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Thread: Sertraline and Amitriptyline (Zoloft & Elevil)

  1. #1
    Join Date
    Jul 2012
    Posts
    191

    Sertraline and Amitriptyline (Zoloft & Elevil)

    Hi
    I have been on sertraline for the past 12 weeks, started at 25mg and been upped pretty quickly by psych to 150mg which I have taken for the last 4 weeks. I haven't felt much improvement to my already severe anxiety with depression but many people on FB and other forums say to stick out the same dose for 12 weeks. I have also just started taking 10mg of Amitriptyline to see if this helps my stomach issues as TCA's usually give constipation as a side effect which I would like as my anxiety and the sertraline have given me awful sickly, stomach, nausea and needing the toilet in a morning ( I know TMI).

    Is there anyone to give me some encouragement either with sticking with the sertraline or if anyone takes an SSRI and TCA at the same time.
    Thanks

  2. #2
    Join Date
    Jan 2017
    Posts
    1,363

    Re: Sertraline and Amitriptyline (Zoloft & Elevil)

    Quote Originally Posted by purplepie View Post
    upped pretty quickly by psych to 150mg which I have taken for the last 4 weeks. I haven't felt much improvement to my already severe anxiety with depression but many people on FB and other forums say to stick out the same dose for 12 weeks.
    Antidepressants work by stimulating the growth of new brain cells in the 2 hippocampal regions of the brain. It is the new cells that produce the therapeutic response, not the AD directly and this process takes time to become effective.

    started taking 10mg of Amitriptyline to see if this helps my stomach issues as TCA's usually give constipation as a side effect
    They often do cause constipation, but a few experience the opposite so there are no guarantees. You should know within a week if it's going to help.

    sertraline have given me awful sickly, stomach, nausea and needing the toilet in a morning
    The problem is that the brain isn't the most serotonergic organ of the body. It is only a minor player making and using less than 2% of the serotonin made. By far the biggest user - over 90% - is the enteric nervous system (ENS), the mini brain that controls the gut so it is likely to be more affected by serotonergic ADs. The ENS usually adapts within a few weeks.

    Ginger and/or vitamin B6 supplements can ease nausea, and remedies containing loperamide such as Imodium should help with diarrhoea.

    BTW - the gut is a major player in anxiety disorder and depression and may through its connections with the heart and lungs via the vagus nerves trigger anxiety side-effects such as rapid pulse and shortness of breath in addition to gut related anxiety symptoms. Electronic vagus nerve stimulators which affect the ability of the gut to communicate with the brain have proven to be an effective for treatment resistant depression, though less so for anxiety disorders. The bottom line is look after your gut, or it could make your life miserable! See: Gut bacteria, the vagus nerve and the brain (PDF).

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