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Thread: Starting Sertraline question

  1. #11
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    Apr 2018
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    Re: Starting Sertraline question

    Quote Originally Posted by panic_down_under View Post
    I wouldn't panic over one or two readings unless they are off the chart. Serotonin has many roles in the body apart from being a brain neurotransmitter including in the regulation of blood vessel tone, constriction and dilation and serotonergic ADs can interfere with this particularly in the first few weeks. They can either raise or lower blood pressure depending on individual responses though lower BP is the more common. They are also mild anticoagulants so may offer some protection against heart attack and ischaemic (blocking) stroke, but slightly increase the risk of the much less common haemorrhagic (bleeding) stroke. Plus, anxiety can also significantly raise BP.



    Unfortunately, there are no quick fixes. These disorders are often a long time in the making and they cannot be resolved in a few days or weeks.



    If you switch overnight to another AD you will retain some of the benefit gained so far. Unless switching to/from a MAOI class AD there is no need for a 'washout' period.
    My readings yesterday were mostly around 155/100 and 160/100 with 2 readings of 180/110.

    I visited my gp and we increased the bisoprolol to control the fast heartbeat and bloodpressure more.

    I have a call with my psychiologist at 11.30 today and will hear what she says.

    I feel completely nervous and jittery inside. I am also very worried about my blood pressure and high heart rate because they come out of nowhere.

    It might be me being so nervous that is causing this all as well.
    I barely slept last night because of my worries and it makes the nervousness so much worse.

    Sometimes I feel like giving up on meds because they make me feel so bad. If my blood pressure and heart rate was ok It would be much easier to cope for me.

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  2. #12
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    Jan 2017
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    Re: Starting Sertraline question

    Quote Originally Posted by tom1984 View Post
    My readings yesterday were mostly around 155/100 and 160/100 with 2 readings of 180/110.
    I'd be very surprised if sertraline was raising your BP from a normal say 120/80 to 180/110. Its impact is usually much less than that.

    I visited my gp and we increased the bisoprolol to control the fast heartbeat and bloodpressure more.
    That sounds like a better option than quitting sertraline at the moment.

    I have a call with my psychiologist at 11.30 today and will hear what she says.
    A psychologist, or psychiatrist? Psychologists usually don't have medical training so unless she does I wouldn't be taking advice on BP and meds from her.

    I feel completely nervous and jittery inside. I am also very worried about my blood pressure and high heart rate because they come out of nowhere.
    Do you take your BP daily because you have health anxiety, or is there another reason?

    It might be me being so nervous that is causing this all as well.
    I barely slept last night because of my worries and it makes the nervousness so much worse.
    Which points to your mental state being the main trigger for the elevated BP.

    I was recently in hospital with a serious leg infection which wasn't responding to antibiotics and facing a real possibly of having it amputated. My BP shot up to around 170/120 for a while and that was definitely all down to stress because my BP is usually kept at a little below the normal range by medication because of a long term lung issue.

    Sometimes I feel like giving up on meds because they make me feel so bad. If my blood pressure and heart rate was ok It would be much easier to cope for me.
    Is cognitive, behavioural (CBT, REBT, etc), or mindfulness therapy an option. They can be as effective as ADs and create the same positive brain changes as the meds. However, the sooner you could start the better. If there are long waiting times I suggest you stick with ADs as your anxious state can also produce the issues you're having and is I suspect mostly responsible for your current situation than the sertraline.
    __________________
    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.

  3. #13
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    Apr 2018
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    57

    Re: Starting Sertraline question

    Quote Originally Posted by panic_down_under View Post
    I'd be very surprised if sertraline was raising your BP from a normal say 120/80 to 180/110. Its impact is usually much less than that.



    That sounds like a better option than quitting sertraline at the moment.



    A psychologist, or psychiatrist? Psychologists usually don't have medical training so unless she does I wouldn't be taking advice on BP and meds from her.



    Do you take your BP daily because you have health anxiety, or is there another reason?



    Which points to your mental state being the main trigger for the elevated BP.

    I was recently in hospital with a serious leg infection which wasn't responding to antibiotics and facing a real possibly of having it amputated. My BP shot up to around 170/120 for a while and that was definitely all down to stress because my BP is usually kept at a little below the normal range by medication because of a long term lung issue.



    Is cognitive, behavioural (CBT, REBT, etc), or mindfulness therapy an option. They can be as effective as ADs and create the same positive brain changes as the meds. However, the sooner you could start the better. If there are long waiting times I suggest you stick with ADs as your anxious state can also produce the issues you're having and is I suspect mostly responsible for your current situation than the sertraline.
    Sorry I had to call my psychiatrist.
    She told me to stop sertraline immediately and gave me an appointment for tomorrow 11.30.

    This will be my 3rd med in 3 weeks. Hopefully a lucky shot without too much side effects.

    I am foing cbt every 2 weeks with a psychologist. After my birnout 2 years ago I started that.

    But because of residual complaints we wanted to go the medication route for a back support.

    I really do feel a lot worse than 2 weeks ago.
    We will see tomorrow.

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  4. #14
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    Jan 2017
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    Re: Starting Sertraline question

    Quote Originally Posted by tom1984 View Post
    This will be my 3rd med in 3 weeks. Hopefully a lucky shot without too much side effects.
    Unfortunately, there is currently no way of determining the most effective AD for an individual other than by trial and error so switching ADs is fairly common.

    I am foing cbt every 2 weeks with a psychologist. After my birnout 2 years ago I started that.
    CBT is supposed to be a time limited therapy which teaches coping strategies such as how to challenge anxious/depressed thoughts and to reframe anxiety and/or depression. It is usually limited to between 5-20 sessions. Is this what you are doing, or are the sessions mostly you talking about your troubles and how you feel about your mother/father while the psychologist nods sagely occasionally?

    I really do feel a lot worse than 2 weeks ago.
    Unfortunately, that is not unusual, but in most cases this is short lived. The best way of getting through it is to actively treat any side-effects that occur and pressing on.
    __________________
    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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