Sertraline above 200mg

Edited , 4 users are following.

Hello, just a question on whether anyone on this forum has been prescribed above the maximum recommended dose of 200mg and their experiences?

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  • Posted

    I have never gone above 200mg and I believe 200mg is the strongest that can be prescribed. the next step would be to change tablets, why would you want to go higher?

    too much can cause serotonin syndrome which can be fatal

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    • Posted

      Tom, I agree. And you are correct. 200mg is the highest dosage that is prescribed daily. And I think I suffered serotonin syndrome a couple of times. Once one leg wouldn't stop shaking. It was horrible, like I had no muscle control over this leg whatsoever.

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    • Posted

      I understand that but ive been on 200mg for over 16 years with minimal side effects. I can't see Pysch until 3rd March and GP will not prescribe Diazepam etc so i have nowhere to go. I cant function at work and feel awful but know that the additional 50mg will bring relief until i see the pysch. I know as i took an additional 50mg at the beginning of the week and felt better for a day at least.

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  • Edited

    I have been prescribed 150mg a day, but I have always monitored my own meds and dosage and I have taken more than 200mg a day for several days - in fairness, quite a few times I wasn't sure if I had taken my dosage for the day and erred on the safe side by taking it again. I do NOT recommend this. I am doing much better nowadays.

    I don't know how it is for other folks, but I can tell you one thing, when I was on a high dosage, I felt totally like a zombie. Affected, I guess is correct term. I wanted to cry so desperately but couldn't. I felt fortified, like a wall of hardened but crumbling bits of concrete where normally if I were my normal strong self, I'd be a nice wall of bricks. As for all the other side effects, they are magnified, be it constipation, perspiration, fatigue, sleepiness, etc. And oh, I had very vivid dreams.

    Hope I answered your question.

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    • Posted

      Hi, yes i appreciate that. I felt 100% normal on 200mg for 16 years with minimal side effects. It just feels like i have built up a tolerance to Sertraline which has manifested in a return of all my symptoms that i have been battling since Sep'19. Each day has been like a ongoing war and after taking 250mg for the last 2 days i feel so much better already. It's like my Serotonin levels just needed topping up. I will wait to see what Psych says as i really rate her. Another person on here was told by their Psych that they prescribe up to 350mg for cases of Anixiety and OCD that are not improving at 200mg.

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  • Posted

    I'm on 300mg daily for a very short period of time so far (been on 250 before). My doctor told me that everybody metabolizes the drug different, and hence all bodies would have to figure out the best dose for them. Since I didnt feel the effects of the lower doses, we kept increasing. He mentioned that in the young adults the sertraline usually has to go to a higher dose to cause the decrease in symptoms.

    In my case though, we are working to decrease the emotional intensity - so we are aiming at inducing a bit of an apathy (which shall allow me to control my emotions better). Definitely at the higher dose you might struggle with more side effects and you should be monitored by your psych doctor regularly.

    Hope this helps

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    • Posted

      Hi s4shenk4, thanks for sharing your experience. I've been on 250mg for a week now and still feeling better than i did on 200mg. I had minimal side effects on 200mg and was on that dose for over 16 years hence another 50mg is really only a 25% increase. Pych appointment on Tues so will find out if she agrees i can stay on higher Sert dose or switch to Venlafaxine. Hoping for the former as not keen on switching meds again when it's worked so well in the past.

      Thanks again

      SS

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  • Edited

    I thought it would be responsible and sensible to respond back on this forum after speaking with my Pysch, especially as her advice supports the sentiments of Tom Turtle and Godservant.

    Psych strongly disagreed that anyone should ever go above 200mg. Any views and papers supporting this are US based and she didn't think that any Pysch in the UK would recommend going above 200mg. I have reduced back down to 200mg immediately.

    Tom Turtle and Godservant, thanks for you opinions that were completely validated by my psych.

