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SUZY Q
23-04-09, 09:59
Hi, Me again sorry to be a pain. I will be taking my 3rd tablet this evening. Ive gone up from 5mg of escitalopram to 10mg. Could someone tell me is it normal to feel some side effects again. I feel dizzy, nauseas, bit spaced out, anxious again and very tired. I went for a quick drive (which i have been doing all of this last week) but i just felt really odd.When i have gone out this week ive been nervous but once i done it i felt really good. I can cope with feeling like this if i know that this will go soon. I have been on escitalopram 4 weeks on monday coming. :unsure:

SUZY Q
24-04-09, 20:05
Hi i thought that i would just write to say how im feeling today after being upped to 10mg. As i wrote yesterday i wasnt feeling that good but today has been amazing. Was nervous and a bit anxious when i got up. But i went to the river with my husband still felt abit anxious but we stayed there for a little while. Then we went to our local shops. All together we were out for about an hour. I was so excited that later on we went to our local pub (where i only had orange juice ha ha) and stayed there for just over an hour before going to pick up our son from school. I cant believe that i have done all of this i certainly couldnt of done any of this a couple of days ago. Its now 8.00pm and im feeling a little bit nauseous and anxious but im also feeling so happy and exhausted. Hopefully will have a good night sleep tonight.:yahoo:

suzy-sue
24-04-09, 20:11
Glad you had a good day Suzy,it does you good to get out.You might feel a bit more anxious with the increase, but it shouldnt be too bad.Try to keep occupied and eat something with your meds. Hope you have another good day tommorow, Luv Sue:hugs:

alias_kev
24-04-09, 23:53
So many Suzy's - Ha-ha. :) Got confused who's thread it was at first. :blush:

Ms Q: It would be normal to feel an increase in side effects or new ones with the increase in dosage. I'd guess that it might take a week or two for your body to adapt again, its having to cope with an increase in both good and bad chemicals.

Your body will (hopefully) be more used to the chemicals involved (taken & metabolic byproducts & waste - which is were some/most side effects come from) BUT the useful chemical effects will also increase, and they involve some side effects. After all those little pills are altering your brain chemistry and at the current stage of medicines they do it a bit randomly. More like a keen amateur running into a signal box and pulling levers to save the day rather than an expert gently altering a level. Some would claim the amateur is blindfolded but I don't think its quite that bad.

The great thing is that the benefits are tangle already. So if you have to have the odd nap, or go to bed early to handle the headache/dizzy feelings etc its not too bad a trade. The anxiety peaks I think can often be a symptom of the drug levels fluctuating with each dose since the medication/improvement easies our own controls and then we get caught unprepared when the medication wears off a bit. Ofcourse some people get paradoxical anxiety where a medication makes things worse (basically 'cos its pulling the wrong levers).

When I started I already had loads of headache/depression/sleeping/anxiety so I didn't notice the side effects so much. I started straight on 10mg so you should have had a milder time of it. 10mg is widely documented as the normal dose for Esticalopram, so few worries there.

SUZY Q
25-04-09, 19:43
Thank you both very much for your replies. Today hasnt been as good as yesterday more anxiety, dizzy and headache. But after reading both of your replies i feel more confident that all will be ok soon. And that the feelings that im getting are temporary and i will soon have alot more good days than bad and to just ride out the bad days. Thanks again :)

alias_kev
25-04-09, 23:42
Glad to help, keep talking to us. Between us the members here can give you an idea of whats normal and what's way too bad. Different meds & dosages suit different individuals/conditions/etc so its a learning process.

Even when the meds kick in and side effects die down we still have to learn to change I think. Especially if we've had problems for a long time, there can be lots of bad habits, bad thinking and tricks like avoidance to unlearn.
The right meds can help a great deal - even be crucial - but a lot has to happen in our minds too. I don't mean that as a downer, just that recovery can be a longer process.

NoPoet
26-04-09, 00:04
Hi, its normal to feel the side effects return whenever you change the dose of an SSRI like escitalopram. As far as I know the side effects for changing the dose level don't last as long as the side effects when you first start taking the medication -- if that makes sense :)

PoppyC
26-04-09, 00:26
Hi everyone :)
Whats the difference between citalopram and escitalopram??? or are they the same??? :shrug:

SUZY Q
27-04-09, 16:05
Thank you all for your replies. After having not a very good day saturday. Yesterday wasnt as bad. This morning i was anxious and tearful but my husband left for work at 6.00am my mum took my son to school and my daughter went to work. I suddenly felt quite alone. But i went to the shop on my own then after i had a nap went to my friends for an hour. Then was able to pick my son up from school with my mum. (hooray). I still feel a bit anxious and have got a terrible headache but know that this must be the tab as im at home and theres nothing to be anxious about. I meant to say before that at the end of May i will be starting CBT. Hope that this will also help. :)

alias_kev
28-04-09, 00:17
Hey PoppyC.

This is hard to define absolutely as the medical authorities (especially) want there to be no difference. The manufacturer claims some significant differences - Escitalopram is certainly chemically different. Patient anecdotes seem to swing in Esc's favour.

Basics:
Citalopram is a much older medication. It is an SSRI and plays around with your brain Serotonin to make your feel better. Its primarily an anti-depressant.
Escitalopram is a newer medication. It is also an SSRI affecting Serotonin. Its primarily an anti-depressant but is also formally identified with the treatment of several anxiety based illnesses.

Chemistry:
Esc' is a variant of Cit'. When Cit' is manufactured TWO chemicals are formed in roughly equal proportions. One is S-Citalopram which produces the desirable effects, the other is R-Citalopram which does not. In Citalopram tablets you get both chemical shapes only half of which works for you. In Escitalopram the two types have been separated and you only get the active half. This is why dosages of Esc' should ALWAYS be at most half of the Cit' dose.

Proponents of Citalopram basically claim that the R- form is irrelevant and that the two medications are the same at comparable doses. Proponents of Esc' say that its purity makes all the difference and that it has less side effects as there is not this extra chemical in the body.

Treatments:
Both Citalopram and Escitalopram appears to be an effective SSRI anti-depressants. They get rid of depression. The actual benefit of SSRIs for anxiety is a matter of opinion. GPs seem very convinced, some patients rather less so. Medics seem to assume that "happy" is the opposite of "afraid" when actually its the opposite of "sad". I fear that one reason for this is that they are cheap, fairly safe and do help some people especially on high doses. If you are spaced out enough you may not feel anxious.

Citalopram is associated ONLY with the treatment of: depressive illness (in the initial phase and as maintenance against potential relapse/recurrence), panic disorder with or without agoraphobia. By panic disorder they mean clinical panic attacks and not say anxiety with panicing, which is rather different.


Escitalopram specifically claims suitability for treatment of: major depressive episodes, panic disorder with or without agoraphobia, social anxiety disorder (social phobia), generalised anxiety disorder, obsessive-compulsive disorder

Side Effects:
Citalopram has a lot of side-effects available, as do all SSRIs. Playing with the brain's serotonin is a pretty big thing. It can produce anxiety worse than you started with. It does seem prone to a lot of side effects during the first few weeks.

Escitalopram also has a lot in its repertoire, but reading suggests that some effects are rarer, milder and shorter lived than with Citalopram. This is often denied by medics. Clearly all the effects of the S- shape will be present but the absence of the R- shape could affect everything (or indeed nothing).

Costs:
Citalopram is a generic drug now and is rumoured to be very cheap, a quick online search gives USA prices as low as $3.50 for 40mg x 30. Escitalopram is still a patent controlled medication and I found USA prices at about $35.00 for 20mg x 30 (a roughly equivalent dose). Some sources were even more expensive. So TEN times more expensive...

There is some suspicion (in my mind at least) that SSRI's are selected in the UK (at least) for anxiety on a cost basis. We get them because they are cheap as long as they are cheap. If they help us then the NHS thinks it got lucky. My PCT told my GP to stop prescribing Esc even if it worked for me!

The two primary information sources are the SPCs for the two drugs:

Citalopram (http://emc.medicines.org.uk/medicine/1070/SPC/Cipramil+Tablets/) Escitalopram (http://emc.medicines.org.uk/medicine/9360/SPC/Cipralex++5%2c+10+and+20+mg+Film-Coated+Tablets+and+10+mg+ml+oral+drops%2c+solution .)


Its worth the slog to read them yourself.
I am no expert just good at research.

alias_kev
28-04-09, 00:26
Hey Suzy, glad you are feeling some benefit already. There can be headache I think its the higher level of seratonin. Fortunately I had quite a bit of it when I started so did not notice that from the meds so much. If possible try and rest/sleep when the effects are worst. They do die down over time.

I also had some CBT which helped a bit, but we only get 5-6 hours in southend.

I read somewhere that taking Escitalopram after eating could help buffer the side effects a bit. I have no idea if this is true as there was only one of me to test it! I always took it after eating and this may be why I found the side effects weaker than many people. I initially took it in the morning after breakfast. My GP eventually had me take half at bedtime (which is another odd GP-ism - its always documented as single dose), but anyway I always ate a snack then too. My theory is that it slows the absorbtion and avoids clobbering you as hard with a sudden surge in both the meds and serotonin. Your Mileage May Vary - as the american's say.

SUZY Q
28-04-09, 18:48
Thanks again Kev. :D

bigmo
05-05-12, 14:58
Hey PoppyC.

This is hard to define absolutely as the medical authorities (especially) want there to be no difference. The manufacturer claims some significant differences - Escitalopram is certainly chemically different. Patient anecdotes seem to swing in Esc's favour.

Basics:
Citalopram is a much older medication. It is an SSRI and plays around with your brain Serotonin to make your feel better. Its primarily an anti-depressant.
Escitalopram is a newer medication. It is also an SSRI affecting Serotonin. Its primarily an anti-depressant but is also formally identified with the treatment of several anxiety based illnesses.

