time for an update:

it's been 8 weeks on 50mg of Sertraline.

on the pro side:
# helps with social anxiety and somewhat with depression
# some subtle psychosomatic symptoms have diminished
# diarrhea no longer an issue! Mr. Hankey is hard and cohesive.

cons:
# insomnia | ****ed up sleep cycle
# weight loss. My appetite is nearly back to normal, but I am still loosing weight or at least not gaining any. BMI 19 right now. That is bothering me. I don't want to become underweight.
# heat intolerance (my entire life I've been loving warmth and heat. I was the guy who could sit at the top row in the sauna for 20min @ 100°C (212 °F), but right now I cannot even stand the mild summer.
# exhaustion (walking 2km around the block makes me feel exhausted & breathless. I feel somewhat weak, without power)
# agitation /motoric restlessness seems to be worse than before taking Sertraline
# and the many times mentioned "zombification"
# mild heachache and "pressure" in my neck. Nothing bad, but very annoying in the mid and long term.

I am unsure about the further course of action: Staying on Sertraline as a standalone treatment is not an option, as the side effects are not bearable in the mid to long term. I've been thinking about the popular Sertraline + Nortriptyline combo, but Lundbeck has withdrawn Nortrilen from the German market, so this is no longer a viable option. I've been also thinking about Sertraline + Mirtazapine (heroic combo | Stephen Stahl), but I am not sure if Mirtazapine will counteract & attenuate the side effects of Sertraline!? Although it might be worth a try before discontinuing Sertraline forever...

What other options are there? Well, there are of course TCAs, which might be worth a try as standalone treatment, for example Amitriptyline, Clomipramine, Trimipramine etc.! Considering Gillmans TCA article & "When to consider avoiding SRIs as first choice" I seem to be a prototype for someone who shouldn't be treated with SSRIs but rather try a TCA as first line treatment *lol*

What are your thoughts?