TaperRick: Tapering 50% of sertraline

[TaperRick]

Hi there!

 

Im here because I am starting my tapering journey from sertraline 100mg to 50mg. Been on 100mg sertraline for about a year combined with 150mg bupropion. Im feeling emotionally stable, by I've got slight sexual dysfunction and problems losing weight. Therefore tapering to 50mg sertraline. If all goes well and Im steady with my new job (which I start januari 2nd) I will start tapering towards zero sertraline. 

 

I am using a tapering schedule provided by drugtaper.com using tablets and liquid. My goal is to be at 50 mg at the end of februari 2023. 

Tapering calculator for antidepressants.pdf

[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 starting your taper off of sertraline.  How have you been feeling since you reduced from 100 mg to 50 mg 8 days ago?  I would suggest that you slow down the rate of your taper.  We suggest only tapering by 10% at a time, of the current dose, every 4 weeks.  I'll explain this more fully later.  

 

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.

 

 Why Taper by 10% of my Dosage  

 

Tips for Tapering Sertraline

 

Here is a link with checklists of common WD symptoms, in case you are experiencing withdrawal: 

 

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

 

Are you experiencing any symptoms since you reduced your sertraline?  

 

Have you had any symptoms before you did your recent sertraline reduction?  If so, what symptoms?  There is a major interaction between sertraline and bupropion according to www.drugs.com.  

 

Interactions between your drugs

Major

buPROPion  sertraline

Applies to: Wellbutrin (bupropion), sertraline

Talk to your doctor before using buPROPion together with sertraline. Combining these medications may increase the risk of seizures, which may occur rarely with either medication. In addition, buPROPion can increase the blood levels of sertraline, which may increase other side effects. You may be more likely to experience seizures with these medications if you are elderly, undergoing alcohol or drug withdrawal, have a history of seizures, or have a condition affecting the central nervous system such as a brain tumoror head trauma. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. You should avoid or limit the use of alcohol during treatment. It is important to tell your doctor about all other medications you use, including vitamins and herbs. 

 

Edited January 1, 2023 by getofflex

[getofflex]

Just FYI, I haven't looked at your download, because I won't risk the safety of my computer. 

[TaperRick]

Thanks for the comment! Ive been feeling a bit emotionally brittle since lowering. I did a direct step to 75mg and am planning to do a 1 mg reduction to 50mg every 3 days. My waves are usually accompanied by thought about how I can escapr this feeling what supplements I should take to get rid of the feeling. I then try to stay with the realization of this thought pattern and allow myself to feel the waves and accept the fsct that I'm mentally reacting to the uncertainty that comes with the waves. This is enough to keep me from spiralling for now. 

 

I will start a supplement called palmitoylethanolamide today. This supplement lowers inflammation and increases allopregnenolone, a neurosteroid that lowers inflammation and anxiety and calms the fight or flight response. SSRIs also increase allopregnenolone, which might be part of why they help anxiety and why they increase anxiety upon tapering. 

 

Palmitoylethanolamide is non-habit forming and does not cause withdrawal symptoms. 

 

I didn't have any drug on drug reactions on the combination of bupropion and sertraline. 

[getofflex]

19 hours ago, TaperRick said:

I did a direct step to 75mg and am planning to do a 1 mg reduction to 50mg every 3 days.

Updosing to 75 mg is fine, but I suggest you hold off on reducing for a while, and allow your nervous system a chance to adapt to the recent drug dose changes you have made.  If you read my link on how psych drug remodel the brain, you'll understand the reasoning behind this.   Reducing by 1 mg every 3 days means you would be reducing faster than the rate that we suggest, which is a harm reduction approach.  Many people who taper quickly end up crashing their nervous systems, and it takes months, sometimes years, to recover from this.  I wouldn't suggest tapering by 50 mg every 3 days, as this would come out to reducing by 20% in a month, and is a linear taper, not an exponential taper, meaning the reductions get smaller and smaller as we get lower in dose. Please read the link in my first post, and click on the link about the SERT Occupancy Studies to see why we should make the reductions smaller as we get lower in our dose.

