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How do you tell if your meds are right?


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To start off: I'm 20, a college sophomore, and I have GAD and OCD, and am taking medication for it.

Previously (a couple years ago), I was on Prozac, and I liked it for the most part, and was on it for about a year until I was doing better, spoke with my doctor, and got off it.

Fast forward to now(ish), and I decided that I needed to go back on meds. I went to the doctor (a GP), and said that I wanted to go back on meds, but didn't want to go back on Prozac because it made me sluggish and gave me headaches. He said fine, and gave me Citalopram (Celexa). I took that for two weeks, and it was awful, and I knew that it wasn't the right drug for me. All I wanted to do was sleep, I was irritable, I didn't eat etc etc. I contacted my doctor again, and he decided that we should try something else, so he started me on Sertraline (Zoloft).

I've been on the Zoloft for almost a month now, 2 weeks on 25mg, and just under 2 weeks on 50mg. I'm doing better than I was before -- I'm sleeping well, have more energy, and have more motivation, but I'm not sure if it's quite right. I'm not quite sure how to explain it, but I still have more ups and downs than I would like, don't have as much energy as I would like and such. I'm thinking that maybe Zoloft isn't the right med for me, but at the same time, it's only been a month, so maybe I should wait more?

How do you know if your meds are right for you? Help!modify_inline.gif

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It's hard to know exactly what meds are doing well and what aren't sometimes, but usually it takes a few weeks medication to really show either an improvement or lack of. I would suggest sticking by it for now, for a few weeks more atleast and if it does't help then go back to your doctor. I would probably bring up the idea of taking Prozac again, seeming you had a great experience with it in the past.

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It's hard to know exactly what meds are doing well and what aren't sometimes, but usually it takes a few weeks medication to really show either an improvement or lack of. I would suggest sticking by it for now, for a few weeks more atleast and if it does't help then go back to your doctor. I would probably bring up the idea of taking Prozac again, seeming you had a great experience with it in the past.

I said I didn't want to go back on Prozac because it made me sluggish and caused headaches. It worked, but at that cost.

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I recommend that you ask for a referral to a pdoc. GPs generally aren't great once you get outside the realm of SSRIs.

Prozac was one of the first meds I tried when I was dx'ed. It wasn't good for me, turned me into a complete zombie and killed my sex drive. There are a ton of other good meds out there and a pdoc will be better able to correctly dx and treat you.

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You should give your med 6 weeks at this dosage before deciding whether or not it needs to be increased. That's pretty much standard.

Would you say that's the case even though it's at a sub-therapeutic level? With it only being at 50mg, I was thinking it might just be a need for a dosage increase...

but generally speaking, SSRIs run 6-8 weeks before you feel the full effect. so I'd say you're either in increase dosage to reach typical therapeutic level land or in wait and see land...not in ditch and try something new.

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50mg is within the therapeutic range for Zoloft (it's 50-200mg). I don't know if my body could handle more than 50mg...or I guess more precisely, if I could handle the side effects of more than 50mg.

And by now, my serotonin levels should be pretty good. I was on Celexa for two weeks before switching to Zoloft (and yes, I know two weeks isn't very long, but I had really bad side effects as I noted in my first post), so I've been having the SSRI effect in my system for about 6 weeks now.

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I could actually go to a pdoc without a referral as my insurance doesn't require referrals to specialists, but I don't really think I need anything special. I pretty simply have OCD and GAD, as Dx'ed by a licensed clinical psychologist.

If you're here asking questions about your meds, getting an expert opinion couldn't hurt, especially if it's available to you. A pdoc will be a lot better at figuring out if you're on the correct meds, and based on your response to them, how long you should keep with what you're on, or try a new approach. My GP is qualified to do my OB/GYN and dermatology stuff, too, but I prefer to see specialists for those things, as well as a pdoc for what's wrong with my head.

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As a strictly non professional, I would say give the zoloft a little more time before ditching it. when switching ADs, it can still take time to feel full effect.

Additionally, there are some reports that 12 weeks, not 6, is really a better assessment of what an SsRi will do to be of assistance. I'm afraid I don't have the energy to link right now, but if you think about it, too many adjustments and switches is just going to leave your brain reeling, not repairing, which is what you want.

