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Thread: Sertraline first timer

  1. #1

    Sertraline first timer

    Hi new here, been suffering along time with anxiety and intrusive thoughts to the point where Iím sometimes scared to be alone, was on 10mg citalopram For 4 years and was doing great until lockdown Went to the docs they decided to switch my meds to sertraline and just swapping straight over. I started sert 15 days ago 50mg, the side effects were awful as many know but after 2 weeks I am starting to feel more myself not completely but a little, started to eat a bit more sleep is still only 6 hours Iíd love a lay in. My doctor has suggested that I up to 75mg as the thoughts were still there not as plaguing but still there I took my first 75 yesterday felt really tired and had headache most of the day, I just donít know whether to carry on taking the 75 or just stick on 50 as I am improving slightly, if anyone can give me insight on wat to do Iím stuck in a single parent of 2 children have lots of support from family and friends.

    Please any info would be appreciated
    Thanks Becky

  2. #2
    Join Date
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    Re: Sertraline first timer

    It is normal to have increased side effects when you increase the dose of medication. I have experienced the same (although I'm on citalopram rather than sertraline). It should settle down again in a few days or so.
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  3. #3

    Re: Sertraline first timer

    Thankyou for replying took my second dose of 75mg this morning, itís just a scary place to be in your own head all the time only time I get a break is wen Iím at work or asleep, I was on cit for years and just stopped working for me hopefully sert is as good if not better xxx

  4. #4
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    Re: Sertraline first timer

    Yes I can relate to how you feel - I restarted citalopram 10 days ago after suffering a relapse of my generalised anxiety disorder, so I'm still going through the early side effects and heightened anxiety. I also feel like I only really get a break from the anxious thoughts when I'm sleeping! Hopefully you'll get some relief soon.
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  5. #5
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    Re: Sertraline first timer

    Quote Originally Posted by Becbec27 View Post
    Hi new here,
    to NMP, Becky

    been suffering along time with anxiety and intrusive thoughts to the point where Iím sometimes scared to be alone, was on 10mg citalopram For 4 years and was doing great until lockdown Went to the docs they decided to switch my meds to sertraline and just swapping straight over.
    Given you had been on what is usually a sub therapeutic dose of citalopram was any thought given to simply upping it?

    I started sert 15 days ago 50mg, the side effects were awful as many know
    It would have been kinder to have been started on 25mg for the first week as this is about equivalent to 10mg citalopram. At 50mg you were being hit by both the effects from the med switch, plus around a doubling of the effective dose.

    but after 2 weeks I am starting to feel more myself not completely but a little, started to eat a bit more sleep is still only 6 hours Iíd love a lay in.
    SSRI induced insomnia is a fairly common initial side-effect. You could try the over-the-counter antihistamine diphenhydramine which is the active chemical in Nytol tablets and liquid. If that isn't effective ask your GP to prescribe a small dose <=15mg of mirtazapine which is marketed as an antidepressant (AD) but is mostly a potent antihistamine. Small doses of another AD, trazodone, would be even better as it has a shorter half-life than mirtazapine so you'd be less likely to be groggy the next morning, but my understanding is the NHS makes prescribing it for that purpose difficult. Still, there's no harm in asking.


    My doctor has suggested that I up to 75mg as the thoughts were still there not as plaguing but still there
    It would usually take more than 2 weeks for an AD to begin having an effect even when switching from another, but going to 75mg is probably not a bad idea. Most take 100-150mg for optimum results.

    I took my first 75 yesterday felt really tired and had headache most of the day, I just donít know whether to carry on taking the 75 or just stick on 50 as I am improving slightly, if anyone can give me insight on wat to do Iím stuck in a single parent of 2 children have lots of support from family and friends.
    Side-effects will often spike after a dose increase due to the initial surge in serotonin activity. They should drop back as biofeedback mechanisms kick in and reduces serotonin synthesis and expression after a week, or two.

