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Going up on Zoloft, Looking for reassurance
I am in my mid-40's, post menopausal, and have been on Zoloft 100mg for 17 years. I recently had a really bad setback with my anxiety and it's been ten days since I increased to 125mg. I have noticed no improvements. I have a lot of health anxiety, and I sometimes convince myself that the Zoloft doesn't work anymore and I am doomed. I feel like after being on Zoloft for this long of a time, a dose increase would show some improvement by now. These setbacks show me how much I take the good times for granted. Should I keep going with it?
Gosh, sorry about set backs. Here is the thing, Zoloft like all of these types of medications can have the 'poop out' effect. It just stops being effective. Not sure if that is what is going on. I will tell you that Zoloft is one of the meds that usually requires the higher dosage range to get full effect and many underdose with it on a regular basis. This could have been you. I'd personally go ahead and go up to 150mg with doctor approval.
If it has pooped out, try another medication. It's been 17 years and there may be something else that helps.
The thing about anxiety treatment though is that you WILL still have anxiety from time to time. It doesn't totally take that away if there is something going on in your life that is difficult. You're still human and haven't been turned into a robot that is programed for "NO ANXIETY". So, judge if it is situational and if it would be natural to have increased anxiety if you are going through something difficult.
As a woman with raging hormones, (my lucky family), I found my anxiety related to menopause to be cyclic. I can track it very easily as my hormones shift. And psychiatrists do treat women's mental health disorders related to hormones. It's a whole subspecialty in psychiatry and in my area, there are doctors who only see women and issues surrounding things like menopause, post partum, PDD (premenstrual dysphoric disorder) are treated. Sometimes they are indeed treated with SSRI's and SRNI's and the hormonal factor is also worked on. Your ob/gyn could probably give you a referral to a doctor in your area who has this subspecialty.
You've had a life long battle with anxiety. That's rough. I have a son who showed signs of anxiety at a very young age. I'm glad you are on Zoloft--- I would increase the dose to give it a chance to help and if not, speak to your doctor about the next step.
Also, I can't say enough about getting good sleep with regards to anxiety and hormones, depression and hormones. It's always worse if our sleep is disrupted and it often is when going through menopause. Hopefully that is better for you now that you're on the other side. I'm still battling that. Cyclic insomnia is another joy I'm experiencing. And exercise. It's a natural mood boost. Get 30 minutes of exercise at least 5 days a week.
Let me know what you think of what I've said!
If it has pooped out, try another medication. It's been 17 years and there may be something else that helps.
The thing about anxiety treatment though is that you WILL still have anxiety from time to time. It doesn't totally take that away if there is something going on in your life that is difficult. You're still human and haven't been turned into a robot that is programed for "NO ANXIETY". So, judge if it is situational and if it would be natural to have increased anxiety if you are going through something difficult.
As a woman with raging hormones, (my lucky family), I found my anxiety related to menopause to be cyclic. I can track it very easily as my hormones shift. And psychiatrists do treat women's mental health disorders related to hormones. It's a whole subspecialty in psychiatry and in my area, there are doctors who only see women and issues surrounding things like menopause, post partum, PDD (premenstrual dysphoric disorder) are treated. Sometimes they are indeed treated with SSRI's and SRNI's and the hormonal factor is also worked on. Your ob/gyn could probably give you a referral to a doctor in your area who has this subspecialty.
You've had a life long battle with anxiety. That's rough. I have a son who showed signs of anxiety at a very young age. I'm glad you are on Zoloft--- I would increase the dose to give it a chance to help and if not, speak to your doctor about the next step.
Also, I can't say enough about getting good sleep with regards to anxiety and hormones, depression and hormones. It's always worse if our sleep is disrupted and it often is when going through menopause. Hopefully that is better for you now that you're on the other side. I'm still battling that. Cyclic insomnia is another joy I'm experiencing. And exercise. It's a natural mood boost. Get 30 minutes of exercise at least 5 days a week.
Let me know what you think of what I've said!
3 Comments
All of your advice is correct. I am in such a bad place right now. I enjoy nothing. I literally tremble all day. It seems that nothing is helping me, but I can't put my life on hold because I have to work. I'm stuck.
Life never actually goes on hold. I had to stop working because my brain and body were destroyed by a medication -- I wish I could work. Not working doesn't put life on hold. It just goes somewhere else. If that somewhere else is a better place to be, you'll feel better, but if work isn't the source of your problem you'll just have even more time to sit and strew over things. What you describe is a growing case of depression. For most of the time I suffered from anxiety I wasn't all that depressed, and life changed but went on. When the drug caused me that damage and all hell broke loose with my mind and body and ability to sleep, that was a whole other thing entirely. Are you in therapy for it? What's your lifestyle like -- do you do things you love to do? I don't mean to get personal, but do you have a sex life -- that can really help with hormonal problems. It definitely helped my wife, who, although she has no mental problems, I've gone through the hormonal problems of thyroid breakdown, perimenopause, menopause, and now post-menopause. Keeping up with her exercise, keeping her normal sexual activity, and, when she retired, getting a doctorate and moving on to writing a book have really kept her going strong. Just some thoughts. I have no answers for the me I am now, but again, when I wasn't broken by an unfortunate medication problem, I was still able to have a life because I was still essentially me. When I lost me, it's been disastrous. Anything you can do to keep remembering the essential you will help, or at least I hope it will. All the best.
I understand what you mean. Try to do.things that make you feel human again.
It's too soon to notice improvement, it might take as long as it took when you first went on it to notice improvement, which might be as long as 4-6 weeks. And it might be that it's pooped out and doesn't work for you anymore. It happens especially when we have been on a drug for a long time, and also when something new happens that is very hard to handle. None of the drugs you take for mental illness cure it, they just tamp down the symptoms. The only cures knows are if it just goes away, which happens, or you fix it in therapy or some other form of treatment that results in you not thinking anxious thoughts anymore. For now, I would do two things: give the increased dosage some time -- you might have to go up even further. And if something new has happened, know that you still have the anxiety disorder, the drug won't solve that problem, so you might need to do some therapy work on this new situation to give the added dosage a better chance to kick in. Good luck.
2 Comments
And I should ask, did this start when you entered menopause? Did you enter menopause because of something that happened, as you are a bit young to be past it already though of course it's different for different people? I ask because if your problem is hormonal, that is what needs addressing -- antidepressants don't deal with hormonal imbalances. There are natural remedies that can help some people, and sometimes you just have to get used to it and work your way through it, but again, these drugs don't deal with that issue.
I am on premarin, but my anxiety has been constant since childhood. Depression definitely worsened after early menopause.
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