Posted by 3 Beer Effect on March 23, 2002, at 0:13:15
In reply to To 3 Beers, posted by geno on March 22, 2002, at 20:08:31
One problem is that at 50 mg, the starting dose of Zoloft, has not proven very effective & would probably make you sleepy- for me, 50 mg didn't have much of an AD effect. Zoloft 100 mg is approximately equivalent to Paxil 20 mg or Prozac 20 mg (Prozac is slightly more stimulating but causes more nervousness) & many people said the makers of Zoloft screwed up by making the starting dose too low. I found Zoloft 100 mg to be a very good & strong anti-depressant, the only trouble was I couldn't sleep at night. But if it was combined with Remeron at night, the Remeron blocks the bad serotonin receptors that cause sexual probs & insomnia that SSRIs like Zoloft or Paxil act on.
I think Zoloft 100 mg/morning and 15 to 30 mg of Remeron at night would be a good combination. Remeron when mixed when an SSRI does not usually cause serotonin syndrome, but if you combined Paxil & Zoloft it could so be careful. Combining 2 SSRIs is almost always a bad idea.
The Klonopin in the day will help offset the sometimes notable anxiety that occurs for about the first month with Zoloft- you probably won't need the dexedrine for the 1st month, in fact I think it might be better for you to avoid it b/c I think the combo would make you too nervous for the first month & you would end up quitting one or both. The first month on Zoloft can be rough because it causes anxiety and takes 3-4 weeks to start working well, but eventually your anxiety lessens (After 1-3 months). But if you do take Dexedrine for social phobia, it is best to take the low dose- 5 mg 2x per day (when you want to wake up & 6 hours later- but never later than 2-4 pm). You might tell him you'd like to switch to a Zoloft/Remeron combo because the Paxil is making you too sleepy and you'd like to quit the Desipramine b/c its an old tricyclic drug with "fill in the blank" whatever side effects its causing.
If the Zoloft and/or Dexedrine are overstimulating & cause insomnia you could reduce the Remeron from 30 mg to 15 mg since Remeron is most sedating at lower doses.
Its hard to tell how to get doctors to give you a prescription. If he knows anything about your GHB or drug use history I seriously doubt he would give you any dexedrine, but I guess it never hurts to ask. To ask, I would make an offhand comment about the dexedrine last, after he has written the Zoloft/Remeron/Klonopin prescriptions & say that you've read that it has helped people improve both their confidence, outgoingness, & that also you have trouble concentrating sometimes anyways. Don't request or tell him to prescribe it, it is better to turn it into a question in order to feed their monstrous Dr. ego. Like "Do you think maybe Dexedrine might be a good idea because I read blah, blah, blah?"
Its always hard to tell what your going to come out of there with. But anyways I would recommend the following for the 1st month- Zoloft 100 mg/morning; Klonopin 1 mg/morning; Remeron 30 mg/bedtime. If you wait to ask for the Dexedrine in the second month (return visit) you would probably have a much better chance of getting it- doctors don't like to make too many medication changes at once. Also, you might not even need the Dexedrine after a month on Zoloft 100 mg.
poster:3 Beer Effect
thread:99534
URL: http://www.dr-bob.org/babble/20020322/msgs/99587.html