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Author Topic: should i up my zoloft from 50 to 75 mg?  (Read 1315 times)

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Offline livelaughlove

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should i up my zoloft from 50 to 75 mg?
« on: February 19, 2013, 04:45:36 AM »
So I am thinking of upping my zoloft dose but haven't talked to doctor yet about it. I was on zoloft 50 mg for nearly 10 years, had no problems, felt really good, so then i went off of it. I was on zoloft for anxiety, no depression. I am back on zoloft 50 mg, i guess it's been about 7 weeks that I have been on it. The initial starting back up of it was tough, but now i am totally adjusted to it. However, I still feel a slight bit of anxiety and worry about stupid stuff that is not realistic (and I know that) so therefore, I wonder if i should up it to 75 mg. For example, I have this semi-fear of not feeling good, and how will I make through the day if I don't feel good ( I have a lot of digestive issues). I kind of get scared of food, I know that sounds stupid. But I get scared that I will eat something that will make me feel nauseous or have diarrhea. I am not anorexic or bulimic or anything. I have just been through a lot this past year with digestive issues, most recently, the norovirus, where i vomited 12 times and had diarrhea about 15 times, and that was awful. So I am contemplating upping my dose. But if I up the dose, I don't want it to take me back to that initial 3 week awful period I went through when i first started taking zoloft again about 7 weeks ago. So i guess i would like some feedback from everyone, like, when you upped your dose, did you feel better? Or did you feel worse before you felt better? I just don't understand why all of a sudden I have this anxiety? I can't think of anything in my life that gives me anxiety other than fear of not feeling good, which is silly to me. Suggestions, please!!!!
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Offline insights

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Re: should i up my zoloft from 50 to 75 mg?
« Reply #1 on: February 19, 2013, 05:45:12 AM »
I just don't understand why all of a sudden I have this anxiety?

Probably because your stress level exceeds the ability of the small Zoloft dose to control it. 50mg is the minimum therapeutic dose. Most people need 100-150mg to get good anxiety control. The fact you did well on 50mg in the past is immaterial. It has becoming increasingly clear than the more often antidepressants (ADs) are discontinued and restarted the less effective they become, requiring progressively higher doses each time to achieve the same result. One study found the odds of achieving any response dropped by 19.9% each time ADs were stopped and restarted (Amsterdam JD, 2009).

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline Momoizkool

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Re: should i up my zoloft from 50 to 75 mg?
« Reply #2 on: February 19, 2013, 12:07:18 PM »
Have you upped the dose yet? I feel we are in a bit of the same boat but I didnt stop taking the zoloft I just increased it. To this day am struggling on what I should do. Because My anxiety has been so high sence I last upped my dose from 75 to 100 and I got through the 3 weeks of crappy anxiety crying all the time blah blah and I dont know if I should up my dose or not or if it is just no longer working for me. I was on 50 for about 3 years then 75 and recently about 9 weeks ago 100 and still dont feel like i did when i first started on 50. Or are you still on 50? Just trying to compare some notes maybe we can help each other some way!  :angel-smiley-006:
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Offline angoli

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Re: should i up my zoloft from 50 to 75 mg?
« Reply #3 on: February 19, 2013, 06:58:05 PM »
I'm tagging along here cause I could have written this post myself.  Started on 25mg, upped to 50.  Been on it for probably 3 weeks or so.  Recently started having anxiety again, thinking stupid stuff that I know is totally irrational.  I'm feeling depressed that I am still having anxiety.  This is a vicious cycle.  Trying to get back to my doc but the kids are off school this week so I have to wait til next week.  Any advice will help. 
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Offline insights

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Re: should i up my zoloft from 50 to 75 mg?
« Reply #4 on: February 19, 2013, 07:22:40 PM »
Trying to get back to my doc but the kids are off school this week so I have to wait til next week.  Any advice will help.

