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Too much sertraline


Sertraline overdose - PubMed

. 1996 Feb;3(2):132-6.

doi: 10.1111/j.1553-2712.1996.tb03400.x.

G T Lau  1 , B Z Horowitz

Affiliations

Affiliation

  • 1 Division of Emergency Medicine and Clinical Toxicology, University of California, Davis, Medical Center, Sacramento 95817, USA.
  • PMID: 8808373
  • DOI: 10.1111/j.1553-2712.1996.tb03400.x

Free article

G T Lau et al. Acad Emerg Med. 1996 Feb.

Free article

. 1996 Feb;3(2):132-6.

doi: 10.1111/j.1553-2712.1996.tb03400.x.

Authors

G T Lau  1 , B Z Horowitz

Affiliation

  • 1 Division of Emergency Medicine and Clinical Toxicology, University of California, Davis, Medical Center, Sacramento 95817, USA.
  • PMID: 8808373
  • DOI: 10.1111/j.1553-2712.1996.tb03400.x

Abstract

Objective: To determine the clinical presenting signs and symptoms in presumed overdoses of sertraline, a recently approved antidepressant.

Methods: A prospective study involving five western regional poison control centers was performed to evaluate the clinical manifestations of presumed sertraline ingestions (overdoses). Information about calls pertaining to sertraline ingestions was recorded on a standard data collection form. Data including subject age, sex, amount ingested, coingestants, time interval to evaluation, vital signs, presenting signs and symptoms, ECG abnormalities, treatment given, disposition, and length of stay in the ED were collected over a nine-month period.

Results: Of 42 ingestions reported, two were adverse reactions to normal doses and 40 were overdoses. Stated amounts of sertraline ingested ranged from 50 to 8,000 mg (mean 1,579 mg). Mean patient age was 35.3 years (range 1 to 69 years). Mean interval to presentation was 3.0 hours. Seventeen of the 40 patients ingested sertraline alone. Of this subgroup, ten had no sign or symptom. The most common abnormalties reported in isolated sertraline overdose were tremor, lethargy, and nausea. Less common findings included agitation, confusion, and vomiting. There was no significant morbidity in this subgroup of presumed isolated sertraline ingestion. Of the 23 patients who ingested other medications along with sertraline, four were asymptomatic. Benzodiazepines and alcohol were the most frequently coingested substances. Lethargy, nausea, dry mouth, and mydriasis were the most common features reported in this group. Treatment included lavage, activated charcoal, and observation. Twelve patients were admitted for 24-hour observation, none had an adverse outcome. Of the patients released from the ED, the mean length of stay was 3.9 hours.

Conclusion: Sertraline is commonly taken in overdose with other medications or alcohol. The signs and symptoms that develop in association with an overdose of sertraline appear to be minor and of short duration.

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Can You Overdose on Zoloft? What You Need To Know- K Health

Zoloft is an antidepressant that is approved by the Food and Drug Administration (FDA) to treat depression and other mood disorders. It is the brand name for sertraline.

Zoloft is a selective serotonin reuptake inhibitor (SSRI) that works by blocking the clearance of serotonin from the brain.

This means that your brain retains more stable access to this balancing neurotransmitter.

Antidepressants like Zoloft are carefully dosed to ensure consistent results.

It is possible to take too much Zoloft and overdose, and the symptoms can range from mild to severe.

When taking antidepressants, it is essential to carefully follow prescription instructions.

In this article, we will explore symptoms of Zoloft overdose, causes, signs, and how it is treated if it happens.

Is Overdose on Zoloft Possible?

An overdose on almost any medication, including Zoloft, is possible.

Medications are dosed specifically based on many factors, including:

  • Weight
  • Age
  • Pre-existing conditions, including liver and kidney health
  • Other medications

Taking a different dosage of Zoloft than prescribed, especially if paired with alcohol or other prescription or drug substances, can change the way that your body metabolizes the medication.

This can result in circulating levels of Zoloft that are much higher than intended.

