fightingbrit: Coming off Sertraline after 17 years; needing some support

[fightingbrit]

Long story short, I went to see my GP when I was in my early 20s with a list of printed off depression symptoms and without offering any other suggestions, I was prescribed Sertraline (I'm the UK, I believe it's commonly called Zoloft in the US?) 

 

Anyway, about 4 years ago I began a long journey of intensive therapy and healing after a traumatic childhood experience came to light, and on this journey, I carefully tapered my Sertraline down to 50mg; and then this year down to 25mg. 

 

My problem is where next. I have read these forums in great depth; trouble is my GP has told me they cannot prescribe liquid; and the 25mg sertraline tablets I take are smooth round ones that crumble horribly when I try cutting them. My GP said I can just stop now I'm at 25mg, but experience from reading people's accounts suggests it just won't be that simple. 

 

I want to do this properly - I don't want to be medicated for the rest of my life and I'm in very much a different place than I was back then. As I near 40, my coping strategies are solid and I have a wonderful network of support. Maybe I'm overthinking it and I can just drop to alternative days from 25mg then stop after a settlement period? Unfortunately my Doctor hasn't been much help at all, so I'm hoping someone here can perhaps give me an insight. 

 

I once tried their recommended taper of 50mg every other day (I think it was last year) but the brain zaps were too much for me (I have an 8 year old child and while my husband is around too, being debilitated for most of the day isn't really an option for me). I can appreciate and tolerate a certain level of discomfort, I know this isn't an easy journey by any means, but it was absolutely too much and I don't want to fall into that trap again and become disheartened. 

 

Really humbly grateful for any guidance, thank you for reading. 

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  Congratulations for getting your sertraline down to 25 mg in a responsible manner!  We can definitely help you.  How has the tapering gone so far?  Have you had any withdrawal symptoms? 

 

Can you please give us specific information in your signature about your drug history for all drugs and supplements 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 specific dates, include the day (as best you can say for example early March if you don't recall the day), drug names, and dosages of each medication decrease or increase. Here is an example: 

 

March 12, ’22: Lexapro 5 mg, Xanax 0.5 mg, Trazodone 50 mg

March 29, ’22: Lexapro 4 mg, Xanax 0.5 mg, Trazodone 50 mg

April 17, ’22:  Lexapro 3.8 mg, Xanax 0.5 mg, Trazodone 50 mg

May 19, ’22:  Lexapro 3.8 mg, Xanax 0.5 mg, Trazodone 25 mg

 

 

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

 

How to List Your Drug History in Your 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

 

 

Just in case, let me share this links about withdrawal. 

 

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 2 ways you can continue your taper:  1) you can grind your tablets into a powder and weigh the powder, or 2) make your own sertraline liquid using tablets and water.  The second link below will explain how to do this.  

 

 Why Taper by 10% of my Dosage  

 

Tips for Tapering Sertraline/Zoloft

 

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

 

Please let us know if you have any questions.  Good luck, and keep us posted on how you are doing. 

[getofflex]

On 6/5/2023 at 10:25 AM, fightingbrit said:

Maybe I'm overthinking it and I can just drop to alternative days from 25mg then stop after a settlement period? Unfortunately my Doctor hasn't been much help at all, so I'm hoping someone here can perhaps give me an insight. 

 

Please do not do this.  It is very essential to take precisely the same dose, at the same time each and every day.  If you don't, the brain will become destabilized, and it can cause major problems that could take many months to resolve.  The nervous system really likes consistent and stability, especially when it is adjusting to tapering off psych drugs.  That is probably why you had the brain zaps when you took the 50 mg every other day in the past.  

[fightingbrit]

10 hours ago, getofflex said:

Please do not do this.  It is very essential to take precisely the same dose, at the same time each and every day.  If you don't, the brain will become destabilized, and it can cause major problems that could take many months to resolve.  The nervous system really likes consistent and stability, especially when it is adjusting to tapering off psych drugs.  That is probably why you had the brain zaps when you took the 50 mg every other day in the past.  

No, I didn’t think this would be wise. So how can I continue tapering when there are no means to use liquid Sertraline and my tablets cannot be accurately cut?

