New to this forum - cipralex need support

[Monza]

Good morning. I am new to this site and I am so grateful for all the information I have found on this site. I suffer from anxiety and panic attacks and lately, it became a bit out of control so my Dr prescribed me some Cipralex and Lorazepam. I did take Cipralex for a year and stopped in May 2013. I was very well when I was taking it and then decided to stop it. I was fine until 1 month ago. I have now been taking cipralex first 2.5 mg for three days, then 5.0 mg for maybe for six days and now 7.5 mg for five days. My anxiety seems much worse than before I started. My main problem is during the night, I wake up every 1h30 from a horrible nightmare and with my heart racing etc...which triggers a panic attack then it takes me quite some time to recover, then I fell asleep to wake up in the same state 2h later... I am getting exhausted. My Dr said these are side effects from the Cipralex and that my body needs time to adjust. I dont remember suffering that bad the first time I took it. I remember having insomnia and a bit of panic attacks but but not the nightmares... I also have jelly/weak legs. I am taking the cipralex at night, do you think I should take it in the morning. Sometimes I want to give up taking it but I also remember how well I was when I took it last year... Is it normal to feel like this after 2 weeks? I thought I would see some improvment by now. My Dr would like to take 10 mg as she said that to have the full effect you need 10 mg over 3 wks. what do you think? thank you so much as I am really struggling to keep faith at the minute and every day seems like a battle at the minutes... I am very grateful for your support

[Flat Stanley]

Hi Monza,

How are you taking the Lorazepam, daily with the Cipralex or for specific attacks only?

I was on 10mg daily Escitalopram (Cipralex) without major incident since 2006 until last year when I decided to taper down my dosage. After nearly eight years without major ups or downs I didn't see the point to staying on a drug that I no longer felt I needed. That was until August when one particularly stressful incident put me right back where I started. At my GP's instruction I went back on my full dosage of Cipralex, to which was added a daily dose of Alprazolam (Zanax). Alprazolam is a benzodiazopine type drug, just like the Lorazepam you mention. My personal experience was that the Cipralex and the Xanax did not work well together, causing me symptoms much like the ones you have described. I would wake up often feeling anxious with shortness of breath and irregular heartbeat. I also started having very very strange dreams. I responded to this by increasing my Cipralex to 15mg per day and have progressively been weening myself off the Xanax. I currently take only 1/4 my initial dosage of Xanax and by the end of next week I plan to be off it altogether. This has definitely helped my sleep patterns return to normal. I still wake up feeling anxious in the mornings, but its not as bad and it abates fairly quickly after I get up. My suggestion, therefore, is that you try something similar. Do, however, consult your GP first before accepting my advice. What I have described worked for me, but may not work for you.

Oh, and I always take my Cipralex in the mornings.

Regards
FS

[Monza]

thank you FS. I only take half a Lorazepam when I have a panic attack or when I feel very anxious before going to sleep, so max would be 1 full tablet of the smallest dose, sometimes I only take half a tablet a day. Maybe I should try to take the Cipralex in the morning but I am scared to feel drowsy... My Dr would like me to take 10 mg of Cipralex but I am worried as I already have so many symptoms at 7.5 mg...it has been 2 weeks already and I do not seem to see any improvements. I was ok during the day when I was at 5mg but since Monday I increased it to 7.5 mg and now I feel very anxious during the day as well. Maybe it it because I am back at work, I dont know (I was off last week). It is so difficult to concentrate at work as I can only think about how I feel...I cannot even say that I look forward to going home tonight as I will have to go to sleep and my nights are even worse than my days. It is a vicious circle...I just want to start feeling better and not have that constant fear.... I am seeing my Dr tomorrow, I will see what she suggests.... thank you again so much for your support.

[Flat Stanley]

Hi Monza,

It is very common with both the Escitalopram and Citalopram based drugs to experience a worsening of symptoms before you get better. Your doctor was right to suggest that you won't feel any improvement until at least 3 weeks after being on 10mg per day and you are correct to ramp your dose upwards as you are doing. Getting back to stability after restarting your Cipralex is going to be a rough ride, but will likely be worth it in the end. I would honestly suggest, however, that you discuss the use of Lorazapam together with Cipralex with your doctor. I can only speak for myself, but using benzodiazepines with Escitalopram did not work for me.

One technique I suggest that you follow that may ease your symptoms during this difficult time is to consciously try to identify the type of thoughts that you are having when they happen. For example, if you find that your mind is starting to ruminate on certain of your worries, for example around work issues while at work, try to suffix your thoughts with the statement "these are worrying thoughts that I am thinking". This is basically a distraction technique to get you to rather think about how your mind is responding to your environment rather than leaving it to keep thinking in circles. Remember, you are not your mind, and your mind is not you. As humans we have the ability to think about how and why we think what we do. The important thing is not to try and stop yourself from worrying as this, in itself, can cause increased anxiety. Basically you become anxious about being anxious, and this is a downward spiral that can go on forever. That continuous circle of worry can be interrupted by identifying the types of thoughts you are having. For example, I tend to repeat conversations with work colleagues over and over again in my head, over analysing every word and thinking through all the alternative outcomes that could have transpired. I break this circle by interrupting my thoughs with the statement "this is not a real conversation and the person I am talking to is not really here". This technique works wonders to take the edge off my anxiety. The more time I spend thinking about how my mind works the less time I spend worrying about arbitrary issues that are outside my circle of influence (beyond my control to put right).

The way this will likely play out for you is as follows:
Eventually the day time anxiety will reduce to mornings only. You'll wake up with it, but you'll find that you can shift the feeling by early afternoon, then midday, then early morning, and eventually you'll go back to waking up symptom free. It won't be an easy road getting to that point, but you should be at that point in at least a months time if you stick with the Cipralex. At least that's how it has worked for me.

Best Wishes
FS

[Monza]

Thank you so much for your recommendations! By the way, my husband is South African :D I will persevere with the cipralex and really hope to feel better soon as I really hate feeling like this as I am dreading never to feel good again... Thank you again

[Flat Stanley]

Thank you so much for your recommendations! By the way, my husband is South African :D I will persevere with the cipralex and really hope to feel better soon as I really hate feeling like this as I am dreading never to feel good again... Thank you again

You're welcome Monza.

The downside to living in SA with anxiety is that I don't get to enjoy Cape wines the way I would like to anymore as I find my mood improves greatly if I avoid any form of stimulant (caffeine included) :). On the bright side I do get to drink as much rooibos tea as I want which I find very calming. I am sure you're husband will know exactly what Rooibos tea is :winks:

All the best to you and I hope you start feeling better soon.