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Cipriani and Sauvageot have shown that for any L2-generator L(2) of a tracially symmetric quantum Markov semigroup on a C*-algebra 𝒜 there exists a densely defined derivation δ from 𝒜 to a Hilbert bimodule H such that L(2)=δ∗∘¯δ. Here, we show that this construction of a derivation can in general not be generalized to quantum Markov semigroups that are symmetric with respect to a non-tracial state. In particular, we show that all derivations to Hilbert bimodules can be assumed to have a concrete form, and then we use this form to show that in the finite-dimensional case the existence of such a derivation is equivalent to the existence of a positive matrix solution of a system of linear equations. We solve this system of linear equations for concrete examples using Mathematica to complete the proof.