The Sertraline Theory

It has taken me a while to get to this point, but I am not embarrassed to say that I am on antidepressants. Each morning I take two 100 mg Sertraline pills and one 150 mg Bupropion XL pill. These were prescribed to me by a psychiatrist to treat my anxiety, depression, and panic disorder.

I was first prescribed Sertraline (the generic for Zoloft) in January 2009.  Over time my dose was increased until I eventually reached 200 mg a day, which is the maximum allowed. When this still wasn’t enough my doctor started trying other medications in addition to the Zoloft. After a few months, she settled on Bupropion XL (the generic for Wellbutrin). This certainly helped control my depression, but my anxiety was still a looming problem. Clonazepam (the generic of Klonopin) was added on a “take as needed” basis. I try not to use these often. I only take one if I’m in the middle of a panic attack. It is nice knowing I have them if I need them, though. They are sort of like a safety net to fall back on.

I am not sure exactly how long I have been on this precise combination of pills and dosages, but I know these are the three medications I was on when I studied abroad in the summer of 2011 (as a frame of reference). I’m not even sure I know who I was before the antidepressants. Some people say the pills change you or dull your personality, but I don’t think that has been my experience at all. The medication makes me feel calm and better equipped to handle life and the challenges of daily living.

I was originally strongly against the idea of taking medication to deal with emotional problems, but I am so glad I changed my viewpoint. I don’t know how I would have made it through the last seven and a half years without the pills. When I started the medication I was practically lifeless. I didn’t care about myself, my success, my passions, or, sometimes even, my existence. Getting out of bed in the mornings was a struggle and I completely lost interest in maintaining friendships and communications with the outside world. I would shut myself in. I had become a shell of my former self, but the antidepressants changed all of that. Things these last seven and a half years have by NO means been easy, but they have been manageable. I no longer feel like the world is collapsing every time I leave my bed.

Why is all of this relevant?  I wanted to paint a picture of how much I believe antidepressants changed my life for the better. I’d like to be completely weaned off of them some day, but not anytime soon. I am terrified of falling back into the rut I was in when I started. I was in a really dark place back then and I have no interest in working backwards.

Today I received a voicemail from the hematology center asking me to call ASAP because my doctor had been trying to get ahold of me. I called on my way home from work and the receptionist put me on hold and went to get the doctor. The doctor picked up the phone and told me that he needed the contact information for my psychiatrist. He went on to say that spontaneous bruising and bloody noses can happen when an ITP patient is at less than 30,000 platelets, but shouldn’t be happening at 54,000. He said the sheer quantity of bloody noses perplexed him, which is why he needed to do the bone marrow biopsy last week and rule out other causes. Now that those results showed no abnormalities, he was back at square one, so he reread my charts and labs. This is when he realized I was on Sertraline. I don’t know all of the logistics yet, but the hematologist told me that Sertraline has been known to make platelets “sensitive”.  He now believes my spontaneous bruising and bloody noses are due, in part, to my antidepressants. I am not sure exactly what my hematologist is going to ask my psychiatrist or what my psychiatrist is going to say.

Will I be tapered to a lower dose of Sertraline?  Is my Bupropion XL also a problem?  Am I going to need to wean off of Sertraline completely?  How will this medication change affect my overall mental state and wellbeing?  Are there any common side effects to weaning off of long-term Sertraline usage?

Did this medication affect my platelets?  Will coming off of this medication increase my platelets?  Are they linked at all?  Or is Sertraline solely linked to “platelet sensitivity” and not destruction?

I am really nervous that the two doctors are going to talk amongst themselves and agree to wean me off of the Sertraline.  I am terrified of not being on it. I barely remember who I was before it, but the parts I do remember are less than ideal. I can’t go back to that place mentally – it took me years to completely claw my way out.  Granted, I feel much better equipped at this point in my life to handle whatever challenges may come my way, but I’m afraid to find out if that is me or the medication talking.