While SSRIs, like Zoloft, have fewer fatal outcomes than other types of antidepressants, there is still a risk.

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What is a dangerous dosage of Zoloft?

Any dosage above what is prescribed can be dangerous, especially if paired with other substances like alcohol, other prescriptions, or illicit drugs.

Zoloft overdoses have been reported in a wide range of dosages, some as low as 50 mg.

Because other factors and ingested substances can so strongly influence how the body processes Zoloft, there is no set amount above the prescribed dose that is necessarily safe.

Taking any medication in excess can cause serious complications.

A safe dose for one person could be a dangerous dose for another person.

This is why it’s essential not to share prescriptions with others since dosing factors in weight, age, and other health conditions.

Standard Zoloft dosing

Zoloft doses can vary widely based on the person’s age, weight, and severity of symptoms.

Typical Zoloft doses range from 50-200 mg per day in adults.

Symptoms of Antidepressant Overdose

When someone overdoses on Zoloft, it may or may not cause immediate symptoms.

Low overdoses may cause no symptoms at all or may be delayed for several hours.

The intensity of Zoloft overdose symptoms can vary from mild to severe, and may rarely be life-threatening.

Even if you have no symptoms, you should still seek medical help if you have a known Zoloft overdose.

Mild symptoms

There are a few common symptoms associated with Zoloft overdose, including:

  • Agitation
  • Nausea or vomiting
  • Dizziness or shakiness
  • Fever
  • Rapid heart rate
  • Feeling sleepy

Severe symptoms

In some cases, more severe symptoms may occur with Zoloft overdose.

If you or someone you care for experiences the following, seek emergency medical care immediately.

  • Sudden changes in blood pressure
  • Fainting
  • Hallucinations
  • Seizures
  • Manic episodes
  • Serotonin syndrome

Serotonin syndrome

A serious risk of Zoloft overdose is serotonin syndrome—a life-threatening condition that results in excessive amounts of serotonin.

Symptoms of serotonin syndrome include tense and rigid muscles, hallucinations and delusions, seizures, and coma.

The risk is higher if more than one antidepressant has been taken at the same time.

Signs or symptoms associated with serotonin syndrome are a medical emergency.

What to Do if You’re Worried About Zoloft Overdose

If you or someone you care for worries that they have accidentally taken too much Zoloft, or have taken Zoloft with other medication or alcohol which may contribute to overdose, seek emergency medical care or contact your healthcare provider right away.

The sooner that you are evaluated, the better your chance of avoiding dangerous symptoms or complications.

If you worry that you have taken too much, but do not feel like it is a medical emergency, contact Poison Control at 1-800-222-1222.

They can help you determine whether you require medical treatment.

How an antidepressant overdose may be treated

If you do require medical attention for an overdose of antidepressants, you will be taken to an emergency room. Depending on how long ago you took the medication, activated charcoal may be given orally to help absorb the medication and prevent continued metabolism of the drug.

In the ER, you may receive a variety of types of care, including:

  • Having your stomach pumped to remove the medication, if it was recently taken
  • Being sedated with benzodiazepines to calm extreme symptoms or agitation
  • Receiving IV fluids or serotonin-blocking drugs to address serotonin syndrome

Depending on how severe your overdose is, and how strong your symptoms are, you may need to stay for observation in the ER for several hours. In rare cases, you may be admitted overnight.

While Zoloft overdose can be serious, it is rarely lethal unless other substances are consumed with it.

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Zoloft Precautions.

If you notice any of the following warning signs in yourself or someone you love, report them immediately to a healthcare provider and seek emergency medical care if you think there is an imminent risk of self-harm:

  • Agitation, aggression, or hostility
  • Increased or worsening anxiety
  • Panic attacks
  • Irritability
  • Insomnia
  • Impulsiveness
  • Unusual changes in behavior
  • Suicidal thoughts or discussion 
  • Restlessness
  • Manic behavior

Never stop taking Zoloft suddenly. If you are weaning off of it, your doctor will create a tapering plan for you to prevent side effects, withdrawal symptoms, or a recurrence.

