antidepressants..Do they help anxiety

[Annie0904]

I took dosulepin for 15 years but came off it a year ago. I am experiencing high anxiety at the moment but I know this was triggered by physical health problems. I need to go in hospital for an operation. I haven't got a date yet and in quite a lot of pain.

When I think back, my anxiety even on the meds was quite high at times.
My GP put me back on dosulepin a week ago. I know they can take 4 weeks to get into my system but the side effects, dry mouth, tinnitus and drowsiness are making me even more anxious.

I am even wondering if it is worth me sticking with it as I am not convinced they will help any way.

Do you think you have improved on medication or not?

[Mpower7]

I was put on sertraline for my Anxiety. They have definitely made an improvement to my anxiety as I'm able to control it a lot better now! I've no experience with the medication you are on but hopefully somebody else has.

[Annie0904]

I think I am just being impatient this time round and want an overnight cure
I was in a state first thing this morning hence my post.
Now I am slightly more rational in thinking and know I need to wait a few more weeks.
I just upped my dose to 50mg last night so I guess that is why I am suffering this morning.

Just wish I didn't have the physical health problems and worry of an op then maybe my anxiety wouldn't have come back.

[panic_down_under]

When I think back, my anxiety even on the meds was quite high at times.

Maybe the dose was inadequate. How much were you on before?

but the side effects, dry mouth, tinnitus and drowsiness are making me even more anxious.

Was tinnitus also a problem when you took dosulepin before and if so is your doctor aware of this?

Do you think you have improved on medication or not?

Dosulepin has kept me pretty much completely anxiety/panic free for 20 years, though I've had to take doses that would probably horrify your GP to get that result.

[Annie0904]

I was taking 150mg at one point but got down to 25mg and seemed stable on that but gp persuaded me to come off them and go on SSRI'S. I had horrendous side effects from those. I pleaded with him to put me on dosulipin again but still going through start up. Took 25mg first week and just went up to 50mg last night.
I am thinking though that until my operation is done I am not going to overcome the anxiety but maybe dosulepin will take the edge of it.

[panic_down_under]

I was taking 150mg at one point but got down to 25mg and seemed stable on that

Staying on a sub therapeutic dose of only 25mg for an extended period may not have been wise. Antidepressants work by stimulating the growth of new brain cells (neurogenesis) to replace cells killed, or prevented from growing by high brain stress hormone levels. The therapeutic response is produced by these new cells and the stronger interconnections they forge, not the meds directly and this requires a certain level of the med in the system to initiate and sustain.

The problem with taking low doses is neurogenesis may be interrupted whenever plasma levels drop below the neurogenesis sustaining threshold which leads to the second issue, the growing evidence that antidepressants become progressively less effective every time they are stopped and restarted, often requiring higher doses to achieve the previous level of control. They may also produce more severe, and/or different, initial side-effects. Two studies, Amsterdam JD, 2016 and Amsterdam, 2009 found the likelihood of antidepressants working after each restart drops by between 19-25% (see also: Amsterdam JD, 2009; Leykin Y, 2007). This applies whether returning to a previously taken antidepressant or a different one. Taking a low dosulepin dose for a long time may effectively create a similar situation as stopping and restarting it. While the neurogenesis interruptions may only be of short duration, they will probably occur much more frequently.

but gp persuaded me to come off them and go on SSRI'S. I had horrendous side effects from those.

Dosulepin is being slowly phased out in the UK because it is highly cardio toxic in overdose. Also many GPs have little experience with older meds and believe the SSRIs are the most effective antidepressants. They aren't, especially for depression. The TCA amitriptyline (Elavil) has similar in action and potency to dosulepin, but less cardio toxic so may be a good alternative, as may imipramine (Tofranil).

I am thinking though that until my operation is done I am not going to overcome the anxiety but maybe dosulepin will take the edge of it.

Unfortunately, antidepressants take time to begin working, new brain cells don't grow overnight, and there is no way of speeding things up.

[Annie0904]

I tried amitriptyline but after a week my face felt numb and I had tingling in my arms. I have taken 50 mg dosulipin the last 2 nights but feel dreadful.

[panic_down_under]

I tried amitriptyline but after a week my face felt numb and I had tingling in my arms.

Both are fairly common initial side-effects which usually diminish after a few weeks.

I have taken 50 mg dosulipin the last 2 nights but feel dreadful.

Most antidepressants can produce unpleasant side-effects at the beginning. Starting on 25mg may have been better.

[Annie0904]

I started on 25mg. I took 25mg for a week then increased to 50mg. It took me until 12 noon to feel well enough to do anything today even though I was awake from 6am.