Increased medicine now too scared to take it

how did you do on the 100 mg?

Maybe see if your doctor will prescribe 125 or 150 for now. Most doctors are pretty flexible and listen to the patient’s concerns.

Either do that or see how the 200 mg is. Maybe you won’t have any side effects.

Okay, I've read your post and there are several points I'd like to make that may help you regarding the position you find yourself in with respect to treatment. Among the other SSRI medications, Zoloft has a considerably safe and predictable side-effect profile. It is very often the drug of choice in the elderly for that reason. SSRI medications in general, however, are mostly beneficial for patients suffering unipolar depression and while SSRI medications are claimed by their manufacturers to be effective in the treatment of Panic Disorder, there are mixed results in that context and to an even greater extent regarding their use where generalized anxiety is concerned in the absence of clinical depression.

Drugs in the class of SSRIs act upon the neurotransmitter serotonin to prevent its reuptake that results in an increase in circulation. Serotonin imparts an upregulation in mood and is more responsible for making patients feel good, which would be the most natural direction to proceed in persons experiencing clinical depression. By contrast, patients who suffer from chronic significant anxiety and Panic Disorder have demonstrated reductions in the neurotransmitter GABA, or gamma-aminobutyric acid that tends to impart a downregulation of mood and nervous system stimulation that results in a calming effect. This would very naturally be the targeted outcome for such patients.

The problem that has thrown a wrench into the matter is that medications best suited for the treatment of significant anxiety and Panic Disorder are those within the class of drugs known as benzodiazepines. While these medications work to increase levels of GABA that consequently calm the nervous system, their use also carries with it an addiction potential that varies among benzodiazepines. In brief, such medications that are short-acting induce worse addiction potential than longer-acting forms. The presence of these medications, which have been around since the 1950s or so, has also become of particular interest to recreational users and together with their addiction potential, these medications are established as Class IV, or controlled substances. As a consequence, it is quite difficult for practitioners to administer them and when they do it is typically for periods no greater than four to six weeks. It's not to say that they are entirely restricted from use, but rather under significant control and use in order to suppress any recreational access while also preventing any addiction potential from arising subsequent to extended use.

This restriction is greatly responsible for the substitution of benzodiazepines by SSRI and SNRI medications wherein pharmaceutical companies seek to capture the portion of the market regarding anxiety and Panic Disorder as much as the patient population where clinical depression is concerned. This is particular true because the SSRI and SNRI medications have not demonstrated the same addiction potential and recreational use that benzodiazepines are known for in the treatment environment.

I have provided an explanation that is quite the long way around but nevertheless informative so that you can better understand why some patients with anxiety and panic disorder rather than depression experience rather paradoxical effects in many instances because treatment with SSRI medications tend to up-regulate neurotransmitter function that can make anxiety and Panic Disorder worse rather than better. Again, the research bears mixed results and with good reason.

I wish to state here, however, that in order to side-step this problem it is important that you determine whether or not your anxiety is better or worse following treatment with an SSRI medication. This is strictly a matter for you to directly approach with the prescribing physician. Also realize that an increase in dosage of Zoloft would more generally result in an increase in side-effects over time rather than instantaneously regarding a single dose.

In other words, it's not considered to represent a danger to your health but rather can provide you the very ammunition that you need to determine whether as an SSRI medication, the Zoloft is taking you in the right direction toward positive results and diminished symptoms regarding treatment for anxiety. Lastly, the ultimate decision to accept an increase to the Zoloft rests with you as a patient.

It must also be remembered that some prescriptions by the general medical community are based on symptomatic presentation. In other words, if administration of a drug brings about improvement then it becomes established as the means of treatment for whatever period you and your physician adopt. If, however, the administration of a drug results in no positive effect or in some instances the opposite effect to the direction intended, then it is set aside and an alternate medication chosen.

SSRI medications such as Zoloft were originally intended to target variants of clinical depression and they work quite well in most all instances for this purpose. Whether or not the claim can be made that they are just as effective in treatment of intense anxiety and Panic Disorder is one that is most clearly demonstrated by you as the patient under treatment with the SSRI drugs, in your instance Zoloft. The increase is either going to make you feel better or worse and it will mark the point where you need to speak directly with your physician regarding its use to any extent and where to proceed next in obtaining treatment that provides you with the relief that you seek.

I'll close by reaffirming that SSRI treatment, particularly the drug Zoloft, would not constitute a clear danger to your health or result in a significant health event within the dosage increase described by you. Again, it will simply tell you whether such treatment is producing worse anxiety or alternatively provides relief at the higher dose. While being afraid is quite common in such instances, this type of fear is largely driven by anxiety itself in the manner of avoidance as means to ensure one's safety and is irrational in context here. You'll be fine. Follow your doctor's advice and as the patient make the determination whether the medication is right for you based upon how you respond to the increase in dosage.

Best regards