Page 1 of 3 123 LastLast
Results 1 to 10 of 23
  1. #1
    Join Date
    Sep 2019
    Posts
    225

    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
    Join Date
    Jan 2017
    Posts
    2,116

    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.
    __________________
    .

    - - What to know about: Telepsychiatry | Teletherapy - -





    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
    Join Date
    Sep 2019
    Posts
    225

    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
    Join Date
    Sep 2019
    Posts
    225

    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

  5. #5
    Join Date
    Sep 2019
    Posts
    225

    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

  6. #6
    Join Date
    Jan 2017
    Posts
    2,116

    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.
    __________________
    .

    - - What to know about: Telepsychiatry | Teletherapy - -





    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
    Join Date
    Sep 2019
    Posts
    225

    Re: Waves of physical anxiety

    Thanks PDU

  8. #8
    Join Date
    Sep 2019
    Posts
    225

    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 ��

  9. #9
    Join Date
    Jan 2017
    Posts
    2,116

    Re: Waves of physical anxiety

    Quote Originally Posted by Windywel View Post
    Hi PDU Iím 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?
    If you plot AD time to response you usually get a bell curve with the peak at around 6 weeks. This is for the first exposure to ADs. It may take longer the second time around.

    Some do seem to respond quickly, but this seems to owe more to the placebo effect than the med and they often, ime, end up crashing within a month, or two and become non responders. The placebo response in most drug trials is usually around 30-40%.

    To quote from the findings of Star*D, the largest and longest AD drug trial so far undertaken:

    "In addition, patience is required. While some people may experience benefits in the first six weeks of a treatment strategy, full benefits may not be realized until 10 or 12 weeks have passed. During this time, doctors should work with their patients to adjust dosages so as to find an optimal level, and avoid stopping a treatment prematurely."

    Iím fact I saw one that said if no response within 2 weeks then you should increase dose or shift as itís a marker that they wonít work!
    And what mechanism do they propose to account for this, given it takes, in the case of citalopram, 7 days just for plasma levels to stabilize and about 7 weeks for hippocampal cells to bud, grow and mature?:

    "Adult neurogenesis can be divided into four phases: a precursor cell phase, an early survival phase, a postmitotic maturation phase, and a late survival phase."

    "The precursor cell phase serves the expansion of the pool of cells that might differentiate into neurons. The early survival phase marks the exit from the cell cycle. Most newborn cells are eliminated within days after they are born. The postmitotic maturation phase is associated with the establishment of functional connections, the growth of axon and dendrites, and synaptogenesis. The late survival phase represents a period of fine-tuning. It has been estimated that the entire period of adult neurogenesis takes ~ 7 wk.

    Another one said that it appeared that SSRIs worked in anxiety first and depression much later
    Undoubtedly true, SSRIs seem to be more effective anti anxiety meds than they are anti depressives.

    but they donít seem to have worked on either for me after 5 weeks.
    I'm not surprised, even if the authors of what you've been reading might be.

    I know I shouldnít have googled
    Sage advice, imho.

    but succumbed after a difficult weekend with lots of crying spells
    Are you still taking lorazepam daily? Has any consideration been given to trying alternatives such as mirtazapine, or propranolol instead as I've suggested?
    __________________
    .

    - - What to know about: Telepsychiatry | Teletherapy - -





    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.

  10. #10
    Join Date
    Mar 2012
    Posts
    776

    Re: Waves of physical anxiety

    Hi Windy,

    I cant totally identify with how you feel. I'm 5weeks on duloxetine, 1st half on 30mg and last 18 dys on 30 evenng and 30 morning. I also take lorazopam daily and all the worries that go with it. mornings are atrocious with shakes, nausea. try to avoid my head all day but its so hard when i feel so low. been trying to keep busy. but the constant thought of when will i get out of this twilight zone and be me again. I have a new consultant i see privately who is really nice, but says i need to persevere a few more weeks and is talking of 90mg. I wish you well and hopefully we can keep each other going.

Page 1 of 3 123 LastLast

Thread Information

Users Browsing this Thread

There are currently 1 users browsing this thread. (0 members and 1 guests)

Similar Threads

  1. Waves of anxiety
    By Windywel in forum General Anxiety / Generalised anxiety disorder (GAD)
    Replies: 10
    Last Post: 15-11-19, 10:40
  2. Inverted T waves and Biphasic T waves in ecg
    By Wilburis in forum Health Anxiety
    Replies: 7
    Last Post: 23-04-16, 23:05
  3. anxiety in waves
    By Mckane07 in forum General Anxiety / Generalised anxiety disorder (GAD)
    Replies: 2
    Last Post: 11-07-13, 19:57
  4. waves of anxiety
    By fruity in forum Health Anxiety
    Replies: 0
    Last Post: 21-06-13, 23:17
  5. Waves of anxiety
    By verity in forum General Anxiety / Generalised anxiety disorder (GAD)
    Replies: 1
    Last Post: 16-08-11, 22:47

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •