Re: 200mg dosage
Originally Posted by
Phoenixess
I began sertraline on the 29th of May initially on 50mg and gradually increased to 150mg but now the GP wants me to try the last hurdle to 200mg and I’ve become really scared to do it.
How long have you been on 150mg and how are your anxiety levels?
I rang the doctor back today after I consented yesterday. Anyway she reassured me but I’m still apprehensive. A) because this is the max dosage and what if it doesn’t help? However the 150mg has made the biggest difference.
Some of us need to take around the maximum dose to get good results from antidepressants, perhaps because we're fast metabolisers. I've always needed large doses, 50% above the recommended maximum dose for the first AD, currently 12% above the max for the one I've been taking for about 25 years.
Unfortunately, the only way to know if 200mg will do the trick is by trying it. There's not much point in taking a med which isn't effective when something else probably will be. One option to consider is adding the noradrenaline, aka norepinephrine reuptake inhibiting AD nortriptyline if sertraline is falling short of full effectiveness to essentially create a bespoke SNRI. This was a very popular combination back in the day before SNRIs became readily available and many of the old time psychiatrists still rate it a better option than taking a SNRI. Given some of the issues with SNRIs they have a point, imho.
B) I’ve never met anyone on max dosage?
It isn't unheard off, especially for depression as SSRIs are less effective for it.
C) I’m scared of serotonin syndrome?!?
Serotonin syndrome is rarely an issue when taking a single serotonergic AD. It can be when taking two, or more, but most serious problems only arise when one of them is a MAOI class AD which are rarely prescribed these days, though they probably should be.
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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.