What is the best time of day to take sertraline

How and when to take sertraline

Dosage and strength

Sertraline is available as 25mg, 50mg or 100mg tablets.

The usual dose of sertraline is 50mg a day in adults. But your doctor may start you on a lower dose, then increase it gradually to a maximum dose of 200mg a day.

If you have liver problems, your doctor might give you a lower dose.

The usual dose of sertraline for children aged 6 to 12 is 25mg a day, but this may be increased to 50mg a day after a week.

The usual dose of sertraline for children aged 13 to 17 is 50mg a day.

Children aged 6 to 17 might have their dose increased up to 200mg a day, if needed.

How to take it

Take sertraline once a day. You can take it with or without food.

You can choose to take sertraline at any time, as long as you stick to the same time every day.

If you have trouble sleeping, it's best to take it in the morning.

How long to take it for

Once you're feeling better it's likely that you'll continue to take sertraline for several more months. Stopping before that time can make depression come back.

Most doctors recommend that you take antidepressants for 6 months to a year after you no longer feel depressed.

If you forget to take it

If you occasionally forget to take a dose, skip the missed dose and take your next dose the next day at the usual time.

Never take 2 doses at the same time to make up for a forgotten one.

If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

If you take too much

The amount of sertraline that can lead to an overdose varies from person to person.

Taking too much can cause symptoms such as:

being sick (vomiting)
shaking
feeling sleepy
feeling dizzy
fast heart rate
fits or seizures

Urgent advice: Contact 111 for advice now if:

you take more than your prescribed dose of sertraline

Go to 111.nhs.uk or call 111

If you need to go to A&E, do not drive yourself. Get someone else to drive you or call for an ambulance.

Take the sertraline packet, or the leaflet inside it, plus any remaining medicine with you.

Stopping sertraline

If you have been feeling better for 6 months or more, your doctor may suggest coming off sertraline.

Your doctor will probably recommend reducing your dose gradually over several weeks, or longer if you have been taking sertraline for a long time.

This is to help prevent any withdrawal symptoms you might get as a reaction to coming off the medicine.

These can include:

feeling dizzy
feeling sick
numbness or tingling in the hands or feet
trouble sleeping
feeling agitated or anxious
headaches
shaking

Page last reviewed: 2 February 2022
Next review due: 2 February 2025

When Is The Best Time of Day to Take Zoloft for Anxiety?

Medically reviewed by Angela Sheddan, DNP, FNP-BC

Written by Our Editorial Team

Last updated 11/6/2021

If you take Zoloft or are thinking about taking it for anxiety, there’s no doubt you want to do whatever you can to make sure the medication is as effective as possible.

After all, dealing with anxiety in your daily life is tough and can have quite an impact on your life.

And if a medical professional has suggested that Zoloft may help, you want to make sure nothing you do stands in the way of it working.

With that, you may have heard that the time of day can affect how well certain medications work. Wondering if Zoloft is one of them? Keep reading to find out.

A Word on Anxiety

Anxiety is incredibly common. In fact, 40 million American adults are experiencing an anxiety disorder.

A common anxiety disorder in adults is Generalized Anxiety Disorder (GAD).

The Anxiety and Depression Association of America say that those who struggle to control their anxiety more days than not over a period of six months, may be dealing with GAD.

The following symptoms are associated with GAD:

Feeling nervous
Experiencing panic or doom
Increased heart rate
Hyperventilation
Sweating
Tiredness and/or weakness
Issues concentrating
Difficulty sleeping
Stomach problems

But GAD is not the only anxiety disorder. Other anxiety disorders include:

Obsessive Compulsive Disorder
Panic Disorder
Post-Traumatic Stress Disorder
Social Anxiety Disorder

Speaking to a health care professional can help you identify if your anxiety is just occasional, run-of-the-mill nervousness or if it could be an anxiety disorder that is impacting your daily life.

If it’s determined that you are dealing with one of these, it may be suggested that you consider anxiety medications to help manage it — like Zoloft.

Some Background on Zoloft

Zoloft is the brand name for sertraline. It falls under the selective serotonin reuptake inhibitor (SSRI) class of antidepressants.

Another fact: It is one of the most popular antidepressants on the market. More than 30 million prescriptions are written for it every year in the United States.

So, what’s Zoloft used for? Sertraline can help treat depression, anxiety, post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD) and panic attacks.

Some medical professionals also prescribe sertraline to treat premature ejaculation.

When it comes to treating mental health disorders, sertraline works by increasing the level of serotonin in the brain.

