Opinions of sertraline

[Bleaney]

My doc said that he's going to put me on sertraline from citalopram. According to him, it's better for anxiety. Any thoughts about this?

It did not touch the sides of my anxiety, but apparently it has helped some people.

I tried Paroxetine, sertraline, and mirtazapine. All of which were supposedly helpful for anxiety.

They had absolutely no effect for me.

With the benefit of hindsight, or if I could go back in time, I'd have stopped Mirtazapine after a few months, seeing as it wasn't really helping for anything except sleep. Although that benefit isn't anything to be sniffed at.

I'd have tried Venlafaxine instead. That is meant to be good for anxiety, by many accounts, although the withdrawal syndrome is said to be particularly nasty.

If even Venlafaxine wasn't helping my anxiety after a few months I'd have stopped taking that too, and concluded that the whole class of meds is no use to me.

I wouldn't have ended up taking mirtazapine for years, just because it helps with sleep. God knows what effects long term usage of these meds has on the mind and body.

I really don't relish the prospect of doing a Mirtazapine taper or reduction whilst holding down a job. I think it would be very rough. Plus you can't even get the same type of pills with every prescription refill. Sometimes they are curved and rounded pills, which are extremely difficult to shave bits off with a blade, in order to reduce. Sometimes you get flat oblongs, which are much easier to shave bits off. But it's certainly no use trying to taper unless you can be sure of getting the same type of pills every time.

If / when I do come off it, I'll have to see if the Dr can prescribe a specific brand for me every time, and if the pharmacy can get the same brand every time. Something like Milpharm, Actavis, or Alamy, for example which are flat oblongs, and so I could work out the weight of one pill, by weighing several to see if they are all the same, and then ever so gradually reduce down, over as long a time frame as I need.

I'll probably get off benzos first though, as a higher priority, whenever I get an opportunity to do so.

 

[Perkins : Reborn]

It did not touch the sides of my anxiety, but apparently it has helped some people.

I tried Paroxetine, sertraline, and mirtazapine. All of which were supposedly helpful for anxiety.

They had absolutely no effect for me.

With the benefit of hindsight, or if I could go back in time, I'd have stopped Mirtazapine after a few months, seeing as it wasn't really helping for anything except sleep. Although that benefit isn't anything to be sniffed at.

I'd have tried Venlafaxine instead. That is meant to be good for anxiety, by many accounts, although the withdrawal syndrome is said to be particularly nasty.

If even Venlafaxine wasn't helping my anxiety after a few months I'd have stopped taking that too, and concluded that the whole class of meds is no use to me.

I wouldn't have ended up taking mirtazapine for years, just because it helps with sleep. God knows what effects long term usage of these meds has on the mind and body.

I really dont relish the prospect of doing a Mirtazapne taper or reduction whilst holding down a job. I think it would be very rough. Plus you can't even get the same type of pills with every prescription refill. Sometimes they are curved and rounded pills, which are extremely difficult to shave bits off with a blade, in order to reduce. Sometimes you get flat oblongs, which are much easier to shave bits off. But it no use trying to taper unless you can be sure of getting the same type of pills every time.

If / when I do come off it, I'll have to see if the Dr can prescribe a specific brand for me every time, and if the pharmacy can get the same brand every time. Something like Milpharm, Actavis, or Alamy, for example which are flat oblongs, and so I could work out the weight of one pill, by weighing several to see if they are all the same, and then ever so gradually reduce down, over as long a time frame as I need.

I'll probably get off benzos first though, as a higher priority, whenever I got an opportunity to do so.

I eventually let a doctor suggest how I should progress

 

[Flynnal]

It did not touch the sides of my anxiety, but apparently it has helped some people.

I tried Paroxetine, sertraline, and mirtazapine. All of which were supposedly helpful for anxiety.

They had absolutely no effect for me.

With the benefit of hindsight, or if I could go back in time, I'd have stopped Mirtazapine after a few months, seeing as it wasn't really helping for anything except sleep. Although that benefit isn't anything to be sniffed at.

I'd have tried Venlafaxine instead. That is meant to be good for anxiety, by many accounts, although the withdrawal syndrome is said to be particularly nasty.

If even Venlafaxine wasn't helping my anxiety after a few months I'd have stopped taking that too, and concluded that the whole class of meds is no use to me.

