Coming off sertraline

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I’ve been on sertraline (100mg if it matters) for around 6 years. Originally for severe post partum anxiety. I’d really like to come off it, but I am worried about the process of reducing the dose and how bad I might feel.

AIBU to just accept that I’ll be on it forever? Has anyone been able to come off completely and not had to start again?

I’ve been on 100mg for the same amount of time. Dont come off without guidance from your GP. You should tell them that you’re thinking about stopping and then they can support you with gradually reducing the dose safely.

In my experience, coming down from 100mg to 50mg is relatively fine (you will have some side effects) … but the reducing down from 50mg was horrendous. You have to take it extremely slowly, and don’t be disheartened if you have to go back up again!

Some of it depends on your particular neuropathy.
Some people stop quite quickly and others take a lot longer.
The most important thing after that many years is to taper it down incredibly gradually. Ask if it's available in a liquid form because ideally new taper down much more slowly than doctors tend to recommend.
So if I was doing it again, I would try 95 milligrams for maybe two weeks or three weeks and if everything okay according to other people then try reducing by five milligrams every month or so.
Personally, first time I stopped it was cold turkey and it was awful for months.

You have to gradually taper your dose down over time. I went and asked our local pharmacist who was very helpful. But I had only been on it for 12 months. Can you get a phone consultation with your GP to discuss?

I started it at the beginning of 2021, and decided last summer that I, too, wanted to come off it.

It wasn't too bad withdrawing, I just felt really dizzy for a couple of weeks, but then it settled.

I stayed off it for a couple of months, but gradually the old feelings of anxiety crept back in, and before I knew it I was overthinking, worrying, crying at the drop of a hat, and worrying that DP was going to leave me (I can see I had no reason to worry now I'm on an even keel again).

I decided that I would rather be on it for the rest of my life, and accept any possible long term effects, than just be anxious and miserable like I was before I went on it.

There's no shame in taking something that helps you function in life.

That being said, I would also say that it's definitely worth trying. If yours was due to post partum hormones, you may find that you can come off it, as those hormones are no longer present.

My anxiety has been an issue since I was a teenager, and it took me two entire decades to ask for help. I wasted two decades of my life, and taking one tiny pill every morning allows me to enjoy life again. I'm not ashamed to say I will likely be on it forever.

I was on it for 4 years, tapered down over a year with GP guidance and have been off it for 2 years. A lot of life changes happened that did help with ability to come off it - long term therapy, change of job etc.

I came off it under GP's supervision with no issues.
Having said that, there is absolutely nothing to "accept" about being on it for the rest of your life. There are many medications that people take forever for their physical health ailments, the only difference is the stigma that comes with MH issues.

I stopped sertraline overnight and never had any issues. I wouldn't recommend anyone else does it though - you need to speak to your GP and get them to taper your dose.

I was on a very low dose of Sertraline for acute menopausal anxiety for about 9 months. I emphasised to my GP that I didn’t want to be on it for any longer than I had to.

I built up very slowly and came down just as slowly. My GP was excellent and reduced my dose down by half a tablet at a time until the course was completed.

This was a while ago now so maybe they've got better but the gp-proposed taper was way too steep when i tried (was either sertealine or citalopram) so the next time I tried (more recently)i stealth tapered, collecting my prescription and breaking the tabs so I went from 1 to 2/3 to 1/2 to 1/2 every couple of days etc. Over months.

Tbh I still take about 1/4 dose every three days or so - partly because I am never fully free of the very occasional dizzy feelings, but also because the anxiety and doom feelings start to creep in, but a very very tiny dose seems to keep them at bay. Might be placebo but seems to work for me.

Eventually I suppose i will run out of my stockpile and have to go back to the gp!

I came off it completely from 100mg. I echo what others say about coming off it v slowly. This may be much slower even than the GP advises.

My GP said to cut down to 50mg for 2 weeks, then 25mg for 2 weeks, then stop completely. The first 2 reductions were fine, no symptoms, but I felt v ill after stopping completely - both physically and mentally

After discussing with the GP, he felt this was withdrawal rather than a recurrence of the depression, due to me having all the physical symptoms, so I went back on 25mg for a few weeks till it stabilised then cut down much more slowly. I cut the tablets in half, then quarters, then sixths, then eighths and left 3-4 weeks between each reduction.

When I stopped completely about 6 months later I had no symptoms at all. (I think I am sensitive to low doses of sertraline because when I originally started on 25mg I felt better very quickly, whereas the GP said that dose should have no therapeutic effect.)

it can be hard, I think, to distinguish between withdrawal and a recurrence of the depression but tapering v slowly won’t harm you and will give you the best chance of coming off.

I was on 100mg for a few years. I managed to reduce from 100mg to 75mg with limited side effects, and felt fine. Then tried reducing from 75 to 50 and no issues with side effects but my mental health declined. So I'm back on 75mg for a bit and will have another attempt at going down to 50mg when I'm ready to try again. I sort of felt I'd 'failed' when I had to go back up from 50 to 75. But I'm trying to focus on the fact that reducing from 100 to 75 is a win. And we have to prioritise our mental health.

Good luck.

