Each drop you seemed to get away with, but each time it was irritating your system, but it was coping, then eventually it snaps on you, particularly at the more potent does which you are just starting to hit.

 

21 minutes ago, Nathan_C said:

This time I'm not getting much in the way of symptoms other than elevated heart rate and 'wired' feeling which seems to persist even when I'm tired. I guess its nervous system activation. I can't seem to affect if whatever I do. I do end up sleeping but its never more than 3 hours. I've also got OCD so I tend to catastrophize. Usually it's been in waves then I crash. I'm looking for ways to mentally cope and try to ride this out without getting too panicked. I worry its going to make me lose my job, etc. 

It's good your symptoms are minimal but yes the sleep isn't great I understand.

 

See how you go now over the next month, you've only just dropped so hold here and see if your sleep improves any.

 

Have a read here and see if anything helps with the OCD. Keeping your mental well being in check is always good so anything you can do work on your OCD will only help things. Have a read of the WD sleep post. It is important to not get in your head about sleep. You will sleep as much as you can. Just accept that. If you dont sleep as much as you like than that is fine. That is what is happening at the moment. Just remind yourself it is not anything you are doing it is just the WD that is causing it.  

 

Non-drug techniques to cope with emotional symptoms

 

Acceptance is key

 

Sleep in WD

 

Some have to taper very gradually indeed. Maybe you need a more extended hold from here once your sleep has settled then try again. Every drop is a drop less, its not a race 🙂 

 

Chippy

1 hour ago, Chippy said:

This is common. Couple of reasons for it.

 

- You were on a very high dose of Sertraline. At very high doses, effect on the brain is minimal. So you can take quite big drops and have no issues. As you drop the doses have a larger proportional effect on the brain.

 

-WD symptoms can be delayed in onset by many months. They can also stack so you they all build up and hit you later on when you arent  expecting it.

 

-Each drop you seemed to get away with, but each time it was irritating your system, but it was coping, then eventually it snaps on you, particularly at the more potent does which you are just starting to hit.

 

It's good your symptoms are minimal but yes the sleep isn't great I understand.

 

See how you go now over the next month, you've only just dropped so hold here and see if your sleep improves any.

 

Have a read here and see if anything helps with the OCD. Keeping your mental well being in check is always good so anything you can do work on your OCD will only help things. Have a read of the WD sleep post. It is important to not get in your head about sleep. You will sleep as much as you can. Just accept that. If you dont sleep as much as you like than that is fine. That is what is happening at the moment. Just remind yourself it is not anything you are doing it is just the WD that is causing it.  

 

Non-drug techniques to cope with emotional symptoms

 

 

Acceptance is key

 

Sleep in WD

 

Some have to taper very gradually indeed. Maybe you need a more extended hold from here once your sleep has settled then try again. Every drop is a drop less, its not a race 🙂 

 

Chippy

I'm going to hold out here until I am stable. I am basically doing a 2-3% taper due to my extended use to be safe. It will take as long as it takes but I'm committed. Thanks for your help. 

Update - I slept well last night. I am trying to just practice acceptance. 

 

So far other than the sleep the 1mg cut has not been hard, I probably could have gone 2mg but I think the conservative taper route is smart. 

 

I think what is the heaviest weight is the fact that I have a long road ahead. 

7 hours ago, Nathan_C said:

Update - I slept well last night. I am trying to just practice acceptance. 

 

So far other than the sleep the 1mg cut has not been hard, I probably could have gone 2mg but I think the conservative taper route is smart. 

 

I think what is the heaviest weight is the fact that I have a long road ahead. 

I’m glad to hear this. You might find you get a little pattern after each drop and it resolves. You’ll find the rhythm. 
 

It’s not a race. As I said every little drop is a drop closer. Better to be stable and taper than rush off and end up in pwd. 

It is good that your poor sleep resolved a while after your drop. You could consider dropping 0.5mg at a time instead of 1mg and see if that makes the sleep disturbances less severe after the initial drop.

I'm decent now other than my mood has crashed and my orgasm is really muted. The latter symptom is really distressing for me as the main motivation for getting off was to improve my sexual function. It had drastically improved until about a month ago. What the hell man. I feel pretty distraught. 

How the heck am I going to do this if I am still 46mg away from the goal and already creeping down 1mg? What a bloody nightmare this is for all of us. 

