Coming off sertraline to get pregnant.

Treatment and medication
1

hello I'm 26 and have been on sertraline for just over two years now on 100mg.

i recently visited my gp to get advice of reducing my dose in the hope of trying for a baby. To be honest he was very vague on the best way for me to do it, and the harms to baby if on tablets. I am currently on week 3 of having 100mg one and and 50mg the next. I have noticest I have been unbelievably tired, really bad head aches and bad tummys since. I honestly can't see how I can come off my tablets with these side affects as I have a full time job. I really need to get my sex drive back also as it's been 0 and my partner won't try for a baby until I'm off them. 

If any one has any advise I'd be very greatful.

2

I would advise to come of in 12.5 steps every few weeks. I know it's hard to split tablets but u can get pill chemists if that helps. I think coming down that quick will do more harm than good. Hope that helps x

3

What do u mean 12.5? I take 100mg one day and 50mg the next, have done for 3 weeks. I'm guessing 50mg every day would be the next step? I just didn't think I'd get such bad side affects when I havnt reduced it by much. Thanks 4 commenting back x

4

 

Hi Laura,

Firstly, did your doctor advise you to do 100mg one day and then 50mg the next?

My understanding is that by changing your dosage in this way, you are putting your body in a constant state of flux whilst it tries to readjust to the different levels, hence the headaches. Coming off sertaline is not pleasant but can be made easier if done correctly. Tapering should be done by first decreasing the dosage until you reach 50mg, then the frequency, missing more days as time goes on.

The reason you can reduce from 50mg to nothing by gradually changing the frequency is because 50mg is such a low dose your body can handle it - this is why there is no 25mg tablet available, it would have no significant effect either way.

By reducing your dose you may find that your sex drive starts to return, when I stopped completely it returned fully. Unfortunately this didn’t aid conception and the stress eventually saw me needing sertaline again, this was 14months after stopping. I couldn’t believe after going through the awful side effects of stopping and then trying for so long without I was back to square one.

My doctor advised me that the risks during the first few months were slim and as I was only on 50mg slimmer still. To avoid withdrawal symptoms showing in the infant she advised tapering off them gradually before the third trimester, this way if I did need to start again I would only have been off them 6 months. Trying to stay off so long caused my mood and outlook, deteriorate along with my relationship.

My advice;

1) Check out this link regarding risks involved http://www.drugs.com/pregnancy/sertraline.html

2) Do not be pressured into coming off sertaline if you are not ready, look at the alternatives such reducing to 50mg and then reducing to nothing once pregnant. Alternative ask your doctor to prescribe a different drug, I can’t recall the name I tried another but it turned me into a zombie, you however may react differently.

3) Go to your doctor with a list of questions and make sure you get answers to them, so you can make an informed decision. My doctor got out books and we looked up certain information there and then. Better still, call your doctors and ask them to make you an appointment with somebody who knows about this stuff, I know there are 2 doctors at my surgery who have more experience in this area.

4) Get your boyfriend to go to the doctors with you so he can ask questions and get answers to any concerns. He needs to know what it is he asking you when he says he wants you to stop. You need to be working from the same page on this.

I hope I have made sense. Anything I have said should be checked with your doctor.

Best of luck!

 

 

 

5

PS - do not split tablets, not all tablets are designed to have the various chemicals evenly distributed.

6

Laura I was on 150 mg., my Dr. took me down 25 mg @ a time, for two - three weeks at a time.  I went to 125 for two weeks, 100 for two weeks, 75 for two weeks and so forth.  It was tough for me I had many side effects even at this slow taper.  I've been off 14 months and still experience withdrawl of nausea, tummy cramps, most mornings, also low blood sugar ~ very frustrating.  The side effects are different for everyone and you may have an easier time.  There's a link on here " do sertraline withdrawl symtoms ever go away"  Check it out for support. 

I wish you well, fatigue is a big one as are the head aches, blurred vision, tingling in the arms etc.  After 8 months I thought I was going crazy, as my Dr. said it wasn't w.d.  I was so happy to have found the above site to verify what I was experiencing was in fact w.d.   These drugs affect our brain chemistry, thus takes many months to right itself apparently!

7

Sorry I ment taper off them slowly as in come down in smaller steps over a longer period so the withdrawal effects won't be as harsh for you. 

8

Wow you've done so well to be off them for that long,wel done. That not great though that the effects last so long, how do you manage them and still hav a life? Part of me trying to come off them and for the depression not to come back was a plan to keep busy, but these past 3 weeks have been like a zombie with no energy. Yes I agree with you, think it will take me some months to keep lowering my dose. Iv read some people have come off them in a month of lowering their dose and for me I just don't c this possible. Also read there is no such thing as 25 mg, I'll go back to my docs in a month about lowering again.

9

Hi Laura

just a few thoughts from a pharmacist, if it helps!

sertraline should be gradually reduced over at least 4 weeks. 

