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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Tammy on March 25, 2000, at 1:59:51
I have just been put on zoloft at 50mg. by my doctor after losing my full term baby boy on September 30, 1999. I was so stuck in my grief that I was having panic attacks and heart palpitations over the slightest little things. Everything became an obsession to me. I have 2 other small boys to care for. (ages 5 & 2) It has helped me so much already. The side effect of appetite loss wore off after 1 1/2 weeks though (darn - a side effect I actually liked!) I can sometimes feel as though the pill is wearing off. I take it in the morning and the panic attacks and heart palpitations seem to start coming again around 4-5pm. Do you think I need a higher dose...or does it take more than 3 weeks to get full effect. (My doctor is on vacation right now...or I would call him.) Also what is the dose that most people take of this. And in treating grief, I am wondering how long I should stay on it. I know the pill can't take away the pain of losing my son, but it has made me able to handle my depression over it much more effectively. So for that I am grateful. It made me feel normal for the first time in months. Any information anyone can tell me about it would be greatly appreciated. (forgive me for rambling...I guess that other side effect...insomnia has set in!)
Tammy
Posted by Cam W. on March 25, 2000, at 11:44:46
In reply to new here: ? about zoloft 4 grief depression, posted by Tammy on March 25, 2000, at 1:59:51
Tammy - I am very sorry to hear about your loss. I can personally relate to your situation. We have lost 2 children, one at 15 weeks and one at 31 weeks (stillborn, although everything was going very well until that point). At the time of the loss of our son, Perry, (Oct./93) I thought I had to 'be strong' and run the family while my wife did her grieving. Boy, was I wrong! By the spring of 1994 I had developed a very deep depression. I was put on Zoloft for 8 months and my depression seemed to resolve. About a year later I had a relapse and the Zoloft made me very sick to my stomach. I was switched to Paxil and it seemed to help with my depression and anxiety. I stayed on Paxil about a year and my depression was in remission. Two years ago, my postion at Mental Health Services began to become too hard (too much work, too fast) and a therapist dragged me in to one of the psychiatrists' office. After that I was put on Wellbutrin and I have never felt better. Lots of energy, few depressive episodes and a generally good outlook on life. I did notice that nearly all of the psychiatrists were watching me (paranoia?) more closely for the first little while and asking how I was feeling. These guys are great.Sorry for the diversion, I really haven't let that off of my chest to that extent in 'public' before.
Back to your questions, Tammy. the 50mg of Zoloft is a low to medium dose. Yes, I would call your doctor or the one covering for him. You might benefit from a increase in the Zoloft, as panic disorder does seem to respond to higher doses of SSRIs (don't increase the dose on your own). If the Zoloft doesn't seem to be working after the increase in dosage (after an adequate 4 week trial), your doctor may decide to try Paxil, as it has some anti-anxiety properties, as well as antidepressant properties. Doses of Paxil in concomittant depression and panic disorder usually range from 30mg to 40mg per day.
A question for you. When are you taking the Zoloft? If you are taking it with supper or bedimte (Zoloft should be taken with a full meal to increase it's effectiveness) and the effect wears off at 4:00 pm, then switch the dosing to breakfast or lunch. Then if the drug wears off, it does so while you sleep. I still do think a dosage increase is due because of the insomnia.
Please try this strategy and also call the doctor on call and tell him. Hell, if it was me I'd call the vacationing doctor even if he was in Calcutta, but this depends on how close of a relationship you have with your doctor. Good luck and give your boys a hug for me.
By the way, my wife now facilitates at perinatal loss group and I think she would like to post to you as well. Sincerely - Cam W.
Posted by Patti-Cam's wife on March 25, 2000, at 11:57:09
In reply to Re: new here: ? about zoloft 4 grief depression, posted by Cam W. on March 25, 2000, at 11:44:46
Tammy I am so sorry about your son. Cam has told you our history. I do now facilitate a pregnancy loss support group. I must run now, I'm sorry, but I will be back later today. We will be checking the board later today and tomorrow. If there is *anything* I can do ,or you want to chat about please let me know. Patti W.
