Zoloft 200 mg: fear of taking Abilify on the side. Do we know why some people don't gain any insight into their illness, especially in paranoid schizophrenia?

Question

I am taking Sertraline 200 mg and my doctor has prescribed Abilify 2 mg because I continue to experience anxiety. I have actually improved since taking Sertraline 200 mg (after four weeks on that dose). I am a little less anxious. The doctor wants me to take an adjuvant to boost the effect of the sertraline. I have had an anxiety disorder for a good 10 years (OCD, generalized anxiety, agoraphobia, social anxiety)... He says that sertraline is good for managing anxiety and OCD. He said you can wait several weeks to see the effect on OCD. Right now, my OCD is there too. I don't sleep well during the week either, with the stress of everyday life (I'm afraid of sleeping badly too!). So I take a Quetiapine to help me sleep). I take half an Ativan occasionally when I'm more anxious, like going out to dinner. I'm reluctant to take Abilify because I don't want to take another medication on top of all those! I also want to be more patient than my doctor maybe? If I have an improvement after 4-5 weeks, maybe it can continue to get better? I'm also afraid of the side effects, like weight gain, sleepiness during the day, I would be afraid of losing my emotions, my personality... Also, I would be afraid of gaining weight, for example, and not knowing if it's the sertraline or the other one that's doing it! So I wonder: when they say that it takes 4 weeks to feel the effects of an antidepressant, is it for the maximum effect or the beginning of the effect and can it get better after that? Also, my doctor told me that we can increase the dose of sertraline to 300 mg to treat OCD. But I read everywhere that the maximum dose is 200. Do not answer it ;) thank you! Yes, thank you!

Naji-tom Samaha · Accepted Answer

Doses above 200mg have been reported in the literature. This will depend on the doctor's experience and the evolution of your situation: if you have felt an improvement to date, this is one of the options to explore. The full effect of the antidepressant can be felt after 6-8 weeks of an effective dose. That being said, many people may need adjustments or additions, even if only temporarily. As for anxiety, there will always be some in the daily life, the important thing is to be able to manage situations, go about normal activities and improve the quality of life. I consider this kind of situation more as a remission than a cure. Sincerely, Tom Samaha, pharmacist