Wrong time to reduce SSRIs?

[Chickens44]

I was on 150mg of sertraline, I cut it down to 125mg earlier this year. A few days ago I cut the dose down to 100mg. I am having a few withdrawal symptoms, nausea, tired, bit shaky, upset tummy, etc. Which I expected. Nothing too bad, but I’m just wondering if I would be better to wait until I have started by B12 injections before I carry on the reductions in dose. I’m hoping the B12 injections will replace my need for the antidepressants. So fed up with taking pills that obviously don’t work. And GP just wants me to take more!

[Nackapan]

Noone can really answer your question .

In my opinion it's best to function and settle on your present reduction of sertraline and start your b12 ASAP.

Only you know how you feel

Others might have been in your situation.

G.p should help you too.

You sound determined to come off it s just when and how .

Hope it all goes well

[ottolinebear]

Slowly, slowly slowly with coming off those things. I have managed it but I took 18 months over it and wished I'd done it even slower. Still getting some symptoms two years later but not enough to pick them up again. Withdrawal for me was worse than the reasons I started them 25 years ago. Nasty. People coming off these is so rare there is almost no long term data, as far as I can see. Get yourself settled at new lower dose before taking it down again. The last 25% is the hardest and should be done slowest...ie I took a year to come off 5mg citalopram by using drops and titrating down every three months after years and years on 20mg.

[Chickens44 in reply to ottolinebear]

I stopped 100mg per day pregabalin in May last year cold turkey, which after a week I realised was a mistake! Had terrible withdrawals. But I felt going back on them also was a mistake so I persevered. I think possibly that added to my current problems. But thankfully I’m off those now. Just need to try and get off the sertraline. To be honest I don’t really think the GPs have much idea about the side effects of a) being on the drugs, and b) withdrawals.

Unfortunately I’ve lost faith in GPs, especially following my recent experiences discussing B12 levels etc. I think possibly a lot of symptoms have been down to low B12 all this time, but GPs have just been giving me pills for each different symptom instead of looking at the overall picture. I’m also on HRT patches because of flushes, but that too could be down to low B12 and iron.

I am going to try and stay at 100mg sertraline for a while and see how the B12 injections and iron infusion make me feel. Then I might think about doing another small reduction. 🤞

[mcg-woo]

I had never taken an antidepressant in my life until I had a b12 deficiency. I was actually prescribed a 5mg dose of Lexaoro because my deficiency symptoms were so severe despite 6 months of b12 injections and good serum levels.

I felt so bad due to severe, relentless anxiety that I thought something else was wrong with me. When I expressed this to my neurologist, she explained that it takes one full year for the brain to heal following a deficiency.

The Lexapro worked and allowed me to start a new job after ten years of being a stay at home mom. I took it for 6 months and weaned because I no longer needed it after feeling much better. However, it took years for me to fully heal due to inadequate injection frequency.

The severity of your deficiency and adequate b12 injections will affect how fast you heal. It was a long journey for me and if it was me, I would not reduce the SSRI further until I was in full remission of b12 symptoms as you may need it to temper those symptoms.

I’m also of the mindset that if you tinker with more than one factor at a time, it’s difficult to determine the cause of a problem. Best of luck and I hope you feel better soon!

[Narwhal10]

Hi Chickens,

I am afraid that nobody really can give you that advice for several reasons. However, it is totally understandable and frustrating when a prescribed medication does not work for you. Plus, the clinician wishes to increase the dosage of that particular drug.

So, I would become rather organised and go to see the person with the knowledge; the pharmacist.

So, you relay information of :- on [ date/year i ] Dr Van Helsing diagnosed you with [ condition ] and they decided to treat said condition with 125 mg of Sertraline orally once a day.

Now, you explain [ if correct ] to the Pharmacist that :-

1. Sertraline has not helped with your cognitive function.

2. Sertraline has not helped with your physical pain.

3. Sertraline has not helped with your ability to carry out minimum/moderate [ delete as appropriate ] daily activities.

4. Sertraline has not helped with your mood.

Therefore, you are seeking THEIR advice regarding this ineffective treatment and management.

You can explain further that you are currently being investigated for PA/B12D. You have low folate and low iron which seriously questions the original diagnosis in [ date/year i ].

Now, my convoluted basis for doing this is for the future. When a GP tries to increase your antidepressants, you can simply say, I spoke to Agatha Christie on [ time ] [ date] at [ name of pharmacy ] and they advised x, y, z.

Sorry to read about your withdrawal symptoms of Pregabalin. Just as a random piece of information as of 2017, Pregabalin was marketed under 104 different names. I do agree with you regarding Clinicians not having much idea about side effects. It is definitely worth reading the literature provided with medication.

[EiCa]

Doctors (most) are totally ignorant about the side effects and withdrawals of these drugs. SOME people can go off fairly quickly but I am not surprised at how sick you feel withdrawing at this rate. It depends on your dose, how long you have been on these drugs, your genetics, and other individual matters how fast you can/should go. Most (literate) doctors and/or professionals advise way too fast causing undue and sometimes protracted, severe withdrawal effects. The rule of thum is cut no more than 10.% of your current dose (current dose is key here) and wait 3-4 weeks and/or until you feel stabilized. (Like as good as you can before you started cutting)Then cut according to what you tolerate. Cold turkeys are highly discouraged. I have learned all this the hard way. If you want some really good ideas of how people do cutting psych drugs go to “Surviving Antidepressants.com”. Don’t be scared by the horror stories but these drugs are notoriously difficult to come off for many people. It is doable if you cut slowly and listen to your body. It is like B12 supplements. Everyone is different. I am not a doctor but I learned the hard way that these drugs are no joke and withdrawing carefully is important. Best of luck to you. My intent is to help, not scare!

[Nackapan in reply to EiCa]

It's scary how easily prescribed they are .I was prescribed sertraline 3 times the last time actually paid for the prescription then on getting home wondered what on earth I was doing .

I was told if I refused everything I couldn't be helped or seen .

I was seeking a diagnosis

I knew I wasnt clinically depressed .

I was very ill though

But told enough times I should consider what was causing anxiety ??

Amytripyline was another 3 neurologists wanted me on.

I finally paid for that prescription and after a 111 call made for me as in horrendous pain ,the doctor told me to take it .

It knocked me out for 3 nights . Lowest dose.

Then the pain was breaking through and I was feeling so drugged.

G.p said to just stop it as only been on it 10 days .

I bought a pill cutter and weaned myself off ......it was very difficult .

I was also asked to trial HRT patches. Took months to.

decide

Another mistake after 7 days got z 6 day migraine. Then a emotional mess got to the surgery.

Told by another G.p should never had been put on it ???

Weaned off that slowly.

9 other drugs suggested at least

Propranolol

Duloxatine

Gaberpentin

Pheny....

Many more.

It was definitely on a trial and error basis to try and control migraines .

I did fight for more B12

Coming off alot of drugs is awful and alot is not explained.

Of course I woukd take a drug if it was clearly the right one for a condition.

[EiCa in reply to Nackapan]

These psychiatric pills are no joke. My son was put on anti-psychotics and became a shell of the man he used to be. I worked with him and his doctors for 8 months to get him off. He is slowly, but very very slowly, recovering but he will never be who he was...