Never increase your Zoloft dose on your own either.

Even if you are on a low dose, your doctor has carefully selected your dosage based on your health and physical factors.

Increasing your dosage without consulting your doctor, even within the normal range of prescriptions, can still result in an overdose.

Zoloft is not safe for individuals with certain health conditions or who take specific prescription medications.

If any of the following are applicable to you, Zoloft may not be appropriate:

  • Takes MAOIs or has within the past 14 days
  • Takes pimozide
  • Is sensitive to sertraline or any ingredients in Zoloft
  • Takes disulfiram (for liquid Zoloft only)

How K Health Can Help

Think you might need a prescription for Zoloft (Sertraline)?

K Health has clinicians standing by 24/7 to evaluate your symptoms and determine if Zoloft is right for you.

Get started with our free assessment, which will tell you in minutes if treatment could be a good fit. If yes, we’ll connect you right to a clinician who can prescribe medication and have it shipped right to your door.

Frequently Asked Questions

Has anyone died from Zoloft?

Tricyclic antidepressants (TCAs) are associated with more potential for fatal overdose outcomes compared to SSRIs like Zoloft or other types of antidepressants. No cases have been reported of death after Zoloft ingestion alone, however, some fatalities have occurred with high doses of Zoloft paired with other substances.

Can you OD on 300 mg of Zoloft?

Standard Zoloft dosing is between 50-200 mg per day, however, an overdose is possible even within that range. A dose of 300 mg of Zoloft would definitely lead to an overdose and should never be taken.

What is it like to overdose on Zoloft?

The most common symptoms of Zoloft overdose include tremor, lethargy, nausea, agitation, confusion, or vomiting. If you have taken too much Zoloft, contact Poison Control or seek emergency care right away to avoid serious side effects.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.

  • Sertraline. (2022).
    https://medlineplus.gov/druginfo/meds/a697048.html

  • Zoloft (sertraline hydrochloride). (2016).
    https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/019839S74S86S87_20990S35S44S45lbl.pdf

  • Sertraline overdose. (1996).
    https://pubmed.ncbi.nlm.nih.gov/8808373/

  • Demystifying serotonin syndrome (or serotonin toxicity). (2018).
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6184959/

  • Serotonin syndrome. (2021).
    https://www.ncbi.nlm.nih.gov/books/NBK482377/

  • Trends in antidepressant overdoses. (2007).
    https://onlinelibrary.wiley.com/doi/abs/10.1002/pds.1355

Zoloft withdrawal syndrome - Center for Healthy Youth

Zoloft - what is this drug? The active substance of the drug is sertraline. It belongs to the pharmacological group of antidepressants and is prescribed to patients with the following symptoms: depression, OCD, panic disorders, PTSD, social phobia. Zoloft is a powerful serotonin reuptake inhibitor in human brain cells.

More than 1/3 of people face the dangerous consequences of abrupt withdrawal of Zoloft. In narcology, this phenomenon is called withdrawal syndrome or withdrawal syndrome. The time of onset of symptoms of withdrawal syndrome when used is directly proportional to the half-life of the drug from the body. A drug such as Zoloft is addictive with systematic irregular use, therefore, there is also a Zoloft withdrawal syndrome, which usually occurs 3-5 days after the last use of the drug. The symptoms of Zoloft withdrawal syndrome are quite difficult to recognize, so people think that the disease has returned and start using the medicine again.

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How to reduce the dose of Zoloft correctly?

The course of treatment with Zoloft usually lasts no more than 8 weeks (about two months). As with the use of other antidepressants, an unreasonable increase in the duration of its use leads to negative consequences for human health. However, even before the period prescribed by the doctor, it is not recommended to stop taking the drug, since the gradual disappearance of symptoms is not a reason to complete the course. How long can I take Zoloft?

How much Zoloft can I take?

Many patients wonder how much Zoloft should be taken? Naturally, the duration of the course is strictly individual. So, how long can you take Zoloft? Only the attending physician, depending on the symptoms present, will be able to tell you how much Zoloft should be taken in your case. A specialist can prescribe a medication for 6-12 months, but this happens in exceptional cases.

