Escitalopram day 9: feels like flu with hot flashes/shivering

I started taking escitalopram last week, cross tapering with mirtazapine. I am taking this mainly for panic attacks, agoraphobia and constant severe anxiety. I am supposed to stay on 15mg mirtazapine for now whilst very slowly building up the dose of escitalopram, with the aim of eventually coming off the mirtazapine altogether.

For four days last week, I split the 5mg tabs in half and took just 2.5mg each day along with the mirt. Didn't notice anything much good or bad! At the weekend I went up to a whole 5mg tablet, sort of felt OK for the first 2 or 3 days but a couple of days ago I started to feel like I had flu, and also felt a bit sick on and off. I managed to cope with this until last night when I was just about to go to bed and really suddenly, within minutes, I felt extremely ill. First of all I got very, very hot to the point where I thought I would never cool off, sweating loads all over, and feeling a bit light-headed and faint. I also felt like I could literally throw up at any moment. After a few minutes I gradually cooled off and the heat was replaced by feeling very cold and shivery with quite violent shivering, teeth chattering etc. I continued to feel quite sick for about an hour, thought I would never sleep but suddenly I was exhausted and did fall asleep in the end.

Today I feel better than I did last night, just back to the flu-like feelings but also very anxious about what this could be and that it might happen again. I'm guessing it's some kind of side effect but I'm concerned that because I'm still taking the mirtazapine this could be serotonin syndrome and I REALLY don't want to keep taking the new pills... I've only managed to find one or two reports of people feeling like this on escitalopram or citalopram alone - can anyone help?

Hi Abs,

Sorry that you are feeling so rough at the moment with the meds.

It's a hard one to call as I have read on here people taking mirtazipine along with a SRRI and doing o.k. so am guessing that it is the side effects from the new meds that is causing the unpleasantness you are experiencing. It is very common to suffer flu-like symptoms and feeling sick etc as I have taken citalopram in the past and when you describe the violent shivering, teeth chattering etc I can relate to all of this....they are typical symptoms of increased anxiety which is a side effect from the meds.

My advice would be to continue doing as you are cross-tapering the meds and if the symptoms become troublesome then consult your GP to be on the safe side. I know when I changed from citalopram to mirtazipine I felt awful and wondered about serotonin syndrome too!!! I think your mind just starts to work overtime and you think the worst.

Were you originally on 30mg of mirtazipine?? As if you were you may be suffering withdrawal effects too.

I hope you feel better soon.

Take care.
Jo.xx

Hi Jo

Thanks so much for the reply. I had only been taking the mirtazapine for about 6 weeks when I started the cross taper. Before that I took dosulepin for 6 months but never felt it did much to help. I had a horrific time changing from the dosulepin to mirtazapine (no cross taper) and eventually got referred to a psychiatrist who said escitalopram would be better for anxiety (though I have found plenty to say that mirt can be effective). Anyway I thought it would be worth a try. I was on 22.5mg mirt so guess I could be having a bit of withdrawal by dropping down to 15mg but was hoping not too much.

I tried citalopram about a year ago and had a horrid reaction after just two tablets so always knew this could be bad. I think it's just that I went through it all so recently in the change from dosulepin to mirt that I just don't have the strength to cope with it, I'm tempted to just go back to the mirt for a bit and give it a chance to be honest... Have you had success with it?

I just feel like every drug I try just makes me worse at the moment and can't believe that anything will work!