In doing so, sertraline can improve overall mood, prevent panic attacks and stop behavior associated with OCD. It can also help with symptoms of anxiety.

Zoloft (and the generic sertraline) comes in tablet form, requires a prescription, and is meant for everyday use.

The average dose is 50mg, though it may be prescribed in a lower or higher dose. The maximum dose of Zoloft is 200mg. It generally takes four to six weeks of taking it before you may notice any effects.

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Side Effects of Zoloft

Like most medications, there are potential side effects associated with Zoloft and the generic sertraline. Thankfully, most people either don’t experience any or only notice mild side effects.

The most common side effects are:

Headaches
Difficulty sleeping
Sleepiness
Diarrhea
Dry mouth
Dizziness
Weakness

More rarely, people who take sertraline may experience severe side effects, such as:

If you experience severe side effects, you should seek medical attention immediately. In fact, if you notice any unwanted side effects, you should run them by your healthcare provider.

It’s also important to tell your healthcare provider about any other prescription medication you may be taking, as there can be drug interactions and adverse effects when you mix meds.

The Best Time of Day to Take Zoloft

If you’re taking Zoloft or sertraline for anxiety, you may be wondering what time of day you should take it. The answer is simple: It doesn’t really matter.

What does matter? Being consistent with when you take it. You should take this medication around the same time each day. If you forget a dose, don’t double up the next day.

One thing to consider when determining what time of day to take sertraline for anxiety is the side effects.

If you generally have trouble sleeping, some medical professionals may recommend taking it in the morning.

Also good to know: You can take sertraline with or without food.

To make sure you don’t forget to take your dose, try to build it into your routine. For example, if you have breakfast at the same time each morning, you could take it then.

Another option would be to set an alarm on your phone to go off at the same time each day.

Oh, and if you want to stop taking Zoloft, it’s important to do so under the guidance of a healthcare professional. Stopping suddenly could lead to withdrawal symptoms.

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talk to a psychiatry provider. it’s never been easier

Taking Zoloft for Anxiety

If you have an anxiety disorder like generalized anxiety disorder, panic disorder or social anxiety disorder, medication may help improve your quality of life.

An online psychiatrist will be able to assist you in figuring out what medication could work for you — or suggest other types of treatments.

If medication is right for you, an SSRI may be prescribed, like Zoloft. It has been found to be an effective medication for anxiety.

If you are taking Zoloft, you don’t have to worry about what time of day you take it. Whatever time you choose, you just have to make sure you are consistent and take it close to the same time each day.

Building your Zoloft tablet into your routine can help you remember to take it. For example, you could take it with your morning orange juice each day.

Another way to remember when to take Zoloft would be to set an alarm for the same time each day.

If you have any other questions on whether Zoloft can help you or need guidance on your treatment plan, speak with a healthcare provider.

8 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

Facts and Statistics. Anxiety and Depression Association of America. Retrieved from https://adaa.org/understanding-anxiety/facts-statistics
Generalized Anxiety Disorder (GAD). Anxiety and Depression Association of America. Retrieved from https://adaa.org/understanding-anxiety/generalized-anxiety-disorder-gad
Symptoms, Generalized Anxiety Disorder. Anxiety and Depression Association of America. Retrieved from https://adaa.org/understanding-anxiety/generalized-anxiety-disorder-gad/symptoms
What are the five types of anxiety disorders? U.S. Department of Health and Human Services. Retrieved from https://www.hhs.gov/answers/mental-health-and-substance-abuse/what-are-the-five-major-types-of-anxiety-disorders/index.html
Sertraline. Medline Plus. Retrieved from https://medlineplus.gov/druginfo/meds/a697048.html
Number of sertraline hydrochloride prescriptions in the U.S. from 2004 to 2018. Statista. Retrieved from https://www.statista.com/statistics/781658/sertraline-hydrochloride-prescriptions-number-in-the-us/
Arafa, M., Shamloul, R., (2006, March 23). Efficacy of sertraline hydrochloride in treatment of premature ejaculation: a placebo-controlled study using a validated questionnaire. International Journal of Impotence Research, 18: 534-538. Retrieved from
Sertraline. NHS. Retrieved from https://www.nhs.uk/medicines/sertraline/#:~:text=Sertraline%20is%20one%20of%20a,called%20serotonin%20in%20the%20brain.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Active substance SERTRALINUM | Compendium - drug reference book

Pharmacological properties
Indications SERTRALINE
Application of SERTRALINE
Contraindications
Side effects
Special instructions
Interactions
Overdose
Diagnosis
Recommended alternatives
Trade names

