MY SA THREAD: https://www.survivingantidepressants.org/forums/topic/31402-leminaseri-introduction-of-myself/#comment-700821

Hello everyone,

For my previous history, you can look at my thread on Surviving Antidepressants.

I honestly do not really have the mental capacity to write this post right now. But I have enough time, so I still want to try.

My last post on SA was about my libido and anhedonia getting worse the closer I got to zero. At that time I was around 7.6 mg of Zoloft. I eventually reached 6.8 mg and stayed around that dose for a few months. Things became much worse around one and a half months ago.

To give some context, I originally took 100 mg of Zoloft for several years. In March 2023 I reduced from 50 mg to 25 mg. Looking back, that was probably the first major crash. After that reduction my libido basically disappeared. I also developed a clear loss of genital sensation.

I then stayed around 25 mg for approximately 14 months. After that I started tapering much more gradually. I reduced from 25 mg to 22.5 mg and later continued with smaller percentage reductions. During this period I repeatedly noticed that my sexual symptoms became worse after reductions.

By September 2025 I was around 7.8 mg. I reduced from 7.8 mg to 7.6 mg, which was only around 2.6 percent. About two weeks later I developed symptoms that were new for me at that intensity. I started getting burning, tingling and numb sensations in different parts of my body. My fingertips were affected and my perception of heat seemed reduced in some areas. Some of those symptoms later improved again.

Until recently I had been tapering by around 2 to 3 percent per month.

I then paid 500 dollars for an online consultation with Mark Horowitz. His new recommendation was to reduce by 0.01 to 0.02 mg every day instead of making one reduction and then holding.

And man, that crashed me hard.

Mark told me that my brain would almost not notice reductions that small. I do not blame him for what happened. Maybe this method works very well for the majority of his patients. My nervous system simply seems to react differently.

I tried reducing by 0.02 mg per day for five days. One night before going to sleep I suddenly became extremely anxious and physically restless. My first thought was akathisia, which obviously made me even more anxious. After holding the dose for around one week, the anxiety and activation started settling down.

That encouraged me to try again.

I did another series of five days at 0.02 mg per day.

The same type of crash happened again, but this time something new happened in my pelvis. My pelvic floor became incredibly tense and my genitals started burning severely. My feet were burning as well. I have also had burning and sensory symptoms in my feet and other areas before, so I became suspicious about small fiber neuropathy. I am planning to have this investigated.

The pelvic and genital symptoms have become one of the worst parts of this entire experience. I now have burning in the penis, tactile genital numbness and a pelvic floor that often feels extremely tense and uncomfortable. Sitting on harder surfaces can even cause pain around my sitting bones and the whole pelvic region.

Before these recent crashes, my libido had already been almost completely gone for years. But my actual sexual functioning was still much better than it is now. I could still have reasonably pleasurable orgasms and sex could still feel physically good despite the absence of libido.

After these two short tapering attempts and the onset of the severe burning and pelvic symptoms, everything seemed to crash together.

Sex now feels almost completely flat. My orgasms are much weaker. My erections are weaker, including morning erections, although they are still present to some degree. My genital sensation is significantly reduced and at times my penis can feel almost absent when I am not touching it.

To me this feels very much like a PSSD type syndrome, even though technically I am still taking the drug. As a married man, this is extremely distressing.

At the moment I am at 6.52 mg of Zoloft and I have stopped tapering. My plan is to hold this dose for at least three months and probably longer if necessary. I do not want to introduce another major change while my nervous system is this unstable.

I also made several lifestyle changes because I genuinely wanted to improve my health. I stopped drinking coffee and quit smoking cigarettes. I also switched to a ketogenic diet because I hoped it might help my metabolism, mood and overall recovery. Looking back, I cannot rule out that making several changes around the same time may have put additional stress on my system and perhaps even made some symptoms worse instead of better. That is difficult for me to accept because all of these changes were meant to support my health, not destabilize it further.

Despite everything, I am still trying to live a reasonably normal life. I recently started vocational training and I am trying very hard to keep functioning even though mentally and physically this has become extremely difficult.

I still hope that my nervous system can stabilize and that some of these symptoms can improve again with enough time. I have already seen certain sensory symptoms fluctuate and improve in the past, so I am trying not to assume that the way I feel right now is permanent.

Thank you very much for keeping this forum active.

There really has not been another place where I could find a community of people who understand what this kind of withdrawal can actually feel like.

Edited September 10Sep 10 by SarahMc

I would like to add, that I get, since my last crash, every day 1h after I take my Zoloft inner restlessness. I can sit still. I would say it’s moderate. But I’m afraid it will develop to something more serious. This happens exactly 1h after taking my dose.

