Comment by firecall | Hacker News Reader

Comment by firecall | Hacker News Reader

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Thats exactly the problem I'm having!

Working with my GP to titrate off Sertraline (Zoloft) at the moment.

My GP, like many others, wasnt really aware of the issues with getting off the drugs!

I describe the brain zaps as like a wave of electricity.

Like a Sci-Fi pulsing wave. As if i've got some sort of giant capacitor discharging in my brain.

The sort of thing from a 50s Sci-Fi movie thats a tower of electricity, glowing and pulsing and radiating an electrical light show!

Exactly the sort of thing that might re-animate Frankenstein!

It's not painful as such, but it's debilitating and causes you to literally pause and make a sharp intake of breath.

I hate being on the bloody things. Wish I'd never started them. CBT is much more effective in the long term, for me. YMMV.

I find SSRIs kill my motivation and creativity.

I'd really suggest anyone think twice before assuming these pills, that GPs dish out like candy, are an easy and consequence free solution!

Someone close to me is doing the same. Sertraline isn't easily available in tiny dose increments useful for weaning off gradually, and its half life isn't very long, so missing or reducing a dose is almost immediately noticeable for some people. A strategy that's helped is cross-titrating and switching to Prozac. Because Prozac has a massively longer half life it's a much smoother ride while you're gradually reducing it.

Generic sertraline comes in pill/tablet form, you can just use a pill splitter to get smaller increments. I just googled to confirm this before posting, and they're even scored down the middle for easy splitting.

Right, but splitting isn't sufficient for many people. The person I know was on 50mg. They tried to carefully shave off 1/8th initially, then 1/4 etc. It was error prone cutting them exactly and even a 1/8th change in dose at a time with a two week adjustment period caused them to have terrible effects. They cross titrated to Prozac and it became easy to taper down slowly. Reddit and forums are full of people that needed to reduce Sertraline by 1-5mg at a time over a period of months if they've been taking it long term.

I think far more people might find that they need to taper very slowly if more people got past the first step of tapering instead of just staying on them indefinitely. Many people feel more anxious and depressed on a slightly lower dose and take that as confirmation that they were born needing it, when it might be more the case that their brain has adapted to depend on it. If they were able to reduce more slowly and comfortably this might be more obvious. That matches what I saw with the person I know who is finally doing well on low dose Prozac.

Ah, I see, I mistakenly thought it came in smaller doses than 25mg.

> Right, but splitting isn't sufficient for many people. The person I know was on 50mg. They tried to carefully shave off 1/8th initially, then 1/4 etc. It was error prone cutting them exactly and even a 1/8th change in dose at a time with a two week adjustment period caused them to have terrible effects.

This was the case for me! It took me months to titrate down to 0 from Sertraline. Withdrawal side effects were terrible, and I’m pretty turned off to SSRIs in general now. My past doctors talked them up as “safe”, and treated the ramp down process as a tiny inconsequential mention.

I had tried to stop after stabilizing on a half dose, 1/4 dose, etc., and the side effects were too unpleasant so I had to start back up. I could only stop after I titrated down to 1/8th, every other day.

Maybe where you are it comes in tablet form. All capsules in Canada.

(Though in theory the contents should be homogenized, so you could dump the powder and take a proportion of it)

I hate being on the bloody things. Wish I'd never started them. CBT is much more effective in the long term, for me. YMMV. I find SSRIs kill my motivation and creativity.

That’s forbidden knowledge. For some reason they tend to just write you a recipe and see ya in a year, good luck with collateral damage to your life.

SSRIs get advertised as making you indifferent to bad things, well, you become indifferent to all things. Like a vegetable. It’s an amplitude modulator, not a negative cut off. I wonder how much that correlates with “psychotypes” and general development, because it almost feels like you become an average normal person, and not in a good sense. Blind, dumbed (not dumb but unmotivated), indifferent, uninterested. Just living through a life with a sort of a brainfog. Maybe SSRIs show success in large enough groups for which this is a natural state??

Also you can’t come. Ever watched The Fist of Rage?

Oh and if you hate bloody things, you’ll hate to cancel these much more :). Brain zaps are not the worst, it feels like all your psyche gets barely hinged together for quite a while. Like a wood house with every joint shaken a little for slack.

I'd really suggest anyone think twice before assuming these pills, that GPs dish out like candy, are an easy and consequence free solution!

Full agree.

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