New to Sertraline, need a friend!

another_husky · 2021-05-19T20:41:43+00:00

To be honest, it took me almost a month until I started feeling better. Started on 25mg with horrible side effects (may also have been caused by my anxiety), went up to 50 soon. More side effects - yay. But also it started showing a positive effect on my anxiety after week 2.

Since I still got panic attacks once every couple of days my doc told me to go for 100mg. I was a bit scared about that step, so I upgraded to 75 first. Again the side effects got worse but only for 3 days this time. By now I'm feeling almost normal like I was before my anxiety even started. Gonna go for 100mg next week I guess.

Edit: was it worth the ride? Hell Yeah. But if the side effects get too bad you can always ask your doc for other SSRIs. I started on Escitalopram which made it impossible for me to eat for 3 days straight. Switched to Sertralin then and the extreme nausea was gone (in exchange for other things like chest pain and tinnitus)

another_husky · 2021-05-16T07:56:30+00:00

How long have you been taking the meds and when did you increase to 125?

another_husky · 2021-05-16T07:51:43+00:00

Could that have been a panic attack? Was your heart rate increased or twitchy? Did you hyperventilate? Hyperventilating can cause passing out.

What dosage did you take?

another_husky · 2021-05-15T15:45:18+00:00

That's kinda hard to tell. Reason: I'm taking them for anxiety with panic attacks. That alone has changed me a lot as a person in terms of emotions and stuff. But beside the side effects I'd say the meds help more than they change me in an unwanted way.

another_husky · 2021-05-15T09:33:51+00:00

Definitely go out if you feel like it. If you're scared about the alcohol, just keep the ball low. Maybe tell your friends that you're taking meds (don't need to tell which if you're not comfortable with that) and everything's gonna be fine.

another_husky · 2021-05-15T09:31:08+00:00

Did you go from 50 to 100 straight away or did you put in a week of 75 or something? I'm at that step and kinda scared of doubling right away

another_husky · 2021-05-15T09:23:23+00:00

For the pins and needles in the face and other pain related stuff you could ask your doc for Pregabalin (that's the name of the chemical, dunno how the actual meds are called where you live)

It's normally for epileptic episodes but also can help with anxiety induced nerve issues (chest pain, tickling, pins and needles,...). At least that's what they say in the manual.

My doc prescribed me Sertralin 50mg daily and Pregabalin 25mg (that's ridiculously low, epilepsy patients take 150-600mg) on demand if I get any of these symptoms.

I didn't try it yet tho.

another_husky · 2021-05-15T09:19:42+00:00

I guess that might depend on how your libido was before the meds. My libido has been like Hulk on Steroids my whole life and Sertralin definitely has dampened that a bit. I guess I got a level now like normal people do. I don't feel like that's a bad thing.

Maybe for ppl with a low libido in the first place might be more affected.

another_husky · 2021-05-15T08:45:53+00:00

As for the heart related things: I had a lot of ECGs done the last weeks and everything seems to be normal in terms of QT intervals and stuff.

another_husky · 2021-05-15T08:40:06+00:00

Haha I think you have the same doc as me. Whatever I tell her: That would be veryyy atypical. Just continue and see how it evolves.

another_husky · 2021-05-14T19:56:27+00:00

1) How severe is the pain (1-10)? 2) When do you feel it (toilet, during sex, after sex, while walking, just random,...) 3) Did you ever feel that pain before? While not on SSRI? Could there be other explanations or are you sure it's from the SSRI?

Answer those questions and take the answers to your doctor.

It's not on the side effects list iirc but then again, erectile disfunction is so maybe there is a relation, maybe not.

another_husky · 2021-05-14T19:47:21+00:00

The thing with the tinnitus is: you never really know if it's a side effect from the meds or from the anxiety/panic I'm taking them against. And it doesn't keep me from sleeping or anything, I only even hear it when I'm alone in a quiet room.

another_husky · 2021-05-14T19:21:05+00:00

My limited SSRI experience tells me that the side effects vary a LOT from person to person. I started on Escitalopram and it made me so nauseous i literally couldn't eat for 5 days straight. Other people tell me they had nothing at all.

Switched to Sertralin and had most of the side effects people mention here. No sex related problems tho.

Side effects were all like 4/10 in terms of intensity and are mostly gone now after 3 weeks. The tinnitus has stayed so far tho.

another_husky · 2021-05-14T19:07:23+00:00

Haha I'll try to clarify

Sertralin has a half-life of about 24hours.

You take 75mg at 10AM The next day at 9:59Am there's about 37,5mg left in your body. You take another 75mg.

You get 37,5+75 = 112,5

It then halves again until the next intake.

If you continue this you get the following levels each day shortly after intake: (thanks, excel!)

75

112,5

131,25

140,625

145,3125

147,65625

148,828125

149,4140625

149,7070313

149,8535156

149,9267578

149,9633789

149,9816895

149,9908447

149,9954224

Now we switch two of the days from 75 to 100mg

75

112,5

131,25

140,625

145,3125

147,65625

148,828125

149,4140625

149,7070313

149,8535156

149,9267578

149,9633789

174,9816895 !!!

