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Increasing dose: side effects?

Quick question: I'm about to increase my sertraline dosage. The side effects in the first few weeks when I started were pretty bad and I felt really rough at times, mainly with nausea, dizziness etc. I was wondering: will this happen again on increasing the dosage? Or should it be OK now my body is used to the drug? If it's likely I'll get some side effects, how long are they likely to last and how bad might they be?

Thanks in advance :-)

18 Replies

  • Guest Guest

    Hello again

    Well I'm due to increase my dose from tomorrow. I think I need to as I've had some anxiety creeping back over the last few weeks and have found some situations hard to deal with. BUT I'm worried about side effects and would really, really appreciate any advice on others' experiences of increasing the dosage. My doctor said I may get minor side effects, but when I started I had bad nausea, stomach cramps, increased anxiety and was generally a bit of a wreck. I'm nervous about this happening again as I have lots of stuff coming up in the next few weeks that I need to be OK for. So pleeeeeease help!

    Cheers :-)


  • Guest Guest

    well nobody ever replied to my post, and I'm actually interested in the fact that I've been feeling quite upset by this, and abandoned, and as though nobody cares! I say interested, because this was one of the things I got with my depression before I went on tablets in the first place - the feeling that really nobody gave a damn about me and therefore I must be a terrible person etc etc.


    In case anyone's interested for future reference what little side effects I did get second time around were FAR less than when I first went on the drug. I got some sleep disturbance and I felt a little shaky (almost in a sort of wired sense!) and I had a couple of periods of minor queasiness, but nothing like last time (when I was actually throwing up.) So, if anyone else is thinking of increasing the dosage, hopefully this will help to reassure you. It's early days and I'm not sure how far increasing the dosage will help (as I said, my anxiety and general negative feelings have increased recently, along with some feelings of just not being able to cope - I was away alone two weeks ago and ended up curled up in my hotel room in actual tears! Not good!)

    Anyway, thanks for reading :-)

    • kirsty67724 kirsty67724 Guest

      Hello thanks for your post I'm thinking I need to up my dose I'm 25 and have been on 50mg for nearly three months but just lately I feel really panicy and upset but when I first started the sertraline I wasn't sleeping I was waking up every hour crying with hot sweats it was so horrible so I'm really scared to up my dose but I haven't felt right for a long time any advice will be helpful xx

  • Hezza Hezza

    Hi NWM,

    I've done a bit of reading on this site but never posted - I read yours a minute ago and thought it was unfortunate that you are feeling upset about posting on something that is meant to help, so here is a response for you smile

    I'm happy to hear your side effects from upping the does weren't as bad as the original. You don't actually say what dosage you are on?

    How are things now after a couple more days?

    The problem with asking people about their side effects (appology if I sound uber patronising here) is that the majority of people who read and post will have had a pretty awful time and you run the risk of reading then thinking 'Oh CRAP, I'm going to feel even worse.' Saying that there does seem to be a few people on here saying that it can be pretty grim to start but stick with it.

    N.B. I reserve the right to ignore my own sound advice here, read far too much negative stuff and worry that my head will fall off. Pot calling kettle black etc.

    You did ask for someone elses experience though so here's the abridged version

    I always have yucky side effects from anything I take and the gastric ones from this have been quite extreme - which does seem quite common. I found this too much to handle going from 100mg to 150mg and so dropped back down. I also played around when I took my dose and split the tablets between morning and night to give a more even release to try and prevent the night sweats. It did for a week or so and then they came back but I still feel splitting the dose makes sense, they aren't slow release and so will have peaks/troughs that you may want to reduce as much as possible.

    I have needed to take prescription antacid and on each increase of dosage had to double this for a week to stop the need to vomit after meals. The stomach cramps eased off eventually but the explosive, rancid toilet activity has continued.

    I found booze and sertraline did not mix at all (damn), the hangover just wasnt worth it. I was also given codiene for a bad back and I collapsed twice during the night when I got up for the loo, so be careful mixing them with other drugs even if they aren't meant to have an interraction.

