Hey everyone, I am new to the Zoloft forum.
I have GAD and major depressive disorder. In June this year after being on 60mgs of Celexa for 8 years, I had a nervous breakdown. I knew the Celexa had stopped working some time ago, but battled on. Anyway, I then tried Lexapro for a few weeks which did nothing then switched (upon pdocs advice) to Remeron without any tapering. I had really bad discontinuation symptoms for about 2.5 weeks. Once the noradrenaline kicked in at 45mgs of Remeron, my anxiety became really bad and I felt crazy. I stopped the Remeron after 4.5 weeks and am now on 50mgs of Zoloft.
As soon as I stopped the Remeron I felt better and my anxiety has gone back to the pre-remeron stage.
I havent had any SE effects from stopping Remeron (Yay!) and no start up SE from the 50mgs of Zoloft I am taking (Yay!). The only other med I take is 2.5-5mgs daily of diazepam to help with my anxiety.
Since starting Zoloft, I am able to think a little more clearly, a little more able to control my anxiety and I feel a little more sane. However, I still have a long way to go and I understand that my recent med switches have an impact.
Anyway...
I am curious about how dosage increases work after starting a new medication. I will not make decisions without consulting my doc, but as I have had no SE from going straight onto 50mgs, when do docs usually increase the dose? I know it is early days yet, but previously I have needed moderate doses of AD's to go into remission.

Thanks ,
I_need_a_miracle

Hey Miracle!

I started on 50mg of Zoloft and have recently gone up to 200mg. For me it took about 8 weeks to kick in fully, after going up 150mg and still now my depression isn't good so that's why I'm trying the 200mg. I'm hoping this is my magic dose, but who knows. It's frustrating!!! Sadly all you can do is wait it out the 6-8 weeks and then see, but you can always go up before that. Talk to your doc about it.

Good luck!

Tink

Hey, Miracle, I'm looking for a miracle, too! I was diagnosed with GAD in my early twenties and had been doing well, or so on thought, for the last five years on 20 mg of paxil. Unlike you, I didn't really notice that it was starting to "poop-out" on me because I wasn't having panic attacks. Unfortunately, I missed a couple of doses in November and December of last year and both times, when I took my next dose, I had terrible anxiety/restlessness/panic. I thought maybe it would just take time to get a good level back, so I kept taking it. No luck. So my new psychiatrist decided it wasn't working and we switched to cymbalta which made my anxiety much worse, then I backed up the dose and it stopped doing anything at all. Went through the same thing with lexapro only the anxiety was even worse. So I weaned off of those and onto a tiny dose of zoloft. I had terrible withdrawal from cymbalta and lexapro but not from the paxil. Sometimes, if you're going straight from an SSRI to another SSRI withdrawal won't be a problem (I think the only reason I had trouble going from lexapro to zoloft is because the lexapro dose I ended up with was more potent than the zoloft I started out with, if you know what I mean.

Coincindentally, I had an appointment with a psychiatrist who said that people with panic disorder (like me) can be VERY sensitive to increases in AD doses and that he's had many patient's who took a LONG time to taper up to a therapeutic dose. I could be wrong, but it's possible that the reason you did so well going straight to 50 mg of zoloft is that it was pretty close to the equivalent of what you were on before. (Keeping in mind that I'm not an MD, but I think remeron affects serotonin along with some other neurotransmitters.) I was pleased to find out that this psychiatrist leaves it up to his patients how fast or slow to increase dosing depending on how they're feeling.

It took about eight to ten weeks for me to feel a difference on the zoloft but if you and your doctor have a target dose you're looking for, there's no reason you should have to wait that long to increase the dose.

Hope this helps. Sometimes I feel like a babbling ***** when I try to reply to people's posts because I tell my whole life story first.

Good luck with the zoloft.

Ali

Hey Tink, I hope that the 200mg dose is the one that helps you. How long did you stay on 50mgs? When you increased your dose, was it by 25mgs or 50mgs at a time?
Alinam, your post was really helpful. I think giving background info is really helpful when asking or answering a post.
I keep reading about how Paxil has helped people, especially with anxiety, but seems to poop out or cause other problems.
This trial and error thing makes me crazy!
My pdoc is away for a month and my general doctor is in charge at the moment. I just don't want to sit at 50mgs for a month if I am going to get benefits from an increased dosage. I know it's early days yet, it's so frustrating! I'm also a bit worried about becoming addicted to my 2.5 - 5mgs of
diazepam daily.