Medicinal preparations containing the active substance SERTRALINE

Prices in pharmacies

Serlift

tablets covered with a shell 100 mg blister, No. 28

SUN

Prices in pharmacies

CERTRALOFT 25

Plos 25 mg blister, No. 30

Health

Sertraloft 50

film-coated tablets 50 mg blister, № 30

Health

Prices in pharmacies

Sertraloft 100

film-coated tablets, № 100 mg 30029

Health

Prices in pharmacies

Stimalon ^®

tablets covered with a shell 50 mg blister, No. 30

EGIS

Prices

Blind 10045 ®

tablets, covered scrap No. 28

EGIS

Prices in pharmacies

Emoto

Capsules 50 mg container, No. 30

Ersel Pharma

Prices

Emoton

Tablets covered with film shell 50 mg Blizer, No. 30

Ersel Pharma

Pharmacy prices

specific serotonin (5-HT) reuptake inhibitor in neurons in vitro . It has little effect on the reuptake of norepinephrine and dopamine. At clinical doses, sertraline blocks the uptake of serotonin in human platelets. It does not have a stimulating, sedative or anticholinergic effect and does not have cardiotoxicity. Due to selective inhibition of 5-HT uptake, sertraline does not enhance catecholaminergic activity. Sertraline has no affinity for muscarinic (cholinergic), serotonin, dopamine, adrenergic, histamine, GABA or benzodiazepine receptors. Long-term use of sertraline in animals led to a decrease in the activity of norepinephrine receptors in the brain; other clinically effective antidepressant and anti-obsessional drugs have a similar effect.

Unlike tricyclic antidepressants, sertraline does not cause weight gain in the treatment of depression or obsessive-compulsive disorder (OCD); in some patients, it even decreases. The development of drug dependence has not been established.

Sertraline is actively biotransformed during the first pass through the liver. The main metabolite, N-desmethylsertraline, is almost 20 times less active than sertraline in vitro and is actually inactive in models of depression in vivo . T _½ N-desmethylsertraline varies within 62–104 hours. Sertraline and N-desmethylsertraline are actively biotransformed in the body; the resulting metabolites are excreted in the feces and urine in equal amounts. Unchanged sertraline is excreted in the urine in small amounts (<0.2%). Eating does not significantly affect the bioavailability of sertraline.

depression (symptomatic treatment), including accompanied by anxiety, with or without a history of mania. After achieving a clinical effect, maintenance therapy with sertraline can prevent relapses of depression.

Sertraline is also indicated for the treatment of OCD, including in children. Long-term (up to 2 years) treatment of OCD with sertraline is quite effective, safe and well tolerated after the initial effect is achieved.

Sertraline is also used to treat panic disorders with or without agoraphobia.

sertraline is prescribed once a day in the morning or evening, regardless of the meal. The usual therapeutic dose is 50 mg/day.

Treatment of panic disorders should be started at 25 mg/day, after 1 week of use the dose of sertraline is increased to 50 mg/day. Such a scheme helps to reduce the frequency of occurrence of negative reactions characteristic of panic disorder at an early stage of treatment.

The daily dose of the drug for all indications can be increased from 50 mg/day (with insufficient therapeutic effect) to 200 mg/day over several weeks.

Initial therapeutic effect may develop within 7 days; however, it usually takes 2-4 weeks or more to achieve the full effect (in the treatment of OCD). Maintenance dose for long-term treatment should be minimally effective; in the future, it is corrected depending on the therapeutic effect. Like many drugs, sertraline should be used with caution in patients with renal or hepatic impairment.

The safety and efficacy of sertraline in children aged 6–17 years has been established. The initial dose for the treatment of OCD in children aged 13-17 years is 50 mg / day, for children aged 6-12 years, a dose of 25 mg / day is prescribed initially, after 1 week it is increased to 50 mg / day. If necessary, in the future, the dose can be increased from 50 mg / day (with insufficient therapeutic efficacy) to 200 mg / day. When increasing the dose to prevent overdose, the lower body weight in children compared with adults should be taken into account. Considering 24 hour T _½ sertraline, the dose should be changed no more than once a week.

simultaneous treatment with MAO inhibitors, hypersensitivity to sertraline.

possible nausea and other dyspeptic symptoms, unstable stool or diarrhea, tremor, dizziness, insomnia, drowsiness, increased sweating, dry mouth and sexual dysfunction in men (mainly delayed ejaculation), withdrawal syndrome (rare cases), asymptomatic increased activity of ALT and AST (usually during the first 9weeks of treatment and quickly disappear after the abolition of sertraline), hyponatremia, platelet dysfunction, sometimes reactions that cannot be distinguished from the manifestations of the course of the underlying disease: paresthesia, hypoesthesia, symptoms of depression, hallucinations, aggressive behavior, agitation, anxiety and psychosis.

during treatment with antidepressants or anti-obsessional agents, there may be cases of exacerbation of mania or hypomania, convulsions. If seizures occur, in all cases, sertraline should be discontinued.

