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Thread: This drug is a nightmare so far

  1. #1

    This drug is a nightmare so far

    My doctor increased my dose a month ago to 100mg and I am a wreck, My anxiety is the worst it's been in years, I can't eat, I am awakened every morning by a huge jolt of adrenaline: heart racing, short of breath, clammy, panicked. Plus I'm now depressed (I was prescribed it for anxiety only). This is NOT NORMAL. I had none of this on citalopram; it just blunted my affect so I didn't give a shit about things that normally would make be obsess and worry. Does it get better? it's been like this since the dose change on November 2. Oh, and the doctor cancelled my review appointment next week and now I need to wait until January 15th like this. Merry Christmas, I guess

  2. #2
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    Re: This drug is a nightmare so far

    Quote Originally Posted by olivia0703 View Post
    My doctor increased my dose a month ago to 100mg and I am a wreck, My anxiety is the worst it's been in years, I can't eat,
    Unfortunately, antidepressants, and especially the serotonergic ones, often make anxiety and depression worse initially because of the increased serotonin activity. This is not the 'feel good' neurotransmitter of popular myth, just the opposite as you've discovered. It should settle down as bio-feedback mechanisms begin downregulating serotonin synthesis and expression. If you can, see your GP asap as there are ways of minimising the heightened anxiety and other initial side-effects.

    I am awakened every morning by a huge jolt of adrenaline: heart racing, short of breath, clammy, panicked.
    Are you taking the sertraline in the evening? If so, try switching to mornings to see if that reduces the adrenaline surge when you awake. In theory it shouldn't make any difference when sertraline is taken, but it often does. A small dose of a beta-blocker such as propranolol might help with the surge too if you can get a prescription.

    I had none of this on citalopram; it just blunted my affect so I didn't give a shit about things that normally would make be obsess and worry.
    Citalopram tends to produce less severe initial side-effects than other SSRIs, though this isn't so for everyone. These side-effects also tend to be more severe when taking a second AD and/or be different than for the first one.

    Oh, and the doctor cancelled my review appointment next week and now I need to wait until January 15th like this.
    Sigh Is there any way of getting an emergency appointment? Make sure the admin staff understand that you really need help asap.
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  3. #3
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    Re: This drug is a nightmare so far

    I am coming onto Sertraline at the moment, having switched from Citalopram, which stopped working for me.

    The side-effects have been shocking, but what I have read suggests they subside after about two weeks (not long for me). Certainly for me I am sleeping again without tablets, and the anxiety is not as bad as it has been.

    I take my 50mg tablet in the morning, and get a spike of anxiety after a couple of hours. This builds until about 2000, when it begins to subside again by bedtime. I wake up with no anxiety!

    It seems that while your body is stabilising, the time you take it will matter, but later on it won't as much, as the half-life means you will sufficient residual in your body.

    I found that Citalopram was good for alleviating my anxiety, but I was not myself, I was dulled and clumsy in my brain, and made alot of mistakes. Already on Sertraline I feel sharper and more with it.

    Some useful views from users here, which I am still finding helpful: https://www.drugs.com/comments/sertr...ty-stress.html

    So, maybe change when you take it, and keep the faith- it will get better!

    And see if you can get an emergency apppointment!
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  4. #4

    Re: This drug is a nightmare so far

    Quote Originally Posted by panic_down_under View Post
    Sigh Is there any way of getting an emergency appointment? Make sure the admin staff understand that you really need help asap.
    Thank you for your reply. it's much appreciated. It helps to hear this is to be expected. I can get in with an NP or PA sooner, but it feels like I'd be starting over and they'd just be guessing. There is no way in hell they will prescribe a benzo, even a very long-acting short-term one. They just do not do it here.
    At this point, I am not sure whether to stick with it or start to taper off? I am so anxious I want out of my skin. I do have propranolol. I didn't think of taking that. I also have a tonne of gabapentin and some pregabalin. Would that help?
    I am doing a GeneSight test at the end of next week. That should provide some guidance about how I metabolise these drugs.

  5. #5

    Re: This drug is a nightmare so far

    Quote Originally Posted by apm View Post
    I am coming onto Sertraline at the moment, having switched from Citalopram, which stopped working for me.

    The side-effects have been shocking, but what I have read suggests they subside after about two weeks (not long for me). Certainly for me I am sleeping again without tablets, and the anxiety is not as bad as it has been.

    I take my 50mg tablet in the morning, and get a spike of anxiety after a couple of hours. This builds until about 2000, when it begins to subside again by bedtime. I wake up with no anxiety!

    It seems that while your body is stabilising, the time you take it will matter, but later on it won't as much, as the half-life means you will sufficient residual in your body.

