9 weeks on escitalopram and really desperate

I am now 9 weeks into 10mg escitalopram - the last week ive been on 15mg. only had one good week, week 6 - 7 - now feeling so bad, shaking from head to toe inside in the morning, so anxious, and not feeling much better all day. Have had to go and get more diazepam 2mg from doctor - is there anyone out there who has taken this long for tablets to work - i did start improving but feel as bad as i did in 1st place now - im so terrified - im wondering whether to up my dose to 20mg - but also terrified of doing this - cant take it much more - its been the worst 9 weeks on my life - i have had this before and have taken escitalopram before and it worked - but didnt take this long before - any help or advice anyone - thank you xx

I personally doubt it would make sense to increase your dose if you are not coping with the side effects of the current dose! You'd need an odd pattern like no-anxiety but bowel upsets or something to make such a choice make any sense.

If you have more anxiety than before (especially after several weeks) it sounds like you have so called paradoxical anxiety where the medication adds anxiety rather than taking it away.

If you tell us more about your original (and recent?) symptoms we may all be able to suggest what worked for us. Myself the Esc' took away all depression (and perhaps even valid sadness) but only took the edge off of my GAD.

As I say, share and we'll all try to help. Use the private messaging if you are troubled to share in public (as it were).

Extra thought:
When in the day do you take your Escitalopram?
Is it before or after food?
Do you feel at all like you have low blood sugar in the mornings?
(More info once I have your answers).

hi there

it sounds like you are feeling bad from side effects to the increase - maybe spk to your doc about going back down to 10mg to see if you feel better on that. you can always increase again

Hi there, I am in week 8 taking cipralex (started on 5mg, then 10mg & now on 20mg) and still not having many good moments. I took citlopram (20mg) last year and it worked much faster. Was thinking of changing but need to be ok for a family occassion in 2 weeks time, so will decide then to change if not better. Please let me know how you are doing as you are a week ahead of me. I'm keeping my fingers crossed for you that you see an improvement soon so that will give me hope. I try to be positive by repeating the phrase..."Every day in every way I am getting better". This seems to get me through things!!!! Anything is worth a try. Take care of yourself.

Hi Chantelle, it was 10 weeks on Sunday 2 of the weeks on 15mg (not that im counting!) - I really hit rock bottom on Saturday but certainly started to feel better Sunday afternoon and have felt a bit better each day - i actually phoned 2 friends for a chat today which is something i just havent done, in fact when theyve called me ive told my husband to say im in shower - how terrible - im always a bit more anxious on my work days (only 2 per week) but once i get there and get busy i stop analysing how i feel and feel better. My stomach has hardly churned at all today and my anxiety levels are much lower - still woke at 3.30am and didnt really go back to sleep afterwards but didnt start stewing up the minute my eyes were open - obviously that doesnt help but im hoping i will have a better night tonight - hang in there because i honestly thought they werent going to work (have taken them twice before and they didnt take this long to work) i know its really hard it just makes you worse by thinking "im never going to get back to normal im stuck like this" this just gets your anxiety really revved up - you will be fine - just stick with it - much love x

Hey shrimp, glad to hear you've felt some improvement. I know what its like to have a phone (related) phobia, even though I guess yours might be more of a social anxiety. Can be limiting in todays world. Being busy and so not having negative rehearsal and over analysing is fairly common I think.

Have you had any CBT recently or indeed in the past?

chantelle: its odd its doing less for you than citalopram. The active component is the same (chemically = S-citalopram) and most things say the Esc' equals two or more times the dosage. So 20mg Escitalopram should be equal to 40mg+ of Citalopram.

shrimp & chantelle: Not sure if it will help get the most of your dose. I read something around when I started mine that suggested that Escitalopram was better absorbed if taken after food. So I always took mine after breakfast (or after a snack). Can't prove that advice but its worth concidering if you find you aren't getting the benefit fo the dosage.
I did find that Esc' upset my sugar balance (which was already a bit wonky even though I passed a blood test), so ensuring I ate sensibly and adding a snack at bedtime avoided low blood suger in the morning. Low blood sugar is an anxiety trigger even in the "normal".

Shrimp - so glad that you are feeling a bit better and for giving me the encouragement that you did - Let me know how you are progressing.
I will hang in there as that gives me more hope.

Kevin - thanks for your reply - I think I'll try to take my tablet after food too.
You have helped me get my head round the citalopram/cipralex question - I think/hope that my negative attitude maybe was affecting my progress - I am now looking forward to getting back to myself - thanks again, Chantelle.

Hey. I think a lot of the issue with no-effect reports for many of the meds is that people compare them with the older "harder" meds that had a massive hit & mod change. Even the 'azepams (let alone older stuff) appear (I've not had any) to be more like illicit, or even intravenous meds. So pop a pill = feel better, for a while at least. The trouble is that effect is addictive behavouraly EVEN if we pretend there is no risk of a chemical or biological addiction.

So most of the prefered meds are slow and steady - even if their side effects are fast and tough. There are even arguments that most of our recoveries are placebo like and our mind plays a far larger part than the medication. I am not convinced by that argument but I thinks its very true that our mental attitude, strength, etc can be stronger (good or bad) than the subtler meds. It takes a lot of grit to face things have have frightened us in the past - even if we no longer have the emotional fear. Think of someone "normal" that was (say) very allergic to something, even if you cured their allergy 100% they would still have to overcome the very necessary caution/fear that they had devoped. If they had known to be careful for years that might be a big challenge especially if the allergy was to something inobvious (nuts, bees, gluten, whatever). Its the same for us, we learn to fear and/or avoid things. Overcoming that behavour even if our chemical/emotional fear is muted is not an eary thing.

The Esc' vs Cit' question is complicated because the UK always chooses drugs on price. The point is that R-citalopram (the unwanted 50% of Cit' does not have the desired effects AND IS documented as being biologically active. So it produces some of the side effects and perhaps just gets in the way a bit too (like mixing 2 jigsaw puzzles). The argument should only be about how much extra benefit vs price difference (factor of 10).

The other difference is that Esc' makes formal claims to treat various anxiety disorders, Cit' does not. Yet the NHS chooses to treat them as interchangeable. The PCT in Southend told my GP to stop prescribing Esc'. In a way I was lucky that it was not helping my anxiety enough - otherwise I'd have had to fight them. It only reduced by GAD score to 17/21 at best, from 20/21.

The thing is even for me it worked a bit though - so do press on. The thing is we can only decide that a dose or med does not help after trying it. If you've more questions then keep posting.