 

If you don't want to do the 10% monthly reductions, another method we suggest is micro tapering, where you make smaller reductions frequently.  

 

Brass Monkey Slide Method of Micro Tapering

 

Also we suggest instead of going by the calendar, that people listen to their bodies, and don't do reductions if they are having symptoms.  We like to wait until we are stable for a couple of weeks before reducing the drug again.  

 

Here is our topic on supplements.  I'm not familiar with the one you are describing.  We don't suggest supplements aside from magnesium and omega 3, because these can have unpredictable effects on our sensitized nervous systems.  

 

Supplements in Withdrawal

 

Hypersensitivity to Supplements, Drugs, Food

 

 

 

 

Edited January 2, 2023 by getofflex

[TaperRick]

Feeling quite sad today. Dont know if its the weather, the fact that its winter (prone to seasonal affective disorder) or that ive tapered too quick (direct jump from 100mg to 75mg)

 

Quite obsessed with how I feel and my mental health atm. Wondering if I should take an extra 25mg today. Also took cbd the past 2 days, could that be the cause of the sadness? Maybe its indeed best to not use any extra supplements to deal with my mental health atm. 

[TaperRick]

On 1/2/2023 at 6:53 PM, getofflex said:

Updosing to 75 mg is fine, but I suggest you hold off on reducing for a while, and allow your nervous system a chance to adapt to the recent drug dose changes you have made.

I will definitely stay at 75 for a while until I'm sure I've stabalized again.  

 

Ill take a look at the brass-monkey method. Sounds like a good middle way between monthky 10% and weekly x percent. 

[getofflex]

On 1/1/2023 at 4:08 PM, TaperRick said:

I did a direct step to 75mg

Can you please add this to your sig, along with the specific date you started this?  Thank you. 

 

6 hours ago, TaperRick said:

Quite obsessed with how I feel and my mental health atm. Wondering if I should take an extra 25mg today.

Please realize that these drugs do not work like an Advil painkiller.  It is not a good idea to vary your doses based on how you feel on one particular day.  Doing this puts you at risk of further destabilizing you and confusing your nervous system.  The level of the drug goes up and down in your bloodstream, and stresses out the nervous system.  It is very important to stick with a precise same dose each and every day, and only change your dose after careful consideration.  Please carefully read: 

 

Considerations About Stability - Don't Jump Around

 

6 hours ago, TaperRick said:

Feeling quite sad today. Dont know if its the weather, the fact that its winter (prone to seasonal affective disorder) or that ive tapered too quick (direct jump from 100mg to 75mg)

Or a combination of all of the above.  Sadness is a normal part of life, although it is not pleasant.  Part of my recovery plan is to learn to accept sadness and to express in in a healthy way and cope with it, instead of trying to numb it with drugs.  Going outside for walk, if you are able, and the weather is OK, can really help.  Or try walking or exercising indoors.  Exercise increases endorphins and is a natural antidepressant.  

 

6 hours ago, TaperRick said:

Also took cbd the past 2 days, could that be the cause of the sadness?

We suggest you stay away from CBD, alcohol, and any other mind altering substances.  These will put you at risk of further destabilizing a sensitized nervous system, and likely to make withdrawal symptoms worse.  

[TaperRick]

1 hour ago, getofflex said:

Can you please add this to your sig, along with the specific date you started this?  Thank you. 

 

Will do!

 

1 hour ago, getofflex said:

The level of the drug goes up and down in your bloodstream, and stresses out the nervous system.  It is very important to stick with a precise same dose each and every day, and only change your dose after careful consideration.  

Yes I did not add an extra 25mg. I have to accept the feelings as they are now and remember my body-mind is now more sensitive to emotional changes. 

1 hour ago, getofflex said:

Going outside for walk, if you are able, and the weather is OK, can really help.  Or try walking or exercising indoors.  Exercise increases endorphins and is a natural antidepressant.  

 

We suggest you stay away from CBD, alcohol, and any other mind altering substances.  These will put you at risk of further destabilizing a sensitized nervous system, and likely to make withdrawal symptoms worse.  

