Brief Answer:
Consultation

Detailed Answer:
Hello, and thanks for your premium question.

You describe your daughter as having continued insomnia, decreased appetite, and hot flashes at night after taking Zoloft 25mg for 4 weeks.

The most likely problem here is that these symptoms are consistent with depression, and her antidepressant dose is much too low. Zoloft treatment doses range from 50-200mg daily, and your daughter is on a very small dose typically too low to be effective for treatment of depression. The first thing I would do as her doctor would be to raise the dose to 50mg for a week, and then raise it again to 100mg. I would also add a sleeping aid to help her sleep while the antidepressant kicks in, something over the counter like melatonin, or a prescription like trazodone. Benadryl's effects wear off over time which may explain why it isn't working.

I hope this answer satisfies you. In the future, for continuity of care, I encourage you to contact me at my direct link below. We receive a significantly higher payment from this website for direct questions, so I prefer this venue in which to work with you. It would be my pleasure to be your personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (XXXX). For a personalized comprehensive evaluation, treatment recommendations, or individual therapy, ask me at HealthCareMagic at this private link: XXXX

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Brief Answer:
Followup

Detailed Answer:
Let me clarify. Is she sleeping or is she not sleeping? If she is sleeping, she should continue Benadryl and Zoloft as they are. If she is not sleeping, then this is insomnia, which is a major symptom of depression. She may be feeling better, which is wonderful, but her insomnia suggests her depression is not being completely treated. The best way to treat insomnia related to depression is by using an antidepressant at therapeutic doses. Therapeutic doses of Zoloft range from 50-200mg. So, her Zoloft should be increased.

I hope this answer satisfies you. In the future, for continuity of care, I encourage you to contact me at my direct link below. We receive a significantly higher payment from this website for direct questions, so I prefer this venue in which to work with you. It would be my pleasure to be your personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (XXXX). For a personalized comprehensive evaluation, treatment recommendations, or individual therapy, ask me at HealthCareMagic at this private link: XXXX

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Brief Answer:
Followup

Detailed Answer:
I see, thanks for the clarification. Sometimes antidepressants can be "activating" when first started while your body is getting used to them, which can result in insomnia sometimes, though after 4 weeks I would expect this side effect to go away. Perhaps you could consider taking Zoloft in the morning? Her stomach is unlikely to get upset now that her body has adjusted. Otherwise, it would be prudent to switch antidepressants to another alternative which I can suggest to you at my private link, or to consider adding a more long-term sleep aid such as melatonin or trazodone, as Benadryl's effects tend to wear off.


I just tested my private link and it appears to be working. I'll paste them again here below:

https://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=70684

or

XXXX

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