Reducing dose from 200mg per day

Treatment and medication
1

Hi everyone, new to the forum and keen to get your thoughts. I've been on 200mg per day for around 9 months now. I've been on Sertraline since 2002. My initial dose was 100mg per day and over the years it's been increased, each time as a result of stress-related breakdowns (due to my working environment) 

Since my last bout of illness at the end of last year, I have completely revamped my working life and feel I have finally achieved the correct balance. The last few months have been the happiest of my life.

So my attention turned to reducing my medication. The doctor said 200mg is the maximum dose I can take. I don't suffer any side effects at all and, having spent the last few years working hard to lose 3 stones, do not want to be put onto any other medication, as I understand they all have weight gain as a side effect. Gaining weight would definitely put me on a downward spiral!

I feel as if, while helping me, the medication 'holds me to ransom.' I know you'll know what I mean when I say that. I would like to have 'wriggle room', the ability to increase the Sertraline if I ever need to in the future.

So, I came up with a plan which would see a super-gradual taper down. I decided on a Monday, to take 150mg and after a 4 weeks, do that on a Tuesday too, until I was taking 150mg every day. Surely, I thought, a 7 month long process would mean I wouldn't notice?

4 weeks in I began to feel spaced out and pressure in my head. Also waves of nausea, although not actually sick. The ones I'm most scared of are losing the rag with people and having brain fog. Thankfully, I haven't experienced those.

If I hadn't reduced my medication and this had happened I'd just think I had a sickness bug, but because I have, I'm super aware of every little sensation. The fear of going on a downward spiral is terrifying.

I am going on holiday at the beginning of September so I've decided to put the doseage back up to 200mg and try reducing again when I come back. If I experience the same symptoms I will KNOW it's because of the medication reduction.

I just find it very difficult to believe that reducing by such a tiny amount can cause all this.

Appreciate your thoughts and experiences guys.

Thanks x

2

Go to this discussion forum: sertaline withdrawl does it go away? It's a discussion on this site as well.

3

Thanks Maureen, I will add to thread.

4

Hi, ive been on sertraline 150 mg for approximately 9 mths.  My depressive state has never really left me since the birth of my first child 17yrs ago and have been on and off A D for a long time sertraline is the only one I've found that will help with not putting on the weight I've lost. I was taking mirtazipine HORRIBLE! I've decided on my own that my mood is no better my sleep pattern is worse than ever I'm anxious just as teary possibly a bit more than usual and the 'head wobbles' are awful I feel like I need to eat to boost my sugar or something but that doesn't work at all. My doctors aren't fussed about my care (or rather that's how it feels) I'm not a patient that will keep going back if that makes sense. I put my trust and faith in my GP and I believe them to have my best interest at heart! I've been referred for cognitive therapy and i'm hoping beyond hope I can get myself out of this big black hole that is swallowing me whole and making not just me suffer but my home and my family. I need something to give because I just can't take it much more!  I definitely don't want sympathy just some understanding from people that are on the same page as me. I've started to take multiple vitamins to help boost my system plenty of fluids but the lethargy I'm feeling is just horrid.  Hope you're experience on this drug gets better after your holidays and you manage to complete the withdrawal safely and you find a happiness in life I so hope to find again x

5

Please don't try to reduce your dosage yourself a neurologist or informed GP or Pharmacist will plan a reduction less likely to cause withdrawal effects. It is achievable but in very minute and with a more gradual management. 

Good luck

6

Hi, and thanks for taking the time to reply and share your experiences. I completely understand how you're feeling. This illness does everything in its power to strip away the real person you know you are. All we ever want is to get that person back. It's especially difficult because there's never a magic bullet answer. It's a complete mind f*ck! I will never do Sertraline down, as I have no doubt it saved my life on more than one occassion, but having used it as a crutch to provide me with the clarity to change my life for the better, I feel I am now left 'addicted' to it. Like I said, I don't suffer any side effects now. I did in the early days, dry mouth, sweating and complete lack of libido mainly, but these have long since gone. Thinking back to when I was a lot younger, I always had 'dark times' but didn't realise what it was at that time. While I accept I may always need a little help through medication, I just don't want to be on this high a dose. Do you exercise? I find it a huge help when I'm feeling low. It's the one thing I will always force myself to do as I know it will make a difference. Don't ever feel alone, I am here x