Posted by bob on March 26, 2000, at 3:27:32
In reply to Re: new here: ? about zoloft 4 grief depression, posted by Patti-Cam's wife on March 25, 2000, at 11:57:09
Hi Tammy,
Zoloft was the first med I was ever on. It took me close to two months to settle into a "stable" response from it.
That doesn't mean I had no response -- besides, you've mentioned that you've already had some promising results from it. What it does mean is that, for me, the first six weeks were a roller coaster. One week I'd be high as a kite, the next week it'd be crash and burn time.
It's good to hear that you aren't having quite the same extremes of reaction to it!
I started at 50mg/day and, after a few weeks, my doc did move me up to 100mg/day ... and that's where I stayed for the next six months or so. So, like Cam said, don't be shy about calling your doc RIGHT NOW and seeing if you can leave a message for him. My pdoc is always going away for a week or so every month or two, and he always responds to patients that leave him a message with his service. If you need more medicine, your doc can always call in the prescription for you, too.
As for when to go off -- that's really a question that needs to be answered by a doctor who (1) knows you well and (2) knows the medication well. One of the potentially worst things you can do is stop your meds too soon because you've been feeling fine for a month or so.
My first time on zoloft, my GP was doing the prescribing. He knew me pretty well, but he really didn't have the knowledge that my pdoc has about zoloft. I had been doing pretty well on zoloft for three or four months when my GP suggested that enough was enough. I was all too happy (and not just from a manic response to the zoloft) to oblige -- I really didn't want to be on a psychotropic medication, anyway. My mood started to crash a few weeks after discontinuing the zoloft, and six weeks after stopping I was worse than I was when I had started. Kinda like Cam's lack of response the second time around, I have never responded adequately to zoloft or any SSRI, for that matter, since. My reaction the second and third trial I had of zoloft was so different from the first, you would have thought they were two different meds.
The point of my story is that my general practitioner meant well but he didn't have the expertise to evaluate my mental disorder and thereby gauge how long I should have stayed on zoloft that first time around. When I finally did start seeing my psychiatrist, I asked him about this issue. He said he would have kept me on it for at least a year ... and that was still early on in our relationship. Given what he has learned about my depression and panic disorders and how he (medically) treats me now, I doubt he would have thought stopping was a reasonable thing to do even now.
Don't be in a rush to get off medication. There used to be this huge sign painted on the side of a building at 72nd and Broadway here in NYC -- Depression is a flaw in chemistry, not in character. Staying on zoloft past the time when you begin to feel "normal" again doesn't mean you're any less of a person for it.
best wishes,
bob
Posted by Tammy on March 29, 2000, at 15:52:13
In reply to Re: new here: ? about zoloft 4 grief depression, posted by Cam W. on March 25, 2000, at 11:44:46
>
> Tammy - I am very sorry to hear about your loss. I can personally relate to your situation. We have lost 2 children, one at 15 weeks and one at 31 weeks (stillborn, although everything was going very well until that point). At the time of the loss of our son, Perry, (Oct./93) I thought I had to 'be strong' and run the family while my wife did her grieving. Boy, was I wrong! By the spring of 1994 I had developed a very deep depression. I was put on Zoloft for 8 months and my depression seemed to resolve. About a year later I had a relapse and the Zoloft made me very sick to my stomach. I was switched to Paxil and it seemed to help with my depression and anxiety. I stayed on Paxil about a year and my depression was in remission. Two years ago, my postion at Mental Health Services began to become too hard (too much work, too fast) and a therapist dragged me in to one of the psychiatrists' office. After that I was put on Wellbutrin and I have never felt better. Lots of energy, few depressive episodes and a generally good outlook on life. I did notice that nearly all of the psychiatrists were watching me (paranoia?) more closely for the first little while and asking how I was feeling. These guys are great.
