Hello all,

I am a newbie here, I have moved across from the wonderful SA site. 

My SA Thread

I’m currently on 36.5mg of Sertraline (Zoloft) after working my way down from 100mg over the past year (hyperbolic) and few months. 
I’ve been feeling a bit weird over the last few weeks and aren’t sure wether it’s dose withdrawal or menopause/stress ect. 
I have learned today that our nhs is unlikely to give liquid for when I get near the lower doses and I am scared. I have heard people make their own liquid but does it work? Also i cant always get the same pill brand and this bothers me too. I dont seem to have had an issue with brand changes so far…Please dont tell me any horror stories as i am a little vulnerable right now…

love H..

Hi Heatherjane

 

Welcome to the forum

 

It is great to have you here.

 

Thank you for posting your introduction topic and updating your signature. Could I ask you when you get a sec to look at your signature. It's kinda hard to read. We just need dates, drugs, and doses in there? 🙂(Format: '01 January 26, Zoloft 50mg' is the easiest to read)

 

I have linked your SA blog above for you.

 

Im sorry you are having troubles at the moment.

 

If you are having WD symptoms it would be a good idea to hold at this dose. Your last dose drop was 10% so inline with SAs guidelines. As you get lower you may find that is too fast. If it doesn't settle in a week a small up dose might be worth considering and then hold there.

 

The NHS should give you access to liquids if needs be. Ive not had to go through the process myself but getting a liquid to help with your taper should be possible. Many taper making up suspensions or cutting and weighing and are successful in this. The obvious advantage here is no risk of sensitivity to a brand switch.

 

Couple of useful links if you have not seen them already:

 

How to calculate dosages and dilutions? Spreadsheets and calculators

 

Transitioning from pills to liquid

 

Did you say you are currently getting switched around with brands of Sertraline in pill form?

 

Might be worth keeping a diary with when you take your dose and the symptoms you are getting. Perhaps noting which symptoms are normal for you, if you have had any during your taper and which are new and suspected WD from the dose drop. Could post that here daily if you can?

 

You are so very welcome here, we are all here to support each other.

 

Speak Soon 

 

Chippy

 

 

Thanks Chippy. Hopefully the signature will read a little better. From what I learned today after speaking to our local pharmacy shop, he said the NHS in this area won’t justify the cost of  liquid as it’s so expensive and to his knowledge no one has every been successful in receiving it round here.
I asked him what was I to do in regard to withdrawing safely and he said when I get to 12.5mg (the 25mg pill cut in half) I should take it every other day so he clearly doesn’t have a clue which makes me very nervous. The cost for a liquid version is priced at £201..

x

1 hour ago, Heatherjane said:

Thanks Chippy. Hopefully the signature will read a little better. From what I learned today after speaking to our local pharmacy shop, he said the NHS in this area won’t justify the cost of  liquid as it’s so expensive and to his knowledge no one has every been successful in receiving it round here.
I asked him what was I to do in regard to withdrawing safely and he said when I get to 12.5mg (the 25mg pill cut in half) I should take it every other day so he clearly doesn’t have a clue which makes me very nervous. The cost for a liquid version is priced at £201..

x

Hey @Heatherjane

 

Thanks for that. I’ll take a look in a bit properly at your signature but a quick glance it looks much better thank you!

Argh honestly I’m not sure what to say. No he has no idea what he’s talking about!

 

The NHS are taking wd more seriously than before. There is a national taper clinic. I’m sure they will give you access to what you need. Just need to push hard. Maybe even taper strips. Perhaps not but liquid shouldn’t be an issue. I’d go see your doctor with a copy of the maudsley de prescribing guidelines and make sure they know what you are doing. Id be surprised if that doesn’t get them on side. Give the pharmacist a wide birth. If you have trouble we can do some research and see what else you can do. Persistance is key I think. The Maudsley book recommends liquids for the latter part of the taper. And the nice guidelines require you have access to drugs that allow you to taper correctly.  So the nhs can’t not get you them. It will be ok I’m sure. 

 

Hi @Heatherjane, I’m having the same problem but I’m tapering Mirtazapine and they do make a version of this that dissolves on your tongue so I’m dissolving that in water. I have my doubts about how accurate the dose will be as I’m getting lower and I asked about the liquid version at my GP’s and she said ‘oh no we only give that out in very special circumstances’!!! Obviously I’m not special enough for the NHS!

i know alot of people make their own liquid by crushing pills and dissolving and use half water and half maple syrup to get a proper suspension. I’ve only used water so far but think I’m going to go the way of 50/50 as I start my taper again as I have to constantly swirl the water at the moment when I draw up my dose.

i may also try appealing to a different GP!