The risk of developing withdrawal symptoms is increased in the following cases:

  • abrupt drug withdrawal and removal from the body;
  • regular intake over two months;
  • excessive anxiety;
  • Combination with antihypertensives, allergies, and antipsychotics.

Do you want to know the cost of services?

8 (800) 333-20-07 - call our specialist

How to cancel and stop drinking Zoloft?

Zoloft causes a withdrawal syndrome when it is stopped abruptly. This drug affects the processes occurring in the human brain, so you should take the medicine only with a doctor's prescription. How to stop taking the drug and "get off" from Zoloft? To avoid the withdrawal syndrome, the dosage of the medication according to the medical plan is reduced by 25 mg every 14 days. If a stable remission is achieved after a course of treatment, the doctor will stop taking the drug. However, the specialist will cancel the drug if the patient experiences side effects, insomnia and headache from Zoloft are not uncommon.

In which case the doctor can cancel the medication:

  • the patient has a headache;
  • causeless sadness, anxiety;
  • feeling of devastation;
  • nervousness, irritability;
  • weakness;
  • suicidal tendencies;
  • sleep and appetite disorders;
  • decrease in concentration.

If a person has lost their appetite or has regular headaches, the doctor begins a gradual process of reducing the dosage. The therapeutic dose is reduced over several weeks, and sometimes months.

Symptoms of withdrawal after taking

Is it possible to abruptly stop taking the medicine? Abrupt withdrawal of the drug threatens the occurrence of withdrawal or withdrawal. The human body, accustomed to a certain dose of the drug, will respond without an adaptation period. Most often, a deterioration in the patient's health is noted within 2-4 days after the last use. Depending on the individual characteristics and the state of the central nervous system, withdrawal symptoms may be different.

Symptoms and signs of withdrawal

  • nervousness;
  • irritability;
  • irritability;
  • insomnia;
  • nausea, vomiting;
  • headaches;
  • incoordination, balancez.

In some cases, a person will not even feel dangerous signs, and sometimes you may need to call an ambulance for narcological help from the Center for Healthy Youth. Therefore, if you feel a deterioration in the condition, it is worth contacting a doctor who will help reduce the dose and improve overall well-being.

How long does Zoloft withdrawal last?

Withdrawal symptoms can persist without drug treatment for quite a long time, for several weeks. While taking antidepressants, the activity of neurons changes, so after stopping the drugs, the body needs time to rebuild and adapt to new conditions. The longer the course of treatment was, the longer the rehabilitation period will be. Withdrawal symptoms will not disappear until the active substance of the drug is excreted from the body. If general weakness lasts for a month, you should contact your doctor or specialists from the Healthy Youth Center.

When does Zoloft start to act and help?

It is important to understand that Zoloft does not begin to act immediately, but after a certain period of time. How long does Zoloft take to work? As a rule, the first positive dynamics begins to be noticeable to the patient only after 2-3 weeks of regular use. The maximum effect is noticeable after 2-3 months of admission.

Discontinuation considerations

When choosing antidepressants, it is important to know which medications the patient has previously taken and which medications they are currently taking. Before prescribing an effective remedy that normalizes the work of the central nervous system, the doctor conducts a number of necessary examinations, identifies existing contraindications and prevents side effects. If Zoloft is not recommended for you, the specialist will offer you a wide range of analogues of this drug, including Cipralex, Prozac, Paxil, Cipramil and other equally effective drugs. The drug Velaksin, Amitriptyline, etc. has a similar effect.

If you experience withdrawal symptoms after taking Zoloft, contact the Healthy Youth Drug Treatment Center for help. We have been treating addictions for over 15 years.

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What is worth knowing about antidepressants

Ekaterina Kushnir

Heals an alarming disturbance

I have a generalized alarm.

For a long time I coped without pills and other help, but one day I got tired of constant anxiety and began to interfere with my normal life. As a result, I turned to a private psychiatrist.

