Zoloft for emotional lability -- side effects?

[BethU]

Hi, all ... I started on Zoloft a week ago for emotional lability. I don't have it very bad, but have had a couple embarrassing crying episodes (like at Kinko's when someone helped me with a FedEx problem, and I was so grateful I burst into tears thanking them!) Have not (yet) had any outbursts of laughter.

The side effects of the Zoloft are really troublesome. Bad tremors ... shaking hands ... shaking all over ... and absolutely no motivation or ambition at all. I just lie in bed all day completely apathetic. I take a couple naps a day, and make it to the computer for a while, then back to bed. It's like I'm completely flat-lined emotionally and psychologically. Haven't even been able to force myself to take a shower in three days! I can't make myself do anything.

Until I started Zoloft, I was in a really good state, emotionally and energy-wise, and getting a lot of things done. Now, I feel like a zombie.

Mentally, I'm really foggy, too. I'll go to the kitchen and just stand there staring into space for 5 or 10 minutes. Today, my feet and hands have become very puffy, which worries me, as I have heart disease, and if I start retaining fluids, I'm in big doo-doo.

My husband has been out of a medication he needs for two days, and I couldn't rouse myself to go to the drug store to get it for him. (He doesn't drive any more.) I finally forced myself to get it for him today, but I can't believe that I actually let him go two days without it just because I couldn't get motivated to get in the car and drive a few blocks.

I'm supposed to increase the Zoloft dosage every two weeks until I'm up to 4 pills a day, and I'm really worried about what a greater dose will do.

Has anybody had any experience with this? Is this a phase you go through until it kicks in, or is this what it's supposed to do? I don't want to live like this. This is not me at all.
Any feedback is greatly appreciated!
BethU

[sharona]

Hi Beth,
You stated that before you started Zoloft you had energy & good state of mind.Why then are you on Zoloft? It is for depression & it sounds to me like it is making you very depressed.Just my opinion I don't take any of them because of how they make me feel .LIKE I'M NOT MY SELF & I don't like the feeling.Talk to your doc before you continue to up that dosage.God Bless.
Sharon

[crystalkk]

Beth,

Did you call your dr and let him know the side effects you are having. I don't think those are the normal side effects. I have tried 4 different antidepressants and couldn't tolorate any of them. I think I would rather cry
than feel that way.

Do you have the pamplet that came with it. If not you can go to webmd.com and under drugs you can look up all the info about the drug including side effects and it will tell you the common ones and the more severe
ones that you should contact your dr.

Please take care of yourself

[JohnMc]

Beth

I have never taken Zoloft, but 12 years ago I took Prozac for depression, which I guess is similar (both are SSRI meds). I didn't have the shaking hands or the mental fog you describe, but the positive effects of the medication did not kick in for about a month after I started taking it. I don't remember having any particularly negative side-effects, but I also didn't see any advantage to the med for a month. After it kicked in, I had more energy than I had before.

The symptoms you are reporting don't seem to be listed as the common side-effects of this medication, so I guess it could be a coincidence. But if you are convinced that the medication is causing the problems you are having, you need to ask yourself whether it is worth it. The emotional lability is a real problem but even if the med completely makes it go away, it may not be worth the problems you are having.

Anyway, good luck with it.

John

[BethU]

Thank you all for your feedback! You're exactly right, Sharon, I don't feel at all like myself ... and I don't like it! Crystal, I will call the doctor this week and report these effects, and will also check out that link. Thanks. (And I'm going to stop taking it until I get the doctor's advice.)

John, that is encouraging about it taking a month for these kinds of meds to start working. If the doctor advises me to continue, I'll have a little more patience.

This forum is a blessing.
BethU

[Mark]

Hi Beth,

The symptoms you describe on Zoloft can happen with any of the SSRIs. They may or may not go away with time. Another medication in this class might be more tolerable. There are certainly other classes of antidepressants. All antidepressants take a minimum of three weeks to work although you may notice something after two weeks. They can also take 4-6 weeks to take effect and the dose may need to be adjusted. Are you seeing a psychiatrist or primary care for medication treatment? There are other classes of antidepressants to choose from. If in fact you are depressed it will be worth pursuing this.

