My sister has had a "breakdown" she says. Has left work angry at someone or some incident, practically screaming, crying and very upset a few times in the last couple of months. She says EVERYTHING upsets her now, even TALKING to ME. She has been on 100 mg. of Zoloft for about 6 years now, but her new HMO Psychiatrist has increased the dosage quite a bit, to 250 MG.

We used to have a good relationship, but without any talking, I can't see how not working through or sharing problems will help it. Recently I had a very stressful event (police were involved) but have gotten over it (without talking to her). I did call her at first, which was before she told me "I UPSET HER," but when I did, she said "she can't get upset" and felt she was feeling stressed and angry and hung up.

I think about her all the time and today is her birthday. She takes everything the doctors offer her. Cholesterol medicine, daily stomach acid RX, high blood pressure RX, and Excedrin every day. In the past I have wondered if she likes the attention she gets when she is "sick" Doctors are nice to her, of course! Or perhaps she is a hypochondriac?

Is this dosage dangerous? I am afraid of Serotonin Syndrome, which is very dangerous.

Her symptoms have developed over an extended time, actually since her Menopause. Initially she was on immediately put on ERT by one of these HMO docs, but when bad news came out, she was told to discontinue it by a different HMO doc. She has excess testosterone, (a slight beard) has had breast cysts, (As you can tell, I am not impressed with the care she gets -- and her company seems to change HMOs almost every year.)

She has had early stage melanoma (removed) and you name it -- a trigger finger operation and two carpal tunnel operations, but the carpal is coming back. I have it too, but I deal with it.

I mentioned new blood tests for the post-menopausal hormone levels and perhaps a CT scan for her pituitary. A possible problem such as "steroid rage" (I didn't use those words) could cause aggression and irritability, but she ignored me and says that her "professional" knows what is best.

Any opinions out there? She is 58 today.