![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Geno on April 24, 2002, at 16:28:10
Hi 3 beers,
I want to give you an update. Iv been on zoloft for 2 weeks now. Im at 50mg for a week. Im not seeing any mood improvement. A bit lower anxiety. Should i up it to 75mg? I also was able to cut my xanax dose in the am to .25. Then at noon, i take .5mg of klonopin. Sometimes feel edgy, but i suspect and im asking you, if i bump up the dose to 75mg i should take 1mg to coutneract the anxiety?ALso on the qt, remember you said zoloft and alcohol dont mix. Well i did some g and wow, i passed out quicker. How come zoloft intacts with alcohol/g so bad>
geno
Posted by 3 Beer Effect on April 25, 2002, at 14:18:59
In reply to UPDATE{{{{ 3 BEERS, posted by Geno on April 24, 2002, at 16:28:10
I never took 75 mgs but my sister did and it worked well. 75mg can be a pain because you have to cut in half a 100 mg pill and a 50 mg pill- unfortunately Pfizer doesn't make a 75 mg Zoloft pill.
When I took 50 mg for 2 months it didn't result in any mood or social phobia improvement. Whenever I took it, it would knock me out kind of like Remeron for hours at a time & I would wake up feeling woozy.
I then quit the Zoloft for a few months. Eventually a few months later I started on 100 mgs Zoloft and it took 3-4 weeks but wow, it was the best anti-depressant I have ever taken (& i've tried almost all of them except Prozac & Paxil). It felt like I had just drank 2 beers 24 hours a day, which I think is the greatest feeling in the world next to the 3 beer effect 24 hours a day of course. It was a great social disinhibitor, I could talk to attractive girls without alcohol for the first time, & could talk or initiate conversations with total strangers- I live in Texas so people here & in the rest of the Southern States (except non-panhandle Florida) are pretty friendly & talking to strangers doesn't bother them, but I suspect strangers wouldn't want to talk to you if you lived in Southern California or the Northeast. But after a few months I think I had a Zoloft induced manic switch, which is relatively rare I think, like 2.4%. I couldn't sleep at all every night but was not taking any medications for sleep/anxiety. Looking back I probably should have taken 75 mgs for a few months first.
But if your not Bipolar or ADD, then you should do well on either 75 or 100 mgs. It is probably better to try 75 mg first, & if that doesn't work well enough then go to 100 mg- if the side effects are too bad you can always cut back.
Some people take up to 200 mg- everyone is different in how they respond, but both Zoloft and Prozac are universally considered the "activating" SSRIs.3 Beers....................................
Posted by Geno on April 25, 2002, at 15:59:24
In reply to Zoloft 50, 75, or 100mgs social phobia/depressio, posted by 3 Beer Effect on April 25, 2002, at 14:18:59
3 beers, ya 50mg is like, mm somedays it makes me anxious, uless i take a xanax with it. i suspect ill def need .5mg of xanax or 1mg of klonopin when i make the 75mg jump. Ya i still do some ghb, due to the fact the zoloft hasnt did squat, maybe worsen my mood. or flat mood.
how does zoloft interact with depressants such as ghb and alcohol. You stated if you drank a few beers and took zoloft you black out. well iv been passing out quick after doing just a little too much g. ANd my benzo mix isnt much, like .5mg of klonopin.
If zoloft is activating, it should couteract a depressant, not make you pass out quicker.Unless the zoloft is really making me drowsy , not activatiing dopamine at this dose. maybe at 100mg the dopamine activity will kick in. thus someome drinkinng a few beers or taking g, would not pass out so quick. Iv used welbutrin and g. WOW, id do 3x my g dose just to calm down. The dopamine rebound was horrible. I was hearing shit, seeing shit. So i stopped welbutrin.