[Altostrata]

Hello, @fightingbrit Your GP is incorrect. Sertraline liquid is available by special request, see https://www.medicines.org.uk/emc/product/14703/smpc#gref

 

Please see 

 

 

 Why Taper by 10% of my Dosage  

 

Tips for Tapering Sertraline/Zoloft

 

To help us out, follow these instructions Please put your drug and withdrawal history in your signature You may need to use a computer to do this.

[fightingbrit]

4 hours ago, Altostrata said:

Hello, @fightingbrit Your GP is incorrect. Sertraline liquid is available by special request, see https://www.medicines.org.uk/emc/product/14703/smpc#gref

 

Please see 

 

 

 Why Taper by 10% of my Dosage  

 

Tips for Tapering Sertraline/Zoloft

 

To help us out, follow these instructions Please put your drug and withdrawal history in your signature You may need to use a computer to do this.

 

I asked my GP again and she said that they cannot prescribe it to me - but wouldn't say why. Not sure where this leaves me to be honest, I don't have many other options than to stop! 

[getofflex]

In a prior post, I told you that you could 

On 6/6/2023 at 3:29 PM, getofflex said:

There are 2 ways you can continue your taper:  1) you can grind your tablets into a powder and weigh the powder, or 2) make your own sertraline liquid using tablets and water.  The second link below will explain how to do this.  

 

 Why Taper by 10% of my Dosage  

 

Tips for Tapering Sertraline/Zoloft

The link above will explain precisely how to do this.  

[fightingbrit]

27 minutes ago, getofflex said:

In a prior post, I told you that you could 

The link above will explain precisely how to do this.  

ah my apologies, I have a horrible habit of skim reading! 
 

Thank you for this - I’ve taken a look and ordered a grinder. 

[getofflex]

OK, no problem.  Please let us know how the reinstatement goes.  You will probably need the scale as well.  

 

https://www.survivingantidepressants.org/topic/1596-using-a-scale-to-weigh-and-measure-doses/

 

Edited June 7, 2023 by getofflex

[Emashy77]

@fightingbrit hi, I just wanted to know how you have been doing with this? I’m in a similar situation and will be speaking to my gp tomorrow about prescribing liquid Sertraline (I’m nervous now you’ve said yours refused). 
 

I hope you have tried another solution and found some success? 

[Altostrata]

Take this to your doctor

 

 

PRINT OUT leaflet: Guidance on stopping antidepressants by UK's Royal College of Psychiatrists

[Emashy77]

@Altostrata thank you so much and apologies for not doing my intro post prior to

commenting 

[fightingbrit]

Hello - I've posted a bit in here but I've had issues getting my full history from my GP here in the UK but I've summarised as best I can in my signature. I've been on sertraline for around 17 years, and after finally being prescribed liquid sertraline in December am currently on 10mg daily (works out at 2ml of liquid). 

 

Generally I feel fine, the only symptom I currently have is a whooshing sound when I move my eyes - not constantly but intermittently throughout the day. It's not debilitating by any means, just a mild annoyance - is this common?

 

What I'm now worried about is my GP has told me liquid sertraline will not be available for the next few months. I still have half a bottle of my 25mg per 5ml bottle - what is the best way to proceed with continuing tapering without having to go back on 25mg tablets? I'm so close! 

 

Trying not to let this overwhelm me or leave me feeling defeated, but unfortunately my GP has been really unhelpful and just keeps telling me to stop taking Sertraline as 10mg is negligible now. 

 

Would be super grateful for any support, kind words, or advice. Thank you. 

[fightingbrit]

Hi all, I just wanted to check back in. 

 

Finally, after continued pushing my GP they prescribed me sertraline liquid in December. I'm currently on 2ml a day, which is equivalent to 10mg. My GP is still pressing me to just stop taking it, they said it's 'negligible' and I won't have any issues but I'm continuing to take things super slow.

 

Honestly the only issues I've had are hyper-arousal (feels like anxiety), and also a whooshing sound when I move my eyes - not all the time but a few times a day. Generally I've been doing really well though. Facing supply issues with the liquid sertraline though so I'm not sure where I go from here. 

[Emashy77]

Hi it’s really interesting reading your update. I too had a battle getting it prescribed but have been on it since October. I have had supply issues too but just found a smaller chemist who so far hasn’t struggled to get it for me. Might be worth ringing around. Places like Boots couldn’t get it at all. 
I’m currently down to 1.6ml and feeling the anxiety kicking in so might slow it down a little more. So far only been questioned by one GP on why I need the liquid. 
Stay firm and strong in your ‘why’s’ and well done on sticking with it.  

