Upped dosage for one day, then resorted back. Advice?
Posted , 4 users are following.
Hey guys,
I recently went from 25mg to 50mg on Sertraline, and the only reason I did so, was because I felt like my Psychiatrist might not have been happy that I didn't follow his plan. He suggested I go from 25-50 after 2 days, 50-100 after another 2 days, and then 150 for 2 weeks.
I've been on sertraline for about 10 days now, and I had been using Lexapro for about a month before, without any real effect. I weaned my Lexapro from 10mg to 5mg for about 5 days, and then started taking Sertraline at 25mg.
I did start noticing that I was feeling better on the sertraline. My derealization was reducing and I was feeling calmer and more in control (I've dysthymic Depression and GAD). I went against the plan only because I didn't feel the need to go up to 50mg given how I felt on 25mg.
I took 25mg 4 more extra days than what he had guided me to, but then I caved and took the 50mg because I felt bad (In hindsight, a silly way to think!). First day on 50mg, I felt absolutely awful. Completely spaced out of it, completely exhausted, brain fog, jittery, sense of detachment was coming back, all round discomfort.
I decided last night that I would go back to 25mg as, even though I'm aware that upping the dose can re-activate symptoms, I don't think I needed to, and only upped because of the guidance from the Pych. I realized I should have just listened to my body and not the advice of someone who doesn't really know "me".
What I'm wondering is, should my body re-climatise to how I felt on the 25mg? A day later and I'm still feeling completely exhausted, which I didn't feel on the 25mg initially. Could it be the residual effect of the 50mg?
Thank you!
0 likes, 5 replies
sparrow- Samrock
Posted
hi sam, yes of course it might take a few days to a week to settle down again, because sertraline has a long half-life; which is, it take about 24 hours for the amount inside you to halve. this means it would take a few days to actually reduce down quite far
your doctor or psychiatrist will use the knowledge and information regarding ssri meds as best as he can, but you can't be too hard on them because, it is a very wide subject regarding what dose people need to reach, what dose they should start on, how long to leave it before each increase... what side effects are they going to experience, and so on.
i think though, i'm not the only one here who would say that, your psych's recommendation of: "25-50mg after 2 days, 50-100mg after another 2 days, and then 150mg for 2 weeks"...
that seems too fast for getting an ssri settled in your system. it might not be so bad if u are long-term using and very used to ssri's at higher doses, but in your case it sounds like there is no need to rush so fast.
im no doctor (sorry that's not a good way to start a sentence here)
... but if i were in your shoes, i would (obviously) stick on 25mg longer. i would only increase your dose if; at some point (doesnt matter when.. eg. in a few days.. or a few months.. or a few years... or never), you find that the dose you are currently on doesnt seem to be working as well as you had felt on it previously. if you do increase, it would be easier on your if you only ever go up in increases of 25mg each time you increase. everyone's different.
Samrock
Posted
@Sparrow:
Thank you for your input friend. I do agree with you on a lot of what you said. I also felt that the upping schedule seemed a bit fast too, hence staying on 25mg for an additional 4 days as I felt like my body needed it.
This is the second night now that I've gone back to 25mg, and I'm feeling quite detached and my anxiety is constantly high. As you mentioned, it might take a few days to a week to settle back down to 25mg. I guess part of me is worried that it won't settle back down, and then I'm not sure what to do next, but I guess only time will tell in that regard
sparrow- Samrock
Posted
hey sam, hopefully u will feel better soon, unfortunately the anxiety speaks loud doesnt it whenever it gets a chance.
recently i was doing really well on 100mg sertraline for several months (i started on 50mg for a month or so before moving to 100mg).. anyway, then recently i took some prescription pain pills for RLS (restless legs syndrome), but on stopping them abruptly due to side effects, some kind of bad reaction happened (stomach trashed, appetite trashed, and anxiety/depression back to say hi !)
so for the last week or so i've had the crappy anxiety going on, which of course ends up with me thinking things like "great, the sertraline no longer works and i'm now screwed. forever!" (that's irrational of course, but when anxiety is strong, that's how we can feel isn't it)
anyway hopefully both of us are gonna feel better in a few days
(i've continued to take my sertraline as normal and if still no progress by friday will go see my doc)
Samrock sparrow-
Posted
Ha! I completely understand where you're coming from!
It's so hard to discern, whether or not the SSRI is being ineffective, or your body is just responding to a hightened level of stress in your life etc.
I'm a HSP (Highly Sensitive Person) and I'm currently living in a stressful environment, so I'm basically a poster-boy for my condition, and unfortunately I will only start to heal once I move from my current situation. I do think that without the meds, my mind would be a lot more stressed out.
However, I wish I had x10 worse anxiety in exchange to rid myself of my derealization (though they are connected). It's without doubt, the most disturbing symptom I've experienced, not feeling like you're connected to reality 24/7.
It's funny, isn't it? That we never give ourselves the chance to think that tomorrow, or the day after, or the day after that, we'll feel better. We think, just because we feel SO crappy right now, it'll continue forever.
Relatability, to me, is humanities greatest attribute. With it, you feel less alone especially when dealing with experiences that feel so alien.
ihavenonickname Samrock
Posted
Ihugs