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elisaac2629

Gets Worse Before It Gets Better

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Posted (edited)

Hello everyone,

I'm new to this forum and I absolutely love it. Reading through these posts have helped me realize quite a bit.

A little background. I was diagnosed with panic disorder in 2001. It got better after that and then got bad again after having first child in 2005. I was finally convinced to start on medication. They started me on Lexapro. The first week that I remember WAS pretty difficult...with heightened anxiety and I call them flash panic attacks. It would hit me fast but then it would go away just as fast. So I took that for 3 years and I feel that it practically saved my life. I found out I was pregnant in 2008 and was slowly weaned off of Lexapro in my last trimester. I did fine with everything after that until a few months after second child was born. Went through A LOT but too long for this forum. Another story another time. I asked my OB to put me on Zoloft because it showed to be the safest while breastfeeding. I started on 25 mg and he told me to titrate up and go see my doctor but I never did go up. I just suffered with mild anxiety and so on. Then, I had some gallbladder problems and had to have emergency surgery. After surgery, I went into a fullblown panic attack. Not sure why...just overwhelmed I guess. So then I told the internist doctor there if I could go ahead and switch back to Lexapro. So, he told me since I was on a such a low dose of Zoloft to just quit that and start on Lexapro right away. Boy, was he wrong. I went through withdrawal and side effects of restarting Lexapro for a couple of weeks. I toughed it out and it finally evened out for me. Well, it worked for the most part on anxiety but I guess I grew a tolerance to the 10 mg that I was on before and that just wasnt' working for me anymore. I knew that if I told my doc, they would just increase my dose. I would have been ok with the increase in dosage but I was afraid of gaining more weight (40 lbs since starting Lexapro) and my blood pressure getting higher. So, this past Christmas break I slowly weaned myself off of it and seemed to do fine. BUT, I was also going through a strict diet change that eliminated all sugars and that is when the depressive feelings started hitting me. Again, I toughed it out and dealt with occasional anxiety and panic but after taking a vacation and experiencing panic on a plane and a boat, I decided it was time to get on meds again. So here I am again, but this time trying Zoloft again.

This is my 13th day on Zoloft. I was put on a week of 25 mg and then went up to 50 mg 4 days ago. The GI side effects are yucky but I have been able to bear through knowing that hopefully they will go away soon. I also am experiencing insomnia, which is just strange to me because I take my Zoloft at night and it does seem to make me drowsy. I also have dry mouth and tingling sensations in my legs..occasionally. The first couple of days were ok but then it got a little worse with heightened anxiety for the next couple of days. Then, the day before i am supposed to up my dosage, I start feeling pretty good but I up my dose anyways. So, a rollercoaster again...heightened anxiety, nausea, GI upset, sweating blah, blah, blah. But then yesterday, I started experiencing some scary feelings of helplessness, worthlessness, no desire. The same feelings I was getting on my diet. My anxiety does seem to be getting better but these feelings are a little scary. So, my question to all of you is....did any of you have a worsening of depression before it got better? I had never experienced depression before this. Not even after I had my children. I know that some of you are going to say that I need to talk to my doctor about this...which I will but I'm also looking for some input. I am barely at 50mg and I'm scheduled to see my doc in a week. I'm just wondering if anyone has experienced this and went away at some point. I would really rather wait to see if this small dose works rather than asking for a higher dose or adding another medication. I think I should give this dose another week or two.

Again, glad to meet you all and am excited to be a part of this forum.

Jess

Edited by elisaac2629
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Posted

Hi,

I am on 100 of zoloft along with abilify and I

remember when I increased from 50 to 100mg

I had anxiety and insomnia for a couple of

weeks but no depression. I dont think it is

uncommon though for your depression to

get worse before it starts getting better. Of

course your doctor should know this but

I hope you can hang in there. For me, Zoloft

has worked better than any med I have ever

taken for my depression/anxiety with the

least side effects. I hope you feel better

soon,

best wishes,

starr

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Posted (edited)

hi elisaac2629,

i'm on lexapro 20 mg. i started with 10 mg 4 yrs ago and my doc. increased it last month. i thought an increase would NOT make me suffer as much but i was wrong. i suffered the increase start ups that were as bad (probably worse) than starting 10 mg.

you found lexapro made you gain weight -- which is why you wish to try zoloft. zoloft might do the same thing (then it might not -- people react differently)

but yes, the start ups are horrible and you will have to suffer them. i'd suggest you suffer at the recommended dose instead of titrating up: for my personal experience suggests that any increase of dose makes you go through the mill all over.