Thanks

Abi

Hi there everyone. most of my life ive been on loads of antidepressants from the age of 15 ,such as prozac , ive have had panic attacks since i was six been places for it .witch dont really help they try.my panics does get worse from time to time , prozac worked for me for a few years , then was taken off , a few years later had bad panic attacks with was so bad ending me being rushed to hospital thinking i was dying .back to square one , they put me on them once again but this time didnt agree with me made me very ill , took me off .
in 2008 my mother died , with had a mental affected on my life with she was the only member of my family that was still alive , she was everything and she died in frount of me and was brought around only to face being brain damaged , didnt know who i was she was in hostpital for 15 days they said we have to turn off life surport with i watched my mother die for 16 hours , after that just lost the plot , my work dropted me my panic attacks started being stronger , had bad depression , thoughts that i could of saved her , i wanted to die .my dr put me on citalopram 30mg with ive been on they did help ,had side affects yawning that felt wonderful and you couldnt stop because it felt sexual lol but couldnt sleep they did keep me going for 2 years i must say they where good , but i had to come off them becaue i became pregant , and my dr said wasnt a good idea for you and the baby so i stopted. in may 2010 they told me my baby was dead i was 3 months on the hostpital gave me a tablet because im so scared to go under anaesthetic because of panic. but i hemariged and lost loads of blood . i nearly died so i was put back on them for my depression
and now they dont work at all cant sleep cant do nothing feeling sick dont want to go out do nothing . so been to the dr today , and she has given me esciltalopram 20mg witch i will start taken , i just hope it helps me and i shall keep you updated and all know how it goes

How are you going on with the Cipralex Gialouise? hope you are feeling better

I am doing the cross tapering thing with Mirt/Cip I am having trouble staying asleep how is your sleep Abs? when to you take the two tablets cos I'm thinking of taking the 2 last thing at night till next week when I'll just be on 10mg of Cipralex wonder if I'll sleep better just scared they won't help during the day that's when my anx is at it's highest let me know, all the best.

Hi Micko

Sorry it took me a few days to notice your reply!

Well I am still in the process of tapering, down to 1/4 of 15mg now. I was originally planning to then go to 1/4 every other day but I'm not sure I can be bothered now, I just want to get it over with!

To answer your question, yes, it has affected my sleep. Generally I still fall asleep quite easily but now wake up a bit more during the night. However usually I can get back to sleep OK - in fact I'm finding it quite hard to wake up in the mornings. What I have noticed though, is a lot more really vivid, detailed and strange dreams, which seem to go on all night every night. I think this makes me feel less rested in the mornings.

I take the Cip in the mornings and the mirt about an hour before bed. This seems to work for me OK. If you are taking both in the evening, perhaps you'd be better off taking the Cip in the morning? I think for most people the SSRIs are activating i.e. they wake you up and can interfere with sleep. Also, I have read that naturally your serotonin levels are highest in the mornings anyway, so taking it in the morning fits in better with your body's natural rhythms.

I am still having a lot of problems with nausea in the mornings after I've taken the Cip, despite having taken it for several weeks now. Have you had this?? It seems to have been worse since I reduced the mirt and I wonder if that was masking it before, since I understand that mirt has an anti-sickness effect.

just feel awful, shaking, sweating, no sleep, more panic attacks, nauseas, my breathing seems to worse wanna just come off it but bloody can't don't know what to do?

Micko please don't give up on the Cip just yet. You will feel better soon. I know it's terrible - I went through this just a couple of weeks ago and I feel sooo much better already. I know the side effects are sh^t but honestly you're nearly at the point where they will lessen so why give up now that you've gone through so much? You've run a marathon and you must be exhausted but the end is in sight so keep going - any day soon, in fact any hour in the near future you'll have come through the other side and suddenly just suddenly you'll feel much better. Keep plodding on. We're all in this with you - you're not alone :)

Thanks Deva, feel worse today than did yesterday dreading tomorrow! what happens if they don't do owt like last time (mind you did stop after few days,started/stopped/changed etc) so scared to even go out, the beds drenched with sweat, can't get my breath, was'nt this bad before I went back on weaning off Clonazepam and Mirtazapine, just taking 1 Cip 10mg at dinner after being started on 5mg can't take much bloody more so much worry with hand constant pain/discomfort worryin' about everything flat, mum, Sandra she does'nt know what to do anymore! it's a 24 hour nightmare! used to look forward to going to bed just for some sleep/respite but just can't sleep for more than an hour! help!!!!!!!