View Full Version : Are anti depressants addictive?
I have recently been advised to taper off Sertraline as it doesn't seem to be working. I have been on it for about 10 years. Being somewhat naive, I had the mentality of 'if it ain't broke don't change it'. So even when I was feeling good I didn't really think about getting off them. I have researched the tapering schedule and if I did it, to try and avoid too many withdrawal symptoms, 12.5mg per week, it would take me two months to get off them. Excuse my ignorance, but why do benzodiazepines get such a bad rap for being addictive. I can't remember ever being warned by anyone that long term use of AD's may cause withdrawal when discontinuing.
Hello,
To answer your question, it really depends what you mean by addictive. You have been taking sertraline for 10 years. This is just my laymans's opinion, but from what I have read the presence of psychiatric medications in one's system cause the nervous system, particularly the brain, to adapt to their presence. Therefore, if you wish to discontinue and avoid serious withdrawal symptoms then it is advisable to taper off very slowly. This gives your brain a chance to recover.
I don't want to frighten you but you should read this.
https://en.wikipedia.org/wiki/Antidepressant_discontinuation_syndrome
Anyway, to minimise the risk of developing the above one approach is to taper off at 10% of your last dose every 4-6 weeks.
For example, if you are taking 100 mg daily of drug X then you reduce to 90 mg. Then you wait 4-6 weeks and then reduce to 81 mg. Then wait another 4-6 weeks and then down to 72 mg (roughly). etc. etc.
It will take a long time to reach zero although this is one approach that seems to work for people as it gives the nervous system time to recover.
To get accurate doses it is worth purchasing a sensitive scale which can be obtained cheaply enough on Amazon. If the tablets are hard then you just have to do the maths and cut them to the required weight.
Be sure to discuss this with a doctor also. If you want further information you can PM me.
Best of luck,
Dedalus.
Hi Dedalus! Thank you for your reply. This topic came about because my psych wanted to drop me from 100mg to 50mg because he wants to try other medications for anxiety that can't be used while I'm on this dose of Sertraline. I suggested I drop to 75 first, but he said no go straight to 50. In any case I haven't done as he suggested because I don't feel comfortable with it. My point is that I can almost guarantee that nearly everyone is warned that benzoz are addictive. That sudden discontinuation will cause withdrawals. This is also the case with anti depressants. Why is it that no one is warned of withdrawal with AD's? Maybe addictive is the wrong word, and maybe it is stated on the information sheet with the tabs. The point being is that I think a lot of people would be on these tablets for years and not realise that they too will face withdrawals at some stage. I am hoping to ask the psych to prescribe 25mg tablets so I can halve them to 12.5mg and cut down by that every few weeks depending how it goes. Thanks again for your reply.
brucealmighty
20-08-16, 11:09
hello there
I had problems coming off citalopram and seroxat some years back but hand on heart I`m not sure if it was discontinuation syndrome or just me not feeling able to do without the crutch of knowing I`d taken my pill. but definitely taper off slowly I did similar to the method dedalus describes. I knew it was possible one day when I`d forgotten to take 1/4 of a pill and had been fine until I remembered - then went into a spin.
so you might have some ups and downs but see it as a long term project and know that a lot of people are here to support you whenever possible
another thing that helped was realising lots of supposedly normal people have dizzy spells, bursts of anger, times when they want to be left alone etc so you should be quietly confident in your own power to be well again
wish you all the very best
MyNameIsTerry
21-08-16, 06:55
Hi Dedalus! Thank you for your reply. This topic came about because my psych wanted to drop me from 100mg to 50mg because he wants to try other medications for anxiety that can't be used while I'm on this dose of Sertraline. I suggested I drop to 75 first, but he said no go straight to 50. In any case I haven't done as he suggested because I don't feel comfortable with it. My point is that I can almost guarantee that nearly everyone is warned that benzoz are addictive. That sudden discontinuation will cause withdrawals. This is also the case with anti depressants. Why is it that no one is warned of withdrawal with AD's? Maybe addictive is the wrong word, and maybe it is stated on the information sheet with the tabs. The point being is that I think a lot of people would be on these tablets for years and not realise that they too will face withdrawals at some stage. I am hoping to ask the psych to prescribe 25mg tablets so I can halve them to 12.5mg and cut down by that every few weeks depending how it goes. Thanks again for your reply.
The difference is that Benzo's cause tolerance so you then have to go higher. Also, just dropping from a level you are tolerant to will cause you lots of withdrawal issues as compared to these milder antidepressants that may or may not cause that in varying degrees.
Also, sudden discontinuation with antidepressants can cause you withdrawal syndrome BUT sudden discontinuation of Benzo's (when tolerant or long term) causes more dangerous withdrawals that include seizures. So, it's dangerous with Benzo's.
Benzo's are also a bigger deal because they are recognised as an abuse drug and controlled by the UN because of their damage to communities and links to crime. We don't get that with antidepressants since no one wants to feel like crap from side effects before they even start helping. :D
Just to add to the above, if you need to cut pills the first thing to check is whether the med is even available for cutting. It's a no no with delayed/extended release meds as they can cause overdose, it's a no no if they are enteric coated due to causing stomach problems and some meds are a no no as they are encased in a capsule to get them past the throat without causing irritation. Another no no, the hardest to determine, is the med isn't homogenized. If it's not, it means the drug isn't evenly spread to allow you to section up doses. Another no no is also cutting down the sides because meds have layers and the drug may be in one or more of the so cutting the top off for a half dose may mean you miss all the active drug when it's lower down. Capsules can't be split but the contents may be able to, it really depends why they have put it in a capsule (like with the enteric coating or to get it past the throat).
