max dose of zoloft

[u2crew]

Hi I'm on 275 mg of Zoloft for OCD because I was not responding to lower levels after going on and off too many times. I do however seem to be responding to 275 mg's but I know that it is above the usual max dose. However my doctor right now believes that it is best to get me stabilized over a period of months before we consider another medication because he believes that switching right now would throw me into a downward spiral. I do believe him but am wondering what your take is on taking 275 mg for a reasonably long length of time. My doc says that it doesn't pose any risk and that it is fairly common for people with OCD to have to take a higher dose. What do you think? He admits that the highest tested dose in long term trials is 200 mg but that 275 will not harm me. He knows many other psychiatrist's that have put people on this high of a dose and who have responded well to it. I have had a sertraline blood level taken at 250mg and there were no problems - the test did not indicate that zoloft was reaching toxic levels in my blood. He mentioned when switching to another med I would do the cross titration method but that he doesn't want to do that now and not any time too soon. He said that serotonin sydrome will not happen to me as I only take Zoloft and that this happens to people who take more than one serotonergic drug.
Anyways thanks in advance for your help.

[Roger Gould, M.D.]

Your doctor sounds like he knows what he is talking about. Dosage levels always have to be experimented with and individually adjusted and monitored closely.  It sounds like that is exactly what he is doing with you.

[ontherecord]

No one knows for sure what the long-term effects of taking high doses of zoloft or any SSRI for a prolonged period of time are.  Yes, these drugs have been prescribed in high doses for many years now, and thus far, research and clinical experience has not shown adverse effects.  However, no one knows, and no psychiatrist can pretend to know what the long-term effects of 275mg of Zoloft are after say, a decade.  Everything within reason however is acceptable.  There are parameters to antidepressant medication -- minimums and clinically accepted maximums -- and it's most advisable to stay within those parameters.  If Zoloft isn't achieving the desired effect within those parameters, then it might not be a bad idea to swtich to a different antidepressant.  It certainly will not help your OCD to be worrying about the dosage of the medication that you are currently taking to relieve those very symptoms.