Iv taking ambien with g, and fell asleep on my computer every night. my head would smaash of the keyboard.
remeron with g, well not that quick, but id pass out in such a vivid dream like iv been sleeping for days and the dream was so real. id wake up thinking i was still in the dream. scary.
iv drank 3 beers with g, while taking benzos and remeron, and ending up int er. BAD MIX
So ok, i dong drink anymore. Im going to up my zoloft to 75mg tommorrow in the am, and take only .5mg of klonopin. If im very anxious, ill have to take 1mg of klonopin the next day, until my body gets used to the zoloft, then drop the klonopin back down, if i decide to.
See here is where i get mad. After a hard days work, i come home. I live in the northeast, depressing, no girlfriend, and at night, i take g to relax and become more social. well lately, iv been ging out quick. I suspect its from the remeron.zoloft mixture. Maybe if i up my zoloft, and up my remeron, and up my xanax, i wont need g, if i get the mood lift, socialability i want.
3 beers respond. No negativity from others.
geno
Posted by 3 Beer Effect on April 26, 2002, at 0:16:20
In reply to Re: Zoloft 50, 75, or 100mgs social phobia/depressio, posted by Geno on April 25, 2002, at 15:59:24
geno,
even after a few months on Zoloft 100 mg, the Zoloft still potentiated alcohol alot even though it was very activating for me to the point of insomnia/mania.
Usually I only blacked out if I drank vodka w/ orange juice, but with Zoloft 2 or 3 beers & I was already wasted and acting like an idiot. Zoloft cut in half the amount of alcohol needed to make you drunk, in other words 3 beers on Zoloft were equivalent to 6 when I was on no medication. People said I would get drunk and would not be able to put any coherent sentences together & act totally dissasociated and weird-almost like I was under anasthesia but still walking around. I ended up getting arrested for DUI (I had a blood alcohol of only .05 but had between 35-50 mgs of Xanax I bought from Thailand in my system- I got thrown out of jail and taken to the hospital because I was so messed up. A few weeks later on Sept. 11 I got extremely drunk & for fun I threw a pool (billiard) ball off of a roof of a house at passing traffic on a busy street & I guess I have good aim because the pool ball busted right through the winshield of a Ford f-250 4x4 that unfortunately for me, some big 300 lb good ole boy from West Texas was driving! He proceeded to pummell me & I was knocked unconscious and went to the ER, where they found out my blood alcohol was 0.30 2 hours after I had gotten beaten up meaning I was probably hovering around 0.32-0.35 a few hours before- most people go into a coma at 0.40. Of course I don't really remember these things because I was blacked out at the time. I never again drank Alcohol or took Zoloft after that!They (my psychiatrist) thought from the above "drug induced mania" meant that I was bipolar II but that ended up being wrong since I never had mania when not taking anything or when drinking alcohol by itself & have no family history of mania. So it turns out I just have major depression w/ social phobia (that I self-medicated by binge drinking) & also ADD.
So I guess the moral is that alcohol & Zoloft potentiate each other, & so binge drinking alcohol & while on Zoloft is a disastrous combination. I've also heard that when you get drunk on the weekends while taking an SSRI that since alcohol is a depressant you often go back to square one depression so all the effects of the SSRI (Zoloft) therapy are negated & that this is the real reason, along with liability issues, that the SSRIs all say not to drink alcohol in the PDR. Since GHB has somewhat similar social disinhibition and depressant/sleep inducing qualities to alcohol (except for the dopamine rebound) I am guessing GHB & Zoloft would probably potentiate each other in a similar way to Zoloft & Alcohol. It is possible that you might fall asleep & never wake up. From stories i've heard, GHB is even more disinhibiting (provided you don't fall asleep/pass out) than alcohol & i'm guessing with an effective dose of Zoloft (75-100 mgs) you will probably end up doing something stupid & end up in jail or the hospital like I did. Remember that Zoloft usually takes about 3-4 weeks to work, with optimal response at 3 months so just because GHB & Zoloft don't combine effects at first, doesn't mean they won't interact in a big way a month from now. Also, Remeron & especially the benzos you take are also potentiating GHBs CNS depressant effects which could result in an accidental overdose. I wouldn't ever take Remeron, Klonopin, Xanax or other benzos before you take GHB ever.
