# 400mg sertraline (Zoloft)



## Barbapapa (Mar 5, 2010)

I'm upping my dosage from 200mg to 400mg. Should I take all 400mg in the morning or should I split the dose am and pm?

http://www.ncbi.nlm.nih.gov/pubmed/16426083

*High-dose sertraline strategy for nonresponders to acute treatment for obsessive-compulsive disorder: a multicenter double-blind trial.*

*OBJECTIVE:*
To evaluate the efficacy and safety of high-dose sertraline for patients with obsessive-compulsive disorder (OCD) who failed to respond to standard sertraline acute treatment.

*METHOD:*
Sixty-six nonresponders to 16 weeks of sertraline treatment who met DSM-III-R criteria for current OCD were randomly assigned, in a double-blind continuation phase of a multicenter trial, either to continue on 200 mg/day of sertraline or to increase their dose to between 250 and 400 mg/day for 12 additional weeks. Efficacy measures included the Yale-Brown Obsessive Compulsive Scale (YBOCS), the National Institute of Mental Health Global Obsessive Compulsive Scale (NIMH Global OC Scale), and the Clinical Global Impressions-Severity of Illness and -Improvement (CGI-I) scales. Data were collected from July 26, 1994, to October 26, 1995.

*RESULTS:*
The high-dose (250-400 mg/day, mean final dose = 357, SD = 60, N = 30) group showed significantly greater symptom improvement than the 200-mg/day group (N = 36) as measured by the YBOCS (p = .033), NIMH Global OC Scale (p = .003), and CGI-I (p = .011). Responder rates (decrease in YBOCS score of > or = 25% and a CGI-I rating < or = 3) were not significantly different for the 200-mg/day versus the high-dose sertraline group, either on completer analysis, 34% versus 52%, or on endpoint analysis, 33% versus 40%. Both treatments showed similar adverse event rates.

*CONCLUSION:*
Greater symptom improvement was seen in the high-dose sertraline group compared to the 200-mg/day dose group during continuation treatment. Both dosages yielded similar safety profiles. Administration of higher than labeled doses of selective serotonin reuptake inhibitors may be a treatment option for certain OCD patients who fail to respond to standard acute treatment.


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## Barbapapa (Mar 5, 2010)

I'm on 3rd day on 400mg. Nothing strange for now


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## Cletis (Oct 10, 2011)

Wow. 

That's a very big dose. Did you get any stomach issues from it? :blank



> I'm upping my dosage from 200mg to 400mg. Should I take all 400mg in the morning or should I split the dose am and pm?


That's a question for your doctor.


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## UltraShy (Nov 8, 2003)

I didn't respond at all to 300 mg, which is already 50% above the max recommended dose and requires 3 of the largest dose tablets.

You'd be the first person I've heard of pushing it to 400 mg.

Why is it they only like to play with mega doses with crap like SSRIs? How about upping my Xanax to 20mg to see if it can do more than 10mg (at some huge amount I suspect it might actually produce an appreciable effect).


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## Barbapapa (Mar 5, 2010)

Still on 400mg. Still don't notice any change from 200 :no


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## Medline (Sep 23, 2008)

UltraShy said:


> Why is it they only like to play with mega doses with crap like SSRIs?


Because the are pretty safe even at high doses and overdoses in contrast to e.g. TCAs.



UltraShy said:


> How about upping my Xanax to 20mg to see if it can do more than 10mg (at some huge amount I suspect it might actually produce an appreciable effect).


For some time... There are people who take like 60 benzo pills a day, doesn't exactly make their life easier in the long term.

@Barbapapa: 
You have to give it more time. In case you are doing this because of OCD quite some weeks.


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## metamorphosis (Dec 18, 2008)

Upping the dose on a benzodiazepine is a much more serious issue, as far as physiological dependency is concerned. That is compared to an SSRI. It's a whole different class of drugs that carry many serious issues. It's like comparing apples to oranges.