First of all, not to be a nag, but saying things like "I need a miracle", are not helpful to your condition. You do not need a miracle, you need a good doctor. Try to stay positive.
You answered your own question- if you still have "a ways to go" before you feel better, then 50 mg- assuming you gave it 4-8 weeks- is not enough. You need to increase the dosage. Dosage increases take about 1-2 weeks before they really kick in, not 6-8 weeks.
As for how high your dosage increase should be, tough to say. I'd say, considering you don't sound too bad, try 75 mg for a week or two, and if it helps you back to 100 percent, stick with it. If not, do not waste time- go up to 100 mg. Who knows what the right dosage for you will turn out to be.
Anyhow, it is very good news that the zoloft has helped you already. That bodes very well for future increases.

Hey Miracle!

I really hope so too. It's almost been a week now, and so far just feel more anxious at times and still very sad, but like we always say "it gets worse before it gets better!" At least I'm not having any side effects!!! Woohoooo for that!

I was only on 50mg for a week end of Aug, then up'd to 150mg a week later and have been on 150mg since then, went up to 200mg last week. It wasn't until about week 8 that I could notice a difference. So it did take awhile for me, but everyone is different. BUT YES it can take up to 8 weeks.

Paxil was a wonder drugs for me. I loved it! It was amazing. I was on it years back and then I gained WAY too much weight and decided to get off it. I was too scared to try it again. But sometimes I wish I would have since I know it worked great for me.

I can't win!!

Just try and be patient (i know it's hard) but maybe you will need an increase, just talk with the doctor.

Let me know how is goes!

Tink

Hi Supersack,
My avatar is not about what I want or expect from my current situation. 8 years ago in the space of 2 weeks, I lost my partner, my son nearly died and my housemate moved out. I lost my faith in life and was feeling very sorry for myself. 'I need a miracle' was a popular song at that time. I joined an online forum and used that avatar.
When I joined DF recently, I was so distressed that choosing a new avatar eluded me, so I used this one. 8 years ago, I felt that I needed a miracle until I realised that my sons recovery was my miracle.
My current battle is made up of hard work, courage, strength of character, education, therapy, diet, exercise, meditation and medication. My avatar reminds me about how much I have grown in 8 years and that I will get better.
I am not going to draw any conclusions as to what your avatar means as I realise that it could mean anything.
Thanku for your advice in regards to Zoloft, your comment 'that bodes very well for future increases' encourages me.

Hey Tink,
Zoloft seems to be a weird drug (lol, aren't the all) in the way that it seems to take longer than other AD's to work effectively. I've noticed that I will be better for a few days, then have a really bad anxiety day then the next day I'm better again. Glad your not having any SE .
When I was on Remeron, I put on so much weight in only 4 weeks, it was unbelievable. I have noticed since stopping it, I have already lost a heap.

The only problem with Zoloft is that I don't have much of an appetite, but food tastes better. I am usually a fairly slim person, so losing too much weight wouldn't be great either.

I went up to 75mgs of Zoloft yesterday. I am also going to start seeing a psychologist tomorrow. The only thing my psychiatrist seems to do is write out scripts and let me vent while just sitting there listening and never saying anything. It creeps me out actually, lol.

Likewise, let me know how you go with the 200mg.

Miracle

You were right to not draw any conclusions- supersack means nothing :)
I didn't even know they call these names "avatars." I thought an avatar was some sort of God
or spiritual leader.
Good to hear you have chosen a positive, realistic path. People who are really negative, or tooo happy, are destructive. I agree that "miracles" are just the outstretched reach of "common" people.
Don't know the song to which you refer, but there is a Grateful Dead song by the same title :)
Good luck with zoloft.

