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Suggest treatment for depression after stopping Zoloft

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Answered by

Psychiatrist
Practicing since : 2005
Answered : 637 Questions
Question
Question regarding Zoloft. My 62 year old girlfriend and I have been dating over the past 1.5 years. She was diagnosed with GAD and prescribed 25mg of Zoloft daily. Her GAD calmed down and we had a great time together for 9 months. She did not like the sexual side effects of Zoloft (inability to achieve orgasm.) One day she said I was here Zoloft and she went off Zoloft cold turkey. Within 3 weeks the GAD returned with severe depression and occasional anger outbursts. Her Psychologist suggested she go back on Zoloft and increase it to 50mg. She refused to go back on it. The anxiety and depression became worse with panic attacks and anger driven tirades. The slightest negative issue would set off her anger. I could not continue to handle the constant GAD and anger issues any longer and ended the relationship was April. My question is: is it possible for her going off 25mg of Zoloft to have such a dramatic impact on her illness. Or does it appears there might be other issues that were never addressed. The anger outbursts were frightening and really concerned me. They were directed at everyone not just me. Still ruminating but recovering. Depression fallout victim - Thanks
Posted Mon, 4 Aug 2014 in General Health
 
 
Answered by Dr. Sunil Gupta 50 minutes later
Brief Answer:
Treatment with other anti-depressants will help

Detailed Answer:
Hi,

I went through your query and do appreciate your concern for your girlfriend.

Zoloft (Sertraline) does have the side effects of delaying orgasm and your girlfriend going off it is understandable. She was doing well on it for a significant time. Hr symptoms returning after stopping zoloft and further worsening of anxiety together with depressive symptoms is not surprising. It can happen if treatment is interrupted in between.

The anger outbursts can very well happen due to depression. Just having anger outbursts doesn't mean that a person is bipolar. In bipolar, there has to be episodes of mania or hypomania which are characterized by continuous periods of elated/irritable mood, decreased need to sleep, increased self esteem and so on.

I feel your girlfriedn should meet her psychiatrist and restart on treatment. Medication like Bupropion and mirtazapine doesn't have the sexual side effects of zoloft and are effective drugs for depression and anxiety. These agents can be considered for her.

I do hope that you as well as your girlfriend get well soon. Please feel free to ask any further queries that you might have. I will be glad to help.

Best wishes,

Dr. Sunil Gupta




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