Still depressed and anxious after 12 weeks on Zoloft. Should I change?

[Marks470]

I took several of the online depression tests yesterday because I still feel pretty bad, anxious and depressed. I still score in the moderate to severely depressed category, depending on which test. I've been on zoloft for 12 weeks, the first seven at 100mg and 150mg since then. Is it time to make a change?

[Mausita66]

I was on zoloft for ten years and it stopped working.  I then switched to celexa and it didn't work.  My doctor put me on effexor 4 weeks ago.  I started at 75mg and then the past three weeks, I have been on 150mg.  I still don't feel good.  Do I need to wait longer?

I hate being depressed and anxious and nobody understands except you guys.  

Can somebody help?!

Thanks for reading.

[rainwave]

If you don't have the neurotransmitters in the first place there isn't much ssri can work with.

[Hensley258]

You see, that is exactly what I'm talking about. A really good Psychiatrist can take clues about your exact symptoms and better match them to the proper antidepressant.

For example if part of your symptoms include Lathargy, heaviness, and lack of motivation, then a Norephinepherine based drug would be a better option because they are more energizing.

Just a note on Effexor: I will tell you a little known secret about Effexor XR. Below the 150Mg a day dosage Effexor is nothing but an SSRI and does not give Norephinepherine action unless the dosage is 150Mg a day and sometimes 225Mgs a day.

Most people find relief on Effexor between 150 to 300mgs a day. If after 5 weeks on Effexor your still not feeling better don't be afrade to go up to 225Mgs a day.
On the same note do not go above 500Mgs a day because that is the danger level. Beyond 500mgs a day is not wise.

Also think about adding Deplin. It has no side effects and really helps Effexor to work much better.

You will hear some people bash Effexor because it makes you sick for about 6 weeks after you stop taking it. To that I say, "I already have one foot in a coffin and I am supposed to be worried about future withdrawl."

Thanks, but I will take relief from my depression and take the risk.

[Marks470]

Thanks for the great feedback.  I couldn't agree more with your opinions on Psychiatrists and there methods.  I've only been seeing one now for about four months and you described him perfectly.  I'm and engineer by training and could do a better job.  When I first went, I mistakenly throught that he would want to hear my symptoms.  When I started to tell him, he interupted me and said we'll get to that in a minute and he went on to as about my SS number, place of employment, insurance,etc.  Then he handed me two scripts and said I'll see you in a month!  Never even gave me the opportunity to say more than I was depressed and anxious.  "here, take zoloft and xanax and I'll see you in a month".  What a joke.  I've been back three more times.  I'm not going again.  My primary care phasician is a much better doctor.  He listened to me for an hour and a half and as long as I needed on several other occasions.  He is working through this with me.  I will talk to him about effexor xr.  I have an appointment tomorrow.  

By the way, my brother-in-law is a pharmacist and he recommended effexor xr as well last night.

Thanks again.

[Hensley258]

It's been 12 weeks at what should be an effective dosage.

You gave Zoloft a good shot with plenty enough time to work. It has failed you.

You will need to try another antidepressant. When Zoloft failed me I switched to Effexor XR and got relief at 150Mgs, which later had to be increased to 300Mgs a day.

There is a chance that you need an antidepressant that effects Norephinepherine. Zoloft doesn't, nor do any SSRI's. This is why I mention Effexor as an alternative.

Other drugs that also effect Norephinepherine are Pristiq, Cymbalta, and several tri-cyclic antidepressants such as Amitriptilyne, Nortriptilyne, and Protriptilyne.

Maybe first make a switch to Effexor XR and then add Deplin (one tablet a day) The Folate in Deplin is absorbed directly into blood plasma and can help antidepressants like Effexor work even better.

(No you can not get this same effect by taking Folic acid suppliments)

If the Effexor and Deplin fail you then you could try adding about 600Mgs a day of Lithium which will act as a booster drug. (No, Lithium is used just as often for uni-polar people as it is Bi-polar people.) It offeres benifets for both. The idea that Lithium is only used for people with Bi-polar is completly wrong.

Psychopharmocology is not an exact science, but rather an art.

Get with your Psychiatrist and tell him streight out, "this is not working and here is what I want to try." If you don't take control of your treatment then don't expect any doctor to do so. Most Psychiatrist have a revolving door in their office. Your in one minute and out the next and they could care less about if they prescribed you the right drugs for your symptoms. This is because most of the time they aren't even listening to your symptoms.

People often ask me, "how did you figure all this out because your not a doctor?"
Well yea, right I am not a doctor, but after years of sub-standard care and 2 minute visits from various Psychiatrist, I had no choice but to become my own doctor.

It was either that or die. I figured I would live so I went to extensive study regarding Psychopharmocology. Now I tell my P-doc what I need because obviously he is too stupid or in too much of a hurry to treat me correctly.

What I have come to learn is that 50% of the time a Chimpanzee can do a better job of prescribing the right psychotropic meds to a patient. This is no joke. That is how bad our health care system has become.

Good luck and do yourself a favor, learn everything you can about these drugs right down to the molecular level. You need to learn which ones are good for what symptoms.