Hopefully you will not need pdoc, but it's always my preference. perhaps your dx and needs are not going to be as simple as you think.... We never know.

Anna

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As a strictly non professional, I would say give the zoloft a little more time before ditching it. when switching ADs, it can still take time to feel full effect.

Additionally, there are some reports that 12 weeks, not 6, is really a better assessment of what an SsRi will do to be of assistance. I'm afraid I don't have the energy to link right now, but if you think about it, too many adjustments and switches is just going to leave your brain reeling, not repairing, which is what you want.

Hopefully you will not need pdoc, but it's always my preference. perhaps your dx and needs are not going to be as simple as you think.... We never know.

Anna

I definitely plan on giving the Zoloft some more time because it is by no means bad...it's just not as good as I would hope.

I haven't switched much (only Celexa to Zoloft). Yes, I did take Prozac before, but that was about 3 years ago, so I would have stopped about 2 years ago.

I also wasn't dx'ed by a GP, I was dx'ed by a clinical psychologist, so I'm pretty sure my dx is just that simple, though there is the possibility of that not being the case, I think that chances are slight.

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I see what you're saying.

OCD is the only dx that has stayed constant. First it was adjustment disorder with a depressed mood, then it was OCD, and now, still OCD, but also GAD.

Maybe I should see a psychiatrist...I don't know. I could talk to my therapist and see, I guess. My school has a consulting psychiatrist that comes every so often, so I could easily see him I'm sure. And if he thinks my meds aren't right, he could always adjust them or rx new/different ones or whatever.

If I were to do that, what would I do with my GP in terms of this? Tell him that I started seeing a pdoc instead?

I'm kind of just thinking right now.

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I didnt do well on prozac, or celexa for that matter. I got anxiety on prozac and weakness on celexa.

that cross-titration of celexa to zoloft put me in an awful awful mixed episode. I almost lost my job I was so irritable. Theres something about celexa that does it to me, but moving to zoloft like that made it 10x worse.

I dont really notice much difference from 75 to 100mg. Might try more just to see what it does, but I have a feeling the irritability will come back. At 50mg it helps with my PTSD symptoms but not the depression. Wellbutrin helps that a little until it poops out after a week or two. Right now exercise is my main antidepressant =(

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If I were to do that, what would I do with my GP in terms of this? Tell him that I started seeing a pdoc instead?

I'm kind of just thinking right now.

Sure, let him know. It is common to move from a GP to a specialist for any condition, not just MI.

nf

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Hmmm...I don't know.

I'll certainly give the Zoloft some more time...another 2-4 weeks, to be fair and give it the full 6-8 weeks you're supposed to give meds.

It probably wouldn't hurt to make the psychiatrist appointment now, b/c its going to be a month or more before you can get in, most likely. If the zoloft starts to do the trick, you could keep or cancel. If you're still having issues, he/she can help you decide if an increase or change makes more sense.

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How do you know if your meds are right for you? Help!

Unfortunately, the best indicator that the meds are right seems to be when you start thinking that you've been doing well enough (with regard to your moods matching your circumstances) to go without the meds.

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People keep saying see a pdoc, and you keep saying "I don't know." Are you scared to see a pdoc? See it as admitting that you're worse off than you originally thought? Hopefully not, for your benefit, but really, you're not the professional so how can you really tell? The meds you're trying obviously aren't working as you'd like. I've been there, with a GP, and in hindsight, wish I'd found the pdoc a lot sooner.

Think of it this way: GPs can deliver babies, too, but would you stick with a GP when you could have an OB? Maybe if you lived in a very small, remote town where that was the only person available, I guess. But everyone I know that's had babies always go with a specialist - OB, midwife, what have you.

My preference for a pdoc has to do with the training they receive. GP's take a course in med school on mental illnesses as part of their rotations. Pdocs do a year or more (or however long their residency and specialty training is) focused only on the subject, after the regular rotations they do like the GPs. They don't have to go dx and treat heart disease before or after they dx and treat your GAD.

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