My story (long sorry)

[hermi]

Hi there!
This is going to be a long post so please bear with me! I had postnatal depression after the birth of my son in 2007...undiagnosed for 11 months, I was started on Citalopram which was fab. I recovered on that and then decided to stop it, I had no withdrawals and stopped it with no problems.

Move forward - December 2010 and the birth of my 2nd son, 8 hours of post birth agitation, crying, depression, hysteria...all started within an hour of birth - must've been my hormones! I was seen by the mental health midwife team and because of my history of PND previously was started on Sertraline 50mg (the only AD they recommended for a breastfeeding mother!).

I started it 3 days later as there was a delay in getting the tablets despite the fact that with one dose of diazepam, 4 hours of sleep and within 24 hours of giving birth I felt much better...I got through the next few days absolutely fine. It was a week after starting Sertraline I suddenly woke up with the worst sweating and anxiety and panic EVER!

I did consider stopping them but after a visit to the G.P. - in fact I saw my Dr every day for a week...he convinced me it was depression and anxiety and to carry on with the meds. Within 10 days of starting them I was admitted to a psychiatric mother and baby unit for 'management' My sertraline was increased even though the symptoms had started to get better...again exactly a week after the increase in dose all the symptoms came back worse resulting in a further increase until I was on the maximum 200mg.

After about 3 weeks I was still suffering the anxiety symptoms although the symptoms were mostly physical not psychological. Plus hearing, and eye sight disturbances, dizzyness, nausea, slowed heart rate, low blood pressure. Eventually these things got easier but I was still weepy and 'depressed'. So they decided to 'kick start' the AD with an antipsychotic - Risperidone, 1mg.
I started with tiredness and after a few weeks muscle aches - I was given procyclidine which I took (and still do to help with the leg stiffness).

Got out of hospital after 3 months better but not right. Mood swings...mood up and down..super happy one week, depressed the next, lack of energy and motivation, unable to function normally.
August 2012 - suicide attempt. I saw my psychiatrist and it was decided to change my AD to mirtazipine...weaned down the sertraline as instructed over 3 weeks then stopped. Started the mirt. at the same time as weaning the sertraline.

Result..sudden increase in physical symptoms of anxiety and sweating...got really bad about a week after stopping sertraline for about 3 days then went back to the level it was at when it started. I decided maybe it was the effect of the mirt. so under advice of my psychiatrist weaned off the mirt. Had 2 weeks of horrendous withdrawals then the anxiety went back to the level it had been at before I weaned the mirt. So no we were thinking had the sertraline been masking side effects of risperidone and when I changed to mirt. they surfaced???

Decided to wean the rispiradone as I had started with muscle tremors, sweating, nausea all in the mornings starting about 6am til 10 or 11 am, always at the same time and never at any other point in the day...I did it quite quickly, a few days after dropping the dose by a tiny amount I would get increase in anxiety symptoms then it would go back to what it had been and so I would then drop the dose again after about a week of it being at the 'normal'level. Im now off the risperidone for about 25 days and the tremors are no better neither is the anxiety. My muscles are stiff and painful somedays. I never had any of this before meds.

I had a couple of good days with hardly any tremors or anxiety day 11 and 12 after stopping the risperidone so I thought I was starting to recover from the withdrawal.

Thanks for reading, any advice or alternative therapy advice would be appreciated. I know I am suffering and maybe have stopped the risperidone +/ the other meds a little too quickly but I don't want to go back on it at all as the other effects I was getting combined with what Im getting now would be too much to tolerate.

If I had known about tapering before stopping these meds I would have done it a lot slower but what is done is done I suppose.

I'm hoping this will end soon and any knowledge from people who have gone through it would be helpful :)

[hermi]

My current psychiatrist (a different one to the one that increased my sert. and started the risperidone) totally agrees from my symptoms that everything I have suffered was due to the side effect of the meds and not due to me. In fact she was very surprised the first consultant did not put all the evidence together and come to the same conclusion. She says I have been super sensitive to seretonin hence all the side effects. I have been totally mismanaged. I do not feel depressed at all, in fact my mood has been VERY stable since stopping the AD's. I v had none of the high and lows, swinging moods I was getting prior to stopping them, nor the feelings of suicide. Mentally I am so much better than when I was on them. Physically its a different story as posted above.

