What do I try next?

[welshdory]

I'm currently on escitralopram and not doing great on it. I have been on it for some time, but I'm also under a great deal of stress daily (terminally ill hubbie) we have a young family and genetal day to day life.

My doctor offered diazepam 2mg (I'm too scared to take them) as I feel like due to my hubbies condition I need to be alert at all times in case I'm needed.

I have tried propranolol previously but didn't feel much benefit from it.

What can I try next that is likely to help with anxiety/depression, but not make me feel drowsy/out of it or pile on a load of weight (I'm already overweight)

Whilst i know that no pill will change life events, i just want to try and feel a bit better to be able to tackle what I know is ahead for our family.

[panic_down_under]

Given your lack of success with SSRIs either a SNRI, or TCA is probably the way to go. As per one of my previous replies I believe a TCA such as amitriptyline, or imipramine would be a better option than a SNRI.

Unfortunately, most ADs can trigger weight-gain. Bupropion is one that usually doesn't, however, it is very stimulating which can worsen anxiety significantly though a few do well on it. Trazodone is also usually benign, but it can be very sedating, especially at the lower doses. These days it is mostly prescribed for SSRI/SNRI induced insomnia.

Weight gain isn't always necessarily a direct side-effect. There can be other factors which play a part too, including that people often regain their appetite once their AD begins to work. I've found a low carb diet plus moderate exercise can work wonders. Exercise is good for anxiety too.