Disclaimer: Do I think that all pharmaceutical medications are bad? No. Do I think that all psychotropic medications are bad? No. Am I personally recommending that no one in the whole entire world take Zoloft? NO. I am sharing this experience so that people can realize that not every medicine is perfect for every person, and not every problem has a “magic bullet.”
After experiencing 6 months of persistent chronic depression symptoms, and knowing that I have a personal history of difficulty in this area, I decided to bite the bullet. Anyone who knows me knows that I hesitate to take any medication at all, preferring to “tough it out” or use more natural, gentle methods to help the body do its job naturally. However, after about a month of intense depressive symptoms that left me drained, I decided to talk to my doctor about a “safe” mood stabilizer for pregnancy.
I was immediately recommended Zoloft™, which is the brand name for sertraline hydrochloride, a popular SSRI (selective serotonin reuptake inhibitor). **See notes below on SSRI function**. I was hesitant to make a commitment right away; honestly, I was expecting her to say, “No, there isn’t anything safe to take during pregnancy.” I called a trusted friend, a former licensed counselor, for advice on the subject. She initially recommended that I avoid the medication, and try behavioral therapy first. She did agree, however, that there was a good chance that the medication would make a temporary solution to make my symptoms more bearable until I could address the underlying issues causing the imbalance.
I also did some private research on Zoloft™, but only in the realm of pregnancy and breastfeeding. Previous experience with SSRIs told me that there would be a time period of adjustment to the medication, just as with any medicine, in which I might experience digestive upsets, drowsiness or insomnia, etc. The red flag that went up for me is that when Zoloft™ is taken during the last trimester of pregnancy, it increases the risk for pulmonary problems in the infant. That makes sense; the last trimester is when the lungs are forming, branching out the bronchi and forming the complex system that brings life-giving oxygen to the blood. So naturally, I called my nurse back to express this concern.
She assured me that in the 10 or so years she had been practicing, she had never seen pulmonary problems in the infants of mothers who took Zoloft™ during the third trimester. Because the only research I had done was in respect to pregnancy and breastfeeding, this assurance was enough to persuade me to put aside my personal fear of pharmaceutical medications and try the Zoloft™ in hopes of alleviating the depressive symptoms long enough to think clearly and address the underlying issues.
The first day wasn’t so bad. About three hours after I took the medication, I had some nausea and lost my appetite, but for the first day on a new medication, I expected it. The second day, the side effects progressed. I started experiencing anxiety symptoms; since I have a problem with anxiety disorder and OCD, this didn’t really throw up any flags. I had auditory hallucinations when trying to sleep at nap time, which I informed my husband of in case it became a recurring issue. By evening, I was so nauseated that I sat at the table and watched my family eat dinner – something I haven’t done since my first pregnancy.
Day Three: I spent some time in my favorite health food store browsing before an appointment across town, and while perusing the foodie section, I came across a bright orange flyer on SSRIs. It was warning about the use of SSRIs in children, but particularly it cited statistics that Zoloft™ was shown to be effective in the treatment of OCD in children at a rate of 59%, 10% more than the placebo sugar pill. 10% more than a sugar pill? Only 59% effective? How strange! The wheels started to turn in my mind, but aside from the concern that I might be enduring all the nausea and hot flashes for nothing, it didn’t change anything. Again, starting three hours from taking the medication, I started experiencing untoward symptoms. I was eating lunch with my husband and children at one of our favorite Chinese restaurants. Suddenly, I was so overcome with nausea that I was unable to eat my lunch, or even to chew it. The taste became as cardboard in my mouth, and I mechanically chewed as much of my meal as I could bear. I boxed half of it to take home. During the course of the meal, however, I started feeling very “loopy” and confused. I would turn my head and it seemed that it took my mind a long, slow time to adjust to the movement. My food didn’t quite look right on the plate. I stared off into space, and realized that I wasn’t hearing my children talking to me. I expressed my concern to my husband about driving home with the children; he just advised me to “push through it.” This agitated me; I was being acted upon by an outside chemical force. How does one push through that?!? I knew he was right about one thing, though – I had to get home. I don’t remember much of the rest of that day. I tried to finish my lunch later in the afternoon and was uncertain whether I could keep it down. The excessive salivation and nausea was enough that I was sure I couldn’t make it to a safe place to vomit if the time came. Thankfully I was able to bear through it.
