I have an unfortunate intersection of a debilitating physical genetic disorder that interacts badly with medication, though I saw immense benefit on my particular combination. If it was not literally killing me in a prolonged, drawn out, unpredictable way, I would have remained happily on the meds, and be much better off, I think. I just don't want to hemorrhage internally (into my eyes, joints, all over my torso from throat to belly button, into my gums, etc) and be in excruciating pain even prescribed opioid medication barely touched. I also metabolize most medications I've tried much more efficiently than typical dose guidelines, so these have all been at minimal, or even sub-clinical doses.
I was prescribed Prazosin for my night terrors in relation to my PTSD, as the clinician I was seeing had had fantastic results in using it off label with her PTSD patients (she specialized in seeing veterans, primarily.) This put me down instantly, and while I had issues with hypnagogic jerks and some cardiac palpitations initially, I was eventually able to pop one before bed about a hour prior, and fall peacefully asleep without any dreams or terrors sending me screaming upright or choking myself in the sheets from the violent thrashing- I move around so much in my sleep from the night terrors I've gored myself before on the head with an unfortunate nightstand placement, and have had to make adjustments to my sleeping arrangements to make falls not potentially disabling.
It did make me quite zombie-esque in a sort of flat, sleepy effect, which was noticeable to people that I knew, but the uninterrupted, blissful sleep was incredible. I haven't had such peaceful sleep since I was in kindergarten, and it was miraculous for my energy levels and general emotional stability- it sort of suppressed the initial surge in heart rate and adrenaline crashing over me that is my day-to-day experience with PTSD, so it kept me calmer, and more levelled out, because it raised the threshold for an explosive reaction significantly. I eventually had to cease taking it due to their concerns about the low blood pressure with my hemorrhagic disorder. Coming off of it was very easy- my nightmares came back with a roaring vengeance, but I had no real physical issues that were major enough to note: I was a bit sleepy perhaps, but nothing big.
I have also been prescribed Sertraline, primarily for my depressive symptoms in relation to my PTSD diagnosis: the clinician I saw suggested it because of my history of diagnosed PTSD and symptoms of OCD in particular, apparently. This was... euphoric. I had an immediately clarity of mind, a brightening of mood, and while it did not erase or negate any big emotions, it simply raised up my baseline to more comfortably straddle a middling point- I didn't start off deep in depression and bounce between being a sluggish husk of a human and intense rage, and more so began at a neutral, easy going point, where joy came much more readily, and while sadness and anger still existed and I had to grapple with them, it felt like much smoother sailing to return to my elevated baseline. It gave me the space to breathe and more capacity to use my coping skills, and it shocked me to finally feel genuine, unguarded joy on it.
There was some brief sexual dysfunction, and while I never returned to the normal engines raring to fire and go libido I had previously while on the medication, I found that I didn't actually need to rely on it compulsively as a coping mechanism with the increased emotional stability, and I was still able to achieve sexual gratification in a typical fashion for me- I just didn't feel the urge to as often. I did find more of a need for psychological foreplay and arousal ahead of time, and I was less 'spontaneous' about my sexual proclivities, but I still found it satisfying and an acceptable trade off for the brightened range of emotionality. Getting off the medication has returned me to my heightened baseline in that regard.
I also was violently, violently ill on it at first- I was puking and had significant GI distress that kept me from leaving the house in so much as I could, and running to known and established bathrooms on campus frequently, for about a month. This nausea tapered off eventually, and after that, I had no issues tolerating it, even without food (though I always took it with water.) I did find that I had to take it at around a specific time, typically around midday, as taking it in the morning made me a bit sleepy, and taking it later in the evening led to me being kept awake, weirdly. I think that was likely due to a similar paradoxical effect I had with the Prazosin initially- my body freaks out when it relaxes, and responds by flooding itself with stress hormones and launching itself into fight mode.
Coming off of it, no joke, almost ruined my fucking life. I was on a sub-clinical dose, and it was not possible for me to taper off on anything smaller increment wise. (I am smaller than the average models for these doses, and have always had a unique relationship with medication: I also am hyper efficient in metabolizing codeine, and anesthetics and laughing gas also wear off much faster on me than most.) It launched me into an acute month long period of intense, active suicidal ideation with attempts at overdosing, a complete lack of self control due to the insane emotional lability, and made me seethingly blinded with rage and fury at everything, and everyone.
I wound up having to isolate myself pre-emptively from everyone in my life, because I was a complete nutcase- I felt completely out of control, and almost put my head through a mirror from sheer impulse. I was constantly agitated, my sleep went to shit, I shook, sweat through all of my clothing for weeks on end even while laying still in bed in the freezing cold, was insanely dizzy while trying to sit up and often fell down, my anxiety was eating my brain alive, I had painful buzzing and tingling of my nerves akin to nerve damage I had experienced many years ago with a near partial amputation of a digit, long bouts of insomnia, and my brain just felt like it was on literal fire, like when you lick your finger and touch a socket.
I've withdrawn from prolonged periods of prescribed opioid use after serious illness/injury, and I would rather be put through withdrawing from morphine again than ever go through withdrawing from Sertraline. I can't even imagine how bad it would have been had I been at a higher dose.
I eventually had to stop taking Sertraline because it inhibited my platelet functionality, which while they promised wouldn't be an issue, nearly killed me from exsanguination. My gums were the color of my skin- nigh alabaster pale then, and I was blacking out repeatedly. I have a hemorrhagic disorder, so my coagulation capacity is heavily impaired- removing that bit of functionality would have proved lethal. I chose to go off of it after the intense torso bleed, which took months to heal. I looked like something fit for autopsy, and while I loved being able to feel normal, and happy- it wasn't worth slowly dying in such a painful way.
