Zoloft and klonopin together

Early coadministration of clonazepam with sertraline for panic disorder

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Clinical Trial

. 2001 Jul;58(7):681-6.

doi: 10.1001/archpsyc.58.7.681.

A W Goddard¹, T Brouette, A Almai, P Jetty, S W Woods, D Charney

Affiliations

Affiliation

¹ Department of Psychiatry, Yale University School of Medicine, and Yale Anxiety Clinic, 100 York St #2J, New Haven, CT 06511, USA. [email protected]

PMID: 11448376
DOI: 10.1001/archpsyc.58.7.681

Clinical Trial

A W Goddard et al. Arch Gen Psychiatry. 2001 Jul.

. 2001 Jul;58(7):681-6.

doi: 10.1001/archpsyc.58.7.681.

Authors

A W Goddard¹, T Brouette, A Almai, P Jetty, S W Woods, D Charney

Affiliation

¹ Department of Psychiatry, Yale University School of Medicine, and Yale Anxiety Clinic, 100 York St #2J, New Haven, CT 06511, USA. [email protected]

PMID: 11448376
DOI: 10.1001/archpsyc.58.7.681

Abstract

Background: There is debate about combining benzodiazepines with selective serotonin reuptake inhibitors in the acute treatment of panic disorder. Although this medication combination is widely used in clinical practice, there is no well-tested, optimal method of coadministering these medications for the treatment of panic disorder. The purpose of this study was to test the efficacy of early coadministration of clonazepam with sertraline in the treatment of panic disorder.

Methods: Fifty patients with panic disorder were randomized into a double-blind clinical trial. Patients received open-label sertraline for 12 weeks (target dose, 100 mg/d), and in addition were randomized to groups receiving either 0.5 mg of active clonazepam 3 times daily or placebo clonazepam for the first 4 weeks of the trial. The clonazepam dose was then tapered during 3 weeks and discontinued.

Results: Thirty-four (68%) of 50 patients completed the trial. Drop-out rates were similar in the sertraline/placebo vs the sertraline/clonazepam group (38% vs 25%) (P =. 5). An intent-to-treat analysis (on last observation carried forward data) revealed a much greater proportion of responders in the sertraline/clonazepam compared with the sertraline/placebo group at the end of week 1 of the trial (41% vs 4%) (P =.003). There was also a significant between-group difference at the end of week 3 with 14 (63%) of 22 of the sertraline/clonazepam group responding to treatment vs 8 (32%) of 25 of the sertraline/placebo group (P =.05). This difference was not observed at other times during the trial.

Conclusion: These data indicate that rapid stabilization of panic symptoms can be safely achieved with a sertraline/clonazepam combination, supporting the clinical utility of this type of regimen for facilitating early improvement of panic symptoms relative to sertraline alone.

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Zoloft and Klonopin Sing A Frustrating Lullaby

It’s no big secret or anything. Anxiety meds can make you sleepy. Like, really sleepy.

From my bottle of Zoloft, an SSRI used to treat my panic disorder: “May cause drowsiness.”

From my bottle of Klonopin, a benzodiazapine my doc has me using to counter the anxiety that sometimes occurs while titrating an SSRI upward: “May cause drowsiness.”

Drowsiness achieved, people. Complete and utter drowsiness.

So, how can I cope?

THIS ISN’T MY FIRST RODEO

First of all, I hate the phrase “this isn’t my first rodeo”, but whatever. It works, and my brain is too tired to think of something more clever.

I took Paxil back in college when I was first diagnosed with panic disorder, and I can barely remember those first three months of taking it.

And why?

I was always sleeping.

Oh, my poor, poor college roommate — I would set my alarm clock for 8 a.m. and then snooze that sonofabitch in 9-minute increments all the way til noon (or later). She’d wake up, watch me slap my alarm clock once or twice, go to class, and then return to find me still huddled under a mass of blankets in my twin bed. She’d then sit down at her desk to study, interrupted every nine minutes.

“BEEP BEEP BEEP BE–”

Smack.

I was exhausted both mentally and physically. I slept like a baby at night — and, “like a baby”, I mean for over 12 hours each evening. I’d still curl up for a nap during the day if I had any time between classes.

THE ZOLOFT AND KLONOPIN SLEEPIES

I call them “the sleepies” in a (mostly futile) effort to make the drowsiness less annoying. (My logic: The word “sleepies” sounds cute, even cuddly, and how can anything cute and cuddly be annoying?)

Here’s what my days have looked like lately: wake up around noon. Wash up, put “real” clothes on (maybe), and immediately regret waking up so late.

Come downstairs to see all the work on my dining room table — a big long list of to-do’s, a list of blog posts I want to write, a video or two I need to edit, some papers I have to grade, and — ew, some bird poop.

Yeah, bird poop. Because I have a parrot, and when I can’t get started on my work, I let him run around on the table and chew things. More than one utility company has received payment via a check with little beakmarks punched around the edge. (No poop on any bills yet, but we’ve had some close calls.)

BRAIN FOG INTERMISSION

What was I writing about again? I’m so tired that I sort of forgot. Birds? Bills? (While we’re at it, why do birds have beaks, yet ducks have bills? This is a tangent that will probably drive me to Wikipedia when I’m done writing. Oh, writing. That’s what I’m doing here.)

Oh. Meds. Yeah.

Anyway, after I take care of the day’s essential basics, I find myself dangerously low on spoons. If I manage to grade some papers, the laundry has to wait until I’ve taken a nap.

If I managed to do the laundry, the paper-grading has to wait. Because…so…much…tired. (Did that last sentence make sense? Good, because it wasn’t really supposed to. )

It’s so hard to get my usual repertoire of stuff done — work stuff, household stuff, social stuff — when I’m this tired.

Iam happy to say that I’m experiencing a reprieve from my severe anxiety. And I haven’t had a “true blue” panic attack in over a month. A month!

But the cost?

Zzzzzzz.

I’ll be back (when I have more spoons) to tell you more about how I cope. But before that, I’d love to hear how you cope with this sort of thing — assuming that you’ve been on an SSRI or a benzo before. (Many, many, MANY of you have, I’m certain.)

So, please comment and let me know: how do you fight the SSRI and benzo lullaby?

Photo: urbanizr77 (Flickr)

Russia again suspended the supply of the antidepressant Zoloft - RBC

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Due to production problems, the Zoloft antidepressant (active ingredient sertraline) is temporarily not supplied to Russia. This is not the first time that the supply of this drug has been interrupted: at the beginning of the year it was not available in pharmacies

Photo: Konstantin Kokoshkin / Global look Press

technical problems in production, RIA Novosti was told in the press service of the Russian division of the American company Viatris.

“Due to technical problems at the production site of a third-party manufacturer of the finished product, supplies of the Zoloft drug to the Russian Federation have been temporarily suspended,” they said, noting that problems arose with the supply of the drug in packages of 28 tablets with a dosage of 100 mg and in packs of 14 or 28 tablets with a dosage of 50 mg.

“The reason for the temporary suspension of supplies is not related to the quality, safety or effectiveness of the finished product,” RBC was told in the press service of the Russian representative office of Viatris.

The company is currently evaluating the timing of the suspension of supplies and recommends that patients who are prescribed Zoloft consult with their doctor to find a possible replacement for the drug.

Zoloft is an antidepressant, a selective serotonin reuptake inhibitor. The active substance sertraline is included in the list of vital and essential drugs (VED).

The drug is popular and widely used by psychiatrists and psychotherapists due to the minimal number of side effects. It has analogues, but the replacement of the drug is very difficult for patients.

Roszdravnadzor notes that since last year in Russia the number of drugs with the active ingredient sertraline has increased by 30%: since the beginning of the year, more than 2 million packages of five trade names have been put on sale, including over 958 thousand packages of Zoloft. Thus, the agency points out, there is no shortage of medicines on the Russian market. “The temporary lack of the drug in some pharmacies in the regions is associated with a rush demand,” Roszdravnadzor believes.