The true realization came on the night of day three, however. Insomnia was at its worst – when you’re exhausted, long for sleep, and yet the sleep doesn’t come. I wasn’t even able to attempt sleep until at least 2-3 AM, 2 hours past my usual ritual relaxation stage. I tried to lie down, and then I was wracked with the most excruciating panic attack I’ve had in years. About 3:30, I woke my husband, begging for help. I couldn’t quite articulate what I needed, and bless him, in his sleepy state he isn’t the most patient of people. “Think of something else!” he says. Think of something else… I couldn’t think of anything else to think of!! But he was half-asleep, so it was excusable. He suggested taking a barefoot walk around the backyard, feeling the cool wetness of the grass on my feet. I stumbled around the yard, crying and praying and begging for help. When I returned to the house, I vacillated between stumbling blindly around the house and kneeling on the floor, rocking back and forth. It was hideous. This lasted until at least 4:30 in the morning, when stumbling to the bathroom for about the 15th time (hooray pregnancy), I had the presence of mind to pray that the Lord would bind the demons that were using my physical weakness to torment my mind, that He would cast them out of my house, and that He would raise up a shield of protection over myself and my family. I stumbled back to the bed, falling into a fitful, exhausted sleep. I woke about every twenty minutes for several more hours. I had hot and cold flashes, physical feelings of intense terror, sweats, and an uncontrollable obsessive thought pattern.
I woke on the morning of Day 4 to the immediate return of the obsessive, intrusive thoughts. I honestly don’t remember much of day 4; it was mostly just surviving. I took my medication faithfully at 9 AM. I thought for a while that perhaps I was finally adjusting to the medication, forgetting that my symptoms never surfaced until about three hours after consuming the pill. I spent some time in the early morning sun, pulling weeds from a seated position. I walked to the mailbox and back, and watched the dogs play. I tried everything I could think of to help ease my panic. Lunchtime hit, and by that point it was obvious that I wasn’t going to be able to eat that day, either. I began to suspect that the Zoloft™ was aggravating my OCD rather than helping it, and looked up the drug information on Zoloft™ on www.drugs.com. Here is what I found:
“Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.”
Whaaaat? Zoloft™ is often prescribed FOR the treatment of OCD and other anxiety disorders. You mean it could make it worse? You’re kidding. I called my nurse up, and she assured me that the medication had not possibly been in my system long enough for the therapeutic effects to start working. I insisted that I thought I should at least give the medication a break for a few days, to see if my anxiety symptoms lessened. If they persisted or got worse, in spite of discontinuing the Zoloft™, I agreed to try something else to target the depression. She was very reluctant to agree to this, but I was adamant. I’m not going to pose risk to my unborn child for a medication that doesn’t work for my body.
The afternoon was terrible. I could barely function. I sat, curled up, on my front stoop, because it faces to the south and had direct, beating sunshine. I attempted to play with my dogs, barely able to concentrate even on the feeling of their fur beneath my fingers. I stayed on the porch there until the nausea from the added heat of the sun became unbearable. I called up my trusted friend again, telling her everything that had happened. She was surprised to find out that a medication commonly used in treating anxiety disorders actually had a warned side effect of increasing the anxiety instead of aiding it. We talked for a long time, and I was able to calm some. It helped to know that she not only believed me, she understood – at least, on an academic level – what I was going through. We discussed a few options to help with my underlying spiritual dryness and the return of my previously controlled OCD. I still felt terrible, but I felt as if a burden had been lifted. I had hope! I wasn’t imagining things. There was a genuine possibility that the medication WAS making me have these terrible intrusive thoughts. It’s not that the medication itself it bad; it’s that it is bad for me, for my body.
