About to start Escitalopram, few questions...

[Vonnyj]

This is such a bloody up and down business!! Seem to get a couple of really good days - then wham! get really bad days. Went up to 7.5mg 3 days ago - hardly slept last night and had bad increased anxiety. Is this normal? When will it settle down? I have only gone up 2.5mg I am surprised this would make me feel so bad! Has anyone else felt like this? Thanks for any replies.

[jayjoe18]

jayjoe18: Sounds like you are doing very well. I found the first 30 days the toughest. After that my system seemed to really settle in. 5 mg is not a high dosage, so i think it might be a little easier for us to start out then people jumping to 10 mg or higher at the beginning. Stay the course... sounds like your side effects have been minimal overall and that i am happy to hear it. I started my Cipralex journey on October 11th last year and by Christmas i was feeling pretty good overall, so keep it up!


Vonnyj: One thing i noticed straight away when i first started on Cipralex was my body started showing different symptoms when i got triggered with bad anxiety. Before the med i would lose my appetite, distance myself from people, cold sweats, minor trembling, insomnia and when really bad would start having panic attacks. The first time i got an anxiety attack on Cipralex was about 5 days or so after i started the med. I was sitting on my couch worrying about something when out of nowhere my whole body heated up and i started having a huge hot flash. It went from my feet all the way to my head. Being male I had never experienced anything like that before. It scared the shit out of me. It went away in like 5 minutes, but i couldn't stop thinking about it for the rest of the day. That was the worst one i have ever had, i think they are called body flushes. Since then i have had others, but not for the same length of time. I don't think i have had one recently, i know i had one in August when i was in Disney World, something triggered me. But again, it passed very quickly. I think these body flushes have replaced full blown panic attacks for me now, because i haven't had one of those in a year. So keep in mind your body could do minor weird things that you havent experienced before, but it becomes more and more manageable with each passing month. Also, I am sure you know this med isnt a complete cure for anxiety. I think if it was a cure everyone in the world would be on it. I do not get triggered anywhere near as often as i used to. Maybe once a month at the most, and i would call those anxiety attacks minor. I think the best way to describe it for me would be this, Cipralex allows me to maintain my composure when i am triggered, making it far easier to rationalize my negative thoughts and emotions. The longer i have been on this med at 5 mg, the easier it has become for me to deal with things i found so tough handling in the past. I work 9 hours a day, Monday through Friday.. and like you i need to be focused when i am at work in order to be productive. My biggest worry going on Cipralex was how it would affect me at work while starting up. I went to work and carried on with my day to day affairs like any other day and it was fine. The first two months I didn't miss a single day of work after starting on Cipralex, i thought keeping my life on my normal schedule would help me keep my mind busy. Make sure you are eating properly too, i find that helps.

Take Care,

Mike


P.S. I used to say "touch wood" all the time too!

Thanks Mike! Yes I'm really pleased to say the least, now I'm just wondering about dosages and whether I might need to go up to 10mg? Not quite sure how it all works and how you know whether or not you need to increase... Any advise would be great

Ha ha, glad I'm not the only one with the 'touch wood' thing, thought it might of just been me being crazy. I had those hot flashes too, that's what happened to me when I first got the visual disturbances, very scary! What you said about the panic attacks makes sense, things become a lot less scary when you have an explanation as to why you get each symptom.

Vonnyj, I can't give you any advice but I hope the meds start to settle soon for you!

[Tunnel]

Thanks Mike! Yes I'm really pleased to say the least, now I'm just wondering about dosages and whether I might need to go up to 10mg? Not quite sure how it all works and how you know whether or not you need to increase... Any advise would be great

Ha ha, glad I'm not the only one with the 'touch wood' thing, thought it might of just been me being crazy. I had those hot flashes too, that's what happened to me when I first got the visual disturbances, very scary! What you said about the panic attacks makes sense, things become a lot less scary when you have an explanation as to why you get each symptom.

