My AED's that I'm on is Tegretol XR.......and Thank you so much for all the information that you've given me. I'm just a little nervous about taking zoloft because I live alone and I'm able to drive so I don't want to take anything that might lower my AED's. I guess in some ways I'm just a huge worry wart.

Dear TigerLilly,

Glad to be of help

I would talk to your epi again... perhaps simply saying you feel very anxious about this new med, and you would be much more comfortable titrating the Zoloft very slowly, at least initially. With this approach, he will not feel challenged medically, and may work with you on this.

Slow titration is ALWAYS best, with ANY med, first and foremost to catch any adverse reaction early, but also to reduce any transient side effects that may occur when initiating the med.

Zoloft takes about a week to reach steady state upon a dosage change, so increases should only be made on a week by week basis or longer.

The first time I started on Zoloft, my pdoc started me at 12.5 mg per day when i started taking it for the first time. after that he would increase or decrease me by 25 at a time.

my titration schedule at the time (doses in mg) was
week 1 - 12.5
week 2 - 25
week 3 - 37.5
week 4 - 50
week 5 - 75
week 6 - 100 (my target dose)

here in europe they do it by 50, but i cheat - and do my increases adding only 25mg if i am afraid of a manic switch (that is my risk as opposed to sz.) Here they have a real bad trend of slapping one on high doses right off the bat, and when you feel bad, they just tell you - oh, it's just an initial effect... it will pass, when, if they would titrate slowly, these effects are usually not noticeable.

if i'm really badly depressed i will increase by 50, partly because i know the med by now and that i tolerate it very well, and partly because i have been full of divalproex and lamotrigine, as anti-manics. i also take a long-acting benzo... delorazepam regularly and as needed, and have lorazepam orosoluble as needed too... so i am basically am under an AED umbrella that could cover a football stadium!

What Sue is saying about Zoloft having potentially bad effects, is true. Of course that is with many meds, though, including AEDs. (Lamictal... Stephen Johnson's Syndrome anyone?) Each individual reacts to meds differently.

Zoloft is activating and increases aggression - the latter is necessary and useful, within measure. Depressed individuals generally lack that healthy measure of the latter! OK... so not to frighten you more... i will explain... there is a blackbox warning on all SSRI's about an increase in suicidality.There is uncertainty in the literature as whether, during the delicate period as the depression starts to lift, a person who is already suicidal has more energy and impetus to act on it, or whether simply due to an unhealthy increase in aggression from the med, then turned upon oneself. The med companies HAVE to warn of this, but this is a great minority of cases.

I am not discounting what Sue said about her dad in the least bit. Many meds can be really bad for certain individuals, and with this i stress the need for slow titration and clinical monitoring.

~ waves ~ from across the ocean

p.s. Tegretol XR and Zoloft was my very first combination of meds! lol
p.p.s. after writing my last post, i moved the paragraphs about some, and the asterisk by divalproex says 'see below' - but the info i was referring to is actually the quoted paragraph on divalproex, ABOVE my meds. i guess i will fix the post for others, but just figured i'd mention it to you.

Hi there, Sue!

nice to see you

First I want to say i'm so sorry to hear about your Dad's experience with Zoloft! I don't blame you one bit for not wanting to go near it with a ten-foot pole witnessing such a bad reaction! Was he ok after the med was stopped?

Unfortunately things like this do happen. For instance, with Paxil (an SSRI just like Zoloft), i actually had an incidence of extra-pyramidal sx (EPS) - extremely rare with AD's! It was horrible: pretty bad akathisia, constant yawning which shook me head to toe, trouble swallowing, and, fwiw, bad nausea. This was at the "low" starting dose of 20 mg my doc put me on (20mg) which i found out is not low - it is already a therapeutic dose, but, as is typical here he did not titrate me from say 10mg. since i knew 20 was not a huge dose, and suicidally depressed, i took it as scripted - no sneaky titration on my part. I had to suspend but after a few days he had me try 10mg - same thing but less severe... but before reaching steady state! Suspended definitely at that point. However even after the med was suspended, and the EPS resolved, I proceeded to have a hypomanic reaction, with a full psychomotor crisis one night - i was hot all over, flushed and lay one the floor which was freezing cold trying to cool off... and couldn't keep still ... i was writhing. And to think, this was the second time he scripted it and I asked him to start "low" and his idea of low was 20mg.

The first time he scripted it for 40mg right off the bat! Gauging by the 20mg reaction, that would have likely put me in hospital! Thank Goodness I never got around to taking it that time because for some reason it was no longer warranted - probably i had switched into hypomania before having the script filled whew! (Proof that Procrastination can be useful! )

~ waves ~ wishing you a healthy, happy New Year

Hi Waves,
Just to let you know I'm not sure if my father is still taking zoloft. He went on the drug after he had heart surgery which I know can depress some people after surgery but after he got better he started acting strange and took off from the family and I haven't seen him in over 2 yrs.
The drug messed him up really bad and he doesn't even seem like the same father I always knew. He doesn't even both to see his grandchildren or any other family members. He's a totally different person with a different personality and lifestyle after he started the zoloft. I hope and pray that nothing like this happens to anyone else taking the drug. Here's wishing all of you well and May God Bless You!

