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Sertraline 50 mg , works for anxiety only?


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Does anyone have a similar experience with this AD managing their anxieties better than depressive moods? Not to say that my moods have dropped any lower but it hasn’t raised much.  On the flip side, my anxiety has improved.  I’m beyond 8 weeks into the medicine. This is the only medication I’m on right now. Also, what would be the next course of action when I see my provider soon? Raise in med? Change in med or augment the AD with something and what would it be? 

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1 hour ago, RoseQuartz said:

Does anyone have a similar experience with this AD managing their anxieties better than depressive moods? Not to say that my moods have dropped any lower but it hasn’t raised much.  On the flip side, my anxiety has improved.  I’m beyond 8 weeks into the medicine. This is the only medication I’m on right now. Also, what would be the next course of action when I see my provider soon? Raise in med? Change in med or augment the AD with something and what would it be? 

Depends what you’re trying to achieve ... are you looking for a mood booster or just trying to reduce anxiety more? In general 50 is pretty low, So I would consider giving it a chance at a higher dose, especially if you’re getting a partial benefit now 

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13 hours ago, Iceberg said:

Depends what you’re trying to achieve ... are you looking for a mood booster or just trying to reduce anxiety more? In general 50 is pretty low, So I would consider giving it a chance at a higher dose, especially if you’re getting a partial benefit now 

this medication was given to me to tackle both issues- depression and anxiety. Major depression to be exact.  I was recently diagnosed with ADHD-CT, which I’m not under medication for right now. I just started the medication with a new provider. If I can share this with you: I’d rather live with depression than anxiety. Odd I know but with anxiety it’s relentless and you are never comfortable. At least with depression you can find moments where you can be comfortable. But it would be nice to find pleasure again.

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6 hours ago, RoseQuartz said:

this medication was given to me to tackle both issues- depression and anxiety. Major depression to be exact.  I was recently diagnosed with ADHD-CT, which I’m not under medication for right now. I just started the medication with a new provider. If I can share this with you: I’d rather live with depression than anxiety. Odd I know but with anxiety it’s relentless and you are never comfortable. At least with depression you can find moments where you can be comfortable. But it would be nice to find pleasure again.

Zoloft can often go up to 200 

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So there's a reason why 50mg is the initial target dose. Treatment of depression and anxiety with SSRIs typically requires occupancy of the serotonin transporter (SERT) of at least 60-80%, which occurs with sertraline somewhere around 50mg. Therefore, when it first came out, they advised you to either start at 50mg for two weeks or take 25mg for a week and then go up to 50mg. Then determine from there if additional efficacy is required. However, since coming to market, it has been found that sertraline can be dosed up to 200mg. What you're basically adding from 50mg to 200mg are small increments of additional SERT occupancy and inhibition. For people with treatment-resistant depression/anxiety, OCD, or panic disorder; higher occupancy is typically required. Therefore, it is not uncommon for patients to be dosed around 100-150mg per day. Additionally, sertraline is particularly non-toxic in higher doses relative to some of its other SSRI/SNRI cohorts like venlafaxine or citalopram, which can be particularly problematic in overdose. Therefore, sertraline became a drug of choice in psychiatric wards.

So do I think 50mg is a low dose? No. In my experience I couldn't really tolerate sertraline any higher than 50mg. I find it quite potent. However, others find the higher doses to not only be tolerable but also quite necessary. So instead of thinking of the 50mg dose as low, it's better to think of it like you have lots of room to grow.

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