Davro12345 I've been taking anti-depressants for the majority of my life. What reason do I have to think coming off them will help?

[Davro12345]

So I was first put on sertraline (an SSRI) when I was 10 years old. From when I was put on the medication, whenever I would have a strong relapse in symptoms, the most common response of my psychiatrist would be to increase my dose. When I was about 23 I was also put on propranolol (a beta-blocker). I'm now 34.

Currently, my mental health is ok, but for a very long time I've suffered from a bunch of related symptoms:

- Inability to sleep

- Extreme difficulty getting up in the morning
- Fatigue

- Unexplained chronic pain

These come and go and occur along with anxiety and low-level depression which the medications are supposed to treat. Doctors haven't been able to identify a cause, and they don't really respond to the standard things people recommend to help treating these symptoms (e.g. eating healthy, etc). Taken as a whole they can make it very difficult to make improvements in my life.

I'd like to come off the medications because I think that the symptoms listed above (not the depression and anxiety) might be caused or exacerbated  by my medication. But the trouble is, I've been on the medications so long I don't really have any idea if the symptoms I have experienced really are being caused or exacerbated by the medications. I managed to reduce my sertraline dosage from 200 to 100mg and I couldn't notice a change in these symptoms, which indicates that maybe they are completely unrelated to my medications

And the severe episodes of anxiety and related symptoms I have experienced have been a living hell. If coming off the medication results in a return of that then I don't want to do it and will end up really regretting it.

So I'm not sure what to do.

Any advice or thoughts would be much appreciated.

[Erimus]

Hello, and welcome to Surviving Antidepressants. We are a peer support forum to assist in tapering off psychiatric drugs safely, or recovering from psychiatric drug withdrawal.

 

This topic is for anything relating to you, and any questions you have. Please do not start another topic.

 

1 hour ago, Davro12345 said:

Currently, my mental health is ok, but for a very long time I've suffered from a bunch of related symptoms:

- Inability to sleep

- Extreme difficulty getting up in the morning
- Fatigue

- Unexplained chronic pain

All of these are common side effects of SSRIs, as well as issues of long term SSRI usage. We have many members on the forum who have succesfully tapered off psychiatric drugs having taken them for 20 or more years.

 

1 hour ago, Davro12345 said:

I managed to reduce my sertraline dosage from 200 to 100mg and I couldn't notice a change in these symptoms, which indicates that maybe they are completely unrelated to my medications

For someone who has taken SSRIs for 20 years this is far too quick, but it's not your fault that you were ill-informed by prescribers. It's not simply a case of quickly removing the drug, it's about slowly undoing the changes it has made in your brain over the last two decades. We recommend tapering by no more than 10% of your CURRENT dose each month, to limit withdrawal symptoms. E.g. 10mg --> 9mg --> 8.1mg --> 7.29mg, but for someone in your position you would likely need to make much smaller cuts, of 5% or less.

 

I can see that in 2022 you went from 150mg to 25mg in a matter of months, is this when you experienced severe anxiety and depression? What symptoms led to you increasing back to 100mg? For someone like you, we would expect it to take multiple years to reduce to 25mg from 150mg. Please read all of the topics in the tapering forum.

 

2 hours ago, Davro12345 said:

And the severe episodes of anxiety and related symptoms I have experienced have been a living hell. If coming off the medication results in a return of that then I don't want to do it and will end up really regretting it.

Have these symptoms been at times when you were stable on your drug and dose? i.e. no previous changes for 3-6 months? In order to be succesful in coming off medication, especially after starting so young, you must learn how to manage anxiety. Being raw and drug free is one thing, but you must relearn how to live in the world with your organic brain chemistry. The slow taper over many years is the solution to manage withdrawal, but you need another solution to work out how you will manage your true self.

 

All the answers you are looking for regarding tapering and antidepressant withdrawal are on this site. Please search around and continue to read as much as you can manage. Use the site search function to search for specific words or phrases, such as drugs or symptoms.

 

Here are a few of the most useful links:

 

Micro tapering

 

Why taper by 10% of my dosage?

 

Taking multiple psych drugs? Which drug to taper first?

 

How to make a liquid from tablets or capsules

 

Using a scale to weigh and measure doses

 

We only recommend two supplements. Omega 3 Fish Oil and Magnesium. Both should be introduced separately and increased slowly.

 

Regards

Erimus

[Davro12345]

2 hours ago, Erimus said:

I can see that in 2022 you went from 150mg to 25mg in a matter of months, is this when you experienced severe anxiety and depression? What symptoms led to you increasing back to 100mg? For someone like you, we would expect it to take multiple years to reduce to 25mg from 150mg. Please read all of the topics in the tapering forum.

 

Have these symptoms been at times when you were stable on your drug and dose? i.e. no previous changes for 3-6 months? In order to be succesful in coming off medication, especially after starting so young, you must learn how to manage anxiety. Being raw and drug free is one thing, but you must relearn how to live in the world with your organic brain chemistry. The slow taper over many years is the solution to manage withdrawal, but you need another solution to work out how you will manage your true self.