Thankyou for your reply Supersack :)
Avatars are related to spirituality in the 'real' world but on the internet they work as an alias in the form of a picture or a user name. My 13 year old son taught me that, lol! I must be getting old.....
I havent heard the Grateful Dead song, the one I was talking about was a dance song, one of those tunes that get stuck in your head..
I gather you are on Zoloft too? I hope it is helping you too :)

Hello side effects! I've been on Zoloft for 14 days now, one week at 50mgs and the last 7 days at 75mgs. I think the side effects kicked in after going up to the 75mgs. I feel AWFUL. No appetite, no energy, I'm shaking, some days I am so depressed I just want to disappear. I wake up in the morning as soon as I hear any noise and am unable to go back to sleep. It's the depression that scares me.
I'd go back down to 50mgs, but won't that make the depression worse?
I have brief moments of feeling ok, and the anxiety seems to have lifted a little, so I am prepared to perservere. My pdoc is still away for another 3 weeks and I really need her advice. I wish there was something I could take other than Valium to get me through this waiting.
I understand that Zoloft seems to take a bit longer than other SSRI's to work, but time is going soooo slow. I miss sleeping.
It is hard to remember that these are just side effects and will go away. How long does it typically take for these side effects to go away?

I know the way you feel. I had similar side effects when starting on 50. I was told the Zoloft should start working after about 2 weeks, in reality it took exactly 3 for me to start feeling better. The weird part was it kinda happened overnight. All of a sudden my side effects were gone, I had figured it would be more of a gradual transition.

Thanks j0j081,
I'm glad it worked for you, I hope that happens to me...
How long have you been on Zoloft for? Are you still on 50mgs?

I am actually up to 100 now and still getting used to it. Overall I'd say it works pretty good (I felt the best on 50) but I think I need to keep taking it longer before making my full conclusion.

How long have you been on Zoloft for?

I'm up to 200mg Zoloft also. This dose seems to work the best for my depression. But it took about 8 wks, to start noticing. I also take a multivitamin with Ginkgo and B vitamins in it, and I have really noticed a difference.

(((Cvoor)))

Yipeee!! Someone up in the 200mg with me!! 8 weeks you say? I've been on 200mg now for 2 weeks. You have given me hope~! My anxiety is under control, just not the depression. I think I'm going to try this vitamin thing, everyone seems to be taking them and feeling better. Just not sure which ones? I hear vitamin B is good or something for depression. Would a multi vitamin be good, or should I just get a specific one type?

Thanks!


Tink

Hey Tink, it's always comforting to hear about someone else doing well at the dose you are on, isn't it?
I can answer the vitamin thing as it has been a religion for me and I work in the natural health industry. A vitamin b complex that incorporates all the b vitamins as well as folic acid and some amino acids are really good for a nervous system that has been under stress. Vitamin B can give you energy, so finding one that states that it is for stress relief will usually incorporate a couple of herbal extracts that are calming ( and do not interact with AD's).
Actually I just realized that I wrote about this on the Z train thread yesterday, so I won't repeat myself.
There is also a good book called Help for Anxiety and Depression by Dr Sandra Cabot. It discusses AD's, amino acids, vitamins etc.

Hey Miracle!

Thanks for the help! I will for sure go out and get some Vitamin B! Anything to help. I was looking at some of the products and was wondering if you knew what MG of Vitamin B6 I should go on? Is this what I want?

Vitamin B6 (Pyridoxine) 25 mgJamieson Vitamin B6 is an essential B-complex nutrient that is available in four effective potencies.

Vitamin B6 (Pyridoxine) helps to metabolize amino acids and carbohydrates and promotes a healthy nervous system. It is involved in the synthesis of red blood cells and may ease symptoms of anxiety and depression.

Vitamin B6 supports cardiovascular health by reducing blood levels of homocysteine and may ease symptoms of premenstrual syndrome (PMS) and the pain and inflammation associated with carpal tunnel syndrome.

Jamieson's Vitamin B6 contains a high quality source of Vitamin B6 that is processed without heat or solvents to ensure the integrity and effectiveness of this important nutrient.

Thanks for your help!!!