    I have actually decided to come off these after only a few months ( ask if you want details, it isn't just the yucky side effects) and know I will feel grim for the time it will take, even cutting down slowly. Pretty similar to side effects of starting them but my brain feels like someone has scooped it out with a spoon, mushed it up and piped it back in.

    I would say that my general anxiety has dropped since taking them, but this could just be an improvement that would have happened anyway - who knows!

    As with anything you have to weigh up the pros and cons. Are the side effects worth the benefit you feel mentally? If so then by sticking with them the side effects should hopefully ease in time.

    Bye for now

  • Guest Guest


    Thank you so much for your post :-) I'm sorry if I sounded all fed up at not receiving a response - it wasn't just that, really, but confirmation if confirmation was necessary that I did need to up my dosage! I totally agree with your point about people posting awful scary things, but actually I'd rather know what was likely to happen than not know, then be surprised and anxious when things are awful!

    I'm now on 100mg. It's been a few days now and I am still feeling a bit nauseous on and off, which is not nice. But I can cope because the nausea when i went on them was really dreadful. I was staying with a mate in Holland about two weeks in, and had the most awful stomach cramps and diziness and remember just sitting in his kitchen in the middle of the night thinking \"Oh my God I'm going to die in my friend's flat and he's going to have to sort everything out\"! (Er so I was probably a little uber-anxious too at that time!)

    Emotionally though I'm so much better. I was very anxious, emotionally up and down and quite self-centred because of how i was feeling before, and now things are much more relaxed, and I have a bit of perspective. I'm also getting more sleep these days, which is good!

    Anyway, thanks again


  • Guest Guest

    PS meant to add - if you do come off them then I hope the withdrawal goes OK, and I hope you feel OK once you've come off them.


  • Hezza Hezza

    Oh I am sorry but I laughed out loud at your reply. Only in that I have had the 'Jesus, I am about to cark it and my dog will have to eat me' feeling on many an occaision. Then you feel like a right tit once it all calms down.

    A while ago I found out I had high BP and then started having really weird turns. BP medication just made them much much worse. Each time they happened I thought I was going to pop my clogs. Doctor and cardiologist both thought they were due to a massive crash in BP but as this didn't happen in tests and they seem to come and go, the general concensus is that I'm having strange humdinger, non-hyperventilating panic attacks, that decide to spring me when I'm least expecting it (although IKEA shopping can be fraught at the best of times). The first time it happened I was telling my boyfriend how he had to meet someone else and not be sad, oh and to look after my dog. Got to laugh now.

    I came off my bike before xmas and ended up in A&E after smacking my head, then everything went a bit mental. Every twinge/chestpain/headache was making my evil inner voice cackle and tell me 'you're gonna die'. And the power of Google wasn't really a wise idea on looking up my symptoms, even though the sensible voice says 'stop being an idiot, it is the BP meds and the bash on your head making you ill, YOU DO NOT HAVE A TUMOUR, YOU MUPPET' Hence they started me on Sertraline to chill me out a bit and I stopped the rubbish BP meds.

    I'm much better than that now (twitch twitch) but after going up to 150mg I had another couple of monster panic attacks after none for 2 months. Nearly called an ambulance on the last one as my BP went up to silly levels, but couldn't find my phone - very glad I didn't now obviously. And as my BP still isn't sorted I am not taking another BP medication until I am off these. I am lucky enough not to have to work at the moment so can deal with the drug yuckies from the comfort of my home.

    So, there you go, don't despair, I am much more mental than you :lol:


  • Guest Guest

    Haha glad that made you laugh! You too made me laugh trying to \"out-mental\" me! :D I do sympathize with panic attacks though - really scary. I consider myself quite a sensible person, but however hard I try you can't get the logical bit of your brain to talk you out of them at the time... Oh and I laughed at the IKEA thing too. I didn't have a panic attack there as such but I did - pre-drugs - get lost in there, and I could feel my heart beating faster and tears in my eyes as I started to think \"OMG I'm never going to get out of here!!\" :D :lol:

    Don't know about BP meds but I was on propranolol, which is a beta-blocker, and which wasn't all that useful because I do a lot of sport, so although it brought my heart rate etc down, which was useful re: panic attacks, it meant I couldn't go running so much as I was tired and my energy levels were low, and running is something that actually helps chill me out.

