Serious divorce anxiety - SSRI?

[Cw8us]

Hello all,

About one month ago, my wife asked for a divorce. We had been near that precipice before but I hadn't the slightest clue how hard it would be to actually go over the edge. I immediately took a two week leave of absence, and spent the time with trusted friends, mostly talking and crying. The anxiety was so bad (heart racing, only an hour or three of sleep even with zolpidem, obsessively thinking about past mistakes and the dismal future) that I got a prescription for clonazepam (benzo). That helped, a lot - between that and zolpidem, I actually got some sleep. I thought the clonazepam was just helping me sleep but when I ran out of it, the anxiety returned, but it was not as bad. Bad enough that I could not sleep much even with zolpidem. Went into my GP and he gave me citalopram, plus clonazepam for the initial week or two. I started taking the citalopram two days ago and feel really terrible. Headache, nausea, cannot eat, am just lying around in bed, etc. So I started researching SSRIs (which I knew nothing about, this is all new territory for me) and am now beginning to think that I jumped the gun on moving onto SSRIs so quickly. I now understand more about the initial adjustment time, the ongoing side effects, the weaning time, and the fact the docs can be quick to reach for them. I guess I am posting here to get opinions on when to go for an SSRI and when to ride it out.

[Poppy Girl]

Hi
So sorry to hear what a tough time you're having. Life can be so hard at times. I resisted medication for a few weeks before I finally admitted I couldn't cope any more.
I think Citalopram is usually the first ssri the doctors prescribe as it seems to be the most common and the cheapest. I had exactly the same side effects as you - nausea, headaches, no sleep at night but kept falling asleep randomly in the day and generally felt like a zombie. After a week I couldn't take any more so I went back to the doctor. To cut a long story short I tried another couple of SSRIs with no relief. I tried no medication again for a couple of weeks but felt like I was falling apart. My doctor had retired by then so I saw my new gp who suggested I try an snri which also helps reuptake of noradrenaline as well as serotonin. So I've been on Venlafaxine for 7 months now and things are much improved. I'm on an extended release tablet so it works slowly throughout the day. I asked my new doctor why I wasn't offered this earlier and she basically said that it was more than double the cost of citalopram so patients are usually tried on the cheaper drugs first. There is a cheaper twice a day Venlafaxine tablet but there are notorious start up side effects and she thought I'd been through enough so put me straight on the extended release one. I've had very few side effects with this - just a lot of yawning and sweating more than normal to start off with and that I could cope with!
I'm not saying that this medication is for everyone but it seems with all anti-anxiety meds it's a case of keep trying until you find the right one. I hope this helps in some way and also that you have support and people to talk to - that's so important. I shut myself off from everyone for two weeks when I was at my worst and so wish I hadn't. Talking to people abput how youre feeling is a major factor in recovery. Meds can help but they can't cure you on their own. It took me a long time to realise that but once I did I turned a corner. So far I think I'm on the right path.
Don't feel alone. There's lots of support on here. We've each got a different story but if we listen and help each other we'll get there.
All the best

[SADnomore]

Hello,

Knowing about the divorce in advance doesn't help much, and, as you say, the emotional impact cannot have been anticipated until you are in the midst of it. You have my sympathies. The inability to sleep, to distract yourself from the pain and worries, indeed, your grief over the end of your marriage make this an extremely difficult time for you. Thankfully, you have caring friends and doctor to help.

Please try to face all this head on, to walk through it all. As tempting as it is to withdraw into the calm of benzodiazepine use and the numbing it provides, it only postpones your progression to the other side of the journey where you will begin to feel better. Believe me. And there is good reason why doctors try to not prescribe them past two weeks: by the end of that time, physical and mental dependency are a very real risk.

My experience with ssris is like Poppy Girl's. I too have found the most solid relief with the Snri Venlaxafine, and the side effects at start-up were no worse than with ssris. The real "costs" are yours, in terms of getting better more surely over time, and hopefully your doctor will be willing to give venlaxafine a trial, although of course he has your complete background and will know if it is an appropriate medication for you.

Ditto Poppy's advice about the once-a-day version of it, there is enough adjusting to the medication and waiting for it to take hold, without the added spike of side effects of the cheaper tablets meanwhile.

It does take time to get to a place of better coping with ven, but it does anyway with most meds. Lots of people on NMP are available to chat and provide a caring ear and sound advice, close to around the clock, so do keep posting. Good luck, however you and your doctor choose to proceed. If you truly do not wish to try an Ssri fairly long-term, then likely other choices will be better to consider. I feel more "normal" and in control on it several months in, than I have in years. I see this as a sign that I do need it to stay on an even keel, and have no problem continuing.

Take care! :bighug1: