Ellen102: Sertraline 50mg just starting tapering

[Ellen102]

Hello, I am in a bit of a pickle, I had no idea about how to taper off slowly and followed the advice of my go to go from 50 to 25mg tablet for few weeks and then stop.

For two weeks, I did 50, 25, 50 with no side effects till the 2 week mark, I got terrible insomnia, night sweats, anxiety, headaches and cold /flu symptoms. 
 

I then found this site, for the last two days I have taken my usual 50mg dose as I was so traumatised by above. I do feel a bit better. I am not sure what to do from here as I have decreased my dose the last two weeks….do I try go back to 50…stabilise and then start from scratch or work down from say 10% already as I have decreased?

 

 

I have done my research and plan to do liquid tapering. I have a few questions, I hope could be helped. 
 

1] Can someone help work out a break down if moving tablet to liquid, I have a picture of the process from previous posts but not sure how to calculate it as such, like do you still use 50mg water? 
2] Would it be possible to have a breakdown of 10% of 50mg my brain is a fog and I am terrible at the maths. 
3] Once I have done my 50ml water with tablet inside and removed the 10% dose with syringe can I add a sweetener to make the drink more easy to drink? 

 

Thank you also so much to who ever runs this site it has been a god send. 

 

 

Edited May 10 by Emonda
Name to title

[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.

 

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• All current supplements you take
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• Click this link to edit your signature: Edit your signature here.

[Ellen102]

Thanks for reply. I have updated my signature. 

[Erimus]

On 5/10/2024 at 8:29 PM, Ellen102 said:

Thanks for reply. I have updated my signature. 

I would suggest returning to 50mg and waiting until you stabilise again, before starting a taper following the guidelines here. Never skip doses to taper again.

 

--------Important topics in the Tapering forum and FAQ--------

 

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

 

--------From the Symptoms and Self-Care Forums--------
 
What is withdrawal syndrome?
 
About reinstating and stabilizing to reduce withdrawal symptoms
 
The Windows and Waves Pattern of Stabilization

 

Hypersensitivity and Kindling

 

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

[Ellen102]

Thanks for the reply. I am back on 50mg and will wait another week or so before transitioning over to liquid form.  Is there any chance to get help with my first questions? 

 

1] Can someone help work out a break down if moving tablet to liquid, I have a picture of the process from previous posts but not sure how to calculate it as such, like do you still use 50mg water? Do you just try cut the tablet into a rough quater, then half when transitioning tablet to liquid. 

I am assuming it is not as strict as when tapering as your taking full dose still...

2] Would it be possible to have a breakdown of 10% talering of 50mg my brain is a fog and I am terrible at the maths.

 
3] Once I have done my 50ml water with tablet inside and removed the 10% dose with syringe can I add a sweetener to make the drink more easy to drink?

 

Thank you for all the help. This is a scary time and I only hope I don't get bad WD symptoms 😢 

[Erimus]

I would suggest you wait longer than a week if you're still experiencing a myriad of symptoms. It is not a race to get off the drug, we go at the pace the brain dictates.

 

Switching from tablet to liquid: Cut tablet into halves and quarters using a pill cutter

 

• Best done in parts over a number of weeks. I would suggest switching a quarter of your dose each week, so 4 weeks in total.
• First week - 3 parts tablet (12.5mg + 12.5mg +12.5mg) + 12.5mg(liquid)
• Second week - 2 parts tablet (12.5mg + 12.5mg) + 25mg(liquid)
• Third week - 1 part tablet (12.5mg) + 37.5mg(liquid)
• Fourth week - 50mg(liquid)

 

Making a liquid suspension:

 

• Dissolve your 50mg tablet in a set volume of water. I would suggest 100ml. You now have 50mg/100ml, which equals 0.5mg/ml.
• To take your first part of liquid (12.5mg), you need to divide the dose you need (12.5) by 0.5, which equals 25. So you need to draw up 25ml.
• Give the pot a stir and use an oral syringe to draw 25ml from the middle of the container.
• You can then add this amount to a vessel of your choosing, and add whatever you may wish to make it more palatable. Just make sure you drink everything from this glass. After drinking it, add some more water, give it a swill, and drink it again.

 

Your first reduction:

 

• Your first reduction is 10% of your current dose, which is 50mg.
• To work this out you simply multiple whatever your current dose is by 0.9
• 50*0.9 = 45mg
• Again, divide this number by the strength of your suspension.
• 45/0.5 = 90ml
• Repeat above and drink the whole solution.

[Ellen102]

Thank you Erimus for your reply, very much appreciated.

 

Your right, I am having terrible insomnia since having tapered what I thought was the right way and was not. I will wait till this has all settled.

 

I also plan on cutting out alcohol for a while as this has really unsettled me when I had a few drinks at the weekend. I am assuming alcohol would disrupt the weaning process?

 

I just need some confirmation as I am a little unclear on your reply. I want to get it right this time. 

 

1) Transition tablet to liquid...you advise to use a pill cutter, to halve pill then quarter this half i.e. 12.5mg. Would you not just immerse this quarter you cut into the liquid then take the other 3/4 of the tablet in tablet form? 

 

Or do you have to exactly take 12.5mg exact from the liquid during transition tablet to liquid. 

How do you know for certain the other part tablet is exact (37.5mg) when your cutting with a pill cutter then? 

 

2) Just to clarify, I thought when doing a liquid taper with 50mg, it would be 50mg tablet to 50mg water...is it best to use 100ml instead for dilution? 

 

Thanks and I hope above is not confusing. 

[Erimus]

4 minutes ago, Ellen102 said:

I also plan on cutting out alcohol for a while as this has really unsettled me when I had a few drinks at the weekend. I am assuming alcohol would disrupt the weaning process?

I cannot emphasise enough how important it is not to consume alcohol throughout the whole tapering process.

 

4 minutes ago, Ellen102 said:

1) Transition tablet to liquid...you advise to use a pill cutter, to halve pill then quarter this half i.e. 12.5mg. Would you not just immerse this quarter you cut into the liquid then take the other 3/4 of the tablet in tablet form? 

Yes, you can just dissolve the quarter in liquid and drink it, I am just preparing you for when you have to make your first reduction.

 

5 minutes ago, Ellen102 said:

How do you know for certain the other part tablet is exact (37.5mg) when your cutting with a pill cutter then? 

Further to my above point, your method would actually be better for ensuring you get the correct dose during transition. Just dissolve the 12.5mg quarter in any volume of liquid and drink it, then take the remaining fragments of tablet.

 

7 minutes ago, Ellen102 said:

2) Just to clarify, I thought when doing a liquid taper with 50mg, it would be 50mg tablet to 50mg water...is it best to use 100ml instead for dilution? 

You can dissolve it in 50ml of water if you find that easier to process, I just chose 100ml as it means you can make smaller cuts. If you dissolve in 50ml instead you will have 1mg/ml. First reduction would be to 45ml.

[Ellen102]

"Further to my above point, your method would actually be better for ensuring you get the correct dose during transition. Just dissolve the 12.5mg quarter in any volume of liquid and drink it, then take the remaining fragments of tablet."

 

Tablet to liquid transition only:

Does it have to be exact 12.5mg quarter and how do you make sure it is if your using a pill cutter as there would be some error is what I'm trying to verify?

 

Thanks for answering the above also - great advice and appreciated! 

 

[Erimus]

4 minutes ago, Ellen102 said:

"Further to my above point, your method would actually be better for ensuring you get the correct dose during transition. Just dissolve the 12.5mg quarter in any volume of liquid and drink it, then take the remaining fragments of tablet."

 

Tablet to liquid transition only:

Does it have to be exact 12.5mg quarter and how do you make sure it is if your using a pill cutter as there would be some error is what I'm trying to verify?

 

Thanks for answering the above also - great advice and appreciated! 

 

It's never going to be perfect when cutting the tablet with a pill cutter, but it doesn't really matter so long as you're not taking more than 50mg.

[Ellen102]

Okay I'll use one tablet to do this transition as accurately as possible. Just wanted to clarify. 

Thanks for all your help! 

[Ellen102]

Hello, Just looking for some guidance... 

I did the 4 week converting tablet to liquid that went well with minimal side effects.

I am now week 4 on the first 10% taper. The second two weeks my sleep has starting deteriorating. Feeling very alert when going to bed...I try meditation,  shakti mat, Baths etc. I get maybe 3-4 hours, sometimes none with out a sleeping tablet. 

 

Should I reduce the amount I am tapering? Like do 5% drops over 4 week periods? I won't drop again till stable again. 

 

Should I keep going with a 10ml reduction of my full 50mg Dose or re-instate higher for a while?

 

To note I have had issues long term with sleep. Since being on the sertraline those sleep issues resolved. I have since starting researching adhd and meet alot of the DSM criteria, especially learning about the symptoms in women. I do plan on exploring a diagnosis at some stage...not sure if this will complicate the tapering process more...

 

Thanks for all the help,

Ellen

[Erimus]

4 hours ago, Ellen102 said:

Should I reduce the amount I am tapering? Like do 5% drops over 4 week periods? I won't drop again till stable again. 

 

Should I keep going with a 10ml reduction of my full 50mg Dose or re-instate higher for a while?

Stay on the same dose until symptoms reduce. When you drop again do a smaller drop, or spread the drop out over the entire month.

[Ellen102]

Okay thanks. I got some sleeping meds from the gp I'll take for a few days.

When you say spread the drop over the entire month, can you explain this more? 

Thanks,

Ellen 

[Erimus]

On 8/10/2024 at 8:14 AM, Ellen102 said:

Okay thanks. I got some sleeping meds from the gp I'll take for a few days.

When you say spread the drop over the entire month, can you explain this more? 

Thanks,

Ellen 

Instead of doing 10% all at once, you can split it into 4 parts of 2.5%. So a 10% drop from 50 to 45mg could be split into 4 drops of 1.25mg (5mg/4 = 1.25mg)

 

This is the basis for The Brassmonkey Slide Method of Micro-tapering

[Ellen102]

Thanks, I am six weeks now on the first taper at 45mg...I still have bad insomnia. 

Sometimes I can get to sleep bit wake through the night. I've always been a light sleeper but this is the worst I've gone through consistently. 

I am not sure whether to start the next taper as my sleep is going to be affected regardless...

 

I have checked out the sleep guidance. I am going to reduce caffeine as that is likely a trigger.

Thanks, 

Ellen

[Erimus]

11 hours ago, Ellen102 said:

Thanks, I am six weeks now on the first taper at 45mg...I still have bad insomnia. 

Sometimes I can get to sleep bit wake through the night. I've always been a light sleeper but this is the worst I've gone through consistently. 

I am not sure whether to start the next taper as my sleep is going to be affected regardless...

 

I have checked out the sleep guidance. I am going to reduce caffeine as that is likely a trigger.

Thanks, 

Ellen

I would wait a few more weeks. When you drop again just do 5%.