Patients with depression are prone to suicidal attempts, therefore, at the beginning of treatment, such patients should be under strict medical supervision.

The safety and efficacy of sertraline in children under 6 years of age have not been established. Sertraline should only be used during pregnancy if the expected benefit to the mother outweighs the potential risk to the fetus. Women of reproductive age during treatment with sertraline should use adequate methods of contraception. There is no information on the penetration of sertraline into breast milk, so it is not recommended to prescribe it during breastfeeding.

severe reactions (symptoms resembling serotonin syndrome) are possible in patients receiving sertraline in combination with MAO inhibitors. Symptoms of the interaction of selective serotonin reuptake inhibitors and MAO inhibitors include: hyperthermia, rigidity, muscle cramps, autonomic instability, changes in mental state (confusion, irritability and excessive arousal with the development of delirium and coma). In this regard, sertraline should not be used in combination with MAO inhibitors and should not be administered within 14 days after stopping treatment with them. You can prescribe an MAO inhibitor no earlier than 14 days after the abolition of sertraline.

When prescribing sertraline with other serotonergic drugs (tryptophan, fenfluramine), care must be taken and, if possible, such a combination should be avoided due to the existing possibility of pharmacodynamic interaction.

Substitution of other antidepressants or anti-obsessional drugs with sertraline should be done with extreme caution, especially when replacing long-acting drugs (eg fluoxetine).

Co-administration of sertraline 200 mg/day does not potentiate the effects of alcohol, carbamazepine, haloperidol, or phenytoin on cognitive and psychomotor function in healthy subjects; however, concomitant use of sertraline and alcohol should be avoided.

Co-administration of sertraline with diazepam or tolbutamide results in a small but statistically significant change in some pharmacokinetic parameters. Cimetidine causes a significant decrease in the clearance of sertraline in their combined use. The clinical significance of this effect is unknown. Sertraline had no effect on the β-adrenergic blocking activity of atenolol. Signs of interaction of sertraline at a dose of 200 mg/day with glibenclamide and digoxin were not identified.

Co-administration of sertraline 200 mg/day with warfarin resulted in a slight but statistically significant increase in prothrombin time; the clinical significance of this effect is unknown. In this regard, the prothrombin time should be carefully monitored at the beginning of sertraline therapy and after its withdrawal.

Caution should be exercised when sertraline is co-administered with drugs such as lithium, the effect of which may be mediated by serotonergic mechanisms.

possible death if the dose of sertraline is exceeded in combination with other drugs and / or alcohol. There is no specific antidote for sertraline. It is advisable to wash the stomach, prescribe enterosorbents, control vital functions, ensure airway patency and adequate ventilation of the lungs, and carry out symptomatic and supportive therapy. Given the large volume of distribution of sertraline, forced diuresis, dialysis, hemoperfusion, and exchange transfusion are ineffective.

What you should know about antidepressants

Ekaterina Kushnir

treats anxiety disorder

I have generalized anxiety disorder.

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 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.

Dosage of SSRIs - NHS

What are the optimal doses of antidepressants - Lancet article

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 right away 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

The 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.

For the first couple of weeks of taking it, there is a risk that you will not feel well - 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 to 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;
sweating and a feeling of heat occur in about 20% of people;
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 is very disturbing, frightening 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 consolidate the effect 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

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.

/psychotherapy-search/

How to choose a psychotherapist

Fact No. 8

Among antidepressants there are original drugs and generics

Preparations can be original and 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 effect of generic drugs should not differ from the effect of original drugs. However, this is possible, since generics may contain other additional substances or the manufacturer may use other raw materials.

Because of 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 confirmed 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 cost	Generics	Cost of generics
Sertraline	Zoloft	About 700 R, 100 mg tablets	Serenata, Sirlift	500-600 R 100mg tablets
Escitalopram	Cipralex	3000 R 10 mg tablets	"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

Generiki

"Serenata"

, tablets 100 mg

Escitalopram

Original

Cipralex

Original price

3000 r, tablets 10 mg

generics

"Selectra", "Elicea"

The cost of generics

500-1300 r, tablets 10 mg

Fluoxetine

"Origin 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 can 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, with tricyclic antidepressants and with 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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