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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by NewQuestions on March 5, 2009, at 14:12:22
After 8 years on zoloft, I experienced poop out (meaning the drug lost some of its effectiveness and I experienced other side effects like fatigue and brain fog). I also noticed that my liver enzyme ALT spiked around the same time. Coincidence?
Posted by bleauberry on March 5, 2009, at 17:33:28
In reply to Liver Enzymes and Poop out, posted by NewQuestions on March 5, 2009, at 14:12:22
All I know about this topic is that with longterm use zoloft triggers its own metabolism and that higher doses are needed to compensate.
Posted by NewQuestions on March 6, 2009, at 8:30:25
In reply to Re: Liver Enzymes and Poop out, posted by bleauberry on March 5, 2009, at 17:33:28
Can you explain by triggers its own metabolism?
Posted by bleauberry on March 7, 2009, at 18:47:09
In reply to Re: Liver Enzymes and Poop out, posted by NewQuestions on March 6, 2009, at 8:30:25
> Can you explain by triggers its own metabolism?
Well actually, scientifically, no I can't. I am not scientifically schooled like some folks here, and I did not get thoroughly engulfed in that particular topic of Zoloft, only that I have read about it three different times from three different sources, one of them being pubmed.
I do not know whether Zoloft increases activity of the liver enzyme that metabolizes it? That might be what happens.
Here's the pattern:
Someone has been on Zoloft 50mg for a month.
They now take a blood level and record it.
They stay on 50mg for year.
After the year they take another blood level.
The new blood level is lower than the one a year earlier, even though the dose didn't change.
A higher dose, maybe 75mg for example, is now needed to get the same blood level they used to get from 50mg.Hopefully SLS or Larry Hoover will pop in with an answer. If not, re-ask this question in a new post directed at them. They are more expert at this scientific stuff than I am.
You could also go to pubmed.com and do some creative searches there. Maybe keywords like "zoloft dosage creep"; "zoloft creep"; "zoloft blood level"; "zoloft serum"; stuff like that. You'll have to look through a lot of abstracts to find the ones you are looking for, but they are there.
Posted by Larry Hoover on March 8, 2009, at 7:26:54
In reply to Liver Enzymes and Poop out, posted by NewQuestions on March 5, 2009, at 14:12:22
> After 8 years on zoloft, I experienced poop out (meaning the drug lost some of its effectiveness and I experienced other side effects like fatigue and brain fog). I also noticed that my liver enzyme ALT spiked around the same time. Coincidence?
Yes, I'd assume that to be a coincidence. I've never heard of poop out being related to changes in gross liver function.
Lar
Posted by Larry Hoover on March 8, 2009, at 7:31:49
In reply to Re: Liver Enzymes and Poop out » NewQuestions, posted by bleauberry on March 7, 2009, at 18:47:09
I just did a quick search, and didn't get any hits using the word creep. Plasma concentration gave me some long-term data that did not indicate any changes in trough concentration or AUC, so induction is not commonplace. That said, there was some rodent work that indicated that sertraline first inhibited, but later induced, the function of enzymes in the CYP2 superfamily. So, it's possible that individuals do face this enhanced metabolic rate effect from sertraline induction, but I'd call that an idiosyncratic reaction because of its apparent rarity.
Lar
This is the end of the thread.
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