Sertraline (Zoloft) side effects

[gsimmons03]

I've been diagnosed with depression for the first time in my life, at age 70.  I have had previous problems with anxiety and have been treated with .5 mg Xanax. My family physician prescribed 25 mg. Zoloft (sertraline) to be taken at bedtime. The insomnia was horrible, so I switched to taking it in the morning.  Insomnia is still pretty bad and I have to take Benadryl to get sleep.  I also am yawning excessively and can't honestly say my depression feels like it's lifting. I've been on the sertraline for just about  2 weeks. All I want to do is sit around and do nothing, haven't been socializing with friends, etc. Is this a normal reaction to the medication? Shouldn't I be feeling somewhat better by now? And what's with the yawning?  I also have loose bowels and slight nausea.

[artemesia2]

My present experience with an antidepressant is with Celexa.   Recently suffered a breakup with a man .  He broke up with me.   We spent ten years together    Ten years together and he decides we're  incompatible.   My primary increased my Celexa (generic) from 20 to 30 mgs.   Just started taking the increased dosage this morning   Too soon to tell if I'll feel any better.  OTOH sometimes the med is right but the wrong dose.   Good luck to you.

[Paxiled]

Just to say, this kind of additional stress can overcome the benefit of medication.  It happened to me once, a drug just stopped working after a breakup.  But it also might be that the drug is still working fine and you're expecting it to solve more than it can.  For me, the issue then was phobias, and I started getting new ones again, so it was pretty clear the drug had stopped working.  In your case, with depression being the issue, nobody would respond to a long relations ending like that without feeling grief and sadness for a fairly long time, depression or no.  Time alone can fix this problem, not medication, which can often make it worse by suppressing grief instead of giving you the time needed to overcome it.  No drug will make this easy or pleasant, you're going to be in for some rough times.  All the best.

[artemesia2]

I'm sorry that happened to you that a drug wasn't effective any more post breakup.     I don't expect it to solve more.  I am hoping it would change my feelings.   ie how I feel about the breakup.   Both my primary and my pdoc both wanted to increase my Citalapram from 20 to 30 mgs.    I feel grief and sadness not just for the breakup but for my future in female/male relationships.  Thinking of   discussing going through this major change in my life and how to do it with my therapist.   All my best.

[del677]

I had to try many different antidepressant medications before finding one that worked for me.

That seems to be typical. It's not a case of one medication works for everyone; it's a case of there are a lot of different antidepressant medications out there, each one works well for a subset of the population. There's no way of knowing which one will work well for any particular person, other than to try them all one by one.

There are some general guidelines which can help in choosing which antidepressant medication to try next, based on how well the previous ones tried worked or did not work.

One may need to try several different antidepressant medications before finding the one that works for them.

It can be an agonizingly long process, but it's worth it when one finds the antidepressant medication that works for them.

A general practitioner can try some initial antidepressant medications. Eventually they may recommend a psychiatrist doctor if none of the initial medications help. The psychiatrist specializes in guessing which medication to try next.

In the meantime, it's typical the first few medications tried don't really work, or may just have annoying side effects, or even intolerable side effects, such as insomnia, or more often being tired all the time. Either one can happen. (One med kept me awake like drinking 20 cups of coffee. The same med put my mother to sleep for 18 hours.)

Keep hope that there's a medication out there that will work wonders, and keep searching for it, and understand it's normal for any particular one not to work for everyone. Each one works for some. One out there will likely work well for you. You'll know when you find it. (I can't explain how you'll know. I can't explain how I knew, I just knew.)

[Paxiled]

Only would caution on one point - while both psychiatrists and general docs have no idea which med will work or not, psychiatrist are theoretically better at dealing with how best to take them and stop taking them.  There are psychiatrist who use certain tests they believe can help select the right med -- some will test liver metabolites, which can determine if you'll absorb a med or not.  Some claim an EEG test can help select which ones will work.  Some will use brain scans.  Don't know if evidence actually backs any of this up and it's hard to find these psychiatrists, but they are out there.

[gsimmons03]

I'm actually seeing a neurologist for a different issue. When I told him about the depression, he offered to run a DNA test (cheek swab) to see what antidepressants would work best for me. Of course, that probably doesn't take side effects into account. I think the results will be in next week.

[Paxiled]

Be cautious about getting help with mental health from a neurologist.  Another specialty that doesn't study this subject.  I'd get the DNA swab for fun, though, to see what he recommends, but the fact is, you'll probably still find it a trial and error situation.  The reason I recommend psychiatrists isn't because they're necessarily all that great at what they do -- most aren't.  But some are, and at least they theoretically study the drugs specifically used for mental health.  They also prescribe them every day, and so should be familiar with how people react to them upon starting up, maintenance, and stopping.  For docs who don't do this as often, it's like anything else -- the more someone does something the better they should get at it.  I asked a neurologist once about this, and he told me that specialty knows almost nothing about mental health.  He said nobody actually knows much about it, because medicine hasn't found a biological cause for it yet and so it's in a murky realm between nurture and nature still.  But on the good side, it's probably more likely neurologists will find the answer if there is one as they do research the brain, whereas psychiatrists by and large don't do much besides sit in their chairs and talk to us or give us drugs.  But I'd take the swab if it were me, why not?  

[gsimmons03]

I heard back from my neurologist yesterday. The drug of choice, based on my genetics, is Wellbutrin. Will talk to my prescribing doc this week to get it changed. Hopefully I'll be able to tolerate the side effects

[gsimmons03]

I heard back from my neurologist yesterday. The drug of choice, based on my genetics, is Wellbutrin. Will talk to my prescribing doc this week to get it changed. Hopefully I'll be able to tolerate the side effects

[specialmom]

Hi. So, first Zoloft is a medication you must take for awhile for it to work. 6 to 8 weeks is when you should have therapeutic effect and hopefully feel better. Side effects happen and there are some that are only in the beginning called transient  side effects. They usually get less and less as you stay on it and gone by 6 weeks. Insomnia could be part of that. Time will tell. You are on a very low dose though. It will typically take a higher dose to really treat it. Is your doctor planning to increase the dose?

[gsimmons03]

I have a history of being very sensitive to meds, so my doc tends to start me on a lower dose. I'm due to see him in a little over a week and he may adjust the dosage upwards at that time, but I don't know that for certain.

[specialmom]

That is totally fine to start on the low dose.  In fact, that is common with this class of medication. They start low and increase the dose slowly to help cut down on start up side effects.  Another thought since you are just getting going on the medication and are on such a low dose is that the sleep issue is actually an anxiety symptom you are having as depression/anxiety are not yet treated with the medication?  I would give it the 6 week trial, understand you may need a higher dose to have it fully work and after that evaluate if it is or not.  If after reaching your therapeutic dose it still isn't helping, then there are other meds to try.  Do you do any counseling?  That can help with developing ways to cope also and to talk through triggers, etc.  How is your family support?

[Paxiled]

As we age, the dosages change too.  They usually drop.  But also as we age, the side effects can be more debilitating, as everything gets more debilitating.  For most people the therapeutic dose of Zoloft is 100-150mg.  You're not most people, you're just you, but that's the median.  Usually it takes 4-6 weeks to notice positive effects for most people, but side effects start right away.  In a way, side effects are a good sign, because it means you're metabolizing the med.  Most people suffer sedation from ssris other than Prozac, but they can make us feel all kinds of ways as they alter how the brain works and it takes time for the brain to get used to that.  That's why tapering up on dosage gradually is a good idea just as you have to taper down slowly to quit them.  I would also advise not doing this with your regular doc.  They don't study much in the way of mental health and don't study much in the way of geriatric mental health especially, which is actually a thing -- my psychiatrist specializes in it though she also does see others as well.  That type of psychiatrist will know more about how these drugs work and which ones have the best track record first of all because they're specialists but a geriatric specialist will also know how they affect older folks.  You also don't mention why you might have started suffering depression at such an old age -- the chronic form for the vast majority of people starts from late teens to early thirties.  When it happens to aging people -- I'm 65 and a half and been going through this since I was young so I've watched how not only I've changed but how my practitioners have changed in how they regard me as well -- there's often a reason for it, such as losing a spouse or not working anymore or chronic pain.  Those kinds of things aren't necessarily treated well by meds -- suppressing certain things can just make them persist -- so if there is a significant change that happened to you you might consider working on that in therapy.  Make sure it's depression, not grief, boredom, sadness, fear of reaching the end --  these are things a regular doc isn't great at recognizing as they're busy all day treating everything under the sun and not focused on any one thing.  For me, things have happened to me as I started aging that felled me and altered the nature of my illness.  It's something to ponder.  As for medication, got to give it time if that's the best course for you, but if a few weeks pass and it's still a problem, you don't want to end up with chronic insomnia, which is what often happens when we treat it with drugs like benadryl.  Don't want to do that too long.  The Zoloft might turn out not to be the right med for you.  Best of luck.

[gsimmons03]

I don't think it's the anxiety because I take Xanax for that. And the insomnia started with taking Zoloft. I saw a counselor today, it was a good session and I will be seeing her again.  My husband is supportive.

[Paxiled]

Keep in mind, Xanax is pretty short-acting and should really only be taken when necessary, not all the time.  If you've taken it for a long time, it can poop out, and require higher and higher doses to still work as with any addictive drug.  Benzos also interfere with REM sleep, so you might sleep while taking them but still feel tired because the sleep isn't the best quality.  But whenever you start a new med and you start to feel something you've not felt before, it's most likely the new drug.  

[gsimmons03]

I've been dealing with chronic pain and other health problems for a while, with no solution in sight.

[Paxiled]

I have chronic pain as well, but it's due to injuries I'm too burned out by anxiety to deal with anymore.  You don't sound like that, but you also don't say what's causing the chronic pain.  But you know, you're 70 years old.  You can't expect to feel 30.  Do you have a diagnosis that explains the chronic pain?  That in itself can amplify or cause depression -- it is sure doing a number on me, as until a year ago I was able to do things much younger people couldn't do.  

[gsimmons03]

I have spinal stenosis, spinal arthritis, peripheral neuropathy, joint pain, fatigue. My doc is sending me to a rheumatologist for evaluation of possible Sjogren's syndrome

[specialmom]

You do have a lot going on.  Certainly all of that will impact mental health as well just dealing with it especially chronic pain.  I feel for you and hope you are able to get some relief.

[Paxiled]

I empathize.  I'm 65 and a half, so we're not so far apart in age.  It just really messes up life when it's hard to do what you want to do.  I hope you find help.