I wouldn't have ended up taking mirtazapine for years, just because it helps with sleep. God knows what effects long term usage of these meds has on the mind and body.

I really dont relish the prospect of doing a Mirtazapne taper or reduction whilst holding down a job. I think it would be very rough. Plus you can't even get the same type of pills with every prescription refill. Sometimes they are curved and rounded pills, which are extremely difficult to shave bits off with a blade, in order to reduce. Sometimes you get flat oblongs, which are much easier to shave bits off. But it no use trying to taper unless you can be sure of getting the same type of pills every time.

If / when I do come off it, I'll have to see if the Dr can prescribe a specific brand for me every time, and if the pharmacy can get the same brand every time. Something like Milpharm, Actavis, or Alamy, for example which are flat oblongs, and so I could work out the weight of one pill, by weighing several to see if they are all the same, and then ever so gradually reduce down, over as long a time frame as I need.

I'll probably get off benzos first though, as a higher priority, whenever I got an opportunity to do so.

Well, the mirt damaged my hearing, caused me to strke myself in the head well over 100+ times, causing brain damage and nydrocephalus from the consequences of the tinnitus and the online bullying I struggled with due to speaking about it about how I wanted to end my life over this shit. The stuff causes diabetes, for me it caused irreversible damage to my hearing, and though it improved sexual function it did so at a great cost. Always woke up with desert mouth, I'm only 47. I still cannot believe they prescribe this stuff. I mean, even an SSRI might have been a better choice over this, albeit at the risk of problems with intimacy.

But mirt nearly killed me. Both times as I was tapering off. But while I was on it I was getting SBUTTs all the time, and those turned into SSNHLs, and I ended up threatening to kill myself online which resulted in bans, and bullying. I hit myself in the head brutally hard about 80+ times. That causes SERIOUS damage to my health, and now, my sexual function is gone, so I guess SSRIs aren't going to jack shit to that now that it's 75%+ gone.

Oh, and it also caused OSA, sleep apnea, if you want to believe that. Coming off the mirt is likely what saved my pitiful ass.

Sertraline it is I guess. My GP put me on that at 50mg. I've yet to take the first dose. I'll take that for a month, and see how that goes. I know that PSSD exists, but for me it never did with 75mg Effexor, nor did it happen with Lexapro at 10mg, nor did it happen with Paroxetine back in 1999. I also tried citalopram and that also did not too much, but I remember Sertraline made me more social and more wanting to go out and chat with people. Was it mania or was it me coming out of my shell? Who knows?

If I'm still posting after a month, and don't suddenly fall off the perch, then you'll know it worked. If it didn't...well, at least I tried to salvage what was left of me. Weed does NOT work, nor does its derivatives like rosin, or that other shit in carts. All that did was fuck up my hearing even more. You cannot make this shit up.

Zoloft it is. I'll give it a go.

EDIT: https://pubmed.ncbi.nlm.nih.gov/33742212/

Apparently, it applies to ALL antidepressants, including the one I took for 20 years. So yes, the risk applies equally across all of them. The more antidepressants you take (as in, mix them), the higher the chance. But it's still relatively risk-adjusted, so overall the risk is still very low. You'd have to be very unlucky to get it.

 

[Perkins : Reborn]

You seem very angry and a little self-pitying.

 

[Flynnal]

You seem very angry and a little self-pitying.

More like frustrated and trying different things, with not much relief. But I'll keep trying. I'll give Sertraline a go and see how it goes. The risk is no greater than being on the mirtazapine, and I've been on that stuff for years. Also, I have lots of steroids to try to fix it if it does happen. Obviously, I can't keep taking courses of corticosteroids in big doses too closely spaced together (as in, more than a few times a year) or I'll end up with adrenal problems.

 

[LoginNotSecure]

Well, the mirt damaged my hearing, caused me to strke myself in the head well over 100+ times, causing brain damage and nydrocephalus from the consequences of the tinnitus and the online bullying I struggled with due to speaking about it about how I wanted to end my life over this shit. The stuff causes diabetes, for me it caused irreversible damage to my hearing, and though it improved sexual function it did so at a great cost. Always woke up with desert mouth, I'm only 47. I still cannot believe they prescribe this stuff. I mean, even an SSRI might have been a better choice over this, albeit at the risk of problems with intimacy.

