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PaulNash

Sertraline, sleep and itching

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My neurologist referred me to a psychiatrist to help me deal with depression. First things that the psychiatrist did was try to put me on anti-depressants ('cos that's what they do).  She prescribed a sub-therapeutic dose (25mg/day) of sertraline.  Took about 2 days before my skin started to itch so much that I would scratch until I was bleeding.  Stopped the meds, itching kept on for another two weeks albeit less intense.  Still scratching, but more gently so no blood-stained sheets any more.

 

I've been on sertraline before, many years ago and higher therapeutic dose, with no significant side effects.  Very weird, presumably the increased serotonin levels trigger some pathways or other to cause the itching.

 

I'm seeing the shrink tomorrow, will try to persuade her to go with CBT or talk therapy instead -- it may be difficult to remember what happens in each session, but there should be fewer side-effects :-)

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Hi Paul there are so many different anti-depressants these days. But trying them all takes time and as you have found is not without consequences, especially as you need to take them for a couple of weeks before they build up in your system enough to make a difference.  The non drug methods do take longer and will require more work from you, but there's no reason you have to go with the "quick" fix. Remember to take your note pad and record your "homework".

Good luck with it.

-Heather

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Hi Heather

 

Thanks for the encouragement.  After the discussion, the shrink gave me a script for a different anti-depressant, which I filed away in my "emergencies only" file.  She also referred me to a group in the hospital who do CBT, and I am starting on etc CBT course in a few weeks. 

 

In the meantime, my mood is actually somewhat positive; I guess that the experience with the sertraline persuaded me that I needed to take control of my life, or maybe it was just tincture of time.  Or a short-term boost that kick some or other part of my brain into action.  Whatever the reason, mood is improving and the CBT should make it even better.  Plus I'm starting to run more consistently (not far, but every little bit helps) which helps my mood.

 

 

 

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hi paul :

 

I feel Cognitive therapy helps, talking with friends & family I personally found blogging & chatting with other survivors very therapeutic for my soul, also keeping routine, exercise, gratitude journal all helped me get off my antidepressants & has made me enjoy my new normal to fullest. hope to see you around often on our board, hatroom, & blogworld often. we do have schedled chats every day M-F 3-4 EST & evening on M,W,F 8-9 PM EST

 

 

 

Asha

 

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Whatever the reason, glad you're feeling better.   Becky

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12 hours ago, becky1 said:

Whatever the reason, glad you're feeling better.   Becky

 

 

 

Agree! :smile:

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Yeah to you for finding the change. There are alll sorts of things that help someone climb out of the hole. Whatever it was life gets easier once you figure out how to turn it around.

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Thanks for the encouragement and suggestions.  Right now I'm mostly OK, but keep a close eye on my mood and if it looks like it is starting to go downwards, I stop and spend 10 minutes clearing my mind which usually helps.

 

I'm still able to run, so we also tried renting a treadmill, and I spend 3/4 hour every second morning running on it.  This also helps my mood significantly.  Once the weather warms up, I can get outdoors and have some fresh air along with the exercise.

 

The biggest change was deciding to take back control of my life (to the extent that I can), rather than waiting to see what happened to me.  I'm starting to repaint the inside of the house, which is getting a bit grubby.  The quality of workmanship is not what it would have been before the stroke, but it still looks better than before the paint and makes me feel that I am still able to do things.  It takes much much longer though, as I have to mask up everything and put down drop cloths to deal with the regular mishaps.  It has turned into a form of practical and useful OT.

 

Oh, and a small data point.  The itching continued for about two weeks after stopping the sertraline, and has pretty much faded away now.  The shrink prescribed a different anti-depressant (also at a  sub-therapeutic dose); I have not filled the script yet, as the exercise seems to do the job OK.  I'm also starting a mindfulness course in about a month, which should improve matters even more. 

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I'm impressed that you are taking those steps to control your life. I'm not  voluntary pill taker myself and would prefer to sort out my problems on my own without the use of them.  Unfortunately this is not always possible!

Regards

Deigh

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I had major allergies as a child, and took bajillion of pills.  As a result, I can dry-swallow just about anything.  I'm not wild about pills, especially for mood, as they tend to have all sorts of side-effects.  I used to be a serious amateur runner, since my stroke I've struggled to run any sort of appreciable distance.  And as soon as I get tired, my left leg starts playing up and I start falling down (which can make for some spectacular crashes when jogging with friends).

 

Some of the meds that I was on initially had side-effects that were worse than the symptoms that they were trying to counter.  At least I'm down to just three pills once per day now.  And no injections (I was on Fragmin, which made me bleed sub-cutaneously, so that I looked like a major addict :-)).

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I hope you are a "good" faller then. Falls can really set you back unless you fall well. Learning to balance the desire to run against your energy level sounds like a good goal for now.  Please do your risk assessment and be sensible (Not that I can tell you off, my Family are forever telling me to be more realistic in my efforts.)  The most hated advice from the physio, "make haste a little more slowly, please"

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I've never been realistic in my goals.  My balance is pretty good, and I've been running on overgrown trails in the hills to get to be very good at falling.  Not always so good at getting up :-).

 

After my stroke, I thought that my balance was great until my OT made me try to stand with my eves closed (I fell flat on my face).  That was allowed by three months of intensive balance exercises (the local facility had no-one trained in cognitive rehab, but are very very good at physical therapy).  I ended up being able to balance on a Bosu on top of a trampoline, so probably better that I was before the stroke.  I just could not remember what order to stack them in :-).