I can only speak from personal experience. My doctors plans for me at first were to go on 5 mg to start for 3 weeks, then increase to 10 mg. But, he told me to base the increase on how i felt. I am not someone who likes taking meds to begin with, so i wanted to wait a longer period of time before increasing if that was the route i was going to go. I got to 6 weeks at 5 mg and was feeling really great, so i decided for me personally 5 mg was enough. I am almost at 14 months on this dosage now, and i still feel great.

Again, everyone is different but in my case i was feeling good enough to leave things alone. So thats what i did and i havent looked back. If down the road i need to increase to 10 mg, then that option is there. As of right now there is no need to increase so i will leave it be.

Reading your above quote it sounds like your introduction and early progress on this med is very similar to mine. Again, i am no doctor but if I were you i'd leave things alone until there is more of a reason to increase. Even though 5 mg's is an extremely low dosage, it might be all your system needs to right itself.

It sounds like you are doing great, which is really, really positive.

Take Care,

Mike

[jayjoe18]

Thanks for this Mike Well just a little update... I went back to my GP this morning as agreed and she's pleased that I'm getting on with minimal side effects, I asked about whether I should increase and she said not to. She said she want's me to take it slowly as if I increase to 10mg I could start to get side effects and as I was very reluctant and afraid to start meds, she doesn't want anything to put me off taking them which I understand. I am still unsure if 5mg will be enough for me though.

She did say that generally lower doses are what's used for anxiety, whereas depression usually needs higher doses, I do trust her word, just wondering if other people have been told this too/think this is correct?

I guess I'm a bit confused as my mum is on 20mg for her anxiety, and mine is just as bad as what hers was, plus she is on Seroxat which is stronger I believe and I'm a bigger build than her, she's very slim.

Anyway, the plan is to keep at 5mg for atleast the 4-6 weeks needed for it to work and then take it from there. I've got a months worth of 5mg plus this weeks tablets which will take me to the end of December and then she want's to see me again, I just hope that it's enough to get me through the Christmas period, I'm so nervous about being around people over the festive season :(

[debs71]

Thanks for this Mike Well just a little update... I went back to my GP this morning as agreed and she's pleased that I'm getting on with minimal side effects, I asked about whether I should increase and she said not to. She said she want's me to take it slowly as if I increase to 10mg I could start to get side effects and as I was very reluctant and afraid to start meds, she doesn't want anything to put me off taking them which I understand. I am still unsure if 5mg will be enough for me though.

She did say that generally lower doses are what's used for anxiety, whereas depression usually needs higher doses, I do trust her word, just wondering if other people have been told this too/think this is correct?

Not sure why she said that, hon.

10mg is the recommended dose for Generalised Anxiety Disorder. The starting dose for PANIC disorder is 5mg and then increasing to 10mg, but across the board - be it panic, anxiety, depression - the ideal management dose is 10mg. (which granted - as she says - is still a low dose, but still higher than 5mg!)

Perhaps she is going by what she has prescribed other sufferers and what has managed their conditions, but 10mg is the recommended dose (increasing to a max 20mg if need be)

It even says this in the leaflet with the tablets!!

It sounds like she is erring on the side of caution with you, which on one hand is very good doctoring. She is doing the considerate thing by starting you very slowly, but my concern would be that the 5mg will continue to help you, or whether you will reach a point where it isn't and you need the 10mg dose.

My advice would be to go with what she says for the time being, but if you do find you are struggling again, and it isn't cutting it, go straight back and make it clear to her.xxx

[Tunnel]

There are many, many people in this world taking 5 mg's of cipralex daily for their anxiety and depression and doing just fine. In my opinion, i think dosage should be based on a case by case basis with the patients doctor. Why would I jump to 10 mg if I don't need too? 10 mg's might be the most common dosage, however many, many people cannot go that high without months of side effects, and might not even need it. I think this doctor is doing the right thing taking things slow. If 3 months from now it is determined that an increase is needed, then by all means she should do it. I've been on 5 mg for 14 months now and it has worked terrifically for me. There is simply no need for me to jump to 10 mg at all, despite the fact many on this med are at 10 mg. My doctor totally agrees. If down the road i start relapsing then at that time i consider my options and increasing my dosage.

