Just started taking Zoloft....

I finally went to see someone regarding my depression. I've been seeing a therapist for the past couple weeks and she though that I would benefit from talking to the pdoc about meds as the combination of meds and therapy can be beneficial.

So earlier today I saw the psychiatrist and after talking with me thought I'd definately benefit from medication. At this point he narrowed it down to Paxil or Zoloft. He said Paxil would probably have a more sedating affect so I opted for Zoloft.

Now I am aware that most anti-depressants have side effects and that was a big thing I had to get around before willing to try meds. So tonight I thought I'd do some research online and came across some sites that seemed to think Zoloft had the possibilty to be quite dangerous:

http://www.zoloft-side-effects-lawyer.com/default.htm

It is just starting to make me very nervous, could I possibly be doing more damage than good with taking meds??

I've just started on the zoloft (been 2 days now) after prozac made me go all weird! However, I don't think that you should worry about it as much as you are. The ssris have side-effects, thats for sure, but if you feel that the drug you're on isn't helping or is presenting you with intolerable side-effects, then you can easily go to your doctor and change them.

The internet is full of sites which say things like "meds ruined my life and now i'm living alone surrounded by rubbish". Pay no attention. millions of people have been helped by these drugs so give them a chance to work for you. I feel the drug companies have made a rod for their own backs by denying the downsides of these drugs for so long, so now everybody's panicking about them. In reality, the most common side effect is an upset tummy! Other common side-effects include problems with sexual function and feeling like you're in a bubble. If this happens to you, tell your dr and he can change you to another one. I'm now on my 6th antidepressant (at the grand old age of 23!) and still remain optimistic as i've felt the results when they do work well.

Some advice, however, even if you still want to quit them, don't just stop the meds without consulting your doctor as you can get withdrawal symptoms which are annoying, so they usually gradually cut you down on them.

hope this helps - get in touch if you have any questions!

mildred

Thanks for the reassurance. I have decided to give it a chance. I'm just one to worry about everything so naturally after finally coming to the decision that I'd try them, I started panicking.

It has only been a few days so far, I've experienced the upset stomach (pretty mild). One question, do some of the side effects tend to go away or lessen after taking the med for a while?

depends on the side-effects and the drug really. Only just started on zoloft so can't say much about that one, but from my experience with other meds, there are side-effects you get when your body's getting used to the drug (eg upset stomach) but these go away after a couple of weeks. Other side-effects tend to stick around but if they're stuff you really can't deal with, your doctor can prescribe another drug with a different side-effect profile.

good luck - let me know if it works for you!

mildred

bgrar - Something to remember when reading product monographs (or any drug information distributed by a drug company) is that the give too much detail. Most mental health professionals realize this, so take info they receive from drug companies with a grain of salt.

So, I see drug monographs as "lawyer documents, written by lawyers, for lawyers".

The side effects listed for most serotonergic antidepressant (SSRIs - like Paxil [paroxetine] and Zoloft [sertraline]) are what I call "start-up" side effects. These side-effects (eg. headache, nausea, anxiety, etc.) are present when you first start taking the drug, but they usually fade and disappear within two weeks to a month after reaching your target dose.

Many times a doc will start by prescribing a lower dose of an SSRI and slowly increase the dose (weekly or twice weekly increases) in order to minimize these initial start-up side effects.

These side effects appear because many times when a person is "depressed" they often have lower than normal levels of serotonin in their brain (the amount of serotonin is "depressed". Serotonin is one of several neurotransmitters in the brain.

Electrical signals run the length of nerve cells (aka neurons), but an electrical signal cannot jump from one neuron to another or it would cause an arc of electricity which would literally fry the neurons (which I guess we could call true "burn-out"). Instead neurons release packets of neurotransmitters into the gap (aka synapse) between the two neurons. If enough of the neurotransmitters bind to receptors on the cell wall of the adjacent, this cause the second neuron to fire and the electrical signal is carried on.

There are literally 100s of different neurotransmitters in the brain, many which have not yet been discovered. When there is a lower than normal concentration of a major neurotransmitter (eg. serotonin, dopamine, GABA, norepinephrine) in the brain, other neurotransmitters will modify their amounts to try to compensate for the lack of the original neurotransmitter.

In other words, in many cases of depression there is a lack of serotonin in the brain. Other neurotransmitters (eg. esp. dopamine and norepinephrine) will increase or decrease their concentrations in certain sites in the brain, trying to compensate for the lack of serotonin. This modification of neurotransmitter concentrations do not fully compensate for the lack of serotonin and the symptoms that result from this incomplete compensation are what we call depression.

This is not the complete story as the body also modifies the number &/or sensitivity of the receptors situated on adjacent neurons, again trying to normalize the flow of electrical signals in the brain. There are other changes such as down regulation of beta-receptors which affect brain activity, but I cannot go into detail because it will just confuse you (heck, it still confuses me very much). The actual mechanism by which antidepressants resolve depressive symptoms is not yet known.

I do not believe that "abnormal" levels of neurotransmitters "cause" depression, but are only a symptom of depression themselves. We do not yet know what physiological changes actual cause depression, but when we artificially increase serotonin (or norepinephrine, or ...) concentrations in the brain, sometimes this alleviates the depressive symptoms.

