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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 13 to 37 of 37. Go back in thread:
Posted by Phillipa on April 20, 2008, at 18:25:03
In reply to Re: Zoloft QuestionPhillipa, posted by Justherself54 on April 20, 2008, at 17:14:07
Couldn't you have gone higher and added ad ad booster maybe a mood stabalizer or now Deplin? Just suggestions. Love Phillipa
Posted by Phillipa on April 20, 2008, at 18:26:10
In reply to Re: Zoloft QuestionPhillipa, posted by Fathe on April 20, 2008, at 17:37:57
Faith poop out is a term when a med stops working for you that used to work and no longer does. Love Phillipa
Posted by Phillipa on April 20, 2008, at 18:28:45
In reply to Re: Zoloft Question, posted by bulldog2 on April 20, 2008, at 17:27:13
Bulldog oh wow must have been horrible. Have yet to have an SSRI eliminate or put a dent in my anxiety. Love Phillipa
Posted by undopaminergic on April 20, 2008, at 20:54:04
In reply to Zoloft Question, posted by bleauberry on April 19, 2008, at 20:48:00
Zoloft (sertraline) is the second most potent SSRI, after Paxil/Seroxat (paroxetine), and has a much more favourable side-effect profile and much lower potential for interactions with other drugs (only surpassed by [es]citalopram in this regard). Furthermore, it has a half-life of about 26 hours, which is suitable for once-daily dosing and titration at weekly intervals, and if you need to quit it, it doesn't stay in your bloodstream for ever like Prozac, so you don't have to wait a month before starting a MAOI. It's a clean SSRI with no known affinities for neurotransmitter receptors or non-serotonin transporters, other than a very slight potency for dopamine reuptake inhibition, which may serve to make the drug a bit more stimulating and pleasant.
It's probably the ideal drug for anyone who might benefit from a serotonergic agent. Unfortunately, I'm not one of them, although I did find it slighly wakefulness-promoting - the very opposite effect of the hypnotic paroxetine. It wasn't quite as tolerable as fluoxetine, but that is only because sertraline is a more potent serotonergic agent, which is precisely what it was meant to be.
Since Zoloft is just about the perfect serotonergic agent, and since seronergic drugs are (or were, in 2007) in vogue, why wouldn't it be the most popular? The reason why it's rarely mentioned here, is because those who come here have tried several serotonergic agents and found them all ineffective, or only briefly or partially effective.
Posted by Phillipa on April 20, 2008, at 21:05:05
In reply to Re: Zoloft Question, posted by undopaminergic on April 20, 2008, at 20:54:04
Thanks from what I understand from family no weight gain as sister went from paxil to it as she did gain a lot of weight on paxil. I myself on l0mg of paxil was quite thin on the med and that was with 4-6 beers a night. But then I was working 3-ll and probably burned more calories. Love Phillipa
Posted by Racer on April 20, 2008, at 23:41:28
In reply to Re: Zoloft Question, posted by undopaminergic on April 20, 2008, at 20:54:04
>The reason why it's rarely mentioned here, is because those who come here have tried several serotonergic agents and found them all ineffective, or only briefly or partially effective.
And/or briefly, partially effective with intolerable adverse effects...
Zoloft was the best of the SSRIs for me -- but I can't stand the flattening. I just don't feel as though I'm living, I can't care about anything, have no motivation to do anything at all, and eventually even talking is too much trouble. (That's at 25mg, too, so I can't even blame the dose being too high!)
Thank you for your analysis, it was very clear, and very informative.
Posted by Justherself54 on April 20, 2008, at 23:44:58
In reply to Re: Zoloft QuestionPhillipa » Justherself54, posted by Phillipa on April 20, 2008, at 18:25:03
At 200 my guts couldn't tolerate it and it was still pooping out. I can't tolerate mood stabilizers and I haven't asked my pdoc about Deplin as too much going on right now with withdrawals.
