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Augmenting Effexor wiht Zoloft?


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You need to be careful combining two medications that do serotonin reuptake inhibition as it can lead to a drastically increased risk of serotonin syndrome, which can be fatal.

I'd look into trying somthing else first. Maybe anything else.

Have you tried Provigil? Its main indication is excessive daytime sleepiness. Wellbutrin? Stimulants? Coffee? Gensing?

Do you snore, toss and turn, or wake up a bunch during the night?

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Why is it a deadly combo? My dr only wants to go up to 50mgs of the zoloft.

My dr wont give me provigil, i dont think he is educated on it. Wellbutrin makes me go nuts. I drink coffee all day long, or soda, and sometimes i take a caffeine pill to keep me going.

I think I am sleeping because I am depressed. But who knows, maybe its vice versa. All I know is I'm very anxious, thinking about stuff all day long. I find myself being irritable and cranky, and scared.

When I first started on Effexor, I had terrible anxiety especially at night, I would have these panic attacks like I thought something really bad was going to happen. And I was paranoid. I got through it and it evened out.

Last night I took 25mgs of the Zoloft... today went fine, well except when I was driving home from work and I thought I heard something. So I turned off the cd player and I still heard this faint murmor of voices and maybe music. I got so scared that I was hallucinating and drove myself into a panic frenzy. I took some Benadryl and .25mg of Klonopin and I turned out to feel better.

<skip to end because this is just ranting and raving now>

i'm so sick of this crap. my life is great. then i want to die. then i want to go do something crazy like get a tattoo at the last minute or spend a lot of money shopping online. i hate myself for this illness. whenever i think i'm doing great, i crash. and i'm overweight now after i started taking the effexor, and thats it, i dont want more weight gain, more lethargy. all antidepressants make me cycle, but then again my biggest problem is my anxiety and depression. enoguh rambling, im going to bed.

<k thanks for listening ;) >

oh ps, yes i snore. i do occasionally wake in the night but only for a moment.

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So far, so good on the addition of the Zoloft. Seeing a therapist now too, so my moods will be more documented, and she might see a change where I might not. I actually stayed up for a couple days (sleeping at night, not sleeping during the day) but today I slept again all day and night, so oh well... can't win

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Less daytime sleepiness and less depression so far! I'm even ambitious to move up from my Psychiatric Technician job and go for LPN classes to have more of the ability to help the patients at the hospital I work at. If I get the LPN, then I will do that for a bit, then might go for being an RN if I can handle it. Things looking up!

Anxiety is very high but we have a tough population lately on my Unit (it is acute care) and the one patient has been aggressively sexual towards the patients and myself. I'm experiencing a bit of PTSD from an event today that he did. But a very normal reaction to such an incident!

Pdoc said to increase the Zoloft to 75mgs or 100mg if I want because it could decrease more anxiety. I asked about Seritonin Syndrome and he said it could happen, but if I start to feel the symptoms of it, to call him and stop taking so much of the Zoloft. I'll definately wait *atleast* another week before upping the dosage- if i do so at all. We decided that if the Zoloft is helping me so far, we will continue and do what we need to do with the dosage.

Maybe this might actually work... some hope again.

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Pdoc said to increase the Zoloft to 75mgs or 100mg if I want because it could decrease more anxiety. I asked about Serotonin Syndrome and he said it could happen, but if I start to feel the symptoms of it, to call him and stop taking so much of the Zoloft. I'll definitely wait *atleast* another week before upping the dosage- if i do so at all. We decided that if the Zoloft is helping me so far, we will continue and do what we need to do with the dosage.

Maybe this might actually work... some hope again.

I'd still get a second opinion. Why chance a potentially fatal side effect when there are other options out there?

Here is a pdf with some more information on it. It's a bit dated but it's 2:30 in the morning and I'm not really up to doing research.

http://uuhsc.utah.edu/poison/healthpros/utox/Vol4_No4.pdf

You have a bit of a medical background. Take a look at that list of symptoms. By the time you had some of the most common ones, it would be a bit late to call any number but 911 for an ambulance, assuming you could even use a phone.

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I don't like benzos because they make me stupid and tired, and I'm really tired always and every day all day. So I'm getting tested for ADD next week so I'll prolly get some Adderall or something for the tiredness. As for the Zoloft and Effexor, if it kills me then whatever- especially if it makes me unable to call for help, even the better.

As for an antipsychotic, that also makes me stupid and tired. I'm so sick of this.

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I'm really just sick of switching meds cause you know how much it messes with your emotions and thoughts... I work in a psychiatric hospital, so when I freak out... you bet the nurses I work with notice :) So I guess if I get deathly ill, I'll be fine anyhow since I work in a hospital and live with my boyfriend... which means I get 3.5 hours tops of alone time ;)

So thanks for the info everyone, I just was hoping you'd all say it would help me...

