Coming off sertraline part 1: initial report

  • Time on any SSRI/SNRI [“modern” antidepressants]: 13 years
  • Time on sertraline (Zoloft): 7 years
  • Sertraline dose during that time: 200mg, then 175mg
  • Day I came off sertraline entirely: 25th June
  • Day today: 30th June (technically 1st July, see also: insomnia)

I’ve been off sertraline fully for a few days. I had heard some horror stories of coming off antidepressants, and was a little frightened about doing it – although I’ve changed between SSRIs in the past, I always did it by reducing the old one and increasing the new one at the same time. The psychiatrist I spoke to said this wasn’t safe with sertraline and clomipramine because of the risk of sertonin syndrome.

I can report that almost everything that’s happened has been in the range of what I am used to experiencing – I had some sleep disturbance, but I’ve had that many times whilst on a high stable dose. My OCD symptoms have arguably got worse, but not dramatically so; they are still within the range of what I experienced whilst on a high stable dose of sertraline. For comparison, the increase in OCD symptoms hasn’t entered the Top 3 Occasions In Which My OCD Got Worse in the past 2 years, and probably wouldn’t make the Top 10 either.

The one thing that is new, for me, is that a few times I have felt on the verge of tears for no reason. The the existence of things happening on the news was one time, as was the concept of watching Stormzy performing at Glastonbury (I’m not particularly interested in Stormzy). One or two of the times the feeling of tearfulness occurred I did feel sad about something, but it also happened when I wasn’t upset or sad. It has only really occurred since I’ve been fully off sertraline – going down to 150/100/50mg didn’t seem to cause it.

What have I learned?

I learned that I was correct in my suspicion that I was paying for a medicine that wasn’t working for many years. I’m angry that this happened, given that for the whole time I was doing this I wasn’t earning enough money to pay tax, so NHS prescription charges weren’t insignificant (I did try to get the medicine for free but didn’t qualify for it). I’m also angry that I spent time feeling frightened that I could lose access to sertraline if the UK left the EU without a deal on 29th March*. Though it should be acknowledged that that fear was justified even though sertraline wasn’t doing much for me – if I had been forced to come off it cold turkey or without psychiatrist oversight the process likely wouldn’t have been so smooth.

*We can debate the likelihood or otherwise that a no deal exit from the EU would lead to medicine shortages, but I’m putting it in this post as an example of the extra stress that this uncertainty caused me, as a person with a mental illness that thrives on uncertainty. Almost by definition those of us with OCD live in deep fear of “what ifs” – if there is a 0.0000001% chance of something terrible happening, that is what OCD will go with, not the 99.9999999% chance that it’ll work out ok. The argument made by some that medicine shortages are very unlikely isn’t much comfort.

Part 2 of my post on the experience of coming off sertraline will be released tomorrow…

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