PhilP: Advice for tapering sertraline

[PhillP]

Hi everyone, 

 

ive taken sertraline for about a year and a half and was stable at 100mgs. I decided to come off it as I was feeling better mentally and had been prescribed cbd and thc which I’d much rather take. Despite the positive results of sertraline, the negative side effects had become too much to handle - continuous diarrhoea, muscle tension, migraines, restless leg syndrome and so I decided to begin the process of coming off them. My dr told me to just start cutting it down over a period of weeks lol 🤦‍♂️ I had read horror stories of that so I decided to play it slow, wait until a good time and then cut down to 75mgs. Which I did about six weeks ago, and two weeks ago I cut down to 50mgs. The last two weeks have been absolute hell - all side effects have been full on and I don’t know whether I’m coming or going, my stomach is in constant ‘free fall’ and I’ve become irritable and agitated at a drop of a hat. Things that used to be easy have now become an arduous task that sends me into sweats as though I’ve just had a shower. 
 

This is awful. 
 

I’ve spent the last few days researching what’s going on and have realised that the drops in my tapering have been too significant and my body’s gone into shock. 
 

My question is: what should I do next?
 

Do I go back up to 75mgs and wait for it all to settle down and then use the 10% method, or do I do as my dr has suggested which is 75mgs one day, 50mgs the next and do for four weeks before then going to 50 for for weeks before then going 50/25mgs for four weeks and then 25mgs for four weeks and then 25/0mgs for four weeks? 
 

Thanks in advance 

Edited May 2, 2021 by Gridley

[Gridley]

Welcome to SA, PhilP.

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.

 

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The symptoms you describe are typical of antidepressant withdrawal.

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

When we take psychiatric medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

 

These explain the healing process really well.

 

Brain Remodelling 

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

Since you've been at 50mg for only two weeks, I would updose back to 75mg and hold there until you stabilize, which can take several months. Once you've stabilized, I would taper down from there using the 10% method.  

 

Why taper by 10% of my dosage?

 

The following link is specifically about tapering sertraline, including how to get the non-standard doses you'll need for your 10% taper.

 

Tips for tapering off sertraline (Zoloft)

 

Under no circumstances would I use the method your doctor suggested.  Alternate day tapering (or varying your dose) is a terrible idea and, aside from cold turkey, is the riskiest way to taper.  It is inconceivable why doctors recommend this type of taper.  

 

NEVER SKIP DOSES TO TAPER - Tapering - Surviving ...

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Add in one at a time and at a low dose in case you do experience problems. Get supplements that are single ingredient (not mixed with other types of supplements).

 

This is your Introduction topic, where you can complete your drug signature, ask questions and connect with other members.  We're glad you found your way here.

 

 

 

Edited May 2, 2021 by Gridley

[PhillP]

Hi Gridley,

 

Thank you very much for your response and the information. 
 

Thank you for verifying my thinking around the tapering process. Doctors are really good at offering medication but seem to be very poor at the discontinuation process - it’s such a dangerous practice to give such poor advices don’t seems so pointless when it will undo any good work. 
 

ive decided to go back up to 75mgs and see how I feel in a few weeks. I think I’d probably be best if I went back up to 100mgs but I’ll see how I go at 75 for a few weeks first - if I can stabilise at that point and feel okay then it would probably be better than going right back to the start. 
 

It’s been a real relief to find this site. 
 

I’ve been doing some research about the microbiology of the gut and the production of serotonin. It seems that my gut microbiology is pretty ruined at the moment- would you (or anybody else) have suggestions of supplements other than the usual probiotics to help restore the good bacteria and to remove the irritation that I’ve got continuously down there?

 

 Thanks 

 

Phil

[Gridley]

5 hours ago, PhillP said:

I think I’d probably be best if I went back up to 100mgs but I’ll see how I go at 75 for a few weeks first - if I can stabilise at that point and feel okay then it would probably be better than going right back to the start. 

You should always be careful with updosing.  During the 2 weeks you've been at 50mg, your system has become somewhat acclimated to that dose, and updosing too much can overwhelm the system, causing further destabilization.

 

I don't know of supplements other than probiotics to restore the good gut bacteria there.  As always with supplements, start at a low dose and work up from there.

[PhillP]

Thanks Gridley,

 

Yes that makes sense about not jumping up too high again. I’ve kept it at 75 and I’ll stay at this until I’ve completely plateaued and then I’ll look to start using the 10% method. 
 

Thanks for all your advice- I’ll let you know how I’m doing once I’m ready to start the 10% reduction. 
 

Best wishes 

 

Phil

[PhillP]

Hi Grindley,

 

Just checking in - I’m about three weeks back on 75mgs of sertraline. Each day’s getting a bit more back to normal but I still don’t feel 100% yet - hopefully a few more weeks will get me to a point where I’m almost feeling good overall.
 

I’m not going to begin the 10% tapering until I’ve had at least a month of feeling ‘normal’.

 

However, I thought I’d begin looking at the process of the tapering of 10% - I’m not really sure how to accurately cut off 7.5mgs from an already inaccurate cut of 25mgs (the tablets are 50mgs each). The pill cutter I have is inaccurate with just cutting the pill into half so I’m pretty sure that’s not going to be the best way to do it - do you have any recommendations?

 

Thanks in advance. 
 