How much Remeron are you taking? I've tried all the higher doses (45 & 60mg) and they all made me feel like crapola & unable to study or even get out of bed in the morning- I think its the way too strong antihistamine effect that Remeron has that lasts all night & most of the day. It's too bad because if Remeron had no anti-histamine effects it would be the perfect antidepressant with no side effects whatsoever except for weight gain. Last night I couldn't sleep, even after taking Sonata 10 mg so I took a 15 mg Remeron & felt terrible all day the next day- I even took 20 mgs of Dexedrine in the morning & 20 mg at 2 pm & that was not even powerful enough to overcome the crappy "took way too many benadryl" Remeron feeling. But many people get relief from Remeron so I may just be different. Remeron does block the bad serotonin receptors that Zoloft increases causing insomnia, sexual side effects, & nausea but leaves the anti-depressant, anti-anxiety 5-HTI & other good serotonin receptor increases intact. So evaluate how you feel with the Zoloft/Remeron combo- it might be a good idea to keep a log book/diary of how you feel each day or week to show your doctor.
My best advice, besides getting off the GHB, is that you should take some time to read through psychiatry studies/journals/ & books to find exactly how GHB works. Don't read the advice of some random internet site written by a some raver kid with no medical background, look for real medical studies. By knowing the exact psychopharmacology & proper dosing of GHB you might prevent a fatal overdose for you or someone you care about- like friends that may take GHB & combine it with alcohol or whatever is available without knowing the possibly fatal outcome of such a combination. You might try to find reputable GHB studies at PubMed which is at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi
Hopefully, after enough study, you might even realize that you don't like GHB anymore & are sick of it and then give Zoloft 75-100 mgs w/ daytime Klonopin the adequate trial (3 months) it deserves.
Unfortunately for me, I can't take Zoloft but I've found 1 mg of Klonopin at breakfast & 1 mg of Klonopin at lunch works good for both social phobia & general anxiety without much in the way of side effects or sleepiness. Klonopin is supposed to be the best social phobia medication, & although personally I think Zoloft is a better social phobia medication, the combination of these two socialbilizing medications should work great. Also benzos (like alcohol) selectively increase the ability of GABA-A (the good GABA) to bind to its receptor in the brain. GHB may act in a similar fashion by greatly increasing the amount of GABA available for use by the brain's GABA receptors but I think it may be nonselective in that it also increases GABA-B which is the "bad" GABA- that is why the medication Gabitril has not been a successful substitute for Benzos- it is not selective for GABA-A & so causes bizarre side effects stemming from GABA-B potentiation.
A good way to quit GHB might be to titrate your doses downward & then, like people who quit smoking, you will be less likely to relapse than if you quit cold turkey. Also, when alcoholic man or lab animals increase the level of serotonin via SSRIs, their usage of alcohol often drops dramatically (but of course the SSRIs take about a month to increase your serotonin to adequate levels). I don't know if GHBer man or lab animals decrease their GHB intake when their serotonin level rises but there may have been studies done on this.
If you find you are unable to titrate you might have to either go to rehab or use the 'method of substitution' to decrease your desire for GHB, similar to the way heroin addicts get off heroin via methadone. For a substitute you might do some research on the old muscle relaxant Baclofen (brand name Lioresal) that is like GHB in that it is an analogue of GABA & crosses the blood brain barrier (like GHB) to a certain extent. I don't know if GHB causes drunken-like discoordination but Baclofen will at the higher end of the dose range but without excessive sedation. Soma is much weaker & probaly wouldn't work for you as a GHB substitue, but oddly enough it is the main abused drug in this class (muscle relaxants). Neither are scheduled controlled medications in the US although they require a doctor's prescription. Gabitril is a GABA analogue that crosses the blood brain barrier but does cause weird side effects such as depersonalization in some.
Also see my post "2 ways of curing depressant addiction."
3 Beers--------
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.