Mental Health Sertraline is making me "numb" and indifferent.

[Holgerr]

Hi guys,

I am suffering from Dystymia and SAD and have been taking Sertraline 50 - 75mg for over a year now. It helps with psychosomatic ailments and moderately attenuates the anxiety & fear. My problem with Sertraline is: It makes me an apathetic zombie, indifferent to life and very unmotivated. I have sleep disturbances, the sleep is unrestful. I've also lost quite a bit of weight and am more agitated. Besides that I have hot-flashes and palpitations on a regular basis. My pdoc said that I will have to live with the sides and that he can't do anything about it. He advised me that I should try to get used to it...

My question: is there something that I could use to augment the Sertraline and make it all more bearable for me?

Thank you very much for your help. I appreciate that!

Greetings, Holgerr

 

[AlphaMethylPhenyl]

If things really are that bad after a year-long trial, why is he so against switching a medication? Usually it's 2-ish months to see if it fits.

 

[Holgerr]

If things really are that bad after a year-long trial, why is he so against switching a medication? Usually it's 2-ish months to see if it fits.

He thinks that according to meta-analysis all medications are equally efficient, so switching won't do me any good...

 

[AlphaMethylPhenyl]

That's somewhat short-sighted. The study is in general, not for everyone. If I read it right, it means that each has the potential to work as well, not that for everyone each medication is as good as the next. Plus, that study came out just a few months ago....

 

[Holgerr]

That's somewhat short-sighted. The study is in general, not for everyone. If I read it right, it means that each has the potential to work as well, not that for everyone each medication is as good as the next. Plus, that study came out just a few months ago....

Indeed, but my doc is an SSRI fanboy and doesn't acknowledge other antidepressant classes

 

[DrFriday]

Going numb with your serotonergic drugs really is more of a feature than a bug. Honestly, how much time have you gotten back now that you feel nothing and have no urge to masturbate? How much easier is it to meet friends now that you can just walk up to strangers, with no anxiety whatsoever, say anything, and not give a fuck what their reaction is? You'll have trouble coming up with something to say, since no one cares, but that's about it.

 

[Abject]

Just because something is an SSRI that does not make it the same as another compound that is an SSRI. Do you think we use prodrugs just to make your body do more work?
I'd suggest that you find a new doctor, but before you go trusting strangers willy nilly I'd suggest you do some rudimentary study on neurochemistry.
Ime psychs fail to see the big picture, as do many people. There can be HUGE factors to mental health, from environment (light, noise, temperature) to diet (how your metabolism functions, vitamin and mineral deficiencies, hormonal state)
For example, CRH is implicated in "depression". Depending on your disorder (and personal physiology) chances are you've either got pathologically low or high CRH.
An easy guess as to which is how you feel in autumn compared to spring. A decline in light (autumn) will reduce serotonin and CRH. Likewise, spring will do the opposite, increasing serotonin and CRH. Lower temperature will also lower serotonin and increase cortisol (higher cortisol will lower CRH)
Light controls melatonin and tyrosine hydroxylase.
Declining light=declining serotonin and tyrosine hydroxylase (enzyme required to make dopamine)
SSRI without addressing environment=dopamine depletion
Light therapy/summer holiday=increase serotonin without lowering dopamine, even increasing tyrosine hydroxylase

What was the point of all that?
Well hopefully to highlight that mental health is poorly understood, and very personal(ised)
Something that makes one person better can make things worse for the next

I happen to struggle with depression (and anxiety to a lesser extent) and I'd never voluntarily take an SSRI
At the same time, biology is king and if SSRIs helped me (rather than actually made things worse) I'd definitely be on one
Having said that, I think the majority of those lacking in serotonin will still end up feeling worse on SSRIs due the suppression of dopamine (and SSRIs don't exactly give you a balanced increased in serotonin)

Here's a meta-analysis you should look at
https://www.ncbi.nlm.nih.gov/pubmed/28178949

 

[Sister_Rags]

Zoloft is known to be an energizing medication. I was on Lamictal and, at higher doses, it made me "flat". No way will I live like that. If your pdoc won't switch you to another SSRI or SNRI I strongly suggest you find a different pdoc. That's ridiculous, after a whole year. Like someone posted, 2 months to try a med, maybe 3 months, is max.

