Why Has Zoloft Stopped Working And What Can Be Done About It?

QUESTION:

Dear Dr. Heller,

Great relief of chronic depression from Zoloft for 3 years, then effectiveness decreased by 75%. Have any other drugs been shown to pick up the slack in this situation?

Thank You

ANSWER:

The two most common causes for this are:

1. BPD (Borderline personality disorder) with chronic dysphoria (anxiety, rage, depression and despair). The depression of dysphoria is neurologically different than regular depression.
2. An imbalance of serotonin with noradrenaline and dopamine. SSRI's like Zoloft raise serotonin and a relative imbalance can occur. Adding Wellbutrin usually solves the problem.