Mental Health SSRIs - anxiety & panic attacks

[llama112]

I've had anxiety as long as I can remember. I've gone through times of depression although, for the past few years, it hasn't happened much at all (or it'll just last for a week). I've had panic attacks in the past. I've tried therapy. In the past two months, I have gone back to that depressed place. I've been anxious about every little thing. And I've been having panic attacks multiple times per week. I was prescribed some SSRI years ago when I went to a doctor but never took it because I had done some research and did NOT want to deal with the side effects.

I'm finally at the point where I just want to feel better. So I went to the doctor and he prescribed me some escitalopram‎. I took 10 mg the other night. It made me sooooo sick. I was back and forth between the washroom and the bed (luckily very close). When I was walking back and forth, I was so dizzy that I just kept falling all over the place. I got the cold sweats too and my body temperature was so off. Anyway that lasted about two hours. It basically felt like I had the flu, plus being dizzy. I got to sleep eventually, woke up multiple times tossing and turning (I NEVER wake up in my sleep.... it takes me hours to get to sleep but once I'm asleep then I'm good). The next day, I went to work, felt a bit nauseous, but I also had the tremors and stuff. My hands were shaking and I couldn't clench anything. And my teeth were chattering. It was on and off but stopped mostly by around 3/4 PM.

I didn't take it again Friday night obviously. But I'm not sure if I should continue taking it. I can't handle that EVERY DAY. Perhaps I could handle it for a week but I have to go on with my normal activities - work, school, etc. I thought I'd try it once more to see if the side effects were as terrible. Or try 5 mg instead (he prescribed 10 mg but it's easy to cut in half), perhaps 5 mg would be better to start so my body gets used to it. Or just not take it at all and try another one. I'm just not sure if this is normal for the first time. I've read many things online that say they don't have it this bad the first time but then others have.... but then others deal with these side effects ALL the time. I'd rather deal with my panic attacks than this every day. But for people who have REALLY REALLY bad anxiety/panic attacks/depression then maybe it is worth it. But for this all the time, definitely not for me.

I'm planning to go in to the doctor this week anyway but wasn't sure if anyone here would have suggestions.

 

[CheeseSandwich]

edit: omg I typed a super long story, but managed to just post the last part for some reason. Well a short version then: I'm 22, wasted all those years to anxiety. Got prescribed lexapro when I was 18 years old. It helped, because it flats out my emotions and because of that it reduces anxiey. Year later I got diagnosed with ADD and got dexedrine. This changed my life in a good way. The problem is I do abuse it sometimes. Even with this meds it didnt really change my constant thinking, never be able to just live in the moment. I begged my shrink for something that can give me some peace in my head.

He gave me lyrica to relax me. Well I can honestly say that lyrica is the cure for anxiety. When I take it, my overthinking just stops and I can actually live in the moment and talk to people without thinking what to say next or where to look.

I am currently on 25 mg dexedrine, 20 mg lexapro and 300 mg lyrica every day. Its a lot for a young guy, but it does work. Expecially the lyrica completely changed me and made me feel at peace and like a normal person. It's still really hard to get used to the new me. I've been so restless my whole life, wasted alot of years of my youth. I hope I can finally start to live a happy peaceful life.

 

[herbavore]

That sounds horrible, llama. I don't really have any advice about the medication other than to hope that your doctor will have an alternative. Your reaction to that drug makes me think of mine to any kind of opiate. Here I am on a site with so many people addicted to opiates and I wonder how the hell they get there because each time (4) I have been prescribed them for pain after a surgery I end up writhing in agony on the bathroom floor. I end up putting up with the original pain rather than the excruciating abdominal pain from a medication other people seem able to take and actually feel better!

Have you tried going deeply into your panic attacks with questions? (Not during a panic attack, but in a calmer state of mind). I was having a lot of panic attacks after my son died--horrible choking physical panic attacks. I thought it was PTSD from finding his body--and it was that for sure but I think it went deeper. I needed to acknowledge the depth of my guilty emotions that his death brought up in me and that was so terrifying to do that I was having panic attacks. Once I began to face what I was really trying so hard to bury (unconsciously) the panic attacks stopped. Do you feel like an actual fear could be lurking under the generalized anxiety?

 

[EllinesMono]

When I first started SSRI's I some bad side effects. Basically I felt like I had the flu and my depression and anxiety was through the roof. So I guess the best thing is for you to tell your doctor which you are obviously doing but I do know that a lot of SSRI's will give you some nasty side effects but most of which are temporary and go away after a while when the meds start kicking in. And thats what happened to me. After I think like 3 weeks or so all the bad sad effects went away and I was left with a little less appetite then normal but thats it.

 

[dopamimetic]

I really don't get it why these SSRIs aren't slowly tapered (up & down), so many of the side effects could be avoided this way. Escitalopram is quite potent (twice the potency of citalopram) and with that one I've only tolerated 10mg, 20mg were too much - overstimulating, ADHD-alike ... so maybe you're better off going down to 5 or even better 2.5mg and then gradually increase the dosage.

They aren't only active in the brain but act all over the body and peripherally serotonin induces nausea and vomiting (among other effects).

Otherwise, I found venlafaxine (Effexor) to be quite well tolerated overall but it has a horrible withdrawal for many, including myself ... this can be managed by very slow gradual tapering.

 

[manboychef]

I had some pretty terrible withdrawal from effexor and lexapro(escitalopram).

I have panic disorder...(panic attacks frequently, and intense fight flight or freeze response), and OCD (anxiety driven intrusive thoughts coupled with compulsive behaviors to help moderate those thoughts). I was taking xanax for my panic attacks which worked extremely well, but I found myself getting hooked on the feeling of my anxiety being gone...so I tapered off. I keep some on hand in case I have a panic attack that is above a 5/10 for me.

as far as SSRIs go, I take 100mg of sertraline(zoloft) in the morning with my coffee. It really helps decrease my panic episodes and lowers my baseline anxiety quite a bit. I would try this. It does take about a month to work, and it is a little stimulating, but not so much as escitalopram, or prozac. I have tried many SSRI because my mental health diagnosis contains major depressive disorder, panic disorder, and OCD. I also have a history of substance abuse/ dependence. Basically, in order to see if something works for you, you will have to try it for at least two weeks slowly titrating up your dose. Keep a journal of your feelings...once in the AM and again in the PM. This will help you establish your pattern of anxiety and thus another tool for your psychiatrist to figure out how to best help you. I hope this has been helpful.

 

[llama112]

Thanks so much for the replies!

The doctor I'm going to right now is a new doctor but seems decent so far. He said the 10 mg was one of the lower doses. Anyway I went back and he prescribed me Effexor (37.5 mg).

I am worried about Effexor because it is an SNRI - the "N" part may have issues with amphetamines, other substances, etc. I have to do more research before I try this one but if it's going to not allow me to use my DOCs then I don't want to get onto it :S

I've started seeing a new therapist (the fourth one in like four years). I'm not sure what you mean about going deeply into panic attacks. I don't understand them most of the time. Well I know extra stress causes them sometimes (I'm always crazy stressed but if there is something EXTRA stressful then I am probably going to have a panic attack at some point). But then other times, I don't know what it is.

If they will make me feel better, I don't want to keep living like this if they can make a difference and make me feel more normal. But I'm also scared of long term effects.

I like that idea of a "feelings" journal. Should probably start that before I start on the new meds (if I do).