    It's good not to work through this though. I didn't tell my boss I was on medication so he thought I had a permanent migraine for a couple of weeks as I had to take a couple of days off when the nausea was bad. (Talking of which I'm meant to be working now so prob ought to stop playing on forums!)

    Look after yourself :D


  • Hezza Hezza

    (added later) Hmmm, you may need a cup of tea before reading this. Or you could just pretend that your computer went funny and deleted all but 4 lines…

    The beta blocker comment is interesting as they were one of the next things I had asked to try (I am now on doctor number 4 + cardiologist. 1st wasn’t great, 2nd & 3rd left. Number 4 seems the best yet – actually asked me how I was feeling about the fact they hadn’t diagnosed WHY my BP had suddenly gone from being fab to crap and actually believes that it makes me feel bad rather than the usual ‘nope, sorry, you can’t be symptomatic from high BP, that’s SO unusual’ and has also ordered a renal scan to tick that one off the list. I started with her a few weeks ago and went in with a firm action plan of what I wanted to do and the next drugs to try. Paid off, she’s happy to do what I want as long as it doesn’t contradict the cardiologist – who is also happy to do what I want now after his first drug didn’t work and I refused to let him up the dose a 4th time. I am also convinced that it was the Cardura – which is mainly used for prostate problems – has given me TINITUS for gods sake and it wont go away :x )

    Propranolol is one of an older type of beta blocker that is classed as non selective (blocks 2 kinds of receptors) and the newer ones that are selective and only block 1 (although doesn’t always work) can give fewer side effects. I am concerned about the tiredness as that seems to be a pervasive theme with me, linked into restless sleep (hence I am not working, yet was awake at 6.15, urgh) and also that my resting heart rate is usually 50 -60 and if they take it 50 then you can have problems. My osteopath has had exactly the same kind of problems as me and for him they work a treat, and he runs a lot. However, as he says to me, medication is just like a key – you need to get the right one for you to open the box, and we all need a different key.

    I am reconsidering trying the BB first now though – I want to do MORE exercise, not struggle with it. Every med I have tried has walloped my energy levels and if I overdo it then I feel really ill. E.g. we were in the lake district at the weekend and we went on a ride (I say ‘ride’, but for me it was more of a ‘ride/bottle it and push/fall off/ride) that was just too hard and too long and I was in bits towards the end and later. My other half has forgiven me for wishing evils on him and imagining dropping large rocks on his head. Then I suppose overdoing it when I have bad withdrawals might not be the best :oops:

    I’d love to start jogging again, assuming my dodgy back can handle it (ooo, I am SO broken, believe me). Even though it is what I call ‘wogging’, which is not something very racist, but a cross between ‘jogging’ and ‘walking’ and old people with zimmers overtake me, I might give it a little longer before I give that a go.

    I have been lucky enough to have a VERY understanding boss over the last couple of years. I had a stinker of a funny turn during a meeting in London. Which was non stressful and a laugh as meetings go, which makes it very odd that it happened. Apparently I went deathly pale, started shaking and when I opened my mouth, a squeak came out. I had felt it coming on and tried to just ignore it. Mortifying, they had to abandon the meeting for a bit whilst people sorted me out. I was there for hours, every time I stood up and thought about getting on the train it started again, my other half drove to London from the midlands to get me. I then had another one the following week in the Isle of White of all places. Decided that it was really not a good idea to be travelling around so was allowed to work from home. Yay, pyjama days every day.