[Luc]

Welcome to IAWP, Hermi!

Yes, it looks like you had an adverse reaction to the drugs and you were then put on more of them to only mask it. That has been quite a merry-go-round of the meds there. Some of them could have caused additional adverse reactions and WDs, too. From a physiological point of view they all work in different ways. So it's good to hear you feel stable now despite it all.

You might be now in a combo of an adverse reaction/s *and* WD/s. The physical symptoms (rigid muscles) as well as those of a psychological nature (anxiety) are the part of it. Also, the sudden mood swings you are experiencing are the WD "waves and windows" pattern.

You may want to have a look at this sub-forum; http://antidepressantwithdrawal.info...ealing-Methods

*especially* the Omega-3 thread.

If you compared how you felt before going off of the Risperidone to the way you feel now, are, on average, the symptoms more or less intense?

[hermi]

If I was to compare it I would say its the same except with the odd day thats better here and there.

As already said my psychiatrist thought that it was side effects of risperidone (that suddenly appeared when I started cutting down the sertraline) that was being controlled by the sertraline and when I stopped the sertraline I had nothing to help with the risperidones effects.
In fact it makes more sense that wasn't the case but it was actually sertraline withdrawal which has carried on this whole time.
I wonder if it looks like I have come off risperidone for side effects that were actually withdrawals from another drug which are still continuing and have been made slightly worse since coming off risperidone. This would explain why these 'side effects' (or withdrawals as they may actually be) have not improved much since stopping risperidone.
Risperidone did have its own set of side effects which I'm better off without. The question is what do I do about this possible sertraline withdrawal which seems to be going on and on?
I suppose if it just a few weeks after stopping it I might consider restarting a smaller dose just to see if eases but its months down the line now and I'm not sure reintroducing a load more side effects would make me feel any better. I suppose managing it the best I can is the best way now.
Iv had a few months of the same symptoms at the same time every morning since I cut it down.
I wonder why its the same time every day?
I tried fish oil - it really aggrevated my symptoms and made them a lot worse. I will see if things settle - I haven't had any for a day or two. I will try that one again in a couple fo weeks just to see if it was that or if it was a coincidence.

[hermi]

The tapering regime given to me was just meant to be over a couple of weeks, I slowed it down very slightly by another week...coming off it wasn't so bad it was after I stopped it that it got worse. The mirtazipine was also stopped very quickly again over 3 weeks. The withdrawals were hell but subsided somewhat after 4 days and I went back to experiencing what I have already explained about above after about 2 weeks from stopping the mirt. This is still ongoing. Some days I feel like it will be forever, I've read that for some people it goes on for years and years.
I am frightened this is this case with me.
I didn't react well on the meds so I didn't expect it to be an easy ride coming off them but I didn't expect it to be this bad.
I see my psychiatrist on the 25th April. I expect she will suggest to reinstate them. For me how do I really know which med is causing me the problems now, or is it a combination of 2 or all 3? No one knows? I don't think that reinstating any of them is a good idea.
The side effects of sertraline put me in hospital for 3 months whilst they 'managed' it with rispiradone and increasing the dose of sertraline. I'm not doing that again! The mirtazipine also had my mood up and down but not as bad as the other.

[Sheila]

Welcome, Hermi!

Oh, I am so, so sorry to hear that you have been put through this iatrogenic hell. It seems clear as day that you had an adverse reaction to the Sertraline, and tons of side effects from the Risperidone.

Am I understanding – you have been off the Sertraline since about August 2012?

Another way of looking at it is that you tolerated the Citalopram OK once, but the second time you took an SSRI, you got a kindling effect. Your system was sensitized to either that class of meds or to any neuro-active med. You might have had the same adverse reaction to any SSRI or psych med at that point.

I’m not an MD, but based on my years of experience hearing these stories in the online support forums, I would say that you have to stay away from any neuro-active meds from now on. Your system is sensitized.

It's possible that your PND also shows that you are very sensitive to hormone shifts. You have a fine-tuned system that needs to not be man-handled.