 

With our extended winter (it was snowing a in Toronto yesterday), we've rented a treadmill, which has done me the world of good.  Both physically (means that I "run" every day or every second day, regardless of schedule or weather) and emotionally (nothing like exercise to get rid of the blues).  And I've started repainting the trim in our house, which has been pretty beaten-up over the past 10 years.

 

I've become very aware how much I have to be grateful for, and how lucky I am.  It's one of the many benefits of this forum; we all have some positives and we can discuss the negatives without being told that they don't really exist or aren't really important (I know a lot of very "positive" people who drive me nuts with that sort of talk; I guess they mean well).

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Right now I envy you Paul. I've had liver problems and am currently banned from all strenuous exercise.  It sucks, so much of my week was geared to my fitness and movement goals.  I lost a heap of weight through not being able to eat and now I'm watching the flab increase while the weight comes back as I'm eating normally again but getting next to no exercise.  We all have some of those "positive" people in our lives and there's not a thing you can do about them (well nothing that is socially acceptable behaviour)  So you have to grin, turn the other cheek, and sit on your hands.

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Hey Heather

 

I sympathize.  I hope that the liver issue resolves soon, and you can start exercising again.  Can you at least take yourself off on long strolls; just getting out and about, even if slowly, can make a huge difference to mood and health.

 

It's quite a pleasant change to have someone envying me :-).  I'll try to remember that to cheer me up next time I need cheering.

 

 

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Hi Paul, yes I'm allowed to walk and I do on the weekends. We are now heading into Autumn here so walking after work doesn't really fit in. I'm trying to get back to walking at lunch time, but I'm also lacking energy so I'm not getting to work very early either so lunch time often gets sacrificed. And after work I eat dinner and crash on the couch.  I'm going to have to beat myself up a bit and break the bad habits I'm forming before they get any worse.

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Paul, 

 I've been on Lexapro and Paxil, at different times in my life, and I know I'm a few meds caused me to itch, either side effects or allergic reaction.

Now that that's out of the way:

 

 Running on trails. Bravo to you. I can walk fast but not run anymore for the stroke left my legs feeing like they weigh 1000 kg each. Heavy. So I admire your ability and I deeply hope you can channel the "runners high" into your emotional health. There are many people that are able to get off the medications. I'm not one of them. No.. that's a lie.. Per my doctor and me, I'm weaning off of my depression medication after over 12 years.. ( so 2 years before stroke I started from Job exhaustion) and I've warned me friends and family that I'm going on an emotional roller coaster now. 

 

I still cannot close my eyes and stand straight. When I close my eyes, I get the ""whirling"" feeling. I did vestibular therapy : posting letter on the wall and turn my head to focus : walking on foam mats to feel my footing ( BTW I still can't walk on anything that's not sturdy) walking on the BTW walking on sand makes me look like a new born deer trying to walk.

 

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Kelli, Sand is very tricky. I was so pleased with myself when at my last disabled surf day I not only walked myself down to the beach I walked across the sand to the tide line without feeling all wonky. And then I kicked off my crocs and did it again barefoot just to prove to myself that I could.  Mind you by the end of a surf day I'm a physical wreck and was glad to have one of the volunteers walk back to the club house with me.  Your Bambi image was me on my first surf day, 2 years ago now.

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13 hours ago, ksmith said:

I still cannot close my eyes and stand straight. When I close my eyes, I get the ""whirling"" feeling. I did vestibular therapy : posting letter on the wall and turn my head to focus : walking on foam mats to feel my footing ( BTW I still can't walk on anything that's not sturdy) walking on the BTW walking on sand makes me look like a new born deer trying to walk.

That's the best analogy yet!  (I went to a beach with my mom and had a terrible time walking in the sand; this describes it perfectly!!)

 

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Our 16 year old granddaughter has a part time job at a local restaurant just above a west coast beach. Occasionally we found ourselves taking her to work. When this happened I would use the occasion to test out my beach walking skills. Handling the sand was not too much of  a problem, but when I pushed the limits and stood in the incoming water surges then all sorts of unexpected things happened. As the water started rushing away my feet naturally sank in the sand and the feeling was remarkably unsettling. Once I got over the panic then I began to enjoy it.

Not game to go for a dip yet, a paddle in the briny was sufficient.

Deigh

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On ‎4‎/‎12‎/‎2018 at 10:21 PM, heathber said:

Kelli, Sand is very tricky. I was so pleased with myself when at my last disabled surf day I not only walked myself down to the beach I walked across the sand to the tide line without feeling all wonky. And then I kicked off my crocs and did it again barefoot just to prove to myself that I could.  Mind you by the end of a surf day I'm a physical wreck and was glad to have one of the volunteers walk back to the club house with me.  Your Bambi image was me on my first surf day, 2 years ago now.

That is wonderful that you were able to do that once again. It's always a great feeling when you do something that you were certain you couldn't. I'm so happy for you!!!

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Disabled Surf days are the highlights of my summer, being sick this year meant I only got to 1 of the 4 that are held a practical distance from home.  The group who organise it are fantastic. But it only happens a limited numbers of times each summer once the water warms up enough.  They take anyone who wants to for a surf, and cater for any and all physical or mental disabilities and all ages.  It's just the shore break but it's the best feeling, and everyone has FUN The volunteers I've spoken to have as much fun as the surfers. The day I did get to this year I got dumped at the end of my last run, but I never felt unsafe the crew were right there ready to fish me out and I came up laughing so hard I could barely stand.

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Sounds wonderful.  Maybe I should pop over to Oz for one of your surf days :-).  

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