Do the same SSRI's work second time round?

[steveo]

My concern comes from being 11 years successfully on Citalopram. Coming off because I felt fine... biggest mistake of my life.

Lasted three months off it. Came back on at the start of Jan this year. Tried for 2 and a half months and it hasn't worked.

Switched to Escitalopram and I'm 40 days in and still climbing the walls with anxiety.

I don't know why these drugs aren't working a second time round. I also don't know how much longer I should keep on my current med before switching again.

Also... I don't know what to switch to! I'm scared to go on some medications such as seroxat and I don't think SNRI's are overly suitable for anxiety. Plus I'm very ANTI medication as it is and believe that 11 years and ruining my serotonin neurotransmitters and I don't want my noreadrenalin messed about with either.

I really don't know what to do.

[ElizabethJane]

It would seem that the answer to your question is no they do not. I don't know why this is so but others have reported this also. I also don't know whether ssris interfere with the brain chemicals permanently? I am aware that the medication that I take can interfere with the workings of my brain but it is a risk that I am prepared to take. I have regular blood tests to check the effect of lithium on my thyroid, liver and kidneys. I also saw my psychiatrist today who said that I needed medication in order to stay well - indefinitely. I feel 90% well.if you have found something that works for you then stick with it. EJ

[steveo]

Yeah I wish I stuck with Citalopram. I went against the old 'If It AINT broke DONT fix it' rule.

But that's hindsight now. And now my life is a wreck. I've had to move back in with my dad. I've been massively anxious and agoraphobic and terribly depressed and suicidal for 4 whole months, worse than I've ever been in my 23 year history of anxiety.

I don't know what to do.

I'm really scared about this. I know that once I get back to 'normal', I will bloody well stay there this time! But for now, I just don't know what I can do.

Does anyone else have experiences with coming off and back on an SSRI?

Also, what other medication should I consider taking next?

Steve

[BobbyDog]

Have you tried a Tricyclic or Tetracyclic? I take Amitriptyline and Mirtazapine respectively and they work for me. I took Citalopram for 10 years and had a severe reaction the second time around - sheer hell.
Hope you find something to tide you over until you are back to your old self again.

[bernie1977]

Hi Steve,

I had a similar situation to you. I was on Citalopram, stopped taking it then tried numerous other medications which all made my condition worse due to the side effects. After a break from Citalopram I was put on Venlafaxine, this wasn't effective and was hell to get off. I then went on Mirtazipine and it did not nothing to help with my depression and anxiety and I gained nearly 2 stone in weight, this came off as soon as I stopped this med. I was then put on Duloxetine which gave me awful side effects. By this time I'd had enough and went med free for a few months. I was no worse but no better. My psychiatrist managed to talk me into giving Trazodone a go. This medication was very good to me in the start up period the only thing to report was a very lethargic feeling that lasted most of the day. I also suffer with Chronic Fatigue Syndrome so hard to know if it was the meds or CFS what was causing the tiredness.

I'm still doing ok on trazodone, I'm getting help from a support worker and CPN before I couldn't let them in the house as my anxiety was so bad.

It's impossible to tell someone what to do with medication as our bodies all react differently. I do know that I will never take a SSRI or SNRI ever again as I genuinely fear for my mental health and well being when taking those as they me feel so low and ill.

A good psychiatrist is your best bet but unfortunately a lot don't seem to understand or appreciate what we describe about SSRIs

Best wishes Steve

[steveo]

Thanks for the replies guys.

I've seen 2 consult psychiatrists in the last 4 months due to this.

The first told me to increase my Citalopram and also start Pregabalin. The increase in the Citalopram gave me side effects, and the Pregabalin made me feel sky high. I did tell him that my main issue was depersonalisation and feelings of unreality but he failed to notice that the main side effect of Pregabalin was that.

The last p'doc I saw a couple of weeks ago wanted to switch me to seroxat and also put me on an anti psychotic, Quetiapine. I obviously had massive concerns about going on Seroxat so I declined that, and the quetiapine I didn't see as a long term solution. I felt that was wallpapering over cracks. Also, I am concerned about the sedative side effects. I was told that would I rather feel anxious or sedated, I still would rather feel like me and be able to function whether it gives me anxiety or not. I've spent 27 years of my life not having to be sedated to live a non anxious life.