Phil

[Nomansland]

Hello @PhillP,

 

"The following link is specifically about tapering sertraline, including how to get the non-standard doses you'll need for your 10% taper:"

 

 

Greetings

 

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[PhillP]

Brilliant- thanks for that 👍

[PhillP]

Hi there,

 

I’ve done four weeks resettling at 75mgs of sertraline after dropping suddenly (after one and a half years, on the advice of my doctor - I was feeling really good and wanted to try life with the strategies I’d gained from using sertraline and without the really miserable side effects that came with taking it) from my therapeutic dose of  100mgs where I was feeling really good, down to 75mgs for four weeks and then dropping to 50mgs for two weeks at which point I was literally climbing the walls. As soon as I realised what was happening I did my research and found this website where I totally agree in doing it by 10%.  I went back up to 75mgs to stabilise and have been doing so for the last four weeks.
 

However, I feel like I’m about to have a nervous breakdown. I’m having continual panic attacks, including now at work (up until the last week I was just having them at home after work whilst trying to relax), I’m having incredibly intense intrusive thoughts and POCD. I’m hardly sleeping and I feel like I’m struggling to stay awake at work or that I’m going to say or do something stupid. I’m now taking daily clonazepam 0.5mgs but the panic attack I’ve literally just had that lasted about an hour to an hour and a half was barely touched by it. I’m absolutely all over the place.
 

I also had an extremely stressful incident last week where I had to urgently contact one of my high school student’s mother as he was threatening to commit suicide, and going through all the procedures I had to go through that that entails, meanwhile at the same time suffering from my own series of suicidal ideation intrusive thoughts that have returned over the last week (I’m not actually suicidal, so please don’t worry about that, but I unfortunately suffer intrusive thoughts about committing suicide whenever I get really stressed and they’re quite frightening and upsetting).
 

I’m currently tossing up whether to take a few days sick leave to try and get myself together and see my doctor. I have a therapist appointment on Wednesday who I haven’t seen for about three of four weeks.  Unfortunately, as a high school teacher it’s quite difficult to take time off without it creating quite a lot of paperwork. 
 

When I was taking sertraline my therapeutic dose was 100mgs. It completely got rid of my anxiety, intrusive thoughts and POCD.  But the side effects were pretty miserable. However, they were nowhere near as bad as I’m feeling right now - everything’s come back with a vengeance after such a long time of not suffering from it and it’s really taking its toll at the moment. 
 

Should I go back up to 100mgs so that I can get myself well again and free of the intrusive thoughts and panic attacks, properly re-settle and then begin the proper process of 10% tapering?  I’m really struggling at the moment and I’m not sure if I can keep dealing with the current withdrawal symptoms- especially if I’m going to be tapering off for such a long time. Is it better to go back one step to then move forward properly or just keep on going with where I’m at now and just hope the intrusive thoughts and panic attacks go away in time? 

What would be your advice?

 

Thanks in advance 

 

Phil

[PhillP]

Advice for 10% tapering of Sertraline

 

Hi there,

 

please could I get some advice - last year between the end of January and approximately July I tried to cut down from 100mgs of sertraline. I was advised by my doctor to drop 25mgs every six to eight weeks. By the time I got 50mgs I was an absolute nervous wreck and felt extremely anxious, irritable and would have quite severe intrusive thoughts. Eventually I had to go back upto 75mgs, stabilised at this for approximately six weeks and then ended up back at 100mgs, which I’ve stayed at since around the end of July and waited until everything was calmed down and I was recovered from the experience. I desperately want to get off sertraline but I’m very concerned about going through such a terrible withdrawal again- my doctor is offering the same advice as previous which I’m pretty certain will lead to a similar outcome and I’m not prepared to go through that again. 
 

I’m very keen to try the 10% method but we don’t get liquid sertraline in my country and so I’m thinking that if I removed 10% of the weight of my tablet and weigh it each time on micro-scales would that be effective enough and would it ensure that I was receiving enough sertraline to be within the 10% drop or is the likelyhood of the amount of sertraline being similar throughout the tablet too low for me to remove 10% of the dose?  (I hope that makes sense?)

 

I currently also use medical thc and cbd and I’m hoping to replace sertraline with thc and cbd entirely along with psilocybin treatment once I’m off sertraline. 
 

Is there a better way than my above idea for tapering?

 

Thank you for your time and please let me know if you’d like more info 👍

 

Thanks in advance 

 

Phil

 

Edited March 19, 2022 by ChessieCat
added Intro topic title before merging with intro topic

[ChessieCat]

New Intro topic has been merged with original Intro topic.  Only one Intro topic per member.

 

You can make your own liquid from tablets.  See the links in the quote below which was previously provided to you by Gridley.

 

On 5/3/2021 at 7:46 AM, Gridley said:

 

Why taper by 10% of my dosage?

 

The following link is specifically about tapering sertraline, including how to get the non-standard doses you'll need for your 10% taper.

 

Tips for tapering off sertraline (Zoloft)

 

 

 

26 minutes ago, PhillP said:

replace sertraline with thc and cbd entirely along with psilocybin treatment once I’m off sertraline. 

 

The idea of tapering following SA's tapering protocol is that you only experience minimal withdrawal symptoms and you can live your life as normally as possible.  The 10%/4 week taper is a guide only.  It is recommended that you do not reduce your dose again if you are experiencing withdrawal symptoms.  It is important to listen to your body/symptoms and taper according to those.

 

psychedelic-mushrooms-ayahuasca-and-other-hallucinogens

 

The only supplements which SA recommends are magnesium and omega 3 fish oil:

 

Magnesium

Omega-3 Fish Oil

 

Please also see:

 

Non-drug techniques

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

Stability

 

WDnormal

 

And Brassmonkey talks more about it here:

 

tao-of-the-brassmonkey