Re: Medication - what next help
Originally Posted by
welshdory
I am feeling so down and unsure whether this is down to my medication not working (currently on 15mg escitralopram), grieving, being perimenopausal (I have also just started HRT) or just life in general.
It is likely all of the above to varying degrees.
I've tried a number of different ones over the years and have always come back to escitalopram as it's the one that I seem to have tolerated best, with the least side effects. However I am feeling so down, I know its not working anymore and hasn't for a while.
Have the other ADs all been SSRIs and SNRIs? If so it might be time to give the older tricyclic antidepressants (TCAs) a try. They are often more effective than the newer meds and less likely to stop working. Their main side-effects are usually dry-mouth and constipation which are manageable.
Another possibly is augmenting escitalopram with a small dose, 20-30mg/day, of buspirone (Buspar). Buspirone is a GAD specific med which works well for some, but not for most. However, when taken with SSRIs it can boost their effectiveness and restore them to full function if they've stopped working. It also often moderates some SSRI side-effects. While there are no guarantees if it works it would produce the quickest result, possibly within 3 weeks. Your main problem is likely to be getting a prescription as the NHS apparently doesn't favour it.
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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.