Zoloft (sertraline) And Suicidal Thoughts?

[bitterfight_]

Where do I even begin? Tomorrow is my last day of this month on Sertraline (25mg) and I have to go back to my doctors to get a new prescription and have a follow-up. I haven't noticed much change for anything at all, and my therapist said I should be noticing a change by now. The only change I have noticed was that for the past week I've been feeling extremely suicidal. Usually, I'm good at avoiding self-harming, but with these urges, come the self harm. I need to see my therapist soon to discuss this, as it ties in with some of what caused my ptsd, but I'm nervous. It's like - is it the Zoloft causing the suicidal feelings to return more strongly, or is it just that (because I'm very deep in my processing therapy) I'm reacting to that and it's amping up my suicidal feelings? It's hard to tell. I just want to know what your suggestions are. It's been really bad lately, but I don't want to go inpatient. I thought Zoloft would fix this, not make it worse or keep it the same. I'm so scared though.. It's been really bad lately.

 

[Deleted member 1860]

Hi
If you feel that the medication is increasing your suicidal thoughts, you need to call your doctor right away. If you feel that you are going to act on hurting yourself, you need to go to the emergency room.

Not all medications work for everyone. It sounds like this one isn't right for you. Perhaps you should talk to your doctor about taking something else?

 

[cdg]

I had trouble with it also. That is great advice. I hope you get better soon.

 

[Promicarus]

This from

http://www.nlm.nih.gov/medlineplus/druginfo/meds/a697048.html

("Zoloft and suicidal thoughts")

"You may become suicidal, especially at the beginning of your treatment and any time that your dose is increased or decreased. You, your family, or your caregiver should call your doctor right away if you experience any of the following symptoms: new or worsening depression; thinking about harming or killing yourself, or planning or trying to do so; extreme worry; agitation; panic attacks; difficulty falling asleep or staying asleep; aggressive behavior; irritability; acting without thinking; severe restlessness; and frenzied abnormal excitement. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor if you are unable to seek treatment on your own."

Where do I even begin? Tomorrow is my last day of this month on Sertraline (25mg) and I have to go back to my doctors to get a new prescription and have a follow-up. I haven't noticed much change for anything at all, and my therapist said I should be noticing a change by now. The only change I have noticed was that for the past week I've been feeling extremely suicidal.

You've mentioned that this is "my last day of this month on Sertraline (25mg)"...but not how long you have in fact been taking it.
If you've only begun recently, then that would jibe with the suicidality--especially considering the added factor of your being "very deep" in your "processing therapy".

How long have been taking Sertraline at this dose?

This from

http://en.wikipedia.org/wiki/Sertraline

"... The more complete data submitted later by the sertraline manufacturer Pfizer indicated increased suicidal behavior.[135] Similarly, the analysis conducted by the UK MHRA found a 50% increase of odds of suicide-related events, not reaching statistical significance, in the patients on sertraline as compared to the ones on placebo.[136][137]"


Also (same source):
"...Akathisia—that is, "inner tension, restlessness, and the inability to stay still"—caused by sertraline was observed in 16% of patients in a case series.[114] This and other reports[115][116][117] note that akathisia begins soon after the initiation of treatment or a dose increase; often, several hours after taking the medication. Akathisia usually disappears within several days after sertraline is stopped or its dose is decreased. In some cases, clinicians confused akathisia with anxiety and increased the dose of sertraline, causing further worsening of the patients' symptoms.[117] Experts note that because of the possible link of akathisia with suicide and the distress it causes to the patient, "it is of vital importance to increase awareness amongst staff and patients of the symptoms of this relatively common condition.

I want to emphasize the fact that I am neither a medical or mental health professional. That being said, I have taken Sertraline, myself, for some years, now. It is in fact indicated in the use of PTSD related depression, and anxiety, specifically. However, everyone's response/reaction to medications is unique-especially psych meds, it would seem.

Usually, it's agreed that low-dose Sertraline (which 25mgs qualifies as--even in those of particularly low body-weight), is only effective for complaints of anxiety--the antidepressive action not being seen until doses of 100-200mg are employed.

As you'll note above, if you suffer from "Akasthesia", an agitation, restleness "inner tension, inability to stay still", I would think that the important thing is to try to keep this in perspective--as a predictable and only temporary side-effect. I, too, experienced same when first starting Sertraline, and at increased doses.

If you're actually in immediate fear of self-harm, or suicide, please contact Emergency Services.

Usually, I'm good at avoiding self-harming, but with these urges, come the self harm.

