sosoren: How to taper by 10% with huge sertraline tablets?

[sosoren]

I have been on 100mg of Sertraline since December 2020 (and on and off it for years before that). After previous disastrous attempts to come off, I wanted to begin to taper by 10% and very gradually, following the advice on this website. I asked the doctor for liquid sertraline in order to do this and he was very unreceptive and told me to order a pill-cutter from Amazon. I don't know how to go down by 10% with a pill cutter. Sertraline only comes in 50mg and 100mg tablet sizes. The doctor did say that people who cannot swallow can request liquid form, but said I could not have it in liquid form. Should I lie and tell another doctor I can't swallow?

Any help appreciated

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  I'm sorry to hear about your difficult previous attempts to get off sertraline.  I'm especially sorry to hear about your authoritative and unhelpful doctor.  

 

Can you please give us more specific information in your signature about your drug history for all drugs you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise vertical list (no symptoms), only drug names, specific dates (as best you can say for example early March if you don't recall the day) and dosages of each medication decrease or increase.  Use this format:

 

Drug name: date, dose, date, dose, date, dose…

Drug name: date, dose, date, dose, date, dose…

Etcetera

 

Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Drug History in Signature

 

Here is some important information about how these drugs actually work.  This explains why we get symptoms from going off of these medications, and why it's so important to taper slowly and carefully, and be very cautious about changing our doses: 

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

Video on Recovery from Psych Drugs

 

Windows and Waves Pattern of Stabilization

 

 

Tapering is best done extremely slowly, and we generally taper by 10% of the current dose no more than once every 4 weeks, so that the reduction becomes exponentially smaller.  There are various ways that you can measure an irregular dose - you can make your own liquid, or you can crush the tablet into a powder, and weight it with a scale.  The link below will explain how to do these things.  

 

 Why Taper by 10% of my Dosage  

 

Tips for Tapering Sertraline

 

Here is a link with checklists of common WD symptoms: 

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

Stability is really important when we are tapering off psych meds.  Please read the link about stability:

 

Keep It Simple, Slow, and Stable

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

Omega 3 Fish Oil

 

How are you feeling since you reduced your dose by 25%?  If you are having some problems, what specific symptoms are you having?  If it were me, I would updose back up to 90 milligrams, which is a 10% reduction.  You may feel OK now, but these things have a way of catching up with us weeks or even 2 or 3 months down the line.  I would do the updose sooner rather than later, so that there is less disruption to the nervous system.  

[sosoren]

Thank you so much for your reply it is really comforting and I will read through all these materials.

I feel fine on 75mg and have no symptoms that I’m aware of at the moment but I know you are right, I should only have gone down by 10%

i have ordered scales so that I can do this
 

 

[getofflex]

I'm glad to hear you have ordered the scales.  If you start to feel any symptoms speak up, and we will help you through doing an updose.  Please don't change your dose until then, thank you.  Instead of putting "now" for 75 mg sertraline in your signature, please change it to a specific date, so it will be clear in the future what date you did this.  

Edited May 29, 2022 by getofflex

[sosoren]

thank you getofflex, I really appreciate that. So you are saying that I should stay on 75mg now unless I get symptoms, and then go down by 10% after that (in the future if stabilised etc)?

 

I have updated my signature  

 

Thank you again for sharing your knowledge

[getofflex]

14 hours ago, getofflex said:

If you start to feel any symptoms speak up, and we will help you through doing an updose.  Please don't change your dose until then, thank you

Sorry I probably didn't say it exactly right.  Many members jump around on their doses without discussing it in the forum, and if they have a bad day, they may jump up on their dose.  This tend to cause further destabilization.  What I meant to say was, please don't do that.  It's best if members discuss their dose changes with a member of the staff first and make the dose change in a proactive and thoughtful and deliberate way, rather than in a reactive impulsive way.  In my first post, I had said that if you wanted to, you could updose back to 90 mg, since that would be a 10% reduction from your original starting dose of 100 mg.  I will leave that decision to you.  If you do decide to updose, please do it sooner rather than later.  Oftentimes, a large reduction, such as you have made, may not be felt for several weeks, to several months, and then the person gets hit with withdrawal symptoms.   Please let us know what you decide to do.  

Edited May 30, 2022 by getofflex

[sosoren]

Ok. I have been on 75mg for around 5 days. I reduced the dose before finding this forum and then thought I had better continue with the reduced dose. The scales are supposed to be arriving tomorrow so fingers crossed they do. I'm also a bit worried about jumping around which is why I was going to wait it out for a few months to stabilise. I know you are right that I could feel the affects of this further down the line, but I am now worried about going back up again. I hope I haven't messed it up.

[getofflex]

I see what you’re saying. Personally if it were me I would go back up to the 90 mg.  Since you’ve only been at the 75 for a few days and if you get the scale tomorrow This might be the safest thing to do. It is your decision what you want to do.

[sosoren]

I think I will go up to 90mg. I want to do this in safe a way as possible and I am not in a rush, I just was nervous about going down and up again. I hope the scales do arrive tomorrow!!

I will report back on my journey soon. Thank you again