 

[Twentypointfive]

Im weaning off zoloft myself. It may or may not decrease depression (ever so slightly) but it isn't worth the "zombie feeling" imo. I mean... The people that tested zoloft; who knows if zoloft/ssri's were as significant/impactive to them as it was to you!

 

[Holgerr]

Im weaning off zoloft myself. It may or may not decrease depression (ever so slightly) but it isn't worth the "zombie feeling" imo.

Indeed! F#ck knows why these things are marketed for depression when they can sometimes cause or enhance the very symptoms people are trying to get rid of...

 

[Holgerr]

Going numb with your serotonergic drugs really is more of a feature than a bug. Honestly, how much time have you gotten back now that you feel nothing and have no urge to masturbate? How much easier is it to meet friends now that you can just walk up to strangers, with no anxiety whatsoever, say anything, and not give a fuck what their reaction is? You'll have trouble coming up with something to say, since no one cares, but that's about it.

But where is the pleasure in life? I don't want to be a Borg drone, feeling nothing. I want things to matter...

 

[Holgerr]

Just because something is an SSRI that does not make it the same as another compound that is an SSRI. Do you think we use prodrugs just to make your body do more work?
I'd suggest that you find a new doctor, but before you go trusting strangers willy nilly I'd suggest you do some rudimentary study on neurochemistry.
Ime psychs fail to see the big picture, as do many people. There can be HUGE factors to mental health, from environment (light, noise, temperature) to diet (how your metabolism functions, vitamin and mineral deficiencies, hormonal state)
For example, CRH is implicated in "depression". Depending on your disorder (and personal physiology) chances are you've either got pathologically low or high CRH.
An easy guess as to which is how you feel in autumn compared to spring. A decline in light (autumn) will reduce serotonin and CRH. Likewise, spring will do the opposite, increasing serotonin and CRH. Lower temperature will also lower serotonin and increase cortisol (higher cortisol will lower CRH)
Light controls melatonin and tyrosine hydroxylase.
Declining light=declining serotonin and tyrosine hydroxylase (enzyme required to make dopamine)
SSRI without addressing environment=dopamine depletion
Light therapy/summer holiday=increase serotonin without lowering dopamine, even increasing tyrosine hydroxylase

What was the point of all that?
Well hopefully to highlight that mental health is poorly understood, and very personal(ised)
Something that makes one person better can make things worse for the next

I happen to struggle with depression (and anxiety to a lesser extent) and I'd never voluntarily take an SSRI
At the same time, biology is king and if SSRIs helped me (rather than actually made things worse) I'd definitely be on one
Having said that, I think the majority of those lacking in serotonin will still end up feeling worse on SSRIs due the suppression of dopamine (and SSRIs don't exactly give you a balanced increased in serotonin)

Thanks for your compact treatise.
I have chronically high cortisol levels, so probably low CRH?
I feel awesome in spring and shitty in autumn and winter.

I have low HbA1c. (4,2% if I remember correctly)

Here's a meta-analysis you should look at

Yeah, that is somewhat disenchanting...
P.K. Gillman also isn't a fan of SSRIs. He considers irreversible non-selective MAOIs & the classical TCAs (Clomipramine, Imipramine, Amitriptyline) als superior to SSRIs.

 

[Twentypointfive]

Plus, you arent supposed to drink on SSRI's (WTF?!). Alcohol is like a depressed person's best friend lol.

 

[AlphaMethylPhenyl]

Yeah alcohol is bad news for someone in mental health recovery. It mires how you present, meaning that one's prescriber has a less accurate view of your issues and how to best work on them.

 

[Twentypointfive]

Oh ya for sure.. i think lol. Can u explain that better? Ur obviously smarter than me lol.
But ya definately dont drink alcohol if youre in a recovery program. That would be bad lol.