anti-depessant stopped working

[TAILFETHERZ]

dear dr., i'm 37 yr women with hashimoto. 2 years ago i had severe breakdown with depression and anxiety. i had been taking zoloft for 9 years for a depression in 95'.the zoloft worked great until this. i startd major hypo symptoms after partial hyster. in 2001. of course it took going through 13 docs to find out was wrong with me even though i had all hypo symptoms.this past april i started comounded t3 and it helped me function again. i even have regained function with no pain on my only ovary that is left. my problem is that i still have severe brain fog, still feel very detatched, among other hypo symptoms which some are getting better. i am still taking zoloft, but only 50 mg as i used to take 100mg. i would go up on zoloft, but i can't see that its doing much, plus since being diagnosed with hypo, i sometimes have side effects that i never had before on it. i have been tested for adrenal amoung other things, and thyroid is my only problem. why is my brain not back, should i add t4, and i understand if one takes zoloft they may need more thyroid meds, why is that? i have been like this for 2 years now, and i was totally normal before this. will i have a sense of well being again? sorry this is so long, but its been very scary. thank you for your time and this wonderful site.

[Mark Lupo, M.D.]

Zoloft appears to increase the metabolism of the thyroid medication (clearing it from the system faster in many patients).  Therefore, a dose increase is sometimes necessary.  I am not sure if this applies to compounded T3 and my experience with compounded T3 has not been consistently favorable.  For that matter, T3 (ie cytomel) may benefit some, but certainly not all patients.

I would work with you psychiatrist regarding anti-depressant dose/brand and regarding thyroid -- keep TSH around 1.0.