How do you know when it's time to come off medication?

[Carnageisthenewnormal]

I was signed off work with anxiety in mid July and, at the same time, was prescribed sertraline which I've been taking since. During my time off I've done as much as possible to reduce my anxiety and improve my mood including CBT, an online course (referred by the health visitor), a local support group and regular exercise. I've also just taken time for self care to clear my head - walking the dog, reading a book etc. I think all of that is working well, especially exercise, and my mood has far improved. I'm not sure how much of the improvement is attributable to the medication but I'm definitely feeling more positive (although not better).

I accepted the prescription for sertraline reluctantly because I hit a low and needed help to settle my feelings and let me see clearly, however, I don't want to be on it long term and my goal is to come off it as soon as possible.

My question is, how do you know when you're ready to come off medication? I'm scared of a relapse and needing to go through weeks of side effects again if I need to restart. The side effects have mostly subsided but I am incredibly sleepy on the medication and can nap for a couple of hours each day after a full night sleep which isn't sustainable once I return to work. We also want to TTC again soon and whilst I understand sertraline is fairly safe during pregnancy, I would prefer to come off it if I felt comfortable that I'd reached that point and could cope without it.

The GP hasn't really given much guidance so just looking for personal experience and hopefully some positive stories.

Hi OP, I recall hearing that you should feel “well” for 6 months on antidepressants before considering coming off them. If you started them in mid July then you haven’t even been on them for two months yet so IMO it is way too soon to think about coming off them.
When you do, it is vital to taper down very slowly to avoid withdrawal symptoms. I haven’t been on Sertraline but have been on other ADs. One I came off without any issues but the other I had bad withdrawal symptoms.
Best of luck. It sounds like you have been very strong and proactive in your recovery so far xx

Having come off meds repeatedly far too early.....

It's a combination of managing day to day life without your mental health being challenge and ideally be able to cope with tricky times without relapse.

In the past as soon as I felt ok again I stopped medication. I soon relapsed. I was the diagnosed with bipolar and medication will likely be part of the rest of my life.

Now the question for me is when to drop to minimal medication.
I had pnd and went from 1 to 4 medications. It took over a year to see improvements and 2 years to get back to normal. After 4-6 months of being me, I made the decision that it was time rather than the last medication that made the difference so I dropped down to 3 medications. I stayed on that medication combination for another 18 months. For the 9 months it felt a bit rocky at times and like one of the meds wasn't quite at the right dose. Then I had 9 months feeling more secure in my mental health. Then I started discussing dropping this medication as it has tricky side effects. Removing this medication meant I had to stop another medication first. So over 8 months I dropped both going back to 1 medication. I was very cautious about dropping medications due to the length of the episode and how hard it was to treat. I generally like stability for around half the length of the episode before being confident that I can then start reducing meds. Sometimes longer sometimes shorter it depends on how much it has taken out of me to get back to me.

I have had short episodes that have responded well to dose increases and been back on lower doses 4 months later and hard to treat episodes where I have needed 6-12+ months to feel secure that I could manage on lower medication.

The trick to finding the right time is finding the right way to come off meds. I used to do it myself and cold turkey. Now I taper down with medical input. It's much easier to make adjustments and see the impact that dropping meds might have. I stayed on a low dose of medication 2 for a extra month earlier this year as I was experiencing a few mild symptoms and I want to make sure nothing came of them before stopping completely

You have barely had enough time for the medication to start working and could well still be suffering some side effects of starting the drug. I understand that you want be drug free but please be patient.

I'd go further than some posters and say relax and give it a year. Make a note to rethink then. When you decide to come off the drug, do it a lot slower than your GP tells you. You can break up your tablets to do this initially and then talk to your GP about a lower dose.

I have found that I am ready to come off the medication when I start to forget to take them - ie, my condition ceases to become such a big deal for a while.

Thanks everyone. Lots to think about. I've always been impatient, feel better when I plan and like to feel in control so it doesn't come naturally to me to wait and see (suppose those personality traits might feed the anxiety). I know now is not the time to come off them but I guess I'd just feel better if I had an understanding of what to look for and a good measure of when the time is right. As it is, the GP wasn't the most supportive and I feel like I've been put on medication then left to it.

I think the medication has certainly taken the edge off and allowed me to be more receptive to CBT and recognise the rut that I've fallen into so that alone has been a big boost. I don't want to undo that by coming off medication too soon but equally, I'm hoping that lifestyle changes will ultimately be what makes the difference and I can leave the medication behind sooner rather than later. It's been helpful to hear everyone's experiences, thank you.