>
> Sorry for the diversion, I really haven't let that off of my chest to that extent in 'public' before.
>
> Back to your questions, Tammy. the 50mg of Zoloft is a low to medium dose. Yes, I would call your doctor or the one covering for him. You might benefit from a increase in the Zoloft, as panic disorder does seem to respond to higher doses of SSRIs (don't increase the dose on your own). If the Zoloft doesn't seem to be working after the increase in dosage (after an adequate 4 week trial), your doctor may decide to try Paxil, as it has some anti-anxiety properties, as well as antidepressant properties. Doses of Paxil in concomittant depression and panic disorder usually range from 30mg to 40mg per day.
>
> A question for you. When are you taking the Zoloft? If you are taking it with supper or bedimte (Zoloft should be taken with a full meal to increase it's effectiveness) and the effect wears off at 4:00 pm, then switch the dosing to breakfast or lunch. Then if the drug wears off, it does so while you sleep. I still do think a dosage increase is due because of the insomnia.
>
I waited till my doctor got back from vacation today and I called him and he put me on 100 mg. So I am happy about that. I didn't want to do it on my own. He was happy that it was helping me so much. And he was happy to up the dosage for me. I am sorry that you and your wife have also experienced this loss. Twice even. It really is the pits. I thank you for your very informative answer. ANd I am glad I enabled you to kind of spill your guts as well! We all need to do that...and I am happy to listen. I was taking the zoloft with my breakfast and it was wearing off by 4 pm., so I defintely think I needed a higher
dose. It is impossible to get over losing a child...but we need to get through it somehow.
Hugs,
Tammy
Posted by Tammy on March 29, 2000, at 16:00:25
In reply to Re: new here: ? about zoloft 4 grief depression, posted by Patti-Cam's wife on March 25, 2000, at 11:57:09
> Tammy I am so sorry about your son. Cam has told you our history. I do now facilitate a pregnancy loss support group. I must run now, I'm sorry, but I will be back later today. We will be checking the board later today and tomorrow. If there is *anything* I can do ,or you want to chat about please let me know. Patti W.
Thank you both for your kind support. I used to facilitate a sibling support group. My brother died in 1990 of a self inflicted gun wound to the head. I thought that was hard, but this is harder. How long has it been for you and Cam? I hope to do something like you are within my church one day down the line. I need to wade through much more of this before I do. It is just so tough.
Luv,
tammy
Posted by Tammy on March 29, 2000, at 16:04:44
In reply to Re: new here: ? about zoloft 4 grief depression, posted by bob on March 26, 2000, at 3:27:32
>
> Don't be in a rush to get off medication. There used to be this huge sign painted on the side of a building at 72nd and Broadway here in NYC -- Depression is a flaw in chemistry, not in character. Staying on zoloft past the time when you begin to feel "normal" again doesn't mean you're any less of a person for it.
>Thanks for the information. I love the quote! I needed to hear all of this stuff from people who actually take the stuff...not things you just read. That was a great letter.
Hugs,
Tammy
Posted by Patti W on March 29, 2000, at 21:01:40
In reply to Re: new here: ? about zoloft 4 grief depression, posted by Tammy on March 29, 2000, at 16:00:25
Tammy, I think you are right, this is one of the toughest types of grief to go thru. In life, you are not supposed to bury your children!
We lost our first baby in Nov of '92. Then we lost our son in Oct of '93.
I have been with the support group (Parent Care) since Jan of '94. And been a facilitator since Sept of '96.
The group helps with my own healing, and hopefully I then in return can help others.
I'm giving you a big hug.If you ever want to chat, please just let me know. I also know of some lovely books if ever you are interested.
Give your boys a hug from Cam and myself, and we'll have a little thought about Tanner.
Patti
This is the end of the thread.
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