> Couldn't you have gone higher and added ad ad booster maybe a mood stabalizer or now Deplin? Just suggestions. Love Phillipa
Posted by Phillipa on April 21, 2008, at 12:09:51
In reply to Re: Zoloft QuestionPhillipa, posted by Justherself54 on April 20, 2008, at 23:44:58
Oh you must be from what I've read only and SSRI responder as it does effect the gut right? If it affects the gut so badly is this an indication of an ad working for you? Truly I don't know. What I do know is my heart goes out to you with the horrible withdrawl from the nardil so sorry. I did have zaps when only that tiny smidgen of paxil at l0mg was discontinued as my Son was coming to live with us and he didn't believe in ad's and wanted to please him so bit off a small piece daily and that helped anyway to do that? Love Phillipa
Posted by Phillipa on April 21, 2008, at 12:14:47
In reply to And/or... » undopaminergic, posted by Racer on April 20, 2008, at 23:41:28
Racer that is a low dose. No wonder pdocs are starting doses lower than normal for those that are med sensitive. But if I can tolerate a higher dose than you what do you think it means? That I am an SSRI responder or a nonresponder I really don't know my knowledge isn't that understanding of neurotransmitters get that SSRI's affect the gut but for some reason don't with me? Is that good or bad? Thanks Phillipa
Posted by Phillipa on April 21, 2008, at 12:17:30
In reply to Re: Zoloft QuestionPhillipa, posted by Justherself54 on April 20, 2008, at 23:44:58
Same with the lexapro? Love Phillipa
Posted by Phillipa on April 21, 2008, at 13:03:51
In reply to Re: Zoloft QuestionPhillipa » Justherself54, posted by Phillipa on April 21, 2008, at 12:09:51
Actually why I assumed it was nardil you were withdrawing from is totally wrong of me as I don't know guess it was on my mind from so many wanting me on it. Apologies. Phillipa
Posted by Phillipa on April 21, 2008, at 13:05:06
In reply to Re: Zoloft QuestionPhillipa » Phillipa, posted by Phillipa on April 21, 2008, at 13:03:51
Posted by bissie66 on April 21, 2008, at 14:29:44
In reply to Zoloft Question, posted by bleauberry on April 19, 2008, at 20:48:00
zoloft poops out for me really quickly, but i now take it for PMS, just a few days, then stop, then take it again the next month for just a few days. however, i can't take it consistently or it just poops out. weird.
Posted by LNH on April 21, 2008, at 17:14:40
In reply to Re: Zoloft Question, posted by bissie66 on April 21, 2008, at 14:29:44
I have been taking 100 mg of Zoloft for the past 5 months. I was given it as a result of my anxiety. I did notice a decrease in my anxiety while taking the Zoloft; however, the past few weeks have been worse than ever. I feel like I am in a constant fog, just going through the motions of the day. I have no emotions or sex drive. My boyfriend and friends also noticed a change in my behavior and I have become more reclussive. My doc switched me over to Lexapro in hopes of an improvement. Any advice / info about Lexapro or another option would be greatly appreciated. Thanks!
Posted by llurpsieNoodle on April 21, 2008, at 18:00:20
In reply to Re: Zoloft Question, posted by LNH on April 21, 2008, at 17:14:40
> I have been taking 100 mg of Zoloft for the past 5 months. I was given it as a result of my anxiety. I did notice a decrease in my anxiety while taking the Zoloft; however, the past few weeks have been worse than ever. I feel like I am in a constant fog, just going through the motions of the day. I have no emotions or sex drive. My boyfriend and friends also noticed a change in my behavior and I have become more reclussive. My doc switched me over to Lexapro in hopes of an improvement. Any advice / info about Lexapro or another option would be greatly appreciated. Thanks!
welcome to babble! There's a lot of information here, and you can get your questions answered by doing a search in the google box below. Like you, I've been taking zoloft for many months, and the sex drive problem was really frustrating. Many pdocs (psychopharm doctors or psychiatrists -that's the short word) will prescribe wellbutrin for this condition, (which is helping my anxiety, strangely) but since you have anxiety issues, maybe the lexapro is the way to go. Have you ever taken any benzodiazepines for anxiety? Klonopin, valium, xanax, etc.? They are very effective and have a good side effect profile. lots of pdocs are wary of prescribing them because sometimes people have a hard time getting off of them (personally I have a harder time withdrawing from antidepressants... but that's just me).
well, hope that helped a little.
Feel better soon (if only it were that easy, right? --- you ever done any psychotherapy?)
-Ll
Posted by Racer on April 21, 2008, at 22:21:31
In reply to Re: And/or... » Racer, posted by Phillipa on April 21, 2008, at 12:14:47
>No wonder pdocs are starting doses lower than normal for those that are med sensitive.
