I started taking a Ssri (Zoloft) and I need serious reassurance

June 2, 2014 1:17 PM

I've been on 50mg/Zoloft per day for the last 10 days for severe anxiety and some depression. To say it's been a rough ride is an understatement – and I really need to hear success stories and make a decision on how bad the side effects get before it gets better.

You are not my doctor, I am seeing my doctor+therapist this week, and I have read previous related Ask Mefi questions :)

I started Zoloft 10 days ago and for the first few days had zero appetite and nausea. Now I just feel more anxious than before I started and feel very sleepy all the time + tremors - which makes me more depressed and feel like it's never going to end (Although i had a very good day Saturday where I felt almost normal - could it be that when it starts to work it is patchy?)

I know side effects are supposed to subside, but how long did you have to put up with it before getting some relief, and more specifically when do you decide the side effects are too much? (especially since maybe they're not side effects but related to my anxiety and depression?). the idea of trying more and more anti depressants really brings me down. Maybe I just need to cope with it for a few more weeks? Anything I can do to make it more bearable?

Any help at all would be appreciated.

posted by anonymous to Human Relations (21 answers total)

Three to six weeks is the norm, I think.

That said, please tell your doctor about your symptoms. Antidepressants are not one-size-fits-all. Most people have to try several different drugs at different doses to find what works best for them. If this particular one isn't working out for you, it's completely normal.
posted by Willie0248 at 1:20 PM on June 2, 2014 [4 favorites]

Two weeks for side effects to subside, about a month for the side effects to go away. Increased anxiety at first is actually often a good sign that the medication will successfully reduce anxiety over time.
posted by jaguar at 1:25 PM on June 2, 2014 [1 favorite]

The problem with SSRIs is that they do require a time investment. Really you should give it at least a month. The first two weeks can be brutal, but many of the side effects will subside.

I've been on a few different anti-depressants and I will say that I found Zoloft to have the worst side effects when starting, but the side effects did go away, and ultimately Zoloft was a good fit for me at one time.

Hang in there. It's worth it.
posted by Lutoslawski at 1:27 PM on June 2, 2014 [1 favorite]

Definitely talk to your doctor about the side effects you are experiencing. Sometimes it takes a couple of weeks for them to go away.

I just wanted to say that even if this isn't the drug for you, that doesn't mean that you won't be able to find one that will work for you. Trying to find the right fit for you can be really difficult, but when you find something that works for you it will be worthwhile.

I'm actually switching from one SNRI to another right now, and my doc prescribed me a very low dose of Ativan that I can take in case the anxiety gets overwhelming. I've only taken it once so far, but it's a bit of a comfort to know it's there in case my stupid brain goes into full on panic mode. Depending on the severity of your anxiety, this could be something to discuss with your doctor.
posted by inertia at 1:37 PM on June 2, 2014

Increased anxiety at first is actually often a good sign that the medication will successfully reduce anxiety over time.

Do you have data that back up this claim? It's the kind of claim, that if true, could really sway someone asking this type of question.

I pay some attention to SSRI data, and I'm not aware of any data that would back it up. In general, I believe that if a medication is not working for you, you need to speak with your doctor.
posted by JohnLewis at 1:43 PM on June 2, 2014

I had virtually zero side effects, apart from some brief fleeting feelings of euphoria. And then very reduced libido. Please tell your doctor about this.
posted by jeff-o-matic at 1:45 PM on June 2, 2014

Call your doc right away. He/she may cut your dose temporarily until you get used to the side effects. He probably started you on too high a dose, at least too high for you. Sometimes you have to build up to an effective dose.

If you have continued problems, I would taper off, and the sooner the better. Do not quit cold turkey, however. To avoid further misery, you must taper off very slowly.
posted by serena15221 at 1:50 PM on June 2, 2014

First time I was inducted onto SSRIs I started sleeping 3-4 hours a night, and felt effects verrry similar to MDMA, constantly, for two weeks.

It was actually kinda fun... I remember sitting the library with a feeling I can only describe as profound earth-shaking euphoria gushing through my head, and waking up with massive energy at 5AM. I also started to act silly and without inhibition.

By four weeks it had subsided.

SSRIs take time, and side effects can vary a fair amount in the first month.
posted by jjmoney at 1:52 PM on June 2, 2014

Absolutely talk to your doctor, but I would say tough it out for a while if you can. When I started the SSRI I finally settled on, I had nausea, poor appetite, and some pretty crazy tremors (made worse by caffeine, which I had to quit for a month or so), but they did eventually fade and I've been stable on those meds for three years or so now with no recurrence.

I would also totally not judge you if you decided you couldn't tough it out, though -- I went through a couple drugs where the side effects were so bad I went back within the week and bailed out. Trial and error fucking sucks when your brain is on the line, but it seems to be all we've got.
posted by dorque at 1:52 PM on June 2, 2014

I've never tried this class of medication, so I can't relate to the symptoms, but in my psych course they said that exactly 2wks after starting medication is the most difficult period for a person because they expect that it should be better by now. Like you've run a marathon and you expected it to end right now, and it's not. But like others have said it just takes longer to kick in.

So I just wanted to say from that perspective you are not alone. Hang in there!
posted by St. Peepsburg at 2:02 PM on June 2, 2014

10 days is kind of the worst time for the side effects - it's ramped up enough that you're feeling the full effects, but it's not long enough to know that they'll disappear entirely, and it's still too early to feel the benefits of the medication.

