View Full Version : Breakthrough anxiety after 4 months of escitalopram.
Hey all,
The past few days I've been suffering with a continuous feeling of anxiety again. The reason being a conversation with my psychiatrist on the current status of my medication. Escitalopram has helped quite a bit for my anxiety but it never got rid of my main symptom. Which is continuous existential obsessive thoughts. These thoughts make me feel as if something is 'off' in the world. For months I've wondered if it was DP/DR but I don't think it's like this because I don't have any of these other symptoms, just lots of rumination on existential topics.
Well back to the conversation with my psych. I was mentioning this to him and he was wondering if escitalopram was working as it should and proposed I tapered off escitalopram and maybe start with a low dose of anti-psychotic medication. At first I kinda agreed with the tapering of the ecit (because after 4 months I still had the thought thing) but the idea of having to start anti-psychotic meds has now really spiked my anxiety. I believe these thoughts are a symptom of anxiety or possibly related to a form of Pure OCD. But I feel my psychiatrist thinks something else.
Anyway, right now (especially during the night and early morning) my thoughts are really warped and I keep thinking what if i'm vulnerable for things like a psychosis etc. My rational me knows that it's again just anxiety pulling its tricks on me but the rational me is getting so outnumbered by my anxious mind at the moment. Last two night I couldn't sleep without Diazepam (1mg) and I would wake after 3 hours with tremor and bathing in sweat. Another milligram of diaz would get me back to sleep for another 3 hours and I'd wake up the same. During the day it's slightly more manageable and I don't take Diazepam. I'm really afraid of the dependence and I'm trying to keep my daily intake below 2mg atm.
I was wondering what your thoughts on the situation are.
Love, mrose
FYI: I did not start the tapering yet. And If I have to switch meds I'd rather cross taper to another SSRI/SNRI instead of an anti-psychotic.
Anyone has some thoughts on this?
Would be much appreciated.
My initial thoughts are...
...is that all psychiatrists do? Prescribe a drug until one works?
Is there a drug to supress existential thoughts? Isn't existential thought a part of the "human dilemma?"
My observation is that you are off-loading your problem onto drugs, rather than constructively facing the problem and finding ways to manage it.
But as always, I am not an expert, and only talk from my experience with obsessive thoughts.
Hey SLA,
Thanks for your insights. I completely agree with you on this point. The reason why I was started on escitalopram in the first place was to somewhat lessen the frequency of the obsessive thoughts. This would hopefully allow me to apply the CBT techniques I learn at therapy. But these last 2 weeks this 'shield' that was placed by escitalopram seems to be broken if you see my point. The thoughts are firing away at such a high intensity to the fact that it's almost impossible to function as I'm so engaged with my thoughts at the moment.
I read your blog about intrusive thoughts: Label, Accept, Move on. I agree that this is the mindfull and CBT way to cope and eventually rid yourself of the anxiety that these thoughts cause. But for me as the frequency is so high right now, I could label pretty much every thought as intrusive. And another thing, I've been trying to 'accept' the thoughts for almost a year now. But there is a difference between saying you accept the thoughts and truly accepting them. I'm obviously still in the first phase here. How does one truly accept their thoughts and not be bothered by them? I guess this is the holy grail of it all. But yeah, I still struggle to find it ;)
But there is a difference between saying you accept the thoughts and truly accepting them.
This is a really good point.
In life sometimes we "don't care" and other times we "ACT like we don't care." So you make a valid point.
It's tough to know what you are going through without actually being in your head.
I'm not suggesting this is a solution, but have you ever tried "mantra meditation?"
It is a fantastic way to gain control over your mind. You repeat a mantra over and over, and all other thought dissipates, leaving you with a very quiet mind.
Given the enormity of the number of thoughts you are having, I am not sure what to suggest!!
I've been on Escitalopram since September this year, and although it's reduced the duration of my panic attacks, it still hasn't eliminated them, despite the fact that I'm on the maximum dosage of 20 mg and occasionally take Rivotril. I used to be on anti-psychotic, and I can tell you that the medication did wonders for my obsessive thoughts and depersonalisation symptoms. I came off it a while ago, but I did have a positive experience with it.
