Can sertraline (selective serotonin reuptake inhibitor) 50mg be stopped after only 2 days?

From the Guidelines

It is not recommended to stop sertraline 50mg after only 2 days without consulting a healthcare provider first, as this may lead to discontinuation syndrome, although the risk is lower due to the short duration of use. When considering stopping sertraline after a short period, it's essential to weigh the potential risks and benefits, prioritizing morbidity, mortality, and quality of life as outcomes. According to the clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders 1, sertraline has been associated with discontinuation syndrome, characterized by symptoms such as dizziness, fatigue, and anxiety. However, the risk of discontinuation syndrome is generally lower with shorter-acting SSRIs like sertraline, especially when the medication has only been taken for a short period, such as 2 days. The guideline also notes that a conservative medication trial for mild to moderate anxiety presentations may entail increasing the dose as tolerated within the therapeutic dosage range in the smallest available increments at approximately 1- to 2-week intervals when prescribing shorter half-life SSRIs like sertraline 1. Some key points to consider when stopping sertraline after a short period include:

• The potential for discontinuation syndrome, although lower with short-acting SSRIs like sertraline
• The importance of consulting with a healthcare provider before stopping the medication
• The need to weigh the potential risks and benefits of stopping the medication, prioritizing morbidity, mortality, and quality of life as outcomes
• The possibility of alternative treatment approaches if sertraline is stopped, to address the underlying condition.

From the FDA Drug Label

Do not stop Sertraline hydrochloride without first talking to your healthcare provider Stopping Sertraline hydrochloride too quickly may cause serious symptoms including: anxiety, irritability, high or low mood, feeling restless or changes in sleep habits headache, sweating, nausea, dizziness electric shock-like sensations, shaking, confusion

Stopping sertraline 50mg after only 2 days is not recommended. It is advised to talk to your healthcare provider before stopping sertraline, as stopping it too quickly may cause serious symptoms. 2

From the Research

Stopping Sertraline 50mg After 2 Days

• There is limited research directly addressing the safety of stopping sertraline 50mg after only 2 days of treatment.
• A case report 3 describes a patient who overdosed on sertraline after being on the medication for 2 years, not after just 2 days, and was able to recover after the medication was discontinued.
• Studies 4, 5 discuss the efficacy and optimal dosing of sertraline for depression, suggesting that 50mg is a common and effective starting dose, but do not provide information on stopping the medication after a short period.
• Other studies 6, 7 report on adverse effects and behavioral activation associated with sertraline, but do not specifically address the issue of stopping the medication after 2 days.
• It is essential to note that sertraline, like other selective serotonin reuptake inhibitors (SSRIs), can have withdrawal symptoms if stopped abruptly, especially after longer periods of use 6.
• However, there is no direct evidence in the provided studies to suggest that stopping sertraline 50mg after only 2 days would lead to significant withdrawal symptoms or other adverse effects.