This is not the first time that Zoloft supply problems have arisen. Thus, Russian pharmacy chains noted a shortage of the drug last January. Roszdravnadzor clarified that the antidepressant had not been on sale since January 1, and expected supplies to resume in the second quarter of this year.

Prior to this, there were interruptions in the supply of Zoloft in March last year, Pharmvestnik reported. Then it ended in pharmacies in Moscow, Omsk, Nizhny Novgorod and other cities.

Authors

Pharmacies reported problems with the supply of a popular antidepressant - RBC

Large pharmacy chains reported interruptions in the supply of an antidepressant with the active ingredient sertraline, which is produced by Viatris under the Zoloft brand. The drug is one of the three most popular antidepressants

Photo: Artyom Geodakyan / TASS

Russian pharmacy chains faced a disruption in the supply of Zoloft antidepressant (active ingredient sertraline) produced by the American pharmaceutical company Viatirs.

Supply problems were reported to RBC by Rigla and 36.6 pharmacy chains, which also includes Gorzdrav. Now there is a small amount of Zoloft in the 36.6 network, but there have been no deliveries since October 2021, the representative of 36. 6 explained.

www.adv.rbc.ru

“There is a shortage of a specific brand - Zoloft. At our request, we have not yet received information about the prospects for the supply of the drug, ”Natalya Burdina, commercial director of the Rigla pharmacy chain, told RBC, noting that the pharmacy has stocks of other drugs with the active ingredient sertraline.

www.adv.rbc.ru

RBC sent inquiries to other large pharmacy chains.

According to the analytical company DSM Group, Zoloft did not show sales drops in the retail segment during 2021. In November-December, pharmacies sold a total of almost twice as many Zoloft packages as in 2020 - more than 170 thousand packages against 96 thousand. The drug, according to analysts, was in third place in 2021 in popularity among consumers in the antidepressant segment

“The numbers that we see in retail sales are the remnants of the drug, the last packages. The deficit began in the regions where the highest consumption was noted - Moscow and Central Russia, but soon it will reach distant regions, ”DSM Group CEO Sergey Shulyak told RBC.

RBC sent inquiries to the distributing companies of Katren and Pharmkomplekt with a request to comment on drug interruptions. A representative of the Pulse company, which also distributes the drug, confirmed that Zoloft is in short supply - the manufacturer does not give a clear delivery date, but it could be the end of January. “The company admits that drug quotas for deliveries to Russia may be reduced due to a surge in depressive disorders around the world against the backdrop of a pandemic. Since there is a shortage in other groups of antidepressants, ”RBC was told at the Pulse company.

The active substance sertraline is included in the list of vital and essential drugs (VED), however, according to DSM Group, only a small part of the drug is involved in the state segment - less than 10% of the total. “Therefore, it would be wrong to say that the entire volume went there,” Shulyak concluded.

What do doctors say about Zoloft? V.P. Serbsky Alexander Fedorovich. “It has analogues, but if, as a result of the selection, the specialist came to the conclusion that this particular drug is effective, then the replacement always involves time and quite a lot of complexity for the patient,” he said.

Viatris Russia confirmed to RBC that there were problems with the supply of Zoloft. “Recently, due to the COVID-19 pandemic, there has been a significant increase in demand for Zoloft in various countries. As a result, there are delays in the supply of the drug, including to Russia," the company told RBC. They added that the resumption of supplies is expected no earlier than March 2022.

Roszdravnadzor RBC reported that from January 2021 to January 2022, more than 847 thousand packages of Zoloft in five dosage forms entered the civil circulation. The agency has not received letters [from the manufacturer] to stop supplies, but in April 2021 there was a letter about delays. Also, over the same period in Russia, more than 1.4 million drugs with the active substance sertraline were introduced into the civil circulation.
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Zoloft and klonopin together

Early coadministration of clonazepam with sertraline for panic disorder

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Zoloft and Klonopin Sing A Frustrating Lullaby

Russia again suspended the supply of the antidepressant Zoloft - RBC

Pharmacies reported problems with the supply of a popular antidepressant - RBC