New to Cit, was OK on 20 but upped to 40 - why?

[Snowfox]

Hi everyone,

My GP prescribed cit for me 6 weeks ago for general anxiety precipitated by a bereavement and also long term unemployment/financial insecurity. I was reluctant to take them at first, this being my first experience of SSRIs/ADs but with the support of my bf, I started on 20mg as prescribed, at 5pm each day. Apart from feeling like I'd been drugged when I woke up, and sleeping longer (from average 9hrs normal to 11-12+), I was fine. My mood picked up, the tears stopped and I started to feel something like I vaguely remembered as 'normal'.

So, I go back to GP 4 weeks later for a follow up and to get next prescription and without a word of warning, she ups my dose to 40mg! Ever since then it's been horrendous. It's been two weeks on 40mg now and I have a permanent low level headache all day long, the few days I changed to taking my dose in the morning, I was in a druggy sleep for 3 hours by mid afternoon and my brain has turned to sludge. I've switched back to taking my dose in the evening which means I can manage to stay awake during the day but I still feel like a zombie and can barely hold a thought in my head for more than a few seconds. Emotionally I feel numb, nothing bothers me at all now and that's not right is it? I'm seeing a counsellor now, which is great and what I wanted in the first place, rather than medication. I've no interest in anything (other than sleep!) and have gone from hill walking 15 miles a week, even at the worst of my anxiety, to struggling to summon up the energy/will to walk to the corner shop. I've got the most horrendous dark circles under my eyes and I don't recognise the person in the mirror any more.

I'm going to see my GP again tomorrow and would really appreciate some advice. Should I struggle on at 40mg in the hope that I will start to function again soon or ask to go back down to 20mg? I'm really unclear as to why I was put on 40 when I was perfectly OK on 20mg, is this standard practice?

I've just finally been offered a new job after over a year and although it's unlikely to start for 3-4 weeks I need to be firing on all cylinders when I do. I'm also concerned that the emotional numbness is stopping me grieving mum and that this will not help me long term.

I would really welcome any suggestions/comments and if you've read this far, thank you!

SF

[oldtime]

I had a similarly bad experience at 40mg, I went back to my doctor after 3 weeks and he said the dose was too high for me, I reduced to 30mg and started feeling a lot better. I think it is common to treat anxiety with a high dose eg. 40mg initially to hit it hard and calm you down then to reduce to 20mg for at least 6-12 months. This has been shown to be the most effective way to treat anxiety, but if you are not doing well on 40mg you need to go back to your dr.

[Snowfox]

I had a similarly bad experience at 40mg, I went back to my doctor after 3 weeks and he said the dose was too high for me, I reduced to 30mg and started feeling a lot better. I think it is common to treat anxiety with a high dose eg. 40mg initially to hit it hard and calm you down then to reduce to 20mg for at least 6-12 months. This has been shown to be the most effective way to treat anxiety, but if you are not doing well on 40mg you need to go back to your dr.

Thanks for the response. I went back to my GP and have been back on 20mg for two weeks now and feeling great

Best wishes,
A newly converted cit fan
SF

[Catya]

Can I ask how long it took for you initially to feel some benefit? I have been on 20mgs for nearly four weeks and they haven't kicked in yet. I'm disappointed : (

[Snowfox]

I would say around 3 - 4 weeks to feel some slight effect however it was not 'feeling great' by any means, rather it was just not feeling panicky and suffering horrendous mood swings all the time, if that makes sense. The first 4 weeks on 20mg I was still pretty tired although when it was upped to 40mg I could've slept all day and was pretty much sleep walking when I was awake anyway. That took me up to week six and after a just a few days back on 20mg I started feeling really good, as opposed to 'not terrible' and that's continued.

I presume if you're on week 4 then you must be due for a follow up session with your GP around about now, so I would see what she suggests. I should also stress that I am taking cit for anxiety rather than depression so that probably has some bearing on things too. But if it's not the one for you, it there are plenty of alternatives out there and it seems very much like a case of trial and error. Good luck!!

SF

[Catya]

Thank you for posting. = )
Well I saw my dr last week and am supposed to have upped to 30mg..... which I have yesterday and today. I, too, have been given it for anxiety which has caused OCD and depression over the years.
I hate medication but see that I cannot go on like this.