[fightingbrit]

Just now, Emashy77 said:

Hi it’s really interesting reading your update. I too had a battle getting it prescribed but have been on it since October. I have had supply issues too but just found a smaller chemist who so far hasn’t struggled to get it for me. Might be worth ringing around. Places like Boots couldn’t get it at all. 
I’m currently down to 1.6ml and feeling the anxiety kicking in so might slow it down a little more. So far only been questioned by one GP on why I need the liquid. 
Stay firm and strong in your ‘why’s’ and well done on sticking with it.  

 

I'm glad you've managed to find the liquid too! 1.6ml is amazing, well done.

 

I am starting to think/worry about the long term effects because it's been so so long with Sertraline in my body. But I'm trying not to think about it too much; I'd just like to be SSRI free by the end of this year (in time to turn 40!) 

[Emashy77]

I absolutely understand your concerns. Same for me too. It’s hard having been medicated for so long to be able to know what is completely ‘normal’ and what is feeling like you aren’t coping well again. Sometimes it just feels easier to stay on them forever.  But to be SSRI free for 40 is an amazing goal 😊 keep going! 

[fightingbrit]

7 minutes ago, Emashy77 said:

I absolutely understand your concerns. Same for me too. It’s hard having been medicated for so long to be able to know what is completely ‘normal’ and what is feeling like you aren’t coping well again. Sometimes it just feels easier to stay on them forever.  But to be SSRI free for 40 is an amazing goal 😊 keep going! 

 

I will! I think I'm also worried how to know if I'm going too fast - at the moment the whooshing and hyper arousal isn't debilitating at all; I think it definitely helps reading the success stories where people eventually do feel normal again. I have hope. 

[Emashy77]

Yes for sure!! That’s what is so great about this forum that we can see the light at the end of the tunnel. Hopefully the side effects will wear off but if not maybe just slow it down a little. It is very tempting to drop down sooner than maybe is best. I’ve heard the further down you drop the more the side effects can show up. But sounds like you are listening to what your body is telling you! 

[fightingbrit]

How have you found side effects to be? 

 

I'm taking my main cue from how I'm able to function in terms of parenting. I'm lucky that my partner is incredibly supportive, but if at any point I notice I'm not 100% present for my little boy, I know that's when I need to ease off - it happened a bit early last year when going from 50mg to 25mg, but I've been ok the last few months. 

[Emashy77]

I’ve usually just tended to have headaches on the few days after i drop down again. However this reduction I’ve felt a lot more anxiety. But it’s been hard to know if this is meds or life related as work has been v stressful. I’m due to drop again this weekend so I’ll see how that goes. 
 

That’s so great that you have a supportive partner alongside the journey with you. That really does make all the difference.
 

I hope this year is our year! 👍🏼

[fightingbrit]

Yes - it will be. Do keep me updated, and feel free to reach out. It's nice to know I'm not alone. 

[Emashy77]

Same to you too!! Reach out anytime 😊

[Patient2022]

14 hours ago, fightingbrit said:

Hello - I've posted a bit in here but I've had issues getting my full history from my GP here in the UK but I've summarised as best I can in my signature. I've been on sertraline for around 17 years, and after finally being prescribed liquid sertraline in December am currently on 10mg daily (works out at 2ml of liquid). 

 

Generally I feel fine, the only symptom I currently have is a whooshing sound when I move my eyes - not constantly but intermittently throughout the day. It's not debilitating by any means, just a mild annoyance - is this common?

 

What I'm now worried about is my GP has told me liquid sertraline will not be available for the next few months. I still have half a bottle of my 25mg per 5ml bottle - what is the best way to proceed with continuing tapering without having to go back on 25mg tablets? I'm so close! 

 

Trying not to let this overwhelm me or leave me feeling defeated, but unfortunately my GP has been really unhelpful and just keeps telling me to stop taking Sertraline as 10mg is negligible now. 

 

Would be super grateful for any support, kind words, or advice. Thank you. 

Hey I stumbled on your thread after doing forum search for headaches in withdrawal. I was similar to yourself, between 10mg and 2mg, the symptoms were minimal, though I have low days before my period (I’m accepting that as a wave to ride through), but as I’m coming to the end of my taper (1.2mg) I notice a dizziness when I wake up some mornings, insomnia and headaches. Though I’m not sure if the headaches are due to a lack of sleep or both. 
 

Anyhow just wanted to offer a little support. If your gp has already prescribed the liquid meds, I would push for it to be on repeat. Is there any other doctor you can see within your gp practice as this one doesn’t sound supportive? Also well done with your progress so far

[fightingbrit]

Feb 2024 update - now on 1.6ml of Liquid Sertraline. Mainly plain sailing thus far although I have noticed some sleep issues in the past week - unsure if this is related.

[Gonzo]

You're not overthinking, you did good coming here and trying to stop Sertraline properly, I guess you already understand what happened to your body after all these years taking the pills, like it happens with many other drugs. It forgot how to function without it, it became physically dependant of this chemical, that's what happens. Some people stop cold turkey and have no issues or not for to long tho but it's not worth taking the risk IMO. It's very important to understand all this so you can be prepared to face the challenges and have the right support.

[fightingbrit]

Hi, I've found this site to be an incredible resource in recent months, though I admit I've found a lot of the information overwhelming. Everything I've taken to my GP (UK) has been given back to me with a curt "please stop using Google, it doesn't help you" along with 'advice' to either stop my Sertraline by alternating days then just stopping, or continue taking it for life. Neither of these are an option, to be honest. 

 

I'm hit a bump in the road in my tapering journey. I fully accept that I became complacent and tapered too fast at the start of this year, so I'm now in damage control mode but I am struggling with where to go from here - I'm not the smartest of people and I struggle with general info, often needing things broken down into instructions (I have basic executive function issues - ADHD) and struggle if things aren't tailored for me. 

 

Anyway, I spent most of 2023 moving from 25mg Sertraline tablets down to half these tablets - 12.5mg - using advice from my Dr by alternating days. I then managed to FINALLY get a liquid sertraline prescription late in November. I didn't know anything about cross-tapering, but moved over to the liquid without any issues through December (my solution is 25mg/5ml so I went straight to taking 2.5ml for 12.5mg). I did start having some mild issues with sleep - getting up to urinate a bit in the night but this also coincided with me drinking a LOT more water during the day. 

 

I dropped a ml every couple of weeks in January (yes, I know it was too fast now) and a week into February I began having awful insomnia. I can usually fall asleep ok, but I wake after every cycle, sometimes I go back to sleep and sometimes I don't.  My sleep hygiene is great, I use blackout blinds, have a regular bed time, wear earplugs, no screens after 9pm, etc., I've been doing everything I can in the background for a while now to help give my body the best chance, including overhauling my diet which is the best it's ever been for a good while now. But this insomnia is absolutely killing me - I am one of these people who needs a decent chunk of sleep in one go to function. I know that the intense anxiety I'm feeling at the moment is largely to do with lack of sleep and I'm panicking that it won't return to normal. 

 

I knew I had to re-instate. For better or worse, I made the decision to re-instate 12.5mg (please go gentle on me for this!) My rationale is I'm finding it harder and harder to get my GP to prescribe me liquid and the last time the did prescribe it the pharmacist said supply issues would be affecting me going forward so the chances are that I'll get tablets in the future. 

 

So. I've been taking 12.5mg via the liquid for a week now, and I am fully prepared to stay at 12.5mg for as many months as I need to in order to stabilise. I have a couple of questions. 

 

1. How long do I wait to see if it's actually helping my sleep before going up further? I am not coping well with the insomnia. My Gp won't prescribe me anything to help me sleep which I guess I should be grateful for, I know adding yet another medication into the mix is probably not the right move. 

2. Should I make the jump now back to tablets knowing that they will DEFINITELY be available? Or should I finish my current bottle of liquid and then move to the halved 25mg tablets? 

3. Should I go back to 25mg knowing that was when I was truly and completely stable... re-stabilise for as long as it takes and then do a very slow taper from that point?

 

I'm also not adverse to going back up to 25mg if it means getting to a much more stable base and then tapering from there - PROPERLY this time using one of the amazing tapering spreadsheets I've found here. I just want to get back to a stable base but I'm struggling to find the right guidance on how I get there - I'm tying myself up in knots over worrying about this and just not sure what to do for the best.