and to answer your question, i got introduced to severe depression during start ups (was never familiar with them before). but peace and tranqulity descended on me after 3 weeks.

may i ask what other meds. are you taking? (esp. benzodiazapines)

Edited by Rahul
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Posted

hi elisaac2629,

i'm on lexapro 20 mg. i started with 10 mg 4 yrs ago and my doc. increased it last month. i thought an increase would NOT make me suffer as much but i was wrong. i suffered the increase start ups that were as bad (probably worse) than starting 10 mg.

you found lexapro made you gain weight -- which is why you wish to try zoloft. zoloft might do the same thing (then it might not -- people react differently)

but yes, the start ups are horrible and you will have to suffer them. i'd suggest you suffer at the recommended dose instead of titrating up: for my personal experience suggests that any increase of dose makes you go through the mill all over.

and to answer your question, i got introduced to severe depression during start ups (was never familiar with them before). but peace and tranqulity descended on me after 3 weeks.

may i ask what other meds. are you taking? (esp. benzodiazapines)

Hi Rahul,

Thanks for your feedback. I really wanted to try another antidepressant first instead of titrating up on Lexapro also because of my blood pressure. When I was on Lexapro, I was also put on Bystolic because of the high blood pressure. Now, off of it, my blood pressure is between normal and borderline...which is probably my anxiety causing that. I also do realize that I may gain weight with Zoloft, but again who knows. I've already lost weight actually since starting it (because of the nausea and loss of appetite). I guess just time will tell.

To answer your question, I also take Xanax as needed. I usually only have to take it when I know I'm on the verge of a panic attack (which I haven't been in a few days) or when the anxiety is just too high to handle. And actually, I take a VERY small dose of Xanax and it still works pretty well for me. I take 1/4 tablet of a 0.25 mg tablet! :yay: I'm just so glad to hear that you went through the same depressive feelings while increasing your dose. I don't feel so alone. I just don't know how to explain it. For a few minutes I feel really hopeless and then the next I feel like my head is shaking all over the place (only in my mind) like I'm going to explode :taz: . Its just really annoying to me. I would almost describe it as manic but I don't want to scare everybody and then telling me to switch medications. I want to give this a chance while I can. I hate starting all over when all I had to do was to wait just a little bit longer. :sigh:

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Posted (edited)

hi elisaac2629,

i take BP medicine and had initially started taking zoloft 4 years ago. i was not acquainted with the start up (severe depression) and i thought i was going nuts and after 4 days quit the med. thinking it wasn't working. after another 4 days of suffering, i switched docs. by this time i had familiarized myself with the start up syndrome through this forum. the new doc. made me switch from zoloft to lexapro for zoloft increases BP. you can google it. so once you are stabilized on zoloft, you might want to check your BP and adjust or start a BP med. it might be that in general, SSRIs increase BP and only zoloft has been targetted in studies. however, i have not had to increase my BP med. on lexapro. again, different people react differently.

benzos like xanax prove to be counter productive in the long run (they exacerbate the symptoms you take them to treat). you are doing the right thing by limiting their use to a SOS/emergency basis (and in such use they do wonders). but then again, 1/4th of 0.25 mg xanax? . :shocked: lol. that's almost a placebo. i'm glad it works for you -- avoid increasing it if you can.

hugs to you. i am sorry you are having to go through nasty start ups (it's hard) but you'll be out of the woods soon. :)

Edited by Rahul

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Just wanted to give an update on my Zoloft startup. So I was on 25 mg for a week, then 50 for another week. At the end of the second week, right before Easter, my husband wanted to get away for the weekend and so we packed up and left. About 20 minutes into the drive, my hands started numbing up, I started panicking, and then a full fledged panic attack with hyperventilation hit me. It was so bad that my arms and legs started cramping up and feeling numb and my whole face was twitching. I took my Xanax as fast as I could but begged my husband to pull over and call 911. I held on to his arm and tried to really relax while he called. They picked up started talking to him and then I started to finally relax. The dispatcher was very friendly and helped to calm me down. I called my doc that night and she upped my dose to 75 mg. I have since been on 75 mg for 4 days. I know that I want to keep up withy the Zoloft but still so worried about the break through and startup anxiety. I have been waking up with horrid an anxiety and so worried that it might get worse like it did this weekend. My experience with lex was not like this and did not seem to take as long. Does it usually take Zoloft longer to work? Do any of u think that this anxiety and panic will subside sometime soon after going up to 75 mg? I'm losing all hope that it's not the right med for me. I really want it to be.