Any advice?

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 withdrawa

l 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.

Please use the format outline here Preferred signature/drug history format

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

2 hours ago, leminaseri said:

To give some context, I originally took 100 mg of Zoloft for several years. In March 2023 I reduced from 50 mg to 25 mg. Looking back, that was probably the first major crash. After that reduction my libido basically disappeared. I also developed a clear loss of genital sensation.

I then stayed around 25 mg for approximately 14 months. After that I started tapering much more gradually. I reduced from 25 mg to 22.5 mg and later continued with smaller percentage reductions. During this period I repeatedly noticed that my sexual symptoms became worse after reductions.

By September 2025 I was around 7.8 mg. I reduced from 7.8 mg to 7.6 mg, which was only around 2.6 percent. About two weeks later I developed symptoms that were new for me at that intensity. I started getting burning, tingling and numb sensations in different parts of my body. My fingertips were affected and my perception of heat seemed reduced in some areas. Some of those symptoms later improved again.

I'm so sorry your taper has been so hard on you. Just to clarify, when you were making your reductions in the period before last September, would your symptoms fully resolve between reductions or did they stick around at the same intensity and then become worse again each time you dropped?

3 hours ago, leminaseri said:

Until recently I had been tapering by around 2 to 3 percent per month.

I then paid 500 dollars for an online consultation with Mark Horowitz. His new recommendation was to reduce by 0.01 to 0.02 mg every day instead of making one reduction and then holding.

And man, that crashed me hard.

Mark told me that my brain would almost not notice reductions that small. I do not blame him for what happened. Maybe this method works very well for the majority of his patients. My nervous system simply seems to react differently.

I tried reducing by 0.02 mg per day for five days. One night before going to sleep I suddenly became extremely anxious and physically restless. My first thought was akathisia, which obviously made me even more anxious. After holding the dose for around one week, the anxiety and activation started settling down.

That encouraged me to try again.

I did another series of five days at 0.02 mg per day.

The same type of crash happened again, but this time something new happened in my pelvis. My pelvic floor became incredibly tense and my genitals started burning severely. My feet were burning as well. I have also had burning and sensory symptoms in my feet and other areas before, so I became suspicious about small fiber neuropathy. I am planning to have this investigated.

I think this kind of micro-tapering is a pretty standard recommendation for someone who is very sensitive to reductions, but I'm so sorry it didn't work out for you. Did you feel like you were stable at the 7.6 mg dose before you started the micro-taper?

3 hours ago, leminaseri said:

To me this feels very much like a PSSD type syndrome, even though technically I am still taking the drug. As a married man, this is extremely distressing.

I would really try not to worry about the PSSD label. We have people on this forum, and I know of several others off the forum, who have recovered from PSSD-type symptoms. I think it's most likely that these symptoms are part of your withdrawal syndrome, and that they will resolve with time along with your other symptoms.

3 hours ago, leminaseri said:

At the moment I am at 6.52 mg of Zoloft and I have stopped tapering. My plan is to hold this dose for at least three months and probably longer if necessary. I do not want to introduce another major change while my nervous system is this unstable.

I definitely think this is the way to go for the moment. I would try not to put a firm timeline on it though, and simply say that you will hold until you feel stable enough to taper, however long that may take. We generally consider stability to be withdrawal symptoms of between a 1-3/10 in severity (10 being very severe) for a prolonged period of time.

3 hours ago, leminaseri said:

I also made several lifestyle changes because I genuinely wanted to improve my health. I stopped drinking coffee and quit smoking cigarettes. I also switched to a ketogenic diet because I hoped it might help my metabolism, mood and overall recovery. Looking back, I cannot rule out that making several changes around the same time may have put additional stress on my system and perhaps even made some symptoms worse instead of better. That is difficult for me to accept because all of these changes were meant to support my health, not destabilize it further.

When did you make these changes? We do advise folks to avoid caffeine and nicotine, but I have seen examples of folks who have quit these substances abruptly while tapering or in protracted withdrawal and have had issues, so I wouldn't be surprised if this caused at least a temporary worsening of symptoms for you.

I know the keto diet has helped some people as well, but we do advise you to be cautious about it and to work with a coach if possible. Keto can sometimes mask withdrawal symptoms but it is not a cure and folks can have trouble coming back off the diet. This is not to discourage you if you feel like keto is helping you -- just be careful as you would be with anything else in WD.