Antidepressants do not "cure" depression; they only diminish or resolve depressive symptoms. To truly resolve depression one must confront their personal problems that led to the depression in the first place. Antidepressants resolve depressive symptoms, allowing the person to work out their problem. This is usually done through counseling, be it from a psychologist, clergy, or even talking it out with a friend. In a sense, antidepressants are only a bandage over a wound (ie depression); they only give you the energy and ability to function in society (rather than hide under the covers all day).

BTW, you should take Zoloft with food. This will not only decrease any stomach upset and nausea, but it also forces more or the intact drug into your blood stream.

I know that this is really long-winded, but read through it a couple times and ask me to clarify anything that you do not understand. I will not be online again until Sunday.

I hope that this is of some help. - Cam

P.S. Bear with spelling mistakes, etc. as I am using an IBM laptop with using Windows and AOL [Arrrrrggghhh!!!]. MACs are so much more user friendly; and what's with this silly flat mouse with left and right clickers placed where your thumbs rest..... [DOH!!]

Cam,

That was a great post. I like the way you explained all that stuff, and I agree with you, especially about that the abnormal neurotransmitter levels are a symptom, not a cause of depression, and that antidepressants diminish the symptoms but are not a cure.

So, what's your take on light therapy? I have read that it is effective for non-seasonal depression too.

And how do you feel about St. John's Wort? I haven't ever used prescription meds for my deprssion, but started SJW last spring. I still need it now, especially approaching winter (I have seasonal affective disorder and do light therapy too - I know about photosensitivity but haven't noticed that being a problem). Wondering how long I will need to keep taking it (my depression has been pretty much life long).

Maybe I should have started a new thread for that.

<font color=green>"Someone may have stolen your dream when it was young and fresh and you were innocent. Anger is natural. Grief is appropriate. Healing is mandatory. Restoration is possible." -Jane Rubietta</font color=green>

Rapunzel - Here are "my" ideas about the following therapies.

1) Light Therapy - There does seem to be noticeable improvement in those with SAD (seasonal affecive disorder), but I have seen little encouraging evidence for it's use in treating other variations of the syndrome of depression.

Using Light in Treating SAD <font color=green>---></font color=green><font color=yellow>></font color=yellow><font color=red>></font color=red><font color=red><</font color=red><font color=yellow><</font color=yellow><<font color=green><---</font color=green>

a) Season Affective Disorder (SAD) - SAD is being recognized as a true sub-type of major depressive disorder (I think). If I had to guess, I'd say that "cabin fever" may have been loneliness exacerbated SAD (just thinking out loud).

Some Reliable Stuff About SAD ---></font color=red><font color=yellow>></font color=yellow><font color=green>></font color=green><font color=green><</font color=green><font color=yellow><</font color=yellow><font color=red><---</font color=red>

2) St. John's Wort (SJW) - this drug is recommended to those with mild to moderate depression. It should not be used in major depressive disorder, nor in bipolar disorder.

Researchers (incl. government - Health Canada, NIMH, etc.) are starting to scientifically study SJW using the good old (good, but not perfect) large-scale, randomized, double-blind clinical trial.

Mild to moderate depressions usually do not require medications (ie. antidepressants). Talk therapies, with a psychologist or a counsellor (depending upon situation and needs) are very useful in mild to moderate depression.

My psychologist; who wrote her PhD thesis on grief after loss of a child. I wish that I had met here 10 years ago. She has shown me why I do what I do, and if I wasn't such a "stodgie old proot" I'd work more these areas.

A good therapist is able to get to the core of your problem, but even the best therapist cannot "make" you better; nor can just taking an anti-depressant "fix a depression". The hardest work, as usual is done by the person with the least amount of energy, those with depression.

Enough of my yapping. Here is NIMH's position on St.John's Wort <font color=red>(NIMH = National Institutes of Mental Health - US)</font color=red>

- Cam

Thanks for all that info Cam, helpful indeed. I have now been on Zoloft for almost 2 weeks. I no longer feel naseaus at all after taking it. The only side effect now I'm finding that my pdoc is asking me to keep a close eye on is my sleeping patterns.

A few days after initially starting Zoloft I found that I was sleeping excessively, 12-14 hours a day. This went on for about 4 days. Then all of a sudden I found I couldnt sleep at all for a couple days. I would try to sleep but would just lay there and then toss and turn restlessly in the couple hours I could actually fall asleep. That started this past Monday and then on Wednesday I went back to sleeping for an excessive amount of time again.

I have found that for a few hours after taking my dose I feel slightly sedated and then about 12 hours after a dose I start to feel hyper. My pdoc initially suggested I take the med after I wake up, which is about 4-6pm since I work nights. He is now thinking I should try taking it right before I go to bed and I'm about to try that and see if that helps any.

Also, one last thing I notice, is that while on the Zoloft there are certain times during the day where I feel "medicated". Almost like a tingly feeling in my arms and head. It is not severe though.

bgar - I've heard other people say that get a tingle in the middle of the day. Sorta like an acid flashback without the disorientation is how I've heard it described. I don't think it's dangerous, but I haven't really thought it through.

- Cam