My epi gave me a perscription for zoloft for my depression and anxiety. I haven't tried it yet because I've been doing some research and first it says do not take of you have Epi. Then for some people they gained 40+ pounds and with the aeds I just don't need to gain anymore weight. Though some people say they lost alot of weight being on zoloft, I know that everyone's body is different and reacts differently. That's why I'm a little nervous about starting this. Right now I'm on cymbalta and have been on many other anti depressents. So if anyone has any info(good or bad) about zoloft your feedback is greatly appreciated. I hope everyone is doing good. God Bless you guys

Hi Tiger Lilly,
I've never taken Zoloft because my epi told me it would just reverse what my AED's do for me. I also saw my father on the med and it messed him up terrible. His personality changed and he seemed like a totally different person. If you do try taking zoloft I would be careful as to how it might mess up your AED's. I wish you only the best of luck and May God Bless You!

Sue

Thank you for your feedback Sue. I'm so nervous about starting the zoloft. I haven't even started it yet because almost everything I've found on zoloft is bad. Very few stories are positive.

Hi Tiger Lilly,
My best advice to you is to speak with your pharmacist about taking zoloft and how it might affect your AED's or any other perscriptions you take. I find it odd how your epi would want you on this drug especially knowing that it can mess up your AED's. Try taking vitamin B12 1000 mcg. a day and see if that helps before taking the zoloft. Here's wishing you well and May God Bless You!

Sue

Sue, It made me wonder too after you told me that zoloft can lower my AED's. My epi is a really great guy and has known me for many years so I was quite confused about him not really telling me it could lower my aed's. I've left messages with his secretary and apparently he's not getting these messages. I will try the B12 and I'll let you know how all this turns out. Thanks again sue. God Bless. And may everyone have a Merry Christmas and a Happy New Year

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:
from the same page, one thing you can check is whether the AED(s) you take are metabolized by cytochrome P450 2D6:
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

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