But mirt nearly killed me. Both times as I was tapering off. But while I was on it I was getting SBUTTs all the time, and those turned into SSNHLs, and I ended up threatening to kill myself online which resulted in bans, and bullying. I hit myself in the head brutally hard about 80+ times. That causes SERIOUS damage to my health, and now, my sexual function is gone, so I guess SSRIs aren't going to jack shit to that now that it's 75%+ gone.

Oh, and it also caused OSA, sleep apnea, if you want to believe that. Coming off the mirt is likely what saved my pitiful ass.

Sertraline it is I guess. My GP put me on that at 50mg. I've yet to take the first dose. I'll take that for a month, and see how that goes. I know that PSSD exists, but for me it never did with 75mg Effexor, nor did it happen with Lexapro at 10mg, nor did it happen with Paroxetine back in 1999. I also tried citalopram and that also did not too much, but I remember Sertraline made me more social and more wanting to go out and chat with people. Was it mania or was it me coming out of my shell? Who knows?

If I'm still posting after a month, and don't suddenly fall off the perch, then you'll know it worked. If it didn't...well, at least I tried to salvage what was left of me. Weed does NOT work, nor does its derivatives like rosin, or that other shit in carts. All that did was fuck up my hearing even more. You cannot make this shit up.

Zoloft it is. I'll give it a go.

EDIT: https://pubmed.ncbi.nlm.nih.gov/33742212/

Apparently, it applies to ALL antidepressants, including the one I took for 20 years. So yes, the risk applies equally across all of them. The more antidepressants you take (as in, mix them), the higher the chance. But it's still relatively risk-adjusted, so overall the risk is still very low. You'd have to be very unlucky to get it.

Sounds like a you problem, not the medication. Do you have low impulse control? Hitting yourself resolves nothing. What you've done to yourself was caused by your actions.

 

[morningstarr]

sertraline takes too long to work

 

[morningstarr]

sertraline takes too long to work

i think it is the one antidepressant which has the longest onset of action which is 15 days.

 

[Flynnal]

Sounds like a you problem, not the medication. Do you have low impulse control? Hitting yourself resolves nothing. What you've done to yourself was caused by your actions.

Well, what I did to myself was AFTER the hearing damage/tinnitus and other shit started. So, yeah, it sure didn't help. But, the problems came before the self-harm, which of course, as you say, didn't solve anything. I should have known that it was not a good idea but I was so full of blind rage. I take full accountability for the self harm, but not for the hearing loss/damage and tinnitus. No one is at fault there, but I am thinking that antidepressants which make you 1/ want to eat like a horse (and not to mention the wrong foods which have a lot of fat and sugar in them), and 2/ slows down your metabolism and 3/ sedates the hell out of you at night and makes you lazy during the day, may well be the cause. Antihistamines are known to cause dementia. Dementia is also related to hearing loss too since the neurological circuits share similar pathways because hearing loss can cause dementia all by itself due to the brain working overtime to be able to function, your brain works harder, which means it tends to cause downstream neuroinflammation over a long period of time, which then leads to plaques forming and bodies forming inside the finest blood vessels and tissues of the brain. Surely this can't cause the problem? Of course it can. I was on that shit for 20 years combined total, so yeah, I sure am not discounting the possibility. Not to mention all the shit that I ate while I was on it. Many people who take it end up so big they can't fit through a standard 28 inch door frame.

Who knows? Maybe I am clutching at straws, but something must have caused this. And it wasn't entirely my fault...but I'm accountable for the self-harm, totally accountable for that. But not for the conditions that preceded it which could have been anything and what doctors told me was idiopathic, but I am 99% sure it had to be vascular since the episodes came on so suddenly (we're talking seconds here) that there could not have been any other possible cause. Ear muscle spasms that won't fully resolve and therefore not fully release the nerve? Microclots? Blood vessel spasms or trigeminal nerve spasms cutting off blood flow (hey, that's vascular too, albeit indirectly) or fluid build up in the inner ear? Menieres isn't just caused by one thing - it's a symptom of some other disease. There is always, always, always a cause. Just because doctors cannot identify it doesn't mean it isn't there. It's just guessing games at this point, but it has turned my life into a complete abortion, and I'm not mincing my words here. I've had to change so much about what I do because of this shit.