The doctor prescribed an antidepressant from the SSRI group - these are selective serotonin reuptake inhibitors. Such drugs are the first thing prescribed in the treatment of depression and a number of other conditions, including my illness.

The doctor immediately warned me about some peculiarities associated with taking the drug. Some of them I then felt on myself. I think everyone who plans to be treated with antidepressants should know about them.

At the same time, it should be taken into account that most of the negative effects of therapy are temporary and not dangerous, and if they do not go away, one medicine can be replaced with another. Antidepressants help many people with mental disorders and other illnesses get rid of their symptoms and return to a full life, so you definitely should not be afraid of them. The main thing is to take such drugs when they are really needed: as prescribed by a competent doctor and under his control.

See a doctor

Our articles are written with love for evidence-based medicine. We refer to authoritative sources and go to doctors with a good reputation for comments. But remember: the responsibility for your health lies with you and your doctor. We don't write prescriptions, we make recommendations. Relying on our point of view or not is up to you.

Fact No. 1

Antidepressants may make symptoms worse at first

Antidepressants can increase anxiety in anxiety disorders, as well as cause irritability and agitation - the so-called causeless motor agitation, the inability to sit still. It's not dangerous, but rather unpleasant. This condition is sometimes referred to as initial anxiety, that is, the anxiety of starting therapy. Up to 65% of people face it.

Antidepressant-induced anxiety syndrome - a systematic review in the British Journal of Psychiatry

There is also evidence that some classes of antidepressants, including SSRIs, may increase suicidal ideation in depression in young people aged 18 to 24 years. These data are not very reliable, and in older people, the risk of suicide no longer increases and even decreases.

Without treatment, depression is more likely to lead to suicidal thoughts, and in case of anxiety, you just need to prepare for such an effect, then it will be easier to survive the attacks.

The doctor told me that in the first two or three weeks there may be an increase in anxiety, but I did not take it too seriously.

Everything was fine for the first week. After about seven days, I became nervous and irritable. And then I woke up at night and after a while I felt an incomprehensible fear. My heartbeat increased, my head was spinning, my throat was constricted. Because of this, I felt a real panic - I spent the rest of the night fighting terrible thoughts, in the morning I got up completely broken.

/list/antidepressant-myths/

8 myths about antidepressants

I have never had such panic attacks before medication - my anxiety was background, general. I got scared and wrote to the doctor, who reassured me and said that it was not dangerous and would pass soon.

After that, I already expected these panic attacks, immediately tried to relax, calm down, remember that this was just a temporary effect of the drugs. And they ended faster, and then they completely disappeared.

My letter to a psychiatrist. I was scared: I expected an increase in background anxiety, but not panic attacks. I even thought about giving up the medicine

Fact No. 2

The effect of antidepressant treatment will not be immediate

Increase the dose of antidepressants gradually to reduce side effects. They usually start with the minimum, and then bring it up to the working one. For example, for SSRIs with the active ingredient "sertraline", the working dose is from 100 mg per day. I started taking such a drug with 25 mg, and then gradually, in several steps, under the supervision of a doctor, raised the dose to 100 mg.

SSRI dosage - NHS

What doses of antidepressants will be optimal - an article in The Lancet

The process of reaching a working dose can take from two weeks to a month or more. It depends on the drug and its tolerance. I turned out to be sensitive to the medicine, it was hard for me to survive every increase in dosage: anxiety increased again, there were other side effects that then stopped. However, this is not the case for everyone, sometimes the process goes faster.

The full therapeutic effect, that is, the disappearance or a strong improvement in the symptoms of the disease, occurs some time after reaching the working dosage. As a rule, this is a week or two, although some positive changes may be earlier. For some people, this process stretches for a longer period: 6-12 weeks. Minimum initial doses of drugs usually do not work.

It is better to prepare for the fact that the symptoms of the disease will not disappear in the first weeks of treatment. And remember - this does not always mean that the drug needs to be changed, sometimes you just need to wait or further increase the dosage under the supervision of a doctor.