Withdrawal symptoms include: dizziness, diarrhoea, nausea, headache, sweating, loss of appetite, electric shock sensation, anxiety and irritability. BUT these are often short-lived and minor so stay positive. Individuals differ in their responses, so one person's experience may be different to what you'll get. Remember, if it becomes intolerable, these symptoms go away if you restart the medication, but I undestand that's not the plan! speak to a pharmacist about what to take to remedy some of these problems if they become troublesome, eg paracetamol.

although 4 weeks is normally recommended, you can reduce slower if you'd prefer, and one source (the drugs and therapeutics bulletin) recommends taking 6-8 weeks. But I can find nothing specific on how to taper the dose. It sounds like you're doing ok with a few withdrawal symptoms on 100mg then 50mg alternate days, that's like 75mg daily. When you're ready, why not try 50mg daily for two weeks. Then 25mg daily for two weeks. Then 25mg alternate days (like 12.5mg daily).  Then see if you can stop. Just a note, these tablets are ok to split, there's no adverse effects of doing this (but always check with a pharmacist first as some tablets must not be split).

it is sensible to try and come off if you're planning a pregnancy (for obvious reasons) but I can assure you they do use sertraline in pregnancy sometimes. With any drug, you need to balance the risks and benefits. For some, the risks posed by untreated depression outweigh the potential harm to an unborn baby from the drug. Speak again to your doctor if you find you can't come off sertraline very easily and ask them more questions about the risks if you become pregnant. 

Focus on the reason for wanting to stop the sertraline and that might get you through the difficult symptoms! SSRIs zap your sex drive as you said, so that's a positive thought straight away. 

Best of luck smile 

 

10

Yes, there are only 50mg and 100mg tablets, but these are fine to split in half, and another way is to alternate day dosing as I've posted in other post. Hope this helps.

11

I live in Canada and we have 25 mg. tablets.  I work out three times per week on the treadmill, which I find beneficial.  During my taper i burst into tears at the drop of a hat.  This has become much better, in the last month!   I never felt really well on this drug, so was happy to taper off them.  Had I known the length of my w.d. I'd of never consented to go on them for seasonal effective disorder!   I was on 150 mg and was having insomnia.  I consulted my pharmacist, she advised me that perhaps if I tapered back, that would benefit the insomnia.  My Dr. wanted to increase me to 200 mg and add a sleeping med. This was the point after 10 months that I said, no more, I want to come off this med!  She was not pleased, but it was my choice.  I'm feeling 95% well again, and hopeful I'll be 100 % soon!!   I find the pharmacists more knowledgable regarding meds than the Drs. .  You might want to consult your pharmacy for advice.   Take care ~

12

Thank you so much for getting back to me, I really appreciate your advise. I was thinking though surly if I incraze my meds back to 100mg everyday ilol get side affect like I did at the beginning of taxing my tablets such as dry mouth, bad tummy head aches ect? I'm just scared if I raper my dose the side affects will get worse and I worry how I'll cope at work feeling so unwell. I am planning a baby within a year and wasn't sure if I should come off my contracept as well as lowering my dose? Or will that just mess with my hormones even more? Also do you think Ill ever get my sex drive back? This really worries me. I keep trying to think positive but feeling anxious at the same time. Thanks again x

13

Some people continue to get side effects of sertraline even after they've stopped taking it for ages, so it's impossible to say how you will react, we are all different. Best to discuss the contraceptive issue with your doctor. It may not be a good idea to come off two things at once hey!? It's up to you really though. Sex drive will come back, it's those blasted SSRIs that kill it. But don't forget, it also lacks when you have depression too, so what's worse? Another point, a general word of advice is never attempt to come off antidepressants this time of year. It's just still too dark and gloomy, and may be easier to achieve it in spring when everything looks better smile 

14

hi laura,

i was in the same position as you, i'm actually 8 weeks pregnant now and still taking my medication. my partner was the same, didn't want to start trying until i'd come off them, but sertraline is the safesty antidepressant on the market to take at the same time as trying to get or already being pregnant. i've spoken to 2 doctors and my midwife about it as i was just as concerned as you and all 3 of them were happy for me to stay on them, i had my booking appt at the hospital yesterday and they confirmed the same, they had absolutely no worries about it at all.  in fact they said that due to the sertaline being in my system for a good year already, there is only ever a risk if you have just started taking them medication as your body isn't used to it and it can cause issues for you  and your baby, but they said as long as i'm coping ok emotionally then you're baby will be coping well emotionally too and that is very very important during pregnancy. i hope that helps :-)

 

 

15

Hi

That's nice to know I'm not the only one with this decision. I have read it's one of the safest ones to be be on durying pregnancy, although iv read that the baby my be distressed once been born. What changed your partners mind? My partner doesn't want me to have the guilt if anything went wrong which I understand. I do worry I may get depressed again if I was to come off them and if I was pregnant starting my tablets again I'd be back to square one. Also stopping my contraceptive I'm sure will make me emotional and like you said you need to be happy for the baby to be happy! Did u find if affected your sex drive at all? My partner really struggles with this. Thank for getting back to me x

16

Hi

well I did think it was strange but yes the doctor advised me to take 100ng and 50mg the other days. I don't get any other way I can taper my dose other than me goin straight to 50mg every day because 25mg isnt made? I've been on it like this for 3weeks now and scared to go to 50 having had these side affects already. I don't feel pressure to come off them I'd like to do it for my self if any one. That's what scares me I won't be able to get pregnant and go through a lot of stress trying, but I want to get my sex drive back to try. Did u manage to get pregnant once being back on them? Do you know the risk of to baby if any? I'm a very stressful person and wouldn't want my baby to get stressed if I'm in them or not. It's very hard as getting a lot of mixed opinions. Thanks x