Another question about Zoloft

[Genesis]

OK, so it is my 5th day taking 50 mg of Zoloft for PPD, anxiety, OCD, intrusive thoughts, etc. Before that, I was on 25 mg for 2 weeks.

When I started the 25 mg, my PPD was getting so severe that it started working right away. My intrusive thoughts and anxiety lessened some, but then after a couple weeks the depression started getting worse. So the doctor told me to start 50 mg. But ever since I started the 50 mg 5 days ago, my anxiety has been UNBELIEVABLY bad. I feel very panicky and nervous, and my intrusive thoughts are starting to increase again because of that. My anxiety has even started to wake me out of sleep at night, and that's when it feels the worst.

My question is, do you think this is because I increased my dose? Will it go away? I need to know that this will pass and I will start to feel better soon. Thanks in advance.




Michele

[mom0810]

Hi Michele,

I think it will go away. It's kind of normal to have these symptoms when you go up in dosage, just like when you first start the meds. Some people get really tired, other people get really amped up.

Ask your psychiatrist if you could have some Ativan or something to get through the anxiety if you need to. this is really common and is safe to use while nursing. You should only need it for a couple of days or a week.

Meanwhile, know that it is a normal reaction and that you will get through it. Talk to your psych about it and let them know this is going on. But I really think they will tell you it's normal.

[Adele_Mommy]

Hmm... I take Zoloft for OCD and I had depression before I started taking it. I started at 25 mg and increased 25 mg a week. My experience and what my therapist told me was that 25 - 50 mg is a good dose for treating depression. However, it is not enough to treat OCD. When I first started taking Zoloft I felt much better very quickly, including lessening of OCD symptoms, but I think that is because the depression was making me less able to cope with the OCD and so treating that made everything better. At each weekly meeting my doctor and I would assess how I was doing and decide what the next step should be. I kept increasing the dosage until 150 mg. 150 was too high, but at that point my OCD did not start getting worse. Instead I started feeling irritable, restless, and having insomnia. I went back to 125 and that is what I take now.

You should not have been able to notice much of a difference on the day you increased your dose. It takes a few days for the drug concentration to build up in your bloodstream. Did you experience additional stress or could something else be causing the increased anxiety? It is possible 50 mg is too a high a dose for you (everyone reacts differently), but it doesn't sound likely to me based on your post. I would make sure your doctor is intending to treat your OCD and anxiety with the Zoloft and not just the depression. I would also make sure your doctor has experience with OCD or possibly ask for a referral to someone who does. Then I would discuss how you are doing with your doctor. At the beginning of taking an SSRI you should be evaluating how you are reacting frequently - at least every 1 - 2 weeks. A different SSRI may work better for you (though for OCD Zoloft is usually the best). I tried lowering my dose to 100 mg once. I did not notice anything for the first 2-3 days and then I had a noticeable increase in intrusive thoughts. I was working closely with my doctor on this experiment so I was able to go back up to 125 with just a phone call. I think you need to change something, but I don't think going back to 25 mg is the answer. Someone with a lot of experience treating OCD will be able to help you figure out what is.

Sorry this is long. Hope it is somewhat helpful. I'm sorry you are having a hard time - it will get better!

[mom0810]

Great post, and I agree.

If you are not working with a therapist, it would be the best thing to do for yourself. There is a website, and I am not sure what it is, but do a search for Jonathan Grayson, who is an expert on OCD, and see if you can find a site with referrals to therapists who specialize in OCD.

Alternatively, you could check www.postpartum.net and find a therapist in your area who has a special interest in PPD, which also includes PPD OCD. It's a difficult thing for a therapist to diagnose if they are not really interested in the subject and haven't done a lot of research into it.

Hope this helps, and I would follow the advice of the PP.

ETA: You also had a great deal of anxiety about going up in dosage, didn't you? Do you think that could be contributing to the anxiety you are feeling now? I would consider that as a possibility rather than just the medicine itself. I know you were worried about the extra 25 mg.

[Adele_Mommy]

Originally Posted by mom0810

Hi Michele,

Ask your psychiatrist if you could have some Ativan or something to get through the anxiety if you need to. this is really common and is safe to use while nursing. You should only need it for a couple of days or a week.

Hi Mom0810. I actually cross-posted, so I had not read your post when I submitted my previous post. Asking for an anti-anxiety is a really good suggestion. My therapist offered that to me and said it was quite common to take an anti-anxiety medication short term while working out the correct dosage of the correct SSRI. I did not actually take one myself, but that is because I have anxieties about medications as part of my OCD! : It sounds like you do too, Michelle, which makes it much harder for us, but I'm sure you will find something that works for you and you will feel better. Good luck!

[Nature nurse]

Zoloft, OCD , etc.

I really feel for you! I am currently on 125 of Zoloft and have been for about 4 weeks, after struggling through the last trimester of pregnancy with increasing anxiety/intrusive thoughts/OCD, little bit of melancoly.... My baby was born last Friday (the 5th) and I am in full-on baby blues, ugh. I started clonazepam about 10 days before her birth and it made an amazing difference. The Zoloft isn't quite therapeutic yet and I had had issues sleeping, etc. Clonazepam and other benzodiazepines like Xanax are sometimes used short-term to get through the speediness that Zoloft can induce in some people, or to deal with symptoms that are not covered by an inadequate dose of Zoloft....definitely talk to your doc about your symptoms an see if they can help you get through the transition.....best wishes! Jen

[Lucilla]

I hope you're feeling better now.

[cdmommie]

I just went through the exact same thing. After a week on the 25 I was bumped up to 50 and things got worse for a few days, but it is coming down now after about a week and a half of the 50mg. It should get better, doubling the dose just throws your body for a loop. I almost stopped taking it when I relapsed, but thank goodness I didn't! Hang in there.

[mchalehm]

I think for some people it does go away. It didn't for me, though. I had a similar experience and I eventually had to stop taking it. I switched to a different AD and had no problems. My doctor told me to give it time, so I did, but it didn't improve over two months and I gave up on it.