Coming off 6 weeks in

[Geoff78]

Hi everyone.

just looking for a bit of advice.

Was on escitalopram for 6 years at 10mg. Did help but I didn’t enjoy some side effects like sexually and lack of emotion.

I reduced down from 10 to 5 and then 0 for 2 months and have been off for 6 weeks now.

To begin I felt much better, even calmer but about 3-4 weeks in I started to feel low, anxious , not sleeping great and all the old feelings I had before started coming back.

I really don’t want to go back on the pills but I also don’t want to feel like this.

I have an appointment with my GP later this month.

Has anyone else had a similar experience? Is this normal ?

thanks.

[panic_down_under]

To begin I felt much better, even calmer but about 3-4 weeks in I started to feel low, anxious , not sleeping great and all the old feelings I had before started coming back.

It is impossible to predict whether these emotions will ease, or deepen over time. Anxiety and depression can be chronic conditions which wax and wane, but never completely go away. Are they becoming more severe, or remaining at about the same intensity?


I really don’t want to go back on the pills but I also don’t want to feel like this.

The emotions loss and sexual dysfunction side-effects are not necessarily universal. There is a good chance you won't experience them with other ADs. They may even have diminished with a switch to citalopram (Celexa) despite it containing the same active compound as escitalopram (citalopram also contains a mostly inactive isomer to the compound which can produce variations in side-effects). There are also (http://www.nomorepanic.co.uk/showpost.php?p=1695131&postcount=7) ways of significantly easing sexual dysfunction.

[Phill2]

Hi everyone.

just looking for a bit of advice.

Was on escitalopram for 6 years at 10mg. Did help but I didn’t enjoy some side effects like sexually and lack of emotion.

I reduced down from 10 to 5 and then 0 for 2 months and have been off for 6 weeks now.

To begin I felt much better, even calmer but about 3-4 weeks in I started to feel low, anxious , not sleeping great and all the old feelings I had before started coming back.

I really don’t want to go back on the pills but I also don’t want to feel like this.

I have an appointment with my GP later this month.

Has anyone else had a similar experience? Is this normal ?

thanks.

I was on 10mg for 5 years and went off them cold turkey.
All was good until a series of crisis hit about 5 yrs ago and I went back on them.
I was off em for 5 - 6 years and all was normal.
Hope you find something that works for you.

[Geoff78]

Thanks for the responses.

I’d say the feelings are changing and becoming a bit more intense. As mentioned, first couple of weeks was fine but new year is the anniversary of my dads death and now I’m close to the age he died at (43) it started my anxiety off and since then I’ve had more physical effects like that constant feeling like something bad is going to happen and my mind wants to go off and think about negative stuff if I let it. My Stomach is churning up and my mood is getting lower. Sexually it’s when I orgasim - it’s like I’m about too but then it just fades away into nothing. I’m trying to get out and exercise when I can to help.

i Have been told it can be hard to come off anything after 6 years and I need to give it time. I have an appointment with my GP at the end of the month to discuss. If these feelings don’t subside or decrease then I may ask to try a different SRI and accept I need to be on them.

any recommendations?

[panic_down_under]

I’m trying to get out and exercise when I can to help.

A very good idea. Exercise can produce the same beneficial affect (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1413959/) on the brain as ADs, albeit not to the same degree, however, may be all that's needed for mild anxiety and/or depression. You don't need to run a daily marathon. A 30 minute walk, 4-5 days a week can make a significant difference. Omega-3/fish oil (http://www.ncbi.nlm.nih.gov/pubmed/23746276) supplements may also help.


i Have been told it can be hard to come off anything after 6 years and I need to give it time.

I'm not convinced it would be harder to come off at 6 years compared to only 1. At least not because of chemistry, or physiology, though it could be more difficult psychologically.


If these feelings don’t subside or decrease then I may ask to try a different SRI and accept I need to be on them.

any recommendations?

No AD is intrinsically more effective than the others (though 2 for OCD may be the rule exception), however, one or two may be for an individual. Unfortunately, there is no way of predicted which it is. It all comes down to trial and error. Of the other SSRIs I'd try sertraline (Zoloft) next.

[Geoff78]

Thanks for the info.

I got on ok with Escitalopram at 10mg but the one side effect that stayed with me was mild insomnia. I could get to sleep but would often wake early so if I did try a different AD I’d prefer one that helped with sleep.

Is this normal for this drug? Looks like others suffer with sleep as well.

Is Sertraline any better? For me a good nights sleep makes such a difference to my anxiety.

[panic_down_under]

I got on ok with Escitalopram at 10mg but the one side effect that stayed with me was mild insomnia. I could get to sleep but would often wake early so if I did try a different AD I’d prefer one that helped with sleep.

Is this normal for this drug? Looks like others suffer with sleep as well.

Is Sertraline any better? For me a good nights sleep makes such a difference to my anxiety.

Sertraline is more likely to be worse, however, ADs are unpredictable meds and you could have a paradoxical reaction. The TCA amitriptyline is usually mildly sedating so might be a better bet. If you really wish to stick with SSRIs then sertraline plus small doses of mirtazapine, or doxepin would be the way to go (small doses of trazodone would be even better as it has a shorter half-life so is likely to be less sedating in the morning, but this doesn't seem to be prescribed much in the UK).

[Phill2]

I lost a lot of sleep when I tried Sertraline.
Dead tired all the time but couldn't get to sleep.

[Geoff78]

Hi everyone.

Quick update - I decided to go back on 5Mg after nearly 2 months off the tablets. I spoke to my wife who knows me best and she said she could see my old symptoms returning and I was starting to spend a lot more time thinking about how I feel.
I'm a bit sad as this may mean I have to take a pill for the rest of my life but suppose it's better that way than suffering from depression.

It's only a small dose to begin, will see how I get on and if I need to go back to 10mg which I know is the therapeutic dose. Not to bad on the side effects so far, just a heavy head - in fact i'd say my stomach at the moment seems to prefer to be on the pills :)
Good luck to everyone out there and thanks for the support. I find this resource so helpful at times of need.

Geoff.

[panic_down_under]

I'm a bit sad as this may mean I have to take a pill for the rest of my life but suppose it's better that way than suffering from depression.

There are worse things in life than popping a pill every day, Geoff. Plus, SSRIs may have other benefits such as reducing the risk of Alzheimer's dementia.


It's only a small dose to begin, will see how I get on and if I need to go back to 10mg which I know is the therapeutic dose.

I urge you not to remain on 5mg for an extended period as this may increase the risk of the med pooping out.

[Geoff78]

There are worse things in life than popping a pill every day, Geoff. Plus, SSRIs may have other benefits such as reducing the risk of Alzheimer's dementia.

I didnt know that - any long term implications?



I urge you not to remain on 5mg for an extended period as this may increase the risk of the med pooping out.

I went back to 10mg today - Doing ok, got a bit of lock jaw and very sweaty hands but otherwsie ok.
(BTW - what does pooping out mean :) )

[panic_down_under]

BTW - what does pooping out mean

The med stops working. SSRIs and MAOI class ADs are more prone to poop-out (tachyphylaxis) than SNRIs (maybe not venlafaxine) and TCAs.