SSRI/ Escitalapram advice please

[wantpeace]

I am having a horrendous experience on Escitalapram and I really, really would appreciate your opinion. I won't take any action other than what I consult with my psychiatrist, so don't be afraid to say what you feel. I would just appreciate your thoughts.

Starting/ Increases:
2.5mg (split pill) - 25 January: 6 weeks ago
5mg - 1 February: 5 weeks ago
7.5mg (split pill) - 25 February: 9 days ago
10mg - 2 March: 3 days ago

I am constantly anxious, restless and agitated. The exception to this is when I take other meds which knock me out.

Before I started the Escitalapram, I was off work for 2 1/2 months due to anxiety and depression, including nearly 3 weeks in hospital. Over the past 2 weeks, I suppose since upping from 5mg to 7.5mg, my anxiety has increased significantly and developed to agoraphobia for most of the day. In fact, I'm pretty scared to leave my bed. I'm now spending 12+ hours in bed trying to escape the discomfort.

I would say I've had 4 maybe 5 ok days since starting Escitalapram.

In your opinion, would you say this is something that just isn't for me or should I still be sticking this out? I suppose the fact that I've only just increased to 7.5 then 10mg means I've got to stick with it, but I'm in so much distress I don't know what to do.

[swgrl09]

I think you have not given your body/brain time to adjust to one dose. You have been changing doses every week or so (which is fine for some people) and you have not been able to get used to it yet. I didn't feel better until 20 mg honestly and I had to be on that dose for 3-4 weeks before I felt used to it. So try to give it some time.

[wantpeace]

I think you have not given your body/brain time to adjust to one dose. You have been changing doses every week or so (which is fine for some people) and you have not been able to get used to it yet. I didn't feel better until 20 mg honestly and I had to be on that dose for 3-4 weeks before I felt used to it. So try to give it some time.

thx swgrl09. It feels like torture a lot of the time for the moment. Although yesterday and today, I had a couple of calm moments shortly after taking 10mg. Maybe a peek into the future?

[debs71]

Stick with it if you can. It will be far better to hang in there than to stop and have to start from scratch again.

I am also on Escitalopram, since 2003. I didn't have a gradual increase...I started on 10mg straight away. The first week I was the same mentally, but I felt very nauseous and had no appetite and felt very drowsy. For about 2-3 weeks after that, my anxiety and panic symptoms really heightened and I was scared of everything, had racing thoughts and couldn't be alone.

It was awful, but the weeks following that everything settled down, bit by bit, and I felt the anxiety symptoms decline and could actually start to get out of the house, but with my parents, not alone.

I think your doc was doing the responsible thing in gradually increasing your dosage to the point that you reach the optimum dose for you personally, but of course everything is stretched out over a much longer time because of this, but I assure you that you SHOULD feel a vast improvement with time. I found that I was able to stay on 10mg, and that is the dose I have been on (on and off) since, but it really depends on the individual as to what dosage really helps their depression and anxiety/panic, etc.

When you feel as bad as you do right now, I know how easy it is to think you will not shake this, feel better, and this is going to last forever, but I promise you it won't. This is just the initial side effects which always make you feel a lot worse before you feel better.

Try if you can to tell yourself that this is just a bad phase to get through.

[wantpeace]

thx Debs. Yes, it's hard really hard but I suppose I've only been on 10mg for 5 days. It does feel like it will never end.

My issues are compounded by the fact I'm tolerant to diazepam (12mg per day) and am on a big dose of Quetiapine (350mg).

I've got my first 1-1 psychologist appointment tomorrow afternoon. Looking forward to it!

[debs71]

thx Debs. Yes, it's hard really hard but I suppose I've only been on 10mg for 5 days. It does feel like it will never end.

My issues are compounded by the fact I'm tolerant to diazepam (12mg per day) and am on a big dose of Quetiapine (350mg).

I've got my first 1-1 psychologist appointment tomorrow afternoon. Looking forward to it!

Ahh ok. Yep, so you find it hard to take the edge of, as it were. For me personally, I found (silly as it sounds) distraction helped me a lot. I know that it is easier said than done when in the middle of high anxiety, but it honestly can help to try to divert your mind, as the speeding thoughts make everything so much worse. I used to sit and (try to) watch a film with my Dad. I would find my mind drifting back to how anxious I felt, have a cry and then pull myself back to the film, but just being with someone and trying to focus on another thing really did help a lot. Also things like playing a game on the internet or a crossword book....stuff like that. The brain finds it hard to fully ramp up the anxious feelings if it is also trying to do something else at the same time.

It is really good that you are seeing the psychologist tomorrow. I had 1-1 counseling through MIND many years ago, and I found it immensely helpful when it came to discussing my thoughts, how I felt, and receiving rational advice. I really hope you find it helpful too.

[Jmac]

Hi Debs,

you mention you've been on escitalopram since 2003. Has that been continuous for all of those years and during that time, do you experience "blips" that knock you sideways? I ask because I've been on 10mg of escitalopram since 2011 (just under 5 years) during which time i've had about 3 episodes of heightened symptoms lasting anywhere from 1 to 3 weeks at a time. I'd go up to 12.5 mg for about a month or so and then come back down to 10mg when things settled down. Right now, I'm in the middle of another "blip" for which my doc has suggested i go straight up to 15mg as the 10mg might not be enough right now. I'm really just looking for reassurance that this is common after long term use. Escitalopram (Cipralex here in Canada) has worked wonderfully for me for the past 5 years and I'm hoping it will continue to do so.

Did you gradually increase your dose over a number of years?

thanks for any support you can provide.

Jmac

[debs71]

Hi Jmac,

I haven't been on Escitalopram continuously, no. I have weaned it slowly down and managed to come off of it around three times, but each time have had to go back on it eventually, as my anxiety and panic attacks came back with a vengeance. The longest time I was off of meds was 2 or 3 years.

I have now been back on meds for around 6 years, and yep, I still have blips ever now and then, that knock me sideways. I can generally relate them to increased stress or tiredness, or just a period of intense worry. My last blip was related to a period of ill, physical health, where I was really worried about tests I was undergoing, and the results.

I started on 10mg, and have stayed on 10mg ever since. None of my doctors have ever suggested altering the dosage to accommodate or deal with the blips. I think (personally) that sometimes this doesn't help matters, as any kind of dose alteration will have an effect on us, and sometimes do more harm than good, as the side effect of a heightening of our symptoms has an impact.

I am not sure though what effect this increase/change in doage has if you have already been taking Cipralex for several years though, as you have been. I know that when initially commencing meds, the side effects occur, which is why doctors generally like to increase gently.

I asked my doc about how normal blips are actually, not so long ago. I was finding that I was slipping backwards into depression again, and had had a couple of panic attacks, and he said that the meds are not designed to totally knock all anxiety on the head. All they do is reduce the anxiety to within reasonable, 'normal' limits, and bring down the horrendous levels of anxiety that GAD brings. I think that possibly - because we are already sensitive to anxiety due to our condition - this may explain the blips we have....they are a little more intense than 'normal' anxiety for us!

I know it is difficult to do, but try if you can not to see these blips as a failure, or a setback, or that the meds are failing in some way. Anxiety will sometimes rear its ugly head at times - usually due to some underlying trigger or cause, as mentioned - but it doesn't have to beat us or overwhelm us. Hang in there! x

[Jmac]

Thanks for your perspective, Debs. Good to know I'm not the only one who goes through it. I'd say I'm good for one a year so I guess this one's just that. Thinking back, there has been some added stress that has all sorted itself out but I guess my system doesn't know the difference!

thx. and you keep well, too.

Mac