Sertraline dosage

[panic_down_under]

I suspected that the dosage was too low, so spoke to GP who increased to 150mg.

I felt much better within a week or so. Another week later, and the anxiety is back again, sleep also bad.

Confused. Four options occur to me:

1) The new dose is still stabilising, and I just need to wait

And the winner is number 1. It takes longer than a week for a dose increase to have an effect. The improvement you noticed was almost certainly either happenstance or placebo. ADs have no direct effect on anxiety in the way say benzodiazepines do. They work by triggering brain changes and it is these physical changes which create the therapeutic response. This take more than a week. Give it at least 5-6 weeks. It could take even longer.

[apm]

I think I probably knew this already, but didn't want to face it! It's horrible to be going through, and I guess I just go lulled by feeling better, then knocked by getting worse again.

I will keep soldiering on!

Many thanks for your insights, PDU. Hope you are keeping well.

[apm]

Day 32, still going. Getting more good days, I think?

Checking in with the doc on friday to talk about dosage.

[panic_down_under]

Day 32, still going. Getting more good days, I think?

Sounds promising. Bad days may still happen, but as long as the good days are becoming ever more frequent then not something to worry about.

Checking in with the doc on friday to talk about dosage.

Are you still on 150mg?

[apm]

Thanks PDU.

It feels like it's getting easier. What is difficult is that I usually wake up anxiety free, and it comes in. Most days I wonder if it's done, and it's not!


Still on 150mg, yes. Assume I will probably stay on that for a bit longer.

[panic_down_under]

It feels like it's getting easier.

What is difficult is that I usually wake up anxiety free, and it comes in.

People fall into 2 categories, those who have little to only minor anxiety in the morning which become more severe during the afternoon, or evening, and those whose anxiety is worse in the morning fading as the day goes on.

When do you take the sertraline? You could try taking it at the opposite time of day, mornings instead of evenings, or the reverse. In theory this shouldn't make any difference as sertraline plasma levels stabilise to a steady-state about a week after a dose change and then vary little over the 24 hours, but it works often enough to giving it a shot worth trying.

Still on 150mg, yes. Assume I will probably stay on that for a bit longer.

If it still isn't fully effective after 8-12 weeks then I'd increase the dose to 200mg/day. Some, e.g. me, need to take the maximum recommended dose of their AD, or above, to achieve optimum results.

[apm]

Thanks PDU, you are a fountain of wisdom and reassurance!

I tend to get the A from the morning, fading by bedtime. I prefer it that way, as it means I sleep ok.

Onward and upward...

Hope you are well down under.

Alex.

[panic_down_under]

I prefer it that way, as it means I sleep ok.

Very wise, Alex!

Onward and upward...

Yes, that's about all we can do.

Hope you are well down under.

I'm doing great for an old fart despite my doctor trying to tell me otherwise. I've decided to prove her wrong by outliving her!

Ian

[Rad1]

PDU I just wanted to say I hope u have a wonderful Christmas. I appreciate you sharing your knowledge with me.
My anxiety is calmer on the sertraline now. I’ve gone up to 150 gsm. Depression is terrible, it’s had no impact.
Cheers!
Rad

[panic_down_under]

I just wanted to say I hope u have a wonderful Christmas.

You too, mate.

My anxiety is calmer on the sertraline now.

This is very good news, Rad

I’ve gone up to 150 gsm. Depression is terrible, it’s had no impact.

The SSRIs seem to be more effective anti anxiety than anti depression meds and may take longer to kick-in for the latter so don't give up yet.

Ian