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Re: I need some advice regarding my medication regimen Hordak

Posted by mtom on August 6, 2019, at 10:53:31

In reply to Re: I need some advice regarding my medication regimen, posted by Hordak on August 6, 2019, at 8:31:54

> Could you please elaborate on your experiences with Sertraline. That would be very helpful. Thank you :=)) And how were Citalopram and Escitalopram compared to Sertraline? Were they less agitating than Sertraline?
>
> Did you try 30mg Mirtazapine?

I had an intense reaction to 1 Sert (Zoloft). Woke through the night feeling I was going to explode, heat, chills, physical agitation and anxiety, etc. Believe it was mild Serotonin Syndrome (my blood pressure was also notably higher than my norm when saw Dr a couple days later - also a SS symptom). HOWEVER - I had been taking St. John's Wort for 2-3 months including that day. Had told Dr when she gave me Zoloft, she didn't know what SJW was and said irrelevant - this was a long time ago, SJW had just started growing in popularity & no info out on interactions. SJW had done nothing anyway & interaction did not occur to me. It was a weekend so until my Dr office opened I used Benzos which I had on hand for occasional use for Flying, Dentists, etc (was not experiencing general anxiety in those days). The reaction wore off gradually over a few days.

Now, I am VERY sensitive to AD's and react to almost all I have tried with increased anxiety & other side effects (including citalopram and escitalopram even on very low subclinical doses - intense, but not to the degree of my Zoloft reaction which was likely exacerbated by the SJW). I know only 2 others personally who have tried Zoloft - 1 no problem, still takes it, other found it too activating but has no problems on Citalopram.

Still taking a very small dose Mirtazapine, started with 3.75 and very recently worked up to 7.5 mg (and still a very small dose Escitalopram). My Doctors want me to stay at this for a few weeks then discuss further increases. No increase in anxiety yet with Mirt, in fact anxiety is somewhat better. But other SE's, some described in my first post. Doubt I will go as high as 30.

My new Pdoc told me he believes some people do well on lower doses of AD's than the "standard" recommendations, but most Docs just prescribe the "standard" in the belief that lower doses are subclinical and won't work. This is likely true for most people, but not all. And of course there is an understandable rush to get relief asap. I also believe it takes longer for some people than others to feel an effect, and some Docs have a tendency to increase dose very quickly if no quick effect. This may often be the right thing to do, but sometimes the effect just takes longer.

Again, everyone is different. I see you wrote that Sert helped your anxiety but brought on other negative symptoms. I also found Citalopram & Escitalopram decreased my motivation further, although it was already low due to depression.

But others I know on Cit and Escit have not experienced this effect. Since starting Mirtazapine (Remeron) I have had a few days of feeling better with increased motivation, but these have been intermittent & inconsistent so far, although noticeable when they occur. And it's possible this is in part because I've been tapering Escitalopram at the same time.

It's even possible that the "Medical" CBD Oil I started taking a few months ago is helping the anxiety, who knows? Little research, but lots of anecdotal reports. I also take it for autoimmune arthritis pain & it's definitely helped with that. Medical Cannabis is available by Prescription from Doctors in Canada, supplied by government regulated licensed providers. As of late last year, Cannabis in Canada is also available through licensed shops without a prescription.


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