ZOLOFT interactions! what's ok and what's not?

[lynnsee]

I've been on Zoloft for 2wks now for panic disorder and mdd. week1 was 25mg and week2 50mg. while I've felt a bit of a difference in both my depression and anxiety, I still worry about a few things. one being drug interactions. I've asked my doctor and pharmacist a couple questions but i'm still hesitant about a couple things.

1. is it ok to drink chamomile tea while on Zoloft?

2. are pain relief meds like ibuprofen and acetaminophen ok to take while on Zoloft?

my third question doesn't exactly have to do with Zoloft but it is part of my anxiety. i developed a fear of caffeine believe it or not. silly i know. but the most I've consumed is about one drink of tea or soda probably about once a week. just to get the taste. and i wont even go near chocolate. that's that i love chocolate and sweet tea. anyway, my question is:

being that i haven't consumed a lot of caffeine like i used to, if i start consuming it again in larger amounts, will it effect the way i feel or have any impact on me at all?  

thanks in advance.

-lynnsee c;

[happynow40]

I read all this post on hear and noticed the dates. I was wondering how you are doing now being it's been a couple years?

[lynnsee]

well I do feel better than I did when I was on 25mg. just not completely better yet. I still fear caffeine and even too much sugar. I hope 50mg works for me though.

[kimberly826]

I was on 50 mgs for over five years and just recently 6 weeks ago needed an up in my dose.  Give it a good six weeks to kick in.  I am on my 5th week at 100 mgs and although I don't feel back to normal I am getting better and am not even near as bad as I was six weeks ago.  It takes time.  But sertraline (zoloft) Gave me a good 5 years.  And I remember thinking each week how I felt better then the week before when I first started!  You will know if you need an increase!  If after 6-8 weeks you still don't feel better then go back in and maybe up it!  Good luck and take time for yourself! I also recently cut out caffeine cuz it triggered my anxiety and i am also scared to drink it now too.  I know though that once my anxiety get back to normal I will drink it in moderation again!

[lynnsee]

oh ok thanks. how would I know if I needed a higher dose? im taking 50mg right now.

[nursegirl6572]

You definitely need to give it more time.  It could take up to 6 weeks to reach a more therapeutic level and also, you may end up needing a higher dose after you reassess it.

Hang in there...you're moving in the right direction.  You're seeing positive changes, which is great.

[lynnsee]

oh ok, thanks. I feel like the zoloft has helped some. I've been on it for almost 3weeks. since I have yet to feel completely better, does that mean that its not working for me, or do I need to give it more time?

[Paxiled]

As I said before, green tea doesn't really give people the caffeine rush that say coffee does or energy drinks do because it's balanced with relaxants.  The reason I say to avoid the sugary teas is just because you sound like you're looking for something to drink regularly and if you find you like a good organic Sencha from a good health food store you'll have a drink you like and that won't overstimulate you -- you won't have to worry about it.  If the Zoloft works, then you won't worry about this stuff so much and you can do what you like in moderate amounts, as Nursegirl says.  I'm not telling you what to eat and not eat, just giving a suggestion for now on something that won't make you worry and that will also be good for you, something positive to do for yourself.

[lynnsee]

thanks again nursegirl. what im afraid of as far as caffeine is I'm worried that if I have too much, I might get hyper or something and freak out and/or have a panic attack :b

[nursegirl6572]

It will take time, hon..you're getting better, which is great!  Just try to make a concerted effort to stop yourself when you notice you're "obsessing" about something.  With practice, you can improve that.

I think you can start reintroducing the things that frighten you gradually, but only after the anxiety is more controlled.  While caffeine isn't a bad thing to give up...you also have a bit of an irrational fear about it, which would be good to face, when the time comes.

Hang in there...keep us updated, you're doing great!

[lynnsee]

ah thank you nursegirl. I know I am most definitely overthinking things but I cant really help it much. the Zoloft has helped me some sense that I feel a bit better but I still worry a lot about things and I still don't completely feel like myself yet. I guess part of it is not knowing whats too much or when I can have more so instead I just take little sips or bites here and there or just don't have those things at all.

[nursegirl6572]

You're overanalyzing this sweetie.  Things in moderation or small amounts are okay, and certainly none of those beverages are an issue with the Zoloft.  