    I was on cit for years and just stopped working for me
    Probably in large part because of being on such a low dose for so long. Antidepressants have no direct effect on anxiety (or depression) in the way say aspirin has on a headache. They work by stimulating the growth of new brain cells (neurogenesis) to replace cells killed, or prevented from growing by high brain stress hormone levels. The therapeutic response is produced by these new cells and the stronger interconnections they forge, not the meds directly, and they take time to bud, grow and mature. For a more detailed explanations see: Depression and the Birth and Death of Brain Cells (PDF) and How antidepressant drugs act.

    The problem with taking sub/borderline therapeutic doses is neurogenesis may be interrupted whenever AD plasma levels drop below the amount needed to sustain it which could lead to the second issue, the growing evidence antidepressants become progressively less effective every time they are stopped and restarted. Two studies, Amsterdam JD, 2016 and Amsterdam, 2009 found the likelihood of antidepressants working after each restart drops by between 19-25% (see also: Bosman RC 2018; Amsterdam JD, 2009; Leykin Y, 2007); Paholpak S, 2002). Taking a low dose for months may create a similar situation as stopping and restarting. While the neurogenesis interruptions may only be of short duration, they occur much more frequently.
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    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. #6

    Re: Sertraline first timer

    THanks for all in the info, had a fairly good day no increased side effects so far from taking the 75mg, appetite has come back with a vengeance though not stopped eating all day,
    I hope you are all well and ok xx

  7. #7

    Re: Sertraline first timer

    Well feel bit any how this morning, didnít sleep to well vivid dreams there awful, I no we all get good and bad days but you forget when you have a good day how the bad days feel, I hate the process of these meds, also my jaw is constantly clenched when I realise Iím doing it I stop does anyone else do this? Xxx

  8. #8
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    Re: Sertraline first timer

    Quote Originally Posted by Becbec27 View Post
    didnít sleep to well vivid dreams there awful,
    Insomnia and broken sleep are a relatively common SSRI side-effect. Vivid dreams also sometimes happen. I don't think they are any different than what we normally dream, but ADs may shorten and/or lighten the depth of REM sleep which can allow the dreams to bleed into conscious awareness. I used to love the ones I had when on imipramine. Full widescreen Technicolor extravaganzas and often really weird. I haven't taken imipramine for nearly 25 years but I still miss them.

    also my jaw is constantly clenched when I realise Iím doing it I stop does anyone else do this? Xxx
    Jaw clenching is another common SSRI side-effect. It is usually temporary.
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    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.

  9. #9

    Alcohol and sertraline

    Evening all, Iíve currently been on 50mg sert for 4 weeks and upgraded to 75 mg on Friday, absolute life saver these meds are Iím already on the right path no anxiety in sight (touch wood),
    Iím planning a weekend away soon and would like to know if anyone drinks alcohol while on sert? I havenít had a drop in 7 weeks, Any advice would be appreciated xxx

  10. #10
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    Re: Alcohol and sertraline

    Quote Originally Posted by Becbec27 View Post
    Iím planning a weekend away soon and would like to know if anyone drinks alcohol while on sert? I havenít had a drop in 7 weeks, Any advice would be appreciated xxx
    There at two issues to be aware of. Firstly, ADs and alcohol can be an unpredictable combination. Some days you may be able to drink a herd of alcoholic elephants under the table without raising a sweat, on others a small drink might turn legs to rubber so be extra cautious until you work out how you're effected and definitely don't drink and drive.

    The other problem is alcohol inhibits the way ADs work. Anxiety disorders and depression are the emotional symptoms of atrophy of part of the two hippocampi regions of the brain caused by high brain stress hormone levels killing brain cells and preventing the growth of replacements. ADs stimulated the growth of new cells and the therapeutic response comes from those new cells and the connections they form (see also: Depression and the Birth and Death of Brain Cells (PDF) and How antidepressant drugs act).

    Even moderate drinking can reduce hippocampus neurogenesis by nearly half (see also: Morris SA, 2010; Crews FT, 2003). An occasional drink or two shouldn't harm, but daily drinking, or getting hammered is not a good idea. Sorry
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    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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