Tink

Sorry it took me so long to get back. But I absolutely agree, taking a Multivitamin with your B's, really makes a difference. I take One a Day Womens 50 Advantage, it's more geared towards us "older" gals. It has a little extra of the b vitamins, and 120mg Ginkgo, and also has a little more of some other things, such as Chromium, Calcium, and Vitamin D. I have taken Centrum but I seem to like the one a day better, I can feel the difference more. I know you have to be careful with Ginkgo, but I have not had any problems thus far. It has given me more energy, seems to enhance the Zoloft, and make me just feel like going out and doing more. But yes, go and get yourself a good multivitamin, and yes, it took about 8 wks to feel better on the 200mg of Zoloft. I have more resistant depression/ and anxiety, and a larger dose is what it took for me, I still can't believe I'm at 200mg, when my Mom is still at 5omg , but we are all different. I wish you the very best, and give the multi a try.

This post has been edited by cvoor: Nov 13 2009, 11:55 AM

Hey Cvoor!

So you are saying I should take a multi vitamin along with a vitamin B?? What dose of it should I go on, as I understand there are many differents MG

I'm really hoping 200mg is what its going to take for me to feel better. I'm getting tired of waiting! This has been going on since June, and after Cymbalta didn't work for me and now worrying about Zoloft not working either it's making me anxious! But with any meds I take these days I always need a high dose of anything to feel it's effects. I have such a high tolerance to meds it's scary.

Thanks for the hope!!!

Tink

Hi Tinkerbell
If you take a Multivitamin, you don't have to take a seperate B complex, because the Multi already has your b vitamins in it. You don't want to take too many supplements, A multi is all you need. I hope the higher dose of Zoloft works for you, it does for me, but it took time.

If it is of any help to anyone, I also take 200 mg of zoloft. I have heard of people going higher but my pdoc says no way. In addition, I use 1.5 mg of klonopin, and 45 mg of buspar.
I used to do fine with 100 mg of zoloft and 1.5 of klonopin (later reduced to .5) But I stopped the zoloft and klonopin last year and got six good months before getting hit with the most stubborn anxiety and depression I have ever had.
Not really sure why I need more now. Anyone know? Could be a tolerance, or could be the kindling effect. Fortunately, I tolerate these pills very well.
All this began in March, and I am just getting back to 100 percent now. I was there for short periods earlier this year, but the relief was fleeting.
Keep in mind, all this occurred despite the fact that things were going quite well in my life, and are even better now. My pdoc says my brain is so run down from previous "episodes" that it cannot fight the disease as well anymore, and that it can recur without any stressors at this point.
It's sad because for 15 years I thought I had this licked (while on zoloft and klonopin), and then felt great for six months after stopping them last year.
Still, if i told you guys what's going on in my life, yet how I am still down, you would laugh. I guess my biology is really screwed up.

Hey Supersack,
I can relate. I find each time I have a major anxiety and depressive episode, I find it harder to get better each time. I attribute this to how cynical I have become over the years. I also feel after each episode, I lose a piece of myself.
I find it ironic that this episode has occured during the most positive period of my life. I have a passion for gardening and horticulture, I have a job ( that I have had to take some time off from) that is amazing, I have financial security while I am working, my son is now a teenager which gives me more 'me' time and I have some solid rewarding friendships. I went through a lot of rotten stuff in the 90's so it didnt surprise me then when I became a mess. While I know intellectually that my life is pretty good, emotionally I am having trouble feeling any interest in it at the moment.
I think though that there is a lot of stressful, miserable stuff happening around the world and sometimes it is hard to see all the good stuff.
I don't know what the 'kindling effect' is, I will have to look it up.
Supersack, do you find the buspar effective? Any downsides? I read a blurb on a psychiatry website about sertraline and buspar being an effective combination and will be asking my pdoc about it when she gets back from her holiday. My gp will not prescribe it to me.

