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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by rgb on February 1, 2008, at 14:40:23
It's hard to put my finger on this so please bear with my attempt at describing it :)
There are positive effects. Things are kind-of starting to change.
I'm less helpless. I'm realizing opportunities for improvement that I didn't before; I think I'm more often dealing with not-so-pleasant issues which I ignored before or where I was stuck in a routine.
Self-esteem has increased (up from way-too-low); less worries what others think of me. I'm more ironic. Some kinds of anxiety and worries have decreased. More online communication and also a bit more in real life, though I'm still pretty lonely. There are periods of time where I'm smiling a lot :)
But I have this odd inner restlessness. But also fatigue attacks that can lead to lying down on the desk or something. I can be quite scattered and ADDish, still not getting too much done. I'm not sure whether this is "dark", purely negative restlessness / akathisia or an actually healthy urge to do something else than spend all my free time online.
Drive for social contact has gone up from "almost none" to "a bit". This is good in principle, but bad in that my habits don't include it and it can make being alone more unpleasant (Coming home to being alone sometimes causes major "comedown"-type feelings). Paradoxically enough, both romantic desire and libido are way up. Thoughts of some women cause particularly intense bittersweet emotions.
I'm often kinda unconcentrated at my studies, but abstract reasoning skills seem to be mostly fine.
FWIW, I've been on it for 9 months.
Sorry if I'm rambling a bit, but maybe someone kinda recognizes this and has advice. I'm really puzzled whether this is good or bad.
Posted by Phillipa on February 2, 2008, at 0:03:57
In reply to Puzzled- sertraline making things better or worse?, posted by rgb on February 1, 2008, at 14:40:23
Nine months and you're saying you're really not much better? Phillipa if so maybe time for a change. Talk to your pdoc.
Posted by CareBear04 on February 2, 2008, at 11:23:13
In reply to Puzzled- sertraline making things better or worse?, posted by rgb on February 1, 2008, at 14:40:23
what you were describing seemed to make more sense before you mentioned that you're been on zoloft for nine months. for some reason, i seem to be sensitive to SSRIs, especially when starting them, and i have all the effects you described. my mood is better with all the improvements that accompany that, but i feel very restless, both physically and mentally. i can still think conceptually but have a hard time organizing and focusing my thoughts for an immediate task at hand. when i've taken SSRIs without a mood stabilizer, i've become manic.
that said, it's curious as to why you're experiencing these effects now after nine months. have you maybe had them for a long time now and are just now noticing them? have you increased your dose or otherwise changed your meds? most people who have akathisia/over activation-type reactions have them at the start, and they either discontinue or the side effects decrease over time.
on balance, do you feel that the zoloft is helping? do the benefits outweigh the restlessness? it's worth talking to your pdoc about the situation and, if you want to stay on it, to discuss adjusting the dose or adding/taking away other meds.
good luck,
cb
Posted by rgb on February 2, 2008, at 13:14:08
In reply to Re: Puzzled- sertraline making things better or wo » rgb, posted by CareBear04 on February 2, 2008, at 11:23:13
@Phillipa: I'm going to stick with it for now since it /does/ have an effect, just with some downsides.
@CareBear04:
> what you were describing seemed to make more sense before you mentioned that you're been on zoloft for nine months. for some reason, i seem to be sensitive to SSRIs, especially when starting them, and i have all the effects you described. my mood is better with all the improvements that accompany that, but i feel very restless, both physically and mentally. i can still think conceptually but have a hard time organizing and focusing my thoughts for an immediate task at hand. when i've taken SSRIs without a mood stabilizer, i've become manic.
Interesting that you had the same reaction. By the way, how did the issue from the other thread work out for you, did you go back on an antidepressant?
> that said, it's curious as to why you're experiencing these effects now after nine months. have you maybe had them for a long time now and are just now noticing them? have you increased your dose or otherwise changed your meds? most people who have akathisia/over activation-type reactions have them at the start, and they either discontinue or the side effects decrease over time.
Yes, it didn't begin suddenly and I think I've mostly become more aware of it. My dose has been 200mg for some months.I did recently switch to a different generic which appears a bit stronger. The wikipedia says that the allowed bioavailability ratio to the original is 80-125% (where I live), which would be a sizeable 1.56-fold difference between the extreme ends.
The occasional serotonergic euphoria was there right from the beginning. Not sure whether the restlessness was there from the start as well.
I know some symptoms resemble minor mania but I like the smiling-a-lot parts and don't really want to start a mood stabilizer (I think I have no bipolar tendencies without drugs).
> on balance, do you feel that the zoloft is helping? do the benefits outweigh the restlessness?I really don't know. I should continue it for now and see whether the restlessness decreases with more social and/or productive activities (easier said than done).
> good luck,
> cbThanks =) Good luck to you too!
Posted by tecknohed on February 3, 2008, at 10:47:35
In reply to Puzzled- sertraline making things better or worse?, posted by rgb on February 1, 2008, at 14:40:23
If its still working after 9 months stick with it. But perhapse an increase in dosage may help. The first thought is often to 'decrease' the dose to lessen the side effects. But actually increasing may well make whats going well even better, and help more with the anxiety. I also suspect the restlessness is indeed pent up energy needing to be released. Do you execise?
I know lethargy can be a problem with SSRIs, but that seems more likely to happen when bored, alone, watching TV, etc. If you were able to be more socially active then your friends will keep you awake :) Maybe a stronger dose would help that. maybe.teck
Posted by Maxime on February 9, 2008, at 3:57:26
In reply to Puzzled- sertraline making things better or worse?, posted by rgb on February 1, 2008, at 14:40:23
Hi there.
What dosage are you taking? I was on 250 mg for four months and I finally came off it a little over a week ago. I didn't experience all the positive effects that you have experienced. All I felt was apathy. I wanted to cry but I couldn't.
Anyhow, my point is that maybe your dosage is too high. I read an article recently that claimed that 50 mg of Zoloft was as effective as 200 mg. I am not sure if I believe it all the way. But I believe reducing the dosage might help.
Best of luck to you.
Maxime
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