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	<title>Comments on: Your Questions</title>
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		<title>By: trmorrisnd</title>
		<link>http://trmorrisnd.com/your-questions/#comment-275</link>
		<dc:creator><![CDATA[trmorrisnd]]></dc:creator>
		<pubDate>Tue, 30 Aug 2011 23:49:29 +0000</pubDate>
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		<description><![CDATA[The average terminal elimination half-life of plasma Sertraline (Zoloft) is about 26 hours. Based on this pharmacokinetic parameter, steady-state Sertraline plasma levels should be achieved after approximately one week of once-daily dosing. Once dosing is stopped, in the average person, the plasma level will be cut in half every 26 hours. It is generally not recommended to stop completely &quot;cold turkey&quot; as this can lead to withdrawal side effects. The risk of these withdrawal effects is greater when taking larger doses. (100 or 150 mg) than it is with smaller doses (25 or 50 mg). The standard recommendation is to taper off the dose.

There have been spontaneous reports of adverse events occurring upon discontinuation of Sertraline hydrochloride and other SSRIs and SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors), particularly when abrupt, including the following: dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesias such as electric shock sensations), anxiety, confusion, headache, lethargy, emotional lability, insomnia, and hypomania. While these events are generally self-limiting, there have been reports of serious discontinuation symptoms.

Patients should be monitored for these symptoms when discontinuing treatment with Sertraline hydrochloride. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose but at a more gradual rate.]]></description>
		<content:encoded><![CDATA[<p>The average terminal elimination half-life of plasma Sertraline (Zoloft) is about 26 hours. Based on this pharmacokinetic parameter, steady-state Sertraline plasma levels should be achieved after approximately one week of once-daily dosing. Once dosing is stopped, in the average person, the plasma level will be cut in half every 26 hours. It is generally not recommended to stop completely &#8220;cold turkey&#8221; as this can lead to withdrawal side effects. The risk of these withdrawal effects is greater when taking larger doses. (100 or 150 mg) than it is with smaller doses (25 or 50 mg). The standard recommendation is to taper off the dose.</p>
<p>There have been spontaneous reports of adverse events occurring upon discontinuation of Sertraline hydrochloride and other SSRIs and SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors), particularly when abrupt, including the following: dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesias such as electric shock sensations), anxiety, confusion, headache, lethargy, emotional lability, insomnia, and hypomania. While these events are generally self-limiting, there have been reports of serious discontinuation symptoms.</p>
<p>Patients should be monitored for these symptoms when discontinuing treatment with Sertraline hydrochloride. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose but at a more gradual rate.</p>
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		<title>By: Megan</title>
		<link>http://trmorrisnd.com/your-questions/#comment-161</link>
		<dc:creator><![CDATA[Megan]]></dc:creator>
		<pubDate>Mon, 28 Mar 2011 00:03:53 +0000</pubDate>
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		<description><![CDATA[I have been on zoloft for 14 days but it made me very ill as i am allergic to it. Ive stopped zoloft for two days. First day, i experienced withdrawal. Today, i feel fine. Should i expect anymore withdrawals?]]></description>
		<content:encoded><![CDATA[<p>I have been on zoloft for 14 days but it made me very ill as i am allergic to it. Ive stopped zoloft for two days. First day, i experienced withdrawal. Today, i feel fine. Should i expect anymore withdrawals?</p>
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		<title>By: trmorrisnd</title>
		<link>http://trmorrisnd.com/your-questions/#comment-3</link>
		<dc:creator><![CDATA[trmorrisnd]]></dc:creator>
		<pubDate>Wed, 06 Jan 2010 02:18:23 +0000</pubDate>