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## ntdc (Jun 29, 2011)

wow i think id be on the toilet 24/7 from that much


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## CopadoMexicano (Aug 21, 2004)

Hmm 200 mg was the most I've taken with sertraline hcl I'm thinking of trying vibryd


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## Cletis (Oct 10, 2011)

ntdc said:


> wow i think id be on the toilet 24/7 from that much


Exactly... :um


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## InterestinglyInteresting (May 7, 2010)

I fail to see how upping zoloft to 400 mg will provide any additional anxiolytic relief. im pretty sure the serotonin transporters get 85 to 90 percent saturated at the lower dosages. the only thing i can see is now zoloft will become a--- mild to moderate dopamine reuptatke inhibitor.



or serotonin syndrome? seizures? who knows.....as long as you got your doctors okay with this it will be interesting to see


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## 546617 (Oct 8, 2014)

Damn he hasnt been online for 4 months.. I wonder how things went.. Im gonna upp my dose to 400 mg to from 200 .. I use sertralin too im 18... lets see how it goes


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## MiMiK (Aug 25, 2011)

KurdishFella said:


> Damn he hasnt been online for 4 months.. I wonder how things went.. Im gonna upp my dose to 400 mg to from 200 .. I use sertralin too im 18... lets see how it goes


thats alot bro. do you get any side effects atm? a friend of mine gave me her sertraline and i was taking 50mg a day. i would get extremely sleepy always yawning. do u get that on 200mg? i was thinking it might be because of the dosage


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## 546617 (Oct 8, 2014)

Yeah I know its a lot but setralin seem to be not doing **** for me .. all it made me is a little more sleepy and cant ejaculate as easy... thats about it


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## Cletis (Oct 10, 2011)

That's a huge dose. I can't imagine any doctor prescribing that much.


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## 546617 (Oct 8, 2014)

Alright guys I took 400 mg this morning which is 8 and I basically feel the same ... Im gonna upp it tho 12 which is 600 mg . Im a bit scared but I will do it ..... I wont go over 600 mg tho if it dont work so be it I will change medicine.. If you got any reasons to why I shouldnt do this please reply ... thanks !


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## 546617 (Oct 8, 2014)

Update... I took 13 of them in a single day in the morning. Im not trolling. I feel sleepy and agressive. It definatly helped .. I dont know if it was the 8 ones I took yesterday that started to take its effect or if it was the 13? Can someone please help? 13 is like 650mg

I think I will take 12 and continue with that....


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## sighsigh (Nov 9, 2010)

Are you self-medicating or is this with a doctor's permission? If it's the former then you have to do it within reason. 650 mg is 325% of max dose. SSRIs are generally non-toxic with overdose but you might be risking other things like post-SSRI sexual dysfunction. I went from moderately reduced sexual function to basically a complete inability to orgasm between 100 mg and 200 mg. I can't imagine what 650 mg would do.


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## 546617 (Oct 8, 2014)

sighsigh said:


> Are you self-medicating or is this with a doctor's permission? If it's the former then you have to do it within reason. 650 mg is 325% of max dose. SSRIs are generally non-toxic with overdose but you might be risking other things like post-SSRI sexual dysfunction. I went from moderately reduced sexual function to basically a complete inability to orgasm between 100 mg and 200 mg. I can't imagine what 650 mg would do.


Doing it wittout the doctors knowledge ... Im gonna talk to her soon about it and see what to do.. I wont be taking 650 but 600mg.. That high dose will only work for me cuz 200mg is way too low for my body.. I dont care about sexual stuff I just wanna enjoy my life


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## 546617 (Oct 8, 2014)

Update 2: Im gonna take 1000 mg tomrrow morning...... 20 of them and one of each contain 50 so thats 1000.. I hope I dont die?


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## livetolovetolive (Jun 11, 2015)

KurdishFella said:


> Update 2: Im gonna take 1000 mg tomrrow morning...... 20 of them and one of each contain 50 so thats 1000.. I hope I dont die?


That is way too much. You're really taking it into your own hands and you're doing it in a real bad way. This is craziness. If they're not working at the prescribed dose than talk to your doctor about taking another drug that might work.


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## 546617 (Oct 8, 2014)

livetolovetolive said:


> That is way too much. You're really taking it into your own hands and you're doing it in a real bad way. This is craziness. If they're not working at the prescribed dose than talk to your doctor about taking another drug that might work.


Another drug it doesen matter which drug it is. Its how high the dose is. And all the max doses for anxiety drugs are too low for me. so I have no choice but go over the limit. im doing it no matter what


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## livetolovetolive (Jun 11, 2015)

KurdishFella said:


> Another drug it doesen matter which drug it is. Its how high the dose is. And all the max doses for anxiety drugs are too low for me. so I have no choice but go over the limit. im doing it no matter what


You will do what you will now but you may regret it later. Just sit there and think about it. Tomorrow comes and this isn't making for a good tomorrow.

