Just been prescribed sertraline (zoloft) what to expect?

[claire]

I know it's different for everyone but just reading through the side effects has put me off starting! All the suicide warnings really worry me especially as I briefly felt suicidal while starting a different antidepressant a couple of years ago and again a couple of months ago during the peak of my anxiety..
I'm kind of better now, I am almost back to being myself but not 100% which is why I thought I'd give the sertraline a go mainly to prevent it getting worse again.
What should I expect? Should I start it when my husband isn't away on business so that I have some extra support or shall I just go for it sooner rather than later?

[Plaidlaid]

I had some experience with Cipralex and there were no problems. Some occasional euphoria and lack of anxiety. On the other hand, I only had mild case of study stress, not a serious depression. It is interesting to think about the actual causes of those suicidal thoughts, and why they are being acted upon. Some materials - http://www.medicaldaily.com/why-do-antidepressants-raise-your-suicide-risk-surprising-science-behind-paradoxical-reactions – suggest that ADs just increase person's energy and activity levels, so preexisting suicidal ideas are being implemented more often. Another point I wanted to make, antidepressants vary in their chemical effects, some affect serotonine route more, others are relatively more active in norepinephrine pathway. Serotonine is more responsible for the mood levels, and norepinephrine is connected to energy levels. Each person is unique, of course, so maybe someone's NE levels have risen faster than SE, especially when norepinephrine reuptake inhibitors were used. It may result, again, in a very upset and energetic person. In reality, a lot of prescription drugs are used to treat depression, olanzapine is one example - https://rxed.eu/en/o/Olazax/ Even though it is often used to treat psychotic conditions, in some cases it is used for depression too.
But in terms of what to do, keep in touch with your doctor, follow the schedule(because discontinuing medication is one of the factors that increase suicidal tendencies), participate in psychotherapy.

[NoPoet]

If the medication is right for you, it shouldn't be a particularly rocky road, but your brain will need to adapt to the medication altering its chemical balance. My honest opinion, through years of painful experience, if that a medication that is right for you will present a few short term side effects (which may be mild but could be unpleasant), and a medication that is wrong would have longer term and more severe side effects.

Bear in mind your fears of becoming suicidal, which I share, will make you hyper vigilant and you'll interpret things as signs of impending doom. Remember that your fears will be magnified and distorted in the early days. You will most likely know if you cannot tolerate the emedication, and you'll know it soon.

Which medication made you feel suicidal in the past?

[Fishmanpa]

I took Zoloft for about 6 months for depression after my 1st heart attack. I was started off at 100mg. I see many starting at far less dosages and ramping up.

TBH, I didn't have any real negative side effects aside from dodgy stomach/bowels. I didn't really notice anything different mentally but those around me did. They said that I seemed more upbeat and positive in my demeanor after a month or so. When I weaned off of them is when I experienced some brain zaps and occasional dizziness and that's when I recognized that I was under the influence of the med.

While I don't want to have to take them again, I would if I needed to. It definitely helped me (along with one on one therapy) to get through a rough time.

Positive thoughts

[NoPoet]

It is interesting to think about the actual causes of those suicidal thoughts, and why they are being acted upon. Some materials - http://www.medicaldaily.com/why-do-antidepressants-raise-your-suicide-risk-surprising-science-behind-paradoxical-reactions – suggest that ADs just increase person's energy and activity levels, so preexisting suicidal ideas are being implemented more often.
How did I miss this informative post? I've read similar research: antidepressants may not necessarily make a person suicidal if they weren't already. They may give an already suicidal person some energy and motivation back, and paradoxically, this improvement might be what makes them attempt it.

This is a very long way from explaining why someone who wasn't suicidal might become it. They can, but it's not common. I have taken certain medications before that made me obsessed with suicide. This seems to be a mixture of wildly increased anxiety levels, and wildly increased intrusive thinking. I don't think I was actually suicidal - I just kept thinking of it. It's like my fears of death were massively over-stimulated. This links into the next point:


Another point I wanted to make, antidepressants vary in their chemical effects, some affect serotonine route more, others are relatively more active in norepinephrine pathway. Serotonine is more responsible for the mood levels, and norepinephrine is connected to energy levels.
Again, this is really perceptive. SSRI medication made me suffer repeated, intrusive thoughts about death. However when I switched to mirtazapine, which (IIRC) acts on norepinephrine, I did not experience any increase in these thoughts at all. They didn't go away, but they were so shocking and inexplicable that no medication would have got rid of them. That's what therapy and self help are for.

Also remember, a medication which is wrong for you is more likely to cause the bad effects. Case in point, prescribing SSRI medication for me had really bad effects because I didn't need that type of medication. Starting on strattera (atomoxetine) massively reduced my anxiety, low moods and intrusive thoughts from day one. I did not experience any side effects from strattera that weren't tolerable and none of them lasted more than a few days. Therefore, the right medication = a much easier and more beneficial experience.