not hear back from you on how long you have been on the Sertraline, so there are a few different options that you can discuss with your doctor that I will outline for you:
1. You can stay on the Sertraline and add
an augment of Mirtazapine at night. Mirtazapine is a unique Serotonin based antidepressant that can further lessen some of the anxiety
you are having as well as the depressive symptoms of losing interest in things and not wanting to take care of one’s self. The pins and needles, memory/focus issues, and headaches could be caused by anxiety which is why the Mirtazapine can help. Mirtazapine also has a sedative
effect so this may be a good sleep aid for you too.
2. You can stay on the Sertraline and add a benzodiazepine, preferably Clonazepam, to your regimen. Benzodiazepines will significantly lessen your anxiety and stress which could be the cause of your headaches, memory/focus issues, and pins and needles feeling. This anxiety and stress could also be exacerbating your depressive symptoms as well. A fast acting benzodiazepine can work within an hour of ingestion so it is quite beneficial, but it is a physically addicting substance. This medication also has a strong sedative effect and can be taken at night to help you sleep too.
3. You can stay on the Sertraline (or possibly switch to another SSRI/SNRI antidepressant) and add an augment of Bupropion. Bupropion is an atypical antidepressant that will increase Dopamine levels which can cause an increase in energy, focus, attention, and motivation. But this medication has a tendency to increase anxiety as well, so if your symptoms are caused by anxiety, like I suspect, than it is possible the Bupropion may exacerbate it. Although the only way to find out would be to try the medication as an augment to start. In addition, you would need to add a sleep aid to your medication regimen which can include Trazodone, Doxepin, Quetiapine, Gabapentin, or a benzodiazepine.
4. Your doctor can switch you from Sertraline to Venlafaxine. Venlafaxine is a SNRI antidepressant which has a norepinephrine component that can help to increase your focus and attention, which will lessen your memory issues. Also this may be more effective for your overall anxiety and depression too. You would need to add a sleep aid to your medication regimen which can include Trazodone, Doxepin, Quetiapine, Gabapentin, or a benzodiazepine.
I hope this answers your questions and gives you some guidance on this issue. I truly wish you all the best with your future treatment and I hope that your doctor can put you on a good regimen to lessen your symptoms. Please let me know if you have any questions or concerns as I am happy to assist and support you regarding this issue.
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