Zoloft is one drug of many kinds of drugs. Try another one, perhaps a stronger one. Zoloft is kind of a lightweight one.


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## Ben12 (Jul 8, 2009)

Woah, man if you need higher doses than what are approved, perhaps it means that you need an augmenting agent. Lithium helps the body produce serotonin better. That can go really well with an ssri if the amount of serotonin reuptake that your getting isn't enough. There's also abilify that you could augment which is great for OCD. Couple all of that with a 5ht2a antagonist like trazodone or low doses of risperidone and you've got yourself a good regimen for OCD. Hell I think the abilify as well has a 5ht2a mechanism too. There's also a medication called clomipramine which is anecdotally one of the best medications for OCD. Raising the dosage of zoloft anymore won't increase it's efficacy. You can take 400mg by all means. But to take 1000mg or 2000mg is not going to be any better.

I've heard of rare cases where patients will take 300-450mg of zoloft, but that's the most I've ever heard. Please don't do something stupid and let your doctor know that the zoloft isn't good enough.


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## Cletis (Oct 10, 2011)

You're taking crazy insane doses!!! :eek You need to cut back and see your doctor. That much Zoloft can't be good for you.


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## sighsigh (Nov 9, 2010)

KurdishFella said:


> Update 2: Im gonna take 1000 mg tomrrow morning...... 20 of them and one of each contain 50 so thats 1000.. I hope I dont die?


What problem are you trying to solve? Major depression? General anxiety? Social anxiety?

If you've tried a lot of medications without success and are willing to go to extremes then you can try for a irreversible MAOI like Nardil or Parnate, which are apparently quite powerful.

There is no guarantee at all that such high doses of SSRIs have greater efficacy, unless you can find a study that says otherwise. And you're risking severe side effects at such high doses - including, as I said earlier, a permanent loss in sexual function.


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## 546617 (Oct 8, 2014)

Update;
Just took 1000mg .. Gonna update later today to see how it goes. Yes im taking this for depression but mostly social anxiety. Im not gonna take 1000 daily becuase i know my doctor would not agree with that so maybe half that 500 daily and hopefully it will work


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## 546617 (Oct 8, 2014)

Hello im back.. Im alive .. I dont know why but it felt like 600 mg had more effect than 1000.. Maybe I got immune to it fast IDK... But as far as im concereed it works for me... Thats what I care about. 200 is too low. The max should be around 500 IMO. Gonna meet up with my doc soon and well chat about it and I will bring a new update


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## 546617 (Oct 8, 2014)

This might be my last post as I dont think anyone cares well... I got a few questions. I took 650 mg then day after I took 1000 but 650 felt like it had more effect. Is more always more effective or not? And Is there anything I should know? I will probably be taking 600 mg each day as it seemed good.

And people said 1000 mg would kill me bla bla bull****

UPDATE: Talked with my doctor she wont prescribe me it anymroe since I take 12 each ... ****ing *****! Its my body let me take what I want. Anyone know where I can get sertraline?

She told me I had to talk with a therapist tommorow which is bull****. But im still going and well see from there..


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## myeloiddetacted (Aug 29, 2015)

I'm only on 50mg a day.

So I think you should split the dose.


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## 546617 (Oct 8, 2014)

UPDATE: I visit the hospital they did tests on my turns out i am healthy and no heart problems etc... But I still have to change meds now to zyprexa I heard it sucks , On monday I will ask to change to Thorazine i heard its pretty good..


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## Reckoner7 (Jan 29, 2007)

KurdishFella said:


> This might be my last post as I dont think anyone cares well... I got a few questions. I took 650 mg then day after I took 1000 but 650 felt like it had more effect. Is more always more effective or not? And Is there anything I should know? I will probably be taking 600 mg each day as it seemed good.
> 
> And people said 1000 mg would kill me bla bla bull****
> 
> ...


Listen to your doctor, you are acting incredibly naive. Just because you didnt see any bad effects on the high dose doesnt mean it wont have a negative effect on you later on if you take that dose for a while.
If you are trying to tackle depression and Sa then therapy is your best bet, meds wont cure depression and SA, you need to find whats causing the depression.


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