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What Causes Anxiety While On Sertraline, Clonazepam And Xanax?

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Posted on Thu, 4 Aug 2016
Question: I am taking 100 mg sertraline at night plus 2 mg of clonazepam and in the morning i take 2 mg xanax but i am anxious all the time . Is what i am taking too much. I am a 63 old female


When do i get the answer please
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (1 hour later)
Brief Answer:
I think there is need to increase sertraline dose

Detailed Answer:
Hello,
Thanks for using health care magic.

From the available description it appears that dose of sertraline is too low to handle your anxiety symptoms. It will be appropriate to discuss about increasing dose of sertraline or changing to some other medication like effexor.

In addition there is need to lower dose of xanax and clonazepam. I do not think the dose of xanax and clonazepam are appropriate as they should be reduced after one month. Since you have active anxiety symptoms it will not be possible initially to lower dose before they are controlled by increasing dose of sertraline or adding some other antidepressant.

I hope this helps you.
If you have more questions feel free to write back to me.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Dr. Ashok Kumar Choudhary (18 hours later)
how do I increase the sertraline. Shall I take 150 mg ? And if I switch to Effexor can I switch straight away after stopping sertraline and what is the dose to start with. I sometimes take 15 mg mirtazapine to help me to sleep because I also suffer from insomnia . I have seen psychiatrists but nothing helped. Could you please help me I am so depressed and cannot do the simple tasks. I do not have interest in doing anything . Your prompt response is highly appreciated as everyday I feel worse.

Am I going to get a reply from you. Thank you

When do I expect your answer and sorry for bothering you
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (1 hour later)
Brief Answer:
You can go for 150 mg of zoloft and than 200 mg if necessary

Detailed Answer:
Hello,
Thanks for reverting back to me.

Sertraline can be upped to 150 mg and than 200 mg after one week. The effective dose of sertraline ranges from 100-200 mg and I think 100 mg is not effective in your case and it should be increased.


In case you want to take effexor sertraline should no be stopped suddenly as it may result in withdrawal symptoms. There should be cross titration which means increasing the dose of effexor and decreasing the dose of sertraline, taking around one month. The ideal starting dose for effexor is 37.5 mg but i your case I feel it can be started from 75 mg.

I understand that previous psychiatrist consultation did not help completely but whatever change you plan to do, do it after discussing with your psychiatrist as he is the best person to heal your depression and not me (online psychiatrist have their limitations).

Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for my future patients.
In future if you wish to contact me directly, you can use the below mentioned link:
http://doctor.healthcaremagic.com/doctors/dr-ashok-kumar/67386
Thanks and regards.
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Dr. Ashok Kumar Choudhary

Psychiatrist

Practicing since :2000

Answered : 3347 Questions

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What Causes Anxiety While On Sertraline, Clonazepam And Xanax?

Brief Answer: I think there is need to increase sertraline dose Detailed Answer: Hello, Thanks for using health care magic. From the available description it appears that dose of sertraline is too low to handle your anxiety symptoms. It will be appropriate to discuss about increasing dose of sertraline or changing to some other medication like effexor. In addition there is need to lower dose of xanax and clonazepam. I do not think the dose of xanax and clonazepam are appropriate as they should be reduced after one month. Since you have active anxiety symptoms it will not be possible initially to lower dose before they are controlled by increasing dose of sertraline or adding some other antidepressant. I hope this helps you. If you have more questions feel free to write back to me. Thanks and regards.