View Full Version : Do you still have anxiety with your antidepressent
I feel like I should be anxiety free by now. I'm starting my 9th week of citalopram at the 40MG dose. I have days where I feel better (and happy), but today I woke up with anxiety. I felt like I was on the verge of a panic attack. I felt shaky inside, but kept going on with my morning routine. I was putting on make up, brushing my hair, etc.. all while feeling super anxious. I took my 1MG of clonazepam and 45 minutes later felt much better.
I don't understand what's going on. I know that I am addicted to the clonazepam since I've been taking it for several months while trying to find the right meds to work for me. I plan to give the citalopram 12 weeks at the highest dose to see if it works. I just feeling like giving up. I'm so sick of going back and forth with pills, having side effects, taking clonazepam, etc. But, I really need a good quality life. I have a child to look after, and my marriage is on the rocks due to my anxiety. I exercise everyday, going to therapy, and do meditation. Does anyone have ups and downs on their meds, or have you found the right one and now feel perfect and anxiety free?
Thanks for listening!:weep:
Benjammin69
27-06-17, 15:20
I'm right with you on this one mate been on my meds since august 2016 - thought I would be fine and dandy now and would suffer less but every day is a new challenge / battle - anxiety and depression is a re occurring disability that meds can help but not diminish
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I'm sorry to hear that. Can I ask what medication you are currently taking??
Benjammin69
27-06-17, 17:00
I'm sorry to hear that. Can I ask what medication you are currently taking??
I take mirtazapine (every dose but currently 30mg) quetiapine (300mg - 100 am and 200 pm) and diazepam as and when needed. There my main meds
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Sometimes. We call it "breakthrough anxiety". Your antidepressants work by regrowing brain cells and help your neurotransmitters work better after they've been put out by repeated stress (e.g. Anxiety, depression, grief). But they aren't a magic, cure all pill. They can only keep up as high as the dose is...and some people have been in the anxiety fog for so long, spiraling out of control, that the damage to repair is a lot. That's why most people who've had a severe bout of anxiety use meds in conjunction with therapy and lifestyle changes.
For instance, you can take an antidepressant all you want, but if you have PTSD, and you never went to therapy to deal with a sexual assault, what's the point? Then the pill is only a bandaid.
Another example, if you have take an antidepressant, but you get very little sleep each night and eat fast food every day...lack of sleep causes anxiety. So can vitamin imbalances. Then you're just working against the pill each day.
The best way to treat anxiety, IMHO, is to find the cocktail of things that work best for you. For me, it's meds, therapy and lifestyle changes.
Thank you AntsyVee,
I'm just having a very high anxiety day today. I had therapy last night. Maybe I do need to change my diet a bit, and even cut out sugar. I just can't understand why I woke up shaking and feeling so anxious. I've been anxious all day--- on the verge of a panic attack. I did some deep breathing, medication, and all that stuff. It worked for 10 minutes and then I took a Xanax. Maybe this is just a blip? I'm worried that i'll slip back to where I was a few months ago. I do expect my period in a week. I do wonder if hormones play a role in this at all?
OMG yes, hormones play a part. I take Yaz for PMDD...I honestly think it helps as much as the escitalopram. Work stress, the kids going psycho, problems with the spouse or in laws, all of that stuff also factors in. Daily exercise helps me and many others too. Anything you can do to make you feel healthier also helps your brain feel healthier. The mind and body don't operate independently of each other.
I'm going to try not to overanalyze this day and take it for what it is. It's an anxiety "blip". Tomorrow's a new day. Heck, I still have the rest of the evening to enjoy at home, once I get off of work. I cannot let this ruin me, or let anxiety win. Thank you for your sound advice, antsy. I'm a work in progress :O
panic_down_under
27-06-17, 22:57
Maybe I do need to change my diet a bit, and even cut out sugar.
I can't say whether this would have a direct affect on anxiety, claims made about sugar being a major factor in these disorders made in the past by people like Shirley Trickett have been long debunked, but it may improve your general wellbeing. I stopped eating anything with more than 4% sugar some years ago, also lowered the carbohydrate content of my diet overall, and have felt much better for it. I have more energy, my blood glucose levels dropped from the high to the low end of the normal range and I lost a couple of pounds too.
I do wonder if hormones play a role in this at all?
Hormones seem to be one of the reasons twice as many women as men develop anxiety disorders and depression. Anxiety and depression often worsen in the 5-12 days before menses.
I'm going to try not to overanalyze this day and take it for what it is. It's an anxiety "blip". Tomorrow's a new day. Heck, I still have the rest of the evening to enjoy at home, once I get off of work. I cannot let this ruin me, or let anxiety win. Thank you for your sound advice, antsy. I'm a work in progress :O
:yesyes: Yeah, that's pretty much all you can do. One day at a time. Geez, sometimes at my worst, it's been down to the next 5 or 10 minutes at a time.
I'm the same as you. I thought when I changed to Nortriptyline that the anxiety would go. It is manageable most days, but still there. I am still on the clonazepam as well. I'm waiting for the psych to come back from holidays, in two weeks. To see if I should persevere. I was going to see if swapping to Clomipramine would make any difference (even though it is a tricyclic as well). Sometimes I think it's just easier to accept that this is my life now...It's hard, but I have been like this for 12 months now. I just can't see stopping the clonazepam until I have something that works.
panic_down_under
28-06-17, 06:10
I thought when I changed to Nortriptyline that the anxiety would go. It is manageable most days, but still there.
...I was going to see if swapping to Clomipramine would make any difference (even though it is a tricyclic as well).
