Medication dilemma - depression/anxiety/pure O?

[Emphyrio]

Hello,

I am currently on citalopram (10mg a day) for depression/anxiety which I find has definitely lifted my mood but at the expense of feeling tense, agitated and restless (which in turn leads to 'pure O' type feelings).

I have been on 20mg of fluoxetine for around 5 years before that which has had similar effects - last September I decided to go to the doctor to change my medication to something which didn't cause so much agitation - I was given citalopram but I reacted very badly to it when I upped to 20mg (agitation, tenseness and intrusive thoughts about harming myself/others) and had to come off it completely. I felt better after being off it for a week so I decided to remain off all medications for a few months. Generally it was great for a month or two - I felt good with no pure O thoughts (a rare occasion!), but then the depression kicked in again and so gave the citalopram another go (this time restricting it to 10mg/day).

Was just wondering then whether people here could recommend a specific kind of medication which improves the depression/anxiety I have (which is generally mild-moderate) but which doesn't lead to agitation/tenseness/restless legs and arms? I'm tempted to come off the medication completely again (esp as I'm on such a low dose of cit anyway) but I don't want to feel like crap again.

I went back to the doctor a couple of days ago and received a prescription for Trazodone - has anyone used it and does it help with agitation/tenseness?

What about natural remedies like St John's Wort?

Thanks for your help,
Pete

[Emphyrio]

Bumping this - have been off all medication for around 6 weeks and am feeling pretty strange at the moment.

I don't feel particularly down/worried about anything in particular and am having no problem sleeping and do not sleep too much, though I'm feeling physically strange:

- muscle tenseness, feeling on edge, occasional pounding heart, yet at the same time fairly weak with lack of energy. Cannot concentrate on anything. Cannot sit still, find it hard to concentrate on people talking.

- intrusive thoughts about harming myself or others - I don't want to, its a case of 'what if' or losing control (I've never acted on my thoughts in the past so why should I this time, but its the worry in case this time I do).

Could this still be the residual medication in my system? I've been off medication twice in the past few years - around 3 years ago I came off Prozac (I was on 20mg a day) and felt pretty down and worried about a lot of things. Likewise when I came off Prozac last September (I also tried citalopram for a couple of weeks but found the side effects when I moved from 10mg to 20mg to be overwhelming, so cut out meds for 3 months). I initially felt good but started feeling more and more down the longer I stayed off it.

The only difference now is that I think I'm beginning to put in place some of the techniques I learned from CBT - I have started doing things that I never felt I would ever do and just going for it essentially. I'm eating a bit more healthily (because of IBS more than anything), I've cut down alcohol considerably (previously I was drinking far too much and was sometimes drinking by myself), have cut out caffeine and am doing a lot more exercise. I'm unsure why I still feel so highly strung, hyper and agitated now even though I'm putting all these beneficial things in place! It's like whatever I have is determined for me to be miserable in whatever sense :(

Does anyone relate? And has anyone found a good medication for Pure 'O' type intrusive thoughts/anxiety which doesn't have agitation/tenseness/feeling on-edge as a side effect? Not that I want to go back down the medication route if I can help it, though if things don't get any better I may have to :(

Thanks for listening to me!

Pete

[lauz_lea]

Hi Pete, sorry no one has responded to your thread, but I thought I would as I recently quit meds a couple of months ago because they were causing more problems that I was taking them for.

I can relate to how you're feeling to a large degree and quitting the meds (paroxetine and mirtazepine) wasn't plain sailing but I'm improving without them. The meds can stay in your system for quite a while after you stop taking them (the old "half-life" story), but even then once they are "out" of your system, there can still be residual effects, both physically and mentally.

I can't really recommend a med that might suit you, simply because it isn't a case of one drug fits all, but it might be worth researching which meds are "activating" and which meds are "sedating" (i.e. some can cause insomnia and may increase pure O for a while, whilst others may make you drowsy and sluggish for a bit).

I'm going to stay on the no meds route for a while, as I generally feel better off them than on them this time (meds have worked very well for me in the past, but my recent experiences have scared me off them for a while).

Good luck with whatever you decide and well done for coming this far without the meds.

[Emphyrio]

Thanks lauz I ideally hope I can stay off the meds, but I'm still getting days in which intrusive thoughts lodge themselves in my mind and stay there, even though I'm trying out tips from my CBT sessions.

What made you decide to come off your meds and how have you found it so far?

[lauz_lea]

I came off them because they made me worse than I was before I started taking them (it's a long story, but I had previously been on meds for about 10yrs, successfully and came off them because my then GP suggested I should). Having been off meds this time for 2-3 months I'm still worse than I was before going back on them, some days are a real struggle, waking with racing thoughts and a feeling of anx in the pit of my stomach, but others are fine, it seems to cycle, so now I'm keeping a diary (of sorts) for the next month to see if my GP can pinpoint anything with regards to hormones.

[Emphyrio]

Thanks for the reply - hope everything works out for you. Have you made many lifestyle changes as well - e.g. exercise, diet, cutting back on caffeine/booze etc? I think in my case, the amount of alcohol I used to drink acted as a sedative; either that or the feelings of depression/anxiety masked the underlying obsessions. It sucks that when I'm finally making positive steps towards improving my life the intrusive thoughts have to try and bring me down :(

Going to see the doc tomorrow and ask to be referred to a specialist. In the meantime I may ask him/her to try a low dose of mirtazapine as it seems to have been used to treat OCD/anxiety and is sedating.

[LAURA48]

Hi Pete - just thought I would reply to your post.

Yes go and see your GP and get a referral to a specialist. I have suffered strange thoughts for years and it came to its head 15 years ago when I was put on prozac - it took it all away and was brilliant - I used to take 0.5mg lorazepam too - as have suffered GAD for 27 years. Anyway after 15 great years in October when my little dog died - everything came back with a vengeance! and tbh it has been hell since - the Prozac has stopped working. Well have been on the med merry go round - to no avail and tbh Mirtzapine was no good for this.

In desperation paid to see a psychiatrist because of long wait and was diagnosed with OCD - thoughts! am being put on 10mg Cit for 2 weeks and then 20mg onwards with a very small dose of Olanzapine and to continue Lorazepam (told him I have been taking a bit more lately) but hoping to get back to my 0.5mg dose! and some CBT - I personally things with this illness meds are the way forward. I know what it was like before Prozac - didn't go on holiday, no job and the thoughts were always there. I am having that feeling again now with no meds. Hopefully it will change when I get them shortly.

Good luck but try to see someone who is professional in this field - GPs are good but they are not experts. It is damned horrid.

Laura