Fact No. 3

Antidepressants are usually taken in combination with other drugs

Another way to mitigate the side effects of antidepressants is to prescribe an additional drug along with them: for example, from the group of tranquilizers. Such drugs may have their own side effects, they should not be taken for a long time. Unlike antidepressants, some of them can be addictive. They are usually appointed for a month, but this period may be shorter or longer.

Antidepressants together with benzodiazepines work better for depression - BMJ magazine

My doctor prescribed a rather mild drug for me. However, he did not suit me. At first, it caused increased drowsiness: during the period of increased anxiety, it went away for a while, but then returned - even with half a pill I turned off and could sleep all day. And if I drank at night, I woke up with difficulty in the morning. The psychiatrist prescribed another medicine, but I could not buy it: the drug was not available in any pharmacy nearby.

As a result, I simply endured all the side effects of therapy - they were unpleasant, but tolerable. When discussing with the doctor, she called this option acceptable if the side effects of the second medicine only worsen the situation.

My prescriptions for drugs. I never used one, because there was no such medicine in pharmacies

Fact No. 4

Side effects are not always, but they are

Modern antidepressants, including SSRIs, are mild and have almost no side effects. Older drugs - tricyclic antidepressants and monoamine oxidase inhibitors - cause more side effects. Doctors usually use them when milder first-line drugs don't work or when they can't be prescribed.

Side effects of antidepressants - the National Health Service of the UK

Side effects of various antidepressants - Uptodate

Side effects of antidepressants and their impact on the treatment of a large depressive disorder - the journal NATURE

STOCE OF RIGHT OF STROTOLNIA 9000 - UPTODATE 9000 effects of antidepressants - advice from the Mayo Clinic staff

Choosing an SSRI drug does not guarantee the absence of side effects - many people tolerate treatment easily, but sometimes a change in drug may be necessary.

The first couple of weeks of taking there is a risk that the state of health will be so-so - it's worth thinking about. It may be worth scheduling the start of therapy on vacation.

I work remotely, and it was easier for me: the first pill was taken on Saturday, I slept through the weekend. Then she continued to work, but refused any additional loads: housework, part-time jobs, training and everything else.

It was hard work: I wanted to sleep, then I began to worry and get distracted. I also had diarrhea, nausea, headaches, tremors, i.e. hand trembling, hot flashes, sweating, palpitations. At night, panic attacks began, in the morning I had difficulty getting up because I was in pain and dizzy.

There are mixed data on how common the side effects of antidepressants are. If we summarize them, then the numbers look something like this:

  • nausea - about 25% feel it;
  • diarrhea - it happens in 15% of people, and 5%, on the contrary, will have constipation;
  • about 20% of people have sweating and feeling hot;
  • sexual dysfunction, decreased libido may occur in 80% of cases;
  • insomnia - in 11% of cases;
  • headache and dizziness - in about 10-11% of cases;
  • weight gain - not all drugs give this effect. Some, on the contrary, can reduce weight. On my medicine, I lost 2 kilograms in the first month, despite the fact that I quit training due to poor health. True, then they returned back.

It can be seen that most side effects occur in less than half of the cases. In addition, in most cases they pass in the first weeks and are not dangerous.

Side effects not listed above are very rare. I was "lucky", and I faced one such - a decrease in visual acuity. Once in the morning I noticed that I see worse without glasses. A little later, I realized that something was wrong with the glasses.

I wrote to the doctor, she replied that this happens, as a rule, is not dangerous and passes, but it is better to visit an ophthalmologist. I went to the ophthalmologist, everything was fine with my eyes, there was nothing terrible, but my vision really worsened - it was not a subjective feeling. On the right eye, it was -0.5 diopters, it became -0.75, and on the left eye it was -1. 5, and it became -3.5.

I was offered to try changing the drug, but I decided to wait. Vision was then restored. I have not yet gone to the doctor to have it measured, but according to subjective feelings, it is at the same level as before: I am comfortable again in my glasses.

