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I was on paxil for almost 10 years - 20 mgs for anxiety.  After another bout with anxiety the dr. upped to 40 and it worked fine, but I gained so much weight that I asked to be taken off.  I was put on zoloft 50 mgs.  I was fine for 2 years on 50 mgs but then got another bout with anxiety.  I was bumped up to 100 mgs and within 3 weeks, I was fine.  Now six months after I was bumped up to 100 mgs. I have it again.  The Dr. has bumped it up to 125 and if that doesn't work, 150mgs.  

My question is why is this happening.  I have the everyday stresses I normally have.  However, I was not exercising, etc.  Why was I fine for so long on Paxil and yet Zoloft has to keep being bumped up  Have you seen this happen before.  
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973741 tn?1342346373
Hi there.  It is my understanding that if you look at the package insert of sertraline/zoloft that the average dose is often quite a bit higher than the starting dose.  It takes a higher mg. amount to get an effect for lots of people.  So, bumping it is trying to get it to therapeutic levels for you.  

Many antidepressants may peter out with time as it sounds like that is what happened with your paxil and may eventually happen with zoloft.  Luckily there are a number of good medications out there to switch to if that happens.

I would look for a pattern to the periods of increased anxiety and see if there are any situations causing it or triggers you can identify.  And I'd definately pay close attention to lifestyle during those times including exercise and other things you do to help with the anxiety.

good luck dear.  
Avatar universal
Thank you so much to your response. I am thinking that a bump up of 25 perhaps won't work. I will perhaps have to take 150 mgs. I finally am keeping a journal of what brings this on. I guess it is about time I did.  I do get scared because I was on the Paxil so long with quite a reprieve in attacks and yet Only on Zoloft for 2 yrs and got another bout.   Thank you again
973741 tn?1342346373
Yes, if you read the package insert of Zoloft, the average dose that was therapeutic for most patients was around the mg. amount you mention.  Work with your doctor on this!

I wish you all the best.  Stay in touch and let us/me know how you are doing, okay?  
Avatar universal
First, Paxil is much stronger in its action than Zoloft, which is also why it's so difficult to get off of.  Often after taking Paxil, other meds don't work as they might have otherwise, and Paxil often doesn't work again, either.  You also can't assume that any med will get rid of your anxiety -- they only cover up symptoms, they don't cure the problem.  Therapy might, other techniques might, but drugs are just a symptom treatment.  So you might find yourself needing higher doses or you might find, as so many others have, that taking Paxil presents unique problems when you stop taking it, but keep at it.  Good luck.
Avatar universal
By the way, the fact that Zoloft worked for you at all is a very good sign given you were on Paxil so long.  That's why I say, keep at it.
973741 tn?1342346373
It's my understanding that antidepressants actually do counteract various things within the brain thereby working on the clinical state it is meant to treat.  Maybe we are talking about the same thing as symptoms are the manifestation of the clinical condition that a person notices.  So, probably we see things the same way but word it differently.  

I absolutely agree about the difference of zoloft and paxil regarding dosages required and effectiveness.  

I'm glad zoloft has worked for you and hope that the higher dose helps keep your anxiety in check.  

I agree that it sounds wise to keep at the zoloft for now and to add on anything else that could help---  the talk therapy, meditation, exercise, healthy diet, etc.  

Lots of luck to the poster!
Avatar universal
Are we saying that because Paxil is considered stronger, other drugs ssris may not work as long as Paxil did. I am of course staying on higher dose of Zoloft, exercise,etc but worried about what happens when Zoloft stops. Will there be other drugs that will work as long as Paxil.
973741 tn?1342346373
Oh, no.  I was saying that 20 mg of Paxil is what typically gets a therapeutic response for the medication --  one tablet.  With zoloft, it often takes more than  one tablet to get a therapeutic response.  So, higher mg strength is often what is required to do that.  While both Paxil and Zoloft are SSRI's, they are still different compounds and dosing is different in that it takes more mg. strength of zoloft typically to control anxiety/depression.  

Don't worry about your zoloft not working.  Follow what your doctor tells you, increase the dose and go from there.  The higher mg. strength may be what you need to alleviate the symptoms.  And if that does not work or at some point peters out, there ARE other medications to try and at this point, a nice big handful of them.  

Try not to worry about this.  Communication with your doctor is key and again, talk therapy is so very very helpful.  peace and luck and let us know how it goes.  
Avatar universal
Thank you. I truly appreciate.  
Avatar universal
Sorry to bother you again. Do people in such a scenerio as mine, that a bump of 150 mgs worked.  First I was fine on 50 for 2-3 years; then 100 for only 6 months (was fine) now got back and on 150mgs.   I read that if zoloft worked for someone at 50 mgs and they get it back again, it won't be effective.   I know that there are many antidepressants out there.  I am just hoping that this will work for at least 6 months or so.  Has anyone seen this happen to another?  Thank you so much
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