1 hour ago, Nathan_C said:

How the heck am I going to do this if I am still 46mg away from the goal and already creeping down 1mg? What a bloody nightmare this is for all of us. 

Not sure if you'll find this helpful or not @Nathan_C. When I came to the realisation that it was going to take a lot longer than I'd envisioned I had to change my goal from getting off as fast as I could to tapering to stay functional. I've got 5 psychiatric drugs to taper so here for the long haul

55 minutes ago, Catbird said:

Not sure if you'll find this helpful or not @Nathan_C. When I came to the realisation that it was going to take a lot longer than I'd envisioned I had to change my goal from getting off as fast as I could to tapering to stay functional. I've got 5 psychiatric drugs to taper so here for the long haul

I have reframed it that way; however sometimes it still seems like too much to handle. 

1 hour ago, Nathan_C said:

I have reframed it that way; however sometimes it still seems like too much to handle. 

Of course it does. sometimes I feel like I have pharmacological handcuffs on. It sucks big time. I'm trying to get on with life as best I can but there's no getting away from it. It's the elephant in the room unfortunately. Try to live life best you can and definitely try to have fun.  I haven't laughed, like really laughed for years. Last night I had a panic surge which I accepted, acknowledged and it diminished within minutes. My partner was in bed doing stuff on the phone and she started laughing. when asked what she was going she said she was looking at clothes online for something to wear to her niece's wedding. The site used AI so you could use a photo of yourself to "try on" different outfits — the final pictures had us in hysterics. I hadn't experienced something so funny in ages. we were both shrieking, laughing and crying all at once. Best 10 minutes of the last 7 years. I couldn't belief I'd gone from sheer panic to hysterics in the space of 2 hours.  I definitely need more episodes like that.  Best of all it doesn't cost anything (as long as you don't buy any of the hideous clothes!!)

Right now I feel anhedonic, every time it starts looking up something else seems to go wrong with my body. 

8 hours ago, Nathan_C said:

Right now I feel anhedonic, every time it starts looking up something else seems to go wrong with my body. 

I’m sorry to hear this. How would rate your symptoms out 10? 10 being thé worst?

 

Current symptom list is poor sleep and now emotional numbing?

16 hours ago, Chippy said:

I’m sorry to hear this. How would rate your symptoms out 10? 10 being thé worst?

 

Current symptom list is poor sleep and now emotional numbing?

Honestly the physical symptoms are quite manageable, I'm just feeling anhedonic and what is really causing me distress is that orgasm is very muted, more so than when i was on a high dose. Which is strange because it really improved as i was tapering. This is a really hard thing for me to tolerate, taking my motivation away. My distress is maybe 8/10 but physically I'm 2 or 3/10

Honestly I feel hopeless right now. 

 

As I started tapering, my sexual function improved, sensitivity, erection, orgasm. 

 

My sensitivity and erection are still quite good, but in the last month orgasm has gotten really muted. 

 

I am now terrified of PSSD, I cannot live with it. I do not know what to do. I am so far away from being finished this hellish journey. 

14 hours ago, Nathan_C said:

Honestly the physical symptoms are quite manageable, I'm just feeling anhedonic and what is really causing me distress is that orgasm is very muted, more so than when i was on a high dose. Which is strange because it really improved as i was tapering. This is a really hard thing for me to tolerate, taking my motivation away. My distress is maybe 8/10 but physically I'm 2 or 3/10

This is good. Emtional numbing and sexual dysfuction are linked for sure. I suspect as your sysmptoms ease so with the sexual elements.

 

You have a couple of choices. You could catch this now with an updose and see if it eases things. But it sounds like it isn't too bad for you at 3/10. Plus you say certain things improved once you tapered. So Im not sure I would do that.

 

I think perhaps you are more stressed about the potential of what you think is coming rather than the actual symptoms themselves?

 

Have a look at some non drug coping skills I linked for you above. Working on our mindset is important in WD.

 

Once you are more stable I would suggets you try Micro Tapering down from here. Basicaly 1/30 of your monthly drop, to trick your brain into not knowing you are tapering. Seems to work well for many.

 

Micro Taper

3 hours ago, Chippy said:

This is good. Emtional numbing and sexual dysfuction are linked for sure. I suspect as your sysmptoms ease so with the sexual elements.

