AZez15: Sertraline and side effects

[AZez15]

My GP started me on generic ativan (.5 up to 3x per day) and sertraline (.5/ once per day but starting at .25) for health anxiety. I have a history of anxiety but had recently escalated and I felt like I was losing my ability cope and function each day. 

 

I only use the ativan before bed (it's been a week), and am very aware of the addictive nature so I am cognizant that this is only a temporary fix. Actually, I haven't even felt the need to use it other than at night I seem to be experiencing withdrawal after the 24 hours of having used it (brain zaps/tingles/what feels a little like parasthesia--but again that could all be anxiety related as well).

 

I'm more concerned, I think, about the sertraline. It's only been a week, but I seem to be getting really bad morning anxiety from it. Everyday, I wake up extremely anxious with chest pain (more like a fullness on my left side---I'm 28 and in great shape so it's a bit disturbing). I'm not sure if I'm experiencing chest pain or anxiety-caused pain.  Otherwise, once the morning anxiety dissipates, I feel fine for most of the day, but am concerned that the chest pain (which only lasts 10 min that I am aware of) is something more seriously.

 

I think I want off the sertraline, but am nervous about quitting cold turkey. Would it be wise to cut from 25mg to 12.5 after one week?

 

I am supposed to be see a psycho pharmacologist tomorrow anyway (this was scheduled before my GP gave me the meds), but am nervous he'll just lead me to another SSRI.

 

Thoughts?

Edited May 27, 2017 by scallywag
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[scallywag]

AZez15: -- Welcome to Surviving Antidepressants (SA)

You're wise to have been paying close attention to your symptoms. Because you've only been on Zoloft for a week, you could halve your dose for 3-5 days and if you have no problems then halve it again for another 3-5 days before "jumping off." It's a good idea to keep notes on paper of your symptoms and the times of your dose(s). This post has a useful format for a daily log:
Take notes of doses and symptoms.

You do want to be careful with benzodiazepine medication such as Ativan. Physical chemical dependency can occur quickly even with only one daily dose, perhaps as little as 2 weeks.

What non-drug treatment options were offered/suggested to deal with health anxiety? Cognitive behavioural therapy, perhaps? Mindfulness meditation? You may find this post about health anxiety by Kittygiggles helpful.

I hope you'll find the information in the SA forums helpful for your situation. I'm sorry that you are in the position that you need the information, but am glad that you found us.

[AmyK]

Get off zoloft and don't ever touch another ssri. It is really hell on eartth to get addicted to those drugs. Well done of you to search for help!

I thought I could take zoloft for half a year, but then I couldn't get off, so my tapering has been going on for years. It's an understatement to say it has not been worth it.

 

You should be very concerned about ativan as well, as you know. It should not be used for weeks, as you may know.

 

Have you tried therapy? As Scallywag mentions, CBT? There are so many other ways. And non-drug-alternatives should be priority one actually.

 

Best of luck!

[AZez15]

Thanks so much for your responses!

 

Today is day 8 of when I began ativan and I am doing my absolute best not to use it. Perhaps if the anxiety ramps up, I might try halving it.

I'm going to think about slowing tapering the SSRI as well.

 

I do want to start CBT, so made a call today and hope to have an appointment within a month.

 

Health anxiety is tiring but I'm not certain these meds are the answer.

[AmyK]

They are not the answer. I hope CBT is!

I would follow Scallywags advice on how to taper zoloft. One week is nothing, better to come of quick.

[AZez15]

I've had some gastrointestinal issues with sertraline (only 50 mg per day). When I first began taking it, about 4 weeks ago, my appetite was definitely stifled in the beginning. It's mostly back to normal, though I still get full pretty quickly, so I was surprised when I went to the doctor and found I lost 10 pounds in 4 weeks without trying. I'm a pretty guy active guy, work out about 4-5x per week, and eat well, but I'm just concerned about the weight loss.

 

I'm only due to be on sertraline for a couple months and then we will taper, according to my doctor, but has anyone else experienced this type of symptom?

Edited June 6, 2017 by scallywag
merged topic from Symptoms forum

[scallywag]

AZez

I've moved your post to your introduction topic so that more people will see your question, and so that all your information, questions and answers are in one place.

 

Weight and appetite changes occur as unintended effects of the drug and also during withdrawal. You may want to check the patient information for sertraline that came with your prescription. If you don't have that, have a look at the information on drugs.com:
Sertraline side effects

Weight gain, Weight loss, and appetite changes during tapering and withdrawal
.

---

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[AZez15]

Hello:

 

I am currently on 50mg/sertraline. I will be beginning my taper in a couple months -- my doctor wanted to be on it for at least 6 months but believes tapering would be fine.

 

On another note, I am having a colonoscopy this week. Part of the prep involves drinking lots of laxative (wonderful, I know), but I saw that there is an interaction on sertraline and miralax. Any thoughts on this? Could I just drink lots and lots of gatorade to replenish electrolytes? Anyone with experience?

moderate - sertraline  polyethylene glycol 3350

Applies to: sertraline, MiraLax (polyethylene glycol 3350)

"Sertraline can cause an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. The risk is increased if you have low blood levels of magnesium or potassium, which can occur with bowel cleansing preparations or excessive use of medications that have a laxative effect. Do not exceed the dose and duration of use of polyethylene glycol 3350 recommended on the product label or prescribed by your doctor. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications. In addition, you should let your doctor know if you experience signs and symptoms of low magnesium or potassium blood level such as weakness, tiredness, drowsiness, dizziness, confusion, tingling, numbness, muscle pain, cramps, nausea, or vomiting. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor."

Edited August 5, 2017 by scallywag
merged topics

[compsports]

Hmm, it sounds like you need to ask your doctor about this as I definitely would be concerned also.

 

You may also want to ask him/her about Suprep to see if that would be a viable alternative.   A family member said it was the most tolerable one she has had during her years of having colonoscopies.

 

Best of luck.

 

CS

[scallywag]

AZez15 - at what time of day do you take your dose of Zoloft?

 

Edited August 5, 2017 by scallywag