You *will* heal from the Sertraline and Risperidone. You just have to wait and keep doing all the things that gently support your health.

Please tell me how much Omega-3 you took and what happened when you took it.

What are your most troubling symptoms now? Maybe we can brainstorm some things to help.

[Luc]

In such cases, Hermi, the best option is to go by the way you yourself feel about this situation. You may want not to risk the next of adverse reactions on top of being in WD from some of the drugs, too. Your system is already healing and, in order to heal to the fullest, it needs lots of free-of-drugs room.

[hermi]

I think I am very hormonally sensitive and for the PND the citalopram got me out of a hole.
I do not believe I had PND with my 2nd son. I had an 'episode' that lasted 8 hours due to the sudden change in hormones after birth, the AD was for precaution given my history of previous PND. I believe I would not have suffered if I had never had taken them. .I can't tell you how many times I have cried over that decision to start taking them or the guilt of putting, my older boy through 3 months of being without his mother or the effects this has had on him. He is very insecure at times since.
I can't help feeling so guilty for him, and now I am suffering physically.
The omega-3, I can't remember how much, it was a very low dose but it cheap supermarket bought with god knows what in them I suppose. I have put my hand in my pocket and bought a purer fish oil that has gone through the process of having toxins removed, and has very little other ingredients that may aggrevate.
Basically I took it in the morning for 2 days and both nights I had anxiety all night almost as severe as the initial withdrawals, insomnia..I only slept 2 hours broken sleep both nights.
Yes I stopped the sertraline in August and the mirtazipine in december...these withdrawals could be from either or both, plus the rispiradone I stopped 26 days ago. I could still run into trouble there yet I suppose as well.

The effects I'm getting at the moment are waking up at approx 5-6am every morning with muscle tremors (all over body), sometimes skin tingling/crawling but not always and most of the time its mild, sometimes sweating - again ranging from soaking wet to very little. Physical anxiety symptoms - 'rushes' of adrenaline going through my chest and head sometimes its more nervousness with shaking (like you would if you were nervous about an audition or interview, BAD fluttering in the stomach and chest) than anxiety. Prickling skin. Feeling like I'm 'up against something' like a resistance or as if some invisisble force is trying to stop me from 'doing' - this is more of a psychological feeling than physical, its hard to explain. I get feelings of frustration and feeling like I want to cry. By about 10am-11am its mostly gone. This is very physical more so, even with it going on I have the ability to get up, sort the kids out, go to work etc. If it was true anxiety I wouldn't be able to act so rationally. Sometimes I get panicky - not from panic attacks to do with illness or withdrawal just with the feeling that I can't do anything to stop all this from happening.

It happens EVERY morning at approximately the same time to varying degress of intensity ranging from 'I can just about feel those tremors if I lie still long enough' to 'OMG the bed is shaking!'

By lunch time I'm ususally fine. Sometimes the feeling stay all day like the nervousness and wanting to cry but the physical things 90% of the time die down by late morning.


Thank you for taking time to read all this and reply. I cannot tell you how grateful I am :)

[Luc]

Hermi, you mention the feeling of guilt. I'm certain you did and do all you can (considering how terrible you feel), to be a great mother for your son. You do all you can to improve, and it will happen. Don't blame yourself for things that you had now influence on.

[Sheila]

Given that you seem to be a chemically / hormonally sensitive person, and that you are functioning very, very well at work and in parenting, my guess is that you would do best to just ride out the w/d and wait for your system to stabilize, perhaps adding a few gentle relaxation techniques or supplements.

I’m sure your older son will heal from the difficulties he had to go through. You’re probably already doing this, but do you explain to him often what happened to you (in general, non-threatening terms), *how this was absolutely not his fault*, and how you are now fine? Over and over?

Just think – because you have learned the hard way about psych meds, you will be able to teach and your children to think critically about them, and protect them when vast numbers of children are being put on psych meds.

All of your early morning symptoms are classic w/d. They will slowly get better by themselves.

I’m not going to push Omega-3 on you. I’m just really interested in the potential of Omega-3 to help us, so, am I understanding right? You haven’t tried the new, higher quality pills yet? How much EPA and DHA do they have in them?