Bobbydog, what was your experience second time round on Citalopram and how long did you stick it out for?

I basically want a medication with no sedation side effects. I just want to be back on my feet. I can't believe I'm still here nearly 4 months on of hell EACH day.

I'm also still popping 4mg Diaz a day too. 2mg am and 2mg PM. I tried to ween myself off and got into a panic.

I appreciate everyones input. I understand no one is able to recommend me a medication etc. Just interested to hear your own stories. Just want to know if it really is true that Citalopram won't work 2nd time round and seeming as Escitalopram is so similar, I doubt that's going to do much either.

I'm going to try 20 more days of Escitalopram which would of been 60 days in total, to make a proper opinion.

Then I',m worried it's going to be months and months and months of trial and error on other meds!!

I'm so so scared. I'm unfortunately very vulnerable to self harm during long acute periods of anxiety and unfortunately have made a couple of silly 'life ending' attempts over these last few months. I'm scared that if this carries on or gets worse, I'm worried about what I'll do.

No professional is willing to help me with this either despite 2 trips to A and E for 'life ending' attempts. The p'doc discharged me from the CMHT because I refused Seroxat and Quetiapine. And because I'm not trying to kill myself daily, the crisis team no longer come round. The CPN I had would come round once every 3 weeks for about 10 mins to ask how I was, take notes, then leave.

I just don't know what to do anymore.

[Pipkin]

Hi Steven,

You know my experience but just to remind you, I've been in venlafaxine 3 times over the course of 10 years and it's worked really well for me each time. It's been my urge to go med free that's caused my problems.

My opinion is that the mind plays a big role in how meds work and leads the way in believing that the medication will work - part of a placebo effect. This doesn't explain your experience with citalopram though. The moral of that story is that we're all different and the effects are hard to predict.

You're right to give your current meds a bit longer. If you do swap, all I'd say is not to rule out anything. You say that SNRIs are not particularly effective for anxiety but, in my case, they are. Others find tricyclics work well and others, anti-psychotics. Your inquisitive mind doesn't help you in this as you, like me, want all the info before embarking on something new and that's not always helpful. We can be our own worst enemy sometimes.

Take care

Pip xx

[violet12]

Hi Steve,

I took Escitalopram for 5 years with no probs and recently tried to go back on it but gave up after 3 weeks as the increase in anxiety was just too much for me to cope with...I was only taking 5 mg a day! I know 3 weeks isn't really long enough, but it didn't affect me like that first time around. I think there's a lot to be said for your state of mind at the time you start the medication.

Originally went on it for depression and the anxiety wasn't really an issue. However, this time around it was predominantly anxiety that I was suffering from.

[Snoodlester]

Hi Steveo
I can't remember when I started on Cit, but it was at least a couple of years ago. I was on about 10mg a day for probably 6 months, and I felt really well. I came off the tablets, but all too quickly the anxiety came back worse. Not really bad, but bad enough for me to go back onto Cit and that's what I was on before I had my 'crises' this year. My doctor reluctantly switched me from cit to Mirtazapine - she said that where Cit works on one part of the brain Mirt works on 2. I went immediately from one to the other overnight and I went through hell the first few weeks. After 2 weeks my doctor said I should increase the dose to 30mg. My second 'crisis' happened, and she then has upped the dose to 45mg and also Zopiclone for my sleeping problems. I don't think Mirtazapime is wholly effective - it's helped with some aspects of my life but not the main problem. My doc says to just carry on and wait for CBT.

Sorry you're still going through 'hell', I really do hope things pick up for you soon.

I've been given a book to read by a friend who had difficulties a decade a go - 'Coping Successfully with Panic Attacks' by Shirley Trickett, she said she got it from Llloyds the chemist. I'm going to start reading it tonight, so I'll see what it's like.

Sue x

[steveo]

Thanks for the further replies.

Violet12 - Are you on any other medication now?

Problem with medication and GPs and p'docs, is that its all subjective. What one p'doc says and prescribes, another might be totally against.

I really don't know what to do.