Originally Posted by
Dragonsblonde74
Background for me is that this is my 5th break in my life
Welcome to NMP,
Have you considered staying on an antidepressants permanently given your history? Not only would you not have to go through this again, but there is evidence 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.
The night was awful, full on waves of panic and anxiety before bed and when i got in. My husband basically had to hold me until about 2am when I fell asleep and then I was awake at 5.
Please discuss this with the prescribing physician as there are ways of easing these side-effects. Small doses of the ADs mirtazapine, or trazodone should help you sleep better, as could the antihistamine *hydroxyzine (Vistaril) which is also pretty good at dampening anxiety, however, I've heard that UK GPs are reluctant to prescribe it for this purpose for some reason, but it won't hurt to ask.
*Hydroxyzine comes in two forms, hydroxyzine pamoate (Vistaril) and hydroxyzine hydrochloride (Atarax). Anecdotally, the pamoate form is claimed to be the more effective anxiolytic, but just how true this is remains a matter of debate.
My meditations don't seem to help and panic is climbing right now just 90 minutes after the tablet. I know I could easily be doing it to myself, but as you will know well it isn't easy to switch that off.
While there is almost certainly a strong psychological component, ADs, and especially the SSRIs and SNRIs, often initially significantly increase anxiety levels. Serotonin is not the 'feel good' neurotransmitter of popular belief, nor are anxiety (and depression) caused by low brain serotonin levels. Stress actually *increases serotonin in areas linked to these disorders, particularly the amygdala, hippocampus, hypothalamus and nucleus caudatus. This increase should prevent that stress from triggering anxiety and depression if the low serotonin hypothesis was correct, but it has the opposite effect.
While ADs do increase serotonin levels for the first few weeks, their longer term effect is to significantly *reduce them to well below pretreatment levels. Unfortunately, that initial serotonin spike often significantly worsens anxiety and is also responsible for some of the other common initial side-effects. For example, the gut is by far the most serotonergic organ of the body, not the brain, making and using over 90% of the body's output compared to less than 2% for the brain. Consequently, it is often more greatly affected by serotonergic ADs triggering side-effects such as nausea and diarrhoea, or, conversely, constipation at the beginning.