SSRI Withdrawal

@AlpacaMittens that sounds very similar to me. I hated the night sweats! I still sometimes get them after drinking alcohol, despite my now very low dose of sertraline.

I’m on old school Seroxat- not prescribed anymore due to the law suits. I have been on it for 25 years now down to 10mgm. I have tried twice ti get off it and it was impossible- just stuck

Just to say I've been on 100mg sertraline for about a year and it's absolutely changed my life for the best. However I have horrendous night sweats with it, to the point where I have such broken sleep I'm constantly tired. I'm now slowly tapering down to 50mg to hopefully address the night sweats. I had such an easy ride with sertraline so far, absolutely no side effects when starting it, and I went up to 100mg fairly quickly (although still gradually) as I had zero side effects with it, absolutely nothing. This makes me hopeful I I'll come down just as easily hopefully, although my GP is very very thorough and had me on a slow gradual tapering.

I'm hoping I'll eventually go down to 25mg and stay there although not sure what 25 would do for my anxiety, but I want to try it.

The likelihood of experiencing withdrawal syndrome when stopping a medicine and its severity is linked to the half life of the medication. Longer half life, smoother withdrawal from the medication. Shorter, worse, as the medication very quickly leaves the system and withdrawal symptoms are more likely to occur.

Of all the SSRIs, fluoxetine has the longest half life and paroxetine/fluvoxamine the shortest so avoid those two.

If you need to be specifically be on an SSRI fluoxetine would be the safest bet if you are worried about missing tablets.

But, if SSRIs are not suiting you there are lots of anti depressants to choose from.

I hope you are okay, can be a rocky road this anti depressant journey. Sending positive vibes.

I was told that by a nurse years ago: in fact she was telling me off!

Do antidepressants work? This British professor says they don’t

https://www.thetimes.com/article/1a4dd9b0-e8e6-4ffe-8e23-da8b5c319dce?shareToken=7b5743363ac4e00594fe1cd7cb808a7c

some bits here about big pharma

am a health professional... what do you mean about the tablets not having equal amounts evenly spread in tablet so you can't cut them? That's false. You CAN divide doses by cutting tablets. Whoever told you that should be shot...they aren't professional

It took my 18 months to get off Venlafaxine (which is an SNRI, but similar) when I wanted to TTC. It was absolute hell. The psychiatrist just told me to taper over a period of two weeks, but that was ridiculous. Even if I was late by an hour with a dose of that stuff I struggled to function.

I'm on sertraline these days and would love to lower the dose but I'm scared of the consequences.

Thanks @Catza Yeah I'm not sure I agree about big pharma hiding anything, but I do think that outside specialist services there is not good enough expertise and awareness of how to do tapering. It's a bit like the lack of knowledge around menopause in General Practice. And I stand by my point that most people on antidepressants have never been seen by a psychiatrist or a mental health specialist. t's not 'freely available' unless you're seeing a specialist...

Community Mental Health Service. Granted, this is more of a specialist service for people with enduring MH illness. I am not sure how things work in GP surgeries, presumably they don't have a luxury of a separate appointment. My post was more to reflect on the fact that OP seems to be suggesting big pharma are hiding withdrawal information which isn't the case and this information is freely available and is used in specialist services.

I'm on sertraline and amitriptyline. I wouldn't be unless I seriously needed them so have never tapered off them.
However I've had withdrawals a couple of times thanks to chemist fuck ups and i felt like I was Alice in Wonderland and jumpy.
Headaches wouldn't bother me if I was withdrawing gradually- I get them anyway from time to time.

Hi @Catza what is CMHT? I was not given a few days to decide - well only that I had the prescription and could decide when to start them. No leaflets. This was nearly 10 years ago. The only side effect my GP mentioned was loss of libido, but said only the men seem to care about that. It did actually affect my ability to orgasm for a while when I was on the higher dose but no one talks about that.

I think it is a GP problem. Most antidepressants are prescribed by GPs and people on them never see a mental health professional. Also when you first go on them, you really really need them, so even if I had been given information about tapering off I wouldn't have thought about it. I did warn a friend off going on them though a few years later.

could you try the dissolving and using a syringe, like I'm doing - see my first long post just now.

Oh sorry, just seen Mark Horowitz already suggested. I agree, what he has written up needs to go to GPs. All of them.

Hi @Nocd39 I saw your post last night and wanted to post something considered and not rushed. I totally agree with you that there's not enough information out there about coming off SSRIs, particularly if you only see a GP. I saw another poster said something about 'this is the protocol' but my frustration is that my GP put me on antidepressants and then none of them knows enough about coming off them! One said 'well when I took them 20 years ago it only took me 3 weeks...' I hope the consultant you're seeing is helpful - I seriously considered seeing a psychiatrist privately at one point. Most people on antidepressants on the NHS, afaik, have only ever seen a GP (or many GPs!).

