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  1. #1
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    Waves of physical anxiety

    Hi all
    I am 7 weeks in on citalopram and 4 and a half on 20mg. I am also on lorazepam. I have been feeling better this past week but I am experimenting with taking the lorazepam less as Iím worried it that that has caused the improvement and when I havenít taken it I still get random waves of physical anxiety out of nowhere - ie I havenít been thinking anxious thoughts. Is this normal? Should this have gone away by now?
    Many thanks

  2. #2
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    Re: Waves of physical anxiety

    Quote Originally Posted by Windywel View Post
    I am experimenting with taking the lorazepam less as Iím worried it that that has caused the improvement and when I havenít taken it I still get random waves of physical anxiety out of nowhere - ie I havenít been thinking anxious thoughts. Is this normal?
    By "physical" do you mean fight-or-flight adrenaline surges, i.e. fast heart rate, dry mouth, sweating, upset stomach, etc? If so, it could be an AD side-effect, maybe rebound withdrawal anxiety from dropping the BZD dose, or just one of the many inexplicable things that anxiety disorders can do. Propranolol is usually very effective in blocking adrenaline surges if they are spooking you.

    Should this have gone away by now?
    Four and a half weeks at 20mg is at the low end of the AD 4-12 week kick-in range. Given this is the second time on citalopram it is more likely to kick-in at the high end of the range than the low end.
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    The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.

  3. #3
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    Re: Waves of physical anxiety

    Thanks for replying PDU - not quite so bad as that but yes hot flush, fast heart rate, sweating but it didn’t last very long. Though the rest of the morning has been a disaster. Recovered ok from the brief anxiety wave first thing but then went to yoga felt anxious all the way through and then we did breath work at the end and that set off my shortness of breath thing so I got more anxious and now having a panic attack. Sitting here crying, shaky not able to breathe properly. Have taken the lorazepam now but clearly it was masking a whole lot and now I think that the citalopram hasn’t been working at all ��

  4. #4
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    Re: Waves of physical anxiety

    Quote Originally Posted by Windywel View Post
    Have taken the lorazepam now but clearly it was masking a whole lot and now I think that the citalopram hasnít been working at all
    I wouldn't have expected it to at 4 and a bit weeks.

    Iím interested in your view of someone on another forum who said that her psychiatrist said that any dose of citalopram was therapeutic and that she had quite a few patients on 5mg. Though I was a bit suspicious as the person in question was only on 10mg and yet had been given alprazolam to take with it for months
    Sigh! I think that wrong on many levels. The fact she also needs alprazolam pretty much proves her shrink is clueless and not worth feeding.

    Unlike that fool's claims, therapeutic dose recommendations aren't pulled out of someone's posterior, but come from trial data. Making AD chemicals is a long, involved process so the pharmaceutical companies aren't going to put more of the active chemical into their pills than they need to. As it is, many people end up taking more than the minimum recommended dose to achieve optimal results.

    he said to go up to 30 and try it for 2 weeks and if no significant improvement he would switch to something else.views?
    I suspect you'll need more than 20mg anyway, so increasing the dose is probably a good idea. I'm less convinced about the 2 week deadline, but at least it brings you into the time frame when ADs are most likely to kick-in.

    next one mightnít etc etc
    There are many ADs with many differing modes of action so there will be one that works. No point in worrying about something which probably won't happen anyway. It's not as if worrying has ever solved a problem.
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  5. #5
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    Re: Waves of physical anxiety

    Thanks so much PDU - that does help a lot. I have tried propranolol but it didnít really do much for me. I asked the psychiatrist about mirtazapine but he said we would keep it in reserve. He said better to keep things simple at this stage with just the citalopram and lorazepam as I was already on it. I am reducing back down to 0.5mg of that a day. I am still worried about increasing the dose though - I know heís going to recommend going up to 30. But lots of people on the forums have said not to as you get the side effects all over again and not many people seem to have had good experiences increasing (mind you I guess the ones who did arenít on here). They reckon staying on 20 for at least 12 weeks.

  6. #6
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    Re: Waves of physical anxiety

    Quote Originally Posted by Windywel View Post
    But lots of people on the forums have said not to as you get the side effects all over again
    Side-effects may indeed increase for a while after ramping up the dose, but they are usually less severe than at the beginning simply because the rate of change is less.

    Forums can give a greatly distorted picture simply because the majority that have few issues don't join them. You're looking at a small subset of patients. Even if 99.99999% claim a particular issue this doesn't mean you will also be affected. Only you have your DNA.

    Dr Google is not your friend. Stop 'listening' to it and looking for reasons to not do something, please. Go for a walk every time you're tempted instead. It will do you far more good.
    __________________
    The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.

  7. #7
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    Re: Waves of physical anxiety

    Also PDU I’m interested in your view of someone on another forum who said that her psychiatrist said that any dose of citalopram was therapeutic and that she had quite a few patients on 5mg. Though I was a bit suspicious as the person in question was only on 10mg and yet had been given alprazolam to take with it for months which seemed odd to me

  8. #8
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    Re: Waves of physical anxiety

    Told my psychiatrist about the dramas this morning and he said to go up to 30 and try it for 2 weeks and if no significant improvement he would switch to something else.views? Seems pretty soon to me? Scares me because of all the implications - ie this one didn’t work, next one mightn’t etc etc

  9. #9
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    Re: Waves of physical anxiety

    Thanks PDU

  10. #10
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    Re: Waves of physical anxiety

    Hi PDU I’m trying to stay focussed on your advice about why ADs take so long to work but there does seem to be a lot of research that says they do work within 4-6 weeks? I’m fact I saw one that said if no response within 2 weeks then you should increase dose or shift as it’s a marker that they won’t work! Another one said that it appeared that SSRIs worked in anxiety first and depression much later but they don’t seem to have worked on either for me after 5 weeks. I know I shouldn’t have googled but succumbed after a difficult weekend with lots of crying spells ��

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