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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by dcruik518 on December 20, 2008, at 9:00:25
Hi all,
I've been taking Zoloft along with Cytomel and Abilify as augmenters for about a month now. I also take 300mg of Trazadone at night. For the past 2 weeks, I've noticed I've felt sort of tired, less energy, but also peaceful and relaxed and sleeping much more, too much actually. Before I had too much energy, wasn't getting enough sleep, and was tense and nervous, but was getting a lot more done. I'm only taking 100mg of Zoloft, but I'm pretty sure that's what is causing the tiredness, etc. I'm wondering if 50 or 75mg might work better, even though that's less than the recommended dose. I was thinking I might need less because of the augmenting drugs. Any ideas?
Posted by SLS on December 20, 2008, at 9:10:47
In reply to Minimum dose of Zoloft with augmentation drugs?, posted by dcruik518 on December 20, 2008, at 9:00:25
For the most part, I believe that there is no change in the minimum effective dosage of an antidepressant simply because other drugs are brought in as adjuncts. That said, you may still want to try reducing the Zoloft. Some people do respond to 50mg. I think the experiment is worthwhile, but don't be too stubborn if you should begin to deteriorate.
- Scott
Posted by bleauberry on December 20, 2008, at 10:40:53
In reply to Minimum dose of Zoloft with augmentation drugs?, posted by dcruik518 on December 20, 2008, at 9:00:25
300mg Traz is a huge dose. Most people take 25mg to 50mg, sometimes 100mg, for sleep. I suspect many people would feel like they had been hit with an elephant dart at 300mg Traz. It does have a short halflife, but still, I've taken 25mg at bedtime before and still felt the lethargy from it up until about late afternoon the next day.
Even with its short halflife, you still have about 150mg of it in you when you get up in the morning, which is a higher dose than most people take at bedtime. And by lunchtime you still have about 75mg left, again, a normal bedtime dose. I don't know, maybe you have developed a tolerance to it or something, but me, that would knock me out for days.
By looking at 50mg zoloft versus 100mg, I just kind of wonder if you aren't looking in the wrong place. If I were to try reducing anything, it would be traz. You didn't mention the dose of abilify, but that is certainly just as much a suspect as anything else.
It does get difficult to know what is doing what when there are several meds. Sometimes it isn't any one med in particular, but rather a synergistic phenomenon that only exists with the mixture but not with any individual med. You kind of have to follow your gut instinct on this one, because there is no way to tell. But from an outsider's point of view, that 300mg Trazodone took center stage, with the abilify right on its heals.
Posted by dcruik518 on December 20, 2008, at 10:49:50
In reply to Re: Minimum dose of Zoloft with augmentation drugs?, posted by SLS on December 20, 2008, at 9:10:47
Thanks,Scott. I took 50mg today and yesterday and already feel less groggy and a bit more energized. So I think this may solve the problem. Somehow I thought 100mg was the minimum dose but on their website it says 50mg.
> For the most part, I believe that there is no change in the minimum effective dosage of an antidepressant simply because other drugs are brought in as adjuncts. That said, you may still want to try reducing the Zoloft. Some people do respond to 50mg. I think the experiment is worthwhile, but don't be too stubborn if you should begin to deteriorate.
>
>
> - Scott
Posted by dcruik518 on December 20, 2008, at 10:55:45
In reply to Re: Minimum dose of Zoloft with augmentation drugs?, posted by bleauberry on December 20, 2008, at 10:40:53
Hi Blueberry, I realize 300mg is a very large dose of trazadone for insomnia. It is still, however, below the dose recommended for depression, which is around 600mg, I believe. Anyway, I was taking the 300mg of Trazadone before I started the Zoloft, and I wasn't having too much trouble with lethargy then. I take Adderall and have pretty severe insomnia. I'm also a big guy, about 275 lbs., so I sometimes require a higher dose than most people. If I could reduce the Trazadone and still sleep, I would.
As for the Abilify, it doesn't make me sleepy. I only take 5-10mg a day, and whatever effect it has is very subtle.