Regarding your fear, I think a lot of anxiety sufferers experience the fear of going 'mad' or psychotic. I get this fear often, though I'm slowly realising that anxiety can't induce a psychosis.
I don't believe that therapists just prescribe medication after medication, but rather that they are simply trying to help the patient by finding the right medication, or a combination of medication so that the patient doesn't suffer unnecessarily. A good therapist will always let the patient know that tablets don't magically cure anxiety. It is the combination of medication, therapy as well as personal efforts that brings actual results.
Hey Ana,
Thanks for your reply. What was the reason you came off anti-psychotics? Reason i'm asking is if they seemed to Work, then why come off? Was it side -effects? I've read that there side effect profile can be very heavy and also recent studies show that most people don't actually show signs of improvements from these meds. Also people have reported to enter a psychosis when coming off these type of meds. Its seems they do more bad than good to be honest. That's why i'm so weary of even thinking about the possibility of taking meds like this.
To be honest, I don't remember why I came off them. I think the reason was that my therapist at the time was looking into changing the combination of medication I was taking. I was on 4 different ones a day, and she cut it down to two (Zoloft and Xanax), so it wasn't because of side-effects, but rather because my therapist believed that was the right thing to do at time. I was young (16), so I didn't question her.
Hmm I've not heard that the withdrawal from these meds causes a person to enter a psychosis. Sounds quite extreme to me, that does.
Hey Ana,
That sounds a sensible thing to do from a psychiatrists point of view. Mine also wanted to take me off ecit first so we can start with a clean slate more or less.
I hope your therapist finds the right combination of meds that really works for you. ☺
Hey all,
The past few days I've been suffering with a continuous feeling of anxiety again. The reason being a conversation with my psychiatrist on the current status of my medication. Escitalopram has helped quite a bit for my anxiety but it never got rid of my main symptom. Which is continuous existential obsessive thoughts. These thoughts make me feel as if something is 'off' in the world. For months I've wondered if it was DP/DR but I don't think it's like this because I don't have any of these other symptoms, just lots of rumination on existential topics.
Well back to the conversation with my psych. I was mentioning this to him and he was wondering if escitalopram was working as it should and proposed I tapered off escitalopram and maybe start with a low dose of anti-psychotic medication. At first I kinda agreed with the tapering of the ecit (because after 4 months I still had the thought thing) but the idea of having to start anti-psychotic meds has now really spiked my anxiety. I believe these thoughts are a symptom of anxiety or possibly related to a form of Pure OCD. But I feel my psychiatrist thinks something else.
Anyway, right now (especially during the night and early morning) my thoughts are really warped and I keep thinking what if i'm vulnerable for things like a psychosis etc. My rational me knows that it's again just anxiety pulling its tricks on me but the rational me is getting so outnumbered by my anxious mind at the moment. Last two night I couldn't sleep without Diazepam (1mg) and I would wake after 3 hours with tremor and bathing in sweat. Another milligram of diaz would get me back to sleep for another 3 hours and I'd wake up the same. During the day it's slightly more manageable and I don't take Diazepam. I'm really afraid of the dependence and I'm trying to keep my daily intake below 2mg atm.
I was wondering what your thoughts on the situation are.
Love, mrose
FYI: I did not start the tapering yet. And If I have to switch meds I'd rather cross taper to another SSRI/SNRI instead of an anti-psychotic.
Hello Mrose,
I know this is an old topic but some psychs precibe anti-psichotic meds to anxiety sufferers because they tend to alleviate anxiety syptmoms, at a very low dosage though. For example I suffer from OCD and this in turn causes anxiety/depression, my psychiatrist has me on 25mg at night of Seroquel and it helps me to sleep and put my mind at ease. Honestly if your're worried confront your doctor and ask him the reason behind this new (now old :blush: ) suggestion.
All the best,
Howdy how.
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