Take time to play with your kids. Exercise is good for anxiety and they will keep your mind occupied and not ruminating.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline laineyk

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Re: should i up my zoloft from 50 to 75 mg?
« Reply #5 on: February 19, 2013, 07:38:58 PM »
 I am in the same boat except that if 50 is not working for you after 7 weeks I would wait a little bit longer before increasing, how long werer you off of it? Just understand that if you increase & that doesnt work you have that much farther to wean off

I am sticking to 50mgs for at least 8 weeks (im on day 5) and then will consider what to do next. I really want off this poison because it has made me so sick after the w/d    getting back on has been HELL
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Offline livelaughlove

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Re: should i up my zoloft from 50 to 75 mg?
« Reply #6 on: February 19, 2013, 08:32:20 PM »
Hi Everyone! well, it is working, but just not as good as it used to work. This is really frustrating to me. What's really frustrating to me, is that I can't pinpoint a specific worry or reason. I don't really feel like I worry or that I have social anxiety or anything like that at this point, I just feel a little bored with life. Same old routine. Nothing challenging. No time to do anything fun. The only real anxiety i get is when i don't feel good, and it always seems to be food related. So that worries me a little, but nothing major. Nobody even realizes I have anxiety. I am very outgoing, very friendly, and warm-spirited. If they only knew. I was on zoloft 50 mg for about 10 years (prior to that it was because i had several panic attacks at night for no reason). Then in october i started getting these strange sensations, always food related, where i would feel like i was getting a hot flash or something (im too young for menopause). So then i wondered if it was the zoloft because no doctor could give me an answer. ALso, i felt like i didn't even need zoloft. So i stopped taking it, but weaned off too fast and had withdrawal. So then after about 5-6 weeks of not being on it i went back on it again. I just couldn't take the extreme nausea, weight loss, and diarrhea any longer. So then i had it even more so the first 2 weeks i went back on it. Now, im just back to my normal digestive problems, which i can't get an answer for. Oh, and i still get those weird hot flash feelings and it is always food/beverage related. THese weird hot flash type feelings i have been getting since october, they are my only source of worry, because i don't feel good when i get them. So from typing this, i just realized that is what is giving me anxiety, is that annoying hot flash type feeling i get (which is not very often). So that is the only thing bothering me. Even more so, is that i can't get an explanation from any doctor, and I have had several tests come back irregular but with no specific diagnosis, such as WBCs in stool but negative for infection, duodenal lymphocytosis but negative H pylori, negative celiac, oh and my RBCs are irregular (poikilocytosis and ovalocytes) but I'm not anemic. Rheumatoid factor elevated but they don't think i have signs of RA so that was dropped. It's just very frustrating because a lot of times I just don't feel good and "walk it off" but it is very draining. ANd i would like to have a drink like once a month but that gives me horrible hot flashes so that kind of bums me out. I was totally fine until october hit for some reason. Ever since then, it's just been downhill. ANd since i cant get an answer from any doctor, i have had to go against my gut instinct and think "well maybe it is health-related anxiety causing irregular test results... even though that's not what i truly believe... but i can't get an answer... so i kind of give up. I just want to feel like how i felt before october hit.
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Offline livelaughlove

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Re: should i up my zoloft from 50 to 75 mg?
« Reply #7 on: February 19, 2013, 08:36:50 PM »
but anyway... I'm just gonna stay on 50 mg at least until the end of the 8 week point. Hopefully I won't have to increase it. I don't like to take any medicine if I can work things out on my own. So I'll post what happens next!
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Offline insights

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Re: should i up my zoloft from 50 to 75 mg?
« Reply #8 on: February 19, 2013, 11:23:54 PM »
Even more so, is that i can't get an explanation from any doctor,

IMHO,  your GI problems being caused by anxiety/stress. Once you get the anxiety under control I'm sure you'll find they'll also clear up. The entire GI tract is controlled by its own brain, the enteric nervous system, which links directly to the main one in the head and when the latter is affected by stress, so is the ENS.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline WyattsMomma

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Re: should i up my zoloft from 50 to 75 mg?
« Reply #9 on: February 20, 2013, 03:46:10 AM »
Just upped mine from 50mg to 100mg, and let me tell you it helped me out soooooo much! I was about to give up on it, but once the higher dose kicked in, I have felt much less anxious.
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Offline livelaughlove

