TigerLilly,
first -
which AED(s) are you on?
second - weight change with Zoloft is minimal if any; that said, weight loss is the more likely than weight gain.
third - (depends on your answer to first question, but) to the extent of my knowledge, Zoloft doesn't quite "mess up AEDs" in general.
from
RxList - Zoloft Side Effects and Drug Interactions:
Quote:
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The effect of sertraline hydrochloride on valproate levels has not been evaluated in clinical trials. In the absence of such data, it is recommended that plasma valproate levels be monitored following initiation of sertraline hydrochloride therapy with appropriate adjustments to the valproate dose.
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from the same page, one thing you can check is whether the AED(s) you take are metabolized by cytochrome P450 2D6:
Quote:
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Many drugs effective in the treatment of major depressive disorder, e.g., the SSRIs, including sertraline, and most tricyclic antidepressant drugs effective in the treatment of major depressive disorder inhibit the biochemical activity of the drug metabolizing isozyme cytochrome P450 2D6 (debrisoquin hydroxylase), and, thus, may increase the plasma concentrations of co-administered drugs that are metabolized by P450 2D6.
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of note, from the same source,
diazepam (Valium) clearance is reduced (i.e. diazepam hangs around longer) and in the case of
delorazepam a.k.a. chlordesmethyldiazepam - a potent benzo n/a in U.S - time-to-peak is lengthened, but "clinical significance" is not known.
Now,
Zoloft can lower sz threshold, but not by much.
Wellbutrin (an SNRI) lowers the sz threshold by about 4% - considerably more and of clinical significance. The warning against taking Zoloft, other SSRIs, and SNRIs with epilepsy is particularly relevant if you are unmedicated, do not have full sz control, or are unmonitored. if you feel afraid of taking the med, talk to your epi again, tell him you read the warnings, and ask if he feels you need an upwards adjustment. i am a very strong advocate of finding out everything one can and pulling docs' teeth for information for anything that goes down my gullet. it is my body after all, right?
NOTE:
I don't have epilepsy, but i have been on several AEDs and antidepressants for bipolar disorder. I have had to taper off too, and at such times i am careful to taper my AD(s) first, and then the AED(s), so as to avoid a sudden drop in sz threshold and possible withdrawal sz.
fwiw i have taken the following with Zoloft:
- carbamazepine (Tegretol),
- oxcarbazepine (Trileptal),
- lamotrigine (Lamictal)
- divalproex (Depakote) *see citation above
- gabapentin (Neurontin)
i know there are lots more AEDs that i have NOT taken eg topiramate, phenytoin, etc, but have not read (based on Zoloft information) of interactions with these.
I sure hope you feel better. depression suxxx
~ waves ~ wishing you a happy, safe, and seizure-free 2008