starting Zoloft

[anxietyadvice]

I am on my 4th day of Zoloft.  I am jittery and more anxious than usual.  Will this go away?  How long before I can benefit from this drug?

[beccerbear]

Hi my name is Rebecca, Im 21. I started zoloft when i was 20. I had the same effects. Very nervous, more than usual. Then i seen an add on the tv for recall of zoloft. It was causing misscarrigaes, and heart problems. After that, it made it seam like my heart was racing and thats the exact opposite i was looking for. There are tons of deppression/anxiety drugs, Try them all if you need to.

[anxietyadvice]

Thank you!  I want to try it a while longer before I stop.  I hope these side effects go away.  I can't handle feeling jittery and anxious like this.

Anyone else have any advice on for me?

[RubyWitch]

It is very common and very normal to feel the way you do when first starting ANY anti-depressant. Often when we begin a new medication, it CAN make our symptoms a bit worse for awhile. Maybe a week or so, but then those feelings should begin to abate. I know it's difficult to keep taking a drug that is making the symptoms worse rather than better........it's the nature if that particular beast. Your doctor obviously should have explained the way antidepressants work much more thoroughly to you, especially if this is your first time on them.

Zoloft usually reaches steady state in about a week. That is the time it takes to build up in your system to therapeutic levels and you begin to notice some changes for the better. One of the most basic lessons those of us on antidepressants need to learn is patience. These drugs take time to work and they don't work overnight. You also need to know that we are all different in how we react to these meds. One person has no problems, the next has nothing but problems. That is why you absolutely must base the drugs efficacy by YOUR experience, nobody else's.

Your doctor has no doubt started you out on a very low dose and has requested that you come back for a follow up in about 2 weeks to see how you're doing. If you have felt no change in your outlook, he/she will probably up the dosage and see if that works. When I began Zoloft, I started off at 50mg but didn't really notice a change in the way I felt until I was up to 150mg. I had some weird side effects at first, but I stuck it out and I'm very glad I did. Zoloft has been the best antidepressant for me with the fewest side effects and excellent results.

The best thing you can do if you have questions or concerns about how you're feeling while taking any kind of psychotropic med is to call your doctor and discuss it with them. If you can't reach your doctor, you can  call your local pharmacist and they can tell you if what you're feeling is normal.

Once you have adjusted to the medication, you won't have any side effects at all. You will simply feel like your old self again.

There is one catch you must be aware of with these kinds of drugs and that is you must NEVER just stop taking them. Even if you've only been on them for two weeks, keep taking them until you talk with your doctor. This is a rule you can't break.

Oh, and BTW. The above poster took an isolated incident about Zoloft and made it sound like this will happen to everyone who takes it. There is no love lost between me and the big pharmaceutical houses, but if Zoloft WAS causing miscarriages and heart problems, do you really think it would still be on the market among the top 5 most commonly prescribed antidepressants? No, it would not. You can scare the wits out of yourself by reading the insert on your bottle of aspirin. I'm not saying we shouldn't be aware of negative side effects, all drugs have SOME kind of negative side effect, but you and your doctor should discuss if those side effects outweigh the benefits.

I think since you've written to an anxiety forum about this, it might be in your best interest to see your doctor again to help set your mind at ease. It's hard enough to battle depression without the added anxiety of being afraid of your meds.
I wish you the best and a rapid recovery
Peace
Greenlydia    

[anxietyadvice]

Thank you for spending the time to write out a thorough comment!  I am on my 5th day.  I have been very anxious today.  I plan to increase when I hit the 7 day mark, but I hope it doesn't make my anxiety even worse.  I am going to stick with it.  I am ready to feel better!

[RubyWitch]

Unless your doctor has already told you that you can go ahead and increase the dose after one week, please do NOT up the dose on your own, ever!  

Zoloft is affective for anxiety as well as depression, but it is not a first line med for anxiety. If you are really having difficulty with anxiety while adjusting to the Zoloft, speak with your doctor about going on a short course of a benzodiazapine.
I know that some people really balk at adding yet another psychotropic med to their regime, but it would only be for a short time and if it will help you stick it out with the Zoloft, then it is worth it.

Good for you for sticking it out. See how you feel on day 7, but do not hesitate to increase the dosage if your doctor gives the OK. It really helps to keep a journal of how you're feeling in the beginning. The positive changes can be very subtle, so sitting quietly and really focusing in on how you're feeling each day may surprise you. (Our memories are faulty which is why I always suggest a journal) The process of conrolling or overcoming depression takes time and it's different for all of us. Just try to keep in mind that you did not become depressed in just a few days, sometimes it has taken months and months for the real depression to hit, and it often takes longer to recover, but not always. No negatives here!