Edited January 27Jan 27 by Emsy

Hey @Heatherjane @Emsy

 

 

You should be getting better support than this.

 

Nice Guidelines on safe de prescribing:

 

Medicines associated with dependence or withdrawal symptoms: safe prescribing and withdrawal management for adults - Nice

 

Ill highlight the following:

 

"Dose reduction 1.5.10

 

-Consider giving the person additional control over the process of dose reduction (for example, by issuing their usual daily dose in a form that allows them to reduce the amount in small decrements at a pace of their choosing, rather than issuing successive prescriptions for reduced daily doses)"

 

BJGP also have this advice for de prescribing:

 

Withdrawing from SSRI antidepressants: advice for primary care - British Journal of General Practice

 

Ill pick out this for you:

 

"HOW SHOULD THE GP STOP SOMEONE’S ANTIDEPRESSANT?

Tapering

SSRIs exhibit a hyperbolic dose–response relationship, that is, when reducing, decreases to smaller doses cause larger change to serotonin receptor occupancy. Because of this, traditional linear dose reductions (for example, reducing sertraline by 50 mg increments) cause increasingly large (or hyperbolic) changes to serotonin receptor inhibition and therefore more severe symptoms.1,6,7 This explains why some patients may tolerate the early stages of their taper but towards the end, at lower doses, they experience withdrawal symptoms.

 

Instead, a proportionate taper, recommended by NICE and the Royal College of Psychiatrists, should be used to reduce withdrawal symptoms.1,4,9 This involves reductions as a proportion of the previous dose (such as 25%); an example tapering plan is shown in Figure 1. Unfortunately, some doses will not be available in tablet form so liquid preparations should be used. These are routinely available for most SSRIs; however, in rural areas or for less common SSRIs, liquid preparations might need to be ordered in advance. To prevent withdrawal symptoms, tapering should take place over a long period of time, spanning months, or even years.1,9 SSRIs with shorter half-lives, such as paroxetine and venlafaxine, require a longer taper."

 

Id print these both off and bring them to your doctor along with the tapering notes from the Maudsley De Prescribing Guidelines.

 

It's hard to say why this is a challenge. Maybe it's lack of training or general knowledge. Perhaps it's a typical human aversion to learning or going the extra mile. Maybe the have budget concerns. Either way please don't let any of that stop you from getting the help you need. You are more important than any of the things I mention above.

 

Let me know if I can help in any other way. Honestly I mean it. I have access to the Maudsley text if you need. Pm me if needs be.

 

Chippy

Hi Heather Jane, I’m sorry I know nothing about sertraline or the NHS, but I have tapered paroxetine and citalopram using liquid.

 

The paroxetine liquid I had made up by a compounding pharmacy, so that might be an option for you if sertraline can be done in the same way.  It was quite expensive, though.
 

Later, when I was tapering citalopram, the same company refused to compound liquid for me (no idea why when they’d already been doing paroxetine) so I had to work out how to make my own.
 

I used half Ora-Plus suspension fluid (which I bought on e-bay) and half distilled water. I made up enough for a couple of weeks and kept it in the fridge and it worked great.

Some good advice from @Chippy.

 

You may want to ask your GP to refer you National Psychiatric Drug Deprescribing Clinic (PDC) | NELFT NHS Foundation Trust

 

Their waiting lists might be long, so the sooner the better, but they have been set up to manage psychiatric withdrawal deprescribing and they may be better placed to provide access to more specific, smaller doses.

 

This isn't medical advice, it is your choice what you ask your GP, I am simply making you aware that this service exists within the NHS.

@Heatherjane

Hi HeatherJane. I am a Zoloft survivor as well, and I also came over from SA. My taper lasted from 2016 to 2022. It was very difficult at first, but once I was able to slow the taper way down, it became much more manageable. Eventually it just worked in the background of my life as I tapered.

 

You already seem very aware of what is going on with your body, and that awareness can make a real difference. I believe you will be able to do this. If you have any questions about my journey please feel free to ask on your page or come over to mine. 

 

Warm wishes.

Hello @Heatherjane and welcome to this site. 

 

I am doing a Zoloft taper using home made liquid (water) as per the guidelines that were on SA. I see that we have some here as well, which will be comprehensive. I also checked the guidelines in the clinical trial I have just finished with Mark H and team at The University of QLD. They are equivalent. 

 

I swapped to home made suspension when I was up at 50 mg to trial it and eliminate any changes at the lower doses. I use 10ml syringes to measure as well as 1 ml. My financial situation is a problem meaning I can't afford compounding pharmacy or expensive measuring gadgets. 

 

I hope this helps and you are welcome to ask me questions. @RachelSusan will have even more experience than me. 

 

Wishing you a gentle, smooth taper. xx

Gosh thankyou everyone for responding @Tracey @Chippy @RachelSusan@Luke @Emsy @Songbird

I have some good news! I went to see a perscribing nurse at my local GP who didn’t know about hyperbolic tapering and I showed her the tapering schedule I found listed on this site. She asked me to email it to her and said she and the surgery would fully support me as they like to take a holistic approach with their patients!  So then and there she wrote me a prescription for a bottle of liquid sertraline!!!!!!  It’s a big bottle that is 50mg/5ml strength. I also have a tiny syringe to use with it. I am using 25mg pills and making up the rest of the dose with the liquid. The crap thing is that the bottle says only use it for 2 months before it expires so there will be a lot wasted. I might do my next drop using all liquid as it seems a shame to chuck it out if it’s going to expire. I am hoping when I get even lower they will compound me a lower dose if you get me…

I am still scared by it all. I am reading the Anders Sorenson book which is helping me but frightening me at the same time…

Bless you friends,

Heather 

10 hours ago, Heatherjane said:

I have some good news! I went to see a perscribing nurse at my local GP who didn’t know about hyperbolic tapering and I showed her the tapering schedule I found listed on this site. She asked me to email it to her and said she and the surgery would fully support me as they like to take a holistic approach with their patients!  So then and there she wrote me a prescription for a bottle of liquid sertraline!!!!!!  It’s a big bottle that is 50mg/5ml strength. I also have a tiny syringe to use with it. I am using 25mg pills and making up the rest of the dose with the liquid. The crap thing is that the bottle says only use it for 2 months before it expires so there will be a lot wasted. I might do my next drop using all liquid as it seems a shame to chuck it out if it’s going to expire. I am hoping when I get even lower they will compound me a lower dose if you get me…

I am still scared by it all. I am reading the Anders Sorenson book which is helping me but frightening me at the same time…

This is fantastic news! Well done! Persistence pays off my wife tells me! She is right of course! 🙂 

 

Yes this is what I am now hearing more of, GPs surgeries seem to want to move away from having people on drugs. We have had this here Im glad to see this is the case for you too.

 

Yeah I would look to go liquid only but read this first Transitioning from pills to liquid.

 

You can get a lower strength version of the liquid for the lower doses. Please pop me a Private Message and I'll send you more information on this and taper schedules. 🙂 

 

Chippy

That's good news.

  

12 hours ago, Heatherjane said:

I am still scared by it all. I am reading the Anders Sorenson book which is helping me but frightening me at the same time…

 

In my time in support groups, my impression is that the overwhelming majority of people who are severely harmed, did not have foreknowledge of the potential for harm and the need to taper at a pace your body can handle.

 

You are armed with this knowledge, so you know that you must be careful, and slow down if it gets difficult. This is a huge advantage.

Hello friends, 

My nurse has referred me to the Nelft clinic. Whether they see me or not depends if Gloucestershire nhs will pay the clinic fees so I have learnt. 
my nurse has been so good, she greatfully received all the tapering info I have sent her and says that she will get me off this drug! I have been granted repeat prescriptions of tablets and liquid to use as I see fit for now. 
I have a question for you knowledgeable folks. I am feeling less odd this week than I did last week but still have a mild bit of dizziness that waxes and wanes.  I’m still managing to do my daily hardcore cardio cycle ride to give it some context and fulfill my other duties of caring for 2 neurodiverse children and a a husband with incurable cancer. I’ve been on 36.5 for about 6 weeks now and have been using my new liquid and 25mg pill combo for 7 days. Would it be acceptable to lower myself to 35mg or should I go to 36mg? Or do I wait ? 
thanks guys,

love Heather..x
 

9 hours ago, Heatherjane said:

Hello friends, 

My nurse has referred me to the Nelft clinic. Whether they see me or not depends if Gloucestershire nhs will pay the clinic fees so I have learnt. 
my nurse has been so good, she greatfully received all the tapering info I have sent her and says that she will get me off this drug! I have been granted repeat prescriptions of tablets and liquid to use as I see fit for now. 
I have a question for you knowledgeable folks. I am feeling less odd this week than I did last week but still have a mild bit of dizziness that waxes and wanes.  I’m still managing to do my daily hardcore cardio cycle ride to give it some context and fulfill my other duties of caring for 2 neurodiverse children and a a husband with incurable cancer. I’ve been on 36.5 for about 6 weeks now and have been using my new liquid and 25mg pill combo for 7 days. Would it be acceptable to lower myself to 35mg or should I go to 36mg? Or do I wait ? 
thanks guys,

love Heather..x
 

Hey Heather

 

Thanks for the update

 

Sounds good! I love how receptive you have found doctors and nurses to be when you supply them with information. Great news and great progress for the NHS!