7

Hi, and thanks for replying. I put my plan to the doctor and he sanctioned it. Surely reducing by 50mg a week shouldn't cause side effects? I really don't know how I can reduce much slower. He also said to me that most people have no problems going from 200mg to 150mg, so that's preying on my mind also. What is your own experience, if you don't mind my asking? C

8

Hey, I've done it the wrong way but I don't feel any better for being on it, so my last dose was sat morning. The effects I'm having are obviously proof to me that they were having some kind of effect on me, but, I just could not see/feel it. My husband hasn't noticed (to my knowledge) that my mood has changed in the past yr! Sex has never been a big thing in my life as much as I've 3 wonderful children and an amazing husband. It's just the way this horrid 'thing' has left me at 17 I was carefree happy go lucky and looking forward to starting college. Then I met my eldests dad (boy do I regret that day!)   & I feel it's gone from bad to worse.  Sorry all this info 😧 I would just love to feel 'normal' again. I really am hoping with all my being that the cognitive therapy is going to help me with my journey. Just out of curiosity your 'nick name' is what I wanted lol its partly my surname and also my year of birth strange coincidence 😊 x

9

That is a very strange coincidence indeed. We're same age smile I remember, way back when I first sought help, being given Fluoxetine. It caused horrible panic attacks so I stopped it immediately. Another doctor (who is still my doctor now) put me onto the Sertraline. I distinctly remember him saying it the 'Rolls Royce' of ADs. I will admit, before I took it, and before I became ill, actually feeling good on any given day was exceptional. I pretty much existed in the dark, and I thought that was just how life was. Sertraline has brought the light back, but I always worry about the long term effects and when I read about all the withdrawl horror stories, I really can't imagine a time when it would be convenient to come off it. I need to function so I can pay the mortgage. Rock and hard place. I really hope the CBT helps you. I think it can to a certain extent, becoming a 'thought detective.' I took it too far before my last breakdown though, changing all the negatives into positives. In actual fact, the working environment I was in was poisonous and far too high pressured. I used to think, if someone else can handle it, why can't I? Actually they weren't handling it. One was eating herself to death, another, snapping at everyone in the office, the list goes on. You didn't mention whether or not you've tried exercise. It really does help, along with breaking patterns that leave you feeling like it's groundhog day. Speak soon, C.

10

Hey yes I've tried the exercise part but I have a hip problem which some days can give me bearable pain and other days I'm on crutches, & strong morphine based painkillers.  I did the race for life this year and that's probably the last time i donned my trainers. I'm hoping to start walking again funnily enough this Sunday with a local walking group. I lost 3st last year until November came and I lost my nan to cancer. Since then I just can't bare any of the daily routine business. She was my anti depressant. She kept me sane but always listened. I too feel the rock and hard place feeling quite a lot, but, like yourself you need to shift yourself into neutral and follow the daily path. As hard as that is. routine (however mundane) is a routine & at the moment I feel that's my only sanity, as hard as it is to drag my backside out of bed! 😴 it's the tiredness I can't bare x

11

My very first AD was fluoxetine I found they helped but I also think I was on too high a dose I'd be euphoric during the day and then take amitryptaline on a night time to bring me back down and knock me out!

12

I used to take 200mg too and with help of gp very gradually came off them completely.  You do need and must have the support of gp, so when you come back from holiday think about what is best fir you.   Dropping off 25mg or 50mg per week and each reduction over 4-6 weeks.   It's a gentle reduction and one where you can recover and keep well too.   Good luck

 

13

Hi Julie, thanks for your reply. It's encouraging to read a positive story! With hindsight, I actually think I've had a wee virus over the past week or so with the symptoms mirroring some of those I've read about regarding Sertraline withdrawl. My doctor also says the reason he puts women on Sertraline is because it tends to be the easiest to cope with in terms of withdrawal. So, as you suggested, I'm going to consider my options when I return from holiday. Staying well is, of course, my top priority. Thanks again, C x

14

*UPDATE*

Came back from holiday and embarking on another attempt to reduce medication.

