Dr. Aditya Gupta
Psychiatry
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Patient's Query
Hello doctor,
I have had abdominal pain for the last seven weeks. I experienced the same kind of pain three years back. I had all the imaging examinations, extensive lab workups, and all were normal. I was on 25 mg of Zoloft and 10 mg of Pamelor for the last two years, and I had little discomfort. I stopped Pamelor and Zoloft about three months ago, which was my decision. Again after two CT scans and extensive lab workups, no pathology was found. I have been labeled with IBS. My doctor referred me to a specialist, who recommended I restart the Zoloft at 50 mg. I feel lousy, and I have lost 10 pounds because I have no appetite and I am at my wit's end. I am scheduled to see the specialist this week. Please advise.
Hello,
Welcome to icliniq.com.
It appears to be a case of IBS (irritable bowel syndrome). Zoloft (Sertraline) usually help in IBS. We will first talk about insomnia, for which, follow steps of sleep hygiene as follows: Sleeping and waking up at a regular time, avoid caffeinated drinks at least eight hours before sleep, avoid using TV, mobile, laptop, etc., half an hour before sleep, do relaxing activities like taking a hot shower, do not take a nap during the day, use your bed only for sleeping, that is, do not eat or watch TV in your bed, practice breath relaxation exercises daily, it will help with IBS too and discuss with your treating doctor regarding Clonazepam. Now coming to IBS symptoms, following things can help: Take small frequent meals with plenty of fluids and fiber-rich diet, take low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet, practice yoga like wind relieving pose, corpse pose, fish pose, locust pose, etc, while lying down, clockwise massage your abdomen with one hand. You can discuss with your treating doctor regarding taking a probiotic like VSL#3. Hope this will help. Feel free to ask if you have any further queries.
Patient's Query
Hi doctor,
Thank you for your suggestions. I do yoga, whirlpool baths, and I get regular massages. But I am very concerned about the loss of appetite. When Zoloft starts acting on my body, will I get my appetite back? Is 50 mg Zoloft a good start? And when will Zoloft start working?
Hello,
Welcome back to icliniq.com.
Zoloft (Sertraline) is a good drug and usually started at a dose of 25 mg or 50 mg a day. It usually starts exerting its effect in about two week time. The dose can be increased further. For appetite, take small frequent meals. Taking more liquid diet also helps. Also, discuss with your treating doctor regarding adding a probiotic and an enzyme preparation. Cyproheptadine also helps with appetite. Hope this will help. Feel free to ask if you have any further queries.
Patient's Query
Hello doctor,
Thank you for replying. You mentioned Clonazepam for sleep, can I take Zoloft with Clonazepam at night? I now take Zoloft in the morning. I also take probiotics.
Hello,
Welcome back to icliniq.com.
Though you can take Zoloft with Clonazepam at night, in my opinion, it is better to take Zoloft in the morning, as it can be arousing in some patients. Hope this solves your query. Feel free to ask if you have any further queries. Thank you.
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Psychiatry
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