Zoloft

[klsn]

I have suffered from depression most of my life. And after six years off of meds I became severly depressed and started on them again two months ago. I have been taking Zoloft, which I had taken six years ago without issue. I initially experienced nausea and insomnia, so had to titrate down to half the medication for one week, which helped. But now I am experiencing horrible GI problems. I have IBS and have not had any problems with it for a year. Once I started the Zoloft and it built up in my system over 1-1 1/2 weeks the GI symptoms went crazy. I take it in the am on a full stomach. Then when I eat lunch I have what is similar to gatric emptying w/ a bypass patient or severe unrelenting IBS. It is not daily however, it is usually 4/7 days, so I do not know when it is going to hit.I have now been on Zoloft for almost two months and the GI distress is getting worse, still some nausea, minor sexual issues and feel it is time to change. Any suggestions?

I have been looking into Celexa as an alternative, as it has a generic and is affordable. (I am a full time student w/o health insurance.) But I was told Luvox (too expensive) and Celexa were the best SSRI's for low occurance of GI issues. That Zoloft was around 21% occurance compared to Celexa 8% and Luvox 5%. Cant find this info.

And since I go to a clinic with doctors that are covered by my state indigent care, they are not well versed, or knowledgable when it comes to any psych meds. It was everything I could do just to get them to treat me. How do I wean of the zoloft and when would I start one of the other SSRI's?

Thank you :)

[Hensley258]

I really hate to see you attempt a med change without the advice and care of a doctor at hand.

It's a shame how people are now forced to treat themselves now days, just because health insurance is only for those who can afford it.

If you must make the change without a doctor, I will give you a taper off, then swap method that my Psychiatrist uses with me when I have to swap two SSRI meds.

I don't know what your current dosage of Zoloft is, but lets say your taking 150Mgs a day for example. You will start first by lowering to 100Mgs a day. Take this 100 a day for the next two weeks. Then after the second week drop down to 50 a day. You can do this by breaking the tablets in half or if you have 50 Mg tabs...Well you get the point.

Then stay on 50mgs a day for one more week. After this one week is up, then go 50Mgs of Zoloft every other day for 8 to 10 days. when that time is over (and only then) do you start the Celexa and stop the Zoloft. Start the Celexa at a low dose for first few weeks. The day you start the Celexa your body will be fairly well washed out on the Zoloft by using this method.

The dosing with Celexa is much different, so do some homework on it's proper dosing. If memory serves me right I think 20Mgs a day is considered a good starting point. I think the max effective dosage for Celexa is 60Mgs a day, with 40Mgs being the middle ground.
MAKE SURE YOU DOUBLE CHECK THIS DOSAGE. My memory could be wrong.

This is the safest way to do it when swapping two SSRI meds. Zoloft and Celexa don't play well together which is why this wash out is nessasary. When swapping from an SSRI to an SNRI or Tri-cyclic, one does not need to bother with this swap method because SSRI meds can be mixed with other AD meds as long as they are not in the same class.Zoloft and Celexa are in the same class, and thus should never be taken together.

I hope that helps.

Zoloft and Celexa are in the same class, and thus should never be taken together.