I decided, with doctor's approval, to cut down extremely slowly. On a Monday for 6 weeks I'd take 150mg instead of 200mg, then after 6 weeks cut down on a Tuesday to 150mg and so on. I felt very little change after cutting down for 6 weeks on a Monday, now I'm 5 weeks into cutting down on the Tuesday too.

I am acutely aware of everything I'm feeling, as obviously, I don't want to fall ill again. I'm experiencing some zaps behind my left eye and the world just doesn't seem so bright anymore. I basically don't feel as 'up' as I did a few weeks ago and although I'm laughing at things because I KNOW they are funnny, I'm not FEELING it. Nothing has changed in my life other than reducing the medication, so that has to be the reason I feel I'm struggling a bit.

It would be easy to tought it out if I knew there would be an end point and this is as bad as it will get. Trouble is, I don't know on either front. I'm scared it gets worse, I start becoming irritable and unable to function properly.

The doctor says I should go back up to 200mg, but I don't want to 'give in' when I've come this far. I'd be happy knowing I've managed the Monday and Tuesday cut, then think about the Wednesday when spring (and more light) come around.

I feel as though I'm stuck between a rock and a hard place. Everyone around me says 'you were great on the 200mg, you coped brilliantly with whatever was thrown at you.' I worry though, where would I go next? I can't increase any further on Sertraline. It's on my mind all the time, so an advice would be gratefully received. Thank you everyone x

 

15

If you read all the replies on the link "does sertratine withdrawl ever go away". You will gather much info from what the rest of us have experienced. I've been totally off sertraline for a year now and still experience symptoms of nausea, insomnia, brain zaps etc. It's been a long journey for many of us. I wish you well.

16

Hi Maureen, I have posted on that thread and read of many other experiences. Thanks for responding to me. I suppose the difficulty is that there's no straightforward 'answer' as such. Suppose I'm just trying to figure out (with where I am right now) if I should try to tough it out (with the ever-present threat of another crash hanging over me) or to up my medication to previous level (but then have no wrigge room in future.) Doc says there are other medications but he told me in the beginning Sertraline was 'the Rolls Royce of ADs' so what could've better?! Like I said, rock and hard place.

17

Everyone's experience on this drug is different, as are the side effects and withdrawl. Personally, the entire experience was a nightmare for me. I never felt well on it. always on edge.

I have a friend who has been on it for 20 years for depression. It has worked well for her. She was at 200 mg. and has gradually reduced to a 100. She didn't feel she needed 200mg. Her Dr. advised her to increase after her mother passed. She said " I was sad not depressed". She has been fine reducing to a 100mg. She noticed as did I upon reduction, heart palpatitions, sweating, and periods of crying.

Ten months in on 150 mg. I was suffering insomnia, my Dr. suggested another increase plus a sleeping med. I finally said ENOUGH, I want to taper down. I contacted my pharmacist. She informed me that if I was experiencing insomnia that in her opinion the dosage was too high. She was right! Drs. in my opinion, have to realize every patient is not a carbon copy of what they learn in their medical journals. My experience over two years was not positive, try one drug, then another, to offset the side effects of another.

I'm now just beginning to feel more like myself after being off Sert. for 11 months. I will never embark on this path again. I go to the gym three times per week and do an hour on the treadmill, weights etc. I find this has helped me tremendously.

Don't worry about reducing if you feel you're slipping you can always increase. You will feel withdrawl though, and this is normal.

Take care

18

Hi Shed

I too am cutting down from 200mg. Been on this dose for several years and doctor has advised to ho to 150mg daily for December then January go down to 100mg...etc. Only been a few days but staying positive - oh the irony!

Good luck and would be great to hear how you are getting on...

ltj

19

Hi Shed

I found you patience to withdraw so gradually very inspiring, thanks for posting your experience. I couldn't help wondering if it might be better to aim to space out the lowered dose days as much as poss? So do Monday and Thursday rather than 2 days in a row which surely might make withdrawal more noticeable? Or maybe my understanding of how they function in our system is basic/flawed and this tweak would make no difference at all!

20

Day 6 on 150mg daily after taking 200mg dailyfor several years...the light head has started to really kick in and having trouble reading words (e.g earlier I read a sentence with 'our' in it and somehow took the 'our' as saying/meaning 'their' lol) Also having trouble with clicking on things on computer screen. 

I shall persevere!!!

smile smile smile