Anxiety BACK: how to know when to switch meds?

[NervousKel]

Hi guys! I'm hoping to get some insight on my dilemma.

I've had GAD, social anxiety, and phobias all my life, but for the most part I had been able to keep them under control without medications. Just a few blips here and there that cleared up after a few weeks.

But, in April 2013, I hit a really rough spot. We had an unusually long winter that year, and I think that greatly contributed to it. I was highly anxious, had depression, negative thought patterns, etc. I went in to the doctor; was initially put on 20 mg Citalopram, and then they bumped me up to 40 mg after a week when I went back in for insomnia.

After the horrible side effects wore off (I don't ever, ever recommend a dosage increase that fast), the Citalopram worked great for me! I've been on it for 5 years now, and it did really change my life for the better.

But....about a month ago, I started to notice I was my face was twitching a bit. I used to do this when my anxiety was high. I also noticed a few times where my heart was racing from anxiety. I didn't think much of it.

Then, almost two weeks ago, the anxiety hit me full force. I think it was partially triggered by a tooth ache that kept me up all night, and made it hard for me to sleep for several nights. We are also having a long winter here again this year, and I think that may have contributed as well.

Since then, I've had ups and downs. Some times during the day (especially in the evening), my anxiety is all ramped up. Other times, I'm calmer. Yesterday, I was so calm for a few hours in the afternoon I had to force myself to stay awake;-). I've had to go back to taking Trazodone at night to sleep, which worries me.

What I can't decide is if I should change medications (doctor suggested Lexapro), or if I should keep on with the Citalopram??!! My big fear is that the Citalopram has quit working. On the other hand, I can't believe it's just coincidence that my anxiety has gotten so bad again during an April when we have a long winter. Is it possible for serotonin levels to get low due to Seasonal Affective Disorder even if you're already on an effective SSRI??

Any thoughts on whether my Citalopram has quit working? Or is this just a seasonal blip?

Thanks!

[ana]

It's hard to be sure, that's the issue. Medication is beneficial in theory, but I doubt even the doctors know how it works exactly, especially given how we're all different. I've had the same issue in the past. I went from Zoloft to no anti-depressant (just Klonopin) to Escitalopram to Venlafaxine.

I swapped from Escitalopram to Venlafaxine because I was well on the former for a few months, but then it just 'stopped working', i.e. it wasn't making my depersonalisation symptoms any easier.

I now feel like Venlafaxine isn't doing much either. It's hard to say whether this is all in my mind, whether I've just lost faith in the medication. It seems that a new medication works well for me for a couple of months and then it just doesn't as much any more...

[NervousKel]

Hi Ana!

I've heard there's a DNA test they can do now that can tell which antidepressants will work best for a person. Maybe that could be an option for you, to narrow things down a bit?

I spent sometime in the sun yesterday, and felt much better. I even fell asleep last night without using Trazadone. I'm going to make a real effort to exercising, and eating better. I was reminded on my walk yesterday how it's the first bit of exercise I've had in months and months.

[ana]

Hmm... I'm not sure DNA testing for meds exists where I am, but I'll ask my therapist when I see her on Tuesday, it can't hurt to ask. Thanks!

Exercise will do you a lot of good, trust me. It provides you with a positive channel to your anxiety.

[Dizzydoll]

I'm in same situation Kel 20mg cit has worked great for me 3yrs plus but now my anxiety is bk n I'm really struggling I duno if to wait it out or go bk to docs I'm terrified of increasing dose or switching meds as I had 10weeks of hell starting citalopram with the side effects n it makes me anxious even thinking if that x