Here are a few things I've done. I'm trying to keep it positive, as it is really hard. I've been on sertraline for nearly 10 years. I went from 100mg to 50mg to 25mg without too much fuss - I think! On a lower dose it means my biggest side effect of night sweats has stopped (a common enough side effect in women of any age, but not well sign posted...) But for over 5 years I've been weaning off in different ways. Because of covid lockdowns, and also feeling abandoned by the NHS, there have been plateaus, and then also some really lows. My motivation for getting off them is a combination of approaching menopause age and wanting to be sure that the symptoms I then have are menopause and not withdrawal symptoms or actual depression (or side effect night sweats!)and feeling that I can mange without them for the rest of my life. I do worry some of my feelings are numbed while I'm still on them. Or sometimes particularly enraged...

The MIND website is good on half lives of the different drugs, and how long they take to come out of your system. However, they are the ones who quite gaily suggest getting liquid prescriptions. I had to fight to get a liquid prescription - the GP insisted I find out the cost from the pharmacy before giving me the right prescription, the pharmacy would only give me the cost if I produced the prescription. I got some for 2 or 3 months eventually but then realised it expired really quickly so panicked about getting more.

So since then, under some guidance from one GP and then more recently the pharmacists from the GP practice I have been dissolving a tablet a day and using a syringe. This might be an option for you if it takes a long time and the liquid can't always be an option. I take one 25 mg tablet of sertraline and cut it in half (you could grind it up a bit). I put it in 10 ml of water. I leave it for a while to dissolve - have my breakfast, do my teeth. I then use a 1ml syringe (really tiny ones - you can order them at the Boots pharmacy counter) and syringe the correct amount. I'm currently at 0.85ml. In November it was 0.9ml. I was dropping by 0.1 of a ml but now it's been suggested as 0.05ml. I can't do the maths I'm afraid, but it means I'm on tiny amount of the 25mg every day. They key thing it is every day. I tried the cutting up and taking them alternate days and that did not work. In Msy last year I was on 1.4ml. I had thought it'll be another 8 months but now it might be 15 months more.

The 'practice pharmacists' are employed by the GP practice and have been really good - they see patients to discuss new medications and managing medications. One is a bit cold fish about asking 'and have you thought of harming yourself this month' but they know their stuff. I'm on other medications for a couple of other things so I get frustrated sometimes they focus on that, and blood pressure and blood tests but I feel at last I've got some continuity of care. That has taken a while though and has been a bit stop / start. I've also not held back from giving print outs and links to GPs new to me about withdrawal symptoms - no idea if they read it all but I've had to really fight to get heard. My 'usual' GP once said 'well, you could just stay on them forever'.

There's a doctor called Mark Horwowitz who is worth googling. He's written a book about his own experience of coming of SSRIs but is also a doctor treating patients coming off. Also look up Joanna Moncreiff. There is also a community out there called 'surviving antidepressants' that might be worth looking up.

Hope this helps - good luck.

I've spoken to many GPs who have advised going every other day with dosage and that a couple of weeks and withdrawals should be over. I've been tapering off 10mg Citalopram for 18 months dropping 10% per month. The problem isn't getting it out of your system, the problem is that your brain has to adapt again to the change of being without the drug it's now used to. This can be fine for roughly half of patients while the other half can experience symptoms worse than those that made them reach out to a drug in the first place. This can last for years. The companies making these drugs don't fully understand what they do, so I try to not get furious when I meet a GP giving the wrong advice.

I was very lucky to have a GP way back in the late 90s who recommended liquid doses for gradual withdrawal - Seroxat.

Since then I've been on and off (mostly on) Seroxat or similar SSRIs and have come across a gamut of withdrawal understanding from GPs. However, most are open to using liquid forms of the SSRI once they understand it is for long-term dosage reduction. The worst understanding I've come across is the just stop GP advice. I don't think many GPs advise that now.

Deciding to live without SSRIs is an important decision and again I'm lucky to have a GP that understands and supports this. He listened to my solution and so far so good - a bit tough going, but then Jan/Feb always has been.

Yes I have tried unsuccessfully to come off Citalopram twice and the anger I experienced was pure rage.

So much so that I am currently still taking them as too terrified to try again.

you have my sympathy, it’s hard.
I did it unsupported myself, and did it wrong (unsurprisingly!) I had horrible side effects and the doctor didn’t believe they were related to the drugs. I’d only been on it maybe 8 -10 weeks but knew I had to come off them.

the cutting down gave me a few days trouble but the stopping was off the chart! I did not expect it to be that bad, as I’d dropped to as small as I could cut them (accurate measurements!)
I rode it out, with sickness, headaches and sleepless nights.
I’m left with impulse control issues now that I never had before.

good luck, they are so quick to put you on them there definitely needs to be more looked at getting off them

Oh my gosh yes it’s all those - angry, ratty, no patience, no tolerance, slamming around the house, agitated, restless. Hates me blames me for everything minor thing going wrong in his life etc. But he doesn’t think it’s the lack of medication he thinks it’s me being an awful person to live with.

I can just tell when he starts changing and I can tell when he starts taking medication again slowly (normally 4-5 weeks and he’s back to calmer him but even within a week he’s nicer to be around). I just don’t know how to talk to him about it without it sounding like blame or criticism, he’s beeh easily hurt and offended