Can Escitalopram suddenly stop working?

[matthew1977]

Advice needed. I just introduced myself in the new members area, but in brief:

• I have had anxiety and depression since at least 17 if not earlier. I'm now 48. Strongly suspect OCD
• First put on Citalopram, moved to Escitalopram about 10 years ago.
• Brielfy supplemented with Risperidone for 'over-valued ideas' – didn't work and side effects awful.
• For just over a year, I was in the process of reducing Escitalopram from 20mg to 15mg to 10mg owing to advice from a prostate doctor.
• Over this time my anxiety, compulsions and addictions have been getting worse.
• I crashed several weeks ago with the trigger being some relationship issues – panic, low mood, terrible self-esteem, doom for my marriage, 'wanting not to be trapped', intense loneliness and despair.

Can Escitalopram suddenly stop working?

Or is it more probably that 10mg was too low and panic grew out of the trigger without enough of a buffer? (I would just like to add that the trigger was a very upsetting relationship one that really upset me and I don't know whether it was my disorder but certainly the rumination about it has been chronic.)

I am now on 15mg on advice from the GP, referred to psychiatrist. I don't feel much better (yet), having gone back up nearly 4 weeks ago now.

Looking forward to some support as I'm not well right now.

[panic_down_under]

to NMP, Matthew

• For just over a year, I was in the process of reducing Escitalopram from 20mg to 15mg to 10mg owing to advice from a prostate doctor.
• Over this time my anxiety, compulsions and addictions have been getting worse.
• I crashed several weeks ago with the trigger being some relationship issues - panic, low mood, terrible self-esteem, doom for my marriage, 'wanting not to be trapped', intense loneliness and despair.

Can Escitalopram suddenly stop working?

The short answer is yes it can. But this doesn't have been the case for according to the above you were steadily going backwards since you began reducing the dose and then got hit by a relationship breakdown. Such major life events are often the trigger which propel us into anxiety and/or depression within a year or so, or makes existing disorders worse.

Or is it more probably that 10mg was too low and panic grew out of the trigger without enough of a buffer?

It seems that 10mg wasn't controlling your anxiety that well even before the breakup so yes, it was probably too low.

I am now on 15mg on advice from the GP, referred to psychiatrist. I don't feel much better (yet), having gone back up nearly 4 weeks ago now.

It may still take a few weeks to kick-in. The problem is antidepressants have no direct effect on anxiety or depression. They don't work like, for example aspirin which has a direct effect on the physical causes of a headache within the hour. Antidepressants (also CBT/REBT/mindfulness therapies) work by stimulating the growth of new brain cells in the hippocampal regions of the brain to replace cells killed or inhibited from growing by high stress hormone levels. These cells and the connects they form create the therapeutic response, not the med, and it takes a while for them to grow and mature.

Plus, I suspect 15mg won't be high enough.