3 hours ago, leminaseri said:

Despite everything, I am still trying to live a reasonably normal life. I recently started vocational training and I am trying very hard to keep functioning even though mentally and physically this has become extremely difficult.

I still hope that my nervous system can stabilize and that some of these symptoms can improve again with enough time. I have already seen certain sensory symptoms fluctuate and improve in the past, so I am trying not to assume that the way I feel right now is permanent.

I'm really glad that you're able to function reasonably well even though I know this is very hard. I think it is very likely that if you give your nervous system some time you will start to see things improving. Of course there will likely be some bumps along the way to stability, but what we see in the community is really that time is the healer and nothing is permanent. It's certainly a good sign that you've noticed symptoms fluctuating and improving previously, that means your nervous system is searching for that equilibrium and will find it given enough time.

 

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.

1 hour ago, leminaseri said:

I would like to add, that I get, since my last crash, every day 1h after I take my Zoloft inner restlessness. I can sit still. I would say it’s moderate. But I’m afraid it will develop to something more serious. This happens exactly 1h after taking my dose.

Any advice?

We have at least a couple members here who experience similar adverse reactions shortly after taking their dose. I suspect that it's yet another sign of a destabilized nervous system and I would hope it would start to improve as you hold.

Are you taking your dose all at once? One option might be to try splitting it and taking your dose twice a day to see if that helps with the reaction, but I'd like to see what others think before you move forward with that. Tagging @Chippy here for his thoughts.

Hey @leminaseri Welcome to the forum, I am so sorry you are having such a rough time of it. I have some experience of Sertraline and Sexual Dysfunction whilst on the drug so I empathise with what that feels like. I was very lucky and as I reduced that function returned to normal.

Looking at your signature this all started in many ways from the CT from Lexapro, I suspect this was the start of this for you. Coming off that fast would have primed you for harm no doubt. Then the fast taper from Sertaline continued this for you.

12 hours ago, SarahMc said:

Just to clarify, when you were making your reductions in the period before last September, would your symptoms fully resolve between reductions or did they stick around at the same intensity and then become worse again each time you dropped?

Would be good to know......

16 hours ago, leminaseri said:

I then paid 500 dollars for an online consultation with Mark Horowitz. His new recommendation was to reduce by 0.01 to 0.02 mg every day instead of making one reduction and then holding.

And man, that crashed me hard.

Mark told me that my brain would almost not notice reductions that small. I do not blame him for what happened. Maybe this method works very well for the majority of his patients. My nervous system simply seems to react differently.

I tried reducing by 0.02 mg per day for five days. One night before going to sleep I suddenly became extremely anxious and physically restless. My first thought was akathisia, which obviously made me even more anxious. After holding the dose for around one week, the anxiety and activation started settling down.

That encouraged me to try again.

I did another series of five days at 0.02 mg per day.

Micro Tapering remains a hot debate in the community. I am quite positive towards is in many ways, however I have heard lots who are not. You would be an example of why they are skepitcal it's a good idea.

When you spoke with Mark what did you discuss about your current (at that time) symptom severity? Could you rate them out of 10 for us? Were they still severe?

Overall I do think holding this dose is a good move.

14 hours ago, leminaseri said:

I would like to add, that I get, since my last crash, every day 1h after I take my Zoloft inner restlessness. I can sit still. I would say it’s moderate. But I’m afraid it will develop to something more serious. This happens exactly 1h after taking my dose.

Any advice?

You may just want to keep observing this and see if it worsens any. You could try as Sarah has suggested and split your dose. What time do you take your dose currently? We would suggest you move the doses apart gradually 1 hour per day until you reach the goal split times.

Did you consider doing a follow up with Mark and see what he thinks of these developments? I know he does email/voice notes which are much cheaper for people he has spoken with already.

Welcome to the forum.

I'm sorry to hear that you crashed after following Mark's advice, sadly the harms that these drugs can do are very challenging to mitigate as we are all very different and react differently.

I would also recommend at least a short hold to preserve your ability to function. It's hard, but it's very much worth trying not to jeopardise that.

It's good that you've cut back on things you feel might interact with withdrawal syndrome, however it's worth considering whether diets like keto are helping or not, personally I've always felt much, much worse trying anything like that and do better just trying to eat as little processed, unhealthy food as I can, whilst eating a balanced, nutritional mix of whole foods as much as I can.

15 hours ago, SarahMc said:

I'm so sorry your taper has been so hard on you. Just to clarify, when you were making your reductions in the period before last September, would your symptoms fully resolve between reductions or did they stick around at the same intensity and then become worse again each time you dropped?