Please consider therapy. Whatever is making you depressed and anxious needs to be addressed and dealt with.
I hope you will keep me informed on how you're doing.
Peace
Greenlydia

[nursegirl6572]

I couldn't agree with greenlydia more.  Zoloft is actually THE most prescribed antidepressant for anxiety disorders, and panic disorder, because of its high success rate and ease of tolerance for most people (with the exception of a couple weeks worth of side effects like you describe, for some people).

Definitely try to stick it out if you can.  Zoloft gave me my life back when I was first diagnosed with panic disorder at age 18.  I had side effects similar to yours (I felt like I drank several pots of coffee), but they almost completely subsided in about 2 weeks.  It was definitely worth dealing with those side effects!

Also, if you are not already, get into some therapy.  Therapy, when used concurrently with medication, increases the success rates significantly.

Best of luck to you!

[anxietyadvice]

Thank you both for your advice!  When do you usually up the dose?  Is a week usually too soon?  I felt good last night, but had some anxiety when I woke up.  I have to travel in 3 weeks.  I hope it kicks in fully before then.  Otherwise I might have to put the trip on hold.  Should it be fully kicked in by then?  I know everyone is different.  I am asking what usually happens.  I hope I am like you, Nursegirl, improvement in 2 weeks.  I am going to stick with it!

[nursegirl6572]

Every doctor is different, some will recommend increasing the dose after 2-3 weeks, and some want you to wait the 4-6 weeks it may take some people to start noticing significant improvements.  I can tell you that you may begin to feel better by your trip, but it is pretty unreasonable to think you would be totally back to normal.  These things take time.  Also, if your dosage IS increased, you again have to wait several weeks before the changes are significant to get you feeling better.  This can be a process of a couple months, which is why why emphasize how important patience is.

You may surprise yourself and do just fine on your trip.  Often, the anticipatory anxiety is much worse than the actual event we feared.  It will be a great sense of accomplishment for you to go on your trip, prove to yourself you can do it.  Just some things to think about!

[kickanxietysbutt]

Hello,

I have been on Lexapro for eight years and the past several months my anxiety has been worse than ever.  I just went to the doctor yesterday and was prescribed 50 mg of Zoloft.  She told me to take half of a pill for the first one to two weeks, depending on how it makes me feel, and then increase to the full tablet at this time if I need it.  She said that too much of the drug can be just as bad as too little, so like other users have said, I'd follow up with your doc.  I really feel for you; I've tried a couple of other antidepressants for anxiety in the past and they've made me feel out of my mind.  I'm terrified to start taking Zoloft, but like you, I'm hoping it works.  Good luck!

[anxietyadvice]

nursegirl6272 - Thank you!  I appreciate your positive words.  I hope to feel better soon.  I find that one hour I feel pretty good, then the next my stomach is in knots from anxiety!

kickanxietysbutt - Good luck!  Keep in mind you will have increase of anxiety, but it starts to level off.  I have had 7 doses & am starting to feel a little bit more relaxed, but am still having some intense anxiety every now & then through the day.  I can't wait until I get the full effect.  I am tired of being anxious.  I want to feel "normal" again.

[anxietyadvice]

Is it normal to have tremors when starting this?  Will they go away?  

[nursegirl6572]

I did for a while....kind of like the coffee shakes?  That's how I would describe it. I had that for about a week, maybe a little less.  You're a week into it, which is great.  You really shouldn't notice side effects getting any worse.  If anything, they should start to improve any day now.  Most people report an improvement by week 2, so you're almost there.  Doing great!

Did your doc prescribe any anti-anxiety medication (like Xanax or Ativan) to use while you adjust to the Zoloft?  

[anxietyadvice]

Thank you, nursegirl6572.  I think I am improving!  I still feel some "knots" in my stomach every now and then, but overall I am pleased with how much better I feel today!  I am a little sleepy today though.  I also feel some shortness of breath every now an then.  I am not sure if that is from the Zoloft or anxiety.  I did not get a script for Xanax.  I took Xanax last year and did not like it.  I was too scared to try it again.  I found that when the Xanax wore off my anxiety was worse than before I took one.  I have been dealing with this anxiety for a while now, so I am happy to FINALLY be doing something about it!  Thank you for your help!  I am thankful people like you are here to help others' out!

[nursegirl6572]

Well, it sounds like you are doing okay without Xanax anyway!  I was just going to tell you that if you DID have it, to take it when you're feeling expecially anxious.

