Autism and Sertraline

Some people experience anxiety as a side effect of sertraline, and that was my experience as well.

It did reduce the crying episodes [but didn’t really address the root cause of my depression] while increasing my anxiety.

I switched to citalopram, but I’ve heard that escitalopram has even fewer side effects than citalopram. It might be worth mentioning to your doctor that your anxiety is high and asking if escitalopram could be a good option for you.

Steraline really does not agree with me. Made me feel like a total zombie after only 3 days. I am now on Fluxotiene and that is ok but I tend to self dose when I need them as I do not want to be on anything long term.

It will vary from person to person, what works for some may not work for others. For me however Sertraline has been helpful. It took me from a depressed anxious wreck and **over time** has allowed me to start living again, I can go out now without crippling anxiety, and i feel much better within myself. Some of the thanks goes to the Sertraline but I have helped myself in other, smaller ways, like by drinking water instead of caffeine and getting in more physical exercise.

Congratulations on changing to a less stressful job. I expect it was a bit of both, your own dedication and the Sertraline. It sounds like you are doing amazingly you should be proud of your achievements. It's no small feat.

Really interesting reading everyone’s experience with different types of medication. I take Citalopram and the first three weeks were tough, I felt very very nauseous and woke up still feeling nauseous. Once I got over that I began to feel very detached from everything including my interests, there wasn’t much to look forward to and I just felt numb and emotionless. I tried to come off them without talking to my gp and after 3 days without them I felt equally awful in a different way and had really bad headaches. I tried for a second time last week and again felt terrible. I am really torn as to what to do as well. 

I have to say Sertraline has worked for me and has made a big improvement.I went onto it when i was diagnosed with Anxiety then when I got the autism and OCD diagnosis other education was given !

I was on sertralien for depresion. It helped but at a cost. I felt a bit muted emotionally and interlectually. But tbh depresion had me in zomby mode for large segments of the day before I went on it. It also screwed around with my sence of taste while I was on it. One of the first things I noticed coming off it is food tasted sweeter. It also made it hugely dificult to get up in the mornings in terms of sleep / tiredness.

Think of it as a mood stabaliser. It will helped take the edge off the lows .. but at the expence of taking it off the highs too. I was glad to come off it but I can't deny it was helpfull for a while.

I took Sertraline for 10 days, I couldn't detect any change in mood, but the daily migraines it gave me I certainly detected. I usually get migraines about  one or two days over a couple of months. For the last 5 days I took Sertraline, I had a migraine each day - a very painful and debilitating migraine. After I stopped, I had two more days with migraine, then two days with just visual aura and no subsequent headache. Then I went back to my usual level of infrequent attacks.

Yeah, the place the world makes the most sense to me is hiking, wild camping, or in my veg garden. The rest of the world is so broken I really relate to the world not being natural and therefore problematic!

I had one propranolol and will never take one ever again. But we are all different.

I didn't want to go on ssri's but had no choice. The way I had to see it was - the world isn't a natural place to be so maybe medication might help. When in actual fact, if you can adjust your life accordingly so it's more natural, you don't need medication.  Maybe I'm one of the lucky ones.

I can't post the link but Stimpunks website has a good link sbout sensory anxiety. I have posted it on this forum before.

There's also kieran rose's video on burnout, which I have posted before.

Often I find accounts of other people online,  sharing their experience,  far more useful than official guidance. Because they offer different perspectives. One of the things I had difficulty with was my literal interpretation of information,  so gathering different perspectives actuslly helped.

Because im so high masking, It's taken me a long time to understand, and I still don't fully, - regression from burnout is a real thing. 

This is an interesting point to be raised. I'm currently looking into whether my anxiety might actually be triggered by sensory stuff. Before COVID lockdowns I never got anxiety, and it was after lockdowns lifted when I attempted to go back to my 'normal' life that I had my first one. Knowing now that I am autistic is changing how I think and reflect on stuff. One of the questions I'm asking and intend to ask my GP about is does the new diagnosis of Autism warrant a reconsideration of the depression and anxiety. What should we do differently (if anything to manage it). To be fair, the propranolol I am on for the anxiety does seem to help calm me so want to be cautious and take the medical advice offered.

It makes me wonder about regression. Put in the proper context the things that led me to be signed off work and then later be pushed through Work Capability Assessments I think now are autistic burnout from which I'm still recovering. Could then, the anxiety be regression associated with burnout? So many questions...

That said, as I and others have said, the anti-depressants do help smooth out and quiet some of the more noisy and problematic thoughts like that I must be lazy because things are feeling more difficult than they once did, or because I'm taking the time out to heal and recover rather than rushing back to work.

As you point out though, I Autism and GAD can both co-exist. [/rambling rant over]

This is not medical advice. 

I was on sertraline for just under 18 months with no effect except lots of sweating and putting on weight. Whenever the GP asked, I couldn't tell if it was making any difference - medication is supposed to improve things - right? I came off it with guidance from my GP and experimented of my own accord with more natural compounds as well as meditation.

