14 weeks on zoloft 50 mg

[Comoso2]

I'm 14 weeks on zoloft 50 mg. I have good and bad days. The mornings are bad almost always. Somedays it doesn't last long some days it eats the day.

I've been prescribed .5 MG clonazepam twice daily but I've read so many horror stories I'm scared to take it. Last week, I took. 25mg in the am Monday through Thursday and felt pretty good. I didn't take Friday and still felt good. Saturday so so and Sunday not so good. Iv went back to the. 25 MG this morning. Should I just stick with the. 25 or am I playing with fire and I'll eventually need increasing doses?

When I first got hit with anxiety I took it for a little over a year and weaned off through much pain believing the Ashton manual and that my problem was my klonopin. I put up with the hell, was med free for 15 months with tons of panic attacks and high anxiety.

It's just now sinking in that maybe anxiety came back because I want talking the med...I guess... it's so hard to decide what to do. Life right now, is definitely not fun so...

[panic_down_under]

I'm 14 weeks on zoloft 50 mg. I have good and bad days. The mornings are bad almost always.

After 14 weeks you are getting pretty much all you will out of the 50mg dose. To achieve better results you will need to increase it. I know higher doses have triggered tinnitus in the past, but there is no point taking a med at ineffective doses, imho.

Last week, I took. 25mg in the am Monday through Thursday and felt pretty good. I didn't take Friday and still felt good. Saturday so so and Sunday not so good. Iv went back to the. 25 MG this morning.

Clonazepam has a longish half-life, around 40 hours which is why you continued to get some benefit days after the last dose.

Should I just stick with the. 25 or am I playing with fire and I'll eventually need increasing doses?

I think you'd be better either increasing the Zoloft dose, or switching to another antidepressant if tinnitus again becomes a problem with Zoloft.

When I first got hit with anxiety I took it for a little over a year and weaned off through much pain believing the Ashton manual and that my problem was my klonopin.

Ashton's manual can be useful for weaning off benzodiazepines, but her scaremongering about these meds seems based more on ideology, not medicine, imho. I've heard she has recently also begun demonizing antidepressants. Having reviewed her testimony in a notorious British legal case, I have very little regard for her.

It's just now sinking in that maybe anxiety came back because I want talking the med

It almost certainly came back because anxiety disorders can be chronic conditions which wax and wane but don't completely go away, though remissions lasting months to several years are relatively common.

[Comoso2]

So is the clonazepam at that low of a dose a bad idea? I honestly think it's helping tinnitus too... I'm prescribed 60 pills per month. I have enough pills to take for several years at .25 per day so a Dr saying I can't have more, I'd have a couple of years back log...

[panic_down_under]

So is the clonazepam at that low of a dose a bad idea? I honestly think it's helping tinnitus too... I'm prescribed 60 pills per month. I have enough pills to take for several years at .25 per day so a Dr saying I can't have more, I'd have a couple of years back log...

Yes. Firstly, because you're taking them without your doctor apparently being aware of it. This is never a good idea, but especially not with drugs like the benzodiazepines (BZDs) which doctors are becoming increasing unwilling to prescribe.

Secondly because of you take clonazepam daily for more than a month or two you will almost certainly become dependent and be in trouble once your stash runs out if you then can't find a doctor willing to prescribe it.

BZDs have also been shown to interfere with the neurogenesis mechanism by which antidepressants work. Given you're on only the usual minimum effective Zoloft dose you really shouldn't be doing anything which reduces its effectiveness, imho.

I believe your best bet is to either raise the Zoloft dose to an effective amount, or if you can't because of tinnitus switch to another antidepressant. I have previously elsewhere suggested some which rarely, if ever trigger it.

[Comoso2]

Yes, you have, and thank you. I think I'll try to up my zoloft to 75 for a week and see how it goes.

My pdoc actually practically begged me to take daily clonazepam last time I was there, 2 weeks ago, it was his talk that got me to try the. 25 for a few days after taking none for 2 months.