I went out with my husband and family again that evening; payday is usually grocery day. We went to a local Italian place in hopes of finding simple, digestible starches for me. Unfortunately I was only able to eat a few bites of my meal and a single piece of bread. The nausea and confusion were coming again in waves, making it difficult to concentrate on my husband’s face as he spoke. I somehow managed to make it through Wal-mart to get a few things, and then we began the drive back to Pittsburg to do our grocery shopping. I could hardly tolerate the ride home, the nausea was so pervasive. Then, about halfway through our shopping, my intrusive, obsessive thoughts came back. The nausea hit in another wave. The hot flashes returned. I pushed through, although I’m sure I forgot a few things that I’ll need to get this weekend. We went home, and I went straight to the phone to call my dear friend. I talked to her as I put away the groceries. She prayed for me, there on the phone, that I would have comfort to make it through the night. Even as I knew that this night would be a battle, I felt encouraged, and my obsessive thoughts began to recede. A warmth suffused my face, and my headache started to recede. I was able to function a little, buoyed up by the hope that on the morrow, I would NOT be taking the medication and would begin to see an improvement over my symptoms.
I paid bills. I listened to a favorite children’s radio program with my husband and son. I piddled about on the internet, and my anxiety stayed at manageable levels. I headed to bed around 12:30, in spite of the rising panic and obsessive thoughts. I knelt and prayed a short prayer – that the Lord would bind the demons tormenting my mind, and that I might rest. I woke about every twenty minutes to repeat this exercise: toilet, stumble to bed, pray, fall into bed, sleep fitfully, wake. Finally, I gave in. Around 3:30, I prayed that if the Lord wanted me to endure this terrible mess, so be it. I would bear it, if only He would give me the courage, and would bind the obsessive thoughts. I slept in as little as possible, the hot flashes and sweating waking me up and keeping me uncomfortable. My son woke screaming with a bloody nose, and I cleaned him up, and brought him to bed with us, wrapping my arms around his tiny body. I prayed again that the Lord would help me to bear the burden He had chosen for me, and I finally slept.
At some point on day 4, I happened to scroll down the rest of the page at www.drugs.com, and here is what I found:
“Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.Call your doctor at once if you have any of these serious side effects:· very stiff (rigid) muscles, high fever, sweating, fast or uneven heartbeats, tremors, overactive reflexes;· nausea, vomiting, diarrhea, loss of appetite, feeling unsteady, loss of coordination; or· headache, trouble concentrating, memory problems, weakness, confusion, hallucinations, fainting, seizure, shallow breathing or breathing that stops.Less serious Zoloft side effects may include:· drowsiness, dizziness, tired feeling;· mild nausea, stomach pain, upset stomach, constipation;· dry mouth;· changes in appetite or weight;· sleep problems (insomnia); or· decreased sex drive, impotence, or difficulty having an orgasm.”(Excerpted from http://www.drugs.com/zoloft.html, emphasis mine)
It was then that I realized that there was no way I could have been imagining the symptoms; I didn’t even read this list until after I had already called my nurse to inform her of my decision to discontinue the medication.
Today is day 5. Slowly over the course of the day, my OCD has lessened to a background irritation, like the buzzing of a fly. I am able to think more clearly, and my appetite is very slowly returning. I have lost three and a half pounds over the course of these few days, bringing me back down below my conception weight. As my mind clears, shaking off the vestiges of the medication, it is becoming more apparent that my gut feeling was right – that this medication, although it may help others, is not for me.
I was really hoping that I would be better by the end of the evening, but the night time symptoms are returning. Granted, they are twenty bajillion times better than they were yesterday, but they are still there. My husband thinks it will be a few days before my system will completely purge itself of the effects. I was sure hoping for a better night's sleep though.
**SSRI – what is an SSRI? An SSRI is a selective serotonin reuptake inhibitor. It functions by slowing your body’s ability to reabsorb the chemical serotonin in your brain, thereby leaving more serotonin available for use.**
Warning from the Mayo Clinic on serotonin syndrome:
“Serotonin syndrome requires immediate medical treatment. Signs and symptoms include:ConfusionRestlessnessHallucinationsExtreme agitationFluctuations in blood pressureIncreased heart rateNausea and vomitingFeverSeizuresComa”(Excerpted from http://www.mayoclinic.com/health/ssris/MH00066)
