Q. I have heard from my friend, they have upped his Zoloft, but that was about 14 days ago, and when I saw him at day 10, I saw little change if any. He is still ambivalent about me, and is not sleeping, and has difficulty focusing. HE thinks he is doing BETTER! I've tried to convince him that his symptoms don't indicate that he is OK.

I have told him that I don't want to end our relationship, and I will be here when the meds kick in. (I am praying that they start soon, because I don't know how much longer I can hang around in the dark closet). The waiting, as they say, is the hardest part.

Doctor, what percentage of people, when they are medicated, have these relapses? Will John continue to have depressions such as these? Is there a chance he will be in remission for extended periods of time (years, decades)?


  A. One of the great things with Zoloft, is that you can measure how much is in you and know if it is enough. You draw a serum level 6-8 hours after the morning dose of medication, and it needs to be 180 ng/ml or higher. If it is less than this, it does not work very well. There is always hope. If the Zoloft fails and the level is okay, use Effexor XR at 450 mg/day