P.s. started Zoloft on march 22

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Posted

Ahhh...my skin feels like its crawling from the inside today. I'm really trying not to take a Xanax but its a little difficult while I'm at work. I'm trying to keep them for emergency panic only. Maybe no one will answer on this post but I'm just trying to keep it active to be able to log how I've been doing on Zoloft. Today is day 21 on Zoloft but only 5 days on 75 mg dosage. I HATE this worsening anxiety. I DO NOT remember feeling this way on Lexapro but I am determined that Zoloft will start working on the anxiety soon. It is SO hard coming to work feeling like this. :sadwalk: I feel like its just so much worse than before I started on Zoloft. But I heard its pretty common to feel that way, right?

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Posted

yes, every time you increase your dose, you go through the same intense start ups (at least it is true for me). you are 5 days into a dose increase -- no wonder your anxiety has increased.

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Posted

Thanks Rahul,

I can always count on you to answer me back and help me feel better. Have you ever been on Zoloft? Does it take longer to feel better on Zoloft than Lexapro?

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Posted

Hi,

I have been on zoloft successfully for over

6 years now and when I increased my dosage

I had some anixety and insomnia which usually

went away after a couple of weeks. For me it

was worth it to tough it out during the side effects

for the benefit I received in the end. My pdoc gave

me Xanax to help in the meantime and I used it

as needed. I hope your anixety goes away and

you start to feel better soon. My pdoc also gave

me with the zoloft a mood stabilizer (neurontin)

which helps with anxiety and sleep.

best wishes,

starr

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Posted (edited)

elisaac,

i was on zoloft for only 4 days and my doc. switched me to lexapro because i was taking BP meds.

from what i have read, lexapro is the fastest acting ssri. so, unfortunately, it might take you a week more than it does for you on lexapro.

you are suffering dose increase heightened anxiety right now i feel. it should alleviate in a couple of weeks. benzos help during start ups.

when i increased my lex dose from 10 mg to 20 mg in end feb'12 (after having been on 10 mg for 4 yrs.), i thought i wouldn't have any start ups. boy, was i wrong! for 4 days, after increasing my dose to 20 mg, i was OK and was chuckling to myself that start ups are only for those who start, not for those who up their dose. day 5 i got slammed. the start ups were worse than the previous time but i got relief after exactly the same duration. look back and try to remember how long lex took for you to kick in. add a week to it for zoloft.

Edited by Rahul
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Posted

Just a quick update. Its been about 4 weeks on sertraline. Although, I have been on 75 mg for about a week and a half. I saw my doc last week and told her everything. She tried to see if I wanted to change meds since it was taking so long and I told her that I am determined to stick it out. I want to give it time before I feel like I need to switch. So anyways, she said that while I was waiting, that she would prescribe Klonopin for a couple of weeks. Well, being that I am paranoid about new meds I was scared to start another one but I did finally that night. I only took 1/4 tablet to see how that worked. Didn't do too much difference, just helped me sleep a little bit. I actually had a nocturnal panic attack that night though. Didn't last too long and I didn't have to take Xanax. Took another 1/4 tablet the next night also and I was extremely nervous about the next day because we were scheduled to drive for 8 hour drive to Houston to my son's doctor appointment. Well, so I took a Xanax before we left. I was a little anxious at the beginning but it dissipated by the end. While in Houston that night I thought I would go ahead and take half a tablet. The next morning went pretty well. I woke up a little shaky but it went away after awhile. Anybody experience this when first taking Klonopin? The Klonopin seemed to last for most of the morning and mid-afternoon but by the afternoon, I had to take a Xanax. I think I was probably just overtired and overwhelmed with the waiting times at the doctor's offices. So since then, I've been taking half the 0.5 mg dose of clonazepam nightly. Now, I don't know if it is the benzo or the sertraline finally working but I am starting to feel slightly better. It seems that most of the mornings have been better (prob bc the Klonopin is still in my system) and then sometimes it gets a little worse as the day goes by but not to where I can't manage. I haven't had to take any emergency Xanax in about 3 days. I'm actually proud of myself. Anxious thoughts and panic seem to be there and hiding in the shadows but seems to be a little easier to manage. The problem now is that I'm not sure if the Zoloft is helping me or if its the Klonopin just making it manageable? My doc told me to stop the Klonopin after 2 weeks. Its been about a week and now of course I'm scared to stop the Klonopin in case I have some breakthrough panic. I hate this waiting game! Its the worst. Anyone feel any better at 4 weeks on Zoloft? How much longer? My doc told me that if nothing by 6 weeks, then we should talk again. I really hope its at least starting to work.... I really need some motivation. Its so hard coming to work, being afraid to be alone, blah, blah, blah.

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Posted (edited)

hi elisaac,

i can totally relate to your confusion. but you were taking 1/4th of 0.25 mg xanax and are now up to 0.5 mg klonopin? klonopin is actually better than xanax for it has a longer half life (translating to longer effect) and is a newer benzo (latest). i'm surprised and eager to learn why and how you climbed up the ladder so fast.

4 weeks is a long time to be on zoloft. but you are still not on a therapeutic dose (by popular reckoning, viz. 100 mg) and you have not had to add xanax to your klonopin for the last 3 days. my personal advice would be to go up to the therapeutic dose and give it 2 weeks before you or your doc contemplate an alternative (and you know there are many).

it is difficult to say if the benzo is helping you right now or the ssri. i'd put my money on the ssri though. that you have not needed xanax for the last three days is a wonder. but, still, you might have to need xanax again -- with ssris and gradual titrating up, everything is not necessarily linear.

Edited by Rahul
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Posted

6 days on Zoloft 50mg and due to change to 100 tomorrow. Minimal side effects but work up this morning extremely anxious and jittery. Could this be anticipation of increasing the dosage tomorrow? Should I wait a few days? Don't know what to do.

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Posted

I'm not sure whether "replying" here or starting a new, but here looks as good as anyplace to start. I've had panic attacks off and on for about ten years. Sometimes it's years before I have one. The last two years, they have been occurring regularly. I would take xanax .25 (1/2) when needed. End of last year I was getting them daily. My Dr. sent me to a therapist and she suggested I talk to my Dr. about an anti depressant to help with "seasonal" depression and my panic attacks. He gave me generic Soloft 50mg. I took one dose and thought I was going to die, my panic attack was sooo extreme. I had to take 3 xanax to get myself under control. That is 6 times what I would normally need! I never took another zoloft.

Anyway, about a month ago I was feeling better, my therapist deemed me "cured" for the most part, but now it's creeping up on me again, both depression and anxiety.My question is this: Would it be better to start at a lower 12.5 or 25mg of Zoloft to start? I don't know if I'm just super-sensitive or if it's just not for me? Any input is welcome. Thank you. :cat_jumps:

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Posted

I'm not sure whether "replying" here or starting a new, but here looks as good as anyplace to start. I've had panic attacks off and on for about ten years. Sometimes it's years before I have one. The last two years, they have been occurring regularly. I would take xanax .25 (1/2) when needed. End of last year I was getting them daily. My Dr. sent me to a therapist and she suggested I talk to my Dr. about an anti depressant to help with "seasonal" depression and my panic attacks. He gave me generic Soloft 50mg. I took one dose and thought I was going to die, my panic attack was sooo extreme. I had to take 3 xanax to get myself under control. That is 6 times what I would normally need! I never took another zoloft.

Anyway, about a month ago I was feeling better, my therapist deemed me "cured" for the most part, but now it's creeping up on me again, both depression and anxiety.My question is this: Would it be better to start at a lower 12.5 or 25mg of Zoloft to start? I don't know if I'm just super-sensitive or if it's just not for me? Any input is welcome. Thank you. :cat_jumps:

Hi AA1977

I would say that Zoloft is a good med to start with for your panic disorder. I don't like the start up side effects but who does? Lexapro was actually a whole lot faster at working but I gained so much weight on it. Now, I'm trying Zoloft. I'm sorry you had a panic attack after taking your first Zoloft. Believe it or not, I did too, but I started at 25 mg. The 25 mg dose is the usual starting place for people with panic disorder. I think starting at 50 mg was too high. I've been on it for 4 weeks now. My doc put me on Klonopin since I was having a hard time with the heightened anxiety and panic that occurs after starting any SSRI. Granted, I have been on it for 4 weeks but the reason I think Zoloft is much slower at getting better is because you have to titrate the doses up slowly and that in turn causes you to kind of back track back into the startup side effects (nausea, GI upset, anxiety, panic). So anyways, I take my Zoloft at night because it tends to make me a little drowsy. I did actually wake up with a nocturnal panic attack that night, and nocturnal ones seem to be stronger, but it dissipated kind of quickly without me having to take my Xanax. Don't worry, you are definitely not the only one that is super sensitive. I am too! So sensitive that I only take 1/4 tablet of a 0.25 Xanax when I have a panic attack. People tell me that it might just be a placebo effect but I really don't think it is. It really helps after a couple of minutes and breathing exercises. After 4 weeks on Zoloft, I am still waiting for this med to really "kick" in. If you want to try it again, you might ask your therapist about Klonopin to tide you over the first couple or maybe a few more weeks. I only take it at night (1/2 tab of 0.5 mg) and it has tremendously helped but it seems to also help until I wake up without having so much morning anxiety (probably from Zoloft). I was so hesitant to start taking the Klonopin but I can tell you that it has really helped me actually get to work without being so worried about having an attack at work. Coming to work and being by myself are big triggers for me. Anyways, I hope that you give Zoloft another try or maybe you can try another like Lexapro. Lexapro had less startup side effects for me but it caused me weight gain in the long run. Everyone is different so it may not cause you weight gain. Doesn't hurt to try. I wish you luck and keep us posted.

