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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by displaced9 on September 17, 2011, at 9:01:17
Hi All,
I started Zoloft (sertraline) about 6 weeks ago, starting at 50mg for 2 weeks, then 100mg for 2 weeks, then 150mg and I've been at that dosage for about 2 weeks. The medication is working wonders for my anxiety HOWEVER I am still having symptoms/side effects that are like physical anxiety symptoms -- numbness around my lips, tingling/numbness in my extremities (fingers, toes) and that general "uneasy" feeling, but no actual mental symptoms of anxiety. PDoc gave me propanolol 20mg BID for these symptoms. 20mg doesn't seem to do it. 40mg will take care of it, but I have to take it more often than 2x/day and propanolol also makes me VERY drowsy and worn out.
Anyways - i'm wondering if these symptoms are a side effect of the zoloft or if it is actual anxiety? I do experience these sx when I'm having an anxiety attack, but these sx appear daily, multiple times per day. If I get up and walk around it will help a little but it only helps for a few mins.
Any input is appreciated. I also take Wellbutrin SR 450mg/daily. I have tried taking L-Theanine, Ashgawanda, and GABA.
Posted by Phillipa on September 17, 2011, at 10:37:10
In reply to Zoloft for Anxiety and Dysthymia - Side effect?, posted by displaced9 on September 17, 2011, at 9:01:17
Do you feel it could be the wellbutrin? If anxiety present could make it worse? Just a thought. Phillipa
Posted by displaced9 on September 17, 2011, at 12:11:23
In reply to Re: Zoloft for Anxiety and Dysthymia - Side effect? » displaced9, posted by Phillipa on September 17, 2011, at 10:37:10
Hi Phillipa,
I thought it might be, although I previously took Wellbutrin (same dosage) with Lexapro and Geodon without these symptoms. I tried going down to 300mg for 1 week but didn't notice any changes.Do you know if it's normal for propanolol (a beta blocker) to make you drowsy? It's not listed as one of the side effects.
Posted by bleauberry on September 17, 2011, at 18:12:40
In reply to Zoloft for Anxiety and Dysthymia - Side effect?, posted by displaced9 on September 17, 2011, at 9:01:17
It's hard to tell where that uneasy feeling is coming from but my guess it is something to do with the meds....too high of a dose at this time, not on it long enough because sometimes it takes a few months to get fully adjusted, something unexplainably weird about the combination of meds in your biochemistry, or just as simple as the meds not being right for you. Any of those.
Since you try supportive supplements, my favorites in situations like yours include Lemon Balm, Passion Flower, Valerian, and Skullcap. Each one on its own is fairly calming and grounding but they work best when any 2 or 3 are combined. For me I usually try new herbs one a time first to get to know them and then it is easier to choose which ones to combine. I find Lemon Balm the most calming without sedation, and Skullcap the most calming with sedation. The other two are good complimentary additions to make the others work better in synergy in my own personal experience with them.
Funny you mentioned L-theanine because I took that once when I was having some anxiety from lexapro and the stuff gave me my first ever full blown panic attack. Had to take a zyprexa to knock it down or else a high dose of xanax. So I don't touch Le-theanine or green tea. Gaba I found somewhat calming, short term, but the only way I could get effect from it was to absorb it under my tongue. Ashwaganda really needs a long trial, several months, to see what it can do. It's a good plant but like most needs a good amount of time to do its thing. It's not really a calming or anti anxiety herb, but rather one that modulates the adrenal/cortical/adrenaline circuits over time. I found it made me mildly stimulated but calmed to the point of sluggishness and tiredness all at the same time, weird. It was a good sexual stimulant already kicking in after a few days.
Dosing with herbs is tricky because any of them could work great or not at all depending on the dose.
Posted by Phillipa on September 17, 2011, at 20:47:34
In reply to Re: Zoloft for Anxiety and Dysthymia - Side effect? » Phillipa, posted by displaced9 on September 17, 2011, at 12:11:23
If it relieves anxiety slows the heart down I feel it could. I was given lopressor 25mg for anxiety with benzos and boy was I tired. Phillipa
Posted by Zyprexa on September 18, 2011, at 0:44:33
In reply to Zoloft for Anxiety and Dysthymia - Side effect?, posted by displaced9 on September 17, 2011, at 9:01:17
You might want to try lowering the high dose of wellbutrin, see if that helps. I doubt its the zoloft giving you anxiety. I take both and coming off the wellbutrin. Feeling better now and less anxiety, less anti social.
