Starting sertraline for OCD - before Christmas, or wait until after?

[StrangeSenseOfCalm]

I've been prescribed Sertraline for OCD/emetophobia. I've been putting off taking it, mainly in case I have nausea as a side effect (although I've also been prescribed anti emetics as well) but also because I've just started a new type of therapy and don't know if I'm better to try the therapy first without having started the medication.

Is starting right before Christmas a stupid idea, as I've read I may well feel worse in the first few weeks? Or should I just go for it and stop making excuses?

Just coming back to this - did you do this yourself? Just wondering how likely I am to have increased side effects when I increase the dose?

@StrangeSenseOfCalm I'm off work until 2nd Jan which is amazing. I did (stupidly) brave Tesco near a Next store (so peak xmas shopping chaos) because I had a chiropractic appt in the area. I was in the car park for so long I thought I'd have to start eating the groceries.

Years ago I started a different antidepressant (full dose - didn't work up to it) and I recall feeling queasy for about two weeks and then I adjusted. I don't think I had the same side effects when I increased my dose. I came off them very very slowly, really tapered off bit by bit, and didn't really notice anything. So I'm hopeful that building up this time around will help.

I started a week ago today for depression. I haven't had any side effects and on my fifth day I felt really positive. I have SAD so always feel down in the dark Winter months

On my sixth day I felt rubbish again which was very disappointing as I thought I was beginning to turn a corner. I feel better again today though and went for an hour walk in the countryside too, the fresh air really helps me. My anxiety has lessened and my sleeping has very slightly improved. I was waking up at awful times and struggling to get back to sleep, the last two nights have been better

How are you doing today @dixon86 ? I’ve read that it often takes 3 weeks to see much improvement so I hope you don’t feel too disheartened that you felt rubbish on day 6.

Im on day 4 here. Unsure whether to up my dose to 25mg today. Feeling quite tired (although I slept ok last night) and spaced out today so don’t know if I should just stick to the quarter tablet for longer. Especially as tomorrow is Christmas Day!

I’ve taken 25mg tonight. Really hoping I feel ok tomorrow!

Well done on starting, OP.

I started Sertraline 50mg for OCD in July. It has been completely life changing for me. I saw a psychiatrist privately after the GP prescribed 50mg. She indicated she may have advised starting on a smaller dose to reduce side effects, but I was already 2 weeks in when I saw her. Honestly, the first 4 weeks were difficult. I had nausea, increased anxiety, insomnia, jitters. I noticed an improvement after 3 weeks and a noticeable change after 4. 12 weeks in and I felt like a different person.

My advice is to stick with it. The side effects are not nice but they are temporary. Have faith things will get better. Sending lots of positive vibes to you.

Thanks @jacquettalux So great to hear you are doing so well on them.

I hope that I won’t feel like this for 4 weeks but I’m trying to convince myself that learning to cope with the nausea is actually good for me (I have emetophobia so nausea completely freaks me out). It’s a hard sell though and I go through phases of wondering why on earth I’m putting myself through it. But hopefully long term it will have been the right thing to do.

I feel more hungover than anything. Nauseous, stomach unsettled, a bit wobbly and lightheaded.

Anywsy I’m off for a run now so kill or cure!

I'm on day 6 of taking 25 mg at night. Feeling less nauseous today so fingers crossed it's going in the right direction. Will keep going with 25 mg for another few days and then go up to 37.5 mg.

Oh and happy Christmas to you all! 🎄

Hey there :),

I've been on Sertraline for almost 4 years now, and it's honestly changed (if not saved) my life.

I went straight in at 50mg and the side effects weren't too bad.

One thing I would say is don't overthink how you feel. I made the mistake of reading up on potential side effects, and the internet made it sound horrific - which I'm sure for some people it is. But for me, it was nothing but positive. I was slightly dizzy for the first couple of days, and my stomach was a little upset - that's it.

If you're constantly looking for side effects, you'll have them.

Honestly, give this medicine a chance. It could be the best thing you ever do :).

Glad the nausea is feeling better - just in time for Christmas! I wondered about the 37.5 dose too or whether to go straight from 25 to 59. Feels like a big leap though so I think you have a good plan to do a middle dose.

Thanks for your post and it’s so good to read how much it has helped you. I’m really hoping it has the same impact on me (and then I’ll probably better myself for not starting it years ago!)

How are you doing @StrangeSenseOfCalm ? I've upped my dose to 37.5 my and all is going well - nausea has settled.

Hi there, glad the nausea has settled for you - what day are you on now? I’m on 25mg and today is day 3 of that dose. I’m doing ok, but had to laugh yesterday when I realised I’ve only actually taken 2.5 tablets so far!! Ah well, slow and steady wins the race, right?

I started last Friday night at bedtime so on it a week now. Hard to remember what day it is - it's the week between Xmas and New Year's where time stands still!

I'm really hopeful that I'll see an improvement in a few weeks.

Ah ok I think maybe we started on the same day then. I hadn’t realised it had been a week! It’s all a blur at this time of year!

Have you noticed any side effects like increase in anxiety or feeling jittery, which I have read other people experiencing?

Yes really hoping to start to feel better in a few weeks too, fingers crossed for us both.

As a side note, not sure if this affects everyone but for me if I don’t take a lot of water with a tablet or if I lay down to sleep after taking it, I get horrific heartburn. Absolutely terrible pain. So just a heads up to everyone!

My anxiety has been pretty high the past few months. I haven't noticed any increase over the last week but I think being off work is helping because I can keep things low key.

Really good advice! I'm the same with not laying down to sleep straight away but also can't take sertraline on an empty-ish stomach it seems so if it's been over four or so hours since i last ate I'll need to have a small snack

Yes it's good timing to have started the meds when you've got some time off work. Did you take the 25mg dose for a week before increasing? Fingers crossed I've been feeling ok on the 25mg for the last 4 days so don't know whether to keep on that for longer or just move up to 37.5.

Thanks for this! I've noticed that the tablet disintegrates really quickly in my mouth (maybe because I'm cutting it up) and it tastes disgusting if I don't swallow it quickly!

I planned on sticking with 25mg for a week but I felt I'd adjusted well after about 5 days (I think - still not sure what day it is!) so I upped it to 37.5 mg.

Haha I've started to write it down in my diary as I can't keep track either! Might increase to 37.5 today and see how it goes. I'm a bit annoyed with myself that I put off starting meds for so long due to my fear of nausea with them, and I've felt a lot better on them than I thought I would.

My teenage ds has moved up from 50 to 200mg for severe ocd. He had a little nausea but now is feeling fine. He is under the Maudsley and they said for ocd you often need to go much higher with the Sertraline. 50mg did absolutely nothing for him unfortunately.
How are you now OP? X

Thanks for your message. I didn’t realise that OCD might need a much higher dose. I’m still pootling along on a subtherapeutic dose of 25mg but plan to increase that today as I’ve been doing ok on that dose. It hasn’t made any difference to my OCD but I can’t really expect it to on such a low dose and only been taking it just over a week. Which feels frustrating but then I have to remind myself that I put off starting this for years so I can’t rush it now!