how soon before increasing dose of zoloft?

[siridimples]

Hi I just signed up to this community and am grateful for all of the info being shared.  THere is a lot of comfort in all of the posts. My question is about Zoloft and trying to figure out what the therapeutic dose is and how soon I can ask my doctor to increase to get there. I Just completed  a SLOW taper of lexapro, while at the time I started a gradual "uphill" taper of the zoloft.  So, I came down in dosage on the old med, while at the same time, working UP to a a so called "therapeutic" dose of the zoloft. My doc has transitioned me very slow as I have trouble with the side effects. I worked up to 37.5 mg of zoloft by the time i was finished with Lexapro.  After three weeks the side effects subsided but the depression and anxiety were still there so she upped me again to 50mg.  The side effects also came back with the upped dose :( , increased anxiety, nausea, insomnia etc. Mind you, I only went up 12.5 mg!  I had to use Klonopin to help with the anxiety. I am on my second week of 50mg and starting to notice a slow improvement with the side effects now subsiding.  I have read from the many posts and others that the drug works better the longer you take them. I also read that It usually takes four to six weeks at the PROPER DOSAGE to get the full effect of the drug and that the medicine doesn't stop working when my side effects go away. Well am still having anxiety, lower level, but with me often, and still feeling low. Are these still side effects? Do I need to wait four more weeks before upping my dose? I read that sometimes a dosage increase is needed  to get the most optimal level of relief. My doctor wants me to wait  4 more weeks and only then go up again only 12.5 to reach 67.5mg, and then six weeks later go to 75mg if needed. That is 12 weeks! So from what I have been reading and the way I understand it, the key to really being able to fairly determine the success of this dose is sticking it out at each level that long (4-6weeks)?  So that gets me to the the theraputic dose, is it when I no longer feel depression and anxiety and can function normally without thinking about the medication anymore? This whole thing is very hard and I know patience is key. I am Trying to remain as busy as I can, to keep my mind off the thoughts surrounding the medication is hard. I am a stay home mom, kids in college. I go to CBT therapy also and find the techniques very useful.  Unfortunately, I have too many large blocks of "nothing time". My mind is too frequently on how bad I feel physically. I want to get to that therapeutic dose a little faster. I appreciate any feedback on this.

[siridimples]

Let me add that at 37.5 mg of zoloft I was waking up with panic which was horribl!!! Now that I am on 50 it has lessoned to feeling like I am on 10 cups of coffee with an added feeling of fear. This tells me that maybe it is working, but it was not enough of an increaase?. I want to talk to my doc about titrating up to 67.5 now rather than waiting the full four weeks. I just can't tell if this is still side effects? I just can't handle this feeling of fear all of the time. :(

[siridimples]

Wow. I did not think about that. I have been off Lexapro completely now for four weeks. I did have some diff withdrawl symptoms, headaches, tremors chills, excessive crying all of which tapered off after a week.  I guess I need more time as you said. Thanks for the info. I will keep you posted.

[Paxiled]

By the way, on the optimistic side, given docs keep doing this despite much research showing it isn't the optimal way to do it, most people do come out all right.  But it's good to know possibilities so you don't eliminate what might be a great medication for you done in a way that doesn't work for you by your physician.  Good luck with it.

[Paxiled]

There is one problem here you left unadressed.  As to your post, we're all different.  You're on a therapeutic dose which might be fine for one but not for you, so you can't generalize.  It does take about six weeks usually for a drug to fully take effect, but the side effects start right away, and some go away, some don't.  Can't generalize there either.  But there's another problem in the way you did this.  Though you slowly tapered off the Lexapro, you started the Zoloft while you were still on Lexapro.  Many of the worst withdrawal effects don't start until you've completely discontinued a drug and sometimes not for weeks afterwards, so what we can't tell if if some of this isn't withdrawal symptoms from the Lexapro.  Remember that none of these drugs is identical in how it works, and so switching from one to another, though most doctors and psychiatrists seem to ignore this, doesn't stop withdrawal from the old one necessarily.  What this means is there's another possibility here that's interfering with you discovering whether Zoloft is a good drug for you if you can't tell what's new and what's old, so to speak.  It might be that it's just taking time for the Zoloft to work, it might be this just isn't your drug, which happens, and it might be you're brain is still stuck on Lexapro.  At this point I guess you just have to give it time and hope all goes well eventually because it's done, but I hope this helps you the next time around if there is a next time.