Sue

Sue... don't mean to bug you, i think this must be a painful subject but something you said (see emphasis) in this last post made me wonder... ... if i get it right, when the depression cleared, he started being strange? that sounds like the Zoloft might have triggered a manic episode. That can happen if a person has "bipolar in their jeans (genes)" ... they may be normal, or have only depressive episodes before treatment with an AD. If he was triggered into mania and cycling, he can be treated. Otherwise he will likely continue to cycle. Unmedicated mania can lead ppl right into a waaaay different "lifestyle" - taking off with no apparent reason or planning is actually quite common! I wonder if anyone in your family can be in touch with him to see how he is.

Of course i don't know in what way he was "acting strange" other than his leaving the family. Do ANY of these sx sound familiar?
hyperactivity (eg psychomotor agitation, rapid and or pressured speech), over-impulsivity (eg spending, gambling, other indiscretions), rage outbursts, mood lability, lack of focus, flight of ideas (jumping from one topic to another another so much that the listener may not even be able to make sense of the conversation), increased expansivity, decreased need for sleep or total sleeplessness for days, taking on multiple projects at once and finishing none, or being completely obsessed with a project to the exclusion of other normal activities; euphoria or dysphoria, grandiose ideas or delusions (eg believing one is a prophet or a famous person, planning ventures well out of proportion with one's abilities or means); potentially also psychotic features incl visual and auditory hallucinations, thought disturbances such as magical thinking, thought broadcasting or thought insertion).

i'm just tossing this out to you... i'm not trying to say that IS what happened... but it is a possibility, especially if there is any family history - even just of depression.

gosh i hope he is ok. i am so sorry that Zoloft took him away from you... whatever the explanation.

((( Sue )))

~ waves ~ wondering... hope i am not offending you or speaking out of place...

Hi Waves,
I will agree with you that my father blew money like crazy buying 3 different RV's, 4 boats, gambling, and much more. I think that what really messed him up is how he had 7 affairs over the yrs while he was married to my mom who forgave him time after time. Now today my father has nothing left to his name he blew all his money over the yrs. and never started a retirement account.
I ask myself the question if maybe my dad isn't messed up because he sees how my brother and I are doing well with our finances and that we both have our homes almost paid off in full. Also when it came down to the divorce I had legal evidence up against my father that I told my mom's lawyer. So now all my dad has left to his name is his new girlfriend, who controls him like you wouldn't believe, where my mom has a house and all of the family. I think there's a lot of jealousy and I know that my dad's girlfriend is stopping him from seeing his grandchildren. It was after my dad left that he started the zoloft and I feel between the affairs he had and the guilty conscience that maybe the reason why he's acting so strange. Here's wishing you well and May God Bless You!

Sue

Well, from what you have said, your dad could indeed be bipolar. The spending and the affairs are both red flags. The guilt following the affairs could have been cycles into depression. The Zoloft could have kicked him into a really bad mania where yes, a person can think and behave like a total stranger. However your reasoning about the affairs/guilt is perfectly reasonable for someone who is not bipolar, and so with the divorce crises you mentioned. It would be more telling, had you witnessed, in the tumultuos marriage, some of the other sx i listed, specifically during the times of the affairs... and whether the spending coincided for instance.

Annnnnyway, the more important would be if he is still messed up, to get him into treatment, for whatever the "mess" is. If someone is in touch with him - to persuade him to see a pdoc, who could evaluate him in person... but getting him there could be a huge undertaking, regardless what his "mess" might be, even psychological. that is all the advice i could offer, but i fully understand that it might not be realistic. And here I close off my prying questions and ad hoc suggestions. (thank goodness eh? waves crashing threads and going on about bipolar... sheesh!!! )

~~~~~~~~~~~~~~~~

Up a whole different alley, now. I have noticed your mood consistently says "lonely" and i have felt so lonely myself so many times, i really feel for you. loneliness can be so deep and powerful. So i want to give you a huge hug. there is a nice HUUUUGE smiley hug i reserve for such occasions but it is animated. It does not flash, but it does move. so i don't want to risk posting that here. howevvvvvver...

(((((((((((((((((((((((((((((( Sue ))))))))))))))))))))))))))))))

that should be seizure-safe!!!

wishing you relief from your loneliness, be it finding moments of peace in solitude, or finding others to share and laugh with.

Sweet blessings to you, Sue, and an angel to watch over you.

~ waves ~ wishes you a wonderful, seizure-free day!