Hi everyone,

Grateful to have found this site. Hoping for some advice, I’m feeling a little lost about what I should be doing.

I started sertraline last August for a bout of anxiety. I’d previously been on it around 3 years ago for 6 months and it helped, no problems coming off.

I came off 25mg at the end of March. 3-4 weeks later - fatigue and brain fog, headaches, low mood, insomnia and muscle twitching. After around four weeks of this, feeling increasingly low and struggling to engage in life and work, I took 12.5mg sertraline to see if it would help. At this point I hadn’t discovered SA and didn’t know about reinstating at lower doses. I thought this was the smallest I could reliably(ish) cut up my 50mg tablets.

Felt a bit of improvement in first couple of days, then a few up and down days and nights of virtually no sleep which were hard. Overall think it has given me more energy to work and do things at home but very up and down and am now feeling a bit ‘nothingy’ - emotionally numbed maybe.

Today is day 13 on 12.5, apart from one day last week when feeling impatient I took 25mg (again before finding and reading SA) but had a very bad night after this and realised it was likely too much.

GP wants me to go back to 50mg as soon as possible.

Can anyone offer advice on:

Should I stay at 12.5mg or attempt to come down slightly, having now realised this was possibly too high to reinstate?

Should I try to make liquid to get a more accurate dose? Because I’m quartering tablets I’m not sure what dose I’m definitely getting. I have a pill cutter but doesn’t feel very accurate. They are the oval pills with a score line in the middle.

Any other tips right now?

Thank you

Hi @Iris_blue

Welcome to the forum!

 

This is a volunteer-run, community forum aimed at helping those who are tapering and/or experiencing difficulties with psychiatric medications and withdrawl syndrome. We are not medical professionals and cannot offer medical advice. We simply offer support and opinions which you could use as talking points with a medical provider knowledgeable in withdrawing off psychiatric medications.

 

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I'm so sorry to read about the tough time you've had recently you will find plenty of support here for sure.

28 minutes ago, Iris_blue said:

I took 12.5mg sertraline to see if it would help. At this point I hadn’t discovered SA and didn’t know about reinstating at lower doses. I thought this was the smallest I could reliably(ish) cut up my 50mg tablets.

Felt a bit of improvement in first couple of days, then a few up and down days and nights of virtually no sleep which were hard. Overall think it has given me more energy to work and do things at home but very up and down and am now feeling a bit ‘nothingy’ - emotionally numbed maybe.

Today is day 13 on 12.5, apart from one day last week when feeling impatient I took 25mg (again before finding and reading SA) but had a very bad night after this and realised it was likely too much.

Glad you found us.

You have a couple of choices.

1. Stay on this dose and wait to stablise.

2. This current dose is a bit high, you have not been taking it too long, and it seems as though it might be numbing you a bit so you could reduce your dose to more like 10% 5mg. We normally suggest a much lower dose than this still, but because you have seen some improvement on 12.5mg and because I wouldn't want you to jump your dose too abruptly, I would suggest if you lower it to aim for 5mg or 6.25 (1/8 tablet)

Either way it is really important to make your dose accurately as this won't be helping you.

I wouldn't suggest making a liquid as this isn't needed and the jump to liquid can be destabilising. So what I would do if get yourself on Amazon and buy these:

https://www.amazon.co.uk/American-Weigh-Gemini-20-Black/dp/B077KC8D8Y/ref=sr_1_7?crid=1BAGQPYMCL56X&dib=eyJ2IjoiMSJ9.B-RoFP5J0Rr7ADoG_yd_MkT_dzSr8YjNZe96LleujvsHab2psQEGm3TGxP2F9igysthiMR1bYAQMQbhMc1-DHs7SIsmnbzAFW-jJUt7bIHlnx99Gf9Mk_bhpyPz0UwNwFDF_X4kxYxyyznMcpAxGTMa-24Uyjs2JsOelJMy2Xl1o1LH5eQlNFCC5gpbPHF9yb-Km2-B6IqIo-clVb0h_M9621Envla1QqwaXdFFKoMK456D4S1x5j8ahSXdwYRe2Duv6i5ZYCONEi9yMBxkqszQCBccYWoR5sb8an_DJMfE.fhznnG5g7npNr-3Ay_8hs6Cy9xPszH1WeuofuX9VQ1M&dib_tag=se&keywords=gem-20%2Bscales&qid=1780653456&sprefix=gem-20%2Bs%2Caps%2C108&sr=8-7&th=1

You can use them to measure your pill accurately each day.

To do this weigh 10 pills and divide that weight by10 to get you an average pill weight, which you use going forward. You can do 5 if you like, 10 is more accurate.

Then you need to calculate how much pill you need to take with a little maths. For 12.5mg it is easy as it is 1/4 of a pill for 5mg more tricky but easy enough to work out. Happy to help with this is you like.

You can buy capsules to put the bits of pill into, or crush the capsules first and use tiny 'drug' spoons to measure some powder and put it into each capsule. You can make a few doses up and keep them neat this way.