So, therefore, I will accept full accountability for the self-harm, but I won't accept even a sliver of accountability for the Menieres disease (I'd prefer to call it a syndrome because that's what it is, some disease, a virus, or a vascular problem, obviously causing the syndrome).

 

[Bleaney]

i think it is the one antidepressant which has the longest onset of action which is 15 days.

I was under the impression, and informed by my GPs, that broadly speaking, the whole class of meds takes a month to start working.

When i had a follow up after 7 days on one of the meds and said that I was feeling better, the Dr totally dismissed and gaslighted me, saying that it must have been a placebo effect, as none of them work that quickly.

I'm not sure if they can work quicker in some people. But he might have been right about the placebo effect, as I don't think any of the anti-depressants I've tried have been worth it, in the long term.

Especially considering what I know now about '"discontinuation syndromes" and severe side effects.

 

[LoginNotSecure]

In many cases, I would arrange a follow-up appointment in approximately four to six weeks to review the patient's progress. Symptoms of low mood or situational distress can often improve with time, particularly where there is an identifiable precipitating factor. Regular review also provides an opportunity to reassess symptoms and determine whether further intervention is required.

It is important to recognise, however, that individuals experiencing severe depression or acute suicidal intent do not always present to primary care before acting. While some patients will seek help, others may not engage with healthcare services at all.

As a matter of practice, I would not routinely initiate antidepressant medication myself in these circumstances. Instead, I would refer the patient to the mental health team for a comprehensive psychiatric assessment, allowing specialists to determine the most appropriate management plan, including whether pharmacological treatment is indicated.

In my clinical experience, I have found that antidepressant medications do not consistently produce the intended therapeutic benefit and, in some cases, appear to exacerbate symptoms. Consequently, I favour specialist assessment before commencing pharmacological treatment.

 

[ageingpartyfiend]

In many cases, I would arrange a follow-up appointment in approximately four to six weeks to review the patient's progress. Symptoms of low mood or situational distress can often improve with time, particularly where there is an identifiable precipitating factor. Regular review also provides an opportunity to reassess symptoms and determine whether further intervention is required.

It is important to recognise, however, that individuals experiencing severe depression or acute suicidal intent do not always present to primary care before acting. While some patients will seek help, others may not engage with healthcare services at all.

As a matter of practice, I would not routinely initiate antidepressant medication myself in these circumstances. Instead, I would refer the patient to the mental health team for a comprehensive psychiatric assessment, allowing specialists to determine the most appropriate management plan, including whether pharmacological treatment is indicated.

In my clinical experience, I have found that antidepressant medications do not consistently produce the intended therapeutic benefit and, in some cases, appear to exacerbate symptoms. Consequently, I favour specialist assessment before commencing pharmacological treatment.

That's good to hear.

Far too much dishing out ssri's going on by GP's who have very little in the way of actual mental health training

Mind you, psychiatrists are also following the medical model and primarily just dish out drugs anyway. But still, you'd expect them to have a much greater knowledge of mental health, and not working outside of capacity is an ethical requirement in healthcare positions so it's great to see someone acting responsibly and referring on.

 

[Bleaney]

The main problem is that access to psychiatrists and the like is beset by huge waiting lists in the public sector. Such appointments are expensive (for the NHS to fund) too.

It's far easier, quicker, and cheaper for Drs to dish out SSRIs after a 2 minute conversation, or a 5 question depression or anxiety "assessment." I think it's safe to say that mental health treatment and assessment on the NHS is extremely poor, on the whole.

Although I totally agree that Logs approach is the right approach, and I personally could have had my neurodivergencies diagnosed some 25 years earlier than I actually did, if my GP had followed his practice, which would have been of huge benefit to me. But Log works in the private sector. Clearly those patients with the financial means potentially have access to far better services.

 

[Perkins : Reborn]

It took a lot of time for me to be offered sertraline; it was only breakthrough depression whilst already on lithium and quetiapine for nearly a decade that prompted it.

Fair enough, it might be overprescribed, but it actually does me some good rather than self-medication with benzodiazepines and / or other downers, which is always a disaster.