Yes I noticed I felt a lot better when I went outside and engaged with the world instead of staying in my home/room the whole day. I wont use any supplements anymore except glycine and lysine (which I need for my auto-immune disorder) 

[getofflex]

"28-12-2022 direct drop from 100mg sertraline to 75mg sertraline. "  

You jumped up to 100 mg again, then dropped down to 75 mg?  In a previous post, you said you just went from 50 mg to 75 mg. 

 

Hopefully, you read my previous post about stability, and the link provided.  

Edited January 5, 2023 by getofflex

[TaperRick]

1 hour ago, getofflex said:

"28-12-2022 direct drop from 100mg sertraline to 75mg sertraline. "  

You jumped up to 100 mg again, then dropped down to 75 mg?  In a previous post, you said you just went from 50 mg to 75 mg. 

Aah now I understand this sentence: (see quote at the end of this post). I recently dropped from 100 to 75 and want to go to 50 and eventually to zero. When I started the sertraline I did 50mg for a few days then went to 100mg. This is my first time at 75mg.

On 1/2/2023 at 6:53 PM, getofflex said:

Updosing to 75 mg is fine

[getofflex]

On 1/5/2023 at 1:09 PM, TaperRick said:

I recently dropped from 100 to 75 and want to go to 50 and eventually to zero. When I started the sertraline I did 50mg for a few days then went to 100mg. This is my first time at 75mg.

On 1/2/2023 at 11:53 AM, getofflex said:

OK.  Please clarify your drug signature with this information, which is confusing.  Thank you.  

 

Just please reduce from 75 and 50 slowly and gradually, as described in previous posts.  This is will help you to minimize or avoid debilitating withdrawal symptoms.  

[TaperRick]

So my stubborn ass convinced itself it could make a direct jump to 50mg from 75mg since the jump from 100mg to 75mg went so smooth. I felt quite good for 1.5 week, but its been 2.5 weeks later now and I feel quite emotionally fragile, as if Im having a burn-out. Wake up every morning feeling very stressed, high heart rate, low confidence, not overseeing al things I have to do for work. Also noticed Ive become much more fidgety.

 

Have been on sick leave for the past 2 days. Hopefully the weekend will bring some relieve. Not sure if its related to the fact that I stopped taking magnesium bisglycinate a week ago when I ran out of it. Will receive new stash tomorrow, hope it'll help a bit. I might take a gym membership to do some cardio a few times a week to help with the stressed feeling in my body. 

[FireflyFyte]

10 minutes ago, TaperRick said:

So my stubborn ass convinced itself it could make a direct jump to 50mg from 75mg since the jump from 100mg to 75mg went so smooth. I felt quite good for 1.5 week, but its been 2.5 weeks later now and I feel quite emotionally fragile, as if Im having a burn-out. Wake up every morning feeling very stressed, high heart rate, low confidence, not overseeing al things I have to do for work. Also noticed Ive become much more fidgety.

 

I can appreciate the desire to make large jumps and get off of these drugs faster but, sadly, it usually prolongs the process by creating intolerable withdrawal symptoms that linger for months or years which is why this site doesn't recommend any faster than 10% reductions per month. You might want to consider up-dosing, stabilizing, and then starting a slow and measured taper.

[getofflex]

What Fire Fly said above.  

 

You reduced from 100 mg to 75 mg on December 28, then on January 2, you made another reduction to 50 mg?  This is waaaaay too fast.  Please go back and carefully reread my intro post, with the information about how these drugs remodel your brain, and why we suggest only reducing 10% every 4-6 weeks. Rushing a taper will put you at risk of causing major problems, and in the long run, will take longer to get off the drugs.  

 

Your information in your thread conflicts with that in your signature.  The signature says you dropped to 50 on January 2, but your post says you dropped it 2.5 weeks ago, which would be around February 1.  Which is correct?  We cannot advise you without the proper information.  I can't suggest an updose amount until I know the details of your recent tapering, including all dosage changes, with their correct dates.  Format it like this 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