I am REALLY glad to have met you here because you are the first person I can really relate to. Why? Because, like you, I also found things going well in my life. Then BOOM. After a little while off the meds, I got sick again. Of course I went off the meds because things were going well in my life.
It is now about one year since I went off all my meds. When I look at things in my life honestly, they are much improved, even from last year! My depression tends to make me worry too much abut the remaining problems though, and it makes problems out of nothing.
Last year is when I felt good enough to try and go off the meds, after about 15 years. With all that time on the meds- and knowing that the first two times I tried to wean off were disasters- you know I had to have been feeling pretty good to even try to get off the meds.
I went three months without a problem once I stopped (typical). Then very minor issues popped up. Then in March it got to be bad again and I was back on the pills, yet they did not work nearly as well.
It is so nice to be able to relate to someone here because I thought I was losing my mind. I kept thinking- why do I feel so bad when things are going well? This caused me so much stress that it made my condition worse! I kept ruminating- maybe my life is a lot worse than I thought, maybe I am a loser.
Therapy only made it worse because we focused on things that were bothering me and that made me ascribe even more power to them.
Now I do have some problems, but who doesn't? My biggest now is my health. I have weathered the recession fine, my social life is better than ever, though not perfect, and my vocation, music, is doing great. Better than I ever dreamed.
But there is a DISCONNECT between what my rational mind tells me and how I feel emotionally. I just don't seem to be able to be as "up" as I was, or as calm. Now, I am about 90 percent improved from my worst, but I want to be me again.
It's funny too, because if something good happens- I go out with a friend or get my endorphins flowing a bit more- I am back to 100 percent. That tells me I am very close, and maybe one more dosage increase will do it.
Today I came down with yet another virus, my fourth of the year. I am sure my stress has lowered my immunity. The virus is making my depression worse. Also had a rough day at work, which normally wouldn't bother me, but in this state has triggered me.
Okay, so you asked about the kindling effect.....
Two pdocs have attributed my problem to this effect, which states that for each episode you have, you become more likely to have another, even if the stressors are low or non existent! In addition, each episode will be more severe than the previous and more stubborn to treat.
Based on what you wrote, I really think the kindling effect is what is to blame for your troubles.
That's not to say it's the end of the world, just that people like you and I need to stay on our meds, and be a little more patient with treatments. Yeah, when I first got early sick, in 1992, it was obvious why. I had been miserable at college for a long time. This year it was like someone just came and spun my world around like it was a wheel.
We should keep in touch, and thank you. Any questions, feel free.

Oh, the Buspar question...
Yes, I have found it effective, in conjunction with the zoloft. It will not have as strong an effect as say zoloft or klonopin, but it sure does help. It has no side effects for me, or most people, costs next to nothing, and you can stop it without any weaning. It is very underutilized.

Hey Supersack,
I am so mad! I just wrote you a really articulate reply and then somehow deleted it. I will try again .
I am glad to have met you on here too .
The only time I ever weaned off meds was with the moclobemide in my early twenties ( Why the hell am I not on moclobemide now?!) I went into remission. I think that being young, resilient and curious about life had a lot to do with it.
Although I hate what I am going through now, I am glad that I came off the cipramil that I have been on the last 8 years. I was at the highest dose and yet I was never 100% or anywhere close. I get frustrated with therapy too because I feel intellectually I have dealt with my stuff. I think emotionally I havent but I don't know how to. I get so cynical with therapists and I really need one that can 'outsmart' my cynicism.
I feel like a jigsaw puzzle with a couple of important missing pieces.
You mention that you have now been sick four times this year. It knocks me around too. By the way, I really liked your flu analogy in an earlier post.
I am interested in the role of the immune system in Mental illness and plan to do some research when I feel better ( I am a natural researcher, almost became a proffessional student, lol). I have always had a misdiagnosed and as yet undiagnosed immune issue and feel that there is some link between that and my mental stuff.
It sounds like your are a 'scanner' too. In my case, it is mainly caused by my role as a carer to my son (who has type 1 diabetes) and my mother (disabled). I worry that if I dont anticipate everything, I will miss something and something bad will happen. When that resulted in a total nervous breakdown, I started (and still am ) 'scanning' myself. How do I feel, why am I doing that, how do I stop, what am I doing wrong, what should I do next, what if the zoloft doesnt help, what will, what if I am untreatable etc. I know why I am doing this and how unproductive this is but I just cannot seem to stop.
The kindling effect scares me!
I want so badly to be the strong, independent person I was again. I want to rejoin my world of an amazing job, financial security ( I dont get sick leave) amazing friendships and my passion of horticulture.
Anyway, I wish that I had my original reply, I am too tired to remember what I wrote.
I have probably already asked you this before (again, I am tired) but how long did it take you to feel more human?
Hope you have a good weekend

