[SingDanceRunLife]

I have multiple anxiety disorders (OCD and GAD) and because of that I am taking meds.

I was on Prozac a couple of years ago for about a year or so, and I liked it for the most part but stopped, after discussion with my doctor, because I was doing much better and didn't want to be on meds.

Fast forward to now(ish), and I decided that I needed to go back on meds. I went to the doctor (a GP), and said that I wanted to go back on meds, but didn't want to go back on Prozac because although it helped with my anxiety a ton it made me sluggish and gave me headaches. He said fine, and gave me Celexa. I took that for two weeks, and it was awful, and I knew that it wasn't the right drug for me. All I wanted to do was sleep, I was irritable, I didn't eat etc etc. I contacted my doctor again, and he decided that we should try something else, so he started me on Zoloft.

I've been on the Zoloft for a month now, 2 weeks on 25mg, 2 weeks on 50mg. I'm doing better than I was before -- I'm sleeping well, have more energy, and have more motivation, but I'm not sure if it's quite right. I'm not quite sure how to explain it, but I still have more ups and downs/mood swings than I would like (there are what seems like a lot!), don't have as much energy as I would like when I'm down and such. I'm thinking that maybe Zoloft isn't the right med for me, but at the same time, it's only been a month, so maybe I should wait more?

How do you know if your meds are right for you? Help! I'm thinking that this isn't right!

To give you a better picture and help you understand my situation a bit more...the week before last, I felt really happy and I was chipper and all that. Last week, I had a terrible week and was just not happy, didn't have energy etc. Over the weekend, I was feeling antisocial, wanted to sleep all the time etc. Monday I had a so-so day but was up late (about 1am, I usually like being in bed by 11:30pm). Yesterday, I woke up early, about 6:45am, and all day I was really super agitated and irritable. Then later on, I switched and was calm and chipper. Again, I was up late (about 2am), and this morning, I woke up at 9am. I'm kind of tired, but part of that is that I went to Zumba -- a great thing to do when you have tons of excess energy and can't sit still which is what I was like earlier today...so I don't know exactly what's up, but I know something is off.

Opinions?

[pgrundy]

You might want to consider scheduling a medication evaluation session with a good psychiatrist. I don't think GPs really have the expertise for this.

[spiritual_emergency]

SingDanceRunLife: To give you a better picture and help you understand my situation a bit more...the week before last, I felt really happy and I was chipper and all that. Last week, I had a terrible week and was just not happy, didn't have energy etc. Over the weekend, I was feeling antisocial, wanted to sleep all the time etc. Monday I had a so-so day but was up late (about 1am, I usually like being in bed by 11:30pm). Yesterday, I woke up early, about 6:45am, and all day I was really super agitated and irritable. Then later on, I switched and was calm and chipper. Again, I was up late (about 2am), and this morning, I woke up at 9am. I'm kind of tired, but part of that is that I went to Zumba -- a great thing to do when you have tons of excess energy and can't sit still which is what I was like earlier today...so I don't know exactly what's up, but I know something is off.

I'm a bit confused. These are the symptoms you describe as having been troublesome and presumably, prompted you to want to try some medication again...

- anxiety
- ups and downs
- mood swings
- not sleeping as well you you'd like
- lack of energy
- lack of motivation

You also note that while on the Celexa, you were
- irritable
- wanted to sleep all the time, and
- didn't eat

As based solely on the symptoms you describe, it sounds as if you have been experiening a mild case of depression. (I say "mild" because I don't see the extremes that some people report with depression.) If I understood you correctly, it is depression you are seeking to treat, not anxiety. Yes? No?

Since you've been on the Zoloft you report that initially you were sleeping better, had more energy and had more motivation. However, you then state that over the past few days you've been getting to bed later than you'd like (1:00 and 2:00 am rather than 11:30 pm), waking earlier than you like and you also describe having an abundance of energy. Is it possible the Zoloft is triggering a manic response? You noted that you've experienced mood swings previously. Have they ever been considered severe enough to warrant a diagnoses of depression or bi-polar?

Whether or not you should remain on the Zoloft might depend on exactly what condition/symptoms you were attempting to address. If it's depression, it might be warranted to give the trial a bit more time to see if some of the symptoms you were experiencing ease up or round off. However, it's probably worth keeping an eye to your energy levels as well in case you're vulnerable to a manic episode.

[SingDanceRunLife]

I am on medication for anxiety, not for depression.

When I was unmedicated, I had extreme anxiety, panic attacks, trouble eating, trouble sleeping (I was lucky if I got 6 hours in a night, and I pretty much never slept through the night), tension all the time...all the classic signs of anxiety along with a lack of energy and motivation, mostly because I wasn't sleeping.

When I started Celexa, I ate even less than I did previously, slept all the time and was irritable when awake.

Mood swings didn't really become a problem until recently...lately it's been getting worse. I have never been diagnosed with depression (though I was close when I first started going to T), or bipolar. Nobody has ever mentioned bipolar to me, so I've never considered it.

[spiritual_emergency]

Thanks for explaining that SingDanceRunLife. I'm not very familiar with medications used for anxiety disorders although I do know that numerous drugs are used off-label, i.e. anti-psychotics for depression; anti-convulsants for bipolar disorder.