Paxiled made a good point that the choice you made to lay off some of those things was a good one, as it's best to steer clear of substances that could exacerbate our anxiety.  When your anxiety is better controlled and you're not so overly focused on worrying about the effects so much, then you could add a reasonable amount of caffeine to your diet.  To do so now will likely put you at risk for an anxiety induced reaction, where you may convince yourself that the caffeine is causing terrible symptoms.

While I give people a lot of credit who cut that stuff out of their diet completely, as that makes the most sense, I also feel that small amounts, or consumption of those items in moderation are fine.  You just have to use common sense and not overdo it...and avoid that kind of stuff while you're still having a good bit of anxiety (which would probably mean now at the present).

Just try not to ruminate too much about every drink out there.  The things you're mentioning all sound reasonable.  If you were asking about yoohoo or espresso, or mega sized energy drinks, it would be different, but you're talking about different kinds of teas.  Don't drive yourself batty overthinking this stuff, ok?

[lynnsee]

oh ok. those brands have green teas as well. lipton even have the ones that say "100% natural" and Snapple has a flavored white tea. are those ok or to sugary. thanks again for all your advice.

[Paxiled]

Well, most of the teas you mention aren't green tea, they're black tea.  Green tea is better for you, white tea even better.  Arizona is just a sugary drink.  I mean good organically grown green tea you brew yourself. You can find many in a good health foods store.  Just for fun, research tea and see how they differ, it's quite interesting.

[lynnsee]

thanks paxiled. are the green teas like lipton, Arizona and teas like that ok to drink or did you mean the kind you brew yourself?

[Paxiled]

Oh, the chamomile tea is fine.  

[Paxiled]

Caffeine is a bad idea if you suffer from anxiety, and all the things you've given up except tea are harmful for your health, so I'd look at this as a good thing!  Now, not sweet tea, but good old green tea --- wonderful for you in so many ways, and the caffeine isn't as stimulating as it is with coffee because it's balanced by natural relaxants also found in green tea.  So there's one thing for you.  All ssris have a warning about taking NSAIDS, which includes acetaminophen and ibuprofen, in that they can cause bruising and bleeding.  But it's just something to watch for, it doesn't mean you can't take them.  Just need to be alert.  And don't overuse them, as they have their own health risks.  Just once in a while.  My view is, try things, if they don't work for you, don't do them.  The only ssri with a lot of drug interaction is Luvox, but it isn't used much in the US.

[lynnsee]

well I've just had about 1/3 of a can of coke-cola. is that a reasonable amount of caffeine, too much or can i have more?

[lynnsee]

thank you both for the advice. i feel a little better about those things now ^_^

[BluCrystal]

Hi, Lynsee!  I have been on Zoloft for over 10 years.  Everyone is different.  But in my own experience chamomile tea, ibuprofen, acetominaphen, and caffeine (1-2 drinks a day) have never been harmful or caused me to feel any different.  Same with chocolate.  You can ask your doctor.  Or you can simply avoid these foods if it makes you feel better to do so.  Blessings - Blu

[nursegirl6572]

It's usually okay, but double check with your doc or pharmacist.  All of these worries are your fear about the medication persisting.  Most things like that are okay...when it doubt, double check!

[lynnsee]

thanks nurse girl.

what about taking multi-vitamins while on Zoloft? and advice one that?

[nursegirl6572]

HI again hon!  I'm glad to hear you're seeing positive improvements!  Way to go!

As far as your questions go...there are no obvious contraindications between Zoloft and the things you asked about.  Of course, you can always ask your doc or pharmacist, but on the books, there is nothing documented warning against concurrent use of those.

As for the caffeine, you COULD notice some symptoms if you significantly increased your caffeine consumption, especially because you've virtually eliminated it from your diet all together.  Moreso than the physical reaction...I would caution against making any changes right now until your anxiety is better under control, as you would really be at risk for having an anxiety induced reaction.  Just makes more sense to avoid it right now than to tempt fate.

As you improve, you will better be able to rationalize that your level anxiety is out of proportion for the risk.  Obviously, a lot of caffeine isn't a good thing for anyone, and certainly CAN trigger anxiety, but small or moderate amounts shouldn't cause overwhelming anxiety...that's your anxiety talking.

For now, I wouldn't rock the boat.  Keep up the great work!  Keep us updated!