    Pysch is still thinking that there might be a physiological explanation as there is no logical pattern to my anxiety. Recommended i continue with eating healthily and continuing with regular exercise. Also recommended i buy Garden of Life Minami Nutrition Platinum Ultimate Daily Omega 3 Fish Oil with Vit D which i've just ordered on Amazon. Also eat plenty of SMASH (Salmon, Mackerel, Anchovies, Sardines and Herring), Walnuts, Macademia nuts. Psych doesn't do private appointments but said that if you went the private route they would be able to do more phsyiological explorations, stool samples for gut flora etc that they can't afford on the NHS.

    Doesn't believe that it is possible to build up a tolerance to Sertraline but they don't know why they stop working. It might be that something else was keeping the anxiety at bay, not just sertraline,

    100% against me taking any Benzo's, e.g. Diazepam, lorazepam etc as is just a sticking plaster, addictive and impacts the effects of anti depressants.

    Don't have to rush the decision to come off the Sertraline so i could stay on it for more than 2 weeks if i did start to feel better.

    The problem is that once i start the withdrawal, i need to go down in 25mg every 2 weeks so it will take about 14-16 weeks to slowly withdraw before i can start the Venlafaxine. There is then no guarantee that Venlafaxine will work so will have to give them time and trial the doses.

    At least i have a strategy and 2 options but neither seem attractive options

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    • Posted

      Hey, thanks for sharing your updates with us.

      My doctor is also against using benzo's because they can be addictive and might cause dependance. I really hope that your doctor's advice would work and you would be able to go back to normal functioning again.

      I found that for me low doses of atypical antipsychotics help with mood regulation, extreme anxiety and sleep problems. However I was introduced to them under a careful observation while I was in a psychiatric ward for 5 weeks (same goes for the high doze of Zoloft). I take Quetiapine on "as needed" basis and from what I know, this medication is not addictive. It affects dopamine and the effects are non-cumulative. This kind of use if not common, but I've heard of it before. (side note - it makes you sleepier, so its not the best option to take it in the morning).

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    • Posted

      SerontoninSurfer, sorry to hear that. I was hoping you had better news. You know I get the horrible feeling when I'm right at something that I wish I was wrong, for the benefit of the party in question.

      What you are possibly going thru is nothing new - it's called the "pooped out" effect of the med. And this is one thing I've always been afraid of happening to me. Hence I always try to get off this med, but then I recently discovered that getting off isn't good either because you don't know if it works again like it did once you get back on. So I guess, the trick is to try to stay on it at the lowest dosage as possible that also allows you to function at your best. Goodness, this living is such an unprofitable endeavor sometimes because it requires constant maintenance! Argh.

      The only advice I can give to you is before you decide to go off this med, are you sure it stopped working for you? I've been on this med and still experienced attack (anxieties) when I am too stressed. So try to do other things to see if it will help. Exercise, get good sleep, eat healthy stuff, and try not to get stressed! Meditate? Do NOT panic. Try breathing exercises?

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    • Posted

      GodsServant, no worries at all. However, i took my psych's advice that it might be physiological . I was reading about aspartame effects on Anxiety as well as sugar, fish oil etc. I started drinking coke zero and diet coke when i gave up alcohol a few years ago and an alarm bell went off in my mind. So i stopped drinking anything containing aspartame and started taking the Omega 3 Oil Fish Oil with Vitamin D that i mentioned above. Now this might be a coincidence and it's very early days but i started this change about 5 days ago and i have just had 3 days almost symptom free in a row. and the best i have felt for about 18 months. I also read that you can get almost immediate benefit from diet changes and supplements as opposed to the months and months waiting for meds to kick in

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    • Posted

      Wow. That's wonderful news. I think my issue is prolly more biological. I started having OCD thoughts since I was a kid of 8 or 9, but I never nipped it in the up and got help then. I didn't tell anyone. I've tried fish oil for years and that didn't do squat. You might also want to look into St John's wort, a supplement. Yeah, you sound good, actually. Me, too. I'm doing very good in terms of not forgetting to take my meds and eating relative healty and walking (my exercise) - 3 years and still going on 100mg daily (although I have been on/off this med for more than 2 decades), and soon I'll have to fight the urge to taper off again, which has always failed in the past. Maybe at the 5 year mark I will taper off. It would be wonderful if you got get off meds completely and not have anxiety! Take are.

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