Sertraline - finding the right dose

[Lovelyjubby78]

Hi there. I started sertraline about two weeks ago for anxiety related to constant miscarriages & ivf stress.
I was prescribed 50mg but did one week at 25mg where I felt fine , just dry mouth. After this first week I upped to 50mg. I feel awful this week - panic attack feelings, lethargic , heart palpitations etc I don’t suffer a lot of these even with my regular anxiety.
I do ivf in three weeks and wondering whether to revert back down to the 25 mg . Has anyone done this ? Is 25 mg enough to do anything ? Thanks for any advice

Hey :).

Everyone's different, but 50 i think is the lowest recommended dose for adults, only at 25 while it's introduced into your system. I can't say it won't do anything, but 25 is really very low, & lots of people need to move up from 50 to 100 and as far as 200 sometimes I believe.

I'd never pretend to be a doctor but I'd have thought that you'd need to get yourself onto the 50 you've been prescribed as soon as you can if you're hoping to see positive effects. You may even need to go higher. I'm on 50 and have been for almost 4 weeks, and I'm thinking that I might need to go up after this prescription.

It's a lot of trial and error when it comes to which medication and then which dosage of that medication.

But what I can tell you is that by being open minded about changing meds and doses, and being honest with your GP about how you're feeling, you WILL be able to make a positive difference.

FWIW my first couple of weeks were a bit rough with side effects, but I feel nothing from them now, 4 weeks in. So anything like that does usually subside!

@LindaEllen thanks so much for taking time out to respond , I really appreciate it. I was up at 2am after a horrendous nightmare and I woke up and my whole body ached(even my teeth!) had to take paracetamol for banging headache. Was up a good hour and have woken up over hour before my alarm with another headache. This is supposed to be my good week ( suffer pms ) so worried how bad my sleep and symptoms will be as I get closer to period.
I’m week 2 but this is only my 1st week at the higher 50 dose . How much longer do you think the symptoms should last? Two more weeks?

[quote Lovelyjubbly78]@LindaEllen thanks so much for taking time out to respond , I really appreciate it. I was up at 2am after a horrendous nightmare and I woke up and my whole body ached(even my teeth!) had to take paracetamol for banging headache. Was up a good hour and have woken up over hour before my alarm with another headache. This is supposed to be my good week ( suffer pms ) so worried how bad my sleep and symptoms will be as I get closer to period.
I’m week 2 but this is only my 1st week at the higher 50 dose . How much longer do you think the symptoms should last? Two more weeks?[/quote]
Sorry you've had a tough night :(. The problem is everyone's different, so for me I was 100% side effect free after 2 weeks, but then my side effects weren't as bad as yours sound.

Another problem is that the medication won't suit everyone. So it's about giving it a chance to settle while having that balance of knowing where to draw the line and asking the GP for something else.

I always say if the side effects are bearable try and hold on for at least two weeks. But if it's no better - or if you can't cope with them - give the GP a call and see what they suggest :).

It can be such a rough drug to start with. I was lucky it settled and I hope it does for you too, but if in doubt phone your GP. There's so much else you can try that there's no point struggling unbearably if there's something else you could look at! :)

Thanks Linda , the issue is this is the main one which is safe for ivf , pregnancy etc so there isn’t too much else on offer . I hope it gets better

Hi @Lovelyjubby78 sorry to hear you've had a rough time with the side effects, it's definitely a common theme on here. I'm also taking sertraline and a few days ago upped to 100mg. Started on 25mg but only for a week before going up to 50mg. Agree with what @LindaEllen says re just getting to the prescribed dose asap - you're going to experience side effects regardless and may as well just get it over and done with! That's my opinion anyway. I actually noticed more effects just starting the 25, increasing was nowhere near as difficult. Hang in there x

@abitfunny thanks for your comments . I’ve continued with 50 thanks to the advice here. I felt ok on 25 for a week but got the bad side effects moving to 50. Shows how different people react differently! I’m going to keep going. I’m about to start my pms two week crazy time ( I hope it’s not super awful with this on top !)

@Lovelyjubby78 - make sure you're being extra kind to yourself. Early nights, healthy hearty breakfasts, plenty of fresh air. X