    I found that Citalopram was good for alleviating my anxiety, but I was not myself, I was dulled and clumsy in my brain, and made alot of mistakes. Already on Sertraline I feel sharper and more with it.

    Some useful views from users here, which I am still finding helpful: https://www.drugs.com/comments/sertr...ty-stress.html

    So, maybe change when you take it, and keep the faith- it will get better!

    And see if you can get an emergency apppointment!
    Thanks for your reply. I am taking it in the morning and it's been nearly four weeks at this dose. I found the exact same thing with citalopram, it made me not care about anything. Also, bad sexual side effects. But now I think I would prefer that than being so wired and anxious. I will take a look at that link. Thanks!

  6. #6
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    Re: This drug is a nightmare so far

    Quote Originally Posted by olivia0703 View Post
    There is no way in hell they will prescribe a benzo, even a very long-acting short-term one. They just do not do it here.
    While benzodiazepines have their uses, there are other, arguably better, options, two of which you already have.

    At this point, I am not sure whether to stick with it or start to taper off? I am so anxious I want out of my skin I do have propranolol. I didn't think of taking that.
    beta-blockers are pretty good at tamper down the adrenaline fuelled flight-or-fight symptoms. They can be all that's needed for mild anxiety. If it has been prescribed for other than anxiety then you should okay it with your GP, however.

    I also have a tonne of gabapentin and some pregabalin. Would that help?
    Maybe. Results seem to be mixed even though in theory they get the same outcome as benzodiazepines (BZDs), albeit by a different route. BZDs slow brain activity by increasing the influx of negatively charged chlorine ions into cells making it harder for them to increase their internal voltage to the 'firing' potential. Gabapentin and pregabalin work by inhibiting the influx of positively charged calcium ions.

    Pregabalin is the better drug as it has linear bioavailability and is absorbed quicker so begins working sooner. Dependency can also be an issue for both meds, but it usually builds slowly so shouldn't be an problem for the short time you're likely to be taking them.

    I am doing a GeneSight test at the end of next week. That should provide some guidance about how I metabolise these drugs.
    I wouldn't get too excited as while genetic tests show promise at this stage they are not that useful from the feedback I've seen.
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  7. #7

    Re: This drug is a nightmare so far

    Thanks you so much, Ian. You've put my mind at ease. The propranolol is for anxiety PRN, so no problem there. I will take a dose of pregabalin. I am actually prescribed it 75mg b.i.d. but stopped taking it as I didn't want to become dependent/build tolerance and have my doctor be uncooperative with dose changes etc

  8. #8
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    Re: This drug is a nightmare so far

    Quote Originally Posted by olivia0703 View Post
    I will take a dose of pregabalin. I am actually prescribed it 75mg b.i.d. but stopped taking it as I didn't want to become dependent/build tolerance and have my doctor be uncooperative with dose changes etc
    Was it effective? Pregabalin/gabapentin are in a group of anxiety meds which work well for some and not at all for most.
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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.

  9. #9

    Re: This drug is a nightmare so far

    Not at that dose, but I have read so many reports, on reddit and elsewhere, about it annihilating people's anxiety at doses of 300mg+. But when I spoke to my doctor about increasing it, he basically made me feel like a drug seeker

  10. #10
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    Re: This drug is a nightmare so far

    Quote Originally Posted by olivia0703 View Post
    Not at that dose, but I have read so many reports, on reddit and elsewhere, about it annihilating people's anxiety at doses of 300mg+.
    Doses typically effective for anxiety range from 200-600mg/day, but as I noted earlier pregabalin is one of those meds which only helps a subset of patients.

    But when I spoke to my doctor about increasing it, he basically made me feel like a drug seeker
    Doctors can be very susceptible to fear campaigns even when they defy what the science tells them and that is especially so in the psychiatric field. Some are terrified of prescribing BZDs and meds like pregabalin because of the perceived 'addiction' issue, but don't hesitate to prescribe a couple of antidepressants which many find much harder to quit. One of the reasons is GPs get relatively little training in psych disorders and the meds used to treat them which is crazy as these disorders are among the most frequent they see in their surgeries, albeit often unrecognised. GPs can be better equipped to deal with rare tropical diseases they'll likely never see than psych disorders.

    'Addiction' is about far more than the meds, but those other factors are mostly ignored. It is easier to just stop prescribing the 'problem' meds than taking the time to deal with the issues that drive the problems some have with them. For example, some taking common garden variety aspirin find it so hard to permanently quit that they will continue taking it to the point of death, as illustrated by this study: Hirschowitz BI, Lanas A. (1998). Aspirin isn't 'addictive' in the classical sense, what drives the compulsion to continuing to take it even in the face of repeated invasive surgery, even certain death, are often the same ones driving the difficulties a few have with BZDs and probably also pregabalin/gabapentin.
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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.

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