It is REALLY important to get your dose accurate asap.

36 minutes ago, Iris_blue said:

GP wants me to go back to 50mg as soon as possible.

Absolutley do not do this!

37 minutes ago, Iris_blue said:

Because I’m quartering tablets I’m not sure what dose I’m definitely getting. I have a pill cutter but doesn’t feel very accurate. They are the oval pills with a score line in the middle.

Pill cutters are not accurate enough. A good tool if you want to get rough peices made but you need to use the scales to weigh them and then shave the bits to size.

Couple of links you will want to read:

Reinstating an Antidepressant

Preparing Doses for Tapering - Weighing & DIY Liquids

Any questions let us know.

In the mean time this is what I would do if I were you:

 

-Stay Hydrated 

 

-Eat a good clean whole food diet, avoiding processed foods and sugars.

 

-Stay away from caffeine, alcohol and antihistamines and any other psychoactive substances.

 

Supplements are to be avoided initially, as they often irritate our nervous systems. Try to get your nutrition through food.

 

Down the line, you may wish to introduce Fish Oil and Magnesium. Those who can tolerate them have found them calming to the nervous system. Be careful try one at a time and start low and see how you get on should you choose to try them.

 

A daily walk is very important as much as you can manage, if you can manage it. Gets you your fresh air and Vitamin D does wonders for your mind!

 

You are very welcome here and I hope you find the site supportive.

Chippy

Welcome to the forum.

@Chippy has linked you to a lot of information already, so I won't add too much to avoid muddying the waters.

Please pay attention to the two options he listed. Frankly, if you're tolerating 12.5 okay, I'd focus on making this dose accurately, with @Chippy 's information, and wait to stabilise here, but if you feel as though this is too much then you could follow his second option.

If you're able to work, and are sleeping, and mostly feel "nothingy" I'd call this reasonably tolerating this dose- it can get a lot worse if you mess around too much, which is why we're urging stability and caution.

Thanks both for the quick responses and all the information, much appreciated.

I’ve ordered the scales, there’s a wait time so I’ve also ordered similar ones arriving today, as will be better than nothing while I wait.

My sleep is mixed, I seem to have a couple of nights where I get 5-6 hours then a bad night with only 1-2.

I’m quite torn what to do, will think on it the rest of the day.

Thank you again for your support

10 minutes ago, Iris_blue said:

Thanks both for the quick responses and all the information, much appreciated.

Pleasure

11 minutes ago, Iris_blue said:

I’ve ordered the scales, there’s a wait time so I’ve also ordered similar ones arriving today, as will be better than nothing while I wait.

Ok, best to use the same scales each time, the two sets might vary in readings. But yes I agree a set of scales quickly makes alot of sense and honestly the second set you have bought will likely be good enough. Make sure you calibrate them each time you use them.

12 minutes ago, Iris_blue said:

My sleep is mixed, I seem to have a couple of nights where I get 5-6 hours then a bad night with only 1-2.

Ok, sleep is certainly a big one in WD, these drugs really mess with our sleep architecture. Have a read: Sleep in WD

13 minutes ago, Iris_blue said:

I’m quite torn what to do, will think on it the rest of the day.

Yes that's fair enough. Can you rate your symptoms now and before you RI out of 10, 10 being the worse and 1 being mild? Might help you understand how the RI has gone so far and perhaps help us advise you further.

Thank you. Sleep aside, I’d say my symptoms are at about a 3-4 now.

Before reinstatement a 7, so definitely improvement.

1 minute ago, Iris_blue said:

Thank you. Sleep aside, I’d say my symptoms are at about a 3-4 now.

Before reinstatement a 7, so definitely improvement.

Ok so based off that perhaps holding here would be best. It is your choice of course.

Thanks Chippy. I have my scales and worked out weights for doses.

Another bad night of sleep so glad I did the maths last night when I was functioning!

I think it’s too risky to cut to 5/6mg now but I wonder if the dose is making my sleep worse. I’m thinking of trying 11mg, what do you think?

4 minutes ago, Iris_blue said:

Thanks Chippy. I have my scales and worked out weights for doses.

Good work!

5 minutes ago, Iris_blue said:

Another bad night of sleep so glad I did the maths last night when I was functioning!

Sorry to read, so common in WD! We have all been there!

5 minutes ago, Iris_blue said:

I think it’s too risky to cut to 5/6mg now but I wonder if the dose is making my sleep worse. I’m thinking of trying 11mg, what do you think?

We can't know how you will react in either case. For me reducing the dose is about getting down to a more 'recommended' RI dose level. Reducing a little won't help I don't think and just gives your brain more changes without any benefit.

We have had people come on here after RI too high and then even jump their dose around and finally settle on a lower dose and be fine. There are no sure ways to know how you will react what ever you do.

I would go to 5mg or stay where you are at 12,5mg. Only you can choose which you think is best. The big factor here is getting you a consitent dose. that is going to be massive for you I think.