Stopping Sertraline

[WhatNowFrantic]

Hi. My DS has been on sertraline for 13 months, started on 25mg then after a few weeks went up to 50mg where he stayed.
He is now in a much better place and feels he wants to stop. The GP has just said dont just suddenly stop, go to 25mg and see how it goes.
Has anyone had experience of this? How long did it take? Did you have side effects?
Thankyou

He needs to speak to his GP and taper down. He might feel he's in a much better place, but the medication may be acting as scaffolding at this time. Best to go slow and under medical supervision.

Thankyou @LifeExperimentation
The reason he needed AD in the first place has now been sorted and hes had Counselling and is in a better place. But I agree, that the reason he is better is because of the medication.
But unless he tries I guess he wont know.
The GP said 50mg is a relatively small dose and he should cut to 25mg for a few weeks and see how he feels.
He was really against taking AD last year and the GP urged him to try them for 6 months, hes done 13 months now.

Yeah cut down as slowly and incrementally as possible. Everyone is different but I was on 150mg for 4 years or so and had to spend half a year coming off them. Going down to 100/50/25 was fine but trying to stop on 25mg was hell. Tired, dizzy, faint spells, horrible horrible brain zaps.

I had to take 12.5mg every day for a month then went to once every 2 days, 3 days etc just to avoid really bad withdrawal!

Thankyou @StormcloakNord

I came off 100mg sertraline last year. I would advise to do it as slowly as he feels he needs. The GPs timescales are always way too fast. I cut down to 75mg then 50mg, then cut the 50mg tablets in half and took 25mg a day, then quartered them and took 12.5mg per day. Then went to 12.5mg every other day, then every 3 days, then finally stopped. The whole process took about 9 months. Don't reduce until the side effects have lessened.
I had horrible side effects: head zaps, dizziness, was very tearful and emotional which made me think the depression was coming back but it was just the side effects.
Take it slow, give him lots of support. It will get worse before it gets better but I've not taken any sertraline since August last year and I feel absolutely fine (which is a miracle considering the nightmare that is covid right now!).
Best of luck

That's good advice @SamoyedPrince thankyou. I'm glad you are doing well.

There's no harm in tapering extra slowly. These are trying times!

I reduced alternate days so I'd do 50 and 25 alternate days for a month. If that's going well, 25 a day for a month. Then 25 every other day etc.

It depends as well how easy the tablets are to break. But definitely don't rush.

Just go as slowly, slowly as possible. Do not rush.

I have been on sertraline on and off for around 9 years now. I would not recommend to stop abruptly. This is speaking from experience. The withdrawal effects are not pleasant. It’s better to slowly lower dosage and come off it that way. When your body is on antidepressants it makes you feel that it is able to come of them instantly after having a period of feeling good. However, decreasing the dosage gradually allows you to understand if your mind is truly ready or not.

@WhatNowFrantic I hope he follows the advice, especially as there's really no downside to tapering slowly. Glad counselling has been helpful for him.

Don't do the half dose yet. The side effects are brutal, he does NOT want the brain zaps, do a quarter less for 3 weeks to start with so cut the tablets in half then again if they are a 50mg pill. Then drop to half for 3 weeks. If he gets side effects, don't drop again until they subside.

Tapering slowly is always the way to go. Why suffer if you don't have to?

@nothingcanhurtmewithmyeyesshut
The 50mg tablets are tiny, he can just about manage to half them, theres no way you can quarter them evenly.
This is day 4 of dropping to 25mg and hes had no effects yet, would he have noticed any side effects yet or is it too early? X

Too early, I think there's a two week lag, if I remember correctly.

You don't have to take the same dose every day. You can halve the dose one day and not the next, for example.

Oh really? The GP didn't mention that,just straight down to 25mg
Thankyou

Funny because when he started them he had side effects from day 1, dizziness, nausea etc. He started on 25mg for 2 weeks then went to 50mg.

Oh yes, starting them was bad! Immediate side effects, but the positive effects build over time.

Weaning off them- I was lucky, a friend's daughter had a bad experience so she warned me. I tapered really slowly and had no ill effects at all. There's no downside to taking it slow, and it's unpleasant and potentially risky to take it too fast.

Don't be tempted to decrease again because there have been no ill effects in the first couple of weeks. Just wait, then reduce every other day.

Thankyou

It'll be days yet, they've got a long half life iirc.

@nothingcanhurtmewithmyeyesshut. That's not what I've read,apparently they have a short half life;
SSri's are fairly well known for having adiscontinuation syndromewhen the medication is stopped suddenly or if it is rapidly weaned. This is more notable with SSRIs with shorter half-lives such as Paxil (paroxetine) and Zoloft (sertraline) and less common with long half-life medications, such as Prozac

@WhatNowFrantic Its 22 to 36 hours. I'd consider that fairly long but I suppose it depends what you compare it to.

Just thought I'd update, it's been 2 weeks now since DS halved his dose down to 25mg, hes had no side effects up until now but the last 2 days has been subdued, it really worries me as this is what he was like before he started taking them.
Is it possible that this is withdrawal or does it mean he shouldn't be coming off them yet? One day he was fine and the next day really down.

Just read the thread.

So first off, congratulations to your son! It's amazing achievement to get to the place he can feel like he can come off the medication.

I know when he has a bad day it can feel very scary but one or two days just isn't enough data to be worried. In fact, you can actually harm his recovery if you make a big deal out of it (I'm sure you are not saying anything to him directly). Even when he is better he will have days where he's down because we all do so it's a lot of pressure on him if he feels he can't have a down day without it being seen as a relapse. I say this as someone who came off sertraline in 2019.

When I came off the medication the doctor did say there could be dips in my mood but everything was on the under a week time frame. So try not to worry. Though it's far easier said than done.

If it keeps going then talk to him/his doctor about it. Otherwise could there have been any triggers? You don't say how old he is, but has he gone back to school? Has he slept poorly? Has he not eaten well? I know that these seem like trivial things and these questions often are used to dismiss mental health concerns but I was on the medication for 8 years and even now my mood can be fragile to general wellness.

Good luck.

@WannabeMathematician thankyou that's so helpful!
He has come such a long way in a year, this time last year was awful, so I really do celebrate (to myself!) every time I hear him sing or laugh! He does seem brighter tonight, and I've not said anything to him.
When he suggested coming off the AD I said he must speak to his GP which he did. He didnt really say what was said apart from going from 50mg to 25mg and see how it goes.
He is early 20's and runs his own business which can be stressful in itself. I'm very proud of him, but also aware how quickly situations can turn.

I completely understand.

Certainly for my mum it was like she was bruised by the experience and any time I had a bad day it was a bit like poking the bruise for her, especially at the beginning. I think it's wonderful he has such a supportive mum (and/or dad!).