A jewellery scale will allow you to measure between 0.01-200g. I've got one as I encapsulate various vitamins & herbals. They only cost a couple of quid off Ebay.
A pill cutter is a couple of quid and can be used for halves & quarters usually. Getting 10% may mean using a blade though so you want a thin, sharp blade like a Stanley knife blade.
A quick way to tell if a med is homogenized is to see if they is a line down the center. That means you can split it. Some have a serious of lines, 2 around the centre line normally.
Here is what the experts say:
http://www.rcpsych.ac.uk/healthadvice/treatmentswellbeing/antidepressants/comingoffantidepressants.aspx
I agree 100% with what Terry has posted. I suppose that the difference is that benzos are routinely abused whereas I've never really heard of anyone taking an antidepressant for recreational purposes! Terry's point regarding whether the tablets are safe to cut is certainly something to bear in mind also. You should research that.
Anyway, if you want to taper off then you should proceed very slowly. If you're lucky you might have no major withdrawal symptoms. Or maybe none at all.
Personally I have been tapering Effexor (venlafaxine) and it has taken me over 2 years to reach my current dose which is 25% of what I started on. It has been rough at times and I have sometimes had to go back up a little for a while due to withdrawal. However, Effexor is notoriously difficult to discontinue. (As it says on the link that I posted.)
For some bizarre reason doctors sometimes don't always have a lot of knowledge when it comes to antidepressants and withdrawal issues. If you want to taper under their guidance then they will sometimes proceed too quickly. That being said, you should definitely keep your doctor informed if you decide to do this.
Best of luck!
Thank you both for you knowledge on the topic and your replies. I have got a family and to be honest, although the anxiety sucks, I can still manage to function, hold down a job etc. The fast taper as the psych has suggested may sound fine (looking at it from a doctors point of view) but from a Mum's point of view, I think the slow taper is going to be better. Totally understand about the benzos being addictive and not the AD's (bad choice of words). Sometimes I get so overwhelmed with changing meds and quantities each week and think, we're not giving anything a proper chance to see if it is working or not. Thanks again. Tracy
MyNameIsTerry
22-08-16, 08:02
I agree with cautious withdrawal.
When I came off Cit, when I knew nothing about meds, my GP just told me to go 20-10mg for a couple of weeks and then drop the rest off. It was ok, fair easily than starting the med.
But really I've found there can be a reason for GP's doing this. Our NHS have no formal agreement about pill splitting so it's left to individual doctors to decide. Some make a patient-centric decision to split pills and some don't want to stick their necks out without having their local trust to call back on. The latter are then found to reduce dose based on what the manufacturer produces hence you get this "drop by 50%" advice from them. It's not in the interests of the patient, it's about liability and ease.
They worry about how pill splitting can mean a consistent dose isn't delivered. Fair enough, but then some GP's have patients withdrawing with a "one day on, one day off" routine which is more drastic to the body than a few missing mgs due to some powder being broken off. Another argument they have is a lack of being able to deliver an exact dose, yet rather than a method with splitting where you could be a mg or so out, they want to go a full 50% out! :doh: It's either ignorance or about restricting liability because neither of those arguments are logical.
Some people handle 50% drops, some don't. If you are recovered, it may be ok but if you are still having difficult times I would be wary.
But I think you are doing the right thing. It just makes it longer but it will make it smoother too.
Sertraline was listed in the 2002 Stanford study in the US as available to be split. But obviously refer to what I said above.
Hi Terry! Thankyou again for your informative reply. Sertraline is scored down the middle, so I think if I get some 25mg tabs prescribed, I will be able to cut them in half and reduce by 12.5mg. If I hadn't been on them for long, it would be less of a worry, but considering it has been 10 years or more, I'm sure my poor old brain would be used to it. I did have quite bad depression and ocd when I was first diagnosed around 20 years ago, and touch wood, these still haven't been giving me problems. It is just the anxiety. Which in the last couple of days seems to have improved. I read on another poster's thread that you had sent a link for cross tapering. I think this was on one of Debs21 threads (not sure if that is her exact forumn name). If it isn't too much trouble could you please post the link for me? Thank you again for your help and knowledge. It is greatly appreciated. Tracy
MyNameIsTerry
22-08-16, 08:59
Hi Tracy,
I think you are absolutely right. The longer on these, the longer the taper is needed. It makes sense that we would need a much longer period of adjustment and testing the waters seems the best way to understand how we will cope with the reduction. You are being very sensible about it all.
Yeah no problem, here's the link:
http://www.gpnotebook.co.uk/simplepage.cfm?ID=1651179592
I think that is right the longer you are on them the longer the taper. I think you seem to be doing pretty good.
Hi mermaid,
I've been on cit for around the same length you have been on your meds. My dr wants me to drop 10mg at a time but I know even a 5mg drop gives me the jitters. It'll take me longer to get off and to get onto something new but after being so long on them I think we have to be a bit more cautious. If I was in a good place I wouldn't think twice about dropping more but as things are I think a gentler approach would be better.
Keep us posted on how you get on x
Hi, i have been on sertraline for 6 years doing really well, until I forgot to take them for a week, no withdrawals, just flare up of HA at the mo (about 6 weeks later) x
Hi, i have been on sertraline for 6 years doing really well, until I forgot to take them for a week, no withdrawals, just flare up of HA at the mo (about 6 weeks later) x
So your anxiety got worse.
Starting the taper tomorrow. 100mg down to 75mg. Will let you know how I go. I think I need to get down to 50 before I can cross taper. Have read some positive stories as well as negative ones, so I'm guessing I'm just going to have to suck it and see...because none of us know how we will feel until we do it.
Shazamataz
25-08-16, 08:37
Do you know what the doc wants to replace it with when you cross-taper?
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