    Our whole dept was made redundant in Feb, which was a result for me as I didn’t want to go back to driving all over the place anyway. So, I’ve taken some time out with the redundancy money and aim to get a correspondence course done

  • Guest Guest

    Ha ha, no I have lots of people around, including a couple of close mates who've had similar issues, so that's handy. It's just a symptom of when I'm very low that I think I start to feel quite demanding of people around me! It's silly as I hadn't contacted any of my friends to say \"I'm feeling really bad\", I think I just imagine that they will use the powers of telepathy and come to my rescue! And of course they don't, and then I feel alone... :roll:

    I don't know a lot about BP meds. Actually I don't know a lot about blood pressure at all! I went to propranolol because I was getting so overly anxious about little things, couldn't sleep, etc. I had a lot on at work and every tiny thing was escalating into a major disaster. Propranolol seemed to work and it didn't have any side effects really (except feeling spaced for the first couple of days). The only thing I noticed was that when I was in the gym exercise was much harder work when I was taking them - the thingy on the machine that monitors your heart rate was showing it was around 145 when it would normally go up to 170 odd, and I was getting tired more quickly. I did a 5K race a few weeks after starting them, and it took 32 minutes (normally it would take me around 26-27.) So I'm not a fan. BUT they did calm everything down and I wasn't getting anxious about, say, buses being late and other minor things. Have you ever been on the No More Panic website, by the way? I think they have a thread on propranolol on their forum. I've browsed it occasionally but I don't contribute as you have to sign up. The other good thing is my doctor says I don't have to take them all the time, but can take them at stressful periods - I do that and it seems to help.

    It's interesting reading your post, cos if I'd replied to it 24 hours ago I'd have some different answers, but I've had a fairly rubbish night so am feeling quite down today. Firstly, I'm envious that your boss is supportive. Panic attack wise, no, I don't really get them any more, not full-blown ones, but then last night my boss forwarded an email I'd replied to to all my colleagues pointing out that my email was wrong, and I sort of spiralled! I couldn't go to bed until around 3am, I was feeling really fidgetty and weepy and my could feel my heart beating - basically like a mild panic attack. I absolutely couldn't sleep and I'm knackered this morning. I'm also feeling queasy today, maybe a mixture of this and the drugs, I don't know. Anyway, my boss isn't really the supportive kind, and that's a problem. Redundancy has its uses! A mate of mine just got made redundant and is finally in a job he actually likes :D

    And yeah, be careful in pregnancy. I know sertraline is one of the ones you shouldn't have if you're pregnant or breastfeeding.

    Hope you're having a good day :D


  • Hezza Hezza

    Urgh, your work thing sounds quite poo. Oh to be one of those people that just shrug it all off and go 'whatever, I don't care that my boss is an arse and all my colleagues think I am an incompetent idiot'. But, the tablets could well be having an affect too though.

    I ALWAYS blame it on the drugs

    I have put on a few pounds: 'It's the drugs',

    I don't fancy sex: 'It's the drugs'

    I leave the front door unlocked: 'It's the drugs'

    I'm a moody beeyatch: 'It's the drugs'

    I burn dinner: 'It's the drugs'

    I don't rinse the bath out and he nearly breaks his neck on the bubble residue: 'It's the drugs'

    See, it makes me like myself much more :D

    I have had a good day today, yesterday I felt bloody awful but it seems Wednesdays are the worst day each week after dropping a dose on a Saturday. This week I went from 75 to 50.

    I hope you get a much better night tonight. I have discovered the power of radio 4 for times like that. I can lie and listen to something that takes my mind off the fact I am stressing about life and what stupid things I have done.

    If you do fancy keeping in touch (you seem like a lovely mentalist) then how about using email?


  • Guest Guest

    Haha I like the title \"Lovely Mentalist\" and may even consider it as the sign off in my email (like people who put their job titles or qualifications under their name!)

    I did think about email but I'm not sure how to get my email address to you on this forum, but another part of me (my inner-mentalist!) is anxious about it anyway... But I promise to lurk around here every now and then if you want to get in touch :-)

    Hope you're feeling OK today. I'm feeling good! No nausea, no anxiety about work (The Boss was nice to me yesterday - just as well as he had some makingu p to do!) And of course it's nearly the weekend!