Overall, I think you're doing well, and just imagine, you're already seeing some vague improvements, in another few weeks, you'll be feeling even better!

My pleasure, we're glad to help...I love watching success stories unfold.  We've watched so many people transition from debilitating anxiety to a medication and therapy, to really feeling like themselves again.  That's so rewarding!

You're getting there...keep up the good work and don't forget to update us along the way...we like to see how you're doing!

[anxietyadvice]

nursegirl6572, I need your advice (and anyone else who can help me).  I am having terrible tremors, where my shoulders, head and hands are shaking.  I know this is not anxiety.  This has to be from the medicine.  I have a few questions.  Is this a possible side effect of Zoloft?  If so will it go away?  If I up the dosage would it help?  I am on a low dose.  I feel discouraged.  I have a family gathering to attend today and am so embarrassed by these tremors I just want to cry.  I know my family will wonder what is going on with me.  Please help.  I'd appreciate any advice.

[nursegirl6572]

Hello again.  Yes, the tremors could be (and likely are) a side effect of the Zoloft.  Like I explained, I had what I would explain as the "coffee shakes' for about a week or so when adjusting to Zoloft.  It's not all that uncommon.

I know that a symptom like this is bothersome and annoying, but if you stick it out, I think you'll see that it will start to subside, probably in a few days.  Of course I would recommend telling your doctor about it, because it is good to keep your doc in the loop regarding any side effects.  This kind of side effect is where something like Xanax as needed comes in handy.  It really helps to minimize that kind of effect.  I would ask your doctor about perhaps giving you a few weeks worth of an anxiolytic to use on an "as needed" basis, just until you get over the hump.

I know you're frustrated...adjusting to these meds certainly can be rough at times, but I would just hate to see you give up when you've come this far, especially because you've already noticed some improvements, which is a good sign indicating that the Zoloft will probably work well for you.

Speak with your doc about what you can do to help make these symptoms more tolerable, and in the meantime, TRY not to worry too much what other people think.  You are probably very self conscious about it.  It may not be as noticeable as you think it is.  You can always just tell people the truth, that you just started a new medication and are having some side effects.  If you don't want to share that with people, tell them you drank too much coffee or something!  I bet people aren't going to be as aware of it as you think.

TRY to hang in there. You are really getting close to the period where things will start turning around..the side effects will start to abate, and the Zoloft will start working.  Call your doc tomorrow to discuss the side effects and ask if you can take something, just until you start feeling better.

Let us know how it's going...try to stay busy and keep your mind occupied.  Distraction is a great way to keep your mind of these things.  The more you sit and think about it, the more you will be overly focused on it.  We're pulling for you!

[anxietyadvice]

Thank you so much!  It was an outdoor gathering.  I was able to walk away when I felt jittery.  I have another question.  Have you ever heard of anyone getting the needed benefit from Zoloft on 12.5 mg or is that too low of a dose to work?  

[nursegirl6572]

It depends on the person, sure people have been on low doses with success.  You'll just have to kind of wait and see how you feel and how it is working for you.

[anxietyadvice]

I'm starting to feel tired.  It's hard to wake up in the morning which is unlike me.  I wonder if I cut down if I would still get the benefit of the drug, but have a bit more energy.  Thank you for your help!

[nursegirl6572]

It may just as easy to change the time of say you take the med.  You are alrerady on a super low dose, I woildn't recommend going much lower, if you want a decent enough therapeutic effect.

Ask your doc if you can take it at a different time of day, tell him you are feeling tired in the morning.

[anxietyadvice]

Thank you.  I already take it at night.  I don't want to be on such a low dose that I don't get a good effect from it.  I'm sure what to do.  I have to get my anxiety under control.  The Zoloft is helping so I don't want to stop taking it.  I appreciate your help.  This forum is the best!  

[anxietyadvice]

I'm NOT sure what to do.  

[nursegirl6572]

Ask your doc, sometimes even if you split the dose up, and take it twice daily, it will minimize that effect.

[kickanxietysbutt]

How are things going for you?  I have the opposite problem with sleep; I have had insomnia for eight years and that's the largest side effect with this drug.  I wish I could trade you problems!  Have you felt dizzy at all on this drug?  I know all SSRI's say they can cause dizziness, and I take two other drugs that say the same, but have never experienced this effect.  I've been on Zoloft for six days now.  The dizziness didn't start until about day three.  Days two and three I also experienced shortness of breath, but that has gone away now.  I'd love to compare notes.