When Do I Use Sertraline/Zoloft

I'm continuing the video series on how to select an SSRI with part 3. This video covers some important points about sertraline/Zoloft and when it might be a good option to choose this medication over other SSRIs.
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[@marieb9961]

I like your videos because you teach the important issues I always look for you in KZbin besides .You are not boring

[@TheBlacksmithingPastor]

Dr Rossi. I love the channel. Keep up the great work! I would really love to hear your take on PTSD, and the current state of both MAPS style and non MAPS style treatment. Specifically chronic or 'complex' PTSD. I suspect it will eventually come out through your Most Common series... Really waiting on it. I would also love it if you would one day look at the intersection of chronic PTSD with insomnia and sleep apnea. The struggle is real with that particular dark triad...

[@ShrinksInSneakers]

I'm planning to cover MDMA assisted psychotherapy in the near future. PTSD is complex and difficult to treat with medication alone. Sleep apnea is also common among psychiatric patients and should be tested for in cases where it's suspected. The good news is sleep apnea can be treated with cPAP which is very effective. Appreciate the comment, new material coming soon.

[@Damo944]

Great. Thanks! Very helpful

[@ShrinksInSneakers]

no problem appreciate the comment

[@Deba7777]

Good info, thanks Doc!

[@ShrinksInSneakers]

No problem, I appreciate the support

[@samohic]

Thanks a lot for the information. I am currently on 50 mg of sertraline (this has helped me overcome agoraphobia and also with the help of ERP/CBT) for OCD and what is the ideal dosage that works for OCD.

[@cassandradays]

Can you talk about Clomipramine/Anafranil please? Love watching your videos Doc!!

[@eliallen3860]

I’m on 200mg. FDA changed their guidelines maximum dose from 150 to 200mg. But, I agree anything more than 200mg is way too much Zoloft.

[@BJJ_Richie]

I am on 100 mg for 4 weeks, and feel not so hot , I heard it takes 6 to 8 weeks when going up to 100 mg , what dosage are you on ?

[@danielbegg6968]

Appreciate the video, What's the best way to wean off 25mg Sertraline? Have taken for 18 months but have been recommended to switch to Agomelatine, harder than I expected.

[@safy2363]

Realy its a great drugs esspecially w geriatrics pt.

[@ShrinksInSneakers]

Agree, appreciate the comment

[@MongoJerryilluminati]

Can you please do video on serteraline and mirtazapine combined together please I really want to her your in depth point a view

[@ShrinksInSneakers]

I will add it to the list

[@victoriawilson7292]

I take this combination too!

[@mohammadkhadra2604]

Zoloft was the most commonly prescribed antidepressant in the USA in 2018 with over 38 million prescriptions.

[@djkubas4]

hey this is not in topic but , what about combination 50mg zoloft+30mg mirtazapine+2mg prucalopride, no interactions? I`m willing that you answer, thanks

[@ShrinksInSneakers]

see my response on the other video

[@lindamastropietro4429]

Can you please talk about some meds for BiPolar type ll? I also have anxiety

[@ShrinksInSneakers]

I’ve covered a bunch of medications for bipolar II in the past, I would look at the videos I have on cariprazine, lamotrigine, quetiapine, lithium, lurasidone, aripiprazole as good starting points. We can do the olanzapine fluoxetine combination as well as some others. Bipolar II treatments are not as well established but I think the basic rules for treating bipolar disorder remain the same even for bipolar II. I think a mood stabilizer or dopamine blocking medication should be the primary option and if antidepressants are used, they should only be used after one of the later medications has been appropriately titrated. I will cover more on the topic in the future, but I don’t think the categories of bipolar I/II fully cover the spectrum of illness and it might be more helpful to think about it that way instead of fixed bipolar I or II categories. Hope this helps, if you haven’t subscribed to the channel please do, and spread the word about what we are doing here.

[@MongoJerryilluminati]

Hi there I was wondering if mirtazapine and effexor is California rocket fuel what is seterline and mirtazapine called? I'm currently taking both

[@ShrinksInSneakers]

No special name, we can make one up if you have something interesting. I would just call it a combination treatment. Sertraline has serotonin and some dopamine activity. The mirtazapine has serotonin and norepinephrine activity. The mechanisms do complement each other which is why it was likely chosen by your doctor.

[@MongoJerryilluminati]

@@ShrinksInSneakers hi there thanks for the reply I have a few names UK rocket fuel, the express bus, two chemicals of happiest I would you to do a video on the two mixed together my sleep is messed up so don't know if I need an increase though .

[@ShrinksInSneakers]

@@MongoJerryilluminati I like the names, I would say the best antidepressant effects with sertraline are seen around 100 mg daily. I think clinically I've seen the best response to mirtazapine around 30 mg at bedtime. Of note the sedating effects decrease as the dose of mirtazapine increases due to the increased NE activity. Hope this helps

[@MongoJerryilluminati]

@@ShrinksInSneakers thanks so if I go to 30mg it could make my sleep even worse I thought it might knock me out instead lol could you please do a video on them combined would love to hear it .thanks again

[@iKam1Kaz1]

Hey, I was just wondering if say I don't really click with my psychiatrist is it ok to just switch to another?

[@ShrinksInSneakers]

I don't see why that would not be an option.

[@iKam1Kaz1]

@@ShrinksInSneakers also thanks for the information as my family member was recent given it by there doctor. Great vid :)

[@MrBenflanagan]

I had appaling reactions to sertraline. Constant vomiting and fierce headaches.

[@ShrinksInSneakers]

Two of the very early side effects that come up with this medication. They usually get better but in my practice I've been far more conservative with prescribing these medications as the side effect can be serious and many people do not respond to them. It's important to select the right patients for medications and be mindful of side effects Thanks for the comment

[@brandiepacula5619]

I took Zoloft before and did well on it but it gave me bruxism. Did not get better until discontinuing the med. is there anything to alleviate this?

[@ShrinksInSneakers]

I usually add buspirone 5-10 mg three times per day. Some case reports have also used low dose aripiprazole although the potential side effects need to be considered. Aripiprazole can be used as an adjunctive treatment for depression which may be of benefit but the pros and cons need to be weighed appropriately. Hope this helps

[@montea5390]

Whenever I start an ssri it greatly increases my anxiety. I have not had this issue with buproprion . Any idea why raising my seratonin has this effect on me ? Should this go away .

[@ShrinksInSneakers]

Transient anxiety at the time of starting medication is common. It should improve with time and adequate dosing. This is something I warn my patients with panic disorder about. Hope this helps, if you haven't subscribed to the channel please do and spread the word about what we are doing here