My partner suffered through the side effects for about 2-3 weeks, and then the side effects disappeared and the benefits came shining through. I'd say stick it out for another week or two, if you can, to see if things change. If there isn't a spot of bright light around Day 24, I'd ask to try something different, or see if you can try a lower dose.

Obviously talk to your doctor, but it's absolutely 100000% possible that the side effects can be miserable on Day 10 and then abate, and then the medicine will start showing its positives.
posted by barnone at 2:05 PM on June 2, 2014

I was ill for roughly three weeks when I started the dose you're on now. Now I feel fine, but definitely talk to your doctor (and your pharmacist! They've always been more than happy to answer my questions.)
posted by Lemmy Caution at 2:07 PM on June 2, 2014

My doctor started me on a very low dose of sertraline, then brought me in every week and then every couple of weeks to discuss how I was doing and write me a new prescription until we hit the right dosage. I had some side effects for the first couple of weeks, and didn't start to feel improvement until around three weeks. The improvement was patchy, as you say. I think it took two months for me to feel evened out, i.e. significantly better 24/7.

Looking back years later, I am so, so glad I stuck it out.

I am also so grateful for my doctor. Meeting with her a lot and increasing the dosage slowly were both critical for me in the early stages.
posted by a fair but frozen maid at 2:14 PM on June 2, 2014 [1 favorite]

Crazy Meds: Zoloft. Amazing, highly-regarded resource.
posted by DarlingBri at 2:28 PM on June 2, 2014

There's a lot of variation in people's reactions to SSRIs and side effects - it's one of the reasons so many people try several. If you don't have an appointment to talk to the prescribing doc in the next few days I'd call him/her. They may well have an immediate suggestion for dosage or change and be able to handle it all by phone.
posted by phearlez at 2:48 PM on June 2, 2014

I started on a very low dose of Zoloft, and my doctor upped the dosage every month as needed until my anxiety attacks had largely stopped. I don't remember a ton of side effects when I first started -- maybe some stomach upset, but nothing too major. I did have a brief spell of really bad nightmares for about a week, but that passed and never happened again. Definitely talk to your doctor -- I was very surprised to learn that the time of day made a big difference in how the medication affected me. I had been taking it at bedtime, since the doctor had warned me it might make me sleepy. The nightmares, though, prompted him to switch me to a morning dose instead, and that made a big difference.
posted by sarcasticah at 4:20 PM on June 2, 2014

I have tried many different meds over the years. I work with a fantastic doctor who won't give up on me. Zoloft was not one of the ones that did not work. Bad side effects are unbearable and if I can't work and think clearly while on a med it has to go. My suggestion would be to try everything you can with a doctor who you completely trust until you find something that works. I wish you the very best!
posted by htm at 4:50 PM on June 2, 2014

It's really good that you are seeing your doctor this week. It's important that you are honest with them about how your medication is affecting you, your symptoms, and they can hopefully help you decide whether how to best move forward.

To give you some anecdotal advice, I'm on a 200mg dose of sertaline (max FDA recommended dose) which was increased over a period of about 11 months. My 50mg dose didn't work, I did pretty well on 100mg for about 6 months until some recent trauma caused an anxiety and depression flare and my GP doubled my dose about 4 months ago.

Both times my dose increased, I found the side effects were some prelevant for about a month then subsided, including insomnia, more anxiety, headaches and nausea. I noticed a huge difference in my symptoms after about 8 weeks with a 100mg dose, and 5 with my 200mg does. The breaking point for me would of been when the side effects began to significantly impair my quality of life (i.e missing work, pain, long periods of insomnia). I tried Paxil prior to Zofloft and it was awful. I was suicidal, sleeping 20 hours a day, and felt like a zombie. I was off to within a week after my partner took me to the doctor a week early.

MeMail me if you want to chat more about anything! Good luck!
posted by snowysoul at 6:30 PM on June 2, 2014 [1 favorite]

What time of day are you taking it?

Back when I was on it, I did better taking it at night. YMMV.

Talk to your doctor, of course. Sometimes when you take one med you have to take a second one to help mitigate side effects if they don't go away.

Also, another thing to be aware of, if you start having panic attacks, etc make SURE they screen you for Bipolar type II.

Most likely you will start feeling better soon, but you are smart to ask questions, and definitely, definitely, DEFINITELY discuss this with your doctor.
posted by St. Alia of the Bunnies at 7:39 AM on June 3, 2014

Huh, it kinda surprises me that the tremors/anxiety started a little later - mine were instant and, like everyone else's, lasted about 2 weeks. However, EVERYONE reacts to SSRIs differently. Wouldn't hurt to run it by your doctor.

I am a "success story" of Zoloft, but I would warn you, I didn't have one moment where I thought, "Hey, this is working!" I think a few months after I started taking it it slowly dawned on me that life didn't suck anymore. YMMV.
posted by chainsofreedom at 9:44 AM on June 3, 2014

Zoloft reduced my depression and anxiety but the tremors never went away in the year and a half I took it (and continued for four to six months after that). I had very bad experiences with Paxil and Wellbutrin (both caused mood swings, panic attacks, and suicidal ideation).
posted by elsietheeel at 6:45 PM on June 3, 2014