Unlike the SSRIs, the TCAs don't all do basically the same thing. Nortriptyline is mostly a noradrenaline reuptake inhibitor having little impact on serotonin, whereas clomipramine is a potent inhibitor of both neurotransmitters, much more so than any of the SNRIs.
If nortriptyline is getting you most of the way to where you want to be then maybe adding some sertraline might be a better option as it will allow fine tuning of the serotonin:noradrenaline inhibiting ratio. Something to explore with your psychiatrist anyway.
Thanks PDU. I have just tapered off sertraline (was on it for over 10 years and it pooped). I was taking sertraline, nortriptyline and Mirtazapine...a few too many anti d's. So I wouldn't go back on sert after just tapering off it. Any other suggestions? Would the clomipramine be worth shot? Is it similar to Nort in start up effect eg doesn't really affect you that much apart from constipation and thirst?
panic_down_under
28-06-17, 07:24
I have just tapered off sertraline (was on it for over 10 years and it pooped).
Ooops. Sorry. That escaped my memory. :sad: darn Russian hackers! :winks:
Would the clomipramine be worth shot?
Sure is. It is arguably the most potent antidepressant apart from the MAOIs.
Is it similar to Nort in start up effect eg doesn't really affect you that much apart from constipation and thirst?
Usually yes. But you shouldn't need to quit nortriptyline first. In most cases switching via a short cross-taper goes fairly smoothly and avoids/limits most of the usual unpleasant initial side-effects. Your psychiatrist will explain the best way of doing it.
Thank you PDU, mermaid, antsyvee, and all of the others who have chimed in. You know, I mentioned the trycyclics to of the veteran doctors while I was in the hospital and he said they don't really prescribe those anymore. He tends to use SSRI's--- depending on the person.
My new younger doctor said she has patients on them and still prescribes them every now and then. My questions is- why don't they prescribe them-? Just because there are newer drugs to replace the older ones? I'm wonder if I should talk to my doctor about the TCA's. I googled them and it seems there's a long list of side effects. DO they usually cause increased anxiety? Or would I be okay since i'm already taken an SSRI? Meaning, could I just transition over smoothly?
Ian, can answer more of that, because he's on a TCA...but the reason they don't prescribe them is because they have more drug interactions and diet interactions. There's just a lot more things you have to take into consideration when taking them. But hey, if nothing else works for you, then to me it's worth the annoyance.
panic_down_under
29-06-17, 22:44
You know, I mentioned the trycyclics to of the veteran doctors while I was in the hospital and he said they don't really prescribe those anymore. He tends to use SSRI's--- depending on the person.
They prefer SSRIs because they are safer in overdose (not actually true for all) and because they believe being the newer drugs they must be better. The first is moot as there is not much evidence those taking SSRIs are less likely to harm themselves than those on TCAs, they just take something else to do so, and despite the claims, the TCAs appear to be generally more effective with the older MAOIs being even more so.
One of the methods used to compare drugs is the Number-Needed-to-Treat (NNT). This measures the effectiveness of a med by estimating the number of patients needing to be treated in order to have an impact on one person. The lower the number, the better. De Lima MS (https://www.ncbi.nlm.nih.gov/pubmed/12495364), 2003, found it to be MAOIs 2.9, TCAs 4.3, SSRIs 5.1. Arroll B (https://www.ncbi.nlm.nih.gov/pubmed/16189062), 2005 came up with TCAs 4, SSRIs 6. However, there is no way of predicting whether this will be so for an individual. In the end the most effective med is the one which best meshes with individual biology, not which class it's from.
I googled them and it seems there's a long list of side effects. DO they usually cause increased anxiety?
Yes, but anxiety is also a listed SSRI side-effect. My observation is those taking SSRIs tend to experience more severe side-effects when first taking them and after dose increases, while those on TCAs have more ongoing ones, usually nuisance ones such as dry-mouth and constipation, however, the secondary TCAs nortriptyline (Pamelor) and desipramine (Norpramin) have similar side-effects profiles to the SSRIs/SNRIs. The TCAs also seem to be generally a little easier to quit than SSRIs and SNRIs.
One thing to be aware of is TCAs can be more cardio-toxic than the SSRIs - except citalopram (Celexa) and escitalopram (Lexapro) - which may be a problem in the case of some types of heart disease, but usually isn't for those in reasonably good health. Clomipramine has a better safety rating than citalopram/escitalopram in this regard, according the the CredibleMeds (https://crediblemeds.org/index.php/drugsearch) data base.
Thank you, Ian. I'm just having so many setbacks with Celexa that I don't think it's working. The Clonazapam it's what's holding me up.
panic_down_under
30-06-17, 22:37
Thank you, Ian. I'm just having so many setbacks with Celexa that I don't think it's working. The Clonazapam it's what's holding me up.
Unfortunately, I think you're right. :sad:
Ethansmom, have you tried Paxil (paroxetine)?
Hi Antsy vee
no I haven't tried Paxil. Have you?
Yes. I wonder if maybe it might be good for you. When I was on it, it was great at first because when I started it I was having a lot of panic attacks. My experience with it was that it was very calming. The reason I went off of it was that it was TOO calming. The house could've been on fire and I would've been like, "Eh" lol.
But for someone in your situation whose anxiety is through the roof and hasn't gotten any relief, it might not be a bad option. Then after a year if you find it too calming like I did, cross taper to a lesser SSRI like then one you're on now.
I've heard it causes major weight gain, which I don't want. I will ask about it. I prefer something sedating instead of activating.
The thing is, they all can cause weight loss or weight gain. It's a toss up really.
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