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Tag: sertraline

Published on Leave a comment on Today is a big decision day!

For the past couple of months, as you may know, I have been reducing the dose of my meds. Sertraline, an SSRI, basically works by increasing serotonin levels. It had been a long time for me since I was last on anti depressants / anti anxiety meds, but last summer, with everything going on at work, I needed some help. That came in the form of meds and counselling.

SInce the final decision was made regarding my WFH status etc, I have definitely been in a better place mentally. Over the past few months I have felt a good positive change in my moods, and ability to function in general. These changes are aside from how I already felt being on the meds. Having used SSRI's previously it has always been important to me to document and be consciously aware of how I feel, and any changes. This helps in the decision making process for weaning myself back off the meds when the time is right.

After the WFH decision was made, I started making note of the meds and moods, and after a few weeks started to reduce the dose. I have not been on a high dose at any point this time around, so things were slightly less critical for me. 
I would like to say this was done with the guidance of the GP, but that is not the case for a number of reasons. Primarily I wanted to feel in control of things. If I don't change the prescription dose, I will always have sufficient meds to increase again. Whereas if I do it with the GP, the prescription will change, and if I wobble and feel the need to increase, I would need to speak to the GP again, and getting an appointment would just add stress, making the whole situation feel worse, and defeat the object. 
Anyway, I have retained the normal prescription for now, and slowly lowered the dose. A few weeks at a time on each dose, until I reached this week. 

Now I am at the point where the dose is so low that I can either stop completely, or do one day on one day off so to speak, as the final step. In reality, with the dose this low, it is really only a mental exercise, and any effects would likely be psychosomatic anyway. But nonetheless, it's all about the process and feeling you have done the right thing. The half life of the drug is 24-32 hours, so by doing one on, one off, the levels will remain present, with no sudden drop off for the off day.

Obviously as will all things like this, timing is key. The timing for me on one hand is perfect, and on the other hand, depending how you look at it, couldn't be worse.
Almost a week post surgery, off work for a week. Three weeks out from a long planned trip to Florida, and four weeks out from getting married. So as the timing goes, if I alternate this week and next, I will be off meds with a week to go to Florida. Again, two weeks in the sun, away from everything, relax, and unwind. But at the same time quite full on with travel too. Not that a micro dose that I am on would change much about that anyway.

I would of course take the meds with me, although they take a few weeks to kick in properly, at least I would have them if I needed to restart the course.

While writing this (as usually happens) I have had the conversations with myself that I needed to, and pretty much come to a decision, but I am always interested in other peoples opinions and experiences, so feel free to share either. 

What do you think?

Published on Leave a comment on Side effects have arrived!

Almost at the end of the first week of taking the news meds, and the side effects are starting to show their face. Nothing alarming, or that I have not experienced before, but they change the game a little all the same. Sertraline is the drug in question this time around, a change to my usual Citalopram, but early days feel the same. 

Due to feelings really run down at the moment, I am already struggling to have the energy to do much, but combined with the early effects of the meds, it has kinda knocked me for six. Currently feeling physically fatigued, my interest in doing anything is badly affected, so I am spending a lot of time sitting around and not doing much. I noticed yesterday when going for a little ride that my energy levels were pretty low. By last night the mouth ulcers including one on my tongue had reached a point of not just discomfort, but annoyance too. Over salivating, so continually swallowing makes it really hard to get to sleep, making you feel like you are drowning in your own saliva. One of the ways to kerb this is to clench my mouth shut, but that leads to headaches. Lose-lose!

Anyway, this is meant to be about side effects of the meds, not ailements of being run down. So let's get back to those. Now the actual intended effects of the meds generally take 4-6 weeks to have a noticable effect on the condition they are treating. However that does not mean they don't start to have an effect straight away. The idea is to build up a level in the body to impact the anxiety, but with a regular dose, it soon starts to have an impact even before levels build up.

Previously, and indeed currently the main effect is a dulling of the thought process. There is a trade off to be had, and I will give a good example of it shortly, but for now, let me try and explain how I feel right now. I feel mentally lethargic, with a lack of focus on anything. Concentration is very, very low, so even something as simple as following the plot of a program I am watching can be difficult. When speaking I can lose my flow mid sentence, or completely tune out of a conversation I am having without warning. Even if I have listened carefully, recalling what was just said can be difficult. Even recalling what I just said can be tough. We all have this sort of thing for a moment, but for me right now, its all day long.

Trying to put a blog entry together is hard work, and in a rare moment of clarity, here I am trying to document what is going on before I lose my way again, and lose the chance to create this valuable reference point for myself. The upside of this feeling of course is the almost inability to dwell on anything. My anxiety can find me caught up in a self destructive loop at times, catastrophising the most simple of thoughts. To go back to the example I promised, last night while suffocating in saliva, I wondered why I was suddenly creating so much. My mind trying to be as irrational as possible took me back a few weekends where I saw a runner at the half marathon running in aid of "saliva gland cancer research"... Of course my mind went to cancer. 

Now, if this was just me, not on medication I can guarentee that I would have got up, googled the symptoms, and somehow worked on making them fit to what was going on, for a moment at least. Instead, my mind went there, the thought entered my mind, exited and was not heard of again for the rest of the night. It is almost like a temporary amnesia which makes it impossible for the conscious mind to hold on to a thought long enough to spiral down with it. Handy in those instances, difficult day to day. Needless to say, concentration comes at a price right now, and that cost is irritability. If I am trying to focus on one thing, and anything distracts me, I become very frustrated, very quickly.  Another cost is energy. To focus on a TV program for an hour, leaves me tired and needing to take a break, which is what I am doing right now.

Other effects include feeling a bit light headed from time to time, lack of interest in doing a lot of things which require any focus or physical energy, and general all round tiredness. Yesterday I liked the idea of going for a couple of rides this weekend, by the time I woke this morning, after a crap nights sleep, I had no interest in doing so whatsoever. Thinking about it, I honestly think I would be a liability on a bike today, as I just can't shake the wandering mind and eyes. We did pop to the shops earlier, and while I felt save taking an easy drive there, my ability to shop  was just not there. No idea what I wanted, so just grabbed a few obvious things, and called it a day. For the rest of the day I shall just rest body and mind.

Fingers crossed the mouth starts to feel a bit better soon, as the over production of saliva and constantly swallowing it leaves me feeling quite nauseous, and I could do without any more ailements right now thanks.
I am gonna leave this one here now as I am struggling a bit to write rather than ramble. Apologies for the waffle and any typos, I just don't have the capacity to do much better. From previous experiences with these meds, these effects should ease a little in the coming weeks. Replaced by some other weird and wonderful side effects, which will also hopefully be short lived.  Just to add, by the end of the week I had received no contact from work at all, no acknowledgement of me calling in sick, or my absence. And no updates on the outcome of my appointment with OH, so that is officially a month without so much as a single word being spoken about it. Nice one! Next week, if I can string a sentence together, I will chase this up.

Thanks as ever for reading.

Footnote..
Apologies to anyone I engage with over the coming few weeks. If I stop talking or replying, or just seem distant, it is just the meds making it hard to concentrate. If you are boring me, I will be sure to just say!