Posted by displaced9 on September 18, 2011, at 8:56:22
In reply to Re: Zoloft for Anxiety and Dysthymia - Side effect?, posted by Zyprexa on September 18, 2011, at 0:44:33
Hi
I went down to 300mg from 450 for a week but didn't notice a difference. How long should it take ?
Posted by Phillipa on September 18, 2011, at 19:57:23
In reply to Re: Zoloft for Anxiety and Dysthymia - Side effect?, posted by displaced9 on September 18, 2011, at 8:56:22
I would think pretty quickly? Phillipa
Posted by Zyprexa on September 19, 2011, at 0:24:53
In reply to Re: Zoloft for Anxiety and Dysthymia - Side effect?, posted by displaced9 on September 18, 2011, at 8:56:22
I notice a difference after a couple of days to a week. Also you are on such a high dose it may require going lower or off it.
Posted by morgan miller on September 19, 2011, at 15:28:01
In reply to Zoloft for Anxiety and Dysthymia - Side effect?, posted by displaced9 on September 17, 2011, at 9:01:17
Lower the Wellbutrin or lower the Zoloft back to 100 mg. You probably don't need that high a dose of both. The idea is to reach 70 to 80 percent improvement and do everything else on your own to get to 100 percent. We also need to accept that we will have some remaining issues with our thoughts and physiology. There is always going to be something wrong with always feeling almost no anxiety and depression on medication. It's simply not natural to feel this way. We need a certain degree of anxiety to keep us driven in certain ways. We need to be eating properly and exercising properly to make our minds and bodies feel better. We need to stay social and stay connected, feeling as much love for the world and others in our life as possible. Medication is NOT the cure guys.
So, I suspect you could reduce Wellbutrin 100 mg and go back down to 100 mg Zoloft, and do everything with your diet, exercise, and social life to get yourself to the place you and all of us want to be in.
New Chapter's Holy Basil, Lithium Orotate, and Magnesium Glycinate or Taurinate are other options to consider for anxiety and easing the mind.
Morgan
Posted by morgan miller on September 19, 2011, at 15:35:52
In reply to Re: Zoloft for Anxiety and Dysthymia - Side effect?, posted by morgan miller on September 19, 2011, at 15:28:01
You need to get the CO2 supercritical extract of holy basil by New Chapter.
One more thing to add, if you are at 50 or 60 percent, and just strong enough, you should be trying to do all of the extra things I listed above, especially diet(paleo/primal) and exercise, if you really want to give yourself a chance of ever making it back to living like you dream of.
Posted by displaced9 on September 19, 2011, at 15:43:31
In reply to Re: Zoloft for Anxiety and Dysthymia - Side effect?, posted by morgan miller on September 19, 2011, at 15:28:01
Hi Morgan,
Thanks for your reply. I do eat pretty well and I take New Chapter Every Man's multivitamin daily, along with Source Naturals Ultra-Mag magnesium complex (it really really helps with muscle tension.)
I am starting an exercise program again this week - I was going to the gym 3-4x week regularly until the medication changes and anxiety took me down.
I have the Holy Basil but haven't been taking it because I was afraid of sedation or drowsiness. Should I take this AM or PM, and how long would it take for me to notice a difference?
I am also doing therapy once a week, and that definitely helped/helps my mental anxiety and some other issues, but doesn't do anything for the physical symptoms.
I am going to back down on the Wellbutrin and go to 300mg and split the dosage into 150mg AM and 150mg around 1-2pm and see how that goes.
Best.
Thanks!
Posted by creepy on September 19, 2011, at 20:42:13
In reply to Zoloft for Anxiety and Dysthymia - Side effect?, posted by displaced9 on September 17, 2011, at 9:01:17
i take zoloft and wellbutrin also. cant go over 150mg without major physical anxiety symptoms.
Id lower or replace wellbutrin if it was me.
Posted by morgan miller on September 19, 2011, at 22:17:22
In reply to Re: Zoloft for Anxiety and Dysthymia - Side effect?, posted by displaced9 on September 19, 2011, at 15:43:31
Hey displaced,
Sounds like you're doing some good things. I would try the holy basil whenever you are stressed. I've taken during the day and been fine. I just take the stuff when I feel more anxious and stressed than usual.
I think lowering Wellbutrin is a good idea. Hope it works out!
Morgan
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