 

I would say hang there for a week and see how you are then. You have improved a bit but you still have some dizziness so maybe it might be worth a wait and see. It is totally up to you and you know your body. Trying to get insync with yourself I think it key here to help you judge when YOU are ready.

 

Always lovely to hear from you 

 

Chippy x

On 1/27/2026 at 7:06 AM, Heatherjane said:

Please dont tell me any horror stories as i am a little vulnerable right now…

Hi @Heatherjane, just stopped by to say hi 👋 and nice to see you on the new site! Agree on horror stories,most of us are in agreement. There has been alot of support and mindfulness here, you are in a safe place! 💖

1 hour ago, HopePerseveres2.0 said:

Hi @Heatherjane, just stopped by to say hi 👋 and nice to see you on the new site! Agree on horror stories,most of us are in agreement. There has been alot of support and mindfulness here, you are in a safe place! 💖

Hello Sweetheart, yes I am here! Hope you’re okay. I have been referred to a specialist nhs deprescribing clinic and am waiting to see if our area will pay for the funding. What ever the outcome I know that God has me in his hand and will sort me out….

 

It’s been a bit of a strange time for me now I’m on a 25mg pill and sertraline liquid for the rest of the dose. My husband messed up the dose a day into the new swap and I ended up with 3mg extra and I freaked out. I seem to be okay now apart from the mild dizziness I’ve noticed since doing the last drop for 40.5 to 36.5 6 weeks ago. 

A general question for the folks… it’s been a long time since I’ve slept without waking every hour/2 hours (I mean years I can’t even remember when this wasn’t a thing)  is there a chance this might improve as I get lower on the doses if it is the sertraline that’s causing this? 

The one thing I do know is that I probably don’t drink enough, I don’t seem to get very thirsty and often forget to drink. I’ve had sinus issues for a few years also and the minor headaches I get I have put down to that. It’s hard to unpack everything and work out what is antidepressant and what is regular. I’m aware I don’t want to blame the antidepressants for every health issue I have but I do wonder what’s what! Sorry to garble on! 
h..

As @Chippy said, I'd give it a bit more time on the new combination. I've seen others on SA go into a destabilised state from switching to them and you've been experiencing some symptoms.

 

23 minutes ago, Heatherjane said:

A general question for the folks… it’s been a long time since I’ve slept without waking every hour/2 hours (I mean years I can’t even remember when this wasn’t a thing)  is there a chance this might improve as I get lower on the doses if it is the sertraline that’s causing this?

 

There's a chance, but it's difficult to predict, and it's not worth rushing a taper for.

 

Some do find they improve or that specific symptoms go away as the dose gets lower on a careful taper (this is based on me reading a significant number of stories over the years).

4 hours ago, Heatherjane said:

A general question for the folks… it’s been a long time since I’ve slept without waking every hour/2 hours (I mean years I can’t even remember when this wasn’t a thing)  is there a chance this might improve as I get lower on the doses if it is the sertraline that’s causing this? 

Antidepressants do mess with our sleep. I wouldn't be surprised, frankly I suspect, your frequent waking is due to the drugs.

It's hard to know when this will improve. I suspect it will resolve eventually for you. Maybe it might take sime time away from the drug to settle noone really knows I am afraid to say.

 

If it helps Ive seen a lot of improvements in my sleep over time. I also have woken frequently every night for nearly two years. (And I was a fantastic sleeper predrug) So I get it. Last 3 weeks or so that has pretty much stopped. Ive done nothing to make that happen. Just the brain making adjustments back to homeostasis. Time is the healer for sure.

 

It's well documented on SA that sleep is often the last thing to return to normal.

10 hours ago, Luke said:

As @Chippy said, I'd give it a bit more time on the new combination. I've seen others on SA go into a destabilised state from switching to them and you've been experiencing some symptoms.

 

 

There's a chance, but it's difficult to predict, and it's not worth rushing a taper for.