Jess

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Posted

hi elisaac,

i can totally relate to your confusion. but you were taking 1/4th of 0.25 mg xanax and are now up to 0.5 mg klonopin? klonopin is actually better than xanax for it has a longer half life (translating to longer effect) and is a newer benzo (latest). i'm surprised and eager to learn why and how you climbed up the ladder so fast.

4 weeks is a long time to be on zoloft. but you are still not on a therapeutic dose (by popular reckoning, viz. 100 mg) and you have not had to add xanax to your klonopin for the last 3 days. my personal advice would be to go up to the therapeutic dose and give it 2 weeks before you or your doc contemplate an alternative (and you know there are many).

it is difficult to say if the benzo is helping you right now or the ssri. i'd put my money on the ssri though. that you have not needed xanax for the last three days is a wonder. but, still, you might have to need xanax again -- with ssris and gradual titrating up, everything is not necessarily linear.

Thanks Rahul,

I took 1/4 of the 0.5 Klonopin and it didn't seem to do much except help me get to sleep so that is why I finally tried the half tablet of 0.5 mg. I'm not up to the whole tablet yet and I may not even get there. I'm hoping the Zoloft is working and I won't need the Klonopin for much longer. I can tell that for the most part, the Klonopin helps the morning anxiety, because by about mid-afternoon I get the nausea and tingly feelings in the my chest. It hasn't been too bad so I avoid taking Xanax unless I really start panicking. Sometimes I just keep myself busy and the tinglies seem to disappear slowly.

When I was talking to my doc about Zoloft and my therapeutic dose, she said that most people with panic disorder will do well at 50 mg. So, I think that I'm either going to stay where I am at for a period longer or my next step is a step forward to 100 mg or step back to 50 mg. She seemed to agree that I could stay at 75 mg until I felt that I could move forward, so I guess we'll see. Just a rollercoaster it seems. :help:

Jess

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Posted

I've been waking up with the morning anxiety without any medication. So I was yes, considering cutting the tablet or even quartering to start off. I know I need to do something :flirt:

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Posted

I am really nervous about increasing my med (Zoloft) from 50 to 100mg tomorrow. think I will try 50 in the am and 50 in the pm instead of 100 all at once. Does this make sense?

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Posted

Hi Bolomom,

I stayed on 50 the entire time I took Zoloft. Do you feel better on 50 or do you feel you need to increase it? I do understand trying to even out the dosage a bit, and I'd be sure to take it about 20 minutes after you've eaten and drink a lot of water. Good luck to you! MaddieLouise

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Posted (edited)

When I was talking to my doc about Zoloft and my therapeutic dose, she said that most people with panic disorder will do well at 50 mg. So, I think that I'm either going to stay where I am at for a period longer or my next step is a step forward to 100 mg or step back to 50 mg. She seemed to agree that I could stay at 75 mg until I felt that I could move forward, so I guess we'll see. Just a rollercoaster it seems. :help:

Jess

ya, your pdoc is probably right. stick with 75 mg for some more time. 6 weeks as the doc. says. 2 more weeks to go. i'm sorry you are having to struggle. {{jess}}

Edited by Rahul

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Posted

I am happy to report that I have 25mg on board over the course of 16 hours and have no problems. I slept fine after the first 12.5 and am well tolerating the 12.5mg from this morning. Obviously a 50 mg start dose is too high for me.

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I am happy to report that I have 25mg on board over the course of 16 hours and have no problems. I slept fine after the first 12.5 and am well tolerating the 12.5mg from this morning. Obviously a 50 mg start dose is too high for me.

That's great! Prayers that you can stick it out for its full benefit.

Jess

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Posted

After a week of 50mg Zoloft, I went to 100 today and can really tell the difference. I feel pretty energetic, able to concentrate, no side effects, and so far no anxiety. Can this be possible, after only one week? Sure hope it continues.

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Posted

ever since friday i've been takeing 50 mg of zoloft

all im really sad about is being unable to go to school cause i cant keep food down

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