 

You have a couple of choices. You could catch this now with an updose and see if it eases things. But it sounds like it isn't too bad for you at 3/10. Plus you say certain things improved once you tapered. So Im not sure I would do that.

 

I think perhaps you are more stressed about the potential of what you think is coming rather than the actual symptoms themselves?

 

Have a look at some non drug coping skills I linked for you above. Working on our mindset is important in WD.

 

Once you are more stable I would suggets you try Micro Tapering down from here. Basicaly 1/30 of your monthly drop, to trick your brain into not knowing you are tapering. Seems to work well for many.

 

Micro Taper

Orgasm has plummeted now, I'm terrified of PSSD. Everything else is working except orgasm, which is hardly present now. 

1 minute ago, Nathan_C said:

Orgasm has plummeted now, I'm terrified of PSSD. Everything else is working except orgasm, which is hardly present now. 

Im sorry @Nathan_C try not to worry about things you can’t control. Trust your body to put things right. 
 

Ill tag @Luke here he has a lot of more experience with people suffering with sexual side effects than I do. 

A muted orgasm and no other sexual side effects is fairly mild sexual dysfunction.

 

You just can't know what will happen with your sexual function after stopping, but that's not necessarily a negative thing- there's no indication that you'll have PSSD long-term after stopping.

 

You've made dose drops that have caused symptoms, and it seems that you're cycling through some of them- the difficulty sleeping might have ended but others are cropping up. It's not necessarily unusual that you're experiencing fluctuations in symptoms after a dose drop that destabilised you and the sexual ones are likely just part of that.

 

I would also consider whether the catastrophising is part of the ruminating, withdrawal thinking and you're experiencing a general "wave" after the drop you made. I understand that it is a worrying symptom but a fluctuation in a symptom you had on the drug tapering is not an indication you're going to have PSSD for life in a condition that is not liveable- you had this symptom on the drug, it began to improve as you tapered, it's now fluctuating somewhat. That's not that surprising.

 

The dose drop was 1.5 weeks ago, you had 5 nights of poor sleep which left you really discouraged, which then stabilised. I realise that this is also distressing but we're talking days here- all you can do is give it more time and hope that it also stabilises.

3 hours ago, Luke said:

A muted orgasm and no other sexual side effects is fairly mild sexual dysfunction.

 

You just can't know what will happen with your sexual function after stopping, but that's not necessarily a negative thing- there's no indication that you'll have PSSD long-term after stopping.

 

You've made dose drops that have caused symptoms, and it seems that you're cycling through some of them- the difficulty sleeping might have ended but others are cropping up. It's not necessarily unusual that you're experiencing fluctuations in symptoms after a dose drop that destabilised you and the sexual ones are likely just part of that.

 

I would also consider whether the catastrophising is part of the ruminating, withdrawal thinking and you're experiencing a general "wave" after the drop you made. I understand that it is a worrying symptom but a fluctuation in a symptom you had on the drug tapering is not an indication you're going to have PSSD for life in a condition that is not liveable- you had this symptom on the drug, it began to improve as you tapered, it's now fluctuating somewhat. That's not that surprising.

 

The dose drop was 1.5 weeks ago, you had 5 nights of poor sleep which left you really discouraged, which then stabilised. I realise that this is also distressing but we're talking days here- all you can do is give it more time and hope that it also stabilises.

I've never had muted orgasm to this degree even on high doses of drug, it's like barely anything. Never happened any other time during the taper either. 

 

Maybe I am over-reacting or I'm weak, but the muting started before I dropped down and then got worse which is confusing. I must admit I do have OCD which makes coping much harder. 

 

I also just feel a complete lack of pleasure generally, like everything is a slog. Typically I was having physical withdrawal symptoms but nothing like this. 

 

I apologize, I am just unable to contemplate living with PSSD. I'm scared. 

Edited March 11Mar 11 by Nathan_C

8 hours ago, Nathan_C said:

I've never had muted orgasm to this degree even on high doses of drug, it's like barely anything. Never happened any other time during the taper either. 

 

Yes, I understand that. It's still a symptom that you experienced whilst on the drug, that's fluctuating whilst you're tapering it.

  

8 hours ago, Nathan_C said:

I must admit I do have OCD which makes coping much harder. 

 

I wouldn't discount withdrawal heavily influencing this type of thinking. It did for me, as it has and does for many others.

 

 

There's no need to apologise.