 

Some do find they improve or that specific symptoms go away as the dose gets lower on a careful taper (this is based on me reading a significant number of stories over the years

12 hours ago, HopePerseveres2.0 said:

Hi @Heatherjane, just stopped by to say hi 👋 and nice to see you on the new site! Agree on horror stories,most of us are in agreement. There has been alot of support and mindfulness here, you are in a safe place! 💖

Hello Guys,

Okay I’m going halt where I am for a while, I can’t afford to get this wrong so will see how I’m doing in a few weeks or so. Just allow myself to fully adjust to the new combination….

FairPlay antidepressants are a load of bone! 🦴 

H…

Hello all, I’m a bit fed up with all this tapering. I’m currently going through menopause and having issues getting a good hrt set up. Are there any ladies on here tapering and trying to manage menopause. It’s difficult to work out which symptoms belong to what. Menopause or taper. I am tapering very slowly.

I think mostly my taper is quite minimal with symptoms and my main issue is my hormones going beserk.

I’m so keen to get off sertraline but struggle with the fact it’s gonna take a few more years. I’m know I’m not going to do anything daft to trigger a bigger problem but it just narks me off.

Looking for some hope and positivity please. Does the taper have to be awful? Am I waiting for everything to turn on me? Will some possible symptoms of tapering reduce with the lower sert occupancy?

God bless

Hey @Heatherjane nice to hear from you on here. :)

I'll let the ladies chip with thoughts on Hormones, but certainly they factor into your taper for sure.

Main thing is understand your base level. If things are mild 1-3/10, then I would continue to taper gently as you have been. If symptoms start to be more severe than this, hold your dose and let things settle down. In many ways it doesn't matter what is causing what. If you are having a rough time I wouldn't white knuckle it through or anything. This can be the start of things not going so well if you do this.

Don't worry about how long it takes for you to get off. You want to be functional and tapering, don't rush! :)

There is lots of hope! Just be patient, take your time, don't be in a hurry.

You will likley find you will need to slow your taper as the dose reduces. Listen to your body and let it guide you.

1 hour ago, Heatherjane said:

Does the taper have to be awful? Am I waiting for everything to turn on me? Will some possible symptoms of tapering reduce with the lower sert occupancy?

It isn't awful for everyone.

Sometimes symptoms increase, and sometimes they reduce as people get to the lower doses and come off.

It's difficult when there are other health issues at play, as you say. It's worth looking into them and discussing options with your doctor.

@Heatherjane I am not tapering but am certainly in withdrawal (8 months off drugs). I am 49 and until starting meds for ADHD at 47, never had huge menopause issues. Once on meds I started getting mood swings, joint pain, night sweats, hot flushes, brain fog, crying spells. I was told it was perimenopause and put on oestrogen gel. They kept putting the dose up, nothing changed. Then they checked my testosterone and told me that was low, so started me on that as well. Nothing changed. Eventually I decided it was an adverse reaction to my Atomoxetine and stopped it. I then went into the withdrawal I am in today. I am still on HRT as I don't want to destabilise my system with another withdrawal, but my honest home take is that all my symptoms are WD.

If you think about it, women over thousands of years went through menopause and never made a song and dance about it. I do believe a small proportion of women get severe depression, anxiety and suicidal due to oestrogen deficiency(my grandmother committed suicide aged 50). I have a patient of mine who literally came alive after starting HRT, when she had been depressed for over 2 years. HOWEVER, my honest belief is this is 5-10% of women. The rest of us have been sold a trend by big pharma, saying menopause is an awful condition that must be held at bay at all costs.

Personally, if I wasn't already on HRT I wouldn't have jumped on it during WD. Oestrogen STRONGLY modulates serotonin receptors and could destabilise things in my opinion. When I tried HRT a year before WD I got anxious and jittery, and stopped after a month. I was convinced to go back on it because of my symptoms, which I now regret.

7 hours ago, Luke said:

It isn't awful for everyone.

Sometimes symptoms increase, and sometimes they reduce as people get to the lower doses and come off.

It's difficult when there are other health issues at play, as you say. It's worth looking into them and discussing options with your doctor.

Yes I’m seeing the doctor this week, I’ve not spoke to this one about the tapering yet so aren’t sure what side of the fence she’s on..

I calculate I have another 3.5 years of tapering left.:☹️

The surgery has been pretty good so far, giving me liquid sertraline and referring me to the deprescribing clinic, although not sure wether our local nhs will pay for it yet..