I actually had good periods in between so I think I stabilized. I had windows with sexual functioning improving. Always temporary though. Always went back to baseline. I had periods feeling really good besides some problems that might not be related to WD at all (impossible to tell, since I was doing extremely bad pre ssri as well). I enjoyed some of my days in the periods in between. But I can not pinpoint when which happened. Most of the time when I dropped I had very mild reactions where I stabilized pretty quickly afterwards.

15 hours ago, SarahMc said:

I think this kind of micro-tapering is a pretty standard recommendation for someone who is very sensitive to reductions, but I'm so sorry it didn't work out for you. Did you feel like you were stable at the 7.6 mg dose before you started the micro-taper?

That was the time when my genital burning was extremely severe. And my sexual functioning deteriorated further. I was having natural anxiety about getting PSSD. But nervous system wise I was fine.

15 hours ago, SarahMc said:

I would really try not to worry about the PSSD label. We have people on this forum, and I know of several others off the forum, who have recovered from PSSD-type symptoms. I think it's most likely that these symptoms are part of your withdrawal syndrome, and that they will resolve with time along with your other symptoms.

Thank you for encouraging. But it is clear that this is not a basic withdrawal/side effect issue. Since I have stayed on the 6,8 dose for almost one year. And my libido (besides rare and very weak breakthroughs here and there) never restored. I don’t understand the logic behind that my libido disappeared only when I dropped from 50mg to 25mg. And furthermore I don’t understand that my sexual symptoms get worse as closer as I get to 0mg.

Another question is:

Why can’t I get better while still being on the drug? Why did I have in higher doses less symptoms than at lower doses. These are paradoxical things. I don’t see why my sexual symptoms should get better just because I got off the drug completely, when they only arrived at a lower dose in first place. That’s not a withdrawal issue.

18 hours ago, SarahMc said:

I'm really glad that you're able to function reasonably well even though I know this is very hard. I think it is very likely that if you give your nervous system some time you will start to see things improving. Of course there will likely be some bumps along the way to stability, but what we see in the community is really that time is the healer and nothing is permanent. It's certainly a good sign that you've noticed symptoms fluctuating and improving previously, that means your nervous system is searching for that equilibrium and will find it given enough time.

As @Chippy said. His symptoms got better as he reduced. So it’s clearly untypical for me.

15 hours ago, SarahMc said:

I definitely think this is the way to go for the moment. I would try not to put a firm timeline on it though, and simply say that you will hold until you feel stable enough to taper, however long that may take. We generally consider stability to be withdrawal symptoms of between a 1-3/10 in severity (10 being very severe) for a prolonged period of time.

Yes.

15 hours ago, SarahMc said:

When did you make these changes? We do advise folks to avoid caffeine and nicotine, but I have seen examples of folks who have quit these substances abruptly while tapering or in protracted withdrawal and have had issues, so I wouldn't be surprised if this caused at least a temporary worsening of symptoms for you.

I know the keto diet has helped some people as well, but we do advise you to be cautious about it and to work with a coach if possible. Keto can sometimes mask withdrawal symptoms but it is not a cure and folks can have trouble coming back off the diet. This is not to discourage you if you feel like keto is helping you -- just be careful as you would be with anything else in WD.

23 days ago. And 30-35 days prior to that I stopped nicotine. I seriously cannot tell what caused what. Today I stopped the carnivore diet. I will just cut ultra processed food as crisps and chips. Avoid every food with QR codes and see if I will do better. I have a hunch that cutting carbs completely didn’t went well. But at the same time I want to avoid gluten because I have hashimotos. Let’s see

18 hours ago, SarahMc said:

I'm really glad that you're able to function reasonably well even though I know this is very hard. I think it is very likely that if you give your nervous system some time you will start to see things improving. Of course there will likely be some bumps along the way to stability, but what we see in the community is really that time is the healer and nothing is permanent. It's certainly a good sign that you've noticed symptoms fluctuating and improving previously, that means your nervous system is searching for that equilibrium and will find it given enough time.

I actually also think that I will, at least, improve dramatically, when enough time has passed after reaching a dose low enough that the dependency can fade out. But my issue is today. It gives me psychologically severe stress to have the following concerns:

• Staying on the drug might cause problems because of toxicity

• Reducing the dosage might cause trouble because of withdrawal

• Increasing the dose might cause trouble as well

So the whole game is a gamble. It literally destroys my mental health. I become depressive regardless of withdrawal.

19 hours ago, SarahMc said:

We have at least a couple members here who experience similar adverse reactions shortly after taking their dose. I suspect that it's yet another sign of a destabilized nervous system and I would hope it would start to improve as you hold.