 

[Bleaney]

On my very first visit to my GP, when presenting with low mood and anxiety issues, IIRC I was asked a pretty leading question, it seems to me. It was something along the lines of "what do you think might help your situation/ why have you come to see me?" ('what do you me to do about it?', essentially being what I was being asked, it seemed to me.) I replied that maybe medication might help. He then went on to discuss various SSRIs, and made a point of mentioning that it was me who had suggested the medication option, and not him. Not sure why he had to make that point, maybe to absolve himself of any future blame or 'guilty conscience' issues, if there were to be any come-backs. I did think it was a bit odd at the time, for him to say such a thing in such a way, and maybe that should have given me pause for thought, but my situation really was pretty bad and quite desperate at that time. I felt that I needed to try something that might help.

There certainly are come-backs and issues now, but it's probably getting on for 30 years later now, and all of this has taken a very long time to crystalise in my mind, and it's only after coming across a lot of accounts of other people's experiences with these medications, mainly via various internet sources, that I have become much more conscious of the potential downsides of these medications, along with the horror stories of patients difficulties with withdrawing from these meds, after long term use.

I don't really think that any of the meds helped my mood or anxiety in the least. Apart from indirectly with Mirtazapine helping with sleep, as obviously poor sleep or lack of sleep has a huge effect on mood and anxiety.

 

[Perkins : Reborn]

Perhaps for me it's different because I was on heavy psychiatric drugs long before I touched sertraline.

I did touch benzos the other week but I regretted it. Just a highway to stupidity and more drugs.

 

[ageingpartyfiend]

It's far easier, quicker, and cheaper for Drs to dish out SSRIs after a 2 minute conversation, or a 5 question depression or anxiety "assessment." I think it's safe to say that mental health treatment and assessment on the NHS is extremely poor, on the whole.

It is indeed.

My issue is that GP's have the authority to liberally dish out what are extremely harmful drugs to many people via what is essentially a tick-box exercise and flow chart. Anyone with an average IQ could do that.

Many (the vast majority?) of GP's get very little training in mental health during their otherwise quite extensive training

 

[Shambles]

My first interaction with psychiatric services resulted in a paroxetine script. After a few decades of bullshit I finally feel like my issues are being addressed.

I was unfortunate enough to hit the time when SSRIs were the new hotness so was, perhaps unsurprisingly, scripted on the spot with one of the worst.

I’d like to think things have improved… but far more recent experience from friends and family suggest it’s still SS(N)RIs first and very much foremost, with prompt referral to psychiatry and/or other forms of talking therapy lagging far, far behind

 

[ageingpartyfiend]

My first interaction with psychiatric services resulted in a paroxetine script. After a few decades of bullshit I finally feel like my issues are being addressed.

I was unfortunate enough to hit the time when SSRIs were the new hotness so was, perhaps unsurprisingly, scripted on the spot with one of the worst.

I’d like to think things have improved… but far more recent experience from friends and family suggest it’s still SS(N)RIs first and very much foremost, with prompt referral to psychiatry and/or other forms of talking therapy lagging far, far behind

Nothing has improved. There isn't the political will seemingly, not to mention the £££

I encountered someone with a shocking case of self harm lately, 3 weeks into taking the fluoxetine after taking a GP's word as gospel. Never a single urge to harm herself prior to two weeks into the meds (yeah yeah correlation / causation blah blah

Yeah you could argue that she 'should' have taken more agency in her approach, but she was 18 and deferred to authority as many do. She cried in the GP surgery so much that she could barely speak, and didn't answer the questions properly and was ushered out with a magic script.

It transpires that she was................................................homesick (is now off the meds and much better). That GP is at best totally incompetent. I'd call it dangerous, abusive even. Mainly however I don't 'blame' the GP's, what else can they do?

 

[LoginNotSecure]

Nothing has improved. There isn't the political will seemingly, not to mention the £££

I encountered someone with a shocking case of self harm lately, 3 weeks into taking the fluoxetine after taking a GP's word as gospel. Never a single urge to harm herself prior to two weeks into the meds (yeah yeah correlation / causation blah blah

Yeah you could argue that she 'should' have taken more agency in her approach, but she was 18 and deferred to authority as many do. She cried in the GP surgery so much that she could barely speak, and didn't answer the questions properly and was ushered out with a magic script.

It transpires that she was................................................homesick (is now off the meds and much better). That GP is at best totally incompetent. I'd call it dangerous, abusive even. Mainly however I don't 'blame' the GP's, what else can they do?

Put a complaint in. Contact the surgery and find out what their official complaints procedure is and go from there.