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Ibs problem
Persistent palpitations (fast heartbeat)
Poor appetite, difficulty gaining weight
Ongoing weight loss
Sleep disturbance (both onset and maintenance insomnia)
Constipation and gastric discomfort
Anxiety and restlessness during the day
Current prescription:
Sertraline 150 mg
Olanzapine (night)
Clonazepam 0.25 mg (as needed)
Concern / Question:
It has been more than 35 days on this regimen, but my appetite, sleep, weight, and palpitations have not improved. At lower doses of Sertraline (50–100 mg), I felt partial relief with fewer side effects. Should the Sertraline dose be reduced, or should an alternative/add-on (such as Mirtazapine or Prothiaden) be considered to improve appetite, sleep, and weight along with controlling palpitations?
Answers (6)
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It sounds like while your anxiety symptoms have been addressed to some extent, the higher dose of Sertraline (150 mg) may be contributing to persistent side effects such as reduced appetite, sleep disturbance, palpitations, and weight loss. In some people, SSRIs can worsen these issues at higher doses.
Next Steps
Since you felt partial relief with lower doses, it is important to share this with your treating psychiatrist. Sometimes, reducing the Sertraline dose or switching/augmenting with medicines like Mirtazapine or Prothiaden (which can improve sleep and appetite) may be considered. However, any changes should only be made by your doctor after reviewing your case in detail.
Health Tips
Please do not adjust your medication on your own. Keep track of your symptoms, appetite, and sleep patterns, and discuss these observations during follow-up. With the right adjustments, it is possible to find a treatment balance that controls anxiety without worsening physical health.
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Hi
If the regimen helped u in reducing anxiety, Palpitations and restlessness then u would recommend you to wait and discuss your concerns with your treating physician. As these medicines take time to gain chemical balance you might notice improvement slowly
Next Steps
Do discuss your concerns in your next visit
Practice Jacobson Progressive muscle relaxation techniques and Deep breathing techniques and make sure to workout regularly
Limit your caffeine use
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Dr. Shailaja Bandla
Psychiatrist
19 yrs exp
Vijayawada
Hi.. will need further history regarding the same to advise appropriately. You may need an adjustment of your medicines. Consult online for treatment
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.