Are you taking your dose all at once? One option might be to try splitting it and taking your dose twice a day to see if that helps with the reaction, but I'd like to see what others think before you move forward with that. Tagging @Chippy here for his thoughts.

Yes I take my 6,52 mg at once. I take my medication every day at 7 pm. This time somehow settled over the years because i didn’t have enough time in the mornings to prepare my dilution.

7 hours ago, Chippy said:

Hey @leminaseri Welcome to the forum, I am so sorry you are having such a rough time of it. I have some experience of Sertraline and Sexual Dysfunction whilst on the drug so I empathise with what that feels like. I was very lucky and as I reduced that function returned to normal.

Looking at your signature this all started in many ways from the CT from Lexapro, I suspect this was the start of this for you. Coming off that fast would have primed you for harm no doubt. Then the fast taper from Sertaline continued this for you.

I’m glad to hear that it turned back to normal for you. I envy you in a positive way. It’s impossible to tell because if the quick lexapro taper caused more problems than I already have had. I have had pre-lexapro very severe, crippling anxiety, anhedonia, depression and dpdr. But it might have contributed to how I feel today for sure. The 100 mg Zoloft helped me tremendously in eliminating anxiety, and that improved a lot other stuff as well. So it’s clear to me, that my preexisting condition was “too much emotion” aka anxiety. I have had a somewhat decent life where I felt less anhedonic and could let myself consume by things around myself. It wasn’t perfect at all. But it gave me the possibility to work, earn money and marry my wife.

7 hours ago, Chippy said:

Micro Tapering remains a hot debate in the community. I am quite positive towards is in many ways, however I have heard lots who are not. You would be an example of why they are skepitcal it's a good idea.

When you spoke with Mark what did you discuss about your current (at that time) symptom severity? Could you rate them out of 10 for us? Were they still severe?

Overall I do think holding this dose is a good move.

Yeah it sounded very logical to me. I didn’t even know that you can dilute the liquid Zoloft to such a thin solution. But it unfortunately didn’t work. I actually wanted to try 0,01mg per day. But I must stabilize first to see what I want to do as a next step at all.

We actually spoke with Mark about sexual problems as they were the only really distressing ones at that time. At that time they were 8/10 today they are 10/10.

Yeah let’s see. The only thing I’m think about is, if it might be smart to go up to 6,6 mg to stabilize. But I don’t wanna gamble.

7 hours ago, Chippy said:

You may just want to keep observing this and see if it worsens any. You could try as Sarah has suggested and split your dose. What time do you take your dose currently? We would suggest you move the doses apart gradually 1 hour per day until you reach the goal split times.

Did you consider doing a follow up with Mark and see what he thinks of these developments? I know he does email/voice notes which are much cheaper for people he has spoken with already.

It’s unfortunately too expensive for me. And after his first recommendation going very bad, I don’t trust him anymore that much.. it’s not his fault I don’t blame him. But I got trust issues for now.

7 hours ago, Luke said:

Welcome to the forum.

I'm sorry to hear that you crashed after following Mark's advice, sadly the harms that these drugs can do are very challenging to mitigate as we are all very different and react differently.

I would also recommend at least a short hold to preserve your ability to function. It's hard, but it's very much worth trying not to jeopardise that.

It's good that you've cut back on things you feel might interact with withdrawal syndrome, however it's worth considering whether diets like keto are helping or not, personally I've always felt much, much worse trying anything like that and do better just trying to eat as little processed, unhealthy food as I can, whilst eating a balanced, nutritional mix of whole foods as much as I can.

Yeah today I stopped carnivore. Let’s see how that will go. And holding is a must anyways.

Thank you everyone for supporting me I appreciate it.

One day maybe the recovery post will come.

2 hours ago, leminaseri said:

Thank you for encouraging. But it is clear that this is not a basic withdrawal/side effect issue. Since I have stayed on the 6,8 dose for almost one year. And my libido (besides rare and very weak breakthroughs here and there) never restored. I don’t understand the logic behind that my libido disappeared only when I dropped from 50mg to 25mg. And furthermore I don’t understand that my sexual symptoms get worse as closer as I get to 0mg.

Another question is:

Why can’t I get better while still being on the drug? Why did I have in higher doses less symptoms than at lower doses. These are paradoxical things. I don’t see why my sexual symptoms should get better just because I got off the drug completely, when they only arrived at a lower dose in first place. That’s not a withdrawal issue.