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		<description><![CDATA[I think that eating five times a day with three hour spacing would probably help you a lot: think 7am-10am-1pm-4pm-7pm (or something that fits your schedule) as the times to eat HALF a regular meal. Another tip is making sure that there is a balance of protein fat and carbs somewhere toward the Zone Diet would also probably help. That aiming for a 7/3/9 ratio (7g-protein/3g-fat/9g-carbohydrates) in your meals and snacks. Caffeine is almost definitely not the friend of anyone with a twitchy stomach that runs toward the nausea side of things. I recommend cutting way back or eliminating it for at least three weeks to see how that affects things. At the very least, only do caffeine after a meal. If none of that helps, you may benefit from food allergy testing, to identify specific foods that your body is having an immunological reaction to. You are right-on when you suggest that nerves are often at the root of digestive problems: exercise, meditation, yoga, tai-chi, qi-gong, hot baths, breathing exercises and other daily relaxation practices might make a big difference for you. There are many good nutriceutical solutions to mood disorders (anxiety, depression, OCD) that we could work on together too.]]></description>
		<content:encoded><![CDATA[<p>I think that eating five times a day with three hour spacing would probably help you a lot: think 7am-10am-1pm-4pm-7pm (or something that fits your schedule) as the times to eat HALF a regular meal. Another tip is making sure that there is a balance of protein fat and carbs somewhere toward the Zone Diet would also probably help. That aiming for a 7/3/9 ratio (7g-protein/3g-fat/9g-carbohydrates) in your meals and snacks. Caffeine is almost definitely not the friend of anyone with a twitchy stomach that runs toward the nausea side of things. I recommend cutting way back or eliminating it for at least three weeks to see how that affects things. At the very least, only do caffeine after a meal. If none of that helps, you may benefit from food allergy testing, to identify specific foods that your body is having an immunological reaction to. You are right-on when you suggest that nerves are often at the root of digestive problems: exercise, meditation, yoga, tai-chi, qi-gong, hot baths, breathing exercises and other daily relaxation practices might make a big difference for you. There are many good nutriceutical solutions to mood disorders (anxiety, depression, OCD) that we could work on together too.</p>
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		<title>By: Jen McIntyre</title>
		<link>http://trmorrisnd.com/your-questions/#comment-2</link>
		<dc:creator><![CDATA[Jen McIntyre]]></dc:creator>
		<pubDate>Wed, 18 Nov 2009 23:52:43 +0000</pubDate>
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		<description><![CDATA[Hi Doc!  I&#039;ve always had trouble being able to quiet my stomach once it gets upset.  If I drink too much I may vomit and not be able to stop for 24h.  In high school I had to go to the hospital for this after I drank too much and couldn&#039;t stop being sick a week later.  I&#039;m thinking of trying to get pregnant in the next few years.  I was pregnant once years ago and was horribly horribly sick.  I also used to have trouble with my stomach where it would palpably spasm for an hour or more, which made me feel quite nauseous.  I&#039;m sure part of this problem is nerves.  I&#039;ve had much fewer troubles since I&#039;ve been chill, but am nervous being pregnant would be a problem for me.  Do you have any suggestions for how to approach this problem?  I&#039;ll be sure to consult you formally should this time arrive, but feel free to use my question in abbreviated form on the blog!]]></description>
		<content:encoded><![CDATA[<p>Hi Doc!  I&#8217;ve always had trouble being able to quiet my stomach once it gets upset.  If I drink too much I may vomit and not be able to stop for 24h.  In high school I had to go to the hospital for this after I drank too much and couldn&#8217;t stop being sick a week later.  I&#8217;m thinking of trying to get pregnant in the next few years.  I was pregnant once years ago and was horribly horribly sick.  I also used to have trouble with my stomach where it would palpably spasm for an hour or more, which made me feel quite nauseous.  I&#8217;m sure part of this problem is nerves.  I&#8217;ve had much fewer troubles since I&#8217;ve been chill, but am nervous being pregnant would be a problem for me.  Do you have any suggestions for how to approach this problem?  I&#8217;ll be sure to consult you formally should this time arrive, but feel free to use my question in abbreviated form on the blog!</p>
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