i feel worse than ever

[magpie girl]

ive been on escitalopram for a week now and i feel worse than ever,the gp took me off citalipram as i was getting horrendus reflux from it.then he tried mirtazapine,but it made me so ill i couldnt function,now these are making me really anxious.I was asleep 10 mins when bang full blown panic,ive been up all night with my heart going mad and stomache pains,this morning my body feels bruised all over.Is there a better drug i could ask for thats more for anxiety????? i even tried rescue remedie last night and it didnt agree with my stomach i had cramps all night :weep: :weep:

[alias_kev]

Hey Magpiegirl.

Sorry to hear you are suffering. From my reading Escitalopram seems to be one of the better SSRIs in terms of early side effects. At least it only contains a useful active ingredient. As you've had issues with citalopram, etc it may be that you are quite sensitive to SSRIs and perhaps even to the changes in serotonin they produce. Even natural serotonin is involved in the whole nausea thing so I suspect thats where some symptoms come from.

When your seratonin is higher you will tend to have more active dreams and it may be that these are interacting with your panic symptoms. Also it generally takes 3-4 weeks for the full benefits to kick in. Some people find it takes a bit longer.

A few questions to help advise you:
a) what dose are you on?
b) what time of day do you take the meds?
c) when do you eat relative to the meds?

If you really are interested in alternative meds specific to anxiety have a look at my thread/posts "alternatives to escitalopram" which you can find with the search function. You do need to give the Esc' some time to do some good though. In general its best not to chop and change too quickly
between meds as that gives your chemistry too much of a work out without getting some benefits.

[magpie girl]

Hi kev thanks for the reply
im on 5mg,and i take it at night!!!
i used to have to take my 10mg of citalipram at night because it gave me horrendus acid reflux thats why i just took the ciplarex(escitalipram)the same.Also my gp took me straight off it left me 24hrs and started the mirtazipine 15mg,i was on that 8 weeks but i sufferd so many side effects he took me off them and started the escitalipram 5mg.
I thought id finally got the panic attacks under control,but my anxiety levels are so high im exausted

[icicledreamz]

maybe u should cut your dose down to taking quarters, like im supposed to be doing. That being said though, you've only been taking the meds for a week, its not enough time for it to "kick in" fully and you can still expierence side effects for up to a full month. Do you have any benzo's or anything you can take while taking this, so you dont panic as much?
What kind of bad side effects are you expierncing?

[reallyfedup]

I have been on escital 1 month. before that citalopram. I have terrible anxiety and panic, especially in the mornings. they are unbearable. what time do you take your meds?:shrug:

[alias_kev]

Hey Magpiegirl, If you are getting bad night time effects it could be a couple of things. It could just be your anxiety coming out. Sometimes as things changed our supressed symptoms get the better of us. It might be the increase in serotonin produced by the meds. In many ways this is the last thing our body expects at night (natural levels fall). There is a yes and no argument for taking it at night. If our personal anxiety is really bad at night and we are not sleeping we may need the serotonin to block our anxiety and let us get to sleep - very true of those with anxious thoughts when trying to fall asleep. The down side is that its less natural to have rising serotonin in the night (as we absorb the meds), so many people take Escitalopram (and other SSRIs) in the morning.

My GP solved the argument by splittling my 20mg dose into two halves - one am, one at bedtime. That is completely non-standard as all the literature says single daily dose.

Unless you are sensitive to these meds 5mg is a very low dose already. So I'm not convinced that reducing it further would help, plus your body would have to adjust down over the following. What ever dose we take alters the minimum and maximum drug levels in our body. With most daily tablets there will be a fairly rapid increase over (a few?) hours then a slow reduction over the remainder of the 24 hours. Again with most dailies the peak level in our bodies/brains falls to half over somewhere between 28 and 50 hours (depending on the medication and us). So eventually our minimum internal level will be say 1-3 times the daily dose, rising by nearly one dose after we've taken the next dose. So there is a daily rise/fall of the medication and an adjustment to any change in dose. Form the maths that suggests a change in dose takes 5-7 days to average out.

There seems to be agreement that Escitalopram takes about 3-4 weeks to get the benefits going. For some people a bit longer. The down side of a very small dose is that it may be enough to give side effects but not enough to do any good. OR it may be necessary if your are extra sensitive to the meds. Its guesswork for us to comment for certain - any not much better for your GP.

Personally I originally took 10mg mornings after food. When I was put on 20mg GP said to take the second 10mg at bedtime as I wasn't gaining any better sleep from the original dosing. This helped my own night time anxiety but I (now) think increased my night time side effects.

[magpie girl]

well i started taking escitalipram in the morning now,and the gp gave me metroclopramide to stop the sickness. the acid is horrendus for me but i have such a low tolerance for meds keeping the zantac and that down is impossible !!!!!!!on a plus side he told me to take the lorazepam 1mg if i feel anyway unable to cope.

[alias_kev]

Hope it goes better. Stay in touch.

I think a lot of the problems/effects are worse because they have a lot in common with people's anxiety/stress reponses. Even without HA or phobias a lot of people get gastric or bowel problems from their anxiety - so add in the meds, and new anxiety about the meds and that old negative anticipation and its a wonder we all get anywhere.

[magpie girl]

well im still being sick and the acid is awfull,my head is really bad but just down the right hand side!!!!!!! i have a constant stitch under my left rib,but i dont feel as anxious:winks: