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-   -   Is anyone on or tried Zoloft? (https://www.neurotalk.org/epilepsy/34069-tried-zoloft.html)

Tiger_lilly07 12-16-2007 01:15 PM

Is anyone on or tried Zoloft?
 
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:eek: 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:grouphug:

Porkette 12-17-2007 07:03 PM

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

Tiger_lilly07 12-18-2007 01:17 PM

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.

Porkette 12-18-2007 06:25 PM

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

Tiger_lilly07 12-20-2007 06:42 PM

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

waves 12-31-2007 05:56 PM

Zoloft lowers sz threshold a bit
 
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:

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

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.
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 :hug:

~ waves ~ wishing you a happy, safe, and seizure-free 2008

Tiger_lilly07 12-31-2007 09:07 PM

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. :)

waves 01-01-2008 05:42 AM

hi again
 
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.

waves 01-01-2008 06:17 AM

Dear Sue
 
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! :( :eek: 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 :mad: 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! :eek: 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 :rolleyes: whew! (Proof that Procrastination can be useful! :D)

~ waves ~ wishing you a healthy, happy New Year

Porkette 01-01-2008 03:05 PM

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

waves 01-01-2008 04:32 PM

AD-triggered mania?
 
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...
Quote:

Originally Posted by Porkette (Post 182170)
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.

... 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:p (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... :o

Porkette 01-03-2008 04:57 PM

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

waves 01-06-2008 06:04 AM

Dear 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!!! ;) :o)

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

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. :o howevvvvvver...

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

that should be seizure-safe!!! :D :D :D

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!


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