[Phill2]

I'm 14 weeks on zoloft 50 mg. I have good and bad days. The mornings are bad almost always. Somedays it doesn't last long some days it eats the day.

I've been prescribed .5 MG clonazepam twice daily but I've read so many horror stories I'm scared to take it. Last week, I took. 25mg in the am Monday through Thursday and felt pretty good. I didn't take Friday and still felt good. Saturday so so and Sunday not so good. Iv went back to the. 25 MG this morning. Should I just stick with the. 25 or am I playing with fire and I'll eventually need increasing doses?

When I first got hit with anxiety I took it for a little over a year and weaned off through much pain believing the Ashton manual and that my problem was my klonopin. I put up with the hell, was med free for 15 months with tons of panic attacks and high anxiety.

It's just now sinking in that maybe anxiety came back because I want talking the med...I guess... it's so hard to decide what to do. Life right now, is definitely not fun so...

I've been on 50mg for nearly 2 years now and it works great
Just follow your Drs advice and you'll be fine

[Comoso2]

Thanks, Phil, was it working well for you by week 14? I think I'm improved, but morning retching and anxiety can still be pretty rough most days. By evening I'm anxiety free but restart the mess the next day...

[Phill2]

Thanks, Phil, was it working well for you by week 14? I think I'm improved, but morning retching and anxiety can still be pretty rough most days. By evening I'm anxiety free but restart the mess the next day...

It was working well for me by 6 weeks but everyone is different that's why it's better to listen to your doctor than others who may have had a different experience.
I was going through a very rough patch and they've proved to be a godsend.

[Comoso2]

Panic, I went to 75 mg at bed time last night, woke up in a panic and retching at 6 am. I had to take .25 klonopin. Well, I didn't have to, I'm just tired of having panic attacks so I did. Nauseated, definite tinnitus increase, ears popping like crazy. 75 mg might be one and done.

[panic_down_under]

Panic, I went to 75 mg at bed time last night, woke up in a panic and retching at 6 am.

This isn't unusual after dose increases. And it may not have just been the med. Anxious minds are very adept at producing the whole catastrophe of side-efects if given half a chance.

Nauseated, definite tinnitus increase, ears popping like crazy. 75 mg might be one and done.

As hard as it is, I'd stick with it a little longer using the clonazepam to ease the increase in anxiety/panic.

But if you're still having issues after a week or two then to reiterate my previous advice to you, I think your best alternatives are norepinephrine, aka noradrenaline (NE) reuptake inhibiting antidepressants as none of the serotonergic antidepressants you've tried have been a success. The meds which fit the bill are the SNRIs Savella (milnacipran) and Fetzima (levomilnacipran) and the older TCAs Pamelor (nortriptyline) and Norpramin (desipramine).

Savella and Fetzima are essentially the same med, the difference is the newer Fetzima only contains the active isomer of the chemical, its basically the same patent extending deal as Celexa (citalopram) and Lexapro (escitalopram), so it probably won't matter much which is chosen, however, Fetzima is still in patent so may be more expensive. But your doctor may prefer it because Savella isn't FDA approved for anxiety and depression (this doesn't mean it won't work, just that it hasn't gone through the expensive approval process). Although this is a moot point, some doctors can be sticklers, especially when they are unfamiliar with the meds. Savella and Fetzima inhibit NE and 5-HT (serotonin) in a ~3:1 and ~2:1 ratio respectively.

Pamelor is pretty much a straight NE reuptake inhibitor having little affect on the serotonin transporters. Norpramin is also mainly a NE inhibitor with a NE:5-HT blocking ratio of about 35:1. It also has very little impact on histamine and acetylcholine muscarinic receptors which produce many of the typical TCA constipation, dry-mouth and sedation side-effects so would be my pick of the 4 meds, with Pamelor my second choice. Both TCAs are on the American Tinnitus Association's list of recommended meds to treat this condition (I can't yet post links so Google: "Drug Therapies" "American Tinnitus Association").