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Re: should i up my zoloft from 50 to 75 mg?
« Reply #10 on: February 20, 2013, 06:00:20 AM »
Ian, thank you for that very informative article. How do you know all this stuff? That's funny that you posted that because that is what my GI doc said... that i have diarrhea-predominant irritable bowel syndrome (but i never get constipation ever)... so it's prob just a motility issue. And yes, I do believe that stress and anxiety cause major gastrointestinal issues. When i had my colonoscopy, the procedure was deemed rather difficult, because my large bowel (colon) was so rigid that they had to apply a lot of abdominal pressure and readjustment of position to get the scope to the cecum. ANd that is when i was under propofol (sedated) so if my colon is that rigid when i am knocked out, no wonder why i have problems! I never had gastro issues until when i had amebiasis back in 2009 from vacation to florida... so possibly post-infectious IBS. I think it altered something in my flora. I have to ask your input on this Ian. End of december i had this bad head cold (but negative for flu). Then the head cold stopped. Then i had loose yellow stool for about 3 weeks with lots of mucus in it. Sometimes, i would just pass mucus and no stool. During this time period, that's when i was readjusting to being back on the zoloft. Also, during this time period, i had CBC with differential and my atypical lymphocytes were high at 5% (they should be zero). Mono test was negative (i had EBV when i was in high school). My segs were slightly high (neutrophils). Everything else was normal, the whole rest of my CBC, CMP, LFTs, thyroid function. During this time period is when i had my stool tested and it was positive WBCs but only 1+ (so that means 25%). Also during this time period is when i had my rheumatoid factor tested and it was slightly elevated. Also during that time period i was having bad joint pains in my large joints only (floating ribs, bilateral knees, and bilateral hips). So the doctor said i prob just had a self-limiting viral infection. What i have read in the medical literature is that if the range of atypical lymph is 5%, that is indicative of toxoplasmosis, parasitic infection, babesiosis, stuff like that. If it is greater than 10% that usually means mono from either EBV or cytolomegalovirus or HIV or hepatitis ( i do not have hepatitis or HIV). Also, adenovirus can cause this. So i wonder if that I was just having such a tough time because of the going off zoloft, then going back on it, then i had caught a viral thing... and all that together, which was just bad timing, made my results abnormal. Do you think zoloft can do that? Most recently, i had what was probably norovirus about  a week ago but am all better now. That was brutal. For about 24 hours... fever of 101, i threw up around 12 times, and had straight watery diarrhea about 15 times. But it was only for like about 24 hours. I work in a hospital in a GI practice so I'm always around germs and stuff. I wash my hands all the time and am very careful... but you can't help when people are coming in sick and they cough and sneeze right in your face! Ewwww! I do have to say we have a new company in clinical trial... they are doing PCR DNA stool tests to check for H pylori and like 20 other pathogens (because biopsy of EGD can sometimes miss H pylori, but DNA in stool will pick it up) so i volunteered to  send in a sample (cause its for free) and i will get my results today, so i will post my results. They are especially interested in me... because i had duodenal lymphocytosis with mild crypt hyperplasia (that finding is rare, it only is found in like 4% of biopsy results, and can be indicative of many things including H pylori and celiac, but H pylori was negative by biopsy and celiac bloodwork was negative as i had DNA test and i do not carry the celiac genes, DQ2 and DQ8). So they are interested in my case because i could be one of the people that actually might have H pylori but biopsy missed it for one reason or another, and that is what caused the increase in duodenal IELs. Very interesting to me! And if that is the case, no big deal, you just take an antibiotic regimen to eradicate the bacterium. And if that test is negative, then yes, i do believe it;s just irritable bowel due to anxiety issues and no further testing is warranted. What do you think???
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Offline insights

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Re: should i up my zoloft from 50 to 75 mg?
« Reply #11 on: February 20, 2013, 06:35:33 PM »
End of december i had this bad head cold (but negative for flu). Then the head cold stopped. Then i had loose yellow stool for about 3 weeks with lots of mucus in it. Sometimes, i would just pass mucus and no stool. During this time period, that's when i was readjusting to being back on the zoloft.

The key is probably in the last sentence. Antidepressants can be weird beasts. For some they cause initial constipation, others get diarrhea. The GI tract makes and uses about 95% of the body's serotonin, compared to only 2% in the brain, so it can be more greatly affected by the initial antidepressant surge in serotonin and its affects on serotonin receptors. 

Quote
Do you think zoloft can do that?

In some circumstances, it sure can.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline livelaughlove

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Re: should i up my zoloft from 50 to 75 mg?
« Reply #12 on: February 21, 2013, 05:37:08 AM »
Ha! i knew i wasn't crazy... turns out my DNA showed up something that is causing all of my symptoms. Finally!!!! I can't comment now but I would like to say the ENTIRE medical field was wrong and I was right!!!! Can't comment any more now until the rest of the test is completed next week. Just wanted to say, always go with your gut instinct, and when doctors say all your symptoms are from anxiety or stress, don't believe a word of that BS if you don't feel it's true in your gut instinct. They are just not thinking outside of the box. Years I have suffered and finally getting an answer... due to my OWN hard work and dedication!
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