Zoloft and Lithium

Cam, I'm on 100mg of Zoloft now - day 2.......earlier I was on edge, felt like I was going to jump out of my skin and several other "adjustment" symptoms. The doctor was suprised that my pdoc started me out at such a high mg.......what do you think?

Mary Alice

Mary Alice - 100mg of Zoloft™ (sertraline) is a fairly high starting dose, unless you are switching from another antidepressant. There can be reasons to start at higher doses; side effects (eg. which are just effects of the drug that we don't want, at the time) can be used instead of resorting to another drug. For instance, Zoloft's initial side effects include sedation and an anti-anxiety effect, which may be why your pdoc started you at the 100mg.

I'd double check with your pdoc and see if he really meant for you to start at that dose. It can't hurt, and it shows that you are involved in your treatment and recovery. ... or you could get your pharmacist to contact your pdoc to confirm that dose.

I am sure that there are other reasons to start at a high dose, I just can't remember them at the moment. I hope that this is of some help. - Cam

Cam, I was on 40mg of Prozac........but now with the Zoloft my nerves are really on the edge, like I want to crawl out of my skin. I have no sedation effects and if anything, my anxiety has been increased. I can actually feel my hands shaking sometimes........and I take the pill first thing in the morning.

I would have preferred a diff category that the SRI's......I see him tomorrow (today actually - lol) and see what else we could switch too.

Thanks for your input.

Mary Alice

Mary Alice,

If it is affecting you that way it sounds like too much to me. Reminds me of taking just a little bit too much of Tylenol PM. If I take too many I get aggitated and anxious and anything but sleepy.

My sister (the one who is a psychiatrist) really likes Effexor. She has used it herself, and so does my other sister, and say that it works well with minimal side effects.

<font color=blue>Life is filled with tragedy; if you let it overwhelm you, you cannot enjoy life's innocent pleasures. -Robert Heinlein</font color=blue>

That's just what he prescribed today, Rapunzel.....3 times a day. Hopefully it will do the trick. Thanks for checking on it for me - tomorrow will be the first day.

Mary Alice

I had ECT last year, it helped for a while... I was feeling so good for a long time. I am thinking about having it again to see if it will help me to get over the feelings I have been having again.

I do remember some of the ECT procedures. The thought still scares me. I have read that it can cause brain damage. The actual shock only last about a minute my doctor told me last week.

Who knows, maybe I can get off meds with it.Guess it's worth a try,

Hi,
I used to be SweetAndSuicidal, but I got my nickname changed. This one fits me a lot better!

Cam, my pdoc recently put me on Seroquel 100mg once in the evening. I sleep REALLY good with it. That is the only med I look forward to taking just because I know I will get some sleep. But lately I have been tired all the time, when I am off work I stay in bed all day... I have been late to work, not because I overslept just because I'm too tired/lazy to get out of bed...I take my SAT on November 1st and I am so not ready because I get too tired when I try to study. I forgot to tell my pdoc about this and I wont get to see her again for another month. If I am taking too much Lithium would it cause me to be tired all the time?

~Angel

<font color=purple>"Death is my only hope!!"</font color=purple>

Razors pain you
Rivers are damp
Acids stain you
Drugs cause cramp
Guns aren't lawful
Nooses give
Gas smells awful...
You might as well live.

-Dorothy Parker

Like the new name :O)
Heidu

The highest reward for a person's toil is not what they get for it, but what they become by it.
John Ruskin

Hi Angelheart, I like your new name!!

Take care,
Fuzzy

Everyone else answered this so well, I thought I'd leave it alone, but ....

A large part of nausea with lithium and Zoloft™ (sertraline) is due to what I call "start-up" side effects. Your body has to adjust to the electrochemical (via neurotransmitters) changes that the medications produce.

Basically, with both drugs you are increasing overall serotonin levels in the body as well as the brain. There are serotonin receptors (5-HT3, for the keeners like bptoo) in the gut (gastrointestinal tract) that are bombarded with serotonin, where there was little prior. The increased serotonin (due to blockade of presynaptic serotonin reuptake mechanism - ya, still with me beep?) is what causes nausea with Zoloft.

The lithium changes the reactivity of nerve cells (neurons) making them more resistant to firing (in a way, sorta) through changes in intracellular calcium ion concentrations (via blockade of the phosphoinosidyl pathway). Your body has to adjust to these changes, as well.

Within a month of steadily taking these meds, the nausea and "blah" feeling to subside (not go away - usually - but not nearly as bad as now).

I hope that this helps. - Cam

well, ty for replying...

i was talkin about the seroquel i didnt know if the mgs are too high or not. i go see the doctor thursday mornin though...

angelheart

<font color=purple>"Death is my only hope!!"</font color=purple>

Razors pain you
Rivers are damp
Acids stain you
Drugs cause cramp
Guns aren't lawful
Nooses give
Gas smells awful...
You might as well live.

-Dorothy Parker

AH - I have seen many people use less Seroquel™ (quetiapine) at bedtime. For getting to sleep, I find that giving a large initial dose of Seroquel (or Zyprexa™ - olanzapine, etc) can be like hitting someone with a hammer; the large doses get you to sleep and keep you asleep, but when that interferes with daily function, the dose may be cut back (depending upon existing circumstances).

The Seroquel can cause the hangover effect that you are describing, especially when starting the drug. This does go away in most people, usually within the first month.

Ask your doc, you might get him/her to lower the dose to 50mg (or even 25mg) to allow you to build the dose gradually, which usually does reduce the tiredness as well.

- Sorry about the mix-up
- Cam