Sertraline help

[sunshine99789]

My husband has been on Sertraline for almost 6 weeks now. He started off on 50mg then on the advice of the GP increased to 100mg.

Having read various things online I'm aware this medication can take a while to kick in but my question is should he be feeling any better by now?

He is jittery all the time, has bad restless legs, palpitations, is sleeping in the day (very unlike him) is very depressed and can't seem to catch his breath, He is highly emotional (not usually) and has had suicidal thoughts although he says he has no intention of actually doing anything.

Booked in for a review the end of the week but it's breaking my heart to see him like this.

He is anxious about the amount of time he has had off work and is worried the GP will send him back to work. He can't even drive at the moment as he feels so bad so I would be very surprised if he got sent back to work.

Could this be the wrong medication for him? He is worse now than he was before he started the Sertraline

I guess it would take a few days to wean off and get it out of his system, but he isn't willing to stop taking it until he has seen the GP, despite how I'll it's making him.

He shouldn't stop taking it abruptly: the recommendation is to taper the dose over 4 weeks. He needs to see a doctor as soon as possible to get this under way. Only about 50% of patients get benefit from an individual antidepressant. He'll probably need to try a different one but he has to get the sertraline out of his system first, otherwise he'll be at risk of serotonin syndrome when starting the new drug.

He shouldn't really just be on an antidepressant anyway. Clinical guidelines say that medication should be combined with psychological interventions (e.g. cognitive behavioural therapy or interpersonal therapy). Obviously there are usually lengthy waiting lists for this, so the medication will be started while the patient waits to access psychotherapy, but he should have some indication that he will be referred for therapy if his condition doesn't resolve in the short term.

Just an update:

G.P took him off Sertraline and he is due to start mirtazapine tomorrow.

Not sure how I feel about this after reading reviews of drowsiness, weight gain etc. Then again, I would be willing to do anything at the moment to help him feel better

Hi sunshine hope things are going ok for you both after the change of meds. Sorry I didn't see your update sooner.

My DH is now on 30mg Mirt after trying many others and it suits him very well. Much less anxiety and is more himself than he was on Prozac, Cit etc although he is still depressed and unwell etc. He sleeps a lot but no weight gain or drowsiness unless he tries to get up too soon (ie before 7 hours, and better having 9). It is so much better for him than any other drug he has tried. I hope it suits your DH too.

Fingers crossed for you both

Try CBD oil. Google for info. CBD Brothers are a very good reputable company to biy from (a bit expensive)

CBD is very good for anxiety etc. Brain doesn't feel as foggy and I don't have such cluttered thoughts anymore. Honestly please look into it.

Sertraline can be very uncomfortable for around a week when starting it at around those dosages. It's rough but it passes.

Six weeks absolutely not ok to be feeling this way and it's particularly concerning that you feel things are worse now than before.

It doesn't sound like the right medication for him and feeling this bad and getting no better will be exhausting him and getting him down. Some meds just don't suit some people, it's trial and error really. Definitely there are others to try, SSRIs like citalopram and third generation group (different actions, different side effects, same aim), so really I think it's important that he talks to a professional and makes a change to try something else.

If at all possible I would try to see a psychiatrist rather than a GP, because a specialist understands properly how the medications work, how people can respond and has significantly more practical and thoughtful experience in prescribing and working with people dealing with these medications.

Oh sorry, I didn't see the update.

Mirtazapine is one of the third generation meds, it can be helpful because where SSRIs cause insomnia and disturbed sleep (which really doesn't help when already feeling bad), mirtazapine actually helps with sleep. Drowsiness is something you have to just be vigilant of and gauge what is safe and what is not. If he just sleeps at night and feels awake during the day, that's normal and good. If sleepy during the day, it's just about making safe decisions about driving, napping, extra sleep at night. Take it as it comes.

For weight gain, that tends to be due to craving massive amounts of food and wanting to eat all the time (fluid retention is possible so watch out for that, it looks and appears differently to fat). If that happens, just try to have the house clear or junk food and full of things that as healthy as possible. A broccoli binge and a chocolate binge are two very different things but satisfy the same urge to eat!

You're right about whatever it takes to have him feel better now. It's a balance and first priority is to get out of this really bad state, so he can start to function to bring in things that will lift his mood without medication. It's easy to say eat well, go out for a walk, get some exercise, do sports, self care blah blah blah but it's nearly impossible to do these things when feeling crushingly terrible. If meds lift that pressure just a little, then he can do just little by little things that will naturally help him up.

SSRIs are known to make depression worse in the initial stages of treatment but they're also known to trigger episodes of mania in people who've never previously been manic. I had a terrible time on Sertraline and I think he needs to get off them.