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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 5456
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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History: Been taking 200MG Zoloft for approx 11 years now.

Resolved Question:

History:

Been taking 200MG Zoloft for approx 11 years now. It has worked fairly well for Anxiety and Depression, sometimes things would happen and I would get Depressed or Panicy but nothing like what is going on now. I would normally just go to a local Medi-Center (drop in random Dr here) who would get me a 3 month perscription. I gained a ton of weight over time (was at 435 pounds at 6-3) but to be honest the weight did not bother me.

Current:

I have been on a diet since Jan 2013 (start of this year) and have lost 92 pounds so far, everything seemed to be going good for me and I was doing a ton of walking.

Approx 5 weeks ago which on vacation with family all my anxiety and depression seemed to come back at once, I had to leave the room and literally go to bed. Since then I have had major anxiety and panic attacks and bouts of crying for no reason (nothing triggered any of this that I can tell). Since then I have quit drinking coffee (used to drink 2 cups a day) quit Decaff as well. A month ago while on a camping trip with family the feelings got really bad (irrational feelings, very sad, felt like I was going nuts) and my family saw the big change and I ended up going to the ER.

At the ER they set me up with a Phychologist who I saw the next day. Him along with a Phychiatrist decided to put me on .5 of Clonzepam 2 times a day (morning and night). Since then I have been taking it daily and to be honest notice no change at all (other then it making me have memory issues) I have still gotten panic attacks and still have had boughts of random crying (Most days I will feel jittery and on edge 1/2 of the day) I recently saw him again and he thinks that I have issues from my childhood and past that I have not delt with that is causing all of this (like i said nothing has triggered this, I have had issues in past (mom died, father was never there then died ect) but everyone deals with that) and decided to cut my Doze of Clonazepam in half .25 2x a day for a week then stop it.The rest of that day I felt ok, and felt ok the following day.

The following day I went for my first Physical (I set up a new Family Dr while this was all happening) and got tests of recent bloodwork back as well as I got sent for a neck Xray (main symptom of the anxiety is neckpain/stiff shoulders) My blood work was ok but he said my B12 was really low (202) and my urine had some protein in it (could be signs of liver issues or dehydration) so he suggested I get 1000mg of B12 and start taking a suppliment every day and he would check my protein in the urine in a month with no fasting. I went that day and got my neck Xray done as well. The next day I got a call from his nurse saying he would like to see me about the neck xray and that it was not urgent. I felt ok, not really anxious about it and will see him next week about it.

Now, Friday and Today I have felt like total shit all day non stop. Would being on the Clonzepam for a month cause a dependancy? It feels like my anxiety and depression have been increased 2x. I asked if I could go off of it because I read the horror stories about dependancy and quitting Benzo's and felt that they were not really affecting me at all.

I do not know where to go from here, I feel like the Zoloft has stopped working after 11 years of helping me. I am on a fairly high dosage of 200mg, does anyone suggest I go up to 250mg or 300mg? Or should I try another SSRI or something else?

Please I would love any advice, It has been 5 weeks since this started and i feel like im losing my mind.

Symptoms are:

Whole Back Radiates (warm Tingling)
Neck/Shoulders really tense
Hot Flashs/Cold Flashes shaking
Sweating
Feeling drunk/unreality
Thinking about 20 things at one (hard to stay on one task at work)
Thinking feeling is going to stay forever
Cannot Concentrate
Pressure base of skull
Very Tired/Weak
Head Pressure
Feel like just wanting to sleep
Feel like want to cry just thinking about it


Since this all came back I have begun taking suppliments

1xMultivitimin
3000iu of Vit D3
500 mg of Magnesium
Omega 3 fish oils.

I am out of ideas, could a issue in my neck be causing this? Alergies? Both times the major panic triggers I was at higher altitude, could it be a issue with my ears (they always feel full).

I read online that low b12 can cause depression and I have been taking 1000 mg for approx 3 days since he said mine was low anyone have any exp with this>?

Please help!
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Z replied 1 year ago.

DoctorZ :

Hello I believe I can help you with your concern

DoctorZ :

I am so sorry that you have been experiencing all of these symptoms, I can imagine how distressing this is for you

DoctorZ :

To answer your first question, yes taking the benzodiazepine for a month can create a dependency, but you were on a very low dose and your weaning of schedule by reducing it by half and then discontinuing it is a good one, so you should have no withdrawal effects or very minor ones at the least.

DoctorZ :

Now to answer your other question about the Zoloft not working. Yes it is possible for the Zoloft to not work after 11 years of use. If this is the case, then your body adapted to the Zoloft and it is no longer effective at its current dosage. It is possible to increase the dosage to get the original effectiveness, but this is not always successful. Some psychiatrists can switch you to another SSRI that will work for you, others may want to switch you to a SNRI (e.g. Effexor), which can be very effective in helping you as well. You can discuss all those options with your psychiatrist if you like.

DoctorZ :

The physical symptoms you described can be caused by an increase in anxiety and depression, they are called psychosomatic symptoms, or they can be caused by something physical in your body. You did the right thing getting your physical with your family doctor and most likely your neck x-ray will come back without any severe issues as the nurse said it was not an urgent matter when you see your doctor again to discuss the xray.

DoctorZ :

Did you discuss your ears and the altitude issues with your family doctor to get them checked out? Some inner ear disorder can cause increase anxiety, even to the level of panic attacks, so I think an ear exam by your doctor would be a logical step

DoctorZ :

And yes you are right that B12 deficiency, typically anything under 200, can cause cause anxiety and depressive symptoms. Since your B12 was very close to 200, I think you are wise to take the B12 supplements and hopefully it should help with your symptoms soon

DoctorZ :

I see that you are most likely offline right now, but if you have any questions or concerns and would like to discuss them further, you are more than welcome to contact me and I will do my best to get back to you as promptly as I can.

Customer:

Thanks for all the replies. The MD did check my ears and said he could see scaring from chronic infections when I was a child, he perscribed a nasal spray in case I had allergies. I see him next week and I will inquire about possibly seeing a ENT to check my ears fully.

Customer:

I have also noticed that I tend to get very cold and shaky since startings the Benzo, is that a side effect?

DoctorZ :

I think that is a good idea to inquire about seeing a Ear Nose and Throat doctor just in case

DoctorZ :

I have heard of the shakiness being a temporary side effect that usually goes away in 4-6 weeks on average, but not the coldness factor you mentioned

Customer:

Ok, thanks for all your help I really Appreceate it

Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 5456
Experience: Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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