(oh and you can get 25mg tablets, I asked my GP to prescribe 50+25 so I wouldn't have to worry about taking half a pill etc)

"it can be hard, I think, to distinguish between withdrawal and a recurrence of the depression"

This is interesting. I'll bear this in mind next time I try to reduce it.

I weaned really slowly and was ok but then got that awful brain zap feeling about three months after stopping. I went back on it as realised I needed it.

Why do people want to come off it ? Why is that seen as the goal? DD has been on it for 3 years, and will be on it for the foreseeable future. As I said to her, if you were Diabetic, you wouldn’t feel the need to stop taking insulin.

There is nothing wrong with anti-anxiety meds.

Hi.

I was on 100mg sertraline for a long time. I'm now on the equivalent of 1mg. I'd suggest you look at these guidelines https://www.wiley.com/en-gb/shop/general-introductory-medical-science/the-maudsley-deprescribing-guidelines-antidepressants-benzodiazepines-gabapentinoids-and-z-drugs-p-9781119823025, look up Mark Horowitz and Joanna Moncrieff and take it very slowly.

https://www.ucl.ac.uk/news/2025/may/antidepressant-withdrawal-symptoms-more-common-among-long-term-users

I'd also be careful about what your GP advises. I've ended up seeing the pharmacist from the GP practice, she's been much on understanding of how the withdrawal symptoms as you taper can mimic the depression and anxiety symptoms. A lot of GPs aren't as up to date as they could be and seem to think it can all be done and dusted in a couple of months.

This website is helpful https://www.survivingantidepressants.org but it's now read only.

If it helps, I found going from 100mg to 50mg OK, then 50mg to 25mg also OK, then I stayed on 25mg for quite a while (Covid and lockdowns got in the way). I now use a pill cutter to cut a 25mg pill in half, dissolve it in 10ml of water and then use a tiny syringe to keep reducing the dose. For me, menopause has got in the way so I'm now stuck at 0.4ml each day (equivalent to 1mg) but I was doing quite well reducing by 0.1ml or 0.2ml a month for a couple of years. It's boring and I sometimes think I will be on it forever. Sorry, that's not what you want to hear.

There are support groups on Facebook - look up coming off SSRIs - but sometimes they're just full of stories that might make you feel despondent! Or people having quite different experiences outside NHS / UK, or even different parts of the country...

I tried the liquid sertraline for a bit but don't recommend it - I had to fight for the prescription, then I was taking such a small amount it expired with loads in the bottle and I couldn't get more. I suspect if you are under a psychiatrist it might be easier to get the liquid (MIND website recommends it). MIND are good for basic info on how SSRis works with half lives etc https://www.mind.org.uk/information-support/drugs-and-treatments/medication/explaining-the-half-life/ and they have a section on tapering but I've found the other links more helpful.

Good luck.

Do it gradually and with the support of your GP. I stopped altogether once and I felt horrific for some time. When I finally came off it, it was gradual. I still felt crap, but not as bad as before. Unfortunately the anxiety and depression had not gone away, and I now take citalopram instead.

When I started it for PPA/D the doctor said to me that when you decide you want to come off it, wait for spring.

She said it is much easier coming off in lighter, warmer days than dreary days of winter.
I tapered down over 6 months from March through August. I was on AD for about 18 months before starting tapering, around 2 years in total.

I'm still having issues with hormones after my periods returned, so contemplating going back on. Have the pills just nervous to start again.

There is a slight association with osteoporosis. As I already have osteoporosis I do try to keep my SSRI dosage v low now if my MH is stable, after around 10-15 years of taking them on and off. Would not hesitate to increase my dose again if my MH required though.

Thanks all, really helpful! I will book an appointment with my GP (who I haven’t actually seen in around 4 years) to discuss

For me, due to a couple of side effects - heat sensitivity and loss of libido

I agree there’s nothing wrong with being on them for life. I just don’t enjoy those particular side effects.

I was on 50mg for 7 years. Tried to come off unsuccessfully twice - successfully the third time.

I tapered so took every other day for two weeks then three times a week then twice and then stopped.

I still have days I think maybe I could do with help but I’m glad to be off it purely because I’m on so many meds.

That’s reminded me I got the most awful night sweats when I was on the higher dose. And this was years before perimenopause. Night sweats are actually quite a common side effect among women I discovered eventually…

I swear the GP didn't warn me about any of these possible side effects when they first prescribed it.

I only discovered the heat sensitivity thing recently when there was a post about it on social media during one of the heatwaves.

Had no idea night sweats could be linked to Sertraline.

The only side effect I sort of knew about was the libido one but I guess that's the one that men care most about so it's reasonably well known

By tapering down very, very slowly. Literally by just no more than 5mg every other day for at least 2 weeks before reducing by a bit more. 100mg is quite high so expect to take your time about it. Cutting up the tablets is the usual way but when you're on a lower dose the liquid form is very useful. You take it by oral syringe and can easily measure per 1mg doses.

I was in 150mg (OCD) - came down slowly and alternated doses, 50mg one day and 100mg the next, once that settled for a few months it was 50mg a day.

Slow and steady.

But I will stay on 50mg for life I think just to keep me balanced with the OCD