    Note to self: MUST blame the drugs more often. Even though I have always managed to burn dinner for as long as I remember...

    Have a good weekend


  • Hezza Hezza

    I am very glad to hear you are having a good day! Always a bonus to end the week on a better note, means you are not stressing about work rubbish over the weekend.

    I felt really muggy headed and wobbly today but decided that I would brave the roads (I have lots of airbags) and go shopping. Needed to do serious farm shop purchases, a friend of mine wants my Sunday roast as her birthday present. And I might treat her to some chocolate brownies too :-)

    This forum doesn't seem to have the capacity to allow you to delete posts which would have been one choice for putting an email on show - not that anyone would get that far through our posts before nodding off. I then noticed a 'PM' button for 'Private Message', which there is on my posts as I 'joined' the site before I realised you could post as a guest.

    Anxious though? I haven't even told you about my uncle who is falsly imprisoned in the middle east and needs your financial help to fight his case. Or my cat that needs a new set of ears because hers were nibbled off by a homeless man that lives in our alleyway.

    Nope - for some reason you just seem like a pleasant chap and you make me larf. I am happily in a relationship so not perving on you, and ok, I AM slightly deranged but hey, you are too! Plus I might need jogging tips one day.

    So, tis up to you. I have created an email account that I would delete after getting propper details. I've written it so it shouldn't be picked up by big brother

    But as I said, I won't be offended if you didn't and would definitely say hi again if I did spot you on here again.




    (Sorry but Patient Admin have removed either a telephone number, an email address, and or web address, from this posting, as it is the policy of Patient UK not to publish these on this forum.

    If you wish to communicate directly with people, you should register, for free, with the forum (click Register in the menu list below the green banner above). You and other registered members will then be able to communicate with each other via Private Messaging (PM) or e-mail.)


  • Guest Guest


    Ha ha that email address made me laugh out loud! :-) Sorry to only just reply - was at my sister-in-law's all weekend stripping wallpaper! May email you later.

    Tentatively I can say things seem to be getting better - I have a big presentation at work today and so far I'm only a little anxious, which is probably natural whether you're a \"mentalist\" or not!

    Have a good day!



    If you wish to communicate directly with people, you should register, for free, with the forum (click Register in the menu list below the green banner above). You and other registered members will then be able to communicate with each other via Private Messaging (PM) or e-mail. [/color:28cd63cdc5]

  • Hezza Hezza

    Brilliant. And I am sure you are/were excellent in the presentation. Stripping wallpaper eh? Every room in our new house needs doing - but it's liveable for the time being. And it will probably be back in fashion by the time we get around to it. I'm not safe to do it myself - am a bit accident prone, not to mention ham fisted. I am not totally useless though, I have many many plant babies this year (proud mum look)

    I can sum up today in one word.



    I look forward to your email, but don't feel it has to be today, I will allow you to have a life outside of our ethernet contact :lol:

  • Hezza Hezza

    Oh dear, I woz rumbled :oops:

    Feeling strangely guilty, like when an adult would say 'I am SO disappointed in you'

    Hope you can remember what the gmale address was or you may have to bite the bullet and register too

    And Iam(still)notastalkerhonest


  • Hezza Hezza

    I doubt you will read this but if you do:

    I am having a horrible time. It looked like 4 or so days after each drop was going to be the worst but it's stretching into 6/7. Bad day yesterday, nearly fainted whilst out with the dog - not good standing in a muddy alley containing dog poo (why can't people pick it up!!!!!) Poor boyfriend heard me come home sobbing.

    Head feels like a bowling ball. Constant headache. Tinitus is really bad. Confusion. Nausea. Vomiting. Gas. Disturbed sleep. Feel like I am getting flu. Can't study due to cabbage brain, feeling totally useless.

    Determined to kick the last amount this week, meant to be going away on the 14th and if I can't drive I am stuffed.

    I knew it was going to be hard but it is so dehibilitating. NEVER EVER EVER EVER EVER going to take anything like this ever again.

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