Good luck,

Mark

[PDaddy]

Hi Beth,
I have been taking Zoloft (Sertraline HCL) for several months now with no side effects. It does what it should for me; no crying at movies and I can talk about emotional things without freezing up but I do "tear up" when I should. Maybe its a matter of dosage?

[CindyM]

That is what I was thinking. I wonder if it would help to cut the dose in half? As long as you are not experimenting with more dosages I cannot see the harm, but then I am no doctor.

[BethU]

PDaddy and Cindy ... I had been thinking of cutting it in half. Maybe I will try that. I think because of my age, meds tend to linger longer in my body, and build up, and they may be more potent than in younger people.

Mark, actually I haven't been depressed, just subject to weepy spells when I'm stressed. But it's good to know there are other options.

The neuro said there is a clinical trial going on now for something for lability that has fewer side effects, which she wanted me to try, but it turned out to be contra-indicated with heart disease. (It's something to do with quinine.)

Appreciate the help!
BethU

[awieleba]

Hi Beth,

I was having awful crying spells and would wake up crying. I did not want to talk. (anyone who knows me, knows if i am not talking or joking then i am not well). They put me on one, i dont remeber the name, and i felt worse! then switched to lexapro, that did it! it helped me sooo much! I am myself and i do still cry when i should. It took abouy 2 weeks and I just felt like myself again. I know a few other folks (not als pts) that have really good luck with this one.

just my expierence with these meds, I never thought I would need these ever!

take care,

april

[BethU]

Thanks, April ...

I did some research online on the side effects, etc., and it turns out that Zoloft "interacts" with three other meds I take, so that could have been intensifying or altering the effect. My neuro had my complete list of meds, so I just assumed she checked them all out before prescribing it.

One of my side effects ... my swollen left foot and ankle ... is in the category of "call your doctor right away if you have any swelling in the feet or lower legs." I didn't take any Zoloft yesterday, and by last night was feeling human again. I'm back to normal today, except very tired. And today the foot swelling is almost gone ... one puffy spot left about the size of a silver dollar, so I probably won't bother call her about it till I see her in August.

I hope she will try something else. But next time, I'm going to research all the contra-indications and interactions and side effects BEFORE I start swallowing new pills!

(Seems to me this should be the easiest kind of computer program to write for doctors: include all the meds on the market -- OTC and prescriptions -- and let the doctor enter what you're taking and what they're thinking of prescribing, and bring up possible interactions and warnings. I had a HUGE problem in January when a neuro dx me with MG and prescribed Mestinon ... and it is absolutely contra-indicated if you take beta-blockers, which I do. Both lower your b/p a lot. I was so dizzy for a couple days, I couldn't stand up without falling over, & couldn't walk more than a few feet. Got the answer from people on an online MG forum, who said, "OMG, you musn't take both those at the same time!!")

BethU

[MtPockets]

I also had side effects with Zoloft. Now I am using Cymbalta and I have not noticed any problems. I just kind of feel in a mellow mood all day. Not sleepy, or anything else. Just seems to help me cope a little.

Everyone is different, but maybe this could benefit you if you want to ask your Doctor about it?

[PDaddy]

Martini's help too! :rolleyes:

[brendapals]

My personal favorite is a strawberry margarita!
Keep the faith,
brenda

[crystalkk]

Beth,

Do you get all your meds filled at the same drug store. If you do they should have caught the bad interaction thing with the mix of the meds. I'm happy to here you are feeling better.

[awieleba]

Oh, nothing better than a good glass of cabernet! Oh and now that they say it is good for your health, we dont have to feel guilty!!!!!

[BethU]

Beth,

Do you get all your meds filled at the same drug store. If you do they should have caught the bad interaction thing with the mix of the meds. I'm happy to here you are feeling better.


Thanks ... yes, I take everything to the same place. Since I take a gazillion meds, you'd think they'd red flag the problems. I found an online med checker, where you can list everything and it will show any interactions. Gonna use it in the future.

Cymbalta sounds good, thanks ... I'll check it out.

