Brief Answer:
Explained below.
Detailed Answer:
Hi XXXXXXX
All anti-depressants can increase
anxiety and cause
nausea. But these side effects last only for a few days. Next time you start one of these, ask your GP to increase your prescription of
Xanax to maybe 0.5 mg thrice daily or four times daily for the first one week. You can then reduce it back to the previous dose and by this time, the side effects would have reduced. SSRIs can cause
insomnia in some and somnolence in others. Since it caused you insomnia, you should always take it in the morning but after breakfast. Also, you should take care to start with the lowest possible dose and hike up after a few days. For
Zoloft, it should have been 25 mg once a day for two days followed by 50 mg once a day. This strategy makes it easier to tolerate the drug.
Many times GPs forget to tell you all this or are themselves not aware and so, quite a few people are unable to benefit from SSRIs. There are still a few SSRIs that you haven't tried so far. Both
Paxil and
Prozac would be good enough. Paxil also has a controlled release formulation to reduce the gastric side effects. That would suit you better than plain Paxil. Whatever you choose, remember that it will take more than a month to see the full response. So be patient.
Please try to do the relaxation exercises. They make a huge difference.
Best wishes.
Dr Preeti Parakh
MD Psychiatry
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