I don't consider "med sensitive" to be a helpful phrase for me. If I had no sensitivity to medications, there would be no point in taking them, since they would have no effect. In my case, it has always required fairly high doses of medications to get benefits, and I have taken high doses of SSRIs and SNRIs. Right now, though, I am not willing to tolerate some of the adverse effects I have from them. It's not about being "med sensitive," it's about setting priorities in my life.
>But if I can tolerate a higher dose than you what do you think it means? That I am an SSRI responder or a nonresponder
It means that mileage varies. Nothing more, nothing less. It probably has nothing to do with whether or not you'd respond to an adequate trial of an SSRI at a therapeutic dose. It only means that your chemistry is different from mine, that you did not experience effects which bothered you at the dose you were taking, during the time you were taking it.
>I really don't know my knowledge isn't that understanding of neurotransmitters get that SSRI's affect the gut but for some reason don't with me?
Yes, they did affect your gut. You may not have had adverse GI effects, which some other people do experience on SSRIs, but there was an effect on your gut while you took them. That is because SSRIs affect the serotonin transport system when you take them -- whether or not that comes along with any adverse effects is a separate point.
Posted by Phillipa on April 21, 2008, at 23:07:06
In reply to Re: And/or... » Phillipa, posted by Racer on April 21, 2008, at 22:21:31
So if they affected my gut is there anyway I'd know? I can take higher doses now so I guess my chemistry has changed maybe after menopause? Seriously without diarrhea, constipation, nausea, lack of appetite which I do have from for a different reason how do I know if they affect my gut no symtoms? Love Phillipa
Posted by LNH on April 22, 2008, at 7:06:06
In reply to Re: Zoloft Question » LNH, posted by llurpsieNoodle on April 21, 2008, at 18:00:20
>Like you, I've been taking zoloft for many months, and the sex drive problem was really frustrating. Many pdocs (psychopharm doctors or psychiatrists -that's the short word) will prescribe wellbutrin for this condition, (which is helping my anxiety, strangely) but since you have anxiety issues, maybe the lexapro is the way to go. Have you ever taken any benzodiazepines for anxiety? Klonopin, valium, xanax, etc.? They are very effective and have a good side effect profile. lots of pdocs are wary of prescribing them because sometimes people have a hard time getting off of them (personally I have a harder time withdrawing from antidepressants... but that's just me).
>
> well, hope that helped a little.
>
> Feel better soon (if only it were that easy, right? --- you ever done any psychotherapy?)
>
> -Ll
>
I also take Xanax as needed for anxiety, but I try to only use that when I really need it. I did some research on Wellbutrin but it seems to only work well for depression and not as much for anxiety. I am starting the Lexapro in a couple days so I guess I'll keep my fingers crossed and find something that works. Thanks for the help!Lauren
Posted by Justherself54 on April 22, 2008, at 8:37:33
In reply to Re: Zoloft Question » llurpsieNoodle, posted by LNH on April 22, 2008, at 7:06:06
> >Like you, I've been taking zoloft for many months, and the sex drive problem was really frustrating. Many pdocs (psychopharm doctors or psychiatrists -that's the short word) will prescribe wellbutrin for this condition, (which is helping my anxiety, strangely) but since you have anxiety issues, maybe the lexapro is the way to go. Have you ever taken any benzodiazepines for anxiety? Klonopin, valium, xanax, etc.? They are very effective and have a good side effect profile. lots of pdocs are wary of prescribing them because sometimes people have a hard time getting off of them (personally I have a harder time withdrawing from antidepressants... but that's just me).
> >
> > well, hope that helped a little.
> >
> > Feel better soon (if only it were that easy, right? --- you ever done any psychotherapy?)
> >
> > -Ll
> >
>
>
> I also take Xanax as needed for anxiety, but I try to only use that when I really need it. I did some research on Wellbutrin but it seems to only work well for depression and not as much for anxiety. I am starting the Lexapro in a couple days so I guess I'll keep my fingers crossed and find something that works. Thanks for the help!
>
> Lauren
>
>I hope Lexapro works for you. It worked very well for me and probably was the fastest working AD I've taken, results within a week, if memory serves and better in the sex drive department I think. Best wishes to you from me for success!!
