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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4363
Experience:  MD Psychiatry
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I have been on Zoloft for 17 years after getting hit by a car

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I have been on Zoloft for 17 years after getting hit by a car (when I was 23 years old) while walking across the street. I have a predisposition to ocd, anxiety, and panic attacks. After the accident, the ocd, anxiety and panic attacks were out of control because I broke both legs and was trapped in bed for 6 months. Five years ago, I got married and prior to gettting married I had a lot of OCD and anxiety. My husband is a wonderful man but I had some trouble gettting married. I have been seeing a psychiatrist for the last 10 years and he helped me get married. Now, 5 years later, I weaned off Zoloft very slowly (we were thinking of having a baby) - it took 9 months and I exercised every day as a substitution. This past January 2013 I got a promotion at work that caused a great deal of anxiety. I am now having OCD thoughts all day long since January about being in a committed relationship with my husband. I am scared to be married again. My psychiatrist put me back on 175mg of Zoloft in Feb 2013 and in March 2013 I had to add 3.0mg of Klonopin daily because the anxiety became unbearable about my marriage. (Our marriage has been good for the last 5 years). My psychiatrist told me if I ever went off Zoloft and then had to go back on it would still work. However, I have read that sometimes Zoloft no longer works when you try to go back on it. Is this true? Also, what do you think about the whole situation regarding my marriage and OCD? I have been suffering since January 2013 very badly with these thoughts about being scared of being married. Is it because I went off my medicine? Any help you can provide would be very much appreciated.
Submitted: 3 years ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 3 years ago.

Hi there,


Welcome to Just answer !


Well you see it is a protocol adopted by most seasoned psychiatrists world over to re-start the same anti depressant drug that has worked effectively previously , so I believe your psychiatrist is doing the right thing here by re-starting you on Zoloft.


Now having said that I will agree with you that in some cases it does happen that after prolonged use of the anti depressant first time , when it is re-introduced second time it fails to provide the same effects as it provided before owing to the body's development of resistance against the drug.


But still I feel Zoloft is more likely to work for you as it has worked before and so says the conventional way of using psychotropic medications , so I will encourage you to follow your doctor's advice as he is adopting the right and most conventional method of managing your condition and usually this works for most people and so shall it work for you as well.


Well yes marriage being a major life event in any one's life can act as a precipitating stressful factor which may trigger the obsessional thinking of doubt which may further unfold more severe compulsive rituals and acts thereby giving way to OCD symptoms. So yes in your case one cannot rule out the possible connection between your marriage and ocd symptoms but having said that I will also like to encourage you to stick to your drug regime which shall see you through this tough phase of your life.


Also going off medicines too must have contributed to your ocd symptoms as had you been on the medicines then you could possibly have bypassed the part where marriage becomes a stressful triggering factor giving way to flare up of ocd symptoms.


So to summarize--


Stick to your doctor's sound advice .


If possible ask your psychiatrist to give you CBT sessions which is a type of counseling technique suited for curbing ocd symptoms.


Have patience and keep faith in your drug regime and your doctor, this will give you inner strength and belief which shall reflect good improvement of your symptoms.


I hope this helps.


Wish you all the best.


Please kindly leave a Positive rating if you are satisfied with the answer as only then will I be credited for my service.


If there is any further assistance needed please feel free to ask using the reply button.



Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4363
Experience: MD Psychiatry
Dr. Kaushik and other Mental Health Specialists are ready to help you
Customer: replied 3 years ago.

How long do you think I should continue with the Zoloft. I started back on it in Mid-February 2013. How many more months do you think I should wait to see if it is going to work? Also, how does one know if one is having an "OCD" thought or true thoughts and feelings about an issue such as my marriage?

Expert:  Dr. Kaushik replied 3 years ago.

Ever since you got re-introduced on Zoloft in mid February with addition of klonopin in march this year , how much percentage of improvement have you noticed in your ocd symptoms till date ?


Well ocd thoughts need to be persistent , repetitive , to be considered as unreasonable , unjustified , illogical by the person himself, there need to be an inner struggle to prevent oneself from having these thoughts , eventually the thoughts win which evokes a sense of guilt and disgust within the person. These thoughts often take a vicious pattern of occurrence with increasing severity as time passes by leading to decompensation in the form of impairment of one's functioning in the social, inter-personal and professional domains of life and taking away quality of life and one's existence. This is hallmark of a ocd thought which shall help you to differentiate it from true thoughts which are based on logic, are justified to a greater extent , do not cloud one's mind so much so to snatch away important time and quality of one's life.


I hope this helps and I will get back to you once you reply to my query.



Customer: replied 3 years ago.

I was put on the Klonopin about a month after increasing the Zoloft dosages. I was put on Klonopin in Mid March (I started increasing Zoloft in mid February). The Klonopin worked somewhat well for about 2 weeks because it calmed me down - enough where I could eat and sleep and go to work. The Klonopin is still helping - I can tell it is the Klonopin because about 40 minutes after taking it I can function better. As far as the OCD thoughts, they are still there - perhaps they improved about 5% but again I suspect it is because of the Klonopin. The Klonopin calms me down to a certain degree - maybe about 25% (when it comes to overall anxiety) but the OCD thoughts are still there underneath - it feels as if the klonopin is masking the OCD which does help. I have a feeling, though, if I were not on the Klonopin, I would not be functioning that well. In the past, whenever I had an OCD episode for weeks, I would take a little xanax - about .75mg per day with the Zoloft until a few weeks went by and then the Zoloft was enough to do the job by itself. This past Feb when my psychiatrist increased the Zoloft rapidly from 25mg to 175mg within about 12 days, the Xanax stopped working. Then the condition got really bad until I was put on the Klonopin in Mid-March. I really don't know if the marriage thoughts are OCD - they are persistent and repetitive and go on all day long. However, because it is not the most "outrageous" kind of thought such as hurting someone, it is confusing me whether it is really valid or not. Do you know what I mean? Thank you again for answering me and giving me your time - I truly appreciate you helping me with all my heart.

Expert:  Dr. Kaushik replied 3 years ago.
Well the marriage thoughts that you are harboring are more likely to be pre-marital jitters which almost everyone gets prior to marriage and i can understand your conundrum regarding these thoughts being obsessional but l it does not appear to be that way though, so you may relax about this sort of linking them up. However i will like to tell here that the ocd thoughts need not necessarily be of violent nature such as hurting someone.

If since mid february when you were re-started on zoloft with addition of klonopin along the way, you have felt only 5 % improvement in your overall ocd symptoms then i reckon your suspicion regarding zoloft 's inefficacy is indeed validated because in 2 and half months of use at least 25 % improvement in overall OCD symptoms is most likely to be expected which is not there to be seen in your case, that too when you are on a fairly high dose. So i feel you should talk to your doctor and ask him to switch you over to another class of anti depressant such as Anafranil ( clomipramine ) which is a TCA class anti depressant as opposed tpo zoloft which is ssri anti depressant. Anafranil at dose of 75 mg is to be started on and then after 2 weeks the dose shall be raised to 100 mg maintained on it. This drug is equally effective as compared to ssri's in dealijng with ocd.

Klonopin shall be continued as it is.

I hope this helps

Wish you all the best.

Please kindly leave a Positive rating if you are satisfied with the answer as only then will i be credited for my service.


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