Side effects should not be tolerated - if something greatly worries, scares or interferes with life, it is better to tell the doctor right away. The psychiatrist will be able to determine whether the side effect of the drug is dangerous and whether it is worth continuing to take it. There are several antidepressants of the SSRI group, in addition, there are groups of drugs with a slightly different mechanism of action. As a rule, doctors manage to find a medicine that gives a good effect without side effects.

If there is no danger, the doctor can adjust the dose or increase it more gradually - this often helps to cope with unpleasant effects.

I wrote to the doctor again when my visual acuity decreased

Fact No. 5

Antidepressants need to be taken long term

Antidepressants are not drugs that you can stop drinking as soon as you get better. They are taken for a long time: usually from several months, less often several years.

Anxiety Therapy - UpToDate

For example, for generalized anxiety disorder, the duration of treatment is at least a year. Moreover, the date is not counted from the very beginning, but from the moment when a lasting effect appeared from the pills. In fact, they will have to be drunk for about 1.5 years - it depends on how long it takes to reach the working dosage of the medicine.

The cost of a package of the most famous antidepressant "Zoloft" is about 700 R, enough for about a month. That is, a course of therapy will cost about 10,000 R - maybe more or less, depending on which drug is selected.

Psychotherapy review - UpToDate

Another drug of the same group already costs more than 2000 R per pack. Source: rigla.ru

The cost of an appointment with a good psychiatrist in Moscow is 3000-5000 R. At first, you will need to visit him about once every 1-1.5 months, then less often.

You can apply to the psycho-neurological dispensary at the place of residence under compulsory medical insurance - it's free. At the same time, they will not put you on psychiatric registration: it was canceled in 1993. People with disorders that do not threaten their lives or those around them are on consultative and diagnostic care. If you stop going to the doctor, he will not find out what happened: a person seeks help at will.

Psychotherapy, usually cognitive-behavioral, is also commonly prescribed to enhance and sustain the effects of antidepressants. In many cases, it improves the effectiveness of drugs, including depression and generalized anxiety disorder. An appointment with a psychotherapist in Moscow costs an average of 5000 R. For treatment, you will need about 10 sessions or more.

/psychotherapy/

How psychotherapy works

Fact No. 6

Antidepressants should not be stopped abruptly

Antidepressants do not develop dependence. However, if you abruptly stop drinking them, there will be a withdrawal syndrome. This is felt as electric current discharges while moving or turning the head, headaches, dizziness, insomnia. Many people experience symptoms similar to the flu or an intestinal virus: low fever, diarrhea, general malaise, chills. Often there is anxiety, there are intrusive images.

Withdrawal symptoms after taking serotonin reuptake inhibitors - Journal of Clinical Psychiatry

How difficult it is to stop taking antidepressants - American Psychological Association

Stopping antidepressants in adults - UpToDate

If you for some reason have stopped taking your pills treatment, they should be canceled only under the supervision of a doctor.

Antidepressant withdrawal occurs as gradually as the start of treatment. The dosage is slowly reduced, usually at this time again a cover-up drug is prescribed to alleviate side effects. As a rule, this is the same medicine that was at the beginning of the intake.

Withdrawal is usually harmless and resolves within the first weeks of stopping the drug. Sometimes even within a few days - it still depends on which medicine was prescribed. If severely disturbing symptoms appear during the withdrawal period, you should consult a doctor.

Fact No. 7

If you need to change the drug, everything will start over

It is far from always possible to immediately find the right antidepressant - sometimes the side effects do not go away and you need to take a new one.

Changing antidepressants in adults - UpToDate

Serotonin syndrome - MSD

Most often, it is started again with a small dosage, this delays the process of obtaining the effect of treatment. The new drug may also have side effects - the same or different. We will have to wait again until they pass.

You won't be able to change the drug on your own, since all antidepressants are sold only by prescription - and that's good. Switching from one drug to another can be dangerous if you do not know the characteristics of different groups of drugs.