I'm sorry things are so hard for you @leminaseri, I can completely understand why it would be very troubling to have these kinds of effects appear and worsen as you're tapering off the drug. I guess I'm struggling to understand, though, why you don't think this is a withdrawal issue? It seems like a pretty clear withdrawal issue to me. Chippy is an example of someone who had similar issues while on the drug that disappeared as he tapered, but we have others on here who've had these issues in withdrawal but not while on their full dose of the drug. Everyone is different, there's very little that is "standard" about withdrawal unfortunately.

If a symptom emerges as you're tapering off the drug I would generally consider that to be a withdrawal issue. Sometimes people have to hold for a very, very long time to stabilize after a crash during withdrawal, so just because you held for almost a year and your symptoms didn't resolve doesn't suggest to me that you can't stabilize on your lower dose. You had small windows during this time, which is a good sign.

Anyways, I don't mean to argue with you, just to say that nothing about your situation screams to me that this is completely abnormal or that you won't heal once off the drug. I hope you begin to see progress as you hold 💜

4 minutes ago, SarahMc said:

I'm sorry things are so hard for you @leminaseri, I can completely understand why it would be very troubling to have these kinds of effects appear and worsen as you're tapering off the drug. I guess I'm struggling to understand, though, why you don't think this is a withdrawal issue? It seems like a pretty clear withdrawal issue to me. Chippy is an example of someone who had similar issues while on the drug that disappeared as he tapered, but we have others on here who've had these issues in withdrawal but not while on their full dose of the drug. Everyone is different, there's very little that is "standard" about withdrawal unfortunately.

If a symptom emerges as you're tapering off the drug I would generally consider that to be a withdrawal issue. Sometimes people have to hold for a very, very long time to stabilize after a crash during withdrawal, so just because you held for almost a year and your symptoms didn't resolve doesn't suggest to me that you can't stabilize on your lower dose. You had small windows during this time, which is a good sign.

Anyways, I don't mean to argue with you, just to say that nothing about your situation screams to me that this is completely abnormal or that you won't heal once off the drug. I hope you begin to see progress as you hold 💜

U may be absolutely right. And thanks for commiserating.

Well I actually accepted my fate. But it went all the time worse. I sometimes think I’m in a simulation where I have to beat every coming year more hard challenges.

Joke aside, the reason why I can’t believe that this is a simple withdrawal issue is that it goes worse as closer as I get to zero or maybe as well, as longer as I take the Zoloft. I already mentioned but I have severe burning in genitals and under my feet. It might be possibly non length dependent small fiber neuropathy. And most most likely due to the Zoloft being neurotoxic at this point. But what can I do? Nothing. I can not taper faster. I can not increase the dose as it wouldn’t help with neurotoxicity..

20 hours ago, leminaseri said:

Well I actually accepted my fate. But it went all the time worse. I sometimes think I’m in a simulation where I have to beat every coming year more hard challenges.

I sometimes think I'm part of a government experiment and one of these days a CIA agent will knock on my door, tell me I'm released, and thank me for my service 😂

20 hours ago, leminaseri said:

Joke aside, the reason why I can’t believe that this is a simple withdrawal issue is that it goes worse as closer as I get to zero or maybe as well, as longer as I take the Zoloft. I already mentioned but I have severe burning in genitals and under my feet. It might be possibly non length dependent small fiber neuropathy. And most most likely due to the Zoloft being neurotoxic at this point. But what can I do? Nothing. I can not taper faster. I can not increase the dose as it wouldn’t help with neurotoxicity..

We also have other folks on here dealing with burning skin, some of whom are off drugs entirely. It's good that you're getting this investigated if you're concerned, and I completely understand being worried about adverse effects of the drug. But to me the fact that it's getting worse as you reduce does make it sound more like withdrawal, so I wouldn't discount that possibility entirely.

28 minutes ago, SarahMc said:

I sometimes think I'm part of a government experiment and one of these days a CIA agent will knock on my door, tell me I'm released, and thank me for my service 😂

Oh man.. that would be so great🤣🤣

29 minutes ago, SarahMc said:

We also have other folks on here dealing with burning skin, some of whom are off drugs entirely. It's good that you're getting this investigated if you're concerned, and I completely understand being worried about adverse effects of the drug. But to me the fact that it's getting worse as you reduce does make it sound more like withdrawal, so I wouldn't discount that possibility entirely.

I feel today very bad. I stopped my carnivore diet yesterday after 23 days. I have eaten 2 big cheeseburgers. I almost got high. I seriously noticed that I’m going out of ketosis. But the weird thing is, that I never noticed any benefit from being on ketosis withdrawal/pssd wise. It might be due to the fact that the nervous system is so occupied with the WD-stress that other interventions don’t reach my consciousness.