Chemistry:
Esc' is a variant of Cit'. When Cit' is manufactured TWO chemicals are formed in roughly equal proportions. One is S-Citalopram which produces the desirable effects, the other is R-Citalopram which does not. In Citalopram tablets you get both chemical shapes only half of which works for you. In Escitalopram the two types have been separated and you only get the active half. This is why dosages of Esc' should ALWAYS be at most half of the Cit' dose.

Proponents of Citalopram basically claim that the R- form is irrelevant and that the two medications are the same at comparable doses. Proponents of Esc' say that its purity makes all the difference and that it has less side effects as there is not this extra chemical in the body.

Treatments:
Both Citalopram and Escitalopram appears to be an effective SSRI anti-depressants. They get rid of depression. The actual benefit of SSRIs for anxiety is a matter of opinion. GPs seem very convinced, some patients rather less so. Medics seem to assume that "happy" is the opposite of "afraid" when actually its the opposite of "sad". I fear that one reason for this is that they are cheap, fairly safe and do help some people especially on high doses. If you are spaced out enough you may not feel anxious.

Citalopram is associated ONLY with the treatment of: depressive illness (in the initial phase and as maintenance against potential relapse/recurrence), panic disorder with or without agoraphobia. By panic disorder they mean clinical panic attacks and not say anxiety with panicing, which is rather different.


Escitalopram specifically claims suitability for treatment of: major depressive episodes, panic disorder with or without agoraphobia, social anxiety disorder (social phobia), generalised anxiety disorder, obsessive-compulsive disorder

Side Effects:
Citalopram has a lot of side-effects available, as do all SSRIs. Playing with the brain's serotonin is a pretty big thing. It can produce anxiety worse than you started with. It does seem prone to a lot of side effects during the first few weeks.

Escitalopram also has a lot in its repertoire, but reading suggests that some effects are rarer, milder and shorter lived than with Citalopram. This is often denied by medics. Clearly all the effects of the S- shape will be present but the absence of the R- shape could affect everything (or indeed nothing).

Costs:
Citalopram is a generic drug now and is rumoured to be very cheap, a quick online search gives USA prices as low as $3.50 for 40mg x 30. Escitalopram is still a patent controlled medication and I found USA prices at about $35.00 for 20mg x 30 (a roughly equivalent dose). Some sources were even more expensive. So TEN times more expensive...

There is some suspicion (in my mind at least) that SSRI's are selected in the UK (at least) for anxiety on a cost basis. We get them because they are cheap as long as they are cheap. If they help us then the NHS thinks it got lucky. My PCT told my GP to stop prescribing Esc even if it worked for me!

The two primary information sources are the SPCs for the two drugs:

Citalopram (http://emc.medicines.org.uk/medicine/1070/SPC/Cipramil+Tablets/) Escitalopram (http://emc.medicines.org.uk/medicine/9360/SPC/Cipralex++5%2c+10+and+20+mg+Film-Coated+Tablets+and+10+mg+ml+oral+drops%2c+solution .)


Its worth the slog to read them yourself.
I am no expert just good at research.


Sorry to reopen an old thread, but have the costs now reduced, is it worth asking my GP to give Escitalopram a go?

ewood79
05-05-12, 23:43
Hey guys,

I was on Citalopram on and off for ten years but the last 3 I was on a high dose of it and really got throw off side effects from it.... All the usual ones and ones that no doubt made my anxiety worse.

When they brought the recommended dose down to 20-40 I really had some difficulty as I'd been on a high dose (60-70mg)....my anxiety came back bad and panic etc was high.... Over two months I got down to 40 mg but it was awful.....

Because I had private health my doctor put me in a private hospital and I swapped from cit straight to lexapro 20mg.... It's been 6 weeks now on 20mg...

After a week of being a bit blah.... I can honestly say that this is a wonderful anti d.....

I'm on 20mg and much calmer, less anxious, can think clearer, rationalize with my anxious thoughts and function a lot better.

I'm also seeing a physcologist etc for counseling and all that jazz...

I would highly recommend this drug for anxiety disorders and co morbid depression associated with the anxiety.

Cheers jarrod

grotbags
06-05-12, 16:25
Sorry to reopen an old thread, but have the costs now reduced, is it worth asking my GP to give Escitalopram a go?

I don't know about costs, but you should ask anyway. I took this drug for a a short time (less than a year) and my GP who prescribed it told me it's supposed to be a new, improved Celexa, and the cleanest of the SSRIs. My GP was a very moral person, and he prescribed the drug he thought would be most useful for me, regardless of costs. Most people get a prescription of Celexa thrown at them because it's cheap.

I suffered really badly from the side effects of the Escitalopram, but I am very phsycially sensitive and get side effects from most things. It was a useful drug though. I started off on 10mg but it was too much of me in terms of side effects, so I gradually weaned, but I found that even 5mg made a huge difference to my life! If you get these rescribed, start slow. You always have the option to increase the dose as needed. But if you want to reduce the dose, it really is not fun. It is not fun at all...

Good luck. I think Escitalopram is worth fighting for and giving a chance.