Take Care,

Mike

[jayjoe18]

Not sure why she said that, hon.

10mg is the recommended dose for Generalised Anxiety Disorder. The starting dose for PANIC disorder is 5mg and then increasing to 10mg, but across the board - be it panic, anxiety, depression - the ideal management dose is 10mg. (which granted - as she says - is still a low dose, but still higher than 5mg!)

Perhaps she is going by what she has prescribed other sufferers and what has managed their conditions, but 10mg is the recommended dose (increasing to a max 20mg if need be)

It even says this in the leaflet with the tablets!!

It sounds like she is erring on the side of caution with you, which on one hand is very good doctoring. She is doing the considerate thing by starting you very slowly, but my concern would be that the 5mg will continue to help you, or whether you will reach a point where it isn't and you need the 10mg dose.

My advice would be to go with what she says for the time being, but if you do find you are struggling again, and it isn't cutting it, go straight back and make it clear to her.xxx

There are many, many people in this world taking 5 mg's of cipralex daily for their anxiety and depression and doing just fine. In my opinion, i think dosage should be based on a case by case basis with the patients doctor. Why would I jump to 10 mg if I don't need too? 10 mg's might be the most common dosage, however many, many people cannot go that high without months of side effects, and might not even need it. I think this doctor is doing the right thing taking things slow. If 3 months from now it is determined that an increase is needed, then by all means she should do it. I've been on 5 mg for 14 months now and it has worked terrifically for me. There is simply no need for me to jump to 10 mg at all, despite the fact many on this med are at 10 mg. My doctor totally agrees. If down the road i start relapsing then at that time i consider my options and increasing my dosage.

Take Care,

Mike

Thanks guys, not to sound arrogant or anything but my anxiety has been very bad over the years, with me not going out for a very long time and my social life is totally in ruins.. this leads me to think I do need a higher dose as it's been so severe and gone on for so long.. I do hope that doesn't sound like I'm putting anyone else down!

Don't get me wrong 5mg is helping me (just posted a new thread about it http://nomorepanic.co.uk/showthread.php?t=147310) but maybe it could be even better?

I went back again this week and she still wants to keep me at 5mg, I'm just impatient and want to get my life back now! I've been on 5mg for over 9 weeks now.

[final]

Hi all, 1hour ago I just popped my 1st half of a 10mg Escitalopram and whilst searching for interactions between this and chamomile tea I came across this group!! My anxiety deemed "reactionary" by my doc, has been mostly medical in nature, so of course I have mild eebie jeebies about the side effects.

Nice to see I'm not the only one in the village, and will follow up with anything useful that might help any of you.

I wish I found this 6 weeks ago, I would have been straight to the doctor!

My dose is after 4 days of half a tablet, 10 mg daily after evening meal.

Until then, many thanks for sharing and taking the time.

[swgrl09]

Hi Final,

I was on escitalopram for about 1 year, 3 months I think ... I got off of it this past spring, but it was a great help to me. I was on it for anxiety and depression and it helped with both. I had some side effects in the beginning (started at 10 mg, moved to 20 mg at 3 months), but they only lasted a couple weeks and weren't unmanageable for me.

Hope you have a good experience! Any side effects should pass.

[jayjoe18]

Hi Guys, just wanted to pop back on the thread to update for anyone wondering how the meds are going... I can happily say all is going well at the moment, I feel settled on the meds and feel that they are really helping. I'm slowly building up confidence and I'm trying to push myself... I'm at the point now that I'm starting to do things normally again without a seconds thought, things that would have sent me into a crazy panic not long ago. I feel much more comfortable out in public and being around people. I'm so so happy with my progress up to now, I've even stuck with my driving lessons and done over 10 weeks worth now. I would say to anyone who is hesitant about medication to atleast give them a go, you never know. What have you to lose? I wish I hadn't waited so long! I will be back on here as much as I can to update. Hope everyone is well