Posted by Justherself54 on April 22, 2008, at 8:46:08
In reply to Re:so. » Racer, posted by Phillipa on April 21, 2008, at 23:07:06
> So if they affected my gut is there anyway I'd know? I can take higher doses now so I guess my chemistry has changed maybe after menopause? Seriously without diarrhea, constipation, nausea, lack of appetite which I do have from for a different reason how do I know if they affect my gut no symtoms? Love Phillipa
When I said it affected my gut at 200 mg, I guess what I should have said was it affected my bowels where I almost wasn't making it to the bathroom..but dosages under 200 didn't have that effect. I have IBS and diverticulitis and couldn't tolerate it at 200...not that I didn't give it a couple of weeks to see if it would abate, and by then it was clear it had pooped out on me (pun intended).
Posted by Justherself54 on April 22, 2008, at 8:55:56
In reply to Re: And/or... » Phillipa, posted by Racer on April 21, 2008, at 22:21:31
I think med sensitive is just a common term. I used to say that but I think now I'm going with the term "side effect sensitive" as all AD's I've taken have done something...some side effects have been really bad and some have been tolerable. I'd type more but my morning java hasn't guite powered in yet! So here's to all the meds that make me poop and then poop out on me! (hangs head at bad joke :-P).
> >No wonder pdocs are starting doses lower than normal for those that are med sensitive.
>
> I don't consider "med sensitive" to be a helpful phrase for me. If I had no sensitivity to medications, there would be no point in taking them, since they would have no effect. In my case, it has always required fairly high doses of medications to get benefits, and I have taken high doses of SSRIs and SNRIs. Right now, though, I am not willing to tolerate some of the adverse effects I have from them. It's not about being "med sensitive," it's about setting priorities in my life.
>
> >But if I can tolerate a higher dose than you what do you think it means? That I am an SSRI responder or a nonresponder
>
> It means that mileage varies. Nothing more, nothing less. It probably has nothing to do with whether or not you'd respond to an adequate trial of an SSRI at a therapeutic dose. It only means that your chemistry is different from mine, that you did not experience effects which bothered you at the dose you were taking, during the time you were taking it.
>
>
>
> >I really don't know my knowledge isn't that understanding of neurotransmitters get that SSRI's affect the gut but for some reason don't with me?
>
> Yes, they did affect your gut. You may not have had adverse GI effects, which some other people do experience on SSRIs, but there was an effect on your gut while you took them. That is because SSRIs affect the serotonin transport system when you take them -- whether or not that comes along with any adverse effects is a separate point.
Posted by undopaminergic on April 22, 2008, at 23:17:20
In reply to And/or... » undopaminergic, posted by Racer on April 20, 2008, at 23:41:28
>
> Zoloft was the best of the SSRIs for me -- but I can't stand the flattening. I just don't feel as though I'm living, I can't care about anything, have no motivation to do anything at all, and eventually even talking is too much trouble.
>That's what I'm normally like, and it was particularly bad around the time that I started Zoloft, when I was spending minutes (up to 15-30 perhaps) at a time doing nothing but staring blankly at nothing and thinking about nothing. The situation improved slightly after starting the Zoloft, but that could be a coincidence, as I found the first few days to be better than the rest of time I took the drug, at up to 200 mg. The absence of any significant improvement, in combination with the gastrointestinal side effects, was the reason I gave up on it (there were also other effects that I regarded as neutral or positive that many would regard as frustrating or intolerable).
Posted by Phillipa on April 22, 2008, at 23:34:16
In reply to Re: And/or..., posted by undopaminergic on April 22, 2008, at 23:17:20
Like what? Love Phillipa
Posted by undopaminergic on April 22, 2008, at 23:49:08
In reply to Re: And/or... » undopaminergic, posted by Phillipa on April 22, 2008, at 23:34:16
> Like what? Love Phillipa
Emotionally flattened, don't care about anything, no motivation for doing anything, etc. Just enough to get out of bed, eat, and kill time reading about drugs and stuff on the Internet and posting a few messages here or elsewhere. The main reason why I have the energy for that is that I'm taking modafinil and methylphenidate. Otherwise, I would be sleeping (and maybe eating) a lot more.
Posted by zatar on April 24, 2008, at 10:02:11
In reply to Zoloft Question, posted by bleauberry on April 19, 2008, at 20:48:00
My daughter does much better on Zoloft compared to Lexapro or Celexa. I think because it targets dopamine more.
Depends on the person... I think one day we'll see many subtypes for depression, anxiety, etc.
-zatar
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