This statement would seem to imply that you've already engaged in self-harm. Whatever the underlying reasons, something should be changed, and urgently, if you're engaging in this behavior currently. Please notify your prescribing physician immediately, and your therapist on first opportunity.

Please post back in order to let us know of your continued well-being, and updates with your progress.

Thanks for your honest post, and reaching out. If you ever feel the need, feel free to IM me with a personal message.

Please remember that there are those who have been in similar positions, and care, and seek help immediately if you are self-harming and/or actively suicidal.
Best wishes

 

[LilBit]

Sorry, my comment is not about the thread... but I love your saying, Someday this pain will be useful. I have found that to be true. And in my present pain, I am remembering and trusting that it will also prove true in the future.

 

[bitterfight_]

should call your doctor right away if you experience any of the following symptoms: new or worsening depression; thinking about harming or killing yourself, or planning or trying to do so; extreme worry; agitation; panic attacks; difficulty falling asleep or staying asleep; aggressive behaviour; irritability; acting without thinking; severe restlessness; and frenzied abnormal excitement.

I don't know.. I've definitely had the worsening depression, but that was before the Sertraline, as were the suicidal thoughts. It got really bad though last week, and since I've been off of it for 3 days now before I can go for my follow-up with my doctor, they have diminished greatly, which makes me think that the Sertraline might be increasing them (but, as I said, I'm getting into a rough patch with my processing therapy so it might be that too). The extreme worry - not so much, nor the agitation. Panic attacks are frequent with me, as is my terrible sleeping pattern due to my nightmares, so I can't really say they're increased or decreased. I also haven't experienced any of the rest like aggressive behaviour; irritability; acting without thinking; severe restlessness; or frenzied abnormal excitement..

but not how long you have in fact been taking it

I have been taking it for a month, so it might not even be nearly enough to do anything for me, although my therapist said I should notice a change around the last week in the month, so the 4th week. My doctor said 6 to 8 weeks though..

it's agreed that low-dose Sertraline (which 25mgs qualifies as--even in those of particularly low body-weight), is only effective for complaints of anxiety--the anti-depressive action not being seen until doses of 100-200mg are employed

Okay well that sucks, but it makes sense since my therapist said she wanted to start off at a low dose and move upwards..

if you suffer from "Akasthesia", an agitation, restlessness "inner tension, inability to stay still"

I don't, thank god. I haven't experienced this at all.

seem to imply that you've already engaged in self-harm

Yes, I used to frequently self harm, and I tend to use it as a backup coping mechanism if the suicidal ideation becomes "bad" or hard to cope with, which made me worried because I've tried to stop using this, and it's addictive. It keeps coming back.

notify your prescribing physician immediately, and your therapist on first opportunity.

I have, which is (thank god) why I have a follow-up in 2 days from today.

Please post back in order to let us know of your continued well-being, and updates with your progress. Thanks for your honest post, and reaching out. If you ever feel the need, feel free to IM me with a personal message.

Thank you so much, I will. I just wondered who else had had these experiences with Zoloft upping their suicidal thoughts/ideation. Thank you for the well-informed and lengthy response! It means a ton.

I've been okay for the past 3 days or so, since I've finished my last dose of it, which is surprising because I would assume that being off it would make me worse, but I've seemed to even out. I haven't spent nights sobbing, or spent hours - days thinking about hurting myself severely, and I haven't had to go call any crisis lines. I've been... "okay", if you know what I mean. Numb, I guess. I don't really feel much right now, which is good because I think right now I would rather feel numb than feel as suicidal as I was feeling. Thanks so much for the responses everyone. I'll post an update once I've talked to my doctor and therapist, which should be around Monday or Wednesday sometime.

 

[bitterfight_]

Also,

my comment is not about the thread... but I love your saying

why thank you. It's one of my favourite sayings, and I have it posted above my door.

I have found that to be true. And in my present pain, I am remembering and trusting that it will also prove true in the future

I find it to be true too, and I'm glad it has brought you comfort and reminded you of your strength.

 

[once normal]

What incredible inner strength you have to have dealt with those problems for a full month. I was prescribed Prozac (same family of meds) and within minutes of taking the dose became suicidal -- my body wanted to end it's life. It was the hardest night of my life trying to flush it out of my system. The Doctor immediately removed me off the meds and returned me to Ativan.

Now, six years later, they want to take away the Ativan and put me on Zoloft. After reading your email here, I know to hold firm and fight against it. I understand what you have been going through and again commend you on your strength to overcome those horrible, difficult, overwhelming feelings!

I am happy for you that you are off of that deadly drug and hope that you can find a medication that works better.