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The dose really should be raised to at least the recommended 10mg and it may then take a month or two to begin having a positive effect. Because of the way escitalopram is metabolized doses don't even need to be reduced for children, the elderly or those with liver disease.Originally Posted by sazarrama
I gave the doctor a ring today. He said that if the panic attacks persist or get worse after another week he'll put me up to 10mg but if its an isolated incudent he'd prefer me to stay on as low a dose as possible. If things haven't improved by my follow up appointment on the 27th I reckon I'll be askes about upping the dosage then.
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Why? Are you taking other medications, or do you have liver disease?
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Are you just seeing a regular GP? That would explain the desire for a lower dose - my GP initially started me on 5mg (after referring me to a psych) until I could get into my psych appointment because he just wasn't sure what the best dosage practices would be. So I did that for a month and then bumped up to 10, then 20.
I don't entirely know how your health care system works, would it be possible to see someone who knows a bit more about these medications?
How are you doing panic-wise? Was the panic attack a one-off thing?
I've noticed I have had some interesting panic attacks and I *think* that I didn't have them before Lexapro (can't totally remember, unfortunately) but thankfully they are pretty quick and quite rare. I've started keeping a journal of them though if they become an issue.
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No nothing like that I just think it was to make it easier for me to come off the medication again when the treatment is over.
Yeah that was just through my regular GP. I've definitely felt that low level of anxiety creeping back in (though my sleep is still good) and I've had a few minor panic attacks but nothing near as bad as that one. I think because we have the NHS and everything is paid for by the state it's really hard to push to see a specialist or get any kind of therapy (although I've started reading through a book on CBT)
Sorry its taken me so long to reply I've been struggling with work. Went back to the GP for a seven week appointment yesterday and she's upped my dose to 10mg and given me a sick note for two weeks off work. I'm going through a really stressful time right now especially in terms of money (my boyfriend is finishing his final year of university and his student loan isn't in until the end of the month so I've essentially been supporting us both) and I was cracking up at work, hysterics, crying the works about small unpleasant incidents (e.g. a minor fight with a co-worker) It didn't help that I've been having a few drinks almost every night to deal with the stress even though I know it stops the medication working as well as it should...I'm silly I know.
Although I wasn't seeing my usual GP she prescribed me 10mg Citalopram and I know from this website that they aren't quite the same drug so I pushed to get my regular GP to fill it out for the Cipralex but he's only prescribed me 5mg! Should I start taking one in the morning, one in the evening type thing?
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It probably won't make any difference, plus taking sub therapeutic doses risks the med pooping-out. Antidepressants work by stimulating the growth of new brain cells (neurogenesis) to replace cells killed, or prevented from growing by high brain stress hormone levels. The therapeutic response is produced by these new cells and the stronger interconnections they forge, not the meds directly and this requires a certain level of the med in the system to initiate and sustain.
The problem with taking borderline therapeutic doses is neurogenesis may be interrupted whenever plasma levels drop below the neurogenesis sustaining threshold which leads to the second issue, the growing evidence that antidepressants become progressively less effective every time they are stopped and restarted, often requiring higher doses to achieve the previous level of control. They may also produce more severe, and/or different, initial side-effects. Two studies, Amsterdam JD, 2016 and Amsterdam, 2009 found the likelihood of antidepressants working after each restart drops by between 19-25% (see also: Amsterdam JD, 2009; Leykin Y, 2007). This applies whether returning to a previously taken antidepressant or a different one. Taking a low escitalopram dose for an extended period may effectively create a similar situation as stopping and restarting it. While the neurogenesis interruptions will only be of short duration, they will probably occur much more frequently.
No, it is paid for by you so demand your money's worth. As I understand it, most NHS trusts offer CBT so ask your GP for a referral.I think because we have the NHS and everything is paid for by the state it's really hard to push to see a specialist or get any kind of therapy (although I've started reading through a book on CBT)
That is naughty!It didn't help that I've been having a few drinks almost every night to deal with the stress even though I know it stops the medication working as well as it should...I'm silly I know.
The GP you saw today accidentally prescribed 10mg citalopram (Celexa) instead of 10mg escitalopram (Cipralex)? If so, take it back and get a prescription for the right med.Although I wasn't seeing my usual GP she prescribed me 10mg Citalopram and I know from this website that they aren't quite the same drug so I pushed to get my regular GP to fill it out for the Cipralex but he's only prescribed me 5mg! Should I start taking one in the morning, one in the evening type thing?
There probably is no point in spitting the dose and taking only half-morning and night as escitalopram (and citalopram) have fairly long half-lives, over 30 hours.
I actually didn't know any of that! Thank you
Hmm I'm not sure if it's different in Northern Ireland though...we're a bit of a confusing situation because even though we're technically the NHS our healthcare budgeting is sorted out by Stormont. We don't even have a properly formed government right nowNo, it is paid for by you so demand your money's worth. As I understand it, most NHS trusts offer CBT so ask your GP for a referral.but I'll deffo push for it at my next appointment, going to see how I get on reading the book and studying it on my own steam.
The GP you saw today accidentally prescribed 10mg citalopram (Celexa) instead of 10mg escitalopram (Cipralex)? If so, take it back and get a prescription for the right med.
Oh yeah I did that's what I meant, got them to change it for me but he's prescribed me the 5mg tabs of Capiralex again rather than the 10mg. I assume the two 5mg doses is the same thing? I remember the doctor saying you can take up to four of them in a day so I imagine it's alright! Although I'll definitely get them to change that at my next appointment too!
No problem! Thanks for letting me know that...took two this morning with breakfast, stomach is a bit gurgling and I feel a bit tired but so far so good!#There probably is no point in spitting the dose and taking only half-morning and night as escitalopram (and citalopram) have fairly long half-lives, over 30 hours.
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Probably, neither does your GP.I actually didn't know any of that! Thank you
Oh, didn't know this. If you need a benevolent dictator to run the place until the pollies get their act together, I'm available and will work relatively cheap by dictator standards.We don't even have a properly formed government right now
The brain isn't the biggest maker and user of serotonin, the enteric nervous system, the mini brain which controls the gut is. It uses about 50 times more serotonin than the brain and is thus often more affected when first taking SSRIs, or increasing their dose, than the brain is.took two this morning with breakfast, stomach is a bit gurgling and I feel a bit tired but so far so good!#
Oh, didn't know this. If you need a benevolent dictator to run the place until the pollies get their act together, I'm available and will work relatively cheap by dictator standards.
Not getting on too badly with the 10mg, pretty much the same level (if not smaller amount of) of side effects as when I started it. The only thing I've noticed is I've become really snappy and irritable with my poor boyfriend. My anxiety used to manifest as irritability before the medication though so I hope this is just the upped dosage settling down and will go away in time as it went away a few weeks after I started the 5mg.
I also joined a gym and they have loads of classes like yoga, tai chi and obviously more physical stuff. Going to try everything at least once and hopefully I'll find something I like! Felt good swimming a load of fast paced lengths yesterday and even got chatting to a guy in the steam room who is overcoming claustrophobia and panic disorder. It definitely makes you feel less alone that's for sure!
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Antidepressants often make anxiety worse at the beginning so if irritability is one of your main anxiety symptoms this will likely worsen too. However, the heightened anxiety is usually short-lived, generally resolving within a couple of weeks, but it may spike again after dose increases.
There are a lot of us about, around 1 in every 4 people you meet are likely to have an anxiety disorder and/or depression.even got chatting to a guy in the steam room who is overcoming claustrophobia and panic disorder. It definitely makes you feel less alone that's for sure!
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