I started taking Sertraline for depression and anxiety. When will the symptoms subside?

Question

Hello doctor,

I am a 53-year-old male. I am a diabetic and have a family history of diabetes and depression. I developed anxiety and depression in 2015 and was on Cipralex 5 mg once daily for the past five years. However, the symptoms of anxiety and depression have come back from the middle of this year, and my doctor switched me to Sertraline 50 mg twice daily. I am taking this medicine for the past three weeks. But there is no visible improvement in my symptoms of depression and anxiety.

Answer 1

Hello,

Welcome to icliniq.com.

I can see your frustration after the trial of two types of medications without any improvement. Let me summarize your problem. You have been experiencing a depressed mood for the last six years, which was improved with an antidepressant. Due to the relapse, a doctor changed the antidepressant. But you are still depressed. You are diabetic with a positive family history of psychiatric disorder. To address your concern, please see the following treatment plan.

If you have any existing stress, you need to solve and cope with that stress.
If your previous antidepressant Cipralex (Escitalopram), was stopped abruptly, you might have some withdrawal depressive mood.
Cipralex and Sertraline are from the same SSRI (selective serotonin reuptake inhibitor) group, so different groups of antidepressants could be tried.
Some medications like anti-psychotics or mood stabilizers could be added to potentiate the effect of the antidepressant.
Overall, medication is only a part of treatment. Changing negative thought processes and lifestyle changes are also essential.

Answer 2

Hello,

Welcome back to icliniq.com.

The maximum dosage of Sertraline is 200 mg. So there is a scope to increase the dosage. But after 4 -6 weeks, if you do not feel any effect, then Sertraline would need to be switched to another anti-depressant. Also, Clonazepam is an addictive medication, so do not be dependent much on it. Keep your diabetes under control and push yourself to do regular exercise. Feel free to contact me if you have further queries.