Coming off Sertraline abruptly

[Scissel]

First off.. Hello and Happy New Year everyone! Sorry I've been so quiet as of late; I've had a lot to deal with last year and still do have a lot on my plate. Anyway.. After being on Sertraline for almost a year now at 100MG it was becoming ineffective at that dosage for me and the only option was to increase the dosage. I've already tried the increase to 150MG and could not tolerate the side effects, so, my APRN told me to just top it (abruptly) and there wouldn't be any WD or negative reaction. Well.. I bed to differ?! After 2 days without it, I noticed this awful sinking feeling and swimming feeling in the head (not necessarily overly depressed though) so luckily I had 8 pills and I will take 50MG until they are gone. She wants me to start escitalopram, but she agreed to allow me time to recover a bit before starting something new. The question is.. Is about 2 weeks enough time for my brain to stabilize from being on Sertraline this long? Thanks in advance

[nomorepanic]

Wow it should never be stopped so abruptly so it is a good job you have some to tide you over with.

[Scissel]

Thank you, Nicola for your fast reply. Yeah, I was like OMG. If after another 15 days I'm still suffering, I'll let her know and I doubt she'll fight me if I ask for 50MG dosage for a little while. Regrettably it just wasn't working anymore and the increase didn't set well with me before. Honestly, I'm still unsure what to do re ADs seeing as a lot of my depression is largely situational. I tend to have side effects to medications that others presumably better tolerate; we'll see, I guess. Thanks again.

[panic_down_under]

First off.. Hello and Happy New Year everyone!

And a Happy New Year to you.

After being on Sertraline for almost a year now at 100MG it was becoming ineffective at that dosage for me and the only option was to increase the dosage. I've already tried the increase to 150MG and could not tolerate the side effects,

Did you increase to 150mg in one step, or via 125mg for the first week? The latter would probably have been easier.

so, my APRN told me to just top it (abruptly) and there wouldn't be any WD or negative reaction.

Sigh. This person is an idiot. A potentially dangerous idiot! Avoid her from now on if at all possible.

Well.. I bed to differ?! After 2 days without it, I noticed this awful sinking feeling and swimming feeling in the head (not necessarily overly depressed though) so luckily I had 8 pills and I will take 50MG until they are gone.

While better than going cold-turkey, reinstating to the full 100mg would be better, imo. Can you get a prescription from a competent APRN, or GP?

She wants me to start escitalopram, but she agreed to allow me time to recover a bit before starting something new. The question is.. Is about 2 weeks enough time for my brain to stabilize from being on Sertraline this long?

There is no need for a washout period when switching between SSRIs and it is arguably counterproductive. Most people can tolerate an overnight switch between SSRIs (from fluoxetine (Prozac) is the exception) and that is reflected in most guidelines (example NZ, (PDF)), however, the NHS likes to be extra cautious so recommends a short cross taper as per this chart: Guidelines for switching between specific antidepressants (PDF)

[Phill2]

First off.. Hello and Happy New Year everyone! Sorry I've been so quiet as of late; I've had a lot to deal with last year and still do have a lot on my plate. Anyway.. After being on Sertraline for almost a year now at 100MG it was becoming ineffective at that dosage for me and the only option was to increase the dosage. I've already tried the increase to 150MG and could not tolerate the side effects, so, my APRN told me to just top it (abruptly) and there wouldn't be any WD or negative reaction. Well.. I bed to differ?! After 2 days without it, I noticed this awful sinking feeling and swimming feeling in the head (not necessarily overly depressed though) so luckily I had 8 pills and I will take 50MG until they are gone. She wants me to start escitalopram, but she agreed to allow me time to recover a bit before starting something new. The question is.. Is about 2 weeks enough time for my brain to stabilize from being on Sertraline this long? Thanks in advance

I cross swapped by taking a half dose of each for 2 weeks then went to 10 mg escitalopram where I've stayed for the last 5 years.
I put on 16kg on Sert and wasn't at all happy.
I've lost that weight again after changing over.

[Scissel]

Thank you, panic_down_under and Phll2; for your advice. Well.. as you can (clearly) see by my numerous typos...ugh...my mind isn't quite as clear as would like it to be (yet) - this is also partly do to the fact that I'm (still) recovering from a (somewhat) mild psychotic break from last October (from which I still haven't' fully recovered). That being said, I don't feel any more (or less) depressed; shockingly. Very shaky and sweaty atm, and unstable (more so than usual), I guess is about it and I don't feel suicidal at all. It just stopped working at 100MG. No, it was not in increments of 25MG, rather, 50MG to 150MG and the sexual side effects caused more depression for me than what I was/am currently dealing with. I will say, only after 3 days of being on 50MG I feel libido (slightly) returning and I feel less groggy. Ok.. what I'll do is go ahead and ask her if I can start the escitalopram then if that is safe. She said ADs do tend to [her words] "Poop Out" for some and the need to switch meds is necessary. Yeah, she leaves a lot to be desired, but unfortunately, I am on state assistance so I have to work with whomever I'm assigned to - 'is what it is' - as they say :( Thanks again, guys! Take good care.

[panic_down_under]

It just stopped working at 100MG. No, it was not in increments of 25MG, rather, 50MG to 150MG and the sexual side effects caused more depression for me than what I was/am currently dealing with. I will say, only after 3 days of being on 50MG I feel libido (slightly) returning and I feel less groggy.

Unfortunately, all ADs may cause sexual dysfunction, however, there are ways of lessening the impact.

She said ADs do tend to [her words] "Poop Out" for some and the need to switch meds is necessary.

'Poop out' is the common term, doctors use the high faluting 'tachyphylaxis' to confuse and confound us lesser mortals. The SSRIs are more prone to poop-out than the older TCAs and MAOI class ADs.

Take good care

You too, buddy.

[Scissel]

...reinstating to the full 100mg would be better, imo. Can you get a prescription from a competent APRN, or GP?

Update: things started to go from unpredictable to intense quickly for me over the last few days. Hard to even put it into words for some reason atm...suffice it to say, I was starting to feel myself heading "downhill", so I called both my APRN and therapist, and she said it was good I know my body well and recognized the symptoms before they got out of hand. So, I'm back on 100mg for the next 2 months to re-stabilize (so-to-speak),and (only) then, will we decide to switch to another AD. Oh, and I did read your thread here you gave me [https://www.nomorepanic.co.uk/showth...1#post1695131] and I'll (certainly) look into some of those options. Thanks again for your help

[panic_down_under]

so I called both my APRN and therapist, and she said it was good I know my body well and recognized the symptoms before they got out of hand.

Ah, the praise the patient to divert attention from her culpability ploy. No apology I assume.

So, I'm back on 100mg for the next 2 months to re-stabilize (so-to-speak),and (only) then, will we decide to switch to another AD.

Sounds like a plan, certainly a better one than going cold-turkey from a highish dose.

[Scissel]

Sorry, guys, I didn't see your replies :(

Nope, no apology. At times, I feel like she is clueless - good thing I do my own research.

So next week I'm dropping down to 50MG and starting escitalopram and I'm a bit worried if I'm being honest. The up and down with meds is wearing me out to say the very least.

Whilst I don't feel awful, I don't feel good either, and certainly not stable by any stretch

PS: I now fixed my javascript issues at my end and everything (including the games are working here). My postings look normal for a change .. YAY!!