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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suffer From Seasonal Depression, On Zoloft. Need Anti-depressant That Works Well With 12mg Suboxone

i am trying to find an anti-depressant that works well with 12mg suboxone..i am currently on 150mg zoloft, but the side effects are extreme tiredness..could sleep all day.
i spoke with my primary dr.on thursday and he increased zoloft 50mg because i have been feeling extremely depressed. but i see on drug interaction page that there is a moderate interaction..i usually only suffer from seasonal depression...any suggestion would be greatly appreciated as the way i am feeling tired depressed and lack of energy will lead me back to opiate use as this was the reasons that i enjoyed them in the first place..thank you jessica
Wed, 17 Apr 2013
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Psychiatrist 's  Response
Hi,
thank you for using health care magic.

Zoloft is very good anti depressant drugs that has very less drug interaction with suboxone.
Your extreme tiredness may be due to
1) Opiate withdrawal
2) as a symptom of depression
3) as a side effect of Zoloft
4) Vitamin B12 or Vitamin D Deficiency
You should consult a psychiatrist for detailed evaluation and proper case management.
the treatment depends on the cause of treatment.
For seasonal affective disorder, many times tricyclic anti depressants like clomipramine are very good.
I hope you will be fine soon.

thanks
Dr Nehal Shah
M.D.PSychiatrist
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  User's Response
Hello Jessica,

You can discuss with your doctor about adding Modafinil to the current treatment regime. Modafinil is specially useful in patients complaining of fatigue, lack of energy, poor concentration and extreme sleepiness.

There are no significant drug interaction between Modafinil and the two medicines you are taking currently also to the best of my knowledge.

Hopefully adding Modafinil by your doctor should be useful in the symptoms you have mentioned.

Kind regards

Vikas
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Suffer From Seasonal Depression, On Zoloft. Need Anti-depressant That Works Well With 12mg Suboxone

Hi, thank you for using health care magic. Zoloft is very good anti depressant drugs that has very less drug interaction with suboxone. Your extreme tiredness may be due to 1) Opiate withdrawal 2) as a symptom of depression 3) as a side effect of Zoloft 4) Vitamin B12 or Vitamin D Deficiency You should consult a psychiatrist for detailed evaluation and proper case management. the treatment depends on the cause of treatment. For seasonal affective disorder, many times tricyclic anti depressants like clomipramine are very good. I hope you will be fine soon. thanks Dr Nehal Shah M.D.PSychiatrist