Zoloft is very effective for panic disorder. Zoloft, generic name sertraline, is an antidepressant medication in the SSRI class (Selective Serotonin Reuptake Inhibitor). Of all the SSRIs, Zoloft has relatively fewer side effects and is generally well tolerated. It is also quite effective for panic disorder.
In reality, all of the SSRIs are effective for panic disorder, but Zoloft is one of the best tolerated. Prozac (fluoxetine) is the least tolerated of the SSRIs, as it can cause activation (jitteriness, restlessness) and more anxiety symptoms when first starting it. Paxil (paroxetine) suffers from having a short half-life, so it has to be dosed at least twice daily to get steady blood levels of the drug throughout the day. And when you miss doses of Paxil, you may get withdrawal effects that feel like having the flu. Celexa (citalopram) appears to be better tolerated than Prozac and Paxil. Lexapro (escitalopram) also appears to be well-tolerated, but it is not available in generic, so it is expensive and may not be covered by your insurance.
So I tend to prescribe Zoloft or Celexa for panic disorder, as both of these medications are effective for panic disorder, and they are well tolerated. Zoloft and Celexa also comes in generic forms, sertraline and citalopram, respectively. When prescription drugs go off patent, then generics can be manufactured, so this reduces the cost of the drug considerably. So this is an additional benefit of Zoloft and Celexa for panic disorder.
Finally, dosing Zoloft and Celexa are relatively easy for panic disorder. Zoloft dosing starts at 25mg, increasing the dose 25mg to 50mg every 2 to 4 weeks until clinical effect- maximum dose 200mg daily. Celexa dosing starts at 10mg, increasing the dose 10mg every 2 to 4 weeks until clinical effect- maximum dose 40mg daily.
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I have panic attacks . I recently went and saw a Dr. He prescribed me Sertraline HCL 50mg for 3 days then take 100mg everyday after. Is that too much to start with? Just wondering since I see everyone else prescribed at lower dosages.
In general, 25mg daily is the starting dose for sertraline (Zoloft). Please consult with your doctor about this.
Should I not start taking it?
50mg is a rather large starting dose.
Doctor, Can anxiety, panic attacks be cure without meds taking meds I’m worried about the side efforts, withdraw.
At the same time I’m tired of waking up feeling scare, and crying because of the symptoms.
Dear John,
Yes, you can treat anxiety and panic attacks without medications, but it will take work. It involves lifestyle changes around your thinking about events, the way you act, what you eat, your activity level, coping skills, and ability to relax. My book, Anxiety Protocol, shows you how to address your anxiety and panic attacks naturally, without medications. If you are also looking for a natural alternative to meds, then KalmPro may be the answer for you.
Hello, Dr.Calo, I have been prescribed Zoloft, I am on 25 mg. I am starting to take it in the morning tomorrow, I already have g=ad been feeling depersonalization for 4 years, will this help me? I also have agoraphobia. Thank you, in advance.
Zoloft is an excellent medication for GAD…can help you to worry less and have less physical anxiety (restlessness, tension). However, depersonalization and agoraphobia requires help from a therapist who is an expert at treating these severe anxiety symptoms. Good luck, and thanks for visiting.
Hi Dr. Carlo,
I’m a 35 yr old male who has been living with depression and panic disorder for the last 4 yrs. About a year ago I took on a high stress job that also have a horrible sleep/work rotating schedule. I’ve been to 3 different PCs and one psychiatrist to find help. I was once on Zoloft 100mg to start. It seemed fine and I do believe helped. I was changed to Mirtazapine by psyc. And that was a horrible drug for me. I was a walking emotionaless zombie. But it worked on the panic attacks. I couldn’t take it any longer and wanted something more fitting for me. So we tried Lexapro 20mg and 60 Er of propranolol. I can’t really grade it after 7 months cause I still found myself with panic and would drive to the ER and sit in the parking lot in my car till I calmed downed. I’d usually be so exhausted for the stress that I fall asleep in my car and walk up feeling ok and head back home. Soo new PC has put me on pristiq 100mg and Buspar. The side effects are not great I’ve had a pounding headache for 3 days straight and muscle soreness/weakness. But I do feel more calm… that was until my overactive thoughts convinced me that I was having seratonin syndrome. (Insert eye roll) WHAT DO I DO!?! I’m literally at my wits end and it is hindering my job as well. I am a hypochondriac fully aware and I live in fear on dropping dead of a heart attack, even though I’ve had many test to disprove this. What do I do? Where do I go from here? Why is it this hard to find something to legitimately help me? Any advice would be great. Thanks.
The risk of Serotonin Syndrome is increased when combining serotonergic agents, so your fears were warranted. Sounds like you need to make a choice about your psychiatrist…either continue with the current psychiatrist and pressure him/her to treat your symptoms immediately, or find another psychiatrist, preferably one who is an expert at anxiety disorders.
