How long before it usually kicks in for people?

[Tyke]

I have been on sertraline before and restarted again a few years ago, but currently my 50mg was no longer working for me and my GP upped it to 100mg around five weeks ago due to a spike in anxiety and depression as a result of increased strain with pandemic issues. I still feel awful and haven't noticed any improvement yet. If anything I've actually got worse.

I just wondered what other experiences people have had in this kind of situation? How long have people found it takes before they get any benefit from it? I'm just hoping the drug will still work for me, as 50mg was fine for me until recently.

Best wishes
Tyke

[panic_down_under]

I have been on sertraline before and restarted again a few years ago, but currently my 50mg was no longer working for me and my GP upped it to 100mg around five weeks ago due to a spike in anxiety and depression as a result of increased strain with pandemic issues. I still feel awful and haven't noticed any improvement yet. If anything I've actually got worse.

Upping the dose increases serotonin activity. Despite the common myths, serotonin isn't a 'feel good' neurotransmitter, just the opposite. It increases anxiety and/or depression. However, after a few weeks bio-feedback mechanisms kick in and reduce serotonin synthesis and expression to below baseline in brain areas that manifest anxiety/depression.

I just wondered what other experiences people have had in this kind of situation? How long have people found it takes before they get any benefit from it? I'm just hoping the drug will still work for me, as 50mg was fine for me until recently.

It typically takes 4-12 weeks. ADs do not directly treat anxiety/panic. 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 and they take time to bud, grow and mature. For more detailed explanations see: Depression and the Birth and Death of Brain Cells (PDF) and How antidepressant drugs act: A primer....

[Tyke]

Thanks for the reply panic_down_under and the useful links.

I guess I'm just being impatient! I sense the increase in anxiety symptoms while I'm waiting for it to work and am still getting a few other side effects too. Nature seems a tad cruel here -it's like 'we'll make you a bit worse before you can get a bit better!' I'm trying to see it now in terms of a marathon rather than the sprint we'd all much prefer.

Best wishes
Tyke

[panic_down_under]

I'm trying to see it now in terms of a marathon rather than the sprint we'd all much prefer.

Unfortunately, that is often the case, Tyke. These disorders are often a long time in the making and there's no way of speeding up recovery. It can be one long hard slog, but the results are usually worth the pain. I liken it to a 4-5 month pregnancy. Rough at the beginning with side-effects akin to morning sickness, boring in the middle stretch and uncomfortable toward the end, but worth every second of the misery once the med kicks-in with all the unpleasantness soon forgotten.