> 300mg Traz is a huge dose. Most people take 25mg to 50mg, sometimes 100mg, for sleep. I suspect many people would feel like they had been hit with an elephant dart at 300mg Traz. It does have a short halflife, but still, I've taken 25mg at bedtime before and still felt the lethargy from it up until about late afternoon the next day.
>
> Even with its short halflife, you still have about 150mg of it in you when you get up in the morning, which is a higher dose than most people take at bedtime. And by lunchtime you still have about 75mg left, again, a normal bedtime dose. I don't know, maybe you have developed a tolerance to it or something, but me, that would knock me out for days.
>
> By looking at 50mg zoloft versus 100mg, I just kind of wonder if you aren't looking in the wrong place. If I were to try reducing anything, it would be traz. You didn't mention the dose of abilify, but that is certainly just as much a suspect as anything else.
>
> It does get difficult to know what is doing what when there are several meds. Sometimes it isn't any one med in particular, but rather a synergistic phenomenon that only exists with the mixture but not with any individual med. You kind of have to follow your gut instinct on this one, because there is no way to tell. But from an outsider's point of view, that 300mg Trazodone took center stage, with the abilify right on its heals.
Posted by SLS on December 20, 2008, at 10:58:12
In reply to Re: Minimum dose of Zoloft with augmentation drugs?, posted by bleauberry on December 20, 2008, at 10:40:53
Hi BB.
You might be right about the trazodone. However, I don't think I have seen too many reports associating Abilify with the development of mental cloudiness. You never know with these drugs, though. I am but one observer.
- Scott> 300mg Traz is a huge dose. Most people take 25mg to 50mg, sometimes 100mg, for sleep. I suspect many people would feel like they had been hit with an elephant dart at 300mg Traz. It does have a short halflife, but still, I've taken 25mg at bedtime before and still felt the lethargy from it up until about late afternoon the next day.
>
> Even with its short halflife, you still have about 150mg of it in you when you get up in the morning, which is a higher dose than most people take at bedtime. And by lunchtime you still have about 75mg left, again, a normal bedtime dose. I don't know, maybe you have developed a tolerance to it or something, but me, that would knock me out for days.
>
> By looking at 50mg zoloft versus 100mg, I just kind of wonder if you aren't looking in the wrong place. If I were to try reducing anything, it would be traz. You didn't mention the dose of abilify, but that is certainly just as much a suspect as anything else.
>
> It does get difficult to know what is doing what when there are several meds. Sometimes it isn't any one med in particular, but rather a synergistic phenomenon that only exists with the mixture but not with any individual med. You kind of have to follow your gut instinct on this one, because there is no way to tell. But from an outsider's point of view, that 300mg Trazodone took center stage, with the abilify right on its heals.
Posted by Phillipa on December 20, 2008, at 12:22:45
In reply to Re: Minimum dose of Zoloft with augmentation drugs? » bleauberry, posted by SLS on December 20, 2008, at 10:58:12
I've also been on 50mg of zoloft and found contrary to what some have posted that it didn't make me anxious at all. But then there is the added synergesic effect of the benzos. Wonder if that effects SSRI's as I feel nothing good or bad on any of them and that includes cymbalta. Wierd. Love Phillipa and certainly hope you've found your answer.
Posted by desolationrower on December 20, 2008, at 13:08:55
In reply to Re: Minimum dose of Zoloft with augmentation drugs?, posted by Phillipa on December 20, 2008, at 12:22:45
The reason a big dose of traz is needed for a strong antidepressant effect is probably it takes that much to cause significant serotonin reuptake inhibition. Not really necessary with the zoloft.
-d/r
Posted by Phillipa on December 20, 2008, at 20:56:01
In reply to Re: Minimum dose of Zoloft with augmentation drugs?, posted by desolationrower on December 20, 2008, at 13:08:55
Thanks d/r that was very clear. Love Phillipa
Posted by Zyprexa on December 21, 2008, at 15:49:20
In reply to Minimum dose of Zoloft with augmentation drugs?, posted by dcruik518 on December 20, 2008, at 9:00:25
Might be the trazodone. 300mg is a high dose for sleep. Could be making you tired. I take zoloft and it makes me slightly sedated, I take 150mg.
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