Fighting Zoloft drowsiness

February 18, 2004 1:54 PM

I take Zoloft (50mg/day) and it's making me drowsy - I'm sleepy during the workday and ready to go to bed by 9:30. I already drink a moderate amount of caffinated beverages, and I work out three to four times a week. What can I do to combat the drowsiness?
posted by ArsncHeart to health & fitness (31 comments total)

Do you take it at night, or in the morning? or both?
posted by PrinceValium at 2:10 PM on February 18, 2004

Not much help, but: try a different med.
posted by mookieproof at 2:10 PM on February 18, 2004

I usually take it in the afternoon, around 2pm. The packaging only recommended taking it at "the same time every day" - is there a time to take it that would lessen the side effects?
posted by ArsncHeart at 2:17 PM on February 18, 2004

As Prince V. suggested, maybe switching your dosage schedule around would help. While I was still taking Lexapro last year (I shudder to think what a 50 mg dose would have done to me) I was able to manage much better by taking it before bed instead of first thing in the morning.
posted by emelenjr at 2:21 PM on February 18, 2004

Definitely try taking it in the evening. Also, are you taking any other meds? Sometimes the drowsiness may come more as an interaction with a secondary medication than as a primary side effect.
posted by scody at 2:29 PM on February 18, 2004

I agree with emelenjr; try taking it just before bed--Zoloft is one of the more faster-acting of the SSRIs and its effects peak about 4-6 hours post-dosing (so says Pfizer). If you've just started taking it, there are a couple things to consider: 1) side effects generally decrease over time, so you're less likely to experience the fatigue in a couple of months. and 2) NEVER miss more than one dose of Zoloft--it metabolizes quickly. If you want to read some horror stories, google "zoloft withdrawal" and thrill to tales of panic attacks, paranoia, rage, etc. Note that these symptoms seem to occur only to people who accidentally or on purpose go cold turkey--stepping down the medication doesn't do it.
posted by vraxoin at 2:49 PM on February 18, 2004

If you do change the time you take it each day, remember to shift it by an hour or less each day.

emelenjr, you can't compare mg dosages between medications. 50 mg is a lot for some antidepressants, but a low dose for others (50 mg, if I remember right, is close to a starting dose for Wellbutrin).
posted by skynxnex at 2:49 PM on February 18, 2004

Talk with a MD. Their professional opinion, combined with other tools such as a check-up and blood screens will be able to sort out if you're merely experiencing a side effect from the zoloft, or something else. Fatigue could be a symptom of something serious, possibly undiagnosed, or it could be a zoloft issue. Let them decide, they're the experts.
posted by jazzkat11 at 3:05 PM on February 18, 2004

I've taken it, both morning and evening (went off it cold turkey under doc supervision too, but that's a tale for another time.)

I'm actually shocked that it makes you drowsy. In my case I started out taking it at night and woke up three or four times at night . Doc then said to switch to morning which I did (I think I just skipped a night dose and took it the next morning.)

I recommend talking with your doctor about it. You may simply need to try another drug. Welbutrin is a good one to ask for-it is extremely energising plus no sexual side effects. (Yes, I took that one too. )
posted by konolia at 3:29 PM on February 18, 2004

Oh I know, skynxnex, I was just imagining what kind of effect the SSRI I was on then would have had at that dosage amount.
posted by emelenjr at 4:04 PM on February 18, 2004

Odd that it makes you drowsy. I take 100mg/day and have been for years and the only side effect I've noticed was (stopped a year or two ago) a slight energy boost. Of course I also take methylphenidate which would easily counteract any drowsiness.
posted by Grod at 4:43 PM on February 18, 2004