I felt today very very depressed. The thing with the genital numbness is, that I feared it a lot. I shitted every day my pants with my genitals becoming numb since I’ve heard about the possibility of getting something like PSSD. I lived with this fear for the last 2 years. And today my long ass fear comes just true. It’s such heartbreaking. 3 days ago I cried so much. I’m doing mentally very bad.

On 9/11/2026 at 9:19 AM, leminaseri said:

have hashimotos.

Are you taking anything for this? Levothyroxine? Any other meds?

My husband has had major issues on this drug even though he isn't on ADs. He has had heart issues, anxiety, tremors, restlessness. He also had Hashimoto's. He ended up in the ER and the dr said the levo is too high.Once he lowered his dose he did much better. His blood work has stayed level despite dropping.

Catina7 was also having issues taking it along with her effexor. She went from 75 mcg to 25 mcg to see major improvement in anxiety. Her blood work showed everything still on the normal range despite the drop.

AI search:

Levothyroxine side effects usually happen when the dose is too high and mimics an overactive thyroid. [1] (https://www.youtube.com/watch?v=nig1VPIwMA0&t=207)Common Side EffectsMost side effects are mild and improve as your body adjusts or your dose is corrected: [1] (https://www.youtube.com/watch?v=nig1VPIwMA0&t=207)Weight loss or changes in appetiteNervousness, anxiety, or irritabilityTremors or shaking handsTrouble sleeping (insomnia)Heat intolerance and excessive sweatingFast or pounding heartbeat (palpitations)Diarrhea, stomach cramps, or vomitingTemporary hair loss during the first few monthsChanges in menstrual periods [1] (https://www.mayoclinic.org/drugs-supplements/levothyroxine-oral-route/description/drg-20072133)Serious Risks and Long-Term EffectsSevere problems are rare but require medical attention: [1] (https://www.nhs.uk/medicines/levothyroxine/)Heart problems: Chest pain, irregular heart rhythms, or heart attack symptoms.Bone loss: Long-term use or high doses can lower bone mineral density and raise the risk of osteoporosis.

A new symptom arrived.

I don’t sweat anymore. One more hint for SFN/dysautonomia.

I was exercising very hard 2 days ago. There I noticed that I don’t sweat as I should.

And today I noticed it again. Despite being hot and humid at home. There just coming 2% sweat. It’s very very clear that there is something going on in the autonomic nervous system.

47 minutes ago, LostinCanada said:

Are you taking anything for this? Levothyroxine? Any other meds?

My husband has had major issues on this drug even though he isn't on ADs. He has had heart issues, anxiety, tremors, restlessness. He also had Hashimoto's. He ended up in the ER and the dr said the levo is too high.Once he lowered his dose he did much better. His blood work has stayed level despite dropping.

Catina7 was also having issues taking it along with her effexor. She went from 75 mcg to 25 mcg to see major improvement in anxiety. Her blood work showed everything still on the normal range despite the drop.

Yeah I take some. But my labs are all in range.

There is a drug interaction between Zoloft and levo

Drug interactions

Moderate drug interactions

levothyroxine sertraline

Applies to: levothyroxine, Zoloft (sertraline)

Using sertraline together with levothyroxine may decrease the effects of sertraline. This can cause fatigue, weight gain, constipation, and low blood pressure. Talk with your doctor before using these medications together and report any side effects promptly. You may need a dose adjustment or thyroid tests to safely take both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

38 minutes ago, LostinCanada said:

There is a drug interaction between Zoloft and levo

Drug interactions

Moderate drug interactions

levothyroxine sertraline

Applies to: levothyroxine, Zoloft (sertraline)

Using sertraline together with levothyroxine may decrease the effects of sertraline. This can cause fatigue, weight gain, constipation, and low blood pressure. Talk with your doctor before using these medications together and report any side effects promptly. You may need a dose adjustment or thyroid tests to safely take both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

My Chat GPT says that it’s the opposite. Taking sertraline can lower the effect of levothyroxine. Not the other way around.

20 minutes ago, leminaseri said:

My Chat GPT says that it’s the opposite. Taking sertraline can lower the effect of levothyroxine. Not the other way around.

This is from drugs.com .

I think that is more reputable.

It may be why it is becoming harder to taper as you get lower.

Edited September 12Sep 12 by LostinCanada

15 hours ago, leminaseri said:

I shitted every day my pants with my genitals becoming numb since I’ve heard about the possibility of getting something like PSSD. I lived with this fear for the last 2 years. And today my long ass fear comes just true.

