Posted by bleauberry on November 30, 2009, at 18:34:45
In reply to Re: Combining SJW with Zoloft or other antidepressants » bleauberry, posted by morganator on November 29, 2009, at 15:38:03
> Bleauberry, If I want to try combining a low dose of SJW with Zoloft, do you think it would be wise to lower the dose of Zoloft?
>
> I really feel like I should just stop taking Zoloft if 200mgs doesn't give me what I need and start trying SJW. It's either that or switch to Prozac, which I had success with in the past.Yikes, that's a tough decision. If I were in your shoes, that would be a difficult decision for me. There are pros and cons either way. Potential benefits and potential risks either way. And unknowns both ways.
Well, let's see, let me logic this out. First of all, switching any SSRI is no picnic. Hard as hell. So right off the bat, I would say stay on Zoloft. My next decision would be, do I lower the dose? I would probably say yes, but by how much, 25mg or 50mg? Longer term as SJW kicks in, 100mg?
Either way, I know there is going to be some weirdness for a couple weeks after doing that. So if I start the SJW in that timeframe, I really won't know what the weirdness is coming from...the lowered Zoloft or the added SJW. How much SJW to add? That's easy. No more than 75mg for at least 4 days. Then add 75mg once every 4 to 7 days as tolerated, as the gut intuition directs, with a top ceiling of 450mg. After being at 450mg for at least 2 weeks, it could be increased by 75mg increments to a top ceiling of 600mg.
But that's just me. I am cautious and methodical. Someone else might do it different, but likely experience potential for a lot more complications than me. Complications that could have been avoided by not getting greedy or going too fast.
We are after all playing with the brain here.
On the other hand, if Prozac was better, well, it would be nice to see if it still can do it again...sometimes it doesn't a second time around, sometimes it does. Either way, add SJW to it in the same manner described above. The downfall with this approach is that it would take a lot more time and have a lot more complications. Switching like that aint easy. I mean, you could do a straight across switch with maybe just two days of washout, but still, there would be a lot of weirdness...Zoloft withdrawals mixed with Prozac startups all in a dizzying confusion.
Another more mainstreet approach that has an excellent track record would be to add Nortriptyline to Zoloft. Nortriptyline doses needed for that can be as low as 10mg, but usually in the 25mg to 75mg range, still far below the high doses used as monotherapy. Zoloft and Nortriptyline is almost as good, and sometimes better, than the MAOIs.
poster:bleauberry
thread:927373
URL: http://www.dr-bob.org/babble/20091127/msgs/927598.html