Consider what the root cause of your anxiety actually is. I was mislead by medical professionals who, with the best of intent, did not understand autistic anxiety or burnout. Neither did i at the time. It wasn't worry but chronic overload. 

Autistic anxiety can have different causes to those of the predominant neurotype. I have come to understand we have a more sensitive fight or flight mechanism so maybe consider if you are in a suitable set up for your life and environment. Of course it's also possible to have GAD and be autistic.

Read Luke Beardon's book about Autistic Anxiety. It provides lots of insight and is very accessible.

I agree I’ve been on and off anti d for 12 years and I didn’t enjoy them much at first but I had to follow gp advice and give them at least six months to settle in ( I still have some side affects including ibs) before making any decisions. How I am on them over a consistent year period of the same dose (100mg), I tried lowering and it didn’t work, is far better than before I went on them. They don’t help me manage melt downs or burn out but they do help me have enough resilience sometimes to tackle day to day things. I still have down periods which I don’t believe will ever go away as i experience low mood, anxiety and have ptsd too. For me just now they are helping but I everyone is different and you need to do what’s right for you and careful consideration. 

I take in the evening too 

I am and have been for around five years. I have anxiety disorder and I am autistic (on waiting list) and I’ve tried coming off them which didn’t go well. I’d say for me they are a necessity just now. Side affects are a pain- sweating, tummy issues 

I’m on a variety of meds including sertraline for anxiety and depression related reasons. Personally this medication has really helped me and I’ve been on it for nearly 2 years. However, when I first went on it I found it wasn’t that effective and I had to tweak my dosage and combine it with other meds to make it work for me this was done under the supervision of a mental health team who knew I was on the waiting list for an autism assessment. Personally I think my depression is quite seperate from my autism and I feel if I didn’t have autism I may still suffer from depression. I think my autism can make me experience it differently but they are still separate which is why sertraline works for me and has a positive impact on me and managing my mood. My partner who’s also autistic is on sertraline and it helped him out of a major depressive episode that was likely to be autistic burnout however he’s looking at coming off it once he is fully happy with his mental health. Medication can be a great tool for some but not for others. Sorry for rambling but maybe bring this up with your GP. 

On Sertraline {and other meds} for a decade or more now. 200mg daily. It helps. Keeps the lid down and the flies out, so to speak. Levels out the anxiety / panic attack / over think / doom scenario mindset way of thinking.

People respond in varying ways to antidepressants, so it is difficult to measure your own experience to against anything you might read, accurate or not as it may be. In general, I have found the side effects of several different antidepressants difficult to tolerate. Most have made me feel lethargic, detached from the world, with a feeling of physical illness. I took Sertraline a long time ago and it made me feel quite high and behave in a hyper fashion, although I remember enjoying the energy and endurance it gave me, so I was changed to a different antidepressant after only a few weeks. Citalopram is the only antidepressant I have taken that has not made me feel unwell and it probably takes no more than “the edge” of my depression, without any noticeable negative side effects. 

Thanks. I found the side effects too much to push through. They made me feel really ill, I was doubled in pain with my stomach and they made me feel really on edge. My pupils being different sizes also really freaked me out and I just couldn't do it.

Bunny thanks for sharing these links. Very interesting, adds a lot of things up for me personally.

OP, my experience of Sertraline was unfortunately negative. It works for some, but defo didn't for me, really upset my stomach and my head. The side effects were absolutely awful! My stomach is very sensitive so this might be why it affected me badly, as so many things do. I've found talking therapy helps me more than medication but I'm glad Sertraline seems to work well for you. Hope you continue feeling awemazing!

I was first on Citalopram and found that it really wiped me out - no energy levels at all. The fatigue was just intolerable. I forget the name of the other, but I felt like I was so detached from the world on that one I just couldn't function well.

My experience with all the different options the GP provided was that time was needed to allow things to settle down. It was rough to begin with even with Sertraline in terms of mood swings, but eventually things settled down. It's not perfect by any means. I still have some really bad periods of downswings, but for me, it smooths out and makes the troughs shallower. For me a bit of time to acclimatise to the meds was needed.

I still, to this day sometimes have staring matches with the box of meds...usually on my worse days. The benefit though is that they help me to make the most of the good days.

What I will say is that it was a Pharmacist that actually helped the most. She highlighted to me that the medication didn't have to be taken only first thing in the morning. I've got erratic sleep patterns at the best of times, so a regular time in the morning isn't always possible. So, I take mine in the evening - which most GPs clearly get confused by. The info sheet in the box of Sertraline, and the Pharmacist both state morning or evening is possible. What worked for me was ignoring the GP telling me to only take it in the morning and listening the Pharmacist and taking it in the evening.

Please do NOT take my comments though as a recommendation or condemnation. I'm happy to tell you my experience, but I am uncomfortable sharing even this much if someone intends to use it as a recommendation. I know a few people on these types of meds and it does appear to vary from person to person. Take advice only from medical professionals.