Anyone who was on sertraline and it didn't work , what did you try next ?

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My dd is 20 and has been on 200 mg on sertraline for a while and it's making her so drowsy that we are currently weaning off to try something else .

She has high functioning autism , anxiety and depression if that relevant ..

The Gp literally asked me which one we wanted to try next !!

We have tried fluoxetine already which did nothing

Should your GP not be referring your DD to a psychiatrist if they are unsure on the best treatment? Citalopram is another medication commonly used but I, not sure if this would be suitable?
How long have they been on 200mg of Sertraline? Was it upped to that dose as the lower dose wasn’t working? It is hard to find the sweet spot, between side effects and helping sometimes. Can take a while for the fatigue to reduce.

I'm on Duloxetine, have tried all the others - currently on 90mg but think it still needs increasing. It's hard finding the right one.

Mirtazapine or venlafaxine seem to be the next port of call with many psychiatrists but it will depend - I'm not impressed they're just asking you.

My daughter swapped to flurexotine which helped her more than setraline.

It takes time to find the right medication and the right dose.
Good luck

Is there any talking therapy available? Is it possible for her environment to be adapted to help reduce her worries? Not as an alternative to meds necessarily but in addition if you have tried some and not helping?

My DH was on 200mg sertraline but has now dropped to 150 and he definitely seems to be less drowsy. Might be worth a try ?

She is at uni and doing'ok'. We have had loads of therapy and cbt etc and she is better but not great .

I find the nhs useless in this scenario and they are seemingly led by our requests rather than making decisions for us .

We worked up to the max dose gradually and she has been in it for 2 years I think but is spending days in bed and not going to lectures so not ideal .

We have done alot privately for her with therapy etc and getting a diagnosis for asd but we need to try a different medication . I know everyone's physiology is different but you never know if someone on Mumsnet may have a Similar situation .

She needs psychiatry input although the wait lists are typically very long

She needs the diagnosis of depression reviewing if maximum dose isn’t helping. There may be an alternative diagnosis or therapy that is more appropriate.

If forced to trial an alternative antidepressant because secondary care cannot be accessed then venlafaxine might be an option but in some areas cannot be initiated in primary care. Mirtazepine will make her more drowsy (mitigated a bit but not totally by taking it at night) but also causes weight gain so not ideal for young women.

She might benefit from one of the more activating antidepressants. My psychiatrist called venlaflaxine "rocket fuel" and only allowed me to try in a hospital setting as I have a long history of mania in response to antidepressants. I only took it for a week as we switched to lithium.

For some people a mood stabiliser can be preferable to an antidepressants. I'm bipolar and have taken quetiapine as a mood stabiliser for 12 years most of this time as a mono therapy. It works for me as an antidepressant as well as antimanic. Lamotrigine is usually the mood stabiliser I see used first if you wanted too look into something different but quetiapine and olanzapine are two antipsychotic that are also used for mood stabilising properties. These are both sedating so I would start by reading about lamotrigine.

The biggest priority for me would be pushing for a medication review by a psychiatrist. I have seen some dodge prescribing from GPs!

I’ve always been expected to research and suggest my own MH meds, it annoys me. GP and even psychiatrist doesn’t know what to do if I don’t suggest, including the dosage!

Venaflaxine has been the best for me, but it’s trial and error.

I can’t add much more to what others have said, I agree with the sentiments. In any other area of health, if a GP did not know what medication to prescribe they would do some research (including speaking to a specialist). And if they still aren’t confident in their prescribing then a referral should be made.

(Note, I don’t mean that they are confident the drug will work, as sadly I do think it’s mostly trial and error, but at least psychiatrists have the experience of previous trials and errors!)

My daughter has asd and anxiety and has recently changed from Sertraline to ecitalopram which has taken away some of the more unwelcome effects aka escalation of suicidal ideation and even more anxiety.

@whydoesitalwayshappentome this is helpful thank you and the sort of anecdote I was looking for .

I think I will ask for this one too as I've heard girls with similar issues have taken it and had good results

Ref the GP .. I guess it's a compliment she thinks I'm smart enough to make an informed choice but I find it hard to believe she would all her patients which tablets they would like ! 🙄

My ds is on escitalopram, max dose of 20mg, with minimum side effects (manageable tiredness). For severe ocd. Def calmed him down and taken the edge off.