Brief Answer:
You need high dose, or go for change in drug.
Detailed Answer:
hello and welcome to HCM!
Aftre reading your question I can say form my clinical experience that you have recurring episode of
depression and had good results with
sertraline 100 mg. Reducing the dosage to 25 mg resulted in relapse and now it is not showing same results with 50 mg...and there is worsening of symptoms.
firstly, I would like to tell your that the dosage of anti depressants usually take two to three weeks to show its effect, and a
psychiatrist usually waits for this durations before hiking it further. So, if it is past this time, then I think your doctor would hike it now.
Secondly, the next important thing is that when someone had effect on a high dosage previously, the it is highly likely that next time the effect would come at that dose or may be little more of it, ( it is usually not effective with lesser dose) ...so, if your doctor wants, he may increase the does to 100 mg fast,,,as their are high chances that you will need to go upto it for getting any results...
You have not mentioned if previously you had same symptoms as you have now...
anxiety , difficulty in breathing ...etc...if they are new sets of symptoms, then may be you need something different this time, better than sertraline. I usually go for SNRIs in such cases, not only they give quick response- (may be few days) but are also more effective in controlling such symptoms...So you may discuss this with your treating doctor.
# had you ever tested your
thyroid levels , this is a very commonly negledpcted comorbidity and it helps a lot in depressive disorders when it is treated..
## you will have to take the medicine for at least 2-3 years (at the dose which makes you better this time), after that one may think of reducing it gradually.
Hope the reply helps you with your problem.
Feel free to ask more questions for any clarifictaion
If you are satisfied then kindly rate the answer.
Dr. Manisha Gopal
MD Psychaitry