So what antidepressants would be better to augment it with, besides Wellbutrin and Prozac (they are the worst for me).

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You could keep going up on the effexor dose. As greeny said, the effect on NA will kick in as you keep going up making it more stimulating. You're at about 1/3 of the max dose now.

Any of the GABA analogs. Lyrica, Gabatril, and Nurontin. Neurontin could make you kinda stupid but the others are less likely to.

Provigil can help a lot with daytime fatigue without contributing much to anxiety. It can also counter the stupids which can be caused by other meds.

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Ammity -

I've had extremely good results with the addition of Adderall to my Effexor XR regimen. The combo finally kicked my Dysthymia (as much as life circumstances will permit :P). I actually have the opposite problem now, not getting enough sleep, but this handily wins the "Which Sucks Less" comparison.

As you're being evaluated for ADD, this might be a natural direction to go, and one to mention to your pdoc.

Cerberus

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Danger, Will Robinson.

I hadn't realized you were Bipolar. What I wrote above - never mind. Effexor is prescribed for the treatment of Major Depressive Disorder (unipolar depression) and GAD. Usage for BP is off-label. Now, as Jerod points out on his Crazymeds page on Effexor, Effexor is doubly risky for users diagnosed with BP because 1.) Effexor can trigger mania and 2.) Although rare, one potential side effect is that the horrible discontinuation symptoms might not stop and you would be forced to become a permanent user. Now, add 1. and 2. together, and you end up strapped and straightjacketed into Hell's Roller Coaster for life.

Scaaaaaaary.

Um... have you by chance checked to see if your pdoc actually has a diploma or anything on the wall? Is it from Wottsamatta U.? Is it signed by Sally Struthers?

I would definitely seek a second opinion.

Cerberus

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hi there! i've taken effex, lamictal, and zoloft at the same time. the zoloft did nothing for me except make me sweat myself soaking at night. i was taking 225mg effex and 50mg zoloft, so i believe, if your doc knows what he/she is doing, it could help you....but for me it was just a recipie for disaster.....

if you can't sleep, have you tried any sleep meds??? if you are bipolar, have you tried any aap's to even you out and put you to bed????

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You need to be really careful about ramping up the antidepressants here, as I'm sure you know...lamictal is often used in place of antidepressants to treat bipolar depression. It sounds strangely like your pdoc is TRYING to throw some mania your way to keep you awake during the day?? I don't even know what to say to that, except I agree with your other replies...get a second opinion. Then wrap it around a brick and throw it at your pdoc's head. (Just kidding!)

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Hi. My pdoc is always open to suggestions and second opinions. as for the zoloft, i told him i wasn't taking it anymore because i turned into a nasty brat. he said ok. this doctor has helped me far more than any other in my past, so i do like him.

as for the bipolar diagnosis... nobody is really sure that's the current 'label' for me. i'm mostly depressed... usually always... the problem is that when i add an antidepressant i get really irratible and sometimes have a hypomanic like effect. so my main symptoms are anxiety, irratibility and depression. when i get the symptoms bad, i can't focus, i can't think a straight thought, i can't remember things, and i come off to people as a flaky bitch. not so good.

oh and i can ALWAYS sleep. I can sleep 40 hours if I get up and take cigarette breaks.

I asked Pdoc about Gabatril once and he said I could try it but that he's never had much success with it. Neurontin I've been on before, but I don't remember its effects because I was on 20,000 other stupid meds. I'll read up on Lyrica. the problem that i experience over and over and over again is that i want to sleep, and that i'm tired 24/7 and have no motivation. i'll look into asking him about Provigil again. I don't know, maybe Adderall would be better. |He'll probably give me Strattera though because pharmaceutical companies are idiots.

by the way, the eyebrow ring has done a job well done-- a nice distraction to keep me feeling a bit more up when I think about it. Its been peirced for ages, just had to get it back through cause it was closed... and get enough guts to wear it to work knowing someone might really insult me and tell me to take it out. so far so good though

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Ask about strattera and provigil both. They can be taken together.

How long does it take you to fall asleep?

Do you fall asleep in inappropriate places? When you're watching a movie or TV? In class?

If so, read up on narcolepsy. My gf was fairly surprised to find out she had it since she doesn't' really have sleep attacks so much as she just dozes off fairly easily when she's tired regardless of where she is at the time. When she started taking provigil for it, it made a huge difference for her depression and and attention as well though. It's sorta like mild narcolepsy was the missing puzzle piece that kept everything else from responding to treatment for years and years.

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