HomeAnswersPsychiatrysertralineI feel low and depressive after stopping Sertraline for three weeks. Should I be concerned?

What could be the reason for feeling low after stopping Sertraline for three weeks?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At October 13, 2023
Reviewed AtOctober 13, 2023

Patient's Query

Hi doctor,

I have been off Sertraline for three weeks now according to my doctor's advice. I have been fine other than the dizziness shortly after coming off the last dose. However, today I woke up feeling in a depressive stage again. I am not sure if it is the ‘can not be bothered with anything’ attitude that I had when my depression started off before. I am going on holiday tomorrow, and I am not sure why I do not feel excited. My heart rate has also been varying for the last few days touching down to 43 bpm. It has been 55-60 bpm at resting. I am not sure why. Should I see a doctor?

Thank you.

Hello,

Welcome to iclinq.com.

I understand your concern.

Did you quit the Tablet Sertraline gradually or in one shot? It might be a relapse of depression or signs of withdrawal. Since how long have you been taking Tablet Sertraline and what dosage was it taken? The variation in heart rate is secondary to anxiety. Also, when you quit any medicine, you need to start exercise and psychotherapy to manage the situation. I suggest you consult your psychiatrist and start with a low dose again if required.

Thank you.

Patient's Query

Hi doctor,

Thanks for the reply.

I was on it for six months, and I came off over a period of seven weeks. I was on 50 mg initially. I was fine after the withdrawal period, but it has just hit me today and I am not sure why. Is my heart rate a concern? I do not really want to start on another dose as I felt I was ready to come off. I am going on a two-week holiday tomorrow, which I have been looking forward to.

Thank you.

Hi,

Once more, thank you for allowing us to be of service to you.

We value the high level of confidence you have in us!

if it is of today only, then not to worry at all. Do not start the medicine, but start some physical exercise for at least 45 minutes a day and start sharing your thoughts and feelings. if you have any stress factors, try to vent your feelings. Heart rate is not a concern at all. It is because of anxiety. Do not overthink and concentrate on your heart rate. Sometimes, such problems should be left unattended. If you feel the medicine is required, you can take it as and when required.

I hope this information will help you. Please revert in case of further queries.

Thank you.

Patient's Query

Hi doctor,

Sorry, I did not understand what you meant. What do you mean when you said 'If it is only for today, do not worry'?

Thank you.

Hi,

Welcome back to icliniq.com.

I understand your concern.

I meant to say if it happened only today, it is not a matter of worry. Sometimes similar symptoms like giddiness and varying heartbeat may occur for one or two days. It could be due to dehydration, extreme tiredness, stress or tension or any other changes in the routine can cause such problems.

I hope this information will help you. Please revert in case of further queries.

Thank you.

Patient's Query

Hi doctor,

Thank you for your reply.

What about in terms of me feeling down today? This is the first day I have woken up feeling lifeless after starting the tablets. I had a little breakdown this afternoon and cried for no reason. I have been looking forward to going on a holiday all year, and now it feels that I am not bothered about it. In terms of going back into Sertraline, would I get the same effects as I had previously? Is it as simple as just starting again? I do not want to be quick at saying jump back on medication. As I said this is the first day since I have come off that feeling.

Thanks for your help.

Hello,

Glad to have you back!

I am here to help you get the best medical advice.

Once you start the medicine, you will get the benefits within a week. It is just a low feel. We will not directly jump to medicine again as your problem was for one day only. I suggest it as an emergency medicine as you are going on holiday. There is no need for any medicine otherwise. It is not necessary that the problem might reoccur, it may be an apprehension regarding your previous anxiety and depression. It is not necessary that some stress factors play a role in relapse or recurrence. Avoid thinking about the problem, just try to be with your friends and family.

I hope this information will help you. Please revert in case of further queries.

Thank you.

Patient's Query

Hi doctor,

Thank you for your reply.

What is an emergency medication when I am on holiday? Can I take the odd Sertraline tablets, maybe once every three days or something - is that what u mean? Thanks I am hoping this goes tonight if I am honest. Not sure if there is anything else that I can do in the meantime. Hopefully when I am on holiday I will be all good. In terms of bpm, no issues if it does to 55 now and then?

Thank you.

Hi,

Welcome back to icliniq.com.

There is nothing to worry about the bpm (beats per minute). Everything will be good in the holidays as you will not think much, and does not concentrate on your problem. Do not think much and take it as a part of life, be with friends and family, and get involved in your hobbies. Also, exercise daily for at least 45 minutes a day. I suggest you start Tablet Sertraline on odd days also. I suggest you take tablet Clonazepam 0.25 mg dissolvable tablet as emergency medicine. Consult your psychiatrist and take the medicine accordingly.

I hope this information will help you. Please revert in case of further queries.

Thank you.

Patient's Query

Hi doctor,

Thank you for your reply.

I have such a busy work routine in school and have also broken up from work for the past six weeks in the summer. So maybe this has affected my routine too.

Thank you.

Hi,

Welcome back to icliniq.com.

Yes, It is possible that you quit your busy schedule for a while. Do something that does not burn you out, and try to maintain a work-life balance.

I hope this information will help you. Please revert in case of further queries.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Vipul Chelabhai Prajapati
Dr. Vipul Chelabhai Prajapati

Psychiatry

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