Wow, that was a great way to put it. Intellectually you know how to deal with stuff, but emotionally you don't. I think that is true for a lot of people, including me.
All right, so if therapy does not work for you- and there are many different types and doctors- then I think what you really need is just a better medicine treatment. Then your intellect and emotions will match up again. The good news is that as you go on with these conditions, you become better equipped to deal with them. For example, panic attacks used to drive me nuts, but now I basically shrug them off!!!!!
Yeah, a jigsaw puzzle with a couple of missing parts- that's another good way to put it!
I really don't know what else to tell you about your cynicism with therapists. It sounds like I should be the pupil here and you the teacher. Maybe you should try to communicate what you need from your therapist- and I think it is positive reinforcement.
All I can say for myself is that I have found therapy to be of limited benefit. It tells me things I already know, or it makes outlandish claims.
For example, with my last pdoc, I nearly fell out of my chair. One of my troubles is that I am single and want to be unsingle. I feel like the odd guy out at my age, 35, like I have been a failure. I am conflicted about kids, too; I like em but don't think the time is right for me. So I tell my pdoc about my single woes, and she tells me I should live alone and not worry about it because being alone isn't so bad!!!
It reminded me of the time my philosophy teacher in college came up with this "brilliant" insight on death- don't be afraid of it, you already were non-existent at one point, and it wasn't so bad!!!
Unable to make me feel better with her first argument, my pdoc then said that "well, a lot of people have social problems." Yeah, that made me a feel a lot better too!!!!!
"Don't worry, you are not the only quadriplegic around..."
For this nonsense I paid $190 an hour, cash.
The sad truth is that I do not think there is much these docs can do to help me with my loneliness. They do not even seem to know where single people meet each other anymore. And actually my problem is more about being able to really connect with someone. I meet people all the time. Plus I am still getting over someone I really felt drawn to. It turned out she had a thing for guys older than her and had a hard time controlling herself in their presence, despite her boyfriend.
"Are you married? Where do you live? We both work nights, I think we'll be seeing a lot of each other at the office."
Tell me, is that what you say to another guy when you are in love with your bf?
The immune psych thing really interests me. My panic attacks began in fourth grade afer I had chicken pox. In fairness, the anxiety problems began earlier. Also, I noticed some years ago that my anxiety and depression would creep back in a bit, RIGHT BEFORE I got a virus. I feel it had to be biological, but my pdoc at the time referenced Freud and said my mom overreacted to my illnesses when I was a child, so I get nervous about them as an adult and probably do feel the virus coming on before the anxiety.
No way.
You should look into how your immune problem could affect this illness.
As for scanning, it is tough because it has two sides. On the one hand, you need to scan, but at the same time it can be a problem. I think you need to know when what you are scanning really is a problem versus when it is fantasy. Also, when you are overdoing it versus when you are giving it due diligence.
As for the example you provided, I can help- in all likelihood zoloft will work for you, although it may need another drug to help it. Also, you WILL be treated and back to normal. That you can take to the bank. Many of your thoughts stem from the disease itself, and nothing else.
Kindling effect should not scare you if you understand it. All it means is that you need to stick to your treatment and not throw your pills down the drain. It also is not a given.
Right now, I can tell that your meds are not helping like they should. My best advice is to increase the Zoloft, if possible, and to take whatever anti anxiety pill you have REGULARLY. I think you will find those anti anxiety pills to be surprisingly effective.

Oh yeah, I forgot you said you had what you consider se's from 75 mgs of zoloft. Consider going back down to 50 mg, or splitting your dosage so you take 25 mg in the morning, and 50 mg at night.
In general, you sound like someone with a low tolerance for ad's, or maybe just bad luck with the ones selected for you. Therefore, your increases should be done very gradually, 25 mg a pop, giving each dosage two weeks. Or, like I said before, try adding buspar to the mix.
BTW: Despite suffering from the kindling effect and zoloft not working like it used to, I am at least 90 percent better now, soon to be 100 percent. So there is hope.

There's always hope! Believe me when I say, it really does get better.

Wishing everyone here a peaceful weekend. to all.

-Bean

This post has been edited by Beanchop99: Today, 03:38 PM