Can a Patient Stop Sertraline After One Week?
Yes, a patient can safely stop sertraline after only one week of use without requiring a gradual taper, as discontinuation syndrome risk is minimal with such short-term exposure.
Rationale for Safe Discontinuation
After just one week of sertraline treatment, the risk of discontinuation syndrome is extremely low because:
- Discontinuation symptoms are primarily associated with longer-term use - The FDA label and clinical guidelines emphasize that withdrawal symptoms occur when stopping sertraline after extended treatment, not after brief exposure 1
- Steady-state concentrations are not yet achieved - Sertraline reaches steady state after approximately 7 days, meaning the patient has barely reached therapeutic drug levels 2, 3
- Minimal physiological adaptation has occurred - One week is insufficient time for significant neuroadaptation to develop that would necessitate gradual dose reduction 4
Evidence Supporting Brief Exposure Safety
The American Academy of Child and Adolescent Psychiatry guidelines specify that:
- Minimum taper duration of 2-4 weeks applies only to short-term therapy (defined as longer than one week but not long-term), while patients on therapy for less than this duration can typically discontinue more abruptly 4
- Sertraline has been associated with discontinuation syndrome characterized by dizziness, fatigue, myalgias, headaches, nausea, insomnia, and sensory disturbances - but these symptoms emerge primarily after extended use, not after one week 4, 1
Important Caveats
While abrupt discontinuation is generally safe after one week, the patient should still:
- Monitor for mild transient symptoms such as headache, nausea, or dizziness in the 24-48 hours following discontinuation, though these are unlikely 1
- Contact their healthcare provider if any concerning symptoms develop, particularly mood changes or anxiety 1
- Understand the reason for discontinuation - if stopping due to side effects versus lack of efficacy versus other reasons, as this may inform future treatment decisions 4
Clinical Context
It's worth noting that:
- Therapeutic response typically requires 2-6 weeks of treatment, with maximal improvement by week 12, so one week is insufficient to assess efficacy 4
- Most adverse effects emerge within the first few weeks, so stopping at one week may be due to early side effects that often resolve with continued treatment 4, 5
- The patient has not yet experienced the full therapeutic potential of sertraline, which may be relevant if the medication was prescribed for depression, anxiety, OCD, panic disorder, PTSD, or PMDD 1, 6, 7