Tapering Zoloft (Sertraline) 150 mg
For sertraline 150 mg, taper gradually over 10-14 days by reducing the dose in increments, or use a slower taper over several weeks to months if the patient has been on the medication long-term or experiences significant withdrawal symptoms. 1
Recommended Tapering Approach
Standard Taper (10-14 Days)
- Reduce sertraline by 25-50 mg every 3-7 days until discontinuation 1, 2
- This approach limits withdrawal symptoms in most patients who have been on stable doses 1
- Example schedule from 150 mg:
- Days 1-3: 100 mg daily
- Days 4-7: 50 mg daily
- Days 8-10: 25 mg daily
- Day 11+: Discontinue
Extended Taper (For Long-Term Use or High Sensitivity)
- Taper more gradually over months if the patient has been on sertraline long-term or develops withdrawal symptoms 2, 3
- Reduce by smaller increments (12.5-25 mg) every 2-4 weeks 3, 4
- Consider hyperbolic tapering: reduce by a fixed percentage (e.g., 25%) of the current dose rather than fixed amounts, as this maintains more consistent receptor occupancy changes 3, 4
- Final doses may need to be very small (as low as 6.25 mg or less) before complete cessation to minimize withdrawal 3, 5
Monitoring for Withdrawal Symptoms
Watch for SSRI discontinuation syndrome, which sertraline can cause despite its moderate half-life 1, 2:
Somatic Symptoms
- Dizziness and light-headedness 2
- Nausea and vomiting 2
- Fatigue, lethargy, myalgia, chills, flu-like symptoms 2
- Sensory disturbances and sleep disturbances 2
Psychological Symptoms
Management of Withdrawal Symptoms
If withdrawal symptoms emerge during tapering 2:
- For mild symptoms: Reassure the patient that symptoms are typically transient and self-limiting 2
- For moderate to severe symptoms: Reinstitute the previous dose and slow the taper rate 2
- Do not mistake withdrawal symptoms for relapse of the underlying condition, as this leads to unnecessary long-term medication 3
Critical Pitfalls to Avoid
- Do not abruptly discontinue sertraline, as it is associated with discontinuation syndrome despite being better tolerated than paroxetine or fluvoxamine 1, 2
- Avoid rapid dose escalation if restarting, as doses above therapeutic thresholds can cause behavioral activation, tremor, and insomnia 6
- Do not use fixed linear tapers for all patients—those on long-term therapy or higher doses may require exponentially slower tapers 3, 4
- Monitor closely in the first 2-4 weeks after discontinuation, as withdrawal symptoms typically emerge in this window 2