Can zoloft cause panic attacks to get worse after 4 weeks.

[RCRA]

Started Zoloft 4 weeks ago for panic attacks caused by stress.  25 mg for two weeks and 50 mg for two 1/2 weeks so far.  Finally getting through the side effects and my mood and body tension so much better --- but Saturday noticed bad panic feelings that last several hours each morning and are kind of hanging there.  I am working really hard on my CBT skills to not let this concern me BUT :)

I want so bad for the Zoloft to work ---- are these new panic attacks a bad sign I am having problems with Zoloft?

Advice would be appreciated.

[nursegirl6572]

Hi there.  Sorry you're having a rough time.  

Were you tapered off the Prozac, or just switched abruptly from the Prozac to the Zoloft?  If you were not tapered first off the Prozac, and just switched to the Zoloft, it's not surprising that you feel like you do.  You're probably dealing with a combination of withdrawal from the Prozac, and the start up side effects of Zoloft (at a very high dose I may add).  

I would encourage you to speak with your doctor ASAP about how you're feeling.  Keep us posted, okay?

[Kimberleyb1968]

Can someone help me please. I was just put on 200 mg of Zoloft to replace Prozac it's been two weeks and now I am having such bad anxiety that I can't leave my house I am really scared. Help.

[schwens3]

I'm at 4 weeks on Zoloft.  Two of them at 50 mg (upped from 25 mg).  I stilln have some really bad days BUT I've had a couple good days with low to no anxiety so I like to think the Zoloft is working it's just taking a LONG time.  From other boards this seems to be normal for Zoloft.  Let's stay in touch!

[RCRA]

4 weeks on zoloft 50 mg and still major groggy/sleepy head and some anxiety --- maybe even some anxiety caused by frustration of groggy head at work.  Last night had panic feelings while cleaning house -- so had to take xanax -that was very weird.  Have been working so hard on CBT skills to not let any feeling stop what I want to do and trying to be positive.

There have been positives --- -but I would like to work to get a little better with the anxiety and stop the extreme groggy head.

Will a couple more weeks on the 50 mg zoloft show improvement?
Should I go up to 75 mg -- but will that make the groggy head worse?

So many unknowns????

[RCRA]

At 3 weeks on the 50 mg of zoloft things have been really going well -- even though some anticipatory anxiety still present, I can definitely see improvement from the zoloft and noticed that my confidence is back and can do things despite the anxiety.

But I also noticed that yesterday and today I again feel a little extra level of anxiety or tension just there --- hanging on -- very annoying :).  Not really enough to need xanax -- but annoying!  Could be because I am pushing myself to get back to my normal routine or could be I am still adjusting to the zoloft increase.  I am trying to be patient and be positive that this will continue to improve at 4 to 6 weeks.

Any thoughts or suggestions.

[Paxiled]

By the way, when I said only time will tell, that's because I agree with nursegirl that you need to give it more time to work.  As for short-term use of an ssri, sometimes that's a nice idea better noted than happening in reality, so take care if you don't want it to be a long-term thing that you don't let it become so by inertia.  

[Paxiled]

Antidepressants can be stimulating to some people, sedating to others.  What works for one may not work for another.  It is a common side effect for an antidepressant to increase anxiety.  So if it doesn't resolve and this started only after you started taking the Zoloft, it might indicate this isn't the right med for you.  Only time will tell, but you're right to be concerned about the connection.

[RCRA]

Tee hee -- you sound just like my therapist.  I definitely agree and hoped that medication would not be needed --- called my therapist as soon as I lost control of the anxiety in hopes that refreshing my CBT skills would nip it in the bud.  But because some major impacting issues occurred back to back, panic attacks started and I just couldn't seem to get my body to relax - even while I was on vacation.  I listed to every relaxation tape and meditation program I could find :)

My therapist recommended a low dose of SSRI to help get my nerves calmed down and continue to work on CBT - changing my stressful behaviours, etc.

My hope is that this bump in the road of life taught me to be more aware of my stress cues --- and take action much, much sooner.

[nursegirl6572]

"This time Panic Attacks hit I had a huge overload of stress at work (promotion, new employess, etc., etc.) and a bunch of charity work I had volunteered for and my nerves just broke!"

Certainly sounds like you had a lot going on....remember that anxiety IS a normal occurrence, especially during stressful times.  If you've identified a trigger (or triggers) for the anxiety, the best approach is working on addressing those things.  Medication wouldn't normally be indicated to treat stress caused by life's circumstances, unless of course the amount of anxiety was significantly disproportionate to the stressor.  

I'm glad to hear that you're working with a therapist, and using CBT techniques.  That's really a great way to approach anxiety treatment.  Hang in there!

[RCRA]

Thanks so much for writing --- your thoughts on this really help!!

I am a major Type A personality --- for both work and outside activities and sometimes get out of control :)  I learned about CBT about 10 years ago and use a really great therapist and have some in-home tapes and books that are great reminders of what we are supposed to do!

This time Panic Attacks hit I had a huge overload of stress at work (promotion, new employess, etc., etc.) and a bunch of charity work I had volunteered for and my nerves just broke!  

My therapist said I needed a little medicine help this time to calm the nerves.  Now just learning to deal with the side effects and having patience for it to work.

Thanks again!

[nursegirl6572]

While everyone is different, I too have had greast success with Zoloft, I'm on it again for the second time (first time was at age 18, when first Dx'ed with PD)...and it has dramatically decreased my anxiety.  It's almost non existent at this point and I'm now doing SO much more that my anxiety presented an obstacle for me before.

Fingers crossed you'll see improvements.  Keep us updated!

[nursegirl6572]

It's really too soon to tell.

As you probably know, it's not at all uncommon for a person to experience an INCREASE in anxiety and panic when first starting Zoloft.  You also just increased your dose significantly, so you have to give that time.

I would say to give the new dose at LEAST 6 weeks before assessing how you feel.  You can always talk to your doctor about prescribing a short term course of an anti-anxiety med (like Xanax) to help you get through until you've adjusted more.

You say you're working on CBT (which is great!)...are you doing that alone, or with a therapist?  

[coh123]

I used to be on zoloft for 12 years, it is a wonderful drug, I think you just need to give it time to adjust. I remember when I first started it, I never thought it would work then one day it was a light came on!! Stick with it, I wish it still worked for me!!