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Suggest Dosage For Sertraline While Treating Stomach Flu And Acid Reflux

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Posted on Sat, 13 Feb 2016
Question: Ive been taking sertraline for 4 years, back in XXXXXXX my family doctor and I decided that we could lower the dose from 50mg to 25mg. All went well no problems. 3 months later we decided to take it every other day. No problems. A couple month or so later we decided to go every 2 days. No real problems.. . Last Wednesday when I was eating dinner I felt a bit sick to my stomach i thought it was just hunger so i kept on eating, i ate desert a little later even had some cereal in the evening. But a couple hours after that I felt nauseous. I laid down on the bed and had a panic attack. Or an anxiety attack I guess.

It subsided in about 30 mins and then I fell asleep. The next day I didnt feel very well in my stomach. I thought maybe I caught a stomach flu, but was worried that it was the meds. So I started taking the Sertraline every day again. Its been a week and I seem to be having reconditioning symptoms. Sweats, not sleeping well, stomach has been feeling ill, nervousness and some anxiety.. I want to know if its because I started back on the meds the way I did and if this will subside. I did go see my family doctor but he seemed to think that it was my hyperacidity affecting my stomach...and that I could continue on the 25mg dose. I feel really anxious too sometimes. I should add, he did give me zofran to take for my nausea but that just gave me major headaches and major anxiousness. I took a total of 4 between Tuesday and Wednesday of this week. Yesterday I did not take any, he told me to stop and gave me something else, but I have not taken it because the nausea isnt that bad. I am trying to figure out what is wrong with me. I do remember having some of these symptoms when I first started on zoloft 4 years ago but this time I was technically never "off" of it completely. It was still in my system somewhat, as I was taking it every 2 days.
doctor
Answered by Dr. Chintan Solanki (2 hours later)
Brief Answer:
initially stomach problem, later it may be due to drug or anxiety

Detailed Answer:
Hello,

Thanks for writing to us. I read your query and understood your problem.

25 mg zoloft on every day is really very low dose and the way you have been reducing your dose there is no possibility of drug discontinuation symptoms. On Wednesday whatever the stomach problem was there, it should be likely due to some stomach problem itself like hyperacidity as mentioned by your doctor.
Second day you again felt some problem and you yourself restarted zoloft 25 mg daily as you were taking before 6 months by just thinking that it was your anxiety problem.
After that you felt more discomfort. This discomfort can be due to one or more of three reasons.

- One is due to zoloft itself as you had history of some symptoms when you had started zoloft first.

- Second is likely due to overall anxiety about your current situation which started on Wednesday.

- Third is recurrence of your basic problems for which zoloft was started before 4 years.

I recommend stopping zoloft in 10 days by doing it half of 25 after 5 days. Take anti acidity and anti-vomiting drug for 10 days. Keep your mind relax with deep breathing and meditation. You may improve completely with this approach. However anytime if you feel your anxiety is not improved or worsened zoloft can again be restarted gradually and titrated up to 50 mg.

Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki (18 minutes later)
So it may not be discontinuation symptoms obviously, maybe I got term wrong.

What I meant was I was down to taking it only ever "2" days. So basically 3 days a week I would take the zoloft. Then all of sudden I started taking it EVERY DAY. So it was in a sense doubling the dose over night. The symptoms I've had are solid with what ive read on the web regarding Zolofts side effects which are to go away after a week or two.

So buy saying " One is due to zoloft itself as you had history of some symptoms when you had started zoloft first. "

You believe that it IS possible that these symptoms I am feeling are because I RESTARTED the medication again so suddenly. Even with such a low dose, its not a discontinue symptom but a "continuation" symptom. IE coming back on something after weaning off of it. I mean you could argue by taking it every 2 days I was basically off the drug almost complete right? Especially at such a low dose. So by coming back on it completely it started creating some side effects. It has been 7 days since I am now back on it every day and the side effects are still persisting as I mentioned in my previous message.
doctor
Answered by Dr. Chintan Solanki (4 hours later)
Brief Answer:
yes you got it right

Detailed Answer:
HI,

Thanks for follow up and sorry for delayed response.

Taking 25 mg every third day it really negligible dose. You have not double but almost thrice as you were taking every third day since a month as you mentioned in your first query.
You were already suffering from some problem of stomach and by relatively increasing the dose you might have worsened that condition.

Discontinuation symptoms mean withdrawal symptoms which generally happen when person is taking Zoloft for long and stop it cold turkey. That was not the case with you. You have tapered off very slowly.

By stopping the drug for a while we can check that these are not side effects of medicines as well as we can treat basic stomach problem if any is there without any doubt in mind. When there is no underlying stomach problem and you are not taking zoloft also and still your anxiety problems persist, it means there is likely recurrence of your psychological problem.

Hope you have got more clear idea now.

Feel free to discuss further.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki (3 days later)
The anxiety is getting worse it seems. Now when I try to take a nap in the morning I cant sleep. I lay there and when I feel like I am falling asleep its like the anxiety suddenly kicks in and i feel this upset feeling in the pit of my stomach that only lasts a few seconds but it keeps me from sleeping. On top the of the sleepless nights of feeling hungry all the time, this is making this almost unmanageable. I have also started developing some left side flank pain as well that comes and goes. I am have an appointment with a gastroenterologist tomorrow morning. I certainly hope he can treat this, I dont know who else to turn to.
doctor
Answered by Dr. Chintan Solanki (11 hours later)
Brief Answer:
anti anxiety drug can help for intimidate relief

Detailed Answer:
Hi,

Thanks for follow up.

Until your gastroenterologist rules out any stomach problem we cannot say that your problem is psychological and anxiety is there only. However in any case anti-anxiety drug like clonazepam or lorazepam can help to relieve your symptoms. After that specific treatment can be done either of basic stomach problem or of psychological problem.

Take care.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Chintan Solanki

Psychiatrist

Practicing since :2007

Answered : 2406 Questions

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Suggest Dosage For Sertraline While Treating Stomach Flu And Acid Reflux

Brief Answer: initially stomach problem, later it may be due to drug or anxiety Detailed Answer: Hello, Thanks for writing to us. I read your query and understood your problem. 25 mg zoloft on every day is really very low dose and the way you have been reducing your dose there is no possibility of drug discontinuation symptoms. On Wednesday whatever the stomach problem was there, it should be likely due to some stomach problem itself like hyperacidity as mentioned by your doctor. Second day you again felt some problem and you yourself restarted zoloft 25 mg daily as you were taking before 6 months by just thinking that it was your anxiety problem. After that you felt more discomfort. This discomfort can be due to one or more of three reasons. - One is due to zoloft itself as you had history of some symptoms when you had started zoloft first. - Second is likely due to overall anxiety about your current situation which started on Wednesday. - Third is recurrence of your basic problems for which zoloft was started before 4 years. I recommend stopping zoloft in 10 days by doing it half of 25 after 5 days. Take anti acidity and anti-vomiting drug for 10 days. Keep your mind relax with deep breathing and meditation. You may improve completely with this approach. However anytime if you feel your anxiety is not improved or worsened zoloft can again be restarted gradually and titrated up to 50 mg. Hope I have answered your query, I will be happy to help further. Regards, Dr.Chintan Solanki.