I was on Zoloft 100mg for almost three years when my Dr decided to titrate me off of it. About 60 days from the last dose I had a severe relapse. We started meds again and worked back up to 100. Thinks we’re getting better until they weren’t. My dr just increased me to 150. I’m scared that this won’t work. Have you heard of this occurring before and did increasing dosing work?
You have to give the Zoloft time to become effective again, and this can take up to 6 to 8 weeks.
Been on Paxil for six days for panic disorder and I feel my anxiety is worse than anything I’ve experienced before, Asked my psychiatrist to stop it. Made me feel restless, on edge, confused. Is this going to happen with every SSRI?
Yes, the side effects you mention can occur with other SSRIs…lasts for a few weeks, then subsides, and eventually, the anxiety goes away within 6 to 8 weeks on a therapeutic dose. If you want a natural treatment for anxiety disorder, consider KalmPro.
I am asking this question for my sister who has come to me as a nurse and I would appreciate a professional opinion. She has severe anxiety (with panic attacks) and was just increased to 30mg Prozac three weeks ago. She also was taking a very small dose of xanax.. .25mg-.5mg q6hrs prn. She has taken the xanax most often in the morning when she wakes up and states she is having horrible anxiety and can’t hardly function. She then takes some more xanax later in the day when the anxiety starts escalating and again at night. She is not consistent in taking the xanax and her anxiety is all over the place. Recently, 2days ago the MD prescribed an increase in the Prozac to 40 mg a day. (which she takes at night) She took one dose and the next morning she had uncontrollable anxiety and states she had very different feelings of depression, and coming out of her skin. She also decided just 2 days ago to make the xanax consistent and taking .5mg q6hrs while awake. (however she has been waking up in the night around 4am with a panic attack) Any suggestions????
Shauna, contact me at carandangc@gmail.com– I have some thoughts that should be shared privately.
Dr Carlos,
I have bad anxiety, My body feels like it is on an adrenaline rush 24/7.
I don’t have depression, just the physical sensations, tight chest, tight throat, tingling in my arms and agitation plus insomnia.
I also have Hashimoto thyroiditis.
What medication would you recommend?
An SSRI, SNRI, or something else?
I’ve heard some good things about Lexapro.
Also, how long does it take for an antidepressant to work?
Thank you,
Andrea
Dr, I have panic disorder and had been very well on 50mg for many years before a relapse 2 months ago. I have gone up to 125 mg (4 weeks on 100 and 1 week on this dose) but still very panicky. Is this normal?
Panic Disorder sometimes require higher dosing of the SSRI. Also, need more time on the higher dose to wait the effect of the medication.
I have GAD & health anxiety and a recent illness caused my anxiety to go out of control. I started worrying obsessively about me having a brain tumour after feeling dizzy, memory loss and having headaches and now I’ve had a clear CT I know everything was down to my anxiety.
I haven’t been sleeping well and now my anxiety has attached itself to my sleep! I’m obsessed with trying to get a good night sleep and the more I worry the worse it is. I’ve been on 50mg sertraline for 11 days now and 25mg for 4 days prior to that. My doctor prescribed me 2 weeks worth of zopliclone whilst these drugs kick in. Even though I have help to sleep with zopliclone, I can’t stop these thoughts in the day about being able to sleep!! They keep popping in and I’m worrying if these drugs will not only work for me but if I will be able to sleep on my own again.
I had duloxetine when I had a bit of a break down before and wondering if I should go back to that? Every time I have a breakdown I have insomnia then obsess about sleep!
Is this normal for the Sertraline to increase my anxiety like this and all these racing thoughts? I’m 29 with a 2 year old and I can’t focus. It’s ruining my life! I’m started to feel very down.
Please help!
Kind regards
Sertraline can increase anxiety initially, but it sounds like you also need psychotherapy to address your ruminating, negative thoughts and worry: https://anxietyboss.com/how-anxiety-evolves-the-negative-cycle-of-anxiety/
I have been panic attack free for seven years while taking Depakote 500mg 2X a day and Buspar 15mg 2x a day. Since last week I have had daily panic attacks and went to my psychiatrist and he did a reevaluation and added Klonopin .25 as needed and Risperidone at night to include taking 2 Depakotes at bedtime and one In the morning and a Buspar with another Buspar 3:30pm. I work 3-11:30pm at local hospital abs love the people abs the job. I have heard good things about Zoloft for panic attacks and don’t want to be Klonopin too long given it’s issues. I also am awaiting my next two week appt and evaluation to include therapy. I look forward to learning how I can help get better with therapy and medicine. Your thoughts are invited as I am on leave of absence for at least one month and my job is protected for 12 weeks. Thanks.
That sounds like a lot of medications. Consider getting a second opinion from another psychiatrist.