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Author Topic: Zoloft/Buspar/Trazadone  (Read 238 times)

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Offline Katiesue04

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Zoloft/Buspar/Trazadone
« on: May 06, 2014, 06:52:20 PM »
I am currently taking 100mg of zoloft at 15mg of buspar three times a day and trazadone for sleep at night.  Every month I rate my anxiety on a scale, 10 being the worst and 1 being the best...it's usually about a 5-6. I think the meds help but I am often left wondering is there is room for improvement.  So we decided to bump up the buspar to 20mg 3 times a day and stay on the zoloft for one month.  I am afraid to switch to different meds.  I have a million thoughts running through my head...side effects, will a different med work as good...am I just setting myself up for failure and should I be happy where I am at right now.  Zoloft and buspar are the first two anxiety drugs I have used.  Not sure what to do or try next.
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Offline insights

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Re: Zoloft/Buspar/Trazadone
« Reply #1 on: May 06, 2014, 08:55:55 PM »
I am currently taking 100mg of zoloft at 15mg of buspar three times a day and trazadone for sleep at night.  Every month I rate my anxiety on a scale, 10 being the worst and 1 being the best...it's usually about a 5-6. I think the meds help but I am often left wondering is there is room for improvement.  So we decided to bump up the buspar to 20mg 3 times a day and stay on the zoloft for one month.

I think it would be better to bump up the Zoloft dose. The primary reason for taking Buspar with a SSRI is to increase the effectiveness of the SSRI (or reduce some side-effects). Given that you're at the low end of the dose range most need to get good results from Zoloft the easiest and probably most effective solution is to increase its dose to 150mg/day.

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 Katiesue04

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Re: Zoloft/Buspar/Trazadone
« Reply #2 on: May 07, 2014, 08:32:25 AM »
We already tried to increase the Zoloft I ended up getting diarrhea for a month straight. 150 mg was too high of a dose.  I was put on zoloft because it works the best for a lot of people.  What else is there to try?
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Offline stevo1111

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Re: Zoloft/Buspar/Trazadone
« Reply #3 on: May 07, 2014, 09:12:39 AM »
I tried Zoloft for 3 months before switching, my guts never were able to tolerate it. If it's not doing it for you and you gave it a fair shake, I suspect you can probably find something that will get you from a 5-6 to a 3 or so.

Monotherapy is generally considered more likely to succeed than combining medications because it is very difficult to determine what is working, and why, when several are used simultaneously.

Perhaps trying a different antidepressant that you can tolerate at the higher end of the therapeutic dose range may be more effective. Since you are having trouble sleeping, a slightly sedating TCA (amitryptaline, clomipramine, there are perhaps several others, but I can't remember right now) may be very helpful.

It is often best to start on a split dose, 3x per day, and you can start at a VERY low dose compared to the therapeutic dose. The start up side effects that can raise anxiety levels to 8-9 out of 10, are, generally speaking, not there with TCAs. At least not to the same level as with SSRIs. The initial slight sedation, which goes away as the medication becomes effective, is often just what we need to reduce the anxiety level. In fact, oddly enough, in my own experience, I would go from baseline anxiety down to almost nothing within 1-2 days as the medication levels increased and I became slightly sedated. Like a honeymoon period, the anxiety would come back to almost the old level, but over 2 weeks it would return back to near the honey moon stage.

I can say with near certainty, it wasn't until I found the right medication at a proper dose that I felt ANY real relief from anxiety, aside from benzos. I spent 2 years battling ineffective medications, start up side effects, and withdrawals which made me see what my anxiety could be at its worst. Finding a med that works, is, in a way, coming full circle.

Good luck! Hang in there! You will find relief. 

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Offline insights

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Re: Zoloft/Buspar/Trazadone
« Reply #4 on: May 07, 2014, 09:36:48 AM »
I was put on zoloft because it works the best for a lot of people.  What else is there to try?

The best tolerated SSRIs are Celexa (citalopram) and Lexapro (escitalopram) which share the same active chemical (Celexa also contains a mostly inactive form of it). Because of the wider dose range, Celexa would be the better choice, IMHO. You can switch from one SSRI to another overnight usually with only minor side-effects for a few days.

Or, as Steve has suggested, there are the older tricyclic antidepressants which are at least as effective as the SSRIs. However, you would need to cross taper between these and Zoloft which makes the switch a little more complicated.

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 Katiesue04

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Re: Zoloft/Buspar/Trazadone
« Reply #5 on: May 08, 2014, 08:22:11 AM »
Thank you insight...I didn't know that I didn't need to taper off the zoloft to switch to a different med.  That eases my mind a bit, at least I won't have to be worried about going back to my premedication anxiety.  I went to fill my script last night and my insurance won't pay for me to take buspar 2-10mg tablets 3 times a day.  They filled this month but I will have to switch to something else next month.  They told me the max I can take is 3 tablets 3 times a day...so I will have to end up switching.  Kind of stupid that an insurance company can run your health and not your doctor!
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Offline insights

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Re: Zoloft/Buspar/Trazadone
« Reply #6 on: May 08, 2014, 06:21:36 PM »
I went to fill my script last night and my insurance won't pay for me to take buspar 2-10mg tablets 3 times a day.  They filled this month but I will have to switch to something else next month.  They told me the max I can take is 3 tablets 3 times a day

Isn't "2-10mg tablets 3 times a day" less than "3 tablets 3 times a day"? You're going to have to refer this back to you doctor. There doesn't seem to be an easy solution as Buspar isn't available in 20mg tablets.

Quote
Kind of stupid that an insurance company can run your health and not your doctor!

Indeed!!  :angry:

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.

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