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Zoloft causing social anxiety, need new drug


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I'm currently dealing with a substantial amount of social anxiety. Living in 1 bedroom apartment has become completely intolerable, given the proximity of neighbors. When I first moved to my apartment I did not have a big issue with neighbors. Many factors worsened my social anxiety, but it seems that Zoloft is the biggest offender. There is GAD too but it's mostly social anxiety.

Back when I was 18, I was put on Zoloft for OCD. I tried many SSRIs, and Zoloft was the only one that really worked. 15 years later, the OCD is less of a problem and now the Zoloft is the problem. It's definately causing anxiety and may even be the sole cause of my anxiety. My psychiatrist suspects that it is making me "mildly" schizophrenic, and really wants me to get off of Zoloft. In the past we talked about the difficulty of withdrawal. At that point he did not express the disbelief of withdrawal like some psychiatrists do. Now he's saying that Zoloft withdrawl is basically all in my head. I seriously wonder wtf is in his head.

I've slowly lowered my Zoloft dosage from 200mg to 75mg. Going from 75mg to 50mg was too fast for me. I experienced bad withdrawal after taking 50mg each day for 3 days. The withdrawal is bad, but the social anxiety, and any schizophrenic symptoms seem to be reduced . ~65mg seems to be a tolerable reduction (I cut a 25mg in half), but of course the anxiety is still there.

I started tapering Zoloft after having a stubborn cold for 2.5 weeks, back in November. When the cold went away, the anxiety got worse. I was also on 2mg Abilify, and switched to 2mg Perphenazine. Recently the anxiety got worse after a bad hangover. I'm off the booze for good now. I have sleep apnea, which I now know was being worsened by alcohol. It also doesn't help that I've been taking Clonidine. I started taking that for ADD, then anxiety. I now know it lowers adrenaline in the body and thus is a CNS depressant. My psychiatrist said he found no interaction beween Clonidine and alcohol. Clonidine and alcohol definitely made my sleep apnea worse. Causing me to wake up, gasping with panic. I still have sleep apnea but the panic associated with it is gone, fortunately.

Sorry for the long story.

Is there an antidepressant that I could switch to, that is less known for causing anxiety?

My psychiatrist wants me to be off Zoloft completely for a whole week before trying a new antidepressant. I'm not willing to do that. In the past I've switched SSRIs after skipping a dose for 24 hours at most. What do other people do?

I really appreciate the help you folks got going on around here.

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If you're having trouble withdrawing from Zoloft because the dosing intervals are too wide, they make an oral concentrate 20 mg/1 mL (contains 12% alcohol) that comes with a dropper you use to remove the required amount of concentrate, which you dilute with 4 oz water, ginger ale, lemon-lime soda, lemonade, or orange juice. With your pdoc's supervision, you could slowly decrease how many drops of the solution you take gradually over time. (1 drop ≈ 0.04 mL; 75 drops ≈ 3 mL ≈ 60 mg Zoloft; 70 drops ≈ 2.8 mL ≈ 56 mg Zoloft; 65 drops ≈ 2.6 mL ≈ 52 mg; ... ; 10 drops ≈ 0.4 mL ≈ 8 mg Zoloft; 5 drops ≈ 0.2 mL ≈ 4 mg Zoloft)

If you wanted to try something other than clonidine, a medicine in the same class is guanfacine. Both are used for ADHD and anxiety. The difference is that clonidine is an imidazoline receptor agonist and guanfacine isn't, which to my limited understanding of that mechanism of action may make it more "depressing" than guanfacine.

Addressing your main question regarding an alternative antidepressant that is less known for causing anxiety, I'm not a doctor, but here are my guesses.

  • First of all, ADs that have actual indications for "social anxiety disorder"
    • paroxetine/paroxetine ER (Paxil/Paxil CR)
    • venlafaxine ER (Effexor XR)—doses up to 75 mg, no proven additional benefit at doses >75 mg/day (from Epocrates)
  • ADs with indications for "generalized anxiety disorder"
    • escitalopram (Lexapro)
    • duloxetine (Cymbalta)
  • ADs not likely to cause anxiety
    • citalopram (Celexa)
  • ADs said to be effective for social anxiety
    • Probably some of the TCAs
    • The MAOI phenelzine (Nardil)—requires a 2-week washout from your prior AD, a special low-tyramine diet, and to avoid certain medicines

Have you ever tried benzodiazepines for your social anxiety? Are you willing to try them? If so, clonazepam (Klonopin), I believe, is said to be extremely effective for social anxiety disorder.

Apparently, some anticonvulsants can help with anxiety disorders, but I don't know which ones specifically... Likely gabapentin (Neurontin) and Lyrica (pregabalin).

I hope this information is of some help to you. Good luck!

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  • 3 weeks later...

I take a mixture of Klonopin, Risperdal, Lamictal, Wellbutrin, and Prozac and find this works for me, but everyone is different and your body can even react different to different medications at different times. I would not recommend Wellbutrin because for a lot of people this increases anxiety. Unfortunately, it's kind of a trial and error process to find the right anti-depressant that works for you. I know how you feel, though. I used to be the same way. Noises used to drive me crazy from neighbors and they would just get on my nerves so bad. Now I can deal a lot better.

Edited by AnxietyGirl74
Forgot one of the meds I was on
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