to lower my antidepressant medication (sertraline) without consulting my doctor?

[onetwosteponmyshoe]

Long story short: I have been on Sertraline for two years. I am currently on 200mg and I would like to lower the dose to 150mg as the start of a longer term plan to come off the medication entirely. The plan would be to stay on 150mg for between 3-6 months - December time, at which point I would hope to go down to 100mg.

My doctor is not a pleasant person and it takes forever to get through to anyone at the surgery. It has been an uphill battle - always - to get a prescription for anything, or a consultation, so I do not fancy having to beg / persuade / explain myself.

This is a decision I have not taken lightly and have given much consideration to.

So: am I being unreasonable to simply lower the dose myself and not consult my GP?

TIA

Yes you are being unreasonable.

Next question.

Hi OP,

Sorry to hear your doctor is a pain to deal with, however I would 100% not advise to lower your medication without consulting a medical professional. I have done this myself in the past and it did not end well. Its a process that needs to be monitored with regular check in's to make sure you are coping well on the reduced dose.

Can you request to see a different doctor at the surgery? Or alternatively enrol at a different surgery nearby?

If you do decide to go ahead without consulting, please make sure you let people close to you know so they can keep an eye out for any changes in your behaviour that you might not be able to see.

xx

You need to consult your GP, or Pharmacist.

No you're not being unreasonable. Presumably you're on 2x100mg tablets per day? I'm not sure what the consquences of breaking a tablet in half are, it may mean it's absorbed into the body faster - some medications are like that, admittedly many are not.

You can usually change your doctor just by requesting it, you don't have to give a reason.

Not telling the doctor you're doing this does have some benefits, you'll keep receiving prescriptions for the full dose so over time you'll build up a decent "stash" of medication. I like to keep 4-6 weeks worth of Sertraline on hand just because of the fact that periodically the doctor or pharmacist fucks up and there's a delay in getting my next prescription

I think if you’re on 200mg, you should consult a professional before you decrease your dose.

I was on 50mg for less than a year for PND and I just stopped taking it. I kept on forgetting to take it each morning and then never took it again. But my lose was so low I personally didn’t feel the difference when I wouldn’t take it.

If I was on 200mg, I’d certainly speak with someone

A 25% decrease is quite steep and you may get withdrawal symptoms. Check a tapering chart. Lots of info here: www.survivingantidepressants.org/forum/14-tapering/

Of course you should talk to your GP, but many GPs do not even follow the RCP/NHS guidelines on stopping SSRIs.

All these people saying consult the doctor first: what do you think the GP is going to say or do ? They will simply ask if you feel ready to lower the dose and be guided by you.
A simple PhQ9 and Gad7 test is all they work on. A simple telephone consultation informing the GP you are lowering the dose is enough.

Why so rude?

Op I get where you're coming from it's horrible having to justify your mh to someone unpleasant but would reccomend speaking to a GP. Is there any way you can change GPs?

It sounds like a reasonable tapering plan OP, but you really need to speak to a GP - who would be able to take into account any relevant medical history, your mood, etc, and advise accordingly.

Could you speak to a different GP? You could always change surgeries if there is really no one there you find helpful.

I know its frustrating when you have made the decision to taper, and the wait to speak to a GP may be a month, but it would be worth getting some proper advice.

I would also suggest doing some online research of the withdrawal effects of sertraline so you know what to expect, as GPs aren't always aware of this. I tapered off sertraline earlier this year and was mostly fine, but found the drop from 25mg to zero a little difficult.

Thank you for the responses. I am going to take some more time to think about it.

YANBU.

I've done it myself with a different antidepressant and slowly weaned myself off completely. However, I was on a low dose and my depression was considered mild.

In the first instance, it's worth trying to see a different GP. Good luck.

I have also done it myself but I was on a lower dose. I very carefully halved the tablets for a few days and then halved again. But I was on a lower dose, different tablet, and had been on it a much shorter time. Take care OP, and whatever you do, take things slowly and discuss with someone if possible

Please reconsider your plan.
The recent Panorama programme highlighted the need for a long, slow taper off of many antidepressants.
It would be preferable to seek the advice of a medically qualified person.
A relapse or withdrawal issues are unpleasant.

No, always talk to your doctor about any medication decision, so you can work together to the best advantage. You could probably get a phone appointment with them, so it's not much hassle.

Also depends on what you were prescribed it for.
If you are over 60, had a long episode of significant depression that took time to resolve - YABU
If you are in your 30's and were given it for anxiety, that's a different matter

You should still dw GP

Does your surgery have nurse practitioners, they could oversee any reduction so reduces risks of withdrawal symptoms without having to see the GP directly. You could quite safely then reduce the dose at a slightly faster rate than your proposed 6 months , it’s quite safe, with monitoring, to go from 200mg to completely stopped in 6 months if you wanted to.

From personal experience of both sertraline and many other different psch meds:
Never come off cold turkey. I came off fluoxetine at a higher dose cold turkey and then came close to killing myself.
Reducing sertraline caused me serious issues with anxiety and depression. It is possible, especially on a higher dose, that you will have very bad withdrawal effects, which will be like the reasons you started in the first place. Keep this in your mind as you reduce as it helps to understand when things are bad.
Whenever a doctor or psychiatrist has agreed to reduce medication, they NEVER give it as much time as you really need if you are going to have an issue with withdrawal. I have found some medications horrendous even when I have reduced by their amounts. I always reduce by much, much less and very, very slowly. I've broken up tablets before (you can buy pill cutters). This doesn't, of course, work with capsules.
If you still are getting the high dose from gp (for now) it will be useful in that if you change your mind or its to much of a drop to quickly you can increase your dose again. You will eventually (if you find it hard to get off) need smaller tablet sizes, however, as it will potentially get harder the lower dose you get to.
On the other hand, you may have no withdrawal at all but should still do things slowly.
Some GP's are useless with reducing psych meds and won't necessarily give good advice.
Good luck. Always advocate for your own experience.

I wouldn't. I've lowered mine slowly from 25mg to 3 over the space of 2 months. I went to the gp for advice and she arranged a call with me four weeks later then another. I'm feeling quite depressed at the moment but it will pass but I'm pleased the gp knows what I'm doing. I would look for a better gp

It went from 25 to 12 over four weeks then 6 then I've cut them in half. I mean it's difficult because they crumble so not an even cut but it's just a tiny bit. Prob why I feel depressed really. But it will pass and that's my point. The gp knows what I'm doing and she's checking in with me

I did during lockdown, a month from 200mg to 150 then a month at 100 then 3 months at 50 then a month 25 then stopped. Got a pill cutter from Amazon.

Sorry how has this turned into a conversation about my use of sertraline? I wasn't advising the op to take 3mg I was merely saying she shouldn't do it alone