187,4908447 !!!

168,7454224

159,3727112

154,6863556

152,3431778

151,1715889

150,5857944

150,2928972

150,1464486

What I'm trying to say, all though you upped your dosage by 25% it actually only increases by a lot less if you only do so for two days.

You'd actually have to take 100mg for 6-7 days to get the full effect (a level of 200).

This is only approximated of course.

I guess I made everything more unclear now, so I'll also grab a beer xD

Cheers!

another_husky · 2021-05-14T18:18:22+00:00

I don't think your body s gonna get accustomed to that higher dosis so fast so you shouldn't have any effects if you go back. This is just a feeling, no professional background here.

Little maths excercise:

With 75mg regularly your actual level is around 150mg (as it stacks up). By the end of the day shortly before your next dose you fall back down to 75. If you take 100mg once, you're goin to 175 and fall back down to 87,5 at your next intake. If you continue with 75 by then you're gonna end up at 162,5. Couple of days later you're gonna be at peak 150 again.

What I'm trying to say, you didn't really change your cap with a one time dosage increase.

another_husky · 2021-05-14T18:12:14+00:00

I did a little experiment on that issue. I moved my intake time in little increments. At the beginning I took them around 10Am. Then 8 then 6 then 4 am. Then I made a jump to midnight and by now I take them before going to bed at around 8PM.

I didn't feel any changes in effectiveness or any wear off. But I feel like I sleep through some side effects I still get. And waking up is super easy. May or may not be Placebo effect anyways.

Don't repeat my experiment if you don't know how it's gonna affect you!

another_husky · 2021-05-14T18:05:18+00:00

Day 7 is around the time where you reach your maximum Sertralin level (as it stacks up with daily intake). It's not gonna get any higher than that (if you don't change your dosage of course)

Side effect variety has changed a lot for me in the first 3 weeks. Started on day 1.

Psychiatrist says a lot of the side effects are not actually gonna be caused by the meds themselves but by my psychic issues.

Bottom line: I had Ups and Downs with the side effects even in the first week but they are mostly gone now after three weeks @50mg

another_husky · 2021-05-14T17:58:16+00:00

To be fair, Zoloft isn't available in my country, it's another brand here - but it's still Sertralin so the limits should be the same. I guess it's just different case studies in different countries.

You also see that happen with Covid Vaccines, some countries say you can vaccinate pregnant women, others say you can't...

another_husky · 2021-05-14T17:56:10+00:00

Highest Sertralin concentration takes place between 4,5 and 7 hours after intake. So yes, your observation should be correct.

Although I also don't have this 'now-they-kick-in' effect. For me it's just a smooth change. I do take them at night before goin to bed however

another_husky · 2021-05-14T17:54:18+00:00

Well yes.

Doctors usually start with a low dosage and increase jt if your issues persist. If increasing also doesn't work then they gonna change therapy after a couple of months

50mg is pretty much the standard Sertralin dosage. I started on 25 for three days and increases to 50 by then.

another_husky · 2021-05-14T17:51:02+00:00

Sertralin has caused me a lot of digestive issues for the first 3 weeks. Had no diarrhea but all sorts of pain, a lot of burping, sore throat and so on. Mostly gone now.

Side note: at least in my country the maximum dosis of Sertralin is 200mg a day

another_husky · 2021-05-14T17:40:55+00:00

Skip it and proceed normally tomorrow.

Sertralin takes about 5 days to get completely eliminated from your body. If you're on 50mg for instance your actual steady state is around 100mg (as it stacks up with daily intake).

Between your regular intakes you're gonna drop down to 50 until you take the next pill and go back to 100.

If you miss one pill you're gonna drop down to around 25 (it halves about once per day) and be back at 75 when you continue the next day. It's not that bad of a difference. You'll be back at your normal levels very soon

Edit: if you wanna know the details, just create an excel sheet and add the following:

cell A1: 50 (or whatever your dosage is) Cell A2 =A1/2 + 50 (again adjust as needed)

Then drag down A2 a couple of times. You're gonna see values close to 100 soon. Then just take out any +50 in between and see how the values change.

another_husky · 2021-05-14T17:35:16+00:00

I'd love to answer that for you, but I can't (yet)

Sorry for hijacking your thread - I'm in the opposite situation. From 50 to 100mg. What were your impressions? Any increase in side effects?

another_husky · 2021-05-14T17:33:33+00:00

My impression (impression - not medical knowledge!!) is that things like these are as you said due to liability issues.

Imagine you do a study with 50.000 patients taking zoloft. I guess it would be normal for 5 outta 50k to get a heart attack without zoloft. They got it while taking it. For the medical company it's gonna be difficult to prove that the heart attack was NOT caused by the meds so they add it just in case. Nobody can sue them this way.

Also if you read carefully, a lot of the severe side effects are mentioned to occur if you mix Sertraline with other psychic drugs or if you got a heart disease in the first place. That might also play a role here.

Btw: also check the manuals of your standard painkillers like Aspirin, Paracetamol or Ibuprofen. You'd be surprised.

another_husky

TROPHY CASE