Tapering from Sertraline 25 mg
For sertraline 25 mg, taper gradually by reducing to 12.5 mg daily for 1-2 weeks before complete discontinuation, as abrupt cessation can cause withdrawal symptoms even at this low dose. 1
Recommended Tapering Protocol
Standard Taper Schedule
- Reduce from 25 mg to 12.5 mg daily for 1-2 weeks, then discontinue 2, 1
- The FDA label explicitly states that "all SSRIs should be slowly tapered when discontinued because of risk of withdrawal effects" and that "medication should be tapered, as rapidly as is feasible, but with recognition that abrupt discontinuation can be associated with certain symptoms" 2, 1
- Given sertraline's 22-36 hour elimination half-life, dose changes should not occur at intervals of less than 1 week 1, 3
Alternative Slower Taper (If Withdrawal Symptoms Emerge)
- If you experience withdrawal symptoms at 12.5 mg, consider extending the taper by alternating 12.5 mg with 6.25 mg (quarter tablet) for another 1-2 weeks before stopping completely 4, 5
- Do NOT use alternate-day dosing (e.g., 25 mg every other day)—this creates pronounced fluctuations in receptor occupancy and significantly increases withdrawal symptom risk 6
Withdrawal Symptoms to Monitor
- Somatic symptoms: dizziness, light-headedness, nausea, fatigue, myalgia, flu-like symptoms, sensory disturbances, sleep disturbances 5
- Psychological symptoms: anxiety, agitation, crying spells, irritability 5
- These symptoms are generally mild, short-lived, and self-limiting but can be distressing 5
- Monitor closely during the first few weeks after each dose reduction and after complete discontinuation 1
Managing Withdrawal Symptoms
- Mild symptoms can be managed with reassurance that they are typically transient 5
- For more severe symptoms, reinstitute the previous dose and slow the taper rate further 5
- If symptoms persist beyond 1-2 weeks after complete discontinuation, contact your prescriber to rule out depression recurrence versus withdrawal 5
Critical Pitfalls to Avoid
- Never stop abruptly: Even at 25 mg (half the minimum therapeutic dose), abrupt discontinuation risks withdrawal symptoms 1, 5
- Avoid alternate-day dosing: Taking 25 mg every other day creates dangerous receptor occupancy fluctuations that worsen withdrawal 6
- Don't confuse withdrawal with relapse: Withdrawal symptoms typically emerge within days of dose reduction and resolve within 1-2 weeks, whereas depression recurrence develops more gradually 5
Special Considerations
- At 25 mg, you are already at half the minimum therapeutic dose (50 mg), making this a relatively straightforward taper 2, 1
- Sertraline has minimal drug interactions and a favorable safety profile, so the primary concern is withdrawal symptom management 3, 7
- The total taper duration from 25 mg should be 2-4 weeks minimum 2, 1