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Thread: Been trying to manage without medication but is it time to give it a go?

  1. #71
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    Re: Been trying to manage without medication but is it time to give it a go?

    Thank you. I decided to go up to 75 for a week and see how I go. Started last night.

  2. #72
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    Re: Been trying to manage without medication but is it time to give it a go?

    Ok just a quick update. Now been on Sertraline for 13 weeks and still feeling anxious every day. I started on 25mg for two weeks and then 9 weeks on 50mg.
    Been taking 75mg for two weeks and don’t know if I need to just be patient and give it time to kick in or up to 100?
    Any thoughts please?

  3. #73
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    Re: Been trying to manage without medication but is it time to give it a go?

    Quote Originally Posted by Lady Penelope View Post
    Been taking 75mg for two weeks and don’t know if I need to just be patient and give it time to kick in or up to 100?
    It is going to take longer than 2 weeks for the dose increase to begin having an impact, but I'd go up to 100mg as most need to take 100-150mg for optimum results.
    __________________
    The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.

  4. #74
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    Re: Been trying to manage without medication but is it time to give it a go?

    Hello
    now been on Sertraline for 19/weeks starting at 25mg. The last 5 weeks on 75mg. It finally beginning to work and I’m having much better days. Also 5 weeks into CBT.
    I have two worries about Sertraline- I am loosing a lot of hair. I can see my hair is becoming thinner and keep finding hairs in the bath and on the floor. I understand this can be a side effect of Sertraline. Is this likely to stop.?
    I am also getting more frequent ocular migraines. I used to get one every few months but it now twice a week. My GP thinks this is a side effect of Sertraline.
    Also I am feeling a bit emotionally numb. I don’t seem to be able to feel any emotion. My son left home this week and I have not even shed a tear. When my daughter left I cried for weeks! I don’t want to stop Sertraline as it is helping my anxiety a lot but should I consider tapering down to 50mg? I am not sure I gave it enough time of 50mg to level and may have gone up too soon. I have read it can take 12-18 weeks for a dose to become fully effective. I would be grateful for your thoughts.
    Last edited by Lady Penelope; 06-12-20 at 11:34. Reason: Typo

  5. #75
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    Re: Been trying to manage without medication but is it time to give it a go?

    Quote Originally Posted by Lady Penelope View Post
    Hello
    now been on Sertraline for 19/weeks starting at 25mg. The last 5 weeks on 75mg. It finally beginning to work and I’m having much better days. Also 5 weeks into CBT.
    This is very good news!

    I have two worries about Sertraline- I am loosing a lot of hair. I can see my hair is becoming thinner and keep finding hairs in the bath and on the floor. I understand this can be a side effect of Sertraline. Is this likely to stop.?
    Hair loss is an uncommon side-effect of many meds, including SSRIs. Often the only remedy is switching to another AD, however, there are a few case reports of zinc or omega-3 fatty acid/fish oil supplements being effective so one, or both may be worth a shot.

    I am also getting more frequent ocular migraines. I used to get one every few months but it now twice a week. My GP thinks this is a side effect of Sertraline.
    It probably is. It is one of those side-effects which could go either way, some have more migraines, in others the SSRI stops them. A small dose of one of the beta-blockers may help. If not the only option is switching to another AD.

    Also I am feeling a bit emotionally numb. I don’t seem to be able to feel any emotion. My son left home this week and I have not even shed a tear. When my daughter left I cried for weeks!
    Sadly, as with the migraines, this can go either way, some experience emotional blunting, others the opposite. It sometimes resolves after a while, but there are no guarantees. If it doesn't again the only option is switching to another med.

    I don’t want to stop Sertraline as it is helping my anxiety a lot but should I consider tapering down to 50mg? I am not sure I gave it enough time of 50mg to level and may have gone up too soon. I have read it can take 12-18 weeks for a dose to become fully effective. I would be grateful for your thoughts.
    Not many do well on only 50mg, but the only way of knowing if you will is to try it.
    __________________
    The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.

  6. #76
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    Re: Been trying to manage without medication but is it time to give it a go?

    Thank you so much for you informative reply. I will definitely try the supplements for hair loss.
    when you say switching to another med do you mean another SSRI or a different type of anti depressant?
    also I don’t want to loose any benefits I have - how does this work when switching?

  7. #77
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    Re: Been trying to manage without medication but is it time to give it a go?

    Quote Originally Posted by Lady Penelope View Post
    when you say switching to another med do you mean another SSRI or a different type of anti depressant?
    also I don’t want to loose any benefits I have - how does this work when switching?
    There is a good chance that switching to another SSRI will work. While they all inhibit serotonin reuptake the same way, each affects other receptors differently and it is those other interactions that mostly cause side-effects. Most can handle a straight overnight switch from one SSRI to an equivalent dose of another with none to only mild symptoms, but some GPs prefer to do it with a short cross taper. AD dose equivalence isn't an exact science so there may need to be some fine tuning over the following weeks, but there shouldn't be any significant loss of efficacy. You definitely won't be going back to square one.

    If you and your GP decide switching is the best option then citalopram would be my choice as it generally produces fewer/less severe side-effects than the other SSRIs.
    __________________
    The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.

  8. #78
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    Re: Been trying to manage without medication but is it time to give it a go?

    Thank you so much.

  9. #79
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    Re: Been trying to manage without medication but is it time to give it a go?

    Hello everyone
    I had been doing ok on 75mg apart from the hair loss. I had a review with GP and she suggested dropping dose to 50mg. I did this 8 weeks ago but I don’t think it’s made any difference to hair loss. I was feeling ok on 50mg and was planning on staying on that dose. I have finished my 12 week CBT course which has also really helped.

    However I am now thinking of coming off it all together. I spent the day in A & E yesterday with a strange headache and pins and needles. Docs suspected TIA and I had loads of tests. They think it was a return of migraines. I had an ECG which resulted in them organising more heart tests. The doctor I saw said I really should be on Aspirin. I had come off it when I started the Sertraline on the advice of my GP but the hospital are very keen for me to return to it. I am thinking of tapering off the Sertraline so I can take the Aspirin. I still have some anxiety every day so don’t really want to come off. Would another anti depressants be better if I’m taking aspirin? Any advice please? I have another appointment with GP on Tuesday. I like to be informed before I speak to GP as I find that none of them in my practice know a great deal about SSRI’s. Thanks for any advice
    Last edited by Lady Penelope; 11-03-21 at 18:33. Reason: Typo

  10. #80
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    Re: Been trying to manage without medication but is it time to give it a go?

    Quote Originally Posted by Lady Penelope View Post
    I was feeling ok on 50mg and was planning on staying on that dose. I have finished my 12 week CBT course which has also really helped.

    I still have some anxiety every day so don’t really want to come off.
    If you're still having some anxiety then a higher dose is warranted. The aim should be to eliminate all anxiety if possible because it reinforces itself.

    Would another anti depressants be better if I’m taking aspirin? Any advice please?
    All the SSRIs and SNRIs, plus the TCAs clomipramine and imipramine may be strong enough anticoagulants to perhaps being risky with aspirin and other NSAIDs, although whether this significant at the low 50-75mg doses I can't say. I'd seek advice from a cardiovascular specialist. The other TCAs should be okay, at least on coagulation, however, they may not be a good choice if you have significant heart issues, and especially not if the problem/s is electrical conductance related, atrial fibrillation, for example. The SSRIs citalopram and escitalopram are possibly also unsuitable for the same reason.
    __________________
    The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.

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