Re: Stabilisation v needing higher dose
Originally Posted by
apm
am taking 50mg daily, in the morning. Anxiety seems to be worse in the afternoon/ evening, tailing off towards bedtime.
You could try switching to taking it in the evening, Alex. In theory this shouldn't make any difference as once plasma levels stabilize which takes about 5 days for sertraline they don't vary much across 24 hours, but in practice sometimes it does.
I know that this medication takes 4-6 weeks to stabilise,
It's not about stabilising, but that it takes time for the brain cells that the AD stimulates into growth take weeks to grow. The new cells and the connections they form create the therapeutic response, not the med directly. ADs typically kick-in between 4-12 weeks with most beginning to see positive signs at around 6 weeks, however, as this isn't your first AD it may take a little longer.
but I am wondering if this pattern is more about my needing to increase the dosage to deal with my anxiety, or just the tail end of stabilisation?
A good question. It could be either, however, my money is on the dose being inadequate. 50mg is the recommended minimum effective dose with most need to take 100-150mg for optimum results and given a previous SSRI pooped-out I doubt 50mg is going to work for you. Also as I understand it you were on 40mg citalopram which is roughly equivalent to about 100mg sertraline (AD equivalence isn't an exact science so some dose tuning may be required).
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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.