I have been taking Fluox for 5 weeks (currently at 30mg) due to increase to 40 mg. I am experiencing extreme anxiety and panic attacks which are causing agoraphobia. My Dr. suggested switching to Lexapro. Have any of you tried this and found success? I have been trying to get my anxiety under control for 5 months and I am so tired... :'(
These meds sometimes cause what you are experiencing. Be cautious of any advice you get here or anywhere else. I would say give it another few weeks on the med and then get an appointment with your doc to discuss alternatives. None of these meds are the magic bullet. They will take you to a place where you can begin to work on your problems.
Hi, Mat! I do understand because there is no one drug that works well for everyone... there are dozens to choose from and it's trial and error finding the one that will work best for you. Try to be patient.
It's true that these classes of medications can seemingly make you feel worse before you feel better and it generally takes 4~6 weeks to start feeling the benefits and 6~8 weeks for the medication to reach steady state therapeutic levels in your bloodstream.
That being said, I have to say that Lexapro was far more effective for me... but that's me and it may not be the same for you.
Try to work closely with your doctor and let her/him help you make these decisions. Basically, what djchurn is saying is don't believe everything you might read on a non-professional forum.
Best regards, Wildcat
I'm going to write a bunch here. Remember this is not medical advice. Talk about all of this with your doctor. I sometimes think doctors don't give enough background information about what to expect and future options, so my goal here is just to give you a little info.
In general, all the SSRIs, especially when people start on them, can be activating. It is one of the reasons why they can be extremely helpful for people with depression; they provide a jolt of energy. However, they can also make people feel a little agitated and restless - like they just had a bunch of coffee. In most cases, but not always, these symptoms go away. But if these side-effects are experienced by someone with anxiety, they can end up making the anxiety worse. What tends to happen is that the person becomes anxious when they get the initial activation, agitation, restlessness. They then start worrying about whether the medication is making things worse. This worry increases their anxiety.
The person is aware that their anxiety has gotten even worse and they start to worry more about the medication, experiences more activation and anxiety ... and so on. When this pattern happens, the person's side-effects from the medication may have actually disappeared, but their general level of anxiety has gotten worse and masks that change.
A little on the medications you mentioned. Fluoxetine tends to be more activating than escitalopram (Lexapro), and escitalopram tends to be more activating than sertraline (Zoloft), but all SSRIs can have that effect. That being said, SSRIs can be very effective at treating anxiety, the trick is getting someone through the initial stages of treatment without falling into that pattern I mentioned. Sometimes people are prescribed benzodiazepines when they begin treatment. They tend to be told that this is because the medication will take a while to start working - which is true, but the other reason is to counter-balance the initial side-effects.
There are two general guidelines that might be helpful for you to know. First, if you aren't getting any benefits, or side-effects are intolerable after 6-8 weeks, then you should probably try something new or your prescriber should attempt to supplement the first medication. Second, most recommendations say that you should try two medications in the same drug class (SSRI) and if those aren't effective try up to two medications in another class (e.g. SNRI), and so on. Ideally, you would want to have each of those trials for 6-8 weeks.
*** For what it is worth, if you are experiencing some agoraphobia, you would probably benefit from also doing some form of gradual exposure therapy with a clinician specializing in anxiety. Alternatively, you could do it on your own with a good workbook if you followed it rigorously and were committed. I don't know your situation, but it would be almost unheard of if you hadn't developed avoidance behaviors that are self-reinforcing (because they reduce anxiety) and need to be modified.
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