You don't have PSSD. PSSD is when symptoms such as this persist long term after stopping all psychiatric drugs.

It's far more common to have these symptoms on these drug and whilst changing doses around, and then find that they improve once you are off, in time.

It's very premature to state that you have sexual dysfunction that has persisted for years after stopping drugs before you stop drugs.

1 hour ago, Luke said:

You don't have PSSD. PSSD is when symptoms such as this persist long term after stopping all psychiatric drugs.

It's far more common to have these symptoms on these drug and whilst changing doses around, and then find that they improve once you are off, in time.

It's very premature to state that you have sexual dysfunction that has persisted for years after stopping drugs before you stop drugs.

Well. Might be true.

Only concerning point to me:

They appeared on lower doses rather than higher. Logically you would have more side effects on higher doses. And less side effects in lower doses. These analogy was the very first thing disturbing my mind. “Why gets my sexual functioning worse, as more as I reduce?” Later I found out about the possibility of PSSD. With almost every reduction my sexual functioning became worse. With the last reductions I got very significant numbness. So the question “What happens at further reductions?” is a very scary one to me.

And the point if that counts as withdrawal or not: I expected them to become better after staying on the 25mg for more than 14 months. They didn’t.

It all might still be very prolonged withdrawal. But something is off with all of the stuff I experience.

Thank you for responding @Luke

@leminaseri the way these drugs work often seems to defy logic.

I had better and better sexual function whilst tapering, which then crashed far, far worse than on the drug once I came off.

Reactions to dose changes to the drugs, and what effects you have whilst taking these drugs, aren't a particularly consistent predictor of what happens once a taper is completed.

On PSSD forums they usually say to wait until you're 6 months clear of all drug use before even considering it.

22 minutes ago, Luke said:

On PSSD forums they usually say to wait until you're 6 months clear of all drug use before even considering it.

Yeah I’ve seen that as well. They banned me from the PSSD subreddit because they kept telling me “don’t panic you are still on medication”. I insisted to telling them, that something is off with my symptoms.

But actually there is no scientific evidence for that, that you must be off the drug. This topic is not touched by any professional in the field of PSSD/withdrawal. In fact, David Healy says, that tactile genital numbness is a precursor for, that it may persist after going off the drug. This “6 months off the drug” is just a safety net. It’s nothing empirically conceptualized.

Tactile genital numbness is not withdrawal. Nor a common SSRI side effect. These aren’t mentioned in any withdrawal literature. At least I didn’t read anything.

Let’s see what the future holds.

@leminaseri Your argument that your reducing the dose lead you to more PSSD symthoms is just a good argument against what you have been told on PSSD subreddit. I mean, they could know that waiting for 6 months after quitting is just one big simplification...

1 hour ago, leminaseri said:

Tactile genital numbness is not withdrawal. Nor a common SSRI side effect.

That's the whole point. Saying that you have PSSD because you are on on off the drug, or because you reduce or up-dose it doesn't make sense at all. And BTW akathisia is the same sheet.

Edited September 13Sep 13 by The Dust

3 minutes ago, The Dust said:

@leminaseri Your argument that your reducing the dose lead you to more PSSD symthoms is just a good argument against what you have been told on PSSD subreddit. I mean, they could know that waiting for 6 months after quitting is just one big simplification. ..

They surely know. It’s just an artificial “mantra” to keep people hopeful as long as they are still on the drug. But not every case is the same. My sexual functioning deteriorates anti-proportionally to the amount of dosage. Since being on 25mg, every step closer to 0mg worsened my sexual function. I don’t see it getting better at any point. Only thing that remains is to quit the drug completely and hope that the body begins to make real healing.

Other than that, I thought today that a low dose of sertraline might be generally a bad thing, since the dose isn’t enough to stabilize nor it’s low enough to readjust to pre-drug state. Yeah it is not solvable without taking big risks. Everything I do today might do harm to me. Whether holding or reducing. It must be one of the worst situations that can happen to mankind.

Edited September 13Sep 13 by leminaseri

Hey @leminaseri warm welcome to the forum, so glad that you found us!

Im really sorry to hear about you having such a hard time with the tapering. Im sure that youll find some good support and knowledge on here!

I wish you the best of luck on your journey.

Yep, not every case is the same. For instance Luke above mentioned just the opposite experience which is nothing surprising anymore.

I never had PSSD, but this year something surprised me. On antibiotic Rifaximin my genitals became surprisingly numb and it felt like real PSSD. Later everything became as it was before, but creepy, isn't it?