(And I agree on the booze, by the way, but alas have to stay away from it these days. :wink:)
BethU

[brendapals]

Hey to everyone,

I couldn't figure out how to start a new thread, so I just came here!

Today my emotions have been crazy!!! While I was at work ( as a nurse in a physician's office ) I burst out crying over NOTHING. Then tonight at the baseball field with my family, one of the coaches starting yelling at my 14 yr old about my 7 yr old's game, and I couldn't stop the crying again.

I have been on Zoloft for about 3 yrs, 100mg a day, then after my dx on 6/3/08, my neuro increased it to 150mg every day. That has kept the emotions in check for the most part, so I guess I wonder if the ALS just sometimes explodes the emotions, or maybe my neuro needs to try something else. He told me in June that the 150mg daily dose might not be the right thing, and that sometimes they add another SSRI.

Or maybe, it's the full moon? I hope to rest good tonight and maybe feel better tomorrow.
A blessed night to all,
brenda

[trying to stay positive]

Hi Brenda,
I'm sorry you're having a hard time. Talking to your dr. is a good idea. Another possibility is that you may just need to give yourself a little more time to adjust to the emotional aspect of your dx. When my DH was dx last August, I went through a period of several months where I would burst into tears over just about anything, and always at the most unexpected times! I also felt like my brain was in a "fog".

Once I had a little time to get used to what was happening & what it all meant, I went back to my old self. Three months worth of anti deppressants didn't hurt either!:mrgreen: This is, to say the least, a difficult disease, physically and emotionally.

You are in my prayers.

[awieleba]

HI,

I feel bad posting as I have no dx yet. But When all my symptoms started I had the over whelming crying. Let me tell, that is not me! had three kids and never even kinda got the baby blues--only joy. I always felt that I may be to happy & positive. So i started crying over everything! I would wake up and cry! Nothing had even happen yet! it was so crazy and our of character. (yes, it could of been the fear of als).

anyway my neuro put me on 20mg of lexapro. from what I hear that is alot? maybe she was worried becasue I have a baby and feared a post partum?
so lexpro dried up those tears and I do feel like my self again. I do feel a little tired with it. but I will take a little tired (or that could be due to 3 young kids) over blubbering non stop.

take care!

april

[galynn]

Hi BethU. You posted almost a week ago, so I'm hoping that you have made some changes to taking Zoloft. The symptoms you described are not typical, and to me (I'm a psychologist), sound alarming. I think you are probably on track that the Zoloft may be interacting with other meds. Have you talked to your Doc about the side effects and making changes? If not, PLEASE do! As for emotional lability, if that is the only symptom, I agree with the person who wondered why take an anti-depressant. I'm thinking emotional lability may be a normal reaction to a crazy disease. Are you talking with anyone about how you've been feeling nowadays? I'll keep you in my prayers. Take care!!

[BethU]

Hi BethU. You posted almost a week ago, so I'm hoping that you have made some changes to taking Zoloft. The symptoms you described are not typical, and to me (I'm a psychologist), sound alarming. I think you are probably on track that the Zoloft may be interacting with other meds. Have you talked to your Doc about the side effects and making changes? If not, PLEASE do! As for emotional lability, if that is the only symptom, I agree with the person who wondered why take an anti-depressant. I'm thinking emotional lability may be a normal reaction to a crazy disease. Are you talking with anyone about how you've been feeling nowadays? I'll keep you in my prayers. Take care!!

Thanks for the input! (And the prayers! I need both.) I haven't talked to the doctor, as I can't be understood on the phone, so have to write her a snail-mail letter and let her know.

I stopped the Zoloft when my feet and ankles started swelling, which was listed as a side effect ... I have heart disease and can't afford to retain fluids, as it brings on congestive heart failure.

The swelling went down after two days, but in the meantime I went into a DEEP depression for about 36 hours ... to the point where I was looking up ways to commit suicide, until I came to the part where it said you had to swallow 100 pills, and I started laughing. I would definitely die of old age before I could possibly swallow 100 pills!! It takes me 15 minutes to get one down. I guess God looks out for us bulbar-onset types.