Thanks for the reply. When I got down to 25 mg I had a relapse that was fairly bad, which is why my dosage was brought back up to 100mg.

And yes, there have been times when I have been stable on my current dose, although I tend to go through rough patches every now and then

[Erimus]

18 minutes ago, Davro12345 said:

Thanks for the reply. When I got down to 25 mg I had a relapse that was fairly bad, which is why my dosage was brought back up to 100mg.

That's not a relapse of your "condition", it's from tapering too quick. Most prescribers don't understand this.

 

20 minutes ago, Davro12345 said:

And yes, there have been times when I have been stable on my current dose, although I tend to go through rough patches every now and then

As I said above, you need to find non-medication ways of dealing with these ups and downs.

 

Do you have any knowledge of the reasons you were put on SSRIs in the first place?

[Believer]

Hi @Davro12345

I too have been on Zoloft/sertraline for about the same length of time. At one point I went up to 150 but didn’t notice any difference so dropped back to my normal dose of 100 and stayed there for years, until I developed brainzaps, this was after about 16 years on the drug. My doc suggested I had pooped out on sertraline so I did a failed direct crossover to Wellbutrin then back to sertraline. When I finally decided I wanted off all/any psychotropics I started my taper, I had symptoms when I hit 25mg, at which time I discovered this site and learned about the occupancy rate of the drug. (See attached.) At 25 mg the curve becomes extremely steep, the need to taper slower becomes more important. I started at 10% and now taper 5-6% every four weeks. This rate has helped minimize my symptoms but it hasn’t been easy. As you know everyone is different, this is my experience. Have a look at the attached, there is also a lot of information on this site about occupancy levels in different psychotropic drugs as well as a newly released book “The Maudsley Deprescribing Guideline” by Mark Horowitz and David Taylor, that goes into more detail. I just received my copy today so haven’t had a chance to dive into it. Take a look at the attached and consider using it as a guide to assist you in your taper.

 

Best wishes on your journey.

 

 

[Davro12345]

6 minutes ago, Erimus said:

Do you have any knowledge of the reasons you were put on SSRIs in the first place?

Yes, I was diagnosed with OCD. But I also had severe anxiety more generally. When you say that I need to learn how to deal with my issues without the medication, then I feel like the prognosis is pretty pessimistic. I have tried all the usual things people recommend for anxiety (mindfulness, CBT, generally healthy living etc), and they do not seem to make much difference. In the case of mindfulness it made things worse over the long term.

[Davro12345]

One question about tapering that I hope someone can answer. I live in the UK, and when I spoke about wanting to taper to my GP before, he said that that the liquid form of sertraline is unlicensed or untested, or something like that and so I couldn't receive my medication in that form. Any advice?

[Erimus]

56 minutes ago, Davro12345 said:

One question about tapering that I hope someone can answer. I live in the UK, and when I spoke about wanting to taper to my GP before, he said that that the liquid form of sertraline is unlicensed or untested, or something like that and so I couldn't receive my medication in that form. Any advice?

I don't know about its availability here as I've never asked for it. Probably better off speaking with the pharmacy staff, they tend to be more educated on medication availability than the GPs.

 

Most people here either prepare their own capsules or make their own liquid suspension. See:

 

Using a scale to weigh and measure doses

 

How to make a liquid from tablets or capsules

Edited March 18 by Erimus

[Davro12345]

44 minutes ago, Erimus said:

Most people here either prepare their own capsules or make their own liquid suspension.

I can't imagine a doctor ever agreeing to that. So do people just taper without it being approved and overseen by  a doctor?

[modelarz71]

2 hours ago, Davro12345 said:

I can't imagine a doctor ever agreeing to that. So do people just taper without it being approved and overseen by  a doctor?

Some people are lucky and use factory blister packs with decreasing doses of SSRIs, not available in other factory production probably someone from the Netherlands wrote about it, then they don't have to cut their own pills.
I'm sure someone will write more about , maybe also your psychiatrist will tell you how to order it if sertraline is available in these tapering strips

People here go and talk to their doctors and are wary of them because GPs want to reduce them quickly (e.g. 1 month all) and people get into health problems and the site shows how to reduce safely i.e. slowly (e.g. 10%/ mc of the last dose every month) to not get sick.
It won't help me anymore because stopping the treatment introduced me to diseases I didn't see existed (but are listed in the leaflet which the GP didn't advise reading)

[Erimus]

3 hours ago, Davro12345 said:

I can't imagine a doctor ever agreeing to that. So do people just taper without it being approved and overseen by  a doctor?

This site exists because of poor practices from healthcare professionals surrounding psychiatric tapering protocols. The methods described here are evidence based in the testimonies of thousands of members that have succesfully, and safely, reduced their medications thanks to the information available.

 

If you want a doctor to oversee your taper you'll find it very difficult to find one that suggests a conservative taper regime. Unless they have personal experience, or a keen interest in the field, they just follow the information listed on the software they use.