Dr Vikas : Hello ! Thank you for your question, I’m Dr. Vikas (M.D Psychiatry) and I’ll try to help you today.
Dr Vikas : Since when you are taking Zoloft?
Dr Vikas : Are you also taking any other medicine along with Zoloft?
Dr Vikas : Is there any recent history of consuming excessive alcohol or coffee?
Dr Vikas : Please reply to my queries so that we can discuss further.
JACUSTOMER-ewxplnb3- : I have been taking Zoloft for 4- 5 yrs
JACUSTOMER-ewxplnb3- : i also take Topamax 50mg 1 daily, ambien 10mg daily ant night, protonic 40mg
JACUSTOMER-ewxplnb3- : the topa max is for migraine headache prevention
JACUSTOMER-ewxplnb3- : i do drink quite some bit of coffee but i do not drink alcohol
Dr Vikas : Thanks for your reply. For controlling anxiety symptoms there are two possible options.
Dr Vikas : Both can be effective in your case.
Dr Vikas : If you are still experiencing anxiety while taking on 100 mg of Zoloft, one possible option is to ask your doctor to further increase the dose to 150 mg or to augment the effect of Zoloft by adding another antidepressant like Remeron (Mirtazapine). In addition, your doctor can also prescribe you a low dose of Clonazepam (very effective antianxiety medicine) to be taken on as and when needed for controlling acute anxiety attacks.
Dr Vikas : Second option which can bring long lasting benefit is to try psychotherapy specially Cognitive Behavior Therapy which can help in changing your thinking pattern and thus will help in controlling anxiety symptoms.
Dr Vikas : Have you ever tried Cognitive Behavior Therapy in past?
JACUSTOMER-ewxplnb3- : no I have not tried cognitive behavior therapy. the strange thing about this whole thing is that I am a plant manger of a union facility with 200 employees. I am very good at my job but the anxiety is taking its toll on my family life and my ability lately. The dose Zoloft I am on now seems to take it toll on my concentration and my drive. all I think about is confrontational issues and i also have panic attacks where i cant catch my breath
Dr Vikas : Thanks a lot for your reply. In that case, the change in your current treatment regime should be definitely helpful in my view.
Dr Vikas : For controlling this anxiety, your doctor can prescribe you Klonopin in a low dose strength of .25 or .5 mg twice a day for few weeks and most likely this should be enough for controlling your anxiety symptoms. Later on once your anxiety symptoms are under control, Klonopin can be taper down and stopped.
Dr Vikas : For attention and concentration issues, your doctor can also add Wellbutrin which is specially useful in patients complaining of lack of attention and concentration, fatigue and tiredness.
Dr Vikas : You can also consider the option of trying Psychotherapy specially Cognitive Behavior therapy online for free before contacting a therapist in person. Cognitive Behavior Therapy can bring long lasting benefit in your thinking pattern and the resultant depression, anxiety and negativity.I am giving you a link to a website which provide free online CBT.Living Life To The Fullhttp://www.llttf.com/
Dr Vikas : My goal is to provide you with excellent service and I hope I’ve provided the information you were seeking, if not, please let me know so that l can continue to help you. If you need more help, please use the reply tab to continue our conversation. If you do not require further assistance,please rate one of the positive ratings (3,4,5 / smiley faces) as this is the only way how we are compensated for our time and expertise.Please take a moment to rate the answer.Kind regardsVikas