Then I remembered that those kinds of thoughts were also listed as a side effect of Zoloft. So I will tell the doctor that I'd better stay far, far away from the serotonin "uptake" types of drugs.

All the effects are gone now, and I feel human again.

The weepy stuff is not in response to the seriousness of the dx. I've done some normal crying about that. But this is out-of-place and very embarrassing. Like, when I went to Kinko's to get a FedEx shipment straightened out, and burst into tears because the clerk was so efficient! Or when I put a cat in a cage to take him to the vet (this was a year before the dx) and got literally hysterical because he looked so sad. Had to let him out of the cage and cancel the appt. because I couldn't stop sobbing about how sad he looked. (Note: I've made hundreds of trips to vets with cats in carriers in my life, and never had that reaction before. And, as I said, this was a year before the dx, so it was not an emotional reaction to knowing I have ALS.)

I think the lability is part of the ALS neurological package, not a normal emotional reaction to a stinky situation.

Thanks again!
BethU

[brendapals]

Hey BethU

I can certainly appreciate the crying outbursts! Just this morning, the rheumatologist I work for, who is also my doc for sjogrens, came to my desk "just to see how you're doing".
He is the most caring, kindest human being I have ever met and just looking at him, I started bawling!!! And it went on for about 45 minutes!
But I'm going to email my neuro at Indy now and see what can be done, since today is about the 5th time this week it has happened. I wonder if I'm just exhausted?
talk soon,
Keep the faith,
brenda

[westjlittle]

I use Zoloft and I find that it works great for me. I was taking Amitriptyline but it raised my Blood pressure and heart rate.

Jim

[JohnMc]

Jim-

Do you take Zoloft for emotional lability, or for depression?

John

[westjlittle]

I use it for lability. I would cry watching the news or laugh too much when my kids misbehave.

Jim

[jimercat]

Jim, I think my husband and you would be two peas in a pod! LOL

I have to ask myself sometimes if he is being silly (he's always been a joker) or is this emotional lability? He gets upset and cries at stuff he would've never thought of crying about before.

The Emory Clinic is participating in a trial for Zenvia for Pseudobulbar Affect (PBA), (that's the fancy word for emotional lability) in patients with MS and ALS. They gave him a one page test that rates PBA and he qualified. Haven't talked with him yet about whether he will participate in the trial.

The PBA is caused from the neurological disease itself and can also be found in people with brain injuries. It can be quite embarrassing and cause people to avoid going out in public. Just another thing to add to list...:evil:

[rose]

The last trip I worked, I was standing outside of the gift shop in the lobby of the hotel, and there were these "chatskie" rabbit fur cats in various positions, i.e. curled up sleeping, or with a paw outstretched playing, and I stood there looking at them and started sobbing! it was awful. There have been a good many other occasions when I've started weeping, but this was the most absurd (so far!) and until this happened, I didn't think it was the emotional lability that I'd been reading about, because I haven't had any inappropriate laughing episodes, I'd just hoped it was "hormonal", after all, I am 52 ... ~ but the cats reducing me to tears was way beyond hormonal! I forgot to bring it up during my last visit at Hopkins, but I have an appointment locally with a new primary care doctor (I got scolded because I don't have one anymore due to an insurance change ~ just all of these specialists!) and the question is, should I ask for a prescription for something to control it? and if so, what seems to be the best?

[BethU]

Hi Rose ... I get weepy over stupid things too, mainly when someone is being unexpectedly kind. I even got teary over "Cute Overload" last week!

At UCLA, the neuro talked about Zenvia, which CJ mentioned. The doc said it was well tolerated by almost everybody and has very few side effects. She wanted to put me in the study, which is ongoing, but it turned out to be contra-indicated for heart disease, so I was disqualified. Hence the Zoloft, which was a Big Mistake.

But I think there are a quite a lot of possible meds that will control the lability. Probably everyone reacts a little differently, so you may have to try a couple till you find the right fit. (I haven't had any laughing episodes, either ... just the tears.) Your primary care doctor may not understand the lability ... I talked to mine today about my reaction to Zoloft, and she thought it was prescribed because this is a depressing disease! ... so you may have to explain that it's part of the disease process.

Good luck,
BethU