This is a good article about anxiety medications. It includes information about alternatives people can also make use of as a means of treatment.

You might find some useful information here as well: askapatient.com. I took a peek and there are over 1300 reviews on Zoloft -- many of the responders were using Zoloft for anxiety.

Reviews at the askapatient site are often mixed because no drug works the same for everyone but they are insightful and honest. It can also be helpful to get a feel for the experiences of others and how your own experience compares. Occasionally, people will also share information on other medications that worked better (or worse) for them. It can be an excellent resource because of the sample size involved.

[SingDanceRunLife]

Thanks.

I've read a lot of Zoloft reviews, but might look at that website.

[sunrise]

SingDanceRunLife, I agree it would be good to consult with a pdoc instead of a GP. GPs just do not have the expertise for much beyond the most basic of psych prescribing (and most will be the first to tell you that). Pdocs tend to be more creative prescribers, due to their experience, whereas GPs tend to follow the most conservative path in the prescription algorithms. Perhaps it is time to look beyond the SSRIs? A pdoc is the person for that. Good luck.

Originally Posted by SingDanceRunLife

How do you know if your meds are right for you? Help! I'm thinking that this isn't right!

Your prescriber is supposed to help you decide that. He/she should ask you assessment questions about your symptoms and compare your answers to before you began the med. He/she should ask you to explain what you mean by not thinking things are right. He/she should listen.... What have your GP's assessments shown?

[Jerrypharmstudent]

Originally Posted by SingDanceRunLife

I have multiple anxiety disorders (OCD and GAD) and because of that I am taking meds.

I was on Prozac a couple of years ago for about a year or so, and I liked it for the most part but stopped, after discussion with my doctor, because I was doing much better and didn't want to be on meds.

Fast forward to now(ish), and I decided that I needed to go back on meds. I went to the doctor (a GP), and said that I wanted to go back on meds, but didn't want to go back on Prozac because although it helped with my anxiety a ton it made me sluggish and gave me headaches. He said fine, and gave me Celexa. I took that for two weeks, and it was awful, and I knew that it wasn't the right drug for me. All I wanted to do was sleep, I was irritable, I didn't eat etc etc. I contacted my doctor again, and he decided that we should try something else, so he started me on Zoloft.

I've been on the Zoloft for a month now, 2 weeks on 25mg, 2 weeks on 50mg. I'm doing better than I was before -- I'm sleeping well, have more energy, and have more motivation, but I'm not sure if it's quite right. I'm not quite sure how to explain it, but I still have more ups and downs/mood swings than I would like (there are what seems like a lot!), don't have as much energy as I would like when I'm down and such. I'm thinking that maybe Zoloft isn't the right med for me, but at the same time, it's only been a month, so maybe I should wait more?

How do you know if your meds are right for you? Help! I'm thinking that this isn't right!

To give you a better picture and help you understand my situation a bit more...the week before last, I felt really happy and I was chipper and all that. Last week, I had a terrible week and was just not happy, didn't have energy etc. Over the weekend, I was feeling antisocial, wanted to sleep all the time etc. Monday I had a so-so day but was up late (about 1am, I usually like being in bed by 11:30pm). Yesterday, I woke up early, about 6:45am, and all day I was really super agitated and irritable. Then later on, I switched and was calm and chipper. Again, I was up late (about 2am), and this morning, I woke up at 9am. I'm kind of tired, but part of that is that I went to Zumba -- a great thing to do when you have tons of excess energy and can't sit still which is what I was like earlier today...so I don't know exactly what's up, but I know something is off.

Opinions?

SDRL-

You must remember some key things when taking an AD:

- The med is NOT going to cure everything
- You are going to still have good days and bad days - the med does not stop bad days from happening
- You are going to have times when you feel aggitated, irritable, etc - this is normal human stuff

You say this med may not be the right med for you - however in your third paragraph you say how much it's helped you more than any other med and that you are feeling so much better. Sounds like the right med to me. And you've been on it what for two weeks? You cannot evaluate whether or not a med is right for you for at least 8-12 weeks. No not 4-6 weeks - 8-12 weeks at least. Yes, it takes that long with many people to get a good steady blood plasma level.

If after 8 weeks you're still having some of your symptoms, talk to your doc. He may suggest adding an adjunct med to help cover those -or even supplements.

If the med is working well for you at 2 weeks, just imagine how well it may work at 8 -12 weeks and beyond? Let the universe unfold as it should and try to calm your obsessive thoughts about whether this med is the right med. In my opinion, it is. And remember: you're human, you're going to have regular emotions - ups and downs, good days and bad days even on medications.

Hope this helps!
Jerry

[SingDanceRunLife]

I feel like I need to clarify:

In my third paragraph, I said I'm doing better than before. Before, I wasn't even a functioning human being and was pretty much at rock bottom...so doing better isn't actually saying a whole lot. I've been on Zoloft for just over a month now.

I'm not saying that it works better than any other med either, except Celexa...but I reacted really badly to Celexa from the start, so that one obviously wasn't the right med. Back a couple years ago, Prozac worked quite well, but had some side effects that I couldn't deal with really long term, and that I didn't want to deal with again which is why my doctor went for something else this time when prescribing.