It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Panic Disorders Message Board

  • Looking for a zoloft combination

  • Post New Thread   Closed Thread
    Thread Tools Search this Thread
    Old 01-06-2004, 06:00 AM   #1
    Punchy
    Member
     
    Punchy's Avatar
     
    Join Date: Aug 2003
    Location: Somehwere
    Posts: 62
    Punchy HB User
    Looking for a zoloft combination

    My doctor has prescribed Zoloft and Inderal. After doing some OCD research on the interaction between the two, I noticed that they do conflict (or there have been reported cases). When I started to take them together I was getting panic attacks worrying about the interactions. I was on strictly Zoloft about 2 years ago and that was the last time I can remember feeling 'normal' or 'happy'. I would like to get back there. Then they found that I have a little bit of HBP (140/90) and doc put me on the Inderal, but I had stopped taking Zoloft for about 1.5 years. Now my medical is covered again, but I want to know if there is a good combination with Zoloft and any other HBP meds that people are using and having good success with. I will be taking the Zoloft in the morning, in case that matters. I see the doc today and will be requesting a possible change. He told me not to worry about the interaction (easier said then done).

     
    Sponsors Lightbulb
       
    Old 01-06-2004, 07:59 AM   #2
    Some12
    Senior Veteran
     
    Some12's Avatar
     
    Join Date: Nov 2003
    Posts: 724
    Some12 HB User
    Cool Re: Looking for a zoloft combination

    Quote:
    Originally Posted by Punchy
    My doctor has prescribed Zoloft and Inderal. After doing some OCD research on the interaction between the two, I noticed that they do conflict (or there have been reported cases). When I started to take them together I was getting panic attacks worrying about the interactions. I was on strictly Zoloft about 2 years ago and that was the last time I can remember feeling 'normal' or 'happy'. I would like to get back there. Then they found that I have a little bit of HBP (140/90) and doc put me on the Inderal, but I had stopped taking Zoloft for about 1.5 years. Now my medical is covered again, but I want to know if there is a good combination with Zoloft and any other HBP meds that people are using and having good success with. I will be taking the Zoloft in the morning, in case that matters. I see the doc today and will be requesting a possible change. He told me not to worry about the interaction (easier said then done).
    \

    Dear Punchy,
    First buy a wrist monitor an keep track of your blood pressure to make sure that you do not have white coat syndrome, which means it is only high at the doctors office or during an attack. Mine is always high at the doctors office no matter what. I do not have high blood pressure. Here is the interaction between zoloft and Inderal and then between zoloft and Lotensin. You should only be on about 10mg a day lotensin at most to start, 140/90 is not that high.

    The Interaction between Zoloft - Inderal
    Limited clinical data suggest that selective serotonin reuptake inhibitors (SSRIs) may potentiate the pharmacologic effects of some beta-blockers. There have been case reports of patients stabilized on beta-blocker therapy who developed bradycardia, hypotension, and complete heart block following the addition of a SSRI, subsequently requiring discontinuation of one or both agents and/or institution of a permanent pacemaker. The interaction is also corroborated by data from in vitro and clinical studies involving paroxetine and metoprolol conducted by one group of investigators. The proposed mechanism is SSRI inhibition (competitive and/or noncompetitive) of CYP450 2D6, the isoenzyme responsible for the metabolic clearance of beta-blockers such as carvedilol, labetalol, metoprolol, propranolol, and timolol. Paroxetine and norfluoxetine (the active metabolite of fluoxetine), in particular, are potent inhibitors of CYP450 2D6 and may be more likely than other SSRIs to cause the interaction. On the other hand, fluvoxamine is a potent inhibitor of CYP450 1A2 and may significantly interact with propranolol, which is a substrate of both CYP450 2D6 and 1A2.MANAGEMENT: During concomitant therapy with SSRIs, a lower initial dosage and more cautious titration of the beta-blocker may be appropriate. Cardiac function should be closely monitored and the beta-blocker dosage adjusted accordingly, particularly following initiation, discontinuation or change of dosage of SSRI in patients who are stabilized on their beta-blocker regimen. Due to the long half-life of fluoxetine and its active metabolite, norfluoxetine, the risk of an interaction may exist for an extended period (up to several weeks) after discontinuation of fluoxetine. To avoid the interaction, use of beta-blockers that are primarily eliminated by the kidney (e.g., atenolol, acebutolol, betaxolol, carteolol, nadolol) may be considered.

    Lotensin (high blood pressure medication)
    Food Interaction for Lotensin
    Moderate-to-high dietary intake of potassium can cause hyperkalemia in some patients who are using angiotensin converting enzyme (ACE) inhibitors. In some cases, affected patients were using a potassium-rich salt substitute. ACE inhibitors can promote hyperkalemia through inhibition of the renin-aldosterone-angiotensin (RAA) system. MANAGEMENT: It is recommended that patients who are taking ACE inhibitors be advised to avoid moderately high or high potassium dietary intake. Particular attention should be paid to the potassium content of salt substitutes.

