Posted by Brainbeard on July 29, 2012, at 16:11:40
In reply to Re: Zoloft 200mg not working. Scared + need advice!, posted by scleme1 on July 18, 2012, at 15:32:05
I had a similar situation where I switched from high dose clomipramine (augmented with fluvoxamine to boost it*), which was effective for depression and OCD, to 200mg Zoloft (sertraline). At first it seemed to be a painless switch, but then anxiety and depression kicked in again big time. :[
Trying all kind of things, one bright morning I popped 1800mg of gabapentin (aka Neurontin) and within a few hours felt great. Relieved from anxiety and in a mood better than well. :D
I still take the gabapentin alongside my 250mg of Zoloft, and it somehow boosts the Zoloft into being truly effective. Gabapentin has serotonergic effects - it makes serotonin more readily available in the body, which is probably the reason why it can boost an SSRI.
I'm experimenting with the dosing of my gabapentin, but usually, it should be taken three times daily.
So adding gabapentin might be an option.
Clomipramine would also be an excellent option, since decades of research show it to be slightly superior to SSRI's for treating OCD.
* Fluvoxamine (better known as Luvox) inhibits the breakdown of clomipramine into its noradrenergic metabolite, desmethylclomipramine. The noradrenergic metabolite works well for depression but probably doesn't help much with OCD.
Current meds: Zoloft (sertraline) 250mg, Neurontin (gabapentin) 1800mg, clomipramine 75mg, Concerta 18mg + methylphenidate (Ritalin) 5mg a time, flupentixol 0,5mg. PRN: alprazolam, clonazepam.