Advice/Reassurance please

[AI]

Hi I've been on cit for 4 and a half weeks, 3.5 weeks on 10mg and on 20mg since Saturday (7 days). I feel awful the worst thing is the heightened anxiety particularly in the mornings. I wake up and within seconds it hits me. Is this to be expected at this stage and any ideas roughly when I'll start to feel the benefits as I'm really struggling with this at the minute. Thanks for reading x

[MyNameIsTerry]

Yes, I'm afraid this is very likely to be expected. 20mg is usually the starting therapeutic dose so your GP has done the smart thing and tapered you on. Mine started me straight on 20mg with no information and 48hrs later he was seeing me again and calling the Crisis Team in as he didn't know what to do (they sorted me out, just needed something to help me sleep to keep the depression down as I had never had that element until starting these).

Usually they say 4-6 weeks for side effects to go however that doesn't mean it remains as strong or constant. I found by the start of week 3 it was reducing but it was really only after week 4 before the side effects went. The first week was the hardest, I found. I think this might be because it takes 3-5 half lives of a med to become "steady-state" in your blood, or in English as much going in as coming out, so at this point you are getting the 100% levels. For Cit, this is about a week.

Hang in there. You will find loads of people on here understand how this stage feels, I hated it with both meds I have tried. The anxiety always hit me upon waking but it reduced over the day. Cortisol levels are always highest when we wake and they decline throughout the day, so it can be connected to that too.

[AI]

Thanks for your help, it really is horrible that we have to feel worse before we feel better. Determined to see it through.