Do SSRI dosage increases have to be permanent

[bargainChristmastree]

I was prescribed antidepressants for the first time last autumn. The GP started me on a relatively low dose, and it turned out to be enough. However I've been struggling a bit more in the last couple of months and my counsellor suggested I go back to the GP to see what they thought about increasing my dose. The GP was happy to increase it.

This was about two weeks ago, but until yesterday I hadn't taken the higher dose. My counsellor said that she didn't think it was clear cut whether or not I needed a higher dose and I wasn't particularly keen to increase it unnecessarily, so I decided to wait it out for a bit to see how things went. But I've been struggling a bit in the last week or so and I'm worried about how I'm going to get through the Christmas period without my usual routine and support network. If I do take the increased dose, will I be permanently stuck on it or could I reduce it back to the original dose in a month or so, once I get through this rough patch?

Of course you can decrease it whenever you are ready. Your GP can advise you; counsellors are not ordinarily medically trained. 😃

If the Dr advised you to increase your dose then it’s for a medical reason. It might not be forever, it might be forever, which ever it is does it honestly matter if it’s helping?

Your counsellor shouldn't be advising you on medication - these are questions and discussions for a doctor.

Medication doses can be reduced but it is not something you should be trying to do alone without medical supervision (from your doctor not counsellor).

Samaritans are there if you need extra support and would find it useful to be able to talk or email someone over the Christmas period. They're not just for people feeling suicidal.

I'm not saying that to be nitpicky but because a counsellor is not medically trained or permitted to give you such advice. Their advice on medication should never extend beyond suggesting you speak to a doctor for medical advice.

no, your antidepressants can go down as well as up. Most people will use them for a while and them taper down and come off them. But decide with your doctor not your counsellor, and they are long term decisions not "I feel ok this week so I'll halve my dose"

If you're struggling I would try the higher dose already agreed with your GP. It's a tough time of year.

@user15364596354862

I'm not saying that to be nitpicky but because a counsellor is not medically trained or permitted to give you such advice. Their advice on medication should never extend beyond suggesting you speak to a doctor for medical advice.

Agreed.

Thanks for responses so far. Maybe I have made what was said by counsellor on medication sound bigger than it was; I didn't feel that she was stepping beyond her remit on it. I understand she's not a doctor and would only ever take direction from my GP on medication (though coincidentally my particular counsellor does have a healthcare background before retraining).

Obviously I wouldn't chop and change dosage from one week to the next depending on how I'm feeling, but I suppose I'm wondering if I could take the higher dose for a couple of months and then go back to the GP and ask for it to be reduced again to the lower dose? (assuming I'm feeling better). Or would I have to be on the higher dose for 6+ months?

Absolutely the dose can come back down again. But it’s not the end of the world if it doesn’t, if you need the higher dose to feel better.

Your dose can definitely go down as well as up. I would suggest not trying to bring it down too soon though. Better to get yourself properly stable on the higher dose, then taper back down with the doctor's help, then go down and have to go straight back up.

Maudsley Prescribing Guidelines in Psychiatry indicate treatment should continue for 6-9 months after recovery from a single episode of depression - there are exceptions to everything of course

My DH has been prescribed sertraline for the first time ever very recently. His dosage was upped, too. It's made him feel so much better, it's unreal. I would take the dosage prescribed by your doctor. Doctors usually up it in consultation with the patient ime (DD has had to take ADs/anti-anxiety medication at various times.

I was on 200mg of sertraline for quite a while but felt no different to when i was on 100 or 150 so went back down and am now just taking 100mg a day. Its worth trying to see how you feel, nothing is permanent.