Oh, by the by, withdrawal is the wrong term to apply to the effects (when present) of suddenly ceasing to use zoloft. Zoloft is not, in fact, addictive, and there are no cravings associated with it. Zoloft cessation shock might be a more apt term. Regardless, if you know you will run out at some point and have no way of acquiring more, gradually step your dosage down. I am assuming that you've just started your course of medication since 50mg is on the edge of effective for most adults. Also, on a couple occasions I've been to broke to buy the stuff and had to stop cold turkey. The result was a gradual return of serious depression as the drug left my bloodstream, took about four days before I really started noticing its absence.
posted by Grod at 4:49 PM on February 18, 2004

here's another vote for taking it in the evening. Do you have a sleeping partner that can tell you if you're grinding your teeth? I started grinding my teeth, which would wake me up only slightly, enough that I wasn't getting a good night sleep. A night guard took care of it, but I ended up switching off zoloft for other reasons (hallucinations)
posted by nprigoda at 4:50 PM on February 18, 2004

Hey Grod, you didn't get the zaps?
posted by nprigoda at 4:51 PM on February 18, 2004

I think that like a lot of people have said, the only real answer is to ask your doctor for a different drug. Every drug affects every person differently. I didn't have any side effects from Zoloft... but I also had no theraputic effects, either.

I agree with konolia-- of all the anti-depressants I've tried, Wellbutrin has the least side effects. It gives me insomnia initially, but I seem to adjust after a few months. It also gives me a lot of energy, which SSRI's never did. Since lack of energy is one of my biggest symptoms, this is quite important to me.

The sexual side effects of SSRIs are not fun, especially for men. My husband was far more upset over the "inability to perform" caused by Paxil than he was over the condition that he was prescribed Paxil for in the first place! He stopped taking it right away, but it was a lot of work to convince him that he wasn't permanently "broken" and that he'd be back to his old self once the Paxil was out of his system. He's taking Wellbutrin now too, and it works for him as well.

One of my doctors wanted me to try Lexapro, which is also an SSRI but is supposed to be refined somehow to have less side effects than Prozac, Zoloft, etc. That may be worth a try, but I have no personal experience with it.
posted by Shoeburyness at 4:52 PM on February 18, 2004

Just a random suggestion, but being dehydrated often makes me drowsy. If you do work out frequently, and drink a fair amount of coffee (a diarrhetic) you may be lacking the water you need to operate.

To re-hydrate in style, I recommend dissolving a packet of "Emergen-C" in sparkling water. Calistoga or Pellegrino work great. This yields a potassium and vitamin-C rich beverage that goes down great, hits your stomach softly, and helps you stay chipper and alert.

We don't always think of "alert" as the opposite of "tired," but it sure can be.
posted by scarabic at 6:55 PM on February 18, 2004

Thanks all: I have a checkup scheduled with my doctor for the end of the month, but wanted to see if anyone else had experienced the same sort of things. Your comments and suggestions are a big help.

nprigoda: I have noticed some teeth grinding, and that I'm remembering my dreams more often (which probably means I'm waking up slightly, as I generally don't remember them if I'm sleeping well).

scarabic: I think I'll try the Emergen-C stuff - whether I need it or not, it sounds nice.
posted by ArsncHeart at 7:25 PM on February 18, 2004

I'm actually shocked that it makes you drowsy.

me too. i'm taking 150mg since september after building up to that for a month or two. the effect has diminished with time but there's no doubt the stuff wires me, if i take it late afternoon i'll have trouble sleeping. a quart or so of vodka and a bowl of hash generally solves that problem, but then i end up having to snort an extra line of crystal meth for breakfast and that gets expensive. lack of money being a major factor in my depression, i've pretty much decided to dump the zoloft.
posted by quonsar at 7:32 PM on February 18, 2004

nprigoda, since I have no idea what "the zaps" are, I am assuming I did not experience them. As I said eariler, all that happened was a gradual return to severe depression.
posted by Grod at 7:35 PM on February 18, 2004

Grod, if you had em, you'd know it. Trust me.

After rereading this thread I think I know why ArsncHeart is tired. When your sleep is screwed up at night you're gonna be drowsy, period.

