Health - New on Zoloft (sertraline), have questions

[Creeping Death]

SWIM took his first 25mg zoloft yesturday. The plan is 25mg for 7 days, then 50mg for 28 days.. SWIM is getting them for depression. SWIM was always against SSRI's.. but swim had never been in such a deep hole mentally before. SWIM just needs to get out of feeling this way, he can't take feeling so hopeless anymore like there is no help.

Hospitals and psychologists themselves have been of completely minimal help to SWIM. They only talk shit and send him to the next doctor. So SWIM said yes to Zoloft. Problem is SWIM will probably get WORSE now, until his body is used to the Zoloft.

What can SWIM expect duing this period? Will he feel so bad that he needs to go to the emergency clinic to get locked up? Doctor said that sideeffects are nothing to worry about, but thats definately not what i have read on google. The idea that SWIM will get worse is confusing him to the point that SWIM's considering stopping the Zoloft before his body is in on them. Since his depression gets milder sometimes, maybe it is better to medicate with illegal drugs for these "lowest periods"? And then hope that SWIM will be okay after a while.. and then he can stay off drugs while the depression is "milder", though it still effects his life. But this means highs and lows, while Zoloft means a more steady mood without peaks. Maybe it is easier to cure SWIMS depression with Zoloft, or without it?? SWIM doesnt know. He just doesnt want to end up addicted to Zoloft and eating them for years. Meanwhile talking to psychologists has seemed completely pointless.

Also SWIM is wondering wich drugs Zoloft will interact with. Wich are safe and wich are not mixable with Zoloft?

Buprenorphine (subutex 8mg)
Ecstacy (maybe cut with Amphetamine or whatever else is in them)
Benzos of the available type, usually Alprazolam (xanax) or Flunitrazepam or Diazepam. But any benzo is possible.
drinking
smoking a joint

Is it dangerous to excercise when you are on Zoloft? I mean really train hard to your bodys limit. It wont cause a siezure or a stroke or anything?

[Jatelka]

Hello Creeping Death, I've not seen you around for a while. Sorry things aren't going so well

Bear in mind that both buprenorphine and sertraline have been reported to reduce seizure threshold, so a combination of the two may have added effects

SSRI's attenuate the effects of MDMA, and so (at best) your monkey will waste the MDMA and (at worst) be at risk of serotonin syndrome, due to cranking up the MDMA dose to get the desired effects

SSRI's and amphetamines are classed as having a "moderate" risk of interaction, but, given that serotonin syndrome may result, it's probably not a risk worth taking

In terms of alcohol, it is generally recommended that it be avoided with SSRI's. There have been reports of excess sedation as well as agitation

Some SSRI's have effects on CYP3A4, the enzyme involved in metabolising certain benzodiazepines (triazolam,alprazolam, and midazolam spring to mind) so there is a risk of interaction here as well, with increased plasma benzodiazepine concentrations, leading to excess sedation.

From a quick search, Sertraline does not seem to have much CYP3A4 activity, but this is still something that should be cautioned against

As for marijuana? Well if one becomes anxious with marijuana then this should also be avoided, as SSRI's also increase anxiety in some.

Generally though, I think your monkey needs to have a think about their depression and whether their psychoactive use may be contributing.

[Creeping Death]

http://en.wikipedia.org/wiki/Serotonin_syndrome

It says that some opiates are also linked to serotonin syndrome. However SWIM has heard that buprenorphine is only potentiated by being on an SSRI, and that it's not dangerous. SWIM will stop using it eventually, but he hasn't done that yet.