Switched from sertreline to Cipralex

[Barnabas75]

Two and a half weeks ago I was switched from sert to cipralex..The sert worked well for over 3 years and I was on 50 mgs ,,then I relapsed a bit and they changed me over to cipralex. The start up effects of the sert were quite intense with hot sweats, diahrea, and jaw clenching, increased anxiety and panic attacks, with vivid dreams. It took almost ten weeks of this agonising before I felt the benefits from it. I am now into the third week of cipralex. And still see no benefits, but getting increasingly worse.

With cipralex its been similar, but with intense suicidal thoughts and ideation thrown in the mix . The suicidal thoughts are the worst part and I never new they could be so strong. I even find myself thinking of ways to do it now. So I saw an emergency Doctor today and he told me its normal and would not change my medication.

Has anybody else been through this on cipralex and pushed through, and when did you finally start to see an improvement ? I plan on finding a private doctor ,someone who actually speaks english as I live in Portugal and its difficult to communicate. The guy I saw today just wants to perscribe pills and more pills..It feels like he is not listening and hardly cares.H eis practically done with me in 5 minutes.

Please tell me how long it took before you noticed the cipralex working. I am thinking about just stopping it because I have a great family who I love and I do not want to suddenly act out the intense thoughts..But they are strong and getting stronger all the time. They ususally come with the adreniline surges that can happen 5 times a day. If that is what they are they come with intense fear...has anybody had this experience. Sort of getting desperate...thanks..

[panic_down_under]

The sert worked well for over 3 years and I was on 50 mgs ,,then I relapsed a bit and they changed me over to cipralex.

50mg is the usual minimum effective dose with most needing 100-150mg for good results. Was any consideration given to just increasing the dose? Imho, it should have been.

With cipralex its been similar, but with intense suicidal thoughts and ideation thrown in the mix . The suicidal thoughts are the worst part and I never new they could be so strong. I even find myself thinking of ways to do it now. So I saw an emergency Doctor today and he told me its normal and would not change my medication.

NO, it is not normal. Tell the prescribing doctor about this asap.

Please tell me how long it took before you noticed the cipralex working.

Generally, a SSRI will work immediately after an overnight switch from another SSRI with maybe some side-effects for a few days.

I plan on finding a private doctor

A very good idea, imho. I wouldn't have much faith in your current one/s. A psychiatrist would be even better.

[Barnabas75]

I told him about the suicidal ideation. I saw the same Doctor who is a psychiatrist as he was on call. I live in Portugal and went through their version of the NHS, but I will make an appointment to see a private one because the Doctor I saw wont speak english and communicating is a problem. I already made queries today for an english speaker and will no doubt get around to seeing one. The psychiatrist I saw yesterday said to stick it out as it takes 3- 4 weeks before it will have an effect. They did put me up to 100mgs on the sert but after 2 months I felt the same so they changed me to cipralex 17 days ago. Today I actually saw a bit of light at the end of the tunnel. The first time since late november. I was supposed to take xanax alongside the cipralex for a month. I guess that is to make the start up effects more bareable. I have taken it on 4 occasions. But I am trying to avoid taking them like the plague.

Its when intense waves of fear come over me that I think of hurting myself. Maybe those waves are in actual fact just adrenaline rushes. I am wondering if they are? I think I felt better today because I have not had one yet. Really appreciate your feedback Panic.

[panic_down_under]

I have taken it on 4 occasions. But I am trying to avoid taking them like the plague.

Its when intense waves of fear come over me that I think of hurting myself. Maybe those waves are in actual fact just adrenaline rushes. I am wondering if they are? I think I felt better today because I have not had one yet.

It is possible that your mind is misinterpreting the adrenaline surges. Was the self harm impulse less/non existent on the days you took a Xanax? What about the adrenaline surges on those days?

[Barnabas75]

When I took the xanax there were no surges. Its probably text book panic. However I never get a racing heart , neither does my blood pressure go up much. So its typical atypical. That is what I was told, that they are atypical..I have no idea....Having Gerd does not help either I gather. Pantoprazol does though.

[panic_down_under]

However I never get a racing heart , neither does my blood pressure go up much. So its typical atypical. That is what I was told, that they are atypical.

The only thing "typical" about anxiety disorders and depression is there are nothing typical about them. Everyones mix of issues and responses is unique to them.

Having Gerd does not help either I gather.

No. Not only is gerd probably another symptom of the underlying problem, but serotonergic antidepressants can upset the apple cart initially because the enteric nervous system (ENS), the mini brain which controls the gut (and to varying extents the heart, lungs and brain too), makes it the most serotonergic organ of the body. It makes and uses around 95% of the body's serotonin compared to a little under 2% for the brain.

[Barnabas75]

Day 18 and still not much better. I thought about increasing from 10-15mgs , but am wondering if its still to early for results from the switchover. Had 3 or 4 waves of adrenaline surges today. refused to reach for a xanax as I know they pass. But they did make me cry today.They were that bad. Fear is a liar sometimes. Just wish I could sleep properly. Set myself a short term goal of seeing how things are on day 21, before deciding on an increase. I know I should give it at least a full 4 weeks. Not going to think to far ahead. Today is hard enough-

[panic_down_under]

but am wondering if its still to early for results from the switchover.

Very likely. I suspect the 50mg sertraline wasn't doing anything so you probably started the escitalopram from effectively a clean slate. It can take 3-12 weeks for antidepressants to fully kick-in from when a therapeutic dose - usually at least 10mg for escitalopram - is first taken.