Just call your doc and ask if you can take it in the morning. I think within a day or two your problem will be taken care of.
posted by konolia at 7:56 PM on February 18, 2004

Shoeburyness, I was on Lexapro for about a year before I admittedly gave up on it because I didn't like what medication in general was doing for the symptoms that needed attention. The side effects were tolerable once I figured out the right time to take it, but there definitely were sexual side effects. It was frustrating enough not having anyone around to notice the side effects but me.
Missing a dose here and there caused no problems for me. There were no "zaps" or odd withdrawal issues when I finally decided to stop taking it, either.
posted by emelenjr at 8:02 PM on February 18, 2004

Effexor is the antidepressant that is the most notorious for the "zaps". Thankfully I never had to mess with that one-it is dang hard to wean off of according to my forum buddies.

I do have to say that of all the meds I have found myself on at one time or another, it is the ssri ADs that have had the strongest beginning side effects.
posted by konolia at 8:14 PM on February 19, 2004

Just goes to show you how different people respond to different meds. Zoloft made me wired, and the doc prescribed Sonata to help me get some sleep at night. (Later switched to a Wellbutrin/Celexa combo that worked well.)
posted by Vidiot at 6:05 AM on February 20, 2004

Welbutrin is a good one to ask for-it is extremely energising plus no sexual side effects.

My doctor told me that when people taking prozac and zoloft complain of diminished sexual desire, welbutrin is often prescribed in addition because of its well known libido enhancing effects.
posted by y2karl at 6:59 AM on February 20, 2004

Gee, someone told me to beware of Welbutrin, which is also used for ADD and for aid to quitting smoking. I had the impression it was causing less libido.
posted by Goofyy at 8:18 AM on February 20, 2004

Effexor is also the anti-depressant with a history of causing irreversible negative personality changes. Approach with caution!

Libido-wise, Celexa killed mine for months. However, once my system stabilized, it came back just fine. Orgasm dysfunctionality remains, but I've discovered that with a bit of THC assistance, I'm multi-orgasmic. Sweet deal, that.
posted by five fresh fish at 9:34 AM on February 20, 2004

Just another couple of cents re: alternatives to SSRIs -- I've been on Serzone for 4+ years (after trying Prozac and Zoloft and having the sense that I was going to involuntarily smash my head through a glass window) and had virtually no side effects, except for a small spell of mild hypomania when I was on a slightly too-high dose for a few months. (I've also briefly tried Remeron, but it made me feel like I was on heroin.) There's been some controversy in recent years over Serzone's possible effects on the liver, but I get regular blood work to monitor it, and have never had a problem.
posted by scody at 10:58 AM on February 20, 2004

elemenjr: thanks for the info. I think I won't ever be trying Lexapro.

Wellbutrin usually has the effect of enhancing libido, or at least not affecting it negatively. Mr. Shoe and I don't find that it really "enhances" things, but it doesn't destroy our sex life like SSRI's do. He also had very bad "zaps" coming off of Paxil. It was probably worse in his case because he didn't want to taper off, he insisted on cold turkey. He said "I'm getting rid of these $#%*@#$ things" and flushed them down the toilet, so I couldn't persuade him to taper off.
posted by Shoeburyness at 11:10 AM on February 20, 2004

I had to look up "zaps" or "zaps"

Still not sure I understand the description.

(and I've even tried that med at some point -
fortunately not high enough dosage I guess.)
posted by milovoo at 11:42 AM on February 20, 2004

The "zaps" are reported to feel like electric shocks in your head. I had a mild case when I was coming off Paxil; the way I always described them was -- you know how when you're really tired, almost anything can startle you, setting off a little adrenaline burst? Well, it feels like that, except you're not tired, and there's no stimulus making you startle.
posted by kindall at 1:35 PM on February 20, 2004

When I was started on Effexor, I had the trippiest things going on. I don't recall being zapped, but I do remember weirdly time-space distortions, vivid bizarro dreams, minor hallucinations/distortions, teeth-grinding, and the weirdest feeling that my joints were all marshmallow foam. "Squoodgy" was the term...
posted by five fresh fish at 7:56 PM on February 20, 2004