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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by mats on July 27, 2002, at 9:18:18
This is my third time on Zoloft. It was working very good in the past, but now it isīt.
Why? Should I switch? What med do you recommend as a alternative to Zoloft?sorry for the spelling!
Posted by mats on July 27, 2002, at 9:23:07
In reply to Why is my Zoloft not working?, posted by mats on July 27, 2002, at 9:18:18
I should state that I am on 200mg.
Posted by cybercafe on July 27, 2002, at 11:34:08
In reply to Why is my Zoloft not working?, posted by mats on July 27, 2002, at 9:18:18
> This is my third time on Zoloft. It was working very good in the past, but now it isīt.
> Why? Should I switch? What med do you recommend as a alternative to Zoloft?it is possible, but you should give zoloft a fair trial...
as for which antidepressant you should try: there are some really decent protocols out there, depending on what has worked for other family members, what type of depression you are experiencing (atypical/vegetative or melancholic/retarded or agitated and anxious), what meds you have taken in the past, whether you have received a partial response from these meds or no response at all (VERY important), whether there is a risk of bipolar or psychosis, whether there is a chance the patient is suicidal or not, other disorders such as ADHD, other medical problems/medication, whether the patient has any problems tolerating meds -- there are actually a few decent flowcharts out there that make the process simple (considering all the information involved)
good luck ;)
cybercafe
Posted by oona on July 27, 2002, at 13:28:33
In reply to Re: Why is my Zoloft not working?, posted by cybercafe on July 27, 2002, at 11:34:08
> > This is my third time on Zoloft. It was working very good in the past, but now it isīt.
> > Why? Should I switch? What med do you recommend as a alternative to Zoloft?
>
> it is possible, but you should give zoloft a fair trial...
>
> as for which antidepressant you should try: there are some really decent protocols out there, depending on what has worked for other family members, what type of depression you are experiencing (atypical/vegetative or melancholic/retarded or agitated and anxious), what meds you have taken in the past, whether you have received a partial response from these meds or no response at all (VERY important), whether there is a risk of bipolar or psychosis, whether there is a chance the patient is suicidal or not, other disorders such as ADHD, other medical problems/medication, whether the patient has any problems tolerating meds -- there are actually a few decent flowcharts out there that make the process simple (considering all the information involved)
>
> good luck ;)
>
> cybercafeHi mats,
I am not an expert on this or anything so let me add that right away.
Just a thought, It took at least three months for Zoloft to work when I started about 7 years ago. Of course I started at 25, then 50, then 100, then at 150.. did not have to go more than that. I am no longer on it am on Celexa now for a trial.Agreeing with cybercafe about other drugs and your history etc...
You do not drink or take marijuana or other drugs, correct? That is always an issue with meds.
I wish you luck and hope it works for you or you find a med that does.
peace,
oona
>
Posted by hildi on July 27, 2002, at 18:48:29
In reply to Re: Why is my Zoloft not working?, posted by cybercafe on July 27, 2002, at 11:34:08
What is atypical/vegetative and melancolic/retarded? Could you explain?
Thanks,
Hildi
Posted by LostBoyinNC1 on July 27, 2002, at 22:50:41
In reply to Why is my Zoloft not working?, posted by mats on July 27, 2002, at 9:18:18
> This is my third time on Zoloft. It was working very good in the past, but now it isīt.
> Why? Should I switch? What med do you recommend as a alternative to Zoloft?
>
> sorry for the spelling!Could be a hundred reasons. But you mentioning this is your third time on it gives a clue why. Stopping and starting antidepressants is bad news. It can lead to "SSRI poopout" and is a common cause of antidepressants losing their full activation. Once you go on an antidepressant, you shouldnt stop it for at least nine months, preferably a year. Then if you are doing OK you can taper off SLOWLY. If your symptoms return, then you can return to the same AD and it will probably retain its former activation. But a third or fourth return and ADs tend to start losing their former activation.
If you raise the dose it might reactivate. Or you might need to switch to another AD. Effexor XR is always good. Or add lithium or Ritalin or lamictal to it. Just dont stop and start antidepressants repeatedly in the future.
Posted by cybercafe on July 28, 2002, at 1:43:42
In reply to Re: Why is my Zoloft not working? ŧ cybercafe, posted by hildi on July 27, 2002, at 18:48:29
> What is atypical/vegetative and melancolic/retarded? Could you explain?
atypical/vegetative usually means there is mood reactivity (more than 50% of your depression lifts from time to time in pleasurable situations) ... also there are vegetative symptoms such as oversleeping and eating more... (hyperphagia and hypersomnia)
melancholic/retarded .. involves no mood reactivity .. insomnia... and eating less/weight loss i believe... and possibly slowed speech, slowed thoughts... or slowed movement ... but mood reactivity is the primary indicator ...
most depressives are atypical
melancholic depression seems to respond favourably to tricyclics
atypical depression seems to respond favourably to MAOIs, but poorly to tricyclics...
good luck
Posted by LostBoyinNC1 on July 28, 2002, at 10:34:18
In reply to Re: Why is my Zoloft not working?, posted by cybercafe on July 28, 2002, at 1:43:42
> > What is atypical/vegetative and melancolic/retarded? Could you explain?
>
> atypical/vegetative usually means there is mood reactivity (more than 50% of your depression lifts from time to time in pleasurable situations) ... also there are vegetative symptoms such as oversleeping and eating more... (hyperphagia and hypersomnia)
>
> melancholic/retarded .. involves no mood reactivity .. insomnia... and eating less/weight loss i believe... and possibly slowed speech, slowed thoughts... or slowed movement ... but mood reactivity is the primary indicator ...
>
> most depressives are atypical
>
> melancholic depression seems to respond favourably to tricyclics
>
> atypical depression seems to respond favourably to MAOIs, but poorly to tricyclics...
>
> good luckThe above is all true, however severe endogenous depression (melancholia) responds best to bilateral and bifrontal ECT. Also, severe melancholic depression responds great to the MAOI Parnate. The MAOIs are useful not in just atypical depressions, but can also be very effective in severe endogenous depressions.
Many cases of severe melancholia the best choices are either ECT or high dose Parnate.
>
Posted by cybercafe on July 28, 2002, at 13:25:58
In reply to Re: Why is my Zoloft not working?, posted by LostBoyinNC1 on July 28, 2002, at 10:34:18
>to bilateral and bifrontal ECT. Also, severe melancholic depression responds great to the MAOI Parnate. The MAOIs are useful not in just
I have total respect for Parnate. I worship Parnate. I am never going off Parnate.
>atypical depressions, but can also be very effective in severe endogenous depressions.
Strangely, I find my exogenous depression is treated much, much faster than my endogenous depression. In social situations I am really happy and content now,.... while my time-alone-depression seems to be improving at a somewhat slower rate.
> Many cases of severe melancholia the best choices are either ECT or high dose Parnate.is that just refractory melancholia or in general do MAOIs work better than TCAs for melancholic depression?
Posted by oracle on July 28, 2002, at 19:19:14
In reply to Why is my Zoloft not working?, posted by mats on July 27, 2002, at 9:18:18
> This is my third time on Zoloft.
A specific AD may stop working if you go off and restart
it.
This is the end of the thread.
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