For example, taking SSRIs is possible only some time after the withdrawal of antidepressants from the group of monoamine oxidase inhibitors - due to the risk of developing serotonin syndrome. This is a potentially fatal condition, accompanied by a change in mental state, high fever, increased muscle tone and other symptoms.

If the drug is changed correctly, there will be no dangerous negative effects, so consultation with a doctor is required.

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Fact No. 8

Among antidepressants there are original drugs and generics

Preparations may be original or generic. Originals are medicines first released by some pharmaceutical company that have passed all clinical trials and checks. Generics are drugs with the same active ingredient from another pharmaceutical company, that is, copied from the original drug.

Theoretically, the action of generics should not differ from the action of original drugs. However, this is possible, since generics may contain other additional substances or the manufacturer may use other raw materials.

Due to my anxiety, I did not read anything in detail about specific drugs before I bought my first antidepressant in a pharmacy so as not to be scared and not think about taking it. I also didn’t think to ask the doctor about this question.

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As a result, I first bought a generic because it was in stock. Then it turned out that, after all, according to the experience of my psychiatrist, the original drug often gives fewer side effects and is better tolerated. As a result, I changed the generic to the original drug - and, indeed, the side effects softened.

In my subjective opinion, which is supported by some data, in the case of antidepressants and other psychotropic drugs, you should always choose the original medicine. Moreover, the cost of originals and generics is not always very different.

Originals and generics of some SSRIs

Active ingredient Original Original price Generics Cost of generics
Sertraline Zoloft About 700 R, 100 mg tablets Serenata, Sirlift 500-600 R 100 mg tablets
Escitalopram Cipralex 3000 R, tablets 10 mg "Selektra", "Elycea" 500-1300 R, 10 mg tablets
Fluoxetine Prozac About 350 R, 20 mg tablets Profluzak, Fluoxetine 100-200 R, tablets 20 mg

CERTRALIN

Original

"Zoloft"

Original cost

about 700 r, tablets 100 mg

generies

"Serenata", "Cerelift"

Cost of

9000 500-600 r. , tablets 100 mg

Escitalopram

Original

Cipralex

Original cost

3000 r, tablets 10 mg

Generiki

Selectra, Elicea

The cost of generics

500-1300 r, tablets 10 mg

Fluoxetine

Prose -

Cost cost

original

About 350 R, tablets 20 mg

Generics

Profluzak, Fluoxetine

Cost of generics

100—200 R, tablets 20 mg

one remained unclaimed

Fact No. 9

Do not take alcohol along with antidepressants

Drinking alcohol while taking antidepressants may exacerbate unpleasant side effects. Also, alcohol is a depressant, that is, it has the opposite effect, and its intake can adversely affect the results of treatment.

Why you shouldn't mix antidepressants and alcohol - Mayo Clinic

Alcohol is strictly forbidden to drink with some groups of antidepressants, for example, tricyclic antidepressants and monoamine oxidase inhibitors: combination with the latter, for example, can lead to an uncontrolled increase in pressure. MAO inhibitors in general require a special diet - it is unlikely that a doctor will prescribe such drugs as the first antidepressants, but if necessary, he will issue a list of what is allowed and prohibited.

With other antidepressants, moderate use may not be dangerous and even pass without consequences, but doctors still recommend abstaining so as not to increase side effects and improve treatment outcome.

The main thing is not to temporarily stop taking the drug in order to drink. This can lead to the development of a withdrawal syndrome.

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Fact No. 10

Antidepressants are incompatible with certain drugs and have contraindications

It is important to tell your doctor what medications you are taking and what chronic illnesses you have. For example, SSRIs may not be suitable for epilepsy and bleeding disorders, and tricyclic antidepressants are usually not prescribed for those who have recently had a heart attack, suffer from glaucoma, or porphyria.

Antidepressant Warnings - NHS

Drug Compatibility Test - Drugs.com

It is also important to be careful if you are about to take any over-the-counter medicine. For example, ibuprofen, which people often take on their own to relieve pain and reduce fever. It should not be taken with SSRIs as it increases the risk of gastrointestinal side effects.

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