Posted by Hordak on April 19, 2018, at 17:46:03
In reply to Re: Sertraline is making me 'numb' and indifferent. » Hordak, posted by SLS on April 19, 2018, at 9:10:48
> > > > > > I am suffering from Dystymia and SAD
> > > > >
> > > > > SAD = Social Anxiety Disorder
> > > > > SAD = Seasonal Affective Disorder
> > > > >
> > > > > Which one?
> > > >
> > > > #==> The first one... Social Anxiety ;=)
> > > >
> > > > > My reaction to sertraline was similar to yours in some ways: brain fog; apathy; amotivation.
> > > >
> > > > #==> What did help you?
> > >
> > > We are still working on that one. My case is an unusual type of bipolar disorder that is difficult to treat. Sertraline was not a good drug for me. Apparently, it is a bad drug for you, too. There are other drugs to choose from. I do better on SNRI drugs like venlafaxine (Effexor) and duloxetine (Cymbalta). If you want to try another SSRI, escitalopram (Lexapro) is often chosen first by psychiatrists. I'm going to try vortioxetine (Trintellix) next.
> > >
> > > It is unreasonable for you to be asked to continue taking sertraline. I would recommend that you see another doctor.
> > >
> > >
> > > - Scott
> >
> > Thanks for your answer. Escitalopram was indeed the next on my list.
> >
> > Vortioxetine is not available where I live.
> >
> > I was thinking about augmenting Sertraline with something like Mirtazapine / Nortriptyline before discontinuing it. Would be worth a try, imho.
>
> -----------------------------------------------------------
>
> You said:
>
> "My problem with Sertraline is: It makes me an apathetic zombie, indifferent to life and very unmotivated. I have sleep disturbances, the sleep is unrestful. I've also lost quite a bit of weight and am more agitated. Besides that I have hot-flashes and palpitations on a regular basis"
>
> I don't think you are going to find a drug to add to sertraline that will remedy the effects you describe. It is possible that some of the brain-fog, apathy, loss of interest, and amotivation are part of the baseline illness. However, sertraline is making them worse - or perhaps has triggered them de novo. SSRIs are notorious for doing these things, but someone often finds a drug that does not produce these side effects.
>
> Changing drugs is not usually too difficult when switching from a SSRI to another SSRI. If you choose to abort a drug trial, you can go back to sertraline at any time, but I > recommend having patience and be prepared to possibly feel worse for awhile.
>
> What were the symptoms of your depression BEFORE you began your fist treatment (baseline)? Knowing this might help as guidance to find the right treatment.#==> I've been doing some reading & research and there is the hypothesis that SSRI-induced-agonism of 5HT2A / 5HT2C & 5HT3 receptors dampens the dopaminergic transmission in certain brain regions thus causing the specific SSRI side effects. Antagonism / Inverse Agonism of these receptors should theoretically resolve the problem. What medications do antagonize / inverse agonize these receptors? Well, according to my sources: Nortriptyline, Mirtazapine, Agomelatine, Trazodone, Nefazodone... and most tricyclics. That's why I was thinking about augmentation.
But I have no problem trying something different. I've been thinking about Clomipramine: seems to be a powerful versatile drug. Or alternately a more sedating SSRI, i.E. Paroxetine.
# depressed mood
# negative thoughts
# exaggerated worries about the future
# lack of motivation
# moderate anhedonia / apathy
# difficult making decisions
# insomnia & Sleeping too much
# weight loss / low appetite
# heart palpitations
# psychosomatic problems (digestive system)
# agitation
poster:Hordak
thread:1098205
URL: http://www.dr-bob.org/babble/20180331/msgs/1098261.html