How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Elliott, LPCC, NCC Your Own Question

Elliott, LPCC, NCC
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7663
Experience:  35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
40019946
Type Your Mental Health Question Here...
Elliott, LPCC, NCC is online now
A new question is answered every 9 seconds

I just started Zoloft 50 mg and have taken four pills so far.

Customer Question

I just started Zoloft 50 mg and have taken four pills so far. I called my doctors NP and she told me to reduce the dose to 25mg. My anxiety has increased and I can't sleep at all. She did not prescribe a sleep aid. What can I do to get some sleep?

Is it safe to just stop the medication? I'm being treated for anxiety.

Submitted: 1 year ago.
Category: Mental Health
Expert:  Elliott, LPCC, NCC replied 1 year ago.

Elliott, LPCC, NCC :

Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Elliott, LPCC, NCC :

Dear friend,

Elliott, LPCC, NCC :

I believe that I can help you with this situation.

Elliott, LPCC, NCC :

Please give me a few minutes to look over your question.

Elliott, LPCC, NCC :

If you are taking Zoloft merely for depression then the starting dose is 50 mg. per day. If you are taking it for anxiety (particularly panic disorder or social anxiety) then the starting dose is 25 mg per day.

Elliott, LPCC, NCC :

After one week, the dose may be increased to 50 mg once a day. Increase dose by 50 mg increments no more often than weekly.

You can increase once a week by 50 mg increments, to a maximum of 200 mg once a day.

Elliott, LPCC, NCC :

Your NP should not have lowered the dose after starting at 50 mg.

Elliott, LPCC, NCC :

Zoloft takes two to three weeks to show any signs of helping.

Elliott, LPCC, NCC :

DO NOT QUIT TAKING THIS DRUG AS YOU MAY SUFFER SERIOUS WITHDRAWAL EFFECTS.

Elliott, LPCC, NCC :

Stopping must be done slowly. Reducing from 50 to 25 might cause some slight effects. If you want to withdraw it should be done VERY SLOWLY over a month or two for safest withdrawal. Your pharmacist will have the best schedule.

Elliott, LPCC, NCC :

If you want faster relief for your anxiety and as a sleep aid, ask your physician for a low dose of Klonopin (clonazepam) which you can take at night. It will help your anxiety and allow you to sleep. You can continue on the Zoloft until it kicks in and then may be able to taper off the Klonopin. Ask your doctor.

Elliott, LPCC, NCC :

You may also want to get the over-the-counter supplement melatonin to help regulate your internal sleep clock (Circadian Rhythms).

Customer:

Now that I took the 25mg, I'm afraid of what might happen.

Elliott, LPCC, NCC :

Then go back up to the 50 mg.

Elliott, LPCC, NCC :

Tell your NP that is what you are doing.

Elliott, LPCC, NCC :

She could have started you on 25 (usual protocol for anxiety) but the 50 will be okay. Try to keep it steady. Let your doctor and not your NP give you medications in future.

Customer:

I took the 25 today at 7:30, so should I take another 25 now?

Elliott, LPCC, NCC :

Klonopin is an antianxiety medication and will help you sleep. It will stay in your system all night.

Elliott, LPCC, NCC :

It won't hurt. You will just be continuing your original dose of 50 mg.

Elliott, LPCC, NCC :

The Klonopin will work right away, however and if you stay at a low dose and don't stay on it for a long period of time you will be fine. It is for anxiety and is usually given at night because it will encourage sleep.

Customer:

So I should start the 50 again tomorrow?

Elliott, LPCC, NCC :

Yes, just stay on the 50 as you originally started and then consult your physician about adding Klonopin at night. Klonopin will work in a very short time (maybe half an hour) instead of 3 or 4 weeks.

Elliott, LPCC, NCC :

Dramamine at night (over-the-counter) can also help you sleep to use occasionally, but your best bet is to get a prescription of Klonopin.

Customer:

Well I wish I could call my Dr. now but it's the weekend and can't call until Monday. Anyway, he doesn't return calls and lets the staff call. I read that dramamine has a negative interaction with zoloft.

Elliott, LPCC, NCC :

Let me check that:

Customer:

Is it normal to have increased anxiety when starting zoloft?

Elliott, LPCC, NCC :

It is not normal but Zoloft occasionally produces anxiety or even panic, and can interfere with sleep, but you already had anxiety, so it cannot be said with complete certainty. It is not the usual reaction but it has been known to happen.

Elliott, LPCC, NCC :

Let me check the compatibility of Zoloft and meclizine (Dramamine). Give me a moment please.

Elliott, LPCC, NCC :

There are no interactions between Dramamine (which is dimenhydrate and not meclizine which is Dramamine Less Sleepy) and sertraline (Zoloft). No problems.

Elliott, LPCC, NCC :

None between the Less Sleepy (but you would not want to use that one anyhow).

Elliott, LPCC, NCC :

So regular Dramamine would help.

Customer:

OK. thanks for your help.

Elliott, LPCC, NCC :

You are most welcome. I shall keep you in my prayers. You will get this under control. Remember to ease off the caffeine and no diet drinks (aspartame is not good for anxiety).

Elliott, LPCC, NCC :

Have a wonderful day and get a good sleep tonight. You will be fine.

Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7663
Experience: 35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
Elliott, LPCC, NCC and other Mental Health Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
< Last | Next >
  • http://ww2.justanswer.com/uploads/DR/Dr.Keane/2013-8-20_204325_drkeane.64x64.jpg Dr. Keane's Avatar

    Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
  • http://ww2.justanswer.com/uploads/RE/resolutions66/2011-1-17_05728_IMG8202smilingeditedforJustAnswer.64x64.jpg Elliott, LPCC, NCC's Avatar

    Elliott, LPCC, NCC

    Psychotherapist

    Satisfied Customers:

    5024
    35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
  • http://ww2.justanswer.com/uploads/formybunch/2010-12-06_191055_img_0975.jpg Kate McCoy, M.Ed, NBCC, LPC's Avatar

    Kate McCoy, M.Ed, NBCC, LPC

    Therapist

    Satisfied Customers:

    3733
    Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
  • http://ww2.justanswer.com/uploads/DR/DrAkiraOlsen/2012-2-20_746_AkiraADpicmain.64x64.jpg Dr. Olsen's Avatar

    Dr. Olsen

    Psychologist

    Satisfied Customers:

    2336
    PsyD Psychologist
  • http://ww2.justanswer.com/uploads/norriem/2009-5-27_134249_nm.jpg Norman M.'s Avatar

    Norman M.

    Psychotherapist

    Satisfied Customers:

    2193
    UK trained in hypnotherapy, counselling and psychotherapy and have been in private practice. ADHP(NC), DEHP(NC), UKCP Registered and ECP.
  • http://ww2.justanswer.com/uploads/PsychologyProf/2010-07-15_171248_logos060400409.jpg Dr. Michael's Avatar

    Dr. Michael

    Psychologist

    Satisfied Customers:

    2177
    Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
  • http://ww2.justanswer.com/uploads/KURTEMMERLING/2010-07-23_215531_just_ask_picture1.jpg Steven Olsen's Avatar

    Steven Olsen

    Therapist

    Satisfied Customers:

    1727
    More than twenty years of expertise in counseling, psychological diagnosis and education
 
 
 
Chat Now With A Mental Health Professional
Elliott, LPCC, NCC
Elliott, LPCC, NCC
5114 Satisfied Customers
35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.