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NCFamilyDoc
NCFamilyDoc, Board Certified Physician
Category: Medical
Satisfied Customers: 58
Experience:  16 years of private practice in Family Medicine
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I have been diagnosed with Depression and have been prescribed

Customer Question

I have been diagnosed with Depression and have been prescribed Sertraline 50mg for 2 weeks and now my dose has been increased to 100mg, yet I still feel very depressed, when can I expect to see an improvement? my situation is such that I cannot switch off and go to sleep at night, strange thoughts about subjects I know nothing about and lack of interest, concentration and energy.
Submitted: 3 years ago.
Category: Medical
Expert:  NCFamilyDoc replied 3 years ago.

NCFamilyDoc :

Hello, I will try to help you this morning.

NCFamilyDoc :

Most people on anti-depressants don't feel any differently until 3 to 4 weeks on a "therapeutic" dose

Customer:

is this the strongest dose that you are able to take? is there anything additional I can do to help sleep better?

NCFamilyDoc :

There are also some "nerve" pills that can be added to the Zoloft to help you "switch off" your mind when it is time to go to sleep. Hypnotics, such as Zolpidem (generic for Ambien) or Benzodiazepines, such as Diazepam (Valium) or Alprazolam (Xanax) are often used temporarily until the anti-depressant kicks in

NCFamilyDoc :

No, Zoloft can be increased up to 200mg daily, but must be done under the care of your physician.

Customer:

is there a best time of the day to take this to get the better benefit? i.e. beginning or end of the day?

NCFamilyDoc :

Not really. Sertraline (Zoloft) is considered sleep neutral. It doesn't promote, nor inhibit sleep.

Customer:

would the strange thoughts be a side effect of the medication?

NCFamilyDoc :

I would suggest that your best bet is to "augment" with the Zolpidem (for sleep) or a Benzo for anxiety and/or sleep until the Zoloft kicks in.

Customer:

sort of a mania type of feeling

NCFamilyDoc :

Possibly

Customer:

Really appreciate your advice, I will speak to my doctor to see if he can help with the lack of sleep and anxiety

NCFamilyDoc :

If you are incorrectly diagnosed as unipolar depression instead of bipolar manic/depressive, then drugs such as Zoloft can tip you over into mania.

Customer:

what is the difference?

NCFamilyDoc :

Depression is always melancholic and "down". Manic/Depression (Bipolar) has swings of "highs" and "lows". Bipolar illness is much less common than depression and much more difficult to treat than depression. Bipolar illness comes along with hallucinations and unbelievalbe hours and hours of energy.

Customer:

thank you the advice has really helped.

NCFamilyDoc and 4 other Medical Specialists are ready to help you
Expert:  NCFamilyDoc replied 3 years ago.
It was a pleasure assisting you today. I wish you the best of luck in treating your illness.