    Food Interaction for Zoloft
    Grapefruit juice may increase the plasma concentrations of some orally administered drugs which are substrates of the CYP450 3A4 isoenzyme. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. The extent and clinical significance are unknown. Moreover, pharmacokinetic alterations associated with interactions involving grapefruit juice are often subject to a high degree of interpatient variability.MANAGEMENT: Patients who regularly consume grapefruits and grapefruit juice should be monitored for adverse effects and altered plasma concentrations of drugs that are metabolized by CYP450 3A4. Grapefruits and grapefruit juice should be avoided if an interaction is suspected. Orange juice is not expected to interact with these drugs.

    No drug interaction found. Good luck, I took this one with an srri and had no problem except I did not have high blood pressure which was easy to determine with a wrist tester. Do not take toporol or metatoporol. You need a blood pressure lowing drug not a hypertesion medication or strong beta blocker which is what you are taking now.

    Sincerely,

    Sickman

     
    Old 01-06-2004, 08:11 AM   #3
    Punchy
    Member
     
    Punchy's Avatar
     
    Join Date: Aug 2003
    Location: Somehwere
    Posts: 62
    Punchy HB User
    Re: Looking for a zoloft combination

    Thanks Sicko ,

    I purchased the self test units for home. Now that i am taking the Inderal I noticed that my BP is around 127/85, which is better. When I get up in the morning it is high (before I take the Inderal). I also had some protein in my urine (my doc has sent me for no follow ups since finding this) but I am going to assume it was not too big of a deal.

    Sorry, but I found your post a little confusing towards the end. Were you recommending that I take zoloft with something else? I read the interaction. I am trying to lose some weight. I have never added salt to anything and my calorie intake is around 2400. Salt is less that the allowed teaspoon.

     
    Old 01-06-2004, 08:22 AM   #4
    Some12
    Senior Veteran
     
    Some12's Avatar
     
    Join Date: Nov 2003
    Posts: 724
    Some12 HB User
    Wink Re: Looking for a zoloft combination

    Quote:
    Originally Posted by Punchy
    Thanks Sicko ,

    I purchased the self test units for home. Now that i am taking the Inderal I noticed that my BP is around 127/85, which is better. When I get up in the morning it is high (before I take the Inderal). I also had some protein in my urine (my doc has sent me for no follow ups since finding this) but I am going to assume it was not too big of a deal.

    Sorry, but I found your post a little confusing towards the end. Were you recommending that I take zoloft with something else? I read the interaction. I am trying to lose some weight. I have never added salt to anything and my calorie intake is around 2400. Salt is less that the allowed teaspoon.
    Dear Punchy,
    No, you apparently are fine with what you are taking. You said you were having panic attacks by reading the possible interactions of the drugs. I was just giving you something that has no apparent reactions if you were going to keep having panic attacks thinking about it. The medications seems to be working with that combination so you should stick with it. I mentioned Toporol and metatoprol only because when you got home from the the Doctor with one of those as the new medication, you would find the same interaction information as Inderal. Maybe I didn't understood your question. I thought you were afraid to keep taking the Inderal because of reading the drug interactions which are moderate at best. Well anyway, things seem to be working out for you, so good luck.

    Sincerely,

    Sickman Sicko? You are Punchy

     
    Closed Thread

    Related Topics
    Thread Thread Starter Board Replies Last Post
    Cymbalta vs.Zoloft economike Depression 14 03-24-2011 09:34 PM
    Zoloft for GAD.. when does it kick in? joebloggs2 Anxiety 32 05-03-2008 07:11 PM
    Paxil to Zoloft and having problems colby88 Anxiety 5 04-15-2008 03:42 PM
    Zoloft-Elavil(Amitriptyline) combination musicarvind Anxiety 6 04-28-2006 03:19 AM
    Zoloft - Amitriptyline combination musicarvind Depression 5 04-24-2006 05:29 AM
    Looking for a good combination...... Punchy High & Low Blood Pressure 1 01-07-2004 02:07 AM
    zoloft pros and cons GeccoGirl Depression 7 12-28-2003 06:20 PM
    Zoloft Wellbutrin Combo? InfiniteDisquietude Panic Disorders 2 10-01-2003 04:28 PM




    Thread Tools Search this Thread
    Search this Thread:

    Advanced Search

    Posting Rules
    You may not post new threads
    You may not post replies
    You may not post attachments
    You may not edit your posts

    BB code is On
    Smilies are On
    [IMG] code is Off
    HTML code is Off
    Trackbacks are Off
    Pingbacks are Off
    Refbacks are Off




    Sign Up Today!

    Ask our community of thousands of members your health questions, and learn from others experiences. Join the conversation!

    I want my free account

    All times are GMT -7. The time now is 10:58 AM.





    © 2020 MH Sub I, LLC dba Internet Brands. All rights reserved.
    Do not copy or redistribute in any form!